ADVENTIST HEALTH SYSTEM GEORGIA INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- ADVENTIST HEALTH SYSTEM GEORGIA INC (EIN 58-1425000)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-14
- IRS object ID
- 201643199349312559
- 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 | 2016-11-14T21:21:07-06:00 | 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 | 581425000 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADVENTIST HEALTH SYSTEM GEORGIA INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ADVE | BusinessNameControlTxt |
| Phone | 7066027800 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1035 RED BUD ROAD | AddressLine1Txt |
| City | CALHOUN | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30701 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LYNN C ADDISCOTT | PersonNm |
| Person Title | ASSISTANT SECRETARY | PersonTitleTxt |
| Phone | 4079751492 | 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 | PETER WEBER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1035 RED BUD ROAD | AddressLine1Txt |
| City | CALHOUN | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30701 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $339,125,500 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 1071 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.GORDONHOSPITAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1981 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | THE PROVISION OF MEDICAL CARE TO THE COMMUNITY THROUGH THE OPERATION OF TWO HOSPITALS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 1108 | TotalEmployeeCnt |
| Total Volunteers | 93 | TotalVolunteersCnt |
| Total Gross UBI | $221,881 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$47,014 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $66,048 | PYContributionsGrantsAmt |
| CY Contributions Grants | $93,480 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $106,110,999 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $127,445,063 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,205,283 | PYInvestmentIncomeAmt |
| CY Investment Income | -$754,259 | CYInvestmentIncomeAmt |
| PY Other Revenue | $363,543 | PYOtherRevenueAmt |
| CY Other Revenue | $1,040,173 | CYOtherRevenueAmt |
| PY Total Revenue | $107,745,873 | PYTotalRevenueAmt |
| CY Total Revenue | $127,824,457 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $128,464 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $67,946 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $57,871,464 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $67,656,466 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $44,566,822 | PYOtherExpensesAmt |
| CY Other Expenses | $55,499,563 | CYOtherExpensesAmt |
| PY Total Expenses | $102,566,750 | PYTotalExpensesAmt |
| CY Total Expenses | $123,223,975 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,179,123 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,600,482 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $167,329,643 | TotalAssetsBOYAmt |
| Total Assets EOY | $168,140,097 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $50,994,236 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $48,542,677 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $116,335,407 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $119,597,420 | 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 | $114,299,077 | ExpenseAmt |
| Grant | $67,946 | GrantAmt |
| Revenue | $128,263,355 | RevenueAmt |
| Desc | OPERATION OF GORDON HOSPITAL, A 69-BED ACUTE CARE HOSPITAL WITH 4,049 PATIENT ADMISSIONS, 15,973 PATIENT DAYS, AND 71,693 OUTPATIENT VISITS DURING THE CURRENT YEAR; AND MURRAY MEDICAL CENTER, A 42-BED ACUTE CARE HOSPITAL WITH 206 PATIENT ADMISSIONS, 549 PATIENT DAYS, AND 17,192 OUTPATIENT VISITS DURING THE PERIOD FROM MAY 1 - DECEMBER 31, 2015. | Desc |
| Total Program Service Expenses | $114,299,077 | 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 | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 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 | Yes (1) | 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 | 134 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1108 | 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 | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | 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 | GA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CORY REEVES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7066027800 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1035 RED BUD ROAD | AddressLine1Txt |
| City | CALHOUN | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30701 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| PETER WEBER | ||||||||||
| CEO/DIR/SECRETARY | 50.00 | 2.40 | Yes (X) | Yes (X) | $0 | $843,100 | $126,809 | |||
| RICHARD REINER | ||||||||||
| CHAIRMAN/DIR (END 5/15) | 0.10 | 50.00 | Yes (X) | $0 | $1,084,868 | $62,839 | ||||
| BRENT BOX MD | ||||||||||
| CMO/DIRECTOR | 50.00 | 0.00 | Yes (X) | $378,115 | $0 | $42,832 | ||||
| JEFF BROWN | ||||||||||
| DIRECTOR | 0.20 | 0.00 | Yes (X) | $250 | $0 | $0 | ||||
| STEVEN FEHLENBERG | ||||||||||
| DIRECTOR | 0.20 | 0.00 | Yes (X) | $250 | $0 | $0 | ||||
| RANDALL HAFFNER PHD | ||||||||||
| CHAIRMAN/DIR (BEG 5/15) | 0.10 | 50.00 | Yes (X) | $0 | $1,835,419 | $242,710 | ||||
| JOE JOYAVE MD | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $5,808 | $0 | $0 | ||||
| DAVID LANCE | ||||||||||
| DIRECTOR | 0.20 | 0.00 | Yes (X) | $250 | $0 | $0 | ||||
| PAUL LEBLANC MD | ||||||||||
| DIRECTOR | 41.70 | 0.00 | Yes (X) | $245,940 | $0 | $30,378 | ||||
| JACQUELIN MILLER MD | ||||||||||
| DIRECTOR (BEG 1/15) | 0.50 | 0.00 | Yes (X) | $3,250 | $0 | $0 | ||||
| DEBRA MOYER | ||||||||||
| DIRECTOR | 0.20 | 0.00 | Yes (X) | $250 | $0 | $0 | ||||
| MAX PARROTT MD | ||||||||||
| CMO/DIRECTOR | 54.80 | 0.00 | Yes (X) | $296,468 | $0 | $15,223 | ||||
| BRITTANY PITTMAN | ||||||||||
| DIRECTOR (BEG 6/15) | 0.10 | 0.00 | Yes (X) | $250 | $0 | $0 | ||||
| EDWARD WRIGHT | ||||||||||
| VICE CHAIR/DIRECTOR | 0.20 | 0.00 | Yes (X) | $250 | $0 | $0 | ||||
| CORY REEVES | ||||||||||
| CFO | 50.00 | 0.00 | Yes (X) | $0 | $354,195 | $73,889 | ||||
| AMELIA D JORDON | ||||||||||
| CNO | 50.00 | 0.00 | $0 | $235,631 | $47,359 | Yes (X) | ||||
| BRANDON NUDD | ||||||||||
| COO | 50.00 | 0.00 | $0 | $221,348 | $50,001 | Yes (X) | ||||
| STEPHEN KING MD | ||||||||||
| PHYSICIAN | 41.50 | 0.00 | $871,796 | $0 | $42,109 | Yes (X) | ||||
| JAMES ERIC TURNER MD | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $769,329 | $0 | $41,350 | Yes (X) | ||||
| ANDREW HESTER MD | ||||||||||
| PHYSICIAN | 41.50 | 0.00 | $710,451 | $0 | $38,672 | Yes (X) | ||||
| DANIEL AHN MD | ||||||||||
| PHYSICIAN | 41.50 | 0.00 | $658,461 | $0 | $40,532 | Yes (X) | ||||
| CYNTHIA BROWN MD | ||||||||||
| PHYSICIAN | 47.20 | 0.00 | $400,234 | $0 | $41,921 | Yes (X) | ||||
| SAM HUENERGARDT | ||||||||||
| FORMER COO | 0.00 | 50.00 | $0 | $304,619 | $36,026 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,341,352 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,879,180 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $932,650 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 80 | 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 |
|---|---|---|---|---|---|
| BRASFIELD & GORRIE LLC | |||||
| 1990 VAUGHN ROAD SUITE 100 | KENNESAW | GA | 30144 | CONSTRUCTION SERVICES | $3,300,127 |
| PT SOLUTIONS HOLDINGS LLC | |||||
| PO BOX 242278 | MONTGOMERY | AL | 36124 | PHYSICAL THERAPY SERVICES | $2,134,964 |
| CALHOUN ANESTHESIA PC | |||||
| PO BOX 128 | CALHOUN | GA | 30703 | ANESTHESIOLOGY SERVICES | $1,312,087 |
| MEDICAL SERVICES INC | |||||
| PO BOX 22266 | CHATTANOOGA | TN | 37422 | BILLING SERVICE | $1,160,570 |
| SIEMENS MEDICAL SOLUTIONS | |||||
| 51 VALLEY STEAM PARKWAY | MALVERN | PA | 19355 | SERVICE CONTRACT | $405,674 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 27 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $86,754 | RelatedOrganizationsAmt |
| All Other Contributions | $6,726 | AllOtherContributionsAmt |
| Total Contributions | $93,480 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT REVENUE | 622110 | $126,335,019 | $126,113,138 | $221,881 |
| CAFETERIA | 622110 | $311,709 | $311,709 | |
| GIFT SHOP | 622110 | $264,324 | $264,324 | |
| MEDICAL OFFICE BUILDING | 622110 | $173,496 | $173,496 | |
| COUNTY SUBSIDY - EMS | 622110 | $161,452 | $161,452 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $199,063 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $199,063 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $127,445,063 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,401,708 | TotalRevenueColumnAmt |
| Exclusion | $1,401,708 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $209,103,321 | SecuritiesAmt |
| Other | $41,755 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $211,199,754 | SecuritiesAmt |
| Other | $101,289 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$2,096,433 | SecuritiesAmt |
| Other | -$59,534 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$2,155,967 | TotalRevenueColumnAmt |
| Exclusion | -$2,155,967 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | EHR REVENUE | Desc |
| Business | 622110 | BusinessCd |
| Total Revenue Column | $1,040,173 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,040,173 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,040,173 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $127,824,457 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $128,263,355 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $221,881 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$754,259 | 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 | $67,946 | TotalAmt |
| Program Services | $67,946 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,971,846 | TotalAmt |
| Management And General | $2,971,846 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,691,887 | TotalAmt |
| Program Services | $47,691,887 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,735,910 | TotalAmt |
| Program Services | $1,689,359 | ProgramServicesAmt |
| Management And General | $46,551 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,928,091 | TotalAmt |
| Program Services | $11,928,091 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,328,732 | TotalAmt |
| Program Services | $3,239,606 | ProgramServicesAmt |
| Management And General | $89,126 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,251 | TotalAmt |
| Management And General | $45,251 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,899 | TotalAmt |
| Management And General | $24,899 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $345,969 | TotalAmt |
| Management And General | $345,969 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,908,779 | TotalAmt |
| Program Services | $10,411,250 | ProgramServicesAmt |
| Management And General | $2,497,529 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $603,011 | TotalAmt |
| Management And General | $603,011 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,800,102 | TotalAmt |
| Program Services | $1,792,388 | ProgramServicesAmt |
| Management And General | $1,007,714 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,889,744 | TotalAmt |
| Program Services | $3,459,641 | ProgramServicesAmt |
| Management And General | $430,103 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,063,334 | TotalAmt |
| Program Services | $4,063,334 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $522,678 | TotalAmt |
| Management And General | $522,678 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,343 | TotalAmt |
| Management And General | $70,343 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,016,063 | TotalAmt |
| Program Services | $1,016,063 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,952,269 | TotalAmt |
| Program Services | $6,952,269 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,410,884 | TotalAmt |
| Program Services | $1,346,017 | ProgramServicesAmt |
| Management And General | $64,867 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $15,845,232 | $15,845,232 | |
| REPAIRS & MAINTENANCE | $3,324,072 | $3,324,072 | |
| GA NET REVENUE TAX | $1,356,986 | $1,356,986 | |
| PURCHASED SERVICES | $74,148 | $74,148 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $245,799 | TotalAmt |
| Program Services | $114,936 | ProgramServicesAmt |
| Management And General | $130,863 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $123,223,975 | TotalAmt |
| Program Services | $114,299,077 | ProgramServicesAmt |
| Management And General | $8,924,898 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,650 | BOYAmt |
| EOY | $6,700 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $81,093,050 | BOYAmt |
| EOY | $59,123,687 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,922,389 | BOYAmt |
| EOY | $18,694,421 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,588,314 | BOYAmt |
| EOY | $1,960,621 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,572,325 | BOYAmt |
| EOY | $1,896,315 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $142,655,284 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $61,120,857 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,634,633 | BOYAmt |
| EOY | $81,534,427 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $97,871 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,415,411 | BOYAmt |
| EOY | $4,923,926 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $167,329,643 | BOYAmt |
| EOY | $168,140,097 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,209,271 | BOYAmt |
| EOY | $9,971,438 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $85,678 | BOYAmt |
| EOY | $119,812 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,699,287 | BOYAmt |
| EOY | $38,451,427 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,994,236 | BOYAmt |
| EOY | $48,542,677 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $116,315,834 | BOYAmt |
| EOY | $119,588,779 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,573 | BOYAmt |
| EOY | $8,641 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $116,335,407 | BOYAmt |
| EOY | $119,597,420 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $167,329,643 | BOYAmt |
| EOY | $168,140,097 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $4,600,482 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$411,552 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$926,917 | 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 | 0 | 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 | $10,526 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $10,526 | 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 | MEMBER DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION AND THE GEORGIA HOSPITAL ASSOCIATION THAT REPRESENT LOBBYING ACTIVITIES CONDUCTED BY THESE TWO ASSOCIATIONS. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,290,654 | OtherCostOrOtherBasisAmt |
| Book Value | $3,290,654 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $82,824,686 | OtherCostOrOtherBasisAmt |
| Depreciation | $23,818,648 | DepreciationAmt |
| Book Value | $59,006,038 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $55,243,739 | OtherCostOrOtherBasisAmt |
| Depreciation | $36,607,240 | DepreciationAmt |
| Book Value | $18,636,499 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,296,205 | OtherCostOrOtherBasisAmt |
| Depreciation | $694,969 | DepreciationAmt |
| Book Value | $601,236 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $81,534,427 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| PAYABLE TO THIRD PARTIES | $3,244,772 |
| CREDIT BALANCES IN A/R | $928,781 |
| INTERCO. ALLOC. OF TE BOND PROCEEDS | $30,988,179 |
| DUE TO RELATED | $406,682 |
| OTHER CURRENT LIABILITIES | $426,416 |
| LEASES PAYABLE | $2,456,597 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $38,451,427 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE FILING ORGANIZATION IS A SUBSIDIARY ORGANIZATION WITHIN 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. | ExplanationTxt |
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 | $8,026,012 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,026,012 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06510 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,305,702 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,009,354 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,296,348 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05110 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $27,331,714 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,009,354 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $14,322,360 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11620 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,206,411 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,206,411 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00980 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,206,411 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,206,411 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00980 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $28,538,125 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,009,354 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $15,528,771 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12600 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $17,023,627 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $1,845,273 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $25,934,588 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $23,388,140 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $2,546,448 | 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 |
| 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 | Emergency Room24 HrsEmergencyRoom24HrsInd |
|---|---|---|---|---|---|---|---|---|---|
| GORDON HOSPITAL | |||||||||
| 1 | 1035 RED BUD ROAD | CALHOUN | GA | 30701 | WWW.GORDONHOSPITAL.COM | 064-334 | Yes (X) | Yes (X) | Yes (X) |
| MURRAY MEDICAL CENTER | |||||||||
| 2 | 707 OLD DALTON ELLIJAY ROAD | CHATSWORTH | GA | 30705 | WWW.MURRAYMEDICAL.ORG | 105-706 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GORDON 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) | 0 | 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) | WWW.GORDONHOSPITAL.COM/PATIENTS-VISITORS/AFTER-MY-STAY/FINANCIAL-ASSISTANCE | Yes (X) | WWW.GORDONHOSPITAL.COM/PATIENTS-VISITORS/AFTER-MY-STAY/FINANCIAL-ASSISTANCE | Yes (X) | WWW.GORDONHOSPITAL.COM/PATIENTS-VISITORS/AFTER-MY-STAY/FINANCIAL-ASSISTANCE | 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 |
| MURRAY MEDICAL CENTER | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 2 | 0 | Yes (1) | 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) | WWW.MURRAYMEDICAL.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE/ | Yes (X) | WWW.MURRAYMEDICAL.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE/ | Yes (X) | WWW.MURRAYMEDICAL.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE/ | 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 (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| GORDON HOSPITAL | PART V, SECTION B, LINE 5: ADVENTIST HEALTH SYSTEM GEORGIA, INC., DBA GORDON HOSPITAL (GH OR THE HOSPITAL), SERVES GORDON COUNTY RESIDENTS IN NORTHWEST GEORGIA. GH IS A 69-BED COMMUNITY HOSPITAL LOCATED IN CALHOUN, GEORGIA AND IS THE ONLY HOSPITAL LOCATED WITHIN GORDON COUNTY. THE HOSPITAL'S PRIMARY SERVICE AREA INCLUDES ALL ZIP CODES WITHIN GORDON COUNTY. IN 2013, THE POPULATION OF GORDON COUNTY WAS APPROXIMATELY 55,409 WITH AN AVERAGE PER CAPITA INCOME OF APPROXIMATELY $19,175. IN CONDUCTING ITS 2013 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), GH SOLICITED INPUT FROM NUMEROUS STAKEHOLDERS FROM THROUGHOUT GORDON COUNTY IN AN EFFORT TO GAIN A THOROUGH UNDERSTANDING OF THE UNIQUE HEALTH NEEDS IN ITS SERVICE AREA. PRIMARY DATA WAS GATHERED THROUGH INTERVIEWS AND SURVEYS. INTERVIEWS WERE CONDUCTED WITH MULTIPLE STAKEHOLDER GROUPS, INCLUDING MEMBERS OF THE GENERAL PUBLIC, RESIDENTS IN FAIRMOUNT GEORGIA, A MEDICALLY UNDERSERVED AREA, SENIOR CITIZENS, SCHOOL NURSES AND INDIVIDUALS UTILIZING THE LOCAL VOLUNTARY ACTION CENTER'S COMMUNITY KITCHEN. THE GENERAL PUBLIC INTERVIEWS WERE CONDUCTED AT SEVERAL RETAIL LOCATIONS WITHIN THE HOSPITAL'S PRIMARY SERVICE AREA WITH THE INTENT TO SOLICIT INPUT FROM ALL SEGMENTS OF THE POPULATION, INCLUDING YOUNG AND OLD AS WELL AS A WIDE RANGE OF ETHNIC AND ECONOMIC GROUPS. ONE OF THE INTERVIEW LOCATIONS WAS IN THE FAIRMOUNT COMMUNITY (A MEDICALLY UNDERSERVED AREA AS NOTED ABOVE). AS A PART OF ITS EFFORTS TO ENSURE BROAD COMMUNITY-BASED INPUT INTO THE CHNA PROCESS, THE HOSPITAL ESTABLISHED A COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE (CHNAC). THE CHNAC WAS INTENDED TO REPRESENT THE NEEDS OF THE GENERAL COMMUNITY, WITH A PARTICULAR FOCUS ON INCLUDING REPRESENTATIVES OF THE MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS. COMMITTEE MEMBERS INCLUDED BOTH INTERNAL AND COMMUNITY STAKEHOLDERS. EACH MEMBER BROUGHT A UNIQUE PERSPECTIVE OF THE COMMUNITY, AVAILABLE SERVICES AND EXPERTISE IN THEIR FIELD. COMMUNITY MEMBERS OF THE CHNAC REPRESENTED THE FOLLOWING ORGANIZATIONS: - THE GORDON HOSPITAL AUTHORITY; - THE LOCAL CHAMBER OF COMMERCE; AND - THE GORDON COUNTY HEALTH DEPARTMENT. |
| GORDON 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. |
| MURRAY MEDICAL CENTER | PART V, SECTION B, LINE 2: EFFECTIVE MAY 1, 2015, THE FILING ORGANIZATION ENTERED INTO A LEASING ARRANGEMENT WHEREBY THE OPERATING ASSETS OF MURRAY MEDICAL CENTER, A 42-BED ACUTE-CARE HOSPITAL LOCATED IN CHATSWORTH, GA, WERE LEASED BY THE FILING ORGANIZATION FROM THE MURRAY COUNTY MEMORIAL HOSPITAL AUTHORITY. PRIOR TO MAY 1, 2015, MURRAY MEDICAL CENTER WAS OPERATED AS A GOVERNMENTAL HOSPITAL, AND TO THE BEST KNOWLEDGE OF THE FILING ORGANIZATION, WAS NOT ALSO RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3). ACCORDINGLY, MURRAY MEDICAL CENTER DID NOT CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT PURSUANT TO IRC SECTION 501(R) WHILE OWNED AND OPERATED BY THE MURRAY COUNTY MEMORIAL HOSPITAL AUTHORITY. TREAS. REG. SECTION 1.501(R)-3(D) PROVIDES AN EXCEPTION FOR ACQUIRED, NEW AND TERMINATED HOSPITAL FACILITIES WITH RESPECT TO MEETING THE REQUIREMENTS OF IRC SECTION 501(R)(3). ACQUIRED FACILITIES MUST CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT BY THE LAST DAY OF THE ORGANIZATION'S SECOND TAXABLE YEAR BEGINNING AFTER THE DATE ON WHICH THE HOSPITAL FACILITY WAS ACQUIRED. ACCORDINGLY, MURRAY MEDICAL CENTER WILL COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT NO LATER THAN DECEMBER 31, 2017. |
| GORDON HOSPITAL | PART V, SECTION B, LINE 11: GORDON HOSPITAL IS LOCATED IN CALHOUN, GEORGIA. BECAUSE THE COMMUNITY IS VERY SMALL (16,000 PEOPLE), SPECIAL EVENTS, SEMINARS AND SCREENINGS CONTINUE TO BE EFFECTIVE TOOLS TO REACH THE COMMUNITY. IN MOST CASES, PARTICIPATION IN HOSPITAL-SPONSORED EVENTS WAS AT LEAST DOUBLE THE ORIGINAL GOAL. PRIORITY: CANCER 2013 DESCRIPTION OF THE ISSUE: CANCER (INCLUDING ALL TYPES) RANKED NUMBER 1 IN OUR COMMUNITY SURVEY IN GORDON COUNTY. THE STATE OF GEORGIA'S AGE ADJUSTED CANCER DEATHS/100,000 IS 181.8 VS. THE U.S. NATIONAL AVERAGE AT 178.4. THE HEALTHY PEOPLE 2020 GOAL IS 160.6. ALTHOUGH THE LATEST CDC SHOWED THAT GORDON COUNTY'S CANCER RATES HAVE STABILIZED, THEY ARE NOT MEETING THE HP2020 GOALS. THEREFORE, THE COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE (COMPRISED OF COMMUNITY MEMBERS INCLUDING THOSE REPRESENTING LOW-INCOME, MINORITY AND OTHER UNDERSERVED POPULATIONS) BELIEVED CANCER TO BE A HIGH PRIORITY FOR OUR COMMUNITY.2015 UPDATE: BECAUSE CANCER WAS IDENTIFIED AS A TOP NEED, GORDON HOSPITAL HELD FREE EVENTS AND SCREENINGS RELATED TO BREAST CANCER, MELANOMA, PROSTATE, ORAL/HEAD/NECK CANCERS, AND SMOKING CESSATION; 120 PEOPLE WERE SCREENED (THE GOAL WAS 75). THE HOSPITAL REACHED 525 PEOPLE (THE GOAL WAS 75) AT CANCER EDUCATION PROGRAMS THAT INCLUDED UNDERSERVED POPULATIONS, MANY OF WHOM RECEIVE FREE CANCER TREATMENT AT THE HOSPITAL'S NEW HARRIS RADIATION THERAPY CENTER. 111 LOW-COST MAMMOGRAMS WERE OFFERED IN COOPERATION WITH THE HEALTH DEPARTMENT (THE GOAL WAS 75). PRIORITY: ACCESS TO HEALTH CARE2013 DESCRIPTION OF THE ISSUE: ANOTHER PRIORITY IDENTIFIED BY COMMUNITY FEEDBACK IS THE LACK OF AFFORDABLE HEALTH CARE AVAILABLE IN ZIP CODE 30139, WHICH IS THE COMMUNITY OF FAIRMOUNT IN GORDON COUNTY. RECENTLY, A PRIVATELY OWNED CLINIC SHUT ITS DOORS FOR FINANCIAL REASONS AND THE COMMUNITY WAS LEFT WITH NO MEDICAL COVERAGE. THIS AREA IS COMPOSED LARGELY OF SENIORS WHO HAVE LITTLE TO NO PUBLIC TRANSPORTATION, AND MOST PHYSICIANS ARE LOCATED 25-30 MINUTES AWAY. THE NEEDS ASSESSMENT COMMITTEE SAW A NEED TO BRING HEALTH CARE ACCESS TO THAT AREA OF OUR COUNTY. 2015 UPDATE: GORDON HOSPITAL OPENED A PRIMARY CARE CLINIC IN FAIRMOUNT; IT HAD OVER 2,400 PATIENT VISITS IN 2015. IN ADDITION, THE HOSPITAL ACCEPTS REFERRALS FROM FREE AND SLIDING FEE SCALE CLINICS OPERATED BY THE HEALTH DEPARTMENT; THE CLINICS ARE 14-19 MILES FROM FAIRMOUNT. PRIORITY: HEART DISEASE AND STROKE 2013 DESCRIPTION OF THE ISSUE: THE HOSPITAL'S NEEDS ASSESSMENT COMMITTEE ALSO CHOSE HEART DISEASE AND STROKE AS PRIORITY ISSUES. CARDIOVASCULAR DISEASE IS THE NUMBER ONE KILLER IN THE STATE OF GEORGIA. FOR GEORGIA, THE AGE-ADJUSTED DEATH RATE PER 100,000 IS 49.7. IT IS 42.2 NATIONALLY, AND THE HEALTHY PEOPLE 2020 GOAL IS 33.8. THIS RANKED VERY HIGH IN OUR SURVEY DATA, AS WELL AS WITHIN OUR LOCAL INDUSTRY SECTOR (MANUFACTURING, HEAVY AND LIGHT INDUSTRY, AND FLOORING PLANTS). EMPLOYEE HEALTH NURSES AT THE VARIOUS PLANTS WERE MORE CONCERNED WITH EMPLOYEES HAVING HEART ATTACKS THAN WITH GETTING HURT ON THE JOB. BY CHOOSING THIS PRIORITY AND FOCUSING ON HEALTHY EATING, WE HOPE TO REDUCE THE INCIDENCE OF OBESITY AND DIABETES FOR OUR COUNTY AS WELL.2015 UPDATE: GORDON HOSPITAL HELD A NUMBER OF COMMUNITY OUTREACH AND EDUCATION EFFORTS, INCLUDING 1,250 FREE MONTHLY BLOOD PRESSURE SCREENINGS (THE GOAL WAS 400) THROUGHOUT THE COMMUNITY AT LOCATIONS SUCH AS WALMART. PATIENTS WERE REFERRED TO THEIR FAMILY PHYSICIANS OR A HEALTH DEPARTMENT CLINIC. THE HOSPITAL'S THREE CREATION HEALTH EDUCATIONAL PROGRAMS (BASED ON THE TENENTS OF CHOICE, REST, ENVIRONMENT, ACTIVITY, TRUST, INTERPERSONAL RELATIONSHIPS, OUTLOOK AND NUTRITION) HAD 75 GRADUATES. OUR WEEKLY CREATION HEALTH FARMERS MARKET AVERAGED 25 VENDORS AND 150 ATTENDEES PER WEEK DURING THE MONTHS OF JUNE, JULY AND AUGUST. GORDON HOSPITAL HAD PLANNED TO EDUCATE 200 FIFTH-GRADERS IN GORDON COUNTY ON HEALTHY EATING, THE NEED FOR PHYSICAL ACTIVITY, AND THE DANGERS OF TOBACCO. WE CHANGED THE FORMAT TO A HEALTH-FOCUSED BACK-TO-SCHOOL-BLAST AT WHICH WE SAW 500 ELEMENTARY SCHOOL STUDENTS (PLUS THEIR PARENTS), INCLUDING MANY FROM LOW-INCOME FAMILIES. PRIORITY: RESPIRATORY DISEASE AND SMOKING 2013 DESCRIPTION OF THE ISSUE: THE FINAL PRIORITY THAT THE NEEDS ASSESSMENT COMMITTEE CHOSE IS RESPIRATORY DISEASE AND SMOKING. FROM OUR INTERVIEWS, WE HAVE SEEN AN INCREASE IN TEEN SMOKING, WHICH IN TURNS LEADS TO HIGHER INCIDENCES OF RESPIRATORY DISEASES. THIS PRIORITY EMERGED IN BOTH OUR COMMUNITY SURVEY AS WELL AS OUR INTERNAL DATA. ACCORDING TO THE CENTERS FOR DISEASE CONTROL AND PREVENTION, GEORGIA'S PERCENTAGE OF SMOKERS IS 17.6%. THE HEALTHY PEOPLE GOAL IS 12%. THE COMMITTEE BELIEVED THESE TWO ITEMS WERE INTERTWINED AND COULD BE ADDRESSED TOGETHER.2015 UPDATE: THE FOCUS OF THE BREATHE FREE TOBACCO CESSATION PROGRAM (OFFERED AT NO COST) HAS MOVED FROM ONE OF GRADUATION TO PARTICIPATION. THIS ALLOWS ATTENDEES TO BE EXPOSED TO OPTIONS FOR TOBACCO CESSATION AND HELP THEM DETERMINE THEIR READINESS TO QUIT. IN 2015, GORDON HOSPITAL HELD 18 BREATHE FREE CLASSES WITH 118 ATTENDEES. THE HOSPITAL ALSO HELD LUNG DISEASE/COPD SEMINARS TARGETED AT LOW-INCOME POPULATIONS IN GORDON COUNTY; 1,175 PEOPLE PARTICIPATED (THE GOAL WAS 75). PRIORITIES CONSIDERED BUT NOT SELECTED SUBSTANCE ABUSE (DRUGS) RANKED HIGH IN OUR COMMUNITY SURVEYS. THE HOSPITAL SUPPORTS EXISTING COMMUNITY PROGRAMS INCLUDING THE DRUGS DON'T WORK PROGRAM, RED RIBBON WEEK, FAMILY INTERVENTION SPECIALISTS, AND DRUG TAKE BACK PROGRAM. WE DO NOT OFFER DRUG REHABILITATION SERVICES BUT CAN HELP COMMUNITY PARTNERS WORK UPSTREAM TO PREVENT OR DECREASE ADDICTIONS.MATERNAL, INFANT AND CHILD HEALTH AND UNPROTECTED SEXUAL ACTIVITY RANKED HIGH IN OUR SURVEY. COMMUNITY PROGRAMS ARE OFFERED THROUGH THE BOYS AND GIRLS CLUB, THE TEEN HEALTH TASK FORCE, AND FAMILY INTERVENTION SPECIALISTS. THE HOSPITAL WORKS WITH THE HEALTHY FAMILIES PROGRAM AFTER A CHILD IS BORN. THIS ISSUE OF UNPROTECTED SEXUAL ACTIVITY IS NOT WITHIN THE HOSPITAL'S AREAS OF EXPERTISE; THE HEALTH DEPARTMENT HANDLES THIS ISSUE. |
| GORDON 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. |
| MURRAY MEDICAL CENTER | 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 USED THE PROSPECTIVE MEDICARE OR MEDICAID METHOD TO DETERMINE ITS AMOUNTS GENERALLY BILLED (AGB) PERCENTAGE. |
| PART V, SECTION B, LINE 7A | URL FOR HOSPITAL'S CHNA: WWW.GORDONHOSPITAL.COM/ABOUT-US/COMMUNITY-BENEFIT |
| PART V, SECTION B, LINE 10A | URL FOR THE HOSPITAL FACILITY'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY: WWW.GORDONHOSPITAL.COM/ABOUT-US/COMMUNITY-BENEFIT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 16 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (16 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - GORDON HOSPITAL OWASA FAMILY MEDICINE | ||||
| 109 HOSPITAL COURT | CALHOUN | GA | 30701 | PHYSICIAN CLINIC - FAMILY PRACTICE |
| 2 - GORDON HOSPITAL INTERNAL & FAMILY MEDICI | ||||
| 400 TIMMS RD | CALHOUN | GA | 30701 | PHYSICIAN CLINIC - FAMILY PRACTICE |
| 3 - NORTH GEORGIA ORTHOPEDIC & SPORTS MEDICI | ||||
| 106 HOSPITAL COURT | CALHOUN | GA | 30701 | PHYSICIAN CLINIC - ORTHOPEDIC |
| 4 - GORDON HOME CARE | ||||
| 104 HOSPITAL COURT | CALHOUN | GA | 30701 | HOME HEALTH SERVICES |
| 5 - GORDON HEALTH DEPOT | ||||
| 824 GI MADDOX PARKWAY | CHATSWORTH | GA | 30705 | PHYSICIAN CLINIC - FAMILY PRACTICE |
| 6 - GORDON ADULT & PEDIATRIC MEDICAL ASSOC | ||||
| 815 CURTIS PARKWAY SE | CALHOUN | GA | 30701 | PHYSICIAN CLINIC - INTERNAL & PEDIATRIC |
| 7 - AMBULANCE SERVICE | ||||
| 101 PROFESSIONAL COURT | CALHOUN | GA | 30701 | AMBULANCE SERVICE |
| 8 - GORDON URGENT CARE - CALHOUN | ||||
| 100 HOSPITAL COURT | CALHOUN | GA | 30701 | PHYSICIAN CLINIC - FAMILY PRACTICE |
| 9 - GORDON HOSPITAL ADAIRSVILLE FAMILY MEDIC | ||||
| 6000 JOE FRANK HARRIS PKWY NW | ADAIRSVILLE | GA | 30103 | PHYSICIAN CLINIC - FAMILY PRACTICE |
| 10 - AMBULANCE SERVICE | ||||
| 104 HOSPITAL DRIVE | CHATSWORTH | GA | 30705 | AMBULANCE SERVICE |
| 11 - NORTHWEST GEORGIA OB GYN | ||||
| 110 HOSPITAL COURT | CALHOUN | GA | 30701 | PHYSICIAN CLINIC - OB GYN |
| 12 - NORTH GEORGIA CANCER CENTER | ||||
| 100 WILLOWBROOK WAY | CALHOUN | GA | 30701 | PHYSICIAN CLINIC |
| 13 - GORDON NEUROLOGY | ||||
| 400 TIMMS RD | CALHOUN | GA | 30701 | PHYSICIAN CLINIC - NEUROLOGIST |
| 14 - GORDON HOSPITAL FAIRMOUNT FAMILY MEDICIN | ||||
| 2712 HWY 411 | FAIRMOUNT | GA | 30139 | PHYSICIAN CLINIC - FAMILY PRACTICE |
| 15 - GORDON HOSPITAL COOK FAMILY PRACTICE | ||||
| 100 HOSPITAL DRIVE | CHATSWORTH | GA | 30705 | PHYSICIAN CLINIC - FAMILY PRACTICE |
| 16 - GORDON URGENT CARE - ADAIRSVILLE | ||||
| 7427 HIGHWAY 140 NW | ADAIRSVILLE | GA | 30103 | PHYSICIAN CLINIC - FAMILY PRACTICE |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 6A: | THE FILING ORGANIZATION WAS A WHOLLY OWNED SUBSIDIARY OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC) DURING ITS CURRENT TAX YEAR. DURING THE CURRENT YEAR, AHSSHC SERVED AS A PARENT ORGANIZATION TO 23 TAX-EXEMPT 501(C)(3) HOSPITAL ORGANIZATIONS THAT OPERATED 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 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. |
| 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 COMPETE 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 COMPETE 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: $ 2,546,448- DIFFERENCE IN COSTING METHODOLOGY: (9,494,341)- UNREIMBURSED COSTS INCURRED FOR SERVICES PROVIDED TO MEDICARE PATIENTS THAT ARE NOT INCLUDED IN THE ORGANIZATION'S MEDICARE COST REPORT: (3,900,103) -------------TOTAL SURPLUS/(SHORTFALL) COSTS OF SERVING ALL MEDICARE PATIENTS PER THE FILING ORGANIZATION'S COMMUNITY BENEFIT REPORTING: $(10,847,996)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: | PRIOR TO MAY 1, 2015, THE FILING ORGANIZATION OPERATED A SINGLE HOSPITAL FACILITY KNOWN AS GORDON HOSPITAL. EFFECTIVE 5/1/15, THE FILING ORGANIZATION BEGAN LEASING THE HOSPITAL OPERATIONAL ASSETS OF A HOSPITAL KNOWN AS MURRAY MEDICAL CENTER. MURRAY MEDICAL CENTER WAS PREVIOUSLY OWNED AND OPERATED BY THE MURRAY COUNTY MEMORIAL HOSPITAL AUTHORITY AND WAS A GOVERNMENTAL HOSPITAL.AS REPORTED IN SCHEDULE H, PART V, SECTION B, LINES 1-8 FOR GORDON HOSPITAL (GH), THE HOSPITAL CONDUCTED ITS INITIAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING 2013. ITS INITIAL CHNA WAS ADOPTED BY ITS GOVERNING BOARD BY DECEMBER 31, 2013, THE END OF GH'S TAXABLE YEAR IN WHICH IT CONDUCTED THE CHNA. GH'S INITIAL 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 COMMUNITY.SUCH PRACTICES AND PROCESSES INVOLVE THE FOLLOWING:1. HOSPITAL OPERATING/COMMUNITY BOARDS COMPOSED OF INDIVIDUALS BROADLY REPRESENTATIVE OF THE COMMUNITY, COMMUNITY LEADERS, AND THOSE WITH SPECIALIZED MEDICAL TRAINING AND EXPERTISE;2. POST-DISCHARGE PATIENT FOLLOW-UP RELATED TO THE ON-GOING CARE AND TREATMENT OF PATIENTS WHO SUFFER FROM CHRONIC DISEASES; 3. SPONSORSHIP AND PARTICIPATION IN COMMUNITY HEALTH AND WELLNESS ACTIVITIES THAT REACH A BROAD SPECTRUM OF THE FILING ORGANIZATION'S 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 THE HOSPITAL FACILITYS' FINANCIAL COUNSELORS ARE PROMINENTLY AND CONSPICUOUSLY POSTED ON THE FILING ORGANIZATION'S HOSPITAL FACILITY'S 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 FACILITY'S WEBSITE ADDRESS 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 THE HOSPITAL FACILITY'S FAP, FAA FORM AND PLS ARE AVAILABLE UPON REQUEST AND WITHOUT CHARGE, BOTH IN PUBLIC LOCATIONS IN THE HOSPITAL FACILITY AND BY MAIL. THE FILING ORGANIZATION'S HOSPITAL FACILITYS' FINANCIAL COUNSELORS SEEK TO PROVIDE PERSONAL FINANCIAL COUNSELING TO ALL INDIVIDUALS ADMITTED TO THE HOSPITAL FACILITY WHO ARE CLASSIFIED AS SELF-PAY DURING THE COURSE OF THEIR HOSPITAL STAY OR AT TIME OF DISCHARGE TO EXPLAIN THE FAP AND FAA FORM AND TO PROVIDE INFORMATION CONCERNING OTHER SOURCES OF ASSISTANCE THAT MAY BE AVAILABLE, SUCH AS MEDICAID. A COPY OF THE HOSPITAL FACILITY'S PLS AND FAA FORM IS DISTRIBUTED TO EVERY INDIVIDUAL BEFORE DISCHARGE FROM THE HOSPITAL FACILITY. A CONSPICUOUS WRITTEN NOTICE IS INCLUDED ON ALL BILLING STATEMENTS SENT TO PATIENTS THAT NOTIFIES AND INFORMS RECIPIENTS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, INCLUDING THE FOLLOWING: 1) THE TELEPHONE NUMBER OF THE HOSPITAL FACILITY'S OFFICE OR DEPARTMENT THAT CAN PROVIDE INFORMATION ABOUT THE FAP AND THE FAA FORM; AND 2) THE WEBSITE ADDRESS WHERE COPIES OF THE FAP, FAA FORM AND PLS MAY BE OBTAINED. REASONABLE ATTEMPTS ARE MADE TO INFORM INDIVIDUALS ABOUT THE HOSPITAL FACILITY'S FAP IN ALL ORAL COMMUNICATIONS REGARDING THE AMOUNT DUE FOR THE INDIVIDUAL'S CARE. |
| PART VI, LINE 4: | ADVENTIST HEALTH SYSTEM GEORGIA, INC., D/B/A GORDON HOSPITAL (GH), IS A 69-BED COMMUNITY HOSPITAL THAT SERVES THE RESIDENTS OF CALHOUN, GORDON COUNTY AND SURROUNDING AREAS IN GEORGIA. THE HOSPITAL'S PRIMARY MARKET HAS A POPULATION OF APPROXIAMTELY 74,512, WITH AN ESTIMATED 8,743 OVER THE AGE OF 65. GORDON HOSPITAL PROVIDES THE FOLLOWING SERVICES TO ITS COMMUNITY: A 24-HOUR EMERGENCY CENTER, AMBULANCE SERVICE, REHABILITATION SERVICES, INTENSIVE AND PROGRESSIVE CARE UNITS, CANCER RESOURCE CENTER, RADIOLOGY, INTERVENTIONAL RADIOLOGY, LAB, CARDIOPULMONARY, SLEEP DISORDERS CENTER, NEW BEGINNINGS MATERNITY CENTER, URGENT CARE CENTERS, ORTHOPEDIC SURGERY, OPTHALMOLOGY SURGERY, AND PASTORAL CARE. IN 2009, THE HOSPITAL OPENED A NEW DIAGNOSTIC CARDIAC CATHETERIZATION LAB. THE HOSPITAL IS THE ONLY HOSPITAL IN NORTHWEST GEORGIA TO BE AN ACCREDITED BREAST IMAGING CENTER OF EXCELLENCE. IN NOVEMBER 2012, THE HOSPITAL OPENED A RADIATION ONCOLOGY CENTER THAT FOR THE FIRST TIME PROVIDES THIS SERVICE WITHIN THE COMMUNITY. THE PER CAPITA INCOME, BASED ON POPULATION, IN GORDON COUNTY IS APPROXIMATELY $19,176. HIGH SCHOOL GRADUATES ACCOUNT FOR APPROXIMATELY 74.4% OF THE PRIMARY MARKET. IT IS ESTIMATED THAT 19.9% OF THE INDIVIDUALS RESIDING IN THE PRIMARY MARKET LIVE BELOW THE POVERTY LEVEL AND THE UNEMPLOYMENT RATE IS ABOUT 7%. IN ADDITION, THE UNINSURED POPULATION IN GORDON COUNTY IS 31.38%.APPROXIMATELY 58.9% OF THE GH'S PATIENTS DURING 2015 WERE COVERED BY MEDICARE AND MEDICAID. MEDICARE PATIENTS COMPRISE ABOUT 44.1% OF GH'S PATIENTS. APPROXIMATELY 14.8% OF GH'S PATIENTS ARE COVERED BY THE MEDICAID PROGRAM, 9.7% REPRESENT SELF-PAY, WITH THE REMAINING 31.4% IN COMMERCIAL PAYORS. APPROXIMATELY 65.3% OF GH'S IN-PATIENTS ARE ADMITTED THROUGH GH'S EMERGENCY DEPARTMENT.ADVENTIST HEALTH SYSTEM GEORGIA, INC., D/B/A MURRAY MEDICAL CENTER (MMC), IS A 42-BED COMMUNITY HOSPITAL THAT SERVES THE RESIDENTS OF CHATSWORTH, MURRAY COUNTY AND SURROUNDING AREAS IN GEORGIA. MMC'S PRIMARY MARKET HAS A POPULATION OF APPROXIAMTELY 108,603, WITH AN ESTIMATED 12,822 OVER THE AGE OF 65. THE PER CAPITA INCOME, BASED ON POPULATION, IN MURRAY COUNTY IS APPROXIMATELY $16,448. HIGH SCHOOL GRADUATES ACCOUNT FOR APPROXIMATELY 65.5% OF THE PRIMARY MARKET. IT IS ESTIMATED THAT 23.3% OF THE INDIVIDUALS RESIDING IN THE PRIMARY MARKET LIVE BELOW THE POVERTY LEVEL AND THE UNEMPLOYMENT RATE IS ABOUT 7.9%. IN ADDITION, THE UNINSURED POPULATION IN MURRAY COUNTY IS 29.81%.APPROXIMATELY 54.4% OF MMC'S PATIENTS FROM MAY 1 - DECEMBER 31,2015 WERE COVERED BY MEDICARE AND MEDICAID. MEDICARE PATIENTS COMPRISED ABOUT 37.2% OF THESE PATIENTS AND APPROXIMATELY 17.2% WERE COVERED BY THE MEDICAID PROGRAM. 24.2% OF MMC'S PATIENTS FROM MAY 1 - DECEMBER 31, 2015 WERE SELF-PAY, WITH THE REMAINING 21.4% IN COMMERCIAL PAYORS. APPROXIMATELY 85.9% OF MMC'S IN-PATIENTS FROM 5/1 - 12/31/15 WERE ADMITTED THROUGH MMC'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 COMMUNITIES 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 $160,815 OF BENEFIT WITH RESPECT TO THE FAITH-BASED AND SPIRITUAL NEEDS OF ITS COMMUNITIES IN CONJUNCTION WITH ITS OPERATION OF COMMUNITY HOSPITALS. THE FILING ORGANIZATION ALSO PROVIDES BENEFITS TO ITS COMMUNITYS' INFRASTRUCTURES BY INVESTING IN CAPITAL IMPROVEMENTS TO ENSURE THAT FACILITIES AND TECHNOLOGY PROVIDE THE BEST POSSIBLE CARE TO THE COMMUNITIES. DURING THE CURRENT YEAR, THE FILING ORGANIZATION EXPENDED $26,290,051 IN NEW CAPITAL IMPROVEMENTS. AS FAITH-BASED MISSION-DRIVEN COMMUNITY HOSPITALS, THE HOSPITALS ARE CONTINUALLY INVOLVED IN MONITORING THEIR 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 COMMUNITY IT SERVES. THE READER OF THIS FORM 990 SHOULD KEEP IN MIND THAT THIS REPORTING ENTITY MAY DIFFER IN CERTAIN AREAS FROM THAT OF A STAND-ALONE HOSPITAL ORGANIZATION DUE TO ITS INCLUSION IN A LARGER SYSTEM OF HEALTHCARE ORGANIZATIONS. AS A PART OF A SYSTEM OF HOSPITAL AND OTHER HEALTH CARE ORGANIZATIONS, THE FILING ORGANIZATION BENEFITS FROM REDUCED COSTS DUE TO SYSTEM EFFICIENCIES, SUCH AS LARGE GROUP PURCHASING DISCOUNTS, AND THE AVAILABILITY OF INTERNAL RESOURCES SUCH AS INTERNAL LEGAL COUNSEL. EACH 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: | THE ANNUAL COMMUNITY BENEFIT REPORT CONTAINED IN THE ANNUAL REPORT PREPARED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC) ON BEHALF OF THE ENTIRE AHS SYSTEM OF HEALTHCARE ORGANIZATION IS NOT FILED WITH ANY STATE AGENCIES. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Non Cash AssistanceNonCashAssistanceAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc | Purpose Of GrantPurposeOfGrantTxt | Cash GrantCashGrantAmt |
|---|---|---|---|---|---|---|---|---|---|---|
| SUNSYSTEM DEVELOPMENT CORPORATION DBA GORDON HOSPITAL FOUNDATION | ||||||||||
| 1035 RED BUD ROAD | CALHOUN | GA | 30701 | 592219301 | 501(C)(3) | $36,508 | COST | GENERAL ADMINISTRATIVE SUPPORT | PROVISION OF GENERAL ADMINISTRATIVE SUPPORT | |
| NORTHWEST GEORGIA REGIONAL CANCER COALITION | ||||||||||
| 96 E CALLAHAN STREET SUITE 479-01 | ROME | GA | 30161 | 020657616 | 501(C)(3) | GENERAL SUPPORT | $10,000 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
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 IRC SECTION 501(C)(3), OR TO OTHER LOCAL CHARITABLE COMMUNITY ORGANIZATIONS, OR TO OTHER 501(C)(3) ORGANIZATIONS THAT ARE A PART OF THE GROUP EXEMPTION RULING ISSUED TO THE GENERAL CONFERENCE OF SEVENTH-DAY ADVENTISTS. ACCORDINGLY, THE FILING ORGANIZATION HAS NOT ESTABLISHED SPECIFIC PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE UNITED STATES AS THE FILING ORGANIZATION DOES NOT HAVE A GRANT MAKING PROGRAM THAT WOULD NECESSITATE SUCH PROCEDURES. | 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 |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (1) | 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 (15 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PETER WEBER | ||||||||||||||
| CEO/DIR/SECRETARY | $0 | $483,799 | $0 | $140,570 | $0 | $218,731 | $0 | $82,797 | $0 | $44,012 | $0 | $969,909 | $0 | $47,928 |
| RICHARD REINER | ||||||||||||||
| CHAIRMAN/DIR (END 5/15) | $0 | $556,753 | $0 | $330,569 | $0 | $197,546 | $0 | $14,388 | $0 | $48,451 | $0 | $1,147,707 | $0 | $0 |
| BRENT BOX MD | ||||||||||||||
| CMO/DIRECTOR | $334,440 | $0 | $33,093 | $0 | $10,582 | $0 | $14,388 | $0 | $28,444 | $0 | $420,947 | $0 | $0 | $0 |
| RANDALL HAFFNER PHD | ||||||||||||||
| CHAIRMAN/DIR (BEG 5/15) | $0 | $729,373 | $0 | $0 | $0 | $1,106,046 | $0 | $156,563 | $0 | $86,147 | $0 | $2,078,129 | $0 | $0 |
| PAUL LEBLANC MD | ||||||||||||||
| DIRECTOR | $209,422 | $0 | $29,216 | $0 | $7,302 | $0 | $13,131 | $0 | $17,247 | $0 | $276,318 | $0 | $0 | $0 |
| MAX PARROTT MD | ||||||||||||||
| CMO/DIRECTOR | $269,542 | $0 | $22,094 | $0 | $4,832 | $0 | $14,388 | $0 | $835 | $0 | $311,691 | $0 | $0 | $0 |
| CORY REEVES | ||||||||||||||
| CFO | $0 | $278,952 | $0 | $51,199 | $0 | $24,044 | $0 | $33,387 | $0 | $40,502 | $0 | $428,084 | $0 | $0 |
| AMELIA D JORDON | ||||||||||||||
| CNO | $0 | $182,758 | $0 | $35,539 | $0 | $17,334 | $0 | $7,526 | $0 | $39,833 | $0 | $282,990 | $0 | $0 |
| BRANDON NUDD | ||||||||||||||
| COO | $0 | $173,996 | $0 | $22,001 | $0 | $25,351 | $0 | $11,028 | $0 | $38,973 | $0 | $271,349 | $0 | $0 |
| STEPHEN KING MD | ||||||||||||||
| PHYSICIAN | $798,954 | $0 | $63,571 | $0 | $9,271 | $0 | $14,388 | $0 | $27,721 | $0 | $913,905 | $0 | $0 | $0 |
| JAMES ERIC TURNER MD | ||||||||||||||
| PHYSICIAN | $701,857 | $0 | $59,570 | $0 | $7,902 | $0 | $14,388 | $0 | $26,962 | $0 | $810,679 | $0 | $0 | $0 |
| ANDREW HESTER MD | ||||||||||||||
| PHYSICIAN | $601,865 | $0 | $91,473 | $0 | $17,113 | $0 | $9,088 | $0 | $29,584 | $0 | $749,123 | $0 | $0 | $0 |
| DANIEL AHN MD | ||||||||||||||
| PHYSICIAN | $407,441 | $0 | $241,538 | $0 | $9,482 | $0 | $14,388 | $0 | $26,144 | $0 | $698,993 | $0 | $0 | $0 |
| CYNTHIA BROWN MD | ||||||||||||||
| PHYSICIAN | $383,345 | $0 | $8,703 | $0 | $8,186 | $0 | $14,388 | $0 | $27,533 | $0 | $442,155 | $0 | $0 | $0 |
| SAM HUENERGARDT | ||||||||||||||
| FORMER COO | $0 | $167,782 | $0 | $57,358 | $0 | $79,479 | $0 | $12,671 | $0 | $23,355 | $0 | $340,645 | $0 | $53,179 |
Supplemental Information Detail SupplementalInformationDetail (4 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: AHSSHC HAS A CORPORATE EXECUTIVE POLICY THAT ADDRESSES ASSISTANCE TO EXECUTIVES WHO HAVE BEEN RELOCATED BY THE COMPANY DURING THE YEAR. RELOCATION ASSISTANCE PROVIDED TO EXECUTIVES MAY INCLUDE RELOCATION ALLOWANCES TO ASSIST WITH DUPLICATE HOUSING EXPENSES. RELOCATION ASSISTANCE IS ADMINISTERED PER AHSSHC POLICY BY AN EXTERNAL RELOCATION COMPANY. ANY TAXABLE REIMBURSEMENTS MADE TO EXECUTIVES IN CONNECTION WITH RELOCATION ASSISTANCE ARE TREATED AS WAGES TO THE EXECUTIVE AND ARE SUBJECT TO ALL PAYROLL WITHHOLDING AND REPORTING REQUIREMENTS. |
| PART I, LINE 3 | THE INDIVIDUAL WHO SERVES AS THE CEO OF THE FILING ORGANIZATION IS 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, 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 AHSSHC BOARD COMPENSATION COMMITTEE, AN INDEPENDENT COMMITTEE OF THE BOARD OF DIRECTORS OF AHSSHC. ANY FUNDS THAT REMAIN AFTER THE COST OF MANDATORY AND ELECTIVE BENEFITS ARE SUBTRACTED FROM THE ANNUAL PRE-DETERMINED BENEFITS ALLOWANCE ARE CONTRIBUTED, AT THE EMPLOYEE'S OPTION, TO EITHER AN IRC 457(F) DEFERRED COMPENSATION ACCOUNT OR TO AN IRC 457(B) ELIGIBLE DEFERRED COMPENSATION PLAN. UPON ATTAINMENT OF AGE 65, ALL PREVIOUS 457(F) DEFERRED AMOUNTS ARE PAID IMMEDIATELY TO THE PARTICIPANT AND ANY FUTURE EMPLOYER CONTRIBUTIONS ARE MADE QUARTERLY FROM THE PLAN DIRECTLY TO THE PARTICIPANT. THE PLAN DOCUMENTS DEFINE AN EMPLOYEE WHO IS ELIGIBLE TO PARTICIPATE IN THE PLAN TO GENERALLY INCLUDE THE CHIEF EXECUTIVE OFFICERS OF 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 ------------------------------------------------------- RICHARD REINER $ 109,965 $ 91,965 $ 0 $ 0 PETER WEBER $ 68,410 $ 57,469 $133,310 $ 0 CORY REEVES $ 18,999 $ 0 $ 0 $ 0 RANDALL HAFFNER $ 142,176 $ 0 $998,147 $ 0 SAM HUENERGARDT $ 8,966 $ 55,445 $ 0 $37,931 *INCLUDING INVESTMENT EARNINGS |
| PART I, LINE 6 | THE FILING ORGANIZATION'S PHYSICIAN COMPENSATION FORMULA IS DESIGNED TO RESULT IN TOTAL COMPENSATION THAT WOULD BE REASONABLE FOR EACH PHYSICIAN. THE FILING ORGANIZATION UTILIZES NATIONAL SURVEY PRODUCTIVITY, COST, AND COMPENSATION DATA IN FORMULATING ALL ASPECTS OF THE COMPENSATION PLAN. PHYSICIAN COMPENSATION CONTRACTUAL AGREEMENTS INCLUDE A CEILING OR REASONABLE MAXIMUM ON THE AMOUNT A PHYSICIAN MAY EARN. THE FILING ORGANIZATION'S EMPLOYED PHYSICIANS ENTER INTO A WRITTEN AGREEMENT THAT REQUIRES THE PHYSICIANS TO PROVIDE MEDICAL CARE TO INDIVIDUALS WHO ARE REFERRED BY THE FILING ORGANIZATION. THE FILING ORGANIZATION'S COMPENSATION ARRANGEMENT DOES NOT USE A METHOD OF COMPENSATION THAT IS BASED UPON A PERCENTAGE OF THE ORGANIZATION'S NET INCOME. UNDER THE COMPENSATION ARRANGEMENT, PHYSICIAN BASE SALARY, INCLUDING ANY ADDITIONAL COMPENSATION BASED ON A PERCENTAGE OF THE PRACTICE/LOCATION NET REVENUE, IS DOCUMENTED AS BEING WITHIN A RANGE OF FAIR MARKET VALUE. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (5 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| JUDY FEHLENBERG | |||
| SPOUSE OF BOARD MEMBER | $27,413 | EMPLOYEE COMPENSATION | 0 |
| BROOKE FEHLENBERG | |||
| FAMILY MEMBER OF BOARD MEMBER | $20,059 | EMPLOYEE COMPENSATION | 0 |
| NORTHWEST GEORGIA SURGICAL ASSOCIATES PC | |||
| 33% OWNED BY BOARD MEMBER FAMILY MEMBER | $365,000 | CONTRACTED ON-CALL SERVICES | 0 |
| JEMGLEN LLLP | |||
| 50% OWNED BY BOARD MEMBER | $261,675 | LEASE AGREEMENT | 0 |
| NORTHWEST GEORGIA MEDICAL PARK LLC | |||
| 45% OWNED BY BOARD MEMBERS | $613,450 | LEASE AGREEMENT | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | BRENT BOX AND MAX PARROTT - BUSINESS RELATIONSHIP |
| FORM 990, PART VI, SECTION A, LINE 4 | EFFECTIVE MAY 1, 2015, THE FILING ORGANIZATION ENTERED INTO A LEASING AGREEMENT WHEREBY THE OPERATING ASSETS OF MURRAY MEDICAL CENTER, A 42-BED ACUTE-CARE HOSPITAL LOCATED IN CHATSWORTH, GEORGIA, WERE LEASED BY THE FILING ORGANIZATION FROM THE MURRAY COUNTY MEMORIAL HOSPITAL AUTHORITY. AS A RESULT OF THIS LEASING ARRANGEMENT AND THE ADDITION OF A SECOND HOSPITAL OPERATION TO THE FILING ORGANIZATION, THE BYLAWS OF THE FILING ORGANIZATION WERE AMENDED IN 2015. THE PURPOSES CLAUSE OF THE BYLAWS WAS AMENDED TO PROVIDE THAT THE FILING ORGANIZATION OPERATES TWO HOSPITALS, NAMELY GORDON HOSPITAL AND MURRAY MEDICAL CENTER. ARTICLE 3.1 OF THE BYLAWS WAS AMENDED TO PROVIDE THAT THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION SHALL SERVICE AS THE BOARD OF DIRECTORS OF GORDON HOSPITAL. NEW ARTICLE VIII OF THE BYLAWS DISCUSSES THE GOVERNANCE AND MANAGEMENT OF MURRAY MEDICAL CENTER. UNDER ARTICLE VII, THE MEMBERSHIP OF THE FILING ORGANIZATION IS TO APPOINT A HOSPITAL BOARD TO OVERSEE THE OPERATIONS OF MURRAY MEDICAL CENTER (MMC). THE MEMBERSHIP SHALL ELECT THE VOTING MEMBERS OF THE MMC HOSPITAL BOARD AND WILL DETERMINE THE NUMBER OF MEMBERS OF THE HOSPITAL BOARD. THE DUTIES OF THE MMC HOSPITAL BOARD ARE IDENTICAL TO THOSE OUTLINED FOR THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION BUT ARE SPECIFIC ONLY TO MMC. ARTICLE VIII PROVIDES FOR AN INDIVIDUAL TO SERVE AS THE CEO OF MMC WITH RESPONSIBILITY FOR OVERSEEING ALL OPERATIONS OF MMC. ARTICLE VIII ALSO PROVIDES THAT THE MMC HOSPITAL BOARD SHALL ORGANIZE A MEDICAL STAFF UNDER MEDICAL STAFF BYLAWS, SUCH BYLAWS TO BE APPROVED BY THE MMC HOSPITAL BOARD. THE AMENDED BYLAWS PROVIDE THAT BOTH THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION AND THE MMC HOSPITAL BOARD MAY MAKE RECOMMENDATIONS FOR CHANGES TO THE FILING ORGANIZATION'S BYLAWS, ANY SUCH CHANGES MUST BE APPROVED BY THE FILING ORGANIZATION'S MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 6 | ADVENTIST HEALTH SYSTEM GEORGIA, INC. (THE FILING ORGANIZATION) HAS ONE MEMBER. THE SOLE MEMBER OF THE FILING ORGANIZATION IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION. ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC) IS A FLORIDA, NOT-FOR-PROFIT CORPORATION THAT IS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3). THERE ARE NO OTHER CLASSES OF MEMBERSHIP IN THE FILING ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE SOLE MEMBER OF THE FILING ORGANIZATION IS AHSSHC. THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION ARE APPOINTED BY THE SOLE MEMBER, AHSSHC, WHO HAS THE RIGHT TO ELECT, APPOINT OR REMOVE ANY MEMBER OF THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7B | AHSSHC, AS THE SOLE MEMBER OF THE FILING ORGANIZATION, HAS CERTAIN RESERVED POWERS AS SET FORTH IN THE BYLAWS OF THE FILING ORGANIZATION. THESE RESERVED POWERS INCLUDE THE FOLLOWING: A) TO APPROVE AND DISAPPROVE THE EXECUTIVE AND/OR ADMINISTRATIVE LEADERSHIP OF THE FILING ORGANIZATION, AND THEIR SALARIES; B) TO ADOPT, AMEND, RESTATE, AND REPEAL THE ARTICLES OF INCORPORATION OR BYLAWS OF THE FILING ORGANIZATION, AND THE MEDICAL STAFF BYLAWS; C) TO SET LIMITS AND TERMS FOR THE BORROWING OF FUNDS; D) TO APPROVE OR DISAPPROVE MAJOR BUILDING PROGRAMS AND/OR PURCHASE OR SALE OF PERSONAL PROPERTY OR REAL PROPERTY EQUAL TO OR IN EXCESS OF ONE MILLION DOLLARS; E) TO APPROVE OR DISAPPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE FILING ORGANIZATION; F) TO DIRECT THE PLACEMENT OF FUNDS AND CAPITAL OF THE FILING ORGANIZATION; G) TO ESTABLISH GENERAL GUIDING POLICIES, TO IMPLEMENT QUALITY ASSESSMENT, IMPROVEMENT AND UTILIZATION REVIEW PROGRAMS; H) TO APPROVE THE APPOINTMENT OF AN AUDITING FIRM AND ELECTION OF THE FISCAL YEAR FOR THE FILING ORGANIZATION; AND I) TO ESTABLISH A PROCESS FOR ADDRESSING PATIENT GRIEVANCES. |
| 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 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. |
| FORM 990, PART IX, LINE 11G | PAYMENTS TO HEALTHCARE PROFESSIONALS : PROGRAM SERVICE EXPENSES 2,185,180. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,185,180. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 5,936,476. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,936,476. AHS MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,143,849. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,143,849. EHR MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 462,253. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 462,253. BILLING & COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 891,427. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 891,427. RECRUITING: PROGRAM SERVICE EXPENSES 21,197. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 21,197. PURCHASED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 1,232,504. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,232,504. ENVIRONMENTAL SERVICES: PROGRAM SERVICE EXPENSES 881,074. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 881,074. TRANSCRIPTION SERVICES: PROGRAM SERVICE EXPENSES 154,819. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 154,819. |
| FORM 990, PART XI, LINE 9: | TRANSFER TO TAX-EXEMPT PARENT -600,002. ALLOCATIONS FROM TAX-EXEMPT PARENT WITH RESPECT TO DEBT -28,012. GIFTS 560,548. TRANSFER FOR EXPENSES -252,482. DONATED PROPERTY 27,108. INTERNALLY ALLOCATED SETTLEMENT AMOUNT -634,079. ROUNDING 2. |
| 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 (102 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) | |
| 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 | 0 |
| 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 | Yes (1) | 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 | Yes (1) | 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 | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (12 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| FLETCHER HOSPITAL INC | ||
| M | $811,520 | COST |
| FLETCHER HOSPITAL INC | ||
| L | $128,723 | COST |
| ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION | ||
| M | $753,989 | % OF FACILITIES OPERATING EXPENSE |
| ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION DBA AHS IS | ||
| M | $3,203,926 | % OF FACILITIES OPERATING EXPENSE |
| ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION | ||
| P | $5,519,853 | COST |
| ADVENTIST HEALTH SYSTEMSUNBELT INC | ||
| M | $462,253 | % OF FACILITIES EHR REVENUE |
| ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION | ||
| C | $74,921 | AMOUNT RECEIVED |
| TAKOMA REGIONAL HOSPITAL INC | ||
| L | $67,757 | COST |
| MEMORIAL HOSPITAL INC | ||
| L | $66,613 | COST |
| SUNSYSTEM DEVELOPMENT CORPORATION DBA GORDON HOSPITAL FOUNDATION | ||
| C | $180,151 | AMOUNT RECEIVED |
| ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION | ||
| B | $600,002 | AMOUNT GIVEN |
| ADVENTIST HEALTH SYSTEMSUNBELT INC | ||
| P | $634,079 | INTERNALLY ALLOC. SETTLEMENT AMT. |