ADVENTHEALTH WEST FLORIDA AMBULATORY SERVICES INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- ADVENTHEALTH WEST FLORIDA AMBULATORY SERVICES INC (EIN 47-1881744)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-10
- IRS object ID
- 202123149349304902
- Schema version
- 2020v4.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-11-10T13:24:25-06:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 471881744 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AdventHealth West Florida Ambulatory | BusinessNameLine1Txt |
| Business Name Line2 | Services Inc | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ADVE | BusinessNameControlTxt |
| Phone | 8138034030 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14055 Riveredge Drive | AddressLine1Txt |
| City | Tampa | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33637 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Clay Presswood | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 8138034030 | PhoneNum |
| Signature | 2021-09-29 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Clay | PersonFirstNm |
| Person Last | Presswood | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Michael Schultz | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14055 Riveredge Drive | AddressLine1Txt |
| City | Tampa | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33637 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $402 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2014 | FormationYr |
| Legal Domicile State | FL | LegalDomicileStateCd |
| Activity Or Mission | To expand the availability of professional medical services to residents and visitors of West Florida; and to promote public health and foster related activities that are consistent with the scientific, educational and charitable purposes. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 9 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $388 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $0 | PYTotalRevenueAmt |
| CY Total Revenue | $388 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $596,255 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $0 | PYOtherExpensesAmt |
| CY Other Expenses | $4,416,222 | CYOtherExpensesAmt |
| PY Total Expenses | $0 | PYTotalExpensesAmt |
| CY Total Expenses | $5,012,477 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $0 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$5,012,089 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,300,000 | TotalAssetsBOYAmt |
| Total Assets EOY | $17,672,146 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,358,695 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,300,000 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $13,313,451 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Adventist Health System Sunbelt Healthcare Corporation and all its subsidiary organizations were established by the Seventh-Day Adventist Church to bring a ministry of healing and health to the communities served. Our mission is to extend the healing ministry of Christ.The filing organization and healthcare system whose parent is Adventist Health System Sunbelt Healthcare Corporation is known as AdventHealth. AdventHealth seeks to be widely respected as a consumer-focused organization that engages individuals in their health by delivering wholistic, best practice care across a connected, comprehensive continuum of services. With Christ as our example, AdventHealth cares for and nurtures people: our employees, our communities, our healthcare professionals, and those who trust us for care and healing. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,025,446 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | The filing organization provides oversight, support and guidance to its wholly-owned subsidiaries that operate and provide out-patient professional medical services. | Desc |
| Total Program Service Expenses | $1,025,446 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 9 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Clay Presswood | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3862314521 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14055 Riveredge Drive | AddressLine1Txt |
| City | Tampa | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33637 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Michael Schultz | ||||||||
| Chairman/Pres/Director | 0.10 | 50.00 | Yes (X) | Yes (X) | $0 | $1,586,063 | $53,434 | |
| Bruce Bergherm | ||||||||
| VP/Secretary/Director | 0.10 | 50.00 | Yes (X) | $0 | $1,203,438 | $138,808 | ||
| Vadym Didenko | ||||||||
| Treasurer/Director | 0.10 | 50.00 | Yes (X) | $0 | $754,003 | $135,314 | ||
| John Johannessen | ||||||||
| Director/Regional SEO Non-Acute | 2.00 | 48.00 | Yes (X) | $0 | $581,774 | $102,018 | ||
| Clay Presswood | ||||||||
| Director/Regional CFO Non-Acute | 2.00 | 48.00 | Yes (X) | $0 | $346,062 | $96,335 | ||
| Ana Ali | ||||||||
| AVP Strategic Innovation | 10.00 | 30.00 | $155,788 | $12,280 | $17,695 | Yes (X) | ||
| Elin Boyd | ||||||||
| Sr Dir Due Dilligence & Tran | 10.00 | 30.00 | $126,947 | $9,032 | $42,463 | Yes (X) | ||
| Rebecca Pessel | ||||||||
| HR Director & HRBP | 10.00 | 30.00 | $141,720 | $10,109 | $13,306 | Yes (X) | ||
| Eugenia Sutton | ||||||||
| Director Outpatient Imaging | 0.00 | 40.00 | $122,981 | $9,587 | $28,225 | Yes (X) | ||
| Kirsten Quinlan | ||||||||
| AVP Physician Recruiting | 0.00 | 40.00 | $108,511 | $0 | $8,407 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $655,947 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,512,348 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $636,005 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMN Healthcare Inc | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1905 Corporate Blvd NW | AddressLine1Txt |
| City | Boca Raton | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33431 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | Medical Staffing Services | ServicesDesc |
| Compensation | $389,798 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Info In Schedule O Part VIII | Yes (X) | InfoInScheduleOPartVIIIInd |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $402 | TotalRevenueColumnAmt |
| Exclusion | $402 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $14 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$14 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$14 | TotalRevenueColumnAmt |
| Exclusion | -$14 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $388 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $388 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,557 | TotalAmt |
| Management And General | $52,557 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $412,562 | TotalAmt |
| Program Services | $306,448 | ProgramServicesAmt |
| Management And General | $106,114 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,441 | TotalAmt |
| Program Services | $8,498 | ProgramServicesAmt |
| Management And General | $2,943 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,170 | TotalAmt |
| Program Services | $38,009 | ProgramServicesAmt |
| Management And General | $13,161 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,525 | TotalAmt |
| Program Services | $50,900 | ProgramServicesAmt |
| Management And General | $17,625 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $205,469 | TotalAmt |
| Management And General | $205,469 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70 | TotalAmt |
| Management And General | $70 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,075,463 | TotalAmt |
| Program Services | $504,878 | ProgramServicesAmt |
| Management And General | $3,570,585 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,157 | TotalAmt |
| Program Services | $4,970 | ProgramServicesAmt |
| Management And General | $15,187 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,206 | TotalAmt |
| Program Services | $4,206 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,320 | TotalAmt |
| Management And General | $3,320 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,387 | TotalAmt |
| Program Services | $4,387 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $102,577 | TotalAmt |
| Program Services | $102,577 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| Other expense-ProgServ | $520 | $520 |
| Medical supplies | $53 | $53 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,012,477 | TotalAmt |
| Program Services | $1,025,446 | ProgramServicesAmt |
| Management And General | $3,987,031 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,450 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $53,522 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $180,420 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $17,518,516 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $102,577 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,294,550 | BOYAmt |
| EOY | $17,415,939 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $22,265 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,300,000 | BOYAmt |
| EOY | $17,672,146 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,786,469 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $2,572,226 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $4,358,695 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,300,000 | BOYAmt |
| EOY | $13,313,451 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,300,000 | BOYAmt |
| EOY | $13,313,451 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,300,000 | BOYAmt |
| EOY | $17,672,146 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$5,012,089 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $558 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $13,024,982 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type2 | Yes (X) | SupportingOrgType2Ind |
| Supported Organizations | 2 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (2 entries)
| EINEIN | Organization TypeOrganizationTypeCd | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| West Florida Health Home Care Inc | ||||
| 593686109 | 10 | 0 | $0 | $0 |
| AdventHealth West Florida Imaging Inc | ||||
| 843225135 | 10 | 0 | $800,000 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 2 | SupportedOrganizationsTotalCnt |
| Support Sum | $800,000 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | 0 | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Majority Dir Trst Supported Org | Yes (1) | MajorityDirTrstSupportedOrgInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule A, Part IV, Section A, Line 1 | FormAndLineReferenceDesc |
| Explanation | The governing documents of the filing organization state that its purposes include the expansion of the availability of professional medical services to residents and visitors of West Florida and to promote public health and foster related activities that are in furtherance of the health ministry of the Seventh-day Adventist Church. Currently, the filing organization is the sole member and supporting organization of two 501(c)(3) subsidiaries that provide professional medical and healthcare services, namely home health services and imaging services. In accordance with Treasury Regulation Section 1.509(a)-4(d)(2), the supported organization is operating in support of organizations that are designated by purpose in the filing organization's Articles of Incorporation. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,444,898 | OtherCostOrOtherBasisAmt |
| Book Value | $6,444,898 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,480,126 | OtherCostOrOtherBasisAmt |
| Depreciation | $91,336 | DepreciationAmt |
| Book Value | $5,388,790 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $44,965 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,241 | DepreciationAmt |
| Book Value | $33,724 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,548,527 | OtherCostOrOtherBasisAmt |
| Book Value | $5,548,527 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $17,415,939 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Due to Related | $2,545,701 |
| AIP AH Cash Mgmt Interest Exp | $4,387 |
| Other Non-Current Liabilities | $22,138 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,572,226 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | 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, 2020 and 2019. NAHS also has temporary deductible differences of approximately $41,800 and $46,500 at December 31, 2020 and 2019, respectively, primarily as a result of net operating loss carryforwards. At December 31, 2020, NAHS had net operating loss carryforwards of approximately $43,500, expiring beginning in 2022 through 2026. Deferred taxes have been provided for these amounts, resulting in a net deferred tax asset of approximately $10,200 and $11,400 at December 31, 2020 and 2019, 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, 2020 and 2019 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, 2020 and 2019. On December 22, 2017, the United States enacted tax reform legislation commonly known as the Tax Cuts and Jobs Act (Act), resulting in significant modifications to existing law. Certain provisions impact tax-exempt organizations, including revisions to taxes on unrelated business activities, excise taxes on compensation of certain employees, and various other provisions. The impact of these provisions on the consolidated financial statements is not, and is not expected, to be significant. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Michael Schultz | ||||||||||||||
| Chairman/Pres/Director | $0 | $929,809 | $0 | $344,679 | $0 | $311,575 | $0 | $15,320 | $0 | $38,114 | $0 | $1,639,497 | $0 | $0 |
| Bruce Bergherm | ||||||||||||||
| VP/Secretary/Director | $0 | $577,492 | $0 | $161,256 | $0 | $464,690 | $0 | $102,001 | $0 | $36,807 | $0 | $1,342,246 | $0 | $59,303 |
| Vadym Didenko | ||||||||||||||
| Treasurer/Director | $0 | $529,724 | $0 | $148,057 | $0 | $76,222 | $0 | $88,405 | $0 | $46,909 | $0 | $889,317 | $0 | $56,171 |
| John Johannessen | ||||||||||||||
| Director/Regional SEO Non-Acute | $0 | $445,434 | $0 | $103,939 | $0 | $32,401 | $0 | $62,635 | $0 | $39,383 | $0 | $683,792 | $0 | $0 |
| Clay Presswood | ||||||||||||||
| Director/Regional CFO Non-Acute | $0 | $282,933 | $0 | $35,799 | $0 | $27,330 | $0 | $57,759 | $0 | $38,576 | $0 | $442,397 | $0 | $0 |
| Ana Ali | ||||||||||||||
| AVP Strategic Innovation | $142,867 | $12,093 | $10,560 | $0 | $2,361 | $187 | $4,323 | $320 | $12,008 | $1,044 | $172,119 | $13,644 | $0 | $0 |
| Elin Boyd | ||||||||||||||
| Sr Dir Due Dilligence & Tran | $106,006 | $8,548 | $14,398 | $0 | $6,543 | $484 | $5,943 | $427 | $33,497 | $2,596 | $166,387 | $12,055 | $0 | $0 |
| Rebecca Pessel | ||||||||||||||
| HR Director & HRBP | $121,476 | $9,987 | $18,239 | $0 | $2,005 | $122 | $4,258 | $264 | $8,188 | $596 | $154,166 | $10,969 | $0 | $0 |
| Eugenia Sutton | ||||||||||||||
| Director Outpatient Imaging | $115,219 | $9,488 | $6,164 | $0 | $1,598 | $99 | $5,650 | $442 | $20,434 | $1,699 | $149,065 | $11,728 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3 | The individual who serves as the President/Board Member of the filing organization is appointed and compensated by Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) for serving as the CEO of the West Florida Region of AdventHealth. AHSSHC is the 501(c)(3) parent organization of the healthcare system known as AdventHealth. Compensation and benefits provided to this individual are determined pursuant to policies, procedures, and processes of AHSSHC that are designed to ensure compliance with the intermediate sanctions laws as set forth in IRC Section 4958. AHSSHC has taken steps to ensure that processes are in place to satisfy the rebuttable presumption of reasonableness standard as set forth in Treasury Regulation Section 53.4958-6 with respect to its active executive-level positions. The AHSSHC Board Compensation Committee (the Committee) serves as the governing body for all executive compensation matters. The Committee is composed of certain members of the Board of Directors (the Board) of AHSSHC. Voting members of the Committee include only individuals who serve on the Board as independent representatives, who hold no employment positions with AHSSHC and who do not have relationships with any of the individuals whose compensation is under their review that impacts their best independent judgment as fiduciaries of AHSSHC. The Committee's role is to review and approve all components of the executive compensation plan of AHSSHC. As an independent governing body with respect to executive compensation, it should be noted that the Committee will often confer in executive sessions on matters of compensation policy and policy changes. In such executive sessions, no members of management of AHSSHC are present. The Committee is advised by an independent third-party compensation advisor. This advisor prepares all the benchmark studies for the Committee. Compensation levels are benchmarked with a national peer group of other not-for-profit healthcare systems and hospitals of similar size and complexity to AdventHealth and each of its affiliated entities. The following principles guide the establishment of individual executive compensation: - The salary of the President/CEO of AdventHealth will not exceed the 50th percentile of comparable salaries paid by similarly situated organizations; and - Other executive salaries shall be established using market medians. The compensation philosophy, policies, and practices of AHSSHC are consistent with the organization's faith-based mission and conform to applicable laws, regulations, and business practices. As a faith-based organization sponsored by the Seventh-day Adventist Church (the Church), AHSSHC's philosophy and principles with respect to its executive compensation practices reflect the conservative approach of the Church's mission of service and were developed in counsel with the Church's leadership. |
| Part I, Line 4b | Executives on the filing organization's management team that hold the position of Vice-President or above are compensated by and on the payroll of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the parent organization of the healthcare system known as AdventHealth. In recognition of the contribution that each executive makes to the success of AdventHealth, AdventHealth provides supplemental executive benefit plans to eligible executives. In 2020, AdventHealth restructured its executive supplemental retirement and benefit plans to reduce complexity, to increase predictability of benefits and to consolidate multiple supplemental executive benefit plans into one plan. Effective 1/1/2020, a new supplemental executive retirement plan (SERP III) was adopted and the three existing plans, described below, were amended and restated. The newly adopted SERP III plan, as well as the amended and restated plans, were reviewed and approved by the AHSSHC Board Compensation Committee, an independent body of the AHSSHC Board of Directors. SERP III Plan (Effective 1/1/2020): To recognize the contribution each executive makes to the success of AdventHealth and to recognize the limitations available to executives in qualified retirement plans due to compensation limits set on such plans, AdventHealth adopted a new supplemental executive retirement plan (SERP III) in 2020. 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. 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 $285,000 in 2020 (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 (Amended and Restated in 2020): In 2020, the SERP II plan was amended and restated to provide that 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. 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. 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 (Amended and Restated in 2020): In 2020, the Flex Plan was amended and restated 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. Additionally, a provision was added to place a maximum limit on the amount of a participant's annual Flex allowance to not be greater than a maximum dollar amount or percentage of compensation as established by the AdventHealth Benefits Administration Committee. 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. 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 is 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, Part I, Line 4b. continuation | Senior Executive Death Benefit Plan (SEDB) (Amended and Restated in 2020): The SEDB plan was originally designed to provide a benefit in an amount equal to the amount the executive's benefit would have been under the SERP II Plan assuming that, on the date of the executive's death (and not before), the executive satisfied the last of the eligibility requirements of the SERP II Plan with present value recognizing an early benefit commencement. In conjunction with the amendment and restatement of the SERP II Plan, the SEDB was similarly amended in 2020 to limit eligible employees to only those who either satisfy the eligibility requirements of SERP II as of January 1 2020, or remain in active employment and will satisfy those requirements prior to December 31, 2027. An eligible executive becomes a participant in the SEDB Plan if the executive dies prior to termination of employment, provided the executive has not satisfied all the eligibility requirements of SERP II as of the executive's date of death but would have satisfied all those requirements within five (5) years following death had the executive lived and continued employment. The SEDB Plan will terminate automatically after December 31, 2027. FLEX Plan FLEX Plan SERP II SERP III Contr. Distr.* Contr./Distr. Contr. Michael Schultz $ 150,000 $ 130,500 $ 0 $ 0 Bruce Bergherm $ 96,682 $ 65,391 $ 329,455 $ 0 Vadym Didenko $ 73,086 $ 57,197 $ 0 $ 0 John Johannessen $ 51,724 $ 0 $ 0 $ 15,091 Clay Presswood $ 14,147 $ 0 $ 0 $ 28,293 * Including Investment Earnings |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 1a | The parent corporation and sole top-tier member of AdventHealth West Florida Ambulatory Services, Inc. (the filing organization) is Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is a Florida, not-for-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). AHSSHC has established a shared service center to centralize the Accounts Payable (A/P) function for all AHSSHC subsidiary organizations. 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 AHSSHC as the payor subject to the information reporting requirements of Section 6041. The facts and circumstances support a position that AHSSHC, as a payor on behalf of its subsidiary organizations in a shared service environment, will have sufficient management and oversight in connection with the subsidiary organizations' payments to meet the standard set forth in Treas. Reg. Section 1.6041-1(e). AHSSHC will not merely be making payments at the direction of its subsidiary organizations. Accordingly, AHSSHC is considered the payor subject to the information reporting requirements of Section 6041. |
| Form 990, Part VI, Section A, line 6 | AdventHealth West Florida Ambulatory Services, Inc. (the filing organization) has one member. The sole member of the filing organization is Adventist Health System Sunbelt Healthcare Corporation, 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 organizaiton. |
| Form 990, Part VI, Section A, line 7a | The Board of Directors of the filing organization are appointed by the member 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 membership of the filing organization has certain reserved powers as set forth in the Bylaws of the filing organization. These reserved powers include the following: (a) amend the Articles of Incorporation or Bylaws; (b) adopt any annual or long-term capital or operational budget for the Corporation, or any changes exceeding ten percent (10%) of the total annual budget; (c) adopt any new, or any changes to, existing long-term or master strategic plan for the Corporation; (d) authorize the Corporation to enter into any contract or engage in any transaction which is not provided for in an annual or long-term capital or operational budget approved by the Member where the amount involved exceeds one hundred thousand dollars ($100,000.00); (e) approve the incorporation, formation, or dissolution of any subsidiary corporation or other entity that is owned or controlled by the Member (a "Subsidiary"); (f) approve the formation, modification, or dissolution of any partnership, limited liability company, joint venture in which the Corporation or any Subsidiary will be a shareholder, partner, member, joint venture or party to an affiliation; (g) enter into, modify, or terminate any affiliation agreement as to which the Corporation or any Subsidiary will be a party; (h) incur any long-term debt; (i) mortgage or otherwise grant a lien or security interest to be placed upon or a Uniform Commercial Code financing statement to be filed against any of the Corporation's assets; (j) merge the Corporation with or consolidate the Corporation into any other entity; (k) sell, assign or otherwise transfer all or substantially all of the Corporation's assets in one or more related transactions; (l) enter into any contract (regardless of the identity of the party and regardless of nature of the product/service acquired) at less than fair market value; (m) grant membership rights to any person or entity other than the Member; (n) enter into, modify, amend, revise, extend or renew any agreement for the management of the business of the Corporation by any person or entity, or terminate any such agreement; (o) approve the voluntary dissolution of the Corporation; (p) appoint and remove the members of the Corporation's Board of Directors; (q) approve the Corporation entering into a new service line; (r) make any distribution permitted in accordance with Section 617.0505 of the Act, as amended; or (s) make a call for additional contributions. |
| Form 990, Part VI, Section B, line 11b | The filing organization's current year Form 990 was reviewed by the Board Chairman, and by the Regional CEO and CFO of AdventHealth's West Florida Region Non-Acute Services prior to its filing with the IRS. The review conducted by the Board Chairman, and the Regional CEO and CFO of AdventHealth's West Florida Region Non-Acute Services 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 | The Conflict of Interest Policy of the filing organization applies to members of its Board of Directors and its principal officers (to be known as Interested Persons). In connection with any actual or possible conflicts of interest, any member of the Board of Directors of the filing organization or any principal officer of the filing organization (i.e. Interested Persons) must disclose the existence of any financial interest with the filing organization and must be given the opportunity to disclose all material facts concerning the financial interest/arrangement to the Board of Directors of the filing organization or to any members of a committee with board delegated powers that is considering the proposed transaction or arrangement. Subsequent to any disclosure of any financial interest/arrangement and all material facts, and after any discussion with the relevant Board member or principal officer, the remaining members of the Board of Directors or committee with board delegated powers shall discuss, analyze, and vote upon the potential financial interest/arrangement to determine if a conflict of interest exists. According to the filing organization's Conflict of Interest Policy, an Interested Person may make a presentation to the Board of Directors (or committee with board delegated powers), but after such presentation, shall leave the meeting during the discussion of, and the vote on, the transaction or arrangement that results in a conflict of interest. Each Interested Person, as defined under the filing organization's Conflict of Interest Policy, shall annually sign a statement which affirms that such person has received a copy of the Conflict of Interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the filing organization is a charitable organization that must primarily engage in activities which accomplish one or more of its exempt purposes. The filing organization's Conflict of Interest Policy also requires that periodic reviews shall be conducted to ensure that the filing organization operates in a manner consistent with its charitable purposes. |
| Form 990, Part VI, Section B, line 15 | The filing organization's President and other officers are not compensated by the filing organization. Such individuals are compensated by the related top-tier parent organization of the filing organization. Please see the discussion concerning the process followed by the related top-tier parent organization in determining executive compensation in our response to Schedule J, Line 3. |
| Form 990, Part VI, Section C, line 19 | 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 governing documents or conflict of interest policy available to the public. |
| Part VII, Section A, Columns E & F | For those Board of Director members who devote less than full-time to the filing organization (based upon the average number of hours per week shown in column (B) on page 7 of the return) the compensation amounts shown in columns (E) and (F) on page 7 were provided in conjunction with that person's responsibilities and roles in serving in an executive leadership position as an employee of Adventist Health System Sunbelt Healthcare Corporation. |
| 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 healthcare professionals: Program service expenses 414,304. Management and general expenses 0. Fundraising expenses 0. Total expenses 414,304. Professional fees: Program service expenses 54,360. Management and general expenses 0. Fundraising expenses 0. Total expenses 54,360. Recruiting: Program service expenses 1,629. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,629. Miscellaneous purchased services: Program service expenses 34,585. Management and general expenses 0. Fundraising expenses 0. Total expenses 34,585. AdventHealth management fees: Program service expenses 0. Management and general expenses 3,528,328. Fundraising expenses 0. Total expenses 3,528,328. AdventHealth shared services fees: Program service expenses 0. Management and general expenses 42,257. Fundraising expenses 0. Total expenses 42,257. |
| Form 990, Part XI, line 9: | Transfer from related tax-exempt organizations 14,093,924. Transfer to related tax-exempt organizations -800,000. Reimbursement to related tax-exempt organizations -268,942. |
| Part XII, Line 3b | For the 2020 fiscal year ending December 31, 2020, AdventHealth was subject to the Single Audit requirements, as set forth in the regulations at 2 CFR Part 200, Subpart F. As a calendar year taxpayer, the deadline to complete and submit the Single Audit Reporting Package to the Federal Audit Clearinghouse, as required under Subpart F of 2 CFR 200.501, is September 30, 2021. However, on March 19th, 2021, the Office of Management and Budget (OMB) issued Memorandum M21-20, which outlined the OMB's efforts to supplement the support in the American Rescue Plan Act of 2021 (ARP), promote public trust in the Federal Government's stewardship of taxpayer resources, and alleviate some of the administrative challenges related to the coronavirus pandemic. As part of the administrative relief included in Memorandum M21-20, the OMB provided a six-month extension of time to complete and submit the Single Audit Reporting Package. The extended reporting deadline for calendar year taxpayers is March 31, 2022. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (104 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 | Yes (1) | |
| AdventHealth Foundation Shawnee Mission | |||||||||||
| 9100 W 74th Street | Shawnee Mission | KS | 66204 | 480868859 | Fund-raising for Tax-exempt hospital | KS | 501(c)(3) | Line 7 | Shawnee Mission Medical Center Inc | Yes (1) | |
| AdventHealth Home Care East Florida LLC | |||||||||||
| 770 West Granada Blvd 319 | Ormond Beach | FL | 32174 | 833768458 | Inactive | FL | 501(c)(3) | Line 12a, I | Memorial Hlth Systems Inc | Yes (1) | |
| AdventHealth Hospice Care East Florida Inc | |||||||||||
| 770 West Granada Blvd 304 | Ormond Beach | FL | 32174 | 833748461 | Inactive | FL | 501(c)(3) | Line 12a, I | Memorial Hlth Systems Inc | Yes (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 | Yes (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 | Yes (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 | Yes (1) | |
| AdventHealth Senior Care Inc fka AH Osceola South Inc | |||||||||||
| 900 Hope Way | Altamonte Springs | FL | 32714 | 841817046 | Inactive | FL | 501(c)(3) | Line 3 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| AdventHealth South Overland ParkInc fka Merriam Hlth Care Prop | |||||||||||
| 7820 W 165th Street | Overland Park | KS | 66223 | 364595806 | Inactive | KS | 501(c)(3) | Line 3 | Adventist Hlth Mid-America Inc | Yes (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 | Yes (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 | Yes (1) | |
| AdventHealth West Florida Ambulatory Svcs Inc | |||||||||||
| 14055 Riveredge Drive Ste 250 | Tampa | FL | 33637 | 471881744 | Operation of Imaging Center & Medical Services | FL | 501(c)(3) | Line 10 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| AdventHealth West Florida Imaging Inc | |||||||||||
| 14055 Riveredge Drive Ste 250 | Tampa | FL | 33637 | 843225135 | Imaging & Testing | FL | 501(c)(3) | Line 10 | AdventHealth West Florida Ambulatory Services Inc | Yes (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 | Yes (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 | Yes (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 | Yes (1) | |
| Adventist Hlth 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 | Yes (1) | |
| Adventist Hlth Partners Inc | |||||||||||
| 2601 Navistar Dr Bldg 4 Finance | Lisle | IL | 60532 | 364138353 | Operation of Physician Practices & Medical Services | IL | 501(c)(3) | Line 3 | AHS Midwest Management Inc | Yes (1) | |
| Adventist Hlth System Sunbelt Hlthcare Corp | |||||||||||
| 900 Hope Way | Altamonte Springs | FL | 32714 | 592170012 | Management Services | FL | 501(c)(3) | Line 12a, I | 0 | N/A | |
| Adventist Hlth 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 | Yes (1) | |
| Adventist Hlth SystemSunbelt Inc | |||||||||||
| 900 Hope Way | Altamonte Springs | FL | 32714 | 591479658 | Operation of Hospital & Related Services | FL | 501(c)(3) | Line 3 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (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 | Yes (1) | |
| Adventist Midwest Health | |||||||||||
| 120 North Oak Street | Hinsdale | IL | 60521 | 362276984 | Operation of Hospital & Related Services | IL | 501(c)(3) | Line 3 | Adventist Hlth SystemSunbelt Inc | Yes (1) | |
| AHP Specialty Care NFP | |||||||||||
| 2601 Navistar Dr Bldg 4 Finance | Lisle | IL | 60532 | 811105774 | Operation of Physician Practices & Medical Services | IL | 501(c)(3) | Line 3 | AHS Midwest Management Inc | Yes (1) | |
| AHS Midwest Management Inc | |||||||||||
| 2601 Navistar Dr Bldg 4 Finance | Lisle | IL | 60532 | 363354567 | Operation of Physician Practice Mgmt | IL | 501(c)(3) | Line 12a, I | Adventist Midwest Health | Yes (1) | |
| AHSCentral Texas Inc (11-12142020) | |||||||||||
| 11801 S Freeway | Burleson | TX | 76028 | 742621825 | Provide Office Space - Medical Professionals | TX | 501(c)(3) | Line 12c, III-FI | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| Apopka Hlth 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 | Yes (1) | |
| Battle Creek Adventist Hospital | |||||||||||
| 900 Hope Way | Altamonte Springs | FL | 32714 | 381359189 | Inactive | MI | 501(c)(3) | Line 3 | Adventist Hlth SystemSunbelt Inc | Yes (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 | 0 | N/A | |
| Bradford Heights Health & Rehab Center Inc | |||||||||||
| 485 North Keller Road 250 | Maitland | FL | 32751 | 205782342 | Inactive | KY | 501(c)(3) | Line 10 | Sunbelt Hlth Care Centers Inc | Yes (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 | Yes (1) | |
| Central Texas Hlthcare Collaborative (11-3312020) | |||||||||||
| 1301 Wonder World Drive | San Marcos | TX | 78666 | 453739929 | Support Operation of Hospital | TX | 501(c)(3) | Line 12a, I | Adventist Hlth SystemSunbelt Inc | Yes (1) | |
| Chickasaw Hlth 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 | Yes (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 | Yes (1) | |
| Coalition For Physician Well-Being Inc (619 - 12312020) | |||||||||||
| 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 | Yes (1) | |
| Courtland Hlth 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 | Yes (1) | |
| Creekwood Place Nursing & Rehab Center Inc | |||||||||||
| 485 North Keller Road 250 | Maitland | FL | 32751 | 205782260 | Inactive | KY | 501(c)(3) | Line 10 | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| Dairy Road Hlth 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 | Yes (1) | |
| East Orlando Hlth & 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 | Yes (1) | |
| Emory-Adventist Inc | |||||||||||
| 900 Hope Way | Altamonte Springs | FL | 32714 | 582171011 | Inactive | GA | 501(c)(3) | Line 3 | Adventist Hlth SystemSunbelt Inc | Yes (1) | |
| Fletcher Hospital Inc | |||||||||||
| 100 Hospital Drive | Hendersonville | NC | 28792 | 560543246 | Operation of Hospital & Related Svcs | NC | 501(c)(3) | Line 3 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (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 | Yes (1) | |
| Florida Hospital Dade City Inc | |||||||||||
| 13100 Fort King Road | Dade City | FL | 33525 | 822567308 | Operation of Hospital & Related Svcs | FL | 501(c)(3) | Line 3 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (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 | Yes (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 | Yes (1) | |
| Florida Hospital Ocala Inc | |||||||||||
| 1500 SW 1st Avenue | Ocala | FL | 34471 | 824372339 | Operation of Hospital & Related Svcs | FL | 501(c)(3) | Line 3 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (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 | Yes (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 | Yes (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 | Yes (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 | Yes (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 | Yes (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 | 0 | N/A | |
| 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 | 0 | N/A | |
| 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 | Yes (1) | |
| In-Motion Rehab Inc | |||||||||||
| 485 North Keller Road 250 | Maitland | FL | 32751 | 208023411 | Therapy services to tax exempt nursing homes | KS | 501(c)(3) | Line 12b, II | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| Lake County Health Care Properties Inc | |||||||||||
| 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 | Yes (1) | |
| Memorial Hlth 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 | 0 | N/A | |
| Memorial Hlth 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 | Yes (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 | Yes (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 | Yes (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 | Yes (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 | Yes (1) | |
| Metroplex Clinic Physicians Inc | |||||||||||
| 2201 S Clear Creek Road | Killeen | TX | 76549 | 113762050 | Physician Hlthcare services to the community | TX | 501(c)(3) | Line 3 | Metroplex Adventist Hospital Inc | Yes (1) | |
| Midwest Health Foundation | |||||||||||
| 120 North Oak Street | Hinsdale | IL | 60521 | 352230515 | Support of subsidiary foundations | IL | 501(c)(3) | Line 7 | 0 | N/A | |
| Mills Health & Rehab Center Inc | |||||||||||
| 485 North Keller Road 250 | Maitland | FL | 32751 | 205782320 | Inactive | KY | 501(c)(3) | Line 10 | Sunbelt Hlth Care Centers Inc | Yes (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 | Yes (1) | |
| Missouri Adventist Health Inc | |||||||||||
| 9100 W 74th Street | Shawnee Mission | KS | 66204 | 431224729 | Support Hlth Care Services | MO | 501(c)(3) | Line 12d, III-O | Adventist Hlth Mid-America Inc | Yes (1) | |
| Ormond Beach Memorial Hospital Auxiliary Inc | |||||||||||
| 301 Memorial Medical Parkway | Daytona Beach | FL | 32117 | 591721962 | Volunteer support services | FL | 501(c)(3) | Line 12c, III-FI | 0 | N/A | |
| 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 | Yes (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 | Yes (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 | Yes (1) | |
| Portercare Adventist Health System (630 YE) | |||||||||||
| 9100 E Mineral Circle | Centennial | CO | 80112 | 840438224 | Operation of Hospital & Related Services | CO | 501(c)(3) | Line 3 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| Princeton Health & Rehab Center Inc | |||||||||||
| 485 North Keller Road 250 | Maitland | FL | 32751 | 205782272 | Inactive | KY | 501(c)(3) | Line 10 | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| Princeton Professional Services Inc | |||||||||||
| 601 E Rollins Street | Orlando | FL | 32803 | 591191045 | Provision of Hlthcare Services | FL | 501(c)(3) | Line 10 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| Quality Circle for Hlthcare Inc | |||||||||||
| 900 Hope Way | Altamonte Springs | FL | 32714 | 263789368 | Hlthcare Quality Services | FL | 501(c)(3) | Line 12a, I | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (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 | Yes (1) | |
| Rocky Mountain Adventist Hlthcare Foundation (630 Year End) | |||||||||||
| 7995 E Prentice Ave 204 | Greenwood Village | CO | 80111 | 840745018 | Fund-raising for Tax-exempt hospital | CO | 501(c)(3) | Line 7 | 0 | N/A | |
| 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 | Yes (1) | |
| San Marcos Hlth Care Properties Inc | |||||||||||
| 1900 Medical Parkway | San Marcos | TX | 78666 | 510605693 | Lease to Related Organization | GA | 501(c)(3) | Line 12c, III-FI | Sunbelt Hlth Care Centers Inc | Yes (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 | Yes (1) | |
| Shawnee Mission Hlth 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 | Yes (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 | Yes (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 | Yes (1) | |
| South Pasco Hlth 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 | Yes (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 | Yes (1) | |
| Southwest Volusia Hlth 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 | Yes (1) | |
| Southwest Volusia Hlthcare Corp | |||||||||||
| 1055 Saxon Blvd | Orange City | FL | 32763 | 593149293 | Operation of Hospital & Related Services | FL | 501(c)(3) | Line 3 | Adventist Hlth SystemSunbelt Inc | Yes (1) | |
| Specialty Physicians of Central Texas Inc (11-3312020) | |||||||||||
| 1301 Wonder World Drive | San Marcos | TX | 78666 | 208814408 | Physician Hlthcare services to the community | TX | 501(c)(3) | Line 3 | Adventist Hlth SystemSunbelt Inc | Yes (1) | |
| Spring View Hlth & Rehab Center Inc | |||||||||||
| 485 North Keller Road 250 | Maitland | FL | 32751 | 205782288 | Inactive | KY | 501(c)(3) | Line 10 | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| Sunbelt Hlth & 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 | Yes (1) | |
| Sunbelt Hlth 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 | Yes (1) | |
| 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 | Yes (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 | Yes (1) | |
| Tarrant County Hlth 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 | Yes (1) | |
| The Comforter Health Care Group Inc | |||||||||||
| 605 Montgomery Road | Altamonte Springs | FL | 32714 | 271857940 | Lease to Related Organization | FL | 501(c)(3) | Line 12c, III-FI | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| The Volunteer Auxiliary of Florida Hospital - Flagler Inc | |||||||||||
| 60 Memorial Medical Parkway | Palm Coast | FL | 32164 | 592486582 | Volunteer support services | FL | 501(c)(3) | Line 12c, III-FI | 0 | N/A | |
| 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 | Yes (1) | |
| Trinity Nursing & Rehab Center Inc (11-91020) | |||||||||||
| 485 North Keller Road 250 | Maitland | FL | 32751 | 205774890 | Operation of Home for the Aged/Hlthcare Delivery | KS | 501(c)(3) | Line 10 | Sunbelt Hlth Care Centers Inc | Yes (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 12a, I | 0 | N/A | |
| University Community Hospital Inc | |||||||||||
| 3100 E Fletcher Ave | Tampa | FL | 33613 | 591113901 | Operation of Hospital & Related Services | FL | 501(c)(3) | Line 3 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (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 | Yes (1) | |
| Zephyr Haven Hlth & 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 | Yes (1) | |
| Zephyrhills Hlth & 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 | Yes (1) | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| 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 | Yes (1) |
| Florida Hospital Home Infusion LLP | |||||||||
| 500 Winderley Place Ste 226 | Maitland | FL | 32751 | 593142824 | Home Infusion Services | FL | N/A | 0 | Yes (1) |
| Functional Neurosurgical Ambulatory Surgery Ctr LLC | |||||||||
| 11 W Dry Creek Circle 120 | Littleton | CO | 80120 | 464426708 | Surgery Center | CO | N/A | 0 | 0 |
| Heart of Florida Surgery Center LLC (11 -10152020) | |||||||||
| 410 Lionel Way 100 | Davenport | FL | 33837 | 812235296 | Surgery Center | DE | N/A | 0 | Yes (1) |
| PAHS OnPoint Urgent Care LLC | |||||||||
| 9100 E Mineral Circle | Centennial | CO | 80112 | 832465331 | Urgent Care Center | CO | N/A | 0 | 0 |
| Princeton Homecare Services LLC | |||||||||
| 1050 Forrer Blvd | Kettering | OH | 45420 | 814196648 | Operation of Home Health Agency | FL | N/A | 0 | 0 |
| San Marcos MRI LP | |||||||||
| 1330 Wonder World Dr Ste 202 | San Marcos | TX | 78666 | 770597972 | Imaging & Testing | TX | 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 (14-12312020) | |||||||||
| 2600 Westhall Lane | Maitland | FL | 32751 | 844261523 | Urgent Care Centers | FL | N/A | 0 | Yes (1) |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (19 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| Altamonte Medical Plaza Condominium Association Inc | |||||||||
| 601 East Rollins Street | Orlando | FL | 32803 | 592855792 | Condo Association | FL | N/A | C | Yes (1) |
| Apopka Medical Plaza Condominium Association Inc | |||||||||
| 601 East Rollins Street | Orlando | FL | 32803 | 593000857 | Condo Association | FL | N/A | C | Yes (1) |
| CC MOB Inc | |||||||||
| 2201 S Clear Creek Road | Killeen | TX | 76549 | 742616875 | Real Estate Rental | TX | N/A | C | Yes (1) |
| Central Texas Medical Associates | |||||||||
| 1301 Wonder World Drive | San Marcos | TX | 78666 | 742729873 | Inactive | TX | N/A | C | Yes (1) |
| Central Texas Providers Network (11-3312020) | |||||||||
| 1301 Wonder World Drive | San Marcos | TX | 78666 | 742827652 | Physician Hospital Org. | TX | N/A | C | Yes (1) |
| Florida Hospital Flagler Medical Offices Association Inc | |||||||||
| 60 Memorial Medical Parkway | Palm Coast | FL | 32164 | 262158309 | Condo Association | FL | N/A | C | Yes (1) |
| 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 | Yes (1) |
| Florida Hospital Healthcare System Inc | |||||||||
| 101 Southhall Lane Ste 150 | Maitland | FL | 32751 | 593215680 | PHSO | FL | N/A | C | Yes (1) |
| Florida Medical Plaza Condominium Association Inc | |||||||||
| 601 East Rollins Street | Orlando | FL | 32803 | 592855791 | Condo Association | FL | N/A | C | Yes (1) |
| Kissimmee Multispecialty Clinic Condominium Association Inc | |||||||||
| 201 Hilda Street Suite 30 | Kissimmee | FL | 34741 | 593539564 | Condo Association | FL | N/A | C | Yes (1) |
| LN Health Partners Inc (11 - 9102020) | |||||||||
| 550 E Rollins Street 6th Floor | Orlando | FL | 32803 | 813556903 | Inactive | FL | N/A | C | Yes (1) |
| Midwest Management Services Inc | |||||||||
| 9100 West 74th Street | Shawnee Mission | KS | 66204 | 480901551 | Inactive | KS | N/A | C | Yes (1) |
| North American Health Services Inc & Sub | |||||||||
| 900 Hope Way | Altamonte Springs | FL | 32714 | 621041820 | Lessor/Holding Co. | TN | N/A | C | Yes (1) |
| Ormond Prof Associates Condo Assoc'n Inc (430 year end) | |||||||||
| 770 W Granada Blvd Ste 101 | Ormond Beach | FL | 32174 | 592694434 | Condo Association | FL | N/A | C | Yes (1) |
| Park Ridge Property Owner's Association Inc | |||||||||
| 1 Park Place Naples Road | Fletcher | NC | 28732 | 030380531 | Condo Association | NC | N/A | C | Yes (1) |
| Porter Affiliated Health Services Inc | |||||||||
| 2525 S Downing Street | Denver | CO | 80210 | 840956175 | Healthcare Services | CO | N/A | C | Yes (1) |
| San Marcos Regional MRI Inc (11-3312020) | |||||||||
| 1301 Wonder World Drive | San Marcos | TX | 78666 | 770597968 | Holding Company | TX | N/A | C | Yes (1) |
| The Garden Retirement Community Inc | |||||||||
| 485 North Keller Road Ste 250 | Maitland | FL | 32751 | 593414055 | Real Estate Rental | FL | N/A | C | Yes (1) |
| Winter Park Medical Office Building I Condo Assoc Inc | |||||||||
| 601 East Rollins Street | Orlando | FL | 32803 | 452228478 | Condo Association | FL | N/A | C | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (12 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| University Community Hospital Inc | ||
| S | $5,554,889 | Actual Amount Transferred |
| Pasco-Pinellas Hillsborough Community Health System Inc | ||
| S | $5,515,967 | Actual Amount Transferred |
| Florida Hospital Zephyrhills Inc | ||
| S | $943,143 | Actual Amount Transferred |
| Florida Hospital Dade City Inc | ||
| S | $189,278 | Actual Amount Transferred |
| Tarpon Springs Hospital Foundation Inc | ||
| S | $479,046 | Actual Amount Transferred |
| Florida Hospital Ocala Inc | ||
| S | $1,007,031 | Actual Amount Transferred |
| West Florida Health Home Care Inc | ||
| S | $404,571 | Actual Amount Transferred |
| AdventHealth West Florida Imaging Inc | ||
| R | $800,000 | Actual Amount Transferred |
| University Community Hospital Inc | ||
| Q | $329,224 | Cost |
| Florida Hospital Physician Group Inc | ||
| Q | $413,668 | Cost |
| West Florida Health Home Care Inc | ||
| Q | $189,085 | Cost |
| AdventHealth West Florida Imaging Inc | ||
| Q | $271,786 | Cost |