4A (Expenses $ 207906847 including grants of $ 333007) (Revenue $ 242647018)
OPERATION OF ADVENTHEALTH GORDON, A 69-BED ACUTE CARE HOSPITAL WITH 4,308 PATIENT ADMISSIONS, 24,260 PATIENT DAYS, AND 101,008 OUTPATIENT VISITS; OF ADVENTHEALTH MURRAY, A 42-BED ACUTE CARE HOSPITAL WITH 878 PATIENT ADMISSIONS, 3,511 PATIENT DAYS, AND 42,836 OUTPATIENT VISITS; AND OF A MEDICAL GROUP WITH 316,842 PHYSICIAN/PATIENT ENCOUNTERS/VISITS DURING THE CURRENT YEAR.

ADVENTHEALTH GORDON
PART V, SECTION B, LINE 5: ADVENTIST HEALTH SYSTEM GEORGIA, INC., DBA ADVENTHEALTH GORDON (AHG OR THE HOSPITAL), SERVES GORDON COUNTY RESIDENTS IN NORTHWEST GEORGIA. AHG IS A 69-BED COMMUNITY HOSPITAL LOCATED IN CALHOUN, GEORGIA AND IS THE ONLY HOSPITAL LOCATED WITHIN GORDON COUNTY. THE HOSPITAL'S PRIMARY SERVICE AREA INCLUDES ALL ZIP CODES WITHIN GORDON COUNTY. THE POPULATION OF GORDON COUNTY IS APPROXIMATELY 193,283 WITH AN AVERAGE PER CAPITA INCOME OF APPROXIMATELY $19,750. THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR THE HOSPITAL WAS BUILT ON INPUT FROM PEOPLE REPRESENTING THE BROAD COMMUNITY, AS WELL AS LOW-INCOME, MINORITY AND OTHER MEDICALLY UNDERSERVED POPULATIONS. PRIMARY DATA WAS COLLECTED THROUGH COMMUNITY SURVEYS AND STAKEHOLDER INTERVIEWS.A. COMMUNITY SURVEYS - PAPER SURVEY QUESTIONNAIRES WERE COLLECTED AT HEALTH FAIRS, HEALTH SCREENINGS, BLOOD PRESSURE SCREENINGS AND BLOOD PRESSURE CLINICS SET UP AT THE LOCAL WAL-MART, LOCAL CHURCHES AND THE GORDON COUNTY FAMILY CONNECTIONS OFFICE. ONLINE SURVEYS WERE DISTRIBUTED VIA EMAIL. THE COMMUNITY COMPLETED 321 SURVEYS (194 PAPER AND 127 ONLINE). B. STAKEHOLDER INTERVIEWS - TWENTY-THREE STAKEHOLDER INTERVIEWS WERE CONDUCTED WITH INDIVIDUALS. ADDITIONALLY, TWO FOCUS GROUP DISCUSSIONS, WITH FOUR PARTICIPANTS IN EACH GROUP, COMPRISED OF REPRESENTATIVES FROM COMMUNITY ORGANIZATIONS, WHICH SERVE LOW INCOME COMMUNITY MEMBERS, WERE HELD.A COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE (CHNAC) WAS FORMED TO HELP ADVENTHEALTH GORDON CONDUCT A COMPREHENSIVE ASSESSMENT OF THE COMMUNITY. THE COMMITTEE INCLUDED REPRESENTATION FROM THE HOSPITAL, PUBLIC HEALTH OFFICIALS AND THE BROAD COMMUNITY AS WELL AS REPRESENTATION FROM LOW-INCOME, MINORITY AND OTHER UNDERSERVED POPULATIONS. COMMUNITY MEMBERS OF THE CHNAC REPRESENTED THE FOLLOWING ORGANIZATIONS: - GEORGE CHAMBERS RESOURCE CENTER, AN ORGANIZATION PROVIDING TRAINING FOR HANDICAPPED ADULTS - GORDON COUNTY SENIOR CENTER, AN ORGANIZATION PROVIDING PROGRAMS AND MEALS FOR SENIOR CITIZENS - GORDON COUNTY HEALTH DEPARTMENT - GORDON COUNTY CHAMBER - FAMILY CONNECTION OF GORDON COUNTY, AN ORGANIZATION PROVIDING HELP FOR ABUSED CHILDREN - VOLUNTARY ACTION CENTER, AN ORGANIZATION PROVIDING EDUCATIONAL PROGRAMS AND ASSISTANCE FOR THE UNDERSERVED - GORDON COUNTY BOYS AND GIRLS CLUB

ADVENTHEALTH MURRAY
PART V, SECTION B, LINE 5: ADVENTIST HEALTH SYSTEM GEORGIA, INC, DBA ADVENTHEALTH MURRAY (AHM OR THE HOSPITAL), SERVES MURRAY COUNTY RESIDENTS IN NORTHWEST GEORGIA. AHM IS A 42-BED COMMUNITY HOSPITAL LOCATED IN CHATSWORTH, GEORGIA AND IS THE ONLY HOSPITAL LOCATED WITHIN MURRAY COUNTY. THE HOSPITAL'S PRIMARY SERVICE AREA INCLUDED ALL ZIP CODES WITHIN MURRAY COUNTY. THE POPULATION OF MURRAY COUNTY IS APPROXIMATELY 111,716 WITH AN AVERAGE PER CAPITA INCOME OF APPROXIMATELY $17,291.THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR THE HOSPITAL WAS BUILT ON INPUT FROM PEOPLE REPRESENTING THE BROAD COMMUNITY, AS WELL AS LOW-INCOME, MINORITY AND OTHER MEDICALLY UNDERSERVED POPULATIONS. PRIMARY DATA WAS COLLECTED THROUGH COMMUNITY SURVEYS AND STAKEHOLDER INTERVIEWS.A. COMMUNITY SURVEYS - PAPER SURVEY QUESTIONNAIRES WERE DISTRIBUTED AND COLLECTED AT HEALTH FAIRS, HEALTH SCREENINGS, BLOOD PRESSURE SCREENINGS AND BLOOD PRESSURE CLINICS. MEMBERS OF THE COMMUNITY COMPLETED A TOTAL OF 200 SURVEYS (157 PAPER AND 43 ONLINE).B. STAKEHOLDER INTERVIEWS - NINE STAKEHOLDER INTERVIEWS AND TWO FOCUS GROUPS WITH FOUR PARTICIPANTS EACH WERE CONDUCTED WITH INDIVIDUALS REPRESENTING COMMUNITY ORGANIZATIONS, WHICH SERVE LOW INCOME, MINORITY AND UNDERSERVED POPULATIONS.A COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE (CHNAC) WAS FORMED TO HELP ADVENTHEALTH MURRAY CONDUCT A COMPREHENSIVE ASSESSMENT OF THE COMMUNITY. THE COMMITTEE INCLUDED REPRESENTATION FROM THE HOSPITAL, PUBLIC HEALTH OFFICIALS AND THE BROAD COMMUNITY AS WELL AS REPRESENTATION FROM LOW-INCOME, MINORITY AND OTHER UNDERSERVED POPULATIONS. COMMUNITY MEMBERS OF THE CHNAC REPRESENTED THE FOLLOWING ORGANIZATIONS: - MURRAY COUNTY SENIOR CENTER, AN ORGANIZATION PROVIDING PROGRAMS AND MEALS FOR SENIOR CITIZENS - NORTHWEST ELEMENTARY SCHOOL - MURRAY COUNTY HEALTH DEPARTMENT - MURRAY COUNTY CHAMBER OF COMMERCE - MURRAY COUNTY BOYS AND GIRLS CLUB

ADVENTHEALTH GORDON
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 MURRAY
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 GORDON
"PART V, SECTION B, LINE 11: ADVENTIST HEALTH SYSTEM GEORGIA, INC. D/B/A ADVENTHEALTH GORDON WILL BE REFERRED TO IN THIS DOCUMENT AS ADVENTHEALTH GORDON 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 GORDON IS PART OF THE MULTI-STATE DIVISION OF ADVENTHEALTH. THE DIVISION INCLUDES 17 HOSPITAL FACILITIES. THIS IS THE SECOND-YEAR UPDATE FOR ADVENTHEALTH GORDON'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 GORDON 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 GORDON CHOSE FOUR PRIORITIES FOR ITS 2020-2022 COMMUNITY HEALTH PLAN: 1. CANCER2. CHRONIC DISEASE3. MENTAL HEALTH 4. VAPINGPRIORITY 1: CANCER 2019 DESCRIPTION OF THE ISSUE:CANCER CONTINUES TO BE THE LEADING CAUSE OF DEATH ACROSS THE UNITED STATES AS WELL AS THE TOP CONCERN ACCORDING TO COMMUNITY SURVEYS AND STAKEHOLDER INTERVIEWS. ACCORDING TO THE CENTER FOR DISEASE CONTROL AND PREVENTION'S NATIONAL VIAL STATISTICS SYSTEM, THE AGE-ADJUSTED DEATH RATE (PER 100,000 POP.) IS 180.33 IN THE HOSPITAL'S PRIMARY SERVICE AREA COMPARED TO THE STATE AVERAGE OF 164.74.ONE IMPORTANT DETERMINING FACTOR FOR INCIDENCE OF CANCER IS THE PERCENT OF ADULTS WHO RECEIVE RECOMMENDED CANCER SCREENINGS. THIS PREVENTIVE BEHAVIOR PROVIDES AN OPPORTUNITY FOR EARLY DETECTION AND TREATMENT OF DISEASE. THIS INDICATOR CAN ALSO HIGHLIGHT A LACK OF ACCESS TO PREVENTIVE CARE, A LACK OF HEALTH KNOWLEDGE, INSUFFICIENT PROVIDER OUTREACH AND/OR SOCIAL BARRIERS PREVENTING UTILIZATION OF SERVICES. CONSISTENTLY, ADVENTHEALTH GORDON PRIMARY SERVICE AREA (PSA) DATA REFLECTS A LOWER PERCENTAGE THAN STATE AVERAGE OF ADULTS RECEIVING RECOMMENDED PREVENTATIVE SCREENINGS. IN THE HOSPITAL'S PSA, 52.2% OF ADULTS 50 AND OLDER SELF-REPORT THAT THEY HAVE EVER HAD A SIGMOIDOSCOPY OR COLONOSCOPY VERSUS THE STATE AVERAGE OF 62.4%. ADDITIONALLY, ONLY 77.8% OF WOMEN AGED 18 OR OLDER SELF-REPORT THEY HAVE HAD A PAP TEST IN THE PAST THREE YEARS, VERSUS THE STATE AVERAGE OF 82.7%.THE AGE ADJUSTED INCIDENCE RATES FOR VARIOUS TYPES OF CANCER ARE SIMILAR TO OR HIGHER THAN THE STATE AVERAGE IN THE HOSPITAL PRIMARY SERVICE AREA AS SHOWN BELOW: - RATES FOR LUNG CANCER IN THE PSA ARE 85.7 VERSUS THE STATE RATE OF 64.1 PER 100,000. - BREAST CANCER RATES IN THE PSA ARE 100 VERSUS THE STATE RATE OF 125.8 PER 100,000. - RATES FOR CERVIX CANCER IN THE PSA ARE 8.8 VERSUS THE STATE RATE OF 7.7 PER 100,000. - COLON AND RECTUM CANCER RATES IN THE PSA ARE 40.4 VERSUS THE STATE RATE OF 41.8 PER 100,000.THE MORTALITY RATE FOR CANCER IN THE HOSPITAL'S PSA (183.58) IS ALSO HIGHER THAN THAT IN THE STATE (162.06) PER 100,000. THE HOSPITAL PLANS TO CONTINUE EFFORTS TO OFFER SCREENINGS AND EDUCATION TO EDUCATE THE COMMUNITY AS WELL AS PROVIDE OPPORTUNITIES FOR INCREASED ACCESS TO EARLY DETECTION.2021 UPDATE: THE ADVENTHEALTH GORDON COMMUNITY HEALTH PLAN HAS TWO DESIRED GOAL STATEMENTS UNDER THE CANCER PRIORITY. 1. PROVIDE FREE SCREENING AND PREVENTIVE INFORMATION IN OUR COMMUNITY2. INCREASE ACCESS TO EARLY DIAGNOSIS AND TREATMENTGOAL 1: PROVIDE FREE SCREENING AND PREVENTIVE INFORMATION IN OUR COMMUNITY THE OBJECTIVE IS TO PROVIDE A FREE ANNUAL MELANOMA CANCER SCREENING EVENT FOR THE COMMUNITY AT LARGE AND FREE CANCER SCREENINGS FOR PUBLIC SAFETY GROUPS ANNUALLY TO RAISE AWARENESS ABOUT CANCER TO COMMUNITY MEMBERS RESIDING IN THE HOSPITAL'S PRIMARY SERVICE AREA (PSA) TO 300 PARTICIPANTS FROM A BASELINE OF ZERO BY THE END OF YEAR THREE. THE OBJECTIVE IS A SHARED INITIATIVE WITH ADVENTHEALTH MURRAY. THE HOSPITALS PARTNERED ON THIS INITIATIVE BECAUSE OF A SHARED CHNA PRIORITY. THE INITIATIVE IS MANAGED THROUGH BOTH HOSPITALS; HOWEVER, ALL FUNDING AND OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. DUE TO COVID-19, THE PUBLIC SAFETY GROUP SCREENING AND MELANOMA MONDAY WERE 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 RECOMMENDATION DEVELOP.GOAL 2: INCREASE ACCESS TO EARLY DIAGNOSIS AND TREATMENT THE OBJECTIVE IS TO DISTRIBUTE EDUCATIONAL INFORMATION AT COMMUNITY EVENTS, SUCH AS THE HEALTH AND WELLNESS CLASSES AT THE VOLUNTARY ACTION CENTER, DINNER WITH A DOC AND LOCAL INDUSTRY HEALTH FAIRS, TO INCREASE CANCER AWARENESS FOR COMMUNITY MEMBERS RESIDING IN THE HOSPITAL'S PSA TO 350 PARTICIPANTS FROM A BASELINE OF ZERO BY THE END OF YEAR THREE. THE HOSPITALS PARTNERED ON THIS INITIATIVE BECAUSE OF A SHARED CHNA PRIORITY. THE INITIATIVE IS MANAGED THROUGH BOTH HOSPITALS; HOWEVER, ALL FUNDING AND OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE EDUCATIONAL MATERIALS PROVIDED INCLUDE INFORMATION ON THE IMPORTANCE OF EARLY DETECTION, DIAGNOSIS AND TREATMENT, AS WELL AS IDENTIFY LOCAL CARE OPTIONS FOR INDIVIDUALS IN NEED. THE HOSPITAL PROGRESSED ON ITS SET METRIC TO PROVIDE FREE EDUCATION INFORMATION FOR ACCESS TO EARLY CANCER DIAGNOSIS AND TREATMENT AT COMMUNITY EVENTS TO 350 INDIVIDUALS BY YEAR THREE WITH 191 INDIVIDUALS SERVED IN YEAR TWO. PRIORITY 2: CHRONIC DISEASE 2019 DESCRIPTION OF THE ISSUE:CHRONIC DISEASE IS THE LEADING CAUSE OF DEATH AND DISABILITY IN THE UNITED STATES. CHOLESTEROL, DIABETES, HEART DISEASE AND HIGH BLOOD PRESSURE WERE ALL IDENTIFIED AS TOP PRIORITIES IN BOTH PRIMARY AND SECONDARY DATA UTILIZED DURING ADVENTHEALTH GORDON'S COMMUNITY. HEALTH OUTCOMES IN THE HOSPITAL'S PSA ARE SIMILAR TO OR WORSE THAN THE STATE AVERAGE ACROSS SEVERAL INDICATORS. - THE PERCENTAGE OF ADULTS WITH HIGH BLOOD PRESSURE IN THE HOSPITAL'S PSA IS 31.42% VERSUS THE STATE AVERAGE OF 31.6%. - IN THE HOSPITAL'S PSA THERE IS A HIGHER PERCENTAGE OF ADULTS DIAGNOSED WITH DIABETES (15.5%) THAN THE STATE AVERAGE (11.15%). - THE PERCENTAGE OF ADULTS WITH HIGH CHOLESTEROL IS IN THE HOSPITAL'S PSA IS 39.9% WHICH IS HIGHER THAN THE STATE AVERAGE OF 37.4%. - IN THE HOSPITAL'S PSA THERE IS A HIGHER PERCENTAGE OF ADULTS DIAGNOSED WITH HEART DISEASE (7.3%) THAN THE STATE AVERAGE (4.4%).(CONTINUED)"

ADVENTHEALTH MURRAY
"PART V, SECTION B, LINE 11: ADVENTIST HEALTH SYSTEM GEORGIA, INC. D/B/A ADVENTHEALTH MURRAY WILL BE REFERRED TO IN THIS DOCUMENT AS ADVENTHEALTH MURRAY 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 MURRAY IS PART OF THE MULTI-STATE DIVISION OF ADVENTHEALTH. THE DIVISION INCLUDES 17 HOSPITAL FACILITIES. THIS IS THE SECOND-YEAR UPDATE FOR ADVENTHEALTH MURRAY'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 MURRAY 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 MURRAY CHOSE FOUR PRIORITIES FOR ITS 2020-2022 COMMUNITY HEALTH PLAN: 1. CANCER2. DIABETES3. VAPING 4. NUTRITIONPRIORITY 1: CANCER 2019 DESCRIPTION OF THE ISSUE:CANCER CONTINUES TO BE THE LEADING CAUSE OF DEATH ACROSS THE UNITED STATES AS WELL AS THE TOP COMMUNITY CONCERN ACCORDING TO COMMUNITY SURVEYS AND STAKEHOLDER INTERVIEWS. ACCORDING TO THE CENTER FOR DISEASE CONTROL AND PREVENTION'S NATIONAL VITAL STATISTICS SYSTEM, THE AGEADJUSTED DEATH RATE (PER 100,000 POP.) IS 181.34 IN THE HOSPITAL'S PRIMARY SERVICE AREA COMPARED TO THE STATE AVERAGE OF 162.06. ONE IMPORTANT DETERMINING FACTOR FOR INCIDENCE OF CANCER IS THE PERCENT OF ADULTS WHO RECEIVE RECOMMENDED CANCER SCREENINGS. THIS PREVENTIVE BEHAVIOR PROVIDES AN OPPORTUNITY FOR EARLY DETECTION AND TREATMENT OF DISEASE. THIS INDICATOR CAN ALSO HIGHLIGHT A LACK OF ACCESS TO PREVENTIVE CARE, A LACK OF HEALTH KNOWLEDGE, INSUFFICIENT PROVIDER OUTREACH AND/OR SOCIAL BARRIERS PREVENTING UTILIZATION OF SERVICES. CONSISTENTLY, ADVENTHEALTH MURRAY PRIMARY SERVICE AREA (PSA) DATA REFLECTS A LOWER PERCENTAGE THAN STATE AVERAGE OF ADULTS RECEIVING RECOMMENDED PREVENTATIVE SCREENINGS AS SHOWN BELOW. - IN THE HOSPITAL'S PSA 40.5% OF INDIVIDUALS RECEIVE THE RECOMMENDED SIGMOIDOSCOPY OR COLONOSCOPY SCREENING LESS THAN THE STATE AVERAGE OF 62.4%. - THE STATE AVERAGE FOR MAMMOGRAM SCREENINGS IS 62.3% WHICH IS HIGHER THAN THAT IN THE HOSPITAL'S PSA (49.9%). - IN THE HOSPITAL'S PSA 81.9% OF WOMEN RECEIVE A PAP TEST, SIMILAR TO THE AVERAGE IN THE STATE OF 82.7%.THE AGE ADJUSTED INCIDENCE RATES FOR VARIOUS TYPES OF CANCER ARE CONSISTENTLY HIGHER THAN THE STATE AVERAGE IN THE HOSPITAL PRIMARY SERVICE AREA AS SHOWN BELOW WITH THE EXCEPTION OF BREAST CANCER, WHICH IS STILL THE SECOND MOST FREQUENT TYPE OF CANCER DIAGNOSED IN THE COMMUNITY.RATES FOR LUNG CANCER IN THE PSA ARE 86.5 VERSUS THE STATE RATE OF 64.1 PER 100,000.BREAST CANCER RATES IN THE PSA ARE 85.9 VERSUS THE STATE RATE OF 125.8 PER 100,000.THERE IS NO DATA ON THE RATES OF CERVICAL CANCER IN THE HOSPITAL'S PSA WHILE THE STATE RATE OF 7.7 PER 100,000.COLON AND RECTUM CANCER RATES IN THE PSA ARE 35.9 VERSUS THE STATE RATE OF 41.8 PER 100,000.RATES FOR PROSTATE CANCER IN THE PSA ARE 88.7 VERSUS THE STATE RATE OF 122.3 PER 100,000. THE HOSPITAL PLANS TO CONTINUE EFFORTS TO OFFER SCREENINGS AND EDUCATION TO INFORM THE COMMUNITY AS WELL AS PROVIDE OPPORTUNITIES FOR INCREASED ACCESS TO EARLY DETECTION.2021 UPDATE: THE ADVENTHEALTH MURRAY COMMUNITY HEALTH PLAN HAS TWO DESIRED GOAL STATEMENTS UNDER THE CANCER PRIORITY. 1. PROVIDE FREE SCREENING AND EDUCATION TO THE COMMUNITY2. INCREASE ACCESS TO EARLY DIAGNOSIS AND TREATMENTGOAL 1: PROVIDE FREE SCREENING AND EDUCATION TO THE COMMUNITYTHE OBJECTIVE IS TO CONTINUE WITH A FREE ANNUAL MELANOMA CANCER SCREENING EVENT FOR THE COMMUNITY AT LARGE, TO RAISE AWARENESS ABOUT CANCER AND HAVE STAFF ON-HAND TO ANSWER QUESTIONS REGARDING CANCER FOR COMMUNITY MEMBERS RESIDING IN THE HOSPITAL'S PSA TO SCREEN 150 PARTICIPANTS FROM A BASELINE OF ZERO BY THE END OF YEAR THREE. THE OBJECTIVE IS A SHARED INITIATIVE WITH ADVENTHEALTH GORDON. THE HOSPITALS PARTNERED ON THIS INITIATIVE BECAUSE OF A SHARED CHNA PRIORITY. THE INITIATIVE IS MANAGED THROUGH BOTH HOSPITALS; HOWEVER, ALL FUNDING AND OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. DUE TO COVID-19, THE FREE ANNUAL MELANOMA CANCER SCREENINGS WERE 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: INCREASE ACCESS TO EARLY DIAGNOSIS AND TREATMENT THE OBJECTIVE IS TO DISTRIBUTE EDUCATION INFORMATION AT COMMUNITY EVENTS, SUCH AS THE DINNER WITH A DOC, LOCAL INDUSTRY HEALTH FAIRS AND THE BLACK BEAR FESTIVAL, TO INCREASE CANCER AWARENESS. THIS OBJECTIVE AIMS TO REACH 250 COMMUNITY MEMBERS FROM A BASELINE OF ZERO BY THE END OF YEAR THREE TO PROMOTE THE BENEFITS OF GETTING AN EARLY DIAGNOSIS. THE OBJECTIVE IS A SHARED INITIATIVE WITH ADVENTHEALTH GORDON. THE HOSPITALS PARTNERED ON THIS INITIATIVE BECAUSE OF A SHARED CHNA PRIORITY. THE INITIATIVE IS MANAGED THROUGH BOTH HOSPITALS; HOWEVER, ALL FUNDING AND OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE EDUCATIONAL MATERIALS PROVIDED INCLUDE INFORMATION ON THE IMPORTANCE OF EARLY DETECTION, DIAGNOSIS AND TREATMENT, AS WELL AS IDENTIFY LOCAL CARE OPTIONS FOR INDIVIDUALS IN NEED. THE HOSPITAL PROGRESSED ON ITS SET METRIC WITH 45 ADDITIONAL COMMUNITY MEMBERS REACHED. PRIORITY 2: DIABETES 2019 DESCRIPTION OF THE ISSUE:DIABETES IS ANOTHER LEADING CAUSE OF DEATH AND DISABILITY IN THE UNITED STATES. THIS CHRONIC DISEASE WAS IDENTIFIED AS AN AREA OF CONCERN FOR BOTH COMMUNITY MEMBERS AND STAKEHOLDERS. TOP 10 INPATIENT ADMISSION DATA INDICATED ENDOCRINOLOGY AS ONE OF THE MOST FREQUENT DIAGNOSES, WHICH REFLECTS A NEED FOR BETTER PREVENTION AND MAINTENANCE TO AVOID UNNECESSARY HOSPITAL STAYS FOR A PREVENTABLE AND MANAGEABLE DISEASE. HEALTH OUTCOMES REFLECT THE NEED FOR STRATEGIC EFFORTS TO ADDRESS DIABETES IN THE ADVENTHEALTH MURRAY COMMUNITY. LEFT UNTREATED, DIABETES CAN LEAD TO REDUCTION IN QUALITY OF LIFE. IN THE HOSPITAL'S PRIMARY SERVICE AREA, THE PERCENTAGE OF ADULTS REPORTING DIABETES IS 19.1%, HIGHER THAN THE STATE AVERAGE OF 11.15%.ACCESS TO CARE CONTINUES TO BE AN ADDITIONAL CONTRIBUTOR TO HIGHER THAN AVERAGE RATES OF DIABETES AMONG THE HOSPITAL PSA. THE BELOW INDICATORS ARE RELEVANT BECAUSE ACCESS TO REGULAR PRIMARY CARE IS IMPORTANT TO PREVENTING MAJOR HEALTH ISSUES AND EMERGENCY DEPARTMENT VISITS. - 33.4% OF ADULTS LACK A CONSISTENT SOURCE OF PRIMARY CARE ACCORDING TO THE CENTER FOR DISEASE CONTROL AND PREVENTION BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM 2011-12 DATA. THIS INDICATOR IS HIGHER THAN THE STATE AVERAGE OF 26.09%. - THE RATE OF PREVENTABLE HOSPITAL EVENTS PER 1,000 MEDICARE ENROLLEES IS ALSO HIGHER THAN STATE AVERAGE AT 67.3 FOR THE PRIMARY SERVICE AREA COMPARED TO THE STATE AVERAGE OF 50.2. THIS INDICATOR IS RELEVANT BECAUSE ACCESS TO REGULAR PRIMARY CARE IS IMPORTANT TO PREVENTING MAJOR HEALTH ISSUES AND EMERGENCY DEPARTMENT VISITS.(CONTINUED)"

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

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

SCH H, PART V, SECTION B, LINE 11 (CONTINUED) - ADVENTHEALTH GORDON
ACCESS TO CARE CONTINUES TO BE AN ADDITIONAL CONTRIBUTOR TO HIGHER THAN AVERAGE RATES OF CHRONIC DISEASE WITH THE HOSPITAL'S PRIMARY SERVICE AREAS (PSAS). THE INDICATORS ARE RELEVANT BECAUSE ACCESS TO REGULAR PRIMARY CARE IS IMPORTANT TO PREVENTING MAJOR HEALTH ISSUES AND EMERGENCY DEPARTMENT VISITS. - 32.7% OF ADULTS LACK A CONSISTENT SOURCE OF PRIMARY CARE ACCORDING TO THE CENTER FOR DISEASE CONTROL AND PREVENTION BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM 2011-12 DATA. THIS INDICATOR IS HIGHER THAN THE STATE AVERAGE OF 26.09%. - THE RATE OF PREVENTABLE HOSPITAL EVENTS PER 1,000 MEDICARE ENROLLEES IS ALSO HIGHER THAN STATE AVERAGE AT 59.2 FOR THE PRIMARY SERVICE AREA COMPARED TO THE STATE AVERAGE OF 50.2. THIS INDICATOR IS RELEVANT BECAUSE ACCESS TO REGULAR PRIMARY CARE IS IMPORTANT TO PREVENTING MAJOR HEALTH ISSUES AND EMERGENCY DEPARTMENT VISITS.2021 UPDATE: THE ADVENTHEALTH GORDON COMMUNITY HEALTH PLAN HAS TWO DESIRED GOAL STATEMENTS UNDER THE CHRONIC DISEASE PRIORITY. 1. PROVIDE FREE SCREENINGS IN OUR COMMUNITY 2. INCREASE NUMBER INDIVIDUALS RECEIVING PREVENTATIVE, EARLY DIAGNOSIS AND TREATMENT GOAL 1: PROVIDE FREE SCREENINGS IN OUR COMMUNITY OBJECTIVE 1: THE FIRST OBJECTIVE IS TO PROVIDE FREE SCREENINGS AT HEALTH FAIRS, SUCH AS DALTON STATE COLLEGE, DIXIE GROUP AND THE LOCAL EMERGENCY PLANNING COMMITTEE (LEPC) PUBLIC SAFETY, TO RAISE AWARENESS ABOUT CHRONIC DISEASE AND BENEFITS OF PROACTIVE SCREENINGS FOR COMMUNITY MEMBERS RESIDING IN THE HOSPITAL'S PSA TO 500 PARTICIPANTS FROM A BASELINE OF ZERO BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED THROUGH ADVENTHEALTH GORDON AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE HOSPITAL PROVIDED BIOMETRIC SCREENINGS TO AN ADDITIONAL 217 COMMUNITY MEMBERS, HAVING EXCEED THE ORIGINAL METRIC IN YEAR ONE. RECOGNIZING THE IMPORTANCE OF EARLY DETECTION IN THE TREATMENT OF CHRONIC DISEASES THE HOSPITAL WILL CONTINUE TO OFFER THESE SERVICES TO THE COMMUNITY, IMPOWERING COMMUNITY MEMBERS TO ACCESS NECESSARY CARE. OBJECTIVE 2: THE SECOND OBJECTIVE IS TO PROVIDE FREE SCREENINGS TO LOW-INCOME FAMILIES AT THE HEALTH AND WELLNESS CLASSES AT THE VOLUNTARY ACTION CENTER IN THE HOSPITAL'S PSA TO 100 PARTICIPANTS FROM A BASELINE OF ZERO BY THE END OF YEAR THREE. THE VOLUNTARY ACTION CENTER IS A LOCAL NON-PROFIT WHICH OFFERS A VARIETY OF SERVICES ADDRESSING NEEDS ASSOCIATED WITH FOOD SECURITY, HOUSING AND OTHER SOCIAL DETERMINANTS OF HEALTH. THE INITIATIVE IS FUNDED AND MANAGED THROUGH ADVENTHEALTH GORDON AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE HOSPITAL PROGRESSED ON ITS SET METRIC AND WILL CONTINUE ITS EFFORTS TO MEET THE OBJECTIVE BY THE END OF YEAR THREE. GOAL 2: INCREASE NUMBER INDIVIDUALS RECEIVING PREVENTATIVE, EARLY DIAGNOSIS AND TREATMENT OBJECTIVE 1: THE FIRST OBJECTIVE IS TO HOST COMMUNITY CLASSES, SUCH AS DIABETES EDUCATION AND THE WEIGHT MANAGEMENT PROGRAM FOR CANCER SURVIVORS, ON A MONTHLY BASIS TO PROVIDE EDUCATION ON CHRONIC DISEASE STRATEGIES FOR COMMUNITY MEMBERS RESIDING IN THE HOSPITAL'S PSA TO 150 PARTICIPANTS FROM A BASELINE OF ZERO BY THE END OF YEAR THREE. THE CLASSES ARE FUNDED AND MANAGED THROUGH ADVENTHEALTH GORDON AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE HOSPITAL PROGRESSED ON ITS SET METRIC BY REACHING 132 COMMUNITY MEMBERS.OBJECTIVE 2: THE SECOND OBJECTIVE IS TO PARTICIPATE IN LOCAL INDUSTRY HEALTH FAIRS TO PROVIDE CHRONIC DISEASE EDUCATIONAL INFORMATION TO COMMUNITY MEMBERS RESIDING IN THE HOSPITAL'S PSA TO 500 PARTICIPANTS FROM A BASELINE OF ZERO BY THE END OF YEAR THREE. THE CHRONIC DISEASE EDUCATION INFORMATION IS FUNDED AND MANAGED THROUGH ADVENTHEALTH GORDON AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE HOSPITAL PROGRESSED ON ITS SET METRIC OF BY PROVIDING INFORMATION TO 370 COMMUNITY MEMBERS.PRIORITY 3: MENTAL HEALTH 2019 DESCRIPTION OF THE ISSUE:MENTAL HEALTH ISSUES ARE OFTEN UNDIAGNOSED DUE TO THE LACK OF KNOWLEDGE REGARDING TREATMENT. MENTAL ILLNESS, ESPECIALLY DEPRESSION, INCREASES THE RISK FOR MANY TYPES OF PHYSICAL HEALTH PROBLEMS, PARTICULARLY LONG-LASTING CONDITIONS LIKE STROKE, TYPE 2 DIABETES AND HEART DISEASE. SOCIAL AND EMOTIONAL SUPPORT IS CRITICAL FOR NAVIGATING THE CHALLENGES OF DAILY LIFE AS WELL AS FOR GOOD MENTAL HEALTH. SOCIAL AND EMOTIONAL SUPPORT IS ALSO LINKED TO EDUCATIONAL ACHIEVEMENT AND ECONOMIC STABILITY. SECONDARY DATA INDICATES THAT 22.7% OF ADULTS OVER THE AGE OF 18 SELF-REPORT THAT THEY RECEIVE INSUFFICIENT SOCIAL AND EMOTIONAL SUPPORT ALL OR MOST OF THE TIME. THIS IS HIGHER THAN THE STATE AVERAGE OF 20.7%. THE ADVENTHEALTH PSA HAS A SLIGHTLY HIGHER RATE OF DEATH DUE TO INTENTIONAL SELF-HARM (SUICIDE) PER 100,000 POPULATION AT 15.35 COMPARED TO THE STATE RATE OF 13.3. THIS INDICATOR IS RELEVANT AS SUICIDE IS A MAJOR INDICATOR OF POOR MENTAL HEALTH. MOREOVER, THE PERCENTAGE OF MEDICARE FEE-FOR-SERVICE POPULATION INSIDE THE HOSPITAL PSA WITH DEPRESSION IS 20.8% COMPARED TO THE STATE AVERAGE OF 17.9%. THE HOSPITAL RECOGNIZES THAT IMPACTING ISSUES SUCH AS MENTAL HEALTH WILL BE MORE SUCCESSFUL WITH COLLABORATION. ADVENTHEALTH GORDON WILL PARTNER WITH COMMUNITY AGENCIES TO EDUCATE THE COMMUNITY AND HELP CONNECT THOSE IN NEED TO AVAILABLE RESOURCES.2021 UPDATE: THE ADVENTHEALTH GORDON COMMUNITY HEALTH PLAN HAS TWO DESIRED GOAL STATEMENTS UNDER THE MENTAL HEALTH PRIORITY. 1. PROVIDE INFORMATION ON RESOURCES IN OUR COMMUNITY 2. INCREASE NUMBER INDIVIDUALS RECEIVING TREATMENT GOAL 1: PROVIDE INFORMATION ON RESOURCES IN OUR COMMUNITY OBJECTIVE 1: THE FIRST OBJECTIVE IS TO SHARE EDUCATIONAL MATERIAL ON MENTAL HEALTH AT COMMUNITY EVENTS WITH 250 COMMUNITY MEMBERS, FROM A BASELINE OF ZERO, TO INCREASE AWARENESS AND REDUCE THE SUICIDE DEATH RATE IN GORDON COUNTY BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED THROUGH ADVENTHEALTH GORDON AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE HOSPITAL PROVIDES MATERIALS ON THE IMPORTANCE OF MENTAL HEALTH AWARENESS, AS WELL AS A RESOURCE GUIDE TO CONNECT COMMUNITY MEMBERS IN NEED TO LOCALLY AVAILABLE RESOURCES. THE HOSPITAL PROGRESSED ON ITS SET METRIC OF PROVIDING MENTAL HEALTH EDUCATION MATERIALS, WITH 112 COMMUNITY MEMBERS REACHED.OBJECTIVE 2: THE SECOND OBJECTIVE IS TO WORK WITH THE THREE PUBLIC HIGH SCHOOLS IN CALHOUN/GORDON COUNTY DURING NATIONAL SUICIDE PREVENTION WEEK BY PROVIDING VOLUNTEERS AND EDUCATIONAL LITERATURE TO INCREASE THE OVERALL AWARENESS OF AVAILABLE RESOURCES TO COMMUNITY MEMBERS RESIDING IN THE HOSPITAL'S PSA TO 600 HIGH SCHOOL STUDENTS FROM A BASELINE OF ZERO BY THE END OF YEAR THREE. THE INITIATIVE IS CONDUCTED THROUGH ADVENTHEALTH GORDON AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. DUE TO COVID-19, THIS OBJECTIVE HAS BEEN DELAYED, HOWEVER WE ARE WORKING TO IDENTIFY WAYS TO SUPPORT THE NEEDS ORIGINALLY IDENTIFIED IN OUR CHNAS, AS RESOURCES AND PUBLIC HEALTH RECOMMENDATION DEVELOP.(CONTINUED)

SCH H, PART V, SECTION B, LINE 11 (CONTINUED) - ADVENTHEALTH GORDON
"GOAL 2: INCREASE NUMBER INDIVIDUALS RECEIVING TREATMENT OBJECTIVE 1: THE FIRST OBJECTIVE IS TO IDENTIFY EXISTING COMMUNITY RESOURCES TO HELP SUPPORT UNINSURED/UNDERINSURED POPULATIONS AND CONNECT COMMUNITY MEMBERS IN NEED WITH THESE COMMUNITY RESOURCES, INCLUDING AVAILABLE TREATMENT OPTIONS. THIS OBJECTIVE WILL PROVIDE FREE RESOURCE GUIDES AT ADVENTHEALTH GORDON'S CLINICS TO UNINSURED/UNDERINSURED POPULATIONS RESIDING IN THE HOSPITAL'S PSA FOR 200 COMMUNITY MEMBERS FROM A BASELINE OF ZERO BY THE END OF YEAR THREE. THE INITIATIVE IS DEPLOYED THROUGH ADVENTHEALTH GORDON AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. IN MANY COMMUNITIES A BARRIER TO ACCESSING CARE IS OFTEN A LACK OF AWARENESS OF AVAILABLE TREATMENT OPTIONS. BY EDUCATING COMMUNITY MEMBERS AND INCREASING AWARENESS OF THE AVAILABLE LOCAL RESOURCES, THE HOSPITAL AIMS TO CONNECT MORE INDIVIDUALS IN NEED TO APPROPRIATE AVENUES OF CARE. DURING THE COURSE OF IDENTIFYING AVAILABLE RESOURCES WHICH SUPPORT MENTAL HEALTH NEEDS IN THE COMMUNITY, IT HAS BECOME CLEAR THERE IS A GAP OF NEEDED SERVICES IN THE HOSPITAL'S PSA. TO BE THE MOST EFFECTIVE WITH THE AVAILABLE HOSPITAL RESOURCES AT THIS TIME, THE HOSPITAL WILL FOCUS ITS EFFORTS ON CONNECTING INDIVIDUALS WITH THE RESOURCES AVAILABLE, WHILE SEEKING WAYS TO ADDRESS THIS GAP IN THE FUTURE. THE METRIC FOR THE OBJECTIVE WAS PROGRESSED ON BY PROVIDING RESOURCE GUIDES TO 117 COMMUNITY MEMBERS. OBJECTIVE 2: THE SECOND OBJECTIVE IS TO CO-SPONSOR A MENTAL HEALTH FAIR FOR PUBLIC HIGH SCHOOL STUDENTS IN CALHOUN/GORDON COUNTY TO INCREASE THE NUMBER OF TEENS AND ADULTS THAT HAVE ACCESS TO TREATMENT INFORMATION TO STUDENTS RESIDING IN THE HOSPITAL'S PSA TO 500 HIGH SCHOOL STUDENTS FROM A BASELINE OF ZERO BY THE END OF YEAR THREE. THE INITIATIVE IS CONDUCTED THROUGH ADVENTHEALTH GORDON AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. DUE TO COVID-19, THIS OBJECTIVE HAS BEEN DELAYED, HOWEVER WE ARE WORKING TO IDENTIFY WAYS TO SUPPORT THE NEEDS ORIGINALLY IDENTIFIED IN OUR CHNAS, AS RESOURCES AND PUBLIC HEALTH RECOMMENDATION DEVELOP.PRIORITY 4: VAPING 2019 DESCRIPTION OF THE ISSUE:VAPING IS QUICKLY BECOMING AN EPIDEMIC AMONG SCHOOL AGE CHILDREN. ADVENTHEALTH GORDON COMMUNITY STAKEHOLDERS VOCALIZED CONCERN OVER THE GROWING NUMBER OF CHILDREN ADOPTING THIS BEHAVIOR. THE USE OF E-CIGARETTES IS UNSAFE FOR CHILDREN, TEENS AND YOUNG ADULTS. MOST E-CIGARETTES CONTAIN NICOTINE, WHICH HAS PROVEN TO BE HIGHLY ADDICTIVE AND HARMFUL TO ADOLESCENT BRAIN DEVELOPMENT. THERE IS GROWING CONCERN REGARDING THE INCREASE IN USE, ESPECIALLY IN THE COMMUNITY'S YOUTH. OPPORTUNITIES HAVE BEEN IDENTIFIED FOR THE HOSPITAL TO PARTNER WITH THE SCHOOL SYSTEM TO HELP BOLSTER EFFORTS TO PROVIDE EDUCATION, SCREENINGS AND STRENGTHEN PREVENTION EFFORTS.2021 UPDATE: THE ADVENTHEALTH GORDON COMMUNITY HEALTH PLAN HAS TWO DESIRED GOAL STATEMENTS UNDER THE VAPING PRIORITY. 1. PARTNER WITH SCHOOL SYSTEMS TO EDUCATE THE STUDENTS IN OUR COMMUNITY 2. PROVIDE INFORMATION AND RESOURCES IN OUR COMMUNITY TO ADULTS GOAL 1: PARTNER WITH SCHOOL SYSTEMS TO EDUCATE THE STUDENTS IN OUR COMMUNITY THE OBJECTIVE IS TO PROVIDE EIGHT LECTURES PER YEAR AT THE CALHOUN/GORDON COUNTY MIDDLE AND HIGH SCHOOLS TO INCREASE THE NUMBER OF STUDENTS THAT ARE AWARE OF THE DANGERS OF VAPING. THE OBJECTIVE IS A SHARED INITIATIVE WITH ADVENTHEALTH MURRAY. THE HOSPITALS PARTNERED ON THIS INITIATIVE BECAUSE OF A SHARED CHNA PRIORITY. THE INITIATIVE IS MANAGED THROUGH BOTH HOSPITALS; HOWEVER, ALL FUNDING AND OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THIS OBJECTIVE WILL EDUCATE 5,400 STUDENTS FROM A BASELINE OF ZERO BY THE END OF YEAR THREE. DUE TO COVID-19, THIS OBJECTIVE HAS BEEN DELAYED, HOWEVER WE ARE WORKING TO IDENTIFY WAYS TO SUPPORT THE NEEDS ORIGINALLY IDENTIFIED IN OUR CHNAS, AS RESOURCES AND PUBLIC HEALTH RECOMMENDATION DEVELOP. GOAL 2: PROVIDE INFORMATION AND RESOURCES IN OUR COMMUNITY TO ADULTS THE OBJECTIVE, TO DEVELOP AND LAUNCH FOUR SOCIAL MEDIA POSTS PER YEAR DIRECTED AT THE ADULT POPULATION TO INCREASE AWARENESS AND EDUCATION AMONG THE ADULT POPULATION ON THE DANGERS OF VAPING, IS A SHARED INITIATIVE WITH ADVENTHEALTH MURRAY. THE HOSPITALS PARTNERED ON THIS INITIATIVE BECAUSE OF A SHARED CHNA PRIORITY. FUNDING AND OUTCOMES REPORTED REPRESENT BOTH HOSPITALS. THE POST WILL BE ""BOOSTED"" FOR $500 PER YEAR TARGETING AUDIENCES AGED 30-60 YEARS OLD IN ORDER TO REACH PARENTS AND GRANDPARENTS RESIDING IN THE HOSPITAL'S PSA TO 20,000 VIEWS FROM A BASELINE OF ZERO BY THE END OF YEAR THREE. DUE TO COVID-19, THIS OBJECTIVE HAS BEEN DELAYED, HOWEVER WE ARE WORKING TO IDENTIFY WAYS TO SUPPORT THE NEEDS ORIGINALLY IDENTIFIED IN OUR CHNAS, AS RESOURCES AND PUBLIC HEALTH RECOMMENDATION DEVELOP.COMMUNITY NEEDS NOT CHOSEN BY ADVENTHEALTH GORDON: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. TEEN PREGNANCY: TEEN PREGNANCY CAN IMPACT QUALITY OF LIFE FOR BOTH MOTHER AND CHILD. TEEN MOTHERS ARE AT A HIGHER RISK FOR POSTPARTUM DEPRESSION AND FUTURE POVERTY. THE COMMUNITY ASSET INVENTORY IDENTIFIED SEVERAL EXISTING PROGRAMS AND ORGANIZATIONS ADDRESSING THIS ISSUE. THE CHNAC CHOSE NOT TO FOCUS ON THIS ISSUE IN ORDER TO AVOID DUPLICATION OF EFFORTS. 2. IMMUNIZATIONS: THE COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE (CHNAC) AGREED THAT, WHILE IMPORTANT, ALREADY EXISTING EFFORTS LED BY THE LOCAL HEALTH DEPARTMENT WERE ADDRESSING THE ISSUE OF IMMUNIZATIONS. THE HOSPITAL WILL CONTINUE TO SUPPORT THE EFFORTS OF THE LOCAL HEALTH DEPARTMENT.3. RESPIRATORY DISEASE: ALTHOUGH SOME COMMUNITY MEMBERS CITED CHILDHOOD ASTHMA AS A COMMUNITY HEALTH PROBLEM, THE CHNAC DID NOT BELIEVE THIS PRIORITY COMPARED TO OTHER ISSUE. ADVENTHEALTH GORDON WILL CONTINUE TO PARTNER WITH THE SCHOOL SYSTEM TO HELP BOLSTER EFFORT TO PROVIDE EDUCATION AND SCREENINGS."

SCH H, PART V, SECTION B, LINE 11 (CONTINUED) - ADVENTHEALTH MURRAY
"2021 UPDATE: THE ADVENTHEALTH MURRAY COMMUNITY HEALTH PLAN HAS TWO DESIRED GOAL STATEMENTS UNDER THE DIABETES PRIORITY. 1. PROVIDE FREE SCREENINGS IN OUR COMMUNITY 2. INCREASE NUMBER INDIVIDUALS RECEIVING PREVENTATIVE, EARLY DIAGNOSIS AND TREATMENT GOAL 1: PROVIDE FREE SCREENINGS IN OUR COMMUNITY THE OBJECTIVE IS TO CONTINUE TO PROVIDE FREE SCREENINGS AT HEALTH FAIRS SUCH AS THE MURRAY COUNTY EMPLOYEE HEALTH FAIR TO RAISE AWARENESS ABOUT DIABETES TO COMMUNITY MEMBERS RESIDING IN THE HOSPITAL'S PSA TO 250 COMMUNITY MEMBERS FROM A BASELINE OF ZERO BY THE END OF YEAR THREE. THE FREE SCREENINGS ARE FUNDED AND MANAGED THROUGH ADVENTHEALTH MURRAY AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. DUE TO COVID-19, THE FREE ANNUAL SCREENINGS WERE 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: INCREASE NUMBER INDIVIDUALS RECEIVING PREVENTATIVE, EARLY DIAGNOSIS AND TREATMENT OBJECTIVE 1: THE FIRST OBJECTIVE IS TO PARTNER WITH THE CHATSWORTH SEVENTH-DAY ADVENTIST CHURCH FOR COMMUNITY CLASSES, SUCH AS DIABETES UNDONE WHICH EMPOWERS PARTICIPANTS TO IMPROVE THEIR HEALTH OUTCOMES THROUGH LIFESTYLE CHANGE, TO PROVIDE EDUCATION ON DIABETES TO COMMUNITY MEMBERS RESIDING IN THE HOSPITAL'S PSA TO 100 COMMUNITY MEMBERS FROM A BASELINE OF ZERO BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED THROUGH ADVENTHEALTH MURRAY AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE HOSPITAL PROGRESSED ON ITS SET METRIC OF PROVIDING DIABETES EDUCATION TO 133 ADDITIONAL COMMUNITY MEMBERS BY THE END OF YEAR THREE. DUE TO COVID-19, THE PARTNERSHIP WITH THE CHATSWORTH SEVENTH-DAY ADVENTIST CHURCH WAS DELAYED. OBJECTIVE 2: THE SECOND OBJECTIVE IS TO CONTINUE TO PARTICIPATE IN LOCAL INDUSTRY HEALTH FAIRS TO PROVIDE COMMUNITY MEMBERS WITH DIABETES EDUCATIONAL INFORMATION THROUGH PRINTED LITERATURE AND A STAFF MEMBER TO ANSWER QUESTIONS FOR COMMUNITY MEMBERS RESIDING IN THE HOSPITAL'S PSA TO 250 COMMUNITY MEMBERS FROM A BASELINE OF ZERO BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND CONDUCTED THROUGH ADVENTHEALTH MURRAY AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. DUE TO COVID-19, PARTICIPATION IN LOCAL HEALTH FAIRS WAS DELAYED. WE ARE WORKING TO IDENTIFY WAYS TO SUPPORT THE NEEDS ORIGINALLY IDENTIFIED IN OUR CHNAS, AS RESOURCES AND PUBLIC HEALTH RECOMMENDATIONS DEVELOP.PRIORITY 3: VAPING 2019 DESCRIPTION OF THE ISSUE:VAPING IS QUICKLY BECOMING AN EPIDEMIC AMONG SCHOOL-AGE CHILDREN. DATA IS LIMITED ON VAPING AND E-CIGARETTE USE AS THIS IS A RELATIVELY NEW HEALTH ISSUE. CURRENT AGE-ADJUSTED PERCENT OF ADULTS WHO SMOKE CIGARETTES IS 25.3% IN THE HOSPITAL PRIMARY SERVICE AREA COMPARED TO THE STATE PERCENT OF 17.8%. ADVENTHEALTH MURRAY COMMUNITY STAKEHOLDERS VOCALIZED CONCERN OVER THE GROWING NUMBER OF CHILDREN ADOPTING THIS BEHAVIOR. THE USE OF E-CIGARETTES IS UNSAFE FOR CHILDREN, TEENS AND YOUNG ADULTS. MOST E-CIGARETTES CONTAIN NICOTINE, WHICH HAS PROVEN TO BE HIGHLY ADDICTIVE AND HARMFUL TO ADOLESCENT BRAIN DEVELOPMENT. THERE IS GROWING CONCERN REGARDING THE INCREASE IN USE, ESPECIALLY IN THE COMMUNITY'S YOUTH. OPPORTUNITIES HAVE BEEN IDENTIFIED FOR THE HOSPITAL TO PARTNER WITH THE SCHOOL SYSTEM TO HELP BOLSTER EFFORTS TO PROVIDE EDUCATION, SCREENINGS AND STRENGTHEN PREVENTION EFFORTS.2021 UPDATE: THE ADVENTHEALTH MURRAY COMMUNITY HEALTH PLAN HAS TWO DESIRED GOAL STATEMENTS UNDER THE VAPING PRIORITY. 1. PARTNER WITH SCHOOL SYSTEMS TO EDUCATE THE STUDENTS IN OUR COMMUNITY 2. PROVIDE INFORMATION AND RESOURCES IN OUR COMMUNITY TO ADULTS GOAL 1: PARTNER WITH SCHOOL SYSTEMS TO EDUCATE THE STUDENTS IN OUR COMMUNITY THE OBJECTIVE IS TO PROVIDE FOUR LECTURES PER YEAR AT THE MURRAY COUNTY MIDDLE AND HIGH SCHOOLS TO INCREASE THE NUMBER OF STUDENTS THAT ARE AWARE OF THE DANGERS OF VAPING TO STUDENTS RESIDING IN THE HOSPITAL'S PSA TO 3,095 STUDENTS FROM A BASELINE OF ZERO BY THE END OF YEAR THREE. THE OBJECTIVE IS A SHARED INITIATIVE WITH ADVENTHEALTH GORDON. THE HOSPITALS PARTNERED ON THIS INITIATIVE BECAUSE OF A SHARED CHNA PRIORITY. THE INITIATIVE IS MANAGED THROUGH BOTH HOSPITALS; HOWEVER, ALL FUNDING AND OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE METRIC FOR THE OBJECTIVE WAS PROGRESSED ON BY PROVIDING LECTURES ON THE DANGERS OF VAPING TO 3,017 STUDENTS IN YEAR TWO. GOAL 2: PROVIDE INFORMATION AND RESOURCES IN OUR COMMUNITY TO ADULTS THE OBJECTIVE IS TO DEVELOP AND LAUNCH FOUR SOCIAL MEDIA POSTS PER YEAR DIRECTED AT THE ADULT POPULATION IN TARGETED ZIP CODES WITHIN ADVENTHEALTH MURRAYS' PSA TO INCREASE AWARENESS AND EDUCATION AMONG THE ADULT POPULATION ON THE DANGERS OF VAPING IS A SHARED INITIATIVE WITH ADVENTHEALTH GORDON. THE HOSPITALS PARTNERED ON THIS INITIATIVE BECAUSE OF A SHARED CHNA PRIORITY. FUNDING AND OUTCOMES REPORTED REPRESENT BOTH HOSPITALS. THE POST WILL BE ""BOOSTED"" FOR $500 PER YEAR TARGETING AUDIENCES AGED 30-60 YEARS OLD IN ORDER TO REACH PARENTS AND GRANDPARENTS RESIDING IN THE HOSPITAL'S PSA TO 20,000 VIEWS FROM A BASELINE OF ZERO BY THE END OF YEAR THREE. DUE TO COVID-19, THE OBJECTIVE WAS DELAYED, AS RESOURCES WERE REALLOCATED TO COVID RELATED NECESSITIES. WE ARE WORKING TO IDENTIFY WAYS TO SUPPORT THE NEEDS ORIGINALLY IDENTIFIED IN OUR CHNAS, AS RESOURCES AND PUBLIC HEALTH RECOMMENDATIONS DEVELOP.PRIORITY 4: NUTRITION 2019 DESCRIPTION OF THE ISSUE:THE NEED TO FOCUS ON NUTRITION WAS REFLECTED IN CONSISTENTLY HIGHER THAN STATE INCIDENCE OF PREVENTABLE, CHRONIC DISEASE. THE COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE AGREED THAT INCREASING THE COMMUNITY'S ABILITY TO ACCESS AND INCORPORATE A MORE BALANCED DIET WOULD HELP WITH THE PREVENTION AND MAINTENANCE OF MANY ISSUES IDENTIFIED THROUGHOUT THE NEEDS ASSESSMENT PROCESS. THE CURRENT FOOD INSECURITY RATE FOR THE ADVENTHEALTH MURRAY PRIMARY SERVICE AREA (PSA) IS 11.2%, WHICH IS SLIGHTLY LOWER THAN THE STATE AVERAGE OF 14.4%. ALTHOUGH A FOOD INSECURITY RATE LOWER THAN STATE AVERAGE IS CONSIDERED POSITIVE, 11.2% OF THE POPULATION TRANSLATES TO APPROXIMATELY ONE IN NINE COMMUNITY MEMBERS WHO EXPERIENCE A LACK OF CONSISTENT ACCESS TO ENOUGH FOOD TO SUSTAIN AN ACTIVE, HEALTHY LIFE. IN ADDITION TO FOOD INSECURITY, THE HOSPITAL ALSO UTILIZED THE FOOD ACCESS RESEARCH ATLAS TO DETERMINE IF A SIGNIFICANT NUMBER OF INDIVIDUALS, OR SHARE OF THE POPULATION, ARE FAR FROM A SUPERMARKET, SUPERCENTER, OR LARGE GROCERY STORE. WHILE LOWER THAN THE STATE AVERAGE OF 30.82%, THE HOSPITAL PSA STILL HAS 19.21%, OR APPROXIMATELY ONE IN FIVE, COMMUNITY MEMBERS WHO LACK REASONABLE ACCESS TO HEALTHY AND NUTRITIOUS FOOD.2021 UPDATE: THE ADVENTHEALTH MURRAY COMMUNITY HEALTH PLAN HAS TWO DESIRED GOAL STATEMENTS UNDER THE NUTRITION PRIORITY. 1. PARTNER WITH COMMUNITY AGENCIES TO EDUCATE LOW INCOME ADULTS 2. EDUCATE INDIVIDUALS IN OUR COMMUNITY ON HEALTHY EATING CHOICES GOAL 1: PARTNER WITH COMMUNITY AGENCIES TO EDUCATE LOW INCOME ADULTS THE OBJECTIVE IS TO WORK WITH THE CHATSWORTH SEVENTH-DAY ADVENTIST CHURCH PROVIDING VOLUNTEERS AND EDUCATIONAL LITERATURE TO EDUCATE OUR COMMUNITY MEMBERS ON HEALTHY EATING HABITS FOR COMMUNITY MEMBERS RESIDING IN THE HOSPITAL'S PSA TO 150 COMMUNITY MEMBERS FROM A BASELINE OF ZERO BY THE END OF YEAR THREE. THE COMMUNITY MEMBERS ARE PROVIDED EDUCATION THROUGH THE DIABETES UNDONE PROGRAM, WHICH APPEARS IN THE THIRD PRIORITY. NUTRITION IS A KEY COMPONENT IMPACTING DIABETES AND OTHER CHRONIC DISEASES AND IS INCLUDED AS PART OF THE DIABETES UNDONE CURRICULUM. THE REPORTED NUMBERS ARE NOT UNIQUE BUT REFLECT A TOTAL OF 150 ACROSS BOTH GOALS/OBJECTIVES. THE INITIATIVE IS FUNDED AND MANAGED THROUGH ADVENTHEALTH MURRAY AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. DUE TO COVID-19, THE PARTNERSHIP WITH THE CHATSWORTH SEVENTH-DAY ADVENTIST CHURCH, WAS DELAYED. THE HOSPITAL IS WORKING TO DEVELOP ALTERNATIVE WAYS TO SUPPORT THE GOAL.(CONTINUED)"

SCH H, PART V, SECTION B, LINE 11 (CONTINUED) - ADVENTHEALTH MURRAY
GOAL 2: EDUCATE INDIVIDUALS IN OUR COMMUNITY ON HEALTHY EATING CHOICES OBJECTIVE 1: THE FIRST OBJECTIVE IS TO SHARE EDUCATION MATERIAL ON HEALTHY EATING AT COMMUNITY EVENTS TO INCREASE AWARENESS FOR A HEALTHIER LIFESTYLE FOR COMMUNITY MEMBERS RESIDING IN THE HOSPITAL'S PSA TO 200 COMMUNITY MEMBERS FROM A BASELINE OF ZERO BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED THROUGH ADVENTHEALTH MURRAY AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE HOSPITAL WAS ABLE TO SHARE EDUCATION MATERIAL ON HEALTHY EATING WITH 185 ADDITIONAL COMMUNITY MEMBERS. THE HOSPITAL EXCEEDED ITS SET METRIC OF SHARING EDUCATION MATERIAL WITH 200 COMMUNITY MEMBERS, WITH 291 COMMUNITY MEMBERS REACHED SINCE YEAR ONE.OBJECTIVE 2: THE SECOND OBJECTIVE IS TO USE CREATION LIFE CLASSES TO PROVIDE ACCESS TO KNOWLEDGE AROUND HEALTHY NUTRITION TO COMMUNITY MEMBERS RESIDING IN THE HOSPITAL'S PSA TO 150 COMMUNITY MEMBERS FROM BASELINE OF ZERO BY THE END OF YEAR THREE. THE CREATION LIFE CLASSES ARE FUNDED AND MANAGED THROUGH ADVENTHEALTH MURRAY AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE INITIATIVE PROVIDES INDIVIDUALS AT RISK FOR CHRONIC DISEASE WITH WELLNESS AND HEALTHY LIFESTYLE PRINCIPLES BASED ON THE TENANTS OF CHOICE, REST, ENVIRONMENT, ACTIVITY, TRUST, INTERPERSONAL RELATIONSHIPS, OUTLOOK AND NUTRITION. THESE EIGHT PRINCIPLES PROVIDE GUIDANCE AND SUPPORT TO HELP TRANSFORM YOUR LIVES IN POSITIVE WAYS. THE CREATION LIFE PRINCIPLES ARE BACKED BY SCIENCE. THEY HAVE BEEN PROVEN SUCCESSFUL IN STUDIES FUNDED BY THE NATIONAL INSTITUTES OF HEALTH, WORLD HEALTH ORGANIZATION AND NATIONAL CANCER INSTITUTE, AMONG OTHERS. DUE TO COVID-19, CREATION LIFE CLASSES WERE DELAYED. 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 MURRAY: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. TEEN PREGNANCY: TEEN PREGNANCY CAN IMPACT QUALITY OF LIFE FOR BOTH MOTHER AND CHILD. TEEN MOTHERS ARE AT A HIGHER RISK FOR POSTPARTUM DEPRESSION AND FUTURE POVERTY. THE COMMUNITY ASSET INVENTORY IDENTIFIED EXISTING PROGRAMS AND ORGANIZATIONS ADDRESSING THIS ISSUE. THE COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE (CHNAC) CHOSE NOT TO FOCUS ON THIS ISSUE IN ORDER TO AVOID DUPLICATION OF EFFORTS.2. IMMUNIZATION CHILDREN: THE CHNAC AGREED THAT WHILE, EXISTING EFFORTS LED BY THE LOCAL HEALTH DEPARTMENT WERE ADDRESSING THE ISSUE OF IMMUNIZATION. THE HOSPITAL WILL CONTINUE TO SUPPORT THE EFFORTS OF THE LOCAL HEALTH DEPARTMENT.3. ASTHMA IN CHILDREN: ALTHOUGH SOME COMMUNITY MEMBERS CITED CHILDHOOD ASTHMA AS A COMMUNITY HEALTH PROBLEM, THE CHNAC DID NOT BELIEVE THIS PRIORITY COMPARED TO OTHER ISSUES IN TERMS OF THE MAGNITUDE OF THE HEALTH PROBLEM IT POSED TO THE COMMUNITY. ADVENTHEALTH MURRAY WILL CONTINUE TO PARTNER WITH THE SCHOOL SYSTEM TO HELP BOLSTER EFFORTS TO PROVIDE EDUCATION AND SCREENINGS.4. HEART DISEASE/HIGH BLOOD PRESSURE/CHOLESTEROL: HEART DISEASE, HIGH BLOOD PRESSURE AND CHOLESTEROL WERE IDENTIFIED CONSISTENTLY AS AREAS OF CONCERN IN BOTH PRIMARY AND SECONDARY DATA. THE HOSPITAL AND COMMUNITY BOTH HAVE EXISTING PROGRAMS IN PLACE. ADVENTHEALTH MURRAY WILL CONTINUE TO PARTNER WITH THE COMMUNITY AND PROVIDE SCREENINGS AND EDUCATION TO COMMUNITY MEMBERS. BY ADDRESSING NUTRITION THROUGH EDUCATION AND PARTNERSHIPS, THE CHNA HOPES TO BE ABLE TO POSITIVELY IMPACT THESE CONDITIONS.

PART V, SECTION B, LINE 7A
URL FOR ADVENTHEALTH GORDON'S CHNA: HTTPS://WWW.ADVENTHEALTH.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENTSURL FOR ADVENTHEALTH MURRAY'S CHNA: HTTPS://WWW.ADVENTHEALTH.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS

PART V, SECTION B, LINE 10A
URL FOR ADVENTHEALTH GORDON'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY: HTTPS://WWW.ADVENTHEALTH.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENTSURL FOR ADVENTHEALTH MURRAY'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY: HTTPS://WWW.ADVENTHEALTH.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS

PART V, LINE 16A, 16B, AND 16C:
PART V, 16A, FAP WEBSITE:ADVENTHEALTH GORDONHTTPS://WWW.ADVENTHEALTH.COM/LEGAL/FINANCIAL-ASSISTANCEADVENTHEALTH MURRAYHTTPS://WWW.ADVENTHEALTH.COM/LEGAL/FINANCIAL-ASSISTANCEPART V, 16B, FAP APPLICATION WEBSITE:ADVENTHEALTH GORDONHTTPS://WWW.ADVENTHEALTH.COM/LEGAL/FINANCIAL-ASSISTANCEADVENTHEALTH MURRAYHTTPS://WWW.ADVENTHEALTH.COM/LEGAL/FINANCIAL-ASSISTANCEPART V, 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE:ADVENTHEALTH GORDONHTTPS://WWW.ADVENTHEALTH.COM/LEGAL/FINANCIAL-ASSISTANCEADVENTHEALTH MURRAYHTTPS://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 PAGES 8 AND 9. PLEASE NOTE THAT DOLLAR AMOUNTS ON THE ATTACHED CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE IN THOUSANDS.

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

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

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

SUPPLEMENTAL SCHEDULE TO SCHEDULE H, PART III, SECTION B
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: $ (1,097,290)- DIFFERENCE IN COSTING METHODOLOGY: (10,220,096)- UNREIMBURSED COSTS INCURRED FOR SERVICES PROVIDED TO MEDICARE PATIENTS THAT ARE NOT INCLUDED IN THE ORGANIZATION'S MEDICARE COST REPORT: (8,914,769) -------------TOTAL SURPLUS/(SHORTFALL) COSTS OF SERVING ALL MEDICARE PATIENTS PER THE FILING ORGANIZATION'S COMMUNITY BENEFIT REPORTING: $(20,232,155)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.

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ADVENTIST HEALTH SYSTEM GEORGIA, INC., D/B/A ADVENTHEALTH GORDON (THE HOSPITAL), IS A 69-BED COMMUNITY HOSPITAL THAT SERVES THE RESIDENTS OF CALHOUN, GORDON COUNTY, AND SURROUNDING AREAS IN GEORGIA. ADVENTHEALTH GORDON OFFERS MULTIPLE SERVICES FOR THE RESIDENTS OF NORTH GEORGIA. THESE INCLUDE: 24-HOUR EMERGENCY CENTER, REHABILITATION SERVICES, INTENSIVE AND PROGRESSIVE CARE UNITS, RADIOLOGY, WOMEN'S DIAGNOSTIC CENTER, GENERAL AND CANCER SURGERY, HOME HEALTH SERVICES, ONCOLOGY SERVICES AND RADIATION THERAPY, URGENT CARE CENTERS, UROLOGY SERVICES, ENDOCRINOLOGY SERVICES, PAIN MANAGEMENT SERVICES AND PASTORAL CARE.IN ADDITION, ADVENTHEALTH GORDON OPERATES THE FOLLOWING SATELLITE ADVENTHEALTH MEDICAL GROUP FACILITIES: URGENT CARE CALHOUN, NORTH GEORGIA EYE CARE, ONCOLOGY, UROLOGY, NORTHWEST GEORGIA ORTHOPEDICS AND SPORTS MEDICINE (THREE LOCATIONS), HOME CARE, NORTHWEST GEORGIA OB/GYN, PRIMARY CARE, NORTHWEST GEORGIA ENDOCRINOLOGY, ADULT & PEDIATRIC MEDICAL ASSOCIATES, INTERNAL AND FAMILY MEDICINE, OWASA FAMILY MEDICINE, NORTH GEORGIA CANCER CENTER, HEALTH DEPOT, COOK FAMILY PRACTICE, AND MICHAEL A. WITT, MD, OFFICES IN CHATSWORTH, GEORGIA.ADVENTHEALTH GORDON DEFINED ITS COMMUNITY AS ITS PRIMARY SERVICE AREA (PSA) FROM WHICH 75-80% OF ITS PATIENTS COME. THIS AREA INCLUDES ALL ZIP CODES LOCATED WITHIN GORDON COUNTY.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 71.1% OF THE HOSPITAL'S IN-PATIENTS WERE ADMITTED THROUGH THE HOSPITAL'S EMERGENCY DEPARTMENT. - MEDICARE PATIENTS 45% - MEDICAID PATIENTS 13.4% - SELF-PAY PATIENTS 6% THE DEMOGRAPHIC MAKEUP OF THE HOSPITAL'S COMMUNITY IS AS FOLLOWS: - POPULATION 193,283 - POPULATION OVER 65 13.0% - POVERTY (BELOW 100% FPL) 19.6% - UNEMPLOYMENT RATE 8.4% - VIOLENT CRIME RATE (PER 100,000 POP.) 266.1 - POP. AGE 25+ WITH NO HIGH SCHOOL DIPLOMA 28.9% - UNINSURED ADULTS 24.8% - UNINSURED CHILDREN 8.5% - FOOD INSECURITY RATE 14.4% - POP. WITH LOW FOOD ACCESS 21.7%ADVENTIST HEALTH SYSTEM GEORGIA, INC., DBA ADVENTHEALTH MURRAY (AHM), IS A 42-BED COMMUNITY HOSPITAL THAT SERVES THE RESIDENTS OF CHATSWORTH, MURRAY COUNTY AND SURROUNDING AREAS IN GEORGIA. ADVENTHEALTH MURRAY OFFERS MULTIPLE SERVICES FOR THE RESIDENTS OF MURRAY COUNTY. THESE SERVICES INCLUDE: 24-HOUR EMERGENCY DEPARTMENT, IMAGING SERVICES, INPATIENT SERVICES, LABORATORY, EMS, ORTHOPEDICS, RESPIRATORY THERAPY, PHYSICAL THERAPY, SPORTS MEDICINE AND SURGICAL SERVICES.IN ADDITION, ADVENTHEALTH MURRAY PARTNERS WITH ADVENTHEALTH GORDON TO PROVIDE THE FOLLOWING SERVICES: CANCER CARE, CARDIAC REHABILITATION, EYE CARE, FAMILY MEDICINE, HOME CARE, HYPERBARIC MEDICINE, INTERNAL MEDICINE, OB/GYN/LABOR & DELIVERY, PEDIATRICS, PHYSICAL THERAPY, ROBOTIC-ASSISTED SURGERY, SLEEP DISORDERS, SPORTS MEDICINE, URGENT CARE, UROLOGY, WOMEN'S HEALTH SERVICES AND WOUND CARE.ADVENTHEALTH MURRAY DEFINED ITS COMMUNITY AS ITS PRIMARY SERVICE AREA (PSA) FROM WHICH 75-80% OF ITS PATIENTS COME. THIS AREA INCLUDES ALL ZIP CODES LOCATED WITHIN MURRAY COUNTY.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 98.2% OF THE HOSPITAL'S IN-PATIENTS WERE ADMITTED THROUGH THE HOSPITAL'S EMERGENCY DEPARTMENT. - MEDICARE PATIENTS 40.6% - MEDICAID PATIENTS 19.0% - SELF-PAY PATIENTS 8.3% THE DEMOGRAPHIC MAKEUP OF THE HOSPITAL'S COMMUNITY IS AS FOLLOWS: - POPULATION 111,716 - POPULATION OVER 65 12.4% - POVERTY (BELOW 100% FPL) 24.3% - UNEMPLOYMENT RATE 9.5% - VIOLENT CRIME RATE (PER 100,000 POP.) 203.7 - POP. AGE 25+ WITH NO HIGH SCHOOL DIPLOMA 35.5% - UNINSURED ADULTS 23.0% - UNINSURED CHILDREN 7.9% - FOOD INSECURITY RATE 15.9% - POP. WITH LOW FOOD ACCESS 26.3%

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"THE PROVISION OF COMMUNITY BENEFIT IS CENTRAL TO THE FILING ADVENTIST HEALTH SYSTEM GEORGIA, INC.'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 $189,142 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 $7,483,837 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."

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ADVENTIST HEALTH SYSTEM GEORGIA, INC. 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.