4A (Expenses $ 220243452 including grants of $ 905326) (Revenue $ 251625452)
THE HOSPITAL OPERATES A 103-BED ACUTE CARE HOSPITAL WITH 3,910 PATIENT ADMISSIONS, 18,140 PATIENT DAYS, 191,400 OUTPATIENT VISITS, AND 271,323 PHYSICIAN PRACTICE PATIENT VISITS IN THE CURRENT YEAR.

ADVENTHEALTH HENDERSONVILLE
PART V, SECTION B, LINE 5: FLETCHER HOSPITAL, INC., D/B/A ADVENTHEALTH HENDERSONVILLE (AHH OR THE HOSPITAL), SERVES A COMMUNITY THAT INCLUDES HENDERSON COUNTY AND SOUTHERN BUNCOMBE COUNTY IN WESTERN NORTH CAROLINA. IN CONDUCTING ITS 2019 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), AHH ENGAGED ITS BROAD COMMUNITY THROUGH PARTICIPATION IN LOCAL AND REGIONAL CHNA COMMITTEES. TO HELP GUIDE THE HOSPITAL THROUGH ITS OWN CHNA PROCESS, THE HOSPITAL UTILIZED THE RESOURCES OF REGIONAL AND LOCAL CHNA COMMITTEES, AS WELL AS ITS OWN INTERNAL CHNA COMMITTEE. THE HENDERSON COUNTY PARTNERSHIP FOR HEALTH SERVED AS THE LOCAL CHNA COMMITTEE AND THE WESTERN NORTH CAROLINA HEALTHY IMPACT STEERING COMMITTEE SERVED AS THE REGIONAL CHNA COMMITTEE. BOTH COMMITTEES INCLUDED REPRESENTATION NOT ONLY FROM THE HOSPITAL, PUBLIC HEALTH AND THE BROAD COMMUNITY, BUT FROM LOW-INCOME, MINORITY AND OTHER UNDERSERVED POPULATIONS. WNC HEALTHY IMPACT IS A REGIONAL PARTNERSHIP OF HOSPITALS AND PUBLIC HEALTH DEPARTMENTS REPRESENTING 18 COUNTIES THAT COMPRISE WESTERN NORTH CAROLINA THAT SERVES TO BRING TOGETHER HOSPITAL REPRESENTATIVES, HEALTH DEPARTMENT OFFICIALS, AND COMMUNITY HEALTH LEADERS TO ASSESS AND ADDRESS HEALTH NEEDS IN THE REGION. WITH RESPECT TO THE HENDERSON COUNTY PARTNERSHIP FOR HEALTH, THE LOCAL CHNA COMMUNITY COMMITTEE, AN EMPHASIS WAS PLACED UPON SOLICITING INPUT FROM REPRESENTATIVES OF ORGANIZATIONS SERVING LOW-INCOME, MINORITY, AND OTHER UNDERSERVED POPULATIONS. MEMBERS OF THE HENDERSON COUNTY COMMUNITY HEALTH ASSESSMENT COMMITTEE THAT REPRESENTED SUCH UNDERSERVED POPULATIONS INCLUDED THE FOLLOWING:- THE HENDERSON COUNTY DEPARTMENT OF PUBLIC HEALTH;- MADISON COUNTY HEALTH DEPARTMENT; - JACKSON COUNTY HEALTH DEPARTMENT;- BUNCOMBE COUNTY HEALTH DEPARTMENT;- RUTHERFORD-POLK-MCDOWELL DISTRICT HEALTH DEPARTMENT; - BLUE RIDGE HEALTH - A FEDERALLY QUALIFIED HEALTH CENTER;- THE FREE CLINICS - AN ORGANIZATION UTILIZING VOLUNTEERS TO PROVIDE FREE HEALTHCARE AND SERVICES TO LOW-INCOME UNINSURED RESIDENTS AND MINORITIES;- SAFELIGHT - AN ORGANIZATION PROVIDING SERVICES AND SHELTER FOR SURVIVORS OF DOMESTIC VIOLENCE, SEXUAL ASSAULT AND CHILD ABUSE; - THRIVE - AN ORGANIZATION THAT SERVES PEOPLE WITH MENTAL HEALTH SYMPTOMS;- HENDERSON COUNTY DEPARTMENT OF SOCIAL SERVICES; - COUNCIL ON AGING FOR HENDERSON COUNTY - AN ORGANIZATION THAT PROVIDES AND COORDINATES SERVICES TO HELP KEEP OLDER ADULTS LIVING INDEPENDENTLY; - HENDERSONVILLE FAMILY YMCA;- HENDERSON COUNTY PUBLIC SCHOOLS; AND- CROSSNORE HENDERSONVILLE, AN ORGANIZATION PROVIDING BEHAVIORAL HEALTH AND FOSTER CARE SERVICES FOR CHILDREN IN HENDERSON COUNTY.

ADVENTHEALTH HENDERSONVILLE
PART V, SECTION B, LINE 7D: THE HOSPITAL HAS ADOPTED A POLICY THAT ADDRESSES THE PUBLIC POSTING REQUIREMENTS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT. UNDER THIS POLICY, THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS MUST BE POSTED ON THE HOSPITAL'S WEBSITE AT LEAST UNTIL THE DATE THE HOSPITAL FACILITY HAS MADE WIDELY AVAILABLE ON ITS WEBSITE ITS TWO SUBSEQUENT COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS. THE HOSPITAL WILL ALSO MAKE A PAPER COPY OF ITS COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST AND WITHOUT CHARGE, AT LEAST UNTIL THE DATE THE HOSPITAL FACILITY HAS MADE AVAILABLE FOR PUBLIC INSPECTION ITS TWO SUBSEQUENT COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.

ADVENTHEALTH HENDERSONVILLE
"PART V, SECTION B, LINE 11: FLETCHER HOSPITAL, INC. D/B/A ADVENTHEALTH HENDERSONVILLE WILL BE REFERRED TO IN THIS DOCUMENT AS ADVENTHEALTH HENDERSONVILLE OR ""THE HOSPITAL"". THE HOSPITAL IS A WHOLLY OWNED SUBSIDIARY OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). AHSSHC IS THE 501(C)(3) PARENT ORGANIZATION OF A HOSPITAL AND HEALTHCARE SYSTEM KNOWN AS ADVENTHEALTH. IN JANUARY 2019, EVERY WHOLLY-OWNED ENTITY OF AHSSHC ADOPTED THE ADVENTHEALTH SYSTEM BRAND. OUR IDENTITY HAS BEEN UNIFIED TO REPRESENT THE FULL CONTINUUM OF CARE OUR SYSTEM OFFERS. ANY REFERENCES TO OUR PRIOR COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNAS) OR PRIOR COMMUNITY HEALTH PLANS (CHPS) WILL UTILIZE OUR NEW NAME FOR CONSISTENCY. ADVENTHEALTH HENDERSONVILLE IS PART OF THE MULTI-STATE DIVISION OF ADVENTHEALTH (THE DIVISION). THE DIVISION INCLUDES NINE HOSPITAL FACILITIES. THIS IS THE SECOND-YEAR UPDATE FOR ADVENTHEALTH HENDERSONVILLE'S 2020-2022 COMMUNITY HEALTH PLAN/IMPLEMENTATION STRATEGY. THE HOSPITAL DEVELOPED THIS PLAN AND POSTED IT IN MAY 2020 AS PART OF ITS 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. FOR THE DEVELOPMENT OF BOTH THE COMMUNITY HEALTH NEEDS ASSESSMENT AND THE COMMUNITY HEALTH PLAN/IMPLEMENTATION STRATEGY, ADVENTHEALTH HENDERSONVILLE WORKED TO DEFINE AND ADDRESS THE NEEDS OF LOW-INCOME, MINORITY AND UNDERSERVED POPULATIONS IN ITS SERVICE AREA. THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT USED PRIMARY DATA INTERVIEWS AND SURVEYS; SECONDARY DATA FROM LOCAL, REGIONAL AND NATIONAL HEALTH-RELATED SOURCES; AND HOSPITAL PREVALENCE DATA TO HELP THE HOSPITAL DETERMINE THE HEALTH NEEDS OF THE COMMUNITY IT SERVES. ONCE THE DATA WAS GATHERED, THE PRIMARY ISSUES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT WERE PRIORITIZED BY COMMUNITY AND HOSPITAL STAKEHOLDERS, WHO THEN SELECTED KEY ISSUES FOR THE HOSPITAL TO ADDRESS IN ITS 2020-2022 COMMUNITY HEALTH PLAN. THE SECOND-YEAR PROGRESS ON THE COMMUNITY HEALTH PLAN IS NOTED BELOW. THE NARRATIVE DESCRIBES THE PRIORITIZED ISSUES IDENTIFIED IN 2019 AND GIVES AN UPDATE ON THE STRATEGIES ADDRESSING THOSE ISSUES. THERE IS ALSO A DESCRIPTION OF THE IDENTIFIED ISSUES THAT THE HOSPITAL DID NOT ADDRESS. ADVENTHEALTH HENDERSONVILLE CHOSE FOUR PRIORITIES FOR ITS 2020-2022 COMMUNITY HEALTH PLAN: 1. MENTAL HEALTH2. SUBSTANCE ABUSE3. PHYSICAL ACTIVITY AND NUTRITION 4. SAFE AND AFFORDABLE HOUSINGPRIORITY 1: MENTAL HEALTH 2019 DESCRIPTION OF THE ISSUE:MENTAL HEALTH HAS BEEN A COMMUNITY HEALTH NEEDS ASSESSMENT HEALTH PRIORITY FOR HENDERSON COUNTY SINCE 2003. ACCESS TO AND THE QUALITY OF MENTAL HEALTH SERVICES HAVE BEEN A SOURCE OF CONCERN FOR MANY YEARS. OVER THE LAST 15 YEARS, MANY CHANGES TO THE MENTAL HEALTH SYSTEM HAVE OCCURRED, WHICH HAVE NEGATIVELY AFFECTED THOSE LIVING WITH MENTAL ILLNESS IN OUR COMMUNITY, AS WELL AS THEIR CAREGIVERS AND OTHER ORGANIZATIONS THAT PROVIDE SUPPORT. MENTAL HEALTH AND PHYSICAL HEALTH ARE CLOSELY CONNECTED. MENTAL HEALTH PLAYS A MAJOR ROLE IN PEOPLE'S ABILITY TO MAINTAIN GOOD PHYSICAL HEALTH. MENTAL ILLNESSES, SUCH AS DEPRESSION AND ANXIETY, IMPACT PEOPLE'S ABILITY TO PARTICIPATE IN HEALTH-PROMOTING BEHAVIORS. IN TURN, PROBLEMS WITH PHYSICAL HEALTH, SUCH AS CHRONIC DISEASES, CAN HAVE A SERIOUS IMPACT ON MENTAL HEALTH AND DECREASE A PERSON'S ABILITY TO PARTICIPATE IN TREATMENT AND RECOVERY. MENTAL ILLNESS CAN AFFECT ANYONE, OF ANY AGE, AT ANY TIME IN THEIR LIVES. EVEN YOUTH ARE NOT IMMUNE. THERE IS OFTEN CO-OCCURRENCE WITH DRUG MISUSE, HOMELESSNESS, AND MENTAL ILLNESS. THE NUMBERS OF WESTERN NORTH CAROLINA RESIDENTS BEING SERVED BY MENTAL HEALTH PROGRAMS HAS DECREASED OVERALL BUT IS BEGINNING TO INCREASE AGAIN. IT IS IMPORTANT TO NOTE THAT DECREASED ACCESS DOES NOT NECESSARILY MEAN DECREASED NEED.WHEN ASKED, SURVEY AND FOCUS GROUP PARTICIPANTS MOST OFTEN REPORTED A GREATER NEED FOR SERVICES PROVIDED IN HENDERSON COUNTY. SERVICES FOR THE UNINSURED AND UNDER-INSURED POPULATIONS, AS WELL AS SERVICES PROVIDED IN SPANISH, ARE LIMITED. THE NEED TO TRAVEL TO BUNCOMBE COUNTY OR ELSEWHERE IN THE STATE TO RECEIVE SERVICES ALSO MAKES ACCESS A PROBLEM. FOR THOSE WHO HAVE INSURANCE, CO-PAYS WERE LISTED MOST FREQUENTLY AS A BARRIER TO CARE. - 14.4% OF ADULTS REPORTED MORE THAN SEVEN DAYS OF POOR MENTAL HEALTH IN THE PAST MONTH. (2018 COMMUNITY HEALTH SURVEY)- 9.2% OF ADULTS REPORTED INABILITY TO GET NEEDED MENTAL HEALTH CARE IN THE PAST YEAR. (2018 COMMUNITY HEALTH SURVEY)- SUICIDE MORTALITY RATE HAS INCREASED TO 18.8 PER 100,000.(NC STATE CENTER FOR HEALTH STATISTICS)- 21.4% OF 9TH GRADERS REPORTED SERIOUSLY CONSIDERING SUICIDE IN THE LAST YEAR.(2017 YOUTH RISK BEHAVIOR SURVEY)- 13% OF ADULTS REPORTED HAVING FOUR OR MORE ADVERSE CHILDHOOD EXPERIENCES.(2018 COMMUNITY HEALTH SURVEY)2021 UPDATE: THE ADVENTHEALTH HENDERSONVILLE COMMUNITY HEALTH PLAN HAS THREE DESIRED GOAL STATEMENTS UNDER THE MENTAL HEALTH PRIORITY. 1. PROVIDE NEEDED MENTAL HEALTH SERVICES AT THE RIGHT PLACE AND TIME2. ENHANCE THE COUNTY'S COMMUNITY-BASED MENTAL HEALTH SYSTEM TO FULLY SUPPORT RELATIONSHIP-BASED, PERSONALIZED CARE3. MAINTAIN SERVICES FOR THE CHRONICALLY MENTALLY ILL IN THE REGIONGOAL 1: PROVIDE NEEDED MENTAL HEALTH SERVICES AT THE RIGHT PLACE AND TIME OBJECTIVE 1: THE FIRST OBJECTIVE IS TO CONTINUE DEVELOPING THE NEXT PHASE OF A ""LIVING ROAD MAP"" FOCUSED SPECIFICALLY ON CAREGIVER/FAMILY SUPPORT TO HELP PATIENTS, PROVIDERS AND SAFETY-NET ORGANIZATIONS NAVIGATE THE REGION'S MENTAL HEALTH SYSTEM AND ACCESS APPROPRIATE COMMUNITY-BASED RESOURCES. THE INITIATIVE IS FUNDED AND MANAGED BY THE HENDERSON COUNTY PARTNERSHIP FOR HEALTH WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND A COMMITTEE OF LOCAL NON-PROFITS, GOVERNMENT AGENCIES AND HEALTH CARE PROVIDERS AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION AND ITS MEMBERSHIP. THE COMMITTEE AND THE HOSPITAL MET ITS SET METRIC OF COMPLETING THE YOUTH SERVICES COMPONENT OF THIS ""LIVING ROAD MAP"" FOR CAREGIVERS AND FAMILIES NAVIGATING THE REGION'S MENTAL HEALTH SYSTEM AND FINALIZED THE YOUTH SERVICES COMPONENT IN 2021.(CONTINUED)"

ADVENTHEALTH HENDERSONVILLE
PART V, SECTION B, LINE 13H: EFFECTIVE MARCH 1, 2020, THE FILING ORGANIZATION'S HOSPITAL FACILITY (OR FACILITIES) AUGMENTED THEIR FINANCIAL ASSISTANCE POLICY WITH A COVID-19 FINANCIAL GRACE ADDENDUM. PURSUANT TO THE COVID-19 FINANCIAL GRACE ADDENDUM, UNINSURED PATIENTS TREATED FOR COVID-19 RELATED EVALUATIONS ARE TO RECEIVE FREE OR DISCOUNTED CARE DEPENDING ON THE PATIENT'S COOPERATION IN SUBMITTING NECESSARY FINANCIAL ASSISTANCE INFORMATION. INSURED PATIENTS TESTED FOR COVID-19 ARE NOT EXPECTED TO HAVE OUT-OF-POCKET EXPENSES BASED ON INSURANCE COMMUNITY RESPONSE TO WAIVE PATIENT FINANCIAL RESPONSIBILITY. IF A PAYER UNEXPECTEDLY FAILS TO WAIVE PATIENT RESPONSIBILITY FOR COVID-19 RELATED TESTING, THE FILING ORGANIZATION WILL NOT BALANCE BILL PATIENTS FOR ANY OUT-OF-POCKET EXPENSES RELATED TO COVID-19. IN ADDITION, PATIENTS WITH EXISTING PAYMENT PLANS ARE PROVIDED OPPORTUNITIES FOR REDUCING THEIR MONTHLY PAYMENTS.

SCHEDULE H, PART V, LINE 7A AND LINE 10A
THE CHNA REPORT CAN BE FOUND AT URL: HTTPS://WWW.ADVENTHEALTH.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENTSTHE IMPLEMENTATION STRATEGY REPORT CAN BE FOUND AT URL: HTTPS://WWW.ADVENTHEALTH.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS

SCHEDULE H, PART V, SECTION B, LINE 11, CONTINUED:
OBJECTIVE 2: THE SECOND OBJECTIVE IS TO INCREASE THE NUMBER OF CHILD MEDICAL EXAMS THROUGH THE BELIEVE CHILD ADVOCACY CENTER (CAC) BY AT LEAST 15% FROM A BENCHMARK OF 120 BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY SAFELIGHT WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THE ORGANIZATION AND THE REPORTING HOSPITAL. SAFELIGHT SURPASSED ITS SET METRIC OF COMPLETING 140 CHILD MEDICAL EXAMS IN 2021. THE BELIEVE CHILD ADVOCACY CENTER (CAC) COMPLETED 230 CHILD MEDICAL EXAMS IN 2021. ADVENTHEALTH HENDERSONVILLE PROVIDED ITS ANNUAL $17,000 DONATION AND CONTINUED TO FUND THE PHYSICIAN ASSISTANT POSITION FOR THE CENTER IN 2021. OBJECTIVE 3:THE THIRD OBJECTIVE IS TO INCREASE THE NUMBER OF CHILDREN SERVED BY CROSSNORE SCHOOL & CHILDREN'S HOME THROUGH ITS SCHOOL-BASED MENTAL HEALTH COUNSELING PROGRAM BY AT LEAST 10% FROM A BASELINE OF 150 STUDENTS BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY CROSSNORE SCHOOL AND CHILDREN'S HOME WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THE ORGANIZATION. CROSSNORE SURPASSED ITS SET METRIC OF SERVING 160 STUDENTS THROUGH ITS SCHOOL-BASED MENTAL HEALTH COUNSELING PROGRAM IN 2021, BY SERVING 304 STUDENTS IN THE PROGRAM LAST YEAR. ADVENTHEALTH HENDERSONVILLE PROVIDED AN ADJUSTED ANNUAL DONATION OF $5,000 TO THE ORGANIZATION DUE TO COVID-19 IMPACTS AND LIMITATIONS IN 2021. OBJECTIVE 4:THE FOURTH OBJECTIVE IS TO INCREASE THE NUMBER OF DOMESTIC VIOLENCE SURVIVORS RECEIVING SAFE, EFFECTIVE, AND TIMELY VICTIM ADVOCACY SERVICES TO ADDRESS THE EFFECTS OF TRAUMA THROUGH HELPMATE BY AT LEAST 5% FROM A BASELINE OF 3,200 WOMEN AND CHILDREN BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY HELPMATE WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THE ORGANIZATION. HELPMATE SURPASSED ITS SET METRIC OF 3,300 IN 2021 BY SERVING 3,647 DOMESTIC VIOLENCE SURVIVORS IN THE LAST YEAR. ADVENTHEALTH HENDERSONVILLE PROVIDED ITS ANNUAL $5,000 DONATION TO THE ORGANIZATION IN 2021. OBJECTIVE 5:THE FIFTH OBJECTIVE IS TO INCREASE THE NUMBER OF SEXUAL ABUSE SURVIVORS SERVED BY OUR VOICE THROUGH ITS RECOVERY PROGRAMS BY AT LEAST 5% FROM A BASELINE OF 877 BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY OUR VOICE WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THE ORGANIZATION. COVID-19 IMPACTS AND RESTRICTIONS PREVENTED OUR VOICE FROM PROGRESSING ON ITS SET METRIC OF SERVING 900 SEXUAL ABUSE SURVIVORS IN 2021. OUR VOICE SERVED 723 SURVIVORS IN 2021. ADVENTHEALTH HENDERSONVILLE PROVIDED ITS ANNUAL DONATION OF $5,000 TO THE ORGANIZATION IN 2021. GOAL 2: ENHANCE THE COUNTY'S COMMUNITY-BASED MENTAL HEALTH SYSTEM TO FULLY SUPPORT RELATIONSHIP-BASED, PERSONALIZED CARE OBJECTIVE 1: THE FIRST OBJECTIVE IS TO SUPPORT AND EXPAND THE PHOENIX PROJECT, IN PARTNERSHIP WITH SAFELIGHT AND THE FREE CLINICS, TO ENHANCE ACCESS TO MENTAL HEALTH SERVICES AND TRAUMA-INFORMED PRIMARY CARE FOR SURVIVORS OF DOMESTIC VIOLENCE AND SEXUAL ASSAULT. THE PROGRAM WILL EXPAND THE NUMBER OF PATIENTS IT SERVES BY AT LEAST 10% FROM A BASELINE OF APPROXIMATELY 100 WOMEN BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY SAFELIGHT AND THE FREE CLINICS WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THESE ORGANIZATIONS. THE PHOENIX PROJECT AND ITS PARTNERS SURPASSED ITS SET METRIC OF 110 PATIENTS IN 2021. BY SERVING 187 PATIENTS IN THE LAST YEAR, ADVENTHEALTH HENDERSONVILLE CONTINUED TO BE THE FISCAL AGENT FOR THE GRANT SUPPORTING THIS PROGRAM AND PROVIDED ITS ANNUAL $17,000 DONATION TO SAFELIGHT AND $10,000 DONATION TO THE FREE CLINICS IN 2021. OBJECTIVE 2: THE SECOND OBJECTIVE IS TO IMPLEMENT AND EXPAND THE FREE CLINICS' BEHAVIORAL HEALTH OUTREACH IN THE HENDERSON COUNTY DETENTION CENTER. THE PROGRAM'S GOAL IS TO CONNECT WITH 75% OF INMATES WITHIN THE DETENTION CENTER TO SCREEN FOR MENTAL HEALTH NEEDS AND TO FOLLOW UP WITH 20% OF INMATES UPON DISCHARGE BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY THE FREE CLINICS WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. THE FREE CLINICS SURPASSED ITS SET METRIC OF CONNECTING WITH 70% OF INMATES WITHIN THE DETENTION CENTER TO SCREEN FOR MENTAL HEALTH NEEDS AND FOLLOWING UP WITH 20% OF INMATES UPON DISCHARGE IN 2021. THE FREE CLINICS CONNECTED WITH 73% OF INMATES FOR SCREENINGS AND FOLLOWED UP WITH 40% OF INMATES UPON DISCHARGE IN 2021. ADVENTHEALTH HENDERSONVILLE PROVIDED ITS ANNUAL $10,000 DONATION TO THE FREE CLINICS IN 2021. OBJECTIVE 3: THE THIRD OBJECTIVE IS TO INCREASE THE NUMBER OF DOMESTIC VIOLENCE AND SEXUAL ASSAULT SURVIVORS SERVED BY SAFELIGHT THROUGH ITS COUNSELING PROGRAMS BY AT LEAST 5% FROM A BASELINE OF 497 ADULTS AND CHILDREN BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY SAFELIGHT WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. COVID-19 IMPACTS AND RESTRICTIONS PREVENTED SAFELIGHT FROM PROGRESSING ON ITS SET METRIC OF SERVING 514 DOMESTIC VIOLENCE AND SEXUAL ASSAULT SURVIVORS IN 2021. SAFELIGHT SERVED 298 SURVIVORS IN 2021. ADVENTHEALTH HENDERSONVILLE PROVIDED ITS ANNUAL $17,000 DONATION TO THE ORGANIZATION IN 2021. OBJECTIVE 4: THE FOURTH OBJECTIVE IS TO INCREASE THE NUMBER OF YOUTH AND YOUNG ADULTS ON THE AUTISM SPECTRUM RECEIVING INTENSIVE APPLIED BEHAVIOR ANALYSIS (ABA) THROUGH ST. GERARD HOUSE BY AT LEAST 10% FROM A BASELINE OF 81 BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY ST. GERARD HOUSE WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. COVID-19 IMPACTS AND RESTRICTIONS PREVENTED ST. GERARD HOUSE FROM PROGRESSING ON ITS SET METRIC OF SERVING 86 YOUTH AND YOUNG ADULTS IN 2021. ST. GERARD HOUSE SERVED 67 YOUTH AND YOUNG ADULTS IN 2021. ADVENTHEALTH HENDERSONVILLE PROVIDED ITS ANNUAL $5,000 DONATION TO THE ORGANIZATION IN 2021. GOAL 3: MAINTAIN SERVICES FOR THE CHRONICALLY MENTALLY ILL IN THE REGION OBJECTIVE 1: THE FIRST OBJECTIVE IS TO CONTINUE SERVING INDIVIDUALS WITH SEVERE AND PERSISTENT MENTAL ILLNESS THROUGH THRIVE IN ITS CLUBHOUSE DAY PROGRAM BY MAINTAINING ITS BASELINE OF 55 ADULTS PER MONTH THROUGH THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY THRIVE WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE. COVID IMPACTS AND RESTRICTIONS PREVENTED THRIVE FROM MEETING ITS SET METRIC OF 55 ADULTS PER MONTH IN 2021. THRIVE SERVED 39 ADULTS PER MONTH IN 2021. ADVENTHEALTH HENDERSONVILLE PROVIDED ITS ANNUAL $7,500 DONATION TO THE ORGANIZATION IN 2021.

SCHEDULE H, PART V, SECTION B, LINE 11, CONTINUED:
PRIORITY 2: SUBSTANCE ABUSE 2019 DESCRIPTION OF THE ISSUE:SUBSTANCE ABUSE REFERS TO A SET OF RELATED CONDITIONS ASSOCIATED WITH THE CONSUMPTION OF MIND- AND BEHAVIOR-ALTERING SUBSTANCES THAT HAVE NEGATIVE BEHAVIORAL AND HEALTH OUTCOMES. SOCIAL ATTITUDES AND POLITICAL AND LEGAL RESPONSES TO THE CONSUMPTION OF ALCOHOL AND ILLICIT DRUGS MAKE SUBSTANCE ABUSE ONE OF THE MOST COMPLEX PUBLIC HEALTH ISSUES. SUBSTANCE ABUSE WAS IDENTIFIED AS A TOP PRIORITY IN ADVENTHEALTH HENDERSONVILLE'S PREVIOUS CHNAS.OPIOIDS CAUSED THE HIGHEST PROPORTION OF DRUG OVERDOSE DEATHS IN HENDERSON COUNTY AND IN THE STATE AND THE RATES OF DEATHS ARE INCREASING. THIS CATEGORY OF DRUGS INCLUDES COMMONLY PRESCRIBED MEDICATIONS LIKE HYDROCODONE, OXYCODONE, MORPHINE, CODEINE AND RELATED DRUGS. IT ALSO INCLUDES HEROIN AND SYNTHETIC NARCOTICS LIKE FENTANYL AND FENTANYL-ANALOGUES (DRUGS THAT ARE SIMILAR TO FENTANYL BUT HAVE BEEN CHEMICALLY MODIFIED TO BYPASS CURRENT DRUG LAWS).OPIOID-RELATED DEATHS INVOLVING PAIN MEDICATIONS LIKE OXYCODONE AND HYDROCODONE HAVE HISTORICALLY BEEN THE LEADING CAUSE OF OVERDOSE DEATHS. ILLICIT SUBSTANCES SUCH AS HEROIN, FENTANYL AND FENTANYL ANALOGUES ARE INCREASINGLY CONTRIBUTING TO OVERDOSE DEATHS, RESULTING IN HIGHER RATES OF OPIOID OVERDOSE DEATHS. AN INCREASE IN BEHAVIORS RELATED TO TOBACCO, ELECTRONIC VAPING AND ALCOHOL USAGE HAVE ALSO BEEN OF CONCERN FOR MANY COMMUNITY MEMBERS DURING THIS CHNA PROCESS.- 24 UNINTENTIONAL OPIOID DEATHS IN HENDERSON COUNTY IN 2017.(NORTH CAROLINA OPIOID DASHBOARD)- 71 OPIOID OVERDOSE EMERGENCY DEPARTMENT VISITS IN 2017.(NORTH CAROLINA OPIOID DASHBOARD)- 21.8% OF ADULTS REPORTED USING OPIATES/OPIOIDS IN THE PAST YEAR-WITH OR WITHOUT A PRESCRIPTION.(2018 COMMUNITY HEALTH SURVEY)- 21.4% OF FATAL CRASHES ARE ALCOHOL RELATED.(NCDOT)- 17.4% OF 9TH GRADERS REPORTED THAT THEY RODE WITH A DRIVER WHO HAD BEEN DRINKING ALCOHOL IN THE LAST 30 DAYS.(2017 YOUTH RISK BEHAVIOR SURVEY)- 39% OF 9TH GRADERS REPORTED THAT THEY HAVE USED ELECTRONIC VAPOR PRODUCTS.(2017 YOUTH RISK BEHAVIOR SURVEY)2021 UPDATE: THE ADVENTHEALTH HENDERSONVILLE COMMUNITY HEALTH PLAN HAS THREE DESIRED GOAL STATEMENTS UNDER THE SUBSTANCE ABUSE PRIORITY. 1. INCREASE AND ENHANCE COMMUNITY SUBSTANCE ABUSE, INCLUDING TOBACCO, VAPING AND ALCOHOL, EDUCATION AND PREVENTION PROGRAMS 2. REDUCE PRESCRIPTION DRUG DIVERSION AND MISUSE 3. DEVELOP COMMUNITY-BASED SUBSTANCE ABUSE TREATMENT OPTIONS AND SUPPORT PROGRAMSGOAL 1: INCREASE AND ENHANCE COMMUNITY SUBSTANCE ABUSE INCLUDING TOBACCO, VAPING AND ALCOHOL EDUCATION AND PREVENTION PROGRAMS OBJECTIVE 1: THE FIRST OBJECTIVE IS FOR HOPE RX AND ITS COMMUNITY PARTNERS, INCLUDING ADVENTHEALTH HENDERSONVILLE, TO INCREASE THE NUMBER OF SUBSTANCE MISUSE-FOCUSED COMMUNITY EDUCATION EVENTS BY AT LEAST 15% FROM A BASELINE OF 20 EVENTS BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY HOPE RX WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. COVID-19 IMPACTS PREVENTED HOPE RX FROM PROGRESSING ON ITS SET METRIC OF 22 SUBSTANCE-MISUSE FOCUSED EVENTS IN 2021. HOPE RX HOSTED 17 SUBSTANCE-MISUSE FOCUSED EVENTS IN 2021 DUE TO COVID-19 RESTRICTIONS THAT CANCELLED MANY HOPE RX PROGRAMS AND LIMITED IN-PERSON GATHERINGS. ADVENTHEALTH HENDERSONVILLE PROVIDED ITS ANNUAL COMMITMENT OF $15,000 THROUGH A COMBINATION OF CASH DONATIONS ($10,000) AND IN-KIND SUPPORT (CREATIVE, PRODUCTION AND EDITING EXCEEDING $5,000) FOR THE CREATION OF A DOCUMENTARY VIDEO ON THE DANGERS OF SUBSTANCE MISUSE FOR YOUTH. OBJECTIVE 2: THE SECOND OBJECTIVE IS FOR HOPE RX TO DEVELOP A LOCAL YOUTH COUNCIL TO ENGAGE HIGH SCHOOL STUDENTS IN SUBSTANCE MISUSE EDUCATION AND PREVENTION PROGRAMS BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY HOPE RX WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. HOPE RX MET ITS SET METRIC OF CREATING AND IMPLEMENTING A YOUTH COUNCIL IN 2021. HOPE RX CREATED ITS YOUTH COUNCIL IN 2021 AND THE ORGANIZATION GREW TO 22 MEMBERS. ADVENTHEALTH HENDERSONVILLE PROVIDED ITS ANNUAL COMMITMENT OF $15,000 THROUGH A COMBINATION OF CASH DONATIONS ($10,000) AND IN-KIND SUPPORT (CREATIVE, PRODUCTION AND EDITING EXCEEDING $5,000) FOR THE CREATION OF A DOCUMENTARY VIDEO ON THE DANGERS OF SUBSTANCE MISUSE FOR YOUTH. GOAL 2: REDUCE PRESCRIPTION DRUG DIVERSION AND MISUSE OBJECTIVE 1: THE FIRST OBJECTIVE IS FOR HOPE RX AND ITS COMMUNITY PARTNERS (INCLUDING ADVENTHEALTH HENDERSONVILLE) TO INCREASE THE ANNUAL NUMBER OF PRESCRIPTION DRUG DROP-OFF EVENTS BY AT LEAST 10% FROM A BASELINE OF 12 DRUG TAKE-BACK EVENTS BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY HOPE RX WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. COVID-19 IMPACTS AND RESTRICTIONS PREVENTED HOPE RX FROM PROGRESSING ON ITS SET METRIC OF HOSTING 13 PRESCRIPTION DRUG DROP-OFF EVENTS IN 2021. HOPE RX HOSTED SEVEN PRESCRIPTION DRUG DROP-OFF EVENTS IN 2021. COVID-19 RESTRICTIONS CANCELLED MANY HOPE RX PROGRAMS DUE TO LIMITATIONS ON IN-PERSON GATHERINGS. ADVENTHEALTH HENDERSONVILLE PROVIDED ITS ANNUAL COMMITMENT OF $15,000 THROUGH A COMBINATION OF CASH DONATIONS ($10,000) AND IN-KIND SUPPORT (CREATIVE, PRODUCTION AND EDITING EXCEEDING $5,000) FOR THE CREATION OF A DOCUMENTARY VIDEO ON THE DANGERS OF SUBSTANCE MISUSE FOR YOUTH. GOAL 3: DEVELOP COMMUNITY-BASED SUBSTANCE ABUSE TREATMENT OPTIONS AND SUPPORT PROGRAMS OBJECTIVE 1: THE FIRST OBJECTIVE IS FOR BLUE RIDGE HEALTH TO INCREASE PARTICIPATION IN MEDICATION ASSISTED THERAPY (MAT) PROGRAMS BY AT LEAST 10% IN WESTERN NORTH CAROLINA FROM A BASELINE OF APPROXIMATELY 200 PATIENTS BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY BLUE RIDGE HEALTH WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. BLUE RIDGE HEALTH SURPASSED ITS SET METRIC OF SERVING 215 PATIENTS THROUGH ITS MEDICATION ASSISTED THERAPY (MAT) IN 2021. BLUE RIDGE HEALTH SERVED 827 PATIENTS THROUGH ITS MEDICATION ASSISTED THERAPY (MAT) IN 2021. COVID-19 RESTRICTIONS PREVENTED BLUE RIDGE HEALTH FROM HOSTING TRADITIONAL FUNDRAISING EVENTS AND ADVENTHEALTH HENDERSONVILLE DID NOT PROVIDE ITS ANNUAL $10,000 DONATION TO THE ORGANIZATION IN 2021. OBJECTIVE 2: THE SECOND OBJECTIVE IS FOR FIRST CONTACT ADDICTION MINISTRIES TO EXPAND ITS SUBSTANCE ABUSE TREATMENT AND FAMILY SUPPORT PROGRAMS BY AT LEAST 10% FROM A BASELINE OF 1,100 CLIENT INTAKES BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY FIRST CONTACT ADDICTION MINISTRIES WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. FIRST CONTACT ADDICTION MINISTRIES SURPASSED ITS SET METRIC OF SERVING 1,174 CLIENTS IN 2021. FIRST CONTACT ADDICTION MINISTRIES SERVED 3,336 CLIENTS IN 2021. ADVENTHEALTH HENDERSONVILLE PROVIDED AN ADJUSTED ANNUAL DONATION OF $10,000 IN 2021 DUE TO THE IMPACTS OF COVID-19. OBJECTIVE 3:THE THIRD OBJECTIVE IS FOR WNC RESCUE MINISTRIES TO INCREASE THE NUMBER OF GRADUATES OF ITS ABBA'S HOUSE RESIDENTIAL PROGRAM FOR NEW MOTHERS STRUGGLING WITH DRUG ADDICTION BY AT LEAST 20% FROM A BASELINE OF 11 BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY WESTERN CAROLINA RESCUE MINISTRIES WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. COVID-19 RESTRICTIONS AND IMPACTS PREVENTED WNC RESCUE MINISTRIES FROM PROGRESSING ON ITS SET METRIC OF SERVING 13 PROGRAM GRADUATES IN 2021. WNC RESCUE MINISTRIES SERVED 7 PROGRAM GRADUATES IN 2021. ADVENTHEALTH HENDERSONVILLE PROVIDED ITS ANNUAL $10,000 DONATION TO THE ORGANIZATION IN 2021.

SCHEDULE H, PART V, SECTION B, LINE 11, CONTINUED:
"OBJECTIVE 4:THE FOURTH OBJECTIVE IS FOR THE FREE CLINICS AND HENDERSON COUNTY TO PARTNER WITH AREA HOSPITALS TO DEVELOP A POST OVERDOSE RESPONSE TEAM (PORT) TO FOLLOW UP WITH PATIENTS 24 HOURS AFTER AN OVERDOSE AND CONNECT THEM WITH COMMUNITY RESOURCES AND RECOVERY PROGRAMS BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY THE FREE CLINICS AND HENDERSON COUNTY WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. THE FREE CLINICS AND HENDERSON COUNTY MET ITS SET METRIC OF DEVELOPING A POST OVERDOSE RESPONSE TEAM (PORT) IN 2021. ADVENTHEALTH HENDERSONVILLE PROVIDED ITS ANNUAL $10,000 DONATION TO THE ORGANIZATION IN 2021. PRIORITY 3: PHYSICAL ACTIVITY AND NUTRITION 2019 DESCRIPTION OF THE ISSUE:OBESITY WAS A TOP HEALTH PRIORITY IN ADVENTHEALTH HENDERSONVILLE'S PAST CHNAS. BEING OVERWEIGHT OR OBESE IS A MAJOR RISK FACTOR FOR MANY CHRONIC DISEASES INCLUDING HEART DISEASE, TYPE 2 DIABETES, HYPERTENSION AND CANCER. THE HENDERSON COUNTY PARTNERSHIP FOR HEALTH CHANGED THE PRIORITY TO PHYSICAL ACTIVITY AND NUTRITION DURING THE LAST CHNA TO AVOID THE STIGMA ASSOCIATED WITH THE TERM ""OBESITY AND ITS NEGATIVE CONNOTATIONS. OBESITY RATES ARE IMPORTANT, BUT NOT THE WHOLE STORY. THE COMMUNITY EMPHASIZED THAT PEOPLE CAN BE HEALTHIER AT ANY WEIGHT IF THEY MAKE EVEN MINOR LIFESTYLE CHANGES. EVIDENCE SHOWS THAT PHYSICAL ACTIVITY AND MAKING GOOD NUTRITIONAL CHOICES CAN HAVE A POSITIVE IMPACT ON OBESITY AND MANY OF THE CHRONIC DISEASES IMPACTED BY OBESITY. THE FOCUS HAS ALWAYS BEEN ON PHYSICAL ACTIVITY AND NUTRITION WHEN THE COMMUNITY WORKED TO ADDRESS ""OBESITY"" IN THE PAST.- 22.4% OF ADULTS IN HENDERSON COUNTY REPORT THEY GET THE RECOMMENDED AMOUNT OF PHYSICAL ACTIVITY.(2018 COMMUNITY HEALTH SURVEY) - 6.7% OF ADULTS REPORT THEY CONSUME FRUITS AND VEGETABLE FIVE OR MORE TIMES A DAY.(2018 COMMUNITY HEALTH SURVEY)- 68.5% (7 OUT OF 10) ADULTS REPORT THEY ARE OVERWEIGHT OR OBESE.(2018 COMMUNITY HEALTH SURVEY) - 1 OUT OF 5 ADULTS REPORT THEY HAVE RUN OUT OF FOOD OR WORRIED ABOUT RUNNING OUT OF FOOD AT LEAST ONCE IN THE PAST YEAR.(2018 COMMUNITY HEALTH SURVEY)- 1 OUT OF 3 CHILDREN ARE OVERWEIGHT OR OBESE.(NC-NPASS DATA: NORTH CAROLINA DIVISION OF PUBLIC HEALTH)2021 UPDATE: THE ADVENTHEALTH HENDERSONVILLE COMMUNITY HEALTH PLAN HAS THREE DESIRED GOAL STATEMENTS UNDER THE PHYSICAL ACTIVITY AND NUTRITION PRIORITY. 1. INCREASE PHYSICAL ACTIVITY AMONG YOUTH 2. REDUCE FOOD INSECURITY IN THE REGION 3. INCREASE ACCESS TO NUTRITIOUS FOOD FOR UNDERSERVED POPULATIONS GOAL 1: INCREASE PHYSICAL ACTIVITY AMONG YOUTH OBJECTIVE 1: THE FIRST OBJECTIVE IS TO INCREASE PARTICIPATION IN GIRLS ON THE RUN OF WESTERN NORTH CAROLINA BY AT LEAST 10% FROM A BASELINE OF 1,002 PARTICIPANTS BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY GIRLS ON THE RUN OF WESTERN NORTH CAROLINA WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. COVID IMPACTS AND RESTRICTIONS AGAIN PREVENTED GIRLS ON THE RUN OF WESTERN NORTH CAROLINA FROM MEETING ITS SET METRIC OF SERVING 1,067 PARTICIPANTS IN 2021. THE ENTIRE GIRLS ON THE RUN PROGRAM WAS PAUSED IN 2021 DUE TO THE ONGOING COVID-19 PANDEMIC AND OTHER EXTENUATING CIRCUMSTANCES. ADVENTHEALTH HENDERSONVILLE PROVIDED ITS $5,000 ANNUAL DONATION TO THE ORGANIZATION THAT WILL BE APPLIED TO FUTURE PROGRAMS. GOAL 2: REDUCE FOOD INSECURITY IN THE REGION OBJECTIVE 1: THE FIRST OBJECTIVE IS TO INCREASE THE NUMBER OF PEOPLE WHO RECEIVED MEALS FROM INTERFAITH ASSISTANCE MINISTRIES' (IAM) BY AT LEAST 10% FROM A BASELINE OF 10,709 PEOPLE BY YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY INTERFAITH ASSISTANCE MINISTRIES (IAM) WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. INTERFAITH ASSISTANCE MINISTRIES (IAM) SURPASSED ITS SET METRIC OF SERVING 11,423 PEOPLE MEALS IN 2021. INTERFAITH ASSISTANCE MINISTRIES (IAM) SERVED 43,056 PEOPLE MEALS IN 2021. ADVENTHEALTH HENDERSONVILLE PROVIDED ITS ANNUAL DONATION OF $10,000 IN 2021. OBJECTIVE 2: THE SECOND OBJECTIVE IS TO INCREASE THE NUMBER OF MEALS/FOOD BOXES DISTRIBUTED BY THE STOREHOUSE BY AT LEAST 10% FROM A BASELINE OF 8,496 BOXES BY YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY THE STOREHOUSE WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. THE STOREHOUSE MET THE EQUIVALENT OF ITS SET METRIC OF SERVING 9,064 MEALS/FOOD BOXES IN 2021. THE STOREHOUSE WAS FORCED TO ADJUST ITS PACKAGING DUE TO SUPPLY CHAIN LIMITATIONS AND SERVED 1,728 SIGNIFICANTLY LARGER FOOD BOXES THAT REPRESENTED 315,000 POUNDS OF FOOD IN 2021. ADVENTHEALTH HENDERSONVILLE PROVIDED AN ADJUSTED ANNUAL DONATION OF $4,000 DUE TO COVID-19 IMPACTS IN 2021. OBJECTIVE 3: THE THIRD OBJECTIVE IS TO INCREASE THE NUMBER OF FOOD BOXES DISTRIBUTED BY ASHEVILLE BUNCOMBE COMMUNITY CHRISTIAN MINISTRIES (ABCCM) BY AT LEAST 10% FROM A BASELINE OF 37,508 FOOD BOXES BY YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY ASHEVILLE BUNCOMBE COMMUNITY CHRISTIAN MINISTRIES (ABCCM) WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. ASHEVILLE BUNCOMBE COMMUNITY CHRISTIAN MINISTRIES (ABCCM) SURPASSED ITS SET METRIC OF PROVIDING 40,008 FOOD BOXES IN 2021. ASHEVILLE BUNCOMBE COMMUNITY CHRISTIAN MINISTRIES (ABCCM) PROVIDED 44,932 FOOD BOXES IN 2021. ADVENTHEALTH HENDERSONVILLE PROVIDED ITS ANNUAL $15,000 DONATION TO THE ORGANIZATION IN 2021. OBJECTIVE 4: THE FOURTH OBJECTIVE IS TO INCREASE THE NUMBER OF HOT MEALS SERVED BY WESTERN CAROLINA RESCUE MINISTRIES BY AT LEAST 10% FROM A BASELINE OF 82,267 MEALS BY YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY WESTERN CAROLINA RESCUE MINISTRIES WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. WESTERN CAROLINA RESCUE MINISTRIES SURPASSED ITS SET METRIC OF PROVIDING 87,752 HOT MEALS IN 2021. WESTERN CAROLINA RESCUE MINISTRIES PROVIDED 143,535 HOT MEALS IN 2021. ADVENTHEALTH HENDERSONVILLE PROVIDED ITS ANNUAL $10,000 DONATION TO THE ORGANIZATION AND PARTNERED TO HOST A THANKSGIVING MEAL EVENT IN 2021. GOAL 3: INCREASE ACCESS TO NUTRITIOUS FOOD FOR UNDERSERVED POPULATIONS OBJECTIVE 1: THE FIRST OBJECTIVE IS FOR THE HENDERSON COUNTY COMMITTEE FOR ACTIVITY AND NUTRITION (CAN) AND ITS PARTNERS, INCLUDING ADVENTHEALTH HENDERSONVILLE, TO INCREASE THE NUMBER OF FARMERS MARKETS IN HENDERSON COUNTY THAT ACCEPT THE SNAP/DEBIT/CREDIT PROGRAM TO A TOTAL OF FOUR FROM A BASELINE OF TWO MARKETS BY YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY HENDERSON COUNTY COMMITTEE FOR ACTIVITY AND NUTRITION (CAN) AND THE HENDERSON COUNTY PARTNERSHIP FOR HEALTH WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION, THE HENDERSON COUNTY COMMITTEE FOR ACTIVITY AND NUTRITION (CAN) PROGRESSED ON ITS SET METRIC BY INCREASING THE NUMBER OF FARMERS MARKETS AND LOCAL FOOD HUBS ACCEPTING THE SNAP/DEBIT/CREDIT PROGRAM TO THREE IN 2021. PRIORITY 4: SAFE AND AFFORDABLE HOUSING: 2019 DESCRIPTION OF THE ISSUE:SAFE AND AFFORDABLE HOUSING WAS A PRIORITY IN ADVENTHEALTH HENDERSONVILLE'S LAST CHNA AND CONTINUES TO BE A COMMUNITY CONCERN. CONSIDERED A SOCIAL DETERMINANT OF HEALTH, HOUSING CAN AFFECT A WIDE RANGE OF HEALTH AND QUALITY-OF-LIFE OUTCOMES. EVERYONE NEEDS A PLACE TO LIVE, REGARDLESS OF AGE, JOB, RACE, DISABILITY, INCOME OR POSITION IN LIFE. BUT NOT EVERYONE'S HOME IS AFFORDABLE. HENDERSON COUNTY RESIDENTS SPEND MORE FOR HOUSING (RENTAL AND MORTGAGES) ON AVERAGE THAN THE REST OF THE REGION. THE DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT (HUD) DEFINES ""AFFORDABLE HOUSING"" AS CONSUMING NO MORE THAN 30% OF A HOUSEHOLD'S MONTHLY INCOME, INCLUDING UTILITIES. THIS IS THE MAXIMUM LEVEL A FAMILY SHOULD SPEND. GENERALLY, WHEN FAMILIES OR INDIVIDUALS SPEND MORE THAN 30% OF THEIR INCOME ON HOUSING, THEY DO NOT HAVE ENOUGH INCOME TO WITHSTAND FINANCIAL SETBACKS OR MEET OTHER BASIC NEEDS SUCH AS FOOD, CLOTHING AND MEDICAL INSURANCE.CRISIS HOUSING ADDRESSES THE IMMINENT HEALTH AND SAFETY ASPECTS OF THIS PRIORITY. THE CHNA IDENTIFIED THE NEED FOR ENSURING THAT DOMESTIC VIOLENCE AND SEXUAL ASSAULT SURVIVORS IN THE REGION HAD ACCESS TO CRISIS SHELTERS AND BASIC NEEDS."

SCHEDULE H, PART V, SECTION B, LINE 11, CONTINUED:
"THE HOMELESS POPULATION IN HENDERSON COUNTY PEAKED IN 2017. ACCORDING TO THE POINT IN TIME SURVEY, AN AVERAGE OF 19% OF THE HOMELESS POPULATION WAS DEEMED ""CHRONICALLY HOMELESS,"" WHICH MEANS THEY HAVE A DISABILITY AND HAVE BEEN HOMELESS FOR AT LEAST ONE YEAR OR HAVE HAD FOUR EPISODES OF HOMELESSNESS IN THREE YEARS.- 46.4% OF RENTERS SPEND MORE THAN 30% OF THEIR INCOME ON HOUSING AND 18.8% OF RENTERS SPEND MORE THAN HALF THEIR INCOME ON HOUSING.(US CENSUS BUREAU)- 16.4% OF MORTGAGE OWNERS SPEND MORE THAN 30% OF THEIR INCOME ON HOUSING AND 6.2% OF MORTGAGE OWNERS SPEND MORE THAN HALF THEIR INCOME ON HOUSING.(US CENSUS BUREAU)- 24% OF ALL HOUSEHOLDS IN HENDERSON COUNTY ARE COST BURDENED (SPEND MORE THAN 30% OF TOTAL INCOME ON HOUSING).(US CENSUS BUREAU)- 112 HOMELESS PERSONS WERE COUNTED IN THE ANNUAL POINT IN TIME COUNT IN 2017.(2017 HENDERSON COUNTY HOMELESS POINT IN TIME COUNT)2021 UPDATE: THE ADVENTHEALTH HENDERSONVILLE COMMUNITY HEALTH PLAN HAS THREE DESIRED GOAL STATEMENTS UNDER THE SAFE AND AFFORDABLE HOUSING PRIORITY. 1. INCREASE ACCESS TO CRISIS SHELTERS FOR SURVIVORS OF DOMESTIC VIOLENCE AND SEXUAL ASSAULT 2. INCREASE ACCESS TO EMERGENCY SHELTER FOR THE HOMELESS IN THE REGION 3. INCREASE ACCESS TO SAFE AND AFFORDABLE HOUSING IN THE REGION GOAL 1: INCREASE ACCESS TO CRISIS SHELTERS FOR SURVIVORS OF DOMESTIC VIOLENCE AND SEXUAL ASSAULT OBJECTIVE 1: THE FIRST OBJECTIVE IS TO INCREASE THE NUMBER OF DOMESTIC VIOLENCE AND SEXUAL ASSAULT SURVIVORS SERVED BY SAFELIGHT IN THE ORGANIZATION'S SHELTER BY AT LEAST 5% FROM A BASELINE OF 289 ADULTS AND CHILDREN BY YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY SAFELIGHT WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND THE OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. COVID-19 IMPACTS AND RESTRICTIONS PREVENTED SAFELIGHT FROM PROGRESSING ON ITS SET METRIC OF SERVING 299 ADULTS AND CHILDREN IN THE ORGANIZATION'S SHELTER IN 2021. SAFELIGHT SERVED 168 INDIVIDUALS IN 2021. ADVENTHEALTH HENDERSONVILLE PROVIDED ITS ANNUAL $17,000 DONATION TO THE ORGANIZATION IN 2021. OBJECTIVE 2: THE SECOND OBJECTIVE IS TO INCREASE THE NUMBER OF DOMESTIC VIOLENCE AND SEXUAL ASSAULT SURVIVORS SERVED BY HELPMATE IN THE ORGANIZATION'S SHELTER BY AT LEAST 5% FROM A BASELINE OF 202 ADULTS AND CHILDREN BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY HELPMATE WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND THE OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. HELPMATE SURPASSED ITS SET METRIC OF SERVING 209 ADULTS AND CHILDREN IN THE ORGANIZATION'S SHELTER IN 2021. HELPMATE SERVED 723 ADULTS AND CHILDREN IN ITS SHELTER IN 2021. ADVENTHEALTH HENDERSONVILLE PROVIDED ITS ANNUAL $5,000 DONATION TO THE ORGANIZATION IN 2021. GOAL 2: INCREASE ACCESS TO EMERGENCY SHELTER FOR THE HOMELESS IN THE REGION OBJECTIVE 1: THE FIRST OBJECTIVE IS TO INCREASE THE ANNUAL NUMBER OF CLIENTS SERVED BY ASHEVILLE BUNCOMBE COMMUNITY CHRISTIAN MINISTRIES (ABCCM) AT STEADFAST HOUSE BY AT LEAST 15% FROM A BASELINE OF 131 BY YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY ASHEVILLE BUNCOMBE COMMUNITY CHRISTIAN MINISTRIES (ABCCM) WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND THE OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. COVID-19 LIMITATIONS, NAMELY THE ONBOARDING PROCESS, QUARANTINE RESTRICTIONS AND TESTING, PREVENTED ASHEVILLE BUNCOMBE COMMUNITY CHRISTIAN MINISTRIES (ABCCM) FROM PROGRESSING ON ITS SET METRIC OF SERVING 145 WOMEN AND CHILDREN IN ITS STEADFAST HOUSE PROGRAM IN 2021. ASHEVILLE BUNCOMBE COMMUNITY CHRISTIAN MINISTRIES (ABCCM) SERVED 123 WOMEN AND CHILDREN IN THE PROGRAM IN 2021. ADVENTHEALTH HENDERSONVILLE PROVIDED ITS ANNUAL $15,000 DONATION TO THE ORGANIZATION IN 2021. OBJECTIVE 2: THE SECOND OBJECTIVE IS TO INCREASE THE ANNUAL NUMBER OF SAFE SHELTER BEDS THROUGH WESTERN CAROLINA RESCUE MINISTRIES BY AT LEAST 5% FROM A BASELINE OF 41,014 BY YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY WESTERN CAROLINA RESCUE MINISTRIES WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND THE OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. COVID-19 RESTRICTIONS PREVENTED WESTERN CAROLINA RESCUE MINISTRIES FROM PROGRESSING ON ITS SET METRIC OF 42,381 SAFE SHELTER BEDS IN 2021. WESTERN CAROLINA RESCUE MINISTRIES PROVIDED 24,764 SAFE SHELTER BEDS IN 2021. ADVENTHEALTH HENDERSONVILLE PROVIDED ITS ANNUAL $10,000 DONATION TO THE ORGANIZATION IN 2021. GOAL 3: INCREASE ACCESS TO SAFE AND AFFORDABLE HOUSING IN THE REGION OBJECTIVE 1: THE FIRST OBJECTIVE IS TO INCREASE THE NUMBER OF CLIENTS SERVED BY THRIVE'S HOUSING CASE MANAGEMENT PROGRAM BY AT LEAST 10% FROM A BASELINE OF APPROXIMATELY 65 BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY THRIVE WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND THE OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. THRIVE SURPASSED ITS SET METRIC OF SERVING 70 CLIENTS THROUGH ITS HOUSING CASE MANAGEMENT PROGRAM IN 2021. THRIVE SERVED 238 CLIENTS IN ITS PROGRAM IN 2021. ADVENTHEALTH HENDERSONVILLE PROVIDED ITS ANNUAL DONATION OF $7,500 TO THE ORGANIZATION IN 2021. OBJECTIVE 2: THE SECOND OBJECTIVE IS TO INCREASE THE NUMBER OF PERMANENT HOUSING PLACEMENTS THROUGH ASHEVILLE BUNCOMBE COMMUNITY CHRISTIAN MINISTRIES' (ABCCM) STEADFAST HOUSE FOR UNDERSERVED WOMEN AND CHILDREN IN BUNCOMBE COUNTY BY AT LEAST 10% FROM A BASELINE OF 70 BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY ASHEVILLE BUNCOMBE COMMUNITY CHRISTIAN MINISTRIES (ABCCM) WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND THE OUTCOMES ARE SPECIFIC TO THE ORGANIZATION. ASHEVILLE BUNCOMBE COMMUNITY CHRISTIAN MINISTRIES (ABCCM) SURPASSED ITS SET METRIC OF SERVING 75 WOMEN AND CHILDREN THROUGH PERMANENT HOUSING PLACEMENTS IN 2021. ASHEVILLE BUNCOMBE COMMUNITY CHRISTIAN MINISTRIES (ABCCM) SERVED 110 WOMEN AND CHILDREN THROUGH THE PROGRAM IN 2021. ADVENTHEALTH HENDERSONVILLE PROVIDED ITS ANNUAL DONATION OF $15,000 TO SUPPORT THE ORGANIZATION IN 2021. OBJECTIVE 3:THE THIRD OBJECTIVE IS TO CONTINUE SUPPORT FOR HENDERSON COUNTY HABITAT FOR HUMANITY AND INCREASE THE NUMBER OF HOUSES COMPLETED BY AT LEAST 10% FROM A BASELINE OF 17 HOMES BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY HENDERSON COUNTY HABITAT FOR HUMANITY WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND THE OUTCOMES ARE SPECIFIC TO THE ORGANIZATION. COVID-19 SEVERELY LIMITED THE ORGANIZATION'S OPERATIONS AND HENDERSON COUNTY HABITAT FOR HUMANITY WAS UNABLE TO PROGRESS ON ITS SET METRIC OF COMPLETING 18 HOUSES IN 2020. HENDERSON COUNTY HABITAT FOR HUMANITY COMPLETED 5 HOUSES IN 2021. ADVENTHEALTH HENDERSONVILLE DID NOT PROVIDE AN ANNUAL DONATION OF $5,000 DUE TO THE IMPACTS OF COVID-19 IN 2021. COMMUNITY NEEDS NOT CHOSEN BY ADVENTHEALTH HENDERSONVILLE:THE PRIMARY AND SECONDARY DATA IN THE COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED MULTIPLE COMMUNITY ISSUES. THE HOSPITAL AND COMMUNITY STAKEHOLDERS USED THE FOLLOWING CRITERIA TO NARROW THE LARGER LIST TO THE PRIORITY AREAS NOTED ABOVE:1. HOW ACUTE IS THE NEED? (BASED ON DATA AND COMMUNITY CONCERN)2. WHAT IS THE TREND? IS THE NEED GETTING WORSE?3. DOES THE HOSPITAL PROVIDE SERVICES THAT RELATE TO THE PRIORITY? 4. IS SOMEONE ELSE, OR MULTIPLE GROUPS IN THE COMMUNITY, ALREADY WORKING ON THIS ISSUE?5. IF THE HOSPITAL WERE TO ADDRESS THIS ISSUE, ARE THERE OPPORTUNITIES TO WORK WITH COMMUNITY PARTNERS? BASED ON THIS PRIORITIZATION PROCESS, THE HOSPITAL DID NOT CHOOSE THE FOLLOWING COMMUNITY ISSUES:1. VAPING WAS HIGHLIGHTED IN COMMUNITY SURVEYS, NAMELY THE YOUTH RISK BEHAVIOR SURVEY, AS AN ISSUE OF HIGH CONCERN. ADVENTHEALTH HENDERSONVILLE AND THE HENDERSON COUNTY PARTNERSHIP FOR HEALTH DETERMINED THAT THE ISSUE OF VAPING WAS MORE EFFECTIVELY INCLUDED AND ADDRESSED IN THE BROADER PRIORITY OF SUBSTANCE ABUSE. 2. SUICIDE, SPECIFICALLY YOUTH CONSIDERING SUICIDE, WAS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT AS AN ISSUE OF HIGH CONCERN. ADVENTHEALTH HENDERSONVILLE AND THE HENDERSON COUNTY PARTNERSHIP FOR HEALTH DETERMINED THAT THE ISSUE OF SUICIDE WAS MORE EFFECTIVELY INCLUDED AND ADDRESSED IN THE BROADER PRIORITY OF MENTAL HEALTH. 3. ADVERSE CHILDHOOD EXPERIENCES (ACES) WERE A CONSISTENT AND PREVALENT CONCERN THROUGHOUT THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. ADVENTHEALTH HENDERSONVILLE AND THE HENDERSON COUNTY PARTNERSHIP FOR HEALTH DETERMINED THAT ACES, SPECIFICALLY TRAUMA-INFORMED CARE, SHOULD BE INCLUDED AS A COMPONENT OF ALL IDENTIFIED HEALTH PRIORITIES. 4. BIRTH OUTCOMES & INFANT MORTALITY: THE INTERNAL COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE (CHNAC) FELT BIRTH OUTCOMES & INFANT MORTALITY WOULD BE ADDRESSED THROUGH THE COMBINATION OF OTHER PRIORITIES NAMELY FOCUSING ON NUTRITION, SUBSTANCE ABUSE, MENTAL HEALTH, AND SOCIAL DETERMINANTS OF HEALTH, SUCH AS SAFE AND AFFORDABLE HOUSING. MANY OF THE CONTRIBUTING FACTORS THAT IMPACT THESE HEALTH PRIORITIES ALSO CONTRIBUTE TO BIRTH OUTCOMES & INFANT MORTALITY."

SCHEDULE H, PART V, LINE 16A, B, AND C:
LINE 16A, FAP WEBSITE:HTTPS://WWW.ADVENTHEALTH.COM/HOSPITAL/ADVENTHEALTH-HENDERSONVILLE/LEGAL/FINANCIAL-ASSISTANCELINE 16B, FAP APPLICATION WEBSITE:HTTPS://WWW.ADVENTHEALTH.COM/HOSPITAL/ADVENTHEALTH-HENDERSONVILLE/LEGAL/FINANCIAL-ASSISTANCELINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE:HTTPS://WWW.ADVENTHEALTH.COM/HOSPITAL/ADVENTHEALTH-HENDERSONVILLE/LEGAL/FINANCIAL-ASSISTANCE

PART I, LINE 6A:
"THE FILING ORGANIZATION WAS A WHOLLY OWNED SUBSIDIARY OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC) DURING ITS CURRENT TAX YEAR. DURING THE CURRENT YEAR, AHSSHC SERVED AS A PARENT ORGANIZATION TO 30 TAX-EXEMPT 501(C)(3) HOSPITAL ORGANIZATIONS AND A NUMBER OF OTHER HEALTH CARE FACILITIES THAT OPERATED IN 10 STATES WITHIN THE U.S. THE SYSTEM OF ORGANIZATIONS UNDER THE CONTROL AND OWNERSHIP OF AHSSHC IS KNOWN AS ""ADVENTHEALTH"". ALL HOSPITAL ORGANIZATIONS WITHIN ADVENTHEALTH COLLECT, CALCULATE, AND REPORT THE COMMUNITY BENEFITS THEY PROVIDE TO THE COMMUNITIES THEY SERVE. ADVENTHEALTH ORGANIZATIONS EXIST SOLELY TO IMPROVE AND ENHANCE THE LOCAL COMMUNITIES THEY SERVE. ADVENTHEALTH HAS A SYSTEM-WIDE COMMUNITY BENEFITS ACCOUNTING POLICY THAT PROVIDES GUIDELINES FOR ITS HEALTH CARE PROVIDER ORGANIZATIONS TO CAPTURE AND REPORT THE COSTS OF SERVICES PROVIDED TO THE UNDERPRIVILEGED AND TO THE BROADER COMMUNITY. EACH ADVENTHEALTH HOSPITAL FACILITY REPORTS THEIR COMMUNITY BENEFITS TO THEIR BOARD OF DIRECTORS AND STRIVES TO COMMUNICATE THEIR COMMUNITY BENEFITS TO THEIR LOCAL COMMUNITIES. ADDITIONALLY, THE FILING ORGANIZATION'S MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT AND ASSOCIATED IMPLEMENTATION STRATEGY CAN BE ACCESSED ON THE FILING ORGANIZATION'S WEBSITE. THE FILING ORGANIZATION PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT ON A SEPARATE ENTITY BASIS FOR THE HOSPITAL(S) THAT IT OWNS AND OPERATES. THE SEPARATE ANNUAL COMMUNITY BENEFIT REPORT IS GENERALLY UTILIZED FOR STATE COMMUNITY BENEFIT REPORTING AND/OR FOR OTHER LOCAL COMMUNITY PURPOSES."

PART I, LINE 7:
THE AMOUNTS OF COSTS REPORTED IN THE TABLE IN LINE 7 OF PART I OF SCHEDULE H WERE DETERMINED BY UTILIZING A COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES, CONTAINED IN THE SCHEDULE H INSTRUCTIONS.

PART I, LINE 7G:
THE FILING ORGANIZATION REPORTED ON PART I, LINE 7G, COLUMN (E) COSTS ATTRIBUTABLE TO WOUND CARE. THE COSTS REPORTED AS COMMUNITY BENEFIT EXPENSE ASSOCIATED WITH WOUND CARE WERE $1,243,097.

PART II, COMMUNITY BUILDING ACTIVITIES:
ADVENTHEALTH HENDERSONVILLE (THE HOSPITAL) IS INVOLVED WITH AND SUPPORTIVE OF VARIOUS OTHER COMMUNITY AGENCIES IN ITS SERVICE AREA THAT WORK COLLABORATIVELY TO HELP THOSE IN NEED AND TO IMPROVE THE HEALTH AND SAFETY OF THE RESIDENTS OF THE COMMUNITY.

PART III, LINE 2:
THE AMOUNT OF BAD DEBT EXPENSE REPORTED ON LINE 2 OF SECTION A OF PART III IS RECORDED IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS ADJUSTMENTS TO REVENUE, NOT BAD DEBT EXPENSE.

PART III, LINE 4:
FINANCIAL STATEMENT FOOTNOTE RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS:THE FINANCIAL INFORMATION OF THE FILING ORGANIZATION IS INCLUDED IN A CONSOLIDATED AUDITED FINANCIAL STATEMENT FOR THE CURRENT YEAR.THE APPLICABLE FOOTNOTE FROM THE ATTACHED CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ADDRESSES ACCOUNTS RECEIVABLE, THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS, AND THE PROVISION FOR BAD DEBTS CAN BE FOUND ON PAGES 8 AND 9. PLEASE NOTE THAT DOLLAR AMOUNTS ON THE ATTACHED CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE IN THOUSANDS.

PART III, LINE 8:
COSTING METHODOLOGY: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST-TO-CHARGE RATIO.RATIONALE FOR INCLUDING A MEDICARE SHORTFALL AS COMMUNITY BENEFIT:AS A 501(C)(3) ORGANIZATION, THE FILING ORGANIZATION PROVIDES EMERGENCY AND NON-ELECTIVE CARE TO ALL REGARDLESS OF ABILITY TO PAY. ALL HOSPITAL SERVICES ARE PROVIDED IN A NON-DISCRIMINATORY MANNER TO PATIENTS WHO ARE COVERED BENEFICIARIES UNDER THE MEDICARE PROGRAM. AS A PUBLIC INSURANCE PROGRAM, MEDICARE PROVIDES A PRE-ESTABLISHED REIMBURSEMENT RATE/AMOUNT TO HEALTH CARE PROVIDERS FOR THE SERVICES THEY PROVIDE TO PATIENTS. IN SOME CASES, THE REIMBURSEMENT AMOUNT PROVIDED TO A HOSPITAL MAY EXCEED ITS COSTS OF PROVIDING A PARTICULAR SERVICE OR SERVICES TO A PATIENT. IN OTHER CASES, THE MEDICARE REIMBURSEMENT AMOUNT MAY RESULT IN THE HOSPITAL EXPERIENCING A SHORTFALL OF REIMBURSEMENT RECEIVED OVER COSTS INCURRED. IN THOSE CASES WHERE AN OVERALL SHORTFALL IS GENERATED FOR PROVIDING SERVICES TO ALL MEDICARE PATIENTS, THE SHORTFALL AMOUNT SHOULD BE CONSIDERED AS A BENEFIT TO THE COMMUNITY. TAX-EXEMPT HOSPITALS ARE REQUIRED TO ACCEPT ALL MEDICARE PATIENTS REGARDLESS OF THE PROFITABILITY, OR LACK THEREOF, WITH RESPECT TO THE SERVICES THEY PROVIDE TO MEDICARE PATIENTS. THE POPULATION OF INDIVIDUALS COVERED UNDER THE MEDICARE PROGRAM IS SUFFICIENTLY LARGE SO THAT THE PROVISION OF SERVICES TO THE POPULATION IS A BENEFIT TO THE COMMUNITY AND RELIEVES THE BURDENS OF GOVERNMENT. IN THOSE SITUATIONS WHERE THE PROVISION OF SERVICES TO THE TOTAL MEDICARE PATIENT POPULATION OF A TAX-EXEMPT HOSPITAL DURING ANY YEAR RESULTS IN A SHORTFALL OF REIMBURSEMENT RECEIVED OVER THE COST OF PROVIDING CARE, THE TAX-EXEMPT HOSPITAL HAS PROVIDED A BENEFIT TO A CLASS OF PERSONS BROAD ENOUGH TO BE CONSIDERED A BENEFIT TO THE COMMUNITY. DESPITE A FINANCIAL SHORTFALL, A TAX-EXEMPT HOSPITAL MUST AND WILL CONTINUE TO ACCEPT AND CARE FOR MEDICARE PATIENTS. TYPICALLY, TAX-EXEMPT HOSPITALS PROVIDE HEALTH CARE SERVICES BASED UPON AN ASSESSMENT OF THE HEALTH CARE NEEDS OF THEIR COMMUNITY AS OPPOSED TO THEIR TAXABLE COUNTERPARTS WHERE PROFITABILITY OFTEN DRIVES DECISIONS ABOUT PATIENT CARE SERVICES THAT ARE OFFERED. PATIENT CARE PROVIDED BY TAX-EXEMPT HOSPITALS THAT RESULTS IN MEDICARE SHORTFALLS SHOULD BE CONSIDERED AS PROVIDING A BENEFIT TO THE COMMUNITY AND RELIEVING THE BURDENS OF GOVERNMENT.

PART VI, LINE 7:
THE FILING ORGANIZATION DOES NOT FILE AN ANNUAL COMMUNITY BENEFIT REPORT WITH ANY STATE AGENCIES.

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 9B:
THE HOSPITAL FILING ORGANIZATION'S COLLECTION PRACTICES ARE IN CONFORMITY WITH THE REQUIREMENTS SET FORTH IN THE 2014 FINAL REGULATIONS REGARDING THE REQUIREMENTS OF INTERNAL REVENUE CODE SECTION 501(R)(4) - (R)(6). NO EXTRAORDINARY COLLECTION ACTIONS (ECA'S) ARE INITIATED BY THE HOSPITAL FILING ORGANIZATION IN THE 120-DAY PERIOD FOLLOWING THE DATE AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS SENT TO THE INDIVIDUAL (OR, IF LATER, THE SPECIFIED DEADLINE GIVEN IN A WRITTEN NOTICE OF ACTIONS THAT MAY BE TAKEN, AS DESCRIBED BELOW). INDIVIDUALS ARE PROVIDED WITH AT LEAST ONE WRITTEN NOTICE (NOTICE OF ACTIONS THAT MAY BE TAKEN) AND A COPY OF THE FILING ORGANIZATION'S PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY THAT INFORMS THE INDIVIDUAL THAT THE HOSPITAL FILING ORGANIZATION MAY TAKE ACTIONS TO REPORT ADVERSE INFORMATION TO CREDIT REPORTING AGENCIES/BUREAUS IF THE INDIVIDUAL DOES NOT SUBMIT A FINANCIAL ASSISTANCE APPLICATION FORM (FAA FORM) OR PAY THE AMOUNT DUE BY A SPECIFIED DEADLINE. THE SPECIFIED DEADLINE IS NOT EARLIER THAN 120 DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS SENT TO THE INDIVIDUAL AND IS AT LEAST 30 DAYS AFTER THE NOTICE IS PROVIDED. A REASONABLE ATTEMPT IS ALSO MADE TO ORALLY NOTIFY AN INDIVIDUAL ABOUT THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY AND HOW THE INDIVIDUAL MAY OBTAIN ASSISTANCE WITH THE FINANCIAL ASSISTANCE APPLICATION PROCESS. IF AN INDIVIDUAL SUBMITS AN INCOMPLETE FAA FORM DURING THE 240-DAY PERIOD FOLLOWING THE DATE ON WHICH THE FIRST POST-DISCHARGE BILLING STATEMENT WAS SENT TO THE INDIVIDUAL, THE HOSPITAL FILING ORGANIZATION SUSPENDS ANY REPORTING TO CONSUMER CREDIT REPORTING AGENCIES/BUREAUS (OR CEASES ANY OTHER ECA'S) AND PROVIDES A WRITTEN NOTICE TO THE INDIVIDUAL DESCRIBING WHAT ADDITIONAL INFORMATION OR DOCUMENTATION IS NEEDED TO COMPLETE THE FAA FORM. THIS WRITTEN NOTICE CONTAINS CONTACT INFORMATION INCLUDING THE TELEPHONE NUMBER AND PHYSICAL LOCATION OF THE HOSPITAL FACILITY'S OFFICE OR DEPARTMENT THAT CAN PROVIDE INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY, AS WELL AS CONTACT INFORMATION OF THE HOSPITAL FACILITY'S OFFICE OR DEPARTMENT THAT CAN PROVIDE ASSISTANCE WITH THE FINANCIAL ASSISTANCE APPLICATION PROCESS OR, ALTERNATIVELY, A NONPROFIT ORGANIZATION OR GOVERNMENTAL AGENCY THAT CAN PROVIDE ASSISTANCE WITH THE FINANCIAL ASSISTANCE APPLICATION PROCESS IF THE HOSPITAL FACILITY IS UNABLE TO DO SO. IF AN INDIVIDUAL SUBMITS A COMPLETE FAA FORM WITHIN A REASONABLE TIME-PERIOD AS SET FORTH IN THE NOTICE DESCRIBED ABOVE, THE HOSPITAL FILING ORGANIZATION WILL SUSPEND ANY ADVERSE REPORTING TO CONSUMER CREDIT REPORTING AGENCIES/BUREAUS UNTIL A FINANCIAL ASSISTANCE POLICY ELIGIBILITY DETERMINATION CAN BE MADE.

SUPPLEMENTAL SCHEDULE TO SCHEDULE H, PART III, SECTION B, LINE 8
RECONCILIATION OF SCHEDULE H REPORTED MEDICARE SURPLUS/(SHORTFALL) TO UNREIMBURSED MEDICARE COSTS ASSOCIATED WITH THE PROVISION OF SERVICESTO ALL MEDICARE BENEFICIARIES:THE MEDICARE REVENUE AND ALLOWABLE COSTS OF CARE REPORTED IN SECTION B OF PART III OF SCHEDULE H ARE BASED UPON THE AMOUNTS REPORTED IN THE FILING ORGANIZATION'S MEDICARE COST REPORT IN ACCORDANCE WITH THE IRS INSTRUCTIONS FOR SCHEDULE H. ON AN ANNUAL BASIS, THE FILING ORGANIZATION ALSO DETERMINES ITS TOTAL UNREIMBURSED COSTS ASSOCIATED WITH PROVIDING SERVICES TO ALL MEDICARE PATIENTS. UNREIMBURSED COSTS ARE CONSIDERED A COMMUNITY BENEFIT TO THE ELDERLY AND ARE COMBINED INTO AN ANNUAL COMMUNITY BENEFIT STATEMENT PREPARED BY ADVENTHEALTH.THE PRIMARY RECONCILING ITEMS BETWEEN THE MEDICARE SURPLUS/(SHORTFALL) SHOWN ON LINE 7 OF SECTION B OF PART III OF SCHEDULE H AND THE FILING ORGANIZATION'S UNREIMBURSED COSTS OF SERVICES PROVIDED TO MEDICARE PATIENTS AS REPORTED IN THE AHS COMMUNITY BENEFIT REPORT ARE AS FOLLOWS:- MEDICARE SURPLUS/(SHORTFALL) SHOWN ON LINE 7 OF SECTION B OF SCHEDULE H: $ (3,027,702)- DIFFERENCE IN COSTING METHODOLOGY: (7,442,566)- UNREIMBURSED COSTS INCURRED FOR SERVICES PROVIDED TO MEDICARE PATIENTS THAT ARE NOT INCLUDED IN THE ORGANIZATION'S MEDICARE COST REPORT: (18,436,058) -------------TOTAL UNREIMBURSED COSTS OF SERVING ALL MEDICARE PATIENTS PER THE FILING ORGANIZATION'S COMMUNITY BENEFIT REPORTING: $(28,906,326) AS INDICATED ABOVE, THE PRIMARY DIFFERENCES BETWEEN THE MEDICARE SURPLUS/(SHORTFALL) REPORTED ON SCHEDULE H, PART III, SECTION B, LINE 7 AND THE FILING ORGANIZATION'S PORTION OF THE COMPANY'S ANNUAL COMMUNITY BENEFIT STATEMENT IS DUE TO A DIFFERENCE IN THE COSTING METHODOLOGY AND DIFFERENCES IN THE POPULATION OF MEDICARE PATIENTS WITHIN THE CALCULATION. THE COST METHODOLOGY UTILIZED IN CALCULATING ANY MEDICARE SURPLUS/(SHORTFALL) FOR PURPOSES OF THE ANNUAL COMMUNITY BENEFIT REPORTING IS BASED UPON THE COST-TO-CHARGE RATIO OUTLINED IN WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. THE SAME COST-TO-CHARGE RATIO IS USED TO DETERMINE THE COSTS ASSOCIATED WITH SERVICES PROVIDED TO CHARITY CARE PATIENTS AND MEDICAID PATIENTS AS REPORTED IN SCHEDULE H, PART I, LINE 7. IN ADDITION, THE MEDICARE COST REPORT EXCLUDES SERVICES PROVIDED TO MEDICARE PATIENTS FOR PHYSICIAN SERVICES, SERVICES PROVIDED TO PATIENTS ENROLLED IN MEDICARE HMOS, AND CERTAIN SERVICES PROVIDED BY OUTPATIENT DEPARTMENTS OF THE FILING ORGANIZATION THAT ARE REIMBURSED ON A FEE SCHEDULE. THE COMPANY'S OWN COMMUNITY BENEFIT STATEMENT CAPTURES THE UNREIMBURSED COST OF PROVIDING SERVICES TO ALL MEDICARE BENEFICIARIES THROUGHOUT THE ORGANIZATION.

PART VI, LINE 2:
THE HOSPITAL CONDUCTS COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) EVERY THREE YEARS. ITS 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 IS LOCATED IN FLETCHER, NORTH CAROLINA SITUATED BETWEEN ASHEVILLE AND HENDERSONVILLE, NORTH CAROLINA. IT CURRENTLY OPERATES ADVENTHEALTH HENDERSONVILLE. ADVENTHEALTH HENDERSONVILLE IS A 103-BED, STATE OF THE ART HOSPITAL THAT INCLUDES CARDIAC CARE AND REHABILITATION, EMERGENCY SERVICES, NATIONALLY AWARDED CANCER CARE, STATE-OF-THE-ART SURGICAL CARE, FULL-SERVICE ORTHOPEDIC CARE, AN AWARD-WINNING LABOR AND DELIVERY EXPERIENCE, AND A FULL RANGE OF IMAGING SERVICES TO HELP PEOPLE ACROSS OUR REGION EXPERIENCE WHOLE HEALTH.ADVENTHEALTH HENDERSONVILLE (THE HOSPITAL) IS A CRUCIAL COMMUNITY AND REGIONAL ASSET. HENDERSON COUNTY HAS A LARGE ELDERLY POPULATION DUE TO A FAVORABLE CLIMATE AND LOCATION FOR RETIREES.DURING 2021, 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 2021, ABOUT 68.5% OF THE HOSPITAL'S IN-PATIENTS WERE ADMITTED THROUGH THE HOSPITAL'S EMERGENCY DEPARTMENT. - MEDICARE PATIENTS 55.4% - MEDICAID PATIENTS 8.2% - SELF-PAY PATIENTS 2.9% THE DEMOGRAPHIC MAKEUP OF THE HENDERSON COUNTY IS AS FOLLOWS: - POPULATION 116,748 - POPULATION OVER 65 24.7% - UNEMPLOYMENT RATE 3.8% - VIOLENT CRIME RATE (PER 100,000 POP.) 151.1 - UNINSURED 22.4%ADVENTHEALTH HENDERSONVILLE DEFINES ITS COMMUNITY AS ITS PRIMARY SERVICE AREA (PSA) FROM WHICH 75-80% OF ITS PATIENTS COME. THIS INCLUDES ALL OF HENDERSON COUNTY AND PORTIONS OF BUNCOMBE COUNTY - NAMELY ARDEN, BLACK MOUNTAIN, FAIRVIEW, FLETCHER, SKYLAND, AND SWANNANOA.

PART VI, LINE 5:
"THE PROVISION OF COMMUNITY BENEFIT IS CENTRAL TO ADVENTHEALTH HENDERSONVILLE'S MISSION OF SERVICE AND COMPASSION. RESTORING AND PROMOTING THE HEALTH AND QUALITY OF LIFE OF THOSE IN THE COMMUNITIES SERVED BY THE HOSPITAL IS A FUNCTION OF ""EXTENDING THE HEALING MINISTRY OF CHRIST AND EMBODIES THE HOSPITAL'S COMMITMENT TO ITS VALUES AND PRINCIPLES. THE HOSPITAL COMMITS SUBSTANTIAL RESOURCES TO PROVIDE A BROAD RANGE OF SERVICES TO BOTH THE UNDERPRIVILEGED AS WELL AS THE BROADER COMMUNITY. IN ADDITION TO THE COMMUNITY BENEFIT AND COMMUNITY BUILDING INFORMATION PROVIDED IN PARTS I, II AND III OF THIS SCHEDULE H, THE HOSPITAL CAPTURES AND REPORTS THE BENEFITS PROVIDED TO ITS COMMUNITY THROUGH FAITH-BASED CARE. EXAMPLES OF SUCH BENEFITS INCLUDE THE COST ASSOCIATED WITH CHAPLAINCY CARE PROGRAMS AND MISSION PEER REVIEWS AND MISSION CONFERENCES. DURING THE CURRENT YEAR, THE HOSPITAL PROVIDED $101,991 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 $6,806,412 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 48 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 WEB-SITE OF ADVENTHEALTH AT WWW.ADVENTHEALTH.COM TO LEARN MORE ABOUT THE MISSION AND OPERATIONS OF ADVENTHEALTH.