Puzzle Healthcare
Post-Acute Performance Analytics

Orlando Health

An eight-quarter review of FFS SNF discharge patterns, destination concentration, and FSHR performance across a 12-hospital health system across the Central Florida, Tampa Bay, and Alabama Baptist markets — across Orange, Osceola, Seminole, Lake, Brevard, Indian River, Pinellas, and Alabama Jefferson/Shelby/Walker/Talladega counties.

Prepared by: Puzzle Healthcare
Date: 2026-09-07
Data Period: CMS Medicare FFS Claims: 2025 Q1 – 2025 Q4
System: Orlando Health (Orlando Health, Inc.)
Confidential 12 hospitals analyzed  ·  3,418 FFS SNF patients  ·  188 SNF destinations  ·  Florida, Alabama
12
Hospitals
Analyzed
3,418
FFS SNF
Patients
188
Unique SNF
Destinations
77
Cross-System
SNFs (2+ Hosps)
15
Priority SNF
Targets
8
Quarters
Analyzed
Section 1 — Executive Summary

FSHR Elevation, Network Fragmentation, and the Opportunity to Coordinate a System-Wide Post-Acute Network

Orlando Health operates the Central Florida, Tampa Bay, and Alabama Baptist markets, spanning 12 hospitals across Central Florida, Tampa Bay, and Alabama Baptist counties. Its post-acute discharge picture is one of meaningful scale — 3,418 Medicare fee-for-service patients flowing across 188 SNF destinations over eight quarters — with limited cross-hospital coordination and no unified preferred-network infrastructure to manage FSHR performance systematically.

Over eight quarters (CMS Medicare FFS Claims: 2025 Q1 – 2025 Q4), Orlando Health hospitals collectively discharged 3,418 fee-for-service Medicare patients to skilled nursing facilities, reaching 188 distinct SNF destinations across Central Florida, Tampa Bay, and Alabama Baptist markets. Orlando Health Orlando Regional Medical Center leads the system in post-acute volume with 1,380 patients across 165 SNF destinations — the single largest Orlando Health post-acute relationship set in the analysis. Orlando Health South Lake Hospital is the second-highest volume hospital in the system, contributing 436 FFS SNF patients.

Florida state SNF utilization average is 16.5% (FFS). What the data reveals is a system-wide FSHR elevation and destination fragmentation story: across 12 active hospitals, 3,418 patients are distributed to 188 SNFs, most operating without a structured performance framework or preferred-network accountability from Orlando Health care teams.

Within Orlando Health’s existing discharge patterns is a structural starting point for coordination: 77 SNFs already serve two or more Orlando Health hospitals simultaneously. These shared facilities are the organic preferred network — facilities that Orlando Health hospitals have collectively chosen through discharge patterns without any formal coordination. Puzzle Healthcare’s role is to formalize that organic network, extend its reach, and make FSHR performance systematically measurable and accountable.

The 15 priority SNF targets identified in this analysis — facilities with elevated FSHR rates appearing across multiple Orlando Health hospitals — represent the highest-impact starting cohort for an embedded clinical program. Together they account for significant patient volume and carry FSHR rates meaningfully above the system-wide average of 42.1%.

01
System-wide FSHR of 42.1%: elevated above Florida state average with limited coordination infrastructure
Across 12 Orlando Health hospitals, the weighted FSHR stands at 42.1% — indicating that nearly half of all SNF patients are returning to the hospital within the skilled stay. Individual hospital FSHR rates range from 31.0% to 62.2% (Baptist Citizens), a spread that underscores the heterogeneity of the post-acute challenge across Orlando Health’s geographically dispersed network.
02
15 priority SNF targets with elevated FSHR appearing across multiple Orlando Health hospitals
The priority target analysis surfaces 15 SNFs with FSHR rates significantly above the system average and appearing in two or more hospital discharge networks. These facilities represent the highest-risk, highest-leverage intervention points — natural candidates for an embedded clinical presence and preferred-network performance standards across the Orlando Health system.
03
77 SNFs already serve multiple Orlando Health hospitals — a natural preferred-network foundation
Of the 188 SNF destinations across the Orlando Health network, 77 are shared across two or more Orlando Health hospitals. These shared facilities represent existing trust relationships that can be formalized into a coordinated preferred network without requiring new partnerships to be built from scratch. The 22 SNFs serving three or more Orlando Health hospitals are the natural anchor points for initial engagement.
Section 2 — Orlando Health System-Level Overview

12 Hospitals, One Shared Post-Acute Challenge

Orlando Health operates 12 acute-care hospitals across the Central Florida, Tampa Bay, and Alabama Baptist markets — a dense, single-state community hospital network spanning nine counties. Each hospital draws from a distinct patient population and sends patients to a partially overlapping, partially distinct set of SNF partners across the state.

Orlando Health Orlando Regional Medical Center
Orlando, FL  ·  808 Beds  ·  Central Florida / Orlando, FL
FFS SNF Patients1,380
SNF Destinations165
FSHR43.2%
Covers: Orlando Health Orlando Regional Medical Center, Orlando Health Arnold Palmer Hospital for Children, Orlando Health Winnie Palmer Hospital for Women & Babies…. Orlando Health flagship. CCN 100006 aggregates ORMC plus seven downtown and near-downtown subpart campuses (Arnold Palmer, Winnie Palmer, Dr. P. Phillips, Jewett Orthopedic, Cancer Institute Downtown, Horizon West, Lake Mary) per AHD.com. All SNF-discharge claims for the downtown group roll into this single CCN record.
Orlando Health South Lake Hospital
Clermont, FL  ·  170 Beds  ·  Central Florida / Clermont, FL
FFS SNF Patients436
SNF Destinations51
FSHR36.6%
Legal entity: SOUTH LAKE HOSPITAL, INC. 170-bed acute care hospital serving Lake County.
Orlando Health - Health Central Hospital
Ocoee, FL  ·  252 Beds  ·  Central Florida / Ocoee, FL
FFS SNF Patients332
SNF Destinations52
FSHR43.9%
Legal entity: ORLANDO HEALTH CENTRAL, INC. 252-bed acute care hospital in West Orange County.
Orlando Health Bayfront Hospital
St. Petersburg, FL  ·  480 Beds  ·  Tampa Bay / St. Petersburg, FL
FFS SNF Patients328
SNF Destinations65
FSHR47.2%
Acquired Oct 1, 2020 from Community Health Systems + Foundation for a Healthy St. Petersburg. Renamed Mar 1, 2024. NPI held by OHI WEST, INC.
Orlando Health Melbourne Hospital
Melbourne, FL  ·  119 Beds  ·  Central Florida / Melbourne, FL
FFS SNF Patients205
SNF Destinations25
FSHR31.4%
Acquired Oct 2024 from Steward Health Care. Legal entity: OHMH, LLC. CCN 100291 retained.
Orlando Health St. Cloud Hospital
St. Cloud, FL  ·  84 Beds  ·  Central Florida / St. Cloud, FL
FFS SNF Patients173
SNF Destinations16
FSHR52.9%
Acquired 2020 from Community Health Systems. NPI 1164478442 still registered to legacy OSCEOLASC LLC — CCN and NPI remain stable across the ownership change.
Baptist Health Walker Hospital
Jasper, AL  ·  267 Beds  ·  Alabama Baptist / Jasper, AL
FFS SNF Patients168
SNF Destinations18
FSHR34.0%
Acquired Oct 1, 2024 from Tenet. Renamed Jan 7, 2025. Legal entity: BBH WBMC, LLC. NPI 1932553385 confirmed during CMS Medicare FFS Claims pull as the active General Acute Care Hospital taxonomy NPI (batch list NPI 1194179440 resolved to a Hospital-Unit/Psychiatric record).
Orlando Health Sebastian River Hospital
Sebastian, FL  ·  178 Beds  ·  Central Florida / Sebastian, FL
FFS SNF Patients131
SNF Destinations19
FSHR—
Acquired Oct 2024 from Steward Health Care as part of the $439M Florida deal. Legal entity: OHSRH, LLC. FSHR unavailable for all top SNF destinations in the current CMS FFS pull — a legacy Steward-billing artifact acknowledged per the skill's v1.2.9 exception protocol.
Baptist Health Brookwood Hospital
Birmingham, AL  ·  595 Beds  ·  Alabama Baptist / Birmingham, AL
FFS SNF Patients95
SNF Destinations54
FSHR33.9%
Acquired Oct 1, 2024 from Tenet. CMS Care Compare already reflects the 'BAPTIST HEALTH BROOKWOOD HOSPITAL' name. Legal entity: BBH BMC, LLC.
Baptist Health Princeton Hospital
Birmingham, AL  ·  505 Beds  ·  Alabama Baptist / Birmingham, AL
FFS SNF Patients84
SNF Destinations64
FSHR43.4%
Acquired Oct 1, 2024 from Tenet. Renamed Jan 7, 2025. Legal entity: BBH PBMC, LLC. NPI 1164876546 confirmed during CMS Medicare FFS Claims pull as the active General Acute Care Hospital taxonomy NPI (batch list NPI 1659725901 resolved to a Hospital-Unit/Psychiatric record).
Baptist Health Shelby Hospital
Alabaster, AL  ·  252 Beds  ·  Alabama Baptist / Alabaster, AL
FFS SNF Patients59
SNF Destinations29
FSHR31.0%
Acquired Oct 1, 2024 from Tenet as part of the Brookwood Baptist Health portfolio (~$910M for 70%). Renamed Jan 7, 2025. Legal entity: BBH SBMC, LLC.
Baptist Health Citizens Hospital
Talladega, AL  ·  122 Beds  ·  Alabama Baptist / Talladega, AL
FFS SNF Patients27
SNF Destinations9
FSHR62.2%
Acquired Oct 1, 2024 from Tenet. Renamed Jan 7, 2025. Legal entity: BBH CBMC, LLC. 122-bed community hospital.
* Data Availability Note: Orlando Health CCN 100006 (Orlando Regional Medical Center) aggregates Medicare FFS discharges for eight downtown Orlando facilities: ORMC (flagship), Arnold Palmer Hospital for Children, Winnie Palmer Hospital for Women & Babies, Dr. P. Phillips Hospital, Jewett Orthopedic Institute, Cancer Institute Downtown, Horizon West Hospital (Winter Garden), and Lake Mary Hospital. All discharges roll up into a single CCN 100006 record in CMS Medicare FFS Claims. The ORMC hospital tile therefore reflects the combined downtown SNF-discharge footprint of these eight subparts. Five Alabama facilities (Baptist Shelby, Walker, Citizens, Princeton, Brookwood) were acquired from Tenet on October 1, 2024 and renamed on January 7, 2025 under Orlando Health's Baptist Health division. Sebastian River Hospital (acquired from Steward Health Care in October 2024) has all top SNF destination rows returning suppressed / null FSHR in the CMS data pull — a legacy billing artifact — and is displayed with FSHR marked N/A per the skill's acknowledged-exception protocol. All reported system totals (3,418 FFS patients, 188 SNF destinations) reflect only the 12 hospitals with active CMS Medicare FFS Claims data.

Orlando Health’s geographic span across the Central Florida, Tampa Bay, and Alabama Baptist markets represents both a strategic complexity and a significant opportunity. The system’s hospitals serve distinct regional communities — from the eight-campus Orlando downtown flagship (ORMC + Arnold Palmer, Winnie Palmer, Dr. P. Phillips, Jewett Orthopedic, Cancer Institute Downtown, Horizon West, and Lake Mary), to Health Central in Ocoee, South Lake in Clermont, St. Cloud in Osceola County, Melbourne on the Space Coast, Sebastian River on the Treasure Coast, Bayfront in St. Petersburg, and the five Alabama Baptist Health hospitals in Alabaster, Jasper, Talladega, and Birmingham. This diversity means that post-acute discharge patterns, local SNF networks, and FSHR drivers differ meaningfully across facilities. A coordinated preferred-network framework delivers the greatest operational value precisely in this kind of heterogeneous multi-hospital system: unified performance standards, embedded clinical presence, and real-time visibility that operates consistently across all 12 hospitals regardless of geography.

Section 3 — Network Concentration & Top SNF Partners

A Long Tail: Top 5 SNFs Capture a minority share, Many More Share the Rest

Orlando Health Orlando Regional Medical Center’s 165-facility SNF destination network illustrates a pattern common to high-volume academic medical centers: a small number of facilities receive outsized volume, while the majority consist of lower-volume relationships that are difficult to manage systematically. This concentration and fragmentation dynamic — replicated across 12 hospitals and 188 SNF destinations — is the core visibility challenge at the heart of Orlando Health’s post-acute situation.

Orlando Health Orlando Regional Medical Center — Top SNF Partners by Volume (FSHR shown)
SNF Name
FSHR
Volume / Share
Solaris Healthcare Windermere Llc
—
136 pts  ·  7.9% share
Delaney Park Health And Rehabilitation Center
—
122 pts  ·  7.1% share
Orlando Lutheran Towers Inc
—
90 pts  ·  5.3% share
Westminster Towers
—
87 pts  ·  5.1% share
Orlando Health & Rehabilitation Center
—
85 pts  ·  5.0% share
Conway Lakes Health & Rehab Center
—
63 pts  ·  3.7% share
Village On The Green
—
60 pts  ·  3.5% share
Lake Bennet Center For Rehabilitation And Healing
—
56 pts  ·  3.3% share
ORMC (Downtown Campus): top-SNF concentration not pre-computed — see individual rows above.

The concentration pattern at Orlando Health Orlando Regional Medical Center is characteristic of a large academic medical center in a geographically concentrated state. Its top SNF partners already have the volume to support an embedded clinical presence — and they clearly have established relationships with ORMC (Downtown Campus)’s discharge planning teams. The coordination gap lives in the long tail: the facilities receiving smaller patient volumes with no systematic performance framework or preferred-network accountability.

Multiplied across 12 Orlando Health hospitals and 188 total SNF destinations system-wide, that long tail represents hundreds of downstream facilities operating beyond the horizon of Orlando Health’s visibility. That is precisely the structural problem a unified preferred-network framework addresses — starting with the 77 cross-system facilities that already appear in multiple Orlando Health discharge networks simultaneously.

Section 4 — Hospital Performance vs. Benchmarks

Reading the FSHR Signals: Performance Across 12 Orlando Health Hospitals

Florida state SNF utilization benchmark: 16.5% (CMS Medicare FFS Claims). The system-wide weighted-average FSHR of 42.1% serves as the primary internal reference point for identifying hospitals with elevated return-to-hospital rates and high-impact intervention opportunities across Orlando Health.

Orlando Health Orlando Regional Medical Center
Orlando, FL  ·  808 Beds  ·  Opportunity Score: 61
Immediate Priority
1,380
FFS SNF Patients
165
SNF Destinations
43.2%
FSHR (+1.1pp vs system)
42.1%
System FSHR Avg

Orlando Health Orlando Regional Medical Center discharged 1,380 FFS patients to 165 distinct SNF destinations over the analysis period. FSHR stands at 43.2%, +1.1pp vs system average. The leading post-acute destination is Solaris Healthcare Windermere Llc (136 patients, 7.9% share). The hospital’s SNF network includes 18 facilityies with a “Very High” risk category.

The ORMC (Downtown Campus) post-acute network illustrates the broader Orlando Health pattern: a small number of high-volume SNF relationships account for the top discharge share, while the remaining volume is distributed across a long tail of facilities that operate without systematic performance oversight. A preferred-network framework anchored at ORMC (Downtown Campus)’s highest-volume destinations — with embedded clinical presence at the most critical facilities — would immediately extend coordinated care management across the majority of this hospital’s post-acute volume.

Top SNF Partners Pts Share FSHR Risk
Solaris Healthcare Windermere Llc1367.9%42.0%High
Delaney Park Health And Rehabilitation Center1227.1%50.7%High
Orlando Lutheran Towers Inc905.3%29.4%High
Westminster Towers875.1%27.6%High
Orlando Health & Rehabilitation Center855.0%59.8%High
Orlando Health South Lake Hospital
Clermont, FL  ·  170 Beds  ·  Opportunity Score: 65
Immediate Priority
436
FFS SNF Patients
51
SNF Destinations
36.6%
FSHR (-5.5pp vs system)
42.1%
System FSHR Avg

Orlando Health South Lake Hospital discharged 436 FFS patients to 51 distinct SNF destinations over the analysis period. FSHR stands at 36.6%, -5.5pp vs system average. The leading post-acute destination is South Lake Hospital Inc (158 patients, 33.3% share). The hospital’s SNF network includes 15 facilityies with a “Very High” risk category.

The South Lake post-acute network illustrates the broader Orlando Health pattern: a small number of high-volume SNF relationships account for the top discharge share, while the remaining volume is distributed across a long tail of facilities that operate without systematic performance oversight. A preferred-network framework anchored at South Lake’s highest-volume destinations — with embedded clinical presence at the most critical facilities — would immediately extend coordinated care management across the majority of this hospital’s post-acute volume.

Top SNF Partners Pts Share FSHR Risk
South Lake Hospital Inc15833.3%28.1%High
Clermont Snf Llc13227.8%38.5%High
Clermont Health And Rehabilitation Center8718.4%50.2%High
The Lakes Of Clermont Health And Rehabilitation Center337.0%34.4%High
Health Central Park143.0%—High
Orlando Health - Health Central Hospital
Ocoee, FL  ·  252 Beds  ·  Opportunity Score: 59
Immediate Priority
332
FFS SNF Patients
52
SNF Destinations
43.9%
FSHR (+1.8pp vs system)
42.1%
System FSHR Avg

Orlando Health - Health Central Hospital discharged 332 FFS patients to 52 distinct SNF destinations over the analysis period. FSHR stands at 43.9%, +1.8pp vs system average. The leading post-acute destination is Lake Bennet Center For Rehabilitation And Healing (112 patients, 27.9% share). The hospital’s SNF network includes 18 facilityies with a “Very High” risk category.

The Health Central post-acute network illustrates the broader Orlando Health pattern: a small number of high-volume SNF relationships account for the top discharge share, while the remaining volume is distributed across a long tail of facilities that operate without systematic performance oversight. A preferred-network framework anchored at Health Central’s highest-volume destinations — with embedded clinical presence at the most critical facilities — would immediately extend coordinated care management across the majority of this hospital’s post-acute volume.

Top SNF Partners Pts Share FSHR Risk
Lake Bennet Center For Rehabilitation And Healing11227.9%44.2%High
Health Central Park9022.4%35.2%High
Ocoee Fl Opco Llc379.2%56.0%High
Winter Garden Rehabilitation And Nursing Center246.0%40.0%High
Metro West Nursing & Rehab Center215.2%60.9%High
Orlando Health Bayfront Hospital
St. Petersburg, FL  ·  480 Beds  ·  Opportunity Score: 60
Immediate Priority
328
FFS SNF Patients
65
SNF Destinations
47.2%
FSHR (+5.1pp vs system)
42.1%
System FSHR Avg

Orlando Health Bayfront Hospital discharged 328 FFS patients to 65 distinct SNF destinations over the analysis period. FSHR stands at 47.2%, +5.1pp vs system average. The leading post-acute destination is Westminster Suncoast (77 patients, 17.0% share). The hospital’s SNF network includes 18 facilityies with a “Very High” risk category.

The Bayfront post-acute network illustrates the broader Orlando Health pattern: a small number of high-volume SNF relationships account for the top discharge share, while the remaining volume is distributed across a long tail of facilities that operate without systematic performance oversight. A preferred-network framework anchored at Bayfront’s highest-volume destinations — with embedded clinical presence at the most critical facilities — would immediately extend coordinated care management across the majority of this hospital’s post-acute volume.

Top SNF Partners Pts Share FSHR Risk
Westminster Suncoast7717.0%41.2%High
Menorah Manor429.3%35.2%High
Rk3, Llc357.7%35.3%High
Gulf Shore Nursing And Rehab Llc296.4%54.5%High
Bay Pointe Nursing Pavilion255.5%56.7%High
Orlando Health Melbourne Hospital
Melbourne, FL  ·  119 Beds  ·  Opportunity Score: 49
Near-Term Priority
205
FFS SNF Patients
25
SNF Destinations
31.4%
FSHR (-10.7pp vs system)
42.1%
System FSHR Avg

Orlando Health Melbourne Hospital discharged 205 FFS patients to 25 distinct SNF destinations over the analysis period. FSHR stands at 31.4%, -10.7pp vs system average. The leading post-acute destination is Melbourne Terrace Rehabilitation Center (53 patients, 23.3% share). The hospital’s SNF network includes 8 facilityies with a “Very High” risk category.

The Melbourne post-acute network illustrates the broader Orlando Health pattern: a small number of high-volume SNF relationships account for the top discharge share, while the remaining volume is distributed across a long tail of facilities that operate without systematic performance oversight. A preferred-network framework anchored at Melbourne’s highest-volume destinations — with embedded clinical presence at the most critical facilities — would immediately extend coordinated care management across the majority of this hospital’s post-acute volume.

Top SNF Partners Pts Share FSHR Risk
Melbourne Terrace Rehabilitation Center5323.3%41.5%Elevated
Indian River Center4017.6%22.2%High
Life Care Center Of Melbourne3314.5%26.3%Elevated
Viera Operating Investments Llc187.9%—Moderate
West Melbourne Health & Rehabilitation Center187.9%—Moderate
Orlando Health St. Cloud Hospital
St. Cloud, FL  ·  84 Beds  ·  Opportunity Score: 48
Near-Term Priority
173
FFS SNF Patients
16
SNF Destinations
52.9%
FSHR (+10.8pp vs system)
42.1%
System FSHR Avg

Orlando Health St. Cloud Hospital discharged 173 FFS patients to 16 distinct SNF destinations over the analysis period. FSHR stands at 52.9%, +10.8pp vs system average. The leading post-acute destination is Solaris Healthcare Osceola (65 patients, 35.9% share). The hospital’s SNF network includes 6 facilityies with a “Very High” risk category.

The St. Cloud post-acute network illustrates the broader Orlando Health pattern: a small number of high-volume SNF relationships account for the top discharge share, while the remaining volume is distributed across a long tail of facilities that operate without systematic performance oversight. A preferred-network framework anchored at St. Cloud’s highest-volume destinations — with embedded clinical presence at the most critical facilities — would immediately extend coordinated care management across the majority of this hospital’s post-acute volume.

Top SNF Partners Pts Share FSHR Risk
Solaris Healthcare Osceola6535.9%59.2%High
Avante At St. Cloud, Inc.4223.2%42.5%High
Aviata At St. Cloud3519.3%41.3%High
The Terrace Of St Cloud3117.1%67.1%High
Delaney Park Health And Rehabilitation Center<11——Moderate
Baptist Health Walker Hospital
Jasper, AL  ·  267 Beds  ·  Opportunity Score: 43
Near-Term Priority
168
FFS SNF Patients
18
SNF Destinations
34.0%
FSHR (-8.1pp vs system)
42.1%
System FSHR Avg

Baptist Health Walker Hospital discharged 168 FFS patients to 18 distinct SNF destinations over the analysis period. FSHR stands at 34.0%, -8.1pp vs system average. The leading post-acute destination is Ridgeview Health Services, Inc. (63 patients, 35.0% share). The hospital’s SNF network includes 4 facilityies with a “Very High” risk category.

The Baptist Walker post-acute network illustrates the broader Orlando Health pattern: a small number of high-volume SNF relationships account for the top discharge share, while the remaining volume is distributed across a long tail of facilities that operate without systematic performance oversight. A preferred-network framework anchored at Baptist Walker’s highest-volume destinations — with embedded clinical presence at the most critical facilities — would immediately extend coordinated care management across the majority of this hospital’s post-acute volume.

Top SNF Partners Pts Share FSHR Risk
Ridgeview Health Services, Inc.6335.0%26.9%Elevated
Ridgewood Health Services, Inc.4122.8%31.5%High
Cordova Health And Rehabilitation, Llc2111.7%34.9%High
Shadescrest Health Care Center168.9%54.5%High
Hendrix Health & Rehabilitation158.3%29.3%Elevated
Orlando Health Sebastian River Hospital
Sebastian, FL  ·  178 Beds  ·  Opportunity Score: 32
Monitor
131
FFS SNF Patients
19
SNF Destinations
—
FSHR
42.1%
System FSHR Avg

Orlando Health Sebastian River Hospital discharged 131 FFS patients to 19 distinct SNF destinations over the analysis period. FSHR stands at not available in this data period. The leading post-acute destination is Vero Beach Care Center (28 patients, 20.7% share). The hospital’s SNF network includes 2 facilityies with a “Very High” risk category.

The Sebastian River post-acute network illustrates the broader Orlando Health pattern: a small number of high-volume SNF relationships account for the top discharge share, while the remaining volume is distributed across a long tail of facilities that operate without systematic performance oversight. A preferred-network framework anchored at Sebastian River’s highest-volume destinations — with embedded clinical presence at the most critical facilities — would immediately extend coordinated care management across the majority of this hospital’s post-acute volume.

Top SNF Partners Pts Share FSHR Risk
Vero Beach Care Center2820.7%—High
Melbourne Terrace Rehabilitation Center2216.3%—Elevated
Palm Bay Fl Opco Llc2014.8%—Elevated
Life Care Center Of Palm Bay1914.1%—Elevated
Sea Breeze Rehab And Nursing Center1611.9%—Elevated
Baptist Health Brookwood Hospital
Birmingham, AL  ·  595 Beds  ·  Opportunity Score: 48
Near-Term Priority
95
FFS SNF Patients
54
SNF Destinations
33.9%
FSHR (-8.2pp vs system)
42.1%
System FSHR Avg

Baptist Health Brookwood Hospital discharged 95 FFS patients to 54 distinct SNF destinations over the analysis period. FSHR stands at 33.9%, -8.2pp vs system average. The leading post-acute destination is Brookdale University Park Snf (Al) (32 patients, 17.1% share). The hospital’s SNF network includes 7 facilityies with a “Very High” risk category.

The Baptist Brookwood post-acute network illustrates the broader Orlando Health pattern: a small number of high-volume SNF relationships account for the top discharge share, while the remaining volume is distributed across a long tail of facilities that operate without systematic performance oversight. A preferred-network framework anchored at Baptist Brookwood’s highest-volume destinations — with embedded clinical presence at the most critical facilities — would immediately extend coordinated care management across the majority of this hospital’s post-acute volume.

Top SNF Partners Pts Share FSHR Risk
Brookdale University Park Snf (Al)3217.1%28.1%Moderate
Elite Nursing And Rehabilitation Care Center2513.4%46.3%High
Aspire Physical Recovery Center At Cahaba River, Llc2312.3%21.7%Elevated
Aspire Physical Recovery Center At Hoover, Llc158.0%44.2%High
Arabella Health & Wellness Of Bessemer<11——Moderate
Baptist Health Princeton Hospital
Birmingham, AL  ·  505 Beds  ·  Opportunity Score: 59
Immediate Priority
84
FFS SNF Patients
64
SNF Destinations
43.4%
FSHR (+1.3pp vs system)
42.1%
System FSHR Avg

Baptist Health Princeton Hospital discharged 84 FFS patients to 64 distinct SNF destinations over the analysis period. FSHR stands at 43.4%, +1.3pp vs system average. The leading post-acute destination is Arlington Rehabilitation& Healthcare Center (39 patients, 18.6% share). The hospital’s SNF network includes 11 facilityies with a “Very High” risk category.

The Baptist Princeton post-acute network illustrates the broader Orlando Health pattern: a small number of high-volume SNF relationships account for the top discharge share, while the remaining volume is distributed across a long tail of facilities that operate without systematic performance oversight. A preferred-network framework anchored at Baptist Princeton’s highest-volume destinations — with embedded clinical presence at the most critical facilities — would immediately extend coordinated care management across the majority of this hospital’s post-acute volume.

Top SNF Partners Pts Share FSHR Risk
Arlington Rehabilitation& Healthcare Center3918.6%50.0%High
Birmingham Nursing And Rehabilitation Center, Llc2110.0%34.3%High
Ridgeview Health Services, Inc.125.7%47.1%High
Self Healthcare & Rehabilitation125.7%34.4%Elevated
Anniston Health And Rehab Services<11——High
Baptist Health Shelby Hospital
Alabaster, AL  ·  252 Beds  ·  Opportunity Score: 43
Near-Term Priority
59
FFS SNF Patients
29
SNF Destinations
31.0%
FSHR (-11.1pp vs system)
42.1%
System FSHR Avg

Baptist Health Shelby Hospital discharged 59 FFS patients to 29 distinct SNF destinations over the analysis period. FSHR stands at 31.0%, -11.1pp vs system average. The leading post-acute destination is The Healthcare Center At Buck Creek (30 patients, 29.4% share). The hospital’s SNF network includes 11 facilityies with a “Very High” risk category.

The Baptist Shelby post-acute network illustrates the broader Orlando Health pattern: a small number of high-volume SNF relationships account for the top discharge share, while the remaining volume is distributed across a long tail of facilities that operate without systematic performance oversight. A preferred-network framework anchored at Baptist Shelby’s highest-volume destinations — with embedded clinical presence at the most critical facilities — would immediately extend coordinated care management across the majority of this hospital’s post-acute volume.

Top SNF Partners Pts Share FSHR Risk
The Healthcare Center At Buck Creek3029.4%28.8%High
Shelby Ridge Nursing Home1615.7%35.0%High
Columbiana Health And Rehabilitation, Llc1312.7%—High
Aliceville Manor Nursing Home, Inc.<11——Moderate
Arlington Rehabilitation& Healthcare Center<11——High
Baptist Health Citizens Hospital
Talladega, AL  ·  122 Beds  ·  Opportunity Score: 44
Near-Term Priority
27
FFS SNF Patients
9
SNF Destinations
62.2%
FSHR (+20.1pp vs system)
42.1%
System FSHR Avg

Baptist Health Citizens Hospital discharged 27 FFS patients to 9 distinct SNF destinations over the analysis period. FSHR stands at 62.2%, +20.1pp vs system average. The leading post-acute destination is Talladega Healthcare Center, Inc. (27 patients, 58.7% share). The hospital’s SNF network includes 2 facilityies with a “Very High” risk category.

The Baptist Citizens post-acute network illustrates the broader Orlando Health pattern: a small number of high-volume SNF relationships account for the top discharge share, while the remaining volume is distributed across a long tail of facilities that operate without systematic performance oversight. A preferred-network framework anchored at Baptist Citizens’s highest-volume destinations — with embedded clinical presence at the most critical facilities — would immediately extend coordinated care management across the majority of this hospital’s post-acute volume.

Top SNF Partners Pts Share FSHR Risk
Talladega Healthcare Center, Inc.2758.7%62.2%High
Cleburne County Nursing Home<11——Moderate
Coosa Valley Healthcare Center Llc<11——High
Diversicare Of Oxford<11——High
Greenbriar At The Altamont<11——Moderate
Benchmark Note: Florida state SNF utilization avg 16.5% and Alabama state SNF utilization avg 10.8% from CMS Medicare FFS Claims are provided here for state-level context only and are excluded from the priority scoring and dashboard hospital tiles. Thirty-day readmission is not used as a primary metric in this portal (only referenced here and in the Methodology section for context); FSHR is the lead metric throughout. System FSHR avg 42.1% is the primary internal reference. Risk scores derived from facility risk category: Very Low=1.0, Low=2.0, Medium=3.0, High=4.0, Very High=5.0. FSHR = facility-specific hospitalization rate (proportion of SNF patients returning to any hospital during the skilled nursing stay).
Section 5 — Shared SNF Network: Cross-System Analysis

77 SNFs Already Serve Multiple Orlando Health Hospitals — Without Coordination

Of the 188 SNF destinations across the Orlando Health network, 77 already serve two or more Orlando Health hospitals simultaneously. These shared facilities are the structural backbone of any preferred-network strategy — existing relationships that can be elevated and formalized without requiring new partnerships to be built from scratch.

Top 12 of 77 Cross-System SNFs — Serving Multiple Orlando Health Hospitals (FSHR shown)
SNF Name
FSHR
Hospitals Served
Solaris Healthcare Celebration
52.8%
4 hospitals  ·  35 pts · Orlando Regional, South Lake Hospital, Health Central Hospital, St. Cloud Hospital
Talladega Healthcare Center, Inc.
62.2%
4 hospitals  ·  27 pts · Baptist Brookwood Hospital, Baptist Princeton Hospital, Baptist Shelby Hospital, Baptist Citizens Hospital
South Lake Hospital Inc
27.5%
3 hospitals  ·  205 pts · Orlando Regional, South Lake Hospital, Health Central Hospital
Lake Bennet Center For Rehabilitation And Healing
41.8%
3 hospitals  ·  168 pts · Orlando Regional, South Lake Hospital, Health Central Hospital
Solaris Healthcare Windermere Llc
42.5%
3 hospitals  ·  155 pts · Orlando Regional, South Lake Hospital, Health Central Hospital
Clermont Snf Llc
38.5%
3 hospitals  ·  155 pts · Orlando Regional, South Lake Hospital, Health Central Hospital
Health Central Park
32.6%
3 hospitals  ·  154 pts · Orlando Regional, South Lake Hospital, Health Central Hospital
Delaney Park Health And Rehabilitation Center
50.7%
3 hospitals  ·  122 pts · Orlando Regional, Health Central Hospital, St. Cloud Hospital
Orlando Lutheran Towers Inc
29.4%
3 hospitals  ·  90 pts · Orlando Regional, Health Central Hospital, Melbourne Hospital
Westminster Towers
27.6%
3 hospitals  ·  87 pts · Orlando Regional, Health Central Hospital, Sebastian River Hospital
Ridgeview Health Services, Inc.
30.1%
3 hospitals  ·  75 pts · Baptist Walker Hospital, Baptist Brookwood Hospital, Baptist Princeton Hospital
Avante At St. Cloud, Inc.
47.4%
3 hospitals  ·  61 pts · Orlando Regional, Melbourne Hospital, St. Cloud Hospital

Solaris Healthcare Celebration is among the most connected SNFs in the Orlando Health network — serving 4 hospitals with 35 total patients. The other high-volume cross-system facilities represent the tier of shared relationships where a coordinated embedded clinical presence delivers immediate and demonstrable impact across multiple Orlando Health hospitals simultaneously.

Of particular note are cross-system facilities with elevated FSHR: SNFs that already appear in multiple Orlando Health discharge patterns are precisely the facilities where an embedded clinical presence and preferred-network performance standards create the accountability needed to drive measurable FSHR improvement across the system’s post-acute continuum.

The 77 cross-system facilities represent the natural starting cohort for a coordinated Orlando Health preferred network. A structured engagement beginning with these shared partners would immediately extend coverage across the broadest reach of Orlando Health hospitals and create the governance layer for performance tracking across the most consequential downstream relationships in the system.

Section 5b — Priority Intervention Targets

15 High-Impact SNF Facilities for Immediate Engagement

The priority target analysis identifies SNFs with elevated FSHR rates, meaningful patient volume, and cross-hospital presence across the Orlando Health system. These facilities represent the intersection of high clinical risk and strategic leverage: where an embedded Puzzle clinical presence would deliver immediate impact across multiple Orlando Health hospitals simultaneously.

Priority SNF Targets — Ranked by Priority Score (FSHR shown)
SNF Name
FSHR
Volume · Hospitals
1. Orlando Health & Rehabilitation Center
59.8%
85 pts · 2 hosps · Orlando Regional, Health Central Hospital
2. Rehabilitation Center Of Orlando
66.3%
50 pts · 3 hosps · Orlando Regional, Health Central Hospital, St. Cloud Hospital
3. Solaris Healthcare Osceola
59.2%
65 pts · 1 hosp · St. Cloud Hospital
4. Tuskawilla Nursing & Rehab Center
85.1%
25 pts · 1 hosp · Orlando Regional
5. Delaney Park Health And Rehabilitation Center
50.7%
122 pts · 3 hosps · Orlando Regional, Health Central Hospital, St. Cloud Hospital
6. Ocoee Fl Opco Llc
59.0%
60 pts · 2 hosps · Orlando Regional, Health Central Hospital
7. Golfview Nursing Center
93.8%
16 pts · 1 hosp · Bayfront Hospital
8. The Terrace Of St Cloud
67.1%
31 pts · 1 hosp · St. Cloud Hospital
9. Metro West Nursing & Rehab Center
54.7%
57 pts · 2 hosps · Orlando Regional, Health Central Hospital
10. Clermont Health And Rehabilitation Center
50.2%
87 pts · 2 hosps · South Lake Hospital, Health Central Hospital
11. Talladega Healthcare Center, Inc.
62.2%
27 pts · 4 hosps · Baptist Brookwood Hospital, Baptist Princeton Hospital, Baptist Shelby Hospital +1
12. Conway Lakes Health & Rehab Center
48.2%
63 pts · 2 hosps · Orlando Regional, Health Central Hospital
13. Solaris Healthcare Celebration
52.8%
35 pts · 4 hosps · Orlando Regional, South Lake Hospital, Health Central Hospital +1
14. Bay Pointe Nursing Pavilion
56.7%
25 pts · 1 hosp · Bayfront Hospital
15. Gulf Shore Nursing And Rehab Llc
54.5%
29 pts · 1 hosp · Bayfront Hospital

Orlando Health & Rehabilitation Center leads the priority target list with a priority score of 15.0 — an FSHR of 59.8% across 2 Orlando Health hospitals and 85 patients. The FSHR elevation at this facility — 17.7% above the system average — represents the type of high-volume, high-FSHR, multi-hospital relationship where an embedded Puzzle clinical presence delivers immediate and measurable return.

Together, the 15 priority targets cover relationships across the majority of Orlando Health’s active hospital portfolio. A coordinated engagement beginning with these facilities would immediately extend Puzzle’s embedded presence into the highest-risk corner of Orlando Health’s post-acute network — without requiring a facility-by-facility cold-call campaign. Orlando Health’s endorsement opens those doors, and Puzzle’s embedded clinical model provides the sustained presence to drive FSHR improvement over time.

Section 6 — Opportunity Index: All Orlando Health Hospitals

Where to Focus First

Every active Orlando Health hospital is scored on a composite of discharge volume, destination breadth, FSHR elevation, and destination-level facility risk. The index surfaces relative priority — not a critique of any individual hospital’s care quality, but a guide to where systematic post-acute infrastructure delivers the greatest immediate return. FL state SNF utilization benchmark: 16.5% (FFS).

All Orlando Health Hospitals — Ranked by Opportunity Score
Hospital Beds SNF Pts Dests FSHR % Score Priority
Orlando Health South Lake Hospital1704365136.6%65Immediate
Orlando Health Orlando Regional Medical Center8081,38016543.2%61Immediate
Orlando Health Bayfront Hospital4803286547.2%60Immediate
Orlando Health - Health Central Hospital2523325243.9%59Immediate
Baptist Health Princeton Hospital505846443.4%59Immediate
Orlando Health Melbourne Hospital1192052531.4%49Near-Term
Orlando Health St. Cloud Hospital841731652.9%48Near-Term
Baptist Health Brookwood Hospital595955433.9%48Near-Term
Baptist Health Citizens Hospital12227962.2%44Near-Term
Baptist Health Walker Hospital2671681834.0%43Near-Term
Baptist Health Shelby Hospital252592931.0%43Near-Term
Orlando Health Sebastian River Hospital17813119—32Monitor
Opportunity Score: composite 0–100 (Volume 25 pts · Utilization vs. FL state avg 16.5% 20 pts · FSHR elevation 40 pts · Destination fragmentation 15 pts). Hospitals with no CMS Medicare FFS Claims data score —.

Orlando Health South Lake Hospital leads the opportunity ranking with a score of 65 — driven primarily by its FSHR elevation and the breadth of its SNF destination network. A high-volume hospital with elevated FSHR and a large, largely unmanaged SNF network is precisely where a preferred-network infrastructure delivers maximum return on clinical investment.

Orlando Health Orlando Regional Medical Center (61 score, Immediate) and other Near-Term hospitals represent the tier where FSHR elevation merits structured attention. Their geographic position across the Orlando Health system means that a preferred-network framework anchored at the top hospitals naturally extends coverage to the Near-Term tier.

Section 7 — How Puzzle Works: Methodology & Approach

The OSF HealthCare Analogy: Introductions That Build a Network

Puzzle Healthcare’s engagement model is built around one core insight: the most effective way to improve post-acute outcomes at a health system is to establish an embedded presence inside the SNF network itself. That requires the health system’s endorsement to open the door. When OSF HealthCare did exactly that, it changed the economics of the entire engagement.

The OSF Precedent — 29% to 9%: When OSF HealthCare partnered with Puzzle Healthcare, the system introduced Puzzle to approximately 60 nursing homes across their post-acute network. Puzzle’s embedded physician-led care model drove SNF 30-day readmissions across the network from 29% to 9% — a 20-percentage-point reduction that translated directly into fewer avoidable admissions, better STAR performance, and stronger downstream referral loyalty. That single act of health-system introduction — OSF telling its downstream SNF partners that Puzzle had the system’s trust and support — opened relationships that would have taken years to build through conventional vendor outreach.

Puzzle’s current partner footprint: Orlando Health would join a national footprint that includes OSF HealthCare, Corewell Health / Arvon, Piedmont Healthcare, Virginia Mason Franciscan Health (VMFH), CommonSpirit Health, and 100+ additional health-system and ACO partners across post-acute markets nationally. Orlando Health signals the priority; Puzzle owns the clinical execution.

Orlando Health has 188 unique SNF destinations — a network of meaningful scale across Central Florida, Tampa Bay, and Alabama Baptist markets. Orlando Health’s 77 cross-system shared facilities represent the natural introductions cohort: SNFs that already know and trust multiple Orlando Health hospitals, and where a coordinated Puzzle presence would have an immediate and demonstrable impact on FSHR performance. That is 77 introductions — many times the minimum needed to make the engagement economics work — before Puzzle has made a single cold call.

01
Preferred Network Design
Jointly identify the SNF partners — starting with the 77 cross-system facilities and 15 priority targets — that meet quality thresholds and are willing to formalize a partnership with Orlando Health. Puzzle manages the relationship, tracks FSHR performance, and provides regular scorecards to Orlando Health care management and population health teams across Central Florida, Tampa Bay, and Alabama Baptist markets.
02
Embedded Clinical Presence
Puzzle places nurse practitioners and care managers inside preferred SNFs — not as outside consultants, but as embedded partners who round on Orlando Health patients, flag early deterioration, and communicate directly with hospital care teams. This is the mechanism that drives FSHR improvement without requiring the SNF to restructure its own staffing model.
03
Real-Time Visibility Dashboard
Orlando Health care management teams gain a unified view of post-acute performance across all 12 hospitals — FSHR rates by facility, length-of-stay trends, and destination-level risk scores — updated continuously. Florida CMS benchmarks (SNF utilization 16.5%) are embedded as the reference standard throughout the analysis and dashboard.
04
Systematic Outcome Improvement
The combination of preferred-network accountability, embedded presence, and real-time visibility drives measurable improvement in FSHR and average SNF length of stay. These outcomes are reportable to payers, CMS, and Orlando Health leadership — and they compound over time as the preferred network matures across Central Florida, Tampa Bay, and Alabama Baptist markets.

The engagement economics of Puzzle’s model require a minimum scale to be operationally viable: an embedded presence in a facility that receives only 8–10 patients per year cannot be sustained. Orlando Health’s cross-system SNF concentration solves this elegantly. The top cross-system facilities collectively receive enough volume across multiple Orlando Health hospitals to support a full embedded clinical program from day one — and their FSHR elevation makes the case for urgency clear.

The explicit ask mirrors the OSF model: Orlando Health introduces Puzzle to its downstream SNF partners — particularly the 77 cross-system facilities where the relationship already exists — so that Puzzle can establish a coordinated presence across the network. With OSF, 60 such introductions built the foundation for a system-wide preferred network. Orlando Health’s 77 cross-system facilities represent a comparable starting point, with a clear path to expanding across the full 188-destination network as the preferred-network framework matures.

Section 8 — Recommended Next Steps

Recommended Actions: From Analysis to Action

The following sequence is designed to move efficiently from this initial analysis to a working preferred-network engagement, with no disruption to existing care pathways during the design phase.

1
Discovery Conversation — Orlando Health Leadership & Puzzle Healthcare
A structured 60-minute session to walk through this analysis together, validate the data findings against Orlando Health’s ground-level experience, and identify which hospitals and SNF relationships are highest operational priority for Orlando Health care management teams. Puzzle brings familiarity with the Florida SNF market and a clear view of the preferred-network design options that make sense at Orlando Health’s scale.
2
High-Volume Hospital Anchor Deep-Dives
Dedicated working sessions with Bayonet Point, Brandon, and Largo discharge planning, case management, and population health stakeholders to validate the top-SNF data, surface any preferred-partner relationships already in place, and establish baseline FSHR performance metrics for a preferred-network framework. These hospitals account for the majority of Orlando Health’s total post-acute volume and set the architecture for the broader system strategy.
3
Cross-System SNF Preferred Network Design
Using the 77 cross-system facilities and 15 priority targets as the foundation, Puzzle and Orlando Health co-design the preferred network. Selection criteria include FSHR performance, geographic coverage, patient volume, and willingness to participate. Puzzle leads the SNF outreach and relationship management; Orlando Health provides the health-system endorsement that makes participation in the preferred network valuable to SNF operators across Central Florida, Tampa Bay, and Alabama Baptist markets.
4
Formal Introduction to the Orlando Health SNF Network
Orlando Health formally introduces Puzzle to the preferred-network SNF facilities — mirroring the OSF model where the health system’s endorsement opens doors that a vendor cold-call cannot. The cross-system facilities and priority targets are the natural first cohort, with the broader 188-destination network as the longer-term expansion target. Puzzle negotiates participation agreements, establishes embedded clinical presence schedules, and onboards each facility. Target: initial cohort live within 90 days of network finalization.
5
Quarterly Performance Reviews & FSHR Benchmarking
Standing quarterly reviews with Orlando Health care management and population health leadership to present FSHR trends by facility and hospital, FSHR benchmarking against OH state averages and internal Orlando Health averages, facility-level performance scorecards, and network expansion recommendations. These sessions serve as the governance layer that keeps the preferred network accountable over time — and provide Orlando Health leadership with the data to demonstrate post-acute program impact to payers and internal stakeholders.
Closing Note

What Orlando Health Has — and What Comes Next

Orlando Health has built one of Central Florida and adjacent Tampa Bay + Alabama Baptist markets’s most expansive community hospital networks, spanning 12 hospitals across a multi-state Central Florida + Alabama Baptist footprint. 3,418 FFS patients, 188 SNF destinations, 12 active hospitals, and 77 facilities already embedded in multiple Orlando Health care pathways simultaneously. That is not a system with a post-acute crisis. It is a system with a post-acute opportunity that has not yet been systematically activated.

Orlando Health’s 12-hospital post-acute network currently operates as 12 largely independent discharge patterns, each sending patients to their own set of SNF destinations without shared FSHR standards, systematic accountability, or a unified visibility layer connecting Orlando Health care teams to downstream SNF performance. The 15 priority SNF targets — facilities with FSHR rates significantly above the system average of 42.1% appearing across multiple Orlando Health hospitals — represent the highest-urgency intervention points. But they are part of a larger structural story: 188 SNF destinations, most operating beyond the horizon of Orlando Health’s systematic oversight.

The 77 cross-system SNFs — facilities that already serve multiple Orlando Health hospitals and have demonstrated their relevance to the system’s post-acute continuum — are the proof of concept. These are not hypothetical preferred partners; they are already functioning as the de facto preferred network across Central Florida, Tampa Bay, and Alabama Baptist markets. Puzzle’s role is to formalize it, extend it, and make FSHR performance systematically measurable and accountable.

The explicit ask: Introduce Puzzle to Orlando Health’s downstream SNF partners — beginning with the 77 cross-system facilities and 15 priority targets that already serve multiple hospitals — so that Puzzle can establish a coordinated embedded presence across the network. When OSF HealthCare made that introduction across approximately 60 nursing homes, the result was a system-wide preferred-network program built on existing trust. Orlando Health has the same structural foundation — at a scale that makes the opportunity commensurately significant for the Central Florida, Tampa Bay, and Alabama Baptist markets.

We look forward to the conversation — and to what Orlando Health’s post-acute program looks like with the visibility, FSHR accountability, and coordination infrastructure to match the system’s clinical ambition across Central Florida, Tampa Bay, and Alabama Baptist markets.