4A (Expenses $ 135243169 including grants of $ 553412) (Revenue $ 137902758)
Operation of acute care hospital totaling 168 beds with 5,591 patient admissions resulting in 35,107 patient days in the current year and 49,555 outpatient visits and 16,508 physician clinic patient visits.

AdventHealth North Pinellas
Part V, Section B, Line 5: Tarpon Springs Hospital Foundation, Inc., d/b/a AdventHealth North Pinellas (AHNP or the Hospital), operates a 168-bed hospital and a free-standing ER location in Pinellas County in Florida. AHNP primarily serves the residents in the northern part of Pinellas County and western Pasco County. CHNA data indicated that the population in the Hospital's service area is primarily Caucasian (approximately 90% of the population) and over 27% of the community's permanent residents are over the age of 65. To provide broad community input with respect to the conduct of its 2019 Community Health Needs Assessment, the Hospital formed a Community Health Needs Assessment Committee (CHNAC). The CHNAC included representatives from the Hospital, representatives from the Pinellas County Health Department, and community participants that represented low-income, minority, and underserved populations. The following is a listing of the community/governmental organizations that were represented on the Hospital's CHNAC:Shepherd Center in Tarpon Springs - a community service agency that provides programs and services to the local homeless and other underserved community members;Citizens Alliance for Progress;Pinellas Safe Harbor - an emergency homeless shelter and a jail-diversion program;St. Vincent de Paul Society - an organization providing volunteer services and a food bank;Community volunteer/activist; Pinellas County Health Department;Mt. Herman Missionary Baptist Church; St. Timothy's Lutheran Church;Methodist Church;Tarpon Springs Police Department; Gulfcoast North Area Health Education Center; Gracepoint - an organization providing mental health services;Salvation Army of Tarpon Springs; and Metropolitan Ministries.The Hospital also worked closely with the Florida Department of Health in Pinellas County to gather community input through a community-wide health survey, stakeholder interviews/surveys, and community focus groups. Community surveys were conducted in collaboration with the Pinellas County Department of Health. A total of 6,494 Pinellas County residents participated in the community survey.

AdventHealth North Pinellas
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 North Pinellas
"Part V, Section B, Line 11: Tarpon Springs Hospital Foundation, Inc. d/b/a AdventHealth North Pinellas will be referred to in this document as AdventHealth North Pinellas 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 North Pinellas is part of the West Florida Division of AdventHealth (the Division). The Division includes 11 hospital facilities. This is the second-year update for AdventHealth North Pinellas'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 North Pinellas 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 North Pinellas chose five priorities for its 2020-2022 Community Health Plan: 1. Obesity2. High Blood Pressure/High Cholesterol/Heart Disease 3. Suicide/Depression (Medicare Population) 4. Tobacco Use 5. Alcohol ConsumptionPriority 1: Obesity2019 Description of the Issue:Obesity occurs when an individual's weight is higher than what is considered healthy. Obesity can be caused by behavioral and genetic factors. Other factors that contribute to obesity is the built environment, for example where you live and if you have access to healthy food and the ability to exercise outside. Obesity can cause serious health complications including high blood pressure, high cholesterol, heart disease, osteoarthritis and some cancers. From 2015-2016, obesity affected about 93 million adults and 13 million children in the U.S. In the AdventHealth North Pinellas primary service area (PSA), 27.2% of adults are obese (BMI greater than 30) which is higher than the state average of 26.6%. Additionally, 36% of adults in the PSA are considered overweight (BMI between 25 and 30). The AdventHealth North Pinellas Community Health Plan has two desired goal statements under the Obesity priority. 1. Implement strategies that support existing community initiatives aimed to address the problem of obesity in the Hospital's Primary Service Area (PSA)2. Increase access to nutrition education by supporting community organizations and other community stakeholders offering health education and resourcesGoal 1: Implement strategies that support existing community initiatives aimed to address the problem of obesity in the Hospital's Primary Service Area (PSA) Objective 1: The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase new partnerships with local community organizations in the Food is Health program to six partners from a baseline of three partners by the end of year three. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital. The Food is Health program is an AdventHealth West Florida Division program which increases access to health education and healthy foods to improve the overall health of the communities the Hospital serves. Through collaboration with community partners the program connects with low-income/low access communities and provides free health education, health screenings and produce vouchers which are used to purchase fresh fruits and vegetables. In year one, we recruited The Hispanic Outreach Center, which provides support to families utilizing a multicultural approach through advocacy and education in Pinellas County. The focus of their mission is to protect vulnerable children and strengthen families by enhancing parenting skills and the financial stability of families. This is done through counseling, parent education and access to resources. Additionally, we have recruited The Shepherd Center, Cops N Kids and Macedonia Church, who all work to serve the underserved and minority communities in Pinellas County. These new partnerships allowed us to lay the foundation for Food is Health in Pinellas County. 2021 Update:The Hospital met its set metric of recruiting six community partners in year two. In addition to the four partners recruited in year one, the Hospital also recruited the UF/IFAS Extension of Pinellas as an educational partner and Renardo Family Produce as a produce vendor for Food is Health. The UF/IFAS Extension offers staff who provide nutrition education in the community, as well as support with gardening and growing food. This team is well-established in the community and a great connector for the program. Renardo Family Produce is a local small business that provides fresh produce and goods at a family-run produce stand. Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase participation in the Food is Health program among low-income families in the Hospital's PSA by 50 participants from a baseline of seven by the end of year three. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital. 2021 Update:The Hospital progressed on its set metric of increasing participants from a baseline of seven to 50 by engaging 14 new participants in the Food is Health program in year two (for a total of 30 toward the objective). Due to COVID-19, we modified several components of the Food is Health program to offer it virtually. We switched from paper to electronic produce vouchers, created a process to allow drive-thru produce pick-up and consulted with our educational partners to convert classes to a virtual format.Objective 3:The third objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is, through the Food is Health program to increase access to health screenings among adults living in food deserts or low-income/low access communities by 75 screenings from a baseline of 15 screenings by the end of year three. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital. 2021 Update:The Hospital progressed on its set metric of increasing health screenings among adults living in low-income/low access communities by 75 screenings. No health screenings were provided in year two. Due to COVID-19, the objective was delayed. AdventHealth's community outreach nursing team was deployed to support COVID-19 response including testing and vaccination.See Continuation 2"

AdventHealth North Pinellas
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.

Continuation of Part V, Section B, Line 11 - continuation 2
Goal 2: Increase access to nutrition education by supporting community organizations and other community stakeholders offering health education and resources Objective 1: The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to provide the Food is Health program to low-income families in the PSA by offering five class series from a baseline of one class by the end of year three. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital. 2021 Update:The Hospital progressed on its set metric of holding five class series by holding one class series in year two. The class was held virtually with the Hispanic Outreach Center and engaged 14 participants. Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase access to culturally appropriate nutritious food options among Food is Health program participants through 200 produce vouchers distributed from a baseline of 51 produce vouchers by the end of year three. This objective is managed at the Divisional level, however all funding and outcomes reported are specific to the reporting Hospital. 2021 Update:The Hospital progressed on its set metric by distributing 48 produce vouchers in year two (for a total of 71 toward the objective), with 15 vouchers redeemed. Each participant in the Food is Health program received one voucher worth $10, for each class attended. The vouchers are redeemable at our local partnering produce vendor, where participants can then receive fresh produce such as fruits and vegetables. The total value for the vouchers redeemed was $150.Objective 3: The third objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective, the Food is Health community employee volunteer initiative, will increase Hospital staff/team volunteer participation efforts with organizations addressing food security from a baseline of zero hours to 500 hours by the end of year three. The objective is managed at the Divisional level, however all funding and outcomes reported are specific to the reporting Hospital. The Hospital provides a paid volunteerism program through which AdventHealth employees are paid at their normal rate to volunteer at community organizations which are addressing this priority area. 2021 Update:The Hospital progressed on its set metric by conducting 14 volunteer hours in the year of 2021. Due to the COVID -19 public health emergency and social distancing precautions, there were limited opportunities for in-person volunteering in year two. The Hospital will continue to identify new opportunities in the coming years to meet the stated objective. The volunteer hours were completed by Hospital leadership serving on boards for organizations who address food insecurity, including Feeding Tampa Bay and the Salvation Army. Priority 2: High Blood Pressure/High Cholesterol/Heart Disease 2019 Description of the Issue:Heart disease is the leading cause of death in the U.S. The major risk factors for heart disease are high blood pressure, high cholesterol, being overweight/obese and having an unhealthy diet. One in four deaths in the U.S. are due to heart disease. By managing blood pressure and cholesterol, eating a healthy diet and incorporating physical activity daily, the risk of developing heart disease could be greatly reduced. In the AdventHealth North Pinellas primary service area (PSA), the rate of death due to heart disease per 100,000 population is 152, which is higher than the state rate of 150. The percentage of adults in the PSA with high blood pressure is 29% and 46% of adults have high cholesterol.The AdventHealth North Pinellas Community Health Plan has two desired goal statements under the High Blood Pressure/High Cholesterol/Heart Disease priority. 1. Improve access to health education, early intervention programs and resources related to prevention of heart disease2. Enhance community to clinical linkages between community organizations and stakeholders to promote coordinated patient care strategies to control high blood pressure and high cholesterolGoal 1: Improve access to health education, early intervention programs and resources related to prevention of heart disease Objective 1: The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. Their objective is to increase the number of Hospital sponsored American Heart Association (AHA) community Cardiopulmonary Resuscitation (CPR) out-of-Hospital bystander classes, also referred to as two-step Hands-Only CPR, for adults and youth from a baseline of zero to five by the end of year three. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital. This initiative provides training to lay community members to be able to save the lives of individuals experiencing a cardiac event by administering the two-step Hands-Only CPR. The Hospital progressed on its set metric of five classes sponsored by December 31st, 2022. In year one the Division team met with our local American Heart Association team on a bi-monthly basis to develop strategies and proposed timelines for training and implementation in year two. As a result of our year one efforts, together with our local AHA team, we have created a novel train-the-trainer model for community CPR classes that will equip participants with the two-step Hands-Only CPR skills to help save a life in the community setting. In addition, we received a donation of adult & child CPR Anytime training kits to launch our 2021 pilot of our community CPR classes. 2021 Update:The Hospital progressed on its set metric of increasing the number of Hands-Only CPR classes from a baseline of zero to five. Our Division team completed the AHA instructor training in May 2021. The North Pinellas Community Health Needs Assessment Committee, along with community partners, continued to plan and strategize on where to offer Hands-Only CPR classes in year three. A connection was made with Tarpon Springs High School to initiate planning for a Hands-Only CPR class for students. Objective 2: The second objective is to increase the amount of paid staff time for Hospital staff/team members to volunteer with community organizations addressing heart disease and stroke from a baseline of zero hours to 250 hours by the end of year three. The initiative is conducted through AdventHealth North Pinellas and all outcomes are specific to the reporting Hospital. The Hospital provides a paid volunteerism program through which AdventHealth employees are paid at their normal rate to volunteer at community organizations which are addressing this priority area. 2021 Update:Due to COVID-19, the staff volunteering objective was delayed. As a result of the continued pandemic, AdventHealth has pivoted where necessary to address the immediate needs of our community. We are working to identify ways to support the needs originally identified in our CHNAs, as resources and public health recommendations develop. See continuation 3

Continuation II of Part V, Section B, Line 11 - Continuation 3
"Goal 2: Enhance community to clinical linkages between community organizations and stakeholders to promote coordinated patient care strategies to control high blood pressure and high cholesterol Objective 1: The first objective is to increase the number of underinsured/uninsured community members receiving linkages to follow up clinical care at Pioneer Medical Group by providing free biometric screenings and health education at a minimum of three Pioneer Medical Group free mobile clinic events for 150 patients from a baseline of zero patients by the end of year three. The initiative is managed by the Division, however all outcomes are specific to the reporting Hospital. The initiative provides service to the community by connecting underinsured and uninsured individuals with free biometric screenings, primary care follow-up and routine care that they may otherwise not have access to. Pioneer Medical Group serves the homeless, refugee, uninsured and underinsured adult community by providing free health care access and hygiene supplies. 2021 Update:The Hospital progressed on its set metric of providing three Pioneer Medical Group free mobile clinics for 150 patients by setting a date in year three for the first planned clinic. The Hospital, Pioneer Medical Group, and other community partners started planning for a clinic event to be held at Mt. Hermon Missionary Baptist Church in May 2022. Priority 3: Suicide/Depression (Medicare Population)2019 Description of the Issue: The burden of mental illness, such as depression and anxiety, in the United States is among the highest of all diseases. Mental disorders are among the most common causes of disability for adults, children and adolescents while suicide is the 10th leading cause of death in the U.S. When mental health disorders are untreated, those affected are at high risk for many unhealthy and unsafe behaviors, including alcohol or drug abuse, violent or self-destructive behavior and suicide. In the AdventHealth North Pinellas PSA, 22% of the Medicare population has depression, which is slightly higher than the state average of 19%. Furthermore, the suicide rate is 18.33 (per 100,000 population) which is higher than the state average of 14.09 per 100,000. The AdventHealth North Pinellas Community Health Plan has two desired goal statements under the Suicide/Depression (Medicare Population) priority. 1. Reduce the stigma associated with mental illness in youth and adults by providing access to health education to help communities better understand and respond to signs of mental illness and substance use disorders2. Increase community-level partnerships to enhance existing efforts currently addressing social determinants of health that impact suicide/depression in youth and adultsGoal 1: Reduce the stigma associated with mental illness in youth and adults by providing access to health education to help communities better understand and respond to signs of mental illness and substance use disorders Objective 1: The first objective is to increase the number of Mental Health First Aid USA certification training classes provided for free to community members residing in the Hospital's PSA to three certification classes from a baseline of zero certification classes by the end of year three. The deployment of the Mental Health First Aid classes is a shared initiative between AdventHealth North Pinellas, AdventHealth Carrollwood, AdventHealth Dade City, AdventHealth Connerton, AdventHealth Zephyrhills, AdventHealth Tampa, AdventHealth Ocala, AdventHealth Wauchula, AdventHealth Lake Placid, AdventHealth Sebring and AdventHealth Wesley Chapel. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The initiative is managed at the Divisional level and funded through the Hospital and all reported outcomes are specific to the reporting Hospital.The initiative provides Mental Health First Aid USA classes to the community for free. The class is a course that teaches you how to help someone who may be experiencing a mental health or substance use challenge. The training helps you identify, understand and respond to signs of addictions and mental illnesses. 2021 Update:The Hospital progressed on its metric of providing three free Mental Health First Aid USA certification training classes to community members residing in the Hospital's PSA from a baseline of zero certification classes by the end of year three. Four Division level team members were trained as instructors in Mental Health First Aid in 2021, providing them the needed credentials to start teaching Mental Health First Aid in the community. The Hospital continued to identify and secure opportunities in the community to offer Mental Health First Aid and aims to complete classes in 2022.Objective 2: The second objective is to increase the number of Pinellas County National Alliance on Mental Illness (NAMI) Nuts and Bolts education classes provided for free to community organizations in the Hospital's PSA by nine from a baseline of zero by the end of year three. The initiative is managed by the Division, however all outcomes are specific to the reporting Hospital. The initiative provides service to the community by giving a general overview of who NAMI is and what they provide. It includes an overview of common mental health conditions and how one can ""break stigma"" around the discussion of mental health/mental illness.2021 Update:The Hospital progressed on its set metric of conducting nine Nuts and Bolts presentations by maintaining communication with NAMI Pinellas and continuing to explore opportunities to offer this presentation in the community. The Hospital also acquired the ability to support virtual presentations with GrubHub vouchers to incentivize participation. We are looking forward to implementing this innovative tool in year three. Goal 2: Increase community-level partnerships to enhance existing efforts currently addressing social determinants of health that impact suicide/depression in youth and adults Objective 1: The first objective is a shared initiative between AdventHealth North Pinellas, AdventHealth Tampa, AdventHealth Carrollwood, AdventHealth Wesley Chapel, AdventHealth Zephyrhills and AdventHealth Dade City. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase the number of Pinellas County NAMI Ending the Silence presentations provided for free to middle and high school-aged youth residing in the Hospital's PSA to six classes from a baseline of zero by the end of year three. The objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital.For this initiative, the Hospital decided to partner with National Alliance on Mental Illness (NAMI) Pinellas, the local affiliate of the National Alliance on Mental Illness. NAMI's mission is to provide advocacy, education, support and public awareness so that all individuals and families affected by mental illness can build better lives. Ending the Silence is a presentation for middle and high school aged youth that helps destigmatize mental illness by providing community members with education to recognize signs and symptoms of an individual dealing with a mental health condition, along with the action steps to help the individual suffering from a mental health crisis. 2021 Update:The Hospital progressed on its set metric of providing six Ending the Silence presentations by supporting one presentation in year two. The presentation was held in May 2021 and offered virtually for youth due to the ongoing pandemic. Objective 2: The second objective is a shared initiative between AdventHealth North Pinellas, AdventHealth Tampa and AdventHealth Carrollwood. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase the number of Hillsborough County National Alliance on Mental Illness (NAMI) In Our Own Voice presentations provided for free to adults residing in the Hospital's PSA to six classes from a baseline of zero by the end of year three. The objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital.See Continuation 4"

Continuation II of Part V, Section B, Line 11 - Continuation 4
For this initiative, the Hospital decided to partner with National Alliance on Mental Illness (NAMI) Pinellas. NAMI's In Our Own Voice presentations change attitudes, assumptions and ideas about people with mental health conditions. NAMI's In Our Own Voice presentations are targeted towards adults. 2021 Update:The Hospital progressed on its set metric of conducting six In Our Own Voice presentations by maintaining communication with NAMI Pinellas and continuing to explore opportunities to offer this presentation in the community. The Hospital also acquired the ability to support virtual presentations with GrubHub vouchers to incentivize participation. We are looking forward to implementing this innovative tool in year three.Objective 3: The third objective is to increase the amount of paid staff time for Hospital staff/team members to volunteer with community organizations addressing mental health from a baseline of zero hours to 250 hours by the end of year three. The initiative is conducted through AdventHealth North Pinellas and all outcomes are specific to the reporting Hospital. The Hospital provides a paid volunteerism program through which AdventHealth employees are paid at their normal rate to volunteer at community organizations which are addressing this priority area. 2021 Update:The Hospital progressed on its set metric of paid staff time for volunteerism by dedicating 80 hours to the Sleep in Heavenly Peace bed-building event. In December 2021, Hospital team members served the community by building beds for children in need. Research shows that having a bed for sleep has positive effects on mental health and academic performance (Sleep in Heavenly Peace). The Hospital also donated $4,000 in supplies for the event. Priority 4: Tobacco Use2019 Description of the Issue:Since 1964, 20 million people in the U.S. have died from using tobacco. Tobacco use can cause a wide range of health issues including cancer, heart disease, diabetes, oral health diseases and harmful reproductive effects. More than 30 million adults in the U.S. smoke cigarettes and more than 50 million are exposed to secondhand smoke, which is just as harmful as smoking. Secondhand smoke can still cause heart disease and lung cancer as well as asthma, sudden infant death syndrome (SIDS) and other respiratory infections in infants and children. In the AdventHealth North Pinellas PSA, 23% of adults aged 18 and above smoke cigarettes, which is higher than the state average of 19%.The AdventHealth North Pinellas Community Health Plan has two desired goal statements under the Tobacco Use priority. 1. Decrease tobacco use among adults and youth residing in the Hospital's PSA2. Increase access to smoking cessation classes for adults by partnering with local community organizations to provide linkages to careGoal 1: Decrease tobacco use in adults and youth community members Objective 1: The first objective is to partner with Gulf Coast Area Health Education Center (AHEC) to increase community awareness of free programs and resources available for tobacco cessation by providing nine community lunch and learn sessions from a baseline of zero by the end of year three. The initiative is conducted through AdventHealth North Pinellas and all outcomes are specific to the reporting Hospital. Gulfcoast North Area Health Education Center (GNAHEC), a local chapter of the national Area Health Education Center (AHEC), is a community focused organization that develops and implements community-based health promotion activities and education programs that target the underserved. For this initiative, we are partnering with GNAHEC to provide community members the tools and resources to assist with tobacco cessation. The AHEC lunch and learns provide community members with knowledge of AHEC services and resources and connects individuals to free tobacco cessation classes.2021 Update:The Hospital progressed on its set metric of providing nine community lunch and learn sessions by maintaining communication with community partners working on this initiative together. The North Pinellas Community Health Needs Assessment Committee and GNAHEC continued working together to identify opportunities for lunch and learn's with local organizations, providers, and community members.Objective 2: The second objective is a shared initiative between AdventHealth North Pinellas, AdventHealth Connerton, AdventHealth Lake Placid, AdventHealth Carrollwood, AdventHealth Sebring, AdventHealth Wauchula and AdventHealth Wesley Chapel. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase knowledge of free tobacco cessation programs and tobacco prevention/treatment resources for patients at discharge by partnering with Gulfcoast North Area Health Education Center (GNAHEC) to provide continuing education (CEU) classes to 200 team members (treating patients with tobacco use) from a baseline of zero by the end of year three. The objective is managed through all Hospitals, however reported outcomes and funding are specific to the reporting Hospital. This initiative provides educational classes that lead to an increase in knowledge for those AdventHealth team members who treat patients with tobacco use, or work with these patients at discharge, about tobacco cessation resources available thereby potentially improving patients' health through support for eliminating tobacco use. 2021 Update:The Hospital progressed on its set metric to provide 200 team members with CEUs by maintaining communication with representatives of GNAHEC. Due to COVID-19, the team member CEUs objective was delayed. As a result of the continued pandemic, AdventHealth has pivoted where necessary to address the immediate needs of our community. We are working to identify ways to support the needs originally identified in our CHNAs, as resources and public health recommendations develop. The Hospital experienced significant staffing challenges in 2021 which put the training initiative on pause.Goal 2: Increase access to smoking cessation classes for adults by partnering with local community organizations to provide linkages to care Objective 1: The first objective is a shared initiative between AdventHealth North Pinellas, AdventHealth Tampa, AdventHealth Carrollwood, AdventHealth Dade City, AdventHealth Zephyrhills, AdventHealth Ocala, AdventHealth Wauchula, AdventHealth Lake Placid, AdventHealth Sebring and AdventHealth Wesley Chapel. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. This objective is managed at the Divisional level, however all funding and outcomes reported are specific to the reporting Hospital. The objective is to provide patient referrals at discharge to enroll in free Gulfcoast North Area Health Education Center (GNAHEC) tobacco cessation programs and receive free intervention therapies to quit smoking tobacco. Through a partnership with GNAHEC we will create an internal referral system to link adults residing in the Hospital's PSA, providing resources for 50 patients from a baseline of zero by end of year three. 2021 Update:The Hospital progressed on its set metric of providing discharge referrals to 50 patients. Due to COVID-19, the tobacco cessation referral initiative was delayed. As a result of the continued pandemic, AdventHealth has pivoted where necessary to address the immediate needs of our community. We are working to identify ways to support the needs originally identified in our CHNAs, as resources and public health recommendations develop. Our partners with GNAHEC have agreed to conduct in-service trainings with Hospital team members in an effort to increase referrals in year three.Objective 2: The second objective is to increase access to tobacco cessation classes for adults residing in the Hospital's PSA by 10 classes from a baseline of zero by the end of year three. This objective is managed at the Divisional level, however all funding and outcomes reported are specific to the reporting Hospital. We are partnering with GNAHEC to provide community members the tools and resources to assist with tobacco cessation. The GNAHEC tobacco cessation classes educate community members on the importance of quitting tobacco products. The classes are free and participants can receive free nicotine replacement therapy products (ex. patches, gum, lozenges). See Continuation 5

Continuation II of Part V, Section B, Line 11 - Continuation 5
2021 Update:The Hospital progressed on its set metric of supporting 10 tobacco cessation classes by supporting one class in year two. The Hospital sponsored lunch for participants of the class. The Hospital, along with partners of the North Pinellas Community Health Needs Assessment Committee, also support the classes by sharing class flyers widely in the community each month. The Hospital, GNAHEC, and community partners look forward to finding innovative ways to continue promoting and supporting the tobacco cessation classes in year three. Priority 5: Alcohol Consumption2019 Description of the Issue:Excessive use of alcohol can have immediate health effects, including unintentional injury, violence, alcohol poisoning, risky sexual behaviors and miscarriage among pregnant women. It can also have long-term health effects, including high blood pressure, heart disease, liver disease, dementia, depression and cancer. Underage drinking, or alcohol consumption by those under the age of 21, has been linked to death from alcohol poisoning, suicide, unintentional injury and alcohol dependence later in life. In the U.S., excessive alcohol use was the cause of one in ten deaths among adults between the ages of 20-64. In 2010, people under the age of 21 accounted for 189,000 ER visits for injuries and other conditions related to alcohol use. In the AdventHealth North Pinellas PSA, 20% of adults aged 18 and above drank excessively which is higher than the state average of 17%.The AdventHealth North Pinellas Community Health Plan has two desired goal statements under the Alcohol Consumption priority. 1. To increase access to treatment programs for substance misuse treatment, specifically for alcoholism, by creating partnerships with community organizations and stakeholders2. To increase education and awareness of substance misuse related to alcoholism by engaging community members, public schools, community organizations and other community stakeholdersGoal 1: To increase access to treatment programs for substance misuse treatment, specifically for alcoholism, by creating partnerships with community organizations and stakeholders Objective 1: The first objective is to increase partnerships with local community organizations that provide resources, interventions and support to adults residing in the Hospital's PSA who are recovering from alcoholism by creating three partnerships from a baseline of zero partnerships by the end of year three. The initiative is conducted through AdventHealth North Pinellas and all outcomes are specific to the reporting Hospital. The initiative provides service to the community by improving access to resources that help to create a sober environment. 2021 Update:The Hospital met its set metric of forming three partnerships. The first year was focused on identifying and establishing relationships with local community agencies serving adults recovering from alcoholism. We connected with Mothers Against Drunk Driving (MADD) West Central Florida Region, Alliance for Substance Addiction Prevention (ASAP) and The Phoenix Florida. MADD's mission is to end drunk driving, help fight impaired driving, support victims and prevent underage drinking. ASAP's mission is to create a community free of substance misuse and its consequences. Finally, the Phoenix's mission is to build a sober active community. In year two, the Hospital maintained communication with these organizations to help support and promote their programs and find creative ways to work together. Objective 2: The second objective is to increase access to community support groups for adults residing in the Hospital's PSA who are recovering from alcoholism by sponsoring three on-going support groups from a baseline of zero by the end of year three. The initiative is conducted through AdventHealth North Pinellas and all outcomes are specific to the reporting Hospital. The initiative provides service to the community by improving access to resources and support that help to create a sober environment for individuals recovering from alcoholism. The Hospital progressed on its set metric of supporting three ongoing support groups. We connected with several community organizations that offer support from both the advocacy perspective and support group perspective. The National Alliance on Mental Illness's (NAMI) mission is to provide advocacy, education, support and public awareness so that all individuals and families affected by mental illness can build better lives. Additionally, we connected with The Phoenix Florida. The Phoenix's mission is to build a sober active community. We are continuing to identify opportunities to collaborate with these organizations and increase awareness of both agencies and the services they provide. In 2020, we were able to support these organizations by marketing their support groups and identifying facilitators to be trained to lead their support groups. 2021 Update:The Hospital progressed on its set metric of supporting three ongoing support groups by maintaining communication with community partners working on this initiative together. The North Pinellas Community Health Needs Assessment Committee continued working with the National Alliance on Mental Illness in Pinellas and The Phoenix to identify opportunities to support the support groups of these organizations. The National Alliance on Mental Illness's mission is to provide advocacy, education, support, and public awareness so that all individuals and families affected by mental illness can build better lives. The Phoenix's mission is to build a sober active community. We are continuing to identify opportunities to collaborate with these organizations and increase awareness of both agencies and the services they provide in year 3.Goal 2: To increase education and awareness of substance misuse related to alcoholism by engaging community members, public schools, community organizations and other community stakeholdersObjective 1: The first objective is a shared initiative between AdventHealth North Pinellas and AdventHealth Connerton. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is that the initiative will increase the reach of the Pasco County Substance Abuse Taskforce (PCSAT) into West Pasco communities by co-hosting at least three meetings in West Pasco from a baseline of zero by end of year three. This objective is managed at the Hospital level and all funding and outcomes reported are specific to the reporting Hospital.The Pasco County Substance Abuse Taskforce began as an outreach by the AdventHealth Wesley Chapel Chaplain services. After several years, it was reimagined as a hybrid approach to both inpatient and community outreach. The taskforce's mission is to develop a partnership with community members focusing on awareness and increasing access to resources for patients suffering from substance misuse. Unfortunately, due to some fundamental shifts in the taskforce's leadership, the taskforce was placed on hold until late 2020.The Hospital progressed on its set metric to co-host three Pasco County Substance Abuse Taskforce meetings by identifying several team members from the Hospital to be involved with the existing AdventHealth Wesley Chapel taskforce. Additionally, the Hospital was able to form key partnerships that will help to expand the existing taskforce and strengthen the work being done. 2021 Update:Due to COVID-19, the Pasco County Substance Abuse Taskforce initiative was delayed. As a result of the continued pandemic, AdventHealth has pivoted where necessary to address the immediate needs of our community. We are working to identify ways to support the needs originally identified in our CHNAs, as resources and public health recommendations develop. Staffing challenges in 2021 put a pause on PCSAT meetings, but team members continued to collaborate with partner agencies on shared priorities of addressing substance misuse in Pasco County.See Continuation 6

Continuation II of Part V, Section B, Line 11 - Continuation 6
Objective 2: The second objective is a shared initiative between AdventHealth North Pinellas and AdventHealth Connerton. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase the current reach of the Pasco County Substance Abuse Taskforce (PCSAT) into West Pasco communities by co-hosting at least one community forum in West Pasco from a baseline of zero by December 31, 2022. This objective is managed at the Divisional level, however all funding and outcomes reported are specific to the reporting Hospital.2021 Update:The Hospital progressed on its set metric to increase the reach of the Pasco County Substance Abuse Taskforce by co-hosting at least one community forum by collaborating with community partners on a shared event. The Wellness Walkthrough virtual event will be held in early 2022. This event will showcase local services and resources for substance use prevention, treatment, and recovery. The Hospital will co-sponsor the event and has provided staffing support during the planning process.Community Needs Not Chosen by AdventHealth North Pinellas: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? 1. Unintentional Injury Deaths: Unintentional injuries were the third leading cause of death in the U.S for 2017. This includes deaths due to falls, motor vehicle accidents, fires, drownings and poisoning. In the AdventHealth North Pinellas PSA, the rate of death due to unintentional injury is 54 per 100,000 of the population. The issue should not be addressed as an individual problem but can be indirectly impacted positively by first addressing alcohol and tobacco use issues selected above by the Hospital Community Health Needs Assessment Committee (CHNAC). 2. Asthma: Asthma is a chronic condition when the airways in the lungs are always inflamed. The inflammation causes coughing, wheezing, chest tightness and shortness of breath. In the AdventHealth North Pinellas PSA, 14% of adults aged 18 and above have asthma. The CHNAC did not perceive the ability to have a measurable impact on the issue within the three years allotted for the Community Health Plan with the current resources available to the community and the Hospital at this time. 3. Uninsured Children: In 2018, 4.3 million children in the U.S. did not have health insurance. The largest decrease in insurance status was seen among children from low-income families using public programs like children's Medicaid or Children's Health Insurance Program (CHIP). In the AdventHealth North Pinellas PSA, 7% of the population under the age of 19 did not have health insurance. The CHNAC did not perceive the ability to have a measurable impact on the issue within the three years allotted for the Community Health Plan with the current resources available to the community and the Hospital at this time. 4. Cancer: Cancer is the second leading cause of death in the U.S. with more than 100 types. Many are preventable and research advances in detection and treatment have greatly improved survival rates. In the AdventHealth North Pinellas PSA, the rate of death due to cancer is 160 per 100,000 of the population. The issue should not be addressed as an individual problem but can be indirectly impacted positively by first addressing obesity, alcohol and tobacco use issues selected by the Hospital CHNAC. 5. Poor Dental Health: Many oral diseases can be prevented with routine care and regular dental checkups. The health of the teeth, the mouth and the surrounding craniofacial (skull and face) structures is central to a person's overall health and well-being. Lack of access to dental care for all ages remains a public health challenge. In the AdventHealth North Pinellas PSA, the access to dentists' rate per 100,000 of the population is 58 (in 2015), as compared to the state rate of 56. The CHNAC did not perceive the ability to have a measurable impact on the issue within the three years allotted for the Community Health Plan with the current resources available to the community and the Hospital at this time. 6. Infant Mortality: Infant mortality is the death of an infant before their first birthday. In 2017, more than 22,000 infants died in the U.S. The causes of infant mortality include birth defects, maternal pregnancy complications, sudden infant death syndrome, preterm birth and injuries such as suffocation. In the AdventHealth North Pinellas PSA, the infant mortality rate is 8 deaths per 1,000 births. The CHNAC did not perceive the ability to have a measurable impact on the issue within the three years allotted for the Community Health Plan with the current resources available to the community and the Hospital at this time.

Schedule H, Part V, Section B, Line 7a:
The CHNA report can be found at URL:https://www.adventhealth.com/community-health-needs-assessments

Schedule H, Part V, Section B, Line 10a:
The most recently adopted implementation strategy can be found at:https://www.adventhealth.com/community-health-needs-assessments

Schedule H, Part V, Section B, Line 16a,b,c:
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 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."

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 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 to be 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 page 8 and 9. Please note that dollar amounts on the attached consolidated audited financial statements are in thousands.

Part VI, Line 7:
The filing organization does not file an annual community benefit report with any state agencies.

Part III, Line 8:
Costing Methodology:Medicare allowable costs were calculated using a cost-to-charge ratio.Rationale for Including a Medicare Shortfall as Community Benefit:As a 501(c)(3) organization, the filing organization provides emergency and non-elective care to all regardless of ability to pay. All hospital services are provided in a non-discriminatory manner to patients who are covered beneficiaries under the Medicare program. As a public insurance program, Medicare provides a pre-established reimbursement rate/amount to health care providers for the services they provide to patients. In some cases, the reimbursement amount provided to a hospital may exceed its costs of providing a particular service or services to a patient. In other cases, the Medicare reimbursement amount may result in the hospital experiencing a shortfall of reimbursement received over costs incurred. In those cases where an overall shortfall is generated for providing services to all Medicare patients, the shortfall amount should be considered as a benefit to the community. Tax-exempt hospitals are required to accept all Medicare patients regardless of the profitability, or lack thereof, with respect to the services they provide to Medicare patients. The population of individuals covered under the Medicare program is sufficiently large so that the provision of services to the population is a benefit to the community and relieves the burdens of government. In those situations where the provision of services to the total Medicare patient population of a tax-exempt hospital during any year results in a shortfall of reimbursement received over the cost of providing care, the tax-exempt hospital has provided a benefit to a class of persons broad enough to be considered a benefit to the community. Despite a financial shortfall, a tax-exempt hospital must and will continue to accept and care for Medicare patients. Typically, tax-exempt hospitals provide health care services based upon an assessment of the health care needs of their community as opposed to their taxable counterparts where profitability often drives decisions about patient care services that are offered. Patient care provided by tax-exempt hospitals that results in Medicare shortfalls should be considered as providing a benefit to the community and relieving the burdens of government.

Part III, Line 9b:
The hospital filing organization's collection practices are in conformity with the requirements set forth in the 2014 Final Regulations regarding the requirements of Internal Revenue Code Section 501(r)(4) - (r)(6). No extraordinary collection actions (ECA's) are initiated by the hospital filing organization in the 120-day period following the date after the first post-discharge billing statement is sent to the individual (or, if later, the specified deadline given in a written notice of actions that may be taken, as described below). Individuals are provided with at least one written notice (notice of actions that may be taken) and a copy of the filing organization's Plain Language Summary of the Financial Assistance Policy that informs the individual that the hospital filing organization may take actions to report adverse information to credit reporting agencies/bureaus if the individual does not submit a Financial Assistance Application Form (FAA Form) or pay the amount due by a specified deadline. The specified deadline is not earlier that 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
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 are as follows:- Medicare surplus/(shortfall) shown on line 7 of Section B of Schedule H: $ (7,353,858)- Difference in costing methodology: 667,789- Unreimbursed costs incurred for services provided to Medicare patients that are not included in the organization's Medicare cost report: (15,643,559) -------------Total Unreimbursed costs of serving all Medicare patients per the filing organization's community benefit reporting: $ (22,329,628)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:
AdventHealth North Pinellas (AHNP), a 168-bed facility, situated on the west coast of central Florida along the Anclote River where the river meets the Gulf of Mexico, serves the residents of North Pinellas and surrounding communities with vital healthcare services. A Medical Staff of more than 430 physicians, including primary care and specialists, have privileges at AHNP. These doctors bring a tremendous resource of medical expertise to the hospital and the communities it serves.AdventHealth North Pinellas is a crucial community asset. In addition to operating a hospital facility, AHNP also operates 2 wound healing institutes, and 1 sleep center. AdventHealth North Pinellas also owns and operates a full service emergency room (ER) location in nearby Palm Harbor, Florida (Pinellas County). The Palm Harbor ER features 24 beds and overnight observation care, on-site imaging, lab and pharmacy services. It offers adult and pediatric emergency care. 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 81.8% of the Hospital's in-patients were admitted through the Hospital's Emergency Department. - Medicare Patients 56.6% - Medicaid Patients 10.8% - Self-Pay Patients 5.2% The demographic makeup of the Hospital's service area is as follows: - Population 160,079 - Population Over 65 27.71% - Poverty (Below 100% FPL) 11.7% - Unemployment Rate 6% - Violent Crime Rate (Per 100,000 Pop.) 482.2 - Pop. Age 25+ with No High School Diploma 8.5% - Uninsured Adults 16.44% - Uninsured Children 6.64% - Food Insecurity Rate 16.2% - Pop. with Low Food Access 20.24%

Part VI, Line 5:
"The provision of community benefit is central to AdventHealth North Pinellas'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 $324,715 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 $26,853,326 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:
AdventHealth North Pinellas 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 AHS 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.