2020-10-14T16:50:41-05:00 2019-12-31 990 2019-01-01 742225672 METROPLEX ADVENTIST HOSPITAL INC METR 2545267523 2201 SOUTH CLEAR CREEK ROAD KILLEEN TX 76549 LYNN C ADDISCOTT ASSISTANT SECRETARY 2545267523 2020-10-12 204.139.85.142 2020-10-12 13:15:23 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 D3B0FA8F46BE33589AD20F8A51A7DE0DA87648FF 2019 2021-01-29 14:40:06Z KEVIN ROBERTS 2201 SOUTH CLEAR CREEK ROAD KILLEEN TX 76549 142385758 0 X ADVENTHEALTH.COM/HOSPITAL/ADVENTHEALTH-CENTRAL-TE X 1980 TX THE PROVISION OF MEDICAL CARE TO THE COMMUNITY THROUGH THE OPERATION OF TWO HOSPITALS. 17 14 1369 153 108881 0 582 99125 127591402 140631661 388027 1638109 819539 0 128799550 142368895 341622 276867 0 0 61243224 66361955 0 0 0 67694996 67626192 129279842 134265014 -480292 8103881 105743106 109719400 12708135 16146902 93034971 93572498 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 124867224 276867 140522780 OPERATION OF ADVENTHEALTH CENTRAL TEXAS HOSPITAL, A 230-BED ACUTE-CARE HOSPITAL AND ADVENTHEALTH ROLLINS BROOK HOSPITAL, A 25-BED ACUTE-CARE HOSPITAL; 7,223 PATIENT ADMISSIONS, 29,764 PATIENT DAYS, AND 113,788 OUTPATIENT VISITS IN THE CURRENT YEAR. 124867224 1 1 0 1 0 0 0 0 0 0 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 0 1 0 0 0 0 0 1 1 1 0 0 1 X 0 0 1369 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 17 14 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 TX X PARKER PRIDGEN 2545198274 2201 S CLEAR CREEK ROAD KILLEEN TX 76549 X FINCH KENNETH CHAIRMAN/REGIONAL CEO (END 12/19) 2.50 47.50 X X 0 1155261 148947 WALTON CARLYLE FORMER CEO/PRESIDENT 0.00 50.00 X 0 515318 82799 SUTTON JESSE DIR/REGIONAL CFO 3.50 46.50 X 0 492494 82508 ROBERTS KEVIN CEO/PRESIDENT 50.00 0.00 X 0 366895 80376 PRIDGEN PARKER CFO/COO (BEG 3/19) 50.00 0.00 X 0 354165 60036 BROCK ROBERT CFO (END 3/19) 50.00 0.00 X 0 365739 22448 RODRIGUEZ TAMMY CNO 50.00 0.00 X 0 237448 41183 DANIELS DON CMO (END 7/19) 20.00 0.00 X 233333 0 0 RUTLEDGE JONATHAN PHARMACY MANAGER 47.30 0.00 X 134109 0 34762 UNDERWOOD ASHLEY ADMINISTRATIVE DIRECTOR 43.60 0.00 X 139530 0 17357 INGRUM KIMBERLY CLINICAL INFORMATICS DIRECTOR 40.00 0.00 X 141196 0 14762 JENKERSON TERRILL PHYSICAL THERAPIST 55.20 0.00 X 136539 0 14670 DOYLE JOHNNY PHARMACIST 47.30 0.00 X 138114 0 11731 GRIFFITH JR BUFORD DIRECTOR 0.10 3.00 X 0 2449 0 BOYD MD JOHN DIRECTOR (END 8/19) 0.10 0.00 X 0 0 0 CONNELL MATT DIRECTOR 0.10 0.00 X 0 0 0 GARRETT HENDERSON SECRETARY 0.10 0.00 X 0 0 0 KLIEWER MARY DIRECTOR 0.10 0.00 X 0 0 0 KWAN MD NATHAN DIRECTOR (BEG 8/19) 0.10 0.00 X 0 0 0 LINDLEY JAMES DIRECTOR 0.10 0.00 X 0 0 0 LOHSE PAULA DIRECTOR 0.10 0.00 X 0 0 0 MOTAKEF SHAHIN DIRECTOR 0.10 0.00 X 0 0 0 PAGE JOHN DIRECTOR 0.10 0.00 X 0 0 0 PAPACONSTANTINOU MD HARRY DIRECTOR 0.10 0.00 X 0 0 0 PROCTER RICHARD DIRECTOR 0.10 0.00 X 0 0 0 RISINGER ALITA DIRECTOR (BEG 8/19) 0.10 0.00 X 0 0 0 SIBBITT MD STEVE DIRECTOR 0.10 0.00 X 0 0 0 STEPP RONALD DIRECTOR 0.10 0.00 X 0 0 0 WEST MD PAUL DIRECTOR 0.10 0.00 X 0 0 0 922821 3489769 611579 46 1 1 1 BAYLOR SCOTT & WHITE HEALTH 2401 S 31ST STREET TEMPLE TX 76508 PHYSICIAN SERVICES 4097144 DIVERSIFIED CLINICAL SERVICES PO BOX 636981 CINCINNATI OH 45263 WOUND CARE SERVICES 2573250 PT SOLUTIONS HOLDINGS LLC PO BOX 724557 ATLANTA GA 31139 PHYSICAL THERAPY SERVICES 1769542 QUANTUM PLUS LLC PO BOX 634850 CINCINNATI OH 45263 PHYSICIAN SERVICES 1255528 TEXAS HEALTH HUGULEY INC 11801 S FREEWAY BURLESON TX 76028 ACCOUNTING/BILLING SERVICES 995173 30 X 28658 70467 99125 NET PATIENT REVENUE 622110 136819118 136806814 12304 CAFETERIA REVENUE 622110 929048 929048 REIMBURSEMENT OF EXPENSES 622110 874166 874166 MEDICAL OFFICE BUILDING 622110 820835 820835 PHARMACY 622110 679167 582590 96577 509327 509327 140631661 1058043 1058043 529929 67000 0 16863 529929 50137 580066 580066 142368895 140522780 108881 1638109 X 276867 276867 1692590 1692590 50534280 50534280 1424636 1391899 32737 8645807 8267475 378332 4064642 3971135 93507 32288 32288 32144 32144 170647 170647 20999468 16954505 4044963 355394 355394 3442193 2263254 1178939 5643228 5094904 548324 3970328 3970328 227427 3615 223812 182165 182165 494 494 6779879 6779879 335828 250622 85206 MEDICAL SUPPLIES 15496232 15496232 STATE ASSESSMENT 5500387 5500387 REPAIRS & MAINTENANCE 4029521 4029521 UBI TAXES 60000 60000 368569 81827 286742 134265014 124867224 9397790 0 4584 6247 27634789 36313281 14948452 14698787 4127714 3977514 1186574 402908 139751768 96685214 45396555 43066554 339327 55628 12105111 11198481 105743106 109719400 6716943 9648492 462850 227178 5528342 6271232 12708135 16146902 X 91568491 92074868 1466480 1497630 93034971 93572498 105743106 109719400 X 8103881 3286677 -10853031 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 4208 4208 0 PART II-B, LINE 1: AMERICAN HOSPITAL ASSOCIATION DUES AND TEXAS HOSPITAL ASSOCIATION DUES 2067842 2067842 77430185 50199214 27230971 54833862 43181437 11652425 5419879 3304563 2115316 43066554 DUE FROM RELATED 477286 OTHER RECEIVABLES 3329695 INVESTMENT IN SUBS 66465 RECEIVABLE FROM THIRD PARTIES 1819676 RECEIVABLE FROM WAIVER PROGRAM 2145643 RIGHT OF USE ASSET-OPER LEASE 3359716 11198481 DUE TO RELATED -534224 PAYABLE TO THIRD PARTIES 1990061 CREDIT BALANCES IN A/R 591638 OTHER CURRENT LIABILITIES 189389 OTHER NONCURRENT LIABILITIES 693213 LEASES PAYABLE 3341155 6271232 X PART X, LINE 2: THE FILING ORGANIZATION IS A SUBSIDIARY ORGANIZATION WITHIN ADVENTHEALTH. THE CONSOLIDATED FINANCIAL STATEMENTS OF ADVENTHEALTH CONTAIN THE FOLLOWING FIN 48 (ASC 740) FOOTNOTE: PLEASE NOTE THAT DOLLAR AMOUNTS ARE IN THOUSANDS. HEALTHCARE CORPORATION AND ITS AFFILIATED ORGANIZATIONS, OTHER THAN NORTH AMERICAN HEALTH SERVICES, INC. AND ITS SUBSIDIARY (NAHS), ARE EXEMPT FROM STATE AND FEDERAL INCOME TAXES. ACCORDINGLY, HEALTHCARE CORPORATION AND ITS TAX-EXEMPT AFFILIATES ARE NOT SUBJECT TO FEDERAL, STATE OR LOCAL INCOME TAXES EXCEPT FOR ANY NET UNRELATED BUSINESS TAXABLE INCOME. NAHS IS A WHOLLY OWNED, FOR-PROFIT SUBSIDIARY OF HEALTHCARE CORPORATION. NAHS AND ITS SUBSIDIARY ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. NAHS FILES A CONSOLIDATED FEDERAL INCOME TAX RETURN AND, WHERE APPROPRIATE, CONSOLIDATED STATE INCOME TAX RETURNS. ALL TAXABLE INCOME WAS FULLY OFFSET BY NET OPERATING LOSS CARRYFORWARDS FOR FEDERAL INCOME TAX PURPOSES; AS SUCH, THERE IS NO PROVISION FOR CURRENT FEDERAL OR STATE INCOME TAX FOR THE YEARS ENDED DECEMBER 31, 2019 AND 2018. NAHS ALSO HAS TEMPORARY DEDUCTIBLE DIFFERENCES OF APPROXIMATELY $46,500 AND $53,000 AT DECEMBER 31, 2019 AND 2018, RESPECTIVELY, PRIMARILY AS A RESULT OF NET OPERATING LOSS CARRYFORWARDS. AT DECEMBER 31, 2019, NAHS HAD NET OPERATING LOSS CARRYFORWARDS OF APPROXIMATELY $47,500, EXPIRING BEGINNING IN 2022 THROUGH 2026. DEFERRED TAXES HAVE BEEN PROVIDED FOR THESE AMOUNTS, RESULTING IN A NET DEFERRED TAX ASSET OF APPROXIMATELY $11,400 AND $13,400 AT DECEMBER 31, 2019 AND 2018, RESPECTIVELY. NAHS REMEASURED ITS DEFERRED TAX ASSETS AND LIABILITIES BASED ON THE RATES AT WHICH THEY ARE EXPECTED TO REVERSE IN THE FUTURE, WHICH IS GENERALLY 21%. A FULL VALUATION ALLOWANCE HAS BEEN PROVIDED AT DECEMBER 31, 2019 AND 2018 TO OFFSET THE DEFERRED TAX ASSET, SINCE HEALTHCARE CORPORATION HAS DETERMINED THAT IT IS MORE LIKELY THAN NOT THAT THE BENEFIT OF THE NET OPERATING LOSS CARRYFORWARDS WILL NOT BE REALIZED IN FUTURE YEARS. THE INCOME TAXES TOPIC OF THE ASC (ASC 740) PRESCRIBES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAX POSITIONS RECOGNIZED IN FINANCIAL STATEMENTS. ASC 740 PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN, OR EXPECTED TO BE TAKEN, IN A TAX RETURN. THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2019 AND 2018. ON DECEMBER 22, 2017, THE UNITED STATES ENACTED TAX REFORM LEGISLATION COMMONLY KNOWN AS THE TAX CUTS AND JOBS ACT (ACT), RESULTING IN SIGNIFICANT MODIFICATIONS TO EXISTING LAW. CERTAIN PROVISIONS IMPACT TAX-EXEMPT ORGANIZATIONS, INCLUDING REVISIONS TO TAXES ON UNRELATED BUSINESS ACTIVITIES, EXCISE TAXES ON COMPENSATION OF CERTAIN EMPLOYEES, AND VARIOUS OTHER PROVISIONS. WHILE FINAL REGULATIONS ON THESE PROVISIONS HAVE NOT YET BEEN PROMULGATED, THE IMPACT OF THESE PROVISIONS ON THE CONSOLIDATED FINANCIAL STATEMENTS IS NOT EXPECTED TO BE SIGNIFICANT. 1 1 X 1 X 0 1 1 1 0 1 0 14709252 14709252 0.10960 23554834 23684826 0 0.00000 38264086 23684826 14709252 0.10960 104193 104193 0.00080 187158 187158 0.00140 291351 291351 0.00220 38555437 23684826 15000603 0.11180 8343 8343 0.00010 8343 8343 0.00010 1 13781318 2749454 38614468 34541434 4073034 X 1 1 1 CLEAR CREEK MOB LTD REAL ESTATE RENTAL 0.60800 0.00000 0.22600 2 1 ADVENTHEALTH CENTRAL TEXAS 2201 S CLEAR CREEK ROAD KILLEEN TX 76549 WWW.ADVENTHEALTH.COM/HOSPITAL/ADVENTHE 000397 X X X A 2 ADVENTHEALTH ROLLINS BROOK 608 N KEY AVENUE LAMPASAS TX 76550 WWW.ADVENTHEALTH.COM/HOSPITAL/ADVENTHE 007209 X X X A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 19 1 0 0 1 X SEE PART V, PAGE 8 X X 1 17 1 SEE PART V, PAGE 8 0 1 X 200.000000000000 X X X X 1 1 X X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X 1 X 0 X X X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: ADVENTHEALTH CENTRAL TEXAS, - FACILITY 2: ADVENTHEALTH ROLLINS BROOK FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5: IN ORDER TO ENSURE BROAD COMMUNITY INPUT, ADVENTHEALTH CENTRAL TEXAS AND ADVENTHEALTH ROLLINS BROOK CREATED A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE (CHNAC) TO HELP GUIDE THE HOSPITALS THROUGH THEIR 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. THE COMMITTEE INCLUDED REPRESENTATION FROM THE HOSPITALS, PUBLIC HEALTH OFFICIALS AND THE BROAD COMMUNITY AS WELL AS REPRESENTATION FROM LOW-INCOME, MINORITY AND OTHER UNDERSERVED POPULATIONS. MEMBERS OF THE CHNAC INCLUDED INDIVIDUALS FROM THE FOLLOWING ORGANIZATIONS: GREATER KILLEEN COMMUNITY CLINIC - PROVIDES HEALTH SERVICES THAT OFFER A COMPRENSIVE APPROACH TOWARD HEALTH, BUILDS INNOVATIVE PARTNERSHIPS AND ADVOCATES FOR THOSE WHO HAVE LIMITED ACCESS TO HEALTH CARE SERVICES.BELL COUNTY INDIGENT HEALTH SERVICES DEPARTMENT - SERVES THE COMMUNITY AND VERY LOW-INCOME RESIDENTS. PROVIDES HEALTH CARE FOR TEXAS RESIDENTS IN NEED WHO DO NOT QUALIFY FOR OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS. UNITED WAY OF GREATER FORT HOOD AREA - PROVIDES SOCIAL SERVICES AND SOCIAL SERVICE FUNDING TO COMMUNITY AGENCIES SERVING LOW-INCOME AND MINORITY POPULATIONS, AS WELL AS LOW-INCOME AND MINORITY FAMILIES FROM FORT HOOD.BELL COUNTY PUBLIC HEALTH DISTRICT - SERVES BELL COUNTY COMMUNITIES, ORGANIZATIONS AND CITIZENS THROUGH EDUCATION AND LEADERSHIP TO PREVENT DISEASE AND PROTECT THE PUBLIC'S HEALTH.TEXAS A&M AGRILIFE EXTENSION - PROVIDES HEALTHY LIVING EDUCATION PROGRAMS AND SUPPORT TO THE COMMUNITY.TEXAS A&M ROLLINS BROOK - IMPROVES HEALTH EDUCATION IN THE AREA THROUGH ITS CURRENT SELECTION OF HEALTH EDUCATION PROGRAMS. CITY OF KILLEEN - SERVES THE CITY OF KILLEEN THROUGH COORDINATION OF HEALTH SERVICES AND MEMBERSHIP ON COMMUNITY HEALTH COALITIONS.CENTRAL TEXAS AREA AGENCY ON AGING - SERVES INDIVIDUALS 60 YEARS OF AGE AND OLDER AND THEIR FAMILIES RESIDING IN BELL AND SURROUNDING COUNTIES.IN CONDUCTING IT 2019 CHNA, ADVENTHEALTH CENTRAL TEXAS AND ADVENTHEALTH ROLLINS BROOK TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENTED THE BROAD INTERESTS OF THE COMMUNITY INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH IN MULTIPLE WAYS. FIRST, THE CHNAC, WHICH INCLUDED INDIVIDUALS THAT REPRESENTED THE BROAD COMMUNITY AND INDIVIDUALS WITH EXPERTISE IN PUBLIC HEALTH, MET QUARTERLY TO BUILD THE CHNA.TO SOLICIT BROAD COMMUNITY INPUT, ADVENTHEALTH CENTRAL TEXAS AND ADVENTHEALTH ROLLINS BROOK CONDUCTED STAKEHOLDER INTERVIEWS AND COMMUNITY SURVEYS. COMMUNITY SURVEYS WERE DISTRIBUTED BOTH IN PERSON AND ONLINE AT VARIOUS LOCATIONS WITHIN BELL, CORYELL AND LAMPASAS COUNTIES. IN PERSON SURVEY LOCATIONS INCLUDED HEALTH SCREENINGS, IMMUNIZATION CLINICS, THE HOSPITALS' WELLNESS CLASSES, THE GREATER KILLEEN COMMUNITY CLINIC AND AMONG VARIOUS CHURCH CONGREGATIONS. ONLINE SURVEYS WERE DISTRIBUTED AMONG ADVENTHEALTH CENTRAL TEXAS AND ROLLINS BROOK TEAM MEMBERS, THE BOYS & GIRLS CLUB OF ROLLINS BROOK AND THROUGH EMAIL. DURING THE CHNA CYCLE, 91 IN-PERSON SURVEYS AND 124 ONLINE SURVEYS WERE COMPLETED BY PEOPLE OF ALL INCOMES AND ETHNICITIES.IN ADDITION TO THE SURVEYS, 25 INDIVIDUAL STAKEHOLDER SURVEYS WERE COLLECTED ONLINE BY EMAILING COMMUNITY LEADERS THAT REPRESENT PUBLIC HEALTH, VARIOUS SPECIAL POPULATIONS, LOW-INCOME AND MINORITY POPULATIONS. SURVEY QUESTIONS FOCUSED ON THE BEST QUALITIES OF BELL AND LAMPASAS COUNTY, ALONG WITH THE MOST NEEDED HEALTH AND HUMAN SERVICES. ADDITIONALLY, THE KEY INFORMANTS AND OTHERS WERE ASKED ABOUT POTENTIAL SOLUTIONS AND RECOMMENDATIONS FOR PROMOTING GOOD HEALTH IN BELL AND LAMPASAS COUNTIES. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 7D: THE HOSPITALS HAVE ADOPTED A POLICY THAT ADDRESSES THE PUBLIC POSTING REQUIREMENTS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT. UNDER THIS POLICY, THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS MUST BE POSTED ON THE HOSPITALS' WEBSITE AT LEAST UNTIL THE DATE THE HOSPITAL FACILITIES HAVE MADE WIDELY AVAILABLE ON THEIR WEBSITE THEIR TWO SUBSEQUENT COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS. THE HOSPITALS WILL ALSO MAKE A PAPER COPY OF THEIR COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST AND WITHOUT CHARGE, AT LEAST UNTIL THE DATE THE HOSPITAL FACILITIES HAVE MADE AVAILABLE FOR PUBLIC INSPECTION THEIR TWO SUBSEQUENT COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 11: THE INFORMATION PROVIDED BELOW EXPLAINS HOW THE HOSPITAL FACILITIES ADDRESSED IN 2019 THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN ITS 2016 COMMUNITY HEALTH NEEDS ASSESSMENT, AND ANY SUCH NEEDS THAT WERE NOT ADDRESSED AND THE REASONS WHY SUCH NEEDS WERE NOT ADDRESSED. THE HOSPITAL FACILITIES CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT IN 2016 AND ADOPTED AN IMPLEMENTATION STRATEGY TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT IN 2017 PRIOR TO MAY 15, 2017.METROPLEX ADVENTIST HOSPITAL, INC. D/B/A ADVENTHEALTH CENTRAL TEXAS AND METROPLEX ADVENTIST HOSPITAL, INC. D/B/A ADVENTHEALTH ROLLINS BROOK WILL BE REFERRED TO IN THIS DOCUMENT AS ADVENTHEALTH CENTRAL TEXAS AND ADVENTHEALTH ROLLINS BROOK RESPECTIVELY OR "THE HOSPITALS".THE HOSPITALS ARE A SUBSIDIARY OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). AHSSHC IS THE 501(C)(3) PARENT ORGANIZATION OF A HOSPITAL AND HEALTHCARE SYSTEM KNOWN AS ADVENTHEALTH. IN JANUARY OF 2019, EVERY WHOLLY-OWNED ENTITY OF AHSSHC ADOPTED THE ADVENTHEALTH SYSTEM BRAND. OUR IDENTITY HAS BEEN UNIFIED TO REPRESENT THE FULL CONTINUUM OF CARE OUR SYSTEM OFFERS. ANY REFERENCE TO OUR 2016 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) OR 2017 COMMUNITY HEALTH PLAN (CHP) WILL UTILIZE OUR NEW NAME FOR CONSISTENCY.ADVENTHEALTH CENTRAL TEXAS AND ADVENTHEALTH ROLLINS BROOK ARE BOTH PART OF THE SOUTHWEST REGION. ADVENTHEALTH ROLLINS BROOK IN LAMPASAS, TEXAS, AND ADVENTHEALTH CENTRAL TEXAS IN KILLEEN, TEXAS SHARE A COMMON LICENSE AND SERVICE AREA: BELL AND LAMPASAS COUNTIES.THIS IS THE THIRD-YEAR UPDATE FOR ADVENTHEALTH CENTRAL TEXAS AND ADVENTHEALTH ROLLINS BROOK'S 2017-2019 COMMUNITY HEALTH PLAN (IMPLEMENTATION STRATEGY). THE HOSPITALS DEVELOPED THIS PLAN AND POSTED IT BY MAY 15, 2017 AS PART OF THEIR 2016 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. FOR THE DEVELOPMENT OF BOTH THE COMMUNITY HEALTH NEEDS ASSESSMENT AND THE COMMUNITY HEALTH PLAN/IMPLEMENTATION STRATEGY, THE HOSPITALS WORKED TO DEFINE AND ADDRESS THE NEEDS OF LOW-INCOME, MINORITY AND UNDERSERVED POPULATIONS IN THEIR SERVICE AREA. THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT USED PRIMARY DATA INTERVIEWS AND SURVEYS; SECONDARY DATA FROM LOCAL, REGIONAL AND NATIONAL HEALTH-RELATED SOURCES; AND HOSPITAL PREVALENCE DATA TO HELP THE HOSPITALS DETERMINE THE HEALTH NEEDS OF THE COMMUNITIES THEY SERVE. ONCE THE DATA WAS GATHERED, THE PRIMARY ISSUES IDENTIFIED IN THE CHNA WERE PRIORITIZED BY COMMUNITY AND HOSPITAL STAKEHOLDERS, WHO THEN SELECTED KEY ISSUES FOR THE HOSPITALS TO ADDRESS IN THEIR 2017-2019 COMMUNITY HEALTH PLAN. THE THIRD-YEAR PROGRESS ON THE COMMUNITY HEALTH PLAN IS NOTED BELOW. THE NARRATIVE DESCRIBES THE ISSUES IDENTIFIED IN 2016 AND GIVES AN UPDATE ON THE STRATEGIES ADDRESSING THOSE ISSUES. THERE IS ALSO A DESCRIPTION OF THE IDENTIFIED ISSUES THAT THE HOSPITALS ARE NOT ADDRESSING.ADVENTHEALTH CENTRAL TEXAS AND ADVENTHEALTH ROLLINS BROOK CHOSE THREE AREAS OF FOCUS FOR THEIR 2017-2019 COMMUNITY HEALTH PLAN: 1. ASTHMA PREVENTION AND MANAGEMENT2. CARDIOVASCULAR DISEASE3. INCREASED EXERCISE AND ACTIVITY.PRIORITY 1: ASTHMA PREVENTION AND MANAGEMENT2016 DESCRIPTION OF THE ISSUE: ASTHMA AFFECTS MORE CHILDREN THAN ANY OTHER CHRONIC DISEASE IN OUR SERVICE AREA AND IS ONE OF THE MOST FREQUENT REASONS FOR HOSPITAL ADMISSIONS AMONG CHILDREN. ASTHMA IS A CHRONIC, POTENTIALLY LIFE-THREATENING, INFLAMMATORY DISEASE OF THE AIRWAYS THAT IS INCREASINGLY BEING RECOGNIZED AS A MAJOR PUBLIC HEALTH PROBLEM. BASED ON DATA, THE PREVALENCE OF ASTHMA HAS RISEN AND CONTINUES TO RISE IN OUR SERVICE AREA AND ACROSS ALL DEMOGRAPHIC GROUPS, WHETHER MEASURED BY AGE, RACE OR GENDER. ASTHMA HAS A MAJOR IMPACT ON THE HEALTH OF OUR POPULATION. CURRENTLY IT IS ESTIMATED THAT 24.7 MILLION PEOPLE NATIONWIDE HAVE ASTHMA. MORE THAN A THIRD OF THOSE WITH ASTHMA ARE INDIVIDUALS UNDER 18. IT IS THE MOST COMMON CHRONIC DISEASE AMONG CHILDREN, AND AS THE LEADING CAUSE OF SCHOOL ABSENTEEISM, COLLECTIVELY RESULTS IN MORE THAN 14 MILLION MISSED SCHOOL DAYS ANNUALLY. ASTHMA HAS SERIOUS CONSEQUENCES AMONG ADULTS AS WELL. IT IS THE FOURTH LEADING CAUSE OF ADULT WORK ABSENCES AND CAN LEAD TO JOB LOSS. ASTHMA ALSO CAN CONTRIBUTE TO DISABILITY AND PREMATURE DEATH. ASTHMA ACCOUNTS FOR MANY LOST NIGHTS OF SLEEP, DISRUPTION OF FAMILY AND CAREGIVER ROUTINES AND REDUCED QUALITY OF LIFE. ELEVEN PERCENT OF ADULTS REPORT HAVING BEEN DIAGNOSED WITH ASTHMA. USING A CONSERVATIVE ESTIMATE OF 10 PERCENT PREVALENCE OF ASTHMA AMONG ALL AGES, OVER 129,395 PEOPLE SUFFER VARYING LEVELS OF DISABILITY, DECREASED QUALITY OF LIFE AND INCREASED MEDICAL COSTS. MUCH OF THIS DISABILITY AND DISRUPTION OF DAILY LIVES IS UNNECESSARY BECAUSE EFFECTIVE TREATMENTS FOR ASTHMA ARE AVAILABLE. HOWEVER, ASTHMA IS A COMPLEX DISEASE WITH NUMEROUS RISK FACTORS. THIS COMPLEXITY REQUIRES A COMPREHENSIVE SOLUTION INVOLVING MANY ORGANIZATIONS AND INDIVIDUALS. THE SOLUTION EXTENDS WELL BEYOND MEDICAL CARE INTO THE REALM OF PUBLIC HEALTH, BEHAVIORAL AND LIFESTYLE MODIFICATION, EDUCATION, HOUSING, ENVIRONMENT AND OTHER GOVERNMENT AND COMMUNITY SERVICES. TO FACILITATE INTEGRATION AND PROVIDE A MEANS TO MONITOR AND MEASURE PROGRESS TOWARD LONG-TERM GOALS, THERE MUST BE A PLAN THAT GUIDES THE EFFORTS OF ALL WHO ARE INVOLVED IN THE MANAGEMENT OF ASTHMA. 2019 UPDATE: IN 2016, THE BOYS AND GIRLS CLUB OF CENTRAL TEXAS WAS AWARDED A THREE-YEAR GRANT THROUGH THE CREATION HEALTH INVESTMENT FUND IN THE AMOUNT OF $225,000. IN SUPPORT OF THIS INITIATIVE, THE HOSPITALS COMMITTED AN ADDITIONAL DONATION OF $75,000 TO BE PAID OUT IN THREE YEARLY INCREMENTS OF $25,000, FOR A TOTAL OF $100,000 IN ANNUAL SUPPORT. IN 2016 AND THE FIRST TWO QUARTERS OF 2017, THE BOYS AND GIRLS CLUB OF CENTRAL TEXAS MET OR EXCEEDED THEIR REQUIREMENTS FOR EACH OF THE LOCATIONS WHERE THE CREATION HEALTH AND ASTHMA PREVENTION PROGRAMMING WAS HOSTED. AS THE PROGRAM REQUIREMENTS WERE MET AT THE TIME, FUNDING WAS PROVIDED IN BOTH YEARS AT $100,000 ANNUALLY FOR A TOTAL OF $200,000. THE PROGRAM INCLUDED A WEEKLY EDUCATIONAL CURRICULUM FOR THE STUDENTS OF THE BOYS AND GIRLS CLUB. CLUB MEMBERS WERE PROVIDED NO-COST, CURRICULUM-BASED ASTHMA EDUCATION CLASSES BY A TRAINED RESPIRATORY THERAPIST. THIS INITIATIVE IMBEDDED CREATION HEALTH PRINCIPLES INTO THE CURRICULUM OFFERED AT THE BOYS & GIRLS CLUB. THE CREATION HEALTH PRINCIPALS FOCUS ON THE IMPORTANCE OF CHOICE, REST, ENVIRONMENT, ACTIVITY, TRUST, INTERPERSONAL RELATIONSHIPS, OUTLOOK, NUTRITION. FOR THE LAST TWO QUARTERS OF 2017, THE BOYS AND GIRLS CLUB DID NOT MEET THE REPORTING REQUIREMENTS TO RECEIVE THE FINAL INSTALLMENT IN THE AMOUNT OF $100,000 AND WAS UNABLE TO COMPLETE THE THIRD YEAR OF THE CREATION HEALTH AND ASTHMA PREVENTION PROGRAM. AS A REQUIREMENT FOR THE GRANT FUNDS, THE BOYS AND GIRLS CLUB STAFF WAS RESPONSIBLE FOR ENROLLING 200 STUDENTS ANNUALLY INTO THE PROGRAM AND REPORTING RESULTS FROM BOTH THE PRE AND POST SURVEYS. THE BOYS AND GIRLS CLUB DID NOT MEET EITHER OF THESE REQUIREMENTS. DUE TO THE FACT THAT THE GRANT PERIOD CONCLUDED IN DECEMBER OF 2018, THERE IS NOTHING TO REPORT FOR THE 2019 TAX YEAR. THIS IS CONSISTENT WITH THE 2017 CHP AS THE ORIGINAL PLAN DID NOT INCLUDE A SET GOAL FOR 2019. THE DECISION TO NOT HAVE A SET GOAL FOR 2019 WAS TO ALLOW TIME TO EVALUATE THE OUTCOMES FROM THE ORIGINAL GRANT ALLOCATION BEFORE COMMITTING ADDITIONAL FUNDING.PRIORITY 2: CARDIOVASCULAR DISEASE2016 DESCRIPTION OF THE ISSUE: CARDIOVASCULAR DISEASE (CVD) REFERS TO SEVERAL TYPES OF CONDITIONS THAT AFFECT THE HEART AND BLOOD VESSELS. THE MOST COMMON TYPE OF HEART DISEASE IN BELL COUNTY IS CORONARY ARTERY DISEASE (CAD), WHICH CAN LEAD TO HEART ATTACKS. IN OUR SERVICE AREA, ALMOST 30 PERCENT OF ADULTS DO NOT PARTICIPATE IN LEISURE TIME PHYSICAL ACTIVITY. MORE THAN 75 PERCENT OF ADULTS IN OUR SERVICE AREA EAT LESS THAN 5 FRUITS AND VEGETABLES A DAY. TWENTY-SEVEN PERCENT OF BELL COUNTY RESIDENTS ARE SMOKERS. THESE FACTORS PLACE RESIDENTS AT RISK FOR CVD. CVD IS THE LEADING CAUSE OF DEATH IN BELL COUNTY FOR BOTH MEN AND WOMEN IN OUR SERVICE AREA. HIGH BLOOD PRESSURE AND HIGH CHOLESTEROL ARE TWO MAJOR RISK FACTORS FOR HEART DISEASE. ABOUT HALF OF ADULTS IN OUR SERVICE AREA WITH HIGH BLOOD PRESSURE AND NEARLY 2 OUT OF 3 ADULTS WITH HIGH CHOLESTEROL DO NOT HAVE THEIR CONDITION UNDER CONTROL. MANY CVD RISK FACTORS SUCH AS HIGH BLOOD PRESSURE, HIGH CHOLESTEROL, EXCESS WEIGHT, POOR DIET, SMOKING AND DIABETES CAN BE PREVENTED OR TREATED THROUGH HEALTH BEHAVIOR CHANGE AND APPROPRIATE MEDICATION. SOME UNPREVENTABLE RISKS FOR CVD ARE RELATED TO HEREDITY, MEDICAL HISTORY, AGE, GENDER AND RACE. THERE ARE ALSO MULTIPLE UNDERLYING SOCIAL, ECONOMIC AND CULTURAL DETERMINANTS OF CVD SUCH AS STRESS, EDUCATION LEVEL, INCOME AND INSURANCE STATUS. **SEE CONTINUATION SCH H, PART V, SECTION B, LINE 11 FACILITY REPORTING GROUP - A**CONTINUATION2019 UPDATE: ADVENTHEALTH CENTRAL TEXAS AND ADVENTHEALTH ROLLINS BROOK HOSTED 25 FREE COMMUNITY HEALTH SCREENINGS TO GIVE COMMUNITY MEMBERS A BASELINE OF THEIR CARDIOVASCULAR RISK FACTORS AND EMPOWER THEM WITH THE NECESSARY INFORMATION TO SPEAK WITH THEIR PRIMARY CARE PROVIDERS. HEALTH SCREENINGS INCLUDED CHOLESTEROL, GLUCOSE, BLOOD PRESSURE, BODY MASS INDEX AND BODY FAT PERCENTAGE. GENERALLY, THE HOSPITALS FACILITATE A TOTAL OF SEVEN TO EIGHT QUARTERLY HEALTH SCREENINGS BETWEEN OUR TWO FACILITIES. THESE SCREENINGS ARE OPEN TO THE PUBLIC AND EMPLOYEES. DURING THESE SCREENINGS, PARTICIPANTS HAVE THEIR CHOLESTEROL, GLUCOSE, BLOOD PRESSURE, BODY FAT PERCENTAGE, BMI, HEIGHT AND WEIGHT, AND BONE DENSITY CHECKED. OCCASIONALLY, FREE ANKLE-BRACHIAL-INDEX (ABI) SCREENINGS ARE ALSO OFFERED. UPON COMPLETING THE SCREENINGS, ALL PARTICIPANTS RECEIVE A CARBON COPY OF THEIR RESULTS, WHICH THEY CAN TAKE TO THEIR PRIMARY CARE PHYSICIAN (PCP) OR HAVE FORWARDED TO THEIR PCP. THE WELLNESS DEPARTMENT COORDINATES THE HEALTH SCREENINGS AND KEEPS TRACK OF THE NUMBER OF PEOPLE SERVED VIA A SIGN-IN SHEET. ALL RESULTS AND SIGN-IN SHEETS ARE FILED AND KEPT IN A LOCKED FILING CABINET IN THE WELLNESS OFFICE FOR 5 YEARS OR MORE. AS A RESULT OF THIS INITIATIVE, 507 INDIVIDUALS WERE SCREENED DURING 2019 FOR CARDIOVASCULAR DISEASE RISK FACTORS, SURPASSING THE GOAL OF 475. AMONG THOSE SCREENED, 68.7 PERCENT HAD MODERATELY HIGH TO HIGH BLOOD PRESSURE, 70.2 PERCENT HAD A BODY MASS INDEX (BMI) INDICATING THEY WERE OVERWEIGHT OR OBESE AND 27.2 PERCENT HAD HIGH CHOLESTEROL. SCREENED PATIENTS THAT WERE IDENTIFIED AS HAVING ONE OR MORE RISK FACTORS FOR CARDIOVASCULAR DISEASE WERE PROVIDED A PHYSICIAN REFERRAL LIST TO HELP MATCH THEM WITH A PRIMARY CARE PROVIDER. SIXTY-THREE INDIVIDUALS WERE REFERRED TO A PRIMARY CARE DOCTOR FOR THEIR CARDIOVASCULAR DISEASE RISK FACTORS, WHICH SURPASSED THE GOAL 53 REFERRALS FOR 2019. OF THE REFERRALS MADE, 38 PERCENT SHOWED IMPROVEMENT IN CARDIOVASCULAR DISEASE RISK FACTORS (THROUGH A FOLLOW-UP SCREENING), WHICH WAS SLIGHTLY BELOW THE GOAL OF 40 PERCENT. IN 2019, ADVENTHEALTH MEDICAL GROUP PHYSICIANS WERE PROVIDED EDUCATIONAL RESOURCES REGARDING CARDIOVASCULAR DISEASE AND MATERIALS ON THE QUARTERLY HEALTH SCREENINGS, FITNESS CLASSES AND NUTRITIONAL CLASSES TO DISPERSE TO PATIENTS IDENTIFIED WITH CARDIOVASCULAR DISEASE RISKS. PRIMARY CARE PHYSICIANS CREDENTIALED AT THE HOSPITALS RECEIVED ADDITIONAL EDUCATIONAL OPPORTUNITIES FOCUSED ON THE IMPORTANCE OF IDENTIFYING INDIVIDUALS WITH GENETIC RISK. OF THE INDIVIDUALS IN ATTENDANCE AT THE HEALTH SCREENINGS, 134 HAD BEEN REFERRED BY THEIR PRIMARY CARE PROVIDER.PRIORITY 3: INCREASED EXERCISE AND ACTIVITY2016 DESCRIPTION OF THE ISSUE: IN OUR SERVICE AREA, THE TOP HEALTH EDUCATION PRIORITIES FOCUSED ON WEIGHT LOSS, HEALTHY COOKING CLASSES AND GENERAL HEALTH EDUCATION CLASSES FOR ALL AGES. LACK OF PHYSICAL ACTIVITY IN OUR SERVICE AREA HAS BECOME A MAJOR ISSUE IN PUBLIC HEALTH. EVIDENCE HAS EMERGED ON THE IMPORTANT ROLE OF PHYSICAL ACTIVITY IN MANAGING AND PREVENTING MANY HEALTH CONDITIONS, INCLUDING OVERWEIGHT AND OBESITY, TYPE 2 DIABETES, CARDIOVASCULAR DISEASE RISK, SKELETAL HEALTH AND MENTAL HEALTH. THE ISSUE OF OBESITY IN YOUTH AND THE LINK BETWEEN THIS CONDITION AND TYPE 2 DIABETES, AS WELL AS THE INCREASES IN DIABETES, IS TOPICAL AND CURRENTLY DEMANDING MUCH ATTENTION IN PHYSICAL ACTIVITY INITIATIVES. ESTABLISHING LINKS BETWEEN PHYSICAL ACTIVITY AND HEALTH OUTCOMES IS A FUNDAMENTAL PHASE OF BEHAVIORAL EPIDEMIOLOGY. AN EARLY PHASE OF THIS FRAMEWORK IS TO IDENTIFY VALID AND RELIABLE WAYS TO ASSESS PHYSICAL ACTIVITY. SUITABLE ASSESSMENT METHODS SHOW THERE ARE POOR HEALTH OUTCOMES ASSOCIATED WITH THE LACK OF PHYSICAL ACTIVITY, WHICH LOGICALLY LEADS TO RESEARCH IDENTIFYING FACTORS ASSOCIATED WITH PHYSICAL ACTIVITY AND INTERVENTIONS TO INCREASE PHYSICAL ACTIVITY.2019 UPDATE: DUE TO A HIGH RISK FOR OBESITY, TYPE 2 DIABETES, CARDIOVASCULAR DISEASE, SKELETAL HEALTH AND MENTAL HEALTH CONCERNS IN OUR SERVICE AREA, ADVENTHEALTH CENTRAL TEXAS AND ADVENTHEALTH ROLLINS BROOK DEVELOPED A ROBUST WELLNESS PROGRAM TO PROVIDE ACCESSIBLE FITNESS CLASSES AND EDUCATIONAL OPPORTUNITIES. THIS INCLUDES FOURTEEN WEEKLY WORKOUT CLASSES, DIABETES SELF-MANAGEMENT COURSES, WALK WITH A DOC PROGRAMING, FOOT REFLEXOLOGY, CREATION LIFE SEMINARS, NUTRITIONAL COUNSELING AND SUPPORT GROUPS. EACH OF THE LISTED ACTIVITIES ARE FREE AND OPEN TO THE COMMUNITY. WALK WITH A DOC AIMS TO INCREASE THE COMMUNITY ACTIVITY BY TAKING HOUR-LONG WALKS LED BY A LOCAL PHYSICIAN WHO DISCUSSES VARIOUS HEALTH TOPICS. IN 2019, ADVENTHEALTH EXPANDED THE WALK WITH A DOC PROGRAM IN PARTNERSHIP WITH BAYLOR SCOTT & WHITE, A NATIONAL NOT-FOR-PROFIT HEALTHCARE SYSTEM WITH FACILITIES IN TEXAS. ADVENTHEALTH ROLLINS BROOK ADDED TWO ADDITIONAL FITNESS CLASSES IN LAMPASAS. EACH OF THE WELLNESS PROGRAMS INCORPORATES THE PRINCIPLES OF CREATION HEALTH TO PROMOTE A COMPREHENSIVE APPROACH TO SELF-CARE. CREATION HEALTH IS A FAITH-BASED WELLNESS PLAN WITH LIFESTYLE SEMINARS AND TRAINING FOR THOSE WHO WANT TO LIVE HEALTHIER AND HAPPIER LIVES AND SHARE THIS UNIQUE WHOLE-PERSON HEALTH PHILOSOPHY. CREATION HEALTH IS BASED ON THE EIGHT PRINCIPLES OF CHOICE, REST, ENVIRONMENT, ACTIVITY, TRUST, INTERPERSONAL RELATIONS, OUTLOOK AND NUTRITION. IN 2019, 30 PARTICIPANTS COMPLETED THE CREATION HEALTH SEMINARS AND 386 UNIQUE INDIVIDUALS ATTENDED THE 14 FITNESS CLASSES. BOTH NUMBERS EXCEEDED THE TARGET GOALS. MANY OF THE WELLNESS PROGRAM OFFERINGS CONTINUE TO BE AT MAX CAPACITY. DUE TO LIMITED ROOM SPACE, WE ARE UNABLE TO ADD ANY ADDITIONAL CLASSES. THE HOSPITAL'S FOUNDATION IS IN THE THIRD YEAR OF RAISING FUNDS FOR A DEDICATED WELLNESS BUILDING. THIS NEW BUILDING WILL GREATLY INCREASE THE HOSPITALS' CAPACITY FOR WELLNESS PROGRAMMING. COMMUNITY NEEDS NOT CHOSEN BY ADVENTHEALTH CENTRAL TEXAS AND ROLLINS BROOK: THE PRIMARY AND SECONDARY DATA IN THE COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED MULTIPLE COMMUNITY ISSUES. HOSPITAL AND COMMUNITY STAKEHOLDERS USED THE FOLLOWING CRITERIA TO NARROW THE LARGER LIST TO THE PRIORITY AREAS NOTED ABOVE:1. HOW ACUTE IS THE NEED? (BASED ON DATA AND COMMUNITY CONCERN)2. WHAT IS THE TREND? IS THE NEED GETTING WORSE?3. DOES THE HOSPITAL PROVIDE SERVICES THAT RELATE TO THE PRIORITY? 4. IS SOMEONE ELSE OR MULTIPLE GROUPS IN THE COMMUNITY ALREADY WORKING ON THIS ISSUE? 5. IF THE HOSPITAL WERE TO ADDRESS THIS ISSUE, ARE THERE OPPORTUNITIES TO WORK WITH COMMUNITY PARTNERS? BASED ON THIS PRIORITIZATION PROCESS, THE HOSPITAL DID NOT CHOOSE THE FOLLOWING COMMUNITY ISSUES:- MENTAL HEALTH AND SUBSTANCE ABUSE: THE HOSPITALS ALREADY PROVIDE MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES. - HEALTH LITERACY: THE HOSPITALS DO NOT HAVE THE CAPACITY TO ADDRESS THE ISSUE. - THE OTHER COMMUNITY-RELATED NEEDS ASSESSMENT EFFORTS NOTED BELOW ARE BEING SPEARHEADED BY VARIOUS GROUPS TO ADDRESS THE REMAINING NEEDS OF THE COMMUNITY FROM THE ASSESSMENT. THE HOSPITALS CONTINUE TO STRIVE TO EXPAND AND RETAIN THE NECESSARY RESOURCES IN THE COMMUNITY BY PARTICIPATING IN THESE EFFORTS WHEN POSSIBLE: 1. HEALTHY EATING 2. PRIMARY CARE SERVICES AND INFORMATION (HEALTH LITERACY) INCLUDING ADEQUATE SPANISH CAPACITY 3. SPECIALTY CARE 4. AFFORDABLE, LOCAL MENTAL HEALTH SERVICES 5. SMOKING CESSATION 6. AFFORDABLE, LOCAL SUBSTANCE ABUSE TREATMENT SERVICES. SCH H, PART V, SECTION B, LINE 7A THE CHNA REPORT CAN BE FOUND AT URL:HTTPS://WWW.ADVENTHEALTH.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS SCH H, PART V, SECTION B, LINE 10A THE HOSPITALS' MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY CAN BE FOUND AT URL:HTTPS://WWW.ADVENTHEALTH.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS SCH H, PART V, SECTION B, LINES 16A, 16B, AND 16C THE FINANCIAL ASSISTANCE POLICY CAN BE FOUND AT URL:HTTPS://WWW.ADVENTHEALTH.COM/LEGAL/FINANCIAL-ASSISTANCETHE FINANCIAL ASSISTANCE POLICY APPLICATION CAN BE FOUND AT:HTTPS://WWW.ADVENTHEALTH.COM/LEGAL/FINANCIAL-ASSISTANCETHE PLAIN LANGUAGE SUMMARY IS AVAILABLE AT:HTTPS://WWW.ADVENTHEALTH.COM/LEGAL/FINANCIAL-ASSISTANCE PART I, LINE 6A: THE FILING ORGANIZATION WAS A PARTIALLY OWNED SUBSIDIARY OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC) DURING ITS CURRENT TAX YEAR. DURING THE CURRENT YEAR, AHSSHC SERVED AS A PARENT ORGANIZATION TO 27 TAX-EXEMPT 501(C)(3) HOSPITAL ORGANIZATIONS AND A NUMBER OF OTHER HEALTH CARE FACILITIES THAT OPERATED IN 10 STATES WITHIN THE U.S. THE SYSTEM OF ORGANIZATIONS UNDER THE CONTROL AND OWNERSHIP OF AHSSHC IS KNOWN AS "ADVENTHEALTH".ALL HOSPITAL ORGANIZATIONS WITHIN ADVENTHEALTH COLLECT, CALCULATE, AND REPORT THE COMMUNITY BENEFITS THEY PROVIDE TO THE COMMUNITIES THEY SERVE. ADVENTHEALTH ORGANIZATIONS EXIST SOLELY TO IMPROVE AND ENHANCE THE LOCAL COMMUNITIES THEY SERVE. ADVENTHEALTH HAS A SYSTEM-WIDE COMMUNITY BENEFITS ACCOUNTING POLICY THAT PROVIDES GUIDELINES FOR ITS HEALTH CARE PROVIDER ORGANIZATIONS TO CAPTURE AND REPORT THE COSTS OF SERVICES PROVIDED TO THE UNDERPRIVILEGED AND TO THE BROADER COMMUNITY. EACH ADVENTHEALTH HOSPITAL FACILITY REPORTS THEIR COMMUNITY BENEFITS TO THEIR BOARD OF DIRECTORS AND STRIVES TO COMMUNICATE THEIR COMMUNITY BENEFITS TO THEIR LOCAL COMMUNITIES. ADDITIONALLY, THE FILING ORGANIZATION'S MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT AND ASSOCIATED IMPLEMENTATION STRATEGY CAN BE ACCESSED ON THE FILING ORGANIZATION'S WEBSITE. PART I, LINE 7: THE AMOUNTS OF COSTS REPORTED IN THE TABLE IN LINE 7 OF PART I OF SCHEDULE H WERE DETERMINED BY UTILIZING A COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES, CONTAINED IN THE SCHEDULE H INSTRUCTIONS. PART II, COMMUNITY BUILDING ACTIVITIES: THE FILING ORGANIZATION IS INVOLVED WITH AND SUPPORTIVE OF VARIOUS ACTIVITIES IN ITS SERVICE AREA THAT WORK COLLABORATIVELY TO HELP THOSE IN NEED AND TO IMPROVE THE HEALTH AND SAFETY OF THE RESIDENTS OF THE COMMUNITY. THE FILING ORGANIZATION'S WELLNESS DEPARTMENT OFFERS VARIOUS HEALTH PROMOTION AND EDUCATIONAL PROGRAMS INCLUDING THE FOLLOWING: ARTHRITIS EXERCISE, LALECHE LEAGUE (ASSISTANCE TO MOTHERS WHO BREASTFEED THROUGH MOTHER-TO-MOTHER SUPPORT, ENCOURAGEMENT, AND EDUCATION), SENIOR EXCERCISE, GRIEF RECOVERY, DIABETES EDUCATION, ASTHMA EDUCATION, SMOKING CESSATION CLASSES, CANCER COSMETOLOGY CLASS AND SUPPORT GROUPS FOR THOSE AFFECTED BY CANCER. IN ADDITION TO THE ACTIVITIES LISTED ABOVE, THE FILING ORGANIZATION ALSO ORGANIZES HEALTH EVENTS & HEALTH FAIRS THAT PROVIDE HEALTH SCREENINGS ALONG WITH HEALTH INFORMATION, IMMUNIZATION CINICS, AND HEART CHECK (BLOOD PRESSURE MONITOR AND HEALTH EDUCATION PAMPHLETS) FREE TO THE PUBLIC. PART III, LINE 2: THE AMOUNT OF BAD DEBT EXPENSE REPORTED ON LINE 2 OF SECTION A OF PART III IS RECORDED IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS ADJUSTMENTS TO REVENUE, NOT BAD DEBT EXPENSE. PART III, LINE 3: METHODOLOGY FOR DETERMINING THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE THAT MAY REPRESENT PATIENTS WHO COULD HAVE QUALIFIED UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY:SELF-PAY PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE BY COMPLETING A FINANCIAL ASSISTANCE APPLICATION FORM (FAA FORM). IF AN INDIVIDUAL DOES NOT SUBMIT A COMPLETE FAA FORM WITHIN 240 DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS SENT TO THE INDIVIDUAL, AN INDIVIDUAL MAY BE CONSIDERED FOR PRESUMPTIVE ELIGIBILITY BASED UPON A SCORING TOOL THAT IS DESIGNED TO CLASSIFY PATIENTS INTO GROUPS OF VARYING ECONOMIC MEANS. THE SCORING TOOL USES ALGORITHMS THAT INCORPORATE DATA FROM CREDIT BUREAUS, DEMOGRAPHIC DATABASES, AND HOSPITAL SPECIFIC DATA TO INFER AND CLASSIFY PATIENTS INTO RESPECTIVE ECONOMIC MEANS CATEGORIES. INDIVIDUALS WHO EARN A CERTAIN SCORE ON THE SCORING TOOL ARE CONSIDERED TO QUALIFY AS ELIGIBLE FOR THE MOST GENEROUS FINANCIAL ASSISTANCE UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. AS DETERMINED BY THE FILING ORGANIZATION, A NOMINAL AMOUNT OF SUCH A PATIENT'S BILL IS WRITTEN OFF AS BAD DEBT EXPENSE, WHILE THE REMAINING PORTION OF THE PATIENT'S BILL IS CONSIDERED NON-STATE CHARITY. THE AMOUNT WRITTEN OFF AS BAD DEBT EXPENSE FOR THOSE PATIENTS WHO POTENTIALLY QUALIFY AS NON-STATE CHARITY USING THE SCORING TOOL IS THE AMOUNT SHOWN ON LINE 3 OF SECTION A OF PART III. RATIONALE FOR INCLUDING CERTAIN BAD DEBTS IN COMMUNITY BENEFIT:THE FILING ORGANIZATION IS DEDICATED TO THE VIEW THAT MEDICALLY NECESSARY HEALTH CARE FOR EMERGENCY AND NON-ELECTIVE PATIENTS SHOULD BE ACCESSIBLE TO ALL, REGARDLESS OF AGE, GENDER, GEOGRAPHIC LOCATION, CULTURAL BACKGROUND, PHYSICIAN MOBILITY, OR ABILITY TO PAY. THE FILING ORGANIZATION TREATS EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF THEIR ABILITY TO PAY OR THE AVAILABILITY OF THIRD-PARTY COVERAGE. BY PROVIDING HEALTH CARE TO ALL WHO REQUIRE EMERGENCY OR NON-ELECTIVE CARE IN A NON-DISCRIMINATORY MANNER, THE FILING ORGANIZATION IS PROVIDING HEALTH CARE TO THE BROAD COMMUNITY IT SERVES. AS A 501(C)(3) HOSPITAL ORGANIZATION, THE FILING ORGANIZATION MAINTAINS A 24/7 EMERGENCY ROOM PROVIDING CARE TO ALL WHOM PRESENT. WHEN A PATIENT'S ARRIVAL AND/OR ADMISSION TO THE FACILITY BEGINS WITHIN THE EMERGENCY DEPARTMENT, TRIAGE AND MEDICAL SCREENING ARE ALWAYS COMPLETED PRIOR TO REGISTRATION STAFF PROCEEDING WITH THE DETERMINATION OF A PATIENT'S SOURCE OF PAYMENT. IF THE PATIENT REQUIRES ADMISSION AND CONTINUED NON-ELECTIVE CARE, THE FILING ORGANIZATION PROVIDES THE NECESSARY CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY. THE FILING ORGANIZATION'S OPERATION OF A 24/7 EMERGENCY DEPARTMENT THAT ACCEPTS ALL INDIVIDUALS IN NEED OF CARE PROMOTES THE HEALTH OF THE COMMUNITY THROUGH THE PROVISION OF CARE TO ALL WHOM PRESENT. CURRENT INTERNAL REVENUE SERVICE GUIDANCE THAT TAX-EXEMPT HOSPITALS MAINTAIN SUCH EMERGENCY ROOMS WAS ESTABLISHED TO ENSURE THAT EMERGENCY CARE WOULD BE PROVIDED TO ALL WITHOUT DISCRIMINATION. THE TREATMENT OF ALL AT THE FILING ORGANIZATION'S EMERGENCY DEPARTMENT IS A COMMUNITY BENEFIT. UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, EVERY EFFORT IS MADE TO OBTAIN A PATIENT'S NECESSARY FINANCIAL INFORMATION TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. HOWEVER, NOT ALL PATIENTS WILL COOPERATE WITH SUCH EFFORTS AND A FINANCIAL ASSISTANCE ELIGIBILITY DETERMINATION CANNOT BE MADE BASED UPON INFORMATION SUPPLIED BY THE INDIVIDUAL. IN THIS CASE, A PATIENT'S PORTION OF A BILL THAT REMAINS UNPAID FOR A CERTAIN STIPULATED TIME PERIOD IS WHOLLY OR PARTIALLY CLASSIFIED AS BAD DEBT. BAD DEBTS ASSOCIATED WITH PATIENTS WHO HAVE RECEIVED CARE THROUGH THE FILING ORGANIZATION'S EMERGENCY DEPARTMENT SHOULD BE CONSIDERED COMMUNITY BENEFIT AS CHARITABLE HOSPITALS EXIST TO PROVIDE SUCH CARE IN PURSUIT OF THEIR PURPOSE OF MEETING THE NEED FOR EMERGENCY MEDICAL CARE SERVICES AVAILABLE TO ALL IN THE COMMUNITY. PART III, LINE 4: FINANCIAL STATEMENT FOOTNOTE RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS:THE FINANCIAL INFORMATION OF THE FILING ORGANIZATION IS INCLUDED IN A CONSOLIDATED AUDITED FINANCIAL STATEMENT FOR THE CURRENT YEAR.THE APPLICABLE FOOTNOTE FROM THE ATTACHED CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ADDRESSES ACCOUNTS RECEIVABLE, THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS, AND THE PROVISION FOR BAD DEBTS CAN BE FOUND ON PAGES 8 AND 9. PLEASE NOTE THAT DOLLAR AMOUNTS ON THE ATTACHED CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE IN THOUSANDS. PART III, LINE 8: COSTING METHODOLOGY:MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST-TO-CHARGE RATIO.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: $ 4,073,034- DIFFERENCE IN COSTING METHODOLOGY: 272,389- UNREIMBURSED COSTS INCURRED FOR SERVICES PROVIDED TO MEDICARE PATIENTS THAT ARE NOT INCLUDED IN THE ORGANIZATION'S MEDICARE COST REPORT: (531,311) -------------TOTAL UNREIMBURSED COSTS OF SERVING ALL MEDICARE PATIENTS PER THE FILING ORGANIZATION'S COMMUNITYBENEFIT REPORTING $ 3,814,112AS INDICATED ABOVE, THE PRIMARY DIFFERENCES BETWEEN THE MEDICARE SURPLUS/(SHORTFALL) REPORTED ON SCHEDULE H, PART III, SECTION B, LINE 7 AND THE FILING ORGANIZATION'S PORTION OF THE COMPANY'S ANNUAL COMMUNITY BENEFIT STATEMENT IS DUE TO A DIFFERENCE IN THE COSTING METHODOLOGY AND DIFFERENCES IN THE POPULATION OF MEDICARE PATIENTS WITHIN THE CALCULATION. THE COST METHODOLOGY UTILIZED IN CALCULATING ANY MEDICARE SURPLUS/(SHORTFALL) FOR PURPOSES OF THE ANNUAL COMMUNITY BENEFIT REPORTING IS BASED UPON THE COST-TO-CHARGE RATIO OUTLINED IN WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. THE SAME COST-TO-CHARGE RATIO IS USED TO DETERMINE THE COSTS ASSOCIATED WITH SERVICES PROVIDED TO CHARITY CARE PATIENTS AND MEDICAID PATIENTS AS REPORTED IN SCHEDULE H, PART I, LINE 7. IN ADDITION, THE MEDICARE COST REPORT EXCLUDES SERVICES PROVIDED TO MEDICARE PATIENTS FOR PHYSICIAN SERVICES, SERVICES PROVIDED TO PATIENTS ENROLLED IN MEDICARE HMOS, AND CERTAIN SERVICES PROVIDED BY OUTPATIENT DEPARTMENTS OF THE FILING ORGANIZATION THAT ARE REIMBURSED ON A FEE SCHEDULE. THE COMPANY'S OWN COMMUNITY BENEFIT STATEMENT CAPTURES THE UNREIMBURSED COST OF PROVIDING SERVICES TO ALL MEDICARE BENEFICIARIES THROUGHOUT THE ORGANIZATION. PART III, LINE 9B: 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 2019 CHNA WAS ADOPTED BY ITS GOVERNING BOARD BY DECEMBER 31, 2019, THE END OF THE HOSPITAL'S TAXABLE YEAR IN WHICH IT CONDUCTED THE CHNA. THE HOSPITAL'S 2019 CHNA COMPLIED WITH THE GUIDANCE SET FORTH BY THE IRS IN FINAL REGULATION SECTION 1.501(R)-3. IN ADDITION TO THE CHNA DISCUSSED ABOVE, A VARIETY OF PRACTICES AND PROCESSES ARE IN PLACE TO ENSURE THAT THE FILING ORGANIZATION IS RESPONSIVE TO THE HEALTH NEEDS OF ITS COMMUNITY.SUCH PRACTICES AND PROCESSES INVOLVE THE FOLLOWING:1. A HOSPITAL OPERATING/COMMUNITY BOARD COMPOSED OF INDIVIDUALS BROADLY REPRESENTATIVE OF THE COMMUNITY, COMMUNITY LEADERS, AND THOSE WITH SPECIALIZED MEDICAL TRAINING AND EXPERTISE;2. POST-DISCHARGE PATIENT FOLLOW-UP RELATED TO THE ON-GOING CARE AND TREATMENT OF PATIENTS WHO SUFFER FROM CHRONIC DISEASES; 3. SPONSORSHIP AND PARTICIPATION IN COMMUNITY HEALTH AND WELLNESS ACTIVITIES THAT REACH A BROAD SPECTRUM OF THE FILING ORGANIZATION'S COMMUNITY; AND 4. COLLABORATION WITH OTHER LOCAL COMMUNITY GROUPS TO ADDRESS THE HEALTH CARE NEEDS OF THE FILING ORGANIZATION'S COMMUNITY. PART VI, LINE 3: THE FINANCIAL ASSISTANCE POLICY (FAP), FINANCIAL ASSISTANCE APPLICATION FORM (FAA FORM), AND THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY (PLS) OF THE FILING ORGANIZATION'S HOSPITAL FACILITY ARE TRANSPARENT AND AVAILABLE TO ALL INDIVIDUALS SERVED AT ANY POINT IN THE CARE CONTINUUM. THE FAP, FAA FORM, PLS, AND CONTACT INFORMATION FOR THE HOSPITAL FACILITY'S FINANCIAL COUNSELORS ARE PROMINENTLY AND CONSPICUOUSLY POSTED ON THE FILING ORGANIZATION'S HOSPITAL FACILITY'S WEBSITE. THE WEBSITE INDICATES THAT A COPY OF THE FAP, FAA FORM, AND PLS IS AVAILABLE AND HOW TO OBTAIN SUCH COPIES IN THE PRIMARY LANGUAGES OF ANY POPULATIONS WITH LIMITED PROFICIENCY IN ENGLISH THAT CONSTITUTE THE LESSER OF 1,000 INDIVIDUALS OR 5% OF THE MEMBERS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY (REFERRED TO BELOW AS LEP DEFINED POPULATIONS). SIGNAGE IS DISPLAYED IN PUBLIC LOCATIONS OF THE FILING ORGANIZATION'S HOSPITAL FACILITY, INCLUDING AT ALL POINTS OF ADMISSION AND REGISTRATION AND THE EMERGENCY DEPARTMENT. THE SIGNAGE CONTAINS THE HOSPITAL FACILITY'S WEBSITE ADDRESS WHERE THE FAP, FAA FORM, AND PLS CAN BE ACCESSED AND THE TELEPHONE NUMBER AND PHYSICAL LOCATION THAT INDIVIDUALS CAN CALL OR VISIT TO OBTAIN COPIES OF THE FAP, FAA FORM AND PLS OR TO OBTAIN MORE INFORMATION ABOUT THE HOSPITAL FACILITY'S FAP, FAA FORM AND PLS. PAPER COPIES OF THE HOSPITAL FACILITY'S FAP, FAA FORM AND PLS ARE AVAILABLE UPON REQUEST AND WITHOUT CHARGE, BOTH IN PUBLIC LOCATIONS IN THE HOSPITAL FACILITY AND BY MAIL. PAPER COPIES ARE MADE AVAILABLE IN ENGLISH AND IN THE PRIMARY LANGUAGES OF ANY LEP DEFINED POPULATIONS. THE FILING ORGANIZATION'S HOSPITAL FACILITY'S FINANCIAL COUNSELORS SEEK TO PROVIDE PERSONAL FINANCIAL COUNSELING TO ALL INDIVIDUALS ADMITTED TO THE HOSPITAL FACILITY WHO ARE CLASSIFIED AS SELF-PAY DURING THE COURSE OF THEIR HOSPITAL STAY OR AT TIME OF DISCHARGE TO EXPLAIN THE FAP AND FAA FORM AND TO PROVIDE INFORMATION CONCERNING OTHER SOURCES OF ASSISTANCE THAT MAY BE AVAILABLE, SUCH AS MEDICAID. A PAPER COPY OF THE HOSPITAL FACILITY'S PLS WILL BE OFFERED TO EVERY PATIENT AS A PART OF THE INTAKE OR DISCHARGE PROCESS. A CONSPICUOUS WRITTEN NOTICE IS INCLUDED ON ALL BILLING STATEMENTS SENT TO PATIENTS THAT NOTIFIES AND INFORMS RECIPIENTS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, INCLUDING THE FOLLOWING: 1) THE TELEPHONE NUMBER OF THE HOSPITAL FACILITY'S OFFICE OR DEPARTMENT THAT CAN PROVIDE INFORMATION ABOUT THE FAP AND THE FAA FORM; AND 2) THE WEBSITE ADDRESS WHERE COPIES OF THE FAP, FAA FORM AND PLS MAY BE OBTAINED. REASONABLE ATTEMPTS ARE MADE TO INFORM INDIVIDUALS ABOUT THE HOSPITAL FACILITY'S FAP IN ALL ORAL COMMUNICATIONS REGARDING THE AMOUNT DUE FOR THE INDIVIDUAL'S CARE. COPIES OF THE PLS ARE DISTRIBUTED TO MEMBERS OF THE COMMUNITY IN A MANNER REASONABLY CALCULATED TO REACH THOSE MEMBERS OF THE COMMUNITY WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE. PART VI, LINE 4: THE FILING ORGANIZATION CURRENTLY OPERATES 2 HOSPITAL FACILITIES, ADVENTHEALTH CENTRAL TEXAS AND ADVENTHEALTH ROLLINS BROOK, IN THE NORTHERN HILL COUNTRY OF CENTRAL TEXAS. COMBINED, THESE FACILITIES ARE A MAJOR HEALTHCARE PROVIDER IN BELL, CORYELL, AND LAMPASAS COUNTIES.ADVENTHEALTH CENTRAL TEXAS (AHCT), LOCATED IN BELL COUNTY, IS LICENSED FOR 170 ACUTE-CARE BEDS AND 60 PSYCHIATRIC CARE BEDS. IN ADDITION, AHCT ALSO OPERATES A 24-HOUR EMERGENCY CENTER, BEHAVIOR HEALTH CARE, DIGESTIVE CARE, HEART AND VASCULAR CARE, IMAGING SERVICES, LAB SERVICES, MEN'S CARE, MOTHER AND BABY CARE, ORTHOPEDIC CARE, SENIOR CARE AND SLEEP CARE. AS THE PRIMARY HEALTH CARE PROVIDER FOR WEST BELL, CORYELL AND LAMPASAS COUNTIES, AHCT SERVES MORE THAN 125,000 PATIENTS PER YEAR, WITH MORE THAN 300 PHYSICIANS OFFERING 43 MEDICAL SPECIALITIES AND A VARIETY OF WELLNESS SERVICES. AHCT IS LOCATED NEXT TO FORT HOOD, THE LARGEST MILITARY BASE IN THE COUNTRY WHICH MAKES THE COMMUNITY HEAVILY DEPENDENT ON THE POST AND THE SOLDIERS (AND THEIR FAMILIES) STATIONED THERE. ADVENTHEALTH ROLLINS BROOK (AHRB), LOCATED IN LAMPASAS COUNTY, TEXAS, IS LICENSED FOR 25 BEDS. BECAUSE OF ITS LOCATION AND POPULATION SERVED, AHRB IS A FEDERALLY DESIGNATED CRITICAL ACCESS HOSPITAL. IN ADDITION, AHRB OFFERS MANY TECHNOLOGICAL SERVICES INCLUDING A 24-HOUR EMERGENCY CENTER, A STATE-OF-THE-ART LABORATORY, MEDICAL/SURGICAL ROOMS, CT SCANNING, MAMMOGRAPHY AND CARDIO-PULMONARY SERVICES WITH EKG AND STRESS TESTING. AHRB ALSO OFFERS ACCESS TO A SLEEP DISORDER CENTER AND BONE DENSITY (DEXA) SCAN CAPABILITIES.AHRB IS A CRUCIAL COMMUNITY AND REGIONAL ASSET. IT IS THE SOLE HOSPITAL FACILITY FOR THE LAMPASAS COMMUNITY. THE COUNTY OF LAMPASAS COVERS APPROXIMATELY 714 SQUARE MILES. SIMILAR TO BELL COUNTY, LAMPASAS COUNTY'S ECONOMY IS ALSO HEAVILY DEPENDENT ON THE SOLDIERS (AND THEIR FAMILIES) STATIONED AT FORT HOOD, LOCATED LESS THAN 25 MILES AWAY. THE DEMOGRAPHIC MAKEUP OF THE HOSPITAL'S COMMUNITY IS AS FOLLOWS: - POPULATION 196,840 - POPULATION OVER 65 7.98% - POVERTY (BELOW 100% FPL) 13.07% - UNEMPLOYMENT RATE 6.10% - VIOLENT CRIME RATE (PER 100,000 POP.) 361.0 - POP. AGE 25+ WITH NO HIGH SCHOOL DIPLOMA 8.70% - UNINSURED ADULTS 17.25% - UNINSURED CHILDREN 7.56% - FOOD INSECURITY RATE 20.90% - POP. WITH LOW FOOD ACCESS 43.54%DURING 2019, THE HOSPITAL'S PATIENT PERCENTAGE POPULATION WAS MADE UP OF THE BELOW PAYORS WITH THE REMAINING PERCENTAGE OF THE PATIENTS BEING COVERED UNDER COMMERCIAL INSURANCE. IN 2019, ABOUT 65.3% OF THE HOSPITAL'S IN-PATIENTS WERE ADMITTED THROUGH THE HOSPITAL'S EMERGENCY DEPARTMENT. - MEDICARE PATIENTS 41.00% - MEDICAID PATIENTS 15.40% - SELF-PAY PATIENTS 10.80% 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 HOSPITAL IS A FUNCTION OF "EXTENDING THE HEALING MINISTRY OF CHRIST AND EMBODIES THE HOSPITAL'S COMMITMENT TO ITS VALUES AND PRINCIPLES. THE HOSPITAL COMMITS SUBSTANTIAL RESOURCES TO PROVIDE A BROAD RANGE OF SERVICES TO BOTH THE UNDERPRIVILEGED AS WELL AS THE BROADER COMMUNITY. IN ADDITION TO THE COMMUNITY BENEFIT AND COMMUNITY BUILDING INFORMATION PROVIDED IN PARTS I, II AND III OF THIS SCHEDULE H, THE HOSPITAL CAPTURES AND REPORTS THE BENEFITS PROVIDED TO ITS COMMUNITY THROUGH FAITH-BASED CARE. EXAMPLES OF SUCH BENEFITS INCLUDE THE COST ASSOCIATED WITH CHAPLAINCY CARE PROGRAMS AND MISSION PEER REVIEWS AND MISSION CONFERENCES. DURING THE CURRENT YEAR, THE HOSPITAL PROVIDED $265,301 OF BENEFIT WITH RESPECT TO THE FAITH-BASED AND SPIRITUAL NEEDS OF THE COMMUNITY IN CONJUNCTION WITH ITS OPERATION OF A COMMUNITY HOSPITAL. THE HOSPITAL ALSO PROVIDES BENEFITS TO ITS COMMUNITY'S INFRASTRUCTURE BY INVESTING IN CAPITAL IMPROVEMENTS TO ENSURE THAT FACILITIES AND TECHNOLOGY PROVIDE THE BEST POSSIBLE CARE TO THE COMMUNITY. DURING THE CURRENT YEAR, THE HOSPITAL EXPENDED $4,449,878 IN NEW CAPITAL IMPROVEMENTS. AS A FAITH-BASED MISSION-DRIVEN COMMUNITY HOSPITAL, THE HOSPITAL IS CONTINUALLY INVOLVED IN MONITORING ITS COMMUNITY, IDENTIFYING UNMET HEALTH CARE NEEDS AND DEVELOPING SOLUTIONS AND PROGRAMS TO ADDRESS THOSE NEEDS. IN ACCORDANCE WITH ITS CONSERVATIVE APPROACH TO FISCAL RESPONSIBILITY, SURPLUS FUNDS OF THE HOSPITAL ARE CONTINUALLY BEING INVESTED IN RESOURCES THAT IMPROVE THE AVAILABILITY AND QUALITY OF DELIVERY OF HEALTH CARE SERVICES AND PROGRAMS TO ITS COMMUNITY. PART VI, LINE 6: THE FILING ORGANIZATION IS A PART OF A FAITH-BASED HEALTHCARE SYSTEM OF ORGANIZATIONS WHOSE PARENT IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). THE SYSTEM IS KNOWN AS ADVENTHEALTH. AHSSHC IS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). AHSSHC AND ITS SUBSIDIARY ORGANIZATIONS OPERATE 47 HOSPITALS THROUGHOUT THE U.S., PRIMARILY IN THE SOUTHEASTERN PORTION OF THE U.S. AHSSHC AND ITS SUBSIDIARIES ALSO OPERATE 12 NURSING HOME FACILITIES AND OTHER ANCILLARY HEALTH CARE PROVIDER FACILITIES, SUCH AS AMBULATORY SURGERY CENTERS AND DIAGNOSTIC IMAGING CENTERS. AS THE PARENT ORGANIZATION OF ADVENTHEALTH, AHSSHC PROVIDES EXECUTIVE LEADERSHIP AND OTHER PROFESSIONAL SUPPORT SERVICES TO ITS SUBSIDIARY ORGANIZATIONS. PROFESSIONAL SUPPORT SERVICES INCLUDE AMONG OTHERS IT, CORPORATE COMPLIANCE, LEGAL, REIMBURSEMENT, RISK MANAGEMENT, AND TAX AS WELL AS TREASURY FUNCTIONS. CERTAIN SUPPORT SERVICES, SUCH AS HUMAN RESOURCES, PAYROLL, A/P, AND SUPPLY CHAIN MANAGEMENT ARE PROVIDED PURSUANT TO A SHARED SERVICES MODEL BY AHSSHC TO ITS SUBSIDIARY ORGANIZATIONS. THE PROVISION OF THESE EXECUTIVE AND SUPPORT SERVICES ON A CENTRALIZED BASIS BY AHSSHC PROVIDES AN APPROPRIATE BALANCE BETWEEN PROVIDING EACH ADVENTHEALTH SUBSIDIARY HOSPITAL ORGANIZATION WITH MISSION-DRIVEN CONSISTENT LEADERSHIP AND SUPPORT WHILE ALLOWING THE HOSPITAL ORGANIZATION TO FOCUS ITS RESOURCES ON MEETING THE SPECIFIC HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES. THE READER OF THIS FORM 990 SHOULD KEEP IN MIND THAT THIS REPORTING ENTITY MAY DIFFER IN CERTAIN AREAS FROM THAT OF A STAND-ALONE HOSPITAL ORGANIZATION DUE TO ITS INCLUSION IN A LARGER SYSTEM OF HEALTHCARE ORGANIZATIONS. AS A PART OF A SYSTEM OF HOSPITAL AND OTHER HEALTH CARE ORGANIZATIONS, THE FILING ORGANIZATION BENEFITS FROM REDUCED COSTS DUE TO SYSTEM EFFICIENCIES, SUCH AS LARGE GROUP PURCHASING DISCOUNTS, AND THE AVAILABILITY OF INTERNAL RESOURCES SUCH AS INTERNAL LEGAL COUNSEL. EACH ADVENTHEALTH SUBSIDIARY PAYS A MANAGEMENT FEE TO AHSSHC FOR THE INTERNAL SERVICES PROVIDED BY AHSSHC. AS A RESULT, MANAGEMENT FEE EXPENSE REPORTED BY AN ADVENTHEALTH SUBSIDIARY ORGANIZATION MAY APPEAR GREATER IN RELATION TO MANAGEMENT FEE EXPENSE THAT MAY BE REPORTED BY A SINGLE STAND-ALONE HOSPITAL. THE SINGLE STAND-ALONE HOSPITAL WOULD LIKELY REPORT COSTS ASSOCIATED WITH MANAGEMENT AND OTHER PROFESSIONAL SERVICES ON VARIOUS EXPENSE LINE ITEMS IN ITS STATEMENT OF REVENUE AND EXPENSE AS OPPOSED TO REPORTING SUCH COSTS IN ONE OVERALL MANAGEMENT FEE EXPENSE. AS THE REPORTING OF THE FORM 990 IS DONE ON AN ENTITY BY ENTITY BASIS, THERE IS NO SINGLE FORM 990 THAT CAPTURES THE PROGRAMS AND OPERATIONS OF ADVENTHEALTH AS A WHOLE. THE READER IS DIRECTED TO VISIT THE WEB-SITE OF ADVENTHEALTH AT WWW.ADVENTHEALTH.COM TO LEARN MORE ABOUT THE MISSION AND OPERATIONS OF ADVENTHEALTH. PART VI, LINE 7, REPORTS FILED WITH STATES TX 1 AMERICAN HEART ASSOCIATION PO BOX 50040 PRESCOTT AZ 86304 135613797 501(C)(3) 10000 GENERAL SUPPORT COVE HOUSE EMERGENCY HOMELESS SHELTER INC 108 E HALSTEAD AVE COPPERAS COVE TX 76522 742764062 501(C)(3) 18000 GENERAL SUPPORT FORT HOOD REGION ECONOMIC DEVELOPMENT FOUNDATION PO BOX 548 KILLEEN TX 76540 821794219 501(C)(3) 20000 GENERAL SUPPORT GREATER KILLEEN FREE CLINIC INC 309 2ND STREET KILLEEN TX 76541 742724725 501(C)(3) 56400 MEDICAL CARE ROLLINS BROOK COMMUNITY CARE CORPORATION INC 2201 SOUTH CLEAR CREEK RD KILLEEN TX 76549 461656773 501(C)(3) 23000 GENERAL SUPPORT SDC DBA ADVENTHEALTH CENTRAL TEXAS FOUNDATION 900 HOPE WAY ALTAMONTE SPRINGS FL 32714 592219301 501(C)(3) 11600 103146 FMV GENERAL ADMINISTRATIVE SUPPORT GENERAL SUPPORT TEXAS A&M UNIVERSITY - CENTRAL TEXAS FOUNDATION 1001 LEADERSHIP PLACE KILLEEN TX 76549 260895118 501(C)(3) 6000 GENERAL SUPPORT 7 0 PART I, LINE 2: IN ORDER TO MONITOR THE USE OF GRANT FUNDS IN THE U.S., A COMMITEE OF 3-4 INDIVIDUALS CONSISTING OF EMPLOYEES AND DIRECTORS ADHERES TO THE FOLLOWING PROCEDURES: 1) A REVIEW OF THE PREVIOUS YEARS' CONTRIBUTIONS MADE TO THE ORGANIZATION REQUESTING THE DONATION; 2) AN ASSESSMENT OF WHETHER THE MISSION OF THE REQUESTING ORGANIZATION REFLECTS THE MISSION AND VALUES OF ADVENTHEALTH; 3) A REVIEW TO ENSURE THAT THE REQUEST WILL NOT EXCEED THE BUDGETED AMOUNT; AND 4) A PROCESS TO FORWARD ANY REQUESTS ABOVE $1,500 TO THE CEO FOR REVIEW AND APPROVAL. X X X X 1 1 1 1 0 0 0 0 0 0 0 FINCH KENNETH CHAIRMAN/REGIONAL CEO (END 12/19) 0 620172 0 209577 0 325512 0 125037 0 23910 0 1304208 0 101279 WALTON CARLYLE FORMER CEO/PRESIDENT 0 367605 0 84822 0 62891 0 56169 0 26630 0 598117 0 16310 SUTTON JESSE DIR/REGIONAL CFO 0 358417 0 85761 0 48316 0 48647 0 33861 0 575002 0 26183 ROBERTS KEVIN CEO/PRESIDENT 0 349919 0 0 0 16976 0 57363 0 23013 0 447271 0 0 PRIDGEN PARKER CFO/COO (BEG 3/19) 0 261909 0 43233 0 49023 0 25471 0 34565 0 414201 0 0 BROCK ROBERT CFO (END 3/19) 0 74283 0 29787 0 261669 0 0 0 22448 0 388187 0 10273 RODRIGUEZ TAMMY CNO 0 215459 0 21779 0 210 0 7733 0 33450 0 278631 0 0 DANIELS DON CMO (END 7/19) 0 0 0 0 233333 0 0 0 0 0 233333 0 0 0 RUTLEDGE JONATHAN PHARMACY MANAGER 129871 0 0 0 4238 0 6875 0 27887 0 168871 0 0 0 UNDERWOOD ASHLEY ADMINISTRATIVE DIRECTOR 133256 0 7099 0 -825 0 6712 0 10645 0 156887 0 0 0 INGRUM KIMBERLY CLINICAL INFORMATICS DIRECTOR 100407 0 6771 0 34018 0 5652 0 9110 0 155958 0 0 0 JENKERSON TERRILL PHYSICAL THERAPIST 97479 0 2622 0 36438 0 3747 0 10923 0 151209 0 0 0 PART I, LINE 1A THE FILING ORGANIZATION IS A PART OF THE SYSTEM OF HEALTHCARE ORGANIZATIONS KNOWN AS ADVENTHEALTH. MEMBERS OF THE FILING ORGANIZATION'S EXECUTIVE MANAGEMENT TEAM THAT HOLD THE POSITION OF VICE-PRESIDENT OR ABOVE ARE COMPENSATED BY AND ON THE PAYROLL OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), THE PARENT ORGANIZATION OF THE HEALTHCARE SYSTEM KNOWN AS ADVENTHEALTH. AHSSHC IS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). THE FILING ORGANIZATION REIMBURSES AHSSHC FOR THE SALARY AND BENEFIT COST OF THOSE EXECUTIVES ON THE PAYROLL OF AHSSHC. AT THE DIRECTION OF AHSSHC, AND IN ACCORDANCE WITH THE RESERVED POWERS IN THE FILING ORGANIZATION'S GOVERNING DOCUMENTS, THE EXECUTIVE TEAM LISTED ON PART VII PROVIDES SERVICES TO THE FILING ORGANIZATION. 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 OF THE FILING ORGANIZATION'S CEO AND CFO. ADDITIONALLY, EMPLOYEES AT THE DIRECTOR LEVEL AND ABOVE ARE ELIGIBLE FOR GROSS-UP PAYMENTS ON GIFTS RECEIVED FOR BOARD OF DIRECTOR SERVICES. DISCRETIONARY SPENDING ACCOUNT: NOMINAL DISCRETIONARY SPENDING AMOUNTS ARE PERIODICALLY PROVIDED TO ELIGIBLE EXECUTIVES WHO ATTEND ANNUAL BUSINESS MEETINGS SUCH AS THE ADVENTHEALTH CFO CONFERENCE OR THE CMO/CNO BUSINESS MEETING ($300 OR LESS PER EXECUTIVE). PAYMENTS PROVIDED TO EACH EXECUTIVE ARE CONSIDERED TAXABLE COMPENSATION TO THE EXECUTIVE. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE: AHSSHC HAS A CORPORATE EXECUTIVE POLICY THAT ADDRESSES ASSISTANCE TO EXECUTIVES WHO HAVE BEEN RELOCATED BY THE COMPANY DURING THE YEAR. RELOCATION ASSISTANCE PROVIDED TO EXECUTIVES MAY INCLUDE RELOCATION ALLOWANCES TO ASSIST WITH DUPLICATE HOUSING EXPENSES. RELOCATION ASSISTANCE IS ADMINISTERED PER AHSSHC POLICY BY AN EXTERNAL RELOCATION COMPANY. ANY TAXABLE REIMBURSEMENTS MADE TO EXECUTIVES IN CONNECTION WITH RELOCATION ASSISTANCE ARE TREATED AS WAGES TO THE EXECUTIVE AND ARE SUBJECT TO ALL PAYROLL WITHHOLDING AND REPORTING REQUIREMENTS. PART I, LINE 3 THE INDIVIDUAL WHO SERVES AS THE CEO OF THE FILING ORGANIZATION IS APPOINTED AND COMPENSATED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). COMPENSATION AND BENEFITS PROVIDED TO THIS INDIVIDUAL ARE DETERMINED PURSUANT TO POLICIES, PROCEDURES, AND PROCESSES OF AHSSHC THAT ARE DESIGNED TO ENSURE COMPLIANCE WITH THE INTERMEDIATE SANCTIONS LAWS AS SET FORTH IN IRC SECTION 4958. AHSSHC HAS TAKEN STEPS TO ENSURE THAT PROCESSES ARE IN PLACE TO SATISFY THE REBUTTABLE PRESUMPTION OF REASONABLENESS STANDARD AS SET FORTH IN TREASURY REGULATION 53.4958-6 WITH RESPECT TO ITS ACTIVE EXECUTIVE-LEVEL POSITIONS. THE AHSSHC BOARD COMPENSATION COMMITTEE (THE COMMITTEE) SERVES AS THE GOVERNING BODY FOR ALL EXECUTIVE COMPENSATION MATTERS. THE COMMITTEE IS COMPOSED OF CERTAIN MEMBERS OF THE BOARD OF DIRECTORS (THE BOARD) OF AHSSHC. VOTING MEMBERS OF THE COMMITTEE INCLUDE ONLY INDIVIDUALS WHO SERVE ON THE BOARD AS INDEPENDENT REPRESENTATIVES OF THE COMMUNITY, WHO HOLD NO EMPLOYMENT POSITIONS WITH AHSSHC AND WHO DO NOT HAVE RELATIONSHIPS WITH ANY OF THE INDIVIDUALS WHOSE COMPENSATION IS UNDER THEIR REVIEW THAT IMPACTS THEIR BEST INDEPENDENT JUDGMENT AS FIDUCIARIES OF AHSSHC. THE COMMITTEE'S ROLE IS TO REVIEW AND APPROVE ALL COMPONENTS OF THE EXECUTIVE COMPENSATION PLAN OF AHSSHC. AS AN INDEPENDENT GOVERNING BODY WITH RESPECT TO EXECUTIVE COMPENSATION, IT SHOULD BE NOTED THAT THE COMMITTEE WILL OFTEN CONFER IN EXECUTIVE SESSIONS ON MATTERS OF COMPENSATION POLICY AND POLICY CHANGES. IN SUCH EXECUTIVE SESSIONS, NO MEMBERS OF MANAGEMENT OF AHSSHC ARE PRESENT. THE COMMITTEE IS ADVISED BY AN INDEPENDENT THIRD-PARTY COMPENSATION ADVISOR. THIS ADVISOR PREPARES ALL THE BENCHMARK STUDIES FOR THE COMMITTEE. COMPENSATION LEVELS ARE BENCHMARKED WITH A NATIONAL PEER GROUP OF OTHER NOT-FOR-PROFIT HEALTHCARE SYSTEMS AND HOSPITALS OF SIMILAR SIZE AND COMPLEXITY TO ADVENTHEALTH AND EACH OF ITS AFFILIATED ENTITIES. THE FOLLOWING PRINCIPLES GUIDE THE ESTABLISHMENT OF INDIVIDUAL EXECUTIVE COMPENSATION: - THE SALARY OF THE PRESIDENT/CEO OF ADVENTHEALTH WILL NOT EXCEED THE 50TH PERCENTILE OF COMPARABLE SALARIES PAID BY SIMILARLY SITUATED ORGANIZATIONS; AND - OTHER EXECUTIVE SALARIES SHALL BE ESTABLISHED USING MARKET MEDIANS. THE COMPENSATION PHILOSOPHY, POLICIES, AND PRACTICES OF AHSSHC ARE CONSISTENT WITH THE ORGANIZATION'S FAITH-BASED MISSION AND CONFORM TO APPLICABLE LAWS, REGULATIONS, AND BUSINESS PRACTICES. AS A FAITH-BASED ORGANIZATION SPONSORED BY THE SEVENTH-DAY ADVENTIST CHURCH (THE CHURCH), AHSSHC'S PHILOSOPHY AND PRINCIPLES WITH RESPECT TO ITS EXECUTIVE COMPENSATION PRACTICES REFLECT THE CONSERVATIVE APPROACH OF THE CHURCH'S MISSION OF SERVICE AND WERE DEVELOPED IN COUNSEL WITH THE CHURCH'S LEADERSHIP. PART I, LINES 4A-B DURING THE YEAR ENDING DECEMBER 31, 2019, ROBERT BROCK RECEIVED SEVERANCE PAYMENTS IN THE AMOUNT OF $201,626. PURSUANT TO THE AHSSHC CORPORATE EXECUTIVE POLICY GOVERNING EXECUTIVE SEVERANCE, SEVERANCE AGREEMENTS FOR EXECUTIVES OPERATING AT THE VICE PRESIDENT LEVEL AND ABOVE ARE ENTERED INTO UPON ELIGIBILITY TO FACILITATE THE TRANSITION TO SUBSEQUENT EMPLOYMENT FOLLOWING AN INVOLUNTARY SEPARATION FROM EMPLOYMENT WITH ADVENTHEALTH. AS DISCUSSED IN LINE 1A ABOVE, EXECUTIVES ON THE FILING ORGANIZATION'S MANAGEMENT TEAM THAT HOLD THE POSITION OF VICE-PRESIDENT OR ABOVE ARE COMPENSATED BY AND ON THE PAYROLL OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), THE PARENT ORGANIZATION OF A HEALTHCARE SYSTEM KNOWN AS ADVENTHEALTH. IN RECOGNITION OF THE CONTRIBUTION THAT EACH EXECUTIVE MAKES TO THE SUCCESS OF ADVENTHEALTH, ADVENTHEALTH PROVIDES TO ELIGIBLE EXECUTIVES PARTICIPATION IN THE ADVENTHEALTH EXECUTIVE FLEX BENEFIT PROGRAM (THE PLAN). THE PURPOSE OF THE PLAN IS TO OFFER ELIGIBLE EXECUTIVES AN OPPORTUNITY TO ELECT FROM AMONG A VARIETY OF SUPPLEMENTAL BENEFITS, INCLUDING A SPLIT DOLLAR LIFE INSURANCE POLICY AND LONG-TERM CARE INSURANCE, TO INDIVIDUALLY TAILOR A BENEFITS PROGRAM APPROPRIATE TO EACH EXECUTIVE'S NEEDS. THE PLAN PROVIDES ELIGIBLE PARTICIPANTS A PRE-DETERMINED BENEFITS ALLOWANCE CREDIT THAT IS EQUAL TO A PERCENTAGE OF THE EXECUTIVE'S BASE PAY FROM WHICH IS DEDUCTED THE COST OF MANDATORY AND ELECTIVE EMPLOYEE BENEFITS. THE PRE-DETERMINED BENEFITS ALLOWANCE CREDIT PERCENTAGE IS APPROVED BY THE AHSSHC BOARD COMPENSATION COMMITTEE, AN INDEPENDENT COMMITTEE OF THE BOARD OF DIRECTORS OF AHSSHC. ANY FUNDS THAT REMAIN AFTER THE COST OF MANDATORY AND ELECTIVE BENEFITS ARE SUBTRACTED FROM THE ANNUAL PRE-DETERMINED BENEFITS ALLOWANCE ARE CONTRIBUTED, AT THE EMPLOYEE'S OPTION, TO EITHER AN IRC 457(F) DEFERRED COMPENSATION ACCOUNT OR TO AN IRC 457(B) ELIGIBLE DEFERRED COMPENSATION PLAN. UPON ATTAINMENT OF AGE 65, ALL PREVIOUS 457(F) DEFERRED AMOUNTS ARE PAID IMMEDIATELY TO THE PARTICIPANT AND ANY FUTURE EMPLOYER CONTRIBUTIONS ARE MADE QUARTERLY FROM THE PLAN DIRECTLY TO THE PARTICIPANT. THE PLAN DOCUMENTS DEFINE AN EMPLOYEE WHO IS ELIGIBLE TO PARTICIPATE IN THE PLAN TO GENERALLY INCLUDE THE CHIEF EXECUTIVE OFFICERS OF ADVENTHEALTH ENTITIES AND VICE PRESIDENTS OF ALL ADVENTHEALTH ENTITIES WHOSE BASE SALARY IS AT LEAST $260,000. THE PLAN PROVIDES FOR A CLASS YEAR VESTING SCHEDULE (2 YEARS FOR EACH CLASS YEAR) WITH RESPECT TO AMOUNTS ACCUMULATED IN THE EXECUTIVE'S 457(F) DEFERRED COMPENSATION ACCOUNT. DISTRIBUTIONS COULD ALSO BE MADE FROM THE EXECUTIVE'S 457(F) DEFERRED COMPENSATION ACCOUNT UPON ATTAINMENT OF AGE 65 OR UPON AN INVOLUNTARY SEPARATION. THE ACCOUNT IS FORFEITED BY THE EXECUTIVE UPON A VOLUNTARY SEPARATION. IN ADDITION TO THE PLAN, ADVENTHEALTH HAS INSTITUTED A DEFINED BENEFIT, NON-TAX-QUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN EXECUTIVES WHO HAVE PROVIDED LENGTHY SERVICE TO ADVENTHEALTH AND/OR TO OTHER SEVENTH-DAY ADVENTIST CHURCH HOSPITALS OR HEALTH CARE INSTITUTIONS. PARTICIPATION IN THE PLAN IS OFFERED TO ADVENTHEALTH EXECUTIVES ON A PRO-RATA SCHEDULE BEGINNING WITH 20 YEARS OF SERVICE AS AN EMPLOYEE OF ADVENTHEALTH AND/OR ANOTHER HOSPITAL OR HEALTH CARE INSTITUTION CONTROLLED BY THE SEVENTH-DAY ADVENTIST CHURCH AND WHO SATISFY CERTAIN OTHER QUALIFYING CRITERIA. THIS SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) WAS DESIGNED TO PROVIDE ELIGIBLE EXECUTIVES WITH THE ECONOMIC EQUIVALENT OF AN ANNUAL INCOME BEGINNING AT NORMAL RETIREMENT AGE EQUAL TO 60% OF THE AVERAGE OF THE PARTICIPANT'S THREE, FIVE OR SEVEN HIGHEST YEARS OF BASE SALARY FROM ADVENTHEALTH ACTIVE EMPLOYMENT INCLUSIVE OF INCOME FROM ALL OTHER SEVENTH-DAY ADVENTIST CHURCH HEALTHCARE EMPLOYER-FINANCED RETIREMENT INCOME SOURCES AND INVESTMENT INCOME EARNED ON THOSE CONTRIBUTIONS THROUGH SOCIAL SECURITY NORMAL RETIREMENT AGE AS DEFINED IN THE PLAN. THE NUMBER OF YEARS INCLUDED IN HIGHEST AVERAGE COMPENSATION IS DETERMINED BY THE INDIVIDUAL'S YEAR OF ENTRY TO THE SERP AND BY THE INDIVIDUAL'S YEAR OF ENTRY TO THE ADVENTHEALTH EXECUTIVE FLEX BENEFIT PROGRAM. ADDITIONALLY, ADVENTHEALTH HAS ADOPTED A SENIOR EXECUTIVE DEATH BENEFIT (SEDB) PLAN IN RECOGNITION OF THE CONSIDERABLE AGE AND SERVICE REQUIREMENTS IN THE SERP. THE SEDB PLAN PROVIDES A BENEFIT IN AN AMOUNT EQUAL TO THE AMOUNT THE EXECUTIVE'S BENEFIT WOULD HAVE BEEN UNDER THE SERP PLAN ASSUMING THAT, ON THE DATE OF THE EXECUTIVE'S DEATH (AND NOT BEFORE), THE EXECUTIVE SATISFIED THE LAST OF THE ELIGIBILITY REQUIREMENTS OF THE SERP PLAN WITH PRESENT VALUE RECOGNIZING AN EARLY BENEFIT COMMENCEMENT. AN ELIGIBLE EXECUTIVE BECOMES A PARTICIPANT IN THE SEDB PLAN IF THE EXECUTIVE DIES PRIOR TO TERMINATION OF EMPLOYMENT, PROVIDED THE EXECUTIVE HAS NOT SATISFIED ALL OF THE ELIGIBILITY REQUIREMENTS OF SERP AS OF THE EXECUTIVE'S DATE OF DEATH BUT WOULD HAVE SATISFIED ALL OF THOSE REQUIREMENTS WITHIN FIVE (5) YEARS FOLLOWING DEATH HAD THE EXECUTIVE LIVED AND CONTINUED EMPLOYMENT. THE SEDB PLAN WAS REVIEWED AND APPROVED BY THE AHSSHC BOARD COMPENSATION COMMITTEE, AN INDEPENDENT BODY OF THE AHSSHC BOARD OF DIRECTORS. FLEX PLAN FLEX PLAN/ SERP 457(B) CY CY EMPLOYER CY CONTRIB./ DISTRIBUTIONS CONTRIB. DISTRIBUTIONS* PAYMENT ------------------------------------------------------- KENNETH FINCH $109,950 $105,347 $171,080 $ 0 CARLYLE WALTON $ 46,683 $ 16,669 $ 35,650 $ 0 JESSE SUTTON $ 33,561 $ 26,785 $ 0 $ 0 KEVIN ROBERTS $ 42,276 $ 0 $ 0 $ 0 ROBERT BROCK $ 4,834 $ 11,585 $ 0 $ 0 PARKER PRIDGEN $ 10,385 $ 0 $ 0 $ 0 * INCLUDING INVESTMENT EARNINGS FORM 990, PART VII, SECTION A, LINE 5: DON DANIELS, MD, WAS THE CMO OF THE FILING ORGANIZATION THROUGH JULY OF 2019 AND WAS COMPENSATED BY BAYLOR SCOTT & WHITE HEALTH, AN UNRELATED IRC SECTION 501(C)(3) ENTITY, FOR SERVICES PROVIDED TO THE FILING ORGANIZATION. THE COMPENSATION DISCLOSED IN SCHEDULE J, PART II, REPRESENTS THE PAYMENTS MADE BY THE FILING ORGANIZATION TO BAYLOR SCOTT & WHITE HEALTH FOR THE SERVICES RENDERED BY DR. DANIELS. THE FILING ORGANIZATION DOES NOT HAVE ACCESS TO THE RECORDS NECESSARY TO REPORT THE TYPE AND AMOUNT OF COMPENSATION PAID BY BAYLOR SCOTT & WHITE HEALTH TO DR. DANIELS FOR THE SERVICES PROVIDED. SPEARS FAMILY ENTERP LLC DBA ZIP CLEANERS COMPANY OWNED BY FAMILY OF BOARD MEMBER 647429 INDEPENDENT CONTRACTOR COMPENSATION 0 PART V, LINE 1A THE PARENT CORPORATION AND SOLE TOP-TIER MEMBER OF METROPLEX ADVENTIST HOSPITAL (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 1 THE BOARD OF DIRECTORS FOR METROPLEX ADVENTIST HOSPITAL, INC. IS COMPRISED OF TWO CLASSES OF MEMBERS WITH POWER TO VOTE ON MATTERS THAT MAY COME BEFORE THE GOVERNING BODY; THE BOARD OF DIRECTORS OF THE CORPORATION AND A COMMUNITY BOARD. THE COMMUNITY BOARD IS PRIMARILY RESPONSIBLE FOR REPORTING TO THE BOARD OF DIRECTORS ON MATTERS AT EACH HOSPITAL LOCATION INVOLVING MEDICAL STAFF APPOINTMENT, REAPPOINTMENT, QUALITY ASSURANCE AND ADMINISTRATION OF MEDICAL STAFF BYLAWS, AND RULES AND REGULATIONS AND POLICIES AND MATTERS INVOLVING THE JOINT COMMISSION. THE BOARD OF DIRECTORS RETAINS FINAL AUTHORITY REGARDING ALL COMMUNITY BOARD ACTIONS TO ENSURE THAT ITS ACTIONS ARE CONSISTENT WITH THE BEST INTERESTS OF THE CORPORATION. THE COMMUNITY BOARD IS COMPRISED OF INDIVIDUALS FROM THE COMMUNITY WHO ARE APPOINTED BY THE BOARD. SIX OF THE EIGHTEEN MEMBERS OF THE COMMUNITY BOARD ARE MEMBERS OF THE GOVERNING BOARD. FORM 990, PART VI, SECTION A, LINE 2 PAULA LOHSE AND RONALD STEPP - BUSINESS RELATIONSHIP FORM 990, PART VI, SECTION A, LINE 6 METROPLEX ADVENTIST HOSPITAL, INC. (MAH) HAS TWO MEMBERS. THE MEMBERS OF MAH ARE ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC) AND SCOTT & WHITE MEMORIAL HOSPITAL AND SCOTT, SHERWOOD AND BRINDLEY FOUNDATION (SCOTT & WHITE). BOTH AHSSHC AND SCOTT & WHITE ARE NOT-FOR-PROFIT CORPORATIONS THAT ARE EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3). THERE ARE NO OTHER CLASSES OF MEMBERSHIP IN MAH. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS (BOARD) OF MAH ARE APPOINTED BY AHSSHC (MAJORITY MEMBER) AND SCOTT & WHITE (MINORITY MEMBER). THE MAJORITY MEMBER IS ENTITLED TO ELECT FOUR DIRECTORS TO THE BOARD OF MAH AND THE MINORITY MEMBER IS ENTITILED TO ELECT TWO DIRECTORS TO THE BOARD. IN ADDITION, THE BOARD MAY APPOINT A COMMUNITY BOARD THAT IS RESPONSIBLE TO REPORT TO THE BOARD ON MATTERS AT EACH HOSPITAL INVOLVING MEDICAL STAFF APPOINTMENT, REAPPOINTMENT, QUALITY ASSURANCE AND ADMINISTRATION OF MEDICAL STAFF BYLAWS, RULES AND REGULATIONS AND POLICIES AND MATTERS INVOLVING THE JOINT COMMISSION. THE COMMUNITY BOARD SHALL CONSIST OF A MAXIMUM OF EIGHTEEN VOTING MEMBERS WHICH MAY BE APPOINTED OR REMOVED BY EACH MEMBER IN PROPORTION TO THE MEMBER'S MEMBERSHIP INTEREST IN MAH. FORM 990, PART VI, SECTION A, LINE 7B AHSSHC AND SCOTT & WHITE, AS THE SOLE MEMBERS OF MAH, HAVE CERTAIN RESERVED POWERS AS SET FORTH IN THE BYLAWS OF MAH. THESE RESERVED POWERS INCLUDE THE FOLLOWING: 1) TO ADD ADDITIONAL MEMBERS OR REQUIRE ADDITIONAL CAPITAL CONTRIBUTIONS FROM EITHER MEMBER; 2) TO AMEND, RESTATE, AND REPEAL THE ARTICLES OF INCORPORATION OR BYLAWS; 3) TO SET LIMITS AND TERMS FOR THE BORROWING OF FUNDS; 4) TO DIRECT THE PLACEMENT OF FUNDS AND CAPITAL; 5) TO MERGE, CONSOLIDATE, REORGANIZE, LIQUIDATE, OR VOLUNTARILY DISSOLVE MAH; 6) TO SELL, TRANSFER, LEASE, DISPOSE, OR ENCUMBER ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF MAH. THOUGH NOT REQUIRING AN APPROVAL BY THE MINORITY MEMBER, SCOTT & WHITE, THE MAJORITY MEMBER, AHSSHC, SHALL CONSULT WITH AND OBTAIN INPUT FROM THE MINORITY MEMBER PRIOR TO TAKING ANY ACTION INVOLVING: 1) AMENDMENT, RESTATEMENT, OR REPEAL OF THE CORPORATE COMPLIANCE POLICY; 2) APPOINTMENT OR REMOVAL OF THE PRESIDENT; 3) APPROVING OR ENTERING INTO LOANS TO, OR GUARANTEES FOR THE BENEFIT OF THIRD PARTIES IN AN AGGREGATE AMOUNT NOT TO EXCEED $100,000 IN ANY YEAR. FORM 990, PART VI, SECTION B, LINE 11B THE FILING ORGANIZATION'S CURRENT YEAR FORM 990 WAS REVIEWED BY THE BOARD CHAIRMAN, BOARD FINANCE COMMITTEE CHAIR, CEO AND BY THE CFO PRIOR TO ITS FILING WITH THE IRS. THE REVIEW CONDUCTED BY THE BOARD CHAIRMAN, BOARD FINANCE COMMITTEE CHAIR, CEO AND THE CFO DID NOT INCLUDE THE REVIEW OF ANY SUPPORTING WORKPAPERS THAT WERE USED IN PREPARATION OF THE CURRENT YEAR FORM 990, BUT DID INCLUDE A REVIEW OF THE ENTIRE FORM 990 AND ALL SUPPORTING SCHEDULES. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY OF THE FILING ORGANIZATION APPLIES TO MEMBERS OF ITS BOARD OF DIRECTORS AND ITS PRINCIPAL OFFICERS (TO BE KNOWN AS INTERESTED PERSONS). IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, ANY MEMBER OF THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION OR ANY PRINCIPAL OFFICER OF THE FILING ORGANIZATION (I.E. INTERESTED PERSONS) MUST DISCLOSE THE EXISTENCE OF ANY FINANCIAL INTEREST WITH THE FILING ORGANIZATION AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS CONCERNING THE FINANCIAL INTEREST/ARRANGEMENT TO THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION OR TO ANY MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS THAT IS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. SUBSEQUENT TO ANY DISCLOSURE OF ANY FINANCIAL INTEREST/ARRANGEMENT AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE RELEVANT BOARD MEMBER OR PRINCIPAL OFFICER, THE REMAINING MEMBERS OF THE BOARD OF DIRECTORS OR COMMITTEE WITH BOARD DELEGATED POWERS SHALL DISCUSS, ANALYZE, AND VOTE UPON THE POTENTIAL FINANCIAL INTEREST/ARRANGEMENT TO DETERMINE IF A CONFLICT OF INTEREST EXISTS. ACCORDING TO THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY, AN INTERESTED PERSON MAY MAKE A PRESENTATION TO THE BOARD OF DIRECTORS (OR COMMITTEE WITH BOARD DELEGATED POWERS), BUT AFTER SUCH PRESENTATION, SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN A CONFLICT OF INTEREST. EACH INTERESTED PERSON, AS DEFINED UNDER THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY, SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE FILING ORGANIZATION IS A CHARITABLE ORGANIZATION THAT MUST PRIMARILY ENGAGE IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS EXEMPT PURPOSES. THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY ALSO REQUIRES THAT PERIODIC REVIEWS SHALL BE CONDUCTED TO ENSURE THAT THE FILING ORGANIZATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES. FORM 990, PART VI, SECTION B, LINE 15 THE FILING ORGANIZATION'S CEO, OTHER OFFICERS AND KEY EMPLOYEES ARE NOT COMPENSATED BY THE FILING ORGANIZATION. SUCH INDIVIDUALS ARE COMPENSATED BY THE RELATED TOP-TIER PARENT ORGANIZATION OF THE FILING ORGANIZATION. PLEASE SEE THE DISCUSSION CONCERNING THE PROCESS FOLLOWED BY THE RELATED TOP-TIER PARENT ORGANIZATION IN DETERMINING EXECUTIVE COMPENSATION IN OUR RESPONSE TO SCHEDULE J, LINE 3. FORM 990, PART VI, SECTION C, LINE 19 THE FILING ORGANIZATION IS A PART OF THE SYSTEM OF HEALTHCARE ORGANIZATIONS KNOWN AS ADVENTHEALTH. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS OF ADVENTHEALTH AND OF THE ADVENTHEALTH "OBLIGATED GROUP" ARE FILED ANNUALLY WITH THE MUNICIPAL SECURITIES RULEMAKING BOARD (MSRB). THE "OBLIGATED GROUP" IS A GROUP OF AHSSHC SUBSIDIARIES THAT ARE JOINTLY AND SEVERALLY LIABLE UNDER A MASTER TRUST INDENTURE THAT SECURES DEBT PRIMARILY ISSUED ON A TAX-EXEMPT BASIS. UNAUDITED QUARTERLY FINANCIAL STATEMENTS PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) ARE ALSO FILED WITH MSRB FOR ADVENTHEALTH ON A CONSOLIDATED BASIS AND FOR THE GROUPING OF ADVENTHEALTH SUBSIDIARIES COMPRISING THE "OBLIGATED GROUP". THE FILING ORGANIZATION DOES NOT GENERALLY MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. PART VII, SECTION A FOR THOSE BOARD OF DIRECTOR MEMBERS, OFFICER(S) AND KEY EMPLOYEES WHO DEVOTE LESS THAN FULL-TIME TO THE FILING ORGANIZATION (BASED UPON THE AVERAGE NUMBER OF HOURS PER WEEK SHOWN IN COLUMN (B) ON PAGE 7 OF THE RETURN) THE COMPENSATION AMOUNTS SHOWN IN COLUMNS (E) AND (F) ON PAGE 7 WERE PROVIDED IN CONJUNCTION WITH THAT PERSON'S RESPONSIBILITIES AND ROLES IN SERVING IN AN EXECUTIVE LEADERSHIP POSITION AS AN EMPLOYEE OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION. PHYSICIAN MEMBERS OF THE BOARD OF DIRECTORS RECEIVED COMPENSATION FROM RELATED ORGANIZATIONS AS A RESULT OF PROVIDING VARIOUS MEDICAL SERVICES TO THOSE RELATED ENTITIES. PART VIII, LINE 7A, B AND C: THE AMOUNTS SHOWN IN PART VIII, LINE 7A(I) AND 7C(I) OF THE FORM 990 REPRESENTS AN ALLOCATED SHARE OF CAPITAL GAIN/(LOSS) FROM A SYSTEM WIDE, CORPORATE ADMINISTERED, INVESTMENT PROGRAM. FORM 990, PART IX, LINE 11G PAYMENTS TO HEALTHCARE PROFESSIONALS: PROGRAM SERVICE EXPENSES 7,678,511. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,678,511. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,055,460. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,055,460. PURCHASED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 5,395,138. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,395,138. ENVIRONMENTAL SERVICES: PROGRAM SERVICE EXPENSES 871,126. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 871,126. MISCELLANEOUS PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 464,133. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 464,133. RECRUITING: PROGRAM SERVICE EXPENSES 420,889. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 420,889. TRANSCRIPTION SERVICES: PROGRAM SERVICE EXPENSES 69,248. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 69,248. ADVENTHEALTH MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 2,061,943. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,061,943. BILLING & COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 717,136. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 717,136. ADVENTHEALTH SHARED SERVICE FEE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,265,884. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,265,884. FORM 990, PART XI, LINE 9: TRANSFER TO TAX-EXEMPT AFFILIATES -10,255,690. GIFTS TO HOSPITAL 327,150. DISSOLUTION OF SUBSIDIARY -892,959. ASC 842 LEASE ACCOUNTING ADJUSTMENTS -31,532. PART X, LINE 2 THE AMOUNTS SHOWN ON LINE 2 OF PART X OF THIS RETURN INCLUDES THE FILING ORGANIZATION'S INTEREST IN A CENTRAL INVESTMENT POOL MAINTAINED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION, THE FILING ORGANIZATION'S TOP-TIER MAJORITY MEMBER. THE INVESTMENTS IN THE CENTRAL INVESTMENT POOL ARE RECORDED AT MARKET VALUE. ADVENTHEALTH FAMILY MEDICINE RURAL HEALTH CLINICS INC FKA HOSPICE OF THE C 187 PR 4060 LAMPASAS TX 76550 271858033 OPERATION OF RURAL HEALTH CLINICS & MEDICAL SERVICES FL 501(C)(3) LINE 3 METROPLEX ADVENTIST HOSPITAL INC 1 ADVENTHEALTH FOUNDATION SHAWNEE MISSION 9100 W 74TH STREET SHAWNEE MISSION KS 66204 480868859 FUND-RAISING FOR TAX-EXEMPT HOSPITAL KS 501(C)(3) LINE 7 SHAWNEE MISSION MEDICAL CENTER INC 1 ADVENTHEALTH HOME CARE EAST FLORIDA LLC (218-123119) 770 WEST GRANADA BLVD 319 ORMOND BEACH FL 32174 833768458 INACTIVE FL 501(C)(3) LINE 12A, I MEMORIAL HLTH SYSTEMS INC 1 ADVENTHEALTH HOSPICE CARE EAST FLORIDA INC (218-123119) 770 WEST GRANADA BLVD 304 ORMOND BEACH FL 32174 833748461 INACTIVE FL 501(C)(3) LINE 12A, I MEMORIAL HLTH SYSTEMS INC 1 ADVENTHEALTH NORTH POLK INC FKA UNIVERSITY COMMUNITY HOSPITAL SPECIALTY CA 3100 E FLETCHER AVE TAMPA FL 33613 593231322 INACTIVE FL 501(C)(3) LINE 12A, I UNIVERSITY COMMUNITY HOSPITAL INC 1 ADVENTHEALTH OSCEOLA SOUTH INC (416-123119) 900 HOPE WAY ALTAMONTE SPRINGS FL 32714 841817046 INACTIVE FL 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 ADVENTHEALTH POLK NORTH INC (418-123119) 40100 US HIGHWAY 27 N DAVENPORT FL 33837 841793121 OPERATION OF HOSPITAL & RELATED SERVICES FL 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 ADVENTHEALTH POLK SOUTH INC (415-123119) 410 SOUTH 11TH STREET LAKE WALES FL 33853 834672945 OPERATION OF HOSPITAL & RELATED SERVICES FL 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 ADVENTHEALTH RANSOM MEMORIAL INC 1301 S MAIN STREET OTTAWA KS 66067 830976641 OPERATION OF HOSPITAL & RELATED SERVICES KS 501(C)(3) LINE 3 ADVENTIST HLTH MID-AMERICA INC 1 ADVENTHEALTH UNIVERSITY INC 671 LAKE WINYAH DRIVE ORLANDO FL 32803 593069793 EDUCATION/OPERATION OF SCHOOL FL 501(C)(3) LINE 2 ADVENTIST HLTH SYSTEMSUNBELT INC 1 ADVENTHEALTH WEST FL AMBULATORY SVCS INC FKA WEST FL HLTH INC 14055 RIVEREDGE DRIVE TAMPA FL 33637 471881744 INACTIVE FL 501(C)(3) LINE 10 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 ADVENTHEALTH WEST FLORIDA IMAGING INC (924-123119) 14055 RIVEREDGE DRIVE STE 250 TAMPA FL 33637 843225135 IMAGING & TESTING FL 501(C)(3) LINE 12A, I ADVENTHEALTH WEST FLORIDA AMBULATORY SERVICES INC 1 ADVENTIST BOLINGBROOK HOSPITAL 500 REMINGTON BLVD BOLINGBROOK IL 60440 651219504 OPERATION OF HOSPITAL & RELATED SERVICES IL 501(C)(3) LINE 3 ADVENTIST MIDWEST HEALTH 1 ADVENTIST CARE CENTERS - COURTLAND INC 730 COURTLAND STREET ORLANDO FL 32804 205774723 OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY FL 501(C)(3) LINE 10 SUNBELT HLTH CARE CENTERS INC 1 ADVENTIST GLENOAKS HOSPITAL 701 WINTHROP AVENUE GLENDALE HEIGHTS IL 60139 363208390 OPERATION OF HOSPITAL & RELATED SERVICES IL 501(C)(3) LINE 3 ADVENTIST MIDWEST HEALTH 1 ADVENTIST HLTH MID-AMERICA INC 9100 W 74TH STREET SHAWNEE MISSION KS 66204 521347407 SUPPORT OF AFFILIATED HOSPITAL KS 501(C)(3) LINE 12C, III-FI ADVENTIST HLTH SYSTEMSUNBELT INC 1 ADVENTIST HLTH PARTNERS INC 2601 NAVISTAR 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TN N/A C 1 ORMOND PROF ASSOCIATES CONDO ASSOC'N INC (430 YEAR END) 770 W GRANADA BLVD STE 101 ORMOND BEACH FL 32174 592694434 CONDO ASSOCIATION FL N/A C 1 PARK RIDGE PROPERTY OWNER'S ASSOCIATION INC 1 PARK PLACE NAPLES ROAD FLETCHER NC 28732 030380531 CONDO ASSOCIATION NC N/A C 1 PORTER AFFILIATED HEALTH SERVICES INC 2525 S DOWNING STREET DENVER CO 80210 840956175 HEALTHCARE SERVICES CO N/A C 1 SAN MARCOS REGIONAL MRI INC 1301 WONDER WORLD DRIVE SAN MARCOS TX 78666 770597968 HOLDING COMPANY TX N/A C 1 THE GARDEN RETIREMENT COMMUNITY INC 485 NORTH KELLER ROAD STE 250 MAITLAND FL 32751 593414055 REAL ESTATE RENTAL FL N/A C 1 WINTER PARK MEDICAL OFFICE BUILDING I CONDO ASSOC INC 601 EAST ROLLINS STREET ORLANDO FL 32803 452228478 CONDO ASSOCIATION FL N/A C 1 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION M 1319185 % OF FACILITY'S OPERATING EXPENSE ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION DBA AIT M 4912057 % OF FACILITY'S OPERATING EXPENSE ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION - SHARED SERVICES M 1265884 % OF FACILITY'S OPERATING EXPENSE ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION P 4317827 COST ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION - INSURANCE ALLOC P 348764 COST ADVENTIST HEALTH SYSTEMSUNBELT INC DBA CENTRAL TEXAS MEDICAL CENTER L 76005 FAIR MARKET VALUE ADVENTIST HEALTH SYSTEMSUNBELT INC DBA CENTRAL TEXAS MEDICAL CENTER P 867978 COST ADVENTIST HEALTH SYSTEMSUNBELT INC DBA CENTRAL TEXAS MEDICAL CENTER Q 66401 COST ADVENTHEALTH FAMILY MEDICINE RURAL HEALTH CLINICS INC R 6662000 ACTUAL AMOUNT LOANED CC MOB INC S 494610 ACTUAL AMOUNT RECEIVED METROPLEX CLINIC PHYSICIANS INC A 59915 FAIR MARKET VALUE METROPLEX CLINIC PHYSICIANS INC R 3202484 ACTUAL AMOUNT LOANED SUNSYSTEM DEVELOPMENT CORP DBA ADVENTHEALTH CENTRAL TEXAS FOUNDATION B 114746 ACTUAL AMOUNT GIVEN SUNSYSTEM DEVELOPMENT CORP DBA ADVENTHEALTH CENTRAL TEXAS FOUNDATION C 289500 ACTUAL AMOUNT RECEIVED