4A (Expenses $ 4689829958 including grants of $ 22086643) (Revenue $ 5631470227)
Operation of 10 acute care hospitals with 148,585 patient admissions, 858,003 patient days and 1,482,429 outpatient visits in the current year. In addition to hospital operations, the corporation provides medical care through a number of other activities such as urgent care centers, physician clinics, home health services, hospice services, sleep centers, wound centers, therapy and rehab.

Part V, Section B
Facility Reporting Group A

Facility Reporting Group A consists of:
- Facility 1: AdventHealth Orlando, - Facility 2: AdventHealth Celebration, - Facility 3: AdventHealth Altamonte Springs, - Facility 4: AdventHealth East Orlando, - Facility 5: AdventHealth Winter Park, - Facility 6: AdventHealth Kissimmee, - Facility 8: AdventHealth Apopka, - Facility 10: AdventHealth Wauchula

Facility Reporting Group - A Part V, Section B, line 5:
See Line 5 footnote below.

Facility Reporting Group - A Part V, Section B, line 7d:
See Line 7d footnote below.

Facility Reporting Group - A Part V, Section B, line 11:
See Line 11 footnote below.

Facility Reporting Group - A Part V, Section B, line 13h:
See Line 13h footnote below.

Part V, Section B
Facility Reporting Group B

Facility Reporting Group B consists of:
- Facility 7: AdventHealth Sebring, - Facility 9: AdventHealth Lake Placid

Facility Reporting Group - B Part V, Section B, line 5:
See Line 5 footnote below.

Facility Reporting Group - B Part V, Section B, line 6a:
See Line 6a footnote below.

Facility Reporting Group - B Part V, Section B, line 7d:
See Line 7d footnote below.

Facility Reporting Group - B Part V, Section B, line 11:
See Line 11 footnote below.

Facility Reporting Group - B Part V, Section B, line 13h:
See Line 13h footnote below.

Part V, Section B, Line 5 Footnote:
Group A-Facility 1 -- AdventHealth OrlandoAdventHealth Orlando (AHO or the Hospital) is the flagship hospital of the seven hospital campuses that operate under a single hospital license. The seven campuses of AdventHealth in Central Florida are known as the AdventHealth Central Florida Division South Region (CFD-South) and are located in the Central Florida counties of Seminole, Orange, and Osceola. AHO is located in and serves the residents of Orange County. AHO has become one of the most trusted and comprehensive hospitals in the region. The CFD-South conducted its 2019 Community Health Needs Assessment (CHNA) in two parts: a regional health needs assessment for four counties in Central Florida (Lake, Orange, Osceola and Seminole) (a sister hospital is located in Lake County, Florida and was a participant in the regional health needs assessment) and a separate health needs assessment focused on each of the seven separate CFD-South hospital campuses. The 2019 CHNA conducted for AHO was built on input from people representing the broad and local community, as well as low-income, minority and other medically underserved populations. This input was solicited throughout 2019 and was gathered and considered in multiple ways as described below.AHO had a local Community Health Needs Assessment Committee (CHNAC) that included representatives from the Hospital and community with a special focus on underserved populations within AHO's community/service area. The following organizations participated in AHO's CHNAC and specifically represented low-income, minority and other medically underserved populations:Second Harvest Food Bank - a non-profit organization that operates a food bank throughout the six counties that make up most of Central Florida and provides a workforce development program for populations at risk for food insecurity;Grace Medical Home - a patient-centered medical home that focuses on serving the clinically underserved through the provision of continuous and comprehensive primary care;Juvenile Diabetes Research Foundation;Ronald McDonald House;United Against Poverty;Healthy Start Coalition of Orange County;Mother's Milk Bank of Central Florida; andOrange County Public Health Department.In order to ensure that input was solicited and gathered from low-income, minority, medically underserved, and other underrepresented community members, a variety of primary data collection efforts were made. Primary data for the 2019 CHNA was collected through a community survey, stakeholder interviews, focus groups, key informant surveys and intercept surveys. The audience for the community survey was the general community with a concentration on underrepresented populations. Both online and paper surveys were made available in four languages. A total of over 1,240 surveys were completed by Orange County residents. Stakeholder interviews were collected from community members who represented underserved populations through the programs and services they offer, such as local food banks and federally qualified health centers. A total of 9 focus groups were held which included representatives from organizations that serve underrepresented populations in Orange County, including organizations that provide services primarily to the homeless populations, seniors, and incarcerated individuals as well as mental health providers. One hundred and eleven key information surveys were collected from individuals who represented a particular population and/or sector in the community that was not able to be included in the stakeholder interviews or focus groups. Additionally, a total of 86 intercept surveys were conducted with individuals at United Against Poverty, AdventHealth Community Medicine Clinic and the Christian Service Center that focused on the health needs of underrepresented Orange County residents.Group A-Facility 2 -- AdventHealth CelebrationAdventHealth Celebration (AHC or the Hospital) is one of seven campuses that operate under a single hospital license. The seven hospital campuses of AdventHealth in Central Florida are known as the AdventHealth Central Florida Division South Region (CFD-South) and are located in the Central Florida counties of Seminole, Orange, and Osceola. AHC is located in Osceola County and it primarily serves residents from Osceola County. The CFD-South conducted its 2019 Community Health Needs Assessment (CHNA) in two parts: a regional health needs assessment for four counties in Central Florida (Lake, Orange, Osceola and Seminole) (a sister hospital is located in Lake County, Florida and was a participant in the regional health needs assessment) and a separate health needs assessment focused on each of the seven separate CFD-South hospital campuses. The 2019 CHNA conducted for AHC was built on input from people representing the broad and local community, as well as low-income, minority and other medically underserved populations. This input was solicited throughout 2019 and was gathered and considered in multiple ways as described below.AHC had a local Community Health Needs Assessment Committee (CHNAC) that included representatives from the Hospital and community with a special focus on underserved populations within AHC's community/service area. The following organizations participated in AHC's CHNAC and specifically represented low-income, minority and other medically underserved populations:Osceola Council on Aging - a non-profit organization with a focus on providing care and essential social services to seniors and families; Community Vision of Osceola County - a community planning non-profit that works to convene regional stakeholders to create a shared vision for a healthy and prosperous Osceola County; Hope Community Center - a social service non-profit that works to connect socioeconomically disadvantaged families to essential services with the goal of helping them to become self-sustaining; The Osceola County Health Department;Celebration Foundation;The City of Kissimmee;Osceola Community Health Services; Park Place Behavioral Health; REACH Marketing; andSecond Harvest Food Bank.In order to ensure that input was solicited and gathered from low-income, minority, medically underserved, and other underrepresented community members, a variety of primary data collection efforts were made. Primary data for the 2019 CHNA was collected through a community survey, stakeholder interviews, focus groups, key informant surveys and intercept surveys. The audience for the community survey was the general community with a concentration on underrepresented populations. Both online and paper surveys were made available in four languages. A total of 289 surveys were completed by Osceola County residents. Stakeholder interviews were collected from community members who represented underserved populations through the programs and services they offer, such as local food banks and federally qualified health centers. A total of nine focus groups were held which included representatives from organizations that serve underrepresented populations in Osceola County, including organizations that provide services primarily to the homeless populations, seniors, and incarcerated individuals as well as mental health providers. Ninety-seven key information surveys were collected from individuals who represented a particular population and/or sector in the community that was not able to be included in the stakeholder interviews or focus groups. Additionally, nine intercept surveys were conducted with patients at a local federally qualified health center. Group A-Facility 3 -- AdventHealth AltamonteAdventHealth Altamonte Springs (AHAlt or the Hospital) is one of seven campuses that operate under a single hospital license. The seven hospital campuses of AdventHealth in Central Florida are known as the AdventHealth Central Florida Division South Region (CFD-South) and are located in the Central Florida counties of Seminole, Orange, and Osceola. AHAlt is located in Seminole County and its primary service area encompasses all of Seminole County. The CFD-South conducted its 2019 Community Health Needs Assessment (CHNA) in two parts: a regional health needs assessment for four counties in Central Florida (Lake, Orange, Osceola and Seminole) (a sister hospital is located in Lake County, Florida and was a participant in the regional health needs assessment) and a separate health needs assessment focused on each of the seven separate CFD-South hospital campuses. **see continuation of footnote

Part V, Section B, Line 5 Continuation of Footnote:
Group A-Facility 3 -- AdventHealth AltamonteThe 2019 CHNA conducted for AHAlt was built on input from people representing the broad and local community, as well as low-income, minority and other medically underserved populations. This input was solicited throughout 2019 and was gathered and considered in multiple ways as described below.AHAlt had a local Community Health Needs Assessment Committee (CHNAC) that included representatives from the Hospital and community with a special focus on underserved populations within AHAlt's community/service area. The following organizations participated in AHAlt's CHNAC and specifically represented low-income, minority and other medically underserved populations:Community Health Centers - an organization providing medical services and representing low-income, minority, and other underrepresented populations;Second Harvest Food Bank; Shepherd's Hope - a primary care clinic serving low-income, minority, and other underrepresented populations; Hope Community Center - an organization that provides education, immigration services, youth and family services and other community programs to low-income, minority, and other underrepresented populations; and The Department of Health in Seminole County. In order to ensure that input was solicited and gathered from low-income, minority, medically underserved, and other underrepresented community members, a variety of primary data collection efforts were made. Primary data for the 2019 CHNA was collected through a community survey, stakeholder interviews, focus groups, key informant surveys and intercept surveys. The audience for the community survey was the general community with a concentration on underrepresented populations. Both online and paper surveys were made available in four languages. A total of 523 surveys were completed by Seminole County residents. Stakeholder interviews were collected from community members who represented underserved populations through the programs and services they offer, such as local food banks and federally qualified health centers. A total of 10 focus groups were held which included representatives from organizations that serve underrepresented populations in Seminole County, including organizations that provide services primarily to the homeless populations, seniors, and incarcerated individuals as well as mental health providers. Eighty-three key information surveys were collected from individuals who represented a particular population and/or sector in the community that was not able to be included in the stakeholder interviews or focus groups. Additionally, fourteen intercept surveys were conducted with patients at a local federally qualified health center. Group A-Facility 4 -- AdventHealth East OrlandoAdventHealth East Orlando (AHEO or the Hospital) is one of seven campuses that operate under a single hospital license. The seven hospital campuses of AdventHealth in Central Florida are known as the AdventHealth Central Florida Division South Region (CFD-South) and are located in the Central Florida counties of Seminole, Orange, and Osceola. AHEO is located in and serves the residents of Orange County. The CFD-South conducted its 2019 Community Health Needs Assessment (CHNA) in two parts: a regional health needs assessment for four counties in Central Florida (Lake, Orange, Osceola and Seminole) (a sister hospital is located in Lake County, Florida and was a participant in the regional health needs assessment) and a separate health needs assessment focused on each of the seven separate CFD-South hospital campuses. The 2019 CHNA conducted for AHEO was built on input from people representing the broad and local community, as well as low-income, minority and other medically underserved populations. This input was solicited throughout 2019 and was gathered and considered in multiple ways as described below.AHEO had a local Community Health Needs Assessment Committee (CHNAC) that included representatives from the Hospital and community with a special focus on underserved populations within AHEO's community/service area. The following organizations participated in AHEO's CHNAC and specifically represented low-income, minority and other medically underserved populations:True Health - a multi-county Federally Qualified Health Center that provides access to care for low-income, uninsured, underinsured and underserved populations in Seminole and Orange Counties regardless of ability to pay;United Global Outreach;Orange County Government; and Second Harvest Food Bank. In order to ensure that input was solicited and gathered from low-income, minority, medically underserved, and other underrepresented community members, a variety of primary data collection efforts were made. Primary data for the 2019 CHNA was collected through a community survey, stakeholder interviews, focus groups, key informant surveys and intercept surveys. The audience for the community survey was the general community with a concentration on underrepresented populations. Both online and paper surveys were made available in four languages. A total of over 1,240 surveys were completed by Orange County residents. Stakeholder interviews were collected from community members who represented underserved populations through the programs and services they offer, such as local food banks and federally qualified health centers. A total of 9 focus groups were held which included representatives from organizations that serve underrepresented populations in Orange County, including organizations that provide services primarily to the homeless populations, seniors, and incarcerated individuals as well as mental health providers. One hundred and eleven key information surveys were collected from individuals who represented a particular population and/or sector in the community that was not able to be included in the stakeholder interviews or focus groups. Additionally, a total of 86 intercept surveys were conducted with individuals at United Against Poverty, AdventHealth Community Medicine Clinic and the Christian Service Center that focused on the health needs of underrepresented Orange County residents. Group A-Facility 5 -- AdventHealth Winter ParkAdventHealth Winter Park (AHWP or the Hospital) is one of seven campuses that operate under a single hospital license. The seven hospital campuses of AdventHealth in Central Florida are known as the AdventHealth Central Florida Division South Region (CFD-South) and are located in the Central Florida counties of Seminole, Orange, and Osceola. AHWP is located in and primarily serves the residents of Orange County. The CFD-South conducted its 2019 Community Health Needs Assessment (CHNA) in two parts: a regional health needs assessment for four counties in Central Florida (Lake, Orange, Osceola and Seminole) (a sister hospital is located in Lake County, Florida and was a participant in the regional health needs assessment) and a separate health needs assessment focused on each of the seven separate CFD-South hospital campuses. The 2019 CHNA conducted for AHWP was built on input from people representing the broad and local community, as well as low-income, minority and other medically underserved populations. This input was solicited throughout 2019 and was gathered and considered in multiple ways as described below.AHWP had a local Community Health Needs Assessment Committee (CHNAC) that included representatives from the Hospital and community with a special focus on underserved populations within AHWP's community/service area. The following organizations participated in AHWP's CHNAC and specifically represented low-income, minority and other medically underserved populations:Second Harvest Food Bank;Seniors First, Inc.;Fleet Farming; andOrange County Health Department. In order to ensure that input was solicited and gathered from low-income, minority, medically underserved, and other underrepresented community members, a variety of primary data collection efforts were made. Primary data for the 2019 CHNA was collected through a community survey, stakeholder interviews, focus groups, key informant surveys and intercept surveys. The audience for the community survey was the general community with a concentration on underrepresented populations. Both online and paper surveys were made available in four languages. A total of over 1,240 surveys were completed by Orange County residents. Stakeholder interviews were collected from community members who represented underserved populations through the programs and services they offer, such as local food banks and federally qualified health centers.**see continuation

Part V, Section B, Line 5 Continuation of Footnote:
Group A-Facility 5 -- AdventHealth Winter ParkA total of 9 focus groups were held which included representatives from organizations that serve underrepresented populations in Orange County, including organizations that provide services primarily to the homeless populations, seniors, and incarcerated individuals as well as mental health providers. One hundred and eleven key information surveys were collected from individuals who represented a particular population and/or sector in the community that was not able to be included in the stakeholder interviews or focus groups. Additionally, a total of 86 intercept surveys were conducted with individuals at United Against Poverty, AdventHealth Community Medicine Clinic and the Christian Service Center that focused on the health needs of underrepresented Orange County residents.Group A-Facility 6 -- AdventHealth KissimmeeAdventHealth Kissimmee (AHK or the Hospital) is one of seven campuses that operate under a single hospital license. The seven hospital campuses of AdventHealth in Central Florida are known as the AdventHealth Central Florida Division South Region (CFD-South) and are located in the Central Florida counties of Seminole, Orange, and Osceola. AHK is located in and serves the residents of Osceola County. The CFD-South conducted its 2019 Community Health Needs Assessment (CHNA) in two parts: a regional health needs assessment for four counties in Central Florida (Lake, Orange, Osceola and Seminole) (a sister hospital is located in Lake County, Florida and was a participant in the regional health needs assessment) and a separate health needs assessment focused on each of the seven separate CFD-South hospital campuses. The 2019 CHNA conducted for AHK was built on input from people representing the broad and local community, as well as low-income, minority and other medically underserved populations. This input was solicited throughout 2019 and was gathered and considered in multiple ways as described below.AHK had a local Community Health Needs Assessment Committee (CHNAC) that included representatives from the Hospital and community with a special focus on underserved populations within AHK's community/service area. The following organizations participated in AHK's CHNAC and specifically represented low-income, minority and other medically underserved populations:Osceola Council of Aging - a non-profit organization with a focus on providing care and essential social services to seniors and families; Community Vision of Osceola County - a community planning non-profit that works to convene regional stakeholders to create a shared vision for a healthy and prosperous Osceola County; Hope Community Center - a social service non-profit that works to connect socioeconomically disadvantaged families to essential services with the goal of helping them to become self-sustaining; The Osceola County Health Department;Celebration Foundation;The City of Kissimmee;Osceola Community Health Services; Park Place Behavioral Health; REACH Marketing; andSecond Harvest Food Bank.In order to ensure that input was solicited and gathered from low-income, minority, medically underserved, and other underrepresented community members, a variety of primary data collection efforts were made. Primary data for the 2019 CHNA was collected through a community survey, stakeholder interviews, focus groups, key informant surveys and intercept surveys. The audience for the community survey was the general community with a concentration on underrepresented populations. Both online and paper surveys were made available in four languages. A total of 289 surveys were completed by Osceola County residents. Stakeholder interviews were collected from community members who represented underserved populations through the programs and services they offer, such as local food banks and federally qualified health centers. A total of nine focus groups were held which included representatives from organizations that serve underrepresented populations in Osceola County, including organizations that provide services primarily to the homeless populations, seniors, and incarcerated individuals as well as mental health providers. Ninety-seven key information surveys were collected from individuals who represented a particular population and/or sector in the community that was not able to be included in the stakeholder interviews or focus groups. Additionally, nine intercept surveys were conducted with patients at a local federally qualified health center.Group A-Facility 8 -- AdventHealth ApopkaAdventHealth Apopka (AHApk or the Hospital) is one of seven campuses that operate under a single hospital license. The seven hospital campuses of AdventHealth in Central Florida are known as the AdventHealth Central Florida Division South Region (CFD-South) and are located in the Central Florida counties of Seminole, Orange, and Osceola. AHApk is located in Orange County and its primary service area encompasses all of Orange County. The CFD-South conducted its 2019 Community Health Needs Assessment (CHNA) in two parts: a regional health needs assessment for four counties in Central Florida (Lake, Orange, Osceola and Seminole) (a sister hospital is located in Lake County, Florida and was a participant in the regional health needs assessment) and a separate health needs assessment focused on each of the seven separate CFD-South hospital campuses. The 2019 CHNA conducted for AHApk was built on input from people representing the broad and local community, as well as low-income, minority and other medically underserved populations. This input was solicited throughout 2019 and was gathered and considered in multiple ways as described below.AHApk had a local Community Health Needs Assessment Committee (CHNAC) that included representatives from the Hospital and community with a special focus on underserved populations within AHApk's community/service area. The following organizations participated in AHApk's CHNAC and specifically represented low-income, minority and other medically underserved populations:Community Health Centers - a federally qualified health center serving Central Florida residents;Seminole County Department of Health;Second Harvest Food Bank; Shepherd's Hope - a free and charitable clinic that provides care to the underinsured and uninsured; andHope Community Center.In order to ensure that input was solicited and gathered from low-income, minority, medically underserved, and other underrepresented community members, a variety of primary data collection efforts were made. Primary data for the 2019 CHNA was collected through a community survey, stakeholder interviews, focus groups, key informant surveys and intercept surveys. The audience for the community survey was the general community with a concentration on underrepresented populations. Both online and paper surveys were made available in four languages. A total of over 1,240 surveys were completed by Orange County residents. Stakeholder interviews were collected from community members who represented underserved populations through the programs and services they offer, such as local food banks and federally qualified health centers. A total of 9 focus groups were held which included representatives from organizations that serve underrepresented populations in Orange County, including organizations that provide services primarily to the homeless populations, seniors, and incarcerated individuals as well as mental health providers. One hundred and eleven key information surveys were collected from individuals who represented a particular population and/or sector in the community that was not able to be included in the stakeholder interviews or focus groups. Additionally, a total of 86 intercept surveys were conducted with individuals at United Against Poverty, AdventHealth Community Medicine Clinic and the Christian Service Center that focused on the health needs of underrepresented Orange County residents. **see continuation of footnote

Part V, Section B, Line 5 Continuation of Footnote:
Group A-Facility 10 -- AdventHealth WauchulaAdventHealth Wauchula is a 25-bed hospital located in Wauchula, Florida in Hardee County. It serves the same communities as its sister hospitals, AdventHealth Sebring and AdventHealth Lake Placid. AdventHealth Wauchula is designated by the state of Florida as a Critical Access Hospital. In conducting its 2019 Community Health Needs Assessment (CHNA), primary and secondary health data was collected and analyzed. Primary data was gathered based upon input from individuals representing the broad community, as well as low-income, minority, and other medically underserved populations. Primary data input was primarily gathered through the establishment of a Community Health Needs Assessment Committee, community surveys, and stakeholder interviews. AH Wauchula formed a Community Health Needs Assessment Committee (CHNAC) that included representatives of the community, with a special focus on underserved populations. Many of the CHNAC members were selected because of their direct ties to the underserved and impoverished communities in the primary service area of AH Wauchula. Key members of the CHNAC included representatives from the following organizations:Drug Free Hardee;MV Transportation - an organization involved in helping to meet transportation needs of those living in disadvantaged communities;Peace River Center - a domestic violence center;Healthy Start Coalition of Hardee, Highlands, and Polk Counties;Highlands County Board of County Commissioners;Nu-Hope Elder Care Services, Inc.;Heartland Regional Transportation Planning Organization;Florida Department of Health in Hardee County;Samaritan's Touch Care Center;Heartland Rural Health Network;Hardee Help Center; RCMA - an organization that provides child-care and child and parent education for migrant and other low-income families; and Central Florida Health Care - a federally qualified health center.Community surveys were completed on-line and in person by participants in community settings. Local community organizations assisted in survey participation efforts by providing access to a computer at community events. Community surveys were also made available at local clinics, community events, department of motor vehicle locations, and the community locations. A total of 578 residents participated in the Community Health Needs Assessment survey. AH Wauchula also gathered primary data through stakeholder interviews. Interviews were conducted on-line by members of the CHNAC.

Part V, Section B, Line 5 Footnote:
Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidAdventHealth Sebring (AH Sebring) and AdventHealth Lake Placid (AH Lake Placid) are both located in Highlands County Florida and operate under a single hospital license. AH Sebring and AH Lake Placid share the same service area which includes Highlands County and portions of adjacent Hardee County. In conducting its 2019 Community Health Needs Assessment (CHNA), primary and secondary health data was collected and analyzed. Primary data was gathered based upon input from individuals representing the broad community, as well as low-income, minority, and other medically underserved populations. Primary data input was primarily gathered through the establishment of a Community Health Needs Assessment Committee, community surveys, and stakeholder interviews. AH Sebring and AH Lake Placid formed a Community Health Needs Assessment Committee (CHNAC) that included representatives of the community, with a special focus on underserved populations. Many of the CHNAC members were selected because of their direct ties to the underserved and impoverished communities in the primary service area of AH Sebring and AH Lake Placid. Key members of the CHNAC included representatives from the following organizations:Drug Free Highlands;Highlands County Sheriff's Office;MV Transportation - an organization involved in helping to meet transportation needs of those living in disadvantaged communities;Peace River Center - a domestic violence center;Healthy Start Coalition of Hardee, Highlands, and Polk Counties; Highlands County Board of County Commissioners;Nu-Hope Elder Care Services, Inc.;Highway Park Neighborhood Council;Heartland Regional Transportation Planning Organization;Florida Department of Health in Highlands County;Samaritan's Touch Care Center;Wings of Faith Christian Worship Center;Heartland Rural Health Network;Highlands County Veteran Services Office;RCMA - an organization that provides child-care and child and parent education for migrant and other low-income families; and Central Florida Health Care - a federally qualified health center.Community surveys were completed on-line and in person by participants in community settings. Local community organizations assisted in survey participation efforts by providing access to a computer at community events. Community surveys were also made available at local clinics, community events, department of motor vehicle locations, and the community locations. A total of 578 residents from Highlands County participated in the Community Health Needs Assessment survey. AH Sebring and AH Lake Placid also gathered primary data through stakeholder interviews. Interviews were conducted on-line by members of the CHNAC.

Part V, Section B, Line 6a Footnote:
Facility Reporting Group - BAdventHealth Sebring and AdventHealth Lake Placid collaborated in conducting their Community Health Needs Assessments (CHNA) in 2019.

Part V, Section B, Line 7a:
Each hospital facility's CHNA report was made widely available through the following websites: Facility 1 -- AdventHealth Hospital Orlandohttps://www.adventhealth.com/community-health-needs-assessmentsFacility 2 -- AdventHealth Celebrationhttps://www.adventhealth.com/community-health-needs-assessmentsFacility 3 -- AdventHealth Altamonte Springshttps://www.adventhealth.com/community-health-needs-assessmentsFacility 4 -- AdventHealth East Orlandohttps://www.adventhealth.com/community-health-needs-assessmentsFacility 5 -- AdventHealth Winter Parkhttps://www.adventhealth.com/community-health-needs-assessmentsFacility 6 -- AdventHealth Kissimmeehttps://www.adventhealth.com/community-health-needs-assessmentsFacility 7 -- AdventHealth Sebringhttps://www.adventhealth.com/community-health-needs-assessmentsFacility 8 -- AdventHealth Apopkahttps://www.adventhealth.com/community-health-needs-assessments Facility 9 -- AdventHealth Lake Placidhttps://www.adventhealth.com/community-health-needs-assessments Facility 10 -- AdventHealth Wauchulahttps://www.adventhealth.com/community-health-needs-assessments Part V, Section B, Line 10a:Each hospital facility's most recently adopted implementation strategy was made widely available through the following websites: Facility 1 -- AdventHealth Hospital Orlandohttps://www.adventhealth.com/community-health-needs-assessments Facility 2 -- AdventHealth Celebrationhttps://www.adventhealth.com/community-health-needs-assessments Facility 3 -- AdventHealth Altamonte Springshttps://www.adventhealth.com/community-health-needs-assessments Facility 4 -- AdventHealth East Orlandohttps://www.adventhealth.com/community-health-needs-assessments Facility 5 -- AdventHealth Winter Parkhttps://www.adventhealth.com/community-health-needs-assessments Facility 6 -- AdventHealth Kissimmeehttps://www.adventhealth.com/community-health-needs-assessments Facility 7 -- AdventHealth Sebringhttps://www.adventhealth.com/community-health-needs-assessments Facility 8 -- AdventHealth Apopkahttps://www.adventhealth.com/community-health-needs-assessments Facility 9 -- AdventHealth Lake Placidhttps://www.adventhealth.com/community-health-needs-assessments Facility 10 -- AdventHealth Wauchulahttps://www.adventhealth.com/community-health-needs-assessments

Part V, Section B, Line 7d Footnote:
Facility Reporting Group - AThe Hospital facilities have adopted a policy that addresses the public posting requirements of the Community Health Needs Assessment. Under this policy, the Community Health Needs Assessment Reports must be posted on the Hospitals' websites at least until the date the hospital facilities have made widely available on its websites its two subsequent Community Health Needs Assessment Reports. The Hospitals will also make a paper copy of its Community Health Needs Assessment Report available for public inspection upon request and without charge, at least until the date the hospital facilities have made available for public inspection its two subsequent Community Health Needs Assessment Reports.

Part V, Section B, Line 7d Footnote:
Facility Reporting Group - BThe Hospital facilities have adopted a policy that addresses the public posting requirements of the Community Health Needs Assessment. Under this policy, the Community Health Needs Assessment Reports must be posted on the Hospitals' websites at least until the date the hospital facilities have made widely available on its websites its two subsequent Community Health Needs Assessment Reports. The Hospitals will also make a paper copy of its Community Health Needs Assessment Report available for public inspection upon request and without charge, at least until the date the hospital facilities have made available for public inspection its two subsequent Community Health Needs Assessment Reports.

Part V, Section B, Line 11 Footnote:
"Group A-Facility 1 -- AdventHealth OrlandoDescription of CHNA Significant NeedsAdventist Health System/Sunbelt, Inc. d/b/a AdventHealth Orlando will be referred to in this document as AdventHealth Orlando 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 Orlando is part of the Central Florida Division of AdventHealth. In 2020, the Central Florida Division North-Region (CFD-N), which includes AdventHealth Daytona Beach, AdventHealth DeLand, AdventHealth Fish Memorial, AdventHealth New Smyrna, AdventHealth Palm Coast and AdventHealth Waterman was combined with the Central Florida Division South-Region (CFD-S), which includes AdventHealth Altamonte, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Heart of Florida, AdventHealth Kissimmee, AdventHealth Lake Wales, AdventHealth Orlando and AdventHealth Winter Park to unify as one under the Central Florida Division. The combination included six hospitals from CFD-N and nine hospitals from CFD-S. The Community Health Plans/Implementation Strategies for both regions were finalized before the combination. The Central Florida Division of AdventHealth now includes 15 hospitals.This is the second-year update for AdventHealth Orlando'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 Orlando 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 Orlando chose four priorities for its 2020-2022 Community Health Plan: 1. Food Security2. Care Coordination3. Mental & Behavioral Health4. Community Development: Affordable Housing & HomelessnessPriority 1: Food Security 2019 Description of the Issue:Over one-third of community survey respondents indicated they lack access to high quality, affordable, healthy food. Having access to proper nutrition is necessary for a healthy life. Proper nutrition can also reduce the risk of, or complications from, certain diseases, such as diabetes. The Central Florida Division of AdventHealth is currently working to address food security with multiple partners, including Second Harvest Food Bank. AdventHealth intends to expand this work through current and future initiatives.2021 Update: The AdventHealth Orlando Community Health Plan has two desired goal statements under the Food Security priority.1. Increase access to healthy and affordable food for community members in need2. Work with community and government officials to address the root causes of food insecurity in our communitiesGoal 1: Increase access to healthy and affordable food for community members in needObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective, to sustain or build partnerships with at least six community organizations that focus on addressing food security is supported by multiple strategies: by providing in-kind contributions, financial support of at least $455,000 and annual board service over the next three years throughout the tri-county region. The tri-county region is defined as Orange, Osceola, and Seminole counties. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The first strategy, to support the objective through in-kind contributions, resulted in sustaining one partnership with a community organization in the Division. This sustained partnership was with Second Harvest Food Bank of Central Florida, a private, nonprofit organization that collects, stores, and distributes donated food to more than 550 feeding partners in six Central Florida counties. The Division continued its support to Second Harvest Food Bank through the Second Helpings program. This program enables each AdventHealth Central Florida Division hospital campus, including the reporting Hospital, to make in-kind donations of excess food to Second Harvest Food Bank to be distributed through local food pantries. In 2021, the reporting Hospital contributed 11,075 pounds of food or 9,229 meals toward this program.The second strategy, to support the objective through financial support, resulted in sustaining 17 partnerships and establishing four new partnerships with community organizations in the Division. In 2021, the reporting Hospital contributed $345,386 in financial support in year two toward the three-year goal of $455,000. Four of these partnerships were sustained on a tri-county level, this includes Orange County, Osceola County and Seminole County. The reporting Hospital sustained three of these partnerships and established one new partnership. Some of these partnerships included financially supporting grassroot efforts at four nonprofits to provide food to those in need through their food pantries or community gardens. Financial support was also provided for Seniors First, an organization that leads the local Meals on Wheels program, which provides home meal deliveries to seniors.The third strategy to support the objective, providing annual representation on boards of organizations focusing on food security which support the tri-county region (Orange, Osceola, and Seminole counties), was sustained by serving on three boards. Knowing that food security is a large-scale community issue, the Central Florida Division of AdventHealth will continue its efforts to serve on boards, coalitions and taskforces which work with local and state officials to address the root causes of food insecurity. This strategy also focuses on advocacy and food system reform to ensure equitable access to healthy food across the community. In 2021, the Central Florida Division of AdventHealth team members continued to serve on the boards of the Second Harvest Food Bank of Central Florida, the American Diabetes Association, and the American Heart Association, all of which impact the Central Florida Division's primary service area. Both the American Diabetes Association and the American Heart Association are nonprofits that provide education on nutrition and food-related conditions.The reporting Hospital continued to provide representation to serve on two boards within their primary service area. The first is on the board of the UP (United Against Poverty) Orlando, a local nonprofit that serves those in poverty by providing crisis case management, transformative education, food and household subsidies, job training and placement, personal empowerment training and referrals to other collaborative social service providers. The reporting Hospital also provides representation on the board of the Heart of Florida, a local nonprofit that provides education, health, and financial stability for every person in Central Florida.**see continuation of footnote"

Part V, Section B, Line 11 Continuation of Footnote:
Group A-Facility 1 -- AdventHealth OrlandoDescription of CHNA Significant Needs ContinuedObjective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to identify new partners and best practices to increase the effectiveness of efforts to bring healthy food to community members in need. These partnerships will be utilized to drive strategies across the tri-county area. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2021, the Division sustained their partnership with two local nonprofits, HEBNI Nutrition Consultants, Inc., and Infinite Zion Farms. HEBNI Nutrition Consultants, Inc was formed to educate high-risk, culturally diverse populations about nutrition strategies to prevent diet-related diseases. This partnership, over the next three-years, will increase the amount of healthy food available to community members in need. HEBNI Nutrition Consultants' services include nutrition education and a mobile market. The reporting Hospital provided $35,895 towards the mobile market which offers produce at a reduced cost in low-income, high-risk communities and food deserts. In 2021, 270 individuals received food prescriptions through the Fresh Stop Veggie Rx & Diabetes Prevention program funding.Through the reporting Hospital's funding, Infinite Zion Farms was able to build its first pilot greenhouse to provide additional fresh produce in Orange County, the county of the reporting Hospital. Infinite Zion Farms is a local nonprofit that is working to establish affordable sources of organic produce and education to the community at large. In 2021, the reporting Hospital provided funding to Infinite Zion Farms of $5,037 towards the installation of tower gardens to increase the fresh produce in Orange County, the county of the reporting Hospital.In 2021, the reporting Hospital also established a new partnership with Urban Smart Farms, a local organization founded to blaze a path in the local farming movement, inspiring and empowering communities to grow their own fresh, healthy produce in a cleaner, simpler, more efficient way. The reporting Hospital spent $16,575 to purchase 18 tower gardens from Urban Smart Farms to donate to local nonprofit partners.Goal 2: Work with community and government officials to address the root causes of food insecurity in our communitiesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority.This shared objective, to identify leadership from the tri-county area to participate in local coalitions focused on advocacy and reform to ensure equitable access to healthy food, is managed at a Divisional level, however all outcomes reported are specific to Orange County. This initiative provides an opportunity to form and participate in multisector collaboratives within Orange County, which are working on a shared goal to identify and strategize on best practices to address the root causes of food insecurity.In 2021, the Division continued to provide representation on behalf of the Hospital by participating in the Orange County Department of Health's Community Health Improvement Planning Committee. This committee is comprised of organizations throughout Orange County that plan and implement community improvement programs. By providing representation at a Divisional level, the Central Florida Division of AdventHealth is able to identify cross-county and various organizational partnerships that will benefit all of the communities they serve, regardless of geography.Priority 2: Care Coordination 2019 Description of the Issue:AdventHealth Orlando identified care coordination as a need, specifically in the areas of prenatal care/early intervention/early childhood, access to care and chronic disease management. Orange County had an increase in infant deaths, low birthweight babies and preterm births. There was also a decrease in the percentage of mothers who had prenatal care in the first trimester. In Orange County, 31.6 percent of community survey respondents indicated that they lacked access to a primary care provider. An additional 35.5 percent indicated they lacked access to a specialist. Limited access to high quality primary care physicians and specialists was identified as a community issue by primary research participants. Orange County also had an increase in individuals who were obese, middle school and high school students who are reporting a body mass index at or above the 95th percentile, adults with diabetes, diabetes hospitalizations for children ages 12 to 18, adults with hypertension and adults who have been told they had a stroke. 2021 Update: The AdventHealth Orlando Community Health Plan has two desired goal statements under the Care Coordination priority.1. Increase the availability of appropriate and affordable care2. Decrease barriers community members encounter while seeking careGoal 1: Increase the availability of appropriate and affordable careObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans in the Central 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 support to existing care facilities through multiple strategies, including financial contributions, in-kind labs, and residency rotations and to seek innovative ways to increase capacity through the provision of in-kind labs/imaging, volunteer services, etc. The first strategy is to provide support to existing care facilities through financial contributions. The strategy to support this objective is managed at a Divisional level. The reporting Hospital's funding included, but was not limited to, contributions for operational support for two local Federally Qualified Health Centers (FQHCs). A $50,379 contribution was made to the Health Care Center for the Homeless, which provides primary medical care, oral health services, behavioral health, and substance use services for underinsured and uninsured individuals. An additional $100,758 was provided to True Health, which delivers medical and mental health services to underserved populations.The reporting Hospital also provided $85,644 to Shepherd's Hope which will support medical homes to increase the availability of affordable care. Shepherd's Hope is a faith-based organization of volunteers who provide access to healthcare for uninsured patients. The second strategy is to provide in-kind labs to existing care facilities. The Division provided in-kind labs to the Health Care Center for the Homeless. In the future, the Division will develop a process to track and quantify in-kind labs and imaging provided to local nonprofits.The third strategy is to support a residency rotation to existing care facilities. The Division had a residency rotation program established with a local nonprofit. In 2021, for a multitude of reasons, including COVID-19, the program was discontinued. The Division has pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that may support residency rotations. The fourth strategy is to seek innovative ways to increase capacity through in-kind labs, imaging, and volunteer services. Due to COVID-19, the 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. **see continuation of footnote

Part V, Section B, Line 11 Continuation of Footnote:
Group A-Facility 1 -- AdventHealth OrlandoDescription of CHNA Significant Needs Continued Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans of AdventHealth Hospitals in Orange County, Osceola County and Seminole County including AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. These Hospitals are part of the Central Florida Division of AdventHealth and are in the same Division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority.This shared objective, to expand on existing care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need, is managed at a Divisional level. This initiative provides an opportunity to support organizations with a shared goal to increase accessible entry points. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2021, the reporting Hospital contributed funding of $60,454 to the American Cancer Society's Road to Recovery Program. This program provides rides to and from cancer treatment for any cancer patient, regardless of insurance or economic status, that has a transportation barrier. In total, the Road to Recovery program provided 209 rides for cancer patients. In 2021, the reporting Hospital also contributed $78,474 in year two towards the three-year funding partnership with AdventHealth University's Hope Clinic. This partnership provides cardiac rehabilitation (wellness maintenance) services to uninsured and underinsured individuals to improve health outcomes and reduce readmissions. The Hope Clinic provides free care to individuals with socio-economic barriers, to increase access to care regardless of financial circumstance. In 2021, the Hope Clinic opened and enrolled 13 patients into the program.Goal 2: Decrease barriers community members encounter while seeking careObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in Orange County, Osceola County and Seminole County including AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. These Hospitals are part of the Central Florida Division of AdventHealth and are in the same Division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This shared objective, to provide case management services for at least 81 patients over three years while identifying additional partners and methods to decrease barriers community members encounter while seeking care, is managed at a Divisional level. In 2021, the Division continued to support the Holistic Health program led by Center for Change, a local nonprofit, which aims to provide health education and social services to individuals and families who lack access to economic, social and health resources. The reporting Hospital contributed $59,474 towards the Holistic Health program which focuses its efforts in high-need communities identified in the CHNA. The Division is progressing on this objective and 48 individuals have been provided case management service. Additionally, in 2021, 276 referrals to services have been provided, 105 individuals have improved their biometrics and 125 individuals have improved health behaviors through the program. Priority 3: Mental & Behavioral Health 2019 Description of the Issue:Mental health, behavioral health and substance use were all identified as top community needs by stakeholders, key informants and focus groups. Only one in ten community survey respondents from Orange County believe there is sufficient substance abuse services. Poor mental health can exacerbate physical health conditions, decreasing quality of life and making it more difficult to maintain stable housing. The Central Florida Division of AdventHealth is heavily invested in addressing mental health and substance abuse and has partnered with community organizations such as the local Federally Qualified Health Centers (FQHCs), Seminole County Sheriff's Office, Aspire Health Partners, and the National Alliance on Mental Illness.2021 Update: The AdventHealth Orlando Community Health Plan has two desired goal statements under the Mental & Behavioral Health priority.1. Increase access to mental and behavioral health services2. Support existing resources and identify new partners and programs that proactively strengthen the communityGoal 1: Increase access to mental and behavioral health servicesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase provider capacity through financial and in-kind support to at least three partners serving the tri-county community. This shared objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This initiative provides an opportunity for the reporting Hospital to support at least three partners that have a shared goal of increasing provider capacity in the space of mental and behavioral health. In 2021, the reporting Hospital sustained partnerships with three partners to implement programs that serve the tri-county community: Aspire Health Partners' Psychosocial Rehabilitation Program, Central Florida Center for the Arts' Community Music Therapy Program, and Health Care Center for the Homeless' Eye Movement Desensitization and Reprocessing (EMDR) Therapy Program. The reporting Hospital met its set metric of providing financial support to at least three partners by funding these organizations for a total of $129,942. With the funding, they were able to provide programs that serve the underinsured and uninsured individuals in the reporting Hospital's service area. Aspire Health Partners is an organization committed to providing individuals and families of Central Florida with compassionate, comprehensive, and cost-effective behavioral health care services that lead to successful living and healthy, responsible lifestyles. Not only does Aspire Health Partners receive financial funding for the Psychosocial Rehabilitation Program, but the Division also leases five crisis stabilization unit (CSU) beds to connect individuals who have acute needs to mental health services. The Division also supports the Central Florida Center for the Arts which exists to serve and build community through the arts. Through the Music Therapy Program, the organization hired a music therapist to support individual and group music therapy across the tri-county area. The Division partnered with the Health Care Center for the Homeless to launch the EMDR Therapy program for homeless and low-income, uninsured, and underinsured community members in need. This therapy will help community members with conditions such as Post-Traumatic Stress Disorder (PTSD), addiction and healing from past trauma. Other initiatives to address this objective include providing in-kind support through board service. In 2021, the reporting Hospital served on the following boards which focus on addressing the mental health needs of Central Floridians: Mental Health Association of Central Florida and IMPOWER. The Mental Health Association of Central Florida is an organization that provides mental health services, support, and information to the members of Orlando and surrounding Central Florida community. IMPOWER is a nonprofit organization based in Central Florida that focuses on changing lives by protecting, counseling, teaching and inspiring individuals and families to reach their full potential.**see continuation of footnote

Part V, Section B, Line 11 Continuation of Footnote:
Group A-Facility 1 -- AdventHealth OrlandoDescription of CHNA Significant Needs ContinuedObjective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. This objective is to develop and support pathways to mental and behavioral healthcare for those in need by expanding care navigation models to include mental and behavioral health focused initiatives over the next three years. This shared objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. In 2021, the reporting Hospital provided $2,518 to Bliss Cares to provide mental health services to their target clients. Bliss Cares is a nonprofit organization that has a mission to save lives by treating and preventing the spread of HIV, Hepatitis, and sexually transmitted diseases (STDs). Goal 2: Support existing resources and identify new partners and programs that proactively strengthen the communityObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. This objective is supported by multiple strategies: provide the Mission: FIT POSSIBLE program to at least two schools annually in the AdventHealth Orlando primary service area that were identified as hot spots and collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. This objective is managed at a Divisional level; however, all outcomes are specific to AdventHealth Hospitals in Orange County. The first strategy was to provide the Mission: FIT POSSIBLE program to at least two schools in the AdventHealth Orlando primary service area per year that were identified as hot spots. This objective was exceeded by the Division, with 27 schools in the reporting Hospital's primary service area receiving the program. Outcomes reported for this strategy, which support the objective, are specific to Orange County. The Mission: FIT POSSIBLE program is a comprehensive wellness program which brings health and wellness education to schools, churches, and community centers. Health and wellness educators provide education during regular visits, as well as supplemental education for teachers and staff to engage kids in activities that teach them how to be physically and emotionally healthy.The second strategy is to collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. Outcomes reported for this strategy, which support the objective, are specific to reporting AdventHealth Hospitals. This objective was met through an initiative, Circle of Security led by the Early Learning Coalition of Orange County (ELCOC). The reporting Hospital contributed $12,594 towards ELCOC's Circle of Security program. ELCOC is dedicated to the success of early childhood development in the community through early education. The Circle of Security program builds teachers' responsiveness to young children's emotional needs to better support their positive mental health. The ELCOC seeks to provide the Circle of Security attachment training to early childhood teachers in Orange County's most under-resourced communities. The reporting Hospital was able to meet this objective in Orange County, the county of the reporting Hospital. In 2021, the reporting Hospital also contributed funding of $50,379 towards the No Limit Health and Education's program, No Limit Unit. No Limit Health and Education is a local nonprofit whose mission is to promote mental health (social, emotional, and psychological) wellness and awareness through advocacy, programs, services, and outreach. Through this partnership, No Limit Unit provides services to adults and youth for both individual empowerment and systemic change in the areas of mental and physical wellness. Barbershop Talk Tours, Thriving Moms Club and Flow Detox reach men, women and children through mental health education, support groups and reduction of stigma. The reporting Hospital will continue to seek additional community partners to collaborate with and strengthen community resiliency in the remaining counties it serves.Priority 4: Community Development: Affordable Housing & Homelessness 2019 Description of the Issue:There were over 1,500 individuals experiencing homelessness in Orange County in 2018. When individuals are experiencing homelessness, it is more difficult to access health care and manage chronic physical and mental conditions. The AdventHealth Central Florida Division is heavily invested in addressing homelessness and is involved with partners such as: Christian Service Center, Coalition for the Homeless of Central Florida, Dave's House, Family Promise of Greater Orlando, Homeless Services Network of Central Florida, and others.2021 Update: The AdventHealth Orlando Community Health Plan has one desired goal statement under the Community Development: Affordable Housing & Homelessness priority.1. Support efforts to increase access to care and provide services to our homeless populationGoal 1: Support efforts to increase access to care and provide services to our homeless populationObjective 1: The first objective is a shared initiative between AdventHealth Orlando, AdventHealth Celebration and AdventHealth Kissimmee. These Hospitals are part of the Central 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 annual financial and in-kind support, including board service and employee volunteers, to support community partners and increase the capacity to care for our homeless population. This objective is managed at the Divisional level; outcomes reported for this objective are for the Division and not specific to the reporting Hospital. The first strategy is to provide financial support to local organizations that are working to address the affordable housing needs and immediate needs of individuals experiencing homelessness. The reporting Hospital progressed on this metric by providing financial support of $96,526 to six organizations in the Hospital's primary service area. Samaritan Resource Center received $57,238 to increase access to mental health resources and job skills training which aims to increase positive outcomes and decrease recidivism in the cycle of homelessness. SALT Outreach was given $20,455 to support their work to help individuals experiencing homelessness access mobile showers and community resources. The Coalition for the Homeless, a low-barrier shelter focusing on stabilization, rehousing and diversion received $2,518. Dave's House received $6,037 to further provide supportive housing for individuals with serious mental illness. Habitat for Humanity received $2,518 to support a special project that served individuals dealing with homelessness. United Against Poverty received $7,556 to serve those in poverty by providing crisis care, case management, transformative education, food and household subsidies, employment training and placement, personal empowerment training and active referrals to other collaborative social service providers.**see continuation of footnote

Part V, Section B, Line 11 Continuation of Footnote:
Group A-Facility 1 -- AdventHealth OrlandoDescription of CHNA Significant Needs ContinuedThe second strategy is to provide in-kind support to local organizations that are working to address the affordable housing needs and immediate needs of individuals experiencing homelessness. The reporting Hospital progressed on this metric with in-kind services, including service on two boards. Boards served on include Christian Service Center and The Sharing Center. Both of these organizations work to address the immediate and/or long-term needs of those experiencing homelessness. Due to COVID-19, the 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. Community Needs Not Chosen by AdventHealth OrlandoThe 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. Community Resources Group: Although there is a multitude of resources available in the community, many community members may not know of these services or how to access them. To optimize utilization of available resources, the local CHNAC discussed potential solutions, which included creating community resource groups to inform community members of available resources, but it will not be included in the Community Health Plan. Although the Hospital did not choose to prioritize this issue and address it through the Community Health Plans, the Community Asset Inventory created for the CHNA report includes a list of available resources in the tri-county area. This Community Asset Inventory will be updated, shared with community organizations, and made publicly available.

Part V, Section B, Line 11 Continuation of Footnote:
"Group A-Facility 2 -- AdventHealth CelebrationDescription of CHNA Significant Needs Adventist Health System/Sunbelt, Inc. d/b/a AdventHealth Celebration will be referred to in this document as AdventHealth Celebration 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 Celebration is part of the Central Florida Division of AdventHealth. In 2020, the Central Florida Division North-Region (CFD-N), which includes AdventHealth Daytona Beach, AdventHealth DeLand, AdventHealth Fish Memorial, AdventHealth New Smyrna, AdventHealth Palm Coast and AdventHealth Waterman was combined with the Central Florida Division South-Region (CFD-S), which includes AdventHealth Altamonte, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Heart of Florida, AdventHealth Kissimmee, AdventHealth Lake Wales, AdventHealth Orlando and AdventHealth Winter Park to unify as one under the Central Florida Division. The combination included six hospitals from CFD-N and nine hospitals from CFD-S. The Community Health Plans/Implementation Strategies for both regions were finalized before the combination. The Central Florida Division of AdventHealth now includes 15 hospitals.This is the second-year update for AdventHealth Celebration'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 Celebration 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 Celebration chose four priorities for its 2020-2022 Community Health Plan: 1. Food Security2. Care Coordination3. Mental & Behavioral Health4. Community Development: Affordable Housing & HomelessnessPriority 1: Food Security 2019 Description of the Issue:More than 40 percent of community survey respondents from Osceola County indicated that they do not have access to healthy, affordable food. Food security was also identified as a need related to chronic conditions. Having access to proper nutrition is necessary for a healthy life. Proper nutrition can also reduce the risk of, or complications from, certain diseases, such as diabetes. The Central Florida Division of AdventHealth (the Division) is currently working to address food security with multiple partners, including Second Harvest Food Bank. The Division intends to expand this work through current and future initiatives.2021 Update: The AdventHealth Celebration Community Health Plan has two desired goal statements under the Food Security priority.1. Increase access to healthy and affordable food for community members in need2. Work with community and government officials to address the root causes of food insecurity in our communitiesGoal 1: Increase access to healthy and affordable food for community members in needObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to sustain or build partnerships with at least six community organizations that focus on addressing food security and is supported by multiple strategies including the provision of in-kind contributions, financial support of at least $455,000 and annual volunteer board service over the next three years throughout the tri-county region. The tri-county region is defined as Orange, Osceola, and Seminole counties. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The first strategy, to support the objective through in-kind contributions, resulted in sustaining one partnership with a community organization in the Division. This sustained partnership was with Second Harvest Food Bank of Central Florida, a private, nonprofit organization that collects, stores, and distributes donated food to more than 550 feeding partners in six Central Florida counties. The Division continued its support to Second Harvest through the Second Helpings program. This program enables each hospital campus, including the reporting Hospital, to make in-kind donations of excess food to Second Harvest to be distributed through local food pantries. In 2021, for a multitude of reasons, including COVID-19, the reporting Hospital was not able to contribute to the Second Helpings program. The reporting Hospital has pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. The reporting Hospital will work to identify ways to support our community and the community-based organizations that may support this strategy. The second strategy, to support the objective through financial support, resulted in sustaining 17 partnerships and establishing four new partnerships with community organizations in the Division. In 2021, the reporting Hospital contributed $84,035 in financial support in year two towards the three-year goal of $455,000. Four of these partnerships were sustained on a tri-county level, this includes Orange County, Osceola County and Seminole County. The AdventHealth reporting Hospital sustained one of these partnerships. Financial support was also provided to Celebration Foundation, an organization that leads the local Learning without Hunger program, which provides food to children living in Osceola County on the weekends. The third strategy to support the objective, providing annual representation on boards of organizations focusing on food security which support the tri-county region (Orange, Osceola, and Seminole counties), was sustained by serving on three boards. Knowing that food security is a large-scale community issue, the Central Florida Division of AdventHealth will continue its efforts to serve on boards, coalitions and taskforces which work with local and state officials to address the root causes of food insecurity. This strategy also focuses on advocacy and food system reform to ensure equitable access to healthy food across the community. In 2021, the Central Florida Division of AdventHealth team members continued to serve on the boards of the Second Harvest Food Bank of Central Florida, the American Diabetes Association, and the American Heart Association, all of which impact the Central Florida Division's primary service area. Both the American Diabetes Association and the American Heart Association are nonprofits that provide education on nutrition and food-related conditions.The reporting Hospital continued to provide representation to serve on one board, Celebration Foundation, within their primary service area. Celebration Foundation is a local organization whose mission is to build better community through the arts, culture, and education.**see continuation of footnote"

Part V, Section B, Line 11 Continuation of Footnote:
Group A-Facility 2 -- AdventHealth CelebrationDescription of CHNA Significant Needs Continued Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to identify new partners and best practices to increase the effectiveness of efforts to bring healthy food to community members in need. These partnerships will be utilized to drive strategies across the tri-county area. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2021, the Division sustained their partnership with one local nonprofit, HEBNI Nutrition Consultants, Inc., which was formed to educate high-risk, culturally diverse populations about nutrition strategies to prevent diet-related diseases. This partnership, over the next three-years, will increase the amount of healthy food available to community members in need. HEBNI Nutrition Consultants' services include nutrition education and a mobile market. The mobile market is funded by the Central Florida Division of AdventHealth and offers produce at a reduced cost in low-income, high-risk communities and food deserts. In 2021, the reporting Hospital also sustained its partnership with the School District of Osceola County (SDOC)'s SMART Bus. The SMART Bus provides food, education, access to Wi-Fi and family support to meet the needs of the 2,500 homeless students enrolled in the SDOC. The new partnership is reported for the Division, not Hospital specific and appears on the community health plans of all Hospitals in Osceola County where the initiative is conducted. This includes the plans of AdventHealth Celebration and AdventHealth Kissimmee.Goal 2: Work with community and government officials to address the root causes of food insecurity in our communitiesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority.This shared objective, to identify leadership from the tri-county area to participate in local coalitions focused on advocacy and reform to ensure equitable access to healthy food, is managed at a Divisional level, however all outcomes reported are specific to Osceola County. This initiative provides an opportunity to form and participate in multisector collaboratives within Osceola County, which are working on a shared goal to identify and strategize on best practices to address the root causes of food insecurity.In 2021, the Division continued to provide representation on behalf of the Hospital to participate in the Osceola Health Leadership Council. This council is comprised of organizations throughout Osceola County that plan and implement community improvement programs. By providing representation at a Divisional level, the Central Florida Division of AdventHealth is able to identify cross-county and various organizational partnerships that will benefit all of the communities they serve, regardless of geography.Priority 2: Care Coordination 2019 Description of the Issue:AdventHealth Celebration identified care coordination as a need, specifically preventative care/health screenings, access to care and pediatric and women's health (including prenatal). Osceola County primary data respondents were less likely to indicate that they accessed preventative care services, such as a PSA test, lab work and Pap tests. In 2016, 23.6 percent of Osceola County adults could not see a doctor due to cost. Primary data respondents from Osceola County also identified transportation and care coordination as barriers to care in relation to chronic conditions when seeking care. A little more than 10 percent of Osceola County community survey respondents indicated that they have difficulty accessing prenatal care.2021 Update: The AdventHealth Celebration Community Health Plan has two desired goal statements under the Care Coordination priority.1. Increase the availability of appropriate and affordable care2. Decrease barriers community members encounter while seeking careGoal 1: Increase the availability of appropriate and affordable careObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central 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 support to existing care facilities through multiple strategies, including financial contributions, in-kind labs, and residency rotations and to seek innovative ways to increase capacity through the provision of in-kind labs/imaging, volunteer services, etc. The first strategy is to provide support to existing care facilities through financial contributions. The strategy to support this objective is managed at a Divisional level. The reporting Hospital's funding included, but was not limited to, contributions for operational support for a local Federally Qualified Health Center (FQHC). A $833 contribution was made to the Health Care Center for the Homeless, which provides primary medical care, oral health services, behavioral health and substance use services for underinsured and uninsured individuals. The reporting Hospital provided $1,905 in financial contribution to Osceola Council on Aging to support clinical operations. Additionally, the reporting Hospital provided $2,977 to Osceola Community Health Services, a local FQHC focused on meeting an individual's physical and mental health care needs, including prevention, wellness, acute and chronic care, for operational support to increase the availability of affordable care.The second strategy is to provide in-kind labs to existing care facilities. The Division provided in-kind labs to the Health Care Center for the Homeless. In the future, the Division will develop a process to track and quantify in-kind labs and imaging provided to local nonprofits.The third strategy is to support a residency rotation to existing care facilities. The Division had a residency rotation program established with a local nonprofit. In 2021, for a multitude of reasons, including COVID-19, the program was discontinued. The Division has pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that may support residency rotations. The fourth strategy is to seek innovative ways to increase capacity through in-kind labs, imaging, and volunteer services. Due to COVID-19, the 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. Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in Orange County, Osceola County and Seminole County: AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. These Hospitals are part of the Central Florida Division of AdventHealth and are in the same Division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority.This shared objective, to expand on existing care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need, is managed at a Divisional level. This initiative provides an opportunity to support organizations with a shared goal to increase accessible entry points. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.**see continuation of footnote

Part V, Section B, Line 11 Continuation of Footnote:
Group A-Facility 2 -- AdventHealth CelebrationDescription of CHNA Significant Needs Continued In 2021, the reporting Hospital has contributed funding of $14,292 to the American Cancer Society's Road to Recovery Program. This program provides rides to and from cancer treatment for any cancer patient, regardless of insurance or economic status, that has a transportation barrier. In total, the Road to Recovery program provided 209 rides for cancer patients. In 2021, the reporting Hospital also contributed $18,552 in year two towards the three-year funding partnership with AdventHealth University's Hope Clinic. This partnership provides cardiac rehabilitation (wellness maintenance) services to uninsured and underinsured individuals to improve health outcomes and reduce readmissions. The Hope Clinic provides free care to individuals with socio-economic barriers, to increase access to care regardless of financial circumstance. In 2021, the Hope Clinic opened and enrolled 13 patients into the program.Goal 2: Decrease barriers community members encounter while seeking careObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in Orange County, Osceola County and Seminole County: AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. These Hospitals are part of the Central Florida Division of AdventHealth and are in the same Division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This shared objective, to provide case management services for at least 81 patients over three years while identifying additional partners and methods to decrease barriers community members encounter while seeking care, is managed at a Divisional level. In 2021, the Division continued to support the Holistic Health program led by Center for Change, a local nonprofit, which aims to provide health education and social services to individuals and families who lack access to economic, social and health resources. The reporting Hospital contributed $14,060 towards the Holistic Health program which focuses its efforts in high-need communities identified in the CHNA. The Division is progressing on this objective and 48 individuals have been provided case management service. Additionally, in 2021, 276 referrals to services have been provided, 105 individuals have improved their biometrics and 125 individuals have improved health behaviors through the program. Priority 3: Mental & Behavioral Health 2019 Description of the Issue:Less than 10 percent of community survey respondents from Osceola County believe there are enough mental health providers and nearly 60 percent of Osceola County community survey respondents indicated they feel depressed or hopeless. When discussing with primary research participants, it was stated that the high level of stress people were experiencing could make it difficult to cope with mental illness. This may be caused by lack of community support and available support services to manage mental health. The Central Florida Division of AdventHealth has several care options for mental health services. These include the Outlook Clinic and connections to FQHCs. The Central Florida Division of AdventHealth is funding several mental and behavioral health services in the community, including an eye movement desensitization and reprocessing (EMDR) psychotherapy treatment at a local FQHC and a music therapy program.2021 Update: The AdventHealth Celebration Community Health Plan has two desired goal statements under the Mental & Behavioral Health priority.1. Increase access to mental and behavioral health services2. Support existing resources and identify new partners and programs that proactively strengthen the communityGoal 1: Increase access to mental and behavioral health servicesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase provider capacity through financial and in-kind support to at least three partners serving the tri-county community. This shared objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This initiative provides an opportunity for the reporting Hospital to support at least three partners that have a shared goal of increasing provider capacity in the space of mental and behavioral health. In 2021, the reporting Hospital sustained partnerships with two partners to implement programs that serve the tri-county community: Central Florida Center for the Arts' Community Music Therapy Program, and Health Care Center for the Homeless' Eye Movement Desensitization and Reprocessing (EMDR) Therapy Program. The reporting Hospital is progressing on its set metric of providing financial support to at least three partners by funding these organizations for a total of $10,759. With the funding, they were able to provide programs that serve the underinsured and uninsured individuals in the reporting Hospital's service area. The reporting Hospital supports the Central Florida Center for the Arts which exists to serve and build community through the arts. Through the Music Therapy Program, the organization hired a music therapist to support individual and group music therapy across the tri-county area. The reporting Hospital also partnered with the Health Care Center for the Homeless to launch the EMDR Therapy program for homeless and low-income, uninsured, and underinsured community members in need. This therapy will help community members with conditions such as Post-Traumatic Stress Disorder (PTSD), addiction and healing from past trauma. Other initiatives to address this objective include providing in-kind support through board service. Due to COVID-19, the 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.**see continuation of footnote

Part V, Section B, Line 11 Continuation of Footnote:
Group A-Facility 2 -- AdventHealth CelebrationDescription of CHNA Significant Needs Continued Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. This objective is to develop and support pathways to mental and behavioral healthcare for those in need by expanding care navigation models to include mental and behavioral health focused initiatives over the next three years. This shared objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. In 2021, the reporting Hospital provided $29,775 to Park Place Behavioral Health Care for operational support. Park Place is an organization that provides therapeutic, psychiatric and substance use disorder services in Central Florida. Goal 2: Support existing resources and identify new partners and programs that proactively strengthen the communityObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. This objective is supported by multiple strategies: provide the Mission: FIT POSSIBLE program to at least two schools annually in the AdventHealth Celebration's primary service area that were identified as hot spots and collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. This objective is managed at a Divisional level; however, all outcomes are specific to Hospitals in Osceola County. The first strategy was to provide the Mission: FIT POSSIBLE program to at least two schools in the AdventHealth Celebration's primary service area per year that were identified as hot spots. This objective was exceeded by the Division, with six schools in the reporting Hospital's primary service area receiving the program. Outcomes reported for this strategy, which supports the objective, are specific to Osceola County. The Mission: FIT POSSIBLE program is a comprehensive wellness program which brings health and wellness education to schools, churches, and community centers. Health and wellness educators provide education during regular visits, as well as supplemental education for teachers and staff to engage kids in activities that teach them how to be physically and emotionally healthy.The second strategy is to collaborate with partners to strengthen community resiliency by proactivity educating and identifying resources to deliver resiliency-focused trainings and resources to the community. Outcomes reported for this strategy, which support the objective, are specific to reporting Hospitals in Osceola County. This includes AdventHealth Celebration and AdventHealth Kissimmee. Due to COVID-19, the 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.Priority 4: Community Development: Affordable Housing & Homelessness 2019 Description of the Issue:Osceola County has the highest percentage of renter households who were cost burdened (24.4 percent) and severely cost burdened (25.1 percent). Osceola County also had 21.1 percent of homeowner residents who are severely cost burdened. Affordable housing has a large impact on other health outcomes and wellbeing. It enables families to have the opportunity to meet their respective health, education, and employment needs. The Central Florida Division of AdventHealth is heavily invested in addressing homelessness and is involved with partners such as: Coalition for the Homeless of Central Florida, Family Promise of Greater Orlando, Homeless Services Network of Central Florida and others.2021 Update: The AdventHealth Celebration Community Health Plan has two desired goal statements under the Community Development: Affordable Housing & Homelessness priority.1. Support efforts to increase access to care and provide services to our homeless population2. Participate in advocacy efforts to provide affordable housing for community membersGoal 1: Support efforts to increase access to care and provide services to our homeless populationObjective 1: The first objective is a shared initiative between AdventHealth Orlando, AdventHealth Celebration and AdventHealth Kissimmee. These Hospitals are part of the Central 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 annual financial and in-kind support, including board service and employee volunteers to support community partners and increase the capacity to care for our homeless population. This objective is managed at the Divisional level; however, all outcomes are specific to Hospitals in Osceola County.The first strategy is to provide financial support to local organizations that are working to address the affordable housing needs and immediate needs of individuals experiencing homelessness. The reporting Hospital progressed on this metric by providing financial support to two organizations in the reporting Hospital's primary service area. Clarita's House received $297 to support their emergency housing service for families in crisis. Habitat for Humanity also received $595 to support a special project that served individuals dealing with homelessness. The second strategy is to provide in-kind support to local organizations that are working to address the affordable housing needs and immediate needs of individuals experiencing homelessness. Due to COVID-19, the 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.**see continuation of footnote

Part V, Section B, Line 11 Continuation of Footnote:
Group A-Facility 2 -- AdventHealth CelebrationDescription of CHNA Significant Needs Continued Goal 2: Participate in advocacy efforts to provide affordable housing for community membersObjective 1: The first objective is a shared initiative between AdventHealth Celebration and AdventHealth Kissimmee. These Hospitals are part of the Central 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 annual financial and in-kind support, including board service and employee volunteers, to support community partners and increase the capacity to care for our homeless population. This objective is managed at the Divisional level, but all outcomes are specific to the reporting Hospitals in Osceola County.The first strategy is to provide financial support to community partners to enhance their capacity to provide care. The reporting Hospital progressed on this metric by providing financial support of $595 to Hope Partnership, a nonprofit organization that aims to provide a holistic continuum of care to end homelessness and poverty in Central Florida.The second strategy is to provide in-kind support to community partners to enhance their capacity to provide care. Due to COVID-19, the 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.Community Needs Not Chosen by AdventHealth CelebrationThe 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. Poverty: The local Community Health Needs Assessment Committee (CHNAC) understands that poverty has a large impact on health and wellbeing. The CHNAC agreed that the scale of this need is too broad, and it would not be a realistic issue to be addressed with the resources available at this time. 2. Education: The local CHNAC discussed education, health education and literacy. It was determined that education was better addressed by existing organizations and resources in the community. Certain aspects of education such as health literacy will be addressed under care coordination initiatives.

Part V, Section B, Line 11 Continuation of Footnote:
"Group A-Facility 3 -- AdventHealth AltamonteDescription of CHNA Significant NeedsAdventist Health System/Sunbelt, Inc. d/b/a AdventHealth Altamonte Springs will be referred to in this document as AdventHealth Altamonte Springs 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 Altamonte Springs is part of the Central Florida Division of AdventHealth. In 2020, the Central Florida Division North-Region (CFD-N), which includes AdventHealth Daytona Beach, AdventHealth DeLand, AdventHealth Fish Memorial, AdventHealth New Smyrna, AdventHealth Palm Coast and AdventHealth Waterman was combined with the Central Florida Division South-Region (CFD-S), which includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Heart of Florida, AdventHealth Kissimmee, AdventHealth Lake Wales, AdventHealth Orlando and AdventHealth Winter Park to unify as one under the Central Florida Division. The combination included six hospitals from CFD-N and nine hospitals from CFD-S. The Community Health Plans/Implementation Strategies for both regions were finalized before the combination. The Central Florida Division of AdventHealth (the Division) now includes 15 hospitals.This is the second-year update for AdventHealth Altamonte Springs' 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 Altamonte Springs 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 Altamonte Springs chose four priorities for its 2020-2022 Community Health Plan: 1. Food Security2. Care Coordination3. Mental & Behavioral Health4. Community Development: Youth Development & Mentorship Priority 1: Food Security 2019 Description of the Issue:More than 25% of community survey respondents from Seminole County indicated that they do not have access to healthy, affordable food. Food security was also defined as a need related to chronic conditions. Having access to proper nutrition is necessary for a healthy life. Proper nutrition can also reduce the risk of, or complications from, certain diseases, such as diabetes. The Central Florida Division of AdventHealth is currently working to address food security with multiple partners, including Second Harvest Food Bank. The Central Florida Division of AdventHealth intends to expand this work through current and future initiatives.2021 Update: The AdventHealth Altamonte Springs Community Health Plan has two desired goal statements under the Food Security priority.1. Increase access to healthy and affordable food for community members in need2. Work with community and government officials to address the root causes of food insecurity in our communitiesGoal 1: Increase access to healthy and affordable food for community members in needObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to sustain or build partnerships with at least six community organizations that focus on addressing food security and is supported by multiple strategies including the provision of in-kind contributions, financial support of at least $455,000 and annual volunteer board service over the next three years throughout the tri-county region. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The first strategy, to support the objective through in-kind contributions, resulted in sustaining one partnership with a community organization in the Division. This sustained partnership was with Second Harvest Food Bank of Central Florida, a private, nonprofit organization that collects, stores, and distributes donated food to more than 550 feeding partners in six Central Florida counties. The Division continued its support to Second Harvest through the Second Helpings program. This program enables each hospital campus, including the reporting Hospital, to make in-kind donations of excess food to Second Harvest to be distributed through local food pantries. In 2021, the reporting Hospital contributed 1,252 pounds of food or 1,043 meals toward this program. The second strategy, to support the objective through financial support, resulted in sustaining 17 partnerships and establishing four new partnerships with community organizations in the Division. In 2021, the reporting Hospital contributed $78,935 in financial support in year two toward the three-year goal of $455,000. Four of these partnerships were sustained on a tri-county level, this includes Orange County, Osceola County, and Seminole County. The reporting Hospital sustained two of these partnerships and established one new partnership. For the reporting Hospital, one of these partnerships included financially supporting a grassroots effort at one local church, Mars Hill, to provide food to those in need through their church food pantry. Financial support was also provided to Meals on Wheels of Seminole County, which provides home meal deliveries to seniors and Harvest Time International which supports a family food voucher program. The outcomes reported for this strategy, which supports the objective, are specific to Seminole County.The third strategy to support the objective, providing annual representation on boards of organizations focusing on food security which support the tri-county region (Orange, Osceola, and Seminole counties), was sustained by serving on three boards. Knowing that food security is a large-scale community issue, the reporting Hospital will continue its efforts to serve on boards, coalitions and taskforces which work with local and state officials to address the root causes of food insecurity. This strategy also focuses on advocacy and food system reform to ensure equitable access to healthy food across the community. In 2021, the Central Florida Division of AdventHealth team members continued to serve on boards of the Second Harvest Food Bank of Central Florida, the American Diabetes Association, and the American Heart Association, all of which impact the Central Florida Division's primary service area. Both the American Diabetes Association and the American Heart Association are nonprofits that provide education on nutrition and food-related conditions.The reporting Hospital also provided representation to serve Meals on Wheels of Seminole County within their primary service area. Meals on Wheels of Seminole County is a local nonprofit that provides meals and assistance for vulnerable seniors living in Seminole County.**see continuation of footnote"

Part V, Section B, Line 11 Continuation of Footnote:
Group A-Facility 3 -- AdventHealth AltamonteDescription of CHNA Significant Needs Continued Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to identify new partners and best practices to increase the effectiveness of efforts to bring healthy food to community members in need. These partnerships will be utilized to drive strategies across the tri-county area. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2021, the Division sustained their partnership with one local nonprofit, HEBNI Nutrition Consultants, Inc., which was formed to educate high-risk, culturally diverse populations about nutrition strategies to prevent diet-related diseases. This partnership, over the next two years, will increase the amount of healthy food available to community members in need. HEBNI Nutrition Consultants' services include nutrition education and a mobile market. The reporting Hospital provided $7,971 toward the mobile market which offers produce at a reduced cost in low-income, high-risk communities and food deserts. In 2021, 270 individuals received food prescriptions through the Fresh Stop Veggie Rx & Diabetes Prevention Program.In 2021, the reporting Hospital also established a new partnership with Urban Smart Farms, a local organization founded to blaze a path in the local farming movement, inspiring and empowering communities to grow their own fresh, healthy produce in a cleaner, simpler, more efficient way. The reporting Hospital spent $1,854 to purchase 18 tower gardens from Urban Smart Farms to donate to local nonprofit partners.Goal 2: Work with community and government officials to address the root causes of food insecurity in our communitiesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. This shared objective, to identify leadership from the tri-county area to participate in local coalitions focused on advocacy and reform to ensure equitable access to healthy food, is managed at a Divisional level, however all outcomes reported are specific to the reporting Hospital. This initiative provides an opportunity to form and participate in multisector collaboratives within Seminole County, which are working on a shared goal to identify and strategize on best practices to address the root causes of food insecurity.In 2021, the Division continued to provide representation on behalf of the Hospital by participating in the Seminole County Department of Health's Healthy Seminole committee. This committee is comprised of organizations throughout Seminole County that plan and implement community improvement programs. By providing representation at a Divisional level, the Central Florida Division of AdventHealth is able to identify cross-county and various organizational partnerships that will benefit all the communities they serve, regardless of geography.Priority 2: Care Coordination 2019 Description of the Issue:AdventHealth Altamonte Springs identified care coordination as a need, specifically affordable specialty care, efficient and holistic care coordination, childhood obesity, and efficient and affordable transportation. In Seminole County, 35.4% of community survey participants indicated that they lacked access to a healthcare provider specialist. Limited access to high quality healthcare specialists was identified as a community issue. Care coordination was identified by the local Community Health Needs Assessment Committee and primary data participants as a needed service. Seminole County has seen an increase in both middle school and high school students reporting a BMI at or above the 95th percentile. More than seven percent of Seminole County community survey respondents indicated that a family member had childhood obesity. Transportation was identified as a barrier related to economic conditions and public transportation was identified as a need. Transportation was also identified as a need related to mental health services, chronic conditions, and overall access to health care. 2021 Update: The AdventHealth Altamonte Springs Community Health Plan has two desired goal statements under the Care Coordination priority.1. Increase the availability of appropriate and affordable care2. Decrease barriers community members encounter while seeking careGoal 1: Increase the availability of appropriate and affordable careObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans in the Central 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 support to existing care facilities through multiple strategies, including financial contributions, in-kind labs, and residency rotations and to seek innovative ways to increase capacity through the provision of in-kind labs/imaging, and volunteer services, etc. The first strategy is to provide support to existing care facilities through financial contributions. The strategy to support this objective is managed at a Divisional level. The reporting Hospital's funding included, but was not limited to, contributions for operational support for two local Federally Qualified Health Centers (FQHCs). A $11,187 contribution was made to the Health Care Center for the Homeless, which provides primary medical care, oral health services, behavioral health, and substance use services for underinsured and uninsured individuals. An additional $22,374 was provided to True Health, which delivers medical and mental health services to underserved populations. The reporting Hospital contributed $19,018 to Shepherd's Hope which will support medical homes to increase the availability of affordable care. Shepherd's Hope is a faith-based organization of volunteers who provide access to healthcare for uninsured patients. The reporting Hospital also provided $335 to IDignity Seminole County which supports their program to aid in obtaining birth certificates, Social Security cards and other documentation needed to obtain a FL ID or license. The second strategy is to provide in-kind labs to existing care facilities. The Division provided in-kind labs to the Health Care Center for the Homeless. In the future, the Division will develop a process to track and quantify in-kind labs and imaging provided to local nonprofits.The third strategy is to support a residency rotation to existing care facilities. The Division had a residency rotation program established with a local nonprofit. In 2021, for a multitude of reasons, including COVID-19, the program was discontinued. The Division has pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that may support residency rotations. The fourth strategy is to seek innovative ways to increase capacity through in-kind labs, imaging, and volunteer services. Due to COVID-19, the 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. **see continuation of footnote

Part V, Section B, Line 11 Continuation of Footnote:
Group A-Facility 3 -- AdventHealth AltamonteDescription of CHNA Significant Needs Continued Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in AdventHealth Hospitals in Orange County, Osceola County and Seminole County: AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority.This shared objective, to expand on existing care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need, is managed at a Divisional level. This initiative provides an opportunity to support organizations with a shared goal to increase accessible entry points. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2021, the reporting Hospital contributed funding of $13,424 to the American Cancer Society's Road to Recovery Program. This program provides rides to and from cancer treatment for any cancer patient, regardless of insurance or economic status, that has a transportation barrier. In total, the Road to Recovery program provided 209 rides for cancer patients. In 2021, the reporting Hospital contributed $17,426 in year two toward the three-year funding partnership with AdventHealth University's Hope Clinic. This partnership provides cardiac rehabilitation (wellness maintenance) services to uninsured and underinsured individuals to improve health outcomes and reduce readmissions. The Hope Clinic provides free care to individuals with socio-economic barriers, to increase access to care regardless of financial circumstance. In 2021, the Hope Clinic opened and enrolled 13 patients into the program.The reporting Hospital is progressing on this objective and is actively working to identify organizations to expand on existing external care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need.Goal 2: Decrease barriers community members encounter while seeking careObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in AdventHealth Hospitals in Orange County, Osceola County and Seminole County: AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This shared objective, to provide case management services for at least 81 patients over three years while identifying additional partners and methods to decrease barriers community members encounter while seeking care, is managed at a Divisional level. In 2021, the Division continued to support the Holistic Health program led by Center for Change, a local nonprofit, which aims to provide health education and social services to individuals and families who lack access to economic, social and health resources. The Holistic Health program focuses its efforts in high-need communities identified in the CHNA. The Division is progressing on this objective and 48 individuals have been provided case management service. Additionally, in 2021, 276 referrals to services have been provided, 105 individuals have improved their biometrics and 125 individuals have improved health behaviors through the program. Priority 3: Mental & Behavioral Health 2019 Description of the Issue:Mental and behavioral health, specifically the need for more providers and services, was identified as a top community need. Only 11% of community survey respondents in Seminole County believe there are enough mental health providers. Nearly 60% of community survey respondents indicate that they feel depressed or hopeless. Poor mental health can exacerbate physical health conditions, decreasing quality of life and making it more difficult to maintain stable housing. 2021 Update: The AdventHealth Altamonte Springs Community Health Plan has two desired goal statements under the Mental & Behavioral Health priority.1. Increase access to mental and behavioral health services2. Support existing resources and identify new partners and programs that proactively strengthen the communityGoal 1: Increase access to mental and behavioral health servicesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase provider capacity through financial and in-kind support to at least three partners serving the tri-county community. This shared objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This initiative provides an opportunity for the Division to support at least three partners that have a shared goal of increasing provider capacity in the space of mental and behavioral health. In 2021, the reporting Hospital sustained partnerships with three partners to implement programs that serve the tri-county community: Aspire Health Partners' Psychosocial Rehabilitation Program, Central Florida Center for the Arts' Community Music Therapy Program, and Health Care Center for the Homeless' Eye Movement Desensitization and Reprocessing (EMDR) Therapy Program. The reporting Hospital met its set metric of providing financial support to at least three partners by funding these organizations for a total of $103,685. With the funding, they were able to provide programs that serve the underinsured and uninsured individuals in the reporting Hospital's primary service area. Aspire Health Partners is an organization committed to providing individuals and families of Central Florida with compassionate, comprehensive, and cost-effective behavioral health care services that lead to successful living and healthy, responsible lifestyles. Not only does Aspire Health Partners receive financial funding for the Psychosocial Rehabilitation Program, but the Division also leases five crisis stabilization unit (CSU) beds to connect individuals who have acute needs to mental health services. The Division also supports the Central Florida Center for the Arts which exists to serve and build community through the arts. Through the Music Therapy Program, the organization hired a music therapist to support individual and group music therapy across the tri-county area. The Division partnered with the Health Care Center for the Homeless to launch the EMDR Therapy program for homeless and low-income, uninsured, and underinsured community members in need. This therapy will help community members with conditions such as Post-Traumatic Stress Disorder (PTSD), addiction and healing from past trauma. Other initiatives to address this objective include providing in-kind support through board service. Due to COVID-19, the 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. The reporting Hospital will continue to seek additional community partners to provide in-kind support through board service.**see continuation of footnote

Part V, Section B, Line 11 Continuation of Footnote:
Group A-Facility 3 -- AdventHealth AltamonteDescription of CHNA Significant Needs ContinuedObjective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. This objective is to develop and support pathways to mental and behavioral healthcare for those in need by expanding care navigation models to include mental and behavioral health focused initiatives over the next three years. This shared objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The reporting Hospital contributed $3,356 to National Alliance on Mental Illness (NAMI) Greater Orlando to provide operational support to increase the existing capacity to expand health services for individuals impacted by mental health. NAMI Greater Orlando is dedicated to improving lives of millions of Americans affected by mental illness.Goal 2: Support existing resources and identify new partners and programs that proactively strengthen the communityObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. This objective is supported by multiple strategies: provide the Mission: FIT POSSIBLE program to at least two schools annually in the AdventHealth Altamonte Springs' primary service area that were identified as hot spots and collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. This shared objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The first strategy was to provide the Mission: FIT POSSIBLE program to at least two schools in the AdventHealth Altamonte Springs' primary service area per year that were identified as hot spots. The Division progressed on this objective by providing the program to one school in the reporting Hospital's primary service area. The outcomes reported for this strategy, which supports the objective, are specific to Seminole County. The Mission: FIT POSSIBLE program is a comprehensive wellness program which brings health and wellness education to schools, churches, and community centers. Health and wellness educators provide education during regular visits, as well as supplemental education for teachers and staff to engage kids in activities that teach them how to be physically and emotionally healthy.The second strategy is to collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. Outcomes reported for this strategy, which supports the objective, are reported at a reporting Hospital level. In 2021, the reporting Hospital contributed funding of $11,187 toward the No Limit Health and Education's program, No Limit Unit. No Limit Health and Education is a local nonprofit whose mission is to promote mental health (social, emotional, and psychological) wellness and awareness through advocacy, programs, services, and outreach. Through this partnership, No Limit Unit provides services to adults and youth for both individual empowerment and systemic change in the areas of mental and physical wellness. Barbershop Talk Tours, Thriving Moms Club and Flow Detox reach men, women and children through mental health education, support groups and reduction of stigma. Priority 4: Community Development: Youth Development & Mentorship 2019 Description of the Issue:Youth development and mentorship, specifically relating to youth education and enrichment, was identified by the local Community Health Needs Assessment Committee as a need. Seminole County has seen an increase in student absenteeism and high school gang activity. Positive influences combined with a strong education as a youth increases the chances for success in adulthood. 2021 Update: The AdventHealth Altamonte Springs Community Health Plan has one desired goal statement under the Community Development: Youth Development and Mentorship priority.1. Increase impact of efforts to provide positive experiences and healthy environments for youthGoal 1: Increase impact of efforts to provide positive experiences and healthy environments for youthObjective 1: The first objective is a shared initiative between AdventHealth Altamonte Springs and AdventHealth Apopka. These Hospitals are part of the Central Florida Division of AdventHealth. The Hospitals partnered on this initiative because of a shared CHNA priority. This objective is to provide annual financial and in-kind support, including board service and employee volunteers, for continuation of annual school engagement events and growing new partnerships to serve youth in the community. This objective is managed at the Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. The first strategy is to provide financial support to local organizations that are working to positively impact youth in the community. The reporting Hospital provided financial support of $279 to Boys Town Central Florida. Boys Town Central Florida is focused on changing the way America cares for children and families by providing an array of life-changing youth care and health care services for each child and family. The second strategy is to provide in-kind support, including board-service and employee volunteers, to local organizations that are working to positively impact youth and host annual school engagement events. Due to COVID-19, the 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. The third strategy is to establish new partnerships to serve youth in the community. The Division progressed on this metric by establishing a partnership with No Limit Health and Education, Inc. which is a local nonprofit that hosts several programs., One of these programs, the Flow Detox program, teaches young adults in historically underserved neighborhoods how to process anger and hostile emotions as well as to positively express themselves. In 2021, 90 of 100 youth completed Flow Detox, increasing their understanding of personal triggers and how to process anger and hostile emotions. Community Needs Not Chosen by AdventHealth Altamonte SpringsThe 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. Affordable Housing: The local Community Health Needs Assessment Committee (CHNAC) did not perceive the ability to improve upon the resources that already exist in Seminole County that address affordable housing. The Hospital decided it would be better to target their efforts in areas where we would have greater impact.

Part V, Section B, Line 11 Continuation of Footnote:
"Group A-Facility 4 -- AdventHealth East OrlandoDescription of CHNA Significant NeedsAdventist Health System/Sunbelt, Inc. d/b/a AdventHealth East Orlando will be referred to in this document as AdventHealth East Orlando 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 East Orlando is part of the Central Florida Division of AdventHealth. In 2020, the Central Florida Division North-Region (CFD-N), which includes AdventHealth Daytona Beach, AdventHealth DeLand, AdventHealth Fish Memorial, AdventHealth New Smyrna, AdventHealth Palm Coast and AdventHealth Waterman was combined with the Central Florida Division South-Region (CFD-S), which includes AdventHealth Altamonte, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Heart of Florida, AdventHealth Kissimmee, AdventHealth Lake Wales, AdventHealth Orlando and AdventHealth Winter Park to unify as one under the Central Florida Division. The combination included six hospitals from CFD-N and nine hospitals from CFD-S. The Community Health Plans/Implementation Strategies for both regions were finalized before the combination. The Central Florida Division of AdventHealth now includes 15 hospitals.This is the second-year update for AdventHealth East Orlando'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 East Orlando 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 East Orlando chose four priorities for its 2020-2022 Community Health Plan: 1. Food Security2. Care Coordination3. Mental & Behavioral Health4. Community Development: Job Skills Training & EmployabilityPriority 1: Food Security 2019 Description of the Issue:Over one-third of community survey respondents indicated they lack access to high quality, affordable, healthy food. Having access to proper nutrition is necessary for a healthy life. Proper nutrition can also reduce the risk of, or complications from, certain diseases, such as diabetes. The Central Florida Division of AdventHealth (the Division) is currently working to address food security with multiple partners, including Second Harvest Food Bank. The Central Florida Division of AdventHealth intends to expand this work through current and future initiatives.2021 Update: The AdventHealth East Orlando Community Health Plan has two desired goal statements under the Food Security priority.1. Increase access to healthy and affordable food for community members in need2. Work with community and government officials to address the root causes of food insecurity in our communitiesGoal 1: Increase access to healthy and affordable food for community members in needObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective, to sustain or build partnerships with at least six community organizations that focus on addressing food security is supported by multiple strategies: by providing in-kind contributions, financial support of at least $455,000, and annual board service over the next three years throughout the tri-county region. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The first strategy, to support the objective through in-kind contributions, resulted in sustaining one partnership with a community organization in the Division. This sustained partnership was with Second Harvest Food Bank of Central Florida, a private, nonprofit organization that collects, stores, and distributes donated food to more than 550 feeding partners in six Central Florida counties. The Division continued its support to Second Harvest through the Second Helpings program. This program enables each hospital campus, including the reporting Hospital, to make in-kind donations of excess food to Second Harvest to be distributed through local food pantries. In 2021, the reporting Hospital contributed 533 pounds of food or 444 meals towards this program.The second strategy, to support the objective through financial support, resulted in sustaining 17 partnerships and establishing four new partnerships with community organizations in the Division. In 2021, the reporting Hospital contributed $65,541 in financial support in year two towards the three-year goal of $455,000. Four of these partnerships were sustained on a tri-county level, this includes Orange County, Osceola County and Seminole County. The reporting Hospital sustained three of these partnerships and established one new partnership. Some of these partnerships included financially supporting grassroots efforts at four nonprofits to provide food to those in need through their food pantries or community gardens. Financial support was also provided for Seniors First, an organization that leads the local Meals on Wheels program, which provides home meal deliveries to seniors. The third strategy to support the objective, providing annual representation on boards of organizations focusing on food security which support the tri-county region (Orange, Osceola, and Seminole counties), was sustained by serving on three boards. Knowing that food security is a large-scale community issue, the Central Florida Division of AdventHealth will continue its efforts to serve on boards, coalitions and taskforces which work with local and state officials to address the root causes of food insecurity. This strategy also focuses on advocacy and food system reform to ensure equitable access to healthy food across the community. In 2021, the Central Florida Division of AdventHealth team members continued to serve on the boards of the Second Harvest Food Bank of Central Florida, the American Diabetes Association, and the American Heart Association, all of which impact the Central Florida Division's primary service area. Both the American Diabetes Association and the American Heart Association are nonprofits that provide education on nutrition and food-related conditions.**see continuation of footnote"

Part V, Section B, Line 11 Continuation of Footnote:
Group A-Facility 4 -- AdventHealth East OrlandoDescription of CHNA Significant Needs ContinuedObjective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to identify new partners and best practices to increase the effectiveness of efforts to bring healthy food to community members in need. These partnerships will be utilized to drive strategies across the tri-county area. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2021, the Division sustained their partnership with two local nonprofits, HEBNI Nutrition Consultants, Inc., and Infinite Zion Farms. HEBNI Nutrition Consultants, Inc was formed to educate high-risk, culturally diverse populations about nutrition strategies to prevent diet-related diseases. This partnership, over the next three-years, will increase the amount of healthy food available to community members in need. HEBNI Nutrition Consultants' services include nutrition education and a mobile market. The reporting Hospital provided $6,618 towards the mobile market which offers produce at a reduced cost in low-income, high-risk communities and food deserts. In 2021, 270 individuals received food prescriptions through the Fresh Stop Veggie Rx & Diabetes Prevention Program funding.Through the reporting Hospital's funding, Infinite Zion Farms was able to build its first pilot greenhouse to provide additional fresh produce in Orange County, the county of the reporting Hospital. Infinite Zion Farms is a local nonprofit that is working to establish affordable sources of organic produce and education to the community at large. In 2021, the reporting Hospital provided funding to Infinite Zion Farms of $928 towards the installation of tower gardens to increase the fresh produce in Orange County, the county of the reporting Hospital.In 2021, the reporting Hospital also established a new partnership with Urban Smart Farms, a local organization founded to blaze a path in the local farming movement, inspiring and empowering communities to grow their own fresh, healthy produce in a cleaner, simpler, more efficient way. The reporting Hospital spent $1,539 to purchase 18 tower gardens from Urban Smart Farms to donate to local nonprofit partners.Goal 2: Work with community and government officials to address the root causes of food insecurity in our communitiesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. This shared objective, to identify leadership from the tri-county area to participate in local coalitions focused on advocacy and reform to ensure equitable access to healthy food, is managed at a Divisional level, however all outcomes reported are specific to Orange County. This initiative provides an opportunity to form and participate in multisector collaboratives within Orange County, which are working on a shared goal to identify and strategize on best practices to address the root causes of food insecurity. In 2021, the Division continued to provide representation on behalf of the Hospital by participating in the Orange County Department of Health's Community Health Improvement Planning Committee. This committee is comprised of organizations throughout Orange County that plan and implement community improvement programs. By providing representation at a Divisional level, the Central Florida Division of AdventHealth is able to identify cross-county and various organizational partnerships that will benefit all of the communities they serve, regardless of geography.Priority 2: Care Coordination 2019 Description of the Issue:AdventHealth East Orlando identified care coordination as a need, specifically in the areas of prenatal care/early intervention/early childhood access to care and chronic disease management. Orange County had an increase in infant deaths, low birthweight babies and preterm births. There was also a decrease in the percentage of mothers who had prenatal care in the first trimester. In Orange County, 31.6 percent of community survey respondents indicated that they lacked access to a primary care provider. An additional 35.5 percent indicated they lacked access to a specialist. Limited access to high quality primary care physicians and specialists was identified as a community issue by primary research participants. Orange County also had an increase in individuals who were obese, middle school and high school students who are reporting a body mass index at or above the 95th percentile, adults with diabetes, diabetes hospitalizations for children ages 12 to 18, adults with hypertension and adults who have been told they had a stroke. 2021 Update: The AdventHealth East Orlando Community Health Plan has two desired goal statements under the Care Coordination priority.1. Increase the availability of appropriate and affordable care2. Decrease barriers community members encounter while seeking careGoal 1: Increase the availability of appropriate and affordable careObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans in the Central 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 support to existing care facilities through multiple strategies, including financial contributions, in-kind labs, and residency rotations and to seek innovative ways to increase capacity through the in-kind provision of labs/imaging, volunteer services, etc. The first strategy is to provide support to existing care facilities through financial contributions. The strategy to support this objective is managed at a Divisional level. The reporting Hospital's funding included, but was not limited to, contributions for operational support for two local Federally Qualified Health Centers (FQHCs). A $9,289 contribution was made to the Health Care Center for the Homeless, which provides primary medical care, oral health services, behavioral health and substance use services for underinsured and uninsured individuals. An additional $18,578 was provided to True Health, which delivers medical and mental health services to underserved populations.The reporting Hospital also provided $15,791 to Shepherd's Hope which will support medical homes to increase the availability of affordable care. Shepherd's Hope is a faith-based organization of volunteers who provide access to healthcare for uninsured patients. The second strategy is to provide in-kind labs to existing care facilities. The Division provided in-kind labs to the Health Care Center for the Homeless. In the future, the Division will develop a process to track and quantify in-kind labs and imaging provided to local nonprofits.The third strategy is to support a residency rotation to existing care facilities. The Division had a residency rotation program established with a local nonprofit. In 2021, for a multitude of reasons, including COVID-19, the program was discontinued. The Division has pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that may support residency rotations. The fourth strategy is to seek innovative ways to increase capacity through in-kind labs, imaging, and volunteer services. Due to COVID-19, the 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. **see continuation of footnote

Part V, Section B, Line 11 Continuation of Footnote:
Group A-Facility 4 -- AdventHealth East OrlandoDescription of CHNA Significant Needs ContinuedObjective 2: The second objective is a Divisional initiative and appears on multiple community health plans of the Central Florida AdventHealth hospital facilities in Orange County, Osceola County and Seminole County: AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. These Hospitals are part of the Central Florida Division of AdventHealth and are in the same Division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority.This shared objective, to expand on existing care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need, is managed at a Divisional level. This initiative provides an opportunity to support organizations with a shared goal to increase accessible entry points. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2021, the reporting Hospital contributed funding of $11,146 to the American Cancer Society's Road to Recovery Program. This program provides rides to and from cancer treatment for any cancer patient, regardless of insurance or economic status, that has a transportation barrier. In total, the Road to Recovery program provided 209 rides for cancer patients. In 2021, the reporting Hospital also contributed $14,469 in year two towards the three-year funding partnership with AdventHealth University's Hope Clinic. This partnership provides cardiac rehabilitation (wellness maintenance) services to uninsured and underinsured individuals to improve health outcomes and reduce readmissions. The Hope Clinic provides free care to individuals with socio-economic barriers, to increase access to care regardless of financial circumstance. In 2021, the Hope Clinic opened and enrolled 13 patients into the program.Goal 2: Decrease barriers community members encounter while seeking careObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans of the Central Florida AdventHealth hospital facilities in Orange County, Osceola County and Seminole County: AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. These Hospitals are part of the Central Florida Division of AdventHealth and are in the same Division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This shared objective, to provide case management services for at least 81 patients over three years while identifying additional partners and methods to decrease barriers community members encounter while seeking care, is managed at a Divisional level. In 2021, the Division continued to support the Holistic Health program led by Center for Change, a local nonprofit, which aims to provide health education and social services to individuals and families who lack access to economic, social and health resources. The reporting Hospital contributed $10,966 towards the Holistic Health program which focuses its efforts in high-need communities identified in the CHNA. The Division is progressing on this objective and 48 individuals have been provided case management service. Additionally, in 2021, 276 referrals to services have been provided, 105 individuals have improved their biometrics and 125 individuals have improved health behaviors through the program. Priority 3: Mental & Behavioral Health 2019 Description of the Issue:Mental health, behavioral health and substance use were all identified as top community needs by stakeholders, key informants and focus groups. Only one in ten community survey respondents from Orange County believe there is sufficient substance abuse services. Poor mental health can exacerbate physical health conditions, decreasing quality of life and making it more difficult to maintain stable housing. The Central Florida Division of AdventHealth is heavily invested in addressing mental health and substance abuse and has partnered with community organizations such as the local Federally Qualified Health Centers (FQHCs), Seminole County Sheriff's Office, Aspire Health Partners and the National Alliance on Mental Illness.2021 Update: The AdventHealth East Orlando Community Health Plan has two desired goal statements under the Mental & Behavioral Health priority.1. Increase access to mental and behavioral health services2. Support existing resources and identify new partners and programs that proactively strengthen the communityGoal 1: Increase access to mental and behavioral health servicesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase provider capacity through financial and in-kind support to at least three partners serving the tri-county community. This shared objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This initiative provides an opportunity for the reporting Hospital to support at least three partners that have a shared goal of increasing provider capacity in the space of mental and behavioral health. In 2021, the reporting Hospital sustained partnerships with three partners to implement programs that serve the tri-county community: Aspire Health Partners' Psychosocial Rehabilitation Program, Central Florida Center for the Arts' Community Music Therapy Program, and Health Care Center for the Homeless' Eye Movement Desensitization and Reprocessing (EMDR) Therapy Program. The reporting Hospital met its set metric of providing financial support to at least three partners by funding these organizations for a total of $23,959. With the funding, they were able to provide programs that serve the underinsured and uninsured individuals in the reporting Hospital's service area. Aspire Health Partners is an organization committed to providing individuals and families of Central Florida with compassionate, comprehensive, and cost-effective behavioral health care services that lead to successful living and healthy, responsible lifestyles. Not only does Aspire Health Partners receive financial funding for the Psychosocial Rehabilitation Program, but the Division also leases five crisis stabilization unit (CSU) beds to connect individuals who have acute needs to mental health services. The Division also supports the Central Florida Center for the Arts which exists to serve and build community through the arts. Through the Music Therapy Program, the organization hired a music therapist to support individual and group music therapy across the tri-county area. The Division partnered with the Health Care Center for the Homeless to launch the EMDR Therapy program for homeless and low-income, uninsured, and underinsured community members in need. This therapy will help community members with conditions such as Post-Traumatic Stress Disorder (PTSD), addiction and healing from past trauma. Other initiatives to address this objective include providing in-kind support through board service. Due to COVID-19, the 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.**see continuation of footnote

Part V, Section B, Line 11 Continuation of Footnote:
Group A-Facility 4 -- AdventHealth East OrlandoDescription of CHNA Significant Needs ContinuedObjective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to develop and support pathways to mental and behavioral healthcare for those in need by expanding care navigation models to include mental and behavioral health focused initiatives over the next three years. This shared objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. In 2021, the reporting Hospital provided $464 to Bliss Cares to provide mental health services to their target clients. Bliss Cares is a nonprofit organization that has a mission to save lives by treating and preventing the spread of HIV, Hepatitis, and sexually transmitted diseases (STDs). The reporting Hospital also contributed $5,573 to support the Mental Health Association's East Orlando Choices Clinic to help individuals dealing with mental health illness in the reporting Hospital's primary service area.Goal 2: Support existing resources and identify new partners and programs that proactively strengthen the communityObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. This objective is supported by multiple strategies: provide the Mission: FIT POSSIBLE program to at least two schools annually in the AdventHealth East Orlando primary service area that were identified as hot spots, and collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. This objective is managed at a Divisional level; however, all outcomes are specific to Hospitals in Orange County. The first strategy was to provide the Mission: FIT POSSIBLE program to at least two schools in the AdventHealth East Orlando primary service area per year that were identified as hot spots. This objective was exceeded by the Division, with 27 schools in the reporting Hospital's primary service area receiving the program. Outcomes reported for this strategy, which support the objective, are specific to Orange County. The Mission: FIT POSSIBLE program is a comprehensive wellness program which brings health and wellness education to schools, churches, and community centers. Health and wellness educators provide education during regular visits, as well as supplemental education for teachers and staff to engage kids in activities that teach them how to be physically and emotionally healthy.The second strategy is to collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. Outcomes reported for this strategy, which supports the objective, are specific to the reporting Hospital. This objective was met through an initiative, Circle of Security led by the Early Learning Coalition of Orange County (ELCOC). The reporting Hospital contributed $2,322 towards ELCOC's Circle of Security program. ELCOC is dedicated to the success of early childhood development in the community through early education. The Circle of Security program builds teachers' responsiveness to young children's emotional needs to better support their positive mental health. The ELCOC seeks to provide the Circle of Security attachment training to early childhood teachers in Orange County's most under-resourced communities. The reporting Hospital was able to meet this objective in Orange County, the county of the reporting Hospital. In 2021, the reporting Hospital also contributed funding of $9,289 towards the No Limit Health and Education's program, No Limit Unit. No Limit Health and Education is a local nonprofit whose mission is to promote mental health (social, emotional, and psychological) wellness and awareness through advocacy, programs, services, and outreach. Through this partnership, No Limit Unit provides services to adults and youth for both individual empowerment and systemic change in the areas of mental and physical wellness. Barbershop Talk Tours, Thriving Moms Club and Flow Detox reach men, women and children through mental health education, support groups and reduction of stigma. The reporting Hospital will continue to seek additional community partners to collaborate with and strengthen community resiliency in the remaining counties it serves.Priority 4: Community Development: Job Skills Training & Employability2019 Description of the Issue:Job skills and training were identified as a top community need in the AdventHealth East Orlando breakout session. By attaining financial stability and alleviating the concerns associated with economic instability, individuals are able to more easily address health concerns. As an anchor organization in our community, the AdventHealth Central Florida Division is able to implement job training and education programs for communities in need.2021 Update: The AdventHealth East Orlando Community Health Plan has one desired goal statement under the Community Development: Job Skills Training and Employability priority.1. Advocate and work within the community to remove barriers to employmentGoal 1: Advocate and work within the community to remove barriers to employmentObjective 1: The first objective is to collaborate with the community to enhance existing efforts to provide training, support, and social services to those currently unemployed and underemployed. The objective is managed by the Division, but all outcomes are specific to the reporting Hospital. The reporting Hospital progressed on this metric by contributing $464 to Samaritan Resource Center, a local nonprofit, providing job skills training and support to persons living in homelessness in East Orlando.Community Needs Not Chosen by AdventHealth East OrlandoThe 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. Adverse Childhood Events (ACEs): AdventHealth East Orlando will incorporate the issue of ACEs into their mental and behavioral health initiatives. The objective of working to identify and implement proactive mental health education and programs which focus on resiliency will include ACEs.2. Housing: By prioritizing job skills training and employability, the Hospital hopes to provide lasting solutions for community members to increase their ability to secure housing and decrease homelessness.

Part V, Section B, Line 11 Continuation of Footnote:
"Group A-Facility 5 -- AdventHealth Winter ParkDescription of CHNA Significant Needs Adventist Health System/Sunbelt, Inc. d/b/a AdventHealth Winter Park will be referred to in this document as AdventHealth Winter Park 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 Winter Park is part of the Central Florida Division of AdventHealth. In 2020, the Central Florida Division North-Region (CFD-N), which includes AdventHealth Daytona Beach, AdventHealth DeLand, AdventHealth Fish Memorial, AdventHealth New Smyrna, AdventHealth Palm Coast and AdventHealth Waterman was combined with the Central Florida Division South-Region (CFD-S), which includes AdventHealth Altamonte, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Heart of Florida, AdventHealth Kissimmee, AdventHealth Lake Wales, AdventHealth Orlando and AdventHealth Winter Park to unify as one under the Central Florida Division. The combination included six hospitals from CFD-N and nine hospitals from CFD-S. The Community Health Plans/Implementation Strategies for both regions were finalized before the combination. The Central Florida Division of AdventHealth now includes 15 hospitals.This is the second-year update for AdventHealth Winter Park'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 Winter Park 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 Winter Park chose four priorities for its 2020-2022 Community Health Plan: 1. Food Security2. Care Coordination3. Mental & Behavioral Health4. Community Development: Senior VulnerabilityPriority 1: Food Security 2019 Description of the Issue:Over one-third of community survey respondents indicated they lack access to high quality, affordable, healthy food. Having access to proper nutrition is necessary for a healthy life. Proper nutrition can also reduce the risk of, or complications from, certain diseases, such as diabetes. The Central Florida Division of AdventHealth is currently working to address food security with multiple partners, including Second Harvest Food Bank. The Central Florida Division of AdventHealth intends to expand this work through current and future initiatives.2021 Update: The AdventHealth Winter Park Community Health Plan has two desired goal statements under the Food Security priority.1. Increase access to healthy and affordable food for community members in need2. Work with community and government officials to address the root causes of food insecurity in our communitiesGoal 1: Increase access to healthy and affordable food for community members in needObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective to sustain or build partnerships with at least six community organizations that focus on addressing food security is supported by multiple strategies: by providing in-kind contributions, financial support of at least $455,000 and annual board service over the next three years throughout the tri-county region. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The first strategy, to support the objective through in-kind contributions, resulted in sustaining one partnership with a community organization in the Division. This sustained partnership was with Second Harvest Food Bank of Central Florida, a private, nonprofit organization that collects, stores, and distributes donated food to more than 550 feeding partners in six Central Florida counties. The Division continued its support to Second Harvest through the Second Helpings program. This program enables each hospital campus, including the reporting Hospital, to make in-kind donations of excess food to Second Harvest to be distributed through local food pantries. In 2021, the reporting Hospital contributed 282 pounds of food or 235 meals towards this program.The second strategy, to support the objective through financial support, resulted in sustaining 17 partnerships and establishing four new partnerships with community organizations in the Division. In 2021, the reporting Hospital contributed $52,200 in financial support towards the three-year goal of $455,000. Four of these partnerships were sustained on a tri-county level, this includes Orange County, Osceola County, and Seminole County. The reporting Hospital sustained three of these partnerships and established one new partnership. Some of these partnerships included financially supporting grassroots efforts at four nonprofits to provide food to those in need through their food pantries or community gardens. Financial support was also provided for Seniors First, an organization that leads the local Meals on Wheels program, which provides home meal deliveries to seniors. The third strategy to support the objective, providing annual representation on boards of organizations focusing on food security which support the tri-county region (Orange, Osceola, and Seminole counties), was sustained by serving on three boards. Knowing that food security is a large-scale community issue, the Central Florida Division of AdventHealth will continue its efforts to serve on boards, coalitions and taskforces which work with local and state officials to address the root causes of food insecurity. This strategy also focuses on advocacy and food system reform to ensure equitable access to healthy food across the community. In 2021, the Central Florida Division of AdventHealth team members continued to serve on the board of the Second Harvest Food Bank of Central Florida, the American Diabetes Association, and the American Heart Association, all of which impact the Central Florida Division's primary service area. Both the American Diabetes Association and the American Heart Association are nonprofits that provide education on nutrition and food-related conditions.**see continuation of footnote"

Part V, Section B, Line 11 Continuation of Footnote:
Group A-Facility 5 -- AdventHealth Winter ParkDescription of CHNA Significant Needs Continued Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. This objective is to identify new partners and best practices to increase effectiveness of efforts to bring healthy food to community members in need. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2021, the Division sustained their partnership with two local nonprofits, HEBNI Nutrition Consultants, Inc., and Infinite Zion Farms. HEBNI Nutrition Consultants, Inc was formed to educate high-risk, culturally diverse populations about nutrition strategies to prevent diet-related diseases. This partnership, over the next three-years, will increase the amount of healthy food available to community members in need. HEBNI Nutrition Consultants' services include nutrition education and a mobile market. The reporting Hospital provided $5,271 towards the mobile market which offers produce at a reduced cost in low-income, high-risk communities and food deserts. In 2021, 270 individuals received food prescriptions through the Fresh Stop Veggie Rx & Diabetes Prevention Program funding.Through the reporting Hospital's funding, Infinite Zion Farms was able to build its first pilot greenhouse to provide additional fresh produce in Orange County, the county of the reporting Hospital. Infinite Zion Farms is a local nonprofit that is working to establish affordable sources of organic produce and education to the community at large. In 2021, the reporting Hospital funded Infinite Zion Farms $739 towards the installation of tower gardens to increase the fresh produce in Orange County, the county of the reporting Hospital.In 2021, the reporting Hospital also established a new partnership with Urban Smart Farms, a local organization founded to blaze a path in the local farming movement, inspiring and empowering communities to grow their own fresh, healthy produce in a cleaner, simpler, more efficient way. The reporting Hospital spent $1,226 to purchase 18 tower gardens from Urban Smart Farms to donate to local nonprofit partners.Goal 2: Work with community and government officials to address the root causes of food insecurity in our communitiesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. This shared objective, to identify leadership from the tri-county area to participate in local coalitions focused on advocacy and reform to ensure equitable access to healthy food, is managed at a Divisional level, however all outcomes reported are specific to Orange County. This initiative provides an opportunity to form and participate in multisector collaboratives within Orange County, which are working on a shared goal to identify and strategize on best practices to address the root causes of food insecurity.In 2021, the Division continued to provide representation on behalf of the Hospital by participating in the Orange County Department of Health's Community Health Improvement Planning Committee. This committee is comprised of organizations throughout Orange County that plan and implement community improvement programs. By providing representation at a Divisional level, the Central Florida Division of AdventHealth is able to identify cross-county and various organizational partnerships that will benefit all the communities they serve, regardless of geography.Priority 2: Care Coordination 2019 Description of the Issue:AdventHealth Winter Park identified care coordination as a need, specifically in the areas of prenatal care/early intervention/early childhood, access to care and chronic disease management. Orange County had an increase in infant deaths, low birthweight babies and preterm births. There was also a decrease in the percentage of mothers who had prenatal care in the first trimester. In Orange County, 31.6 percent of community survey respondents indicated that they lacked access to a primary care provider. An additional 35.5 percent indicated they lacked access to a healthcare specialist. Limited access to high quality primary care physicians and specialists was identified as a community issue by primary research participants. Orange County also had an increase in individuals who were obese, middle school and high school students who are reporting a body mass index at or above the 95th percentile, adults with diabetes, diabetes hospitalizations for children ages 12 to 18, adults with hypertension and adults who have been told they had a stroke. 2021 Update: The AdventHealth Winter Park Community Health Plan has two desired goal statements under the Care Coordination priority.1. Increase the availability of appropriate and affordable care2. Decrease barriers community members encounter while seeking careGoal 1: Increase the availability of appropriate and affordable careObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans in the Central 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 support to existing care facilities through multiple strategies, including financial contributions, in-kind labs, and residency rotations, and to seek innovative ways to increase capacity through the provision of in-kind labs/imaging and volunteer services, etc. The first strategy is to provide support to existing care facilities through financial contributions. The strategy to support this objective is managed at a Divisional level. The reporting Hospital's funding included, but was not limited to, contributions for operational support for two local Federally Qualified Health Centers (FQHCs). A $7,398 contribution was made to the Health Care Center for the Homeless, which provides primary medical care, oral health services, behavioral health and substance use services for underinsured and uninsured individuals. An additional $14,796 was provided to True Health, which delivers medical and mental health services to underserved populations.The reporting Hospital also provided $12,577 to Shepherd's Hope which will support medical homes to increase the availability of affordable care. Shepherd's Hope is a faith-based organization of volunteers who provide access to healthcare for uninsured patients. The second strategy is to provide in-kind labs to existing care facilities. The Division provided in-kind labs to the Health Care Center for the Homeless. In the future, the Division will develop a process to track and quantify in-kind labs and imaging provided to local nonprofits.The third strategy is to support a residency rotation to existing care facilities. The Division had a residency rotation program established with a local nonprofit. In 2021 the program was discontinued. The Division has pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that may support residency rotations. The fourth strategy is to seek innovative ways to increase capacity through in-kind labs, imaging, and volunteer services. Due to COVID-19, the 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. **see continuation of footnote

Part V, Section B, Line 11 Continuation of Footnote:
Group A-Facility 5 -- AdventHealth Winter ParkDescription of CHNA Significant Needs ContinuedObjective 2: The second objective is a Divisional initiative and appears on multiple community health plans of AdventHealth hospitals in Orange County, Osceola County and Seminole County including AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. These Hospitals are part of the Central Florida Division of AdventHealth and are in the same Division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority.This shared objective, to expand on existing care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need, is managed at a Divisional level. This initiative provides an opportunity to support organizations with a shared goal to increase accessible entry points. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2021, the reporting Hospital contributed funding of $60,454 to the American Cancer Society's Road to Recovery program. This program provides rides to and from cancer treatment for any cancer patient, regardless of insurance or economic status, that has a transportation barrier. In total, the Road to Recovery program provided 209 rides for cancer patients. The reporting Hospital is progressing on this objective and is actively working to identify organizations to expand on existing external care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need.Goal 2: Decrease barriers community members encounter while seeking careObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans of AdventHealth hospitals in Orange County, Osceola County and Seminole County including AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. These Hospitals are part of the Central Florida Division of AdventHealth and are in the same Division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This shared objective, to provide case management services for at least 81 patients over three years while identifying additional partners and methods to decrease barriers community members encounter while seeking care, is managed at a Divisional level. In 2021, the Division continued to support the Holistic Health program led by Center for Change, a local nonprofit, which aims to provide health education and social services to individuals and families who lack access to economic, social and health resources. The reporting Hospital contributed $8,733 towards the Holistic Health program which focuses its efforts in high-need communities identified in the CHNA. The Division is progressing on this objective and 48 individuals have been provided case management service. Additionally, in 2021, 276 referrals to services have been provided, 105 individuals have improved their biometrics and 125 individuals have improved health behaviors through the program. In 2021, the reporting Hospital contributed $11,524 in year two towards the three-year funding partnership with AdventHealth University's Hope Clinic. This partnership provides cardiac rehabilitation (wellness maintenance) services to uninsured and underinsured individuals to improve health outcomes and reduce readmissions. The Hope Clinic provides free care to individuals with socio-economic barriers, allowing increased access to care regardless of financial circumstance. In 2021, the Hope Clinic opened and enrolled 13 patients into the program.Priority 3: Mental & Behavioral Health 2019 Description of the Issue:Mental health, behavioral health and substance use were all identified as top community needs by stakeholders, key informants and focus groups. Only one in ten community survey respondents from Orange County believe there is sufficient substance abuse services. Poor mental health can exacerbate physical health conditions, decreasing quality of life and making it more difficult to maintain stable housing. The Central Florida Division of AdventHealth is heavily invested in addressing mental health and substance abuse and has partnered with community organizations such as the local Federally Qualified Health Centers (FQHCs), Seminole County Sheriff's Office, Aspire Health Partners, and the National Alliance on Mental Illness.2021 Update: The AdventHealth Winter Park Community Health Plan has two desired goal statements under the Mental & Behavioral Health priority.1. Increase access to mental and behavioral health services2. Support existing resources and identify new partners and programs that proactively strengthen the communityGoal 1: Increase access to mental and behavioral health servicesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans of AdventHealth hospitals in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase provider capacity through financial and in-kind support to at least three partners serving the tri-county community. This shared objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This initiative provides an opportunity for the reporting Hospital to support at least three partners that have a shared goal of increasing provider capacity in the space of mental and behavioral health. In 2021, the reporting Hospital sustained partnerships with three partners to implement programs that serve the tri-county community: Aspire Health Partners' Psychosocial Rehabilitation Program, Central Florida Center for the Arts' Community Music Therapy Program, and Health Care Center for the Homeless' Eye Movement Desensitization and Reprocessing (EMDR) Therapy Program. The reporting Hospital met its set metric of providing financial support to at least three partners by funding these organizations for a total of $19,082. With the funding, they were able to provide programs that serve the underinsured and uninsured individuals in the reporting Hospital's service area. Aspire Health Partners is an organization committed to providing individuals and families of Central Florida with compassionate, comprehensive, and cost-effective behavioral health care services that lead to successful living and healthy, responsible lifestyles. Not only does Aspire Health Partners receive financial funding for the Psychosocial Rehabilitation Program, but the Division also leases five crisis stabilization unit (CSU) beds to connect individuals who have acute needs to mental health services. The Division also supports the Central Florida Center for the Arts which exists to serve and build community through the arts. Through the Music Therapy Program, the organization hired a music therapist to support individual and group music therapy across the tri-county area. The Division partnered with the Health Care Center for the Homeless to launch the EMDR Therapy program for homeless and low-income, uninsured, and underinsured community members in need. This therapy will help community members with conditions such as Post-Traumatic Stress Disorder (PTSD), addiction and healing from past trauma. Other initiatives to address this objective include providing in-kind support through board service. **see continuation of footnote

Part V, Section B, Line 11 Continuation of Footnote:
Group A-Facility 5 -- AdventHealth Winter ParkDescription of CHNA Significant Needs ContinuedObjective 2: The second objective is a Divisional initiative and appears on multiple community health plans of AdventHealth hospitals in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. This objective is to develop and support pathways to mental and behavioral healthcare for those in need by expanding care navigation models to include mental and behavioral health focused initiatives over the next three years. This shared objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. In 2021, the reporting Hospital provided $369 to New Hope for Kids for their grief counseling program. New Hope for Kids is a nonprofit organization that help children and their families during some of life's most difficult challenges. Goal 2: Support existing resources and identify new partners and programs that proactively strengthen the communityObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. This objective is supported by multiple strategies: provide the Mission: FIT POSSIBLE program to at least two schools annually in the AdventHealth Winter Park primary service area that were identified as hot spots and collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. This objective is managed at a Divisional level; however, all outcomes are specific to Hospitals in Orange County. The first strategy was to provide the Mission: FIT POSSIBLE program to at least two schools in the AdventHealth Winter Park primary service area per year that were identified as hot spots. This objective was exceeded by the Division, with 27 schools in the reporting Hospital's primary service area receiving the program. Outcomes reported for this strategy, which supports the objective, are specific to Orange County. The Mission: FIT POSSIBLE program is a comprehensive wellness program which brings health and wellness education to schools, churches, and community centers. Health and wellness educators provide education during regular visits, as well as supplemental education for teachers and staff to engage kids in activities that teach them how to be physically and emotionally healthy.The second strategy is to collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. Outcomes reported for this strategy, which supports the objective, are specific to the reporting Hospital. This objective was met through an initiative, Circle of Security led by the Early Learning Coalition of Orange County (ELCOC). The reporting Hospital contributed $1,849 towards ELCOC's Circle of Security program. ELCOC is dedicated to the success of early childhood development in the community through early education. The Circle of Security program builds teachers' responsiveness to young children's emotional needs to better support their positive mental health. The ELCOC seeks to provide the Circle of Security attachment training to early childhood teachers in Orange County's most under-resourced communities. The reporting Hospital was able to meet this objective in Orange County, the county of the reporting Hospital. In 2021, the reporting Hospital also contributed funding of $7,398 towards the No Limit Health and Education's program, No Limit Unit. No Limit Health and Education is a local nonprofit whose mission is to promote mental health (social, emotional, and psychological) wellness and awareness through advocacy, programs, services, and outreach. Through this partnership, No Limit Unit provides services to adults and youth for both individual empowerment and systemic change in the areas of mental and physical wellness. Barbershop Talk Tours, Thriving Moms Club and Flow Detox reach men, women and children through mental health education, support groups and reduction of stigma. The reporting Hospital will continue to seek additional community partners to collaborate with and strengthen community resiliency in the remaining counties it serves.Priority 4: Community Development: Senior Vulnerability2019 Description of the Issue:Seniors were identified as a unique population for AdventHealth Winter Park. Senior safety was identified as a community issue related to unintentional injuries by Orange County primary data participants. The senior population is especially vulnerable to negative effects of isolation including poor health outcomes and higher rates of depression. 2021 Update: The AdventHealth Winter Park Community Health Plan has one desired goal statement under the Community Development: Senior Vulnerability priority.1. Address unique mental, physical and spiritual needs of high senior populationGoal 1: Address unique mental, physical and spiritual needs of high senior populationObjective 1: The first objective is the reporting Hospital's initiative and appears only on the community health plan of AdventHealth Winter Park. The objective is to provide care navigation and social services for the senior population. The objective is managed by the Division, but all outcomes are specific to the reporting Hospital. The reporting Hospital progressed on this objective by funding $184 to Easter Seals in support of their Senior Daybreak program. Easter Seals is a local organization that provides home and community-based services offering adults and seniors resources that support independent living, improve quality of life, and maintain health and wellness.Objective 2: The second objective is the reporting Hospital's initiative and appears only on the community health plan of AdventHealth Winter Park. The objective is to provide services to educate and support caregivers in the community to increase quality of life for both the caregiver and receiver of care. The objective is managed by the Division, but all outcomes are specific to the reporting Hospital.The Division sustained and funded a position, Senior Care Navigator, at the reporting Hospital's Emergency Department (ED) to help address the unique needs of seniors. In 2021, more than 1,700 seniors and their caregivers were educated on additional social services and were referred for specialty consultations.Community Needs Not Chosen by AdventHealth Winter ParkThe 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 issue:1. Built Environment (Affordable Housing): The local Community Health Needs Assessment Committee (CHNAC) did not perceive the ability to improve upon the resources that already exist in Orange County that address this issue. The Hospital decided it would be better to target their efforts in areas where it would have greater impact.

Part V, Section B, Line 11 Continuation of Footnote:
"Group A-Facility 6 -- AdventHealth KissimmeeDescription of CHNA Significant NeedsAdventist Health System/Sunbelt, Inc. d/b/a AdventHealth Kissimmee will be referred to in this document as AdventHealth Kissimmee 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 Kissimmee is part of the Central Florida Division of AdventHealth. In 2020, the Central Florida Division North-Region (CFD-N), which includes AdventHealth Daytona Beach, AdventHealth DeLand, AdventHealth Fish Memorial, AdventHealth New Smyrna, AdventHealth Palm Coast and AdventHealth Waterman was combined with the Central Florida Division South-Region (CFD-S), which includes AdventHealth Altamonte, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Heart of Florida, AdventHealth Kissimmee, AdventHealth Lake Wales, AdventHealth Orlando and AdventHealth Winter Park to unify as one under the Central Florida Division. The combination included six hospitals from CFD-N and nine hospitals from CFD-S. The Community Health Plans/Implementation Strategies for both regions were finalized before the combination. The Central Florida Division of AdventHealth now includes 15 hospitals.This is the second-year update for AdventHealth Kissimmee'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 Kissimmee 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 Kissimmee chose four priorities for its 2020-2022 Community Health Plan: 1. Food Security2. Care Coordination3. Mental & Behavioral Health4. Community Development: Affordable Housing & HomelessnessPriority 1: Food Security 2019 Description of the Issue:More than 40 percent of community survey respondents from Osceola County indicated that they do not have access to healthy, affordable food. Food security was also identified as a need related to chronic conditions. Having access to proper nutrition is necessary for a healthy life. Proper nutrition can also reduce the risk of, or complications from, certain diseases, such as diabetes. The Central Florida Division of AdventHealth (the Division) is currently working to address food security with multiple partners, including Second Harvest Food Bank. The Division intends to expand this work through current and future initiatives.2021 Update: The AdventHealth Kissimmee Community Health Plan has two desired goal statements under the Food Security priority.1. Increase access to healthy and affordable food for community members in need2. Work with community and government officials to address the root causes of food insecurity in our communitiesGoal 1: Increase access to healthy and affordable food for community members in needObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to sustain or build partnerships with at least six community organizations that focus on addressing food security and is supported by multiple strategies including the provision of in-kind contributions, financial support of at least $455,000 and annual volunteer board service over the next three years throughout the tri-county region. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The first strategy, to support the objective through in-kind contributions, resulted in sustaining one partnership with a community organization in the Division. This sustained partnership was with Second Harvest Food Bank of Central Florida, a private, nonprofit organization that collects, stores, and distributes donated food to more than 550 feeding partners in six Central Florida counties. The Division continued its support to Second Harvest through the Second Helpings program. This program enables each Hospital campus, including the reporting Hospital, to make in-kind donations of excess food to Second Harvest to be distributed through local food pantries. In 2021, the reporting Hospital contributed 80 pounds of food or 67 meals towards this program.The second strategy, to support the objective through financial support, resulted in sustaining 17 partnerships and establishing four new partnerships with community organizations in the Division. In 2021, the reporting Hospital contributed $40,044 in financial support in year two towards the three-year goal of $455,000. Four of these partnerships were sustained on a tri-county level, this includes Orange County, Osceola County and Seminole County. The reporting Hospital sustained two of these partnerships. Financial support was also provided to Osceola Council on Aging, an organization that leads the local Meals on Wheels program, which provides home meal deliveries to seniors.The third strategy to support the objective, providing annual representation on boards of organizations focusing on food security which support the tri-county region (Orange, Osceola, and Seminole counties), was sustained by serving on three boards. Knowing that food security is a large-scale community issue, the Central Florida Division of AdventHealth will continue its efforts to serve on boards, coalitions and taskforces which work with local and state officials to address the root causes of food insecurity. This strategy also focuses on advocacy and food system reform to ensure equitable access to healthy food across the community. In 2021, the Central Florida Division of AdventHealth team members continued to serve on the boards of the Second Harvest Food Bank of Central Florida, the American Diabetes Association, and the American Heart Association, all of which impact the Central Florida Division's primary service area. Both the American Diabetes Association and the American Heart Association are nonprofits that provide education on nutrition and food-related conditions.The reporting Hospital also provides representation to serve on the board of the Osceola Council on Aging, within their primary service area. **see continuation of footnote"

Part V, Section B, Line 11 Continuation of Footnote:
Group A-Facility 6 -- AdventHealth KissimmeeDescription of CHNA Significant Needs ContinuedObjective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to identify new partners and best practices to increase the effectiveness of efforts to bring healthy food to community members in need. These partnerships will be utilized to drive strategies across the tri-county area. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2021, the reporting Hospital sustained their partnership with one local nonprofit, HEBNI Nutrition Consultants, Inc., which was formed to educate high-risk, culturally diverse populations about nutrition strategies to prevent diet-related diseases. This partnership, over the next three-years, will increase the amount of healthy food available to community members in need. HEBNI Nutrition Consultants' services include nutrition education and a mobile market. The mobile market is funded by the Central Florida Division of AdventHealth and offers produce at a reduced cost in low-income, high-risk communities and food deserts. In 2021, the reporting Hospital also sustained its partnership with the School District of Osceola County (SDOC)'s SMART Bus. The SMART Bus provides food, education, access to Wi-Fi and family support to meet the needs of the 2,500 homeless students enrolled in the SDOC. The new partnership is reported for the Division, not Hospital specific and appears on the community health plans of all Hospitals in Osceola County where the initiative is conducted. This includes the plans of AdventHealth Celebration and AdventHealth Kissimmee.Goal 2: Work with community and government officials to address the root causes of food insecurity in our communitiesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority.This shared objective, to identify leadership from the tri-county area to participate in local coalitions focused on advocacy and reform to ensure equitable access to healthy food, is managed at a Divisional level, however all outcomes reported are specific to Osceola County. This initiative provides an opportunity to form and participate in multisector collaboratives within Osceola County, which are working on a shared goal to identify and strategize on best practices to address the root causes of food insecurity.In 2021, the Division continued to provide representation on behalf of the Hospital by participating in the Osceola Health Leadership Council. This council is comprised of organizations throughout Osceola County that plan and implement community improvement programs. By providing representation at a Divisional level, the Central Florida Division of AdventHealth is able to identify cross-county and various organizational partnerships that will benefit all the communities they serve, regardless of geography.Priority 2: Care Coordination 2019 Description of the Issue:AdventHealth Kissimmee identified care coordination as a need, specifically preventative care/health screenings, access to care and pediatric and women's health (including prenatal). Osceola County primary data respondents were less likely to indicate that they accessed preventative care services, such as a PSA test, lab work and Pap tests. In 2016, 23.6 percent of Osceola County adults could not see a doctor due to cost. Primary data respondents from Osceola County also identified transportation and care coordination as barriers to care in relation to chronic conditions when seeking care. A little more than 10 percent of Osceola County community survey respondents indicated that they have difficulty accessing prenatal care.2021 Update: The AdventHealth Kissimmee Community Health Plan has two desired goal statements under the Care Coordination priority.1. Increase the availability of appropriate and affordable care2. Decrease barriers community members encounter while seeking careGoal 1: Increase the availability of appropriate and affordable careObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central 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 support to existing care facilities through multiple strategies, including financial contributions, in-kind labs, and residency rotations and to seek innovative ways to increase capacity through the provision of in-kind labs/imaging, volunteer services, etc. The first strategy is to provide support to existing care facilities through financial contributions. The strategy to support this objective is managed at a Divisional level. The reporting Hospital's funding included, but was not limited to, contributions for operational support for a local Federally Qualified Health Center (FQHC). A $5,675 contribution was made to the Health Care Center for the Homeless, which provides primary medical care, oral health services, behavioral health and substance use services for underinsured and uninsured individuals. The reporting Hospital provided $908 in financial contribution to Osceola Council on Aging to support clinical operations. Additionally, the reporting Hospital provided $1,418 to Osceola Community Health Services, a local FQHC focused on meeting an individual's physical and mental health care needs, including prevention, wellness, acute and chronic care, for operational support to increase the availability of affordable care.The second strategy is to provide in-kind labs to existing care facilities. The Division provided in-kind labs to the Health Care Center for the Homeless. In the future, the Division will develop a process to track and quantify in-kind labs and imaging provided to local nonprofits.The third strategy is to support a residency rotation to existing care facilities. The Division had a residency rotation program established with a local nonprofit. In 2021, for a multitude of reasons, including COVID-19, the program was discontinued. The Division has pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that may support residency rotations. The fourth strategy is to seek innovative ways to increase capacity through in-kind labs, imaging, and volunteer services. Due to COVID-19, the 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. **see continuation of footnote

Part V, Section B, Line 11 Continuation of Footnote:
Group A-Facility 6 -- AdventHealth KissimmeeDescription of CHNA Significant Needs ContinuedObjective 2: The second objective is a Divisional initiative and appears on multiple community health plans in Orange County, Osceola County and Seminole County to include AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. These Hospitals are part of the Central Florida Division of AdventHealth and are in the same Division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority.This shared objective, to expand on existing care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need, is managed at a Divisional level. This initiative provides an opportunity to support organizations with a shared goal to increase accessible entry points. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2021, the reporting Hospital contributed funding of $6,810 to the American Cancer Society's Road to Recovery Program. This program provides rides to and from cancer treatment for any cancer patient, regardless of insurance or economic status, that has a transportation barrier. In total, the Road to Recovery program provided 209 rides for cancer patients. In 2021, the reporting Hospital also contributed $8,840 in year two towards the three-year funding partnership with AdventHealth University's Hope Clinic. This partnership provides cardiac rehabilitation (wellness maintenance) services to uninsured and underinsured individuals to improve health outcomes and reduce readmissions. The Hope Clinic provides free care to individuals with socio-economic barriers, allowing increased access to care regardless of financial circumstance. In 2021, the Hope Clinic opened and enrolled 13 patients into the program.Goal 2: Decrease barriers community members encounter while seeking careObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in Orange County, Osceola County and Seminole County to include AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. These Hospitals are part of the Central Florida Division of AdventHealth and are in the same Division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This shared objective, to provide case management services for at least 81 patients over three years while identifying additional partners and methods to decrease barriers community members encounter while seeking care, is managed at a Divisional level. In 2021, the Division continued to support the Holistic Health program led by Center for Change, a local nonprofit, which aims to provide health education and social services to individuals and families who lack access to economic, social and health resources. The reporting Hospital contributed $6,700 towards the Holistic Health program which focuses its efforts in high-need communities identified in the CHNA. The Division is progressing on this objective and 48 individuals have been provided case management service. Additionally, in 2021, 276 referrals to services have been provided, 105 individuals have improved their biometrics and 125 individuals have improved health behaviors through the program. Priority 3: Mental & Behavioral Health 2019 Description of the Issue:Less than 10 percent of community survey respondents from Osceola County believe there is a sufficient number of mental health providers and nearly 60 percent of Osceola County community survey respondents indicated they feel depressed or hopeless. When discussing with primary research participants, it was stated that the high level of stress people are experiencing could make it difficult to cope with mental illness. This may be caused by lack of community support and available support services to manage mental health. The Central Florida Division of AdventHealth has several care options for mental health services. These include the Outlook Clinic and connections to FQHCs. The Central Florida Division of AdventHealth is funding several mental and behavioral health services in the community, including an eye movement desensitization and reprocessing (EMDR) psychotherapy treatment at a local FQHC and a music therapy program.2021 Update: The AdventHealth Kissimmee Community Health Plan has two desired goal statements under the Mental & Behavioral Health priority.1. Increase access to mental and behavioral health services2. Support existing resources and identify new partners and programs that proactively strengthen the communityGoal 1: Increase access to mental and behavioral health servicesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase provider capacity through financial and in-kind support to at least three partners serving the tri-county community. This shared objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This initiative provides an opportunity for the reporting Hospital to support at least three partners that have a shared goal of increasing provider capacity in the space of mental and behavioral health. In 2021, the reporting Hospital sustained partnerships with two partners to implement programs that serve the tri-county community: Central Florida Center for the Arts' Community Music Therapy Program, and Health Care Center for the Homeless' Eye Movement Desensitization and Reprocessing (EMDR) Therapy Program. The reporting Hospital is progressing on its set metric of providing financial support to at least three partners by funding these organizations for a total of $5,127. With the funding, they were able to provide programs that serve the underinsured and uninsured individuals in the reporting Hospital's service area. The reporting Hospital supports the Central Florida Center for the Arts which exists to serve and build community through the arts. Through the Music Therapy Program, the organization hired a music therapist to support individual and group music therapy across the tri-county area. The reporting Hospital also partnered with the Health Care Center for the Homeless to launch the EMDR Therapy program for homeless and low-income, uninsured, and underinsured community members in need. This therapy will help community members with conditions such as Post-Traumatic Stress Disorder (PTSD), addiction and healing from past trauma. Other initiatives to address this objective include providing in-kind support through board service. Due to COVID-19, the 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.**see continuation of footnote

Part V, Section B, Line 11 Continuation of Footnote:
Group A-Facility 6 -- AdventHealth KissimmeeDescription of CHNA Significant Needs ContinuedObjective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. This objective is to develop and support pathways to mental and behavioral healthcare for those in need by expanding care navigation models to include mental and behavioral health focused initiatives over the next three years. This shared objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. In 2021, the reporting Hospital provided $14,188 to Park Place Behavioral Health Care for operational support. Park Place is an organization that provides therapeutic, psychiatric and substance use disorder services in Central Florida. Goal 2: Support existing resources and identify new partners and programs that proactively strengthen the communityObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. This objective is supported by multiple strategies: provide the Mission: FIT POSSIBLE program to at least two schools annually in AdventHealth Kissimmee's primary service area that were identified as hot spots and collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. This objective is managed at a Divisional level; however, all outcomes are specific to Hospitals in Osceola County. The first strategy was to provide the Mission: FIT POSSIBLE program to at least two schools in the AdventHealth Kissimmee primary service area per year that were identified as hot spots. This objective was exceeded by the Division, with six schools in the reporting Hospital's primary service area receiving the program. Outcomes reported for this strategy, which supports the objective, are specific to Osceola County. The Mission: FIT POSSIBLE program is a comprehensive wellness program which brings health and wellness education to schools, churches, and community centers. Health and wellness educators provide education during regular visits, as well as supplemental education for teachers and staff to engage kids in activities that teach them how to be physically and emotionally healthy.The second strategy is to collaborate with partners to strengthen community resiliency by proactivity educating and identifying resources to deliver resiliency-focused training and resources to the community. Outcomes reported for this strategy, which support the objective, are specific to reporting Hospitals in Osceola County. This includes AdventHealth Celebration and AdventHealth Kissimmee. Due to COVID-19, the 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.Priority 4: Community Development: Affordable Housing & Homelessness 2019 Description of the Issue:Osceola County has the highest percentage of renter households who were cost burdened (24.4 percent) and severely cost burdened (25.1 percent). Osceola County also had 21.1 percent of homeowner residents who are severely cost burdened. Affordable housing has a large impact on other health outcomes and wellbeing. It enables families to have the opportunity to meet their respective health, education, and employment needs. The Central Florida Division of AdventHealth is heavily invested in addressing homelessness and is involved with partners such as: Coalition for the Homeless of Central Florida, Family Promise of Greater Orlando, Homeless Services Network of Central Florida and others.2021 Update: The AdventHealth Kissimmee Community Health Plan has two desired goal statements under the Community Development: Affordable Housing & Homelessness priority.1. Support efforts to increase access to care and provide services to our homeless population2. Participate in advocacy efforts to provide affordable housing for community membersGoal 1: Support efforts to increase access to care and provide services to our homeless populationObjective 1: The first objective is a shared initiative between AdventHealth Orlando, AdventHealth Celebration and AdventHealth Kissimmee. These Hospitals are part of the Central 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 annual financial and in-kind support, including board service and employee volunteers, to support community partners and increase the capacity for care for our homeless population. This objective is managed at the Divisional level; however, all outcomes are specific to Hospitals in Osceola County.The first strategy is to provide financial support to local organizations that are working to address the affordable housing needs and immediate needs of individuals experiencing homelessness. The reporting Hospital progressed on this metric by providing financial support to two organizations in the reporting Hospital's primary service area. Clarita's House received $141 to support their emergency housing service for families in crisis. Habitat for Humanity also received $283 to support a special project that served individuals dealing with homelessness. The second strategy is to provide in-kind support to local organizations that are working to address the affordable housing needs and immediate needs of individuals experiencing homelessness. Due to COVID-19, the 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.Goal 2: Participate in advocacy efforts to provide affordable housing for community membersObjective 1: The first objective is a shared initiative between AdventHealth Celebration and AdventHealth Kissimmee. These Hospitals are part of the Central 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 annual financial and in-kind support, including board service and employee volunteers, to support community partners and increase the capacity for care for our homeless population. This objective is managed at the Divisional level, but all outcomes are specific to the reporting Hospitals in Osceola County.The first strategy is to provide financial support to community partners to enhance their capacity to provide care. The reporting Hospital progressed on this metric by providing financial support of $283 to Hope Partnership, a nonprofit organization that aims to provide a holistic continuum of care to end homelessness and poverty in Central Florida.The second strategy is to provide in-kind support to community partners to enhance their capacity to provide care. Due to COVID-19, the 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.**see continuation of footnote

Part V, Section B, Line 11 Continuation of Footnote:
Group A-Facility 6 -- AdventHealth KissimmeeDescription of CHNA Significant Needs ContinuedCommunity Needs Not Chosen by AdventHealth KissimmeeThe 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. Poverty: The local Community Health Needs Assessment Committee (CHNAC) understands that poverty has a large impact on health and wellbeing. The CHNAC agreed that the scale of this need is too broad and would not be a realistic issue to be addressed with the resources available at this time. 2. Education: The local CHNAC discussed education, health education and literacy. It was determined that education was better addressed by existing organizations and resources in the community. Certain aspects of education such as health literacy will be addressed under care coordination initiatives.

Part V, Section B, Line 11 Continuation of Footnote:
"Group A-Facility 8 -- AdventHealth ApopkaDescription of CHNA Significant NeedsAdventist Health System/Sunbelt, Inc. d/b/a AdventHealth Apopka will be referred to in this document as AdventHealth Apopka 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 Apopka is part of the Central Florida Division of AdventHealth. In 2020, the Central Florida Division North-Region (CFD-N), which includes AdventHealth Daytona Beach, AdventHealth DeLand, AdventHealth Fish Memorial, AdventHealth New Smyrna, AdventHealth Palm Coast and AdventHealth Waterman was combined with the Central Florida Division South-Region (CFD-S), which includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Heart of Florida, AdventHealth Kissimmee, AdventHealth Lake Wales, AdventHealth Orlando and AdventHealth Winter Park to unify as one under the Central Florida Division. The combination included six hospitals from CFD-N and nine hospitals from CFD-S. The Community Health Plans/Implementation Strategies for both regions were finalized before the combination. The Central Florida Division of AdventHealth (the Division) now includes 15 hospitals.This is the second-year update for AdventHealth Apopka'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 Apopka 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 from 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 Apopka chose four priorities for its 2020-2022 Community Health Plan: 1. Food Security2. Care Coordination3. Mental & Behavioral Health4. Community Development: Youth Development & Mentorship Priority 1: Food Security 2019 Description of the Issue:Over one-third of community survey respondents indicated they lack access to high quality, affordable, healthy food. Having access to proper nutrition is necessary for a healthy life. Proper nutrition can also reduce the risk of, or complications from, certain diseases, such as diabetes. The Central Florida Division of AdventHealth is currently working to address food security with multiple partners, including Second Harvest Food Bank. The Central Florida Division of AdventHealth intends to expand this work through current and future initiatives.2021 Update: The AdventHealth Apopka Community Health Plan has two desired goal statements under the Food Security priority.1. Increase access to healthy and affordable food for community members in need2. Work with community and government officials to address the root causes of food insecurity in our communitiesGoal 1: Increase access to healthy and affordable food for community members in needObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to sustain or build partnerships with at least six community organizations that focus on addressing food security and is supported by multiple strategies including the provision of in-kind contributions, financial support of at least $455,000 and annual volunteer board service over the next three years throughout the tri-county region. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The first strategy, to support the objective through in-kind contributions, resulted in sustaining one partnership with a community organization in the Division. This sustained partnership was with Second Harvest Food Bank of Central Florida, a private, nonprofit organization that collects, stores, and distributes donated food to more than 550 feeding partners in six Central Florida counties. The Division continued its support to Second Harvest through the Second Helpings program. This program enables each hospital campus, including the reporting Hospital, to make in-kind donations of excess food to Second Harvest to be distributed through local food pantries. In 2021, the reporting Hospital contributed 188 pounds of food or 157 meals toward this program.The second strategy, to support the objective through financial support, resulted in sustaining 17 partnerships and establishing four new partnerships with community organizations in the Division. In 2021, the reporting Hospital contributed $29,353 in financial support in year two toward the three-year goal of $455,000. Four of these partnerships were sustained on a tri-county level, this includes Orange County, Osceola County, and Seminole County. The reporting Hospital sustained one of these partnerships. Some of these partnerships included financially supporting grassroots efforts at four nonprofits to provide food to those in need through their food pantries or community gardens. Financial support was also provided for Seniors First, an organization that leads the local Meals on Wheels program, which provides home meal deliveries to seniors. The third strategy to support the objective, providing annual representation on boards of organizations focusing on food security which support the tri-county region (Orange, Osceola, and Seminole counties), was sustained by serving on three boards. Knowing that food security is a large-scale community issue, the Central Florida Division of AdventHealth will continue its efforts to serve on boards, coalitions and taskforces which work with local and state officials to address the root causes of food insecurity. This strategy also focuses on advocacy and food system reform to ensure equitable access to healthy food across the community. In 2021, the Central Florida Division of AdventHealth team members continued to serve on boards of the Second Harvest Food Bank of Central Florida, the American Diabetes Association, and the American Heart Association, all of which impact the Central Florida Division's primary service area. Both the American Diabetes Association and the American Heart Association are nonprofits that provide education on nutrition and food-related conditions.**see continuation of footnote"

Part V, Section B, Line 11 Continuation of Footnote:
Group A-Facility 8 -- AdventHealth ApopkaDescription of CHNA Significant Needs ContinuedObjective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. This objective is to identify new partners and best practices to increase effectiveness of efforts to bring healthy food to community members in need. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2021, the Division sustained their partnership with two local nonprofits, HEBNI Nutrition Consultants, Inc., and Infinite Zion Farms. HEBNI Nutrition Consultants, Inc was formed to educate high-risk, culturally diverse populations about nutrition strategies to prevent diet-related diseases. This partnership, over the next three-years, will increase the amount of healthy food available to community members in need. HEBNI Nutrition Consultants' services include nutrition education and a mobile market. The reporting Hospital provided $2,964 toward the mobile market which offers produce at a reduced cost in low-income, high-risk communities and food deserts. In 2021, 270 individuals received food prescriptions through the Fresh Stop Veggie Rx & Diabetes Prevention Program funding.Through the reporting Hospital's funding, Infinite Zion Farms was able to build its first pilot greenhouse, to provide additional fresh produce in Orange County, the county of the reporting Hospital. Infinite Zion Farms is a local nonprofit that is working to establish affordable sources of organic produce and provide education to the community at large. In 2021, the reporting Hospital funded Infinite Zion Farms $416 toward the installation of tower gardens to increase the fresh produce in Orange County, the county of the reporting Hospital.In 2021, the reporting Hospital also established a new partnership with Urban Smart Farms, a local organization founded to blaze a path in the local farming movement, inspiring and empowering communities to grow their own fresh, healthy produce in a cleaner, simpler, more efficient way. The reporting Hospital spent $689 to purchase 18 tower gardens from Urban Smart Farms to donate to local nonprofit partners.Goal 2: Work with community and government officials to address the root causes of food insecurity in our communitiesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. This shared objective, to identify leadership from the tri-county area to participate in local coalitions focused on advocacy and reform to ensure equitable access to healthy food, is managed at a Divisional level, however all outcomes reported are specific to Orange County. This initiative provides an opportunity to form and participate in multisector collaboratives within Orange County, which are working on a shared goal to identify and strategize on best practices to address the root causes of food insecurity. In 2021, the Division continued to provide representation on behalf of the Hospital by participating in the Orange County Department of Health's Community Health Improvement Planning Committee. This committee is comprised of organizations throughout Orange County that plan and implement community improvement programs. By providing representation at a Divisional level, the Central Florida Division of AdventHealth can identify cross-county and various organizational partnerships that will benefit all the communities they serve, regardless of geography.Priority 2: Care Coordination 2019 Description of the Issue:AdventHealth Apopka identified care coordination as a need, specifically in the areas of prenatal care/early intervention/early childhood, access to care and chronic disease management. Orange County had an increase in infant deaths, low birthweight babies and preterm births. There was also a decrease in the percentage of mothers who had prenatal care in the first trimester. In Orange County, 31.6 percent of community survey respondents indicated that they lacked access to a primary care provider. An additional 35.5 percent indicated they lacked access to a healthcare provider specialist. Limited access to high quality primary care physicians and specialists was identified as a community issue by primary research participants. Orange County also had an increase in individuals who were obese, middle school and high school students who are reporting a body mass index at or above the 95th percentile, adults with diabetes, diabetes hospitalizations for children ages 12 to 18, adults with hypertension and adults who have been told they had a stroke. 2021 Update: The AdventHealth Apopka Community Health Plan has two desired goal statements under the Care Coordination priority.1. Increase the availability of appropriate and affordable care2. Decrease barriers community members encounter while seeking careGoal 1: Increase the availability of appropriate and affordable careObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the Central 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 support to existing care facilities through multiple strategies, including financial contributions, in-kind labs, and residency rotations and to seek innovative ways to increase capacity through the provision of in-kind labs/imaging, volunteer services, etc. The first strategy is to provide support to existing care facilities through financial contributions. The strategy to support this objective is managed at a Divisional level. The reporting Hospital's funding included, but was not limited to, contributions for operational support for two local Federally Qualified Health Centers (FQHCs). A $4,160 contribution was made to the Health Care Center for the Homeless, which provides primary medical care, oral health services, behavioral health and substance use services for underinsured and uninsured individuals. An additional $8,320 was provided to True Health, which delivers medical and mental health services to underserved populations.The reporting Hospital also provided $7,072 to Shepherd's Hope which will support medical homes to increase the availability of affordable care. Shepherd's Hope is a faith-based organization of volunteers who provide access to healthcare for uninsured patients. The second strategy is to provide in-kind labs to existing care facilities. The Division provided in-kind labs to the Health Care Center for the Homeless. In the future, the Division will develop a process to track and quantify in-kind labs and imaging provided to local nonprofits.The third strategy is to support a residency rotation to existing care facilities. The Division had a residency rotation program established with a local nonprofit. In 2021, for a multitude of reasons, including COVID-19, the program was discontinued. The Division has pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that may support residency rotations. The fourth strategy is to seek innovative ways to increase capacity through in-kind labs, imaging, and volunteer services. Due to COVID-19, the 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. **see continuation of footnote

Part V, Section B, Line 11 Continuation of Footnote:
Group A-Facility 8 -- AdventHealth ApopkaDescription of CHNA Significant Needs ContinuedObjective 2: The second objective is a Divisional initiative and appears on multiple community health plans in Orange County, Osceola County and Seminole County: AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. These Hospitals are part of the Central Florida Division of AdventHealth and are in the same Division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority.This shared objective, to expand on existing care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need, is managed at a Divisional level. This initiative provides an opportunity to support organizations with a shared goal to increase accessible entry points. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2021, the reporting Hospital contributed funding of $4,992 to the American Cancer Society's Road to Recovery Program. This program provides rides to and from cancer treatment for any cancer patient, regardless of insurance or economic status, that has a transportation barrier. In total, the Road to Recovery program provided 209 rides for cancer patients. In 2021, the reporting Hospital contributed $6,480 in year two toward the three-year funding partnership with AdventHealth University's Hope Clinic. This partnership provides cardiac rehabilitation (wellness maintenance) services to uninsured and underinsured individuals to improve health outcomes and reduce readmissions. The Hope Clinic provides free care to individuals with socio-economic barriers, allowing increased access to care regardless of financial circumstance. In 2021, the Hope Clinic opened and enrolled 13 patients into the program.The reporting Hospital also contributed $4,409 to Community Health Centers to support a nurse navigator to assist patients coming from the reporting Hospital's primary service area. Community Health Centers is an organization of Central Florida family health centers that provide high-quality, affordable medical, pediatric, dental, and pharmacy care throughout Central Florida.Goal 2: Decrease barriers community members encounter while seeking careObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in Orange County, Osceola County and Seminole County to include AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. These Hospitals are part of the Central Florida Division of AdventHealth and are in the same Division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This shared objective, to provide case management services for at least 81 patients over three years while identifying additional partners and methods to decrease barriers community members encounter while seeking care, is managed at a Divisional level. In 2021, the Division continued to support the Holistic Health program led by Center for Change, a local nonprofit, which aims to provide health education and social services to individuals and families who lack access to economic, social and health resources. The reporting Hospital contributed $4,911 toward the Holistic Health program which focuses its efforts in high-need communities identified in the CHNA. The Division is progressing on this objective and 48 individuals have been provided case management service. Additionally, in 2021, 276 referrals to services have been provided, 105 individuals have improved their biometrics and 125 individuals have improved health behaviors through the program. Priority 3: Mental & Behavioral Health 2019 Description of the Issue:Mental health, behavioral health and substance use were all identified as top community needs by stakeholders, key informants and focus groups. Only one in ten community survey respondents from Orange County believe there is sufficient substance abuse services. Poor mental health can exacerbate physical health conditions, decreasing quality of life and making it more difficult to maintain stable housing. The Central Florida Division of AdventHealth is heavily invested in addressing mental health and substance abuse and has partnered with community organizations such as local Federally Qualified Health Centers (FQHCs), the Seminole County Sheriff's Office, Aspire Health Partners, and the National Alliance on Mental Illness.2021 Update: The AdventHealth Apopka Community Health Plan has two desired goal statements under the Mental & Behavioral Health priority.1. Increase access to mental and behavioral health services2. Support existing resources and identify new partners and programs that proactively strengthen the communityGoal 1: Increase access to mental and behavioral health servicesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase provider capacity through financial and in-kind support to at least three partners serving the tri-county community. This shared objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This initiative provides an opportunity for the reporting Hospital to support at least three partners that have a shared goal of increasing provider capacity in the space of mental and behavioral health. In 2021, the reporting Hospital sustained partnerships with three partners to implement programs that serve the tri-county community: Aspire Health Partners' Psychosocial Rehabilitation Program, Central Florida Center for the Arts' Community Music Therapy Program, and Health Care Center for the Homeless' Eye Movement Desensitization and Reprocessing (EMDR) Therapy Program. The reporting Hospital met its set metric of providing financial support to at least three partners by funding these organizations for a total of $19,082. With the funding, they were able to provide programs that serve the underinsured and uninsured individuals in the reporting Hospital's service area. Aspire Health Partners is an organization committed to providing individuals and families of Central Florida with compassionate, comprehensive, and cost-effective behavioral health care services that lead to successful living and healthy, responsible lifestyles. Not only does Aspire Health Partners receive financial funding for the Psychosocial Rehabilitation Program, but the Division also leases five crisis stabilization unit (CSU) beds to connect individuals who have acute needs to mental health services. The Division also supports the Central Florida Center for the Arts which exists to serve and build community through the arts. Through the Music Therapy Program, the organization hired a music therapist to support individual and group music therapy across the tri-county area. The Division partnered with the Health Care Center for the Homeless to launch the EMDR Therapy program for homeless and low-income, uninsured, and underinsured community members in need. This therapy will help community members with conditions such as Post-Traumatic Stress Disorder (PTSD), addiction and healing from past trauma. Other initiatives to address this objective include providing in-kind support through board service. In 2021, the reporting Hospital served on the board of Dave's House which focuses on providing permanent supportive housing for individuals with serious mental illness (SMI) and co-occurring disabilities.**see continuation of footnote

Part V, Section B, Line 11 Continuation of Footnote:
Group A-Facility 8 -- AdventHealth ApopkaDescription of CHNA Significant Needs ContinuedObjective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. This objective is to develop and support pathways to mental and behavioral healthcare for those in need by expanding care navigation models to include mental and behavioral health focused initiatives over the next three years. This shared objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. In 2021, due to COVID-19, the 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. Goal 2: Support existing resources and identify new partners and programs that proactively strengthen the communityObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. This objective is supported by multiple strategies: provide the Mission: FIT POSSIBLE program to at least two schools annually in the AdventHealth Apopka primary service area that were identified as hot spots and collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused training and resources to the community. This objective is managed at a Divisional level; however, all outcomes are specific to Hospitals in Orange County. The first strategy was to provide the Mission: FIT POSSIBLE program to at least two schools in the AdventHealth Apopka primary service area per year that were identified as hot spots. This objective was exceeded by the Division, with 27 schools in the reporting Hospital's primary service area receiving the program. Outcomes reported for this strategy, which supports the objective, are specific to Orange County. The Mission: FIT POSSIBLE program is a comprehensive wellness program which brings health and wellness education to schools, churches, and community centers. Health and wellness educators provide education during regular visits, as well as supplemental education for teachers and staff to engage kids in activities that teach them how to be physically and emotionally healthy.The second strategy is to collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. Outcomes reported for this strategy, which supports the objective, are specific to the reporting Hospital. This objective was met through an initiative, Circle of Security led by the Early Learning Coalition of Orange County (ELCOC). The reporting Hospital contributed $1,040 toward ELCOC's Circle of Security program. ELCOC is dedicated to the success of early childhood development in the community through early education. The Circle of Security program builds teachers' responsiveness to young children's emotional needs to better support their positive mental health. The ELCOC seeks to provide the Circle of Security attachment training to early childhood teachers in Orange County's most under-resourced communities. The reporting Hospital was able to meet this objective in Orange County, the county of the reporting Hospital. In 2021, the reporting Hospital also contributed funding of $4,160 toward the No Limit Health and Education's program, No Limit Unit. No Limit Health and Education is a local nonprofit whose mission is to promote mental health (social, emotional, and psychological) wellness and awareness through advocacy, programs, services, and outreach. Through this partnership, No Limit Unit provides services to adults and youth for both individual empowerment and systemic change in the areas of mental and physical wellness. Barbershop Talk Tours, Thriving Moms Club and Flow Detox reach men, women and children through mental health education, support groups and reduction of stigma. The reporting Hospital will continue to seek additional community partners to collaborate with and strengthen community resiliency in the remaining counties it serves.Priority 4: Community Development: Youth Development & Mentorship 2019 Description of the Issue:Youth development and mentorship, specifically relating to youth education and enrichment, was identified by the local Community Health Needs Assessment Committee as a need. Orange County has seen an increase in student absenteeism. Positive influences combined with a strong education as a youth increases the chances for success in adulthood. 2021 Update: The AdventHealth Apopka Community Health Plan has one desired goal statement under the Community Development: Youth Development and Mentorship priority.1. Increase impact of efforts to provide positive experiences and healthy environments for youthGoal 1: Increase impact of efforts to provide positive experiences and healthy environments for youthObjective 1: The first objective is a shared initiative between AdventHealth Altamonte Springs and AdventHealth Apopka. These Hospitals are part of the Central Florida Division of AdventHealth. The Hospitals partnered on this initiative because of a shared CHNA priority. This objective is to provide annual financial and in-kind support, including board service and employee volunteers, for continuation of annual school engagement events and growing new partnerships to serve youth in the community. This objective is managed at the Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. The first strategy is to provide financial support to local organizations that are working to positively impact youth in the community. In 2021, the reporting Hospital provided financial support of $208 to AMIKids, which is an organization that works to protect public safety and positively impact as many youths as possible through the efforts of a diverse and innovative staff. AMIKids works in partnership with youth agencies, local communities, and families.The second strategy is to provide in-kind support, including board-service and employee volunteers, to local organizations that are working to positively impact youth and host annual school engagement events. Due to COVID-19, the 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. The third strategy is to establish new partnerships to serve youth in the community. The Division progressed on this metric by establishing a partnership with No Limit Health and Education, Inc. which is a local nonprofit that hosts several programs., One of these programs, the Flow Detox program, teaches young adults in historically underserved neighborhoods how to process anger and hostile emotions as well as to positively express themselves. In 2021, 90 of 100 youth completed Flow Detox, increasing their understanding of personal triggers and how to process anger and hostile emotions. **see continuation of footnote

Part V, Section B, Line 11 Continuation of Footnote:
Group A-Facility 8 -- AdventHealth ApopkaDescription of CHNA Significant Needs ContinuedCommunity Needs Not Chosen by AdventHealth ApopkaThe 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. Homelessness: The local Community Health Needs Assessment Committee (CHNAC) did not perceive the ability to improve upon the resources that already exist in Orange County that address this issue. The Hospital decided it would be better to target their efforts in areas where we would have greater impact.

Part V, Section B, Line 11 Continuation of Footnote:
"Group A-Facility 10 -- AdventHealth WauchulaDescription of CHNA Significant NeedsAdventist Health System/Sunbelt, Inc., dba AdventHealth Wauchula will be referred to in this document as AdventHealth Wauchula 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 Wauchula is part of the West Florida Division (the Division) of AdventHealth. The Division includes 11 hospital facilities. This is the second-year update for AdventHealth Wauchula'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 Wauchula 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 Wauchula chose four priorities for its 2020-2022 Community Health Plan: 1. Mental Health (Behavioral Health)2. Access to Health Care 3. Cardiovascular Disease 4. Education (Social Determinant of Health) Priority 1: Mental Health (Behavioral Health)2019 Description of the Issue:The burden of mental illness in the United States is among the highest of all diseases, and mental disorders are among the most common causes of disability for adults, children, and adolescents. When mental health disorders are untreated, those affected are at high risk for many unhealthy and unsafe behaviors, including alcohol or drug abuse, violent or self-destructive behavior and suicide. Mental health disorders are the 11th leading cause of death in the United States for all age groups and the second leading cause of death among people age 25 to 34. In the AdventHealth Wauchula primary service areas (PSA), the rate of death due to self- harm (suicide) is 19 (per 100,000 population), which is higher than the state rate of 14 (per 100,000 population). Furthermore, 25% (16,345 persons) of the adults in the PSA population selfreport that they receive insufficient social and emotional support all or most of the time, which is higher than the state rate (21%). This indicator is relevant because social and emotional support is critical for navigating the challenges of daily life as well as for good mental health. Additionally, 17% (15,062 persons) of the Medicare-fee-for-service PSA population is depressed.2021 Update: The AdventHealth Wauchula Community Health Plan has two desired goal statements under the Mental Health (Behavioral Health) priority. 1. To increase education and awareness related to mental health by engaging public schools, community members, organizations and stakeholders2. To increase community-level partnerships to enhance existing efforts currently addressing factors that impact mental health in youth and adultsGoal 1: To increase education and awareness related to mental health by engaging public schools, community members, organizations and stakeholders Objective 1: The first objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. 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 partner with the Champion for Children Advocacy Center to raise awareness of the impact of mental health in youth and adults residing in the Hospital's PSA by creating and implementing two local social media campaigns from a baseline of zero local social media campaigns by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This social media campaign initiative brings awareness to both youth and adult community members regarding mental illnesses and helps to encourage conversations around the topic of mental health to ultimately destigmatize mental illnesses and encourage those suffering to seek help. Champion for Children's Advocacy Center split into two organizations after the creation of our 2020-2022 Community Health Plans. The two new organizations are the Ruth E. Handley Children's Advocacy Center and the Champion for Children Foundation. We are partnering with both organizations for this initiative. The Ruth E. Handley Children's Advocacy Center's mission is to minimize trauma of child abuse victims and provide prevention support to families needing assistance to keep them intact. The Champion for Children Foundation offers prevention services and assistance programs to protect children, educate parents, strengthen families, assist caregivers, reduce trauma, and provide resources. These partnerships, as well as insight from members of our Community Health Needs Assessment Committee (CHNAC), have helped us to determine the most important topics to address for our social media campaigns moving forward, which will be depression and anxiety. The Hospitals progressed on the set metric of two local social media campaigns created and implemented by the end of year three. Throughout year two, we have continued to connect with mental health partners and collect resources to share with community members. The system-wide social media campaign was paused and as a result, our local social media campaign was paused as well. **see continuation of footnote"

Part V, Section B, Line 11 Continuation of Footnote:
Group A-Facility 10 -- AdventHealth WauchulaDescription of CHNA Significant Needs ContinuedObjective 2: The second 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 by the end of year three. The deployment of the Mental Health First Aid classes is a shared initiative between AdventHealth Wauchula, AdventHealth Carrollwood, AdventHealth Connerton, AdventHealth Dade City, AdventHealth North Pinellas, AdventHealth Ocala, AdventHealth Sebring, AdventHealth Tampa, AdventHealth Zephyrhills, AdventHealth Lake Placid 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.This initiative provides Mental Health First Aid USA certification classes to the community for free. The class is a course that teaches individuals how to help someone who may be experiencing mental health or substance use challenges. The training helps one to identify, understand and respond to signs of addictions and mental illnesses. Mental Health First Aid USA is a national program developed to teach the skills to respond to the signs of mental illness and substance use.The Hospital progressed on its set metric of providing three free Mental Health First Aid USA certification training classes to community members residing in the Hospital's PSA by the end of year three. During year two, four team members became certified instructors for Mental Health First Aid's adult curriculum. We have also continued to identify community partners and training locations to begin teaching classes in year three. Goal 2: To increase community-level partnerships to enhance existing efforts currently addressing factors that impact mental health in youth and adults Objective 1: The first objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. 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 provide vouchers to cover the costs of household supplies for homeless adults residing in the Hospital's PSA who receive housing services at Peace River Center (PRC) from a baseline of zero vouchers to three by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved unless otherwise indicated.This initiative provides vouchers in the form of monetary funds to help cover some of the cost associated with purchasing household and personal supplies for community members that are supported by the residential housing programs offered at Peace River Center, who is our community partner. This will thereby lead to improved health outcomes by providing these essential supplies. Peace River Center is a 501(c)(3) not-for-profit organization that strives to impact the lives of its clients and the community they serve by engaging, restoring and empowering individuals to reach their fullest potential by offering a broad range of mental health, victim services and substance use disorder services throughout Polk, Highlands and Hardee counties, including housing and domestic violence shelters. The Hospitals progressed on the set metric of providing three vouchers to cover the cost of household supplies for those residents residing at Peace River Center by year three. Year two was spent determining the budgeted dollar amount to donate based on the supplies needed by the facility. Donations will be sent out in year three. Objective 2: The second objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. 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 awareness of Hospital sponsored community benefit programs and resources available to uninsured/underinsured adults and youth residing in the Hospital's PSA through a partnership with Peace River Center (PRC), by providing three informative in-service presentations to Crisis Response Outreach Counselors at PRC from a baseline of zero presentations by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This initiative provides information about our Hospital sponsored Community Benefit programs that are free to community members and targeted to reach those uninsured/underinsured, underserved, low-income and minority members of the community. These programs include, but are not limited to, our Food is Health program that gives participants 10 dollars' worth of free produce for participating in an education class about nutrition and healthy living. These informative in-service presentations are presented to the Crisis Response Outreach Counselors at Peace River Center who connect directly with those community members in need of mental health and crisis response counseling. They may also benefit from our free community programs. By sharing our programs with these counselors, they can then share this information with their clients. The Hospitals progressed on the set metric of providing three informative in-service presentations to Crisis Response Outreach Counselors at PRC by the end of year three. Year two was spent getting our programs back up and running in the community so that in year three, we will have these programs available to share with the Crisis Response Outreach Counselors.Objective 3: The third objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. 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 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 200 hours by the end of year three. The objective is funded and managed through all Hospitals, however reported outcomes are specific to the reporting Hospital. This initiative provides a paid volunteerism program through which AdventHealth employees are paid at their normal rate to volunteer at community organizations addressing this priority area. The Hospitals progressed on the set metric of 200 hours of paid staff time spent volunteering in the community to address mental health by the end of year three. Our team developed a volunteer portal to market volunteer opportunities to team members, track volunteer hours and notify community partners when team members sign up for an event. Year two was spent identifying volunteer opportunities in the community to add to the portal. Unfortunately, due to COVID-19, many team members were still unavailable to spend any extra work time volunteering, and because of this, the mental health 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. Priority 2: Access to Health Care 2019 Description of the Issue:Access to health care is the equitable use of health services to achieve the highest level of health. Barriers to accessing healthcare services include cost of care, insurance coverage, availability of services and culturally competent care. Failure to overcome these barriers leads to delayed care, health complications and financial burdens. Accessing healthcare services is vital to prevent and treat diseases thereby reducing the likelihood of disability and premature death.In the AdventHealth Wauchula PSA, 24% of adults and 8% of children are uninsured or without medical insurance (both percentages are higher than the state averages). Additionally, 27% of adults do not have a regular doctor which is higher than the state average of 24.8%. **see continuation of footnote

Part V, Section B, Line 11 Continuation of Footnote:
"Group A-Facility 10 -- AdventHealth WauchulaDescription of CHNA Significant Needs Continued2021 Update: The AdventHealth Wauchula Community Health Plan has two desired goal statements under the Access to Health Care priority. 1. To implement strategies to reduce transportation barriers leading to improved access to primary care providers2. To provide resources that support the expansion of services that are available to community members and increase access. To increase partnerships with local community organizations with resources to offer community members assistance with gaining health insurance coverageGoal 1: To implement strategies to reduce transportation barriers leading to improved access to primary care providers Objective 1: The first objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. 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 primary service area. The objective is to increase access to primary care by decreasing transportation challenges (barriers) among vulnerable adults residing in the Hospital's Primary Service Area (PSA) by developing, implementing and evaluating three new collaborative strategies with community partners from a baseline of zero strategies by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. The initiative created a partnership between our Hospital and community organizations who also share a goal to reduce transportation challenges within the community. Through this collaboration, we exchanged ideas, resources, and programs. We also evaluated what additional resources are available, or may become available, to community members with transportation challenges.The Hospital progressed on its set metric of implementing three new collaborative strategies to aid in decreasing transportation challenges among vulnerable adults residing in the Hospital's PSA by year three. Year two was spent working with our transportation action team and the Heartland Regional Transportation Planning Organization to plan the community summits that will occur in year three. These summits will include informative presentations about the various transportation programs available to residents in need who reside in Highlands and Hardee counties. The Heartland Regional Transportation Planning Organization coordinates transportation plans for the Heartland Region including the six counties of DeSoto, Glades, Hardee, Hendry, Highlands and Okeechobee and the urbanized area of Highlands County, including the cities of Sebring and Avon Park. The Central Florida Regional Planning Council's mission is to provide support to the citizens and counties of the Heartland region and to seek ways to improve the quality of life of the citizens of the Heartland.Objective 2: The second objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. 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 primary service area. The objective is to establish a new transportation taskforce in Hardee and Highlands Counties to co-host at least two community summits (with AdventHealth Sebring and AdventHealth Lake Placid) from a baseline of zero summits to increase awareness of the impact of transportation accessibility on community health and wellness and employment sustainability for community members residing in the Hospital's PSA by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This initiative brings together multiple organizations from the community who share a common goal in seeking to improve transportation access and a platform for getting the transportation programs available out to the communities we serve. The Hospitals progressed on the set metric of establishing a transportation taskforce to co-host two community summits by the end of year three. Year two was spent working with the Heartland Regional Transportation Planning Organization to identify a team member to join their established transportation taskforce. This team member was identified and joined in the meetings. Planning began with this taskforce to help co-host the community summits that will take place in year three. Goal 2: To provide resources that support the expansion of services that are available to community members and increase access. To increase partnerships with local community organizations with resources to offer community members assistance with gaining health insurance coverageObjective 1: The first objective is to partner with the Florida Department of Health in Hardee and Highlands Counties to develop and implement ""Health Insurance 101"" community workshop series (enrollment, how to use insurance, KidCare education, terms, and definitions, etc.) for adults residing in the Hospital's PSA by providing three free community workshop series from a baseline of zero workshop series by the end of year three. The initiative is funded and managed through AdventHealth Wauchula and all outcomes are specific to the reporting Hospital. The initiative provides health education to uninsured and underinsured residents to help them understand how to enroll in affordable health insurance, utilize health insurance and seek out primary care services. This is done in partnership with the Healthcare Planning Council of Southwest Florida. This organization employs health insurance navigators to educate the public on the health insurance marketplace and other government assisted health insurance programs. Their mission is to improve the health and wellness of the community by promoting healthy lifestyles, reducing health disparities, increasing access to quality health related services, detecting, and eliminating gaps in services, expanding knowledge through education, and facilitating community partnerships. The Hospital progressed on its set metric of providing three free ""Health Insurance 101"" workshops for the community by the end of year three. In year two we partnered with the Healthcare Planning Council of Southwest Florida to deliver one of the three workshops virtually. Objective 2: The second objective is to increase access to primary care services among underinsured/uninsured community members by providing donated medical supplies to two local community clinics from a baseline of one by the end of year three. The initiative is funded and managed through AdventHealth Wauchula and all outcomes are specific to the reporting Hospital. The initiative provides two identified clinics within the Hospital's PSA who serve low-income, uninsured, or underinsured populations, with donated medical supplies. The Hospital progressed on its set metric of providing donated medical supplies to two local community clinics by the end of year three. Upon identifying and creating partnerships with two community clinics who serve the underserved population, the clinics chosen were Samaritan's Touch Care Center and Central Florida Health Care (CFHC) of Hardee County. Samaritan's Touch is a faith-based, charitable healthcare center in Highlands County offering free primary and specialized medical, dental and vision care to uninsured financially struggling families who have no medical insurance of any kind and whose income is at or below 200% of the Federal Poverty Guidelines. CFHC of Hardee County is the local federally qualified healthcare clinic. Year two was spent determining the budgeted dollar amount to donate to both clinics based on the supplies needed. Donations will be sent out in year three. **see continuation of footnote"

Part V, Section B, Line 11 Continuation of Footnote:
"Group A-Facility 10 -- AdventHealth WauchulaDescription of CHNA Significant Needs ContinuedPriority 3: Cardiovascular Disease2019 Description of the Issue:Coronary heart disease is a leading cause of death in the U.S. and is also related to high blood pressure, high cholesterol, and heart attacks. In the AdventHealth Wauchula primary service area (PSA), 9% (7,614 persons) of adults aged 18 and older have coronary heart disease or angina (heart related chest pain). Additionally, the rate of death due to heart disease per 100,000 population is 155 (268 average annual deaths from 2012 2016), which is higher than the state rate of 150 and 22% (13,201 persons) of the PSA population smoke cigarettes (higher than the state rate of 19%). Tobacco use is also linked to cardiovascular disease.2021 Update: The AdventHealth Wauchula Community Health Plan has two desired goal statements under the Cardiovascular Disease priority. 1. Improve access to health education, early intervention programs and resources related to cardiovascular disease2. Decrease tobacco use in adults and youth community membersGoal 1: Improve access to health education, early intervention programs and resources related to cardiovascular 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. The objective is to increase the number of Hospital sponsored American Heart Association (AHA) community CPR (Cardiopulmonary Resuscitation) out-of-hospital bystander classes for adults and youth from a baseline of zero to two 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 two classes sponsored by the end of year three. In year two we marketed our Hands-Only CPR class throughout the community and have met with new partners to begin scheduling classes in year three. Objective 2: The second objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. 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 partner with the Florida Department of Health (FDOH) in Highlands County to provide patient referrals at discharge to enroll in free Diabetes Self-Management Education and Support (DSMES) classes by creating an internal referral system to refer 75 underinsured/uninsured adults residing in the Hospital's PSA from a baseline of zero by the end of year three. The objective is funded and managed through all Hospitals, however reported outcomes are specific to the reporting Hospital. This initiative provides an internal referral system for the Hospital to directly enroll patients in need of the FDOH's DSMES classes. The Florida Department of Health works to protect, promote and improve the health of all people in Florida through integrated state, county, and community efforts. The DSMES referral program connects diabetic and pre-diabetic individuals to health education that provides them with knowledge and tools to self-manage their chronic condition, improve health behaviors, and change health outcomes. The Hospitals progressed on the set metric of creating an internal referral system to refer 75 underinsured/uninsured adults residing in the Hospital's PSA by the end of year three. The internal plan for referring participants to the DSMES classes involves a tremendous amount of collaborative efforts with our AdventHealth Care 360 team to create an ""at discharge"" referral system to connect patients to our Community Benefit programs and initiatives. In year two, the referral system was piloted to connect patients (at discharge) with a history of tobacco use to free tobacco cessation classes offered by the Central Florida Area Health Education Center (AHEC). As mentioned, this system was implemented for the tobacco initiative in year two and is still undergoing the pilot before expanding to include the DSMES initiative, which will begin in year three. 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 objective states the Food is Health program will support a series of five nutrition education class series among low-income families in the PSA from a baseline of two 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.The Hospital progressed on its set metric of five class series offered to low-income families by the end of year three. In year two, we scheduled a Food is Health class in partnership with UF/IFAS Extension but the class did not meet the minimum number of required attendees (10) and was therefore canceled. Additionally, we searched for a new produce vendor in year two because the former produce vendor was no longer able to fulfill the requirements of the program. Unfortunately, the new produce vendor identified was unable to be legally onboarded as a vendor for AdventHealth. We will continue the search for another produce vendor in year three to successfully enable the program to be back up and running. Objective 4:The fourth 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 objective states the Food is Health program will distribute 200 produce vouchers (valued at $10 each) to program participants from a baseline of 72 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 Hospital progressed on its set metric of distributing 200 produce vouchers to program participants by the end of year three. In year two, we scheduled a Food is Health class in partnership with UF/IFAS Extension but the class did not meet the minimum number of required attendees (10) and was therefore canceled. Additionally, we searched for a new produce vendor in year two because the former produce vendor was no longer able to fulfill the requirements of the program. Unfortunately, the new produce vendor identified was unable to be legally onboarded as a vendor for AdventHealth. We will continue the search for another produce vendor in year three to successfully enable the program to be back up and running. Objective 5: The fifth 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 objective states the Food Is Health program will build and maintain partnerships with local community organizations serving low-income/low access communities by engaging seven community partners from a baseline of four by the end of year three. This objective is managed at a Divisional level, and outcomes reported represent the Hospitals in Hardee and Highlands counties; AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. The Hospital progressed on its set metric of building and maintaining partnerships by engaging and recruiting four of the seven new community partner organizations by the end of year three. In year two, we maintained our partnership with UF/IFAS Extension as the educational partner for our program. We also identified and met with potential partners, the Senior Connection Center and Feeding Tampa Bay. Additionally, we identified and tried to onboard a new produce vendor, Wauchula Curbside Market. Year three will be spent identifying and solidifying a new produce vendor partner and educational partner, while maintaining the current educational partnership with UF/IFAS Extension. **see continuation of footnote"

Part V, Section B, Line 11 Continuation of Footnote:
Group A-Facility 10 -- AdventHealth WauchulaDescription of CHNA Significant Needs ContinuedObjective 6: The sixth 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 objective states the Food is Health program will increase the number of participants among low-income families in the PSA to 50 from a baseline of 15 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 Hospital progressed on its set metric of increasing program participation to 50 participants by the end of year three. In year two, we scheduled a Food is Health class in partnership with UF/IFAS Extension but the class did not meet the minimum number of required attendees (10) and was therefore canceled. Additionally, we searched for a new produce vendor in year two because the former produce vendor was no longer able to fulfill the requirements of the program. Unfortunately, the new produce vendor identified was unable to be legally onboarded as a vendor for AdventHealth. We will continue the search for another produce vendor in year three to successfully enable the program to be back up and running. Objective 7:The seventh 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 objective states the Food is Health program will increase the number of health screenings among adults living in food deserts or low-income/low access communities to 75 from a baseline of 23 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 Hospital has not progressed on its set metric of 75 health screenings by the end of year three. In year two, due to COVID-19, no community health screenings for this program occurred. 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. Goal 2: Decrease tobacco use in adults and youth community members Objective 1: The first objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. 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 knowledge of free tobacco cessation programs and tobacco prevention/treatment resources for patients at discharge by partnering with the Central Florida Area Health Education Center (AHEC) to provide continuing education classes to 50 team members (treating patients with tobacco use) from a baseline of zero by the end of year three. The objective is funded through all Hospitals but managed by the Division. Funding and outcomes reported represent all Hospitals involved. 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, which could potentially improve patients' health through support for eliminating tobacco use. This is conducted through a partnership with Central Florida AHEC, the local affiliate of the national organization of AHEC, that is a community focused organization that develops and implements community-based health promotion activities and education programs which target the underserved. AHEC also provides community members tools and resources to assist with tobacco cessation, including tobacco replacement when medically necessary and available, and accredited classes for continuing education units (CEUs) and continuing medical education (CMEs) for Hospital team members. The Hospital progressed on its set metric of educating 50 team members about tobacco cessation resources by the end of year three. Our team successfully completed a memorandum of understanding (MOU) between the Hospitals and Central Florida AHEC. The MOU illustrates how Central Florida AHEC will offer tobacco cessation programming in partnership with us, which includes flyer and promotion templates, program materials and client communications on our behalf. This also includes the understanding that Central Florida AHEC will provide accredited tobacco cessation education to providers and staff of AdventHealth Wauchula, thereby resulting in earned CEUs and CMEs for these team members. In year two, due to COVID-19, no tobacco cessation educational classes for our team members occurred because of the increased need of their work time devoted to COVID-19 patients. 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. In year two, we have identified classes offered by AHEC to satisfy these requirements and will offer them to our team members in year three. Objective 2: The second objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. 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 provide patient referrals at discharge to enroll in free AHEC tobacco cessation programs and receive free intervention therapies to quit smoking tobacco through a partnership with AHEC and create an internal referral system to link adults residing in the Hospital's PSA, providing resources for 18 patients from a baseline of zero by end of year three. The objective is funded through AdventHealth Sebring but managed by the Division. Reported referrals are specific to the reporting Hospital.This initiative provides an internal patient referral system at discharge to enroll in free AHEC tobacco cessation programs and receive free intervention therapies to quit tobacco. This initiative is conducted through a partnership with AHEC and the Hospital's internal Care 360 team. The Hospital's internal Care 360 team works with patients at discharge and serves to identify patients needing tobacco cessation. Once identified, the Care 360 team can use this internal referral system to directly enroll patients into AHEC's tobacco cessation program. The Hospitals progressed on the set metric of providing resources for 18 patients at discharge through an internal referral system between the Hospital and AHEC by the end of year three. Our team successfully completed a memorandum of understanding (MOU) between the Hospitals and AHEC. The MOU illustrates how AHEC will offer tobacco cessation programming in partnership with us, which includes flyer and promotion templates, program materials and client communications on our behalf. Additionally, the Division team formed a partnership between AHEC and our internal Care 360 team and the creation of the internal referral system began. In year two, the Care 360 team piloted the internal referral system with our sister hospital, AdventHealth Sebring, as well as other hospitals within the West Florida Division. At the end of year two, ten patients of AdventHealth Sebring had been referred to AHEC's program through this method, with one patient accepting the referral. In year three, we are seeking to work out any issues with the referral system and increase the pilot to our other hospitals to meet our objective of providing resources for 18 patients at discharge. **see continuation of footnote

Part V, Section B, Line 11 Continuation of Footnote:
Group A-Facility 10 -- AdventHealth WauchulaDescription of CHNA Significant Needs ContinuedObjective 3: The third objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. 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 access to tobacco cessation classes for adults residing in the Hospital's PSA by five classes from a baseline of zero by the end of year three. The objective is funded through all Hospitals but managed by the Division. Funding and outcomes reported represent all Hospitals involved. This initiative increases access to tobacco cessation classes that improve health through a partnership with Central Florida Area Health Education Centers (AHEC). The Hospitals progressed on the set metric of increasing access to five tobacco cessation classes by the end of year three. Our team successfully completed a memorandum of understanding (MOU) between the Hospitals and AHEC. The MOU illustrates how AHEC will offer tobacco cessation programming in partnership with us, which includes flyer and promotion templates, program materials and client communications on our behalf. Additionally, the Division team formed a partnership between AHEC and our internal Care 360 team and the creation of the internal referral system began. In year two, the Care 360 team piloted the internal referral system and collected data to share with our team on the success of this initiative. In year two, we marketed two of AHEC's tobacco cessation classes by promoting their classes through the sharing of flyers and through the direct internal referral system via Care 360. At the end of year two, ten patients of AdventHealth Sebring had been referred to AHEC's program through this method, with one patient accepting the referral to attend the class. In year three we will begin hosting AHEC's classes at our hospital campuses and offering food incentives for their participants. Priority 4: Education (Social Determinant of Health)2019 Description of the Issue:In the AdventHealth Wauchula primary service area, 20% (12,547 persons) of the population aged 25 and older do not have a high school diploma (or equivalency) or higher and this percentage is higher than the state average of 12%. Educational attainment is a social determinant of health and is linked to health outcomes. Additionally, improving health literacy may be a useful strategy for reducing disparities in health related to education.2021 Update: The AdventHealth Wauchula Community Health Plan has two desired goal statements under the Education (Social Determinant of Health) priority. 1. To increase partnerships with local school-based programs to better understand the problem of educational attainment as a social determinant of health2. To support community efforts that address the problem of educational attainment as a social determinant of healthGoal 1: To increase partnerships with local school-based programs to better understand the problem of educational attainment as a social determinant of health Objective 1: The first objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. 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 partner with local community school and/or college programs to create a community-based professional development program (interviewing skills, resume writing, basic computer skills, mentoring) for underserved adults residing in the Hospital's PSA by providing three community workshops from a baseline of zero by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This initiative provides underserved adults with educational and hands-on training skills, such as resume writing and computer skills, needed to enter the workforce. The Hospitals progressed on the set metric of providing three community workshops to underserved adults by the end of year three. We established a partnership with CareerSource Heartland, South Florida State College and the Panthers Youth Program. CareerSource Heartland is a not-for-profit corporation that operates as a demand-driven and business focused public-private partnership. Through oversight provided by the local elected officials from DeSoto, Hardee, Highlands and Okeechobee counties, their Board of Directors offer workforce development related growth opportunities to business customers and job seekers throughout their four-county service delivery area. South Florida State College is a public college in Florida with campuses in Highlands, Desoto and Hardee counties and is part of the Florida College System. The South Florida State College Adult Education Program provides General Education Development (GED) preparation and testing. The Panthers Youth Partners program is affiliated with CareerSource Heartland and South Florida State College and serves to provide youth with services that will develop and strengthen employability skills, talents, and interests. Through these partnerships, we have identified resources - including teachers, classes, locations, and target audience members - for these development programs. Due to COVID-19, no soft skills educational workshops for the community occurred. 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. Additionally, Division-wide restrictions on in-person gatherings were also enforced for our Hospitals and company policy prevented us from hosting in-person classes on our Hospital campuses. We have pivoted where necessary and in year three will begin partnering with these organizations to deliver this program virtually or in-person. We will do this by having our team members offer lessons about real-world career opportunities at AdventHealth and sharing the process of attaining and maintaining a successful career. In year three, our Hospital will offer support in the form of free meeting space to host the classes for these partner organizations, free marketing materials and additional costs covered of delivering these classes. Objective 2: The second objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. 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 establish a new partnership with local community organizations to identify education access barriers in underserved adults residing in the Hospital's PSA from a baseline of zero organizations to three by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved.This initiative creates a partnership with local community organizations working in adult education to help discover challenges to educational attainment and means to help resolve them. The Hospitals met the set metric of establishing three new partnerships with local community organizations to identify barriers for accessing education in underserved adults by the end of year three. We established a partnership with three new community partners - CareerSource Heartland, South Florida State College, and the Panthers Youth Program. Through the formation of these three new partnerships, we were able to discuss barriers to educational access for those underserved members of our community. The barriers identified include inaccessible or unreliable means of transportation, lack of child-care, work-hour inflexibility, financial constraints, and home-life challenges. In year three, we will provide donated funds to South Florida State College to help alleviate some of the financial constraints mentioned for those low-income individuals seeking to attain their high school diploma through the General Educational Development (GED) program.**see continuation of footnote

Part V, Section B, Line 11 Continuation of Footnote:
Group A-Facility 10 -- AdventHealth WauchulaDescription of CHNA Significant Needs ContinuedGoal 2: To support community efforts that address the problem of educational attainment as a social determinant of health Objective 1: The first objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. 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 provide education vouchers to cover the costs of General Educational Development (GED) materials (textbooks, registration fees and tests) for adults residing in the Hospital's PSA from a baseline of zero vouchers to three vouchers by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This initiative provides education vouchers in the form of monetary funds to help cover some of the cost associated with the GED test. The Hospitals progressed on the set metric of providing three education vouchers in the form of monetary funds for adults residing in the Hospital's PSA by the end of year three. Upon identifying and establishing a partnership with the local GED preparation and testing organization, South Florida State College, year two was spent determining the budgeted dollar amount to donate based on the need of those individuals served by this facility. Donations will be sent out in year three to support those low-income, underserved individuals seeking to attain their high school diploma through the GED program. Objective 2: The second objective is a shared initiative with AdventHealth Lake Placid and AdventHealth Sebring. 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 amount of paid staff time for Hospital staff/team members to volunteer with community organizations addressing education (as a social determinant of health) from a baseline of zero hours to 150 hours by the end of year three. The objective is funded and managed through all Hospitals; however, outcomes are specific to the reporting Hospital. This initiative 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. The Hospitals progressed on the set metric of 150 hours of paid staff time spent volunteering in the community to address education (as a social determinant of health) by the end of year three. Our team developed a volunteer portal to market volunteer opportunities to team members, track volunteer hours and notify community partners when team members sign up for an event. Year two was spent identifying volunteer opportunities in the community to add to the portal. Unfortunately, due to COVID-19, many team members were still unavailable to spend any extra work time volunteering, and because of this, the educational 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. Community Needs Not Chosen by AdventHealth Wauchula: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. 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 Wauchula Primary Service Area (PSA), the access to qualified dentists at a rate (per 100,000 pop.) is 36 (in 2015 year), as compared to the state rate of 56. The Community Health Needs Assessment Committee (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.2. Tobacco Use: In the AdventHealth Wauchula PSA, an estimated 13,201 of adults age 18 or older selfreport currently smoking cigarettes some days or every day. This indicator is relevant because tobacco use is linked to leading causes of death such as cancer and cardiovascular disease. In the Hospital PSA, 22% of adults are currently smoking cigarettes, which is higher than the state percentage of 19%. The CHNAC felt the issue should not be addressed as an individual problem. Therefore, interventions to address tobacco use will be wrapped into the priority area of heart disease.3. Obesity/Overweight/Obese: In the AdventHealth Wauchula PSA, approximately 33% of adults aged 20 and older (21,963 persons) selfreport that they have a Body Mass Index (BMI) greater than 30.0 (obese) in the report area. The state percentage is 27%. Excess weight may indicate an unhealthy lifestyle and puts individuals at risk for further health issues. The CHNAC felt the issue should not be addressed as an individual problem. Therefore, interventions to address Obesity/Overweight/Obese will be wrapped into the education priority area. The Community Health Needs Assessment Committee (CHNAC) will approach this area of need more comprehensively, as other barriers contribute to negative health outcomes in this area of priority.

Part V, Section B, Line 11 Footnote:
"Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant NeedsAdventist Health System/Sunbelt, Inc. d/b/a AdventHealth Sebring and AdventHealth Lake Placid will be referred to in this document as AdventHealth Sebring 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 Sebring is part of the West Florida Division (the Division) of AdventHealth. The Division includes 11 hospital facilities. This is the second-year update for AdventHealth Sebring'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 Sebring 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 Sebring chose four priorities for its 2020-2022 Community Health Plan: 1. Mental Health (Behavioral Health)2. Transportation 3. Cardiovascular Disease 4. Education (Social Determinant of Health) Priority 1: Mental Health (Behavioral Health)2019 Description of the Issue:The burden of mental illness in the United States is among the highest of all diseases, and mental disorders are among the most common causes of disability for adults, children, and adolescents. When mental health disorders are untreated, those affected are at high risk for many unhealthy and unsafe behaviors, including alcohol or drug abuse, violent or self-destructive behavior and suicide. Mental health disorders are the 11th leading cause of death in the United States for all age groups and the second leading cause of death among people age 25 to 34. In the AdventHealth Sebring primary service areas (PSA), the rate of death due to self-harm (suicide) is 19 (per 100,000 population), which is higher than the state rate of 14 (per 100,000 population). Furthermore, 25% of the adults in the PSA population selfreport that they receive insufficient social and emotional support all or most of the time, which is higher than the state rate (21%). This indicator is relevant because social and emotional support is critical for navigating the challenges of daily life as well as for good mental health. Additionally, 17% of the Medicare-fee-for-service PSA population are depressed.2021 Update: The AdventHealth Sebring Community Health Plan has two desired goal statements under the Mental Health (Behavioral Health) priority. 1. To increase education and awareness related to mental health by engaging public schools, community members, organizations and stakeholders2. To increase community-level partnerships to enhance existing efforts currently addressing factors that impact mental health in youth and adultsGoal 1: To increase education and awareness related to mental health by engaging public schools, community members, organizations and stakeholders Objective 1: The first objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. 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 partner with the Champion for Children Advocacy Center to raise awareness of the impact of mental health in youth and adults residing in the Hospital's PSA by creating and implementing two local social media campaigns from a baseline of zero local social media campaigns by the end of year three. The objective is funded and managed through all Hospitals and outcomes reported represent all Hospitals involved. This social media campaign initiative brings awareness to both youth and adult community members regarding mental illnesses and helps to encourage conversations around the topic of mental health to ultimately destigmatize mental illnesses and encourage those suffering to seek help. Champion for Children's Advocacy Center split into two organizations after the creation of our 2020-2022 Community Health Plans. The two new organizations are the Ruth E. Handley Children's Advocacy Center and the Champion for Children Foundation. We are partnering with both organizations for this initiative. The Ruth E. Handley Children's Advocacy Center's mission is to minimize the trauma of child abuse victims and provide prevention support to families needing assistance to keep them intact. The Champion for Children Foundation offers prevention services and assistance programs to protect children, educate parents, strengthen families, assist caregivers, reduce trauma, and provide resources. These partnerships, as well as insight from members of our Community Health Needs Assessment Committee (CHNAC), have helped us to determine the most important topics to address for our social media campaigns moving forward, which will be depression and anxiety. The Hospitals progressed on the set metric of two local social media campaigns created and implemented by the end of year three. Throughout year two, we have continued to connect with mental health partners and collect resources to share with community members. The system-wide social media campaign was paused and as a result, our local social media campaign was paused as well. **see continuation of footnote"

Part V, Section B, Line 11 Continuation of Footnote:
Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant Needs ContinuedObjective 2: The second 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 by the end of year three. The deployment of the Mental Health First Aid classes is a shared initiative between AdventHealth Sebring, AdventHealth Carrollwood, AdventHealth Connerton, AdventHealth Dade City, AdventHealth North Pinellas, AdventHealth Ocala, AdventHealth Tampa, AdventHealth Zephyrhills, AdventHealth Wauchula, AdventHealth Lake Placid 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.This initiative provides Mental Health First Aid USA certification classes to the community for free. The class is a course that teaches individuals how to help someone who may be experiencing mental health or substance use challenges. The training helps one to identify, understand and respond to signs of addictions and mental illnesses. Mental Health First Aid USA is a national program developed to teach the skills to respond to the signs of mental illness and substance use.The Hospital progressed on its set metric of providing three free Mental Health First Aid USA certification training classes to community members residing in the Hospital's PSA by the end of year three. During year two, four team members became certified instructors for Mental Health First Aid's adult curriculum. We have also continued to identify community partners and training locations to begin teaching classes in year three. Goal 2: To increase community-level partnerships to enhance existing efforts currently addressing factors that impact mental health in youth and adults Objective 1: The first objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. 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 provide vouchers to cover the costs of household supplies for homeless adults residing in the Hospital's PSA who receive housing services at Peace River Center (PRC) from a baseline of zero vouchers to three by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved unless otherwise indicated. This initiative provides vouchers in the form of monetary funds to help cover some of the cost associated with purchasing household and personal supplies for community members that are supported by the residential housing programs offered at Peace River Center, who is our community partner. This will thereby lead to improved health outcomes by providing these essential supplies.Peace River Center is a 501(c)(3) not-for-profit organization that strives to impact the lives of its clients and the community they serve by engaging, restoring, and empowering individuals to reach their fullest potential by offering a broad range of mental health, victim and substance use disorder services throughout Polk, Highlands, and Hardee counties, including housing and domestic violence shelters. The Hospitals progressed on the set metric of providing three vouchers to cover the cost of household supplies for those residents residing at Peace River Center by year three. Year two was spent determining the budgeted dollar amount to donate based on the supplies needed by the facility. Donations will be sent out in year three. Objective 2: The second objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. 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 awareness of Hospital sponsored community benefit programs and resources available to uninsured/underinsured adults and youth residing in the Hospital's PSA through a partnership with Peace River Center (PRC) by providing three informative in-service presentations to Crisis Response Outreach Counselors at PRC from a baseline of zero presentations by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This initiative provides information about our Hospital sponsored Community Benefit programs that are free to community members and targeted to reach those uninsured/underinsured, underserved, low-income and minority members of the community. These programs include, but are not limited to, our Food is Health program that gives participants 10 dollars' worth of free produce for participating in an education class about nutrition and healthy living. These informative in-service presentations are presented to the Crisis Response Outreach Counselors at Peace River Center who connect directly with those community members in need of mental health and crisis response counseling. They may also benefit from our free community programs. By sharing our programs with these counselors, they can then share this information with their clients. The Hospitals progressed on the set metric of providing three informative in-service presentations to Crisis Response Outreach Counselors at PRC by the end of year three. Year two was spent getting our programs back up and running in the community so that in year three, we will have these programs available to share with the Crisis Response Outreach Counselors.Objective 3: The third objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. 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 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 300 hours by the end of year three. The objective is funded and managed through all Hospitals, however reported outcomes are specific to the reporting Hospital. This initiative provides a paid volunteerism program through which AdventHealth employees are paid at their normal rate to volunteer at community organizations addressing this priority area. The Hospitals progressed on the set metric of 300 hours of paid staff time spent volunteering in the community to address mental health by the end of year three. Our team developed a volunteer portal to market volunteer opportunities to team members, track volunteer hours and notify community partners when team members sign up for an event. Year two was spent identifying volunteer opportunities in the community to add to the portal. Unfortunately, due to COVID-19, many team members were still unavailable to spend any extra work time volunteering, and because of this, the mental health 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 of footnote

Part V, Section B, Line 11 Continuation of Footnote:
Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant Needs ContinuedPriority 2: Transportation 2019 Description of the Issue:A poor transportation system prevents those who do not own a car or have reliable transportation from accessing healthcare. Transportation barriers lead to rescheduled or missed appointments, delayed care, and missed or delayed medication use. In the AdventHealth Sebring primary service area (PSA), 3% (1,026 persons) of the population are currently using public transportation as their primary means of transportation to work. Furthermore, 27% of the population (28,585 persons) age 18 years and older do not have a regular healthcare provider, which is higher than the state average of 25%.2021 Update: The AdventHealth Sebring Community Health Plan has two desired goal statements under the Transportation priority. 1. To increase community partnerships with local transportation systems, leaders, and businesses to develop new strategies for improving access to transportation2. To increase access to culturally appropriate nutritious food options in food desert or low income/low access areas by implementing the Food is Health programGoal 1: To increase community partnerships with local transportation systems, leaders, and businesses to develop new strategies for improving access to transportation Objective 1: The first objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. 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 primary service area. The objective is to decrease transportation challenges (barriers) among vulnerable adults residing in the Hospital's PSA by creating and implementing two new collaborative strategies from a baseline of zero strategies by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. The initiative created a partnership between our Hospital and community organizations who also share a goal to reduce transportation challenges within the community. Through this collaboration, we exchanged ideas, resources, and programs. We also evaluated what additional resources are available, or may become available, to community members with transportation challenges.The Hospital progressed on its set metric of implementing two new collaborative strategies to aid in decreasing transportation challenges among vulnerable adults residing in the Hospital's PSA by year three. Year two was spent working with our transportation action team and the Heartland Regional Transportation Planning Organization to plan the community summits that will occur in year three. These summits will include informative presentations about the various transportation programs available to residents in need who reside in Highlands and Hardee counties. The Heartland Regional Transportation Planning Organization coordinates transportation plans for the Heartland Region including the six counties of DeSoto, Glades, Hardee, Hendry, Highlands and Okeechobee and the urbanized area of Highlands County, including the cities of Sebring and Avon Park. The Central Florida Regional Planning Council's mission is to provide support to the citizens and counties of the Heartland region and to seek ways to improve the quality of life of the citizens of the Heartland.Objective 2: The second objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. 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 primary service area. The objective is to establish a new transportation taskforce in Hardee/Highlands Counties to co-host at least two community summits (with AdventHealth Wauchula and AdventHealth Lake Placid) from a baseline of zero summits to increase awareness of the impact of transportation accessibility on community health, wellness and employment sustainability for community members residing in the Hospital's PSA by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This initiative brings together multiple organizations from the community who share a common goal in seeking to improve transportation access and a platform for getting the transportation programs available out to the communities we serve. The Hospitals progressed on the set metric of establishing a transportation taskforce to co-host two community summits by the end of year three. Year two was spent working with the Heartland Regional Transportation Planning Organization to identify a team member to join their established transportation taskforce. This team member was identified and joined in the meetings. Planning began with this taskforce to help co-host the community summits that will take place in year three. Goal 2: Increase access to culturally appropriate nutritious food options in food desert or low income/low access areas 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 objective states the Food is Health program will support a series of three nutrition education class series among low-income families in the PSA from a baseline of one 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.The Hospital progressed on its set metric of three class series offered to low-income families by the end of year three. In year two, we scheduled a Food is Health class in partnership with UF/IFAS Extension but the class did not meet the minimum number of required attendees (10) and was therefore canceled. Additionally, we searched for a new produce vendor in year two because the former produce vendor was no longer able to fulfill the requirements of the program. Unfortunately, the new produce vendor identified was unable to be legally onboarded as a vendor for AdventHealth. We will continue the search for another produce vendor in year three to successfully enable the program to be back up and running.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 objective states the Food is Health program will distribute 120 produce vouchers (valued at $10 each) to program participants from a baseline of 40 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 Hospital progressed on its set metric of distributing 120 produce vouchers to program participants by the end of year three. In year two, we scheduled a Food is Health class in partnership with UF/IFAS Extension but the class did not meet the minimum number of required attendees (10) and was therefore canceled. Additionally, we searched for a new produce vendor in year two because the former produce vendor was no longer able to fulfill the requirements of the program. Unfortunately, the new produce vendor identified was unable to be legally onboarded as a vendor for AdventHealth. We will continue the search for another produce vendor in year three to successfully enable the program to be back up and running. **see continuation of footnote

Part V, Section B, Line 11 Continuation of Footnote:
"Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant Needs ContinuedObjective 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 objective states the Food Is Health program will build and maintain partnerships with local community organizations serving low-income/low access communities by engaging six community partners from a baseline of three by the end of year three. This objective is managed at a Divisional level, and outcomes reported represent the Hospitals in Hardee and Highlands counties; AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. The Hospital progressed on its set metric of building and maintaining partnerships by engaging and recruiting four of the six new community partner organizations by the end of year three. In year two, we maintained our partnership with UF/IFAS Extension as the educational partner for our program. We also identified and met with potential partners, the Senior Connection Center and Feeding Tampa Bay. Additionally, we identified and tried to onboard a new produce vendor, Wauchula Curbside Market. Year three will be spent identifying and solidifying a new produce vendor partner and educational partner, while maintaining the current educational partnership with UF/IFAS Extension. Objective 4: The fourth 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 objective states that the Food is Health program will increase the number of participants among low-income families in the PSA to 30 from a baseline of 11 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 Hospital progressed on its set metric of increasing program participation to 30 participants by the end of year three. In year two, we scheduled a Food is Health class in partnership with UF/IFAS Extension but the class did not meet the minimum number of required attendees (10) and was therefore canceled. Additionally, we searched for a new produce vendor in year two because the former produce vendor was no longer able to fulfill the requirements of the program. Unfortunately, the new produce vendor identified was unable to be legally onboarded as a vendor for AdventHealth. We will continue the search for another produce vendor in year three to successfully enable the program to be back up and running. Objective 5:The fifth 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 objective states the Food is Health program will increase the number of health screenings among adults living in food deserts or low-income/low access communities to 45 from a baseline of 13 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 Hospital has not progressed on its set metric of 45 health screenings by the end of year three. In year two, due to COVID-19, no community health screenings for this program occurred. 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. Priority 3: Cardiovascular Disease2019 Description of the Issue:Coronary heart disease is a leading cause of death in the U.S. and is also related to high blood pressure, high cholesterol, and heart attacks. In the AdventHealth Sebring primary service area (PSA), 9% of adults aged 18 and older have coronary heart disease or angina (heart related chest pain). Additionally, the rate of death due to heart disease per 100,000 population is 156 (370 average annual deaths from 2012 2016), which is higher than the state rate of 150 and 22% of the PSA population smoke cigarettes (higher than the state rate of 19%). Tobacco use is also linked to cardiovascular disease.2021 Update: The AdventHealth Sebring Community Health Plan has two desired goal statements under the Cardiovascular Disease priority. 1. Improve access to health education, early intervention programs and resources related to cardiovascular disease2. Decrease tobacco use in adults and youth community membersGoal 1: Improve access to health education, early intervention programs and resources related to cardiovascular 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. The objective is to increase the number of Hospital sponsored American Heart Association (AHA) community CPR (Cardiopulmonary Resuscitation) out-of-hospital bystander classes for adults and youth from a baseline of zero to two by the end of year three. 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. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital. The Hospital progressed on its set metric of two classes sponsored by the end of year three. In year two we marketed our Hands-Only CPR class throughout the community and have met with new partners to begin scheduling classes in year three. Objective 2: The second objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. 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 partner with the Florida Department of Health (FDOH) in Highlands County to provide patient referrals at discharge to enroll in free Diabetes Self-Management Education and Support (DSMES) classes by creating an internal referral system to refer 100 underinsured/uninsured adults residing in the Hospital's PSA from a baseline of zero by the end of year three. The objective is funded and managed through all Hospitals, however reported outcomes are specific to the reporting Hospital. This initiative provides an internal referral system for the Hospital to directly enroll patients in need in the FDOH's DSMES classes. The Florida Department of Health works to protect, promote and improve the health of all people in Florida through integrated state, county, and community efforts. The DSMES referral program connects diabetic and pre-diabetic individuals to health education that provides them with knowledge and tools to self-manage their chronic condition, improve health behaviors, and change health outcomes. The Hospitals progressed on the set metric of creating an internal referral system to refer 100 underinsured/uninsured adults residing in the Hospital's PSA by the end of year three. The internal plan for referring participants to the DSMES classes involves a tremendous amount of collaborative efforts with our AdventHealth Care 360 team to create an ""at discharge"" referral system to connect patients to our Community Benefit programs and initiatives. In year two, the referral system was piloted to connect patients (at discharge) with a history of tobacco use to free tobacco cessation classes offered by the Central Florida Area Health Education Center (AHEC). As mentioned, this system was implemented for the tobacco initiative in year two and is still undergoing the pilot before expanding to include the DSMES initiative, which will begin in year three. **see continuation of footnote"

Part V, Section B, Line 11 Continuation of Footnote:
Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant Needs ContinuedObjective 3:The third objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. 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 amount of paid time for Hospital staff/team members to volunteer with community organizations addressing heart disease and stroke from a baseline of zero hours to 200 hours by the end of year three. The objective is funded through all Hospitals and managed by the Division, however reported outcomes are specific to the reporting Hospital. This initiative 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. The Hospital progressed on the set metric of 200 hours of paid staff time spent volunteering in the community to address heart disease and stroke by the end of year three. Our team developed a volunteer portal to market volunteer opportunities to team members, track volunteer hours and notify community partners when team members sign up for an event. The Division team also created screensavers to advertise the volunteer portal. Year two was spent identifying volunteer opportunities in the community to add to the portal. Unfortunately, many team members were still unavailable to spend any extra work time volunteering due to COVID-19, and because of this, the cardiovascular disease 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.Goal 2: Decrease tobacco use in adults and youth community members Objective 1: The first objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. 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 knowledge of free tobacco cessation programs and tobacco prevention/treatment resources for patients at discharge by partnering with Central Florida Area Health Education Center (AHEC) to provide continuing education classes to 50 team members (treating patients with tobacco use) from a baseline of zero by the end of year three. The objective is funded through all Hospitals but managed by the Division. Funding and outcomes reported represent all Hospitals involved. 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, which could potentially improve patients' health through support for eliminating tobacco use. This is conducted through a partnership with Central Florida AHEC, the local affiliate of the national organization of AHEC, that is a community focused organization that develops and implements community-based health promotion activities and education programs, which target the underserved. AHEC also provides community members tools and resources to assist with tobacco cessation, including tobacco replacement when medically necessary and available, and accredited classes for continuing education units (CEUs) and continuing medical education (CMEs) for Hospital team members.The Hospital progressed on its set metric of educating 50 team members about tobacco cessation resources by the end of year three. Our team successfully completed a memorandum of understanding (MOU) between the Hospitals and Central Florida AHEC. The MOU illustrates how Central Florida AHEC will offer tobacco cessation programming in partnership with us, which includes flyer and promotion templates, program materials and client communications on our behalf. This also includes the understanding that Central Florida AHEC will provide accredited tobacco cessation education to providers and staff of AdventHealth, thereby resulting in earned CEUs and CMEs for these team members. In year two, due to COVID-19, no tobacco cessation educational classes for our team members occurred because of the increased need of their work time devoted to COVID-19 patients. 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. In year two, we have identified classes offered by AHEC to satisfy these requirements and will offer them to our team members in year three. Objective 2: The second objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. 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 provide patient referrals at discharge to enroll in free AHEC tobacco cessation programs and receive free intervention therapies to quit smoking tobacco through a partnership with AHEC and create an internal referral system to link adults residing in the Hospital's PSA, providing resources for 18 patients from a baseline of zero by the end of year three. The objective is funded through AdventHealth Sebring but managed by the Division. Reported referrals are specific to the reporting Hospital.This initiative provides an internal patient referral system at discharge to enroll in free AHEC tobacco cessation programs and receive free intervention therapies to quit tobacco. This initiative is conducted through a partnership with AHEC and the Hospital's internal Care 360 team. The Hospital's internal Care 360 team works with patients at discharge and serves to identify patients needing tobacco cessation. Once identified, the Care 360 team can use this internal referral system to directly enroll patients into AHEC's tobacco cessation program. The Hospital progressed on its set metric of providing resources for 18 patients at discharge through an internal referral system between the Hospital and AHEC by the end of year three. Our team successfully completed a memorandum of understanding (MOU) between the Hospitals and AHEC. The MOU illustrates how AHEC will offer tobacco cessation programming in partnership with us, which includes flyer and promotion templates, program materials and client communications on our behalf. Additionally, the Division team formed a partnership between AHEC and our internal Care 360 team and the creation of the internal referral system began. In year two, the Care 360 team piloted the internal referral system. At the end of year two, ten patients of AdventHealth Sebring had been referred to AHEC's program through this method, with one patient accepting the referral. In year three, we are seeking to work out any issues with the referral system and increase the pilot to our other hospitals to meet our objective of providing resources for 18 patients at discharge. Objective 3: The third objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. 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 access to tobacco cessation classes in adults residing in the Hospital's PSA by five classes from a baseline of zero by the end of year three. The objective is funded through all Hospitals but managed by the Division. Funding and outcomes reported represent all Hospitals involved. This initiative increases access to tobacco cessation classes that improve health through a partnership with Central Florida Area Health Education Centers (AHEC). **see continuation of footnote

Part V, Section B, Line 11 Continuation of Footnote:
Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant Needs ContinuedThe Hospitals progressed on the set metric of increasing access to five tobacco cessation classes by the end of year three. Our team successfully completed a memorandum of understanding (MOU) between the Hospitals and AHEC. The MOU illustrates how AHEC will offer tobacco cessation programming in partnership with us, which includes flyer and promotion templates, program materials and client communications on our behalf. Additionally, the Division team formed a partnership between AHEC and our internal Care 360 team and the creation of the internal referral system began. In year two, the Care 360 team piloted the internal referral system and collected data to share with our team on the success of this initiative. In year two, we marketed two of AHEC's tobacco cessation classes by promoting their classes through the sharing of flyers and through the direct internal referral system via Care 360. At the end of year two, ten patients of AdventHealth Sebring had been referred to AHEC's program through this method, with one patient accepting the referral to attend the class. In year three we will begin hosting AHEC's classes at our hospital campuses and offering food incentives for their participants. Priority 4: Education (Social Determinant of Health)2019 Description of the Issue:In the AdventHealth Sebring primary service area, 17% (14,018 persons) of the population aged 25 and older do not have a high school diploma (or equivalency) or higher and is higher than the state average of 12%. Educational attainment is a social determinant of health and is linked to health outcomes. Additionally, improving health literacy may be a useful strategy for reducing disparities in health related to education.2021 Update: The AdventHealth Sebring Community Health Plan has two desired goal statements under the Education (Social Determinant of Health) priority. 1. To increase partnerships with local school-based programs to better understand the problem of educational attainment as a social determinant of health2. To support community efforts to address the problem of educational attainment as a social determinant of healthGoal 1: To increase partnerships with local school-based programs to better understand the problem of educational attainment as a social determinant of health Objective 1: The first objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. 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 partner with local community school and/or college programs to develop, implement and evaluate a community-based professional development program (interviewing skills, resume writing, basic computer skills, mentoring) for underserved adults residing in the Hospital's PSA by providing three community workshops from a baseline of zero by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This initiative provides underserved adults with educational and hands-on training skills, such as resume writing and computer skills, needed to enter the workforce. The Hospitals progressed on the set metric of providing three community workshops to underserved adults by the end of year three. We established a partnership with CareerSource Heartland, South Florida State College, and the Panthers Youth Program. CareerSource Heartland is a not-for-profit corporation that operates as a demand-driven and business focused public-private partnership. Through oversight provided by the local elected officials from DeSoto, Hardee, Highlands and Okeechobee counties, their Board of Directors offer workforce development related growth opportunities to business customers and job seekers throughout their four-county service delivery area.South Florida State College is a public college in Florida with campuses in Highlands, Desoto and Hardee counties and is part of the Florida College System. The South Florida State College Adult Education Program provides General Education Development (GED) preparation and testing. The Panthers Youth Partners program is affiliated with CareerSource Heartland and South Florida State College and serves to provide youth with services that will develop and strengthen employability skills, talents, and interests. Through these partnerships, we have identified resources - including teachers, classes, locations, and target audience members- for these development programs. Due to COVID-19, no soft skills educational workshops for the community occurred. 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. Additionally, Division-wide restrictions on in-person gatherings were also enforced for our Hospitals and company policy prevented us from hosting in-person classes on our Hospital campuses. We have pivoted where necessary and in year three, will begin partnering with these organizations to deliver this program virtually or in-person. We will do this by having our team members offer lessons about real-world career opportunities at AdventHealth and sharing the process of attaining and maintaining a successful career. In year three, our Hospital will offer support in the form of free meeting space to host the classes for these partner organizations, free marketing materials and additional costs covered of delivering these classes. Objective 2: The second objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. 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 establish a new partnership with local community organizations to identify education access barriers in underserved adults residing in the Hospital's PSA from a baseline of zero organizations to two by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This initiative creates a partnership with local community organizations working in adult education to help discover challenges to educational attainment and means to help resolve them. The Hospitals exceeded the set metric of establishing two new partnerships with local community organizations to identify barriers for accessing education in underserved adults by the end of year three. We established a partnership with three new community partners- CareerSource Heartland, South Florida State College, and the Panthers Youth Program. Through the formation of these three new partnerships, we were able to discuss barriers to educational access for those underserved members of our community. The barriers identified include inaccessible or unreliable means of transportation, lack of child-care, work-hour inflexibility, financial constraints, and home-life challenges. In year three, we will provide donated funds to South Florida State College to help alleviate some of the financial constraints mentioned for those low-income individuals seeking to attain their high school diploma through the General Educational Development (GED) program. **see continuation of footnote

Part V, Section B, Line 11 Continuation of Footnote:
Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant Needs ContinuedGoal 2: To support community efforts that address the problem of educational attainment as a social determinant of health Objective 1: The first objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. 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 to provide education vouchers to cover the costs of General Educational Development (GED) materials (textbooks, registration fees and tests) for adults residing in the Hospital's PSA from a baseline of zero vouchers to three vouchers by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This initiative provides education vouchers in the form of monetary funds to help cover some of the cost associated with the GED test. The Hospitals progressed on the set metric of providing three education vouchers in the form of monetary funds for adults residing in the Hospital's PSA by the end of year three. Upon identifying and establishing a partnership with the local GED preparation and testing organization, South Florida State College, year two was spent determining the budgeted dollar amount to donate based on the need of those individuals served by this facility. Donations will be sent out in year three to support those low-income, underserved individuals seeking to attain their high school diploma through the GED program. Objective 2: The second objective is a shared initiative with AdventHealth Wauchula and AdventHealth Lake Placid. 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 amount of paid staff time for Hospital staff/team members to volunteer with community organizations addressing education (as a social determinant of health) from a baseline of zero hours to 150 hours by the end of year three. The objective is funded and managed through all Hospitals; however, outcomes are specific to the reporting Hospital. This initiative 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. The Hospitals progressed on the set metric of 150 hours of paid staff time spent volunteering in the community to address education (as a social determinant of health) by the end of year three. Our team developed a volunteer portal to market volunteer opportunities to team members, track volunteer hours, and notify community partners when team members sign up for an event. Year two was spent identifying volunteer opportunities in the community to add to the portal. Unfortunately, due to COVID-19, many team members were still unavailable to spend any extra work time volunteering, and because of this, the educational 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.Community Needs Not Chosen by AdventHealth Sebring: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. 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 Sebring Primary Service Area (PSA), the access to dentists' rate (per 100,000 pop.) is 36.5 (in 2015 year), as compared to the state rate of 56. The Community Health Needs Assessment Committee (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.2. Tobacco Use: In the AdventHealth Sebring PSA, an estimated 16,314 of adults age 18 or older selfreport currently smoking cigarettes some days or every day. This indicator is relevant because tobacco use is linked to leading causes of death such as cancer and cardiovascular disease. In the Hospital PSA, 22% of adults are currently smoking cigarettes, which is higher than the state percentage of 19%. The CHNAC felt the issue should not be addressed as an individual problem. Therefore, interventions to address tobacco use will be wrapped into the priority area of heart disease.3. Obesity/Overweight/Obese: In the AdventHealth Sebring PSA, approximately 33% of adults aged 20 and older selfreport that they have a Body Mass Index (BMI) greater than 30 (obese) in the report area. The state percentage is 27%. Excess weight may indicate an unhealthy lifestyle and puts individuals at risk for further health issues.The CHNAC felt the issue should not be addressed as an individual problem. Therefore, interventions to address Obesity/Overweight/Obese will be wrapped into the education priority area. The Community Health Needs Assessment Committee (CHNAC) will approach this area of need more comprehensively, as other barriers contribute to negative health outcomes in this area of priority.

Part V, Section B, Line 11 Continuation of Footnote:
"Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant NeedsAdventist Health System/Sunbelt, Inc. d/b/a AdventHealth Sebring and AdventHealth Lake Placid will be referred to in this document as AdventHealth Lake Placid 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 Lake Placid is part of the West Florida Division (the Division) of AdventHealth. The Division includes 11 hospital facilities.This is the second-year update for AdventHealth Lake Placid'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 Lake Placid 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 Lake Placid chose four priorities for its 2020-2022 Community Health Plan:1. Mental Health (Behavioral Health)2. Transportation 3. Cardiovascular Disease4. Education (Social Determinant of Health)Priority 1: Mental Health (Behavioral Health)2019 Description of the Issue:The burden of mental illness in the United States is among the highest of all diseases and mental disorders are among the most common causes of disability for adults, children, and adolescents. When Mental health disorders are untreated, those affected are at high risk for many unhealthy and unsafe behaviors, including alcohol or drug abuse, violent or self-destructive behavior and suicide. Mental health disorders are the 11th leading cause of death in the United States for all age groups and the second leading cause of death among people ages 25 to 34. In the AdventHealth Lake Placid primary service areas (PSA), the rate of death due to self harm (suicide) is 20.5 (per 100,000 population), which is higher than the state rate of 14 (per 100,000 population). Furthermore, 25% (16,345 persons) of the adults in the PSA population selfreport that they receive insufficient social and emotional support all or most of the time, which is higher than the state rate (21%). This indicator is relevant because social and emotional support is critical for navigating the challenges of daily life as well as for good mental health. Furthermore, 17% of the Medicare-fee-for-service PSA population are depressed.2021 Update: The AdventHealth Lake Placid Community Health Plan has two desired goal statements under the Mental Health (Behavioral Health) priority. 1. To increase education and awareness related to mental health by engaging public schools, community members, organizations and stakeholders2. To increase community-level partnerships to enhance existing efforts currently addressing factors that impact mental health in youth and adultsGoal 1: To increase education and awareness related to mental health by engaging public schools, community members, organizations and stakeholders Objective 1: The first objective is a shared initiative between AdventHealth Lake Placid, AdventHealth Sebring and AdventHealth Wauchula. 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 partner with the Champion for Children Advocacy Center to raise awareness of the impact of mental health in youth and adults residing in the Hospital's PSA by creating and implementing two local social media campaigns from a baseline of zero local social media campaigns by the end of year three. The objective is funded and managed through the Hospitals and outcomes reported represent all Hospitals involved. This social media campaign initiative brings awareness to both youth and adult community members regarding mental illnesses and helps to encourage conversations around the topic of mental health to ultimately destigmatize mental illnesses and encourage those suffering to seek help. Champion for Children's Advocacy Center split into two organizations after the creation of our 2020-2022 Community Health Plans. The two new organizations are the Ruth E. Handley Children's Advocacy Center and the Champion for Children Foundation. We are partnering with both organizations for this initiative. The Ruth E. Handley Children's Advocacy Center's mission is to minimize trauma of child abuse victims and provide prevention support to families needing assistance to keep them intact. The Champion for Children Foundation offers prevention services and assistance programs to protect children, educate parents, strengthen families, assist caregivers, reduce trauma, and provide resources. These partnerships, as well as insight from members of our Community Health Needs Assessment Committee (CHNAC), have helped us to determine the most important topics to address for our social media campaigns moving forward, which will be depression and anxiety. The Hospitals progressed on the set metric of two local social media campaigns created and implemented by the end of year three. Throughout year two, we have continued to connect with mental health partners and collect resources to share with community members. The system-wide social media campaign was paused, and as a result our local social media campaign was paused as well. **see continuation of footnote"

Part V, Section B, Line 11 Continuation of Footnote:
Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant Needs ContinuedObjective 2: The second 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 by the end of year three. The deployment of the Mental Health First Aid classes is a shared initiative between AdventHealth Lake Placid, AdventHealth Carrollwood, AdventHealth Connerton, AdventHealth Dade City, AdventHealth North Pinellas, AdventHealth Ocala, AdventHealth Sebring, AdventHealth Tampa, AdventHealth Zephyrhills, 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 initiative is managed at the Divisional level and funded through the Hospital and all reported outcomes are specific to the reporting Hospital.This initiative provides Mental Health First Aid USA certification classes to the community for free. The class is a course that teaches individuals how to help someone who may be experiencing mental health or substance use challenges. The training helps one to identify, understand and respond to signs of addictions and mental illnesses. Mental Health First Aid USA is a national program developed to teach the skills to respond to the signs of mental illness and substance use.The Hospital progressed on its set metric of providing three free Mental Health First Aid USA certification training classes to community members residing in the Hospital's PSA by the end of year three. During year two, four team members became certified instructors for Mental Health First Aid's adult curriculum. We have also continued to identify community partners and training locations to begin teaching classes in year three. Goal 2: To increase community-level partnerships to enhance existing efforts currently addressing factors that impact mental health in youth and adults Objective 1: The first objective is a shared initiative between AdventHealth Lake Placid, AdventHealth Sebring and AdventHealth Wauchula. 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 provide vouchers to cover the costs of household supplies for homeless adults residing in the Hospital's PSA who receive housing services at Peace River Center (PRC) from a baseline of zero vouchers to three by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved unless otherwise indicated.This initiative provides vouchers in the form of monetary funds to help cover some of the cost associated with purchasing household and personal supplies for community members that are supported by the residential housing programs offered at Peace River Center, who is our community partner. This will thereby lead to improved health outcomes by providing these essential supplies.Peace River Center is a 501(c)(3) not-for-profit organization that strives to impact the lives of its clients and the community they serve by engaging, restoring, and empowering individuals to reach their fullest potential by offering a broad range of mental health, victim and substance use disorder services throughout Polk, Highlands, and Hardee counties, including housing and domestic violence shelters. The Hospitals progressed on the set metric of providing three vouchers to cover the cost of household supplies for those residents residing at Peace River Center by year three. Year two was spent determining the budgeted dollar amount to donate based on the supplies needed by the facility. Donations will be sent out in year three. Objective 2: The second objective is a shared initiative between AdventHealth Lake Placid, AdventHealth Sebring and AdventHealth Wauchula. 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 awareness of Hospital sponsored community benefit programs and resources available to uninsured/underinsured adults and youth residing in the Hospital's PSA through a partnership with Peace River Center (PRC), by providing three informative in-service presentations to Crisis Response Outreach Counselors at PRC from a baseline of zero presentations by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This initiative provides information about our Hospital sponsored Community Benefit programs that are free to community members and targeted to reach those uninsured/underinsured, underserved, low-income and minority members of the community. These programs include, but are not limited to, our Food is Health program that gives participants 10 dollars worth of free produce for participating in an education class about nutrition and healthy living. These informative in-service presentations are presented to the Crisis Response Outreach Counselors at Peace River Center who connect directly with those community members in need of mental health and crisis response counseling. They may also benefit from our free community programs. By sharing our programs with these counselors, they can then share this information with their clients. The Hospitals progressed on its set metric of providing three informative in-service presentations to Crisis Response Outreach Counselors at PRC by the end of year three. Year two was spent getting our programs back up and running in the community so that in year three, we will have these programs available to share with the Crisis Response Outreach Counselors. Objective 3: The third objective is a shared initiative between AdventHealth Lake Placid, AdventHealth Sebring and AdventHealth Wauchula. 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 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 300 hours by the end of year three. The objective is funded and managed through all Hospitals, however reported outcomes are specific to the reporting Hospital. This initiative provides a paid volunteerism program through which AdventHealth employees are paid at their normal rate to volunteer at community organizations addressing this priority area. The Hospital progressed on its set metric of 300 hours of paid staff time spent volunteering in the community to address mental health by the end of year three. Our team developed a volunteer portal to market volunteer opportunities to team members, track volunteer hours and notify community partners when team members sign up for an event. Year two was spent identifying volunteer opportunities in the community to add to the portal. Unfortunately, due to COVID-19, many team members were still unavailable to spend any extra work time volunteering, and because of this, the mental health 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 of footnote

Part V, Section B, Line 11 Continuation of Footnote:
Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant Needs ContinuedPriority 2: Transportation 2019 Description of the Issue:A poor transportation system prevents those who do not own a car or have reliable transportation from accessing healthcare. Transportation barriers lead to rescheduled or missed appointments, delayed care, and missed or delayed medication use. In the AdventHealth Lake Placid primary service area (PSA), 3.62% (1,022 persons) of the population are currently using public transportation as their primary means of transportation to work. Additionally, approximately 30% of the population (22,810 persons) age 18 years and older do not have a regular healthcare provider, which is higher than the state average of 25%.2021 Update: The AdventHealth Lake Placid Community Health Plan has two desired goal statements under the Transportation priority. 1. To increase community partnerships with local transportation systems, leaders, and businesses to develop new strategies for improving access to transportation2. To increase access to culturally appropriate nutritious food options in food desert or low income/low access areas by implementing the Food is Health programGoal 1: To increase community partnerships with local transportation systems, leaders, and businesses to develop new strategies for improving access to transportation Objective 1: The first objective is a shared initiative between AdventHealth Lake Placid, AdventHealth Sebring and AdventHealth Wauchula. 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 primary service area. The objective is to decrease transportation challenges (barriers) among vulnerable adults residing in the Hospital's PSA by creating and implementing two new collaborative strategies from a baseline of zero strategies by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. The initiative created a partnership between our Hospitals and community organizations who also share a goal to reduce transportation challenges within the community. Through this collaboration, we exchanged ideas, resources, and programs. We also evaluated what additional resources are available, or may become available, to community members with transportation challenges. The Hospitals progressed on the set metric of implementing two new collaborative strategies to aide in decreasing transportation challenges among vulnerable adults residing in the Hospital's PSA by year three. Year two was spent working with our transportation action team and the Heartland Regional Transportation Planning Organization to plan the community summits that will occur in year three. These summits will include informative presentations about the various transportation programs available to residents in need who reside in Highlands and Hardee counties. The Heartland Regional Transportation Planning Organization coordinates transportation plans for the Heartland Region including the six counties of DeSoto, Glades, Hardee, Hendry, Highlands and Okeechobee and the urbanized area of Highlands County, including the cities of Sebring and Avon Park. The Central Florida Regional Planning Council's mission is to provide support to the citizens and counties of the Heartland region and to seek ways to improve the quality of life of the citizens of the Heartland.Objective 2: The second objective is a shared initiative between AdventHealth Lake Placid, AdventHealth Sebring and AdventHealth Wauchula. 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 primary service area. The objective is to establish a new transportation taskforce in Hardee/Highlands County to co-host at least two community summits (with AdventHealth Wauchula and AdventHealth Sebring) from a baseline of zero summits to increase awareness of the impact of transportation accessibility on community health, wellness and employment sustainability for community members residing in the Hospital's PSA by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This initiative brings together multiple organizations from the community who share a common goal in seeking to improve transportation access and a platform for getting the transportation programs available out to the communities we serve. The Hospitals progressed on the set metric of establishing a transportation taskforce to co-host two community summits by the end of year three. Year two was spent working with the Heartland Regional Transportation Planning Organization to identify a team member to join their established transportation taskforce. This team member was identified and joined in the meetings. Planning began with this taskforce to help co-host the community summits that will take place in year three. Goal 2: Increase access to culturally appropriate nutritious food options in food desert or low income/low access areas 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 objective states the Food is Health program will support a series of three nutrition education class series among low-income families in the PSA from a baseline of zero 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.The Hospital progressed on its set metric of three class series offered to low-income families by the end of year three. In year two, we scheduled a Food is Health class in partnership with UF/IFAS Extension but the class did not meet the minimum number of required attendees (10) and was therefore canceled. Additionally, we searched for a new produce vendor in year two because the former produce vendor was no longer able to fulfill the requirements of the program. Unfortunately, the new produce vendor identified was unable to be legally onboarded as a vendor for AdventHealth. We will continue the search for another produce vendor in year three to successfully enable the program to be back up and running. **see continuation of footnote

Part V, Section B, Line 11 Continuation of Footnote:
Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant Needs ContinuedObjective 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 objective states the Food is Health program will distribute 120 produce vouchers (valued at $10 each) to program participants from a baseline of zero 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 Hospital progressed on its set metric of distributing 120 produce vouchers to program participants by the end of year three. In year two, we scheduled a Food is Health class in partnership with UF/IFAS extension, but the class did not meet the minimum number of required attendees (10) and was therefore canceled. Additionally, we searched for a new produce vendor in year two because the former produce vendor was no longer able to fulfill the requirements of the program. Unfortunately, the new produce vendor identified was unable to be legally onboarded as a vendor for AdventHealth. We will continue the search for another produce vendor in year three to successfully enable the program to be back up and running. 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 objective states the Food Is Health program will build and maintain partnerships with local community organizations serving low-income/low access communities by engaging four community partners from a baseline of zero by the end of year three. This objective is managed at a Divisional level and outcomes reported represent the Hospitals in Hardee and Highlands counties; AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. The Hospitals progressed on the set metric of building and maintaining partnerships by engaging and recruiting four new community partner organizations by the end of year three. In year two, we maintained our partnership with UF/IFAS Extension as the educational partner for our program. We also identified and met with potential partners, the Senior Connection Center and Feeding Tampa Bay. Additionally, we identified and tried to onboard a new produce vendor, Wauchula Curbside Market. Year three will be spent identifying and solidifying a new produce vendor partner and educational partner, while maintaining the current educational partnership with UF/IFAS Extension. Objective 4: The fourth 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 objective states the Food is Health program will increase the number of participants among low-income families in the PSA to 30 from a baseline of zero 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 Hospital progressed on its set metric of increasing program participation to 30 participants by the end of year three. In year two, we scheduled a Food is Health class in partnership with UF/IFAS Extension but the class did not meet the minimum number of required attendees (10) and was therefore canceled. Additionally, we searched for a new produce vendor in year two because the former produce vendor was no longer able to fulfill the requirements of the program. Unfortunately, the new produce vendor identified was unable to be legally onboarded as a vendor for AdventHealth. We will continue the search for another produce vendor in year three to successfully enable the program to be back up and running. Objective 5:The fifth 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 objective states the Food is Health program will increase the number of health screenings among adults living in food deserts or low-income/low-access communities to 45 from a baseline of zero 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 Hospital has not progressed on its set metric of 45 health screenings by the end of year three. In year two, due to COVID-19, no community health screenings for this program occurred. 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. Priority 3: Cardiovascular Disease2019 Description of the Issue:Coronary heart disease is a leading cause of death in the U.S. and is also related to high blood pressure, high cholesterol, and heart attacks. In the AdventHealth Lake Placid primary service area (PSA), 9% (7,820 persons) of adults aged 18 and older have coronary heart disease or angina (heart related chest pain). Additionally, the rate of death due to heart disease per 100,000 population is 151 (289 average annual deaths from 2012 2016), which is higher than the state rate of 150 and 22% (13,180 persons) of the PSA population smoke cigarettes (higher than the state rate of 19%). Tobacco use is also linked to cardiovascular disease.2021 Update: The AdventHealth Lake Placid Community Health Plan has two desired goal statements under the Cardiovascular Disease priority. 1. Improve access to health education, early intervention programs and resources related to cardiovascular disease2. Decrease tobacco use in adults and youth community membersGoal 1: Improve access to health education, early intervention programs and resources related to cardiovascular 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. The objective is to increase the number of Hospital sponsored American Heart Association (AHA) community CPR (Cardiopulmonary Resuscitation) out-of-hospital bystander classes for adults and youth from a baseline of zero to two 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 two classes sponsored by the end of year three. In year two we marketed our Hands-Only CPR class throughout the community and have met with new partners to begin scheduling classes in year three. **see continuation of footnote

Part V, Section B, Line 11 Continuation of Footnote:
"Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant Needs ContinuedObjective 2: The second objective is a shared initiative between AdventHealth Lake Placid, AdventHealth Sebring and AdventHealth Wauchula. 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 partner with the Florida Department of Health (FDOH) in Highlands County to provide patient referrals at discharge to enroll in free Diabetes Self-Management Education and Support (DSMES) classes by creating an internal referral system to refer 100 underinsured/uninsured adults residing in the Hospital's PSA from a baseline of zero by the end of year three. The objective is funded and managed through all Hospitals, however reported outcomes are specific to the reporting Hospital. This initiative provides an internal referral system for the Hospital to directly enroll patients in need in the FDOH's DSMES classes. The Florida Department of Health works to protect, promote and improve the health of all people in Florida through integrated state, county, and community efforts. The DSMES referral program connects diabetic and pre-diabetic individuals to health education that provides them with knowledge and tools to self-manage their chronic condition, improve health behaviors, and change health outcomes. The Hospital progressed on its set metric of creating an internal referral system to refer 100 underinsured/uninsured adults residing in the Hospital's PSA by the end of year three. The internal plan for referring participants to the DSMES classes involves a tremendous amount of collaborative efforts with our AdventHealth Care 360 team to create an ""at discharge"" referral system to connect patients to our Community Benefit programs and initiatives. In year two, the referral system was piloted to connect patients (at discharge) with a history of tobacco use to free tobacco cessation classes offered by the Central Florida Area Health Education Center (AHEC). As mentioned, this system was implemented for the tobacco initiative in year two and is still undergoing the pilot before expanding to include the DSMES initiative, which will begin in year three. Objective 3:The third objective is a shared initiative between AdventHealth Lake Placid, AdventHealth Sebring and AdventHealth Wauchula. 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 amount of paid time for Hospital staff/team members to volunteer with community organizations addressing heart disease and stroke from a baseline of zero hours to 100 hours by the end of year three. The objective is funded through all Hospitals and managed by the Division, however reported outcomes are specific to the reporting Hospital. This initiative 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. The Hospital progressed on its set metric of 100 hours of paid staff time spent volunteering in the community to address heart disease and stroke by the end of year three. Our team developed a volunteer portal to market volunteer opportunities to team members, track volunteer hours and notify community partners when team members sign up for an event. The Division team also created screensavers to advertise the volunteer portal. Year two was spent identifying volunteer opportunities in the community to add to the portal. Unfortunately, many team members were still unavailable to spend any extra work time volunteering due to COVID-19, and because of this, the cardiovascular disease 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. Goal 2: Decrease tobacco use in adults and youth community members Objective 1: The first objective is a shared initiative between AdventHealth Lake Placid, AdventHealth Sebring and AdventHealth Wauchula. 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 knowledge of free tobacco cessation programs and tobacco prevention/treatment resources for patients at discharge by partnering with Central Florida Area Health Education Center (AHEC) to provide continuing education classes to 50 team members (treating patients with tobacco use) from a baseline of zero by the end of year three. The objective is funded through all Hospitals but managed by the Division. Funding and outcomes reported represent all Hospitals involved. 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, which could potentially improve patients' health through support for eliminating tobacco use. This is conducted through a partnership with Central Florida AHEC, the local affiliate of the national organization of AHEC, who is a community focused organization that develops and implements community-based health promotion activities and education programs, which target the underserved. AHEC also provides community members tools and resources to assist with tobacco cessation, including tobacco replacement when medically necessary and available, and accredited classes for continuing education units (CEUs) and continuing medical education (CMEs) for Hospital team members. The Hospitals progressed on the set metric of educating 50 team members about tobacco cessation resources by the end of year three. Our team successfully completed a memorandum of understanding (MOU) between the Hospitals and Central Florida AHEC. The MOU illustrates how Central Florida AHEC will offer tobacco cessation programming in partnership with us, which includes flyer and promotion templates, program materials and client communications on our behalf. This also includes the understanding that Central Florida AHEC will provide accredited tobacco cessation education to providers and staff of AdventHealth, thereby resulting in earned CEUs and CMEs for these team members. In year two, due to COVID-19, no tobacco cessation educational classes occurred for our team members because of the increased need of their work time devoted to COVID-19 patients. 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. In year two, we have identified classes offered by AHEC to satisfy these requirements and will offer them to our team members in year three. **see continuation of footnote"

Part V, Section B, Line 11 Continuation of Footnote:
Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant Needs ContinuedObjective 2: The second objective is a shared initiative between AdventHealth Lake Placid, AdventHealth Sebring and AdventHealth Wauchula. 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 provide patient referrals at discharge to enroll in free AHEC tobacco cessation programs and receive free intervention therapies to quit smoking tobacco through a partnership with AHEC and create an internal referral system to link adults residing in the Hospital's PSA, providing resources for 18 patients from a baseline of zero by end of year three. The objective is funded through all Hospitals but managed by the Division. Funding and outcomes reported represent all Hospitals involved. This initiative provides an internal patient referral system at discharge to enroll in free AHEC tobacco cessation programs and receive free intervention therapies to quit tobacco. This initiative is conducted through a partnership with AHEC and the Hospital's internal Care 360 team. The Hospital's internal Care 360 team works with patients at discharge and serves to identify patients needing tobacco cessation. Once identified, the Care 360 team can use this internal referral system to directly enroll patients into AHEC's tobacco cessation program. The Hospitals progressed on the set metric of providing resources for 18 patients at discharge through an internal referral system between the Hospital and AHEC by the end of year three. Our team successfully completed a memorandum of understanding (MOU) between the Hospitals and AHEC. The MOU illustrates how AHEC will offer tobacco cessation programming in partnership with us, which includes flyer and promotion templates, program materials, and client communications on our behalf. Additionally, the Division team formed a partnership between AHEC and our internal Care 360 team and the creation of the internal referral system began. In year two, the Care 360 team piloted the internal referral system with our sister hospital, AdventHealth Sebring, as well as other hospitals within the West Florida Division. At the end of year two, ten patients of AdventHealth Sebring had been referred to AHEC's program through this method, with one patient accepting the referral. In year three, we are seeking to work out any issues with the referral system and increase the pilot to our other hospitals to meet our objective of providing resources for 18 patients at discharge. Objective 3: The third objective is a shared initiative between AdventHealth Lake Placid, AdventHealth Sebring and AdventHealth Wauchula. 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 access to tobacco cessation classes in adults residing in the Hospital's PSA by five classes from a baseline of zero by the end of year three. The objective is funded through all Hospitals but managed by the Division. Funding and outcomes reported represent all Hospitals involved. This initiative increases access to tobacco cessation classes that improve health through a partnership with Central Florida Area Health Education Centers (AHEC).The Hospitals progressed on the set metric of increasing access to five tobacco cessation classes by the end of year three. Our team successfully completed a memorandum of understanding (MOU) between the Hospitals and AHEC. The MOU illustrates how AHEC will offer tobacco cessation programming in partnership with us, which includes flyer and promotion templates, program materials and client communications on our behalf. Additionally, the Division team formed a partnership between AHEC and our internal Care 360 team and the creation of the internal referral system began. In year two, the Care 360 team piloted the internal referral system and collected data to share with our team on the success of this initiative. In year two, we marketed two of AHEC's tobacco cessation classes by promoting their classes through the sharing of flyers and through the direct internal referral system via Care 360. At the end of year two, ten patients of AdventHealth Sebring had been referred to AHEC's program through this method, with one patient accepting the referral to attend the class. In year three we will begin hosting AHEC's classes at our hospital campuses and offering food incentives for their participants. Priority 4: Education (Social Determinant of Health)2019 Description of the Issue:In the AdventHealth Lake Placid primary service area, 17% (10,986 persons) of the population aged 25 and older do not have a high school diploma (or equivalency) or higher and this percentage is higher than the state average of 12%. Educational attainment is a social determinant of health and is linked to health outcomes. Additionally, improving health literacy may be a useful strategy for reducing disparities in health related to education.2021 Update: The AdventHealth Lake Placid Community Health Plan has two desired goal statements under the Education (Social Determinant of Health) priority. 1. To increase partnerships with local school-based programs to better understand the problem of educational attainment as a social determinant of health2. To support community efforts that address the problem of educational attainment as a social determinant of healthGoal 1: To increase partnerships with local school-based programs to better understand the problem of educational attainment as a social determinant of health Objective 1: The first objective is a shared initiative between AdventHealth Lake Placid, AdventHealth Sebring and AdventHealth Wauchula. 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 partner with local community school and/or college programs to develop, implement and evaluate a community-based professional development program (interviewing skills, resume writing, basic computer skills, mentoring) for underserved adults residing in the Hospital's PSA by providing three community workshops from a baseline of zero by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This initiative provides underserved adults with educational and hands-on training skills, such as resume writing and computer skills, needed to enter the workforce. The Hospitals progressed on the set metric of providing three community workshops to underserved adults by the end of year three. We established a partnership with CareerSource Heartland, South Florida State College, and the Panthers Youth Program. CareerSource Heartland is a not-for-profit corporation that operates as a demand-driven and business focused public-private partnership. Through oversight provided by the local elected officials from DeSoto, Hardee, Highlands and Okeechobee counties, their Board of Directors offer workforce development related growth opportunities to business customers and job seekers throughout their four-county service delivery area. South Florida State College is a public college in Florida with campuses in Highlands, Desoto and Hardee counties and is part of the Florida College System. The South Florida State College Adult Education Program provides General Education Development (GED) preparation and testing. The Panthers Youth Partners program is affiliated with CareerSource Heartland and South Florida State College and serves to provide youth with services that will develop and strengthen employability skills, talents, and interests. **see continuation of footnote

Part V, Section B, Line 11 Continuation of Footnote:
Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant Needs ContinuedThrough these partnerships, we have identified resources - including teachers, classes, locations, and target audience members - for these development programs. Due to COVID-19, no soft skills educational workshops for the community occurred. 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. Additionally, Division-wide restrictions on in-person gatherings were also enforced for our Hospitals and company policy prevented us from hosting in-person classes on our Hospital campuses. We have pivoted where necessary and in year three, will begin partnering with these organizations to deliver this program virtually or in-person. We will do this by having our team members offer lessons about real-world career opportunities at AdventHealth and sharing the process of attaining and maintaining a successful career. In year three, our Hospital will offer support in the form of free meeting space to host the classes for these partner organizations, free marketing materials and additional costs covered of delivering these classes. Objective 2: The second objective is a shared initiative between AdventHealth Lake Placid, AdventHealth Sebring and AdventHealth Wauchula. 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 establish a new partnership with local community organizations to identify education access barriers in underserved adults residing in the Hospital's PSA from a baseline of zero organizations to two by the end of year three. The objective is funded and managed through all Hospitals, funding and outcomes reported represent all Hospitals involved.This initiative creates a partnership with local community organizations working in adult education to help discover challenges to educational attainment and means to help resolve them. The Hospitals exceeded the set metric of establishing two new partnerships with local community organizations to identify barriers for accessing education in underserved adults by the end of year three. We established a partnership with three new community partners - CareerSource Heartland, South Florida State College, and the Panthers Youth Program. Through the formation of these three new partnerships, we were able to discuss barriers to educational access for those underserved members of our community. The barriers identified include inaccessible or unreliable means of transportation, lack of child-care, work-hour inflexibility, financial constraints, and home-life challenges. In year three, we will provide donated funds to South Florida State College to help alleviate some of the financial constraints mentioned for those low-income individuals seeking to attain their high school diploma through the General Educational Development (GED) program. Goal 2: To support community efforts that address the problem of educational attainment as a social determinant of health Objective 1: The first objective is a shared initiative between AdventHealth Lake Placid, AdventHealth Sebring and AdventHealth Wauchula. 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 provide education vouchers to cover the costs of General Educational Development (GED) materials (textbooks, registration fees and tests) for adults residing in the Hospital's PSA from a baseline of zero vouchers to three vouchers by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This initiative provides education vouchers in the form of monetary funds to help cover some of the cost associated with the GED test. The Hospitals progressed on the set metric of providing three education vouchers in the form of monetary funds for adults residing in the Hospital's PSA by the end of year three. Upon identifying and establishing a partnership with the local GED preparation and testing organization, South Florida State College, year two was spent determining the budgeted dollar amount to donate based on the need of those individuals served by this facility. Donations will be sent out in year three to support those low-income, underserved individuals seeking to attain their high school diploma through the GED program.Objective 2: The second objective is a shared initiative with AdventHealth Wauchula and AdventHealth Sebring. 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 amount of paid staff time for Hospital staff/team members to volunteer with community organizations addressing education (as a social determinant of health) from a baseline of zero hours to 150 hours by the end of year three. The objective is funded and managed through all Hospitals; however, outcomes are specific to the reporting Hospital. This initiative 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. The Hospital progressed on its set metric of 150 hours of paid staff time spent volunteering in the community to address education (as a social determinant of health) by the end of year three. Our team developed a volunteer portal to market volunteer opportunities to team members, track volunteer hours and notify community partners when team members sign up for an event. Year two was spent identifying volunteer opportunities in the community to add to the portal. Unfortunately, due to COVID-19, many team members were still unavailable to spend any extra work time volunteering, and because of this, the educational 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 of footnote

Part V, Section B, Line 11 Continuation of Footnote:
Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant Needs ContinuedCommunity Needs Not Chosen by AdventHealth Lake Placid: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. 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 Lake Placid Primary Service Area (PSA), the access to dentists' rate (per 100,000 pop.) is 36 (in 2015 year), as compared to the state rate of 56. The Community Health Needs Assessment Committee (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.2. Tobacco Use: In the AdventHealth Lake Placid PSA, an estimated 13,180 of adults aged 18 or older selfreport currently smoking cigarettes some days or every day. This indicator is relevant because tobacco use is linked to leading causes of death such as cancer and cardiovascular disease. In the Hospital PSA, 22.5% of adults are currently smoking cigarettes, which is higher than the state percentage of 19%.The CHNAC felt the issue should not be addressed as an individual problem. Therefore, interventions to address tobacco use will be wrapped into the priority area of heart disease.3. Obesity/Overweight/Obese: In the AdventHealth Lake Placid PSA, approximately 33% of adults aged 20 and older (21,741 persons) selfreport that they have a Body Mass Index (BMI) greater than 30.0 (obese) in the report area. The state percentage is 27%. Excess weight may indicate an unhealthy lifestyle and puts individuals at risk for further health issues.The CHNAC felt the issue should not be addressed as an individual problem. Therefore, interventions to address Obesity/Overweight/Obese will be wrapped into the education priority area. The Community Health Needs Assessment Committee (CHNAC) will approach this area of need more comprehensively, as other barriers contribute to negative health outcomes in this area of priority.

Part V, Section B, Line 13h Footnote:
Facility Reporting Group - AEffective 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.

Part V, Section B, Line 13h Footnote:
Facility Reporting Group - BEffective 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.

Part V, Section B, Line 16a-16c:
Each hospital facility's FAP, FAP application form and plain language summary of the FAP was made widely available through the following websites: Facility 1 -- AdventHealth Orlandohttps://www.adventhealth.com/legal/financial-assistance Facility 2 -- AdventHealth Celebrationhttps://www.adventhealth.com/legal/financial-assistance Facility 3 -- AdventHealth Altamonte Springshttps://www.adventhealth.com/legal/financial-assistance Facility 4 -- AdventHealth East Orlandohttps://www.adventhealth.com/legal/financial-assistance Facility 5 -- AdventHealth Winter Park https://www.adventhealth.com/legal/financial-assistance Facility 6 -- AdventHealth Kissimmeehttps://www.adventhealth.com/legal/financial-assistance Facility 7 -- AdventHealth Sebringhttps://www.adventhealth.com/legal/financial-assistance Facility 8 -- AdventHealth Apopkahttps://www.adventhealth.com/legal/financial-assistance Facility 9 -- AdventHealth Lake Placidhttps://www.adventhealth.com/legal/financial-assistance Facility 10 -- AdventHealth Wauchulahttps://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 assessments and associated implementation strategies can be accessed on the filing organization's websites."

Part I, Line 7:
The amounts of costs reported in the table in line 7 of Part I of Schedule H were determined by utilizing a cost-to-charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges, contained in the Schedule H instructions.

Part II, Community Building Activities:
The costs of community building activities reported on Part II of Schedule H primarily represent the costs associated with commercially sponsored research conducted by one of the organization's hospitals. This one hospital participates in clinical drug and device research that is performed on patients who have a condition or disease for which the eventual commercial use of a drug or device is intended. This research is related to patient care and serves to expand scientific knowledge with respect to potential treatments and cures for various diseases and conditions. The remainder of the costs incurred stem from the hospitals' involvement in and support 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. The organization's hospitals participate with a number of other community organizations to address the healthcare needs of all its communities. Both cash and in-kind donations are made annually to various local charitable organizations.

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 9b:
Collection Policies: The hospital filing organization's collection practices are in conformity with the requirements set forth in the 2014 Final Regulations regarding the requirements of Internal Revenue Code Section 501(r)(4) - (r)(6). No extraordinary collection actions (ECA's) are initiated by the hospital filing organization in the 120-day period following the date after the first post-discharge billing statement is sent to the individual (or, if later, the specified deadline given in a written notice of actions that may be taken, as described below). Individuals are provided with at least one written notice (notice of actions that may be taken) and a copy of the filing organization's Plain Language Summary of the Financial Assistance Policy that informs the individual that the hospital filing organization may take actions to report adverse information to credit reporting agencies/bureaus if the individual does not submit a Financial Assistance Application Form (FAA Form) or pay the amount due by a specified deadline. The specified deadline is not earlier than 120 days after the first post-discharge billing statement is sent to the individual and is at least 30 days after the notice is provided. A reasonable attempt is also made to orally notify an individual about the filing organization's Financial Assistance Policy and how the individual may obtain assistance with the Financial Assistance application process. If an individual submits an incomplete FAA Form during the 240-day period following the date on which the first post-discharge billing statement was sent to the individual, the hospital filing organization suspends any reporting to consumer credit reporting agencies/bureaus (or ceases any other ECA's) and provides a written notice to the individual describing what additional information or documentation is needed to complete the FAA Form. This written notice contains contact information including the telephone number and physical location of the hospital facility's office or department that can provide information about the Financial Assistance Policy, as well as contact information of the hospital facility's office or department that can provide assistance with the financial assistance application process or, alternatively, a nonprofit organization or governmental agency that can provide assistance with the financial assistance application process if the hospital facility is unable to do so. If an individual submits a complete FAA Form within a reasonable time-period as set forth in the notice described above, the hospital filing organization will suspend any adverse reporting to consumer credit reporting agencies/bureaus until a financial assistance policy eligibility determination can be made.

Part VI, Line 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 VI, Line 2:
As reported in Schedule H, Part V, Section B, the filing organization's hospital facilities conduct their community health needs assessments (CHNAs) every three years. Their 2019 CHNAs were adopted by all hospital governing boards by December 31, 2019, the end of the filing organization's taxable year in which the CHNAs were conducted. All of the filing organization's hospital facilities' 2019 CHNAs complied with the guidance set forth by the IRS in Final Regulation Section 1.501(r)-3. In addition to the CHNAs discussed above, a variety of practices and processes are in place to ensure that the filing organization is responsive to the health needs of all of its communities. Such practices and processes involve the following:1. Hospitals' operating/community boards 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 hospital communities; and 4. Collaboration with other local community groups to address the health care needs of the filing organization's hospital communities.

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. Reconciliation of Schedule H Reported Medicare Surplus/(Shortfall) to Unreimbursed Medicare Costs Associated with the Provision of ServicesTo All Medicare Beneficiaries: The Medicare revenue and allowable costs of care reported in Section B of Part III of Schedule H are based upon the amounts reported in the filing organization's Medicare cost report in accordance with the IRS instructions for Schedule H. On an annual basis, the filing organization also determines its total unreimbursed costs associated with providing services to all Medicare patients. Unreimbursed costs are considered a community benefit to the elderly and are combined into an annual Community Benefit Statement prepared by AdventHealth. The primary reconciling items between the Medicare surplus/(shortfall) shown on line 7 of Section B of Part III of Schedule H and the filing organization's unreimbursed costs of services provided to all Medicare patients are as follows: - Medicare surplus/(shortfall) shown on line 7 of Section B of Schedule H: $(123,475,396) - Difference in costing methodology: (6,896,114) - Unreimbursed costs incurred for services provided to Medicare patients that are not included in the organization's Medicare cost report: (272,696,807) ------------- Total Unreimbursed costs of serving all Medicare patients per the filing organization's communitybenefit reporting $(403,068,347) 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 3:
The Financial Assistance Policy (FAP), Financial Assistance Application Form (FAA Form), and the Plain Language Summary of the Financial Assistance Policy (PLS) of the filing organization's hospital facilities are transparent and available to all individuals served at any point in the care continuum. The FAP, FAA Form, PLS, and contact information for the hospital facilities' financial counselors are prominently and conspicuously posted on the filing organization's hospital facilities' websites. Each hospital facility's 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 relevant hospital facility (referred to below as LEP defined populations). Signage is displayed in public locations of the filing organization's hospital facilities, including at all points of admission and registration and the Emergency Department. The signage contains each hospital facility's website address where the FAP, FAA Form, and PLS can be accessed and the telephone number and physical location that individuals can call or visit to obtain copies of the FAP, FAA Form and PLS or to obtain more information about the hospital facility's FAP, FAA Form and PLS. Paper copies of each hospital facility's FAP, FAA Form and PLS are available upon request and without charge, both in public locations in 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 facilities' financial counselors seek to provide personal financial counseling to all individuals admitted to the hospital facilities who are classified as self-pay during the course of their hospital stay or at time of discharge to explain the FAP and FAA Form and to provide information concerning other sources of assistance that may be available, such as Medicaid. A paper copy of each hospital facility's PLS will be offered to every patient as a part of the intake or discharge process. A conspicuous written notice is included on all billing statements sent to patients that notifies and informs recipients about the availability of financial assistance under the filing organization's financial assistance policy, including the following: 1) the telephone number of the hospital facilities' 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 facilities' FAP in all oral communications regarding the amount due for the individual's care. Copies of the PLS are distributed to members of each hospital facility's community in a manner reasonably calculated to reach those members of the community who are most likely to require financial assistance.

Part VI, Line 5:
"The provision of community benefit is central to the filing organization's mission of service and compassion. Restoring and promoting the health and quality of life of those in the communities served by the filing organization is a function of ""extending the healing ministry of Christ and embodies the filing organization's commitment to its values and principles. The filing organization commits substantial resources to provide a broad range of services to both the underprivileged as well as the broader community. In addition to the community benefit and community building information provided in Parts I, II and III of this Schedule H, the filing organization captures and reports the benefits provided to its community through faith-based care. Examples of such benefits include the cost associated with chaplaincy care programs and mission peer reviews and mission conferences. During the current year, the filing organization provided $8,515,736 of benefit with respect to the faith-based and spiritual needs of the communities it serves in conjunction with its operation of community hospitals. The filing organization also provides benefits to its communities' infrastructure by investing in capital improvements to ensure that facilities and technology provide the best possible care. During the current year, the filing organization expended $466,155,781 in new capital improvements. As faith-based mission-driven community hospitals, the filing organization is continually involved in monitoring its communities, identifying unmet health care needs and developing solutions and programs to address those needs. In accordance with its conservative approach to fiscal responsibility, surplus funds of the Hospitals are continually being invested in resources that improve the availability and quality of delivery of health care services and programs to its communities."

Part VI, Line 4:
"In 2021, the filing organization operated 3 separately licensed hospitals that together encompassed 10 separate campus locations and 8 off-site emergency departments. The hospitals are located in Florida. A description of each of the hospital campuses is described below. Adventist Health System/Sunbelt, Inc. dba AdventHealth Sebring:AdventHealth Sebring is comprised of three separate hospital campuses with a total of 229 beds. Two of the hospital campuses are located in Highlands County, Florida and operate under a single hospital license and the third separately licensed campus is located in Hardee County, Florida. Highlands and Hardee counties are in the south central areas of Florida and are adjacent to each other.During 2021, the patient percentage population for all three campuses of AdventHealth Sebring was made up of the below payors with the remaining percentage of the patients being covered under commercial insurance. In 2021, about 73.6% of the Hospital's in-patients were admitted through the Hospital's Emergency Department. - Medicare Patients 61.9% - Medicaid Patients 13.4% - Self-Pay Patients 2.7%*AdventHealth Sebring (Highlands County) - The main 171-bed hospital facility is located in north Sebring. AdventHealth Sebring has key service lines, including a heart & vascular center, Cancer Institute, Breast Care Center, Blessed Beginnings Birthing Center, and Emergency Services. Most recently, the Hospital has established a retail pharmacy and Orthopedic unit. AdventHealth Sebring is on the cutting edge of technology in Highlands County, being the only Orthopedic program to use the MAKOplasty Robot and only Surgical Services Program to use the da Vinci Robot. The Hospital has received recognition for its patient safety, orthopedics, heart care, and as a breast imaging center of excellence. In 2018, AdventHealth Sebring was named Highland News Sun ""Business of the Year.""The demographic makeup of AdventHealth Sebring's community is as follows: - Population 108,572 - Population Over 65 31.52% - Poverty (Below 100% FPL) 19.40% - Unemployment Rate 7.80% - Violent Crime Rate (Per 100,000 Pop.) 319.6 - Pop. Age 25+ with No High School Diploma 17.30% - Uninsured Adults 23.07% - Uninsured Children 7.77% - Food Insecurity Rate 15.80% - Pop. with Low Food Access 34.64%*AdventHealth Lake Placid (Highlands County) - This satellite facility houses 33 medical and surgical beds, the county's only 17-bed inpatient mental health unit and a wide range of services that are highly sophisticated for a small community hospital. This campus also specializes in inpatient geriatric psychiatric services within Highlands and Hardee counties. The need for behavioral health services is extreme in both counties since there is no other program closer than sixty miles. AdventHealth Lake Placid has received national recognition in patient safety, ultrasound and computed tomography (CT), and Emergency Department (ED) areas. To better meet the needs of Highlands County, the Hospital offers a Wellness Center, along with educational classes, for the community. Key service lines include ER, ICU and the Medical Surgical Unit. AdventHealth Lake Placid is on the leading edge of technology in Highlands County as the only Hospital to utilize virtual and room sterilization technology.The demographic makeup of AdventHealth Lake Placid's community is as follows: - Population 87,256 - Population Over 65 31.26% - Poverty (Below 100% FPL) 19.50% - Unemployment Rate 7.70% - Violent Crime Rate (Per 100,000 Pop.) 310.2 - Pop. Age 25+ with No High School Diploma 17.00% - Uninsured Adults 23.23% - Uninsured Children 7.78% - Food Insecurity Rate 15.70% - Pop. with Low Food Access 35.83%*AdventHealth Wauchula (Hardee County) - Built at a new location in 2017, this campus is licensed for 25 beds and specializes in emergency and outpatient care, while offering excellent medical inpatient services. The Hospital contains the only ER in Hardee County. AdventHealth Wauchula offers many inpatient and outpatient services, including physical & occupational therapy, a transitional care unit, medical surgical swing unit, and the only mammography unit in Hardee County, the Linda Adler Mammography Center. In 2019, AdventHealth Wauchula opened a Wellness Center to better meet the health needs of Hardee County. The Hospital has been recognized as a Top Rural Hospital by The Leapfrog Group and best hospital for patient safety.The demographic makeup of AdventHealth Wauchula's community is as follows: - Population 90,145 - Population Over 65 27.66% - Poverty (Below 100% FPL) 21.00% - Unemployment Rate 7.50% - Violent Crime Rate (Per 100,000 Pop.) 303.7 - Pop. Age 25+ with No High School Diploma 19.50% - Uninsured Adults 23.93% - Uninsured Children 7.87% - Food Insecurity Rate 15.50% - Pop. with Low Food Access 34.42% *** see continuation of footnote"

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.

Part VI, Line 4 Continuation of Footnote:
Description of Community Information - Continued*AdventHealth Kissimmee (Osceola County) - AdventHealth Kissimmee is a 242-bed community-focused hospital, conveniently located near Walt Disney World. The team located at AdventHealth Kissimmee is dedicated to bringing mission-focused, faith-based care to residents and visitors of Osceola and Orange Counties. This facility has recently expanded to include a new medical office building, patient tower, new main entrance, expanded Emergency Department and a parking garage. The new three-story patient tower includes private patient rooms and a host of modern amenities and technologies. Services offered include cardiovascular services, orthopedics and rehabilitation, neuroscience, cancer, diabetes, gastroenterology, emergency services, urology, and imaging resources. The demographic makeup of AdventHealth Kissimmee's community is as follows: - Population 368,559 - Population Over 65 15.40% - Poverty (Below 100% FPL) 15.89% - Unemployment Rate 14.00% - Violent Crime Rate (Per 100,000 Pop.) 470.0 - Pop. Age 25+ with No High School Diploma 12.80% - Uninsured Adults 19.50% - Uninsured Children 6.90% - Food Insecurity Rate 11.10% - Pop. with Low Food Access 27.03%*AdventHealth Winter Park (Orange County) - AdventHealth Winter Park is a 373-bed facility that is a model of community health and wellness. The facility boasts spacious patient care areas and a full spectrum of specialties and services, including the Dr. P. Phillips Baby Place (with Level II NICU), AdventHealth Orthopedic Institute, and state-of-the-art surgery, recovery and rehabilitation at the AdventHealth Cancer Institute. In 2019, the new 5-story Nicholson Pavilion opened, adding 80 all-private rooms to the AdventHealth Winter Park campus. AdventHealth Winter Park has the Central Florida Region's only senior-friendly emergency room. Services offered at AdventHealth Winter Park include cancer, cardiovascular, digestive health, women's health, neuroscience, ophthalmology, orthopedics and rehabilitation, urology, and sports medicine. The Hospital also provides timely, convenient and quality emergency care at its state-of-the-art freestanding emergency room, AdventHealth Oviedo ER, which is staffed with physicians trained to provide medical treatments for adults and children. The demographic makeup of AdventHealth Winter Park's community is as follows: - Population 1,391,240 - Population Over 65 12.20% - Poverty (Below 100% FPL) 14.99% - Unemployment Rate 10.10% - Violent Crime Rate (Per 100,000 Pop.) 517.6 - Pop. Age 25+ with No High School Diploma 9.50% - Uninsured Adults 18.50% - Uninsured Children 6.60% - Food Insecurity Rate 13.10% - Pop. with Low Food Access 27.31%

Part VI, Line 4 Continuation of Footnote:
"Description of Community Information - ContinuedAdventist Health System/Sunbelt, Inc.:AdventHealth's Central Florida Division South Region consists of a 3,140-bed medical complex in Central Florida with seven separate hospital campuses and 8 off-site emergency departments (the Hospitals) that operate under a single hospital license. The Hospitals serve the residents of Central Florida (primarily serving the residents of Orange, Osceola, Seminole and Lake County) but also draw patients from other parts of the Southeastern United States, the Caribbean and South America. The 7-campus health system is the largest healthcare provider in Central Florida with more than 2 million patient visits per year and is the nation's largest Medicare provider. It is the second largest employer in the area.The main campus of AdventHealth's Central Florida Division South Region is located in Orlando, Florida (Orange County) near the downtown area. The other 6 campuses are located in surrounding communities in the counties of Orange, Osceola, and Seminole. In addition to operating the 7 hospitals, it also operates 50 full-service urgent care clinics in convenient community settings.During 2021, the patient percentage population for all seven campuses was made up of the below payors with the remaining percentage of the patients being covered under commercial insurance. In 2021, about 72.3% of the Hospital's in-patients were admitted through the Hospital's Emergency Department. - Medicare Patients 41.5% - Medicaid Patients 15.6% - Self-Pay Patients 5.0%A brief description of each of the 7 hospital campuses is described below:*AdventHealth Orlando (Orange County) - At the core of AdventHealth's Central Florida Division South Region, AdventHealth Orlando (AHO) is a 1,400-bed acute-care tertiary hospital. AHO is home to nationally recognized Centers of Excellence for cancer, cardiology, children's health, diabetes, neuroscience, orthopedics, transplant and global robotics. AdventHealth Orlando houses one of the largest Emergency Departments and cardiac catheterization labs in the country and is one of the busiest hospitals in the nation, providing service excellence to more than 48,000 inpatients and 75,000 outpatients in 2021. The campus also includes a state-of-the-art Cardiac Diagnostic Center featuring 15 Cath and electro physiology (EPS) Labs. The cardiology team performed over 17,000 cardiac catheterizations and over 1,300 open heart surgeries in 2021. In 2018, two orthopedic floors in the patient tower were totally renovated. In 2019, an inpatient Hospice unit was opened.Additionally, AHO houses the Translational Research Institute, a 54,000 square-foot facility devoted to the study of obesity and metabolic origins of cardiovascular disease with the aim of developing new treatments to battle diabetes and obesity. AHO also serves as a teaching hospital for family medicine, allopathic and osteopathic tracts, emergency medicine, neuromusculoskeletal medicine, general surgery, podiatric medicine and surgery, and internal medicine. As one of the premier health systems in the nation, AHO sets the standard for innovation, quality and comprehensive care.AdventHealth for Women at Orlando is a 12-story hospital located on the Orlando campus. The first floor houses the Breastfeeding Center, parent education classroom as well as obstetrical triage and registration. 10 of the 12 floors are complete, which include 72 mother-baby rooms and high-risk OB rooms, 14 labor and delivery suites, 13 operating rooms, 82 NICU beds, 104 oncology beds which include GYN oncology, medical oncology, 32-bed ICU capable BMT unit, and a 36-bed thoracic pulmonary Unit.Also located on the AHO Campus is the Walt Disney Pavilion at AdventHealth for Children. The Walt Disney Pavilion is not a stand-alone facility but rather a 7-story, 198-bed tower located on AHO's campus. It is a full-service facility served by more than 140 pediatric specialists and a highly trained pediatric team of more than 800 employees. The Walt Disney Pavilion at AdventHealth for Children delivers a complete range of pediatric health services for younger patients including advanced surgery, oncology, neurosurgery, cardiology and transplant services; full-service pediatrics; and an innovative health and obesity platform.The demographic makeup of AdventHealth Orlando's community is as follows: - Population 1,391,240 - Population Over 65 12.20% - Poverty (Below 100% FPL) 14.90% - Unemployment Rate 9.50% - Violent Crime Rate (Per 100,000 Pop.) 448.7 - Pop. Age 25+ with No High School Diploma 10.90% - Uninsured Adults 17.60% - Uninsured Children 6.70% - Food Insecurity Rate 13.30% - Pop. with Low Food Access 33.71%*AdventHealth Altamonte (Seminole County) - AdventHealth Altamonte is a 393-bed facility, which has recently doubled in size with a new patient tower to better serve a busy community. AdventHealth Altamonte was the first ""satellite"" hospital, built in 1973 on what was then pastureland, miles from the nearest business district. Located north of Orlando in fast-growing Seminole County, AdventHealth Altamonte is the largest satellite campus within AdventHealth's Central Florida Division South Region. In addition to maternity, pediatric, NICU, emergency, medical and surgical services, the hospital operates the Martin Andersen Cancer Center (along with the region's only Cancer Resource Library), a heart catheterization lab, and a comprehensive outpatient program which includes surgery, diagnostics, and medical treatment programs. In 2014, the Mother Baby Unit was expanded to provide a 15-bed CDU, 10 new LDR rooms, 6 triage rooms, and a new C-section operating room and recovery unit. In 2018, a 10-bed Level II Neonatal Intensive Care Unit (NICU) was added.The demographic makeup of AdventHealth Altamonte's community is as follows: - Population 473,408 - Population Over 65 16.30% - Poverty (Below 100% FPL) 12.42% - Unemployment Rate 8.50% - Violent Crime Rate (Per 100,000 Pop.) 421.8 - Pop. Age 25+ with No High School Diploma 7.90% - Uninsured Adults 14.00% - Uninsured Children 5.40% - Food Insecurity Rate 12.40% - Pop. with Low Food Access 33.37% *** see continuation of footnote"

Part VI, Line 4 Continuation of Footnote:
Description of Community Information - Continued*AdventHealth Apopka (Orange County) - In 1975, AdventHealth Apopka became the second satellite hospital. For over four decades, AdventHealth Apopka has set the standard in hometown health care by providing high-tech, quality care with a personalized touch. In December, 2017, construction was completed on a $203 million replacement facility located approximately three miles from the existing facility. The new, 320,000 square foot facility was built on a 71-acre site. Five of the seven floors have been built out with the remaining two floors to be shelled in for future expansion. The 120-bed facility includes intensive care, emergency medicine, endoscopy, outpatient, diagnostic, respiratory, and rehabilitation services.AdventHealth Apopka also operates AdventHealth Winter Garden ER, an off-site emergency room that provides urgent care to the community as well as specialized respiratory care and advanced stroke treatment as a designated stroke center. The demographic makeup of AdventHealth Apopka's community is as follows: - Population 1,391,240 - Population Over 65 12.20% - Poverty (Below 100% FPL) 14.24% - Unemployment Rate 11.40% - Violent Crime Rate (Per 100,000 Pop.) 596.6 - Pop. Age 25+ with No High School Diploma 12.60% - Uninsured Adults 18.30% - Uninsured Children 7.60% - Food Insecurity Rate 13.70% - Pop. with Low Food Access 31.30% *AdventHealth Celebration (Osceola County) - AdventHealth Celebration is a cornerstone of Disney's planned community in Celebration, Florida. Today, this 317-bed acute care hospital delivers a state-of-the-art healing environment to residents of Osceola, Orange, Polk and Lake Counties, as well as to visitors from across the United States and the world. From its creation, AdventHealth Celebration has been about promoting health and wellness as well as healing. Inside the resort-style hospital there is a wellness center, complete with workout area, pool, and rehabilitation facility. AdventHealth Celebration also houses the Global Robotics Institute, which provides patients with access to some of the most experienced robotic surgeons in the world. The Nicholson Center for Surgical Advancement also is a location where surgeons from around the world travel to learn the latest robotic surgery techniques. The Institute for Interactive Patient Care is a 234,000 square-foot patient tower with 62 beds and was the first of its kind in the nation where physicians can study everything from new patient safety technology to the impact of changing communication with patients about their care. In 2013, a four-story medical office building was added in which the Women's Institute is situated. In 2014, a new 5th floor inpatient 32 bed state-of-the art medical/surgical unit was added. In 2018, two inpatient surgical cardiovascular OR's were added. In 2020, a five-story, 166,000 square foot tower was added which, in addition to 80 new acute care beds, includes a state-of-the art unit featuring six Cath labs and two cardiac operating rooms. The expansion allowed for the launch of comprehensive stroke care, which includes 24/7 emergency neurosurgery and interventional neurosurgery. AdventHealth Celebration offers services in cancer, digestive health, neuroscience, weight-loss services and surgery, orthopedic health, spine health, thoracic surgery, women's and men's health, robotic-assisted surgeries and imaging diagnostics. The demographic makeup of AdventHealth Celebration's community is as follows: - Population 368,559 - Population Over 65 15.40% - Poverty (Below 100% FPL) 14.59% - Unemployment Rate 13.00% - Violent Crime Rate (Per 100,000 Pop.) 454.9 - Pop. Age 25+ with No High School Diploma 12.10% - Uninsured Adults 19.40% - Uninsured Children 7.00% - Food Insecurity Rate 11.90% - Pop. with Low Food Access 35.53%*AdventHealth East Orlando (Orange County) - AdventHealth East Orlando is an innovative local leader that fills a vital need in a fast-growing area. A recent 200,000 square-foot expansion project upgraded the Hospital to 295 beds, with a spacious patient tower and 80 new private rooms designed to enhance the holistic care experience. In 2014, an expanded ED provided 60 new treatment rooms. AdventHealth East Orlando includes a teaching hospital with residencies in family medicine, podiatry and emergency medicine. The campus is also home to an outpatient surgery center, a hospital-based Center for Medical Simulation and Education, a Cancer Institute featuring state-of-the-art technology for radiation oncology and a dedicated infusion center, as well as a 12-bed Children's Emergency Center. Alongside having the largest emergency room in Central Florida, other services include cardiovascular, pulmonary and digestive health, orthopedics and rehabilitation, ear/nose/throat, andrology, and urology. The Hospital also meets the diverse needs of its growing community at its brand-new, freestanding emergency room, AdventHealth Waterford Lakes ER, which offers hospital-based ER services by board-certified emergency physicians, critical care nurses, and stroke and chest pain experts. The demographic makeup of AdventHealth East Orlando's community is as follows: - Population 1,391,240 - Population Over 65 12.20% - Poverty (Below 100% FPL) 16.67% - Unemployment Rate 11.60% - Violent Crime Rate (Per 100,000 Pop.) 607.2 - Pop. Age 25+ with No High School Diploma 11.10% - Uninsured Adults 18.50% - Uninsured Children 7.70% - Food Insecurity Rate 13.80% - Pop. with Low Food Access 25.18%*** see continuation of footnote