2019-11-15T09:18:07-06:00 2018-12-31 990 2018-01-01 610594620 MEMORIAL HOSPITAL INC MEMO 6065985104 210 MARIE LANGDON DRIVE MANCHESTER KY 40962 LYNN C ADDISCOTT ASSISTANT SECRETARY 6065981002 2019-11-13 204.139.85.141 2019-11-13 15:31:18 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 2D951D70D370B284B8357A24D7DC4FA93EDF4DEB 2018 2020-04-17 16:48:07Z ADVENTHEALTH MANCHESTER CHRISTOPHER SELF 210 MARIE LANGDON DRIVE MANCHESTER KY 40962 59127881 0 1071 X WWW.ADVENTHEALTH.COM/HOSPITAL/ X 1917 KY THE PROVISION OF MEDICAL CARE TO THE COMMUNITY THROUGH THE OPERATION OF A 49 BED HOSPITAL. 12 7 602 27 96751 0 9499 10 57239550 58517720 624561 553963 264520 -5321 58138130 59066372 151276 137184 0 0 35083598 35226765 0 0 0 25283451 25775936 60518325 61139885 -2380195 -2073513 37572905 35726878 17831423 18662601 19741482 17064277 X 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 HOSPITAL 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. 0 0 55988664 137184 58438956 OPERATION OF ACUTE CARE HOSPITAL TOTALING 49 BEDS WITH 1,627 PATIENT ADMISSIONS, 5,578 PATIENT DAYS, AND 49,969 OUTPATIENT VISITS. 55988664 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 X 0 0 1 602 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 12 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 KY X STEVEN MILLER 6065981003 210 MARIE LANGDON DRIVE MANCHESTER KY 40962 X WEBER PETER M CHAIRMAN/DIRECTOR/REG. CEO 6.25 43.75 X 0 1260921 148407 CORNETT MD ANITA F DIRECTOR (BEGAN 1/2018) 47.00 0.00 X 299721 0 41193 DAVIDSON JAMES C DIRECTOR 0.20 0.00 X 0 0 0 DUNZWEILER AMY DIRECTOR 0.20 0.00 X 0 0 0 HOUSE MARSHALL B DIRECTOR 0.20 0.00 X 0 0 0 NEWSWANGER DO JEFFREY DIRECTOR/CMO 50.00 0.00 X 347455 0 33886 PHILLIPS JAMES DIRECTOR 0.20 0.00 X 0 0 0 REEVES CORY D DIRECTOR/REG. CFO 6.25 43.75 X 0 525684 95768 ROSE STEVE DIRECTOR 0.20 0.00 X 0 0 0 SAMPLES REECIA DIRECTOR 0.20 0.00 X 0 0 0 SIZEMORE LESLIE DIRECTOR 0.20 0.00 X 0 0 0 STONE CHARLES DIRECTOR 0.20 0.00 X 0 0 0 SKULA ERIKA DIRECTOR/CEO (ENDED 9/2018) 50.00 0.00 X X 0 424155 50537 SELF CHRISTOPHER E COO/CEO (BEGAN CEO 10/2018) 50.00 0.00 X 0 228576 40228 MILLER STEVEN S CFO 50.00 0.00 X 0 265634 48321 STIMSON MICHAEL A CNO 50.00 0.00 X 0 264429 43009 GORDEN MD SHAWN R PHYSICIAN 38.00 0.00 X 379500 0 40846 GUPTA MD GIRIRAJ PHYSICIAN 40.00 0.00 X 357821 0 38543 FAUGHN MD LAURA LYNNE PHYSICIAN 45.00 0.00 X 348010 0 27438 GHIMIRE MD BIJAYA PHYSICIAN 43.00 0.00 X 346386 0 27401 PUTRAKUL MD KOBKIT PHYSICIAN 45.00 0.00 X 340556 0 34789 WALKER DANIEL T FORMER CFO 0.00 50.00 X 0 125515 20923 2419449 3094914 691289 40 1 1 0 ADVANCED CARE STAFFING 522 DEVONIA STREET HARRIMAN TN 37748 PHYSICIAN STAFFING SERVICES 1381346 MOUNTAIN REHABILITATION SERVICES 702 PHILLIPS LANE CORBIN KY 40701 PHYSICAL THERAPY 1301985 SWEET DREAMS ANESTHESIA PO BOX 291264 NASHVILLE TN 37229 CRNA SERVICES 639100 THE HASKELL COMPANY 111 RIVERSIDE AVENUE JACKSONVILLE FL 32202 CONSTRUCTION SERVICES 389074 APPALACHIAN REGIONAL HEALTHCARE INC 100 AIRPORT GARDENS ROAD HAZARD KY 41701 CARDIOLOGISTS STAFFING 376340 32 X 10 10 NET PATIENT REVENUE 622110 56662220 56574309 87911 PHARMACY REVENUE 622110 1376109 1376109 CAFETERIA REVENUE 622110 275820 275820 GIFT SHOP REVENUE 622110 133895 133895 REGIONAL ALLOCATION OF CENTRAL BI 622110 9486 9486 60190 51350 8840 58517720 82465 82465 7699 31007 -23308 -23308 -23308 502000 30502 0 -30502 502000 471498 471498 EHR REVENUE 622110 17987 17987 17987 59066372 58438956 96751 530655 X 137184 137184 1928913 722255 1206658 25022953 25022953 947058 923581 23477 5329327 5329327 1998514 1948940 49574 26592 26592 28546 28546 15604 15604 9966355 7551862 2414493 217072 217072 2388635 1971855 416780 2214813 1920462 294351 1203444 1203444 293248 20641 272607 41648 41648 115285 115285 1624425 1624425 1177226 1098611 78615 MEDICAL SUPPLIES 4387193 4387193 REPAIRS & MAINTENANCE 983872 983872 STATE TAX INDIGENT ASSE 687132 687132 LICENSES & PERMITS 72924 72924 331922 266718 65204 61139885 55988664 5151221 0 X 9193 5802 10296985 4051 6097104 6432343 676296 627263 1014603 900999 47471380 23107684 17295236 24363696 2183488 3392724 37572905 35726878 4542067 4970240 132007 74252 13157349 13618109 17831423 18662601 X 19626651 16985998 114831 78279 19741482 17064277 37572905 35726878 X -2073513 -123222 -480470 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 4568 4568 0 PART II-B, LINE 1: DUES WERE PAID TO THE AMERICAN HOSPITAL ASSOCIATION AND THE KENTUCKY HOSPITAL ASSOCIATION. 91795 91795 28810198 9202778 19607420 17318464 13515205 3803259 1250923 389701 861222 24363696 DUE FROM RELATED 262707 OTHER RECEIVABLES 153 RECEIVABLE FROM THIRD PARTIES 3129243 DUE FROM AFFILIATED 621 3392724 DUE TO RELATED 2128648 PAYABLE TO THIRD PARTIES 2377061 CREDIT BALANCES IN A/R 407615 INTERCO. ALLOC. OF TE BOND PROCEEDS 8595662 LEASES PAYABLE -331 OTHER LIABILITIES 109454 13618109 X PART X, LINE 2: THE FILING ORGANIZATION IS A SUBSIDIARY ORGANIZATION WITHIN ADVENTHEALTH. THE CONSOLIDATED FINANCIAL STATEMENTS OF ADVENTHEALTH CONTAIN THE FOLLOWING FIN 48 (ASC 740) FOOTNOTE: PLEASE NOTE THAT DOLLAR AMOUNTS ARE IN THOUSANDS. HEALTHCARE CORPORATION AND ITS AFFILIATED ORGANIZATIONS, OTHER THAN NORTH AMERICAN HEALTH SERVICES, INC. AND ITS SUBSIDIARY (NAHS), ARE EXEMPT FROM STATE AND FEDERAL INCOME TAXES. ACCORDINGLY, HEALTHCARE CORPORATION AND ITS TAX-EXEMPT AFFILIATES ARE NOT SUBJECT TO FEDERAL, STATE OR LOCAL INCOME TAXES EXCEPT FOR ANY NET UNRELATED BUSINESS TAXABLE INCOME. NAHS IS A WHOLLY OWNED, FOR-PROFIT SUBSIDIARY OF HEALTHCARE CORPORATION. NAHS AND ITS SUBSIDIARY ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. NAHS FILES A CONSOLIDATED FEDERAL INCOME TAX RETURN AND, WHERE APPROPRIATE, CONSOLIDATED STATE INCOME TAX RETURNS. ALL TAXABLE INCOME WAS FULLY OFFSET BY NET OPERATING LOSS CARRYFORWARDS FOR FEDERAL INCOME TAX PURPOSES; AS SUCH, THERE IS NO PROVISION FOR CURRENT FEDERAL OR STATE INCOME TAX FOR THE YEARS ENDED DECEMBER 31, 2018 AND 2017. NAHS ALSO HAS TEMPORARY DEDUCTIBLE DIFFERENCES OF APPROXIMATELY $53,000 AND $55,700 AT DECEMBER 31, 2018 AND 2017, RESPECTIVELY, PRIMARILY AS A RESULT OF NET OPERATING LOSS CARRYFORWARDS. AT DECEMBER 31, 2018, NAHS HAD NET OPERATING LOSS CARRYFORWARDS OF APPROXIMATELY $54,500, EXPIRING BEGINNING IN 2022 THROUGH 2026. DEFERRED TAXES HAVE BEEN PROVIDED FOR THESE AMOUNTS, RESULTING IN A NET DEFERRED TAX ASSET OF APPROXIMATELY $13,400 AND $14,100 AT DECEMBER 31, 2018 AND 2017, 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, 2018 AND 2017 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 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, 2018 AND 2017. 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 WILL IMPACT TAX-EXEMPT ORGANIZATIONS, INCLUDING REVISIONS TO TAXES ON UNRELATED BUSINESS ACTIVITIES, EXCISE TAXES ON COMPENSATION OF CERTAIN EMPLOYEES, AND VARIOUS OTHER PROVISIONS. THE REGULATIONS NECESSARY TO IMPLEMENT THE LAW HAVE NOT YET BEEN PROMULGATED, AND THE ULTIMATE OUTCOME OF THESE REGULATIONS AND THE IMPACT TO THE SYSTEM CANNOT BE DETERMINED PRESENTLY. THE SYSTEM WILL CONTINUE TO REVIEW AND ASSESS THE IMPACT OF THE LEGISLATION TO THE CONSOLIDATED FINANCIAL STATEMENTS, BUT DOES NOT EXPECT THAT THE IMPACT WILL BE SIGNIFICANT. 1 1 X 1 X 0 1 1 1 0 1 0 358001 358001 0.00590 25255003 23794438 1460565 0.02390 25613004 23794438 1818566 0.02980 116542 116542 0.00190 37011 37011 0.00060 153553 153553 0.00250 25766557 23794438 1972119 0.03230 1 1930418 75969 11573110 13361181 -1788071 X 1 1 1 1 ADVENTHEALTH MANCHESTER 210 MARIE LANGDON DRIVE MANCHESTER KY 40962 WWW.ADVENTHEALTH.COM/HOSPITAL/ADVENTHE 100075 X X X ADVENTHEALTH MANCHESTER 1 0 0 1 X X X X X X X X X 16 1 0 0 1 X SEE PART V, PAGE 8 X X 1 17 1 SEE PART V, PAGE 8 0 1 X 200.000000000000 X X X X 1 1 X X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X 1 X 0 X X X X 1 X 0 0 ADVENTHEALTH MANCHESTER PART V, SECTION B, LINE 5: MEMORIAL HOSPITAL, INC. D/B/A ADVENTHEALTH MANCHESTER (ADVENTHEALTH MANCHESTER OR THE HOSPITAL) SERVES A RURAL COMMUNITY IN CLAY COUNTY, KENTUCKY WHICH IS LOCATED IN THE FOOTHILLS OF THE APPALACHIAN MOUNTAINS. ADVENTHEALTH MANCHESTER OPERATES A 49-BED HOSPITAL AND PROVIDES THE FOLLOWING SERVICE LINES: HOME HEALTH, LAB, IMAGING, SURGERY, WEEKEND EXPRESS CARE, PEDIATRICS, FAMILY MEDICINE, INTERNAL MEDICINE, ORTHOPEDICS, CARDIOLOGY, UROLOGY, AND WOMEN'S HEALTH. THE PRIMARY SERVICE AREA (PSA) FOR THE HOSPITAL IS CLAY COUNTY WHICH HAS A TOTAL POPULATION OF APPROXIMATELY 21,500 WITH MANY MEMBERS OF THE COMMUNITY STRUGGLING WITH POVERTY. APPROXIMATELY 38% OF THE POPULATION IS BELOW 100% OF THE FEDERAL POVERTY LEVEL. THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT WAS BUILT ON INPUT FROM PEOPLE REPRESENTING THE BROAD COMMUNITY, AS WELL AS LOW-INCOME, MINORITY, AND OTHER MEDICALLY UNDERSERVED POPULATIONS. INPUT WAS SOLICITED THROUGHOUT 2016, AND WAS GATHERED AND CONSIDERED IN MULTIPLE WAYS.IN ORDER TO ASSURE BROAD COMMUNITY INPUT, THE HOSPITAL UTILIZED COMMUNITY SURVEYS, PUBLIC HEALTH INPUT AND EXPERTISE AND BY FORMING A COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE (CHNAC) THAT INCLUDED REPRESENTATIVES OF THE HOSPITAL AND THE COMMUNITY. THE CHNAC INCLUDED REPRESENTATIVES FROM A VARIETY OF ORGANIZATIONS, SUCH AS THE UNIVERSITY OF KENTUCKY, RED BIRD MISSION, CLAY COUNTY HEALTH DEPARTMENT, CLAY COUNTY PUBLIC-SCHOOL SYSTEM AND HEALTHY CLAY (HEALTHY CLAY IS A GROUP THAT ENCOURAGES HEALTHY LIFESTYLE CHOICES BY THOSE LIVING AND WORKING IN CLAY COUNTY THROUGH POLICY AND COMMUNITY CHANGE). THE CHNAC ALSO INCLUDED OTHER INDIVIDUALS WHO REPRESENTED THE NEEDS OF LOW-INCOME AND UNDERSERVED POPULATIONS. ADVENTHEALTH MANCHESTER PART V, SECTION B, LINE 7D: THE HOSPITAL HAS ADOPTED A POLICY THAT ADDRESSES THE PUBLIC POSTING REQUIREMENTS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT. UNDER THIS POLICY, THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS MUST BE POSTED ON THE HOSPITAL'S WEBSITE AT LEAST UNTIL THE DATE THE HOSPITAL FACILITY HAS MADE WIDELY AVAILABLE ON ITS WEBSITE ITS TWO SUBSEQUENT COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS. THE HOSPITAL WILL ALSO MAKE A PAPER COPY OF ITS COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST AND WITHOUT CHARGE, AT LEAST UNTIL THE DATE THE HOSPITAL FACILITY HAS MADE AVAILABLE FOR PUBLIC INSPECTION ITS TWO SUBSEQUENT COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS. ADVENTHEALTH MANCHESTER PART V, SECTION B, LINE 11: THE INFORMATION PROVIDED BELOW EXPLAINS HOW THE HOSPITAL FACILITY ADDRESSED IN 2018 THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN ITS 2016 COMMUNITY HEALTH NEEDS ASSESSMENT, AND ANY SUCH NEEDS THAT WERE NOT ADDRESSED AND THE REASONS WHY SUCH NEEDS WERE NOT ADDRESSED. THE HOSPITAL FACILITY CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT IN 2016 AND ADOPTED AN IMPLEMENTATION STRATEGY TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT IN 2017 PRIOR TO MAY 15, 2017. MEMORIAL HOSPITAL, INC. D/B/A ADVENTHEALTH MANCHESTER WILL BE REFERRED TO IN THIS DOCUMENT AS ADVENTHEALTH MANCHESTER OR "THE HOSPITAL". IN JANUARY OF 2019, EVERY WHOLLY-OWNED ENTITY ACROSS OUR ORGANIZATION ADOPTED THE ADVENTHEALTH SYSTEM BRAND. OUR IDENTITY HAS BEEN UNIFIED TO REPRESENT THE FULL CONTINUUM OF CARE OUR SYSTEM OFFERS. THROUGHOUT THIS REPORT, WE WILL REFER TO OUR HOSPITAL BY ADVENTHEALTH MANCHESTER. ANY REFERENCE TO OUR 2016 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) OR 2017 COMMUNITY HEALTH PLAN (CHP) WILL UTILIZE OUR NEW NAME FOR CONSISTENCY. ADVENTHEALTH MANCHESTER IS PART OF THE SOUTHEAST REGION OF ADVENTHEALTH WHICH INCLUDES FOUR HOSPITAL FACILITIES. THIS IS THE SECOND-YEAR UPDATE FOR ADVENTHEALTH MANCHESTER'S 2017-2019 COMMUNITY HEALTH PLAN (IMPLEMENTATION STRATEGY). ADVENTHEALTH MANCHESTER DEVELOPED THIS PLAN AND POSTED IT BY MAY, 15 2017 AS PART OF ITS 2016 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS.FOR THE DEVELOPMENT OF BOTH THE COMMUNITY HEALTH NEEDS ASSESSMENT AND THE COMMUNITY HEALTH PLAN/IMPLEMENTATION STRATEGY, ADVENTHEALTH MANCHESTER WORKED TO DEFINE AND ADDRESS THE NEEDS OF LOW-INCOME, MINORITY, AND UNDERSERVED POPULATIONS IN OUR SERVICE AREA. THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT USED PRIMARY DATA INTERVIEWS AND SURVEYS; SECONDARY DATA FROM LOCAL, REGIONAL, AND NATIONAL HEALTH-RELATED SOURCES; AND HOSPITAL PREVALENCE DATA TO HELP THE HOSPITAL DETERMINE THE HEALTH NEEDS OF THE COMMUNITY WE SERVE. ONCE THE DATA WAS GATHERED, THE PRIMARY ISSUES IDENTIFIED IN THE NEEDS ASSESSMENT WERE PRIORITIZED BY COMMUNITY AND HOSPITAL STAKEHOLDERS, WHO THEN SELECTED KEY ISSUES FOR THE HOSPITAL TO ADDRESS IN ITS 2017-2019 COMMUNITY HEALTH PLAN. THE SECOND-YEAR PROGRESS ON THE COMMUNITY HEALTH PLAN IS NOTED BELOW. THE NARRATIVE DESCRIBES THE ISSUES IDENTIFIED IN 2016 AND GIVES AN UPDATE ON THE STRATEGIES ADDRESSING THOSE ISSUES. THERE IS ALSO A DESCRIPTION OF THE IDENTIFIED ISSUES THAT THE HOSPITAL IS NOT ADDRESSING.ADVENTHEALTH MANCHESTER CHOSE FOUR AREAS OF FOCUS FOR THEIR 2017-2019 COMMUNITY HEALTH PLAN: 1. OBESITY/OVER-WEIGHT POPULATION2. TOBACCO USAGE3. BEHAVIORAL HEALTH (DRUG/SUBSTANCE ABUSE)4. DIABETES5. CANCERPRIORITY 1: OBESITY/OVERWEIGHT POPULATION2016 DESCRIPTION OF THE ISSUE: THE WASHINGTON POST PUBLISHED AN ARTICLE IN 2010 TITLED, "UNHEALTHY MANCHESTER", LABELING MANCHESTER, IN CLAY COUNTY, AS ONE OF THE UNHEALTHIEST PLACES IN THE NATION. WHILE THE STATISTICS FOUND IN THAT ARTICLE HAVE BEEN CALLED INTO QUESTION (52 PERCENT OBESITY IN CLAY COUNTY), OUR CURRENT STATISTICS SHOW THAT 33 PERCENT OF ADULTS IN CLAY COUNTY ARE OBESE. WITH GROWING COMMUNITY CONCERN AND A HEALTHY PEOPLE 2020 NATIONAL GOAL OF 30 PERCENT FOR OBESITY, WE SEE THIS AS A LARGE CONCERN. THERE HAVE BEEN SEVERAL GROUPS WORKING TO COMBAT THIS ISSUE, BUT THEY HAVE FUNDING ISSUES AND WE ARE HOPING TO HELP IN ALLEVIATING THAT PROBLEM, AS WELL AS PROVIDE SOME ADDITIONAL ONGOING PROGRAMS. THIS ISSUE WAS HIGHLIGHTED BY BOTH COMMITTEES AND HAS TO BE ADDRESSED, AS REDUCING THE NUMBER OF PEOPLE THAT ARE OVERWEIGHT WOULD, INEVITABLY, REDUCE A MYRIAD OF OTHER HEALTH DISPARITIES.2018 UPDATE: ADVENTHEALTH MANCHESTER IS MOVING FORWARD WITH BOTH THE LIVE IT UP AND THE MISSION IN MOTION INITIATIVES. THESE TWO PROGRAMS ARE TOUCHING LIVES IN THE COUNTY AND SURROUNDING COMMUNITIES. LIVE IT UP IS A VERY ENERGETIC PROGRAM THAT GOES DIRECTLY INTO THE SCHOOLS TEACHING CREATION HEALTH PRINCIPALS WITH A CONCENTRATION ON NUTRITION AND CHOICES. IN 2018, 5,539 KIDS PARTICIPATED IN THIS PROGRAM AND WE WILL CONTINUE OFFERING THIS IN 2019.MISSION IN MOTION IS A MOBILE SCREENING FACILITY THAT ALLOWS ADVENTHEALTH MANCHESTER THE FLEXIBILITY TO TRAVEL THROUGHOUT THE REGION AND PROVIDE FREE HEALTH SCREENINGS TO THE COMMUNITY. IN 2018, 136 PEOPLE WHO DO NOT ORDINARILY HAVE THE MEANS TO OBTAIN THESE HEALTHCARE SERVICES WERE ABLE TO RECEIVE SCREENINGS. ADVENTHEALTH MANCHESTER HAS BEEN CHOSEN AS AN ADVENTHEALTH GLOBAL MISSION SITE FOR THE YEARS 2019 - 2024. THIS OPPORTUNITY WILL ALLOW US TO ADOPT NEW STRATEGIES FOR THE UPCOMING YEARS. THE GREATEST CHALLENGE LIES WITHIN THE EDUCATIONAL OPPORTUNITIES AND FUNDING FOR ADDITIONAL EQUIPMENT. PRIORITY 2: TOBACCO USAGE2016 DESCRIPTION OF THE ISSUE: APPROXIMATELY THIRTY-FIVE PERCENT OF THE POPULATION AGED 18 AND ABOVE INDULGE IN SMOKING. THE AGE-ADJUSTED RATE FOR LUNG AND BRONCHUS CANCER DEATHS PER 100,000 POPULATION WAS 98 FOR CLAY COUNTY COMPARED TO 67 FOR KENTUCKY. A LACK OF EDUCATION AND SUPPORT ARE STRONG CONTRIBUTING FACTORS TO THE HIGH SMOKING POPULATION. 2018 UPDATE: ADVENTHEALTH MANCHESTER PARTNERS WITH FREEDOM FROM SMOKING, A SUBSIDIARY OF THE AMERICAN LUNG ASSOCIATION. THE HOSPITAL OFFERED FOUR EIGHT-WEEK CLASSES LAST YEAR. FORTY SMOKERS TOOK PART IN THE CLASSES, WITH 85 PERCENT SUCCESSFULLY QUITTING SMOKING WITH THE SUPPORT OF THIS CLASS ALONG WITH NICOTINE PATCHES AND OTHER EDUCATION MATERIAL PROVIDED FROM THE CLASSES.OUR GREATEST CHALLENGE IS OUR DEMOGRAPHIC LOCATION. TWENTY-FIVE PERCENT OF KENTUCKIANS USE TOBACCO PRODUCTS COMPARED TO THE NATIONAL RATE OF 19 PERCENT. THE GREATEST CHALLENGE IS CLAY COUNTY'S INCREASING RATE OF SMOKERS WHICH HAS NOW REACHED 39 PERCENT.PRIORITY 3: BEHAVIORAL HEALTH (DRUG/SUBSTANCE ABUSE)2016 DESCRIPTION OF THE ISSUE: APPROXIMATELY 23 PERCENT OF ADULTS AGED 18 AND OLDER SELF-REPORT THAT THEY RECEIVE INSUFFICIENT SOCIAL AND EMOTIONAL SUPPORT ALL OR MOST OF THE TIME. WITH THIS DATA AND HAVING AN OVERVIEW OF THE PROBLEMS EXISTING IN THE COMMUNITY, THE COMMITTEES FELT THAT THIS LACK OF SOCIAL SUPPORT WAS LEADING A LARGE MAJORITY OF THE YOUTH TO INDULGE IN WRONGFUL PRACTICES LIKE TOBACCO, DRUG, AND SUBSTANCE ABUSE. 2018 UPDATE: ADVENTHEALTH MANCHESTER IS VERY EXCITED ABOUT THE WORK WE HAVE DONE IN THE AREA OF BEHAVIORAL HEALTH. MANY PEOPLE IN OUR COMMUNITY LACK THE EMOTIONAL OR SOCIAL SUPPORTED NEEDED TO OVERCOME THE EFFECTS OF ANXIETY AND OTHER BEHAVIORAL HEALTH PROBLEMS. WE RECENTLY OPENED A WHOLE CARE CENTER ALONG WITH A BEHAVIORAL HEALTH DEPARTMENT. THE WHOLE CARE CENTER INTRODUCES GROUP THERAPY AND OTHER SERVICES TO MEET PSYCHOLOGICAL NEEDS. IN 2018, RECOVERY OPPORTUNITIES WERE OFFERED TO 427 PATIENTS AND WE CURRENTLY HAS A WAITING LIST OF 318. THE CENTER ALONG WITH SKILLED LICENSED CLINICAL SOCIAL WORKERS ARE PROVIDING FREE EDUCATION AND LITERATURE TO HELP COMBAT THE ENORMOUS OPIOID CRISIS IN OUR COMMUNITY. WE ARE STRIVING TO EDUCATE THE COMMUNITY ABOUT THE WAY WE ADDRESS ADDICTION BY PROVIDING A SAFE, CHRIST-LIKE ENVIRONMENT.PRIORITY 4: DIABETES2016 DESCRIPTION OF THE ISSUE: OF THE CLAY COUNTY POPULATION, 12.1 PERCENT ARE DIAGNOSED AS HAVING DIABETES. THE NATIONAL PERCENTAGE IS 9.11 PERCENT (WITH THE STATE BEING 10.79 PERCENT). WHILE THE HEALTH DEPARTMENT PROVIDES EDUCATION THROUGH SUPPORT GROUPS, THEIR ATTENDANCE IS LOW AND WE SEE MANY PATIENTS IN OUR HOSPITAL WITH HIGH GLUCOSE LEVELS AND OUR STAFF FINDS THAT, MANY TIMES, THESE PATIENTS DON'T KNOW THE BEST PRACTICES FOR TREATING THEIR DIABETES (DIET, ACTIVITY, ETC.). IT IS ALSO A GOAL OF OUR HOSPITAL TO REDUCE HIGH GLUCOSE RATES DURING PATIENT STAY, RECOGNIZING THAT THE PRACTICE NEEDS TO CONTINUE AFTER PATIENTS ARE DISCHARGED.2018 UPDATE: THE PREVIOUS YEAR WAS A STRUGGLE WITH THIS INITIATIVE DUE TO THE LACK OF PERSONNEL. WE LOST OUR DIABETIC EDUCATOR AND WERE NOT ABLE TO MEET OUR GOAL. WE HAVE SINCE HIRED A NEW EDUCATOR AND PLAN ON RENEWING OUR COMMITMENT TO THE COMMUNITY INDIVIDUALS WHO SUFFER FROM DIABETES. WE DO PLAN ON PARTNERING WITH OUR LOCAL HEALTH DEPARTMENT (CUMBERLAND VALLEY HEALTH) TO COLLABORATE AND DEVELOP BEST PRACTICES. (CONTINUED) SCHEDULE H, PART V, SECTION B, LINE 7A THE CHNA REPORT CAN BE FOUND AT URL:HTTPS://WWW.ADVENTHEALTH.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS SCHEDULE H, PART V, SECTION B, LINE 10A THE IMPLEMENTATION STRATEGY CAN BE FOUND AT URL: HTTPS://WWW.ADVENTHEALTH.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS SCHEDULE H, PART V, SECTION B, LINE 16A, 16B, AND 16C THE FINANCIAL ASSISTANCE POLICY CAN BE FOUND AT URL:HTTPS://WWW.ADVENTHEALTH.COM/LEGAL/FINANCIAL-ASSISTANCETHE FINANCIAL ASSISTANCE POLICY APPLICATION CAN BE FOUND AT:HTTPS://WWW.ADVENTHEALTH.COM/LEGAL/FINANCIAL-ASSISTANCETHE PLAIN LANGUAGE SUMMARY IS AVAILABLE AT:HTTPS://WWW.ADVENTHEALTH.COM/LEGAL/FINANCIAL-ASSISTANCE PART V, SECTION B, LINE 11 (CONTINUED): PRIORITY 5: CANCER2016 DESCRIPTION OF THE ISSUE: CLAY COUNTY'S CANCER MORTALITY RATES ARE 1.5 TIMES LARGER THAN THE NATIONAL AVERAGE. COMMUNITY CONCERN IS ON THE GROWING NUMBER OF CANCER DIAGNOSES OCCURRING IN THE AREA. WE HAVE A FEW SMALL GROUPS PROVIDING EDUCATION AND EVENTS, BUT THEY TEND TO FOCUS ON WOMEN'S ISSUES. WE WOULD LIKE TO PARTNER IN THOSE EVENTS AND BRING SOME ATTENTION TO THE MEN IN THE COMMUNITY ENCOURAGING THEM TO GET SCREENINGS.2018 UPDATE:IN 2018 WE OPENED OUR ONCOLOGY PROGRAM, ENABLING US TO PROVIDE SERVICES TO RESIDENTS IN CLAY COUNTY. WE WERE ABLE TO TREAT PATIENTS IN THEIR HOMES WHICH REDUCED THEIR NEED TO TRAVEL FOR TREATMENT. THE HOSPITAL LAUNCHED AND LED SUCCESSFUL DIGITAL MEDIA CAMPAIGNS TO CREATE AWARENESS ABOUT CANCER AND THE IMPORTANCE OF ANNUAL SCREENINGS. WE ALSO PARTNERED WITH THE CUMBERLAND HEALTH DEPARTMENT (CHD) TO PROVIDE FREE/DISCOUNTED MAMMOGRAMS. COMMUNITY NEEDS NOT CHOSEN BY ADVENTHEALTH MANCHESTERTHE PRIMARY AND SECONDARY DATA IN THE COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED MULTIPLE COMMUNITY ISSUES. HOSPITAL AND COMMUNITY STAKEHOLDERS USED THE FOLLOWING CRITERIA TO NARROW THE LARGER LIST TO THE PRIORITY AREAS NOTED ABOVE:1. HOW ACUTE IS THE NEED? (BASED ON DATA AND COMMUNITY CONCERN)2. WHAT IS THE TREND? IS THE NEED GETTING WORSE?3. DOES THE HOSPITAL PROVIDE SERVICES THAT RELATE TO THE PRIORITY? 4. IS SOMEONE ELSE OR MULTIPLE GROUPS IN THE COMMUNITY ALREADY WORKING ON THIS ISSUE? 5. IF THE HOSPITAL WERE TO ADDRESS THIS ISSUE, ARE THERE OPPORTUNITIES TO WORK WITH COMMUNITY PARTNERS? BASED ON THIS PRIORITIZATION PROCESS, THE HOSPITAL DID NOT CHOOSE THE FOLLOWING COMMUNITY ISSUES:A. HEART DISEASE: SINCE OUR LAST CHNA (2013), THE HOSPITAL OPENED A NEW CARDIOLOGY CLINIC TO SERVICE THE CLAY COUNTY AREA, IN PARTNERSHIP WITH UK GILL HEART INSTITUTE AND APPALACHIAN REGIONAL HOSPITAL (ARH). THE LOCAL HEALTH DEPARTMENT HAS ALSO STARTED EXTENSIVE MICRO-CLINICS TO COMBAT HEART DISEASE, AND THE HOSPITAL ALREADY OFFERS SCREENINGS ON ITS MOBILE MEDICAL UNIT.B. TEEN PREGNANCIES: THROUGH OUR CREATION HEALTH PROGRAM, THE HOSPITAL IS TRYING TO EMPOWER THE YOUNGER GENERATION INTO MAKING BETTER CHOICES FOR THEMSELVES. 1 1 - ADVENTHEALTH MEDICAL GROUP - EAR NOSE 120 MARIE LANGDON DRIVE SUITE 2 MANCHESTER KY 40962 ENT CLINIC (PT OPERATION) PART I, LINE 6A: THE FILING ORGANIZATION WAS A WHOLLY OWNED SUBSIDIARY OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). DURING THE CURRENT YEAR, AHSSHC SERVED AS A PARENT ORGANIZATION TO 24 TAX-EXEMPT 501(C)(3) HOSPITAL ORGANIZATIONS AND A NUMBER OF OTHER HEALTH CARE FACILITIES THAT OPERATED IN 10 STATES WITHIN THE U.S. THE SYSTEM OF ORGANIZATIONS UNDER THE CONTROL AND OWNERSHIP OF AHSSHC IS KNOWN AS "ADVENTHEALTH".ALL HOSPITAL ORGANIZATIONS WITHIN ADVENTHEALTH COLLECT, CALCULATE, AND REPORT THE COMMUNITY BENEFITS THEY PROVIDE TO THE COMMUNITIES THEY SERVE. ADVENTHEALTH ORGANIZATIONS EXIST SOLELY TO IMPROVE AND ENHANCE THE LOCAL COMMUNITIES THEY SERVE. ADVENTHEALTH HAS A SYSTEM-WIDE COMMUNITY BENEFITS ACCOUNTING POLICY THAT PROVIDES GUIDELINES FOR ITS HEALTH CARE PROVIDER ORGANIZATIONS TO CAPTURE AND REPORT THE COSTS OF SERVICES PROVIDED TO THE UNDERPRIVILEGED AND TO THE BROADER COMMUNITY. EACH ADVENTHEALTH HOSPITAL FACILITY REPORTS THEIR COMMUNITY BENEFITS TO THEIR BOARD OF DIRECTORS AND STRIVES TO COMMUNICATE THEIR COMMUNITY BENEFITS TO THEIR LOCAL COMMUNITIES. ADDITIONALLY, THE FILING ORGANIZATION'S MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT AND ASSOCIATED IMPLEMENTATION STRATEGY CAN BE ACCESSED ON THE FILING ORGANIZATION'S WEBSITE. PART I, LINE 7: THE AMOUNTS OF COSTS REPORTED IN THE TABLE IN LINE 7 OF PART I OF SCHEDULE H WERE DETERMINED BY UTILIZING A COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES, CONTAINED IN THE SCHEDULE H INSTRUCTIONS. PART II, COMMUNITY BUILDING ACTIVITIES: THE COSTS OF COMMUNITY BUILDING ACTIVITIES REPORTED ON PART II OF SCHEDULE H PRIMARILY REPRESENT THE COSTS ASSOCIATED WITH PROVIDING EDUCATION FOR THE FILING ORGANIZATION'S STAFF PHYSICIANS AND EMPLOYEES. THE FILING ORGANIZATION'S PROVISION OF THESE EDUCATIONAL PROGRAMS/ACTIVITIES TO STAFF PHYSICIANS AND EMPLOYEES PROVIDES AN OPPORTUNITY FOR HEALTH CARE PROFESSIONALS TO ENHANCE THEIR SKILLS AND EXPERTISE AND KEEP UP-TO-DATE WITH THE LATEST ADVANCEMENTS IN MEDICAL PROCEDURES AND TECHNOLOGY. IN ADDITION, TRAINING OPPORTUNITIES ARE OFTEN PROVIDED ON-SITE AT THE FILING ORGANIZATION'S HOSPITAL FACILITY, THEREBY ALLOWING FOR HEALTH CARE PROFESSIONALS TO BE MORE READILY AVAILABLE TO ASSIST IN MEETING IMMEDIATE PATIENT CARE NEEDS. EDUCATION AND TRAINING PROVIDED TO THE FACILITY'S WORKFORCE IS VITAL IN ASSISTING HEALTH CARE PROFESSIONALS DIRECTLY INVOLVED IN PATIENT CARE WITH KEEPING ABREAST OF THE LATEST DEVELOPMENTS IN THEIR RESPECTIVE AREAS OF EXPERTISE, LEARNING POSSIBLE NEW AND INNOVATE WAYS OF DELIVERING CARE TO PATIENTS, AND UNDERSTANDING THE NEWEST TECHNOLOGIES AVAILABLE FOR THE TREATMENT OF PATIENTS. PART III, LINE 2: THE AMOUNT OF BAD DEBT EXPENSE REPORTED ON LINE 2 OF SECTION A OF PART III IS RECORDED IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS ADJUSTMENTS TO REVENUE, NOT BAD DEBT EXPENSE. PART III, LINE 3: METHODOLOGY FOR DETERMINING THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE THAT MAY REPRESENT PATIENTS WHO COULD HAVE QUALIFIED UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY:SELF-PAY PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE BY COMPLETING A FINANCIAL ASSISTANCE APPLICATION FORM (FAA FORM). IF AN INDIVIDUAL DOES NOT SUBMIT A COMPLETE FAA FORM WITHIN 240 DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS SENT TO THE INDIVIDUAL, AN INDIVIDUAL MAY BE CONSIDERED FOR PRESUMPTIVE ELIGIBILITY BASED UPON A SCORING TOOL THAT IS DESIGNED TO CLASSIFY PATIENTS INTO GROUPS OF VARYING ECONOMIC MEANS. THE SCORING TOOL USES ALGORITHMS THAT INCORPORATE DATA FROM CREDIT BUREAUS, DEMOGRAPHIC DATABASES, AND HOSPITAL SPECIFIC DATA TO INFER AND CLASSIFY PATIENTS INTO RESPECTIVE ECONOMIC MEANS CATEGORIES. INDIVIDUALS WHO EARN A CERTAIN SCORE ON THE SCORING TOOL ARE CONSIDERED TO QUALIFY AS ELIGIBLE FOR THE MOST GENEROUS FINANCIAL ASSISTANCE UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. AS DETERMINED BY THE FILING ORGANIZATION, A NOMINAL AMOUNT OF SUCH A PATIENT'S BILL IS WRITTEN OFF AS BAD DEBT EXPENSE, WHILE THE REMAINING PORTION OF THE PATIENT'S BILL IS CONSIDERED NON-STATE CHARITY. THE AMOUNT WRITTEN OFF AS BAD DEBT EXPENSE FOR THOSE PATIENTS WHO POTENTIALLY QUALIFY AS NON-STATE CHARITY USING THE SCORING TOOL IS THE AMOUNT SHOWN ON LINE 3 OF SECTION A OF PART III. RATIONALE FOR INCLUDING CERTAIN BAD DEBTS IN COMMUNITY BENEFIT:THE FILING ORGANIZATION IS DEDICATED TO THE VIEW THAT MEDICALLY NECESSARY HEALTH CARE FOR EMERGENCY AND NON-ELECTIVE PATIENTS SHOULD BE ACCESSIBLE TO ALL, REGARDLESS OF AGE, GENDER, GEOGRAPHIC LOCATION, CULTURAL BACKGROUND, PHYSICIAN MOBILITY, OR ABILITY TO PAY. THE FILING ORGANIZATION TREATS EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF THEIR ABILITY TO PAY OR THE AVAILABILITY OF THIRD-PARTY COVERAGE. BY PROVIDING HEALTH CARE TO ALL WHO REQUIRE EMERGENCY OR NON-ELECTIVE CARE IN A NON-DISCRIMINATORY MANNER, THE FILING ORGANIZATION IS PROVIDING HEALTH CARE TO THE BROAD COMMUNITY IT SERVES. AS A 501(C)(3) HOSPITAL ORGANIZATION, THE FILING ORGANIZATION MAINTAINS A 24/7 EMERGENCY ROOM PROVIDING CARE TO ALL WHOM PRESENT. WHEN A PATIENT'S ARRIVAL AND/OR ADMISSION TO THE FACILITY BEGINS WITHIN THE EMERGENCY DEPARTMENT, TRIAGE AND MEDICAL SCREENING ARE ALWAYS COMPLETED PRIOR TO REGISTRATION STAFF PROCEEDING WITH THE DETERMINATION OF A PATIENT'S SOURCE OF PAYMENT. IF THE PATIENT REQUIRES ADMISSION AND CONTINUED NON-ELECTIVE CARE, THE FILING ORGANIZATION PROVIDES THE NECESSARY CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY. THE FILING ORGANIZATION'S OPERATION OF A 24/7 EMERGENCY DEPARTMENT THAT ACCEPTS ALL INDIVIDUALS IN NEED OF CARE PROMOTES THE HEALTH OF THE COMMUNITY THROUGH THE PROVISION OF CARE TO ALL WHOM PRESENT. CURRENT INTERNAL REVENUE SERVICE GUIDANCE THAT TAX-EXEMPT HOSPITALS MAINTAIN SUCH EMERGENCY ROOMS WAS ESTABLISHED TO ENSURE THAT EMERGENCY CARE WOULD BE PROVIDED TO ALL WITHOUT DISCRIMINATION. THE TREATMENT OF ALL AT THE FILING ORGANIZATION'S EMERGENCY DEPARTMENT IS A COMMUNITY BENEFIT. UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, EVERY EFFORT IS MADE TO OBTAIN A PATIENT'S NECESSARY FINANCIAL INFORMATION TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. HOWEVER, NOT ALL PATIENTS WILL COOPERATE WITH SUCH EFFORTS AND A FINANCIAL ASSISTANCE ELIGIBILITY DETERMINATION CANNOT BE MADE BASED UPON INFORMATION SUPPLIED BY THE INDIVIDUAL. IN THIS CASE, A PATIENT'S PORTION OF A BILL THAT REMAINS UNPAID FOR A CERTAIN STIPULATED TIME PERIOD IS WHOLLY OR PARTIALLY CLASSIFIED AS BAD DEBT. BAD DEBTS ASSOCIATED WITH PATIENTS WHO HAVE RECEIVED CARE THROUGH THE FILING ORGANIZATION'S EMERGENCY DEPARTMENT SHOULD BE CONSIDERED COMMUNITY BENEFIT AS CHARITABLE HOSPITALS EXIST TO PROVIDE SUCH CARE IN PURSUIT OF THEIR PURPOSE OF MEETING THE NEED FOR EMERGENCY MEDICAL CARE SERVICES AVAILABLE TO ALL IN THE COMMUNITY. PART III, LINE 4: FINANCIAL STATEMENT FOOTNOTE RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS:THE FINANCIAL INFORMATION OF THE FILING ORGANIZATION IS INCLUDED IN A CONSOLIDATED AUDITED FINANCIAL STATEMENT FOR THE CURRENT YEAR.THE APPLICABLE FOOTNOTE FROM THE ATTACHED CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ADDRESSES ACCOUNTS RECEIVABLE, THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS, AND THE PROVISION FOR BAD DEBTS CAN BE FOUND ON PAGES 8-9. PLEASE NOTE THAT DOLLAR AMOUNTS ON THE ATTACHED CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE IN THOUSANDS. PART III, LINE 8: COSTING METHODOLOGY: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST-TO-CHARGE RATIO. PART III, LINE 9B: COLLECTION POLICIES:THE HOSPITAL FILING ORGANIZATION'S COLLECTION PRACTICES ARE IN CONFORMITY WITH THE REQUIREMENTS SET FORTH IN THE 2014 FINAL REGULATIONS REGARDING THE REQUIREMENTS OF INTERNAL REVENUE CODE SECTION 501(R)(4) (R)(6). NO EXTRAORDINARY COLLECTION ACTIONS (ECA'S) ARE INITIATED BY THE HOSPITAL FILING ORGANIZATION IN THE 120-DAY PERIOD FOLLOWING THE DATE AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS SENT TO THE INDIVIDUAL (OR, IF LATER, THE SPECIFIED DEADLINE GIVEN IN A WRITTEN NOTICE OF ACTIONS THAT MAY BE TAKEN, AS DESCRIBED BELOW). INDIVIDUALS ARE PROVIDED WITH AT LEAST ONE WRITTEN NOTICE (NOTICE OF ACTIONS THAT MAY BE TAKEN) AND A COPY OF THE FILING ORGANIZATION'S PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY THAT INFORMS THE INDIVIDUAL THAT THE HOSPITAL FILING ORGANIZATION MAY TAKE ACTIONS TO REPORT ADVERSE INFORMATION TO CREDIT REPORTING AGENCIES/BUREAUS IF THE INDIVIDUAL DOES NOT SUBMIT A FINANCIAL ASSISTANCE APPLICATION FORM (FAA FORM) OR PAY THE AMOUNT DUE BY A SPECIFIED DEADLINE. THE SPECIFIED DEADLINE IS NOT EARLIER THAN 120 DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS SENT TO THE INDIVIDUAL AND IS AT LEAST 30 DAYS AFTER THE NOTICE IS PROVIDED. A REASONABLE ATTEMPT IS ALSO MADE TO ORALLY NOTIFY AN INDIVIDUAL ABOUT THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY AND HOW THE INDIVIDUAL MAY OBTAIN ASSISTANCE WITH THE FINANCIAL ASSISTANCE APPLICATION PROCESS. IF AN INDIVIDUAL SUBMITS AN INCOMPLETE FAA FORM DURING THE 240-DAY PERIOD FOLLOWING THE DATE ON WHICH THE FIRST POST-DISCHARGE BILLING STATEMENT WAS SENT TO THE INDIVIDUAL, THE HOSPITAL FILING ORGANIZATION SUSPENDS ANY REPORTING TO CONSUMER CREDIT REPORTING AGENCIES/BUREAUS (OR CEASES ANY OTHER ECA'S) AND PROVIDES A WRITTEN NOTICE TO THE INDIVIDUAL DESCRIBING WHAT ADDITIONAL INFORMATION OR DOCUMENTATION IS NEEDED TO COMPLETE THE FAA FORM. THIS WRITTEN NOTICE CONTAINS CONTACT INFORMATION INCLUDING THE TELEPHONE NUMBER AND PHYSICAL LOCATION OF THE HOSPITAL FACILITY'S OFFICE OR DEPARTMENT THAT CAN PROVIDE INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY, AS WELL AS CONTACT INFORMATION OF THE HOSPITAL FACILITY'S OFFICE OR DEPARTMENT THAT CAN PROVIDE ASSISTANCE WITH THE FINANCIAL ASSISTANCE APPLICATION PROCESS OR, ALTERNATIVELY, A NONPROFIT ORGANIZATION OR GOVERNMENTAL AGENCY THAT CAN PROVIDE ASSISTANCE WITH THE FINANCIAL ASSISTANCE APPLICATION PROCESS IF THE HOSPITAL FACILITY IS UNABLE TO DO SO. IF AN INDIVIDUAL SUBMITS A COMPLETE FAA FORM WITHIN A REASONABLE TIME-PERIOD AS SET FORTH IN THE NOTICE DESCRIBED ABOVE, THE HOSPITAL FILING ORGANIZATION WILL SUSPEND ANY ADVERSE REPORTING TO CONSUMER CREDIT REPORTING AGENCIES/BUREAUS UNTIL A FINANCIAL ASSISTANCE POLICY ELIGIBILITY DETERMINATION CAN BE MADE. SCHEDULE H, PART III, SECTION B: SUPPLEMENTAL SCHEDULE TO SCHEDULE H, PART III, SECTION BRECONCILIATION OF SCHEDULE H REPORTED MEDICARE SURPLUS/(SHORTFALL) TO UNREIMBURSED MEDICARE COSTS ASSOCIATED WITH THE PROVISION OF SERVICESTO ALL MEDICARE BENEFICIARIES:THE MEDICARE REVENUE AND ALLOWABLE COSTS OF CARE REPORTED IN SECTION B OF PART III OF SCHEDULE H ARE BASED UPON THE AMOUNTS REPORTED IN THE FILING ORGANIZATION'S MEDICARE COST REPORT IN ACCORDANCE WITH THE IRS INSTRUCTIONS FOR SCHEDULE H. ON AN ANNUAL BASIS, THE FILING ORGANIZATION ALSO DETERMINES ITS TOTAL UNREIMBURSED COSTS ASSOCIATED WITH PROVIDING SERVICES TO ALL MEDICARE PATIENTS. UNREIMBURSED COSTS ARE CONSIDERED A COMMUNITY BENEFIT TO THE ELDERLY AND ARE COMBINED INTO AN ANNUAL COMMUNITY BENEFIT STATEMENT PREPARED BY ADVENTHEALTH. THE PRIMARY RECONCILING ITEMS BETWEEN THE MEDICARE SURPLUS/(SHORTFALL) SHOWN ON LINE 7 OF SECTION B OF PART III OF SCHEDULE H AND THE FILING ORGANIZATION'S UNREIMBURSED COSTS OF SERVICES PROVIDED TO MEDICARE PATIENTS AS REPORTED IN THE AHS COMMUNITY BENEFIT REPORT ARE AS FOLLOWS:- MEDICARE SURPLUS/(SHORTFALL) SHOWN ON LINE 7 OF SECTION B OF SCHEDULE H: $ (1,788,071) - DIFFERENCE IN COSTING METHODOLOGY: 392,669- UNREIMBURSED COSTS INCURRED FOR SERVICES PROVIDED TO MEDICARE PATIENTS THAT ARE NOT INCLUDED IN THE ORGANIZATION'S MEDICARE COST REPORT: (2,594,778) ------------TOTAL UNREIMBURSED COSTS OF SERVING ALL MEDICARE PATIENTS PER THE FILING ORGANIZATION'S COMMUNITY BENEFIT REPORTING: $ (3,990,180)AS INDICATED ABOVE, THE PRIMARY DIFFERENCES BETWEEN THE MEDICARE SURPLUS/(SHORTFALL) REPORTED ON SCHEDULE H, PART III, SECTION B, LINE 7 AND THE FILING ORGANIZATION'S PORTION OF THE COMPANY'S ANNUAL COMMUNITY BENEFIT STATEMENT IS DUE TO A DIFFERENCE IN THE COSTING METHODOLOGY AND DIFFERENCES IN THE POPULATION OF MEDICARE PATIENTS WITHIN THE CALCULATION. THE COST METHODOLOGY UTILIZED IN CALCULATING ANY MEDICARE SURPLUS/(SHORTFALL) FOR PURPOSES OF THE ANNUAL COMMUNITY BENEFIT REPORTING IS BASED UPON THE COST-TO-CHARGE RATIO OUTLINED IN WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. THE SAME COST-TO-CHARGE RATIO IS USED TO DETERMINE THE COSTS ASSOCIATED WITH SERVICES PROVIDED TO CHARITY CARE PATIENTS AND MEDICAID PATIENTS AS REPORTED IN SCHEDULE H, PART I, LINE 7. IN ADDITION, THE MEDICARE COST REPORT EXCLUDES SERVICES PROVIDED TO MEDICARE PATIENTS FOR PHYSICIAN SERVICES, SERVICES PROVIDED TO PATIENTS ENROLLED IN MEDICARE HMOS, AND CERTAIN SERVICES PROVIDED BY OUTPATIENT DEPARTMENTS OF THE FILING ORGANIZATION THAT ARE REIMBURSED ON A FEE SCHEDULE. THE COMPANY'S OWN COMMUNITY BENEFIT STATEMENT CAPTURES THE UNREIMBURSED COST OF PROVIDING SERVICES TO ALL MEDICARE BENEFICIARIES THROUGHOUT THE ORGANIZATION. PART VI, LINE 2: THE HOSPITAL CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) DURING 2013 AND 2016. IT'S 2016 CHNA WAS ADOPTED BY ITS GOVERNING BOARD BY DECEMBER 31, 2016, THE END OF THE HOSPITAL'S TAXABLE YEAR IN WHICH IT CONDUCTED THE CHNA. THE HOSPITAL'S 2016 CHNA COMPLIED WITH THE GUIDANCE SET FORTH BY THE IRS IN FINAL REGULATION SECTION 1.501(R)-3. IN ADDITION TO THE CHNA DISCUSSED ABOVE, A VARIETY OF PRACTICES AND PROCESSES ARE IN PLACE TO ENSURE THAT THE FILING ORGANIZATION IS RESPONSIVE TO THE HEALTH NEEDS OF ITS COMMUNITY.SUCH PRACTICES AND PROCESSES INVOLVE THE FOLLOWING:1. A HOSPITAL OPERATING/COMMUNITY BOARD COMPOSED OF INDIVIDUALS BROADLY REPRESENTATIVE OF THE COMMUNITY, COMMUNITY LEADERS, AND THOSE WITH SPECIALIZED MEDICAL TRAINING AND EXPERTISE;2. POST-DISCHARGE PATIENT FOLLOW-UP RELATED TO THE ON-GOING CARE AND TREATMENT OF PATIENTS WHO SUFFER FROM CHRONIC DISEASES; 3. SPONSORSHIP AND PARTICIPATION IN COMMUNITY HEALTH AND WELLNESS ACTIVITIES THAT REACH A BROAD SPECTRUM OF THE FILING ORGANIZATION'S COMMUNITY; AND 4. COLLABORATION WITH OTHER LOCAL COMMUNITY GROUPS TO ADDRESS THE HEALTH CARE NEEDS OF THE FILING ORGANIZATION'S COMMUNITY. PART VI, LINE 3: THE FINANCIAL ASSISTANCE POLICY (FAP), FINANCIAL ASSISTANCE APPLICATION FORM (FAA FORM), AND THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY (PLS) OF THE FILING ORGANIZATION'S HOSPITAL FACILITY ARE TRANSPARENT AND AVAILABLE TO ALL INDIVIDUALS SERVED AT ANY POINT IN THE CARE CONTINUUM. THE FAP, FAA FORM, PLS, AND CONTACT INFORMATION FOR THE HOSPITAL FACILITY'S FINANCIAL COUNSELORS ARE PROMINENTLY AND CONSPICUOUSLY POSTED ON THE FILING ORGANIZATION'S HOSPITAL FACILITY'S WEBSITE. THE WEBSITE INDICATES THAT A COPY OF THE FAP, FAA FORM, AND PLS IS AVAILABLE AND HOW TO OBTAIN SUCH COPIES IN THE PRIMARY LANGUAGES OF ANY POPULATIONS WITH LIMITED PROFICIENCY IN ENGLISH THAT CONSTITUTE THE LESSER OF 1,000 INDIVIDUALS OR 5% OF THE MEMBERS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY (REFERRED TO BELOW AS LEP DEFINED POPULATIONS). SIGNAGE IS DISPLAYED IN PUBLIC LOCATIONS OF THE FILING ORGANIZATION'S HOSPITAL FACILITY, INCLUDING AT ALL POINTS OF ADMISSION AND REGISTRATION AND THE EMERGENCY DEPARTMENT. THE SIGNAGE CONTAINS THE HOSPITAL FACILITY'S WEBSITE ADDRESS WHERE THE FAP, FAA FORM, AND PLS CAN BE ACCESSED AND THE TELEPHONE NUMBER AND PHYSICAL LOCATION THAT INDIVIDUALS CAN CALL OR VISIT TO OBTAIN COPIES OF THE FAP, FAA FORM AND PLS OR TO OBTAIN MORE INFORMATION ABOUT THE HOSPITAL FACILITY'S FAP, FAA FORM AND PLS. PAPER COPIES OF THE HOSPITAL FACILITY'S FAP, FAA FORM AND PLS ARE AVAILABLE UPON REQUEST AND WITHOUT CHARGE, BOTH IN PUBLIC LOCATIONS IN THE HOSPITAL FACILITY AND BY MAIL. PAPER COPIES ARE MADE AVAILABLE IN ENGLISH AND IN THE PRIMARY LANGUAGES OF ANY LEP DEFINED POPULATIONS. THE FILING ORGANIZATION'S HOSPITAL FACILITY'S FINANCIAL COUNSELORS SEEK TO PROVIDE PERSONAL FINANCIAL COUNSELING TO ALL INDIVIDUALS ADMITTED TO THE HOSPITAL FACILITY WHO ARE CLASSIFIED AS SELF-PAY DURING THE COURSE OF THEIR HOSPITAL STAY OR AT TIME OF DISCHARGE TO EXPLAIN THE FAP AND FAA FORM AND TO PROVIDE INFORMATION CONCERNING OTHER SOURCES OF ASSISTANCE THAT MAY BE AVAILABLE, SUCH AS MEDICAID. A PAPER COPY OF THE HOSPITAL FACILITY'S PLS WILL BE OFFERED TO EVERY PATIENT AS A PART OF THE INTAKE OR DISCHARGE PROCESS. A CONSPICUOUS WRITTEN NOTICE IS INCLUDED ON ALL BILLING STATEMENTS SENT TO PATIENTS THAT NOTIFIES AND INFORMS RECIPIENTS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, INCLUDING THE FOLLOWING: 1) THE TELEPHONE NUMBER OF THE HOSPITAL FACILITY'S OFFICE OR DEPARTMENT THAT CAN PROVIDE INFORMATION ABOUT THE FAP AND THE FAA FORM; AND 2) THE WEBSITE ADDRESS WHERE COPIES OF THE FAP, FAA FORM AND PLS MAY BE OBTAINED. REASONABLE ATTEMPTS ARE MADE TO INFORM INDIVIDUALS ABOUT THE HOSPITAL FACILITY'S FAP IN ALL ORAL COMMUNICATIONS REGARDING THE AMOUNT DUE FOR THE INDIVIDUAL'S CARE. COPIES OF THE PLS ARE DISTRIBUTED TO MEMBERS OF THE COMMUNITY IN A MANNER REASONABLY CALCULATED TO REACH THOSE MEMBERS OF THE COMMUNITY WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE. PART VI, LINE 4: MEMORIAL HOSPITAL, INC. (ADVENTHEALTH MANCHESTER) IS A 49-BED FACILITY LOCATED IN MANCHESTER, KENTUCKY. MEMORIAL HOSPITAL SERVES THE RESIDENTS OF MANCHESTER AND SURROUNDING COMMUNITIES WITH VITAL HEALTHCARE SERVICES PROVIDING DIAGNOSTIC AND MEDICAL TREATMENT (BOTH SURGICAL AND NONSURGICAL) TO INPATIENTS AND OUTPATIENTS WITH A WIDE VARIETY OF MEDICAL CONDITIONS.MEMORIAL HOSPITAL IS A CRUCIAL COMMUNITY ASSET. MEDICARE HAS DESIGNATED MEMORIAL HOSPITAL AS A SOLE COMMUNITY PROVIDER AND A RURAL REFERRAL CENTER FOR CLAY COUNTY, KENTUCKY. THE NEAREST OTHER HOSPITAL IS 22 MILES AWAY. IN ADDITION TO OPERATING A HOSPITAL FACILITY, MEMORIAL HOSPITAL ALSO OPERATES A RANGE OF CLINICS SUCH AS: PEDIATRIC, FAMILY PRACTICE CLINICS, PHYSICAL THERAPY CLINICS, WALK-IN CLINIC, CARDIOLOGY CLINIC, ENT CLINIC, ORTHOPEDIC CLINIC, UROLOGY CLINIC, ONCOLOGY CLINIC, WOMEN'S CARE CLINIC, GENERAL SURGERY CLINIC, AND SEVERAL HOME HEALTH LOCATIONS. IN 2018, ADVENTHEALTH MANCHESTER ADDED MANCHESTER PRIMARY CARE, ONEIDA PRIMARY CARE AND PARKWAY MEDICAL CLINIC IN 2018. COMBINED, THESE OPERATIONS MAKE MEMORIAL HOSPITAL, INC. MANCHESTER'S LARGEST EMPLOYER AND THE SECOND LARGEST IN CLAY COUNTY.MANCHESTER, KENTUCKY IS LOCATED IN CLAY COUNTY AND IS IN THE MIDDLE OF THE DANIEL BOONE NATIONAL FOREST. MEMORIAL HOSPITAL'S PRIMARY SERVICE AREA HAS A POPULATION OF APPROXIMATELY 20,366. THE PER CAPITA INCOME IN THE PRIMARY SERVICE AREA IS APPROXIMATELY $22,174. CLAY COUNTY HAS BEEN NAMED THE 9TH POOREST COUNTY IN THE COUNTRY BY US CENSUS BUREAU- USA COUNTIES IN PROFILE. HIGH SCHOOL GRADUATES ACCOUNT FOR APPROXIMATELY 63.7% OF THE PRIMARY SERVICE AREA. IT IS ESTIMATED THAT 42.1% OF THE INDIVIDUALS RESIDING IN PRIMARY SERVICE AREA LIVE BELOW 100% OF THE FEDERAL POVERTY LEVEL AND THE UNEMPLOYMENT RATE IS ABOUT 7.6%. EXPANSION OF MEDICAID UNDER THE AFFORDABLE CARE ACT REDUCED CLAY COUNTY'S UNINSURED RATE TO APPROXIMATELY 8.7%.APPROXIMATELY 40.2% OF THE HOSPITAL'S PATIENTS DURING 2018 WERE MEDICARE PATIENTS, ABOUT 42.1% WERE MEDICAID PATIENTS, ABOUT 1.5% WERE SELF-PAY PATIENTS AND THE REMAINING PERCENTAGE WERE PATIENTS COVERED UNDER COMMERCIAL INSURANCE. IN 2018, ABOUT 77.4% OF THE HOSPITAL'S IN-PATIENTS WERE ADMITTED THROUGH THE HOSPITAL'S EMERGENCY DEPARTMENT. PART VI, LINE 5: THE PROVISION OF COMMUNITY BENEFIT IS CENTRAL TO ADVENTHEALTH MANCHESTER'S MISSION OF SERVICE AND COMPASSION. RESTORING AND PROMOTING THE HEALTH AND QUALITY OF LIFE OF THOSE IN THE COMMUNITIES SERVED BY THE HOSPITAL IS A FUNCTION OF "EXTENDING THE HEALING MINISTRY OF CHRIST AND EMBODIES THE HOSPITAL'S COMMITMENT TO ITS VALUES AND PRINCIPLES. THE HOSPITAL COMMITS SUBSTANTIAL RESOURCES TO PROVIDE A BROAD RANGE OF SERVICES TO BOTH THE UNDERPRIVILEGED AS WELL AS THE BROADER COMMUNITY. IN ADDITION TO THE COMMUNITY BENEFIT AND COMMUNITY BUILDING INFORMATION PROVIDED IN PARTS I, II AND III OF THIS SCHEDULE H, THE HOSPITAL CAPTURES AND REPORTS THE BENEFITS PROVIDED TO ITS COMMUNITY THROUGH FAITH-BASED CARE. EXAMPLES OF SUCH BENEFITS INCLUDE THE COST ASSOCIATED WITH CHAPLAINCY CARE PROGRAMS AND MISSION PEER REVIEWS AND MISSION CONFERENCES. DURING THE CURRENT YEAR, THE HOSPITAL PROVIDED $123,132 OF BENEFIT WITH RESPECT TO THE FAITH-BASED AND SPIRITUAL NEEDS OF THE COMMUNITY IN CONJUNCTION WITH ITS OPERATION OF A COMMUNITY HOSPITAL. THE HOSPITAL ALSO PROVIDES BENEFITS TO ITS COMMUNITY'S INFRASTRUCTURE BY INVESTING IN CAPITAL IMPROVEMENTS TO ENSURE THAT FACILITIES AND TECHNOLOGY PROVIDE THE BEST POSSIBLE CARE TO THE COMMUNITY. DURING THE CURRENT YEAR, THE HOSPITAL EXPENDED $8,692,885 IN NEW CAPITAL IMPROVEMENTS. AS A FAITH-BASED MISSION-DRIVEN COMMUNITY HOSPITAL, THE HOSPITAL IS CONTINUALLY INVOLVED IN MONITORING ITS COMMUNITY, IDENTIFYING UNMET HEALTH CARE NEEDS AND DEVELOPING SOLUTIONS AND PROGRAMS TO ADDRESS THOSE NEEDS. IN ACCORDANCE WITH ITS CONSERVATIVE APPROACH TO FISCAL RESPONSIBILITY, SURPLUS FUNDS OF THE HOSPITAL ARE CONTINUALLY BEING INVESTED IN RESOURCES THAT IMPROVE THE AVAILABILITY AND QUALITY OF DELIVERY OF HEALTH CARE SERVICES AND PROGRAMS TO ITS COMMUNITY. PART VI, LINE 6: MEMORIAL HOSPITAL, INC. IS A PART OF A FAITH-BASED HEALTHCARE SYSTEM OF ORGANIZATIONS WHOSE PARENT IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). THE SYSTEM IS KNOWN AS ADVENTHEALTH. AHSSHC IS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). AHSSHC AND ITS SUBSIDIARY ORGANIZATIONS OPERATE 44 HOSPITALS THROUGHOUT THE U.S., PRIMARILY IN THE SOUTHEASTERN PORTION OF THE U.S. AHSSHC AND ITS SUBSIDIARIES ALSO OPERATE 11 NURSING HOME FACILITIES AND OTHER ANCILLARY HEALTH CARE PROVIDER FACILITIES, SUCH AS AMBULATORY SURGERY CENTERS AND DIAGNOSTIC IMAGING CENTERS. AS THE PARENT ORGANIZATION OF ADVENTHEALTH, AHSSHC PROVIDES EXECUTIVE LEADERSHIP AND OTHER PROFESSIONAL SUPPORT SERVICES TO ITS SUBSIDIARY ORGANIZATIONS. PROFESSIONAL SUPPORT SERVICES INCLUDE AMONG OTHERS IT, CORPORATE COMPLIANCE, LEGAL, REIMBURSEMENT, RISK MANAGEMENT, AND TAX AS WELL AS TREASURY FUNCTIONS. CERTAIN SUPPORT SERVICES, SUCH AS HUMAN RESOURCES, PAYROLL, A/P, AND SUPPLY CHAIN MANAGEMENT ARE PROVIDED PURSUANT TO A SHARED SERVICES MODEL BY AHSSHC TO ITS SUBSIDIARY ORGANIZATIONS. THE PROVISION OF THESE EXECUTIVE AND SUPPORT SERVICES ON A CENTRALIZED BASIS BY AHSSHC PROVIDES AN APPROPRIATE BALANCE BETWEEN PROVIDING EACH ADVENTHEALTH SUBSIDIARY HOSPITAL ORGANIZATION WITH MISSION-DRIVEN CONSISTENT LEADERSHIP AND SUPPORT WHILE ALLOWING THE HOSPITAL ORGANIZATION TO FOCUS ITS RESOURCES ON MEETING THE SPECIFIC HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES. THE READER OF THIS FORM 990 SHOULD KEEP IN MIND THAT THIS REPORTING ENTITY MAY DIFFER IN CERTAIN AREAS FROM THAT OF A STAND-ALONE HOSPITAL ORGANIZATION DUE TO ITS INCLUSION IN A LARGER SYSTEM OF HEALTHCARE ORGANIZATIONS. AS A PART OF A SYSTEM OF HOSPITAL AND OTHER HEALTH CARE ORGANIZATIONS, THE FILING ORGANIZATION BENEFITS FROM REDUCED COSTS DUE TO SYSTEM EFFICIENCIES, SUCH AS LARGE GROUP PURCHASING DISCOUNTS, AND THE AVAILABILITY OF INTERNAL RESOURCES SUCH AS INTERNAL LEGAL COUNSEL. EACH ADVENTHEALTH SUBSIDIARY PAYS A MANAGEMENT FEE TO AHSSHC FOR THE INTERNAL SERVICES PROVIDED BY AHSSHC. AS A RESULT, MANAGEMENT FEE EXPENSE REPORTED BY AN ADVENTHEALTH SUBSIDIARY ORGANIZATION MAY APPEAR GREATER IN RELATION TO MANAGEMENT FEE EXPENSE THAT MAY BE REPORTED BY A SINGLE STAND-ALONE HOSPITAL. THE SINGLE STAND-ALONE HOSPITAL WOULD LIKELY REPORT COSTS ASSOCIATED WITH MANAGEMENT AND OTHER PROFESSIONAL SERVICES ON VARIOUS EXPENSE LINE ITEMS IN ITS STATEMENT OF REVENUE AND EXPENSE AS OPPOSED TO REPORTING SUCH COSTS IN ONE OVERALL MANAGEMENT FEE EXPENSE. AS THE REPORTING OF THE FORM 990 IS DONE ON AN ENTITY BY ENTITY BASIS, THERE IS NO SINGLE FORM 990 THAT CAPTURES THE PROGRAMS AND OPERATIONS OF ADVENTHEALTH AS A WHOLE. THE READER IS DIRECTED TO VISIT THE WEB-SITE OF ADVENTHEALTH AT WWW.ADVENTHEALTH.COM TO LEARN MORE ABOUT THE MISSION AND OPERATIONS OF ADVENTHEALTH. PART VI, LINE 7, LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT: THE FILING ORGANIZATION DOES NOT FILE AN ANNUAL COMMUNITY BENEFIT REPORT WITH ANY STATE AGENCIES. 1 MANCHESTER SEVENTH-DAY ADVENTIST CHURCH 168 SDA SCHOOL ROAD MANCHESTER KY 40962 611086259 501(C)(3) 34955 GENERAL SUPPORT SUNSYSTEM DEVELOPMENT CORPORATION DBA ADVENTHEALTH MANCHESTER FOUNDATION 210 MARIE LANGDON DRIVE MANCHESTER KY 40962 592219301 501(C)(3) 56645 COST GENERAL ADMINISTRATIVE SUPPORT PROVISION OF GENERAL ADMINISTRATIVE SUPPORT ONEIDA-LAUREL CREEK CHURCH OF GOD WORSHIP CENTER 1203 N HIGHWAY 11 MANCHESTER KY 40962 352226256 501(C)(3) 6000 GENERAL SUPPORT 3 0 PART I, LINE 2: GRANTS ARE GENERALLY MADE ONLY TO RELATED ORGANIZATIONS THAT ARE EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3), OR TO OTHER LOCAL CHARITABLE COMMUNITY ORGANIZATIONS, OR TO OTHER 501(C)(3) ORGANIZATIONS THAT ARE A PART OF THE GROUP EXEMPTION RULING ISSUED TO THE GENERAL CONFERENCE OF SEVENTH-DAY ADVENTISTS. ACCORDINGLY, THE FILING ORGANIZATION HAS NOT ESTABLISHED SPECIFIC PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE UNITED STATES AS THE FILING ORGANIZATION DOES NOT HAVE A GRANT MAKING PROGRAM THAT WOULD NECESSITATE SUCH PROCEDURES. X X X X 1 1 0 1 0 0 0 0 0 0 0 WEBER PETER M CHAIRMAN/DIRECTOR/REG. CEO 0 575880 0 260748 0 424293 0 102568 0 45839 0 1409328 0 70618 CORNETT MD ANITA F DIRECTOR (BEGAN 1/2018) 244604 0 0 0 55117 0 14849 0 26344 0 340914 0 0 0 NEWSWANGER DO JEFFREY DIRECTOR/CMO 270989 0 0 0 76466 0 14849 0 19037 0 381341 0 0 0 REEVES CORY D DIRECTOR/REG. CFO 0 357801 0 127062 0 40821 0 48207 0 47561 0 621452 0 20608 SKULA ERIKA DIRECTOR/CEO (ENDED 9/2018) 0 281229 0 71022 0 71904 0 21323 0 29214 0 474692 0 3311 SELF CHRISTOPHER E COO/CEO (BEGAN CEO 10/2018) 0 205166 0 15192 0 8218 0 14877 0 25351 0 268804 0 0 MILLER STEVEN S CFO 0 208612 0 28156 0 28866 0 12916 0 35405 0 313955 0 0 STIMSON MICHAEL A CNO 0 175388 0 17804 0 71237 0 10084 0 32925 0 307438 0 0 GORDEN MD SHAWN R PHYSICIAN 293295 0 30000 0 56205 0 9349 0 31497 0 420346 0 0 0 GUPTA MD GIRIRAJ PHYSICIAN 307256 0 44929 0 5636 0 14849 0 23694 0 396364 0 0 0 FAUGHN MD LAURA LYNNE PHYSICIAN 306572 0 0 0 41438 0 14849 0 12589 0 375448 0 0 0 GHIMIRE MD BIJAYA PHYSICIAN 312527 0 0 0 33859 0 14849 0 12552 0 373787 0 0 0 PUTRAKUL MD KOBKIT PHYSICIAN 262935 0 0 0 77621 0 14849 0 19940 0 375345 0 0 0 WALKER DANIEL T FORMER CFO 0 109085 0 0 0 16430 0 6037 0 14886 0 146438 0 0 PART I, LINE 1A THE FILING ORGANIZATION IS A PART OF THE SYSTEM OF HEALTHCARE ORGANIZATIONS KNOWN AS ADVENTHEALTH. MEMBERS OF THE FILING ORGANIZATION'S EXECUTIVE 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 ADVENTHEALTH. AHSSHC IS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). THE FILING ORGANIZATION REIMBURSES AHSSHC FOR THE SALARY AND BENEFIT COST OF THOSE EXECUTIVES ON THE PAYROLL OF AHSSHC. AT THE DIRECTION OF AHSSHC, AND IN ACCORDANCE WITH THE RESERVED POWERS IN THE FILING ORGANIZATION'S GOVERNING DOCUMENTS, THE EXECUTIVE TEAM LISTED ON PART VII PROVIDES SERVICES TO THE FILING ORGANIZATION. TRAVEL FOR COMPANIONS: AHSSHC HAS A CORPORATE EXECUTIVE POLICY THAT PROVIDES A BENEFIT TO ALLOW FOR A TRAVELING AHSSHC EXECUTIVE TO HAVE HIS OR HER SPOUSE ACCOMPANY THE EXECUTIVE ON CERTAIN BUSINESS TRIPS EACH YEAR. TYPICALLY, REIMBURSEMENT IS ONLY PROVIDED TO CERTAIN EXECUTIVE LEADERS AND IS USUALLY LIMITED TO ONE BUSINESS TRIP PER YEAR BEYOND THE ANNUAL ADVENTHEALTH PRESIDENT'S COUNCIL BUSINESS MEETING AND OTHER MEETINGS WHERE THE SPOUSE IS SPECIFICALLY INVITED. THE AHSSHC CORPORATE EXECUTIVE SPOUSAL TRAVEL POLICY WAS ORIGINALLY APPROVED AND REVIEWED BY THE AHSSHC BOARD COMPENSATION COMMITTEE, AN INDEPENDENT BODY OF THE AHSSHC BOARD OF DIRECTORS. ALL SPOUSAL TRAVEL COSTS REIMBURSED TO THE EXECUTIVE ARE CONSIDERED TAXABLE COMPENSATION TO THE EXECUTIVE. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: ADVENTHEALTH HAS A SYSTEM-WIDE POLICY ADDRESSING GROSS-UP PAYMENTS PROVIDED IN CONNECTION WITH EMPLOYER-PROVIDED BENEFITS/OTHER TAXABLE ITEMS. UNDER THE POLICY, CERTAIN TAXABLE BUSINESS-RELATED REIMBURSEMENTS (I.E. TAXABLE BUSINESS-RELATED MOVING EXPENSES, TAXABLE ITEMS PROVIDED IN CONNECTION WITH EMPLOYMENT) PROVIDED TO ANY EMPLOYEE MAY BE GROSSED-UP AT A 25% RATE UPON APPROVAL BY THE FILING ORGANIZATION'S CEO AND CFO. ADDITIONALLY, EMPLOYEES AT THE DIRECTOR LEVEL AND ABOVE ARE ELIGIBLE FOR GROSS-UP PAYMENTS ON GIFTS RECEIVED FOR BOARD OF DIRECTOR SERVICES. DISCRETIONARY SPENDING ACCOUNT: A NOMINAL DISCRETIONARY SPENDING AMOUNT WAS PROVIDED IN THE CURRENT YEAR TO ALL ELIGIBLE EXECUTIVES WHO ATTEND THE ANNUAL ADVENTHEALTH PRESIDENT'S COUNCIL BUSINESS MEETING ($500 PER EXECUTIVE) OR THE ANNUAL ADVENTHEALTH CFO CONFERENCE OR CMO/CNO BUSINESS MEETING ($300 PER EXECUTIVE). OTHER DISCRETIONARY SPENDING ACCOUNTS MAY BE PROVIDED IN CONNECTION WITH OTHER ADVENTHEALTH SPONSORED CONFERENCES BUT TYPICALLY DO NOT EXCEED $200 PER PARTICIPANT. THE PAYMENT PROVIDED TO EACH EXECUTIVE WAS CONSIDERED TAXABLE COMPENSATION TO THE EXECUTIVE. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE: AHSSHC HAS A CORPORATE EXECUTIVE POLICY THAT ADDRESSES ASSISTANCE TO EXECUTIVES WHO HAVE BEEN RELOCATED BY THE COMPANY DURING THE YEAR. RELOCATION ASSISTANCE PROVIDED TO EXECUTIVES MAY INCLUDE RELOCATION ALLOWANCES TO ASSIST WITH DUPLICATE HOUSING EXPENSES. RELOCATION ASSISTANCE IS ADMINISTERED PER AHSSHC POLICY BY AN EXTERNAL RELOCATION COMPANY. ANY TAXABLE REIMBURSEMENTS MADE TO EXECUTIVES IN CONNECTION WITH RELOCATION ASSISTANCE ARE TREATED AS WAGES TO THE EXECUTIVE AND ARE SUBJECT TO ALL PAYROLL WITHHOLDING AND REPORTING REQUIREMENTS. PART I, LINE 3 THE INDIVIDUAL WHO SERVES AS THE CEO OF THE FILING ORGANIZATION IS IS APPOINTED AND COMPENSATED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). 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 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 OF THE COMMUNITY, 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 AS DISCUSSED IN LINE 1A ABOVE, 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 A HEALTHCARE SYSTEM KNOWN AS ADVENTHEALTH. IN RECOGNITION OF THE CONTRIBUTION THAT EACH EXECUTIVE MAKES TO THE SUCCESS OF ADVENTHEALTH, ADVENTHEALTH PROVIDES TO ELIGIBLE EXECUTIVES PARTICIPATION IN THE ADVENTHEALTH EXECUTIVE FLEX BENEFIT PROGRAM (THE PLAN). THE PURPOSE OF THE PLAN IS TO OFFER ELIGIBLE EXECUTIVES AN OPPORTUNITY TO ELECT 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 PLAN PROVIDES ELIGIBLE PARTICIPANTS A PRE-DETERMINED BENEFITS ALLOWANCE CREDIT THAT IS EQUAL TO A PERCENTAGE OF THE EXECUTIVE'S BASE PAY FROM WHICH IS DEDUCTED THE COST OF MANDATORY AND ELECTIVE EMPLOYEE BENEFITS. THE PRE-DETERMINED BENEFITS ALLOWANCE CREDIT PERCENTAGE IS APPROVED BY THE AHSSHC BOARD COMPENSATION COMMITTEE, AN INDEPENDENT COMMITTEE OF THE BOARD OF DIRECTORS OF AHSSHC. ANY FUNDS THAT REMAIN AFTER THE COST OF MANDATORY AND ELECTIVE BENEFITS ARE SUBTRACTED FROM THE ANNUAL PRE-DETERMINED BENEFITS ALLOWANCE ARE CONTRIBUTED, AT THE EMPLOYEE'S OPTION, 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 DOCUMENTS DEFINE AN EMPLOYEE WHO IS ELIGIBLE TO PARTICIPATE IN THE PLAN TO GENERALLY INCLUDE THE CHIEF EXECUTIVE OFFICERS OF ADVENTHEALTH ENTITIES AND VICE PRESIDENTS OF ALL ADVENTHEALTH ENTITIES WHOSE BASE SALARY IS AT LEAST $250,000. 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 IS FORFEITED BY THE EXECUTIVE UPON A VOLUNTARY SEPARATION. IN ADDITION TO THE PLAN, ADVENTHEALTH HAS INSTITUTED 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. PARTICIPATION IN THE PLAN IS OFFERED TO ADVENTHEALTH EXECUTIVES 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) 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 THE SERP AND BY THE INDIVIDUAL'S YEAR OF ENTRY TO THE ADVENTHEALTH EXECUTIVE FLEX BENEFIT PROGRAM. ADDITIONALLY, ADVENTHEALTH HAS ADOPTED A SENIOR EXECUTIVE DEATH BENEFIT (SEDB) PLAN IN RECOGNITION OF THE CONSIDERABLE AGE AND SERVICE REQUIREMENTS IN THE SERP. THE SEDB PLAN PROVIDES A BENEFIT IN AN AMOUNT EQUAL TO THE AMOUNT THE EXECUTIVE'S BENEFIT WOULD HAVE BEEN UNDER THE SERP 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 PLAN WITH PRESENT VALUE RECOGNIZING AN EARLY BENEFIT COMMENCEMENT. 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 OF THE ELIGIBILITY REQUIREMENTS OF SERP AS OF THE EXECUTIVE'S DATE OF DEATH BUT WOULD HAVE SATISFIED ALL OF THOSE REQUIREMENTS WITHIN FIVE (5) YEARS FOLLOWING DEATH HAD THE EXECUTIVE LIVED AND CONTINUED EMPLOYMENT. THE SEDB PLAN WAS REVIEWED AND APPROVED BY THE AHSSHC BOARD COMPENSATION COMMITTEE, AN INDEPENDENT BODY OF THE AHSSHC BOARD OF DIRECTORS. FLEX PLAN FLEX PLAN/ SERP 457(B) CY CY EMPLOYER CY CONTRIB./ DISTRIBUTIONS* CONTRIB. DISTRIBUTIONS* PAYMENT ------------------------------------------------------- WEBER, PETER M. $ 87,719 $ 89,707 $293,069 $ 0 REEVES, CORY D. $ 33,358 $ 24,243 $ 0 $ 0 SKULA, ERIKA $ 24,974 $ 4,034 $ 0 $ 0 SELF, CHRISTOPHER E. $ 3,066 $ 0 $ 0 $ 0 * INCLUDING INVESTMENT EARNINGS THERACARE INC BOARD MEMBER- OWNER OF THERACARE 286650 PHYSICAL THERAPY SERVICE 0 PART V, LINE 1A: THE PARENT CORPORATION AND SOLE TOP-TIER MEMBER OF MEMORIAL HOSPITAL, 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 MEMORIAL HOSPITAL, INC. (THE FILING ORGANIZATION) HAS ONE MEMBER. THE SOLE MEMBER OF THE FILING ORGANIZATION IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION. ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC) IS A FLORIDA, NOT-FOR-PROFIT CORPORATION THAT IS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3). THERE ARE NO OTHER CLASSES OF MEMBERSHIP IN THE FILING ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER OF THE FILING ORGANIZATION IS AHSSHC. THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION ARE APPOINTED BY THE SOLE MEMBER, AHSSHC, WHO HAS THE RIGHT TO ELECT, APPOINT OR REMOVE ANY MEMBER OF THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B AHSSHC, AS THE SOLE MEMBER 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) TO APPROVE AND DISAPPROVE THE EXECUTIVE AND/OR ADMINISTRATIVE LEADERSHIP OF THE FILING ORGANIZATION, AND THEIR SALARIES; B) TO ADOPT, AMEND, RESTATE, AND REPEAL THE ARTICLES OF INCORPORATION OR THE BYLAWS OF THE FILING ORGANIZATION, AND THE MEDICAL STAFF BYLAWS; C) TO SET LIMITS AND TERMS FOR THE BORROWING OF FUNDS; D) TO APPROVE OR DISAPPROVE MAJOR BUILDING PROGRAMS AND/OR PURCHASE OR SALE OF PERSONAL PROPERTY OR REAL PROPERTY EQUAL TO OR IN EXCESS OF ONE MILLION DOLLARS; E) TO APPROVE OR DISAPPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE FILING ORGANIZATION; F) TO DIRECT THE PLACEMENT OF FUNDS AND CAPITAL OF THE FILING ORGANIZATION; G) TO ESTABLISH GENERAL GUIDING POLICIES, TO IMPLEMENT QUALITY ASSESSMENT, IMPROVEMENT AND UTILIZATION REVIEW PROGRAMS; AND H) TO APPROVE THE APPOINTMENT OF AN AUDITING FIRM AND ELECTION OF THE FISCAL YEAR FOR THE FILING ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE FILING ORGANIZATION'S CURRENT YEAR FORM 990 WAS REVIEWED BY THE BOARD CHAIRMAN, BOARD FINANCE COMMITTEE CHAIR, CEO AND BY THE CFO PRIOR TO ITS FILING WITH THE IRS. THE REVIEW CONDUCTED BY THE BOARD CHAIRMAN, BOARD FINANCE COMMITTEE CHAIR, CEO AND THE CFO 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 CEO, OTHER OFFICERS AND KEY EMPLOYEES 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: FOR THOSE BOARD OF DIRECTOR MEMBERS (NOT INCLUDING PHYSICIAN MEMBERS OF THE BOARD), OFFICER(S) AND KEY EMPLOYEES 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. PHYSICIAN MEMBERS OF THE BOARD OF DIRECTORS RECEIVED COMPENSATION FROM RELATED ORGANIZATIONS AS A RESULT OF PROVIDING VARIOUS MEDICAL SERVICES TO THOSE RELATED ENTITIES. 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 3,404,987. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,404,987. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 3,649,070. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,649,070. ENVIRONMENTAL SERVICES: PROGRAM SERVICE EXPENSES 5,000. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,000. TRANSCRIPTION SERVICES: PROGRAM SERVICE EXPENSES 19,466. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,466. RECRUITING: PROGRAM SERVICE EXPENSES 64,709. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 64,709. MISCELLANEOUS PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 203,185. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 203,185. AHS MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 697,380. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 697,380. BILLING & COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,151,873. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,151,873. EHR MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 7,195. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,195. AHS SHARED SERVICE FEE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 558,045. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 558,045. PURCHASED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 205,445. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 205,445. PART X, LINE 2: THE AMOUNTS SHOWN ON LINE 2 OF PART X OF THIS RETURN INCLUDE THE FILING ORGANIZATION'S INTEREST IN A CENTRAL INVESTMENT POOL MAINTAINED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION, THE FILING ORGANIZATION'S TOP-TIER PARENT. THE INVESTMENTS IN THE CENTRAL INVESTMENT POOL ARE RECORDED AT MARKET VALUE. FORM 990, PART XI, LINE 9: TRANSFER TO TAX-EXEMPT PARENT -445,348. ALLOCATION FROM TAX-EXEMPT PARENT WITH RESPECT TO DEBT -30,158. RESTRICTED GIFTS 108,345. TRANSFER FOR EXPENSES -113,309. 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 1 ADVENTHEALTH UNIVERSITY INC FKA ADV UNIV OF HLTH SCIENCES INC 671 LAKE WINYAH DRIVE ORLANDO FL 32803 593069793 EDUCATION/OPERATION OF SCHOOL FL 501(C)(3) LINE 2 ADVENTIST HLTH SYSTEMSUNBELT INC 1 ADVENTHEALTH RANSOM MEMORIAL INC (619-123118) 1301 S MAIN STREET OTTAWA KS 66067 830976641 OPERATION OF HOSPITAL & RELATED SERVICES KS 501(C)(3) LINE 3 ADVENTIST HLTH MID-AMERICA INC 1 ADVENTIST BOLINGBROOK HOSPITAL 500 REMINGTON BLVD BOLINGBROOK IL 60440 651219504 OPERATION OF HOSPITAL & RELATED SERVICES IL 501(C)(3) LINE 3 ADVENTIST MIDWEST HEALTH 1 ADVENTIST CARE CENTERS - COURTLAND INC 730 COURTLAND STREET ORLANDO FL 32804 205774723 OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY FL 501(C)(3) LINE 10 SUNBELT HLTH CARE CENTERS INC 1 ADVENTIST GLENOAKS HOSPITAL 701 WINTHROP AVENUE GLENDALE HEIGHTS IL 60139 363208390 OPERATION OF HOSPITAL & RELATED SERVICES IL 501(C)(3) LINE 3 ADVENTIST MIDWEST HEALTH 1 ADVENTIST 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 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 1 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 900 HOPE WAY ALTAMONTE SPRINGS FL 32714 592170012 MANAGEMENT SERVICES FL 501(C)(3) LINE 12A, I N/A 0 ADVENTIST HLTH SYSTEM GEORGIA INC 1035 RED BUD ROAD CALHOUN GA 30701 581425000 OPERATION OF HOSPITAL & RELATED SERVICES GA 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 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 1 ADVENTIST HLTH SYSTEMTEXAS INC 11801 S FREEWAY BURLESON TX 76028 742578952 LEASING PERSONNEL TO AFFILIATED HOSPITAL TX 501(C)(3) LINE 12C, III-FI ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 ADVENTIST MIDWEST HEALTH 120 NORTH OAK STREET HINSDALE IL 60521 362276984 OPERATION OF HOSPITAL & RELATED SERVICES IL 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEMSUNBELT INC 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 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 1 AHSCENTRAL TEXAS INC 1301 WONDER WORLD DRIVE SAN MARCOS TX 78666 742621825 PROVIDE OFFICE SPACE - MEDICAL PROFESSIONALS TX 501(C)(3) LINE 12C, III-FI ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 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 1 BATTLE CREEK ADVENTIST HOSPITAL 900 HOPE WAY ALTAMONTE SPRINGS FL 32714 381359189 INACTIVE MI 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEMSUNBELT INC 1 BOLINGBROOK HOSPITAL FOUNDATION 500 REMINGTON BLVD BOLINGBROOK IL 60440 900494445 FUND-RAISING FOR TAX-EXEMPT HOSPITAL IL 501(C)(3) LINE 7 MIDWEST HLTH FOUNDATION 0 BRADFORD HEIGHTS HLTH & REHAB CENTER INC 950 HIGHPOINT DRIVE HOPKINSVILLE KY 42240 205782342 OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY KY 501(C)(3) LINE 10 SUNBELT HLTH CARE CENTERS INC 1 BURLESON NURSING & REHAB CENTER INC 301 HUGULEY BLVD BURLESON TX 76028 205782243 OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY TX 501(C)(3) LINE 10 SUNBELT HLTH CARE CENTERS INC 1 CALDWELL HLTH CARE PROPERTIES INC 1333 WEST MAIN PRINCETON KY 42445 510605680 LEASE TO RELATED ORGANIZATION GA 501(C)(3) LINE 12C, III-FI SUNBELT HLTH CARE CENTERS INC 1 CENTRAL TEXAS HLTHCARE COLLABORATIVE 1301 WONDER WORLD DRIVE SAN MARCOS TX 78666 453739929 SUPPORT OPERATION OF HOSPITAL TX 501(C)(3) LINE 12A, I ADVENTIST HLTH SYSTEMSUNBELT INC 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 1 CHIPPEWA VALLEY HOSPITAL & OAKVIEW CARE CENTER INC 1220 THIRD AVENUE WEST DURAND WI 54736 391365168 OPERATION OF HOSPITAL & RELATED SERVICES WI 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEMSUNBELT INC 1 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 1 CREEKWOOD PLACE NURSING & REHAB CENTER INC 107 BOYLES DRIVE RUSSELLVILLE KY 42276 205782260 OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY KY 501(C)(3) LINE 10 SUNBELT HLTH CARE CENTERS INC 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 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 1 EMORY-ADVENTIST INC 900 HOPE WAY ALTAMONTE SPRINGS FL 32714 582171011 INACTIVE GA 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEMSUNBELT INC 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 1 FLNC INC 3355 E SEMORAN BLVD APOPKA FL 32703 205774761 OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY FL 501(C)(3) LINE 10 SUNBELT HLTH CARE CENTERS INC 1 FLORIDA HOSPITAL DADE CITY INC 13100 FORT KING ROAD DADE CITY FL 33525 822567308 OPERATION OF HOSPITAL & RELATED SVCS FL 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 FLORIDA HOSPITAL HEALTHCARE PARTNERS INC 770 WEST GRANADA BLVD 101 ORMOND BEACH FL 32174 462354804 OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES FL 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEMSUNBELT INC 1 FLORIDA HOSPITAL MEDICAL GROUP INC 2600 WESTHALL LANE 4TH FLOOR MAITLAND FL 32751 593214635 OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES FL 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEMSUNBELT INC 1 FLORIDA HOSPITAL OCALA INC 1500 SW 1ST AVENUE OCALA FL 34471 824372339 OPERATION OF HOSPITAL & RELATED SVCS FL 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 FLORIDA HOSPITAL PHYSICIAN GROUP INC 12470 TELECOM DR 100 TAMPA FL 33637 462021581 OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES FL 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 FLORIDA HOSPITAL WATERMAN INC 1000 WATERMAN WAY TAVARES FL 32778 593140669 OPERATION OF HOSPITAL & RELATED SERVICES FL 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 FLORIDA HOSPITAL ZEPHYRHILLS INC 7050 GALL BLVD ZEPHYRHILLS FL 33541 592108057 OPERATION OF HOSPITAL & RELATED SERVICES FL 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEMSUNBELT INC 1 FLORIDA RADIOLOGY IMAGING AT LAKE MARY LLC (222-123118) 2600 WESTHALL LANE 4TH FLOOR MAITLAND FL 32751 550789387 IMAGING & TESTING FL 501(C)(3) LINE 3 FLORIDA HOSPITAL MEDICAL GROUP INC 1 FOUNTAIN INN NURSING & REHAB CENTER INC 485 NORTH KELLER ROAD 250 MAITLAND FL 32751 472180518 OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY FL 501(C)(3) LINE 10 SUNBELT HLTH CARE CENTERS INC 1 GLENOAKS HOSPITAL FOUNDATION 701 WINTHROP AVENUE GLENDALE HEIGHTS IL 60139 363926044 FUND-RAISING FOR TAX-EXEMPT HOSPITAL IL 501(C)(3) LINE 7 MIDWEST HLTH FOUNDATION 0 HELEN ELLIS MEMORIAL HOSPITAL AUXILIARY INC 1395 S PINELLAS AVE TARPON SPRINGS FL 34689 592106043 FUND-RAISING FOR TAX-EXEMPT HOSPITAL/FOUNDATION FL 501(C)(3) LINE 12C, III-FI N/A 0 HELEN ELLIS MEMORIAL HOSPITAL FOUNDATION INC 1395 S PINELLAS AVE TARPON SPRINGS FL 34689 593690149 FUND-RAISING FOR TAX-EXEMPT HOSPITAL FL 501(C)(3) LINE 7 N/A 0 HINSDALE HOSPITAL FOUNDATION 120 NORTH OAK STREET HINSDALE IL 60521 521466387 FUND-RAISING FOR TAX-EXEMPT HOSPITAL IL 501(C)(3) LINE 7 MIDWEST HLTH FOUNDATION 0 HOSPICE OF THE COMFORTER INC 480 W CENTRAL PARKWAY ALTAMONTE SPRINGS FL 32714 592935928 OPERATION OF HOSPICE FL 501(C)(3) LINE 10 THE COMFORTER HEALTH CARE GROUP INC 1 HOSPICE OF THE COMFORTER FOUNDATION INC 480 W CENTRAL PARKWAY ALTAMONTE SPRINGS FL 32714 271858033 INACTIVE FL 501(C)(3) LINE 7 THE COMFORTER HEALTH CARE GROUP INC 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 1 LA GRANGE MEMORIAL HOSPITAL FOUNDATION 5101 S WILLOW SPRINGS RD LA GRANGE IL 60525 300247776 FUND-RAISING FOR TAX-EXEMPT HOSPITAL IL 501(C)(3) LINE 7 MIDWEST HLTH FOUNDATION 0 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 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 N/A 0 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 1 MEMORIAL HOSPITAL - WEST VOLUSIA INC 701 WEST PLYMOUTH AVENUE DELAND FL 32720 593256803 OPERATION OF HOSPITAL & RELATED SERVICES FL 501(C)(3) LINE 3 MEMORIAL HLTH SYSTEMS INC 1 MEMORIAL HOSPITAL FLAGLER INC 60 MEMORIAL MEDICAL PARKWAY PALM COAST FL 32164 592951990 OPERATION OF HOSPITAL & RELATED SERVICES FL 501(C)(3) LINE 3 MEMORIAL HLTH SYSTEMS INC 1 MEMORIAL HOSPITAL INC 210 MARIE LANGDON DRIVE MANCHESTER KY 40962 610594620 OPERATION OF HOSPITAL & RELATED SERVICES KY 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 MERRIAM HLTH CARE PROPERTIES INC 9700 WEST 62ND STREET MERRIAM KS 66203 364595806 LEASE TO RELATED ORGANIZATION KS 501(C)(3) LINE 12C, III-FI SUNBELT HLTH CARE CENTERS INC 1 METROPLEX ADVENTIST HOSPITAL INC 2201 S CLEAR CREEK ROAD KILLEEN TX 76549 742225672 OPERATION OF HOSPITAL & RELATED SERVICES TX 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 METROPLEX CLINIC PHYSICIANS INC 2201 S CLEAR CREEK ROAD KILLEEN TX 76549 113762050 PHYSICIAN HLTHCARE SERVICES TO THE COMMUNITY TX 501(C)(3) LINE 3 METROPLEX ADVENTIST HOSPITAL INC 1 MIDWEST HLTH FOUNDATION 120 NORTH OAK STREET HINSDALE IL 60521 352230515 SUPPORT OF SUBSIDIARY FOUNDATIONS IL 501(C)(3) LINE 12B, II N/A 0 MILLS HLTH & REHAB CENTER INC 500 BECK LANE MAYFIELD KY 42066 205782320 OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY KY 501(C)(3) LINE 10 SUNBELT HLTH CARE CENTERS INC 1 MISSION STRATEGIES OF GEORGIA INC 485 NORTH KELLER ROAD 250 MAITLAND FL 32751 900866024 PROVISION OF SUPPORT TO THE NURSING HOME DIVISION GA 501(C)(3) LINE 12B, II SUNBELT HLTH CARE CENTERS INC 1 MISSOURI ADVENTIST HLTH 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 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 N/A 0 OSCEOLA HEALTH CARE PROPERTIES INC 485 NORTH KELLER ROAD 250 MAITLAND FL 32751 813165729 LEASE TO RELATED ORGANIZATION GA 501(C)(3) LINE 12C, III-FI SUNBELT HLTH CARE CENTERS INC 1 OVERLAND PARK NURSING & REHAB CENTER INC 6501 WEST 75TH STREET OVERLAND PARK KS 66204 205774821 OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY KS 501(C)(3) LINE 10 SUNBELT HLTH CARE CENTERS INC 1 PARAGON HLTH CARE PROPERTIES INC 950 HIGHPOINT DRIVE HOPKINSVILLE KY 42240 510605686 LEASE TO RELATED ORGANIZATION GA 501(C)(3) LINE 12C, III-FI SUNBELT HLTH CARE CENTERS INC 1 PASCO-PINELLAS HILLSBOROUGH COMMUNITY HLTH SYSTEM INC 2600 BRUCE B DOWNS BLVD WESLEY CHAPEL FL 33544 208488713 OPERATION OF HOSPITAL & RELATED SERVICES FL 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 PORTERCARE ADVENTIST HLTH SYSTEM (630 YEAR END) 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 1 PRINCETON HLTH & REHAB CENTER INC 1333 WEST MAIN PRINCETON KY 42445 205782272 OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY KY 501(C)(3) LINE 10 SUNBELT HLTH CARE CENTERS INC 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 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 1 RESOURCE PERSONNEL INC 485 NORTH KELLER ROAD 250 MAITLAND FL 32751 208040875 PROVIDE ADMINISTRATIVE SUPPORT TO TAX EXEMPT NURSING HOMES FL 501(C)(3) LINE 12B, II SUNBELT HLTH CARE CENTERS INC 1 ROCKY MOUNTAIN ADVENTIST HLTHCARE 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