2024-05-15T15:53:57-05:00 2023-06-30 990 2022-07-01 840438224 Portercare Adventist Health System PORT 3037656861 6061 S Willow Drive Greenwood Village CO 80111 Lynn C Addiscott Assistant Secretary 4073572317 2024-05-15 Lynn Addiscott 999009999 0 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z X Brett Spenst 6061 S Willow Drive Greenwood Village CO 80111 1539602702 0 1071 X https://www.adventhealth.com X 1930 CO Our company, a faith based organization, invests in charity care, community programs and sponsorships designed to nurture the health of the people of Colorado with a goal to keep them healthy. 5 2 6878 706 2475839 0 12381852 352291 1434991828 1514190632 26031640 11152807 10822520 10341453 1484227840 1536037183 1986824 2386590 0 0 522499302 571928748 0 0 0 845590567 894231813 1370076693 1468547151 114151147 67490032 1937409919 1992859331 503031555 499722731 1434378364 1493136600 We extend the healing ministry of Christ by caring for those who are ill and by nurturing the health of the people in our communities. 0 0 1241321768 2386589 1522056246 Operation of 5 acute care hospitals with 34,115 patient admissions, 149,432 patient days and 302,938 outpatient visits in the current year. In addition to hospital operations, the corporation provides medical care through a number of other activities such as urgent care centers, physician clinics, home health services, hospice services, sleep centers, wound centers, therapy and rehab. 1241321768 1 1 0 1 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 X 0 0 1 6878 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 5 2 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 0 X Jeremy Pittman 3036431229 6061 S Willow Drive Greenwood Village CO 80111 Rathbun Paul Board Member / AH CFO 1.00 50.00 X 0 2536010 211956 Bacon Kenneth Board Chairman/AH CEO Multi State 5.00 45.00 X 0 1621638 290272 Houmann Lars Board Member 1.00 1.00 X 0 682872 13112 Thurber Gary Board Member 1.00 3.00 X 0 6063 0 Thurber John Mic Board Member 1.00 2.00 X 0 5088 0 Enderson Dan Secretary-Group President 5.00 45.00 X 0 1659367 256943 Gaasch Andrew Treasurer/CFO 5.00 45.00 X 0 1263429 215974 Goebel Michael CEO Parker Adventist Hospital 50.00 0.00 X 0 879818 135883 Folkenberg Todd CEO Porter Adventist Hospital 50.00 0.00 X 0 759525 134932 Sendros Isaac CEO Avista Adv Hosp(end 2/23) 50.00 0.00 X 0 550929 107665 Pittman Jeremy CEO Castle Rock Adv Hospital 50.00 0.00 X 0 441716 89615 Travis Carol CFO Avista Adv Hospital 50.00 0.00 X 0 353151 36569 Ward Erin CFO Parker Adv Hospital 50.00 0.00 X 0 347363 7212 Whitlock Andrew CFO Porter Adv Hosp(beg 12/22) 50.00 0.00 X 0 194516 36569 Dodds Rick CEO Littleton Adv Hospital 50.00 0.00 X 0 794364 76509 Gal Matt CFO Castle Rock Adv Hospital 50.00 0.00 X 0 272573 8095 Still Danae CFO Littleton(beg 2/23) 50.00 0.00 X 0 230466 40111 Miner MD Todd Orthopedic Surgeon 50.00 0.00 X 1200856 0 35142 Yang MD Charlie Orthopedic Surgeon 50.00 0.00 X 1216204 0 37920 Jennings MD Jason Orthopedic Surgeon 50.00 0.00 X 1398131 0 41270 Sanchez II MD Anthony Orthopedic Surgeon 50.00 0.00 X 1107538 0 37656 Rajpal Sharad Neuro Surgeon 50.00 0.00 X 1004601 0 11942 Banko Peter Former President CHC 0.00 50.00 X 0 3734177 771093 Dean Morre Former Officer/CIO 0.00 0.00 X 0 588393 22337 Huenergardt Samuel Former Key Emp/CEO Mid-America 0.00 50.00 X 0 1080966 193052 McKinney Jillyan Former Key Emp/CEO AHMG Central FL 0.00 0.00 X 0 636517 128575 Fisher Jonathan Former Key Emp/CFO Wesley 0.00 50.00 X 0 345345 103582 Beckner Michelle Former CFO Littleton 0.00 0.00 X 0 319429 31708 5927330 19303715 3075694 859 1 1 0 South Denver Cardiology Associates PC 1000 SouthPark Dr Littleton CO 80120 Cardiology Services 31560728 Neurosurgery One 7780 S Broadway Ste 350 Littleton CO 80122 Neuro/Spine Services 10011094 HSS Security 1395 S Platte River Dr Denver CO 80223 Security Services 5659856 Peak Gastroenterology Associates 2920 N Cascade 3rd Floor Colorado Springs CO 80907 Gastroenterology Services 5219842 CHER LLC PO Box 30 Denver CO 80201 Imaging Services 3511686 80 X 352291 352291 Net Patient Revenue 622110 1500378035 1500378035 Cafeteria Revenue 622110 3664670 3664670 Pharmacy Revenue 622110 3641381 1450063 2191318 Medical Office Building Rentals 622110 3278518 2993997 284521 Ins Bus Interrupt - Fires 622110 1575003 1575003 1653025 1653025 1514190632 6949028 6949028 119928 19575 100353 100353 100353 7749723 2851442 694502 -2851442 7055221 4203779 4203779 Equity Earnings Subsidiaries 622110 10241100 10241100 10241100 1536037183 1522056246 2475839 11152807 X 2386590 2386590 5227004 5227004 462575622 428871693 33703929 16201326 14873157 1328169 56320519 51224167 5096352 31604277 29013390 2590887 175810 175810 452111 452111 825764 825764 347307805 183893004 163414801 3151870 3151870 23314091 18473234 4840857 6988494 6496504 491990 32973711 32973711 652106 456734 195372 1146474 1146474 8804129 8804129 89618574 89618574 9692049 9426016 266033 Medical Supplies 252424132 252424132 State Assessment 85625872 85625872 Repairs and Maintenance 24599884 24599884 True Up w/related tax-e 3037113 3037113 3441824 2160977 1280847 1468547151 1241321768 227225383 0 306130 1003815 22477017 124258532 236517398 239805770 4001223 3766019 39200742 38911389 19089282 17645096 1637969756 932276073 697119769 705693683 507537309 448880136 66309429 58030231 344851620 354864660 1937409919 1992859331 88786792 101057961 1470293 916807 412774470 397747963 503031555 499722731 X 1434274508 1493032744 103856 103856 1434378364 1493136600 1937409919 1992859331 X 67490032 2277871 -11009667 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 27732 27732 0 Part II-B, Line 1i, Lobbying Activities: American Hospital Association dues and Colorado Health Association dues. 4698235 229573 4927808 4012908 1050965 151945 517583 4698235 3870411 142497 4012908 3713610 156801 3870411 3529788 49444 134378 3713610 0.01790 0.70160 0.28050 1 1 1 134786913 134786913 935718205 533087764 402630441 464444401 373269372 91175029 103020237 25918937 77101300 705693683 Share of Parent Centralized Investment Pool 448880136 F 448880136 Investment in Subsidiaries 141888153 Other Receivables 144290 Due from Related 179207392 Receivable from Third Parties 3405764 Other Assets 1576602 Right-of-Use Asset-Operating Lease 28642459 354864660 Interco Alloc of TE Bond Proceeds 308422377 Malpractice Liability 50515057 Environmental Remediation 8537 Due to Related 3394764 Unemployment Claims Liability 74774 Credit Balances in A/R 5902830 Payable to Third Parties 384519 Operating Lease Liability 28878621 Accrued Interest Payable 166484 397747963 X Part V, Line 4: Rocky Mountain Adventist Healthcare Foundation (RMAHF), a related organization formed and maintained exclusively to further the exempt purpose of Portercare Adventist Health System (PAHS), held assets in temporary endowment and permanent endowment funds during the current tax year. RMAHF's endowment consists of individual donor restricted endowment funds and pledges receivable where the assets have been designated for endowment. Temporarily and Permanently restricted endowment funds are intended to benefit various programs and departments of the five Hospitals and its patients. The endowment funds held by RMAHF were inadvertently omitted from prior years' Form 990 of the taxpayer. Additional information became available in the current year that provided the amounts now reflected in Schedule D, Part V. Part X, Line 2: The filing organization is a subsidiary organization within AdventHealth. The consolidated financial statements of AdventHealth contain the following FIN 48 (ASC 740) footnote: Please note that dollar amounts are in thousands. Healthcare Corporation and its affiliated organizations, other than North American Health Services, Inc. and its subsidiary (NAHS), are exempt from state and federal income taxes. Accordingly, Healthcare Corporation and its tax-exempt affiliates are not subject to federal, state or local income taxes except for any net unrelated business taxable income. NAHS is a wholly owned, for-profit subsidiary of Healthcare Corporation. NAHS and its subsidiary are subject to federal and state income taxes. NAHS files a consolidated federal income tax return and, where appropriate, consolidated state income tax returns. All taxable income was fully offset by net operating loss carryforwards for federal income tax purposes; as such, there is no provision for current federal or state income tax for the years ended December 31, 2022 and 2021. NAHS also has temporary deductible differences of approximately $18,200 and $33,000 at December 31, 2022 and 2021, respectively, primarily as a result of net operating loss carryforwards. At December 31, 2022, NAHS had net operating loss carryforwards of approximately $10,000, expiring in 2023 through 2026. Deferred taxes have been provided for these amounts, resulting in a net deferred tax asset of approximately $4,500 and $8,100 at December 31, 2022 and 2021, respectively. NAHS remeasured its deferred tax assets and liabilities based on the rates at which they are expected to reverse in the future, which is generally 21%. A full valuation allowance has been provided at December 31, 2022 and 2021 to offset the deferred tax asset since Healthcare Corporation has determined that it is more likely than not that the benefit of the net operating loss carryforwards will not be realized in future years. The Income Taxes Topic of the Accounting Standards Codification (ASC) (ASC 740) prescribes the accounting for uncertainty in income tax positions recognized in financial statements. ASC 740 prescribes a recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken, or expected to be taken, in a tax return. There were no material uncertain tax positions as of December 31, 2022 and 2021. 1 1 X 1 X 250.000000000000 1 X 1 1 0 1 1 18601139 18601139 0.01270 280818283 177763471 103054812 0.07020 299419422 177763471 121655951 0.08290 937615 34869 902746 0.00060 17506 17506 0.00000 955121 34869 920252 0.00060 300374543 177798340 122576203 0.08350 233619 233619 0.00020 233619 233619 0.00020 1 -15936980 7556924 179678536 219483030 -39804494 X 1 1 1 Functional Neurosurgical Ambulatory Surgery Center LLC Surgery Center 0.51000 0.49000 2 Crown Point Surgery Center LLC Surgery Center 0.27930 0.41940 3 Flatirons Surgery Center LLC Surgery Center 0.25000 0.49900 4 Harvard Park Surgery Center LLC Surgery Center 0.25000 0.48500 5 South Denver Musculoskeletal Surgical Partners LLC Surgery Center 0.26850 0.46200 6 Summit View Surgery Center LLC Surgery Center 0.25000 0.45630 7 OnPoint OBGYN LLC OBGYN Center 0.51000 0.24500 5 1 Parker Adventist Hospital 9395 Crown Crest Blvd Parker CO 80138 https://www.adventhealth.com/hospital/ 1005 X X X A 2 Porter Adventist Hospital 2525 S Downing St Denver CO 80210 https://www.adventhealth.com/hospital/ 1036 X X X X A 3 Littleton Adventist Hospital 7700 S Broadway Littleton CO 80122 https://www.adventhealth.com/hospital/ 1034 X X X A 4 Avista Adventist Hospital 100 Health Park Drive Louisville CO 80027 https://www.adventhealth.com/hospital/ 90831 X X X A 5 Castle Rock Adventist Health Campus 2350 Meadows Blvd Castle Rock CO 80109 https://www.adventhealth.com/hospital/ 01L581 X X X A Facility Reporting Group A 0 0 1 X X X X X X X X X 21 1 0 0 1 X See Part V, Page 8 X 1 22 1 See Part V, Page 8 0 1 X 250.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X See Part V, Page 8 X See Part V, Page 8 X See Part V, Page 8 X X X X X X 1 X 0 X X X X 1 X 0 0 Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: Parker Adventist Hospital, - Facility 2: Porter Adventist Hospital, - Facility 3: Littleton Adventist Hospital, - Facility 4: Avista Adventist Hospital, - Facility 5: Castle Rock Adventist Health Campus Facility Reporting Group A Part V, Section B, line 5: In order to assess the needs of the community while conducting its fiscal year 2022 Community Health Needs Assessment (CHNA), the Hospitals received input from community-based organizations focused on health and social determinants of health regarding medically underserved, low-income and minority populations in the service area. Each Hospital conducted Community Health Needs Assessment Advisory Subcommittee meetings with community-based organizations in their respective communities. Organizations were identified based upon their connection with the community, including those serving people who are medically underserved and at greater risk of poor health and those organizations with influence on overall health in the community. Stakeholders provided input in multiple meetings to rank and prioritize health issues, identify both community assets and gaps, and to identify strategies for the health priorities. Lastly, the Hospitals engaged in the local County Health Departments and the Hospital Transformation Program Community and Health Neighborhood Engagement process focusing on the Medicaid population through which both community and Medicaid data were analyzed and focus groups were conducted. Schedule H, Part V, Section B, Line 7a, Hospital Facility CHNA Website Facility 1 - Parker Adventist Hospitalhttps://www.adventhealth.com/hospital/adventhealth-parker/community-health-needs-assessmentsFacility 2 - Porter Adventist Hospitalhttps://www.adventhealth.com/hospital/adventhealth-porter/community-health-needs-assessmentsFacility 3 - Littleton Adventist Hospitalhttps://www.adventhealth.com/hospital/adventhealth-littleton/community-health-needs-assessmentsFacility 4 - Avista Adventist Hospital https://www.adventhealth.com/hospital/adventhealth-avista/community-health-needs-assessmentsFacility 5 - Castle Rock Adentist Health Campushttps://www.adventhealth.com/hospital/adventhealth-castle-rock/community-health-needs-assessments Schedule H, Part V, Section B, Line 10: Each hospital facility's most recently adopted implementation strategy was made widely available through the following websites:Facility 1 - Parker Adventist Hospitalhttps://www.adventhealth.com/hospital/adventhealth-parker/community-health-needs-assessmentsFacility 2 - Porter Adventist Hospitalhttps://www.adventhealth.com/hospital/adventhealth-porter/community-health-needs-assessmentsFacility 3 - Littleton Adventist Hospitalhttps://www.adventhealth.com/hospital/adventhealth-littleton/community-health-needs-assessmentsFacility 4 - Avista Adventist Hospital https://www.adventhealth.com/hospital/adventhealth-avista/community-health-needs-assessmentsFacility 5 - Castle Rock Adentist Health Campushttps://www.adventhealth.com/hospital/adventhealth-castle-rock/community-health-needs-assessments Schedule H, Part V, Section B, Line 16a - c: Each hospital facility's FAP, FAP application form and plain language summary of the FAP was made widely available through the following websites:Facility 1 - Parker Adventist Hospitalhttps://www.mountain.commonspirit.org/patient-tools/billing-and-financial-servicesFacility 2 - Porter Adventist Hospitalhttps://www.mountain.commonspirit.org/patient-tools/billing-and-financial-servicesFacility 3 - Littleton Adventist Hospitalhttps://www.mountain.commonspirit.org/patient-tools/billing-and-financial-servicesFacility 4 - Avista Adventist Hospital https://www.mountain.commonspirit.org/patient-tools/billing-and-financial-servicesFacility 5 - Castle Rock Adentist Health Campushttps://www.mountain.commonspirit.org/patient-tools/billing-and-financial-services Schedule H, Part V, Section B, Line 11: The information provided below explains how each Hospital facility addressed in the fiscal year 2022 (year ended June 30, 2023) the significant health needs identified in its fiscal year 2022 Community Health Needs Assessment, any such needs that were not addressed, and the reasons why such needs were not addressed.This is the first-year update for the filing organization's fiscal year 2022-2024 (Calendar year 2023-2025) Community Health Implementation Plan. The filing organization developed this Plan and posted it by November 15, 2022 as part of its fiscal year 2022 Community Health Needs Assessment process. The following narrative describes the issues identified in fiscal year 2021 by each Hospital facility and gives an update on the strategies addressing those issues. There is also a description of the identified issues that the facilities are not addressing.Facility 1 - Parker Adventist Hospital Parker Adventist Hospital (PKAH) conducted its FY 2021 Community Health Needs Assessment (CHNA) through a collaborative partnership with Castle Rock Adventist Hospital and the Tri-County Public Health Departments. Both qualitative and quantitative primary and secondary data were gathered, along with numerous health indicators, and were prioritized by using a form of the Hanlon Method for Prioritizing Health Problems. Each identified need was rated against a) size, b) severity, and c) alignment with PKAH and community existing efforts. Total scores were compiled and resulted in the identification of the following prioritized health issues: Suicide Prevention, Substance Use Prevention, and Food Security. PKAH recognizes that focusing on a few health issues leads to greater progress than dispersing efforts across many issues. For each issue, best practices for screening and treatment as well as prevention through environmental and behavioral changes were identified.During fiscal year 2022, the following actions were taken with respect to Suicide Prevention. PKAH implemented the Zero Suicide Framework, a best practice to screen for the risk of suicide attempts and refer people to resources. As part of this work, PKAH implemented a pathway to care for patients that screen low on the C-SSRS. Patients who scored low were fast-tracked and then seen by behavioral health before medical clearance using the Safe-T model to see if an additional assessment was needed. If it was not needed, patients were given behavioral resources. If an additional screening was necessary, patients were seen by a member of the Crisis Assessment Team for a full safety assessment. Furthermore, while we currently don't have a suicide care pathway fully developed yet, current procedure is quite comprehensive. For example, patients are universally screened with the C-SSRS and then depending on the risk level, are put on a suicide care management pathway. If a patient scores low or moderate, a behavioral health clinician will assess them using the Safe-T. If a higher risk level is not determined, the patient will be discharged with at least 2 resources, automatic enrollment to Caring Contacts for follow-up care, and a referral to RMCP hospital follow-up program (if patient accepts). If a patient scores high, the patient will have a full safety assessment completed including Safe-T, Audit C+ Two, SBIRT, CALM (Counseling Access to Lethal Means) and a Stanley Brown Safety Plan (if discharged). Patients will either be discharged home or sent to a crisis stabilization unit, an acute treatment unit, or inpatient behavioral health unit based on risk assessment. Patients that are discharged home will receive at least 2 referrals, automatic enrollment into our Caring Contacts program for follow-up care, and a referral to RMCP Hospital Follow-Up program (if patient accepts). We recently were able to give patients access to their safety plans in their patient portal, as well as the hard copy provided at discharge. Primary care doctors also have the availability to review patient safety plans when patients have follow-up appointments if they are within the Rocky Mountain Region network. During this reporting period, the Rocky Mountain Region screened a total of 3,194 people for suicide risk, and 3,194 received a safety assessment. During this reporting period, we were unable to differentiate the screening rates just for PKAH. In reporting year 2023, we will have an improved tracking method.We also understand that there needs to be a focus on training in evidence-based approaches to suicide prevention. In partnership with community-based organizations, 2,964 community clinical staff were trained, and 32 non-clinical community staff were trained. Training focused on the following programs: Assessing and Managing Suicide Risk (AMSR), Applied Suicide Intervention Skills Training (ASIST), Collaborative Assessment and Management of Suicidality (CAMS), Columbia Suicide Severity Rating Scale (CSSRS), Counseling on Access to Lethal Means (CALM), Dialectical Behavioral Therapy (DBT), LivingWorks Start or QPR, Mental Health First Aid (MHFA), Safety Planning, FAITH, VA Cultural Competency, VA Substance Abuse Training, Resiliency Training, and Gender Bias.For Substance Use Prevention, the Alternatives to Opioids (ALTO) program is being conducted by PKAH to help prevent opioid addiction. PKAH participated in the Let's Talk Campaign, done in partnership with other organizations in the community, to reduce the stigma associated with mental health and has established partnerships with other community-based organizations that reach black and LatinX communities. PKAH also participated in the Lift The Label Campaign. Lift The Label is a public awareness campaign that strives to remove damaging labels and stigmas that prevent those with opioid addiction from seeking effective treatment.With respect to the prioritized need of Food Security, the PKAH identified food insecurity risk in 117 households. These households were provided with local resources to help meet their unique needs. PKAH partnered to conduct Double Up Food Bucks outreach to increase the number of people using this program so that lower income families can purchase produce and increase the number of businesses offering the program. We also established a partnership with Nourish Colorado, an anti-hunger organization, to increase the number of stores accepting SNAP/WIC in communities. This program activated Community Health Navigators that focused on training and educating eligible bodegas on public assistance resources that would allow them to accept SNAP/WIC benefits.PKAH did not address the following identified health issues due to limited resources and the availability of other community organizations to address such needs: Intentional Injury, Access to Oral Health, and Access to Primary Care.See Continuation Schedule H, Part V, Section B, Line 11: - continuation Facility 2 - Porter Adventist HospitalPorter Adventist Hospital (PAH) conducted its FY 2021 Community Health Needs Assessment (CHNA) through a collaborative partnership with Littleton Adventist Hospital and the Denver and Tri-County Public Health Departments. Both qualitative and quantitative primary and secondary data were gathered, along with numerous health indicators, and were prioritized by using a form of the Hanlon Method for Prioritizing Health Problems. Each identified need was rated against a) size, b) severity, and c) alignment with PAH and community existing efforts. Total scores were compiled and resulted in the identification of the following prioritized health issues: Suicide Prevention, Substance Use Prevention, and Food Security. PAH recognizes that focusing on a few health issues leads to greater progress than dispersing efforts across many issues. For each issue, best practices for screening and treatment as well as prevention through environmental and behavioral changes were identified.During fiscal year 2022, the following actions were taken with respect to Suicide Prevention. PAH implemented the Zero Suicide Framework, a best practice to screen for the risk of suicide attempts and refer people to resources. As part of this work, PAH implemented a pathway to care for patients who screen low on the C-SSRS. Patients who scored low were fast-tracked and then seen by behavioral health before medical clearance using the Safe-T model to see if an additional assessment was needed. If it was not needed, patients were given behavioral resources. If an additional screening was necessary, patients were seen by a member of the Crisis Assessment Team for a full safety assessment. Furthermore, while we currently don't have a suicide care pathway fully developed yet, the current procedure is quite comprehensive. For example, patients are universally screened with the C-SSRS and then depending on the risk level, are put on a suicide care management pathway. If a patient scores low or moderate, a behavioral health clinician will assess them using the Safe-T. If a higher risk level is not determined, the patient will be discharged with at least 2 resources, automatic enrollment to Caring Contacts for follow-up care, and a referral to RMCP hospital follow-up program (if patient accepts). If a patient scores high, the patient will have a full safety assessment completed including Safe-T, Audit C+ Two, SBIRT, CALM (Counseling Access to Lethal Means) and a Stanley Brown Safety Plan (if discharged). Patients will either be discharged home or sent to a crisis stabilization unit, an acute treatment unit, or inpatient behavioral health unit based on risk assessment. Patients that are discharged home will receive at least 2 referrals, automatic enrollment into our Caring Contacts program for follow-up care, and a referral to RMCP Hospital Follow-Up program (if patient accepts). We recently were able to give patients access to their safety plans in their patient portal, as well as the hard copy provided at discharge. Primary care doctors also have the availability to review patient safety plans when patients have follow-up appointments if they are within the Rocky Mountain Region network. During this reporting period, the Rocky Mountain Region screened a total of 3,194 people for suicide risk, and 3,194 received a safety assessment. During this reporting period, we were unable to differentiate the screening rates just for PAH. In reporting year 2023, we will have an improved tracking method.We also understand that there needs to be a focus on training in evidence-based approaches to suicide prevention. In partnership with community-based organizations, 2,964 community clinical staff were trained, and 32 non-clinical community staff were trained. The training focused on the following programs: Assessing and Managing Suicide Risk (AMSR), Applied Suicide Intervention Skills Training (ASIST), Collaborative Assessment and Management of Suicidality (CAMS), Columbia Suicide Severity Rating Scale (CSSRS), Counseling on Access to Lethal Means (CALM), Dialectical Behavioral Therapy (DBT), LivingWorks Start or QPR, Mental Health First Aid (MHFA), Safety Planning, FAITH, VA Cultural Competency, VA Substance Abuse Training, Resiliency Training, and Gender Bias.For Substance Use Prevention, the Alternatives to Opioids (ALTO) program is being conducted by PAH to help prevent opioid addiction. PAHS participated in the Let's Talk Campaign, done in partnership with other organizations in the community, to reduce the stigma associated with mental health and has established partnerships with other community-based organizations that reach black and LatinX communities. PAH also participated in the Lift The Label Campaign. Lift The Label is a public awareness campaign that strives to remove damaging labels and stigmas that prevent those with opioid addiction from seeking effective treatment.With respect to the prioritized need of Food Security, PAH identified food insecurity risk in 147 households by utilizing a social determinants of health screening tool. These households were provided local resources to help meet their unique needs. PAH also partnered to conduct Double Up Food Bucks outreach to increase the number of people using this program for lower income families to purchase produce and increase the number of businesses offering the program. We also established a partnership with Nourish Colorado, an anti-hunger organization, to increase the number of stores accepting SNAP/WIC in communities. This program activated Community Health Navigators that focused on training and educating eligible bodegas on public assistance resources that would allow them to accept SNAP/WIC benefits.PAH did not address intentional injury or health equity as prioritized identified health issues due to limited resources and the availability of other community organizations to address such needs.See continuation Schedule H, Part V, Section B, Line 11: - continuation Facility 3 - Littleton Adventist HospitalLittleton Adventist Hospital (LAH) conducted its FY 2021 Community Health Needs Assessment (CHNA) through a collaborative partnership with Porter Adventist Hospital and the Denver and Tri-County Public Health Departments. Both qualitative and quantitative primary and secondary data were gathered, along with numerous health indicators, and were prioritized by using a form of the Hanlon Method for Prioritizing Health Problems. Each identified need was rated against a) size, b) severity, and c) alignment with LAH and community existing efforts. Total scores were compiled and resulted in the identification of the following prioritized health issues: -Suicide Prevention, Housing Stability, and Food Security. LAH recognizes that focusing on a few health issues leads to greater progress than dispersing efforts across many issues. For each issue, best practices for screening and treatment, as well as prevention through environmental and behavioral changes, were identified.During fiscal year 2022, the following actions were taken with respect to Suicide Prevention. LAH implemented the Zero Suicide Framework, a best practice to screen for the risk of suicide attempts and refer people to resources. As part of this work, LAH implemented a pathway to care for patients who screen low on the C-SSRS. Patients who scored low were fast-tracked and then seen by behavioral health before medical clearance using the Safe-T model to see if an additional assessment was needed. If it was not needed, patients were given behavioral resources. If an additional screening was necessary, patients were seen by a member of the Crisis Assessment Team for a full safety assessment. Furthermore, while we currently don't have a suicide care pathway fully developed yet, the current procedure is quite comprehensive. For example, patients are universally screened with the C-SSRS and then depending on the risk level, are put on a suicide care management pathway. If a patient scores low or moderate, a behavioral health clinician will assess them using the Safe-T. If a higher risk level is not determined, the patient will be discharged with at least 2 resources, automatic enrollment to Caring Contacts for follow-up care, and a referral to RMCP hospital follow-up program (if patient accepts). If a patient scores high, the patient will have a full safety assessment completed including Safe-T, Audit C+ Two, SBIRT, CALM (Counseling Access to Lethal Means) and a Stanley Brown Safety Plan (if discharged). Patients will either be discharged home or sent to a crisis stabilization unit, an acute treatment unit, or inpatient behavioral health unit based on risk assessment. Patients that are discharged home will receive at least 2 referrals, automatic enrollment into our Caring Contacts program for follow-up care, and a referral to RMCP Hospital Follow-Up program (if patient accepts). We recently were able to give patients access to their safety plans in their patient portal, as well as the hard copy provided at discharge. Primary care doctors also have the availability to review patient safety plans when patients have follow-up appointments if they are within the Rocky Mountain Region network. During this reporting period, the Rocky Mountain Region screened a total of 3,194 people for suicide risk, and 3,194 received a safety assessment. During this reporting period, we were unable to differentiate the screening rates just for LAH. In reporting year 2023, we will have an improved tracking method.We also understand that there needs to be a focus on training in evidence-based approaches to suicide prevention. In partnership with community-based organizations, 2,964 community clinical staff were trained, and 32 non-clinical community staff were trained. Training focused on the following programs: Assessing and Managing Suicide Risk (AMSR), Applied Suicide Intervention Skills Training (ASIST), Collaborative Assessment and Management of Suicidality (CAMS), Columbia Suicide Severity Rating Scale (CSSRS), Counseling on Access to Lethal Means (CALM), Dialectical Behavioral Therapy (DBT), LivingWorks Start or QPR, Mental Health First Aid (MHFA), Safety Planning, FAITH, VA Cultural Competency, VA Substance Abuse Training, Resiliency Training, and Gender Bias.With respect to the prioritized need of Housing Stability, LAH identified housing instability risk in 128 households by utilizing a social determinants of health screening tool. These households were provided local resources to help meet their unique needs. Furthermore, the Hospital partnered with a local housing coalition made up of 30+ housing organizations that aim to prevent homelessness, and coordinate services for eligible households.With respect to the prioritized need of Food Security, LAH identified food insecurity risk in 123 households by utilizing a social determinants of health screening tool. These households were provided with local resources to help meet their unique needs. LAH partnered to conduct Double Up Food Bucks outreach to increase the number of people using this program so that lower income families can purchase produce and increase the number of businesses offering the program. LAH also established a partnership with Nourish Colorado, an anti-hunger organization, to increase the number of stores accepting SNAP/WIC in communities. This program activated Community Health Navigators that focused on training and educating eligible bodegas on public assistance resources that would allow them to accept SNAP/WIC benefits.LAH did not address the following identified health issues due to limited resources and the availability of other community organizations to address such needs: Intentional Injury, Substance Abuse, and Access to Primary Care.See continuation Schedule H, Part V, Section B, Line 11: - continuation Facility 4 - Avista Adventist HospitalAvista Adventist Hospital (AAH) conducted its FY 2021 Community Health Needs Assessment (CHNA) through a collaborative partnership with the Boulder County Public Health Department, Broomfield Public Health, and community stakeholders. Both qualitative and quantitative primary and secondary data were gathered, along with numerous health indicators, and were prioritized by using a form of the Hanlon Method for Prioritizing Health Problems. Each identified need was rated against a) size, b) severity, and c) alignment with AAH and community existing efforts. Total scores were compiled and resulted in the identification of the following prioritized health issues: Suicide Prevention, Housing Stability, and Food Security. AAH recognizes that focusing on a few health issues leads to greater progress than dispersing efforts across many issues. For each issue, best practices for screening and treatment as well as prevention through environmental and behavioral changes were identified.During fiscal year 2022, the following actions were taken with respect to Suicide Prevention. AAH implemented the Zero Suicide Framework, a best practice to screen for the risk of suicide attempts and refer people to resources. As part of this work, AAH implemented a pathway to care for patients who screen low on the C-SSRS. Patients who scored low were fast-tracked and then seen by behavioral health before medical clearance using the Safe-T model to see if an additional assessment was needed. If it was not needed, patients were given behavioral resources. If an additional screening was necessary, patients were seen by a member of the Crisis Assessment Team for a full safety assessment. Furthermore, while we currently don't have a suicide care pathway fully developed yet, the current procedure is quite comprehensive. For example, patients are universally screened with the C-SSRS and then depending on the risk level, are put on a suicide care management pathway. If a patient scores low or moderate, a behavioral health clinician will assess them using the Safe-T. If a higher risk level is not determined, the patient will be discharged with at least 2 resources, automatic enrollment to Caring Contacts for follow-up care, and a referral to RMCP hospital follow-up program (if patient accepts). If a patient scores high, the patient will have a full safety assessment completed including Safe-T, Audit C+ Two, SBIRT, CALM (Counseling Access to Lethal Means) and a Stanley Brown Safety Plan (if discharged). Patients will either be discharged home or sent to a crisis stabilization unit, an acute treatment unit, or inpatient behavioral health unit based on risk assessment. Patients that are discharged home will receive at least 2 referrals, automatic enrollment into our Caring Contacts program for follow-up care, and a referral to RMCP Hospital Follow-Up program (if patient accepts). We recently were able to give patients access to their safety plans in their patient portal, as well as the hard copy provided at discharge. Primary care doctors also have the availability to review patient safety plans when patients have follow-up appointments if they are within the Rocky Mountain Region network. During this reporting period, the Rocky Mountain Region screened a total of 3,194 people for suicide risk, and 3,194 received a safety assessment. During this reporting period, we were unable to differentiate the screening rates just for AAH. In the reporting year 2023, we will have an improved tracking method.We also understand that there needs to be a focus on training in evidence-based approaches to suicide prevention. In partnership with community-based organizations, 2,964 community clinical staff were trained, and 32 non-clinical community staff were trained. The training focused on the following programs: Assessing and Managing Suicide Risk (AMSR), Applied Suicide Intervention Skills Training (ASIST), Collaborative Assessment and Management of Suicidality (CAMS), Columbia Suicide Severity Rating Scale (CSSRS), Counseling on Access to Lethal Means (CALM), Dialectical Behavioral Therapy (DBT), LivingWorks Start or QPR, Mental Health First Aid (MHFA), Safety Planning, FAITH, VA Cultural Competency, VA Substance Abuse Training, Resiliency Training, and Gender Bias.With respect to the prioritized need of Housing Stability, the Hospital identified housing instability risk in 138 households by utilizing a social determinants of health screening tool. These households were provided local resources to help meet their unique needs.For Food Security, the Hospital identified food insecurity risk in 136 households by utilizing a social determinants of health screening tool. These households were provided with local resources to help meet their unique needs. AAH partnered to conduct Double Up Food Bucks outreach to increase the number of people using this program so that lower income families can purchase produce and increase the number of businesses offering the program. We also established a partnership with Nourish Colorado, an anti-hunger organization, to increase the number of stores accepting SNAP/WIC in communities. This program activated Community Health Navigators that focused on training and educating eligible bodegas on public assistance resources that would allow them to accept SNAP/WIC benefits.AAH did not address the identified health issue of Access to Primary Care due to limited resources and other organizations that address these needs.See continuation Schedule H, Part V, Section B, Line 11: - continuation Facility 5 - Castle Rock Adventist HospitalCastle Rock Adventist Hospital (CRAH) conducted its FY 2021 Community Health Needs Assessment (CHNA) through a collaborative partnership with Parker Adventist Hospital and Tri-County Public Health Departments. Both qualitative and quantitative primary and secondary data were gathered, along with numerous health indicators, and were prioritized by using a form of the Hanlon Method for Prioritizing Health Problems. Each identified need was rated against a) size, b) severity, and c) alignment with CRAH and community existing efforts. Total scores were compiled and resulted in the identification of the following prioritized health issues: Suicide Prevention, Substance Use Prevention, and Food Security. CRAH recognizes that focusing on a few health issues leads to greater progress than dispersing efforts across many issues. For each issue, best practices for screening and treatment as well as prevention through environmental and behavioral changes were identified.During fiscal year 2022, the following actions were taken with respect to Suicide Prevention. CRAH implemented the Zero Suicide Framework, a best practice to screen for the risk of suicide attempts and refer people to resources. As part of this work, CRAH implemented a pathway to care for patients who screen low on the C-SSRS. Patients who scored low were fast-tracked and then seen by behavioral health before medical clearance using the Safe-T model to see if an additional assessment was needed. If it was not needed, patients were given behavioral resources. If an additional screening was necessary, patients were seen by a member of the Crisis Assessment Team for a full safety assessment. Furthermore, while we currently don't have a suicide care pathway fully developed yet, the current procedure is quite comprehensive. For example, patients are universally screened with the C-SSRS and then depending on the risk level, are put on a suicide care management pathway. If a patient scores low or moderate, a behavioral health clinician will assess them using the Safe-T. If a higher risk level is not determined, the patient will be discharged with at least 2 resources, automatic enrollment to Caring Contacts for follow-up care, and a referral to RMCP hospital follow-up program (if patient accepts). If a patient scores high, the patient will have a full safety assessment completed including Safe-T, Audit C+ Two, SBIRT, CALM (Counseling Access to Lethal Means) and a Stanley Brown Safety Plan (if discharged). Patients will either be discharged home or sent to a crisis stabilization unit, an acute treatment unit, or inpatient behavioral health unit based on risk assessment. Patients that are discharged home will receive at least 2 referrals, automatic enrollment into our Caring Contacts program for follow-up care, and a referral to RMCP Hospital Follow-Up program (if patient accepts). We recently were able to give patients access to their safety plans in their patient portal, as well as the hard copy provided at discharge. Primary care doctors also have the availability to review patient safety plans when patients have follow-up appointments if they are within the Rocky Mountain Region network. During this reporting period, the Rocky Mountain Region screened a total of 3,194 people for suicide risk, and 3,194 received a safety assessment. During this reporting period, we were unable to differentiate the screening rates just for CRAH. In reporting year 2023, we will have an improved tracking method.We also understand that there needs to be a focus on training in evidence-based approaches to suicide prevention. In partnership with community-based organizations, 2,964 community clinical staff were trained, and 32 non-clinical community staff were trained. The training focused on the following programs: Assessing and Managing Suicide Risk (AMSR), Applied Suicide Intervention Skills Training (ASIST), Collaborative Assessment and Management of Suicidality (CAMS), Columbia Suicide Severity Rating Scale (CSSRS), Counseling on Access to Lethal Means (CALM), Dialectical Behavioral Therapy (DBT), LivingWorks Start or QPR, Mental Health First Aid (MHFA), Safety Planning, FAITH, VA Cultural Competency, VA Substance Abuse Training, Resiliency Training, and Gender Bias.For Substance Use Prevention, the Alternatives to Opioids (ALTO) program is being conducted by CRAH to help prevent opioid addiction. CRAH participated in the Let's Talk Campaign, done in partnership with other organizations in the community, to reduce stigma associated with mental health and has established partnerships with other community-based organizations that reach black and LatinX communities. CRAH also participated in the Lift The Label Campaign. Lift The Label is a public awareness campaign that strives to remove damaging labels and stigmas that prevent those with opioid addiction from seeking effective treatment.With respect to the prioritized need of Food Security, the Hospital identified food insecurity risk in 77 households by utilizing a social determinants of health screening tool. These households were provided local resources to help meet their unique needs. CRAH partnered to conduct Double Up Food Bucks outreach to increase the number of people using this program for lower income families to purchase produce and increase the number of businesses offering the program. CRAH also established a partnership with Nourish Colorado, an anti-hunger organization, to increase the number of stores accepting SNAP/WIC in communities. This program activated Community Health Navigators that focused on training and educating eligible bodegas on public assistance resources that would allow them to accept SNAP/WIC benefits.CRAH did not address the following identified health issues due to limited resources and the availability of other community organizations to address such needs: Intentional Injury, Access to Oral Health, and Access to Primary Care. 68 1 - CHPG WOMENS HLTH AT Littleton 7720 S Broadway Ste 250 Littleton CO 801222634 Healthcare Services Clinic 2 - Southmoor ER and Urgent Care 7000 E Hampden Ave Denver CO 80224 Healthcare Urgent Care Clinic 3 - OnPoint OBGYN LLC 7780 S Broadway Ste 280 Littleton CO 80122 Healthcare Services Clinic 4 - Centura Health Emergency And Urgent Care M 9949 S Oswego St Ste 100 Parker CO 80134 Healthcare Urgent Care Clinic 5 - Centura Orthopedic & Spine Primary Care 9949 S Oswego St Ste 200 Parker CO 80134 Healthcare Services Clinic 6 - CHPG Primary Care Southmoor 5570 DTC PARKWAY Greenwood Village CO 80111 Healthcare Services Clinic 7 - CHPG RIDGEGATE OBGYN AT LONE TREE 9695 S Yosemite St Ste 255B Lone Tree CO 80124 Healthcare Services Clinic 8 - CHPG NEUROSURGERY ONE 7780 S Broadway Ste 350 Littleton CO 801222633 Healthcare Services Clinic 9 - PINNACLE WOMEN'S HEALTHCARE AT PARKER 9403 Crown Crest Blvd Ste 200 Parker CO 80138 Healthcare Services Clinic 10 - Colorado Joint Replacement 2535 S Downing St Ste 100 Denver CO 80210 Healthcare Services Clinic 11 - INTEGRATED OBGYN AT PARKER 9403 Crown Crest Blvd Ste 200 Parker CO 80138 Healthcare Services Clinic 12 - Functional Neurosurgical Ambulatory Surger 11 W Dry Creek Circle Ste 120 Littleton CO 80120 Healthcare Services Clinic 13 - Centura Spine & Neurosurgical Associates L 90 Health Park Dr Ste 350 Louisville CO 800279742 Healthcare Services Clinic 14 - Centura Orthopedic & Spine 2352 Meadows Blvd Ste 300 Castle Rock CO 801098419 Healthcare Services Clinic 15 - PAHS OnPoint Urgent Care LLC 9205 S Broadway Highlands Ranch CO 80129 Healthcare Urgent Care Clinic 16 - CHPG Primary Care Church Ranch 7233 Church Ranch Blvd Ste C Westminster CO 800214094 Healthcare Services Clinic 17 - TIMBERVIEW CLINIC AT PARKER 9403 Crown Crest Blvd Ste 300 Parker CO 80138 Healthcare Services Clinic 18 - Primary Care (Harvard Park) 950 E Harvard Ave Ste 200 Denver CO 80210 Healthcare Services Clinic 19 - CAH HealthFit Medical Professionals & Fitn 2356 Meadows Blvd Ste 140B Castle Rock CO 80109 Healthcare Services Clinic 20 - PORTER HOSPICE 5020 E ARAPAHOE RD Centennial CO 80111 Hospice Services 21 - CHPG INTERNAL MEDICINE PARKER 9403 Crown Crest Blvd Ste 300 Parker CO 80138 Healthcare Services Clinic 22 - PAHS OnPoint Urgent Care LLC 24300 E Smoky Hill Rd Aurora CO 80016 Healthcare Urgent Care Clinic 23 - CHPG NORTHWEST GASTROENTEROLOGYDIMENSION 80 Health Park Dr Ste 270 Louisville CO 800279584 Healthcare Services Clinic 24 - COLORADO ENT SPECIALISTS 9403 Crown Crest Blvd Ste 300 Parker CO 80138 Healthcare Services Clinic 25 - CHPG Women's Health Porter 2555 S Downing St 1st Floor Denver CO 802105855 Healthcare Services Clinic 26 - CHPG Urology Castle Rock 2352 Meadows Blvd Ste 300 Urology Castle Rock CO 80109 Healthcare Services Clinic 27 - Cornerstar Primary CareWomen's Health 15901 E Briarwood Cir Ste 200 Aurora CO 80016 Healthcare Services Clinic 28 - RIDGELINE FAMILY MEDICINE 2352 Meadows Blvd Ste 300 Castle Rock CO 801098419 Healthcare Services Clinic 29 - HIGHLANDS RANCH MEDICAL ASSOCIATES 9137 S Ridgeline Blvd Ste 100 Highlands Ranch CO 801292395 Healthcare Services Clinic 30 - PAHS OnPoint Urgent Care LLC 9695 S Yosemite St Lone Tree CO 80124 Healthcare Urgent Care Clinic 31 - RIDGELINE FAMILY MEDICINE AT CASTLE PINES 250 Max Drive Ste 102 Castle Pines CO 801089518 Healthcare Services Clinic 32 - CHPG Primary Care Highlands 2490 W 26th Ave Ste A120 Denver CO 802115317 Healthcare Services Clinic 33 - Centura Gastroenterology Porter 2535 S Downing St Ste 410 Denver CO 802105850 Healthcare Services Clinic 34 - PAHS OnPoint Urgent Care LLC 10120 E Dry Creek Rd Englewood CO 80112 Healthcare Urgent Care Clinic 35 - Castle Rock CMG Internal Medicine 2352 Meadows Blvd Ste 300 Castle Rock CO 80109 Healthcare Services Clinic 36 - GRACE FAMILY PRACTICE 6909 S Holly Cir Ste 100 Centennial CO 801126300 Healthcare Services Clinic 37 - Aspen Creek Family Medicine 19461 E Parker Square Drive Ste A Parker CO 80134 Healthcare Services Clinic 38 - CHPG NEUROSURGERY ONE PARKER 9403 Crown Crest Blvd Ste 200 Parker CO 80138 Healthcare Services Clinic 39 - Centura Gastroenterology Castle Rock 2352 Meadows Blvd Ste 300 GI Castle Rock CO 801098419 Healthcare Services Clinic 40 - PARKER PRIMARY CARE 9949 S Oswego St Ste 300 Parker CO 80134 Healthcare Services Clinic 41 - CHPG Colorado Comprehensive Spine 2535 S Downing Ste 180 Denver CO 80210 Healthcare Services Clinic 42 - SOUTH QUEBEC FAMILY MEDICINE 6081 S Quebec Street Ste 100 Centennial CO 80111 Healthcare Services Clinic 43 - SouthPark Internal Medicine 9088 South Ridgeline Blvd Ste 201 Highlands Ranch CO 80129 Healthcare Services Clinic 44 - AVISTA FAMILY MEDICINE ERIE 611 Mitchell Way 103 Erie CO 805165443 Healthcare Services Clinic 45 - CHPG COLORECTAL SURGERY AT PARKER 9403 Crown Crest Blvd Ste 200 Parker CO 80138 Healthcare Services Clinic 46 - CHPG Woodlands Primary Care 4345 Woodlands Blvd Ste 260 Castle Rock CO 80104 Healthcare Services Clinic 47 - Family Practice at Cherry Creek 425 S Cherry Street Suite 410 GLENDALE CO 80246 Healthcare Services Clinic 48 - PARKER GASTROENTEROLOGY MERIDIAN 9403 Crown Crest Blvd Ste 420 Parker CO 80138 Healthcare Services Clinic 49 - CHPG Gastroenterology Littleton 7780 S Broadway Ste 260 Littleton CO 801222633 Healthcare Services Clinic 50 - Centura Health Emergency and Urgent Care L 3280 S Wadsworth Blvd Lakewood CO 80227 Healthcare Urgent Care Clinic 51 - SOUTH SUBURBAN INTERNAL MEDICINE 7750 S Broadway Ste 150 Littleton CO 801222630 Healthcare Services Clinic 52 - NeurosurgeryOne Castle Rock 9695 S Yosemite St Ste 377 Lone Tree CO 80124 Healthcare Services Clinic 53 - Colorado NEUROVASCULAR SPEC PHYS 7780 S Broadway Ste 340 Littleton CO 801222633 Healthcare Services Clinic 54 - CMG PRIMARY CARE ELIZABETH 240 Elizabeth Street Unit B Elizabeth CO 80107 Healthcare Services Clinic 55 - CHPG Neurosurgical and Spine 850 E Harvard Ave Suite 255 Denver CO 80210 Healthcare Services Clinic 56 - Centura Pain Specialists Porter 2535 S Downing Ste 180F Denver CO 80210 Healthcare Services Clinic 57 - PAHS OnPoint Imaging LLC 9205 S Broadway Ste 101 Highlands Ranch CO 80129 Healthcare Services Clinic 58 - CHPG Primary Care Lafayette 511 Crossing Drive Ste 202 Lafayette CO 800262629 Healthcare Services Clinic 59 - CASTLE ROCK AFFILIATED ENT 2352 Meadows Blvd Ste 300 ENT Castle Rock CO 80109 Healthcare Services Clinic 60 - Primary Care at Green Valley Ranch 4809 Argonne St 200 Denver CO 80249 Healthcare Services Clinic 61 - Encompass Health Rehabilitation Hospital 1001 West Mineral Ave Littleton CO 80120 Rehabilitation Services 62 - Colorado Joint Replacement Lone Tree 9695 S Yosemite St Ste 255C Lone Tree CO 80124 Healthcare Services Clinic 63 - Portercare Health Professionals Billings 2900 12th Ave N 400 Billings MT 59707 Physician Clinic 64 - Portercare Health Professionals 315 N 25th St 201 Billings MT 59102 Physician Clinic 65 - Jason Jenings MD-Orthopedic Surgery 4028 Laramie Street Cheyenne WY 82001 Physician Clinic 66 - PAHS Physician Clinic 1760 Praire Ave Cheyenne WY 82009 Physician Clinic 67 - PAHS Physician Clinic 1141 Wilkins Circle Casper WY 82601 Physician Clinic 68 - PAHS Physician Clinic 640 Flormann St Rapid City SD 57701 Physician Clinic Part I, Line 6a: The filing organization operates as a part of Centura Health Corporation (Centura), a joint operating company that integrally manages a number of hospital and other healthcare provider facilities. All hospital organizations within Centura collect, calculate, and report the community benefits they provide to the communities they serve. Centura organizations exist solely to improve and enhance the local communities they serve. Centura 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 Centura 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 are posted on the filing organization's website. Part I, Line 7: Portercare Adventist Health System does not use a cost accounting system to determine the cost of charity care. The estimated cost of care is calculated as the ratio of each facility's total expenses to total gross revenue. Worksheet 2 was not used to develop the cost to charge ratio. There are no physician clinics included in subsidized health services. Part II, Community Building Activities: The costs of community building activities reported on Part II of Schedule H primarily represent the costs associated with providing education for the filing organization's staff physicians and employees. The filing organization's provision of these educational programs/activities to staff physicians and employees provides an opportunity for health care professionals to enhance their skills and expertise and keep up-to-date with the latest advancements in medical procedures and technology. In addition, training opportunities are often provided on-site at the filing organization's hospital facilities, thereby allowing for health care professionals to be more readily available to assist in meeting immediate patient care needs. Education and training provided to each facility's workforce is vital in assisting health care professionals directly involved in patient care with keeping abreast of the latest developments in their respective areas of expertise, learning possible new and innovative ways of delivering care to patients, and understanding the newest technologies available for the treatment of patients. Part III, Line 2: Portercare Adventist Health System (PAHS) uses the overall cost to gross charge ratio applicable to each facility to determine the costs in Part III Lines 2 and 3. PAHS automatically discounts all self pay patient accounts by 30% and also offers a prompt pay discount. This allowance is not included in the calculation of the cost of bad debts in instances where a patient does not pay his or her bill. Part III, Line 3: 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 24/7 emergency rooms providing care to all whom present. When a patient's arrival and/or admission to a 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 24/7 Emergency Departments that accept 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 Departments 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 Departments 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: 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 8-9. Please note that dollar amounts on the attached consolidated audited financial statements are in thousands. Part III, Line 8: Costing Methodology: Medicare allowable costs were calculated using a cost-to-charge ratio.Rationale for Including a Medicare Shortfall as Community Benefit:As a 501(c)(3) organization, the filing organization provides emergency and non-elective care to all regardless of ability to pay. All hospital services are provided in a non-discriminatory manner to patients who are covered beneficiaries under the Medicare program. As a public insurance program, Medicare provides a pre-established reimbursement rate/amount to health care providers for the services they provide to patients. In some cases, the reimbursement amount provided to a hospital may exceed its costs of providing a particular service or services to a patient. In other cases, the Medicare reimbursement amount may result in the hospital experiencing a shortfall of reimbursement received over costs incurred. In those cases where an overall shortfall is generated for providing services to all Medicare patients, the shortfall amount should be considered as a benefit to the community. Tax-exempt hospitals are required to accept all Medicare patients regardless of the profitability, or lack thereof, with respect to the services they provide to Medicare patients. The population of individuals covered under the Medicare program is sufficiently large so that the provision of services to the population is a benefit to the community and relieves the burdens of government. In those situations where the provision of services to the total Medicare patient population of a tax-exempt hospital during any year results in a shortfall of reimbursement received over the cost of providing care, the tax-exempt hospital has provided a benefit to a class of persons broad enough to be considered a benefit to the community. Despite a financial shortfall, a tax-exempt hospital must and will continue to accept and care for Medicare patients. Typically, tax-exempt hospitals provide health care services based upon an assessment of the health care needs of their community as opposed to their taxable counterparts where profitability often drives decisions about patient care services that are offered. Patient care provided by tax-exempt hospitals that results in Medicare shortfalls should be considered as providing a benefit to the community and relieving the burdens of government. Part 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 each hospital facility's office or department that can provide information about the Financial Assistance Policy, as well as contact information of each hospital facility's office or department that can provide assistance with the financial assistance application process or, alternatively, a nonprofit organization or governmental agency that can provide assistance with the financial assistance application process if the hospital facility is unable to do so. If an individual submits a complete FAA Form within a reasonable time-period as set forth in the notice described above, the hospital filing organization will suspend any adverse reporting to consumer credit reporting agencies/bureaus until a financial assistance policy eligibility determination can be made. Supplemental Schedule to Schedule H, Part III, Section B, Line 8: Reconciliation of Schedule H Reported Medicare Surplus/(Shortfall) to Unreimbursed Medicare Costs Associated with the Provision of ServicesTo All Medicare Beneficiaries:The Medicare revenue and allowable costs of care reported in Section B of Part III of Schedule H are based upon the amounts reported in the filing organization's Medicare cost report in accordance with the IRS instructions for Schedule H. On an annual basis, the filing organization also determines its total unreimbursed costs associated with providing services to all Medicare patients. Unreimbursed costs are considered a community benefit to the elderly and are combined into an annual Community Benefit Statement. The primary reconciling items between the Medicare surplus/(shortfall) shown on line 7 of Section B of Part III of Schedule H and the filing organization's unreimbursed costs of services provided to all Medicare patients are as follows:- Medicare surplus/(shortfall) shown on line 7 of Section B of Schedule H: $ (39,804,494)- Difference in costing methodology: (41,656,725)- Unreimbursed costs incurred for services provided to Medicare patients that are not included in the organization's Medicare cost report: (90,595,416) -------------Total Unreimbursed costs of serving all Medicare patients per the filing organization's communitybenefit reporting $ (172,056,635)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 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 filing organization's hospitals provide several services and resources to the communities they serve beyond the prioritized needs specifically identified in the Community Health Needs Assessments. They sponsor wellness events such as breast feeding education, asthma screenings, and financially support wellness initiatives of cities and public schools. They also provide transportation for low income patients and housing at no cost or very low cost for the families of low income patients of the hospitals that are far from their residence. They also support, financially and through volunteerism, initiatives such as soup kitchens and Meals on Wheels to provide food and nutrition education to address hunger issues. Hospital staff also volunteer to serve as preceptors for students of local health professional programs and serve on boards of local community organizations that provide social services to populations in need. Part VI, Line 3: The Financial Assistance Policy (FAP), Financial Assistance Application Form (FAA Form), and the Plain Language Summary of the Financial Assistance Policy (PLS) of the filing organization's hospital facilities are transparent and available to all individuals served at any point in the care continuum. The FAP, FAA Form, PLS, and contact information for each hospital facility's financial counselors are prominently and conspicuously posted on each filing organization's hospital facility's website. The websites indicate 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 each hospital facility (referred to below as LEP defined populations). Signage is displayed in public locations of each filing organization's hospital facility, including at all points of admission and registration and the Emergency Department. The signage contains each hospital facility's website address where the FAP, FAA Form, and PLS can be accessed and the telephone number and physical location that individuals can call or visit to obtain copies of the FAP, FAA Form and PLS or to obtain more information about the hospital facility's FAP, FAA Form and PLS. Paper copies of 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. Each of 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 each hospital facility's PLS will be offered to every patient as a part of the intake or discharge process. A conspicuous written notice is included on all billing statements sent to patients that notifies and informs recipients about the availability of financial assistance under the filing organization's financial assistance policy, including the following: 1) the telephone number of the hospital 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: Littleton Adventist HospitalTo understand the profile of Littleton Adventist Hospital's community, we analyzed the demographic and health indicator data of the population within the defined service area. The demographic makeup of these communities is as follows: - Race: The population is 66% white, 7.1% black, 5.9% Asian, 0.4% Native American/Alaskan Native, 0.2% native Hawaiian/Pacific Islander, 17.4% some other race, and 3% multiple races.- Ethnicity: 17.3% Hispanic or Latino.Approximately 51.9% of the Hospital's patients during the tax year were Medicare patients, about 11.9% were Medicaid patients, about 2.3% were self-pay patients, and the remaining percentage were patients covered under commercial insurance. In the current tax year, about 63.9% of the Hospital's in-patients were admitted through the Hospital's Emergency Department.Porter Adventist HospitalTo understand the profile of Porter Adventist Hospital's community, we analyzed the demographic and health indicator data of the population within the defined service area. The demographic makeup of these communities is as follows: - Race: The population is 53.1% white, 10.4% black, 5.3% Asian, .5% Native American/Alaskan Native, .2% native Hawaiian/Pacific Islander, 27.3% some other race, and 3.1% multiple races. - Ethnicity: 27.1% Hispanic or Latino.Approximately 48.3% of the Hospital's patients during the tax year were Medicare patients, about 15.3% were Medicaid patients, about 4.0% were self-pay patients, and the remaining percentage were patients covered under commercial insurance. In the current tax year, about 52.7% of the Hospital's in-patients were admitted through the Hospital's Emergency Department.Parker Adventist HospitalTo understand the profile of Parker Adventist Hospital's community, we analyzed the demographic and health indicator data of the population within the defined service area. The demographic makeup of these communities is as follows: - Race: The population is 66% white, 7.1% black, 5.9% Asian, 0.4% Native American/Alaskan Native, 0.2% native Hawaiian/Pacific Islander, 17.4% some other race, and 3% multiple races.- Ethnicity: 17.3% Hispanic or Latino.Approximately 41.1% of the Hospital's patients during the tax year were Medicare patients, about 14.2% were Medicaid patients, about 3.0% were self-pay patients, and the remaining percentage were patients covered under commercial insurance. In the current tax year, about 69.7% of the Hospital's in-patients were admitted through the Hospital's Emergency Department.Avista Adventist HospitalTo understand the profile of Avista Adventist Hospital's community, we analyzed the demographic and health indicator data of the population within the defined service area. The demographic makeup of these communities is as follows: - Race: The population is 76.9% white, 1% black, 5.1% Asian, 0.4% Native American/Alaskan Native, 0.1% Native Hawaiian/Pacific Islander, 14.3% some other race, and 2.4% multiple races. - Ethnicity: 14.1% Hispanic or LatinoApproximately 30.9% of the Hospital's patients during the tax year were Medicare patients, about 16.7% were Medicaid patients, about 7.1% were self-pay patients, and the remaining percentage were patients covered under commercial insurance. In the current tax year, about 25.2% of the Hospital's in-patients were admitted through the Hospital's Emergency Department.Castle Rock Adventist HospitalTo understand the profile of Castle Rock Adventist Health Campus's community, we analyzed the demographic and health indicator data of the population within the defined service area. The demographic makeup of these communities is as follows: - Race: The population is 82% white, 1.3% black, 4.9% Asian, 0.3% Native American/Alaskan Native, 0.1% native Hawaiian/Pacific Islander, 9% some other race, and 2.4% multiple races.- Ethnicity: 8.9% Hispanic or Latino. Approximately 38.0% of the Hospital's patients during the tax year were Medicare patients, about 13.5% were Medicaid patients, about 4.3% were self-pay patients, and the remaining percentage were patients covered under commercial insurance. In the current tax year, about 60.7% of the Hospital's in-patients were admitted through the Hospital's Emergency Department. Part VI, Line 5: The provision of community benefit is central to Portercare Adventist Health System's mission of service and compassion. Restoring and promoting the health and quality of life of those in the communities served by the filing organization is a function of "extending the healing ministry of Christ by caring for those who are ill and by nuturing the health of the people in our communities and embodies the filing organization's commitment to its values and principles. The filing organization commits substantial resources to provide a broad range of services to both the underprivileged as well as the broader community. In addition to the community benefit and community building information provided in Parts I, II and III of this Schedule H, the filing organization captures and reports the benefits provided to its community through faith-based care. Examples of such benefits include the cost associated with chaplaincy care programs and mission peer reviews and mission conferences. During the current year, the filing organization provided $1,388,213 of benefit with respect to the faith-based and spiritual needs of its communities in conjunction with its operation of community hospitals. The filing organization also provides benefits to each of 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 filing organization expended $87,412,560 in new capital improvements. As faith-based mission-driven community hospitals, the filing organization is continually involved in monitoring its communities, identifying unmet health care needs and developing solutions and programs to address those needs. In accordance with its conservative approach to fiscal responsibility, surplus funds of the filing organization are continually being invested in resources that improve the availability and quality of delivery of health care services and programs to its communities. Part VI, Line 6: Portercare Adventist Health System is operated as part of Centura Health Corporation ("Centura"). Centura and its affiliated organizations are dedicated to extending the healing ministry of Christ by caring for those who are ill and by nurturing the health of the people in our communities. Specifically, Centura has launched a system-wide strategic plan to improve the quality, consistency, availability, and affordability of health care to communities throughout Colorado. The three main components of this strategy are (1) to continue investing in technology advancements that improve the quality, costs, and coordination of care including the establishment of electronic health records linking our physicians, clinics, hospitals, long-term facilities and home care services; (2) providing wellness care, thereby potentially reducing health care costs by helping patients to maintain good health, growing the level of support and outreach provided to rural communities, and increasing access, affordability and quality of health care; and (3) coordinate and develop systems of care, looking to each facility and entity in Centura to share best practices and improve overall efficiency and communication system-wide from birth to home care. Part VI, Line 7, Reports Filed With States CO 1 JEFFCO ACTION CENTER INC 8755 W 14th Ave Lakewood CO 80215 237019679 501(c)(3) 17500 0 General Support ADVOCATES FOR VICTIMS OF ASSAULT INC PO Box 1859 Frisco CO 80443 840950954 501(c)(3) 17500 0 General Support BARTON INSTITUTE FOR COMMUNITY ACTION 1114 W 7th Ave Ste 215 Denver CO 80204 834295300 501(c)(3) 17500 0 General Support The Boulder Chamber of Commerce 2440 Pearl Street Boulder CO 80302 840152700 501(c)(6) 7225 0 General Support BREAK THE SILENCE INC 411 W Platte Ave Ste A Box 165 Fort Morgan CO 80701 843100049 501(c)(3) 15827 0 General Support BROTHER JEFF'S CULTURAL CENTER 2836 WELTON ST DENVER CO 80205 320034993 501(c)(3) 21000 0 General Support CASTLE ROCK CHAMBER OF COMMERCE 420 Jerry St Castle Rock CO 80104 840802658 501(c)(6) 15000 0 General Support CASTLE ROCK SEVENTH DAY ADVENTIST CHURCH 2350 MEADOWS BLVD Castle Rock CO 80109 815259884 501(c)(3) 10000 0 General Support CATHOLIC CHARITIES OF CENTRAL COLORADO INC 228 NORTH CASCADE AVE COLORADO SPRINGS CO 80903 840586169 501(c)(3) 17500 0 General Support CENTER FOR AFRICAN AMERICAN HEALTH 3350 HUDSON ST DENVER CO 80207 841477546 501(c)(3) 26250 0 General Support THE CHANDA PLAN FOUNDATION 1630 CARR STREET LAKEWOOD CO 80214 204358964 501(c)(3) 17500 0 General Support NEW DANCE THEATRE INC Dba CLEO PARKER ROBINSON DANCE 119 Park Ave W Denver CO 80205 840632111 501(c)(3) 29750 0 General Support CLINICA CAMPESINA FAMILY HEALTH SERVICES 345 PLAZA COURT NORTH LAFAYETTE CO 80026 840743432 501(c)(3) 15950 0 General Support COAL CREEK MEALS ON WHEELS 455 N BURLINGTON AVE LAFAYETTE CO 80026 840634856 501(c)(3) 8750 0 General Support COLLEGE TRACK 112 Linden Street Oakland CA 94607 943279613 501(c)(3) 35000 0 General Support COLORADO CHANGEMAKERS COLLECTIVE 12075 45th Ave Ste 300 Denver CO 80239 832846355 501(c)(3) 24500 0 General Support COMMUNITY COMPASSION OUTREACH 10 Town Plaza 315 Durango CO 81301 825001338 501(c)(3) 35000 0 General Support COMMUNITY FOOD SHARE INC 650 S TAYLOR AVE LOUISVILLE CO 80027 742227731 501(c)(3) 17500 0 General Support COMMUNITY HEALTH PARTNERSHIP 121 South Tejon St COLORADO SPRINGS CO 80903 841388331 501(c)(3) 26250 0 General Support BOULDER COUNTY RSVP BOARD INC DBA CULTIVATE 6325 Gunpark Dr Ste F Boulder CO 80301 840769724 501(c)(3) 8750 0 General Support DOCTORS CARE 609 W Littleton Blvd Suite 100 Littleton CO 80120 841150815 501(c)(3) 30000 0 General Support ERIE CHAMBER OF COMMERCE 235 Wells St Erie CO 80516 841325423 501(c)(6) 5450 0 General Support FACE IT TOGETHER INC 5020 S Tennis Lane 4 SIOUX FALLS SD 57108 272501220 501(c)(3) 26250 0 General Support FINNEY COUNTY COMMUNITY HEALTH COALITION INC 310 E WALNUT ST 202 GARDEN CITY KS 67846 275247081 501(c)(3) 21000 0 General Support FOCUS POINTS FAMILY RESOURCE CENTER 2501 E 48th Ave Denver CO 80216 841353944 501(c)(3) 31500 0 General Support FRIENDS OF BROOMFIELD INC 11851 Saulsbury Street Broomfield CO 80020 841516104 501(c)(3) 52500 0 General Support FRONT LINE FARMING 2830 Clayton Street Denver CO 80205 833496361 501(c)(3) 35000 0 General Support FRONT RANGE AREA HEALTH EDUCATION CENTER PO Box 21886 Denver CO 80221 854209627 501(c)(3) 26250 0 General Support HEART MIND HAVEN 6833 S MILLER ST LITTLETON CO 80127 833158421 501(c)(3) 35000 0 General Support HOMEWARD PIKES PEAK 2010 E BIJOU ST COLORADO SPRINGS CO 80909 134242773 501(c)(3) 17500 0 General Support IMPACT ON EDUCATION INC 721 Front Street Suite A Louisville CO 80027 840943046 501(c)(3) 12680 0 General Support INTERNATIONAL RESCUE COMMITTEE INC 1873 S BELLAIRE ST 500 DENVER CO 80222 135660870 501(c)(3) 35000 0 General Support LATINA SAFEHOUSE INITIATIVE PO Box 11174 Denver CO 80211 320298603 501(c)(3) 10500 0 General Support LOUISVILLE CHAMBER OF COMMERCE 901 Main St Louisville CO 80027 840892240 501(c)(6) 11200 0 General Support DOWNTOWN BUSINESS ASSOCIATION OF LOUISVILLE INC PO Box 311 Louisville CO 80027 841291020 501(c)(6) 5000 0 General Support MANNA - THE DURANGO SOUP KITCHEN PO Box 1196 Durango CO 81302 841004473 501(c)(3) 17500 0 General Support MERCY HOUSING MOUNTAIN PLAINS 1600 Broadway Suite 2000 Denver CO 80202 201583332 501(c)(3) 23570 0 General Support MID-AMERICA UNION CONFERENCE OF SEVENTH-DAY ADVENTISTS 8307 Pine Lake Rd Lincoln NE 68516 476006806 501(c)(3) 10225 0 General Support MILE HIGH ACADEMY 1733 DAD CLARK DRIVE HIGHLANDS RANCH CO 80126 840525223 501(c)(3) 70000 0 General Support MOUNTAIN RESOURCE CENTER PO Box 425 Conifer CO 80433 841178699 501(c)(3) 24686 0 General Support MUSLIM YOUTH FOR POSITIVE IMPACT 1880 Golden Eagle Court Broomfield CO 80020 830998674 501(c)(3) 35000 0 General Support NATIONAL KIDNEY Foundation Inc 30 E 33rd St New York NY 10016 131673104 501(c)(3) 23250 0 General Support NEWDAY ADVENTIST CHURCH 9030 MILLER RD PARKER CO 80134 276167861 501(c)(3) 12000 0 General Support NOURISH COLORADO 3532 Franklin St Suite F Denver CO 80205 262464764 501(c)(3) 51867 0 General Support Greater Parker Foundation 20120 E Mainstreet PARKER CO 80138 263664272 501(c)(3) 5000 0 General Support PARA TI MUJER 494 N Sheridan Blvd Lakewood CO 80226 453584876 501(c)(3) 26250 0 General Support PARKER TASK FORCE FOR HUMAN SERVICES 19105 Longs Way Parker CO 80134 742494265 501(c)(3) 7500 0 General Support PEER COACH ACADEMY COLORADO 2614 W Pikes Peak Ave COLORADO SPRINGS CO 80904 813460352 501(c)(3) 28375 0 General Support POSADA 827 East 4TH ST PUEBLO CO 81001 742473501 501(c)(3) 26250 0 General Support PROJECT ANGEL HEART 4950 Washington Street Denver CO 80216 841199481 501(c)(3) 17500 0 General Support PROJECT WORTHMORE 1666 ELMIRA ST AURORA CO 80010 450933835 501(c)(3) 35000 0 General Support RISE COLORADO 1595 Elmira Street AURORA CO 80010 473566342 501(c)(3) 26250 0 General Support Rocky Mountain Adventist Healthcare Foundation 960 E Harvard Avenue Ste 230 Denver CO 80210 840745018 501(c)(3) 512075 0 General Support THE ROCKY MOUNTAIN CONFERENCE OF SEVENTH-DAY ADVENTISTS 2520 S DOWNING ST DENVER CO 80210 274456014 501(c)(3) 18000 0 General Support ROCKY MOUNTAIN SEED ALLIANCE INC 4785 N 1115 E Buhl ID 83316 465661943 501(c)(3) 17500 0 General Support ROSE ANDOM CENTER INC 1330 FOX ST DENVER CO 80204 900990929 501(c)(3) 17500 0 General Support SAFE SHELTER OF ST VRAIN VALLEY PO Box 231 Longmont CO 80502 840781353 501(c)(3) 17500 0 General Support SECOND CHANCE THROUGH FAITH 1551-1553 VAPOR TRAIL COLORADO SPRINGS CO 80916 463236114 501(c)(3) 17500 0 General Support LA RAZA SERVICES INC DBA SERVICIOS DE LA RAZA 3131 W 14th Avenue Denver CO 80204 840625478 501(c)(3) 61250 0 General Support SIDE BY SIDE CORPORATION 15700 RIVERDALE RD BRIGHTON CO 80602 832678502 501(c)(3) 17500 0 General Support SOLID ROCK COMMUNITY DEVELOPMENT CORPORATION PO BOX 15631 COLORADO SPRINGS CO 80935 260381727 501(c)(3) 19250 0 General Support LITTLETON TRANSPORTATION NETWORK DBA SOUTH METRO COMMUNITY FOUNDATION PO BOX 401 Littleton CO 80160 825192442 501(c)(3) 17500 0 General Support SOUTHERN COLORADO COMMUNITY ACTION AGENCY INC 535 Candelaria Drive Ignacio CO 81137 840576978 501(c)(3) 35000 0 General Support SOUTHWESTERN COLORADO AREA HEALTH EDUCATION CENTER 701 Camino Del Rio Ste 320 Durango CO 81301 272461746 501(c)(3) 31500 0 General Support SUN VALLEY COMMUNITY CENTER 1260 Decatur Street Denver CO 80204 474226132 501(c)(3) 21000 0 General Support DOMESTIC VIOLENCE INITIATIVE FOR WOMEN WITH DISABILITIES DBA THE INITIATIVE 6825 E Tennessee Ave 475 Denver CO 80224 841068953 501(c)(3) 8750 0 General Support PIKES PEAK JUSTICE & PRO BONO CENTER DBA THE JUSTICE CENTER PO Box 429 COLORADO SPRINGS CO 80901 274331236 501(c)(3) 28000 0 General Support THE PLACE 423 EAST CUCHARRAS ST COLORADO SPRINGS CO 80903 841549702 501(c)(3) 28000 0 General Support TRAILHEAD INSTITUTE 1999 Broadway Suite 600 Denver CO 80202 841267213 501(c)(3) 26250 0 General Support TREELINE PASS 5910 S University Blvd C-18 Greenwood Village CO 80121 825279131 501(c)(3) 38815 0 General Support TRI-LAKES CARES PO Box 1301 Monument CO 80132 742501356 501(c)(3) 17500 0 General Support VETERANS COMMUNITY PROJECT 8900 TROOST AVE KANSAS CITY MO 64131 474960735 501(c)(3) 21000 0 General Support VIVE PO Box 11003 Denver CO 80211 814059452 501(c)(3) 35000 0 General Support VUELA FOR HEALTH 3532 N Franklin Street Denver CO 80205 841444277 501(c)(3) 49666 0 General Support ARTHRITIS FOUNDATION INC 1355 Peachtree St Suite 600 Atlanta GA 30309 581341679 501(c)(3) 5500 0 General Support WILD PLUM CENTER FOR YOUNG CHILDREN AND FAMILIES 82 21st Ave NO B Longmont CO 80501 474709774 501(c)(3) 10500 0 General Support Hunger Free Colorado 1355 S Colorado Blvd 201 Denver CO 80222 680551464 501(c)(3) 26250 0 General Support 72 5 Part I, Line 2: Grants are generally made only to related organizations that are exempt from federal income tax under IRC Section 501(c)(3), or to other local charitable community organizations, or to other 501(c)(3) organizations that are a part of the group exemption ruling issued to the General Conference of Seventh-Day Adventists. Accordingly, the filing organization has not established specific procedures for monitoring the use of grant funds in the United States as the filing organization does not have a grant making program that would necessitate such procedures. X X X X 1 1 1 1 0 0 0 0 0 0 0 Banko Peter Former President CHC 0 1824268 0 1743952 0 165957 0 741441 0 29652 0 4505270 0 0 Rathbun Paul Board Member / AH CFO 0 1218839 0 421406 0 895765 0 166400 0 45556 0 2747966 0 150000 Enderson Dan Secretary-Group President 0 840720 0 619513 0 199134 0 236376 0 20567 0 1916310 0 0 Bacon Kenneth Board Chairman/AH CEO Multi State 0 1226644 0 338892 0 56102 0 243332 0 46940 0 1911910 0 0 Gaasch Andrew Treasurer/CFO 0 732691 0 520620 0 10118 0 182073 0 33901 0 1479403 0 0 Jennings MD Jason Orthopedic Surgeon 1134773 0 263358 0 0 0 10675 0 30595 0 1439401 0 0 0 Huenergardt Samuel Former Key Emp/CEO Mid-America 0 751872 0 196309 0 132785 0 144531 0 48521 0 1274018 0 85211 Yang MD Charlie Orthopedic Surgeon 1107436 0 108768 0 0 0 7175 0 30745 0 1254124 0 0 0 Miner MD Todd Orthopedic Surgeon 1100412 0 100444 0 0 0 9800 0 25342 0 1235998 0 0 0 Sanchez II MD Anthony Orthopedic Surgeon 933400 0 174138 0 0 0 10675 0 26981 0 1145194 0 0 0 Rajpal Sharad Neuro Surgeon 964601 0 40000 0 0 0 0 0 11942 0 1016543 0 0 0 Goebel Michael CEO Parker Adventist Hospital 0 440085 0 331276 0 108457 0 107503 0 28380 0 1015701 0 0 Folkenberg Todd CEO Porter Adventist Hospital 0 425510 0 215362 0 118653 0 99358 0 35574 0 894457 0 0 Dodds Rick CEO Littleton Adv Hospital 0 416907 0 158474 0 218983 0 48335 0 28174 0 870873 0 0 McKinney Jillyan Former Key Emp/CEO AHMG Central FL 0 506702 0 116355 0 13460 0 86050 0 42525 0 765092 0 0 Houmann Lars Board Member 0 0 0 0 0 682872 0 0 0 13112 0 695984 0 0 Sendros Isaac CEO Avista Adv Hosp(end 2/23) 0 365085 0 177926 0 7918 0 78999 0 28666 0 658594 0 0 Dean Morre Former Officer/CIO 0 0 0 0 0 588393 0 0 0 22337 0 610730 0 0 Pittman Jeremy CEO Castle Rock Adv Hospital 0 331890 0 106664 0 3162 0 56472 0 33143 0 531331 0 0 Fisher Jonathan Former Key Emp/CFO Wesley 0 291209 0 40361 0 13775 0 61382 0 42200 0 448927 0 0 Travis Carol CFO Avista Adv Hospital 0 275644 0 76904 0 603 0 6523 0 30046 0 389720 0 0 Ward Erin CFO Parker Adv Hospital 0 276882 0 69888 0 593 0 7212 0 0 0 354575 0 0 Beckner Michelle Former CFO Littleton 0 202512 0 63450 0 53467 0 0 0 31708 0 351137 0 0 Gal Matt CFO Castle Rock Adv Hospital 0 179974 0 38983 0 53616 0 2206 0 5889 0 280668 0 0 Still Danae CFO Littleton(beg 2/23) 0 201299 0 0 0 29167 0 7602 0 32509 0 270577 0 0 Whitlock Andrew CFO Porter Adv Hosp(beg 12/22) 0 174237 0 20012 0 267 0 7010 0 29559 0 231085 0 0 Part I, Line 1a As discussed in Part VI, Section B, Line 15, the filing organization's top management officials are compensated by Centura Health Corporation (CHC). All officers and key employees are compensated by CHC, who manages the daily activities of Portercare Adventist Health System under a joint operating agreement dated December 8, 1995 between Adventist Health System Sunbelt Healthcare Corp. and Common Spirit Health. As such, their salaries are paid to them by CHC, a related organization, for services rendered in their capacity as key employees or officers of PAHS. All of their reportable compensation is disclosed on Form 990, Schedule J, Part II, row (ii) and Form 990, Part VII, column (e) as compensation from related organizations. Travel for companions: CHC provides reimbursement for spousal travel when certain of its executives attend conferences sponsored by Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the tax-exempt top-tier parent of Portercare Adventist Health Systesm (PAHS). All spousal travel costs reimbursed to the executive are considered taxable compensation to the executive. Tax Indemnification and gross-up payments: CHC has a system-wide policy addressing gross-up payments provided in connection with employer-provided benefits/other taxable items. Under the policy, certain taxable business-related reimbursements (i.e. taxable business-related moving expenses) provided to any employee may be grossed-up upon approval by the filing organization's CEO and CFO. Discretionary spending account: A cash discretionary spending account was provided in the current year to eligible executives in the form of a car allowance of $750 per month to help offset business travel expense. Other discretionary spending accounts may be provided in connection with attendance at conferences but typically do not exceed $300 per participant. Taxable travel and other spending accounts are considered taxable compensation to the executive. Housing allowance or residence for personal use: CHC has a Corporate Executive Policy that addresses assistance to executives who have been relocated by the company during the year. Relocation assistance is administered per CHC policy by an external relocation company. Any taxable reimbursements made to executives in connection with relocation assistance are treated as wages to the executive and are subject to all payroll withholding and reporting requirements. Part I, Lines 4a-b Line 4a: During 2022, Lars Houmann received severance payments in the amount of $661,887 from Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) the top-tier 501(c)(3) parent of the filing organization. Pursuant to the AHSSHC Corporate Executive Policy governing executive severance, severance agreements for executives operating at the Vice President level and above are entered into upon eligibility to facilitate the transition to subsequent employment following an involuntary separation from employment with AdventHealth. During 2022, Morre Dean and Michelle Beckner received severance payments in the amount of $588,393 and $53,078 respectively from CHC. Pursuant to the CHC Corporate Executive Policy governing executive severance, severance agreements for executives operating at the Vice President level and above are entered into upon eligibility to facilitate the transition to subsequent employment following an involuntary separation from employment with CHC. Line 4b: As discussed in Line 1 above, the organization's top management officials' compensation is paid by Centura Health Corporation (CHC). All officers and key employees are compensated by CHC, who manages the daily activities of Portercare Adventist Health System (PAHS). As such, their salaries and all associated benefits are paid to them by CHC for services rendered in their capacity as key employees or officers of PAHS. All of their reportable compensation is disclosed on Form 990, Schedule J, Part II, row (ii) and Form 990, Part VII, column (e) as compensation from related organizations. Senior executives on the filing organization's management team that hold the position of Senior Vice-President or Hospital CEO are eligible to participate in the CHC EXECU-FLEX Benefit Plan (the Plan). In recognition of the contribution that each executive makes to the success of CHC, CHC provides for participation in the Plan to the eligible executives. The purpose of the Plan is to offer an opportunity to elect from among a variety of supplemental benefits to individually tailor a benefits program appropriate to each executive's needs. The executive is provided with a Flex allowance equivalent to 10% of base salary to purchase selected benefits and to contribute into a deferred non-qualified supplemental executive retirement plan. The Plan provides for a five-year cliff-vesting schedule with respect to amounts accumulated in the executive's deferred compensation account. CHC contributes into these deferred compensation accounts semi-annually and amounts are subject to a substantial risk of forfeiture with active participation required at time of vesting. In addition, CHC provides a Pension Restoration Benefit (PRB) to restore qualified plan contributions lost on income in excess of the current federal maximum allowable compensation to a qualified plan. The PRB provides contributions by restoring the amount that would have been contributed to the executive's retirement savings plan for compensation in excess of the legislative limits. Benefit amounts are added to the participant's flex allowance each year based on their total compensation from the prior year. The following received contributions to a non-qualified plan for the calendar year 2022: CY Employer CY Employer CY SERP CY PRB SERP Contr. PRB Contr. Distrib. Distrib. Peter Banko 387,101 344,401 104,983 47,166 Daniel Enderson 128,713 98,213 108,037 75,076 Andrew Gaasch 102,699 72,199 0 0 Michael Goebel 61,884 31,384 0 0 Todd Folkenberg 60,204 29,704 80,618 26,873 Rick Dodds 42,700 0 0 0 Isaac Sendros 49,412 18,912 0 0 Jeremy Pittman 46,632 12,132 0 0 Schedule J, Line 4b: Additionally, in calendar year 2022 Board members of the filing organization, L. Houmann, P. Rathbun, and K. Bacon were compensated by and on the payroll of Adventist Health System Sunbelt Healthcare Corporation (AHSSSHC), the parent organization of a healthcare system known as AdventHealth. Current employees Ken Finch and Danae Still as well as Former Key Employees S. Huenergardt, J. Fisher, J. McKinney, and B. Spenst, were also compensated by Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) for a portion or for all of calendar year 2022. AdventHealth is exempt from federal income tax under Section 501(c)(3) of the Internal Revenue Code. In recognition of the contribution that each executive makes to the success of AdventHealth, AdventHealth provides supplemental executive retirement benefit plans to eligible executives. As the supplemental executive retirement benefit plans were updated in 2020 and certain individuals still participate as grand-fathered participants in certain plans, the narrative below discusses all plans in which there were any participants in 2022. The SERP III plan effectively replaces the prior SERP II plan, the Executive Flex Benefit Program Plan, and the Senior Executive Death Benefit Plan for qualified executives except for certain grandfathered executive employees. SERP III Plan: The SERP III plan provides eligible executives a percentage of their base pay, which is credited to a deferred compensation account. The plan also provides for compensation deferral and selection of life insurance coverage and long-term care insurance. To be eligible to participate in the SERP III plan, executives must be on the AHSSHC corporate payroll and be either a CEO of an AdventHealth entity, an AHSSHC Vice President (VP) or VP of an AdventHealth entity with a base salary of at least $305,000 in 2022 (adjusted annually by the same percentage as IRC Section 401(a)(17) limit increases), or other leader specifically approved by the AdventHealth President. Eligible executives do not include grandfathered executives, meaning those executives who would satisfy all the eligibility requirements of the SERP II plan prior to Dec 31, 2027, had the plan not been amended and restated as of Jan. 1, 2020. Contribution credits will be established and maintained by class year accounts for each participant using tiered contribution credit percentages of annual base compensation. Contribution credit percentages range between 15% and 19% of base compensation. Contribution credits will be made each quarter in 25% increments with reductions in contributions if the executive is also a grandfathered FLEX participant (see below). SERP III provides for a class year vesting and payment schedule (7 years for each class year) with respect to amounts accumulated in the executive's deferred compensation account. Upon attainment of a normal retirement age (age 62), or upon certain other circumstances as defined in the SERP III plan document, all deferred amounts are paid immediately to the participant. For any executives working beyond the normal retirement age, future employer contributions will be made quarterly from SERP III directly to the participant as a taxable cash bonus. SERP II Plan: The SERP II plan is a defined benefit, non-tax-qualified deferred compensation plan for certain executives who have provided lengthy service to AdventHealth and/or to other Seventh-day Adventist Church hospitals or health care institutions. Under the provisions of the SERP II plan, benefits are provided to qualifying executive participants on a pro-rata schedule beginning with 20 years of service as an employee of AdventHealth and/or another hospital or health care institution controlled by the Seventh-day Adventist Church and who satisfy certain other qualifying criteria. Eligible employees are restricted to those executives who, as of January 1, 2020, satisfied, or if employment continues, will satisfy the eligibility requirements of SERP II prior to December 31, 2027. This supplemental executive retirement plan (SERP II) was designed to provide eligible executives with the economic equivalent of an annual income beginning at normal retirement age equal to 60% of the average of the participant's three, five or seven highest years of base salary from AdventHealth active employment inclusive of income from all other Seventh-day Adventist Church healthcare employer-financed retirement income sources and investment income earned on those contributions through social security normal retirement age as defined in the plan. The number of years included in highest average compensation is determined by the individual's year of entry to SERP II and by the individual's year of entry to the AdventHealth Executive FLEX Benefit Program. FLEX Plan: The Flex Plan was originally designed to provide eligible executives an opportunity to select from among a variety of supplemental benefits, including a split dollar life insurance policy and long-term care insurance, to individually tailor a benefits program appropriate to each executive's needs. In 2020, the Flex Plan was amended to exclude employed executives who are hired or promoted after a certain date from being eligible to participate in the Flex Plan except for certain insurance coverage features of the plan. The Flex Plan provides eligible participants a pre-determined benefits allowance credit that is equal to a percentage of the executive's base pay from which the cost of mandatory and elective employee benefits is deducted. The benefits allowance credit percentage for any plan year shall not be greater than the maximum dollar amount or the percentage of compensation as determined by the AdventHealth Benefits Administration Committee. For grandfathered eligible employees, the annual pre-determined Flex allowance is contributed and any funds that remain after the cost of mandatory and elective benefits are subtracted are, at the employee's option, contributed to either an IRC 457(f) deferred compensation account or to an IRC 457(b) eligible deferred compensation plan. Upon attainment of age 65, all previous 457(f) deferred amounts are paid immediately to the participant and any future employer contributions are made quarterly from the Plan directly to the participant. The Plan provides for a class year vesting schedule (2 years for each class year) with respect to amounts accumulated in the executive's 457(f) deferred compensation account. Distributions could also be made from the executive's 457(f) deferred compensation account upon attainment of age 65 or upon an involuntary separation. The account will be forfeited by the executive upon a voluntary separation. With respect to grandfathered participants, the Flex Plan documents define eligible employees to include the Chief Executive Officers of AdventHealth entities and Vice Presidents of all AdventHealth entities whose base salary was at least equal to the Internal Revenue Code Section 401(a)(17) compensation limit each year. Schedule J, Line 4b: continuation Flex Plan Flex Plan SERP II SERP III Contr. Distr.* Contr./Distr. Contr. ------------------------------------------------------- Paul Rathbun $ 150,000 $ 197,530 $ 607,786 $ 0 Kenneth Bacon $ 0 $ 0 $ 0 $226,932 Samuel Huenergardt $ 128,131 $ 115,142 $ 0 $ 0 Jillyan McKinney $ 0 $ 0 $ 0 $ 75,750 Jonathan Fisher $ 0 $ 0 $ 0 $ 45,073 * Including Investment Earnings Ryan Folkenberg Family of Key Employee 14538 Employee Compensation 0 Aaron Speegle Family of Officer 134141 Employee Compensation 0 Part V, Line 1a-1b Pursuant to an Affiliation Agreement between Adventist Health System Sunbelt Healthcare Corporation and Common Spirit Health, Portercare Adventist Health System (the filing organization) is managed by Centura Health Corporation (CHC), a joint operating company. CHC is a Colorado, not-for-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). CHC has established a shared service center to centralize the Accounts Payable (A/P) functions. The facts and circumstances support a position that CHC, as a payor on behalf of its managed organizations in a shared service environment, will have sufficient management and oversight in connection with the managed organizations' payments to meet the standard set forth in Treas. Reg. Section 1.6041-1(e). CHC will not merely be making payments at the direction of its managed organizations. Accordingly, CHC is considered the payor subject to the information reporting requirements of Section 6041. The filing organization has entered "0" in Part V, Line 1a because the filing organization no longer issues Form 1099 returns, rather, all such returns are filed by and under the name and EIN of CHC as the payor subject to the information reporting requirements of Section 6041. Form 990, Part VI, Section A, line 1a Pursuant to Article IV of the Bylaws of Portercare Adventist Health System, the Board of Trustees may, by resolution or resolutions passed by a majority of the Trustees thereof, appoint an Executive Committee or such other Committees for any purpose and delegate to such committees any of the powers and authority of the Board of Trustees as is permitted by law. Colorado law precludes a committee of the Board from (I) authorizing distributions; (II) approving or proposing to the member actions that Articles 121-137 of Title 7 of the Colorado revised statutes require to be approved by the member; (III) amending the corporation's amended and restated Articles of Incorporation; (IV) adopting, amending or repealing the Bylaws; (V) approving a plan of merger not requiring approval of the member; or (VI) approving a sale, lease, exchange or other disposition of all, or substantially all, of its property, with or without good will, other than in the usual and regular course of business subject to approval of the member. Such Committees shall have the power to act only in intervals between meetings of the Board of Trustees and shall, at all times, be subject to the control of the Board of Trustees. The Board of Trustees, or if the Board does not act, the Committees, shall establish rules and regulations for meetings and shall meet at such times as are deemed necessary, provided that a reasonable notice of all meetings shall be given to Committee members. No act of a Committee shall be valid unless approved by the vote or written consent of a majority of its members. Committees shall keep regular minutes of proceedings and report the same to the Board from time to time as the Board may require. Form 990, Part VI, Section A, line 2 Gary Thurber and John (Mic) Thurber - Family Relationship Form 990, Part VI, Section A, line 6 Portercare Adventist Health System (the filing organization) has one member. The sole member of the filing organization is Adventist Health System Sunbelt Healthcare Corporation. Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) is a Florida, not-for-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). There are no other classes of membership in the filing organization. Form 990, Part VI, Section A, line 7a The sole member of the filing organization is AHSSHC. The Board of Directors of the filing organization are appointed by the sole member, AHSSHC, who has the right to elect, appoint or remove any member of the Board of Directors of the filing organization. Form 990, Part VI, Section A, line 7b The Corporate member, AHSSHC, acting through the Board of Directors, maintains all rights permitted to be exercised by Directors of a Colorado corporation except as limited by the organization's Articles, Bylaws, or Affiliation Agreement with Common Spirit Health (CSH), F/K/A Catholic Health Initiatives. The Agreement of both AHSSHC and CSH is required for certain significant decisions involving Centura facilities. In addition, pursuant to the Affiliation Agreement between CSH, Colorado Health Initiatives Colorado (CHIC), Centura Health Corporation, and Portercare Adventist Health System (PAHS), certain matters affecting PAHS must be approved by both PAHS and CHIC. Those items include: - The transfer of assets valued at over $3,000,000 - The issuance of a debt instrument in excess of $250,000 - The amendment of the organizing documents - The admission of a new sponsor - A merger or dissolution or reorganization - Settlement of legal proceedings in excess of $2,000,000 - Capital expenditures in excess of $5,000,000 Form 990, Part VI, Section B, line 11b The filing organization's current year Form 990 was reviewed by the CFO of the filing organization prior to its filing with the IRS. The review conducted by the CFO of the filing organization did not include the review of any supporting workpapers that were used in preparation of the current year Form 990, but did include a review of the entire Form 990 and all supporting schedules. Form 990, Part VI, Section B, line 12c Portercare Adventist Health System has adopted Centura Health's Conflict of Interest Policy: 1. Conflict of Interest Policy: 1.1 Consistent with Centura integrity standards, it is policy that each board of trustee member, corporate officer, and key employee act at all times in a manner that is consistent with Centura's mission and values-based service to the community and exercise care that he or she does not have any personal interest which might conflict with or appear to conflict with the interest of Centura or which might influence their judgment or actions in performing their duties. 1.1.1 In connection with an actual or possible transaction or arrangement involving Centura, any board member, corporate officer, or key employee who has a direct or indirect financial interest must disclose and be given the opportunity to share all material facts with the board considering the proposed transaction or arrangement. 1.1.2 Board members, corporate officers, and key employees are also required to disclose any possible conflicts on an annual basis through the conflict of interest questionnaire. 2. Procedure for disclosing and reviewing transactions or arrangements of potential conflict of interests: 2.1 Board members, corporate officers, and key employees that have a financial interest in any actual or possible transaction involving Centura are required to disclose the financial interest. 2.1.1 In order to determine if a conflict of interest exists, the individual who is considered to have a financial interest may make a presentation at the board or board committee meeting. After such presentation, the individual shall leave the meeting for discussion and a vote on the issue. 2.1.2 After exercising due diligence, the board or board committee shall determine whether Centura can obtain a more advantageous transaction with reasonable efforts from another person or entity. If a more advantageous transaction is not reasonably attainable, the board or board committee shall determine by a majority vote of the disinterested members whether the transaction is in Centura's best interest and is fair. 3. Procedure for disclosing and reviewing other potential conflicts of interest: 3.1 Board members, corporate officers, and key employees shall also disclose in advance to Centura leaders any non-transactional actions or relationships that have the potential to create a conflict of interest. 3.1.1 The board or board committee shall carefully review and scrutinize any potential conflict of interest. By a majority vote of the disinterested members, the board shall take whatever action is deemed appropriate with respect to the board member, corporate officer, or key employee under the circumstances, including possible corrective action, in order to best protect the interests of Centura. 3.1.2 On an annual basis, board members, corporate officers, and key employees will also be sent an email requesting they complete the board member and corporate officer conflict of interest questionnaire by the specified due date in the email. 3.1.3 The corporate responsibility department shall notify the chairperson of the board of any potential conflicts and the chairperson, or designee, shall perform further investigation as he or she deems appropriate. 4. Record of proceedings: 4.1 The minutes of the board and board committee shall contain: 4.1.1 The names of persons who disclosed or otherwise were found to have a financial interest and the nature of the financial interest. 4.1.2 The names of persons who were present for discussions and votes relating to any financial interest, the content of the discussion, including any alternatives, and a record of the board or board committee decision. 5. Violations of the conflicts of interest policy: 5.1 If the board or board committee has reasonable cause to believe that an individual has failed to disclose either an actual or potential conflict of interest, or all material facts surrounding an actual or possible conflict, the individual will be given a chance to explain. 5.1.1 After hearing the response, the board will conduct such additional investigation as appropriate. If the board determines that the individual has in fact failed to disclose as required by the conflict of interest policy, the board shall take appropriate disciplinary or corrective action. Form 990, Part VI, Section B, line 15 The organization's top management officials' compensation is paid by Centura Health Corporation. All officers and key employees are compensated by Centura Health Corporation, who manages the daily activities of Portercare Adventist Health System under a joint operating agreement dated December 8, 1995 between Adventist Health System Sunbelt Healthcare Corp. and Common Spirit Health. As such, their salaries are paid to them by Centura Health Corporation, a related organization, for services rendered in their capacity as key employees or officers of PAHS. All of their reportable compensation is disclosed on Form 990, Schedule J, Part II, row (ii) and Form 990, Part VII, column (e) as compensation from related organizations. External consultants are engaged to provide market-based compensation studies to make recommendations to Centura Health Corporation's (CHC) Compensation Committee regarding the compensation of the filing organization's CEO and CFO. The Compensation Committee is appointed by the Board of Trustees of CHC. The Board of Trustees may remove at any time, with or without cause, any member of the Compensation Committee; provided the filing organization's members, Portercare Adventist Health System (PAHS) and Catholic Health Initiatives Colorado (CHIC), shall have exclusive authority to appoint or remove, with or without cause, any member it or they appoint to the Compensation Committee. The consultant's recommendations are presented to and deliberated by CHC's Compensation Committee. The Compensation Committee relies upon all available comparable compensation data in finalizing its decision concerning compensation for its senior executive positions. The Compensation Committee deliberations and decisions are documented appropriately. CHC's Human Resources department performs an annual analysis of the market to determine compensation ranges for the remainder of CHC's Executives which are reviewed and approved by CHC's senior leadership. Form 990, Part VI, Section C, line 19 The organization's governing documents are available on the Colorado Secretary of State's website. The filing organization is a part of the system of healthcare organizations known as AdventHealth. The audited consolidated financial statements of AdventHealth and of the AdventHealth "Obligated Group" are filed annually with the Municipal Securities Rulemaking Board (MSRB). The "Obligated Group" is a group of AHSSHC subsidiaries that are jointly and severally liable under a Master Trust Indenture that secures debt primarily issued on a tax-exempt basis. Unaudited quarterly financial statements prepared in accordance with Generally Accepted Accounting Principles (GAAP) are also filed with MSRB for AdventHealth on a consolidated basis and for the grouping of AdventHealth subsidiaries comprising the "Obligated Group". The filing organization does not generally make its conflict of interest policy available to the public. Form 990, Part VI, Line 16B, Joint Venture Policy: Portercare Adventist Health System has not formally adopted a written policy or written procedure regarding joint ventures. Practices are in place that require the filing organization to perform an analysis and evaluation of its participation in every joint venture in which the filing organization will have an ownership interest. The internal review and analysis ensures that the filing organization will not become a participant in any joint ventures that could potentially threaten the tax-exempt status of the filing organization. Form line reference: Part VIII, Lines 7a, b and c: The amount shown in Part VIII, Line 7c(i) of the Form 990 represents an allocated share of capital gain/(loss) from a system wide, corporate administered, investment program. Form 990, Part IX, line 11g Payments to Hlthcare Professionals: Program service expenses 107,442,883. Management and general expenses 0. Fundraising expenses 0. Total expenses 107,442,883. Professional Fees: Program service expenses 45,442,398. Management and general expenses 0. Fundraising expenses 0. Total expenses 45,442,398. Purchased Medical Services: Program service expenses 25,653,273. Management and general expenses 0. Fundraising expenses 0. Total expenses 25,653,273. Environmental Services: Program service expenses 4,791,578. Management and general expenses 0. Fundraising expenses 0. Total expenses 4,791,578. Transcription Services: Program service expenses 347,628. Management and general expenses 0. Fundraising expenses 0. Total expenses 347,628. Recruiting: Program service expenses 215,244. Management and general expenses 0. Fundraising expenses 0. Total expenses 215,244. Management Fees: Program service expenses 0. Management and general expenses 156,524,721. Fundraising expenses 0. Total expenses 156,524,721. Billing and Collection Services: Program service expenses 0. Management and general expenses 6,890,080. Fundraising expenses 0. Total expenses 6,890,080. Form 990, Part XI, line 9: Transfer to Tax-Exempt Parent -14,055,521. Joint Venture Equity Changes 320,068. Tax-Exempt Intercompany Debt Reconcilation -244,209. Allocation with Respect to Debt from Tax-Exempt Parent 1,449,937. Expenses for Affiliated Tax-Exempt Organization -490,568. Transfer to Related Tax-Exempt Organization 2,010,416. Rounding and other adjustment 210. Form 990, Part XII, Line 3b Although the taxpayer is not required to undergo an audit as set forth in the Single Audit Act and OMB Circular A-133, the taxpayer is part of a controlled group of organizations that comprise a consolidated financial statement audit. The controlled group's parent is Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), a 501(c)(3) organization. The system of healthcare entities owned and controlled by AHSSHC is known as AdventHealth. For the year ended December 31, 2022, AdventHealth will file a consolidated Single Audit which will include all entities that are part of the controlled group. Accordingly, the taxpayer has checked yes to the questions on Part XII, line 3a and 3b. HealthFit Family Medicine LLC 9100 E Mineral Circle Centennial CO 80112 815310593 Medical Services - family practice (inactive) CO 0 0 Portercare Adventist Health System HealthFit Medical Professionals LLC 9100 E Mineral Circle Centennial CO 80112 473561708 Medical Services - family practice (inactive) CO 0 0 Portercare Adventist Health System HealthFit Wellness Professionals LLC 9100 E Mineral Circle Centennial CO 80112 815325418 Fitness Center (inactive) CO 0 0 Portercare Adventist Health System AdventHealth Ashville Inc (5922 - 123122) 900 Hope Way Altamonte Springs FL 32714 921144574 Future Operation of Hospital & Related Services NC 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 AdventHealth Family Medicine Rural Health Clinics Inc 187 PR 4060 Lampasas TX 76550 271858033 Operation of Rural Health Clinics & Medical Services FL 501(c)(3) Line 3 Metroplex Adventist Hospital Inc 1 AdventHealth Foundation fka SunSystem Development Corp 900 Hope Way Altamonte Springs FL 32714 592219301 Fund-Raising for Affiliated Tax-Exempt Hospitals FL 501(c)(3) Line 7 Adventist Hlth System Sunbelt Hlthcare Corp 1 AdventHealth Home Care East Florida LLC 770 West Granada Blvd 319 Ormond Beach FL 32174 833768458 Inactive FL 501(c)(3) Line 10 Memorial Hlth Systems Inc 1 AdventHealth Hospice Care East Florida Inc 770 West Granada Blvd 304 Ormond Beach FL 32174 833748461 Inactive FL 501(c)(3) Line 10 Memorial Hlth Systems Inc 1 AdventHealth Kansas City Foundation 7315 E Frontage Road Merriam KS 66204 480868859 Fund-raising for Tax-exempt hospitals KS 501(c)(3) Line 7 Shawnee Mission Medical Center Inc 1 AdventHealth North Polk Inc 3100 E Fletcher Ave Tampa FL 33613 593231322 Inactive FL 501(c)(3) Line 12a, I University Community Hospital Inc 1 AdventHealth Palm Coast Parkway Inc fka AH East Florida Inc 900 Hope Way Altamonte Springs FL 32714 882288563 Future Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 AdventHealth Polk North Inc 40100 US Highway 27 N Davenport FL 33837 841793121 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 AdventHealth Polk South Inc 410 South 11th Street Lake Wales FL 33853 834672945 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 AdventHealth Ransom Memorial Inc 1301 S Main Street Ottawa KS 66067 830976641 Operation of Hospital & Related Services KS 501(c)(3) Line 3 Adventist Hlth Mid-America Inc 1 AdventHealth Riverview Inc 14055 Riveredge Drive Ste 150 Tampa FL 33637 870901094 Future Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 AdventHealth Senior Care Inc 900 Hope Way Altamonte Springs FL 32714 841817046 Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 AdventHealth South Overland Park Inc 7820 W 165th Street Overland Park KS 66223 364595806 Operation of Hospital & Related Services KS 501(c)(3) Line 3 Adventist Hlth Mid-America Inc 1 AdventHealth University Inc 671 Winyah Drive Orlando FL 32803 593069793 Education/Operation of School FL 501(c)(3) Line 2 Adventist Hlth SystemSunbelt Inc 1 AdventHealth West Florida Ambulatory Services Inc 14055 Riveredge Drive Ste 250 Tampa FL 33637 471881744 Support of Imaging Center & Home Health Subsidiaries FL 501(c)(3) Line 12b, II Adventist Hlth System Sunbelt Hlthcare Corp 1 AdventHealth West Florida Imaging Inc 14055 Riveredge Drive Ste 250 Tampa FL 33637 843225135 Imaging & Testing FL 501(c)(3) Line 3 AdventHealth West Florida Ambulatory Services Inc 1 Adventist Bolingbrook Hospital 500 Remington Blvd Bolingbrook IL 60440 651219504 Operation of Hospital & Related Services IL 501(c)(3) Line 3 Adventist Midwest Health 1 Adventist Care Centers - Courtland Inc 730 Courtland Street Orlando FL 32804 205774723 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Adventist GlenOaks Hospital 701 Winthrop Avenue Glendale Heights IL 60139 363208390 Operation of Hospital & Related Services IL 501(c)(3) Line 3 Adventist Midwest Health 1 Adventist Health Mid-America Inc 9100 W 74th Street Shawnee Mission KS 66204 521347407 Support of Affiliated Hospital KS 501(c)(3) Line 12c, III-FI Adventist Hlth SystemSunbelt Inc 1 Adventist Health Partners Inc 5101 S Willow Springs Rd Suite B101 La Grange IL 60525 364138353 Operation of Physician Practices & Medical Services IL 501(c)(3) Line 3 Adventist Midwest Health 1 Adventist Health System Georgia Inc 1035 Red Bud Road NE Calhoun GA 30701 581425000 Operation of Hospital & Related Services GA 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Adventist Hlth System Sunbelt Hlthcare Corp 900 Hope Way Altamonte Springs FL 32714 592170012 Management Services FL 501(c)(3) Line 12a, I N/A 0 Adventist Hlth SystemSunbelt Inc 900 Hope Way Altamonte Springs FL 32714 591479658 Operation of Hospitals & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Adventist Hlth SystemTexas Inc 11801 S Freeway Burleson TX 76028 742578952 Leasing Personnel to Affiliated Hospital TX 501(c)(3) Line 12c, III-FI Adventist Hlth System Sunbelt Hlthcare Corp 1 Adventist Midwest Health 120 North Oak Street Hinsdale IL 60521 362276984 Operation of Hospitals & Related Services IL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 AHP Specialty Care NFP 5101 S Willow Springs Rd Suite B101 La Grange IL 60525 811105774 Operation of Physician Practices & Medical Services IL 501(c)(3) Line 3 Adventist Midwest Health 1 AHS Midwest Management Inc 500 Remington Blvd Bolingbrook IL 60440 363354567 Operation of Physician Practice Management IL 501(c)(3) Line 12a, I Adventist Hlth System Sunbelt Hlthcare Corp 1 Apopka Health Care Properties Inc 305 E Oak Street Apopka FL 32703 510605694 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Bert Fish Medical Center Auxiliary Inc 401 Palmetto Street New Smyrna Beach FL 32168 591054892 Volunteer support services FL 501(c)(3) Line 10 Southeast Volusia Healthcare Corp 0 Bradford Heights Health & Rehab Center Inc (11-122222) 485 North Keller Road 250 Maitland FL 32751 205782342 Inactive - Wind-Down KY 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Burleson Nursing & Rehab Center Inc 301 Huguley Blvd Burleson TX 76028 205782243 Operation of Home for the Aged/Hlthcare Delivery TX 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Centura Health Corporation 9100 E Mineral Circle Centennial CO 80112 841335382 Joint Operating Company CO 501(c)(3) 0 Chickasaw Health Care Properties Inc 250 S Chickasaw Trail Orlando FL 32825 510605681 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Chippewa Valley Hospital & Oakview Care Center Inc 1220 Third Avenue West Durand WI 54736 391365168 Operation of Hospital & Related Services WI 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Coalition For Physician Well-Being Inc 900 Hope Way Altamonte Springs FL 32714 463477012 Provide support for Physician well-being FL 501(c)(3) Line 10 Adventist Hlth System Sunbelt Hlthcare Corp 1 Courtland Health Care Properties Inc 730 Courtland Street Orlando FL 32804 510605682 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Creekwood Place Nursing & Rehab Center Inc (11-12622) 485 North Keller Road 250 Maitland FL 32751 205782260 Inactive - Wind-Down KY 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Dairy Road Health Care Properties Inc 7350 Dairy Road Zephyrhills FL 33540 510605684 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 East Orlando Health & Rehab Center Inc 250 S Chickasaw Trail Orlando FL 32825 205774748 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Fletcher Hospital Inc 100 Hospital Drive Hendersonville NC 28792 560543246 Operation of Hospital & Related Services NC 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 FLNC Inc 3355 E Semoran Blvd Apopka FL 32703 205774761 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Florida Hospital Dade City Inc 13100 Fort King Road Dade City FL 33525 822567308 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Florida Hospital Healthcare Partners Inc 770 West Granada Blvd 101 Ormond Beach FL 32174 462354804 Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Florida Hospital Medical Group Inc 2600 Westhall Lane 4th Floor Maitland FL 32751 593214635 Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Florida Hospital Ocala Inc 1500 SW 1st Avenue Ocala FL 34471 824372339 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Florida Hospital Physician Group Inc 12470 Telecom Dr 100 Tampa FL 33637 462021581 Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Florida Hospital Waterman Inc 1000 Waterman Way Tavares FL 32778 593140669 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Florida Hospital Zephyrhills Inc 7050 Gall Blvd Zephyrhills FL 33541 592108057 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Florida Radiology Imaging at Lake Mary LLC 2600 Westhall Lane 4th Floor Maitland FL 32751 550789387 Imaging & Testing FL 501(c)(3) Line 3 Florida Hospital Medical Group Inc 1 Fountain Inn Nursing & Rehab Center Inc 4501 Waterman Way Tavares FL 32778 472180518 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Helen Ellis Memorial Hospital Auxiliary Inc 1395 S Pinellas Ave Tarpon Springs FL 34689 592106043 Fund-raising for Tax-exempt hospital/foundation FL 501(c)(3) Line 12c, III-FI N/A 0 Helen Ellis Memorial Hospital Foundation Inc 1395 S Pinellas Ave Tarpon Springs FL 34689 593690149 Fund-raising for Tax-exempt hospital FL 501(c)(3) Line 7 N/A 0 Hinsdale Hospital Foundation 120 North Oak Street Hinsdale IL 60521 521466387 Fund-raising for Tax-exempt hospital IL 501(c)(3) Line 7 Midwest Hlth Foundation 0 Hospice of the Comforter Inc 480 W Central Parkway Altamonte Springs FL 32714 592935928 Operation of Hospice FL 501(c)(3) Line 10 The Comforter Health Care Group Inc 1 In-Motion Rehab Inc (11-122722) 485 North Keller Road 250 Maitland FL 32751 208023411 Inactive KS 501(c)(3) Line 12b, II Sunbelt Hlth Care Centers Inc 1 Lake County Health Care Properties Inc (11-122822) 485 North Keller Road 250 Maitland FL 32751 813923985 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Memorial Health Systems Foundation Inc 305 Memorial Medical Pkwy 212 Daytona Beach FL 32117 311771522 Fund-raising for Tax-exempt hospital FL 501(c)(3) Line 7 N/A 0 Memorial Health Systems Inc 301 Memorial Medical Parkway Daytona Beach FL 32117 590973502 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Memorial Hospital - West Volusia Inc 701 West Plymouth Avenue Deland FL 32720 593256803 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Memorial Hlth Systems Inc 1 Memorial Hospital Flagler Inc 60 Memorial Medical Parkway Palm Coast FL 32164 592951990 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Memorial Hlth Systems Inc 1 Memorial Hospital Inc 210 Marie Langdon Drive Manchester KY 40962 610594620 Operation of Hospital & Related Services KY 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Metroplex Adventist Hospital Inc 2201 S Clear Creek Road Killeen TX 76549 742225672 Operation of Hospital & Related Services TX 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Metroplex Clinic Physicians Inc 2201 S Clear Creek Road Killeen TX 76549 113762050 Physician Healthcare services to the community TX 501(c)(3) Line 3 Metroplex Adventist Hospital Inc 1 Midwest Health Foundation 120 North Oak Street Hinsdale IL 60521 352230515 Fund-Raising for Supported Exempt Hospitals IL 501(c)(3) Line 7 N/A 0 Mills Health & Rehab Center Inc(11-12622) 485 North Keller Road 250 Maitland FL 32751 205782320 Inactive - Wind-Down KY 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Mission Strategies of Georgia Inc 485 North Keller Road 250 Maitland FL 32751 900866024 Provision of support to the nursing home division GA 501(c)(3) Line 12b, II Sunbelt Hlth Care Centers Inc 1 Missouri Adventist Health Inc 9100 W 74th Street Shawnee Mission KS 66204 431224729 Support Health Care Services MO 501(c)(3) Line 12d, III-O Adventist Hlth Mid-America Inc 1 Osceola Health Care Properties Inc 485 North Keller Road 250 Maitland FL 32751 813165729 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Overland Park Nursing & Rehab Center Inc 6501 West 75th Street Overland Park KS 66204 205774821 Operation of Home for the Aged/Hlthcare Delivery KS 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Pasco-Pinellas Hillsborough Community Hlth System Inc 2600 Bruce B Downs Blvd Wesley Chapel FL 33544 208488713 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Portercare Adventist Health System (630 YE) 9100 E Mineral Circle Centennial CO 80112 840438224 Operation of Hospitals & Related Services CO 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Princeton Health & Rehab Center Inc (11-12622) 485 North Keller Road 250 Maitland FL 32751 205782272 Inactive - Wind-Down KY 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Princeton Homecare Services LLC (81 - 123122) 602 Courtland Street 310 Orlando FL 32804 814196648 Home Health Care Servcies FL 501(c)(3) Line 10 Princeton Prof Services Inc 1 Princeton Professional Services Inc 601 E Rollins Street Orlando FL 32803 591191045 Provision of Healthcare Services FL 501(c)(3) Line 10 Adventist Hlth System Sunbelt Hlthcare Corp 1 Quality Circle for Healthcare Inc 900 Hope Way Altamonte Springs FL 32714 263789368 Healthcare Quality Services FL 501(c)(3) Line 12a, I Adventist Hlth System Sunbelt Hlthcare Corp 1 Redmond Park Hospital LLC 501 Redmond Road NW Rome GA 30165 581123037 Operation of Hospital & Related Services GA 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Resource Personnel Inc 485 North Keller Road 250 Maitland FL 32751 208040875 Provide administrative support to tax exempt nursing homes FL 501(c)(3) Line 12b, II Sunbelt Hlth Care Centers Inc 1 Rocky Mountain Adventist Hlthcare Foundation (630 YE) 960 E Harvard Avenue Ste 230 Denver CO 80210 840745018 Fund-raising for Tax-exempt hospital CO 501(c)(3) Line 7 N/A 0 Rollins Brook Community Care Corp 2201 S Clear Creek Road Killeen TX 76549 461656773 Support Operation of Hospital TX 501(c)(3) Line 12a, I Adventist Hlth SystemSunbelt Inc 1 San Marcos Nursing & Rehab Center Inc 1900 Medical Parkway San Marcos TX 78666 205782224 Operation of Home for the Aged/Hlthcare Delivery TX 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Shawnee Mission Hlth Care Properties Inc 485 North Keller Road 250 Maitland FL 32751 813914908 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Shawnee Mission Health Care Inc 6501 West 75th Street Overland Park KS 66204 480952508 Lease to Related Organization KS 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Shawnee Mission Medical Center Inc 9100 W 74th Street Shawnee Mission KS 66204 480637331 Operation of Hospital & Related Services KS 501(c)(3) Line 3 Adventist Hlth Mid-America Inc 1 South Pasco Health Care Properties Inc 38250 A Avenue Zephyrhills FL 33542 510605679 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Southeast Volusia Healthcare Corp 401 Palmetto Street New Smyrna Beach FL 32168 473793197 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Southwest Volusia Health Services Inc 1055 Saxon Blvd Orange City FL 32763 593281591 Medical Office Building for Hospital FL 501(c)(3) Line 12a, I Southwest Volusia Hlthcare Corp 1 Southwest Volusia Healthcare Corp 1055 Saxon Blvd Orange City FL 32763 593149293 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Spring View Health & Rehab Center Inc (11-122222) 485 North Keller Road 250 Maitland FL 32751 205782288 Inactive - Wind-Down KY 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Sunbelt Health & Rehab Center - Apopka Inc 305 East Oak Street Apopka FL 32703 205774856 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Sunbelt Health Care Centers Inc 485 North Keller Road 250 Maitland FL 32751 581473135 Management Services TN 501(c)(3) Line 12b, II Adventist Hlth System Sunbelt Hlthcare Corp 1 Tarpon Springs Hospital Foundation Inc 1395 S Pinellas Ave Tarpon Springs FL 34689 590898901 Operation of Hospital & Related Services FL 501(c)(3) Line 3 University Community Hospital Inc 1 Tarrant County Health Care Properties Inc 301 Huguley Blvd Burleson TX 76028 510605677 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 The Comforter Health Care Group Inc 605 Montgomery Road Altamonte Springs FL 32714 271857940 Support Services to Related Hospice FL 501(c)(3) Line 12c, III-FI Adventist Hlth System Sunbelt Hlthcare Corp 1 Tri-County Nursing and Rehab Center Inc 1290 Celebration Blvd Kissimmee FL 34747 472219363 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 University Community Hospital Foundation Inc 3100 E Fletcher Ave Tampa FL 33613 592554889 Fund-raising for Tax-exempt hospital FL 501(c)(3) Line 7 N/A 0 University Community Hospital Inc 3100 E Fletcher Ave Tampa FL 33613 591113901 Operation of Hospitals & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 West Florida Health Home Care Inc 13601 Bruce B Downs Blvd Ste 110 Tampa FL 33613 593686109 Home Health Services GA 501(c)(3) Line 10 AdventHealth West Florida Ambulatory Svcs Inc 1 Zephyr Haven Health & Rehab Center Inc 38250 A Avenue Zephyrhills FL 33542 205774930 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Zephyrhills Health & Rehab Center Inc 7350 Dairy Road Zephyrhills FL 33540 205774967 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Fletcher Hospital Surgical Ventures LLC 9131 Anson Way Ste 304 Raleigh NC 27615 861482646 Indirect Interest in Surgery Center NC N/A 0 0 Florida Hospital DMERT LLC 500 Winderley Place Ste 324 Maitland FL 32751 202392253 Medical Equipment FL N/A 0 1 Florida Hospital Home Infusion LLP 500 Winderley Place Ste 226 Maitland FL 32751 593142824 Home Infusion Services FL N/A 0 1 Functional Neurosurgical Ambulatory Surgery Ctr LLC 11 W Dry Creek Circle 120 Littleton CO 80120 464426708 Surgery Center CO Portercare Adventist Health System Related 1180369 1587553 0 0 0.51000 M&O Orlando MOB I LLC 1919 N Orange Ave Ste E Orlando FL 32804 844259138 Operation of Medical Office Building DE N/A 0 0 OnPoint OBGYN LLC (21-123122) 7780 S Broadway 280 Littleton CO 80122 873522453 Healthcare Services CO Portercare Adventist Health System Related -1103212 528667 0 0 0.51000 PAHS OnPoint Imaging LLC 9205 S Broadway Highlands Ranch CO 80129 833275105 Imaging Center CO Portercare Adventist Health System Related -325576 520421 0 0 0.51000 PAHS OnPoint Urgent Care LLC 9100 E Mineral Circle Centennial CO 80112 832465331 Urgent Care Center CO Portercare Adventist Health System Related -1484947 9392109 0 0 0.54000 Princeton Homecare Services LLC (11-8122) 602 Courtland Street 310 Orlando FL 32804 814196648 Operation of Home Health Agency FL N/A 0 0 Surgery Center of Rome LP 501 Redmond Road NW Rome GA 30165 200390305 Surgery Center GA N/A 0 0 The Bariatric Center of Kansas City LLC 9100 W 74th Street Merriam KS 66204 823025378 Surgery Center KS N/A 0 0 Urgent Care Centers of Brevard County LLC 2600 Westhall Lane Maitland FL 32751 844261523 Urgent Care Centers FL N/A 0 1 AdventHealth Orlando Network Inc (11 - 41922) 900 Hope Way Altamonte Springs FL 32714 862639185 Inactive FL N/A C 0 AdventHealth Professional Staffing Inc (11 - 12822) 900 Hope Way Altamonte Springs FL 32714 880742779 INACTIVE FL N/A C 0 AdventHealth Tampa Network Inc (11 - 41922) 900 Hope Way Altamonte Springs FL 32714 862666178 Inactive FL N/A C 0 AdventHealth Team Members Inc (11 - 12822) 900 Hope Way Altamonte Springs FL 32714 880763664 INACTIVE FL N/A C 0 AdventHealth Value Based Bundle Management LLC (61-123122) 101 Southhall Lane Ste 150 Maitland FL 32751 873487910 Medical Contracting and Billing FL N/A C 0 Altamonte Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando FL 32803 592855792 Condo Association FL N/A C 0 Apopka Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando FL 32803 593000857 Condo Association FL N/A C 0 Battle Creek Adventist Hospital 900 Hope Way Altamonte Springs FL 32714 381359189 Inactive MI N/A C 0 Florida Hospital Flagler Medical Offices Association Inc 60 Memorial Medical Parkway Palm Coast FL 32164 262158309 Condo Association FL N/A C 0 Florida Hosp Hlth Village Property Owner's Assoc Inc 550 E Rollins Street 7th Floor Orlando FL 32803 821748255 Condo Association FL N/A C 0 Florida Hospital Healthcare System Inc 2600 Lucien Way Maitland FL 32751 593215680 PHSO / CIN FL N/A C 0 Florida Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando FL 32803 592855791 Condo Association FL N/A C 0 Kissimmee Multispecialty Clinic Condominium Association Inc 201 Hilda Street Suite 30 Kissimmee FL 34741 593539564 Condo Association FL N/A C 0 Midwest Management Services Inc 9100 West 74th Street Shawnee Mission KS 66204 480901551 Inactive KS N/A C 0 North American Health Services Inc & Sub 900 Hope Way Altamonte Springs FL 32714 621041820 Holding Co. TN N/A C 0 Ormond Prof Associates Condo Assoc Inc (430 year end) 770 W Granada Blvd Ste 101 Ormond Beach FL 32174 592694434 Condo Association FL N/A C 0 Park Ridge Property Owner's Association Inc 1 Park Place Naples Road Fletcher NC 28732 030380531 Condo Association NC N/A C 0 Park Ridge Condominium #1 Unit Owners Association Inc 1 Park Place Naples Road Fletcher NC 28732 010584623 Condo Association NC N/A C 0 Surgicare of Rome Inc 501 Redmond Rd Rome GA 30165 200376307 Holding Company GA N/A C 0 Redmond Park Health Services Inc 501 Redmond Rd Rome GA 30165 621330078 Holding Company GA N/A C 0 The Garden Retirement Community Inc 485 North Keller Road Ste 250 Maitland FL 32751 593414055 Real Estate Rental FL N/A C 0 Winter Park Medical Office Building I Condo Assoc Inc 601 East Rollins Street Orlando FL 32803 452228478 Condo Association FL N/A C 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 Adventist Health System Sunbelt Healthcare Corporation B 13617184 Amount Given Adventist Health System Sunbelt Healthcare Corporation M 11406557 % of Facility's Operating Expense Adventist Health System Sunbelt Healthcare Corporation P 5060907 Cost Centura Health Corporation M 122101376 % of Facility's Operating Exp/Rev Centura Health Corporation P 47981707 Cost Rocky Mountain Adventist Healthcare Foundation B 512075 Amount Given Rocky Mountain Adventist Healthcare Foundation C 1935088 Amount Received