4A (Expenses $ 256715046 including grants of $ 591266) (Revenue $ 354202164)
Operation of acute care hospital totaling 169 beds. During the current year there were 10,201 admissions resulting in 40,948 patient days and 96,113 outpatient visits.

AdventHealth Wesley Chapel
Part V, Section B, Line 5: Pasco-Pinellas Hillsborough Community Health System, Inc., d/b/a AdventHealth Wesley Chapel, (AHWC or the Hospital) opened its new hospital facility in October of 2012. Since its opening in 2012 with 83-beds, the Hospital has expanded to a 169-bed acute care hospital and offers a full range of inpatient and outpatient health services, including surgery, imaging, rehabilitation, and emergency services for adults and children. The Hospital's primary service area includes 13 zip codes in west Central Florida, including the communities of Wesley Chapel, Land O'Lakes, Dade City, Lutz, San Antonio, and Zephyrhills. 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. The Hospital formed a Community Health Needs Assessment Committee (CHNAC) that included representatives of the community and the Hospital, 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 Hospital's primary service area. Key members of the CHNAC included representatives from the District School Board of Pasco County, Premier Community Health Care Group, Inc., a federally qualified health center, Pioneer Medical Group, a physician group providing services at homeless primary care clinics in Pasco and Hillsborough Counties, Healthy Start Coalition - Pasco County, the Hispanic Service Council, the Alliance for Substance Abuse Prevention Coalition, and the Pasco County Department of Health. Community surveys were completed in collaboration with the Florida Department of Health Pasco County Community Health Collaborative partnership. Surveys were administered in paper format as well as on-line and were offered in English and Spanish. A total of 3,038 Pasco County residents participated in the collaborative Community Health Needs Assessment survey. AHWC also gathered primary data through stakeholder interviews. Interviews were conducted on-line by members of the CHNAC. Various sources of secondary data were reviewed to understand the larger issues plaguing the Hospital's primary service area.

AdventHealth Wesley Chapel
Part V, Section B, Line 7d: The Hospital has adopted a policy that addresses the public posting requirements of the Community Health Needs Assessment. Under this policy, the Community Health Needs Assessment Reports must be posted on the Hospital's website at least until the date the hospital facility has made widely available on its website its two subsequent Community Health Needs Assessment Reports. The Hospital will also make a paper copy of its Community Health Needs Assessment Report available for public inspection upon request and without charge, at least until the date the hospital facility has made available for public inspection its two subsequent Community Health Needs Assessment Reports.

AdventHealth Wesley Chapel
"Part V, Section B, Line 11: Pasco-Pinellas Hillsborough Community Health System, Inc. d/b/a AdventHealth Wesley Chapel will be referred to in this document as AdventHealth Wesley Chapel 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 Wesley Chapel is part of the West Florida Division of AdventHealth (the Division). The Division includes 11 hospital facilities. This is the second-year update for AdventHealth Wesley Chapel'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 Wesley Chapel 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 Wesley Chapel chose five priorities for its 2020-2022 Community Health Plan: 1. Mental Health/Suicide/Depression2. Substance Misuse 3. Diabetes 4. Heart Disease/Stroke/High Blood Pressure 5. Respiratory Disease Priority 1: Mental Health & Mental Disorders2019 Description of the Issue:The burden of mental illness in the United States is among the highest of all diseases. Moreover, 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 Wesley Chapel primary service area (PSA), 22% of the PSA Medicare population is experiencing depression, which is at a higher percentage of depression than the state average (18.9%). Illnesses such as, heart attack, heart disease (coronary artery disease), stroke, diabetes and cancer can lead to depression.2021 Update: The AdventHealth Wesley Chapel Community Health Plan has two desired goal statements under the Mental Health & Mental Disorders priority. 1. Reduce the stigma associated with mental illness in youth and adults by providing access to health education to help communities better understand and respond to signs of mental illness and substance use disorders2. Increase community-level partnerships to enhance current efforts addressing transportation barriers (social determinants of health) impacting access to mental health care for adults.Goal 1: Reduce the stigma associated with mental illness in youth and adults by providing access to health education to help communities better understand and respond to signs of mental illness and substance use disordersObjective 1: The first objective is to increase Hospital support of local advocacy groups that provide resources, interventions and support to adults and youth who are affected by mental illness in the Hospital's PSA by supporting three advocacy groups from a baseline of zero advocacy groups by the end of year three. The initiative is conducted through AdventHealth Wesley Chapel and all outcomes are specific to the reporting Hospital. The initiative provides service to the community by improving access to resources and support that help individuals suffering from mental illness. The Hospital progressed on its set metric of supporting three local advocacy groups. We connected with several community organizations that offer support from the advocacy frame of reference, which includes the following organizations: National Alliance on Mental Illness (NAMI), The Phoenix Florida and Alliance for Substance Addiction Prevention (ASAP). The National Alliance on Mental Illness' (NAMI) mission is to provide advocacy, education, support, and public awareness so that all individuals and families affected by mental illness can build better lives. The Phoenix's mission is to build a sober active community. Finally, ASAP's mission is to create a community free of substance misuse and its consequences. We are continuing to identify opportunities to collaborate with these organizations and increase awareness of these agencies and the services they provide. Each organization offers advocacy at the state and local level. The Hospital progressed on its set metric of supporting three local advocacy groups by maintaining communication with partner organizations in the community, which include the National Alliance on Mental Illness of Pasco (NAMI Pasco), The Phoenix Florida, and the Alliance for Substance Addiction and Prevention (Pasco ASAP). The Wesley Chapel Community Health Needs Assessment Committee helped promote and market programs and resources offered by these organizations. A dedicated team member from the Hospital contributed to Pasco ASAP initiatives by participating on their planning committees. Objective 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 certification classes by the end of year three. The deployment of the Mental Health First Aid classes is a shared initiative between AdventHealth Wesley Chapel, AdventHealth Carrollwood, AdventHealth Dade City, AdventHealth Connerton, AdventHealth Zephyrhills, AdventHealth Tampa, AdventHealth Ocala, AdventHealth Wauchula, AdventHealth Lake Placid, AdventHealth Sebring and AdventHealth North Pinellas. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The initiative is managed at the Divisional level and funded through the Hospital and all reported outcomes are specific to the reporting Hospital.The initiative provides the Mental Health First Aid USA classes to the community for free. The class is a course that teaches you how to help someone who may be experiencing a mental health or substance use challenge. The training helps you identify, understand, and respond to signs of addictions and mental illnesses.The Hospital progressed on its metric of providing three free Mental Health First Aid USA certification training classes to community members residing in the Hospital's PSA from a baseline of zero certification classes by the end of year three. Four Division level team members were trained as instructors in Mental Health First Aid in 2021, providing them the needed credentials to start teaching Mental Health First Aid in the community. The Hospital continued to identify and secure opportunities in the community to offer Mental Health First Aid and aims to complete classes in 2022.See Continuation 2"

Part V, Section B, Line 11 - continuation 2
Objective 3:The third objective is to increase the amount of paid staff time for Hospital staff/team members to volunteer with community organizations addressing mental health from a baseline of zero hours to 300 hours by the end of year three. The initiative is conducted through AdventHealth Wesley Chapel and all outcomes are specific to the reporting Hospital. The Hospital provides a paid volunteerism program through which AdventHealth employees are paid at their normal rate to volunteer at community organizations which are addressing this priority area. The Hospital progressed on its set metric of 300 hours of paid staff volunteer time with 10 volunteer hours served. Due to COVID-19, the mental health volunteer 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. Despite these challenges, Hospital team members have tried to dedicate time to volunteerism.Goal 2: Increase community-level partnerships to enhance current efforts addressing transportation barriers (social determinants of health) impacting access to mental health care for adults Objective 1: The first objective is to decrease transportation challenges (barriers) among vulnerable adults residing in the Hospital's PSA by creating three new collaborative strategies from a baseline of zero strategies by the end of year three. The initiative is conducted through AdventHealth Wesley Chapel and all outcomes are specific to the reporting Hospital. The initiative provides service to the community by improving access to transportation and supporting the larger objective of removing transportation barriers for community members seeking mental health treatment and services. The Hospital progressed on its set metric of creating three new collaborative strategies. The Hospital has partnered with the Hillsborough Area Regional Transit Authority (HART) to offer convenient bus routes outside of the Hospital for patients upon discharge, as well as other community members seeking access to services. Additionally, transport for patients upon discharge using the HART bus service is funded through the Hospital's budget on a case-by-case basis. Similarly, the Hospital offers Lyft services for patients upon discharge to connect them to their needs at the expense of the Hospital. We are continuing to work with the Community Health Needs Assessment Committee to identify additional ways to decrease transportation challenges for the population of individuals suffering from mental illness and seeking support within the Hospital's primary service area. Objective 2: The second objective is a shared initiative between AdventHealth Wesley Chapel, AdventHealth Tampa, AdventHealth Carrollwood, AdventHealth Connerton, AdventHealth Zephyrhills, AdventHealth Dade City and AdventHealth North Pinellas. 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 to increase the number of Pasco County National Alliance on Mental Illness (NAMI) Ending the Silence presentations provided for free to middle and high school-aged youth residing in the Hospital's PSA to six classes from a baseline of zero by the end of year three is managed at a Divisional level; however all funding and outcomes reported are specific to the reporting Hospital.Ending the Silence is a presentation for middle and high school-aged youth that helps destigmatize mental illness by providing community members with education to recognize signs and symptoms of an individual dealing with a mental health condition, along with the action steps to help the individual suffering from a mental health crisis. The Hospital progressed on its set metric of providing six presentations by supporting one presentation in year two. The Hospital maintained communication with community partners working together on this initiative, including NAMI Pasco, Pasco County Schools, and the Wesley Chapel Community Health Needs Assessment Committee. Together these partners organized and delivered one Ending the Silence presentation in February 2021. The Hospital provided gift cards as incentives for participants who joined the presentation. Priority 2: Substance Misuse 2019 Description of the Issue:Tobacco use can lead to tobacco/nicotine dependence and serious health problems. Quitting smoking greatly reduces the risk of developing smoking-related diseases such as lung disease. Twenty-five percent of the adult (age 18+) population in the AdventHealth Wesley Chapel primary service area (PSA) are current cigarette smokers (tobacco usage). An estimated 20.3% of adults (18+ and older) self-reported heavy alcohol consumption in the AdventHealth Wesley Chapel primary service area (PSA). Heavy alcohol consumption is defined as more than two drinks per day on average for men and one drink per day on average for women. Excessive drinking behavior patterns are determinants of future health and may be the cause of significant health issues, such as cirrhosis, cancers, and untreated mental and behavioral health needs. 2021 Update: The AdventHealth Wesley Chapel Community Health Plan has two desired goal statements under the Substance Misuse priority. 1. Decrease the misuse of alcohol, tobacco and other substances among adults and youth residing in the Hospital's PSA2. Increase local collaborations with community organizations to develop to create new strategies that prevent the misuse of alcohol, tobacco and other substances in youth and adultsGoal 1: Decrease the misuse of alcohol, tobacco and other substances among adults and youth residing in the Hospital's PSA Objective 1: The first objective is to increase Hospital support of local community organizations in the Hospital's PSA that provide resources, interventions and support to adults and youth who are affected by the misuse of alcohol, tobacco, and other substances by supporting three advocacy groups from a baseline of zero advocacy groups by the end of year three. The initiative is conducted through AdventHealth Wesley Chapel and all outcomes are specific to the reporting Hospital. The initiative provides service to the community by influencing legislation and policy that will help to improve access to resources and support for individuals suffering from substance misuse.The Hospital progressed on its set metric of supporting three local advocacy groups by maintaining communication with community partners working together on this initiative, including Mothers Against Drunk Driving (MADD), the National Alliance on Mental Illness Pasco (NAMI Pasco), The Phoenix Florida, and the Pasco Alliance for Substance Addiction and Prevention (Pasco ASAP). The Wesley Chapel Community Health Needs Assessment Committee and partner organizations continued working together to identify opportunities to support these advocacy groups. Objective 2: The second objective is to increase access to community support groups for adults residing in the Hospital's PSA who are recovering from misuse of alcohol, tobacco, and other substances by sponsoring three on-going support groups from a baseline of zero by the end of year three. The initiative is conducted through AdventHealth Wesley Chapel and all outcomes are specific to the reporting Hospital. The initiative provides service to the community by improving access to resources that help to create a sober environment. The Hospital progressed on its set metric of supporting three ongoing support groups by maintaining communication with community partners working on this initiative together. The Wesley Chapel Community Health Needs Assessment Committee continued working with the National Alliance on Mental Illness in Pasco and The Phoenix to identify opportunities to support the support groups of these organizations. The National Alliance on Mental Illness' mission is to provide advocacy, education, support, and public awareness so that all individuals and families affected by mental illness can build better lives. The Phoenix's mission is to build a sober active community. We are continuing to identify opportunities to collaborate with these organizations and increase awareness of both agencies and the services they provide in year three.See continuation 3

Part V, Section B, Line 11 - continuation 3
Goal 2: Increase local collaborations with community organizations to develop to create new strategies that prevent the misuse of alcohol, tobacco and other substances in youth and adults Objective 1: The first objective is to increase the reach of the Pasco County Substance Abuse Taskforce (PCSAT) into West Pasco communities by co-hosting at least three meetings in West Pasco from a baseline of zero by end of year three. The initiative is conducted through AdventHealth Wesley Chapel and all outcomes are specific to the reporting Hospital. The initiative provides service to the community by expanding the reach of the existing taskforce in areas that are lacking resources and support. The Pasco County Substance Abuse Taskforce began as an outreach by the AdventHealth Wesley Chapel Chaplain services. After several years, it was reimagined as a hybrid approach to both inpatient and community outreach. The taskforce's mission is to develop a partnership with community members focusing on awareness and increasing access to resources for patients suffering from misuse. Unfortunately, due to some fundamental shifts in the taskforce's leadership, the taskforce was placed on hold for much of 2020. However, the taskforce was restarted in November of 2020. The Hospital progressed on its set metric to increase the reach of the Pasco County Substance Abuse Taskforce by co-hosting at least three meetings in West Pasco through identifying new leadership from the Hospital to restart the taskforce. Additionally, the Hospital was able to form key partnerships that will help to expand the existing taskforce and strengthen the work being done. Due to COVID-19, the Pasco County Substance Abuse Taskforce initiative was delayed. As a result of the continued pandemic, AdventHealth has pivoted where necessary to address the immediate needs of our community. We are working to identify ways to support the needs originally identified in our CHNAs, as resources and public health recommendations develop. Staffing challenges in 2021 put a pause on PCSAT meetings, but team members continued to collaborate with partner agencies on shared priorities of addressing substance misuse in Pasco County.Objective 2: The second objective is to increase the current reach of the Pasco County Substance Abuse Taskforce (PCSAT) into West Pasco communities by co-hosting at least one community forum in West Pasco from a baseline of zero by end of year three. The initiative is conducted through AdventHealth Wesley Chapel and all outcomes are specific to the reporting Hospital. The initiative provides service to the community by offering resources, education, and tools for those who are suffering from substance misuse. The Hospital achieved its set metric to increase the reach of the Pasco County Substance Abuse Taskforce by co-hosting at least one community forum. Hospital team members and community partners worked together to design and record a virtual community forum called No Family is Immune: The Truth About Substance Misuse in August 2021. The event was designed to showcase information and local resources on substance use treatment and recovery. The event was professionally filmed and produced and shared widely on social media for on-demand viewing. Hospital team members from marketing, communications, nursing, physicians, and leadership contributed their time to bring this event to life. Objective 3: The third objective is to increase the amount of paid staff time for Hospital staff/team members to volunteer with community organizations addressing the misuse of alcohol, tobacco, and other substances from a baseline of zero hours to 200 hours by the end of year three. The initiative is conducted through AdventHealth Wesley Chapel and all outcomes are specific to the reporting Hospital. The Hospital provides a paid volunteerism program through which AdventHealth employees are paid at their normal rate to volunteer at community organizations which are addressing this priority area. The Hospital progressed on its set metric of 200 hours of paid staff volunteer time addressing the misuse of alcohol, tobacco, and other substances by seeking out opportunities and planning for year three. Due to COVID-19, the substance misuse volunteer objective was delayed. As a result of the continued pandemic, AdventHealth has pivoted where necessary to address the immediate needs of our community. We are working to identify ways to support the needs originally identified in our CHNAs, as resources and public health recommendations develop. The Hospital experienced significant staffing challenges in 2021 which put the volunteerism initiative on pause.Priority 3: Diabetes2019 Description of the Issue:Diabetes is a prevalent problem in the United States and obesity is the leading risk factor for type 2 diabetes. An estimated 38.2% of adults aged 18 and older in the AdventHealth Wesley Chapel primary service area self-report that they have a Body Mass Index (BMI) between 25.0 and 30.0 (overweight). Additionally, 10.5% have been diagnosed with diabetes, which is greater than the state average of 9.22%. Food insecurity is the household-level economic and social condition of limited or uncertain access to adequate food. In the AdventHealth Wesley Chapel primary service area, a total of 39,201 households are food insecure, which represents an estimated 29% of the total population and the population under age 18 that experienced food insecurity at some point during 2017 but are ineligible for State or Federal nutrition assistance. Food insecurity increases risks for obesity. Obesity/Overweight increases the chances of developing type 2 diabetes, high blood pressure, heart disease and stroke.2021 Update:The AdventHealth Wesley Chapel Community Health Plan has two desired goal statements under the Diabetes priority. 1. Implement strategies that support existing community health education initiatives aimed to address the problem of diabetes in the Hospital's PSA2. Increase access to culturally appropriate nutritious food options in food desert or low income/low access areas Goal 1: Implement strategies that support existing community health education initiatives aimed to address the problem of diabetes in the Hospital's PSA Objective 1: The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to provide the Food is Health program to low-income families in the PSA by offering five nutrition education class series from a baseline of zero classes 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 offering five nutrition class series by completing one class series in year two. The virtual class was taught by community partners with UF/IFAS Extension Office of Pasco and provided 6 weeks of nutrition education to 14 participants. 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 Hospitals partnered on this initiative because of a shared CHNA priority. The Food is Health program will distribute 200 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 200 produce vouchers by distributing 65 vouchers in year two. See continuation 4

Part V, Section B, Line 11 - continuation 4
Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is through the Food is Health program to 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, however all funding and outcomes reported are specific to the reporting Hospital. The Hospital met its set metric of recruiting four community partners with four partners recruited. We recruited Bay Chapel Church, Morrison Food Service, St. Leo University and Dube's Mobile Market who has helped to expand our Food is Health program throughout Pasco County and create a more robust produce system. Bay Chapel's mission is primarily focused on serving underserved community members. The church has a large footprint within the Hospital's primary service area and will help us expand our reach to those in need. Additionally, Morrison Food Service and St. Leo University will help expand our educational partnerships.In year two, the Hospital connected with additional partners to support the AdventHealth Food is Health program. Premier Community Healthcare joined a planning committee to help find opportunities in the community to offer Food is Health. The Hospital also made additional connections to the faith-based community, including Grace Church and Mt. Carmel Friendship Church in Wesley Chapel.Objective 3: The third objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase participation in the Food is Health program among low-income individuals and families in the Hospital's PSA by 50 participants from a baseline of zero by the end of year three. This objective is managed at the Divisional level, however all funding and outcomes reported are specific to the reporting Hospital. The Hospital progressed on its set metric of increasing participants from a baseline of zero to 50 by engaging 14 participants in a Food is Health class series in year two. 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 Hospitals partnered on this initiative because of a shared CHNA priority. The objective is, through the Food is Health program, to increase access to health screenings among adults living in food deserts or low-income/low access communities to 75 screenings from a baseline of zero by the end of year three. This objective is managed at the Divisional level, however all funding and outcomes reported are specific to the reporting Hospital. The Hospital progressed on its set metric of increasing health screenings among adults living in low-income/low access communities by 75 screenings. No health screenings were provided in year two. Due to COVID-19, the objective was delayed. AdventHealth's community outreach nursing team was deployed to support COVID-19 response including testing and vaccination.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 Hospitals partnered on this initiative because of a shared CHNA priority. The objective, the Food is Health community employee volunteer initiative to increase Hospital staff/team volunteer participation efforts with organizations addressing food security from a baseline of zero hours to 600 hours by the end of year three, is funded and managed through AdventHealth Wesley Chapel. All funding and outcomes reported are specific to the reporting Hospital. The Hospital provides a paid volunteerism program through which AdventHealth employees are paid at their normal rate to volunteer at community organizations which are addressing this priority area. The Hospital progressed on its set metric of 600 volunteer hours addressing food security by conducting two volunteer hours in year two. Hospital team members volunteered on paid staff time at Feeding Tampa Bay, a local food bank. Team members helped inspect perishable and/or non-perishable foods for their expiration date and quality, then packaged those good foods into bags/boxes that will be distributed to hungry neighbors.Priority 4: Heart Disease/Stroke/High Blood Pressure2019 Description of the Issue:Heart disease and stroke are largely preventable, yet they remain leading causes of death, disability, and health care spending in the United States. In the AdventHealth Wesley Chapel primary service area, 16,255 or 7.6% of adults aged 18 and older have been told by a doctor that they have coronary heart disease or angina. Additionally, 47.07% have high cholesterol and 29.45% have high blood pressure. High blood pressure and high cholesterol are risk factors of heart disease and stroke.2021 Update: The AdventHealth Wesley Chapel Community Health Plan has two desired goal statements under the Heart Disease/Stroke/High Blood Pressure priority. 1. Improve access to health education, early intervention programs and resources related to prevention of heart disease2. Enhance community to clinical linkages between community organizations and stakeholders to promote coordinated patient care strategies to control high blood pressure and high cholesterolGoal 1: Improve access to health education, early intervention programs and resources related to prevention of heart disease Objective 1: The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective, to increase the number of Hospital sponsored American Heart Association (AHA) community cardiopulmonary resuscitation (CPR) out-of-hospital bystander classes for adults and youth from a baseline of zero to five by the end of year three, is managed at the 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. In year one the Division team met with our local American Heart Association team on a bi-monthly basis to develop strategies and proposed timelines for training and implementation in year two. As a result of our year one efforts, together with our local AHA team, we have created a novel train-the-trainer model for community CPR classes that will equip participants with the two-step Hands-Only CPR skills to help save a life in the community setting. In addition, we received a donation of adult & child CPR Anytime training kits to launch our 2021 pilot of community CPR classes. The Hospital progressed on its set metric of increasing the number of Hands-Only CPR classes from a baseline of zero to five. Our Division team completed the AHA instructor training in May 2021. The Wesley Chapel Community Health Needs Assessment Committee, along with community partners, continued to plan and strategize on where to offer Hands-Only CPR classes in year three. Objective 2: The second objective is to increase the amount of paid staff time for Hospital staff/team members to volunteer with community organizations addressing heart disease and stroke from a baseline of zero hours to 300 hours by the end of year three. The initiative is conducted through AdventHealth Wesley Chapel and all outcomes are specific to the reporting Hospital. The Hospital provides a paid volunteerism program through which AdventHealth employees are paid at their normal rate to volunteer at community organizations which are addressing this priority area. The Hospital progressed on its set metric of 300 hours of paid staff volunteer time by contributing 8 hours of paid staff time.Staff from AdventHealth Wesley Chapel volunteered to provide screenings and support at a community screening event in February 2021 in collaboration with Pioneer Medical Foundation. Over 200 community members received heart health screenings such as blood pressure, cholesterol, glucose, and Body Mass Index. See continuation 5

Part V, Section B, Line 11 - continuation 5
Goal 2: Enhance community to clinical linkages between community organizations and stakeholders to promote coordinated patient care strategies to control high blood pressure and high cholesterol Objective 1: The first objective is to increase the number of underinsured/uninsured community members receiving linkages to follow up clinical care at Pioneer Medical Group by providing free biometric screenings and health education at a minimum of three Pioneer Medical Group free mobile clinic events for 150 patients from a baseline of zero patients by the end of year three. The initiative is managed by the Division, however all outcomes are specific to the reporting Hospital. The initiative provides service to the community by connecting underinsured and uninsured individuals with free biometric screening, primary care follow-up and routine care that they may otherwise not have access to. Pioneer Medical Group serves the homeless, refugee, uninsured and underinsured adult community by providing them with free health care access and hygiene supplies. The Hospital progressed on its set metric of providing three Pioneer Medical Group free mobile clinics for 150 patients by supporting one mobile clinic. In February 2021, Pioneer Medical Group hosted a community screening event where over 200 community members received heart health screenings such as blood pressure, cholesterol, glucose, and Body Mass Index. The event was supported by the Hospital, which contributed staff to volunteer and supplies for the event. The Hospital has begun planning for additional events with Pioneer Medical Group in year three. Priority 5: Respiratory Disease2019 Description of the Issue:Tobacco use can lead to tobacco/nicotine dependence and serious health problems. Quitting smoking greatly reduces the risk of developing smoking-related diseases such as lung disease. Asthma is a respiratory disease that is often exacerbated by poor environmental conditions such as seasonal patterns, cigarette smoke, etc. Twenty-five percent of the adult (age 18+) population in the AdventHealth Wesley Chapel primary service area (PSA) are current cigarette smokers (tobacco usage), 15.7% of adults have asthma and 53 of the PSA population (per 100,000) die from lung disease.2021 Update: The AdventHealth Wesley Chapel Community Health Plan has two desired goal statements under the Respiratory Disease priority. 1. Decrease tobacco use in adults and youth community members2. Increase access to smoking cessation classes for adults by partnering with local community organizations to provide linkages to careGoal 1: Decrease tobacco use in adults and youth community members Objective 1: The first objective is to partner with Gulf Coast Area Health Education Center (AHEC) to increase community awareness of free programs and resources available for tobacco cessation by providing nine community lunch and learn sessions from a baseline of zero by the end of year three. The initiative is conducted through AdventHealth Wesley Chapel and all outcomes are specific to the reporting Hospital. Gulf Coast North Area Health Education Center (GNAHEC), a local chapter of the national Area Health Education Center (AHEC), is a community focused organization that develops and implements community-based health promotion activities and education programs that target the underserved. As it relates to our relationship with GNAHEC, we are partnering with GNAHEC to provide community members the tools and resources to assist with tobacco cessation. Additionally, GNAHEC provides continuing education credits (CEUs) to our internal team members. The AHEC lunch and learns provide community members with knowledge of AHEC services and resources and connects individuals to free tobacco cessation classes.The Hospital progressed on its set metric of providing nine community lunch and learn sessions by maintaining communication with community partners working on this initiative together. The Wesley Chapel Community Health Needs Assessment Committee and GNAHEC continued working together to identify opportunities for lunch and learns with local organizations, providers, and community members.Objective 2: The second objective is a shared initiative between AdventHealth Wesley Chapel, AdventHealth Connerton, AdventHealth Lake Placid, AdventHealth Carrollwood, AdventHealth Sebring, AdventHealth Wauchula and AdventHealth North Pinellas. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase knowledge of free tobacco cessation programs and tobacco prevention/treatment resources for patients at discharge by partnering with Gulf Coast North Area Health Education Center (GNAHEC) to provide continuing education (CEU) classes to 200 team members (treating patients with tobacco use) from a baseline of zero by the end of year three. This initiative is managed through all Hospitals, however reported outcomes and funding are specific to the reporting Hospital. This initiative provides educational classes that lead to an increase in knowledge for those AdventHealth team members who treat patients with tobacco use, or work with these patients at discharge, about tobacco cessation resources available thereby potentially improving patients' health through support for eliminating tobacco use. The Hospital progressed on its set metric to provide 200 team members with CEUs by maintaining communication with representatives of GNAHEC. Due to COVID-19, the team member CEUs objective was delayed. As a result of the continued pandemic, AdventHealth has pivoted where necessary to address the immediate needs of our community. We are working to identify ways to support the needs originally identified in our CHNAs, as resources and public health recommendations develop. The Hospital experienced significant staffing challenges in 2021 which put the training initiative on pause.Goal 2: Increase access to smoking cessation classes for adults by partnering with local community organizations to provide linkages to care Objective 1: The first objective is a shared initiative between AdventHealth Wesley Chapel, AdventHealth Tampa, AdventHealth Carrollwood, AdventHealth Dade City, AdventHealth Zephyrhills, AdventHealth Ocala, AdventHealth Wauchula, AdventHealth Lake Placid, AdventHealth Sebring and AdventHealth North Pinellas. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. This objective is managed by the Hospital and all funding and outcomes reported are specific to the reporting Hospital.The objective is to provide patient referrals at discharge to enroll in free Gulf Coast North Area Health Education Center (GNAHEC) tobacco cessation programs and receive free intervention therapies to quit smoking tobacco. Through a partnership with GNAHEC, a local chapter of the national Area Health Education Center (AHEC) organization, we will create an internal referral system to link adults residing in the Hospital's PSA to resources for 50 patients from a baseline of zero by end of year three. The Hospital progressed on its set metric of providing discharge referrals to 50 patients by providing two referrals in year two. Due to COVID-19, the tobacco cessation referral initiative was delayed. As a result of the continued pandemic, AdventHealth has pivoted where necessary to address the immediate needs of our community. We are working to identify ways to support the needs originally identified in our CHNAs, as resources and public health recommendations develop. Our partners with GNAHEC have agreed to conduct in-service trainings with Hospital team members in an effort to increase referrals in year three. See continuation 6

Part V, Section B, Line 11 - continuation 6
Objective 2: The second objective is to increase access to tobacco cessation classes for adults residing in the Hospital's PSA by 10 classes from a baseline of zero by the end of year three. The initiative is conducted through AdventHealth Wesley Chapel and all outcomes are specific to the reporting Hospital. We are partnering with GNAHEC to provide community members the tools and resources to assist with tobacco cessation. The GNAHEC tobacco cessation classes educate community members on the importance of quitting tobacco products. The classes are free and participants can receive free nicotine replacement therapy products (ex. patches, gum, lozenges). The Hospital progressed on its set metric of supporting 10 tobacco cessation classes. The Hospital helped promote tobacco cessation classes by sharing the class flyers widely in the community. Due to COVID-19, the tobacco cessation class 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. Throughout year two, the Hospital was unable to host outside classes due to the pandemic. Community Needs Not Chosen by AdventHealth Wesley Chapel: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? After review and discussion, the Community Health Needs Assessment Committee (CHNAC) agreed that the below issues would not be addressed due to the following: (1) The issue should not be addressed as an individual problem but can be indirectly impacted positively by first addressing multiple issues selected above by the Hospital CHNAC; and/or (2) The CHNAC did not perceive the ability to have a measurable impact on the issue with the current resources available to the community and the Hospital. Based on the prioritization process as described above, the Hospital did not choose the following community issues:1. Unintentional Injury: Accidents are the leading cause of death in the United States. In the AdventHealth Wesley Chapel primary service areas the age adjusted rate of death due to unintentional injury (accident) per 100,000 population is 55.1, which is higher than the state rate of 44.4.2. Exercise, Nutrition & Weight (Physical Inactivity, Obesity/Overweight): In the AdventHealth Wesley Chapel primary service area, approximately 57,264 or 25.8% of adults aged 20 and older self report no leisure time for activity, which may illustrate a cause of significant health issues, such as obesity and poor cardiovascular health. In the AdventHealth Wesley Chapel primary service area, a total of 39,201 households are food insecure, which represents an estimated 29% of the total population that experienced food insecurity at some point during 2017 but are ineligible for State or Federal nutrition assistance. Food insecurity increases risks for obesity. Furthermore, 38.2% of adults aged 18 and older self report that they have a Body Mass Index (BMI) between 25.0 and 30.0 (overweight), which is slightly higher than the state percentages. Excess weight may indicate an unhealthy lifestyle and puts individuals at risk for further health issues.3. Cancer Mortality: Cancer is a leading cause of death and it is important to identify cancers separately to better target interventions. In the AdventHealth primary service areas, the cancer incidence rate (new cases) for lung, prostate, cervical, and colon and rectum cancers are higher than the state rate. Furthermore, the rate of death due to malignant neoplasm (cancer) per 100,000 population is 168.8, which is higher than the state rate of 152.94. Oral Health (Poor Dental Health): In the AdventHealth primary service area, the rate of qualified dentists per 100,000 population is 38 and is lower than the state rate. This has a negative effect on access to dental care. 5. Maternal, Fetal & Infant Health (High Teen Births): In the AdventHealth Wesley Chapel primary service areas, deaths to infants less than one year of age per 1,000 births is 6.7 (7.0 is the state rate). This indicator is relevant because high rates of infant mortality indicate the existence of broader issues pertaining to access to care and maternal and child health. Furthermore, the rate of total births to women age of 15-19 per 1,000 (for the female population age 15-19) is 36.85, which is higher than the state rate of 36.1. This indicator is relevant because, in many cases, teen parents require unique social, economic and health support services. Additionally, high rates of teen pregnancy may indicate the prevalence of unsafe sex practices.6. High Unemployment Rates: In the AdventHealth Wesley Chapel primary service areas, unemployment rates are 6.3% compared to the state average of 3.8%. This is a contributing factor to uninsured rates as well as poverty. Unemployment may negatively impact psychological wellbeing of community members as well.

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

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

Schedule H, Part V, Section B, Line 16a,b,c:
The Financial Assistance Policy can be found at URL:https://www.adventhealth.com/legal/financial-assistanceThe Financial Assistance Policy application can be found at:https://www.adventhealth.com/legal/financial-assistanceThe plain language summary is available at:https://www.adventhealth.com/legal/financial-assistance

Part I, Line 6a:
"The filing organization was a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) during its current tax year. During the current year, AHSSHC served as a parent organization to 30 tax-exempt 501(c)(3) hospital organizations and a number of other health care facilities that operated in 10 states within the U.S. The system of organizations under the control and ownership of AHSSHC is known as ""AdventHealth"".All hospital organizations within AdventHealth collect, calculate, and report the community benefits they provide to the communities they serve. AdventHealth organizations exist solely to improve and enhance the local communities they serve. AdventHealth has a system-wide community benefits accounting policy that provides guidelines for its health care provider organizations to capture and report the costs of services provided to the underprivileged and to the broader community. Each AdventHealth hospital facility reports their community benefits to their Board of Directors and strives to communicate their community benefits to their local communities. Additionally, the filing organization's most recently conducted community health needs assessment and associated implementation strategy can be accessed on the filing organization's website."

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

Part III, Line 2:
The amount of bad debt expense reported on line 2 of Section A of Part III is recorded in accordance with Healthcare Financial Management Association Statement No. 15. Discounts and payments on patient accounts are recorded as adjustments to revenue, not bad debt expense.

Part III, Line 3:
Methodology for Determining the Estimated Amount of Bad Debt Expense that May Represent Patients who could Have Qualified under the Filing Organization's Financial Assistance Policy:Self-pay patients may apply for financial assistance by completing a Financial Assistance Application Form (FAA Form). If an individual does not submit a complete FAA Form within 240 days after the first post-discharge billing statement is sent to the individual, an individual may be considered for presumptive eligibility based upon a scoring tool that is designed to classify patients into groups of varying economic means. The scoring tool uses algorithms that incorporate data from credit bureaus, demographic databases, and hospital specific data to infer and classify patients into respective economic means categories. Individuals who earn a certain score on the scoring tool are considered to qualify as eligible for the most generous financial assistance under the filing organization's Financial Assistance Policy. As determined by the filing organization, a nominal amount of such a patient's bill is written off as bad debt expense, while the remaining portion of the patient's bill is considered non-state charity. The amount written off as bad debt expense for those patients who potentially qualify as non-state charity using the scoring tool is the amount shown on line 3 of Section A of Part III. Rationale for Including Certain Bad Debts in Community Benefit:The filing organization is dedicated to the view that medically necessary health care for emergency and non-elective patients should be accessible to all, regardless of age, gender, geographic location, cultural background, physician mobility, or ability to pay. The filing organization treats emergency and non-elective patients regardless of their ability to pay or the availability of third-party coverage. By providing health care to all who require emergency or non-elective care in a non-discriminatory manner, the filing organization is providing health care to the broad community it serves. As a 501(c)(3) hospital organization, the filing organization maintains a 24/7 emergency room providing care to all whom present. When a patient's arrival and/or admission to the facility begins within the Emergency Department, triage and medical screening are always completed prior to registration staff proceeding with the determination of a patient's source of payment. If the patient requires admission and continued non-elective care, the filing organization provides the necessary care regardless of the patient's ability to pay. The filing organization's operation of a 24/7 Emergency Department that accepts all individuals in need of care promotes the health of the community through the provision of care to all whom present. Current Internal Revenue Service guidance that tax-exempt hospitals maintain such emergency rooms was established to ensure that emergency care would be provided to all without discrimination. The treatment of all at the filing organization's Emergency Department is a community benefit. Under the filing organization's Financial Assistance Policy, every effort is made to obtain a patient's necessary financial information to determine eligibility for financial assistance. However, not all patients will cooperate with such efforts and a financial assistance eligibility determination cannot be made based upon information supplied by the individual. In this case, a patient's portion of a bill that remains unpaid for a certain stipulated time period is wholly or partially classified as bad debt. Bad debts associated with patients who have received care through the filing organization's Emergency Department should be considered community benefit as charitable hospitals exist to provide such care in pursuit of their purpose of meeting the need for emergency medical care services available to all in the community.

Part III, Line 4:
Financial Statement Footnote Related to Accounts Receivable and Allowance for Uncollectible Accounts:The financial information of the filing organization is included in a consolidated audited financial statement for the current year.The applicable footnote from the attached consolidated audited financial statements that addresses accounts receivable, the allowance for uncollectible accounts, and the provision for bad debts can be found on page 8-9. Please note that dollar amounts on the attached consolidated audited financial statements are in thousands.

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

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

Part III, Line 9b:
The hospital filing organization's collection practices are in conformity with the requirements set forth in the 2014 Final Regulations regarding the requirements of Internal Revenue Code Section 501(r)(4)-(r)(6). No extraordinary collection actions (ECA's) are initiated by the hospital filing organization in the 120-day period following the date after the first post-discharge billing statement is sent to the individual (or, if later, the specified deadline given in a written notice of actions that may be taken, as described below). Individuals are provided with at least one written notice (notice of actions that may be taken) and a copy of the filing organization's Plain Language Summary of the Financial Assistance Policy that informs the individual that the hospital filing organization may take actions to report adverse information to credit reporting agencies/bureaus if the individual does not submit a Financial Assistance Application Form (FAA Form) or pay the amount due by a specified deadline. The specified deadline is not earlier 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 III, Line 8
Reconciliation of Schedule H Reported Medicare Surplus/(Shortfall) to Unreimbursed Medicare Costs Associated with the Provision of ServicesTo All Medicare Beneficiaries:The Medicare revenue and allowable costs of care reported in Section B of Part III of Schedule H are based upon the amounts reported in the filing organization's Medicare cost report in accordance with the IRS instructions for Schedule H. On an annual basis, the filing organization also determines its total unreimbursed costs associated with providing services to all Medicare patients. Unreimbursed costs are considered a community benefit to the elderly and are combined into an annual Community Benefit Statement prepared by AdventHealth. The primary reconciling items between the Medicare surplus/(shortfall) shown on line 7 of Section B of Part III of Schedule H and the filing organization's unreimbursed costs of services provided to Medicare patients as reported in the AHS Community Benefit Report are as follows:- Medicare surplus/(shortfall) shown on line 7 of Section B of Schedule H: $ (10,414,642)- Difference in costing methodology: (195,183)- Unreimbursed costs incurred for services provided to Medicare patients that are not included in the organization's Medicare cost report: (16,128,434) -------------Total Unreimbursed costs of serving all Medicare patients per the filing organization's community benefit reporting: $(26,738,260)As indicated above, the primary differences between the Medicare surplus/(shortfall) reported on Schedule H, Part III, Section B, line 7 and the filing organization's portion of the Company's annual community benefit statement is due to a difference in the costing methodology and differences in the population of Medicare patients within the calculation. The cost methodology utilized in calculating any Medicare surplus/(shortfall) for purposes of the annual community benefit reporting is based upon the cost-to-charge ratio outlined in Worksheet 2 of the Schedule H instructions. The same cost-to-charge ratio is used to determine the costs associated with services provided to charity care patients and Medicaid patients as reported in Schedule H, Part I, line 7. In addition, the Medicare cost report excludes services provided to Medicare patients for physician services, services provided to patients enrolled in Medicare HMOs, and certain services provided by outpatient departments of the filing organization that are reimbursed on a fee schedule. The Company's own community benefit statement captures the unreimbursed cost of providing services to all Medicare beneficiaries throughout the organization.

Part VI, Line 2:
The Hospital conducts community health needs assessments (CHNA) every three years. Its 2019 CHNA was adopted by its governing board by December 31, 2019, the end of the Hospital's taxable year in which it conducted the CHNA. The Hospital's 2019 CHNA complied with the guidance set forth by the IRS in Final Regulation Section 1.501(r)-3. In addition to the CHNA discussed above, a variety of practices and processes are in place to ensure that the filing organization is responsive to the health needs of its community.Such practices and processes involve the following:1. A hospital operating/community board composed of individuals broadly representative of the community, community leaders, and those with specialized medical training and expertise;2. Post-discharge patient follow-up related to the on-going care and treatment of patients who suffer from chronic diseases; 3. Sponsorship and participation in community health and wellness activities that reach a broad spectrum of the filing organization's community; and 4. Collaboration with other local community groups to address the health care needs of the filing organization's community.

Part VI, Line 3:
The Financial Assistance Policy (FAP), Financial Assistance Application Form (FAA Form), and the Plain Language Summary of the Financial Assistance Policy (PLS) of the filing organization's hospital facility are transparent and available to all individuals served at any point in the care continuum. The FAP, FAA Form, PLS, and contact information for the hospital facility's financial counselors are prominently and conspicuously posted on the filing organization's hospital facility's website. The website indicates that a copy of the FAP, FAA Form, and PLS is available and how to obtain such copies in the primary languages of any populations with limited proficiency in English that constitute the lesser of 1,000 individuals or 5% of the members of the community served by the hospital facility (referred to below as LEP defined populations). Signage is displayed in public locations of the filing organization's hospital facility, including at all points of admission and registration and the Emergency Department. The signage contains the hospital facility's website address where the FAP, FAA Form, and PLS can be accessed and the telephone number and physical location that individuals can call or visit to obtain copies of the FAP, FAA Form and PLS or to obtain more information about the hospital facility's FAP, FAA Form and PLS. Paper copies of the hospital facility's FAP, FAA Form and PLS are available upon request and without charge, both in public locations in the hospital facility and by mail. Paper copies are made available in English and in the primary languages of any LEP defined populations. The filing organization's hospital facility's financial counselors seek to provide personal financial counseling to all individuals admitted to the hospital facility who are classified as self-pay during the course of their hospital stay or at time of discharge to explain the FAP and FAA Form and to provide information concerning other sources of assistance that may be available, such as Medicaid. A paper copy of the hospital facility's PLS will be offered to every patient as a part of the intake or discharge process. A conspicuous written notice is included on all billing statements sent to patients that notifies and informs recipients about the availability of financial assistance under the filing organization's financial assistance policy, including the following: 1) the telephone number of the hospital facility's office or department that can provide information about the FAP and the FAA Form; and 2) the website address where copies of the FAP, FAA Form and PLS may be obtained. Reasonable attempts are made to inform individuals about the hospital facility's FAP in all oral communications regarding the amount due for the individual's care. Copies of the PLS are distributed to members of the community in a manner reasonably calculated to reach those members of the community who are most likely to require financial assistance.

Part VI, Line 4:
The filing organization owns and operates one 169 bed hospital facility, AdventHealth Wesley Chapel, (AHWC or the Hospital) on a 52 acre campus and operates an Emergency Department located in Lutz, a neighboring community. From state-of-the-art equipment to the most intricate building details, AdventHealth Wesley Chapel was designed from the ground up to maximize healing, patient care and wellness. Since opening in October of 2012, the hospital has been recognized as a leader in patient satisfaction, quality, and safety, earning national recognitions including, being the only hospital in Tampa Bay to receive a 5-star CMS ranking in 2020. The hospital offers a full range of inpatient and outpatient health services, including surgery, imaging and rehabilitation services, emergency services for adults and children, and Inspiration Place, a comprehensive women's health center that incorporates female physician specialists, women's imaging, pelvic floor and female physical therapy and a boutique spa. In addition, the hospital opened in January 2018 an offsite 24 bed, 24/7 emergency room in Central Pasco to better serve the emergency health needs of residents in west and central Pasco. The hospital features a 50,000 sq. ft. community fitness, Wellness Center, and a wide range of community offerings such as health and wellness presentations, screenings, and events. AdventHealth Wesley Chapel primarily serves eastern Pasco and northeastern Hillsborough Counties (including Wesley Chapel, New Tampa (northeast Tampa), Land O'Lakes and portions of San Antonio, Lutz and Zephyrhills). The Hospital is located in between two AdventHealth facilities (AdventHealth Tampa- 15 miles, AdventHealth Zephyrhills- 16 miles) in a suburb just north of Tampa. The largest hospital system in the Tampa Bay Market is BayCare Health System. There are two BayCare hospitals near AdventHealth Wesley Chapel (St. Joseph's Hospital (also has a children's hospital and a women's hospital) and St. Joseph's North ( a community hospital that opened two years before AHWC). During 2021, the Hospital's patient percentage population was made up of the below payors with the remaining percentage of the patients being covered under commercial insurance. In 2021, about 83.6% of the Hospital's in-patients were admitted through the Hospital's Emergency Department. - Medicare Patients 44.2% - Medicaid Patients 9% - Self-Pay Patients 3.8% `The demographic makeup of the Hospital's community is as follows: - Population 288,127 - Population Over 65 16.62% - Poverty (Below 100% FPL) 10.2% - Unemployment Rate 6.4% - Violent Crime Rate (Per 100,000 Pop.) 323.6 - Pop. Age 25+ with No High School Diploma 9.2% - Uninsured Adults 17.92% - Uninsured Children 5.65% - Food Insecurity Rate 15.2% - Pop. with Low Food Access 50.5%

Part VI, Line 5:
"The provision of community benefit is central to AdventHealth Wesley Chapel's mission of service and compassion. Restoring and promoting the health and quality of life of those in the communities served by the Hospital is a function of ""extending the healing ministry of Christ and embodies the Hospital's commitment to its values and principles. The Hospital commits substantial resources to provide a broad range of services to both the underprivileged as well as the broader community. In addition to the community benefit and community building information provided in Parts I, II and III of this Schedule H, the Hospital captures and reports the benefits provided to its community through faith-based care. Examples of such benefits include the cost associated with chaplaincy care programs and mission peer reviews and mission conferences. During the current year, the Hospital provided $175,086 of benefit with respect to the faith-based and spiritual needs of the community in conjunction with its operation of a community hospital. The Hospital also provides benefits to its community's infrastructure by investing in capital improvements to ensure that facilities and technology provide the best possible care to the community. During the current year, the Hospital expended $5,679,585 in new capital improvements. As a faith-based mission-driven community hospital, the Hospital is continually involved in monitoring its community, identifying unmet health care needs and developing solutions and programs to address those needs. In accordance with its conservative approach to fiscal responsibility, surplus funds of the Hospital are continually being invested in resources that improve the availability and quality of delivery of health care services and programs to its community."

Part VI, Line 6:
AdventHealth Wesley Chapel is a part of a faith-based healthcare system of organizations whose parent is Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). The system is known as AdventHealth. AHSSHC is an organization exempt from federal income tax under IRC Section 501(c)(3). AHSSHC and its subsidiary organizations operate 48 hospitals throughout the U.S., primarily in the Southeastern portion of the U.S. AHSSHC and its subsidiaries also operate 10 nursing home facilities and other ancillary health care provider facilities, such as ambulatory surgery centers and diagnostic imaging centers. As the parent organization of AdventHealth, AHSSHC provides executive leadership and other professional support services to its subsidiary organizations. Professional support services include among others IT, corporate compliance, legal, reimbursement, risk management, and tax as well as treasury functions. Certain support services, such as human resources, payroll, A/P, and supply chain management are provided pursuant to a shared services model by AHSSHC to its subsidiary organizations. The provision of these executive and support services on a centralized basis by AHSSHC provides an appropriate balance between providing each AdventHealth subsidiary hospital organization with mission-driven consistent leadership and support while allowing the hospital organization to focus its resources on meeting the specific health care needs of the community it serves. The reader of this Form 990 should keep in mind that this reporting entity may differ in certain areas from that of a stand-alone hospital organization due to its inclusion in a larger system of healthcare organizations. As a part of a system of hospital and other health care organizations, the filing organization benefits from reduced costs due to system efficiencies, such as large group purchasing discounts, and the availability of internal resources such as internal legal counsel. Each AHS subsidiary pays a management fee to AHSSHC for the internal services provided by AHSSHC. As a result, management fee expense reported by an AdventHealth subsidiary organization may appear greater in relation to management fee expense that may be reported by a single stand-alone hospital. The single stand-alone hospital would likely report costs associated with management and other professional services on various expense line items in its statement of revenue and expense as opposed to reporting such costs in one overall management fee expense. As the reporting of the Form 990 is done on an entity by entity basis, there is no single Form 990 that captures the programs and operations of AdventHealth as a whole. The reader is directed to visit the web-site of AdventHealth at www.adventhealth.com to learn more about the mission and operations of AdventHealth.