2015-11-16T16:04:22-06:00 2014-12-31 990 2014-01-01 592935928 Hospice of the Comforter Inc HOSP 4076820808 480 W Central Parkway Altamonte Springs FL 32714 Ernesto Lopez Assistant Secretary 4076820808 2015-11-16 2014 2016-04-25 22:37:26Z Ernesto Lopez 480 W Central Parkway Altamonte Springs FL 32714 21727887 0 X www.Hospiceofthecomforter.org X 1990 FL To provide compassionate & expert care to hospice patients. 9 5 341 227 0 0 304264 52471 24664907 21669555 69514 5861 0 0 25038685 21727887 10348 6732 0 0 15878275 14058142 0 0 0 13882114 10819439 29770737 24884313 -4732052 -3156426 16908914 6424979 8509436 12674959 8399478 -6249980 X Hospice of the Comforter is compassionate people providing compassionate and expert end of life care. Hospice is guided by the highest ethical principles while caring for the physical, emotional and spiritual needs of the patients and their families facing an incurable illness. 0 0 19848064 6732 21669555 Hospice provides services in Orange, Seminole, and Osceola counties - we were privileged in 2014 to provide end-of-life compassionate care to 2,399 adults and children living in Orange, Seminole and Osceola county and also at Hospice House or Robison Residence on our campus. We keep our promise that no patient will be turned away due to an inability to pay and the generosity of donors in our community provided $214,659 in charity care. In 2014, 341 staff members and 227 active volunteers joined together believing in one mission. Our patients and families believe in our work and we are privileged to believe in our mission first. More information can be found on our website: www.hospiceofthecomforter.org or on our foundation website at www.floridahospital.com/foundation/hospice-comforter. Hospice House - "I don't know what I would have done without Hospice House when my husband needed around the clock care. They are there for him and for me and I will never forget them..." MargieIn 2014, 918 patients were cared for at Hospice House with an average length of stay of 5.0 days. As the only free-standing hospice facility in the Tri-County service community, 16 private suites with a private lanaii welcome patients and families 24 hours a day with a children's area, chapel and cafeteria."Robison Residence - when there is no one or no able caregiver."On a quiet wooded lot is a renovated beautiful home with six private bedrooms for hospice residents greeted by staff and volunteers every day - it's their home. During 2014, 55 hospice patients called Robison Residence home. Horizons Bereavement Center - We are the experts in grief and care for families of our patients for 13 months after a death. This commitment is seen at our Horizon's loss program for adults in 2014 providing 1,324 individual counseling sessions in addition to 149 group sessions offered at no cost to adults regardless of whether their loved one was served by our organization. Children are the "forgotten grievers" and our licensed counselors saw 119 children in addition to providing 40 group sessions, Camp Healing Hearts and public school grief support visits. Bereavement support is not reimbursed and is provided at no cost through the generosity of our community. 19848064 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 44 0 1 341 1 0 0 0 0 0 0 0 0 0 0 X 9 5 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X Jay Oh 4076820808 480 W Central Parkway Altamonte Springs FL 32714 Terry R Owen Chairman (beg 1/1/14) 1.00 50.00 X 0 626776 92592 Suzan Chick Director 1.00 0.00 X 0 0 0 Todd A Goodman Vice Chairman (beg 1/1/14) 1.00 50.00 X 0 497444 76026 Farlen Halikman Director 1.00 0.00 X 0 0 0 Jeff Hurst Director (beg 1/1/14) 1.00 50.00 X 0 461801 68989 Ernesto Lopez CEO/Administrator/Dir (beg 1/1/14) 48.00 2.00 X X 0 172384 41919 Dwan M McAndrews Director 1.00 0.00 X 0 0 0 Raymond Andrew McDonald Director (beg 1/1/14) 1.00 0.20 X 0 200 0 Sandra Randolph Director/Secretary 1.00 2.00 X 0 0 0 Jay Oh CFO 38.00 2.00 X 0 118008 8125 Julius Garner MD Physician 40.00 0.00 X 140018 0 0 Eric Moore MD CMO 40.00 0.00 X 124389 0 15830 Darcey Harnage Admin Dir. - Quality & Safety 40.00 0.00 X 100393 0 7687 Robert G Wilson Former President/CEO/Dir 0.00 0.00 X 0 617636 0 364800 2494249 311168 3 1 1 0 Intell-Intella Triage 781 S Midlothiam Rd 314 Mundelein IL 60060 Service Contracts 239823 Weatherbee Resources Inc 540 Main Street Ste 16B Hyannis MA 02601 Consulting Services 106107 2 52471 52471 Net Patient Service 900099 21374838 21374838 Rent from tax-exempt affiliate 531120 264811 264811 Cafe Sales 900099 14081 14081 15825 15825 21669555 5861 5861 21727887 21669555 0 5861 X 6732 6732 340436 340436 9747246 7940289 1806957 278054 219955 58099 2880906 2318532 562374 811500 641938 169562 469767 469767 1511402 1488976 22426 192799 192799 1074641 229990 844651 11957 11957 1424650 1424650 478291 306062 172229 2796 2796 62271 62271 63741 14141 49600 Room & Board Expense 2889629 2889629 0 0 Medical Supplies 2139055 2139055 0 0 Outpatient Services 163048 163048 0 0 Dues & Licenses 50805 0 50805 0 284587 284587 24884313 19848064 5036249 0 3407 2740989 1049171 1470700 1157473 158943 211202 118157 193028 1112968 122108 459635 990860 15 0 14698057 82256 16908914 6424979 1495737 3297416 2220000 0 4793699 9377543 8509436 12674959 X 8279600 -6249980 119878 0 8399478 -6249980 16908914 6424979 X -3156426 -11493032 X 0 1 X 1 0 X 1724982 1223974 700579 304264 52471 4006270 45397275 37387983 30525878 24664907 21669555 159645598 47122257 38611957 31226457 24969171 21722026 163651868 0 0 0 163651868 298216 417558 62349 5861 783984 298216 417558 62349 5861 783984 10000 10000 47420473 39029515 31298806 24969171 21727887 164445852 0.99520 0.99520 0.00480 0.00470 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 43365 43365 37165 6200 43365 25077 9700 3659 915 356 37165 0 1 1 1108942 122108 986834 4026 4026 990860 Due to Related 9104534 Other liabilities 273009 9377543 X Part V, Line 4: Prior to January 1, 2014, Hospice of the Comforter Foundation, Inc. (HCF), a related organization established to support the operations of Hospice of the Comforter, Inc. held assets in permanent endowment funds. Effective January 1, 2014, the top-tier membership of the HCF was transferred to Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the parent organization of a faith-based healthcare system that operates hospitals, nursing homes, and other healthcare organizations. AHSSHC is exempt from federal income tax under IRC Section 501(c)(3). The immediate parent of HCF prior to and subsequent to the transfer noted above is The Comforter Health Care Group, Inc. (EIN: 27:1857940). The membership of The Comforter Health Care Group, Inc. was transferred to AHSSHC on 1/1/14. The Comforter Health Care Group, Inc. also is the sole member of Hospice of the Comforter, Inc. In connection with the change in membership discussed above, a decision was made to transfer the fund-raising and philanthropic activities formally conducted by the HCF to a brother-sister affiliate that conducts fund-raising and philanthropic activities for a number of tax-exempt hospital organizations whose membership is held by AHSSHC. The brother-sister affiliate, SunSystem Development Corporation (EIN: 59-2219301), is also exempt from federal income tax under IRC Section 501(c)(3). During the months of June and July of 2014, all of the operations previously conducted by HCF ceased and all of the net assets of the HCF were transferred to SunSystem Development Corporation. The permanent endowment in the amount of $43,365 was also transferred to the related 501(c)(3) foundation organization during 2014. Part X, Line 2: The filing organization is part of a consolidated audited financial statement. The consolidated audited financial statement includes the following FIN 48 footnote - The Division follows the Income Taxes Topic of the Accounting Standard Codification (ASC) (ASC 740), which 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, 2014. 0 1 0 0 0 0 0 0 0 Terry R Owen Chairman (beg 1/1/14) 0 417593 0 120667 0 88516 0 59604 0 32988 0 719368 0 38638 Todd A Goodman Vice Chairman (beg 1/1/14) 0 342896 0 83025 0 71523 0 37914 0 38112 0 573470 0 33323 Jeff Hurst Director (beg 1/1/14) 0 322780 0 77771 0 61250 0 35716 0 33273 0 530790 0 18671 Ernesto Lopez CEO/Administrator/Dir (beg 1/1/14) 0 139382 0 26460 0 6542 0 8264 0 33655 0 214303 0 0 Robert G Wilson Former President/CEO/Dir 0 0 0 0 0 617636 0 0 0 0 0 617636 0 0 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 of the filing organization and its supporting organization. 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 Certain members of the Board of Directors of the filing organization 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) for serving in various executive leadership positions. 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 $224,000. 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 ------------------------------------------------------- Todd Goodman $ 41,309 $ 41,539 $0 $0 Jeffery Hurst $ 39,111 $ 23,719 $0 $0 Terry Owen $ 62,999 $ 52,700 $0 $0 * Including Investment Earnings In addition, the individual who served as a Former Officer of the filing organization was compensated by and on the payroll of Comforter Health Care Group, Inc. (CHCG), the sole member of the filing organization. CHCG implemented a Non-Qualified Deferred Compensation Plan (CHCG Plan) in 2007 for certain key executives. This plan was terminated as of January 2014. During 2014, Robert Wilson received payments from the CHCG Plan in the amount of $463,972. The total amount distributed to Mr. Wilson in 2014 was reported as taxable wages and included on Box 1 of his 2014 Form W-2. Form 990, Part VI, Section A, line 4 Effective January 1, 2014, the filing organization became affiliated with Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) and the health ministry of the Seventh-day Adventist Church. The Articles of Incorporation of the filing organization were amended and restated to reflect such affiliation and name The Comforter Health Care Group, Inc. (CHCG) as the sole member. The dissolution clause of the Articles of Incorporation was also amended to provide that, upon dissolution, all remaining assets of the filing organization not applied to liabilities shall be distributed to CHCG, as member, so long as it is recognized by the Internal Revenue Service as a 501(c)(3) organization. The Bylaws of the filing organization were also amended to reflect the affiliation with AHSSHC and to list the reserved powers held by CHCG as the sole member of the filing organiztion. Form 990, Part VI, Section A, line 6 Hospice of the Comforter, Inc. (the filing organization) has one member. The sole member of the filing organization is The Comforter Health Care Group, Inc. (CHCG). CHCG 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 The Comforter Health Care Group, Inc. (CHCG). The Board of Directors of the filing organization are appointed by the sole member, CHCG, 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 CHCG, 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; b) to approve or disapprove the Bylaws of the filing organization; c) to set limits and terms for the borrowing of funds; d) to approve or disapprove major building programs and the 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; h) to implement quality assessment, improvement and utilization review programs; and i) to approve the appointment of an auditing firm for the Hospice Facility and election of the fiscal year for the filing organization. Form 990, Part VI, Section B, line 11 The filing organization's current year Form 990 was reviewed by the CEO and by the CFO prior to its filing with the IRS. The review conducted by the 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 is not compensated by the filing organization. The CEO is 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's governing documents, conflict of interest policy and financial statements are available upon request. Form 990, Part IX, line 11g Contracted Labor: Program service expenses 13,082. Management and general expenses 0. Fundraising expenses 0. Total expenses 13,082. Payments to Healthcare Professionals: Program service expenses 328,384. Management and general expenses 0. Fundraising expenses 0. Total expenses 328,384. Contracted Services: Program service expenses 702,804. Management and general expenses 22,426. Fundraising expenses 0. Total expenses 725,230. Environmental Services: Program service expenses 114,046. Management and general expenses 0. Fundraising expenses 0. Total expenses 114,046. Ambulance Services: Program service expenses 124,562. Management and general expenses 0. Fundraising expenses 0. Total expenses 124,562. Transcription: Program service expenses 10,601. Management and general expenses 0. Fundraising expenses 0. Total expenses 10,601. Therapy Services: Program service expenses 14,247. Management and general expenses 0. Fundraising expenses 0. Total expenses 14,247. Triage Services: Program service expenses 181,250. Management and general expenses 0. Fundraising expenses 0. Total expenses 181,250. Form 990, Part XI, line 9: Forgiveness of Debt owed by tax-exempt parent -14,120,520. Transfer from affiliated tax-exempt organization 2,300,000. Transfer of restricted asset to tax-exempt affiliated Foundation Org. -119,879. Transfer of unrestricted asset to tax-exempt affiliated Foundation Org. -283,707. Tax-exempt affiliated Foundation Support 143,048. Acquisition accounting adjustment 579,174. Other Adjustment 8,855. Rounding -3. Adventist Bolingbrook Hospital 500 Remington Blvd Bolingbrook IL 60440 651219504 Operation of Hospital & Related Services IL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 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 1 Adventist GlenOaks Hospital 701 Winthrop Avenue Glendale Heights IL 60139 363208390 Operation of Hospital & Related Services IL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Adventist Hlth Mid-America Inc 9100 W 74th Street Shawnee Mission KS 66204 521347407 Hlthcare Related Services KS 501(c)(3) Line 11a, I Adventist Hlth SystemSunbelt Inc 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 1 Adventist Hlth System Sunbelt Hlthcare Corp 900 Hope Way Altamonte Springs FL 32714 592170012 Management Services FL 501(c)(3) Line 11a, I N/A 0 Adventist Hlth System Georgia Inc 1035 Red Bud Road Calhoun GA 30701 581425000 Operation of Hospital & Related Services GA 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Adventist Hlth SystemSunbelt Inc 900 Hope Way Altamonte Springs FL 32714 591479658 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Adventist Hlth SystemTexas Inc 11801 S Freeway Burleson TX 36028 742578952 Leasing Personnel to Affiliated Hospital TX 501(c)(3) Line 11c, III-FI Adventist Hlth System Sunbelt Hlthcare Corp 1 ADVENTIST HINSDALE HOSPITAL 120 North Oak Street Hinsdale IL 60521 362276984 Operation of Hospital & Related Services IL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 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 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 Hlth SystemSunbelt Inc 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 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 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 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 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 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 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 1 Central Texas Medical Center Foundation 1301 Wonder World Drive San Marcos TX 78666 742259907 Fund-raising for Tax-exempt hospital TX 501(c)(3) Line 7 0 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 1 Chippewa Valley Hospital & Oakview Care Center Inc 1220 Third Avenue West Durand WI 54736 391365168 Operation of Hospital & Related Services WI 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Cobb Medical Associates LLC 3949 South Cobb Drive SE Smyrna GA 30080 582617089 Operation of Physician Practices & Medical Services GA 501(c)(3) Line 3 Emory-Adventist Inc 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 1 Creekwood Place Nursing & Rehab Center Inc 683 E Third Street Russellville KY 42276 205782260 Operation of Home for the Aged/Hlthcare Delivery KY 501(c)(3) Line 9 Sunbelt Hlth Care Centers Inc 1 Dairy Road Hlth Care Properties Inc 7350 Dairy Road Zephyrhills FL 33540 510605684 Lease to Related Organization GA 501(c)(3) Line 11c, III-FI Sunbelt Hlth Care Centers Inc 1 East Orlando Hlth & Rehab Center Inc 250 S Chickasaw Trail Orlando FL 32825 205774748 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 9 Sunbelt Hlth Care Centers Inc 1 Emory-Adventist Inc 3949 South Cobb Drive Smyrna GA 30080 582171011 Operation of Hospital & Related Svcs GA 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Fletcher Hospital Inc 100 Hospital Drive Hendersonville NC 28792 560543246 Operation of Hospital & Related Svcs NC 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 FLNC Inc 3355 E Semoran Blvd Apopka FL 32703 205774761 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 9 Sunbelt Hlth Care Centers Inc 1 FLORIDA HOSPITAL HEALTHCARE PARTNERS INC 770 West Granada Blvd 101 Ormond Beach FL 32174 462354804 Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Florida Hospital Medical Group Inc 2600 Westhall Ln Maitland FL 32751 593214635 Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Florida Hospital Physician Group Inc 14055 Riveredge Drive Ste 250 Tampa FL 33637 462021581 Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Florida Hospital Waterman Inc 1000 Waterman Way Tavares FL 32778 593140669 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Florida Hospital Zephyrhills Inc 7050 Gall Blvd Zephyrhills FL 33541 592108057 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 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 1 Fountain Inn Nursing & Rehab Center Inc(1024-123114) 602 Courtland St Ste 200 Orlando FL 32804 472180518 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 9 Sunbelt Hlth Care Centers Inc 1 GlenOaks Hospital Foundation 701 Winthrop Avenue Glendale Heights IL 60139 363926044 Fund-raising for Tax-exempt hospital IL 501(c)(3) Line 7 Midwest Hlth Foundation 0 Helen Ellis Memorial Hospital Auxiliary Inc 1395 S Pinellas Ave Tarpon Springs FL 34689 592106043 Fund-raising for Tax-exempt hospital/foundation FL 501(c)(3) Line 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 11c, III-FI 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 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 1 In-Motion Rehab Inc 602 Courtland Street Ste 200 Orlando FL 32804 208023411 Therapy services to tax exempt nursing homes KS 501(c)(3) Line 11b, II Sunbelt Hlth Care Centers Inc 1 Jellico Community Hospital Inc 188 Hospital Lane Jellico TN 37762 620924706 Operation of Hospital & Related Services TN 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 La Grange Memorial Hospital Foundation 5101 S Willow Springs Rd La Grange IL 60525 300247776 Fund-raising for Tax-exempt hospital IL 501(c)(3) Line 7 Midwest Hlth Foundation 0 Lake County Health Care Properties Inc(1017-123114) 602 Courtland St Ste 200 Orlando FL 32804 472179868 Lease to Related Organization FL 501(c)(3) Line 11c, III-FI Sunbelt Hlth Care Centers Inc 1 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 1 Memorial Hospital - West Volusia Inc 701 West Plymouth Avenue Deland FL 32720 593256803 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Memorial Hlth Systems Inc 1 Memorial Hospital Flagler Inc 60 Memorial Medical Parkway Palm Coast FL 32164 592951990 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Memorial Hlth Systems Inc 1 Memorial Hospital Inc 210 Marie Langdon Drive Manchester KY 40962 610594620 Operation of Hospital & Related Services KY 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Merriam Hlth Care Properties Inc 9700 West 62nd Street Merriam KS 66203 364595806 Lease to Related Organization KS 501(c)(3) Line 11c, III-FI Sunbelt Hlth Care Centers Inc 1 Metroplex Adventist Hospital Inc 2201 S Clear Creek Road Killeen TX 76549 742225672 Operation of Hospital & Related Services TX 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Metroplex Clinic Physicians Inc 2201 S Clear Creek Road Killeen TX 76549 113762050 Physician Hlthcare services to the community TX 501(c)(3) Line 3 Metroplex Adventist Hospital Inc 1 Metroplex Hospital Inc 900 Hope Way Altamonte Springs FL 32714 461256516 Future Operation of Hospital & Related Svcs FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Midwest Hlth Foundation 120 North Oak Street Hinsdale IL 60521 352230515 Support of subsidiary Foundations IL 501(c)(3) Line 11b, II N/A 0 Mills Hlth & Rehab Center Inc 500 Beck Lane Mayfield KY 42066 205782320 Operation of Home for the Aged/Hlthcare Delivery KY 501(c)(3) Line 9 Sunbelt Hlth Care Centers Inc 1 Mission Strategies of Georgia Inc 3949 S Cobb Drive Smyrna GA 30080 900866024 Provision of support to the nursing home division GA 501(c)(3) Line 11b, II Sunbelt Hlth Care Centers Inc 1 Missouri Adventist Hlth Inc 9100 W 74th Street Shawnee Mission KS 66204 431224729 Support Hlth Care Services MO 501(c)(3) Line 11d, III-O Adventist Hlth Mid-America Inc 1 North Regional EMS Inc 188 Hospital Lane Jellico TN 37762 262653616 EMS Services TN 501(c)(3) Line 9 Jellico Community Hospital Inc 1 Ormond Beach Memorial Hospital Auxiliary Inc 301 Memorial Medical Parkway Daytona Beach FL 32117 591721962 Volunteer support services FL 501(c)(3) Line 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 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 1 Pasco-Pinellas Hillsborough Community Hlth System Inc 2600 Bruce B Downs Blvd Wesley Chapel FL 33544 208488713 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Portercare Adventist Hlth System (630 Year End) 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 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 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 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 1 Resource Personnel Inc 602 Courtland Street Ste 200 Orlando FL 32804 208040875 Provide administrative support to tax exempt nursing homes FL 501(c)(3) Line 11b, II Sunbelt Hlth Care Centers Inc 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 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 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 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 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 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 1 South Central Inc 900 Hope Way Altamonte Springs FL 32714 593689740 Management Support GA 501(c)(3) Line 11c, III-FI N/A 0 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 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 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 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 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 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 1 Sunbelt Hlth Care Centers Inc 602 Courtland Street Ste 200 Orlando FL 32804 581473135 Management Services TN 501(c)(3) Line 11b, II Adventist Hlth System Sunbelt Hlthcare Corp 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 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 1 TAKOMA REGIONAL HOSPITAL Foundation INC (710-123114) 401 Takoma Ave Greeneville TN 37743 471334302 Fund Raising for Affiliated Tax-Exempt Hospital TN 501(c)(3) Line 7 Takoma Regional Hospital Inc 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 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 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 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 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(1030-123114) 602 Courtland St Ste 200 Orlando FL 32804 472219363 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 9 Sunbelt Hlth Care Centers Inc 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 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 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 1 West Florida Health Home Care Inc fka South Cent Nurs Home Prop(11-1114) PO Box 1289 Tampa FL 33601 593686109 Will be operating Home Health Agency GA 501(c)(3) Line 11d, III-O Adventist Hlth System Sunbelt Hlthcare Corp 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 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 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 1 Appalachian Therapy Services LLC 100 Hospital Drive Hendersonville NC 28792 202463851 Therapy Staffing NC N/A 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 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 Altamonte Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando FL 32803 592855792 Condo Association FL N/A C 1 Apopka Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando FL 32803 593000857 Condo Association FL N/A C 1 CC MOB Inc 2201 S Clear Creek Road Killeen TX 76549 742616875 Real Estate Rental TX N/A C 1 Central Texas Medical Associates 1301 Wonder World Drive San Marcos TX 78666 742729873 Physician Clinics TX N/A C 1 Central Texas Provider's Network 1301 Wonder World Drive San Marcos TX 78666 742827652 Physician Hospital Org. TX N/A C 1 Florida Hospital Flagler Medical Offices Association Inc 60 Memorial Medical Parkway Palm Coast FL 32164 262158309 Condo Association FL N/A C 1 Florida Hospital Healthcare System Inc 602 Courtland Street Orlando FL 32804 593215680 PHO/TPA FL N/A C 1 Florida Medical Plaza Condo Association Inc 601 East Rollins Street Orlando FL 32803 592855791 Condo Association FL N/A C 1 Florida Memorial Health Network Inc 770 W Granada Blvd Ste 317 Ormond Beach FL 32174 593403558 Physician Hospital Org. FL N/A C 1 HUGULEY ALLIANCE FOUNDATION (11-8414) 11801 South Freeway Fort Worth TX 76115 752642209 Inactive TX N/A C 1 Kissimmee Multispecialty Clinic Condominium Association Inc 201 Hilda Street Suite 30 Kissimmee FL 34741 593539564 Condo Association FL N/A C 1 Midwest Management Services Inc 9100 West 74th Street Shawnee Mission KS 66204 480901551 Real Estate Rental KS N/A C 1 North American Health Services Inc & Subs 900 Hope Way Altamonte Springs FL 32714 621041820 Lessor/Holding Co. TN N/A C 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 1 Park Ridge Property Owner's Association Inc 1 Park Place Naples Road Fletcher NC 28732 030380531 Condo Association NC N/A C 1 Porter Affiliated Hlth Services Inc dba Diversified Affiliated Hlth Svcs 2525 S Downing Street Denver CO 80210 840956175 Healthcare Services CO N/A C 1 San Marcos Regional MRI Inc 1301 Wonder World Drive San Marcos TX 78666 770597968 Holding Company TX N/A C 1 The Garden Retirement Community Inc 602 Courtland Street Ste 200 Orlando FL 32804 593414055 Real Estate Rental FL N/A C 1 Winter Park Medical Office Building I Condo Assoc Inc 200 Lakemont Ave Winter Park FL 32792 452228478 Physician Clinics FL N/A C 1 0 0 1 0 0 0 0 0 0 1 1 0 1 0 0 0 0 1 0 The Comforter Health Care Group Inc K 1967412 Cost Hospice of the Comforter Foundation Inc C 66671 Actual Amount Received The Comforter Health Care Group Inc R 14120520 Debt Amount Forgiven Florida Hospital DMERT LLC M 591729 Cost Adventist Health SystemSunbelt Inc dba Florida Hospital J 193351 FMV Rental Rate Florida Hospital DMERT LLC J 56400 FMV Rental Rate Adventist Health SystemSunbelt Inc C 2300000 Actual Amount Received