ADVENTIST MIDWEST HEALTH: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization: ADVENTIST MIDWEST HEALTH (EIN 36-2276984)
Tax period: 2015-01-01 to 2015-12-31
Filed: 2016-11-14
IRS object ID: 201623199349307397
Schema version: 2015v2.1
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2016-11-14T15:14:48-06:00	ReturnTs
Tax Period End	2015-12-31	TaxPeriodEndDt
Return Type	990	ReturnTypeCd
Tax Period Begin	2015-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	362276984	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ADVENTIST MIDWEST HEALTH	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	ADVE	BusinessNameControlTxt
Phone	6308569000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	120 NORTH OAK STREET	AddressLine1Txt
City	HINSDALE	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	60521	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	LYNN C ADDISCOTT	PersonNm
Person Title	ASSISTANT SECRETARY	PersonTitleTxt
Phone	6308566001	PhoneNum
Signature	2016-11-14	SignatureDt

Field	Value	IRS element (for citing)
Tax	2015	TaxYr
Build TS	2017-02-10 21:41:12Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	MICHAEL GOEBEL	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	120 NORTH OAK STREET	AddressLine1Txt
City	HINSDALE	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	60521	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$834,463,654	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.KEEPINGYOUWELL.COM	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1904	FormationYr
Legal Domicile State	IL	LegalDomicileStateCd
Activity Or Mission	THE PROVISION OF MEDICAL CARE TO THE COMMUNITY THROUGH THE OPERATION OF TWO HOSPITALS.	ActivityOrMissionDesc
Voting Members Governing Body	20	VotingMembersGoverningBodyCnt
Voting Members Independent	14	VotingMembersIndependentCnt
Total Employee	2667	TotalEmployeeCnt
Total Volunteers	517	TotalVolunteersCnt
Total Gross UBI	$2,779,571	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$265,075	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$1,206,164	PYContributionsGrantsAmt
CY Contributions Grants	$1,270,167	CYContributionsGrantsAmt
PY Program Service Revenue	$284,125,414	PYProgramServiceRevenueAmt
CY Program Service Revenue	$446,597,288	CYProgramServiceRevenueAmt
PY Investment Income	$523,793	PYInvestmentIncomeAmt
CY Investment Income	-$1,079,498	CYInvestmentIncomeAmt
PY Other Revenue	$831,550	PYOtherRevenueAmt
CY Other Revenue	$412,949	CYOtherRevenueAmt
PY Total Revenue	$286,686,921	PYTotalRevenueAmt
CY Total Revenue	$447,200,906	CYTotalRevenueAmt
PY Grants And Similar Paid	$1,039,385	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$1,061,241	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$132,891,223	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$144,560,619	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$147,774,198	PYOtherExpensesAmt
CY Other Expenses	$296,581,314	CYOtherExpensesAmt
PY Total Expenses	$281,704,806	PYTotalExpensesAmt
CY Total Expenses	$442,203,174	CYTotalExpensesAmt
PY Revenues Less Expenses	$4,982,115	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$4,997,732	CYRevenuesLessExpensesAmt
Total Assets BOY	$468,352,553	TotalAssetsBOYAmt
Total Assets EOY	$651,082,039	TotalAssetsEOYAmt
Total Liabilities BOY	$220,152,282	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$379,640,582	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$248,200,271	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$271,441,457	NetAssetsOrFundBalancesEOYAmt
Mission	ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION AND ALL OF 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.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$386,855,785	ExpenseAmt
Grant	$1,061,241	GrantAmt
Revenue	$444,067,308	RevenueAmt
Desc	OPERATION OF AMITA HEALTH HINSDALE, A 276-BED ACUTE CARE HOSPITAL AND AMITA HEALTH LA GRANGE, A 204-BED ACUTE CARE HOSPITAL; 19,419 PATIENT ADMISSIONS, 82,392 PATIENT DAYS, AND 300,890 OUTPATIENT VISITS IN THE CURRENT YEAR.	Desc
Total Program Service Expenses	$386,855,785	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	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
Temp Or Permanent Endowments	Yes (1)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	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	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	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	Yes (1)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	0	BusinessRlnWithOfficerEntInd
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
IRP Document	273	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	2667	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
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
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	20	GoverningBodyVotingMembersCnt
Independent Voting Member	14	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	Yes (1)	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	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (1)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	IL	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	REBECCA MATHIS	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	6308569000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	120 N OAK STREET	AddressLine1Txt
City	HINSDALE	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	60521	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (37 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
RANDALL HAFFNER PHD
CHAIRMAN (BEG 6/15)	0.10	50.00	Yes (X)	$0	$1,835,419	$242,710
RICHARD REINER
CHAIRMAN (END 6/15)	1.00	50.00	Yes (X)	$0	$1,084,868	$62,839
DONALD LIVESAY
VICE CHAIRMAN	0.10	4.00	Yes (X)	$0	$2,457	$0
VENANZIO ARQUILLA
DIRECTOR	0.10	0.50	Yes (X)	$0	$0	$0
DAVID CRANE
PRESIDENT/SECRETARY	22.50	27.50	Yes (X)	$0	$2,703,120	$180,726	Yes (X)
LINDA EASTMAN
DIRECTOR	0.10	0.50	Yes (X)	$0	$0	$0
MARSHALL GRAY JR
DIRECTOR (END 12/15)	0.10	0.50	Yes (X)	$0	$0	$0
LARRY GUNN MD
DIRECTOR	0.10	0.50	Yes (X)	$0	$0	$0
RONNIE HAWKINS
DIRECTOR	0.10	0.50	Yes (X)	$0	$0	$0
CARLENE JAMERSON
DIRECTOR (BEG 1/15)	0.50	0.90	Yes (X)	$0	$130,319	$604
PETER O'CONNOR
DIRECTOR	0.10	0.50	Yes (X)	$0	$0	$0
JOHN PAYNE MD
DIRECTOR (END 12/15)	8.40	0.50	Yes (X)	$61,500	$0	$0
RUSSELL PETRAK MD
DIRECTOR (END 12/15)	0.10	0.50	Yes (X)	$0	$0	$0
RAY PICHETTE
DIRECTOR	0.10	3.00	Yes (X)	$0	$1,432	$0
GLYNN SCOTT
DIRECTOR	0.10	3.00	Yes (X)	$0	$2,457	$0
GREG SHARON MD
DIRECTOR (BEG 1/15)	0.10	0.50	Yes (X)	$0	$0	$0
CHRISTINE SMITH
DIRECTOR	0.10	0.50	Yes (X)	$0	$0	$0
BRENT SNYDER
TREASURER/DIRECTOR	1.00	50.00	Yes (X)	$0	$1,247,230	$161,878
GARY THURBER
DIRECTOR	0.10	3.00	Yes (X)	$0	$2,182	$0
DINO VALLERA MD
DIRECTOR	0.10	0.50	Yes (X)	$0	$0	$0
JONATHAN WRIGHT
DIRECTOR	0.10	0.50	Yes (X)	$0	$0	$0
MICHAEL GOEBEL
CEO	50.00	0.00		$0	$638,427	$116,254	Yes (X)
REBECCA MATHIS
CFO	15.00	35.00		$0	$375,981	$54,982	Yes (X)
MICHAEL MURRILL
COO (BEG 3/15)	33.30	16.70		$0	$332,182	$53,894		Yes (X)
GARY LIPINSKI MD
CMO	50.00	0.00		$0	$534,358	$86,138		Yes (X)
SHEVAWN TYRELL
CNO (END 6/15)	50.00	0.00		$0	$441,109	$44,068		Yes (X)
RON WEHTJE
REGIONAL CFO	12.50	37.50		$0	$645,353	$97,208		Yes (X)
GEORGE MAYZELL MD
REGIONAL CMO (END 8/15)	21.70	28.30		$0	$882,947	$84,325		Yes (X)
MARY MURPHY
REGIONAL CNO	25.00	25.00		$0	$362,651	$48,316		Yes (X)
KATHLEEN FERKET
VP CARE CONTINUUM	60.00	0.00		$244,126	$0	$27,456			Yes (X)
ZEWDU HAILE MD
DIR - FAMILY PRACTICE RESI	60.00	0.00		$225,860	$0	$36,617			Yes (X)
GARRY GIERTUGA
ASSIT VP HUMAN RESOURCES	60.00	0.00		$196,457	$0	$27,916			Yes (X)
LESLIEE SLEUWEN
ASSOC DIR - FAMILY PRACTICE	60.00	0.00		$183,043	$0	$34,828			Yes (X)
KATE GUNNELL
ASSOC DIR - FAMILY PRACTICE	60.00	0.00		$174,932	$0	$33,211			Yes (X)
JANICE HAGENSICKER
FORMER CFO	0.00	50.00		$0	$684,107	$80,818				Yes (X)
ALAN SCHNEIDER
FORMER COO/CHIEF PSO	0.00	50.00		$0	$212,805	$37,232				Yes (X)
RICHARD CARROLL MD
FORMER CMO	0.00	50.00		$0	$594,669	$88,543				Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,085,918	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$12,714,073	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,600,563	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	142	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
BULLEY & ANDREWS LLC
1755 W ARMITAGE AVE	CHICAGO	IL	60622	CONTRACTOR SERVICES	$10,841,555
PT SOLUTIONS
PO BOX 441146	KENNESAW	GA	30160	PHYSICAL THERAPY SERVICES	$3,524,964
ARUP LABORATORIES
PO BOX 27964	SALT LAKE CITY	UT	84127	LAB SERVICES	$1,038,705
CARDIOTHORACIC & VASCULAR SURGICAL ASSOC
4400 W 95TH ST STE 205	OAK LAWN	IL	60453	MEDICAL SERVICES	$724,929
BVK
250 W COVENTRY CT	MILWAUKEE	WI	53217	MARKETING SERVICES	$676,016

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	93	CntrctRcvdGreaterThan100KCnt
Related Organizations	$1,225,223	RelatedOrganizationsAmt
Government Grants	$44,944	GovernmentGrantsAmt
Total Contributions	$1,270,167	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT REVENUE	622110	$429,649,943	$427,002,684	$2,647,259
MANAGEMENT SVCS TO RELATED	622110	$12,423,726	$12,423,726
PROF OFFICE BUILDING/EMP HOUSING	622110	$1,859,285	$1,859,285
CAFETERIA	622110	$1,094,043	$1,094,043
PHARMACY	622110	$367,969	$362,929	$5,040

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,202,322	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,184,132	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$18,190	UnrelatedBusinessRevenueAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$446,597,288	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,408,961	TotalRevenueColumnAmt
Exclusion	$2,408,961	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$260,202	RealAmt
Personal	$115,250	PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$96,844	RealAmt
Personal	$6,168	PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$163,358	RealAmt
Personal	$109,082	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$272,440	TotalRevenueColumnAmt
Unrelated Business Revenue	$109,082	UnrelatedBusinessRevenueAmt
Exclusion	$163,358	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$381,747,646	SecuritiesAmt
Other	$1,923,631	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$385,574,981	SecuritiesAmt
Other	$1,584,755	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	-$3,827,335	SecuritiesAmt
Other	$338,876	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$3,488,459	TotalRevenueColumnAmt
Exclusion	-$3,488,459	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	EHR REVENUE	Desc
Business	622110	BusinessCd
Total Revenue Column	$140,509	TotalRevenueColumnAmt
Related Or Exempt Func Income	$140,509	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$140,509	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$447,200,906	TotalRevenueColumnAmt
Related Or Exempt Func Income	$444,067,308	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$2,779,571	UnrelatedBusinessRevenueAmt
Exclusion	-$916,140	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$1,061,241	TotalAmt
Program Services	$1,061,241	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$4,352,832	TotalAmt
Management And General	$4,352,832	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$103,616,166	TotalAmt
Program Services	$90,736,705	ProgramServicesAmt
Management And General	$12,879,461	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$3,034,745	TotalAmt
Program Services	$2,564,411	ProgramServicesAmt
Management And General	$470,334	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$26,482,124	TotalAmt
Program Services	$21,974,864	ProgramServicesAmt
Management And General	$4,507,260	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$7,074,752	TotalAmt
Program Services	$5,973,624	ProgramServicesAmt
Management And General	$1,101,128	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$262,746	TotalAmt
Management And General	$262,746	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$80,575	TotalAmt
Management And General	$80,575	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$631,616	TotalAmt
Management And General	$631,616	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$53,396,980	TotalAmt
Program Services	$47,717,024	ProgramServicesAmt
Management And General	$5,679,956	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$706,328	TotalAmt
Management And General	$706,328	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$8,167,280	TotalAmt
Program Services	$5,636,309	ProgramServicesAmt
Management And General	$2,530,971	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$15,938,375	TotalAmt
Program Services	$14,007,454	ProgramServicesAmt
Management And General	$1,930,921	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$9,833,633	TotalAmt
Program Services	$8,647,771	ProgramServicesAmt
Management And General	$1,185,862	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$998,097	TotalAmt
Management And General	$998,097	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$9,368,392	TotalAmt
Program Services	$9,368,392	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$28,048,245	TotalAmt
Program Services	$28,048,245	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$4,536,456	TotalAmt
Program Services	$3,751,591	ProgramServicesAmt
Management And General	$784,865	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$67,784,870	$67,784,870
LEASED PERSONNEL	$60,695,613	$55,260,080	$5,435,533
STATE TAX INDIGENT ASSE	$17,585,615	$17,585,615
UNRELATED BUSINESS INCO	$385,015	$0	$385,015

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$18,161,478	TotalAmt
Program Services	$6,737,589	ProgramServicesAmt
Management And General	$11,423,889	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$442,203,174	TotalAmt
Program Services	$386,855,785	ProgramServicesAmt
Management And General	$55,347,389	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$5,707	BOYAmt
EOY	$10,646	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$82,535,410	BOYAmt
EOY	$82,129,988	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$42,153,546	BOYAmt
EOY	$62,877,282	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$7,698,666	BOYAmt
EOY	$12,964,333	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$8,955,981	BOYAmt
EOY	$13,383,991	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$804,057,412	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$503,028,187	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$149,626,105	BOYAmt
EOY	$301,029,225	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$892,144	BOYAmt
EOY	$382,143	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$2,662,485	BOYAmt
EOY	$2,662,485	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
EOY	$2,926,634	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$173,822,509	BOYAmt
EOY	$172,715,312	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$468,352,553	BOYAmt
EOY	$651,082,039	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$27,902,769	BOYAmt
EOY	$37,562,247	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$5,293,983	BOYAmt
EOY	$357,553	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$186,955,530	BOYAmt
EOY	$341,720,782	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$220,152,282	BOYAmt
EOY	$379,640,582	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$241,264,153	BOYAmt
EOY	$263,647,737	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$5,945,538	BOYAmt
EOY	$6,782,267	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$990,580	BOYAmt
EOY	$1,011,453	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$248,200,271	BOYAmt
EOY	$271,441,457	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$468,352,553	BOYAmt
EOY	$651,082,039	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$4,997,732	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$770,611	NetUnrlzdGainsLossesInvstAmt
Prior Period Adjustments	-$100	PriorPeriodAdjustmentsAmt
Other Changes In Net Assets	$19,014,165	OtherChangesInNetAssetsAmt
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	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	Yes (1)	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$146,357	OtherActivitiesAmt
Total Lobbying Expenditures	$146,357	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	DUES WERE PAID TO THE AMERICAN HOSPITAL ASSOCIATION AND ILLINOIS HOSPITAL ASSOCIATION. OUTSIDE CONSULTANTS WILLIAM FILAN AND JOHN ANDREW KANE WERE PAID IN THE CURRENT YEAR, AND SALARY EXPENSE OF $66,682 WAS INCURRED FOR PAID STAFF ENGAGED IN LOBBYING ACTIVITIES.	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,709,572	BeginningYearBalanceAmt
Contributions	$90,685	ContributionsAmt
Investment Earnings Or Losses	$67,588	InvestmentEarningsOrLossesAmt
Other Expenditures	$20,025	OtherExpendituresAmt
End Year Balance	$1,847,820	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,641,940	BeginningYearBalanceAmt
Investment Earnings Or Losses	$67,632	InvestmentEarningsOrLossesAmt
End Year Balance	$1,709,572	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,754,512	BeginningYearBalanceAmt
Investment Earnings Or Losses	$67,497	InvestmentEarningsOrLossesAmt
Other Expenditures	$180,069	OtherExpendituresAmt
End Year Balance	$1,641,940	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,690,924	BeginningYearBalanceAmt
Investment Earnings Or Losses	$63,588	InvestmentEarningsOrLossesAmt
End Year Balance	$1,754,512	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,631,892	BeginningYearBalanceAmt
Investment Earnings Or Losses	$59,032	InvestmentEarningsOrLossesAmt
End Year Balance	$1,690,924	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.89960	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.10040	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.00000	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (1)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (1)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$17,030,151	OtherCostOrOtherBasisAmt
Book Value	$17,030,151	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$446,691,108	OtherCostOrOtherBasisAmt
Depreciation	$262,041,188	DepreciationAmt
Book Value	$184,649,920	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$280,086,443	OtherCostOrOtherBasisAmt
Depreciation	$233,409,815	DepreciationAmt
Book Value	$46,676,628	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$60,249,710	OtherCostOrOtherBasisAmt
Depreciation	$7,577,184	DepreciationAmt
Book Value	$52,672,526	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$301,029,225	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (6 entries)

DescDesc	Book ValueBookValueAmt
OTHER RECEIVABLES	$601,130
INTERCOMPANY RECEIVABLE	$152,799,452
BENEFICIAL INTEREST IN FOUNDATION	$14,228,363
RECEIVABLE FROM THIRD PARTIES	$8,043
DUE FROM RELATED	$4,784,579
DUE FROM AFFILIATED	$293,745

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$172,715,312	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (8 entries)

DescDesc	AmtAmt
CREDIT BALANCES IN A/R	$3,057,310
INTERCO. ALLOC. OF TE BOND PROCEEDS	$273,422,283
PAYABLE TO THIRD PARTIES	$42,955,535
LEASES PAYABLE	$2,476,652
OTHER NONCURRENT LIABILITIES	$9,355,748
DUE TO RELATED	-$406,721
OTHER CURRENT LIABILITIES	$389,147
DUE TO AFFILIATED	$10,470,828

Field	Value	IRS element (for citing)
Total Liability	$341,720,782	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

PART V, LINE 4:

ALL ENDOWMENT FUNDS ARE HELD BY THE FOLLOWING RELATED 501(C)(3) EXEMPT FOUNDATIONS: HINSDALE HOSPITAL FOUNDATION (HHF): FORMED AND MAINTAINED EXCLUSIVELY TO FURTHER THE EXEMPT PURPOSE OF AMITA HEALTH HINSDALE. HHF HELD ASSETS IN PERMANENT ENDOWMENT AND QUASI-ENDOWMENT FUNDS DURING THE CURRENT YEAR. HHF'S ENDOWMENT CONSISTS OF TWO INDIVIDUAL FUNDS ESTABLISHED TO SUPPORT THE HOSPITAL'S OPLER CANCER CENTER AND FUNDS DESIGNATED BY THE BOARD OF DIRECTORS TO FUNCTION AS ENDOWMENTS TO SUPPORT VARIOUS PURPOSES BENEFITING THE HOSPITAL AND ITS PATIENTS. LA GRANGE MEMORIAL HOSPITAL FOUNDATION (LMHF): FORMED AND MAINTAINED EXCLUSIVELY TO FURTHER THE EXEMPT PURPOSE OF AMITA HEALTH LA GRANGE. LMHF'S PERMANENT ENDOWMENT CONSISTS OF A SCHOLARSHIP FUND ESTABLISHED TO SUPPORT NURSING SCHOLARSHIPS.

PART X, LINE 2:

THE FILING ORGANIZATION IS A SUBSIDIARY ORGANIZATION WITHIN ADVENTIST HEALTH SYSTEM (AHS). THE CONSOLIDATED FINANCIAL STATEMENTS OF AHS CONTAIN THE FOLLOWING FIN 48 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, 2015 AND 2014. NAHS ALSO HAS TEMPORARY DEDUCTIBLE DIFFERENCES OF APPROXIMATELY $62,700 AND $63,600 AT DECEMBER 31, 2015 AND 2014, RESPECTIVELY, PRIMARILY AS A RESULT OF NET OPERATING LOSS CARRYFORWARDS. AT DECEMBER 31, 2015, NAHS HAD NET OPERATING LOSS CARRYFORWARDS OF APPROXIMATELY $62,500, EXPIRING BEGINNING IN 2022 THROUGH 2026. DEFERRED TAXES HAVE BEEN PROVIDED FOR THESE AMOUNTS, RESULTING IN A NET DEFERRED TAX ASSET OF APPROXIMATELY $23,800 AND $24,200 AT DECEMBER 31, 2015 AND 2014, RESPECTIVELY. A FULL VALUATION ALLOWANCE HAS BEEN PROVIDED AT DECEMBER 31, 2015 AND 2014 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, 2015 AND 2014.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	0	FPGReferenceDiscountedCareInd
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	0	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,350,113	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$3,350,113	NetCommunityBenefitExpnsAmt
Total Expense	0.00760	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$52,439,605	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$41,232,200	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$11,207,405	NetCommunityBenefitExpnsAmt
Total Expense	0.02530	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$55,789,718	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$41,232,200	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$14,557,518	NetCommunityBenefitExpnsAmt
Total Expense	0.03290	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$615	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$475	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$140	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$12,043,986	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,330,007	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$7,713,979	NetCommunityBenefitExpnsAmt
Total Expense	0.01740	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$450,833	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$450,833	NetCommunityBenefitExpnsAmt
Total Expense	0.00100	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$12,495,434	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,330,482	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$8,164,952	NetCommunityBenefitExpnsAmt
Total Expense	0.01840	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$68,285,152	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$45,562,682	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$22,722,470	NetCommunityBenefitExpnsAmt
Total Expense	0.05130	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$197,893	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$696	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$197,197	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$197,893	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$696	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$197,197	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$10,879,324	BadDebtExpenseAmt
Bad Debt Expense Attributable	$526,077	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$123,436,207	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$135,586,477	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$12,150,270	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

Field	Value	IRS element (for citing)
Business Name Line1	1 HINSDALE SURGICAL CENTER LLC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Primary Activities	SURGICAL SERVICES	PrimaryActivitiesTxt
Org Profit Or Ownership	0.31550	OrgProfitOrOwnershipPct
Ofcr Etc Profit Or Ownership	0.00000	OfcrEtcProfitOrOwnershipPct
Physicians Profit Or Ownership	0.47230	PhysiciansProfitOrOwnershipPct

Field	Value	IRS element (for citing)
Hospital Facilities	2	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Website AddressWebsiteAddressTxt	State LicenseStateLicenseNum	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Teaching HospitalTeachingHospitalInd	Emergency Room24 HrsEmergencyRoom24HrsInd	Research FacilityResearchFacilityInd
ADVENTIST HINSDALE HOSPITAL
1	120 NORTH OAK STREET	HINSDALE	IL	60521	WWW.KEEPINGYOUWELL.COM/AHH	0000976	Yes (X)	Yes (X)	Yes (X)	Yes (X)
ADVENTIST LA GRANGE MEMORIAL HOSPITAL
2	5101 S WILLOW SPRINGS ROAD	LA GRANGE	IL	60525	WWW.KEEPINGYOUWELL.COM/ALMH	0005017	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (2 entries)

FacilityFacilityNum	First Licensed CY Or PYFirstLicensedCYOrPYInd	Tax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYInd	CHNA ConductedCHNAConductedInd	Community DefinitionCommunityDefinitionInd	Community DemographicsCommunityDemographicsInd	Existing ResourcesExistingResourcesInd	How Data ObtainedHowDataObtainedInd	Community Health NeedsCommunityHealthNeedsInd	Other Health IssuesOtherHealthIssuesInd	Community Hlth Needs Id ProcessCommunityHlthNeedsIdProcessInd	Consulting ProcessConsultingProcessInd	CHNA ConductedCHNAConductedYr	Take Into Account Others InputTakeIntoAccountOthersInputInd	CHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsInd	CHNA Conducted With Non FcltsCHNAConductedWithNonFcltsInd	CHNA Report Widely AvailableCHNAReportWidelyAvailableInd	Rpt Available On Own WebsiteRptAvailableOnOwnWebsiteInd	Own Website URLOwnWebsiteURLTxt	Paper Copy Public InspectionPaperCopyPublicInspectionInd	Rpt Available Thru Other MethodRptAvailableThruOtherMethodInd	Implementation Strategy AdoptImplementationStrategyAdoptInd	Implementation Strategy AdptImplementationStrategyAdptYr	Strategy Posted WebsiteStrategyPostedWebsiteInd	Strategy Website URLStrategyWebsiteURLTxt	Strategy AttachedStrategyAttachedInd	Organization Incur Excise TaxOrganizationIncurExciseTaxInd	Elig Criteria ExplainedEligCriteriaExplainedInd	FPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntInd	FPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePct	Asset Level CriteriaAssetLevelCriteriaInd	Medical Indigency CriteriaMedicalIndigencyCriteriaInd	Insurance Status CriteriaInsuranceStatusCriteriaInd	Explained BasisExplainedBasisInd	App Financial Asst ExplnAppFinancialAsstExplnInd	Described InfoDescribedInfoInd	Described Suprt DocDescribedSuprtDocInd	Provided Hospital ContactProvidedHospitalContactInd	Provided Nonprofit ContactProvidedNonprofitContactInd	Includes Publicity MeasuresIncludesPublicityMeasuresInd	FAP Available On WebsiteFAPAvailableOnWebsiteInd	FAP Available On Website URLFAPAvailableOnWebsiteURLTxt	FAP App Available On WebsiteFAPAppAvailableOnWebsiteInd	FAP App Available On Website URLFAPAppAvailableOnWebsiteURLTxt	FAP Summary On WebsiteFAPSummaryOnWebsiteInd	FAP Summary On Website URLFAPSummaryOnWebsiteURLTxt	FAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeInd	FAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgInd	FAP Sum Avlbl On Request No ChrgFAPSumAvlblOnRequestNoChrgInd	FAP Notice DisplayedFAPNoticeDisplayedInd	Communtity Notified FAPCommuntityNotifiedFAPInd	FAP Actions On NonpaymentFAPActionsOnNonpaymentInd	Permit No ActionsPermitNoActionsInd	Collection ActivitiesCollectionActivitiesInd	FAP Notified Upon AdmissionFAPNotifiedUponAdmissionInd	FAP Notified Before DischargeFAPNotifiedBeforeDischargeInd	FAP Notified All PatientsFAPNotifiedAllPatientsInd	Documented Elig DeterminationDocumentedEligDeterminationInd	Nondis Emergency Care PolicyNondisEmergencyCarePolicyInd	Other Method UsedOtherMethodUsedInd	Amounts Generally BilledAmountsGenerallyBilledInd	Gross ChargesGrossChargesInd
ADVENTIST HINSDALE HOSPITAL
1	0	0	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	13	Yes (1)	Yes (1)	0	Yes (1)	Yes (X)	SEE STATEMENT	Yes (X)	Yes (X)	Yes (1)	14	Yes (1)	SEE STATEMENT	0	0	Yes (1)	Yes (X)	200.000000000000	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	SEE STATEMENT	Yes (X)	SEE STATEMENT	Yes (X)	SEE STATMENT	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	0
ADVENTIST LA GRANGE MEMORIAL HOSPITAL
2	0	Yes (1)	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	13	Yes (1)	Yes (1)	0	Yes (1)	Yes (X)	SEE STATEMENT	Yes (X)	Yes (X)	Yes (1)	14	Yes (1)	SEE STATEMENT	0	0	Yes (1)	Yes (X)	200.000000000000	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	SEE STATEMENT	Yes (X)	SEE STATEMENT	Yes (X)	SEE STATMENT	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	0

Supplemental Information SupplementalInformationGrp (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
ADVENTIST HINSDALE HOSPITAL	PART V, SECTION B, LINE 5: ADVENTIST HINSDALE HOSPITAL (THE HOSPITAL) IS ONE OF FOUR NOT-FOR-PROFIT RELATED HOSPITALS LOCATED IN THE WESTERN AND SOUTHWESTERN SUBURBS OF CHICAGO. EACH OF THESE FOUR HOSPITALS IS A PART OF ADVENTIST HEALTH SYSTEM (AHS). AHS IS A HEALTH CARE SYSTEM PRIMARILY CONSISTING OF TAX-EXEMPT 501(C)(3) HOSPITAL ORGANIZATIONS THAT OPERATE 44 HOSPITALS IN 10 STATES WITHIN THE US. THE FOUR RELATED HOSPITAL ORGANIZATIONS LOCATED IN CHICAGO, ARE CLINICALLY INTEGRATED, SHARE OVERLAPPING COMMUNITIES, AND ARE TIED TOGETHER BY COMMON MISSION, VALUES, AND VISION. AS THE FOUR HOSPITALS ARE LOCATED IN THE SAME METROPOLITAN SERVICE AREA, THE HOSPITALS COLLABORATED IN 2013 TO CONDUCT A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE FOUR RELATED HOSPITAL ORGANIZATIONS ARE ADVENTIST GLENOAKS HOSPITAL, ADVENTIST MIDWEST HEALTH DBA ADVENTIST HINSDALE HOSPITAL, ADVENTIST BOLINGBROOK HOSPITAL, AND ADVENTIST HEALTH SYSTEM/SUNBELT, INC., DBA ADVENTIST LA GRANGE MEMORIAL HOSPITAL.IN CONDUCTING ITS 2013 JOINT CHNA, THE FOUR HOSPITALS NAMED ABOVE COLLECTED PRIMARY AND SECONDARY DATA USING A NUMBER OF DATA COLLECTION METHODOLOGIES. ADVENTIST GLENOAKS HOSPITAL, ADVENTIST HINSDALE HOSPITAL, AND ADVENTIST LA GRANGE MEMORIAL HOSPITAL PARTNERED WITH THE METROPOLITAN CHICAGO HEALTHCARE COUNCIL TO CONDUCT ITS PRIMARY RESEARCH, CONSISTING OF TELEPHONE SURVEYS, FOCUS GROUPS, AND WRITTEN SURVEYS. A LIST OF RECOMMENDED PARTICIPANTS TO BE INCLUDED IN THE FOCUS GROUPS WAS PROVIDED BY THE METROPOLITAN CHICAGO HEALTHCARE COUNCIL. PARTICIPANTS INCLUDED REPRESENTATIVES OF PUBLIC HEALTH, INDIVIDUALS WHO WORK WITH LOW-INCOME, MINORITY OR OTHER MEDICALLY UNDERSERVED POPULATIONS, AND THOSE WHO WORK WITH PERSONS WITH CHRONIC DISEASE CONDITIONS.
ADVENTIST LA GRANGE MEMORIAL HOSPITAL	PART V, SECTION B, LINE 5: ADVENTIST LA GRANGE MEMORIAL HOSPITAL (THE HOSPITAL) IS ONE OF FOUR NOT-FOR-PROFIT RELATED HOSPITAL ORGANIZATIONS LOCATED IN THE WESTERN AND SOUTHWESTERN SUBURBS OF CHICAGO. EACH OF THESE FOUR HOSPITALS IS A PART OF ADVENTIST HEALTH SYSTEM (AHS). AHS IS A HEALTH CARE SYSTEM PRIMARILY CONSISTING OF TAX-EXEMPT 501(C)(3) HOSPITAL ORGANIZATION THAT OPERATE 44 HOSPITALS IN 10 STATES WITHIN THE US. THE FOUR RELATED HOSPITAL ORGANIZATIONS LOCATED IN CHICAGO, ARE CLINICALLY INTEGRATED, SHARE OVERLAPPING COMMUNITIES, AND ARE TIED TOGETHER BY COMMON MISSION, VALUES, AND VISION. AS THE FOUR HOSPITALS ARE LOCATED IN THE SAME METROPOLITAN SERVICE AREA, THE HOSPITALS COLLABORATED IN 2013 TO CONDUCT A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE FOUR RELATED HOSPITAL ORGANIZATIONS ARE ADVENTIST GLENOAKS HOSPITAL, ADVENTIST MIDWEST HEALTH, ADVENTIST BOLINGBROOK HOSPITAL, AND ADVENTIST HEALTH SYSTEM/SUNBELT, INC., DBA ADVENTIST LA GRANGE MEMORIAL HOSPITAL.IN CONDUCTING ITS 2013 JOINT CHNA, THE FOUR HOSPITALS NAMED ABOVE COLLECTED PRIMARY AND SECONDARY DATA USING A NUMBER OF DATA COLLECTION METHODOLOGIES. ADVENTIST GLENOAKS HOSPITAL, ADVENTIST MIDWEST HEALTH, AND ADVENTIST LA GRANGE MEMORIAL HOSPITAL PARTNERED WITH THE METROPOLITAN CHICAGO HEALTHCARE COUNCIL TO CONDUCT ITS PRIMARY RESEARCH, CONSISTING OF TELEPHONE SURVEYS, FOCUS GROUPS, AND WRITTEN SURVEYS. A LIST OF RECOMMENDED PARTICIPANTS TO BE INCLUDED IN THE FOCUS GROUPS WAS PROVIDED BY THE METROPOLITAN CHICAGO HEALTHCARE COUNCIL. PARTICIPANTS INCLUDED REPRESENTATIVES OF PUBLIC HEALTH, INDIVIDUALS WHO WORK WITH LOW-INCOME, MINORITY OR OTHER MEDICALLY UNDERSERVED POPULATIONS, AND THOSE WHO WORK WITH PERSONS WITH CHRONIC DISEASE CONDITIONS.
ADVENTIST HINSDALE HOSPITAL	PART V, SECTION B, LINE 6A: THE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED BY ADVENTIST HINSDALE HOSPITAL (THE HOSPITAL) WAS BASED UPON THE HOSPITAL'S INVOLVEMENT AND ENRICHMENT OF THOSE WHO LIVE WITHIN DUPAGE COUNTY, ILLINOIS. THE CHNA WAS CONDUCTED IN CONJUNCTION WITH RELATED HOSPITALS IN THE CHICAGO METROPOLITAN AREA:ADVENTIST GLENOAKS HOSPITALADVENTIST BOLINGBROOK HOSPITALADVENTIST HEALTH SYSTEM/SUNBELT, INC. DBA ADVENTIST LA GRANGE MEMORIAL HOSPITAL
ADVENTIST LA GRANGE MEMORIAL HOSPITAL	PART V, SECTION B, LINE 6A: THE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED BY ADVENTIST LA GRANGE MEMORIAL HOSPITAL (THE HOSPITAL) WAS BASED UPON THE HOSPITAL'S INVOLVEMENT AND ENRICHMENT OF THOSE WHO LIVE WITHIN DUPAGE COUNTY, ILLINOIS. THE CHNA WAS CONDUCTED IN CONJUNCTION WITH RELATED HOSPITALS IN THE CHICAGO METROPOLITAN AREA: ADVENTIST HINSDALE HOSPITALADVENTIST BOLINGBROOK HOSPITALADVENTIST GLENOAKS HOSPITAL
ADVENTIST HINSDALE HOSPITAL	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 REPORT MUST BE POSTED ON THE HOSPITAL'S WEBSITE BY THE END OF THE YEAR IN WHICH IT IS CONDUCTED. THE HOSPITAL WILL MAKE A COPY OF ITS COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AVAILABLE UPON REQUEST. THE HOSPITAL WILL ALSO MAKE A PAPER COPY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AVAILABLE FOR PUBLIC INSPECTION AT THE HOSPITAL FACILITY.
ADVENTIST LA GRANGE MEMORIAL HOSPITAL	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 REPORT MUST BE POSTED ON THE HOSPITAL'S WEBSITE BY THE END OF THE YEAR IN WHICH IT IS CONDUCTED. THE HOSPITAL WILL MAKE A COPY OF ITS COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AVAILABLE UPON REQUEST. THE HOSPITAL WILL ALSO MAKE A PAPER COPY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AVAILABLE FOR PUBLIC INSPECTION AT THE HOSPITAL FACILITY.
ADVENTIST LA GRANGE MEMORIAL HOSPITAL	PART V, SECTION B, LINE 2: ON 1/31/2015, THE NET ASSETS ASSOCIATED WITH THE OPERATION OF ADVENTIST LA GRANGE MEMORIAL HOSPITAL (ALMH) WERE TRANSFERRED FROM ADVENTIST HEALTH SYSTEM/SUNBELT, INC., A RELATED 501(C)(3) TAX-EXEMPT ORGANIZATION.
ADVENTIST HINSDALE HOSPITAL	PART V, SECTION B, LINE 11: AS NOTED IN PART V, SECTION B, LINE 5 AND LINE 6, THE HOSPITAL (AHH) IS A PART OF ADVENTIST HEALTH SYSTEM AND CONDUCTED A JOINT CHNA WITH THE FOLLOWING RELATED AHS HOSPITALS IN 2013:- ADVENTIST MIDWEST HEALTH DBA ADVENTIST HINSDALE HOSPITAL (AHH)- ADVENTIST MIDWEST HEALTH DBA ADVENTIST LA GRANGE MEMORIAL HOSPITAL (ALMH), FKA ADVENTIST HEALTH SYSTEM/SUNBELT, INC. DBA ADVENTIST LA GRANGE MEMORIAL HOSPITAL - ADVENTIST BOLINGBROOK HOSPITAL (ABH)- ADVENTIST GLENOAKS HOSPITAL THESE FOUR HOSPITALS ARE KNOWN COLLECTIVELY AS THE ADVENTIST MIDWEST REGION (AMR), AND AS A REGION, HAVE PRIORITIZED AND ADDRESSED THE SIGNIFICANT NEEDS WITHIN THEIR REGION AS A RESULT OF THE JOINT CHNA CONDUCTED AND OUTLINED BELOW. THE FOLLOWING IS A LISTING OF PROGRAMS/ACTIVITIES UNDERTAKEN TO ADDRESS IDENTIFIED SIGNIFICANT NEEDS: PRIORITY 1: ACCESS TO HEALTH CARE (LACK OF INSURANCE)- HEALTH INSURANCE EXCHANGE ENROLLMENT FOR 210 PEOPLE AHH/ALMH MADE THE DECISION TO REFER TO LOCAL NAVIGATORS IN 2014 AS THERE WERE DUPLICATIVE SERVICES AVAILABLE IN CONVENIENT LOCATIONS FOR LOCAL COMMUNITY MEMBERS. - MEDICAID ENROLLMENT FOR HOSPITAL PATIENTSTHE AMR HOSPITALS CONTRACTED FOR THE SERVICE OF A SERVICE PROVIDER TO ASSIST WITH THE ENROLLMENT OF MEDICAID PATIENTS AT AHH, ALMH, ABH, AND AGO. - DISCHARGE MEDICATIONS FOR UNINSURED PATIENTSTHIS GOAL WAS EXCEEDED. AHH - 119 PATIENTS WERE PROVIDED WITH DISCHARGE MEDICATION ASSISTANCE. - LINKS WITH COMMUNITY PARTNERS (I.E. AGING CONNECTIONS) TO HELP PREVENT AVOIDABLE READMISSIONS - AHH - 10.5% DECREASE IN AVOIDABLE READMISSIONS.- FREE BREAST AND CERVICAL CANCER SCREENINGS AT HINSDALE FAMILY CARE CENTERRESIDENTS OF ALMH FAMILY MEDICINE CLINICS DO PROVIDE FREE SERVICES THROUGH THE LA GRANGE COMMUNITY NURSES ASSOCIATION. IN 2015, APPROXIMATELY 338 PHYSICIAN HOURS WERE PROVIDED. - PROVIDE OB SERVICES AT THE HOSPITALSAT AHH, OBSTETRICAL SERVICES WERE PROVIDED TO WOMEN WITH FINANCIAL AND ACCESS NEEDS. AS A RESULT, THERE WERE 160 DELIVERIES AT AHH. - PROVIDE FREE FLU AND PNEUMONIA VACCINES AND VACCINE EDUCATION AT HINSDALE FAMILY MEDICAL CENTERPOSTED INFORMATION ON WEBSITE. FREE FLU VACCINES WERE PROVIDED AT THE RESIDENCY PROGRAM AT AHH. THE HINSDALE FAMILY PRACTICE RESIDENCY PROGRAM CONTINUES TO BE A PLACE FOR THOSE WITH FINANCIAL NEEDS AS NO PATIENTS ARE TURNED AWAY. - HELP PATIENTS MAKE APPOINTMENTS WITH LOCAL FQHCSAN FQHC ADMINISTERED BY THE VNA WAS ESTABLISHED IN THE CAMPUS OF ABH. A PROCESS IS IN PLACE AT BOTH THE ED AND REGISTRATION DEPARTMENTS TO HELP GUIDE ELIGIBLE PATIENTS TO MAKE AN APPOINTMENT AT THE FQHC AND ULTIMATELY FIND A MEDICAL HOME. AHH, ALMH, AND AGO ALSO PROVIDE SOME INFORMATION ABOUT FQHS IN THE AREA TO ANY PATIENTS WHO MAY BENEFIT. - PARTNER WITH THE AMERICAN KIDNEY FOUNDATION ON FREE KIDNEY DISEASE SCREENINGS FOR UNDERSERVED PEOPLE AT ADVENTIST MIDWEST HEALTH FACILITIES. IN 2015, THERE WERE SCREENINGS WITH THE KIDNEYMOBILE IN LOMBARD, PLAINFIELD, AND BOLINGBROOK REACHING OVER 200 PEOPLE. - OPERATE TWO FAMILY PRACTICE RESIDENCY PROGRAMS AND SUPPORT AN RN TO BSN PROGRAM AT ALL AMR HOSPITALS TO HELP EXPAND THE HEALTH CARE WORK FORCE. THE HINSDALE HOSPITAL FAMILY PRACTICE RESIDENCY PROGRAM CONTINUES TO SUCCESSFULLY TRAIN AND EDUCATE COMPETENT PHYSICIANS AS WELL AS PROVIDE ACCESS TO CARE FOR INDIVIDUALS WITH FINANCIAL NEED. IN 2015, HINSDALE HOSPITAL FAMILY PRACTICE RESIDENCY HAD 9 GRADUATES.AMR HAS MADE SIGNIFICANT STRIDES IN THE RN TO BSN PROGRAM. AHH SUPPORTED 9 RNS TO BECOME BSNS. - POST-DISCHARGE CHRONIC DISEASE MANAGEMENTOFFERED STANFORD CHRONIC DISEASE SELF-MANAGEMENT PROGRAM (SIX-WEEK POST DISCHARGE EDUCATIONAL PROGRAM) WITH PATIENTS FROM ALL 4 HOSPITALS USING CREATION HEALTH PRINCIPLES. THE NUMBER OF PARTICIPANTS IN 2015 WAS 39. PRIORITY 2: INFLUENZA VACCINE (18-64 YEARS)- COMMUNITY EDUCATIONS PROGRAMS WERE HELD THROUGHOUT THE COMMUNITIES SERVED BY THE FOUR AMR HOSPITALS; AHH, ALMH, ABH, AND AGO. - FREE FLU VACCINES WERE GIVEN AT HEALTH FAIRS FLU CLINICS, AND AT THE TWO FAMILY RESIDENCY PROGRAMS. - THE AGO HEALTH FAIR ALONE GAVE 600 FREE FLU VACCINESPRIORITY 3: PNEUMOCOCCUS VACCINE (65 YEARS AND OLDER)- FREE PNEUMOCOCCUS VACCINATIONS WERE GIVEN AT THE HINSDALE FAMILY PRACTICE MEDICINE CLINIC. - COMMUNITY EDUCATION ON THE IMPORTANCE OF IMMUNIZATIONS WAS CONDUCTED AS WELL. PRIORITY 4: HYPERTENSION (OVER 18 YEARS)- THROUGHOUT AMR, FREE BLOOD PRESSURE SCREENINGS WERE CONDUCTED BY TEAMS FROM THE FOUR HOSPITALS. ADDITIONALLY, THERE WERE SOME SCREENINGS CONDUCTED IN PARTNERSHIP WITH VARIOUS HEALTH CARE PROVIDERS AND LOCAL YMCA'S THROUGHOUT THE SURROUNDING COMMUNITIES. - WEB SITE EDUCATION ON HYPERTENSION WAS PROVIDED- EDUCATION REGARDING HYPERTENSION THROUGH SYSTEM WIDE NEWSLETTER. PRIORITIES CONSIDERED BUT NOT SELECTED ACCESS TO HEALTHCARE: ACCESS TO PRIMARY AND SECONDARY SERVICES - ADVENTIST BOLINGBROOK HOSPITALRATIONALE: DURING THIS ASSESSMENT PERIOD, ADVENTIST BOLINGBROOK HOSPITAL, IN CONJUNCTION WITH VNA, OPENED A FEDERALLY QUALIFIED HEALTH CENTER ON THE HOSPITAL CAMPUS, INCREASING ACCESS TO PRIMARY AND SECONDARY HEALTH SERVICES FOR THOSE COMMUNITY MEMBERS WITH FINANCIAL NEED.PREVENTION AND MANAGEMENT OF CHRONIC CARE ISSUES: HEART DISEASE [BLOOD CHOLESTEROL LEVELS]RATIONALE: WHILE THIS TESTED WELL ON THE IMPACT ANALYSIS MATRIX, USING THE DECISION TREE, IT WAS DETERMINED THAT THIS IS A COMMONLY AVAILABLE PREVENTION MEASURE AT MOST SURROUNDING PROVIDERS. IT IS FREQUENTLY A PART OF COMMUNITY HEALTH FAIRS AND ROUTINE PHYSICIAN VISITS.BEHAVIORAL HEALTH AND SUBSTANCE ABUSE RATIONALE: ADVENTIST MIDWEST HEALTH PROVIDES COMPREHENSIVE INPATIENT PROGRAMS FOR BEHAVIORAL HEALTH (ADVENTIST GLENOAKS HOSPITAL AND ADVENTIST HINSDALE HOSPITAL) AND OUTPATIENT PROGRAMS FOR BOTH BEHAVIORAL HEALTH AND SUBSTANCE ABUSE (ADVENTIST HINSDALE HOSPITAL). SERVING THE ADVENTIST MIDWEST HEALTH COMMUNITY, THE HOSPITALS SUPPORT COUNTY INITIATIVES TO BRING THESE NECESSARY SERVICES TO THOSE IN NEED. PRIORITIZING ACCESS TO CARE AS ONE OF THE SELECTED HEALTH PRIORITIES WILL ASSIST ADVENTIST MIDWEST HEALTH IN EXTENDING SERVICES FOR THOSE WHO CURRENTLY LACK SUCH ACCESS.
ADVENTIST LA GRANGE MEMORIAL HOSPITAL	PART V, SECTION B, LINE 11: NOTE: ON 1/31/2015, THE NET ASSETS ASSOCIATED WITH THE OPERATION OF ADVENTIST LA GRANGE MEMORIAL HOSPITAL (ALMH) WERE TRANSFERRED FROM ADVENTIST HEALTH SYSTEM/SUNBELT, INC., A RELATED 501(C)(3) TAX-EXEMPT ORGANIZATION. ALTHOUGH FINANCIAL OPERATIONS HAVE ONLY BEEN REPORTED FOR THE PERIOD 2/1/2015 - 12/31/2015, THE FOLLOWING ACTIVITIES ARE REPORTED FOR THE PERIOD 1/1/2015 - 12/31/2015. AS NOTED IN PART V, SECTION B, LINE 5 AND LINE 6, THE HOSPITAL (ALMH) IS A PART OF ADVENTIST HEALTH SYSTEM AND CONDUCTED A JOINT CHNA WITH THE FOLLOWING RELATED AHS HOSPITALS IN 2013:- ADVENTIST MIDWEST HEALTH DBA ADVENTIST HINSDALE HOSPITAL (AHH)- ADVENTIST HEALTH SYSTEM/SUNBELT, INC. DBA ADVENTIST LAGRANGE MEMORIAL HOSPITAL (ALMH)- ADVENTIST BOLINGBROOK HOSPITAL (ABH)- ADVENTIST GLENOAKS HOSPITAL THESE FOUR HOSPITALS ARE KNOWN COLLECTIVELY AS THE ADVENTIST MIDWEST REGION (AMR), AND AS A REGION, HAVE PRIORITIZED AND ADDRESSED THE SIGNIFICANT NEEDS WITHIN THEIR REGION AS A RESULT OF THE JOINT CHNA CONDUCTED AND OUTLINED BELOW. THE FOLLOWING IS A LISTING OF PROGRAMS/ACTIVITIES UNDERTAKEN TO ADDRESS IDENTIFIED SIGNIFICANT NEEDS: PRIORITY 1: ACCESS TO HEALTH CARE (LACK OF INSURANCE)- HEALTH INSURANCE EXCHANGE ENROLLMENT FOR 210 PEOPLE AHH/ALMH MADE THE DECISION TO REFER TO LOCAL NAVIGATORS IN 2014 AS THERE WERE DUPLICATIVE SERVICES AVAILABLE IN CONVENIENT LOCATIONS FOR LOCAL COMMUNITY MEMBERS. - MEDICAID ENROLLMENT FOR HOSPITAL PATIENTSTHE AMR HOSPITALS CONTRACTED FOR THE SERVICE OF A SERVICE PROVIDER TO ASSIST WITH THE ENROLLMENT OF MEDICAID PATIENTS AT AHH, ALMH, ABH, AND AGO. - DISCHARGE MEDICATIONS FOR UNINSURED PATIENTSTHIS GOAL WAS EXCEEDED. ALMH - 54 PATIENTS WERE PROVIDED WITH DISCHARGE MEDICATION ASSISTANCE. - LINKS WITH COMMUNITY PARTNERS (I.E. AGING CONNECTIONS) TO HELP PREVENT AVOIDABLE READMISSIONS - ALMH - 15.0% DECREASE IN AVOIDABLE READMISSIONS.- FREE BREAST AND CERVICAL CANCER SCREENINGS AT HINSDALE FAMILY CARE CENTERRESIDENTS OF ALMH FAMILY MEDICINE CLINICS DO PROVIDE FREE SERVICES THROUGH THE LA GRANGE COMMUNITY NURSES ASSOCIATION. IN 2015, APPROXIMATELY 338 PHYSICIAN HOURS WERE PROVIDED. - PROVIDE OB SERVICES AT THE HOSPITALSAT ALMH, OBSTETRICAL SERVICES WERE PROVIDED TO WOMEN WITH FINANCIAL AND ACCESS NEEDS. AS A RESULT, THERE WERE 80 DELIVERIES AT ALMH. - PROVIDE FREE FLU AND PNEUMONIA VACCINES AND VACCINE EDUCATION AT HINSDALE FAMILY MEDICAL CENTERPOSTED INFORMATION ON WEBSITE. FREE FLU VACCINES WERE PROVIDED AT THE RESIDENCY PROGRAM AT ALMH. THE LA GRANGE FAMILY PRACTICE RESIDENCY PROGRAM CONTINUES TO BE A PLACE FOR THOSE WITH FINANCIAL NEEDS AS NO PATIENTS ARE TURNED AWAY. - HELP PATIENTS MAKE APPOINTMENTS WITH LOCAL FQHCSAN FQHC ADMINISTERED BY THE VNA WAS ESTABLISHED IN THE CAMPUS OF ABH. A PROCESS IS IN PLACE AT BOTH THE ED AND REGISTRATION DEPARTMENTS TO HELP GUIDE ELIGIBLE PATIENTS TO MAKE AN APPOINTMENT AT THE FQHC AND ULTIMATELY FIND A MEDICAL HOME. AHH, ALMH, AND AGO ALSO PROVIDE SOME INFORMATION ABOUT FQHS IN THE AREA TO ANY PATIENTS WHO MAY BENEFIT. - PARTNER WITH THE AMERICAN KIDNEY FOUNDATION ON FREE KIDNEY DISEASE SCREENINGS FOR UNDERSERVED PEOPLE AT ADVENTIST MIDWEST HEALTH FACILITIES. IN 2015, THERE WERE SCREENINGS WITH THE KIDNEYMOBILE IN LOMBARD, PLAINFIELD, AND BOLINGBROOK REACHING OVER 200 PEOPLE. - OPERATE TWO FAMILY PRACTICE RESIDENCY PROGRAMS AND SUPPORT AN RN TO BSN PROGRAM AT ALL AMR HOSPITALS TO HELP EXPAND THE HEALTH CARE WORK FORCE. THE LA GRANGE MEMORIAL HOSPITAL RESIDENCY PROGRAM CONTINUES TO SUCCESSFULLY TRAIN AND EDUCATE COMPETENT PHYSICIANS AS WELL AS PROVIDE ACCESS TO CARE FOR INDIVIDUALS WITH FINANCIAL NEED. IN 2015, LA GRANGE MEMORIAL HOSPITAL HAD 7 GRADUATES.AMR HAS MADE SIGNIFICANT STRIDES IN THE RN TO BSN PROGRAM. ALMH SUPPORTED 13 RNS BECOME BSNS. - POST-DISCHARGE CHRONIC DISEASE MANAGEMENTOFFERED STANFORD CHRONIC DISEASE SELF-MANAGEMENT PROGRAM (SIX-WEEK POST DISCHARGE EDUCATIONAL PROGRAM) WITH PATIENTS FROM ALL 4 HOSPITALS USING CREATION HEALTH PRINCIPLES. THE NUMBER OF PARTICIPANTS IN 2015 WAS 39. PRIORITY 2: INFLUENZA VACCINE (18-64 YEARS)- COMMUNITY EDUCATIONS PROGRAMS WERE HELD THROUGHOUT THE COMMUNITIES SERVED BY THE FOUR AMR HOSPITALS; AHH, ALMH, ABH, AND AGO. - FREE FLU VACCINES WERE GIVEN AT HEALTH FAIRS FLU CLINICS, AND AT THE TWO FAMILY RESIDENCY PROGRAMS. THE AGO HEALTH FAIR ALONE GAVE 600 FREE FLU VACCINESPRIORITY 3: PNEUMOCOCCUS VACCINE (65 YEARS AND OLDER)- FREE PNEUMOCOCCUS VACCINATIONS WERE GIVEN AT THE HINSDALE FAMILY PRACTICE MEDICINE CLINIC. - COMMUNITY EDUCATION ON THE IMPORTANCE OF IMMUNIZATIONS WAS CONDUCTED AS WELL. PRIORITY 4: HYPERTENSION (OVER 18 YEARS)- THROUGHOUT AMR, FREE BLOOD PRESSURE SCREENINGS WERE CONDUCTED BY TEAMS FROM THE FOUR HOSPITALS. ADDITIONALLY, THERE WERE SOME SCREENINGS CONDUCTED IN PARTNERSHIP WITH VARIOUS HEALTH CARE PROVIDERS AND LOCAL YMCA'S THROUGHOUT THE SURROUNDING COMMUNITIES. - WEB SITE EDUCATION ON HYPERTENSION WAS PROVIDED- EDUCATION REGARDING HYPERTENSION THROUGH SYSTEM WIDE NEWSLETTER. PRIORITIES CONSIDERED BUT NOT SELECTED ACCESS TO HEALTHCARE: ACCESS TO PRIMARY AND SECONDARY SERVICES - ADVENTIST BOLINGBROOK HOSPITALRATIONALE: DURING THIS ASSESSMENT PERIOD, ADVENTIST BOLINGBROOK HOSPITAL, IN CONJUNCTION WITH VNA, OPENED A FEDERALLY QUALIFIED HEALTH CENTER ON THE HOSPITAL CAMPUS, INCREASING ACCESS TO PRIMARY AND SECONDARY HEALTH SERVICES FOR THOSE COMMUNITY MEMBERS WITH FINANCIAL NEED.PREVENTION AND MANAGEMENT OF CHRONIC CARE ISSUES: HEART DISEASE [BLOOD CHOLESTEROL LEVELS]RATIONALE: WHILE THIS TESTED WELL ON THE IMPACT ANALYSIS MATRIX, USING THE DECISION TREE, IT WAS DETERMINED THAT THIS IS A COMMONLY AVAILABLE PREVENTION MEASURE AT MOST SURROUNDING PROVIDERS. IT IS FREQUENTLY A PART OF COMMUNITY HEALTH FAIRS AND ROUTINE PHYSICIAN VISITS.BEHAVIORAL HEALTH AND SUBSTANCE ABUSE RATIONALE: ADVENTIST MIDWEST HEALTH PROVIDES COMPREHENSIVE INPATIENT PROGRAMS FOR BEHAVIORAL HEALTH (ADVENTIST GLENOAKS HOSPITAL AND ADVENTIST HINSDALE HOSPITAL) AND OUTPATIENT PROGRAMS FOR BOTH BEHAVIORAL HEALTH AND SUBSTANCE ABUSE (ADVENTIST HINSDALE HOSPITAL). SERVING THE ADVENTIST MIDWEST HEALTH COMMUNITY, THE HOSPITALS SUPPORT COUNTY INITIATIVES TO BRING THESE NECESSARY SERVICES TO THOSE IN NEED. PRIORITIZING ACCESS TO CARE AS ONE OF THE SELECTED HEALTH PRIORITIES WILL ASSIST ADVENTIST MIDWEST HEALTH IN EXTENDING SERVICES FOR THOSE WHO CURRENTLY LACK SUCH ACCESS.
ADVENTIST HINSDALE HOSPITAL	PART V, SECTION B, LINE 22D: IN DETERMINING THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO FINANCIAL ASSISTANCE POLICY-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE, THE HOSPITAL USED THE FOLLOWING METHODOLOGY IN 2015:THE HOSPITAL UTILIZED THE LOOK-BACK METHOD FOR DETERMINING ITS AMOUNTS GENERALLY BILLED (AGB) PERCENTAGE. IN CALCULATING ITS AGB PERCENTAGE, THE HOSPITAL INCLUDED CLAIMS ALLOWED DURING ITS PRIOR 12-MONTH PERIOD BY MEDICARE FEE-FOR-SERVICE (INCLUDING MEDICARE ADVANTAGE) AND ALL COMMERCIAL PAYORS THAT HAD ANY ACTIVITY WITH THE HOSPITAL DURING THE TAXABLE YEAR.
ADVENTIST LA GRANGE MEMORIAL HOSPITAL	PART V, SECTION B, LINE 22D: IN DETERMINING THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO FINANCIAL ASSISTANCE POLICY-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE, THE HOSPITAL USED THE FOLLOWING METHODOLOGY IN 2015:THE HOSPITAL UTILIZED THE LOOK-BACK METHOD FOR DETERMINING ITS AMOUNTS GENERALLY BILLED (AGB) PERCENTAGE. IN CALCULATING ITS AGB PERCENTAGE, THE HOSPITAL INCLUDED CLAIMS ALLOWED DURING ITS PRIOR 12-MONTH PERIOD BY MEDICARE FEE-FOR-SERVICE (INCLUDING MEDICARE ADVANTAGE) AND ALL COMMERCIAL PAYORS THAT HAD ANY ACTIVITY WITH THE HOSPITAL DURING THE TAXABLE YEAR.
SCHEDULE H, PART V, SECTION B, LINE 7A	EACH HOSPITAL FACILITY'S CHNA REPORT WAS MADE WIDELY AVAILABLE THROUGH THE FOLLOWING WEBSITES:FACILITY 1 -- ADVENTIST HINSDALE HOSPITALHTTP://WWW.KEEPINGYOUWELL.COM/PORTALS/32/DOCS/COMUNITY%20BENEFITS/ADVENTIST%20HINSDALE%20HOSPITAL%202013%20CHNA.PDFFACILITY 2 -- ADVENTIST LA GRANGE MEMORIAL HOSPITALHTTP://WWW.KEEPINGYOUWELL.COM/PORTALS/33/DOCS/COMMUNITY%20BENEFITS/ADVENTIST%20LA%20GRANGE%20HOSPITAL%202013%20CHNA.PDF
SCHEDULE H, PART V, SECTION B, LINE 10A:	EACH HOSPITAL FACILITY'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY WAS MADE WIDELY AVAILABLE THROUGH THE FOLLOWING WEBSITES:FACILITY 1 -- ADVENTIST HINSDALE HOSPITAL HTTP://WWW.KEEPINGYOUWELL.COM/PORTALS/3/DOCS/ABOUT%20US/COMMUNITY%20BENEFIT/AHH%2014-16%20COMMUNITY%20HEALTH%20PLAN.PDFFACILITY 2 -- ADVENTIST LA GRANGE MEMORIAL HOSPITAL HTTP://WWW.KEEPINGYOUWELL.COM/PORTALS/3/DOCS/ABOUT%20US/COMMUNITY%20BENEFIT/ALMH%2014-16%20COMMUNITY%20HEALTH%20PLAN.PDF
SCHEDULE H, PART V, SECTION B, LINE 16A,B,C:	EACH HOSPITAL'S FINANCIAL ASSISTANCE POLICY CAN BE FOUND AT:HTTPS://KEEPINGYOUWELL.COM/PORTALS/3/DOCS/FINANCIAL%20ASSISTANCE/2015%20UPDATES/PFS%2009%20CHARITY%20CARE%20POLICY%20IV%20MAR%209%202014%20CHANGES%20ACCEPTED.PDFEACH HOSPITAL FACILITY'S FINANCIAL ASSISTANCE POLICY APPLICATION WAS MADE WIDELY AVAILABLE THROUGH THE FOLLOWING WEBSITES:FACILITY 1 -- ADVENTIST HINSDALE HOSPITAL HTTPS://WWW.KEEPINGYOUWELL.COM/AHH/PATIENTS-VISITORS/BILLING-AND-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCEFACILITY 2 -- ADVENTIST LA GRANGE MEMORIAL HOSPITALHTTPS://WWW.KEEPINGYOUWELL.COM/ALMH/PATIENTS-VISITORS/BILLING-AND-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCEEACH HOSPITAL FACILITY'S PLAIN LANGUAGE SUMMARY IS AVAILABLE AT:FACILITY 1 -- ADVENTIST HINSDALE HOSPITAL HTTPS://KEEPINGYOUWELL.COM/PORTALS/3/DOCS/FINANCIAL%20ASSISTANCE/2015%20UPDATES/FINANCIAL%20ASSISTANCE%202015%20MIDWEST%20-%20EN.PDFFACILITY 2 -- ADVENTIST LA GRANGE MEMORIAL HOSPITALHTTPS://KEEPINGYOUWELL.COM/PORTALS/3/DOCS/FINANCIAL%20ASSISTANCE/2015%20UPDATES/FINANCIAL%20ASSISTANCE%202015%20MIDWEST%20-%20EN.PDF

Field	Value	IRS element (for citing)
Facility	31	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (31 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt	Address Line2USAddress/AddressLine2Txt
1 - ADVENTIST HEART & VASCULAR
11 SALT CREEK LANE	HINSDALE	IL	60521	VASCULAR INTERVENTION CENTER
2 - HINSDALE IMAGING CENTER
908 ELM ST SUITE 404	HINSDALE	IL	60521	IMAGING CENTER
3 - NEW DAY CENTER FOR ADDICTIONSOPTIONS
740 PASQUINELLI DR SUITE 104	WESTMONT	IL	60521	BEHAVORIAL HEALTH
4 - WESTMONT IMAGING CENTER
6311 S CASS AVE	WESTMONT	IL	60559	IMAGING CENTER
5 - HEALTH CARE AT HOME
5101 S WILLOW SPRINGS RD 2ND FLOOR	LA GRANGE	IL	60525	HOME HEALTH
6 - ST THOMAS HOSPICE & PALLIATIVE CARE
119 E OGDEN AVE SUITE 111	HINSDALE	IL	60521	HOSPICE CARE
7 - LA GRANGE CANCER TREATMENT PAVILLION
1325 MEMORIAL DR	LA GRANGE	IL	60525	CANCER CENTER/WOUND CARE FACILITY
8 - FAMILY HEALTH CARE
908 N ELM ST SUITE 207	HINSDALE	IL	60521	FAMILY MEDICINE CENTER
9 - ADVENTIST PAULSON REHAB - WILLOWBROOK
619 PLAINFIELD ROAD	WILLOWBROOK	IL	60521	REHABILITATION CENTER
10 - ADVENTIST PAULSON PEDIATRIC REHAB
222 E OGDEN AVE	HINSDALE	IL	60521	OUTPATIENT REHABILITATION FACILITY
11 - ADVENTIST LAB PARTNERS
412 63RD ST	DOWNERS GROVE	IL	60516	LAB SERVICE CENTER
12 - ADVENTIST LAB PARTNERS
908 N ELM ST SUITE 210	HINSDALE	IL	60521	LAB SERVICE CENTER
13 - ADVENTIST LAB PARTNERS
5101 S WILLOW SPRINGS RD 2ND FLOOR	LA GRANGE	IL	60525	LAB SERVICE CENTER
14 - ADVENTIST LAB PARTNERS
15720 SOUTH ROUTE 59	PLAINFIELD	IL	60544	LAB SERVICE CENTER
15 - ADVENTIST HINSDALE FAMILY MEDICAL CENTER
135 N OAK ST	HINSDALE	IL	60521	FAMILY MEDICINE CENTER
16 - ADVENTIST LA GRANGE FAMILY MEDICAL CTR
5201 S WILLOW SPRINGS ROAD SUITE	LA GRANGE	IL	60525	FAMILY MEDICAL CENTER	300
17 - ADVENTIST LAB PARTNERS
396 REMINGTON BLVD SUITE 141	BOLINGBROOK	IL	60440	LAB SERVICE CENTER
18 - ADVENTIST LAB PARTNERS
6311 S CASS AVE	WESTMONT	IL	60521	LAB SERVICE CENTER
19 - ADVENTIST LAB PARTNERS
5207 MAIN ST	DOWNERS GROVE	IL	60515	LAB SERVICE CENTER
20 - ADVENTIST LAB PARTNERS
6283 S ARCHER AVE	CHICAGO	IL	60638	LAB SERVICE CENTER
21 - ADVENTIST LAB PARTNERS
303 ARMY TRAIL ROAD SUITE 410B	BLOOMINGDALE	IL	60108	LAB SERVICE CENTER
22 - ADVENTIST LAB PARTNERS
644 S WEBER RD	ROMEOVILLE	IL	60446	LAB SERVICE CENTER
23 - ADVENTIST LAB PARTNERS
1107 N PROSPECT AVE	ITASCA	IL	60143	LAB SERVICE CENTER
24 - ADVENTIST LAB PARTNERS
333 CHESTNUT ST SUITE 204	HINSDALE	IL	60521	LAB SERVICE CENTER
25 - ADVENTIST LAB PARTNERS
11 SALT CREEK LANE	HINSDALE	IL	60521	LAB SERVICE CENTER
26 - ADVENTIST LAB PARTNERS
105 E BURLINGTON AVE	RIVERSIDE	IL	60546	LAB SERVICE CENTER
27 - ADVENTIST LAB PARTNERS
199 S ADDISON RD STE 108	WOODDALE	IL	60191	LAB SERVICE CENTER
28 - ADVENTIST LAB PARTNERS
7234 W OGDEN AVE	RIVERSIDE	IL	60546	LAB SERVICE CENTER
29 - ADVENTIST LAB PARTNERS
24024 BRANCASTER DR	NAPERVILLE	IL	60564	LAB SERVICE CENTER
30 - ADVENTIST LAB PARTNERS
2425 W 22ND ST SUITE 104	OAKBROOK	IL	60523	LAB SERVICE CENTER
31 - FAMILY MEDICINE CENTER
7425 JANES AVE STE 205	WOODRIDGE	IL	60517	FAMILY MEDICINE CENTER

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 6A:	THE FILING ORGANIZATION IS A WHOLLY OWNED SUBSIDIARY OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC) DURING ITS CURRENT TAX YEAR. AHSSHC SERVES AS A PARENT ORGANIZATION TO 23 TAX-EXEMPT 501(C)(3) HOSPITAL ORGANIZATIONS THAT OPERATE 44 HOSPITALS IN TEN STATES WITHIN THE U.S. THE SYSTEM OF ORGANIZATIONS UNDER THE CONTROL AND OWNERSHIP OF AHSSHC IS KNOWN AS "ADVENTIST HEALTH SYSTEM" (AHS).ALL HOSPITAL ORGANIZATIONS WITHIN AHS COLLECT, CALCULATE, AND REPORT THE COMMUNITY BENEFITS THEY PROVIDE TO THE COMMUNITIES THEY SERVE. AHS ORGANIZATIONS EXIST SOLELY TO IMPROVE AND ENHANCE THE LOCAL COMMUNITIES THEY SERVE. AHS 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. ON AN ANNUAL BASIS, THE COMMUNITY BENEFITS OF ALL AHS ORGANIZATIONS ARE CONSOLIDATED AND REPORTED IN THE AHS ANNUAL REPORT DOCUMENT PREPARED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION.(EIN 59-2170012). ADDITIONALLY, THE FILING ORGANIZATION'S MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT AND ASSOCIATED IMPLEMENTATION STRATEGY ARE POSTED ON THE FILING ORGANIZATION'S WEBSITE.
PART I, LINE 7:	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 FILING ORGANIZATION IS INVOLVED WITH AND SUPPORTIVE OF VARIOUS OTHER COMMUNITY AGENCIES IN ITS SERVICE AREA THAT WORK COLLABORATIVELY TO HELP THOSE IN NEED AND TO IMPROVE THE HEALTH AND SAFETY OF THE RESIDENTS OF THE COMMUNITY. THE HOSPITAL PARTICIPATES WITH A NUMBER OF OTHER COMMUNITY ORGANIZATIONS TO ADDRESS THE HEALTHCARE NEEDS OF THE COMMUNITY, SUCH AS THE DUPAGE HEALTH COALITION. THE HOSPITAL IS SUPPORTIVE OF OTHER HEALTH AND WELLNESS PROGRAMS CURRENTLY CONDUCTED IN ITS COMMUNITY, SUCH AS THE WELLNESS HOUSE, A CHARITABLE ORGANIZATION FORMED TO ENCOURAGE, EDUCATE, AND PROVIDE SUPPORT TO SURVIVING CANCER PATIENTS. THE FILING ORGANIZATION ALSO PARTICIPATES IN CLINICAL DRUG AND DEVICE RESEARCH THAT IS PERFORMED ON PATIENTS WHO HAVE A CONDITION OR DISEASE FOR WHICH THE EVENTUAL COMMERCIAL USE OF A DRUG OR DEVICE IS INTENDED. THIS RESEARCH IS RELATED TO PATIENT CARE AND SERVES TO EXPAND SCIENTIFIC KNOWLEDGE WITH RESPECT TO POTENTIAL TREATMENTS AND CURES FOR VARIOUS DISEASES AND CONDITIONS.
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 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 NON-STATE CHARITY PATIENTS. AN AMOUNT UP TO $1,000 OF SUCH A PATIENT'S BILL IS WRITTEN OFF AS BAD DEBT EXPENSE, WHILE THE REMAINING PORTION OF THE PATIENT'S BILL IS CONSIDERED TO BE 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 TO BE 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 PAGE 9. PLEASE NOTE THAT DOLLAR AMOUNTS ON THE ATTACHED CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE IN THOUSANDS.
PART III, LINE 8:	COSTING METHODOLOGY: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST-TO-CHARGE RATIO.RATIONALE FOR INCLUDING A MEDICARE SHORTFALL AS COMMUNITY BENEFIT:AS A 501(C)(3) ORGANIZATION, THE FILING ORGANIZATION PROVIDES EMERGENCY AND NON-ELECTIVE CARE TO ALL REGARDLESS OF ABILITY TO PAY. ALL HOSPITAL SERVICES ARE PROVIDED IN A NON-DISCRIMINATORY MANNER TO PATIENTS WHO ARE COVERED BENEFICIARIES UNDER THE MEDICARE PROGRAM. AS A PUBLIC INSURANCE PROGRAM, MEDICARE PROVIDES A PRE-ESTABLISHED REIMBURSEMENT RATE/AMOUNT TO HEALTH CARE PROVIDERS FOR THE SERVICES THEY PROVIDE TO PATIENTS. IN SOME CASES, THE REIMBURSEMENT AMOUNT PROVIDED TO A HOSPITAL MAY EXCEED ITS COSTS OF PROVIDING A PARTICULAR SERVICE OR SERVICES TO A PATIENT. IN OTHER CASES, THE MEDICARE REIMBURSEMENT AMOUNT MAY RESULT IN THE HOSPITAL EXPERIENCING A SHORTFALL OF REIMBURSEMENT RECEIVED OVER COSTS INCURRED. IN THOSE CASES WHERE AN OVERALL SHORTFALL IS GENERATED FOR PROVIDING SERVICES TO ALL MEDICARE PATIENTS, THE SHORTFALL AMOUNT SHOULD BE CONSIDERED AS A BENEFIT TO THE COMMUNITY. TAX-EXEMPT HOSPITALS ARE REQUIRED TO ACCEPT ALL MEDICARE PATIENTS REGARDLESS OF THE PROFITABILITY, OR LACK THEREOF, WITH RESPECT TO THE SERVICES THEY PROVIDE TO MEDICARE PATIENTS. THE POPULATION OF INDIVIDUALS COVERED UNDER THE MEDICARE PROGRAM IS SUFFICIENTLY LARGE SO THAT THE PROVISION OF SERVICES TO THE POPULATION IS A BENEFIT TO THE COMMUNITY AND RELIEVES THE BURDENS OF GOVERNMENT. IN THOSE SITUATIONS WHERE THE PROVISION OF SERVICES TO THE TOTAL MEDICARE PATIENT POPULATION OF A TAX-EXEMPT HOSPITAL DURING ANY YEAR RESULTS IN A SHORTFALL OF REIMBURSEMENT RECEIVED OVER THE COST OF PROVIDING CARE, THE TAX-EXEMPT HOSPITAL HAS PROVIDED A BENEFIT TO A CLASS OF PERSONS BROAD ENOUGH TO BE CONSIDERED A BENEFIT TO THE COMMUNITY. DESPITE A FINANCIAL SHORTFALL, A TAX-EXEMPT HOSPITAL MUST AND WILL CONTINUE TO ACCEPT AND CARE FOR MEDICARE PATIENTS. TYPICALLY, TAX-EXEMPT HOSPITALS PROVIDE HEALTH CARE SERVICES BASED UPON AN ASSESSMENT OF THE HEALTH CARE NEEDS OF THEIR COMMUNITY AS OPPOSED TO THEIR TAXABLE COUNTERPARTS WHERE PROFITABILITY OFTEN DRIVES DECISIONS ABOUT PATIENT CARE SERVICES THAT ARE OFFERED. PATIENT CARE PROVIDED BY TAX-EXEMPT HOSPITALS THAT RESULTS IN MEDICARE SHORTFALLS SHOULD BE CONSIDERED AS PROVIDING A BENEFIT TO THE COMMUNITY AND RELIEVING THE BURDENS OF GOVERNMENT.
PART III, LINE 9B:	THE HOSPITAL FILING ORGANIZATION'S COLLECTION PRACTICES ARE IN CONFORMITY WITH THE REQUIREMENTS SET FORTH IN THE 2012 PROPOSED 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 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) 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 THAT 120 DAYS AFTER THE FIRST BILLING STATEMENT IS SENT TO THE INDIVIDUAL AND IS AT LEAST 30 DAYS AFTER THE NOTICE IS PROVIDED. IF AN INDIVIDUAL SUBMITS AN INCOMPLETE FAA FORM DURING THE 240-DAY PERIOD FOLLOWING THE DATE ON WHICH THE FIRST BILLING STATEMENT WAS SENT TO THE INDIVIDUAL, THE HOSPITAL FILING ORGANIZATION SUSPENDS ANY REPORTING TO CONSUMER CREDIT REPORTING AGENCIES/BUREAUS AND PROVIDES A WRITTEN NOTICE TO THE INDIVIDUAL DESCRIBING WHAT ADDITIONAL INFORMATION OR DOCUMENTATION IS NEEDED TO COMPLETE THE FAA FORM. THIS WRITTEN NOTICE INCLUDES A COPY OF THE HOSPITAL FILING ORGANIZATION'S PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY (PLS) AND INFORMS THE INDIVIDUAL THAT THE HOSPITAL FILING ORGANIZATION MAY ENGAGE IN ADVERSE REPORTING TO CONSUMER CREDIT REPORTING AGENCIES/BUREAUS IF THE FAA FORM IS NOT COMPLETED BY A SPECIFIED DEADLINE WHICH IS NO EARLIER THAN THE 240-DAY PERIOD FOLLOWING THE DATE ON WHICH THE FIRST BILLING STATEMENT WAS SENT TO THE INDIVIDUAL OR, IF LATER, 30 DAYS AFTER THE WRITTEN NOTICE IS PROVIDED. IF AN INDIVIDUAL SUBMITS A COMPLETE FAA FORM WITHIN THE 240-DAY PERIOD AFTER THE FIRST BILLING STATEMENT IS SENT, THE HOSPITAL FILING ORGANIZATION WILL SUSPEND ANY ADVERSE REPORTING TO CONSUMER CREDIT REPORTING AGENCIES/BUREAUS UNTIL A FINANCIAL ASSISTANCE POLICY ELIGIBILITY DETERMINATION CAN BE MADE.
SUPPLEMENTAL SCHEDULE TO SCHEDULE H, PART III, SECTION B:	RECONCILIATION OF SCHEDULE H REPORTED MEDICARE SURPLUS/(SHORTFALL) TO UNREIMBURSED MEDICARE COSTS ASSOCIATED WITH THE PROVISION OF SERVICESTO ALL MEDICARE BENEFICIARIES:THE MEDICARE REVENUE AND ALLOWABLE COSTS OF CARE REPORTED IN SECTION B OF PART III OF SCHEDULE H ARE BASED UPON THE AMOUNTS REPORTED IN THE FILING ORGANIZATION'S MEDICARE COST REPORT IN ACCORDANCE WITH THE IRS INSTRUCTIONS FOR SCHEDULE H. ON AN ANNUAL BASIS, THE FILING ORGANIZATION ALSO DETERMINES ITS TOTAL UNREIMBURSED COSTS ASSOCIATED WITH PROVIDING SERVICES TO ALL MEDICARE PATIENTS. UNREIMBURSED COSTS ARE REPORTED AS A COMMUNITY BENEFIT TO THE ELDERLY AND ARE INCLUDED IN THE CONSOLIDATED ADVENTIST HEALTH SYSTEM (AHS OR THE COMPANY) COMMUNITY BENEFITS REPORT CONTAINED IN THE AHS ANNUAL REPORT DOCUMENT. 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: $(12,150,269)- DIFFERENCE IN COSTING METHODOLOGY: 5,345,867- UNREIMBURSED COSTS INCURRED FOR SERVICES PROVIDED TO MEDICARE PATIENTS THAT ARE NOT INCLUDED IN THE ORGANIZATION'S MEDICARE COST REPORT: (12,034,814) -------------TOTAL SURPLUS(SHORTFALL) COSTS OF SERVING ALL MEDICARE PATIENTS PER THE FILING ORGANIZATION'S COMMUNITY BENEFIT REPORTING: $(18,839,216)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:	EFFECTIVE 2/1/15, THE NET ASSETS OF ADVENTIST LA GRANGE MEMORIAL HOSPITAL WERE TRANSFERRED FROM ADVENTIST HEALTH SYSTEM/SUNBELT, INC. (AHSSI) TO THE FILING ORGANIZATION. AHSSI IS THE 501(C)(3) PARENT HOSPITAL ORGANIZATION OF THE FILING ORGANIZATION. ACCORDINGLY, THE FILING ORGANIZATION CURRENTLY OWNS AND OPERATES TWO HOSPITALS - AMITA HEALTH HINSDALE AND AMITA HEALTH LA GRANGE. IN 2013, 4 RELATED HOSPITAL ORGANIZATIONS THAT WERE PART OF ADVENTIST HEALTH SYSTEM, INCLUDING AMITA HEALTH HINSDALE AND AMITA HEALTH LA GRANGE, CONDUCTED A JOINT CHNA. THE JOINT CHNA COMPLIED WITH THE GUIDANCE SET FORTH BY THE IRS IN PROPOSED 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 COMMUNITIES:SUCH PRACTICES AND PROCESSES INVOLVE THE FOLLOWING:1. HOSPITAL OPERATING/COMMUNITY BOARDS COMPOSED OF INDIVIDUALS BROADLY REPRESENTATIVE OF EACH 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 COMMUNITIES; AND 4. COLLABORATION WITH OTHER LOCAL COMMUNITY GROUPS TO ADDRESS THE HEALTH CARE NEEDS OF THE FILING ORGANIZATION'S COMMUNITIES.
PART VI, LINE 3:	THE FINANCIAL ASSISTANCE POLICY (FAP) OF THE FILING ORGANIZATION'S HOSPITAL FACILITIES IS TRANSPARENT AND AVAILABLE TO ALL INDIVIDUALS SERVED AT ANY POINT IN THE CARE CONTINUUM. THE FAP, THE FINANCIAL ASSISTANCE APPLICATION FORM (FAA FORM), THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY (PLS), AND CONTACT INFORMATION FOR EACH HOSPITAL FACILITY'S FINANCIAL COUNSELORS ARE PROMINENTLY AND CONSPICUOUSLY POSTED ON THE FILING ORGANIZATION'S HOSPITAL FACILITYS' WEBSITES. SIGNAGE IS DISPLAYED IN THE FILING ORGANIZATION'S HOSPITAL FACILITIES AT ALL POINTS OF ADMISSION AND REGISTRATION, INCLUDING THE EMERGENCY DEPARTMENT. THE SIGNAGE CONTAINS THE HOSPITAL FACILITYS' WEBSITE ADDRESSES WHERE THE FAP AND THE FAA FORM CAN BE ACCESSED AND THE TELEPHONE NUMBER AND PHYSICAL LOCATION THAT INDIVIDUALS CAN CALL OR VISIT WITH ANY QUESTIONS ABOUT THE FAP OR THE APPLICATION PROCESS. PAPER COPIES OF EACH HOSPITAL FACILITY'S FAP, FAA FORM AND PLS ARE AVAILABLE UPON REQUEST AND WITHOUT CHARGE, BOTH IN PUBLIC LOCATIONS IN EACH HOSPITAL FACILITY AND BY MAIL. THE FILING ORGANIZATION'S HOSPITAL FACILITYS' FINANCIAL COUNSELORS SEEK TO PROVIDE PERSONAL FINANCIAL COUNSELING TO ALL INDIVIDUALS ADMITTED TO EACH 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 COPY OF EACH HOSPITAL FACILITY'S PLS AND FAA FORM IS DISTRIBUTED TO EVERY INDIVIDUAL BEFORE DISCHARGE FROM THE HOSPITAL FACILITY. ADDITIONALLY, A COPY OF THE PLS IS INCLUDED WITH AT LEAST THREE BILLING STATEMENTS THAT ARE SENT TO THE INDIVIDUAL DURING THE 120-DAY PERIOD AFTER THE FIRST BILLING STATEMENT IS SENT. INDIVIDUALS ARE INFORMED ABOUT THE HOSPITAL FACILITY'S FAP IN ALL ORAL COMMUNICATIONS REGARDING THE AMOUNT DUE FOR THE INDIVIDUAL'S CARE.
PART VI, LINE 4:	THE FILING ORGANIZATION CURRENTLY OPERATES 2 HOSPITAL FACILITIES, AMITA HEALTH HINSDALE AND AMITA HEALTH LA GRANGE. BOTH LOCATED IN ILLINOIS, THESE FACILITIES ARE MAJOR HEALTHCARE PROVIDERS IN THE COMMUNITIES THEY SERVE. AMITA HEALTH HINSDALE (AHH) IS LOCATED IN HINSDALE, ILLINOIS. IT CURRENTLY OPERATES A HOSPITAL FACILITY AND IS LICENSED FOR 276 BEDS. IN ADDITION TO OPERATING A HOSPITAL, THE FILING ORGANIZATION ALSO OPERATES 2 IMAGING CENTERS, 1 OUTPATIENT REHABILITATION FACILITY, 1 BEHAVIORAL HEALTH CENTER, 1 VASCULAR INTERVENTION CENTER, AND 2 FAMILY HEALTH MEDICINE CENTERS. AHH IS A CRUCIAL COMMUNITY AND REGIONAL ASSET. IT IS THE ONLY TEACHING HOSPITAL IN DUPAGE COUNTY, ILLINOIS. MANY OF THE MEDICAL STAFF MEMBERS HOLD TEACHING POSITIONS AT CHICAGO'S PREMIER MEDICAL SCHOOLS AND ACADEMIC MEDICAL CENTERS, AND PARTICIPATE IN MEDICAL RESEARCH STUDIES AND CLINICAL TRIALS. AHH IS HOME TO MANY OF ITS SERVICE AREA'S FIRST AND LATEST IN MEDICAL TECHNOLOGY AND RESEARCH. AHH'S OPLER CANCER CENTER IS ONE OF THE FEW IN ILLINOIS TO OFFER TERTIARY-LEVEL CANCER SERVICES, SUCH AS AUTOLOGOUS BONE MARROW TRANSPLANTS. AHH'S SLEEP LAB IS THE ONLY PROGRAM ACCREDITED BY THE AMERICAN SLEEP DISORDER ASSOCIATION IN DUPAGE COUNTY. AS NOTED ABOVE, AHH IS THE SITE OF DUPAGE COUNTY'S ONLY PHYSICIAN TEACHING PROGRAM. THERE ARE THREE COMPETING HOSPITALS WITHIN A RADIUS OF LESS THAN 10 MILES FROM AHH. DUPAGE COUNTY IS PRIMARILY A RESIDENTIAL COMMUNITY LOCATED IN THE SUBURBS OF THE GREATER CHICAGO AREA. DUPAGE COUNTY HAS A POPULATION OF APPROXIMATELY 923,000, WITH AN ESTIMATED 12.1% OVER THE AGE OF 65. HIGH SCHOOL GRADUATES ACCOUNT FOR APPROXIMATELY 92% OF DUPAGE COUNTY. IT IS ESTIMATED THAT 6.9% OF THE INDIVIDUALS RESIDING IN DUPAGE COUNTY LIVE BELOW THE POVERTY LEVEL AND THE UNEMPLOYMENT RATE IS ABOUT 4.8%. APPROXIMATELY 38% OF AHH'S PATIENTS DURING 2015 WERE MEDICARE PATIENTS, ABOUT 9% WERE MEDICAID PATIENTS, ABOUT 1.2% WERE SELF-PAY PATIENTS, AND THE REMAINING PERCENTAGE WERE PATIENTS COVERED UNDER COMMERCIAL INSURANCE. IN 2015, ABOUT 49.6% OF AHH'S IN-PATIENTS WERE ADMITTED THROUGH AHH'S EMERGENCY DEPARTMENT.AMITA HEALTH LA GRANGE (AHLG) IS A 204-BED FACILITY PROVIDING OUTPATIENT AND INPATIENT PRIMARY CARE, TRAUMA CARE AND WELLNESS SERVICES TO RESIDENTS OF CHICAGO'S WESTERN SUBURBS. AHLG IS A LEADER IN OFFERING COMPREHENSIVE ONCOLOGY SERVICES, ORTHOPEDIC SERVICES, ADVANCED CARDIAC CARE, WOMEN'S HEALTH AND MATERNITY CARE, EMERGENCY, GERIATRIC AND MANY OTHER SPECIALTIES THAT CATER TO THE COMMUNITIES IT SERVES. THE COMMUNITIES SERVED BY AHLG CONTAIN A HIGH SENIOR POPULATION. TO ADDRESS THE UNIQUE NEEDS OF ITS SERVICE AREA, AHLG OFFERS A BROAD SPECTRUM OF SERVICES DESIGNED TO MEET THE DIVERSE NEEDS OF AGING ADULTS. LA GRANGE, ILLINOIS IS LOCATED IN COOK COUNTY. COOK COUNTY HAS A POPULATION OF APPROXIMATELY 5,200,000, WITH AN ESTIMATED 12.2% OVER THE AGE OF 65. HIGH SCHOOL GRADUATES ACCOUNT FOR APPROXIMATELY 85% OF COOK COUNTY. IT IS ESTIMATED THAT 16.9% OF THE INDIVIDUALS RESIDING IN COOK COUNTY LIVE BELOW THE POVERTY LEVEL AND THE UNEMPLOYMENT RATE IS ABOUT 6.3%. APPROXIMATELY 52% OF AHLG'S PATIENTS DURING 2015 WERE MEDICARE PATIENTS, ABOUT 9% WERE MEDICAID PATIENTS, ABOUT 1.7% WERE SELF-PAY PATIENTS, AND THE REMAINING PERCENTAGE WERE PATIENTS COVERED UNDER COMMERCIAL INSURANCE. IN 2015, ABOUT 71% OF ALGH'S IN-PATIENTS WERE ADMITTED THROUGH THE HOSPITAL'S EMERGENCY DEPARTMENT.
PART VI, LINE 5:	THE PROVISION OF COMMUNITY BENEFIT IS CENTRAL TO THE FILING ORGANIZATION'S MISSION OF SERVICE AND COMPASSION. RESTORING AND PROMOTING THE HEALTH AND QUALITY OF LIFE OF THOSE IN THE COMMUNITIES SERVED BY THE FILING ORGANIZATION IS A FUNCTION OF "EXTENDING THE HEALING MINISTRY OF CHRIST AND EMBODIES THE FILING ORGANIZATION'S COMMITMENT TO ITS VALUES AND PRINCIPLES. THE FILING ORGANIZATION COMMITS SUBSTANTIAL RESOURCES TO PROVIDE A BROAD RANGE OF SERVICES TO BOTH THE UNDERPRIVILEGED AS WELL AS THE BROADER COMMUNITY. IN ADDITION TO THE COMMUNITY BENEFIT AND COMMUNITY BUILDING INFORMATION PROVIDED IN PARTS I, II AND III OF THIS SCHEDULE H, THE FILING ORGANIZATION CAPTURES AND REPORTS THE BENEFITS PROVIDED TO ITS COMMUNITY THROUGH FAITH-BASED CARE. EXAMPLES OF SUCH BENEFITS INCLUDE THE COST ASSOCIATED WITH CHAPLAINCY CARE PROGRAMS AND MISSION PEER REVIEWS AND MISSION CONFERENCES. DURING THE CURRENT YEAR, THE FILING ORGANIZATION PROVIDED $1,094,974 OF BENEFIT WITH RESPECT TO THE FAITH-BASED AND SPIRITUAL NEEDS OF THE COMMUNITY IN CONJUNCTION WITH ITS OPERATION OF COMMUNITY HOSPITALS. THE FILING ORGANIZATION 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 FILING ORGANIZATION EXPENDED $49,805,052 IN NEW CAPITAL IMPROVEMENTS. AS FAITH-BASED MISSION-DRIVEN COMMUNITY HOSPITALS, THE FILING ORGANIZATION IS CONTINUALLY INVOLVED IN MONITORING ITS COMMUNITIES, IDENTIFYING UNMET HEALTH CARE NEEDS AND DEVELOPING SOLUTIONS AND PROGRAMS TO ADDRESS THOSE NEEDS. IN ACCORDANCE WITH ITS CONSERVATIVE APPROACH TO FISCAL RESPONSIBILITY, SURPLUS FUNDS OF THE FILING ORGANIZATION ARE CONTINUALLY BEING INVESTED IN RESOURCES THAT IMPROVE THE AVAILABILITY AND QUALITY OF DELIVERY OF HEALTH CARE SERVICES AND PROGRAMS TO ITS COMMUNITIES.
PART VI, LINE 6:	THE FILING ORGANIZATION 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 ADVENTIST HEALTH SYSTEM (AHS). AHSSHC IS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). AHSSHC AND ITS SUBSIDIARY ORGANIZATIONS OPERATE 44 HOSPITALS IN 10 STATES THROUGHOUT THE U.S., PRIMARILY IN THE SOUTHEASTERN PORTION OF THE U.S. AHSSHC AND ITS SUBSIDIARIES ALSO OPERATE 16 NURSING HOME FACILITIES AND OTHER ANCILLARY HEALTH CARE PROVIDER FACILITIES, SUCH AS AMBULATORY SURGERY CENTERS AND DIAGNOSTIC IMAGING CENTERS. AS THE PARENT ORGANIZATION OF THE AHS SYSTEM, AHSSHC PROVIDES EXECUTIVE LEADERSHIP AND OTHER PROFESSIONAL SUPPORT SERVICES TO ITS SUBSIDIARY ORGANIZATIONS. PROFESSIONAL SUPPORT SERVICES INCLUDE AMONG OTHERS CORPORATE COMPLIANCE, LEGAL, HUMAN RESOURCES, REIMBURSEMENT, RISK MANAGEMENT, AND TAX AS WELL AS TREASURY FUNCTIONS. THE PROVISION OF THESE EXECUTIVE AND SUPPORT SERVICES ON A CENTRALIZED BASIS BY AHSSHC PROVIDES AN APPROPRIATE BALANCE BETWEEN PROVIDING EACH AHS 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 COMMUNITIES 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 HOSPITALS 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 AHS SUBSIDIARY PAYS A MANAGEMENT FEE TO AHSSHC FOR THE INTERNAL SERVICES PROVIDED BY AHSSHC. AS A RESULT, MANAGEMENT FEE EXPENSE REPORTED BY A AHS 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 AHS AS A WHOLE. THE READER IS DIRECTED TO VISIT THE WEB-SITE OF AHS AT WWW.ADVENTISTHEALTHSYSTEM.COM TO LEARN MORE ABOUT THE MISSION AND OPERATIONS OF AHS AND TO ACCESS AHS'S ANNUAL REPORT THAT CONTAINS FINANCIAL DATA AS WELL AS COMMUNITY BENEFIT REPORTING FOR THE ENTIRE SYSTEM.
PART VI, LINE 7, REPORTS FILED WITH STATES	IL

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (6 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt	Non Cash AssistanceNonCashAssistanceAmt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceDesc
DUPAGE HEALTH COALITION
511 THORNHILL DRIVE STE M	CAROL STREAM	IL	60188	364448208	501(C)(3)	$116,100	GENERAL SUPPORT
COMMUNITY HOUSE
415 W 8TH STREET	HINSDALE	IL	60521	362167735	501(C)(3)	$20,000	GENERAL SUPPORT
HINSDALE HOSPITAL FOUNDATION
7 SALT CREEK LANE	HINSDALE	IL	60521	521466387	501(C)(3)		PROVISION OF GENERAL ADMINISTRATIVE SUPPORT	$647,691	COST	GENERAL ADMINISTRATIVE SUPPORT
ILLINOIS CONFERENCE OF SEVENTH DAY ADVENTIST
619 PLAINFIELD ROAD	WILLOWBROOK	IL	60527	362277365	501(C)(3)	$5,895	GENERAL SUPPORT
LAKE UNION CONFERENCE OF SEVENTH DAY ADVENTIST
PO BOX 287	BERRIEN SPRINGS	MI	49103	381474933	501(C)(3)	$11,400	GENERAL SUPPORT
LA GRANGE MEMORIAL HOSPITAL FOUNDATION
5101 SOUTH WILLOW SPRINGS ROAD	LA GRANGE	IL	60525	300247776	501(C)(3)		PROVISION OF GENERAL ADMINISTRATIVE SUPPORT	$260,155	COST	GENERAL ADMINISTRATIVE SUPPORT

Field	Value	IRS element (for citing)
Total501c3 Org	6	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	GRANTS ARE GENERALLY MADE ONLY TO RELATED ORGANIZATIONS THAT ARE EXEMPT FROM FEDERAL INCOME TAX UNDER 501(C)(3), 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, OR TO OTHER 501(C)(3) COMMUNITY ORGANIZATIONS INVOLVED IN HEALTH-RELATED CAUSES. 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.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Travel For Companions	Yes (X)	TravelForCompanionsInd
Idemnification Gross Up Pmts	Yes (X)	IdemnificationGrossUpPmtsInd
Discretionary Spending Acct	Yes (X)	DiscretionarySpendingAcctInd
Housing Allowance Or Residence	Yes (X)	HousingAllowanceOrResidenceInd
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (1)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (1)	SubstantiationRequiredInd
Severance Payment	Yes (1)	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 (20 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
RANDALL HAFFNER PHD
CHAIRMAN (BEG 6/15)	$0	$729,373	$0	$0	$0	$1,106,046	$0	$156,563	$0	$86,147	$0	$2,078,129	$0	$0
RICHARD REINER
CHAIRMAN (END 6/15)	$0	$556,753	$0	$330,569	$0	$197,546	$0	$14,388	$0	$48,451	$0	$1,147,707	$0	$0
DAVID CRANE
PRESIDENT/SECRETARY	$0	$756,033	$0	$236,919	$0	$1,710,168	$0	$135,272	$0	$45,454	$0	$2,883,846	$0	$127,976
BRENT SNYDER
TREASURER/DIRECTOR	$0	$688,079	$0	$224,700	$0	$334,451	$0	$127,852	$0	$34,026	$0	$1,409,108	$0	$99,713
MICHAEL GOEBEL
CEO	$0	$439,771	$0	$103,743	$0	$94,913	$0	$73,386	$0	$42,868	$0	$754,681	$0	$51,740
REBECCA MATHIS
CFO	$0	$275,254	$0	$52,428	$0	$48,299	$0	$14,420	$0	$40,562	$0	$430,963	$0	$10,660
MICHAEL MURRILL
COO (BEG 3/15)	$0	$262,079	$0	$47,817	$0	$22,286	$0	$14,388	$0	$39,506	$0	$386,076	$0	$0
GARY LIPINSKI MD
CMO	$0	$382,314	$0	$74,937	$0	$77,107	$0	$41,185	$0	$44,953	$0	$620,496	$0	$26,116
SHEVAWN TYRELL
CNO (END 6/15)	$0	$126,515	$0	$51,393	$0	$263,201	$0	$14,388	$0	$29,680	$0	$485,177	$0	$46,049
RON WEHTJE
REGIONAL CFO	$0	$422,500	$0	$111,329	$0	$111,524	$0	$54,798	$0	$42,410	$0	$742,561	$0	$38,614
GEORGE MAYZELL MD
REGIONAL CMO (END 8/15)	$0	$339,275	$0	$89,568	$0	$454,104	$0	$45,290	$0	$39,035	$0	$967,272	$0	$37,967
MARY MURPHY
REGIONAL CNO	$0	$258,346	$0	$50,451	$0	$53,854	$0	$30,769	$0	$17,547	$0	$410,967	$0	$22,864
KATHLEEN FERKET
VP CARE CONTINUUM	$219,794	$0	$15,614	$0	$8,718	$0	$11,751	$0	$15,705	$0	$271,582	$0	$0	$0
ZEWDU HAILE MD
DIR - FAMILY PRACTICE RESI	$220,532	$0	$1,754	$0	$3,574	$0	$11,632	$0	$24,985	$0	$262,477	$0	$0	$0
GARRY GIERTUGA
ASSIT VP HUMAN RESOURCES	$175,580	$0	$11,299	$0	$9,578	$0	$10,046	$0	$17,870	$0	$224,373	$0	$0	$0
LESLIEE SLEUWEN
ASSOC DIR - FAMILY PRACTICE	$182,480	$0	$0	$0	$563	$0	$9,877	$0	$24,951	$0	$217,871	$0	$0	$0
KATE GUNNELL
ASSOC DIR - FAMILY PRACTICE	$173,628	$0	$0	$0	$1,304	$0	$9,237	$0	$23,974	$0	$208,143	$0	$0	$0
JANICE HAGENSICKER
FORMER CFO	$0	$379,609	$0	$91,575	$0	$212,923	$0	$50,215	$0	$30,603	$0	$764,925	$0	$28,711
ALAN SCHNEIDER
FORMER COO/CHIEF PSO	$0	$180,844	$0	$25,478	$0	$6,483	$0	$11,133	$0	$26,099	$0	$250,037	$0	$0
RICHARD CARROLL MD
FORMER CMO	$0	$396,346	$0	$65,390	$0	$132,933	$0	$44,576	$0	$43,967	$0	$683,212	$0	$28,353

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 1A	THE FILING ORGANIZATION IS A PART OF THE SYSTEM OF HEALTHCARE ORGANIZATIONS KNOWN AS ADVENTIST HEALTH SYSTEM (AHS). 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 AHS. 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 THAT PROVIDE SERVICES AND ARE ON THE MANAGEMENT TEAM OF 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 VICE PRESIDENTS AND ABOVE AND IS USUALLY LIMITED TO ONE BUSINESS TRIP PER YEAR BEYOND THE ANNUAL AHS 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: AHS 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 OF 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 AHS PRESIDENT'S COUNCIL BUSINESS MEETING ($500 PER EXECUTIVE) OR THE ANNUAL AHS CFO CONFERENCE OR CMO/CNO BUSINESS MEETING ($300 PER EXECUTIVE). OTHER DISCRETIONARY SPENDING ACCOUNTS MAY BE PROVIDED IN CONNECTION WITH OTHER AHS SPONSORED CONFERENCES BUT TYPICALLY DO NOT EXCEED $200 PER PARTICIPANT. WITH RESPECT TO THE AHS PRESIDENT'S COUNCIL MEETING, ELIGIBLE EXECUTIVES MAY INCLUDE AHSSHC VICE PRESIDENTS AND ABOVE AND ALL AHSSHC SUBSIDIARY ORGANIZATION CEOS AND REGIONAL CFOS. THE PAYMENT PROVIDED TO EACH EXECUTIVE WAS CONSIDERED TAXABLE COMPENSATION TO THE EXECUTIVE. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE: THE AHS EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED AND ADMINISTERED TO COMPENSATE EXECUTIVES FOR DUTIES PERFORMED IRRESPECTIVE OF GEOGRAPHIC MARKET DIFFERENCES. CERTAIN AHS HOSPITALS ARE LOCATED IN COMMUNITIES WHERE THE COST OF HOUSING IS SIGNIFICANTLY GREATER THAN IN OTHER HOSPITAL LOCATIONS IN AHS. ACCORDINGLY, AHS PROVIDES HOUSING ASSISTANCE IN THE FORM OF A SHARED EQUITY INTEREST IN A RESIDENCE TO ELIGIBLE EXECUTIVES WHO ARE EXPECTED TO LIVE WITHIN THE IMMEDIATE PROXIMITY OF HOSPITAL FACILITIES LOCATED IN HIGH-COST COMMUNITIES. UNDER THE AHS SYSTEM-WIDE POLICY GOVERNING THE EMPLOYER-PROVIDED HOUSING ASSISTANCE, ONLY THREE INDIVIDUALS WERE ELIGIBLE IN 2015 TO RECEIVE THE HOUSING BENEFIT (AN AHS REGIONAL CEO, CFO AND CMO). AS WITH ALL AHSSHC CORPORATE EXECUTIVE POLICIES, THE HOUSING BENEFIT POLICY WAS AUTHORIZED AND APPROVED BY THE AHSSHC BOARD COMPENSATION COMMITTEE, AN INDEPENDENT COMMITTEE OF THE AHSSHC BOARD OF DIRECTORS. THE APPROPRIATE ANNUAL DOLLAR AMOUNT OF THE HOUSING BENEFIT PROVIDED TO THE ABOVE-DESCRIBED ELIGIBLE EXECUTIVES IS TREATED AS TAXABLE COMPENSATION TO THE EMPLOYEE. AHS REVIEWS THE OVERALL COMPENSATION OF ITS EXECUTIVES ON AN ANNUAL BASIS TO ENSURE THAT THE TOTAL COMPENSATION PACKAGE IS REASONABLE. HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES: AHSSHC HAS A CORPORATE EXECUTIVE POLICY THAT ADDRESSES BUSINESS DEVELOPMENT EXPENDITURES. UNDER THIS POLICY, CERTAIN AHS ELIGIBLE EXECUTIVES MAY BE REIMBURSED FOR MEMBER DUES AND USAGE CHARGES FOR A COUNTRY CLUB OR OTHER SOCIAL CLUB UPON AUTHORIZATION. CLUB MEMBERSHIPS MUST BE RECOMMENDED BY THE CEO OF THE AHS HOSPITAL ORGANIZATION AND APPROVED BY THE CHAIRMAN OF THE BOARD OF DIRECTORS OF THE ORGANIZATION. IN ADDITION, THE PROPOSED MEMBERSHIP MUST BE APPROVED ANNUALLY BY THE AHSSHC BOARD COMPENSATION COMMITTEE, AN INDEPENDENT COMMITTEE OF THE BOARD OF DIRECTORS OF AHSSHC. ELIGIBLE EXECUTIVES ARE LIMITED TO CERTAIN SENIOR LEVEL EXECUTIVES (HOSPITAL ORGANIZATION CEOS, THE CEO OF THE NURSING HOME DIVISION OF AHS, SENIOR VICE PRESIDENTS AT THREE LARGE HOSPITAL ORGANIZATIONS, REGIONAL CEOS AND CFOS AND THE PRESIDENT AND SENIOR VICE PRESIDENTS OF AHSSHC). IN THE CURRENT YEAR, FOR THIS FILING ORGANIZATION, ONE EXECUTIVE WAS ELIGIBLE TO RECEIVE REIMBURSEMENT FOR CLUB FEES. EACH AHS EXECUTIVE WHO IS APPROVED FOR A CLUB MEMBERSHIP MUST SUBMIT AN ANNUAL REPORT TO THE AHSSHC BOARD COMPENSATION COMMITTEE THAT DESCRIBES HOW THE MEMBERSHIP BENEFITED THEIR ORGANIZATION DURING THE PRECEDING YEAR.
PART I, LINE 3	THE INDIVIDUAL WHO SERVES AS THE CEO OF THE FILING ORGANIZATION IS COMPENSATED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC) FOR THAT INDIVIDUAL'S ROLE IN SERVING AS THE CEO. 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 AHS AND EACH OF ITS AFFILIATED ENTITIES. THE FOLLOWING PRINCIPLES GUIDE THE ESTABLISHMENT OF INDIVIDUAL EXECUTIVE COMPENSATION: - THE SALARY OF THE PRESIDENT/CEO OF AHS WILL NOT EXCEED THE 40TH 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, LINES 4A-B	LINE 4A: DURING THE YEAR ENDING DECEMBER 31, 2015, GEORGE MAYZELL, MD AND SHEVAWN TYRRELL RECEIVED SEVERANCE PAYMENTS IN THE AMOUNT OF $159,931 AND $164,914 RESPECTIVELY. PURSUANT TO THE AHSSHC CORPORATE EXECUTIVE POLICY GOVERNING EXECUTIVE SEVERANCE, SEVERANCE AGREEMENTS FOR EXECUTIVES OPERATING AT THE VICE PRESIDENT LEVEL AND ABOVE ARE ENTERED INTO UPON ELIGIBILITY TO FACILITATE THE TRANSITION TO SUBSEQUENT EMPLOYMENT FOLLOWING AN INVOLUNTARY SEPARATION FROM EMPLOYMENT WITH AHS. 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 ADVENTIST HEALTH SYSTEM (AHS). IN RECOGNITION OF THE CONTRIBUTION THAT EACH EXECUTIVE MAKES TO THE SUCCESS OF AHS, AHS PROVIDES TO ELIGIBLE EXECUTIVES PARTICIPATION IN THE AHS 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 DEFERRED COMPENSATION BENEFITS TAXABLE UNDER INTERNAL REVENUE CODE (IRC) SECTION 457(F), 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 AHS 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 AHS ENTITIES AND VICE PRESIDENTS OF ALL AHS ENTITIES WHOSE BASE SALARY IS AT LEAST $230,000. 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, AHS HAS INSTITUTED A DEFINED BENEFIT, NON-TAX-QUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN EXECUTIVES WHO HAVE PROVIDED LENGTHY SERVICE TO AHS AND/OR TO OTHER SEVENTH-DAY ADVENTIST CHURCH HOSPITALS OR HEALTH CARE INSTITUTIONS. PARTICIPATION IN THE PLAN IS OFFERED TO AHS EXECUTIVES ON A PRORATA SCHEDULE BEGINNING WITH 20 YEARS OF SERVICE AS AN EMPLOYEE OF AHS 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 AHS 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 AHS EXECUTIVE FLEX BENEFIT PROGRAM. FLEX PLAN FLEX PLAN/ SERP 457(B) CY CY EMPLOYER CY CONTRIB./ DISTRIBUTIONS CONTRIB. DISTRIBUTIONS* PAYMENT ------------------------------------------------------- RANDALL HAFFNER, PHD $142,176 $ 0 $ 998,147 $ 0 RICHARD K. REINER $109,965 $ 91,965 $ 0 $ 0 DAVID L. CRANE $138,885 $128,053 $1,479,628 $ 0 BRENT G. SNYDER $131,464 $ 99,771 $ 167,822 $ 0 MICHAEL GOEBEL $ 64,299 $ 62,515 $ 0 $ 0 REBECCA MATHIS $ 18,032 $ 12,107 $ 0 $ 0 MICHAEL MURRILL $ 11,539 $ 0 $ 0 $ 0 GARY R. LIPINSKI, MD $ 44,798 $ 29,320 $ 0 $ 0 SHEVAWN TYRRELL $ 10,373 $ 75,695 $ 0 $ 49,459 RON WEHTJE $ 58,411 $ 43,544 $ 0 $ 0 GEORGE MAYZELL, MD $ 48,903 $128,259 $ 0 $ 0 MARY MURPHY $ 34,382 $ 25,871 $ 0 $ 0 JANICE HAGENSICKER $ 53,827 $ 28,728 $133,723 $ 0 RICHARD CARROLL, MD $ 48,188 $ 31,762 $ 0 $ 0 *INCLUDING INVESTMENT EARNINGS

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
BLAIR WEHTJE
FAMILY MEMBER OF BOARD MEMBER	$55,161	EMPLOYEE COMPENSATION	0
MEGAN WEHTJE
FAMILY MEMBER OF BOARD MEMBER	$32,816	EMPLOYEE COMPENSATION	0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 4	THE BYLAWS OF THE FILING ORGANIZATION WERE AMENDED IN 2015 TO REFLECT CERTAIN CHANGES TO THE PURPOSES AND GOVERNANCE OF THE FILING ORGANIZATION AS A RESULT OF AN AFFILIATION AGREEMENT ENTERED INTO BETWEEN ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC) AND ASCENSION HEALTH ON FEBRUARY 1, 2015. AHSSHC IS THE 501(C)(3) TOP-TIER PARENT ORGANIZATION OF THE FILING ORGANIZATION AND THE PARENT OF A SYSTEM OF HOSPITAL AND OTHER HEALTHCARE PROVIDER ORGANIZATIONS OPERATING IN TEN STATES. THE SYSTEM IS KNOWN AS ADVENTIST HEALTH SYSTEM (AHS). UNDER THE AFFILIATION AGREEMENT ENTERED INTO BETWEEN AHSSHC AND ASCENSION HEALTH, A JOINT OPERATING COMPANY, ALEXIAN BROTHERS - AHS MIDWEST REGION HEALTH CO., WAS FORMED. THE JOINT OPERATING COMPANY DOES BUSINESS UNDER THE NAME, AMITA HEALTH. ALEXIAN BROTHERS - AHS MIDWEST REGION HEALTH CO. (JOC OR AMITA HEALTH) HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS A TAX-EXEMPT ORGANIZATION UNDER IRC SECTION 501(C)(3). THE JOC PROVIDES FOR THE HOSPITALS AND OTHER HEALTHCARE PROVIDER ORGANIZATIONS OWNED AND OPERATED IN THE NORTHWEST SUBURBS OF CHICAGO BY ALEXIAN BROTHERS HEALTH SYSTEM AND BY AHS TO INTEGRATE FINANCIALLY AND OPERATIONALLY TO ACHIEVE A MORE EFFECTIVE AND EFFICIENT SYSTEM OF DELIVERING HEALTHCARE AND HOSPITAL SERVICES TO THE RESIDENTS OF THE COMMUNITIES SERVED. THE JOC MANAGES AND OPERATES ITS "COVERED AFFILIATES". THE FILING ORGANIZATION IS ONE OF THE COVERED AFFILIATES OF THE JOC. THE MEMBERSHIP OF THE JOC IS HELD BY ADVENTIST MIDWEST HEALTH AND ALEXIAN BROTHERS HEALTH SYSTEM. ADVENTIST MIDWEST HEALTH (AMH) IS A 501(C)(3) SECOND-TIER SUBSIDIARY OF AHSSHC AND A DIRECT SUBSIDIARY OF ADVENTIST HEALTH SYSTEM/SUNBELT, INC. (AHSSI). AHSSI AND ALEXIAN BROTHERS HEALTH SYSTEM ARE BOTH EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). THE PURPOSES CLAUSE OF THE FILING ORGANIZATION'S BYLAWS WAS AMENDED IN 2015 TO REFLECT THE FILING ORGANIZATION'S STATUS AS A COVERED AFFILIATE OF THE NEW JOC KNOWN AS AMITA HEALTH. THE GOVERNANCE AND RESERVED POWERS ARTICLES OF THE BYLAWS WERE AMENDED TO SET FORTH THE RIGHTS AND RESERVED POWERS OVER THE FILING ORGANIZATION BY THE SPONSOR, AHSSHC, BY THE MEMBER, AHSSI, BY BOTH MEMBERS OF THE JOC, NAMELY, THE FILING ORGANIZATION AND ALEXIAN BROTHERS HEALTH SYSTEM, AND THE BOARD OF DIRECTORS OF AMITA HEALTH. PLEASE SEE OUR RESPONSE TO QUESTION 7B OF SECTION A OF PART VI OF FORM 990 FOR A LISTING OF THE POWERS RESERVED BY THE SPONSOR, BY AHSSI (MEMBER), BY BOTH AMH AND ALEXIAN BROTHERS HEALTH SYSTEM (MEMBERS), AND BY THE BOARD OF DIRECTORS OF AMITA HEALTH, THE JOC. PRIOR TO AMENDMENT OF THE FILING ORGANIZATION'S BYLAWS ON 2/1/15, THE PRESIDENT OF THE FILING ORGANIZATION WAS ELECTED BY THE MEMBER. THE BYLAWS, AS AMENDED, PROVIDE THAT THE PRESIDENT'S APPOINTMENT, RETENTION AND REMOVAL SHALL BE AT THE DISCRETION OF THE CEO OF THE JOC, SUBJECT TO THE SPONSOR'S APPROVAL.
FORM 990, PART VI, SECTION A, LINE 6	ADVENTIST MIDWEST HEALTH (THE FILING ORGANIZATION) HAS ONE MEMBER. THE SOLE MEMBER OF THE FILING ORGANIZATION IS ADVENTIST HEALTH SYSTEM/SUNBELT, INC. (AHSSI). AHSSI 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 MEMBERS OF THE BOARD OF DIRECTORS (GOVERNING BOARD) OF THE FILING ORGANIZATION ARE APPOINTED BY THE CORPORATE MEMBER, ADVENTIST HEALTH SYSTEM/SUNBELT, INC. THE CORPORATE MEMBER IS ENTITLED TO ELECT NOT LESS THAN EIGHTEEN (18) AND NO MORE THAN TWENTY THREE (23) VOTING MEMBERS TO THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION PURSUANT TO THE PROVISIONS OF THE BYLAWS, SUBJECT TO THE RATIFICATION OF THE AMITA HEALTH BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B	AS NOTED IN OUR RESPONSE TO PART VI, SECTION A, LINE 4, THE FILING ORGANIZATION, ADVENTIST MIDWEST HEALTH (AMH), IS A COVERED AFFILIATE OF THE JOC KNOWN AS AMITA HEALTH. THE SOLE MEMBER OF THE FILING ORGANIZATION IS ADVENTIST HEALTH SYSTEM/SUNBELT, INC. (AHSSI). AMH IS ONE OF TWO MEMBERS IN AMITA HEALTH. THE OTHER MEMBER OF AMITA HEALTH IS ALEXIAN BROTHERS HEALTH SYSTEM. THE TOP-TIER PARENT OF AMH IS AHSSHC (SPONSOR). THE GOVERNING DOCUMENTS OF THE FILING ORGANIZATION, AS AMENDED, PROVIDE FOR CERTAIN AUTHORITIES AND RESERVED POWERS OVER THE FILING ORGANIZATION BY AHSSHC, AS SPONSOR, BY AHSSI AS MEMBER, BY BOTH MEMBERS OF THE JOC, NAMELY, AMH AND ALEXIAN BROTHERS HEALTH SYSTEM (MEMBERS), AND BY THE BOARD OF DIRECTORS OF THE JOC AS FOLLOWS. AHSSHC, AS SPONSOR HAS THE FOLLOWING AUTHORITY WITH RESPECT TO THE FILING ORGANIZATION: A. TO DIRECT THE DISPOSITION OF THE FILING ORGANIZATION'S ASSETS WITH A VALUE NOT TO EXCEED THREE MILLION DOLLARS ($3,000,000). B. TO RATIFY, TOGETHER WITH THE OTHER SPONSOR OF THE JOC, THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE FILING ORGANIZATION. C. TO DIRECT AN INTERNAL ASSET TRANSFER BETWEEN OR AMONG THE SPONSOR'S COVERED AFFILIATES (INCLUDING THE FILING ORGANIZATION) WITH A VALUE NOT IN EXCESS OF THREE MILLION DOLLARS ($3,000,000). D. TO DIRECT A SALE TO A THIRD PARTY OF PART OF THE FILING ORGANIZATION'S ASSETS MANAGED AND OPERATED BY THE JOC, OR A TRANSFER OF PART OF SPONSOR'S MEMBERSHIP INTEREST IN THE FILING ORGANIZATION TO A THIRD PARTY, SUBJECT TO A SUPERMAJORITY VOTE OF THE JOC BOARD OF DIRECTORS. CERTAIN GOVERNANCE POWERS ARE RESERVED TO AHSSI, AS THE MEMBER OF THE FILING ORGANIZATION. THE RESERVED POWERS OF AHSSI INCLUDE THE FOLLOWING: A. FAITH-BASED TENETS AND ETHICAL PRINCIPLES OF THE FILING ORGANIZATION. B. THE ALTERATION, RESTATEMENT OR REPEAL OF THE ARTICLES OF INCORPORATION, BYLAWS OR MISSION STATEMENT OF THE FILING ORGANIZATION, PROVIDED THAT SUCH ACTIONS ARE NOT INCONSISTENT WITH THE JOC BYLAWS OR THE AFFILIATION AGREEMENT. C. THE APPOINTMENT OF THE FILING ORGANIZATION'S BOARD OF DIRECTORS, SUBJECT TO THE RATIFICATION OF THE JOC BOARD OF DIRECTORS. D. THE APPROVAL OF ANY JOC BOARD RECOMMENDED WAIVER OR OTHER CLAIM OR ACTION AGAINST OR BROUGHT BY OR ON BEHALF OF THE FILING ORGANIZATION IF THE UNINSURED PORTION OF THE AMOUNT IN CONTROVERSY IS IN EXCESS OF SUCH THRESHOLD AMOUNT DESIGNATED IN SPONSOR POLICY AS REQUIRING MEMBER APPROVAL. POWERS RESERVED TO BOTH MEMBERS OF THE JOC: A. TO SELL, TRANSFER OR OTHERWISE DISPOSE OF ANY REAL ESTATE OR ANY ASSET OWNED BY THE FILING ORGANIZATION WITH A FAIR MARKET VALUE IN EXCESS OF TEN MILLION DOLLARS ($10,000,000). B. TO DIRECT ASSET TRANSFERS FROM THE FILING ORGANIZATION TO ANY OF THE ALEXIAN COVERED AFFILIATES (OR VICE VERSA) IN EXCESS OF TEN MILLION DOLLARS ($10,000,000). C. TO APPROVE ANY OPERATING LEASE UNDER WHICH THE FILING ORGANIZATION IS THE LESSEE, WHICH OPERATING LEASE SHALL BE CONSISTENT WITH THE OPERATING LEASE POLICIES OF ITS SPONSOR. D. OTHER THAN WITH RESPECT TO A COVERED AFFILIATE LEGACY LIABILITY OF THE MEMBER OR ITS SPONSOR, WHICH MATTER WILL BE HANDLED BY THE MEMBER AND ITS SPONSOR, TO APPROVE ENTERING INTO ANY CORPORATE INTEGRITY AGREEMENT OR SIMILAR AGREEMENT WITH A GOVERNMENT ENTITY OR AGENCY IMPOSING COMPLIANCE OBLIGATIONS ON THE JOC OR THE FILING ORGANIZATION. E. TO ACQUIRE ANY REAL ESTATE, PERSONAL PROPERTY, MEMBERSHIP, OWNERSHIP OR INVESTMENT INTEREST FOR THE FILING ORGANIZATION OR MAKE ANY CAPITAL EXPENDITURE WHETHER OR NOT PURSUANT TO AN ANNUAL BUDGET, OR SUBSTITUTIONS FOR CAPITAL EXPENDITURES WITHIN A CAPITAL BUDGET, WHICH EXCEED INDIVIDUALLY, OR IN THE AGGREGATE, TEN MILLION DOLLARS ($10,000,000) IN ANY FISCAL YEAR; PROVIDED, HOWEVER, THAT ANY CONTRIBUTION NECESSARY TO FUND UNBUDGETED EXPENDITURES BY THE JOC IS SUBJECT TO MEMBER APPROVAL. POWERS OF THE BOARD OF DIRECTORS OF THE JOC OVER THE FILING ORGANIZATION: A. TO ADOPT AND MODIFY THE ANNUAL (AND INTERIM IF DEEMED APPROPRIATE) OPERATING AND CAPITAL BUDGETS OF THE FILING ORGANIZATION, WHICH BUDGETS WILL BE SUBJECT TO RATIFICATION BY EACH SPONSOR. B. TO ADOPT AND MODIFY A STRATEGIC PLAN FOR THE FILING ORGANIZATION AND APPROVE ANY UPDATE THEREOF. C. TO SELL, TRANSFER OR OTHERWISE DISPOSE OF ANY REAL ESTATE OR ANY OTHER ASSET OF THE FILING ORGANIZATION WITH A FAIR MARKET VALUE UP TO THE THRESHOLD OF TEN MILLION DOLLARS ($10,000,000). D. TO DIRECT ASSET TRANSFERS FROM THE FILING ORGANIZATION TO ANY OF THE ALEXIAN COVERED AFFILIATES (OR VICE VERSA) UP TO THE THRESHOLD OF TEN MILLION DOLLARS ($10,000,000). E. TO RECOMMEND FOR MEMBER APPROVAL ENTERING INTO ANY OPERATING LEASE IN WHICH THE FILING ORGANIZATION IS THE LESSEE CONSISTENT WITH THE OPERATING POLICIES OF THE SPONSOR. F. TO APPROVE ANY CONTRACT UNDER WHICH EITHER MEMBER OR ANY AFFILIATE OF A MEMBER WILL PROVIDE ITEMS OR SERVICES TO THE JOC OR A COVERED AFFILIATE OF THE OTHER MEMBER. G. TO RECOMMEND TO THE MEMBER ANY WAIVER, SETTLEMENT OR COMPROMISE OF ANY CLAIM AGAINST OR BROUGHT BY OR ON BEHALF OF THE FILING ORGANIZATION IF THE UNINSURED PORTION OF THE AMOUNT IN CONTROVERSY IS UP TO SUCH THRESHOLD AMOUNT AS DESIGNATED IN SPONSOR POLICY AS REQUIRING APPROVAL. H. TO MAKE ANY CAPITAL EXPENDITURE, INCLUDING BUT NOT LIMITED TO REAL ESTATE, PERSONAL PROPERTY, MEMBERSHIP, OWNERSHIP OR INVESTMENT INTEREST FOR THE FILING ORGANIZATION OR GOODWILL OR OTHER INTANGIBLE ASSETS WHICH ARE LESS THAN, INDIVIDUALLY OR IN THE AGGREGATE, TEN MILLION DOLLARS ($10,000,000) IN ANY FISCAL YEAR. I. TO DETERMINE THE SERVICES PROVIDED BY THE FILING ORGANIZATION, INCLUDING THE AUTHORITY TO DIRECT THE EXPANSION, REDUCTION AND CONSOLIDATION OF CLINICAL PROGRAMS, PATIENT CARE SERVICES AND ADMINISTRATIVE CAPABILITIES OR OTHER MAJOR CHANGES IN THE OPERATION OF THE FILING ORGANIZATION. J. TO ENTER INTO, ON BEHALF OF THE FILING ORGANIZATION, ANY RISK-BASED MANAGED CARE CONTRACT UNDER WHICH THE FILING ORGANIZATION WILL PROVIDE SERVICES. K. ANY CORPORATE COMPLIANCE POLICY APPLICABLE TO THE FILING ORGANIZATION AND ANY MODIFICATIONS THEREOF. L. TO MONITOR AND AUDIT THE FILING ORGANIZATION'S COMPLIANCE WITH THE DIRECTIVES OF THE MEMBERS ISSUED IN ACCORDANCE WITH THE AFFILIATION AGREEMENT. M. TO ADOPT CLINICAL INTEGRATION AND PERFORMANCE IMPROVEMENT PROGRAMS TO ENHANCE THE QUALITY AND COST-EFFECTIVENESS OF CLINICAL SERVICES AT THE FILING ORGANIZATION, INCLUDING BUT NOT LIMITED TO THROUGH CLINICAL PROTOCOLS, BEST PRACTICE STANDARDS, OUTCOMES MEASUREMENT MECHANISMS, POPULATION MANAGEMENT PROGRAMS AND COLLABORATION ON INFORMATION TECHNOLOGY INITIATIVES. N. TO APPROVE THE INTEGRATION OR PARTIAL INTEGRATION OF THE MEDICAL STAFFS OF ONE OR MORE FACILITIES OF THE FILING ORGANIZATION AND ANY OTHER COVERED AFFILIATES, AND ANY CREDENTIALING AND PRIVILEGING POLICY AND PROCEDURE RELATED THERETO PURSUANT TO SECTION 3.2 OF THE AFFILIATION AGREEMENT. O. TO RATIFY THE APPOINTMENT OF THE FILING ORGANIZATION'S BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 11	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 CONFLICT OF INTERESTS, 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 INTERESTS 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 ADVENTIST HEALTH SYSTEM (AHS). EACH YEAR, AHS PUBLISHES AN ANNUAL REPORT DOCUMENT THAT INCLUDES A FINANCIAL REPORT FOR THE RELEVANT YEAR AS WELL AS A COMMUNITY BENEFIT REPORT. THE FINANCIAL REPORT AND COMMUNITY BENEFIT REPORT ARE PRESENTED ON A CONSOLIDATED BASIS AND REPRESENT ALL OF THE ACTIVITIES, RESULTS OF OPERATIONS, AND FINANCIAL POSITION AT YEAR-END OF THE ENTIRE AHS SYSTEM. IN ADDITION, THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS OF AHS AND OF THE AHS "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 AHS ON A CONSOLIDATED BASIS AND FOR THE GROUPING OF AHS 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 WITHIN ADVENTIST HEALTH SYSTEM. PHYSICIAN MEMBERS OF THE BOARD OF DIRECTORS RECEIVED COMPENSATION FROM RELATED ORGANIZATIONS AS A RESULT OF PROVIDING VARIOUS MEDICAL SERVICES TO THOSE RELATED ENTITIES.
FORM 990, PART IX, LINE 11G	PAYMENTS TO HEALTHCARE PROFESSIONALS: PROGRAM SERVICE EXPENSES 16,301,815. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,301,815. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 12,728,414. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,728,414. PURCHASED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 7,742,314. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,742,314. ENVIRONMENTAL SERVICES: PROGRAM SERVICE EXPENSES 1,934,917. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,934,917. RECRUITING: PROGRAM SERVICE EXPENSES 304,622. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 304,622. FOOD SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 885,791. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 885,791. MISCELLANEOUS PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 7,819,151. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,819,151. AHS MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 4,037,669. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,037,669. BILLING & COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,610,148. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,610,148. EHR MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 32,139. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 32,139.
FORM 990, PART XI, LINE 9:	TRANSFER OF NET ASSETS OF ADVENTIST LA GRANGE MEMORIAL HOSPITAL FROM TAX-EXEMPT 2ND-TIER PARENT 24,734,113. PURCHASE OF REAL ESTATE FROM TAXABLE AFFILIATE 1,216,276. NET TRANSFER TO TAX-EXEMPT AFFILIATES -5,199,143. TRANSFER TO TAX-EXEMPT PARENT -1,596,811. SWAP LOSS AMORTIZATION -158,427. ALLOCATIONS FROM TAX-EXEMPT PARENT WITH RESPECT TO DEBT -129,356. TRANSFER FOR EXPENSES -603,932. GIFTS 605,848. OTHER -27. INTEREST IN FOUNDATION 71,774. ADJUSTMENT RELATED TO STEP-UP BASIS 73,850.
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.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (103 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
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 9	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 11C, III-FI	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
ADVENTIST HLTH PARTNERS INC
1000 REMINGTON BLVD STE 200	BOLINGBROOK	IL	60440	364138353	OPERATE OUT-PATIENT PHYSICIAN CLINICS	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 11A, I		0	N/A
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	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	36028	742578952	LEASING PERSONNEL TO AFFILIATED HOSPITAL	TX	501(C)(3)	LINE 11C, 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)
ADVENTIST UNIVERSITY OF HEALTH SCIENCES INC (630 YEAR END)
671 LAKE WINYAH DRIVE	ORLANDO	FL	32803	593069793	EDUCATION/OPERATION OF SCHOOL	FL	501(C)(3)	LINE 2	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
AHP SPECIALTY CARE NFP (1230-123115)
3040 SALT CREEK LANE	ARLINGTON HEIGHTS	IL	60005	811105774	OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES	IL	501(C)(3)	LINE 3	AHS MIDWEST MANAGEMENT INC	Yes (1)
AHS MIDWEST MANAGEMENT INC
1000 REMINGTON BLVD STE 200	BOLINGBROOK	IL	60440	363354567	OPERATION OF PHYSICIAN PRACTICE MGMT	IL	501(C)(3)	LINE 11A, I	ADVENTIST MIDWEST HEALTH	Yes (1)
AHSCENTRAL TEXAS INC
1301 WONDER WORLD DRIVE	SAN MARCOS	TX	78666	742621825	PROVIDE OFFICE SPACE - MEDICAL PROFESSIONALS	TX	501(C)(3)	LINE 11C, III-FI	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
ALEXIAN BROTHERS-AHS MIDWEST REGION HLTH CO DBA AMITA HEALTH
3040 W SALT CREEK LANE	ARLINGTON HEIGHTS	IL	60005	472360513	JOINT OPERATING COMPANY	IL	501(C)(3)	LINE 11B, II	ADVENTIST MIDWEST HEALTH	Yes (1)
APOPKA HLTH CARE PROPERTIES INC
305 E OAK STREET	APOPKA	FL	32703	510605694	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 11C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
BATTLE CREEK ADVENTIST HOSPITAL
1000 REMINGTON BLVD STE 200	BOLINGBROOK	IL	60440	381359189	INACTIVE	MI	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
BOLINGBROOK HOSPITAL FOUNDATION
1000 REMINGTON BLVD N ENTRANCE 2ND	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 9	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 9	SUNBELT HLTH CARE CENTERS INC	Yes (1)
CALDWELL HLTH CARE PROPERTIES INC
1333 WEST MAIN	PRINCETON	KY	42445	510605680	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 11C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
CENTRAL TEXAS HLTHCARE COLLABORATIVE
1301 WONDER WORLD DRIVE	SAN MARCOS	TX	78666	453739929	SUPPORT OPERATION OF HOSPITAL	TX	501(C)(3)	LINE 11A, 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 11C, 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)
COBB MEDICAL ASSOCIATES LLC (11-122315)
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	582617089	INACTIVE	GA	501(C)(3)	LINE 3	EMORY-ADVENTIST INC	Yes (1)
COURTLAND HLTH CARE PROPERTIES INC
730 COURTLAND STREET	ORLANDO	FL	32804	510605682	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 11C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (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 9	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 11C, 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 9	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 9	SUNBELT HLTH CARE CENTERS INC	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 LN	MAITLAND	FL	32751	593214635	OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
FLORIDA HOSPITAL PHYSICIAN GROUP INC
2700 HEALING WAY	WESLEY CHAPEL	FL	33545	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)
FOUNDATION FOR SHAWNEE MISSION MEDICAL CENTER INC
9100 W 74TH STREET	SHAWNEE MISSION	KS	66204	480868859	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	KS	501(C)(3)	LINE 11A, I	SHAWNEE MISSION MEDICAL CENTER INC	Yes (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 9	SUNBELT HLTH CARE CENTERS INC	Yes (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 11C, III-FI		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	TARPON SPRINGS HOSPITAL FOUNDATION INC	0
HINSDALE HOSPITAL FOUNDATION
7 SALT CREEK LANE SUITE 203	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 9	THE COMFORTER HEALTH CARE GROUP INC	Yes (1)
HOSPICE OF THE COMFORTER FOUNDATION INC
480 W CENTRAL PARKWAY	ALTAMONTE SPRINGS	FL	32714	271858033	FUND RAISING FOR AFFILIATED TAX-EXEMPT HOSPICE	FL	501(C)(3)	LINE 7	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 11B, II	SUNBELT HLTH CARE CENTERS INC	Yes (1)
JELLICO COMMUNITY HOSPITAL INC (11-43015)
188 HOSPITAL LANE	JELLICO	TN	37762	620924706	OPERATION OF HOSPITAL & RELATED SERVICES	TN	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (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
MEMORIAL HLTH SYSTEMS FOUNDATION INC
770 WEST GRANADA BLVD	ORMOND BEACH	FL	32174	311771522	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	FL	501(C)(3)	LINE 7		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	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)
MERRIAM HLTH CARE PROPERTIES INC
9700 WEST 62ND STREET	MERRIAM	KS	66203	364595806	LEASE TO RELATED ORGANIZATION	KS	501(C)(3)	LINE 11C, III-FI	SUNBELT HLTH CARE CENTERS INC	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)
METROPLEX HOSPITAL INC (11-6815)
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	461256516	INACTIVE	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
MIDWEST HLTH FOUNDATION
120 NORTH OAK STREET	HINSDALE	IL	60521	352230515	SUPPORT OF SUBSIDIARY FOUNDATIONS	IL	501(C)(3)	LINE 11B, II		0	N/A
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 9	SUNBELT HLTH CARE CENTERS INC	Yes (1)
MISSION STRATEGIES OF GEORGIA INC
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	900866024	PROVISION OF SUPPORT TO THE NURSING HOME DIVISION	GA	501(C)(3)	LINE 11B, II	SUNBELT HLTH CARE CENTERS INC	Yes (1)
MISSOURI ADVENTIST HLTH INC
9100 W 74TH STREET	SHAWNEE MISSION	KS	66204	431224729	SUPPORT HLTH CARE SERVICES	MO	501(C)(3)	LINE 11D, III-O	ADVENTIST HLTH MID-AMERICA INC	Yes (1)
NORTH REGIONAL EMS INC (11-41615)
188 HOSPITAL LANE	JELLICO	TN	37762	262653616	EMS SERVICES	TN	501(C)(3)	LINE 9	JELLICO COMMUNITY HOSPITAL 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 11C, III-FI		0
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 9	SUNBELT HLTH CARE CENTERS INC	Yes (1)
PARAGON HLTH CARE PROPERTIES INC
950 HIGHPOINT DRIVE	HOPKINSVILLE	KY	42240	510605686	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 11C, III-FI	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 HLTH SYSTEM (630 YEAR END)
2525 S DOWNING STREET	DENVER	CO	80210	840438224	OPERATION OF HOSPITAL & RELATED SERVICES	CO	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (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 9	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 9	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 11A, 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 11B, 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
ROLLINS BROOK COMMUNITY CARE CORP
2201 S CLEAR CREEK ROAD	KILLEEN	TX	76549	461656773	INACTIVE	TX	501(C)(3)	LINE 11A, I	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
RUSSELLVILLE HLTH CARE PROPERTIES INC
683 EAST THIRD STREET	RUSSELLVILLE	KY	42276	510605691	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 11C, III-FI	SUNBELT HLTH CARE CENTERS 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 11C, 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 9	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 11C, 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 CENTRAL INC
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	593689740	MANAGEMENT SUPPORT	GA	501(C)(3)	LINE 11C, III-FI		0	N/A
SOUTH PASCO HLTH CARE PROPERTIES INC
38250 A AVENUE	ZEPHYRHILLS	FL	33542	510605679	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 11C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
SOUTHEAST VOLUSIA HEALTHCARE CORP (421-123115)
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	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 11A, 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
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
718 GOODWIN LANE	LEITCHFIELD	KY	42754	205782288	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	KY	501(C)(3)	LINE 9	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 9	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 11B, 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)
TAKOMA REGIONAL HOSPITAL INC (630 YEAR END)
401 TAKOMA AVE	GREENEVILLE	TN	37743	510603966	OPERATION OF HOSPITAL & RELATED SERVICES	TN	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
TAKOMA REGIONAL HOSPITAL FOUNDATION INC
401 TAKOMA AVE	GREENEVILLE	TN	37743	471334302	FUND RAISING FOR AFFILIATED TAX-EXEMPT HOSPITAL	TN	501(C)(3)	LINE 7	TAKOMA REGIONAL HOSPITAL INC	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 11C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
TAYLOR CREEK HLTH CARE PROPERTIES INC
718 GOODWIN LANE	LEITCHFIELD	KY	42754	510605678	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 11C, 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 11C, 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 11C, III-FI		0
TRI-COUNTY NURSING AND REHAB CENTER INC
485 NORTH KELLER ROAD 250	MAITLAND	FL	32751	472219363	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	FL	501(C)(3)	LINE 9	SUNBELT HLTH CARE CENTERS INC	Yes (1)
TRINITY NURSING & REHAB CENTER INC
9700 WEST 62ND STREET	MERRIAM	KS	66203	205774890	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	KS	501(C)(3)	LINE 9	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 11A, I		0
UNIVERSITY COMMUNITY HOSPITAL SPECIALTY CARE INC
3100 E FLETCHER AVE	TAMPA	FL	33613	593231322	INACTIVE	FL	501(C)(3)	LINE 11A, I	UNIVERSITY COMMUNITY HOSPITAL INC	Yes (1)
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 KENTUCKY HLTH CARE PROPERTIES INC
500 BECK LANE	MAYFIELD	KY	42066	510605676	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 11C, III-FI	SUNBELT HLTH CARE CENTERS 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 9	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 9	SUNBELT HLTH CARE CENTERS INC	Yes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (9 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd
CLEAR CREEK MOB LTD
2201 S CLEAR CREEK RD	KILLEEN	TX	76549	742609195	REAL ESTATE	TX	N/A
ENDOSCOPY CENTER AT PORTER LLC
1001 SOUTH PARK DRIVE	LITTLETON	CO	80120	205855038	MEDICAL SERVICES	CO	N/A
FLORIDA HOSPITAL DMERT LLC
2450 MAITLAND CENTER PKWY STE 200	MAITLAND	FL	32751	202392253	MEDICAL EQUIPMENT	FL	N/A
FLORIDA HOSPITAL HOME INFUSION LLP
2450 MAITLAND CENTER PKWY STE 200	MAITLAND	FL	32751	593142824	HOME INFUSION SERVICES	FL	N/A
FUNCTIONAL NEUROSURGICAL AMBULATORY SURGERY CENTER LLC
777 S WILLIAMS ST	DENVER	CO	80209	464426708	SURGERY CENTER	CO	N/A
PAHSLARKIN VENTURES LLC
188 INVERNESS DR WEST 500	ENGLEWOOD	CO	80112	474211060	MEDICAL SERVICES	CO	N/A
PAHSUSP SURGERY CENTERS LLC
15305 DALLAS PKWY STE 1600 LB 28	ADDISON	TX	75010	263057950	MEDICAL SERVICES	CO	N/A
SAN MARCOS MRI LP
1330 WONDER WORLD DR STE 202	SAN MARCOS	TX	78666	770597972	IMAGING & TESTING	TX	N/A
SHAWNEE MISSION OPEN MRI LLC
9100 W 74TH STREET BOX 2923	SHAWNEE MISSION	KS	66201	270011796	IMAGING & TESTING	KS	N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (20 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 PROVIDER'S NETWORK
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 EIN APPLIED FOR
550 E ROLLINS STREET 7TH FLOOR	ORLANDO	FL	32803		CONDO ASSOCIATION	FL	N/A	C	Yes (1)
FLORIDA HOSPITAL HEALTHCARE SYSTEM INC
602 COURTLAND STREET	ORLANDO	FL	32804	593215680	PHSO	FL	N/A	C	Yes (1)
FLORIDA MEDICAL PLAZA CONDO ASSOCIATION INC
601 EAST ROLLINS STREET	ORLANDO	FL	32803	592855791	CONDO ASSOCIATION	FL	N/A	C	Yes (1)
FLORIDA MEMORIAL HEALTH NETWORK INC
770 W GRANADA BLVD STE 317	ORMOND BEACH	FL	32174	593403558	PHYSICIAN HOSPITAL ORG.	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)
LAKE COUNTY HEALTH CARE PROPERTIES INC (END 123115)
485 NORTH KELLER ROAD STE 250	MAITLAND	FL	32751	472179868	REAL ESTATE RENTAL	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 YR 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 AFF HLTH SVCS INC DBA DIVERSIFIED AFF HLTH SVCS
2525 S DOWNING STREET	DENVER	CO	80210	840956175	HEALTHCARE SERVICES	CO	N/A	C	Yes (1)
SAN MARCOS REGIONAL MRI INC
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	Yes (1)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	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	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (24 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
HINSDALE HOSPITAL FOUNDATION
C	$1,025,810	ACTUAL AMOUNT RECEIVED
ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION
C	$238,084	ACTUAL AMOUNT RECEIVED
LA GRANGE MEMORIAL HOSPITAL FOUNDATION
C	$81,349	ACTUAL AMOUNT RECEIVED
HINSDALE HOSPITAL FOUNDATION
B	$647,691	ACTUAL AMOUNT GIVEN
LA GRANGE MEMORIAL HOSPITAL FOUNDATION
B	$260,155	ACTUAL AMOUNT GIVEN
ADVENTIST HEALTH PARTNERS
B	$5,970,844	ACTUAL AMOUNT GIVEN
ADVENTIST HEALTH SYSTEMSUNBELT INC
S	$24,734,113	NBV OF NET ASSETS TRANSFERRED
ADVENTIST BOLINGBROOK HOSPITAL
C	$438,235	ACTUAL AMOUNT RECEIVED
ADVENTIST GLENOAKS HOSPITAL
C	$333,465	ACTUAL AMOUNT RECEIVED
ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION
B	$1,596,811	ACTUAL AMOUNT GIVEN
ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION
M	$3,333,846	% OF FACILITY'S OPERATING EXPENSE
ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION DBA AHS IS
M	$15,093,094	% OF FACILITY'S OPERATING EXPENSE
ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION
P	$19,659,580	COST
NORTH AMERICAN HEALTH SERVICES INC DBA ELM CREEK PROPERTY MGT
S	$1,216,276	FMV OF PROPERTY RECEIVED
ADVENTIST GLENOAKS HOSPITAL
Q	$4,120,841	COST
CHIPPEWA VALLEY HOSPITAL & OAKVIEW CARE CENTER INC
Q	$516,199	COST
ADVENTIST BOLINGBROOK HOSPITAL
Q	$6,799,090	COST
ADVENTIST HEALTH PARTNERS
Q	$257,788	COST
AHS MIDWEST MANAGEMENT INC
Q	$2,685,171	COST
ADVENTIST GLENOAKS HOSPITAL
P	$720,952	COST
ADVENTIST BOLINGBROOK HOSPITAL
P	$1,420,356	COST
NORTH AMERICAN HEALTH SERVICES INC DBA ELM CREEK PROPERTY MGT
P	$153,826	COST
ADVENTIST HEALTH PARTNERS
P	$10,909,817	COST
AHS MIDWEST MANAGEMENT INC
P	$2,114,575	COST