ADVENTIST HEALTH SYSTEM SUNBELT INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
ADVENTIST HEALTH SYSTEM SUNBELT INC (EIN 59-1479658)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-15
IRS object ID
201343199349306794
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-11-15T14:45:41-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN591479658EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Adventist Health SystemSunbelt IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlADVENameControl
Phone4073572419Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1900 Hope WayAddressLine1
CityAltamonte SpringsCity
StateFLState
ZIP Code32714ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameLynn C AddiscottName
TitleAsst SecretaryTitle
Phone4079751492Phone
Date Signed2013-11-15DateSigned
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDonald JerniganNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1900 Hope WayAddressLine1
CityAltamonte SpringsCity
StateFLState
ZIP Code32714ZIPCode
FieldValueIRS element (for citing)
Gross Receipts3121396258GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number1071GroupExemptionNumber
Organization501c3XOrganization501c3
Web Sitewww.adventisthealthsystem.comWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1973YearFormation
State Legal DomicileFLStateLegalDomicile
Activity Or Mission DescriptionOperation of 13 acute-care hospitals & related healthcare services.ActivityOrMissionDescription
Nbr Voting Members Governing Body24NbrVotingMembersGoverningBody
Nbr Independent Voting Members16NbrIndependentVotingMembers
Total Nbr Employees24812TotalNbrEmployees
Total Nbr Volunteers4404TotalNbrVolunteers
Total Gross UBI11980115TotalGrossUBI
Net Unrelated Business Txbl Income49158NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year6313788ContributionsGrantsPriorYear
Contributions Grants Current Year8143760ContributionsGrantsCurrentYear
Program Service Revenue Prior Year2899300597ProgramServiceRevenuePriorYear
Program Service Revenue CY3052566284ProgramServiceRevenueCY
Investment Income Prior Year25573839InvestmentIncomePriorYear
Investment Income Current Year32324587InvestmentIncomeCurrentYear
Other Revenue Prior Year5264364OtherRevenuePriorYear
Other Revenue Current Year22908437OtherRevenueCurrentYear
Total Revenue Prior Year2936452588TotalRevenuePriorYear
Total Revenue Current Year3115943068TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year14980749GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY23414566GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year1350533428SalariesEtcPriorYear
Salaries Etc Current Year1378955690SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1348234659OtherExpensePriorYear
Other Expenses Current Year1463590734OtherExpensesCurrentYear
Total Expenses Prior Year2713748836TotalExpensesPriorYear
Total Expenses Current Year2865960990TotalExpensesCurrentYear
Revenues Less Expenses Prior Year222703752RevenuesLessExpensesPriorYear
Revenues Less Expenses CY249982078RevenuesLessExpensesCY
Total Assets BOY5913996141TotalAssetsBOY
Total Assets EOY6299999146TotalAssetsEOY
Total Liabilities BOY3954358511TotalLiabilitiesBOY
Total Liabilities EOY4064813224TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1959637630NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY2235185922NetAssetsOrFundBalancesEOY
Mission DescriptionAdventist 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.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense2691002141Expense
Grants23414566Grants
Revenue3060931959Revenue
DescriptionOperation of 13 acute care hospitals with 158,029 patient admissions, 744,132 patient days and 1,215,547 outpatient visits in the current year. In addition to hospital operations, the corporation provides medical care through a number of other activities such as urgent care centers, physician clinics, home health services, hospice services, sleep centers, wound centers, therapy and rehab.Description
Total Program Service Expense2691002141TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements1ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities1ForeignActivities
More Than5000 K To Organizations1MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account1EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10962076NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees24812NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members24NbrVotingGoverningBodyMembers
Number Independent Voting Members16NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Terry ShawBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4073572463TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1900 Hope WayAddressLine1
CityAltamonte SpringsCity
StateFLState
ZIP Code32714ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (45 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Carlson Ronald
Director0.103.00X010710
Cauley DMin Michael F
Director0.103.00X010710
Cazeau Esq RoseMarie
Director (end 12/12)0.103.00X010710
Craig Carlos
Director0.103.00X010710
Davidson James R
Director0.103.00X020710
Griffith Jr Buford
Director0.103.00X018210
Grove Rodney A
Director0.103.00X020710
Hagele Elaine M
Director0.103.00X018210
Hayes Alta Sue
Director0.103.00X010710
Houmann Lars D
Director35.0015.00X01371852242069
Jernigan PhD Donald L
Director/CEO0.1050.00X01976362106120X
Johnson MD Mark
Director0.103.00X010710
Knutson J Deryl
Director0.103.00X020710
Lemon Thomas L
Vice Chairman/Director0.104.00X028500
Livesay MDiv Donald E
Chairman/Director0.104.00X028500
Moore MDiv Larry R
Vice Chairman/Director0.104.00X028500
Morel Hubert J
Director0.103.00X010710
Pichette Ray
Director0.103.00X010710
Reiner Richard K
Director0.1050.00X0168189262430
Robinson Randy
Director0.103.00X020710
Scott Glynn CW
Director0.103.00X020710
Shaw Terry D
Director0.1050.00X01343770234647X
Smith DMin PhD Ron C
Vice Chair/Sec/Director0.104.00X026710
Valentine MDiv II Maurice
Director (end 9/12)0.103.00X013210
Werner Thomas L
Director0.103.00X010710
Banks David P
Senior VP - FH50.000.000711547136324X
Cummings Jr Desmond
Exec VP - FH50.000.00080221430032X
Dodds Sheryl D
Senior VP - FH50.000.00047356258115X
Fulbright Robert D
Senior VP - FH50.000.00051614898711X
Goodman Todd A
Senior VP - FH50.000.00043871382799X
Hilliard Douglas W
Senior VP - FH50.000.00045819579129X
Hurst Jeffry D
Senior VP - FH50.000.00045104953349X
Moorhead MD John David
Senior VP - FH50.000.000719614100925X
Owen Terry R
Senior VP - FH50.000.00075056780630X
Paradis J Brian
Exec VP - FH50.000.000926299174546X
Reed MD Monica P
Senior VP - FH50.000.000648656114429X
Soler Eddie
CFO - FL Divison50.000.000821215140493X
Lee MD Kathy
Physician50.000.00894576026308X
Eubanks Jr MD William Stephen
Executive Director of Academic Surgery50.000.00828534024754X
Bittner MD Hartmuth
Medical Director56.000.00814044021993X
Torres MD Ramon M
Physician50.000.00696531033179X
Jones MD Phillip E
Physician50.000.00691828032040X
Grim-Marcarelli Karen
Former key employee50.000.00040945143883X
Hamilton Connie A
Former key employee50.000.00040792231155X
Herrin Arlene K
Former key employee50.000.00032673553759X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3925513TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs15271941TotalReportableCompFrmRltdOrgs
Total Other Compensation2061819TotalOtherCompensation
Number Individuals GT100 K1038NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Brasfield & Gorrie LLC
200 Colonial Ctr Pwy Ste 200Lake MaryFL32746Construction Services23409134
Cerner Corporation
2800 Rockcreek ParkwayKansas CityMO64117Technology Solutions Support11284868
Koosharem Corporation
24223 Network PlaceChicagoIL60673Staffing9927646
Crothall Healthcare Inc
13028 Collection Center DrChicagoIL60693Housekeeping5038118
Hardee Services of Rehab Inc
1330 Hwy 17 SouthWauchulaFL33873Physical Therapy3940658
FieldValueIRS element (for citing)
Number Of Contractors GT100 K388NumberOfContractorsGT100K
Related Organizations6397990RelatedOrganizations
Government Grants1344621GovernmentGrants
All Other Contributions401149AllOtherContributions
Noncash Contributions12368NoncashContributions
Total Contributions8143760TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
Patient Revenue900099297226909829632130089056090
Management Fee9000992361089722861771749126
Cafeteria/Vending Rev.9000991964631819210185436133
Medical Office Building5311201033913310339133
Education90009968761236876123

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column19824715TotalRevenueColumn
Related Or Exempt Function Income18875374RelatedOrExemptFunctionIncome
Unrelated Business Revenue949341UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Program Service Revenue3052566284TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column13567527TotalRevenueColumn
Exclusion$13,567,527ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column468130TotalRevenueColumn
Exclusion$468,130ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column279441TotalRevenueColumn
Exclusion$279,441ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real4451065Real
Personal209742Personal

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real1587978Real
Personal198Personal

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real2863087Real
Personal209544Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column3072631TotalRevenueColumn
Unrelated Business Revenue789425UnrelatedBusinessRevenue
Exclusion$2,283,206ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities17704540Securities
Other4449404Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities0Securities
Other3865014Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities17704540Securities
Other584390Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column18288930TotalRevenueColumn
Exclusion$18,288,930ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EHR Revenue9000991369026613690266
Equity earnings from related enti90009957282595728259
Investment in Subs900099137840137840
FieldValueIRS element (for citing)
Total Other Revenue19556365TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column3115943068TotalRevenueColumn
Related Or Exempt Function Income3060931959RelatedOrExemptFunctionIncome
Unrelated Business Revenue11980115UnrelatedBusinessRevenue
Exclusion$34,887,234ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total23324989Total
Program Services23324989ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total89577Total
Program Services89577ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total10481182Total
Management And General10481182ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total1014789755Total
Program Services996359720ProgramServices
Management And General18430035ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total35665232Total
Program Services34933961ProgramServices
Management And General731271ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total241586585Total
Program Services224807891ProgramServices
Management And General16778694ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total76432936Total
Program Services74884216ProgramServices
Management And General1548720ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total7109607Total
Management And General7109607ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total619331Total
Management And General619331ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total247139753Total
Program Services219221732ProgramServices
Management And General27918021ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total16718428Total
Management And General16718428ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total103235818Total
Program Services78654716ProgramServices
Management And General24581102ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total18779905Total
Program Services16460410ProgramServices
Management And General2319495ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total60472743Total
Program Services60348793ProgramServices
Management And General123950ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total6087663Total
Program Services3073025ProgramServices
Management And General3014638ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total1312476Total
Program Services880046ProgramServices
Management And General432430ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total70189549Total
Program Services58749904ProgramServices
Management And General11439645ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total159039466Total
Program Services159039466ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total42169859Total
Program Services40349825ProgramServices
Management And General1820034ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
Medical Supplies509526071509526071
Extinguishment of Debt8377064883770648
Repairs/Maintenance6620358666203586
Assessments3502934035029340

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total36186491Total
Program Services5294225ProgramServices
Management And General30892266ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total2865960990Total
Program Services2691002141ProgramServices
Management And General174958849ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY99490BOY
EOY104616EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1458843277BOY
EOY1559001735EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY370664906BOY
EOY421785860EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY69068975BOY
EOY73594192EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY15053517BOY
EOY29239839EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis3461478497LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1684128752LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1773627027BOY
EOY1777349745EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY277876782BOY
EOY278044188EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY11840997BOY
EOY34901310EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1936921170BOY
EOY2125977661EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY5913996141BOY
EOY6299999146EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY195866090BOY
EOY211662358EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY3588586470BOY
EOY3620560952EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY169905951BOY
EOY232589914EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY3954358511BOY
EOY4064813224EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1956618834BOY
EOY2233704874EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3018796BOY
EOY1481048EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1959637630BOY
EOY2235185922EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY5913996141BOY
EOY6299999146EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses249982078ReconcilationRevenueExpenses
Reconciliation Unrealized Invest-1473263ReconciliationUnrealizedInvest
Reconcilation Prior Adjustment-33917ReconcilationPriorAdjustment
Reconcilation Other Changes27073394ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management1PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations1RalliesDemonstrations
Rallies Demonstrations$3,240RalliesDemonstrationsAmount
Other Activities1OtherActivities
Other Activities$443,034OtherActivitiesAmount
Total Lobbying Expenditures IIB446274TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Explanation of Lobbying Activities:Part II-B, Line 1:The corporation reimbursed traveling expenses and paid fees to retain the services of four consulting firms which performed lobbying activities on behalf of the corporation. The four firms were William Filan, John Andrew Kane, Dick Batchelor, and Johnson & Blanton and were paid a total of $284,944 during the year. Additionaly, dues were paid to the American Hospital Association, Florida Hospital Association, Illinois Hospital Association, Texas Hospital Association, Association of Organ Procurement and the Metropolitan Chicago Healthcare Council who use a portion of the dues to conduct lobbying activities.
Part IV, Supplemental Information:Part II-B 1(b) During 2012 salary expense of $24,118 was incurred for paid staff engaged in lobbying activities.

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Protection Of Natural HabitatXProtectionOfNaturalHabitat
Nmbr Easements Modified0NmbrEasementsModified
Nmbr States In Which Easements Held1NmbrStatesInWhichEasementsHeld
Written Policy Monitoring0WrittenPolicyMonitoring
Staff Hours Spent On Enforcement0.00StaffHoursSpentOnEnforcement
Expenses Incurred For Enforcement0ExpensesIncurredForEnforcement

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance15730537BeginningOfYearBalance
Contributions79402Contributions
Investment Earnings Or Losses780118InvestmentEarningsOrLosses
End Of Year Balance16590057EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance15221113BeginningOfYearBalance
Contributions121143Contributions
Investment Earnings Or Losses753535InvestmentEarningsOrLosses
Other Expenditures365254OtherExpenditures
End Of Year Balance15730537EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance14810178BeginningOfYearBalance
Contributions30263Contributions
Investment Earnings Or Losses720592InvestmentEarningsOrLosses
Grants Or Scholarships339920GrantsOrScholarships
End Of Year Balance15221113EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance14077615BeginningOfYearBalance
Contributions57189Contributions
Investment Earnings Or Losses696088InvestmentEarningsOrLosses
Grants Or Scholarships117114GrantsOrScholarships
Administrative Expenses-96400AdministrativeExpenses
End Of Year Balance14810178EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance3027408BeginningOfYearBalance
Contributions79953Contributions
Other Expenditures233695OtherExpenditures
End Of Year Balance2873666EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.80940BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.19060PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.00000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs1EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R1AreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis193465472OtherCostOrOtherBasis
Book Value193465472BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1262084896OtherCostOrOtherBasis
Depreciation520591642Depreciation
Book Value741493254BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1855192486OtherCostOrOtherBasis
Depreciation1109475993Depreciation
Book Value745716493BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis150735643OtherCostOrOtherBasis
Depreciation54061117Depreciation
Book Value96674526BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1777349745TotalOfBookValueLandBuildings

Other Assets OtherAssets (9 entries)

DescriptionDescriptionBook ValueBookValue
Funds Held in Trust9892860
Other Current Receivables12544777
Due From Related Parties and Affiliates42173540
Donor Restricted Assets12874
Deferred Charges and Costs21893194
Long-term Investments60976783
Other Non-Current Assets8213023
Receivable - Interco Alloc of Tax-Exempt Bond Proceeds1959372596
Receivable from Third Party10898014
FieldValueIRS element (for citing)
Total Book Value Other Assets2125977661TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (7 entries)

DescriptionDescriptionAmountAmount
Accounts Receivable - Credit Balances$7,926,003
Payable to Third Party$72,642,513
Due to Related-Affiliated Entities$33,604,832
Other Current Liabilities$5,576,869
Other Non-Current Liabilities$103,834,580
Notes and Loans Payable - Current$176,725
Leases Payable$8,828,392
FieldValueIRS element (for citing)
Total Of Amounts232589914TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Description of How Organization Reports Conservation Easements:Part II, Line 9:The filing organization has recorded the land conservation easement on its financial statements as a Property, Plant, and Equipment Asset. The conservation easement generates no revenue and the filing organization did not incur any expense in 2012 related to the maintenance and monitoring of the conservation easement.
Description of Intended Use of Endowment Funds:Part V, Line 4:All endowment funds are held by related 501(c)(3) exempt foundations. These endowment funds have been established for a variety of purposes in support of related tax-exempt hospitals. All of the foundation's permanently restricted endowment funds are required to be retained permanently either by explicit donor stipulation or by the Florida Uniform Prudent Management of Institutional Funds Act. Part V, line 1a, column (b) Prior year - Explanation for change in opening balance: During the year 2009, management of a related Foundation determined that there were temporarily restricted net assets that should have been classified as unrestricted board-designated endowment funds as of December 31, 2008. This included $11,203,949 of board-designated endowments that should have been released from restriction in fiscal year 2008 or an earlier period. As a result, the related Foundation restated beginning board-designated endowment funds on the statement of activities in its 2009 tax year.
Description of Uncertain Tax Positions Under FIN 48:Part X, Line 2:The filing organization is a subsidiary organization within Adventist Health System (AHS). The consolidated financial statements of AHS contain the following FIN 48 footnote: Please note that dollar amounts are in thousands. Healthcare Corporation and its affiliated organizations, other than North American Health Services, Inc. and its subsidiaries (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. For the years ended December 31, 2012 and 2011, unrelated business income activities conducted by Healthcare Corporation and its tax-exempt affiliates did not generate a material amount of combined federal, state and local income tax. NAHS is a wholly owned, for-profit subsidiary of Healthcare Corporation. NAHS and its subsidiaries are subject to federal and state income taxes. NAHS files a consolidated federal income tax return and, where appropriate, consolidated state income tax returns. For the years ended December 31, 2012 and 2011, NAHS generated taxable income of approximately $2,400 and $1,000, respectively. This taxable income was fully offset by net operating loss carryforwards for federal income tax purposes. Although one state in which NAHS conducts business has suspended the utilization of net operating loss carryforwards for the year ended December 31, 2012, no material state income tax liability resulted. Accordingly, there is no provision for current federal or state income tax for the years ended December 31, 2012 and 2011. NAHS also has temporary deductible differences of approximately $64,800 and $67,500 at December 31, 2012 and 2011, respectively, primarily as a result of net operating loss carryforwards. At December 31, 2012, NAHS had net operating loss carryforwards of approximately $64,300 of which $21,000 will expire in 2023, with the remaining $43,300 expiring beginning in 2018 through 2026. Some of these net operating losses are subject to the separate return limitation year rules. Deferred taxes have been provided for these amounts, resulting in a net deferred tax asset of approximately $24,600 and $25,600 at December 31, 2012 and 2011, respectively. A full valuation allowance has been provided at December 31, 2012 and 2011, respectively, 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.

Schedule F IRS990ScheduleF

FieldValueIRS element (for citing)
Grant Records Maintained1GrantRecordsMaintained

Accts Actvs Out US Table AcctsActvsOutUSTable (28 entries)

RegionRegionNumber Of OfficesNumberOfOfficesNumber Of EmployeesNumberOfEmployeesType Of Activities ConductedTypeOfActivitiesConductedTotal ExpendituresTotalExpendituresSpecific Services ProvidedSpecificServicesProvided
Central America and the Caribbean00Grantmaking4235
Central America and the Caribbean00Meetings6904
Central America and the Caribbean00Program Services34262Medical Care Mission Trips
East Asia and the Pacific00Meetings830
Europe (including Iceland and Greenland)00Grantmaking10000
Europe (including Iceland and Greenland)00Meetings/Conferences48742
Europe (including Iceland and Greenland)00Program Services210Mission Trip Planning
Europe (including Iceland and Greenland)00Program Services3368Surgical Care
Middle East and North Africa00Urological Society Conference1541
North America (which includes Canada and Mexico, but not the U.S.)00Meetings/Conferences7928
South America00Grantmaking9200
South America00Meetings/Conferences5690
South America00Program Services38567Medical/dental clinics
South America00Program Services2062Surgical Care
South America00Program Services80423Mission trips and Conferences. Medical supplies and other donated supplies.
South Asia00Meetings/Conferences10496
Sub-Saharan Africa00Grant for Mission trip500
Sub-Saharan Africa00Program Services24922Mission trip ultrasound equipment & PT supplies and items puchased locally
00
00
00
00
00
00
00
00
00
00
FieldValueIRS element (for citing)
Subtotal Number Of Offices0SubtotalNumberOfOffices
Subtotal Number Of Employees0SubtotalNumberOfEmployees
Cont Number Of Offices0ContNumberOfOffices
Cont Number Of Employees0ContNumberOfEmployees
Total Number Of Offices0TotalNumberOfOffices
Total Number Of Employees0TotalNumberOfEmployees
Subtotal Amount Spent108551SubtotalAmountSpent
Cont Amount Spent181329ContAmountSpent
Total Amount Spent289880TotalAmountSpent

Grants To Orgs Outside US GrantsToOrgsOutsideUS (5 entries)

RegionRegionPurpose Of GrantPurposeOfGrantAmount Of Cash GrantAmountOfCashGrantManner Of Cash DisbursementMannerOfCashDisbursementMethod Of ValuationMethodOfValuationAmount Of Non Cash AssistanceAmountOfNonCashAssistanceDescription Of Non Cash AssistanceDescriptionOfNonCashAssistance
Central America and the CaribbeanMedical Supplies or Equipment11900CheckBook
South AmericaMedical Mission Trip13550CheckBook
South AmericaMedical Supplies or EquipmentBook5494Medical Supplies
Sub-Saharan AfricaMedical Supplies or EquipmentBook9566Medical Supplies
Europe (including Iceland and Greenland)Sponsorship of German Hospital10000Electronic FundsBook
FieldValueIRS element (for citing)
Total Number Of501c3 Orgs5TotalNumberOf501c3Orgs
Total Number Of Other Orgs0TotalNumberOfOtherOrgs
Transfer To Foreign Corp0TransferToForeignCorp
Interest In Foreign Trust0InterestInForeignTrust
Own Foreign Corp0OwnForeignCorp
Passive Foreign Invest Co0PassiveForeignInvestCo
Foreign Partnership0ForeignPartnership
Boycott Countries0BoycottCountries

Form990 Schedule F Part V Form990ScheduleFPartV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants Outside the U.S.:Identifier
ExplanationSchedule F, Part I, Line 2: Foreign grants are generally non-cash donations of medical equipment and supplies to assist foreign health care providers in fulfilling their mission of providing health care services to the populations they serve. The foreign health care providers are often hospitals and/or clinics operated and/or sponsored by or affiliated with the Seventh-Day Adventist Church. The foreign hospitals/clinics may be located in remote and/or underserved villages and townships of developing countries. Grants are typically made to other U.S. charitable organizations or foreign entities recognized as charitable by the foreign country in which they are located. As a result of the nature of the grants as non-cash medical equipment and supplies and the fact that most grants are made indirectly through other U.S. or foreign charitable organizations, the filing organization has not established specific procedures for monitoring the use of grant funds outside the United States.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense155179851TotalCommunityBenefitExpense
Net Community Benefit Expense155179851NetCommunityBenefitExpense
Percent Of Total Expense0.05410PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense434070792TotalCommunityBenefitExpense
Direct Offsetting Revenue273481625DirectOffsettingRevenue
Net Community Benefit Expense160589167NetCommunityBenefitExpense
Percent Of Total Expense0.05600PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense589250643TotalCommunityBenefitExpense
Direct Offsetting Revenue273481625DirectOffsettingRevenue
Net Community Benefit Expense315769018NetCommunityBenefitExpense
Percent Of Total Expense0.11010PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense14949141TotalCommunityBenefitExpense
Direct Offsetting Revenue222934DirectOffsettingRevenue
Net Community Benefit Expense14726207NetCommunityBenefitExpense
Percent Of Total Expense0.00510PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense44005649TotalCommunityBenefitExpense
Direct Offsetting Revenue10553059DirectOffsettingRevenue
Net Community Benefit Expense33452590NetCommunityBenefitExpense
Percent Of Total Expense0.01170PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense352627TotalCommunityBenefitExpense
Direct Offsetting Revenue425DirectOffsettingRevenue
Net Community Benefit Expense352202NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense1579642TotalCommunityBenefitExpense
Direct Offsetting Revenue1201099DirectOffsettingRevenue
Net Community Benefit Expense378543NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense16300405TotalCommunityBenefitExpense
Net Community Benefit Expense16300405NetCommunityBenefitExpense
Percent Of Total Expense0.00570PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense77187464TotalCommunityBenefitExpense
Direct Offsetting Revenue11977517DirectOffsettingRevenue
Net Community Benefit Expense65209947NetCommunityBenefitExpense
Percent Of Total Expense0.02270PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense666438107TotalCommunityBenefitExpense
Direct Offsetting Revenue285459142DirectOffsettingRevenue
Net Community Benefit Expense380978965NetCommunityBenefitExpense
Percent Of Total Expense0.13280PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense19933654TotalCommunityBuildingExpense
Direct Offsetting Revenue5163707DirectOffsettingRevenue
Net Community Building Expense14769947NetCommunityBuildingExpense
Percent Of Total Expense0.00520PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense384219TotalCommunityBuildingExpense
Direct Offsetting Revenue40310DirectOffsettingRevenue
Net Community Building Expense343909NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense10450TotalCommunityBuildingExpense
Net Community Building Expense10450NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense20328323TotalCommunityBuildingExpense
Direct Offsetting Revenue5204017DirectOffsettingRevenue
Net Community Building Expense15124306NetCommunityBuildingExpense
Percent Of Total Expense0.00530PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$96,817,676BadDebtExpenseAmount
Amount Attributable To7332132AmountAttributableTo
Amount Reimbursed By Medicare685288744AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare779908106CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-94619362MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (5 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipOfficers Etc Profit Or OwnershipOfficersEtcProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
1 Surgical Center at Sun'N Lake LLC
Ambulatory Surgery0.500000.000000.50000
2 Huguley Surgery Center LLP (ended 412)
OP Surgeries0.641000.000000.35900
3 San Marcos MRI LP
Imaging Center0.500000.000000.50000
4 Central Texas Ambulatory Endoscopy
Endoscopy Center0.188000.000000.81200
5 Surgery Management Associates of Kissimmee LLC
Management/Admin0.300000.000000.70000
FieldValueIRS element (for citing)
Number Of Hospital Facilities13NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (13 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeWebsite AddressWebsiteAddressLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalChildrens HospitalChildrensHospitalTeaching HospitalTeachingHospitalResearch FacilityResearchFacilityEr24 HoursEr24HoursFacility Reporting GroupFacilityReportingGroupOtherOtherCritical Access HospitalCriticalAccessHospital
Florida Hospital Orlando
1601 E Rollins StreetOrlandoFL32803www.floridahospital.com/orlandoXXXXXXA
Florida Hospital Celebration Health
2400 Celebration PlaceCelebrationFL34747www.floridahospital.com/celebration-hXXXXA
Florida Hospital Altamonte
3601 E Altamonte DriveAltamonte SpringsFL32701www.floridahospitalaltamonte.comXXXXA
Florida Hospital East Orlando
47727 Lake Underhill DriveOrlandoFL32822www.floridahospitaleast.comXXXXA
Winter Park Memorial Hospital
5200 N Lakemont AvenueWinter ParkFL32822www.floridahospital.com/winter-park-mXXXXA
Adventist La Grange Memorial Hospital
65101 S Willow Springs RoadLa GrangeIL60525www.keepingyouwell.com/almh/XXXXXA
FH Heartland Medical Center
74200 Sun N Lake BlvdSebringFL33872fhheartland.orgXXXA
Florida Hospital Kissimmee
82450 North Orange Blossom TrailKissimmeeFL34741www.floridahospital.com/kissimmeeXXXXA
Central Texas Medical Center
91301 Wonder World DrSan MarcosTX78666ctmc.orgXXXA
Florida Hospital Apopka
10201 N Park AvenueApopkaFL32703www.floridahospitalapopka.comXXXXA
FH Heartland Medical Center Lake Placid
111210 US 27 NLake PlacidFL33852fhheartland.orgXXXASenior Behavioral Unit
Florida Hospital Wauchula
12533 W Carlton StreetWauchulaFL33873fhheartland.orgXXXASkilled NursingX
Huguley Memorial Medical Center
1311801 South FreewayFort WorthTX76115www.huguley.orgXXXAHuguley Home Health Agency

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1GROUP ABusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number14HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent400.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities138NumberOfOtherFacilities

Other Facilities OtherFacilities (138 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityTypeAddress Line2Address/AddressLine2
Florida Hospital Cancer Institute
2501 N Orange Avenue Suites 139 181OrlandoFL32804Cancer Center
Florida Hospital Rehabilitation and Spor
5165 Adanson StreetOrlandoFL32804Therapy Center
Florida Hospital Orlando Pathology Lab
2855 N Orange AvenueOrlandoFL32803Lab Services
Florida Hospital Cancer Institute - Kiss
1300 West Oak StreetKissimmeeFL34741Cancer Center
Florida Hospital Cancer Care Center
2100 Glenwood DriveWinter ParkFL32792Radiation Oncology
Florida Hospital Altamonte Imaging Cente
661 E Altamonte Drive Suite 112Altamonte SpringsFL32701MRI/CT
Florida Hospital Kidney Stone Center
2501 N Orange Avenue Suite 121OrlandoFL32804Outpatient Services
Florida Hospital Altamonte Cancer Center
601 E Altamonte DriveAltamonte SpringsFL32701Cancer Center
Florida Hospital Altamonte Ambulatory Su
661 E Altamonte Drive Suite 110Altamonte SpringsFL32701Outpatient Surgery Center
Florida Hospital Altamonte Medical Plaza
661 E Altamonte DriveAltamonte SpringsFL32701Physician Clinics
Florida Hospital Medical Plaza
2501 N Orange AvenueOrlandoFL32804Physician Clinics
Florida Hospital Transplant Center
2415 N Orange Avenue Suite 700OrlandoFL32804Organ Tissue/Transplant Center
FRi Princeton
235 E Princeton Street Suite 100OrlandoFL32804Imaging Center
Florida Hospital Center for Behavioral H
501 E King Street 1st FloorOrlandoFL32803Med/Psych
Florida Hospital Advanced Nuclear Imagin
328 Spruce StreetOrlandoFL32803Radiology Services
Florida Hospital Surgery Center East Or
258 S Chickasaw Trail Suite 100OrlandoFL32825Outpatient Surgery
Florida Hospital Altamonte Imaging Cente
894 E Altamonte Drive Suite 1100Altamonte SpringsFL32701Radiology Services
FHCC - LAKE BUENA VISTA #2
12500 S Apopka Vineland RdOrlandoFL32836Urgent care Clinic
Adventist Paulson Rehab - Willowbrook
619 Plainfield RoadWillowbrookIL60521Rehabilitation Center
FRi Lake Mary
775 Primera Blvd Suite 1031Lake MaryFL32746Imaging Center
Florida Hospital Gamma Knife
2501 N Orange Ave Suite 101 SOrlandoFL32804Gamma Knife
Loch Haven OBGyn Group
235 E Princeton Street Suite 200OrlandoFL32804Physician Clinics
Florida Hospital Rehabilitation & Sports
8701 Maitland Summit BlvdOrlandoFL32810Therapy Center
Family Health East Orlando Women's Pavil
7975 Lake Underhill Drive Suite 100OrlandoFL32822Women's Health Clinic
Surgical Center at Sun N' Lake LLC
4240 Sun n Lake BlvdSebringFL33872Outpatient Surgery
Florida Hospital Rehabilitation & Sports
7975 Lake Underhill Drive Suite 300OrlandoFL32822Therapy Center34
FHCC - WATERFORD
250 N Alafaya Trail Suite 135OrlandoFL32825Urgent care Clinic
FHHMC Cardiology Associates
4638 Sun n Lake BlvdSebringFL33872Outpatient Phys Clinic
Central Texas Ambulatory Endoscopy
1303 Wonder World DRSan MarcosTX78666Endoscopy Services
Winter Park Memorial Hospital Women's Ce
1925 Mizell Ave Suites 105 107Winter ParkFL32792Women's Health Clinic, Imaging
FHCC - SANFORD
4451 West 1st StreetSanfordFL32771Urgent care Clinic
Florida Hospital Rehabilitation & Sports
400 Celebration Place Suite 200CCelebrationFL34747Therapy Center
Florida Hospital Center for Thrombosis
2501 N Orange Avenue Suite 786OrlandoFL32804Thrombosis Center
Florida Hospital Altamonte Mammography C
661 E Altamonte Drive Suite 130Altamonte SpringsFL32701Imaging Center
FHCC - WINTER PARK
3099 Aloma AvenueWinter ParkFL32792Urgent care Clinic
FRi Oviedo
8000 Red Bug Lake Road Suite 120OviedoFL32765Imaging Center
Florida Hospital Altamonte Pain Medicine
711 East Altamonte Drive Suite 100Altamonte SpringsFL32701Pain Medicine
FHCC - WINTER GARDEN
3005 Daniels RoadWinter GardenFL34787Urgent care Clinic
FRi Waterford Lake
12301 Lake Underhill Rd Suite 113OrlandoFL32828Imaging Center
Family Health Center Winter Park
2950 Aloma Ave Suite 100Winter ParkFL32792Physician Clinics, Medicine Specialists, Surgical Specialists
Florida Hospital Center for Sleep Disord
501 E King Street 2nd FloorOrlandoFL32803Sleep Disorder Center
CTMC Hospice
1315 IH 35 NorthSan MarcosTX78666Hospice services
FHCC - ORANGE LAKE
8201 W Irlo Bronson HighwayKissimmeeFL34747Urgent care Clinic
FHHMC SeaScape Imaging OP Center
2950 Alt US 27 SSebringFL33870Outpatient Imaging Center
FHCC - OnsiteBusiness Health Services
901 N Lake Destiny Road Suite 400MaitlandFL32750Onsite Services
FHCC - LEE ROAD
2540 Lee RoadWinter ParkFL32789Urgent care Clinic
FHCC - ALTAMONTE
440 W Highway 436Altamonte SpringsFL32714Urgent care Clinic
FH Wauchula Pioneer Medical Center
515 Carlton StreetWauchulaFL33873Outpatient Phys Clinic
FHCC - COLONIAL TOWN
630 North Bumby AveOrlandoFL32803Urgent care Clinic
FHCC - DR PHILLIPS
8014 Conroy-Windermere Rd Suite 104OrlandoFL32835Urgent care Clinic
La Grange Cancer Treatment Pavillion
1325 Memorial DrLa GrangeIL60525Cancer Center/Wound Care Facility
FHCC - KISSIMMEE
4320 W Vine StreetKissimmeeFL34746Urgent care Clinic
Florida Hospital Rehabilitation & Sports
711 E Altamonte Drive Suite 200Altamonte SpringsFL32701Therapy Center
FHCC - RDV
8701 Maitland Summit BlvdMaitlandFL32810Urgent care Clinic
FHCC - HUNTERS CREEK
3293 Greenwald Way NorthKissimmeeFL34741Urgent care Clinic
FHCC - SAND LAKE
2301 Sand Lake RoadOrlandoFL32809Urgent care Clinic
Florida Hospital Rehabilitation & Sports
8000 Red Bug Lake Road Suite 140OviedoFL32765Therapy Center
FHCC - MT DORA
9015 US Highway 441Mount DoraFL32757Urgent care Clinic
Florida Hospital Sleep Disorder Center -
1925 Mizell Avenue Suite 200Winter ParkFL32792Sleep Center
Adventist La Grange Family Medical Cente
5101 S Willow Springs RoadLa GrangeIL60525Family Medical Center
FHCC - OVIEDO
8010 Red Bug RoadOviedoFL32765Urgent care Clinic
FHCC - AZALEA PARK
509 S Semoran BlvdOrlandoFL32807Urgent care Clinic
FHCC - CLERMONT
15701 State Road 50 Suite 101ClermontFL34711Urgent care Clinic
Florida Hospital Rehabilitation & Sports
615 E Princeton St Suite 104OrlandoFL32803Therapy Center
FHHMC Family Practice Center
1006 W Pleasant StreetAvon ParkFL33825Outpatient Phys Clinic
FHCC - LONGWOOD
855 S US Highway 17-92LongwoodFL32750Urgent care Clinic
FHHMC Pulmonary and Critical Care Specia
4409 Sun n Lake Blvd Suite ESebringFL33872Outpatient Phys Clinic
Florida Hospital Rehab and Sport Medicin
2005 Mizell AveWinter ParkFL32792Therapy Center
FHCC - UNIVERSITY
11550 University BlvdOrlandoFL32817Urgent care Clinic
FHHMC Therapy Center
6325 US Hwy 27 NSebringFL33870Outpatient Physical Therapy
Huguley Surgery Center LLP
15305 Dallas Pkwy Ste 1600 LB 28AddisonTX75001Outpatient Surgery Center
Florida Hospital Rehab and Sports Medici
100 Waymont Court Suite 120Lake MaryFL32746Therapy & Hearing Center
Medical Plaza - Florida Hospital Kissimm
2400 North Orange Blossom TrailKissimmeeFL34744Physician Clinics
FHHMC Heartland Women's Health
37 Ryant BlvdSebringFL33870Outpatient Phys Clinic
FHHMC Center Priority Health Care
4200 Sun n Lake BlvdSebringFL33872Outpatient Phys Clinic
Family Health Center East
7975 Lake Underhill Drive Suite 200OrlandoFL32822Physician Clinics
San Marcos MRI LP
1330 Wonder World DrSan MarcosTX78666Imaging Services
FHCC - CONWAY
5810 S Semoran BlvdOrlandoFL32822Urgent care Clinic
FHHMC Interventional Cardiology
6325 US 27 North Suite 202SebringFL33872Outpatient Phys Clinic
Florida Hospital Rehabilitation & Sports
201 Hilda Street Suite 12KissimmeeFL34741Therapy Center
Florida Hospital Celebration Health Outp
410 Celebration Place Suite 408CelebrationFL34747Outpatient Surgery Center
Celebration Hand Therapy
410 Celebration Place Suite 300CelebrationFL34747Therapy Center
CTMC Home Health
2007 Medical ParkwaySan MarcosTX78666Home Health services
FHHMC Wound Care
4143 Sun N LakeSebringFL33872Wound Care
Florida Hospital Rehabilitation & Sports
2520 N Orange Avenue Suite 100OrlandoFL32804Therapy Center
Florida Hospital Rehabilitation & Sports
205 N Park Avenue Suite 110ApopkaFL32703Therapy Center
Florida Hospital Rehabilitation and Spor
1603 S Hiawassee RoadOrlandoFL32835Therapy Center
Florida Hospital Laboratory - Orlando
2501 N Orange Avenue Suite 370OrlandoFL32804Lab Services
Florida Hospital Diabetes Institute
2415 N Orange Ave Suite 501OrlandoFL32804Diabetes
CTMC Rehab Services
1340 Wonder World DrSan MarcosTX78666OP Rehab Services
FHHMC Women's Wellness Center Sebring
4240 Sun n Lake BlvdSebringFL33872Outpatient Phys Clinic
FHHMC Center for Infectious Disease
4409 Sun n Lake Blvd Suite ESebringFL33870Outpatient Phys Clinic
FHHMC Priority Health Care
1210 US Highway 27 NLake PlacidFL33852Outpatient Phys Clinic
FHHMC Family Medicine Specialist
2315 US Highway 27 NorthAvon ParkFL33825Outpatient Phys Clinic
FHHMC Sleep Lab
4301 Sun N Lake BlvdSebringFL33872Sleep Lab
Florida Hospital Sleep Disorder Center -
203 N Park Avenue Suite 106ApopkaFL32703Sleep Center
FHHMC Highlands Surgical Associates
4301 Sun n Lake Blvd Suite 103SebringFL33872Outpatient Phys Clinic
FHHMC Psychiatric Services
4023 Sun n Lake BlvdSebringFL33872Outpatient Phys Clinic
FHHMC SeaScape South Laboratory
2950 Alt US 27 SSebringFL33870Outpatient Laboratory
Eden Spa
2501 N Orange Ave Suite 186OrlandoFL32804Outpatient Therapy & Consumer goods and services
FHHMC CareNow
4421 Sun n Lake Blvd Suite BSebringFL33872Outpatient Phys Clinic
FH Wauchula The Therapy Center
1330 Hwy 17 SWauchulaFL33873Outpatient Physical Therapy
Darden Onsite
1000 Darden Center DriveOrlandoFL32837Employer Onsite Clinic
FHHMC Gastroenterology & Women's Wellnes
1352 US 27 NorthLake PlacidFL33852Outpatient Phys Clinic
FHHMC Therapy Center Lake Placid
1210 US 27 NLake PlacidFL33852Outpatient Physical Therapy
Florida Hospital Laboratory - Lucerne Te
1723 Lucerne TerraceOrlandoFL32806Blood collection stations
FH Wauchula Hardee Family Medicine
522 W Carlton StreetWauchulaFL33873Outpatient Phys Clinic
FHHMC Gastroenterology Center Sebring
4421 Sun n Lake Blvd Suite BSebringFL33872Outpatient Phys Clinic
Florida Hospital Laboratory - Palm Sprin
631 Palm Springs Drive Suite 113Altamonte SpringsFL32701Blood collection stations
FHHMC Internal Medicine Specialist
6801 US Hwy 27 North Suite B-2SebringFL33870Outpatient Phys Clinic
Florida Hospital Laboratory - Tavares
1769 David Walker DriveTavaresFL32778Blood collection stations
FHHMC Pain Management
4145 Sun N LakeSebringFL33872Pain Management
Siemens Onsite
4400 N Alafaya Trail MC Q1-240OrlandoFL32826Employer Onsite Clinic
Wyndham Onsite
6277 Sea Harbor DrOrlandoFL32821Employer Onsite Clinic
FHHMC Outpatient Laboratory
2315 US Hwy 27 NAvon ParkFL33825Outpatient Laboratory
Florida Hospital Laboratory - Altamonte
661 East Altamonte Drive Suite 131Altamonte SpringsFL32701Lab Services
FHHMC Psychiatric Services
1346 US Highway 27 SLake PlacidFL33852Outpatient Phys Clinic
FHHMC Cardio-Pulmonary
4635 Sun N Lake BlvdSebringFL33872Cardio Pulmonary Rehab
CTMC OP Lab and Radiology
151 Kirkham CircleKyleTX78640OP lab, rehab & medical imaging
Florida Hospital Hearing Center East Or
7975 Lake Underhill Drive Suite 300OrlandoFL32822Hearing Center
Florida Hospital Laboratory - Winter Par
1925 Mizell Ave Suite 100Winter ParkFL32792Lab Services
FHHMC Outpatient Laboratory
6801 US Hwy 27 N Suite C -1SebringFL33872Outpatient Laboratory
FHHMC Neurology
4421 Sun n Lake Blvd Suite BSebringFL33872Outpatient Phys Clinic
Florida Hospital Women's CenterLactatio
2520 N Orange Avenue Suite 103OrlandoFL32804Lactation Center, Birthing Classes
FH Wauchula Sleep Lab & Wound Care
457 W Carlton StWauchulaFL33873Sleep Lab & Wound Care
FHHMC Seascape Internal Medicine Sebring
2950 Alt US 27 South Suite BSebringFL33870Outpatient Phys Clinic
Florida Hospital Rehabilitation and Spor
601 E Rollins StreetOrlandoFL32803Therapy Center
Waterman Onsite
1000 Waterman WayTavaresFL32778Employer Onsite Clinic
Florida Hospital Pediatric
615 E Princeton St Suite 540OrlandoFL32803EPS Cath Lab
Total Healthcare Management
1000 Universal Studios Plaza 3OrlandoFL32819Employer Onsite Clinic
ALT EDEN SPA
601 E Altamonte Drive Suite 1721Altamonte SpringsFL32701Outpatient Therapy & Consumer goods and services
FHHMC Highlands Surgical Associates Lake
1352 US 27 NorthLake PlacidFL33852Outpatient Phys Clinic
OCG Onsite
450 E South StreetOrlandoFL32802Employer Onsite Clinic
FHHMC Family Medicine Center of Lake Pla
1352 US 27 NorthLake PlacidFL33852Outpatient Phys Clinic
FHHMC Diabetes Center
4023 Sun N LakeSebringFL33872Diabetes Center
FHHMC ENT Specialist
4325 Sun n Lake Blvd Suite 102SebringFL33872Outpatient Phys Clinic
FH Wauchula Womens Wellness Center
526 W Carlton StreetWauchulaFL33873Outpatient Phys Clinic
FHHMC LP Wound Care
1352 US Hwy 27 NLake PlacidFL33852Wound Care

Form990 Schedule H Part VI Form990ScheduleHPartVI (43 entries)

ExplanationExplanationReturn ReferenceReturnReferenceIdentifierIdentifier
Part I, Line 6a: The filing organization is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC serves as a parent organization to 24 tax-exempt 501(c)(3) hospital organizations that operate 43 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).
Part I, Line 7: The amounts of costs reported in the table in line 7 of Part I of Schedule H were determined by utilizing a cost-to-charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges, contained in the Schedule H instructions.
Part II: The costs of community building activities reported on Part II of Schedule H primarily represent the costs associated with commercially sponsored research conducted by two of the organization's hospitals. These two hospitals participate in clinical drug and device research that is performed on patients who have a condition or disease for which the eventual commercial use of a drug or device is intended. This research is related to patient care and serves to expand scientific knowledge with respect to potential treatments and cures for various diseases and conditions.The remainder of the costs incurred stem from the hospitals' involvement in and support of various other community agencies in its service area that work collaboratively to help those in need and to improve the health and safety of the residents of the community. The organization's hospitals participate with a number of other community organizations to address the healthcare needs of the community. Both cash and in-kind donations are made annually to various local charitable organizations.
Part III, Line 8: Costing Methodology: Medicare allowable costs were calculated using a cost-to-charge ratio.Rationale for Including a Medicare Shortfall as Community Benefit:As a 501(c)(3) organization, the filing organization provides emergency and non-elective care to all regardless of ability to pay. All hospital services are provided in a non-discriminatory manner to patients who are covered beneficiaries under the Medicare program. As a public insurance program, Medicare provides a pre-established reimbursement rate/amount to health care providers for the services they provide to patients. In some cases, the reimbursement amount provided to a hospital may exceed its costs of providing a particular service or services to a patient. In other cases, the Medicare reimbursement amount may result in the hospital experiencing a shortfall of reimbursement received over costs incurred. In those cases where an overall shortfall is generated for providing services to all Medicare patients, the shortfall amount should be considered as a benefit to the community. Tax-exempt hospitals are required to accept all Medicare patients regardless of the profitability, or lack thereof, with respect to the services they provide to Medicare patients. The population of individuals covered under the Medicare program is sufficiently large so that the provision of services to the population is a benefit to the community and relieves the burdens of government. In those situations where the provision of services to the total Medicare patient population of a tax-exempt hospital during any year results in a shortfall of reimbursement received over the cost of providing care, the tax-exempt hospital has provided a benefit to a class of persons broad enough to be considered a benefit to the community. Despite a financial shortfall, a tax-exempt hospital must and will continue to accept and care for Medicare patients. Typically, tax-exempt hospitals provide health care services based upon an assessment of the health care needs of their community as opposed to their taxable counterparts where profitability often drives decisions about patient care services that are offered. Patient care provided by tax-exempt hospitals that results in Medicare shortfalls should be considered as providing a benefit to the community and relieving the burdens of government.
Part III, Line 9b: Collection Policies:At the time of patient registration, non-elective self-pay patients are informed of the minimum discount available under the filing organization's self-pay discount policy. Such patients are also informed of the filing organization's charity care policy and told that they will be required to submit necessary financial data in order to potentially receive any additional discounts. Under the filing organization's financial assistance policy, percentage discounts are applied to a patient's account based upon amounts generally billed to individuals who have insurance covering such care.Under the filing organization's policies, payment plans for partial charity accounts will be individually developed with the patient. Partial charity accounts result when a financial assistance eligibility determination allows for a percentage reduction but leaves the patient with a self-pay balance. If the patient complies with the agreed-upon payment plan, the filing organization does not pursue any collection action with respect to the patient. However, if a patient does not make any payments for three consecutive months, the account may be referred for further collection activity. The filing organization does not pursue collection of amounts from patients determined to qualify for a 100% reduction in charges under its charity care policy.
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 2:
Methodology for Determining the Estimated Amount of Bad Debt Expense that May Represent Patients who Could Have Qualified under the Filing Organization's Charity Care Policy:Self-pay patients are required to complete a Patient Financial Assistance Application Short Form (PFAA). If the PFAA is not completed after reasonable attempts to obtain it are exhausted, patient information is processed through a Scorer product. The Scorer product utilizes publicly available data, such as credit reports, to assess an individual patient's financial viability. Patients who earn a certain score on the Scorer product 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 Scorer product 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 Charity Care Policy, every effort is made to obtain a patient's necessary financial information to determine eligibility for charity care. However, not all patients will cooperate with such efforts and a charity care eligibility determination can not be made. 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 3:
Financial Statement Footnote Related to Accounts Receivable and Allowance for Uncollectible Accounts:The financial information of the filing organization is included in a consolidated audited financial statement for the current year.The applicable footnote from the attached consolidated audited financial statements that addresses accounts receivable, the allowance for uncollectible accounts, and the provision for bad debts can be found on pages 8 and 9. Please note that dollar amounts on the attached consolidated audited financial statements are in thousands.Part III, Line 4:
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: $(94,619,362)- Difference in costing methodology: 16,195,295- Unreimbursed costs incurred for services provided to Medicare patients that are not included in the organization's Medicare cost report: (61,483,719) -------------Total Unreimbursed costs of serving all Medicare patients per the filing organization's community benefit reporting: $(139,907,786)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.Supplemental Schedule to Schedule H, Part III, Section B
Part VI, Line 2: In accordance with IRC Section 501(r)(3), the filing organization's hospitals have adopted and implemented a policy that sets forth the general requirements, processes and procedures with respect to conducting a community health needs assessment and associated implementation strategy. During 2012, the filing organization's hospitals were in the process of planning for their initial Community Health Needs Assessments (CHNA) that are to be completed by 12/31/2013. In addition to the CHNAs that are being conducted, a variety of practices and processes are in place to ensure that the filing organization's hospitals are responsive to the health needs of their communities. Such practices and processes involve the following:1. Hospitals' 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 hospital communities; and 4. Collaboration with other local community groups to address the health care needs of the filing organization's hospital communities.
Part VI, Line 3: The filing organization's hospitals have a process in place whereby patients are informed about the Hospital's Charity Care Policy and other forms of financial assistance, such as self-pay discounts. Signage is posted in the Emergency Rooms indicating that financial assistance is available for those self-pay patients meeting eligibility requirements. After EMTALA medical screening and stabilization requirements are met, registration personnel will secure financial information on as many self-pay patients as possible at the time of service. For those who appear to qualify for Medicaid or under the Hospital's Charity Care Policy, the financial counselors will continue to work with those patients until final account resolution is achieved. All other self-pay patients are covered under this process. At any time during the process that data is provided showing that a patient qualifies for assistance under the Charity Care Policy the discounts extended under that policy will be applied.As part of the billing process, the filing organization's Hospitals include the application for charity care assistance along with the initial patient bill. The Hospitals' charity care applications are also available to patients on the Hospitals' web-sites in both an English and Spanish version. Additionally, the Hospitals' financial counselors are available to work with every patient during the first 120 days of the billing process to assist the patient with completing charity care applications and investigating other potential sources of third-party assistance. The determination of a patient's eligibility for charity care is made on a case-by-case basis. Various factors are considered in that determination. Each individual patient who is identified as potentially being eligible to receive charity care is seen by a financial counselor at the Hospital. The financial counselor will work with the patient to make sure that other sources of assistance (public or otherwise) have been sought to the fullest extent possible. When other forms of assistance are not available or have been exhausted, the Hospitals will gather certain financial information from the patient to determine the patient's ability to pay based upon level of income.
Part VI, Line 4: In 2012, the filing organization operated 5 hospitals that together encompassed 13 separate campus locations. The hospitals are located in Florida, Illinois and Texas. A description of each of the 5 hospitals is described below.Adventist Health System/Sunbelt, Inc. dba Central Texas Medical Center:Central Texas Medical Center (CTMC) is a 178-bed acute-care hospital providing a wide range of healthcare services in San Marcos, Texas and the neighboring communities within Hays and Caldwell counties, Texas. Special services offered at CTMC include a 24/7, Level 4 emergency and trauma center, state-of-the-art medical imaging and laboratory services, a new women's center featuring a Level 2 Neonatal Intensive Care Unit, newly renovated and expanded surgery suites, a Rehabilitation Institute, a center for advanced wound healing and hyperbaric medicine, and a cardiac catheterization lab. As a health resource for their community, CTMC's Institute for Healthy Living also annually hosts the oldest and largest health screening and fair event in Hays County as well as a number of ongoing classes and workshops ranging in topics from diabetes prevention and management to heart disease, stroke, arthritis, self-help, nutrition and more. CTMC received accreditation as a certified chest pain center from the Society of Chest Pain Centers in 2011. The accreditation enhances the hospital's ability to receive and treat patients suffering from chest pain and/or a possible heart attack. The result is a focus on reduced time from symptom onset to diagnosis and treatment, getting patients treated more quickly during the critical window of time when the integrity of the heart muscle can be preserved, and monitoring of patients whose diagnosis is uncertain to ensure they are not sent home too quickly or admitted unnecessarily. In 2010, 2011 and 2012, CTMC was named The Best Hospital in Hays County. In 2012, CTMC became the first operating room along the IH-35 corridor between Austin and San Antonio to be equipped with a da Vinci robotic-assisted surgery suite.San Marcos, Texas is located in Hays County and is in close proximity to Austin and San Antonio. The Hospital's primary market has a population of approximately 89,000, with an estimated 8,400 over the age of 65. The weighted average household income, based on population, in the primary market is approximately $39,000. High school graduates account for approximately 87% of Hays County, with an estimated 32% having a bachelor's degree or higher. It is estimated that 18% of the individuals residing in Hays County live below the poverty level and the unemployment rate is about 8%. Approximately 39% of the Hospital's patients during 2012 were Medicare patients, about 13% were Medicaid patients, about 15% were self-pay patients and the remaining percentage were patients covered under commercial insurance. In 2012, about 66% of the hospital's in-patients were admitted through the hospital's Emergency Department.Adventist Health System/Sunbelt, Inc. dba Florida Hospital Heartland Medical Center:Florida Hospital Heartland Medical Center (FHHMC) is comprised of 3 separate hospital campuses with a total of 222 beds. Two of the hospital campuses are located in Highlands County, Florida and the third campus is located in Hardee County, Florida. Highlands and Hardee counties are in the south central areas of Florida and are adjacent to each other. *FHHMC Sebring Campus - The main 147-bed hospital facility is located in Sebring, FL in Highlands County. The Sebring facility provides a wide range of healthcare services including a Stroke Center and vascular surgery center, imaging services (CT scanner/MRI), stroke and cardiac rehabilitation, and a Cardiac Catheterization Lab. A community education center and library are also located on the Sebring campus offering free and low-cost community classes, screenings and a resource information library. In 2009, the hospital began performing percutaneous coronary intervention (PCI) in a new cath lab and a second cath lab was opened in 2010. *FHHMC Lake Placid Campus houses 33 medical and surgical beds, Highland County's only 17 bed inpatient mental health unit, an outpatient counseling center, and a wide range of services that are highly sophisticated for a small community hospital. The Lake Placid campus also specializes in inpatient geriatric psychiatric services and outpatient behavioral health counseling centers within Highlands and Hardee counties. The need for behavioral health services is extreme in both counties since there is no other program closer than sixty miles.*FHHMC Wauchula Campus is licensed for 25 beds and specializes in emergency and outpatient care, while offering excellent medical inpatient services. The inpatient unit is mixed with both acutely ill patients and patients who need short-term rehabilitation (transitional care). FHHMC Wauchula campus became the first Critical Access Hospital in the State of Florida in the year 2000.As noted above, Highlands and Hardee counties in Florida are located in the heart of the Florida Peninsula. The Hospital's primary market has a population of approximately 133,000 with an estimated 35,000 over the age of 65. The weighted average household income, based on population, in the primary market is approximately $34,000. High school graduates account for approximately 77% of Highlands County, with an estimated 14% having a bachelor's degree or higher. It is estimated that 16% of the individuals residing in Highlands County live below the poverty level and the unemployment rate is about 10%. Approximately 65% of the Hospital's patients during 2012 were Medicare patients, about 13% were Medicaid patients, about 6% were self-pay patients and the remaining percentage were patients covered under commercial insurance. In 2012, about 67% of the hospital's in-patients were admitted through the hospital's Emergency Department.Adventist Health System/Sunbelt, Inc. dba Florida Hospital (FH):FH is a 2,377 bed medical complex in Central Florida with seven separate hospital campuses. FH serves the residents of Central Florida (primarily serving the residents of Orange, Osceola, Seminole and Lake County) but also draws patients from other parts of the Southeastern United States, the Caribbean and South America. The 7-campus health system is the largest healthcare provider in Central Florida and the nation's largest Medicare provider with FH being the second largest employer in the area.The main campus of the FH system is located in Orlando, Florida (Orange County) near the downtown area. The other 6 campuses are located in surrounding communities in the counties of Orange, Osceola, and Seminole. In addition to operating the 7 hospitals, FH also operates 21 full-service urgent care clinics in convenient community settings. A brief description of each of the 7 hospital campuses is described below:*Florida Hospital Orlando (Orange County) - At the core of the FH system, FH Orlando is a 1,183 bed acute-care tertiary hospital caring for more than 1.7 million patients a year. FH Orlando is home to nationally recognized Centers of Excellence for cancer, cardiology, children's health, diabetes, neuroscience, orthopedics, transplant and global robotics. Florida Hospital Orlando houses one of the largest Emergency Departments and cardiac catheterization labs in the country and is one of the busiest hospitals in the nation, providing service excellence to more than 53,000 inpatients and 170,000 outpatients each year. The recent opening of a 15-story patient tower features 200 more beds and 500 new jobs. The campus also includes a state-of-the-art Cardiac Diagnostic Center featuring 15 Cath and electro physiology (EPS) Labs. The cardiology team currently treats 25,000+ individuals for chest pain and performs over 1,300 open heart surgeries each year making them first in the state for the number of surgeries performed. Also located on the Florida Hospital Orlando Campus is the Walt Disney Pavilion at Florida Hospital for Children. The Walt Disney Pavilion is not a stand-alone facility but rather a 7-story, 171-bed tower located on Florida Hospital Orlando's campus. It is a full-service facility served by more than 60 pediatric specialists and a highly trained pediatric team of more than 600 employees. The Walt Disney Pavilion at Florida Hospital for Children delivers a complete range of pediatric health services for younger patients including advanced surgery, oncology, neurosurgery, cardiology and transplant services; full-service pediatrics; and an innovative health and obesity platform. *** see continuation of footnote
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 information provided in Parts I, II and III of this Schedule H, the filing organization captures and reports the benefits provided to its community through faith-based care. Examples of such benefits include the cost associated with chaplaincy care programs and mission peer reviews and mission conferences. During the current year, the filing organization provided $7,294,149 of benefit with respect to the faith-based and spiritual needs of the communities it serves in conjunction with its operation of community hospitals. The filing organization also provides benefits to its communities' infrastructure by investing in capital improvements to ensure that facilities and technology provide the best possible care. During the current year, the filing organization expended $194,840,238 in new capital improvements. As faith-based mission-driven community hospitals, the filing organization is continually involved in monitoring its communities, identifying unmet health care needs and developing solutions and programs to address those needs. In accordance with its conservative approach to fiscal responsibility, surplus funds of the Hospitals 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 Sec. 501(c)(3). AHSSHC and its subsidiary organizations operate 43 hospitals in 10 states throughout the U.S., primarily in the Southeastern portion of the U.S. AHSSHC and its subsidiaries also operate 16 nursing home facilities and other ancillary health care provider facilities, such as ambulatory surgery centers and diagnostic imaging centers. As the parent organization of the AHS system, AHSSHC provides executive leadership and other professional support services to its subsidiary organizations. Professional support services include among others corporate compliance, legal, human resources, reimbursement, risk management, and tax as well as treasury functions. The provision of these executive and support services on a centralized basis by AHSSHC provides an appropriate balance between providing each AHS subsidiary hospital organization with mission-driven consistent leadership and support while allowing the hospital organization to focus its resources on meeting the specific health care needs of the communities it serves. The reader of this Form 990 should keep in mind that this reporting entity may differ in certain areas from that of a stand-alone hospital organization due to its inclusion in a larger system of healthcare organizations. As a part of a system of 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.
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. Certain hospitals within the filing organization file annual community benefit reports with the state in which they are located. Specifically, Huguley Memorial Medical Center and Central Texas Medical Center file community benefit reports with the State of Texas and Adventist La Grange Memorial Hospital files a community benefit report with the State of Illinois.Part VI, Line 7
Orlando is located in Orange County, Florida. The Hospital's primary market has a population of approximately 1,822,000 with an estimated 197,000 over the age of 65. The weighted average household income, based on population, in the primary market is approximately $52,000. High school graduates account for approximately 87% of Orange County, with an estimated 30% having a bachelor's degree or higher. It is estimated that 13% of the individuals residing in Orange County live below the poverty level and the unemployment rate is about 8%. Approximately 42% of the Hospital's patients during 2012 were Medicare patients, about 17% were Medicaid patients, about 7% were self-pay patients and the remaining percentage were patients covered under commercial insurance. In 2012, about 71% of the hospital's in-patients were admitted through the hospital's Emergency Department.*Florida Hospital Altamonte (Seminole County) - FH Altamonte is a 340-bed facility, which has recently doubled in size with a new patient tower to better serve a busy community. FH Altamonte was the first "satellite" hospital, built in 1973 on what was then pastureland, miles from the nearest business district. Located north of Orlando in fast-growing Seminole County, Florida Hospital Altamonte is the largest satellite campus within the Florida Hospital health care system. In addition to maternity, pediatric, emergency, medical and surgical services, the hospital operates the Martin Andersen Cancer Center (along with the region's only Cancer Resource Library), a heart catheterization lab, and a comprehensive outpatient program which includes surgery, diagnostics, and medical treatment programs. *Florida Hospital Apopka (Orange County) - In 1975, FH Apopka became the second satellite hospital. For nearly three decades, Florida Hospital Apopka has set the standard in hometown health care by providing high-tech, quality care with a personalized touch. They are situated just 12 miles northwest of Orlando, with a small, yet advanced, 50-bed campus that houses a certified Chest Pain Center and a multitude of inpatient and outpatient services.*Florida Hospital Celebration Health (Osceola County) - FH Celebration Health is a cornerstone of Disney's planned community in Celebration, Florida. Today, this 174-bed acute care hospital delivers a state-of-the-art healing environment to residents of Osceola, Orange, Polk and Lake Counties, as well as to visitors from across the United States and the world. From its creation FH Celebration Health has been about promoting health and wellness as well as healing. Inside the resort-style hospital there is a wellness center, complete with workout area, pool, rehabilitation facility. FH Celebration Health also houses the Global Robotics Institute, which provides patients with access to some of the most experienced robotic surgeons in the world. The Nicholson Center for Surgical Advancement also is a location where surgeons from around the world travel to learn the latest robotic surgery techniques. In 2011, the new 234,000 square-foot patient tower added 62 beds and will house the Interactive Patient Care Unit, the first of its kind in the nation. In connection with the Institute for Interactive Patient Care, everything from new patient safety technology to changing ways to communicate with patients about their care could be studied as part of the unit. *Florida Hospital East Orlando (Orange County) - FH East Orlando is now an innovative local leader that fills a vital need in a fast-growing area. A recent 200,000 square-foot expansion project upgraded the hospital to 225 beds, with a spacious patient tower and 80 new private rooms designed to enhance the holistic care experience.*Florida Hospital Kissimmee (Osceola County) - FH Kissimmee is an 83-bed community-focused hospital, conveniently located near Walt Disney World. The team located at FH Kissimmee is dedicated to bringing mission-focused, faith-based care to residents and visitors of Osceola and Orange Counties. This facility has recently expanded to include a new medical office building, patient tower, new main entrance and a parking garage.*Florida Hospital Winter Park (Orange County) - FH Winter Park Memorial Hospital is a 322-bed facility that is a model of community health and wellness. The facility boasts spacious patient care areas and a full spectrum of specialties and services, including the Dr. P. Phillips Baby Place (with Level II NICU), Florida Hospital Orthopedic Institute, and state-of-the-art surgery, recovery and rehabilitation at the Florida Hospital Cancer Institute. Adventist Health System/Sunbelt, Inc. dba Huguley Memorial Medical Center:Note: On 5/1/2012, the net assets associated with the operation of Huguley Memorial Medical Center (HMMC) were transferred into Texas Health Huguley, Inc., a 501(c)(3) tax-exempt organization which is owned 49% by Adventist Health System/Sunbelt, Inc. and 51% by Texas Health Resources. Accordingly, only the operations for HMMC for the period 1/1/12 4/30/2012 are included in this return. Huguley Memorial Medical Center (HMMC) is a 223-bed acute-care hospital in Burleson, Texas. The hospital houses two intensive care units, a progressive care unit, an open-heart surgery center, a behavioral health center and a 24/7 emergency department. HMMC has a 16-bed intensive care unit for patients with medical care and respiratory needs and a 12-bed intensive care unit concentrating on cardiovascular patients. A 4-bed dialysis center is available for renal patients with critical needs. Additionally, there is a 33-bed Progressive Care Unit designed to bridge the gap between the Intensive Care Unit and the medical-surgical units. Part of HMMC's primary service area includes a number of smaller communities with limited access to healthcare services. To meet the needs of these residents, HMMC has established multiple primary care clinics throughout its primary service area. In addition, the Mobile Health Services Bus provides health screenings and wellness education services throughout Tarrant and Johnson counties. Burleson, Texas is located in Johnson County and serves the South Fort Worth area. The Hospital's primary market has a population of approximately 212,000, with an estimated 25,000 over the age of 65. The weighted average household income, based on population, in the primary market is approximately $53,000. High school graduates account for approximately 82% of Johnson County, with an estimated 16% having a bachelor's degree or higher. It is estimated that 11% of the individuals residing in Johnson County live below the poverty level and the unemployment rate is about 8%. Approximately 51% of the Hospital's patients during 2012 were Medicare patients, about 14% were Medicaid patients, about 8% were self-pay patients and the remaining percentage were patients covered under commercial insurance. In 2012, about 74% of the hospital's in-patients were admitted through the hospital's Emergency Department.Adventist Health System/Sunbelt, Inc. dba Adventist La Grange Memorial Hospital:Adventist La Grange Memorial Hospital (ALMH) is a 205-bed facility providing outpatient and inpatient primary care, trauma care and wellness services to residents of Chicago's western suburbs. The hospital is a leader in offering comprehensive oncology services, orthopedic services, advanced cardiac care, women's health and maternity care, emergency, geriatric and many other specialties that cater to the communities it serves. The communities served by ALMH contain a high senior population. To address the unique needs of its service area, ALMH offers a broad spectrum of services designed to meet the diverse needs of aging adults. La Grange, Illinois is located in Cook County. The Hospital's primary market has a population of approximately 158,000, with an estimated 25,000 over the age of 65. The weighted average household income, based on population, in the primary market is approximately $68,000. High school graduates account for approximately 85% of Cook County, with an estimated 33% having a bachelor's degree or higher. It is estimated that 15% of the individuals residing in Cook County live below the poverty level and the unemployment rate is about 9%. Approximately 54% of the Hospital's patients during 2012 were Medicare patients, about 7% were Medicaid patients, about 3% were self-pay patients and the remaining percentage were patients covered under commercial insurance. In 2012, about 75% of the hospital's in-patients were admitted through the hospital's Emergency Department.Part VI, Line 4 Continuation of FootnoteDescription of Community Information - Continued
See belowPart V, Line 8 Facility Reporting Group A
The filing organization has developed a patient-friendly summary version of its financial assistance policy (FAP). The filing organization's FAP provides that its hospital facility will post the patient-friendly summary version of its FAP on the Hospital's website. In addition, the FAP of the Hospital facility states that signage regarding the availability of the Hospital facility's FAP will be visible at points of admission and registration, including the emergency department.Part V, Section B, line 14g:Facility 1 -- Florida Hospital Orlando
In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital uses the following methodology:The Hospital identifies all commercial payors whose volume of activity with the Hospital equals or exceeds $100,000 for the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates is determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determines the maximum amount that can be charged to patients eligible under the Hospital's financial assistance policy.Part V, Section B, line 20d:Facility 1 -- Florida Hospital Orlando
The filing organization has developed a patient-friendly summary version of its financial assistance policy (FAP). The filing organization's FAP provides that its hospital facility will post the patient-friendly summary version of its FAP on the Hospital's website. In addition, the FAP of the Hospital facility states that signage regarding the availability of the Hospital facility's FAP will be visible at points of admission and registration, including the emergency department.Part V, Section B, line 14g:Facility 2 -- Florida Hospital Celebration Health
In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital uses the following methodology:The Hospital identifies all commercial payors whose volume of activity with the Hospital equals or exceeds $100,000 for the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates is determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determines the maximum amount that can be charged to patients eligible under the Hospital's financial assistance policy.Part V, Section B, line 20d:Facility 2 -- Florida Hospital Celebration Health
The filing organization has developed a patient-friendly summary version of its financial assistance policy (FAP). The filing organization's FAP provides that its hospital facility will post the patient-friendly summary version of its FAP on the Hospital's website. In addition, the FAP of the Hospital facility states that signage regarding the availability of the Hospital facility's FAP will be visible at points of admission and registration, including the emergency department.Part V, Section B, line 14g:Facility 3 -- Florida Hospital Altamonte
In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital uses the following methodology:The Hospital identifies all commercial payors whose volume of activity with the Hospital equals or exceeds $100,000 for the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates is determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determines the maximum amount that can be charged to patients eligible under the Hospital's financial assistance policy.Part V, Section B, line 20d:Facility 3 -- Florida Hospital Altamonte
The filing organization has developed a patient-friendly summary version of its financial assistance policy (FAP). The filing organization's FAP provides that its hospital facility will post the patient-friendly summary version of its FAP on the Hospital's website. In addition, the FAP of the Hospital facility states that signage regarding the availability of the Hospital facility's FAP will be visible at points of admission and registration, including the emergency department.Part V, Section B, line 14g:Facility 4 -- Florida Hospital East Orlando
In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital uses the following methodology:The Hospital identifies all commercial payors whose volume of activity with the Hospital equals or exceeds $100,000 for the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates is determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determines the maximum amount that can be charged to patients eligible under the Hospital's financial assistance policy.Part V, Section B, line 20d:Facility 4 -- Florida Hospital East Orlando
The filing organization has developed a patient-friendly summary version of its financial assistance policy (FAP). The filing organization's FAP provides that its hospital facility will post the patient-friendly summary version of its FAP on the Hospital's website. In addition, the FAP of the Hospital facility states that signage regarding the availability of the Hospital facility's FAP will be visible at points of admission and registration, including the emergency department.Part V, Section B, line 14g:Facility 5 -- Winter Park Memorial Hospital
In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital uses the following methodology:The Hospital identifies all commercial payors whose volume of activity with the Hospital equals or exceeds $100,000 for the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates is determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determines the maximum amount that can be charged to patients eligible under the Hospital's financial assistance policy.Part V, Section B, line 20d:Facility 5 -- Winter Park Memorial Hospital
The filing organization has developed a patient-friendly summary version of its financial assistance policy (FAP). The filing organization's FAP provides that its hospital facility will post the patient-friendly summary version of its FAP on the Hospital's website. In addition, the FAP of the Hospital facility states that signage regarding the availability of the Hospital facility's FAP will be visible at points of admission and registration, including the emergency department.Part V, Section B, line 14g:Facility 6 -- Adventist La Grange Memorial Hospital
In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital uses the following methodology:The Hospital identifies all commercial payors whose volume of activity with the Hospital equals or exceeds $100,000 for the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates is determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determines the maximum amount that can be charged to patients eligible under the Hospital's financial assistance policy.Part V, Section B, line 20d:Facility 6 -- Adventist La Grange Memorial Hospital
The filing organization has developed a patient-friendly summary version of its financial assistance policy (FAP). The filing organization's FAP provides that its hospital facility will post the patient-friendly summary version of its FAP on the Hospital's website. In addition, the FAP of the Hospital facility states that signage regarding the availability of the Hospital facility's FAP will be visible at points of admission and registration, including the emergency department.Part V, Section B, line 14g:Facility 7 -- FH Heartland Medical Center
In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital uses the following methodology:The Hospital identifies all commercial payors whose volume of activity with the Hospital equals or exceeds $100,000 for the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates is determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determines the maximum amount that can be charged to patients eligible under the Hospital's financial assistance policy.Part V, Section B, line 20d:Facility 7 -- FH Heartland Medical Center
The filing organization has developed a patient-friendly summary version of its financial assistance policy (FAP). The filing organization's FAP provides that its hospital facility will post the patient-friendly summary version of its FAP on the Hospital's website. In addition, the FAP of the Hospital facility states that signage regarding the availability of the Hospital facility's FAP will be visible at points of admission and registration, including the emergency department.Part V, Section B, line 14g:Facility 8 -- Florida Hospital Kissimmee
In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital uses the following methodology:The Hospital identifies all commercial payors whose volume of activity with the Hospital equals or exceeds $100,000 for the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates is determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determines the maximum amount that can be charged to patients eligible under the Hospital's financial assistance policy.Part V, Section B, line 20d:Facility 8 -- Florida Hospital Kissimmee
The filing organization has developed a patient-friendly summary version of its financial assistance policy (FAP). The filing organization's FAP provides that its hospital facility will post the patient-friendly summary version of its FAP on the Hospital's website. In addition, the FAP of the Hospital facility states that signage regarding the availability of the Hospital facility's FAP will be visible at points of admission and registration, including the emergency department.Part V, Section B, line 14g:Facility 9 -- Central Texas Medical Center
In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital uses the following methodology:The Hospital identifies all commercial payors whose volume of activity with the Hospital equals or exceeds $100,000 for the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates is determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determines the maximum amount that can be charged to patients eligible under the Hospital's financial assistance policy.Part V, Section B, line 20d:Facility 9 -- Central Texas Medical Center
The filing organization has developed a patient-friendly summary version of its financial assistance policy (FAP). The filing organization's FAP provides that its hospital facility will post the patient-friendly summary version of its FAP on the Hospital's website. In addition, the FAP of the Hospital facility states that signage regarding the availability of the Hospital facility's FAP will be visible at points of admission and registration, including the emergency department.Part V, Section B, line 14g:Facility 10 -- Florida Hospital Apopka
In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital uses the following methodology:The Hospital identifies all commercial payors whose volume of activity with the Hospital equals or exceeds $100,000 for the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates is determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determines the maximum amount that can be charged to patients eligible under the Hospital's financial assistance policy.Part V, Section B, line 20d:Facility 10 -- Florida Hospital Apopka
The filing organization has developed a patient-friendly summary version of its financial assistance policy (FAP). The filing organization's FAP provides that its hospital facility will post the patient-friendly summary version of its FAP on the Hospital's website. In addition, the FAP of the Hospital facility states that signage regarding the availability of the Hospital facility's FAP will be visible at points of admission and registration, including the emergency department.Part V, Section B, line 14g:Facility 11 -- FH Heartland Medical Center Lake Placid
In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital uses the following methodology:The Hospital identifies all commercial payors whose volume of activity with the Hospital equals or exceeds $100,000 for the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates is determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determines the maximum amount that can be charged to patients eligible under the Hospital's financial assistance policy.Part V, Section B, line 20d:Facility 11 -- FH Heartland Medical Center Lake Placid
The filing organization has developed a patient-friendly summary version of its financial assistance policy (FAP). The filing organization's FAP provides that its hospital facility will post the patient-friendly summary version of its FAP on the Hospital's website. In addition, the FAP of the Hospital facility states that signage regarding the availability of the Hospital facility's FAP will be visible at points of admission and registration, including the emergency department.Part V, Section B, line 14g:Facility 12 -- Florida Hospital Wauchula
In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital uses the following methodology:The Hospital identifies all commercial payors whose volume of activity with the Hospital equals or exceeds $100,000 for the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates is determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determines the maximum amount that can be charged to patients eligible under the Hospital's financial assistance policy.Part V, Section B, line 20d:Facility 12 -- Florida Hospital Wauchula
The filing organization has developed a patient-friendly summary version of its financial assistance policy (FAP). The filing organization's FAP provides that its hospital facility will post the patient-friendly summary version of its FAP on the Hospital's website. In addition, the FAP of the Hospital facility states that signage regarding the availability of the Hospital facility's FAP will be visible at points of admission and registration, including the emergency department.Part V, Section B, line 14g:Facility 13 -- Huguley Memorial Medical Center
In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital uses the following methodology:The Hospital identifies all commercial payors whose volume of activity with the Hospital equals or exceeds $100,000 for the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates is determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determines the maximum amount that can be charged to patients eligible under the Hospital's financial assistance policy.Part V, Section B, line 20d:Facility 13 -- Huguley Memorial Medical Center

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (95 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistanceAddress Line2AddressUS/AddressLine2
ADVENTIST CARE CENTERS - COURTLAND INC
730 COURTLAND STORLANDOFL32804205774723501(c)(3)218100General Support
AFRICAN AMERICAN CHAMBER OF COMMERCE OF CENTRAL FLORIDA INC
315 E ROBINSON ST STE 100ORLANDOFL32801593314330501(c)(6)12500General Support
AMERICAN ASSOCIATION OF PHYSICIANS OF INDIAN ORIGIN
600 ENTERPRISE DR STE 108OAK BROOKIL60523382532505501(c)(3)12000General Support
AMERICAN CANCER SOCIETY INC FLORIDA DIVISION INC
3709 W Jetton AvenueTampaFL33873590657320501(c)(3)31000General Support
AMERICAN DIABETES ASSOCIATION
1101 N LAKE DESTINY RD STE 415MAITLANDFL32751131623888501(c)(3)12500General Support
AMERICAN HEART ASSOCIATION INC
1101 NORTHCHASE PKWY SE STE 1MARIETTAGA30067135613797501(c)(3)110000General Support
AMERICAN LUNG ASSOCIATION OF THE SOUTHEAST INC
851 OUTER RDORLANDOFL32814590662271501(c)(3)35000General Support
BOY SCOUNTS OF AMERICA INC CENTRAL FLORIDA COUNIL
PO BOX 422101KISSIMMEEFL34742590624376501(c)(3)43500General Support
CELEBRATION FOUNDATION INC
610 SYCAMORE STCELEBRATIONFL34747593370753501(c)(3)6000General Support
CENTRAL FLORIDA FAMILY HEALTH CENTER INC
2400 STATE ROAD 415SANFORDFL32771591741286501(c)(3)110000General Support
CENTRAL FLORIDA PARTNERSHIP INC
75 S IVANHOE BLVDORLANDOFL32804331202266501(c)(6)100000General Support
CENTRAL FLORIDA YOUNG MEN'S CHRISTIAN ASSOCIATION
433 NORTH MILLS AVENUEORLANDOFL32803590624430501(c)(3)13750General Support
CENTRAL TEXAS HEALTHCARE COLLABORATIVE
1301 WONDER WORLD DRSAN MARCOSTX78666453739929501(c)(3)1047149Provision of Indigent Care
CENTRAL TEXAS MEDICAL CENTER FOUNDATION
1301 WONDER WORLD DRSAN MARCOSTX78666742259907501(c)(3)General Support77441BookProvision of general administrative support
CHAMBER OF COMMERCE FOR PERSONS WITH DISABILTIES INC
3201 E COLONIAL DRORLANDOFL328035174208994529501(c)(6)6000General Support
CHRISTIAN SERVICE CENTER FOR CENTRAL FLORIDA INC
808 W CENTRAL BLVDORLANDOFL32805591353031501(c)(3)13000General Support
CITY OF ALTAMONTE SPRINGS
150 CRANES ROOST BLVD STE 2200ALTAMONTE SPRINGSFL32701596000263Gov't30000General Support
CITY OF ORLANDO
400 South Orange AvenueORLANDOFL32801596000396Gov't4921000General Support
CITY OF ORLANDO COMMUTER RAIL SYSTEM
400 South Orange AvenueORLANDOFL32801596000396Gov't375812General Support
CITY OF WINTER PARK
401 S PARK AVEWINTER PARKFL32789596000454Gov't10000General Support
COMMUNITY VISION
704 GENERATION PT APT 101KISSIMMEEFL347445918592896657501(c)(3)12500General Support
D12 FOUNDATION INC
711 N MAGNOLIA AVEORLANDOFL32803273846066501(c)(3)10000General Support
DOWN SYNDROME FOUNDATION OF FLORIDA
PO BOX 533462ORLANDOFL328533462272436041501(c)(3)5250General Support
DOWNTOWN COLLEGE PARK PARTNERSHIP INC
PO BOX 547744ORLANDOFL32854237250533501(c)(3)13500General Support
EAST ORLANDO HEALTH & REHAB CENTER INC
250 S CHICKASAW TRAILORLANDOFL32825205774748501(c)(3)1404864General Support
FLNC INC
3355 E SEMORAN BLVDAPOPKAFL32703205774761501(c)(3)2199240General Support
FLORIDA CHAMBER OF COMMERCE FOUNDATION INC
136 S BRONOUGH STTALLAHASSEEFL323017706596209605501(c)(3)25000General Support
FLORIDA CHAMBER OF COMMERCE INC
PO BOX 11309 136 SOUTH BRONOUGHTALLAHASSEEFL32302590248200501(c)(6)100000General SupportSTREET
Florida Hospital Waterman Inc
1000 Waterman WayTavaresFL32778593140669501(c)(3)239166General Support
FLORIDA INTERFAITH INSTITUTE
PO BOX 3310WINTER PARKFL327903310455420165501(c)(3)25000General Support
FOREST LAKE ACADEMY
500 EDUCATION LOOPAPOPKAFL327036176590816443501(c)(3)6500General Support
FOUNDATION FOR EARLY CHILDHOOD DEVELOPMENT
PO BOX 540387ORLANDOFL328540387861076294501(c)(3)20000General Support
FOUNDATION FOR WOMEN'S CANCER
230 W MONROE STCHICAGOIL606064902363797707501(c)(3)15000General Support
GET HEALTHY FLORIDA
142 W LAKEVIEW AVE STE 2040LAKE MARYFL327462903200463380Other35000General Support - Flu Shot Event Sponsor
GR8 TO DON8 INC
968 MOSS TREE PLLONGWOODFL32750271946207501(c)(3)10000General Support
GRACE MEDICAL HOME INC
51 PENNSYLVANIA STREETORLANDOFL328062938281817966501(c)(3)101500General Support
HARBOR HOUSE OF CENTRAL FLORIDA INC
PO BOX 12434ORLANDOFL32801591712936501(c)(3)5500General Support
HEALTH CARE CENTER FOR THE HOMELESS INC
232 N ORANGE BLOSSOM TRLORLANDOFL32805593185020501(c)(3)130000General Support
HEALTHY START COALITION OF ORANGE COUNTY INC
600 COURTLAND ST STE 565ORLANDOFL32804593125675501(c)(3)25000General Support
HEALTHY START COALITION OF OSCEOLA COUNTY INC
PO BOX 701995ST CLOUDFL34770593212535501(c)(3)7500General Support
HEART OF FLORIDA UNITED WAY INC
1940 TRAYLOR BLVDORLANDOFL32804590808854501(c)(3)79025General Support
Heartland Triathlon of Highlands County Inc
1200 Highlands DriveLake PlacidFL33852452232127501(c)(3)13000General Support
Highlands County Habitat for Humanity
159 S Commerce AvenueSebringFL33870593023727501(c)(3)15000Construction
HISPANIC BUSINESS INITIATIVE FUND OF FLORIDA INC
3201 E COLONIAL DR UNIT A20ORLANDOFL32803593341405501(c)(3)33000General Support
HISPANIC CHAMBER OF COMMERCE METRO ORLANDO INC
315 E ROBINSON ST STE 465ORLANDOFL32801593103840501(c)(6)21000General Support
HOPE NOW INTERNATIONAL INC
PO BOX 181173CASSELBERRYFL327181173274498303501(c)(3)10000General Support
HOSPICE OF THE COMFORTER INC
480 WEST CENTRAL PARKWAYALTAMONTE SPRINGSFL32714592935928501(c)(3)7500General Support
INSTITUTE FOR DIVERSITY IN HEALTH MANAGEMENT INC
75 REMITTANCE DRCHICAGOIL606751072582094118501(c)(3)15000General Support
IVANHOE VILLAGE INC
320 E PRINCETON STORLANDOFL32804261797406501(c)(3)7000General Support
JEWISH NATIONAL FUND (KEREN KAYEMETH LEISRAL) INC
1951 NW 19TH STBOCA RATONFL334317344131659627501(c)(3)20000General Support
Johnson County Community Care Corporation
11801 South FreewayBurlesonTX76028452793120501(c)(3)474032Indigent Care
JUNIOR ACHIEVEMENT OF CENTRAL FLORIDA INC
PO BOX 917197ORLANDOFL32891590972112501(c)(3)34000General Support
KIDS HOUSE OF SEMINOLE INC
5467 NORTH RONALD REGAN BLVDSANFORDFL32773593415005501(c)(3)5500General Support
KISSIMMEEOSCEOLA COUNTY CHAMBER OF COMMERCE
1425 E VINE STREETKISSIMMEEFL34744590319865501(c)(6)12000General Support
La Grange Memorial Hospital Foundation
5101 South Willow Springs RoadLa GrangeIL60525300247776501(c)(3)General Support293533BookProvision of general administrative support
LAKESIDE BEHAVIORAL HEALTHCARE INC
1800 MERCY DRIVE STE 302ORLANDOFL32808592301233501(c)(3)1199261General Support
LIFEWORK LEADERSHIP
301 E PINE STREET STE 150ORLANDOFL32801371592618501(c)(3)10000General Support
MARCH OF DIMES FOUNDATION
341 N MAITLAND AVE STE 115MAITLANDFL32751131846366501(c)(3)18000General Support
METHODIST HEALTHCARE FOUNDATION
1211 UNION AVENUE STE 733MEMPHISTN381046638237320638501(c)(3)20000General Support
MICHELEE PUPPETS INC
4420 PARKWAY COMMERCE BLVD AORLANDOFL32808592616456501(c)(3)5190General Support
NATIONAL KIDNEY FOUNDATION OF FLORIDA INC
1040 WOODCOCK RD STE 119ORLANDOFL328033510592190073501(c)(3)16000General Support
NEW IMAGE YOUTH CENTER INC
208 S PARRAMORE AVEORLANDOFL32805562482818501(c)(3)10000General Support
ORLANDO HEALTH INC
86 W UNDERWOOD STREETORLANDOFL328061110591726273501(c)(3)7000General Support
ORLANDO JUNIOR ACADEMY
30 E EVANS STREETORLANDOFL32804262325009501(c)(3)12600General Support
ORLANDO SCIENCE CENTER INC
777 E PRINCETON STREETORLANDOFL32803590896343501(c)(3)7500General Support
ORLANDO SHAKESPEARE THEATER INC
812 E ROLLINS STORLANDOFL328031202592931698501(c)(3)10000General Support
OSCEOLA COUNTY COUNCIL ON AGING INC
700 GENERATION POINTKISSIMMEEFL34744591595398501(c)(3)93622General Support
ROLLINS COLLEGE
1000 HOLT AVENUE - 2722WINTER PARKFL327894499590624440501(c)(3)10000General Support
RONALD MCDONALD HOUSE CHARITIES OF CENTRAL FLORIDA INC
1350 N ORANGE AVEWINTER PARKFL32789593211250501(c)(3)10000General Support
RUNWAY TO HOPE INC
189 S ORANGE AVEORLANDOFL328013261273272616501(c)(3)6250General Support
Samaritan Touch Care Center Inc
3015 Herring AvenueSebringFL33870020773338501(c)(3)229167Medical care
SANFORD HEALTH
PO BOX 1667SANFORDFL327721667311527032501(c)(3)243333General Support - Childhood Diabetes Education
SECOND HARVEST FOOD BANK OF CENTRAL FLORIDA INC
2008 BRENGLE AVENUEORLANDOFL32808592142315501(c)(3)25000General Support
SEMINOLE STATE COLLEGE
100 WELDON BLVDSANFORDFL327736199591210158Gov't7000General Support
SHEPHERD'S HOPE INC
4851 S APOPKA VINELAND RDORLANDOFL328193128593420727501(c)(3)28000General Support
SOCIETY FOR THE PREVENTION OF CRUELTY TO ANIMALS OF CENTRAL FLORIDA INC
2727 CONROY RDORLANDOFL32839590637883501(c)(3)10500General Support
South Florida State College
600 W College DriveAvon ParkFL33825591218159Gov't23000General Support
South Florida State College Foundation Inc
13 E Main StreetAvon ParkFL33825593050497501(c)(3)7666General Support
SOUTHERN ADVENTIST UNIVERSITY
PO BOX 370COLLEGEDALETN37315620536733501(c)(3)118000General Support
STRENGTHEN ORLANDO INC
400 SOUTH ORANGE AVE 6TH FLOORORLANDOFL328013360271964941501(c)(3)7500General Support
SUNBELT HEALTH & REHAB CENTER - APOPKA INC
305 EAST OAK STAPOPKAFL32703205774856501(c)(3)450000General Support
SunSystem Development Corporation
900 HOPE WAYALTAMONTE SPRINGSFL32714592219301501(c)(3)4861894General Support
SUSAN G KOMEN BREAST CANCER FOUNDATION
1350 ORANGE AVE STE 260WINTER PARKFL32789752854957501(c)(3)10000General Support
SYNECHION INC
6757 ARAPAHO STE 711-238DALLASTX75248752640985Other12000General Support
The School Board of Highlands County
426 School StreetSebringFL33870596000654Gov't10000General Support - Senior Education
US DREAM ACADEMY INC
10400 LITTLE PATUXENT PKWAY SUITECOLUMBIAMD21044593514841501(c)(3)30000General Support300
UNITED GLOBAL OUTREACH INC
2311 MOUNT VERNON STORLANDOFL32803030511875501(c)(3)201126General Support
UNIVERSAL ORLANDO FOUNDATION INC
1000 UNIVERSAL STUDIOS PLAZAORLANDOFL32819593510383501(c)(3)15000General Support
UNIVERSITY OF CENTRAL FLORIDA
PO BOX 160046ORLANDOFL328160046592924021Gov't13750General Support
UNIVERSITY OF CENTRAL FLORIDA FOUNDATION INC
12424 RESEARCH PARKWAY STE 140ORLANDOFL32826596211832501(c)(3)55000General Support
VALENCIA COLLEGE FOUNDATION INC
190 S ORANGE AVEORLANDOFL328013204237442785501(c)(3)214500General Support
WEST ORANGE CHAMBER OF COMMERCE
12184 W COLONIAL DRIVEWINTER GARDENFL347874146590576757501(c)(6)8000General Support
WINTER PARK HEALTH FOUNDATION INC
220 EDINBURGH DRWINTER PARKFL32792590669460501(c)(3)135000General Support
WINTER PARK HISTORICAL ASSOCIATION INC
PO BOX 51WINTER PARKFL32790591664195501(c)(3)5500General Support
WINTER PARK YOUTH BASEBALL INC
PO BOX 3702WINTER PARKFL327903702270647788501(c)(3)6000General Support
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants86TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations9TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants in the U.S.:Identifier
Return ReferencePart I, Line 2:ReturnReference
ExplanationSchedule I, Part I, Line 2: Grants are generally made to related organizations that are exempt from Federal Income Tax under 501(c)(3), other 501(c)(3) organizations that are a part of the group exemption ruling issued to the General Conference of Seventh-Day Adventists, or to other local or local affiliate of national charitable organizations whose purposes are healthcare-related. 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.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Discretionary Spending AccountXDiscretionarySpendingAccount
Housing Allowance Or ResidenceXHousingAllowanceOrResidence
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org1CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (24 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Houmann Lars D
Director0869760026676902353230189569052500016139210158447
Jernigan PhD Donald L
Director/CEO0947487028812907407460135990925210208248200
Reiner Richard K
Director0871778026676905433450135990488310174432200
Shaw Terry D
Director0869760026676902072410189569045078015784170158447
Banks David P
Senior VP - FH047880001349240978230905080458160847871062300
Cummings Jr Desmond
Exec VP - FH046495901484930188762013599016433083224600
Dodds Sheryl D
Senior VP - FH03227220991120517280436880144270531677020470
Fulbright Robert D
Senior VP - FH03702420992910466150591360395750614859028216
Goodman Todd A
Senior VP - FH03056850959710370570469210358780521512022392
Hilliard Douglas W
Senior VP - FH03089880968190523880442970348320537324023081
Hurst Jeffry D
Senior VP - FH02981830912500616160272700260790504398010316
Moorhead MD John David
Senior VP - FH0461871013031701274260756170253080820539051075
Owen Terry R
Senior VP - FH0381058011348602560230522360283940831197034002
Paradis J Brian
Exec VP - FH061856901983130109417012383105071501100845089762
Reed MD Monica P
Senior VP - FH042941601238220954180779960364330763085055086
Soler Eddie
CFO - FL Divison05281840170651012238001064720340210961708061612
Lee MD Kathy
Physician36623904528400754970135990127090920884000
Eubanks Jr MD William Stephen
Executive Director of Academic Surge683365014007605093085990161550853288000
Bittner MD Hartmuth
Medical Director779709056034279085990133940836037000
Torres MD Ramon M
Physician599997089773067610135990195800729710000
Jones MD Phillip E
Physician5857280812500248500135990184410723868000
Grim-Marcarelli Karen
Former key employee02443750590250106051021076022807045333404746
Hamilton Connie A
Former key employee0006814003397820135990175560439077051225
Herrin Arlene K
Former key employee02349220576780341350355710181880380494023067

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part I, Line 1aAs discussed in our response to Section B, Part VI, Question 15a & b, 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 Strategy & 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 business meeting ($300 per executive). 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. Health or social club dues or initiation fees: AHSSHC has a Corporate Executive Policy that addresses business development expenditures. Under this policy, certain AHS eligible executives may be reimbursed for member dues and usage charges for a country club or other social club upon authorization. Club memberships must be recommended by the CEO of the AHS hospital organization and approved by the Chairman of the Board of Directors of the organization. In addition, the proposed membership must be approved annually by the AHSSHC Board Strategy & Compensation Committee, an independent committee of the Board of Directors of AHSSHC. Eligible executives are limited to certain senior level executives (hospital organization CEOs, the CEO of the nursing home division of AHS, senior vice presidents at three large hospital organizations, regional CEOs and CFOs and the president and senior vice presidents of AHSSHC). In the current year, for this filing organization, four executives were eligible to receive reimbursement for club fees. Each AHS executive who is approved for a club membership must submit an annual report to the AHSSHC Board Strategy & Compensation Committee that describes how the membership benefited their organization during the preceding year.
Part I, Lines 4a-bDuring the year ending December 31, 2012, Connie A. Hamilton received severance payments in the amount of $288,425. Pursuant to the AHSSHC Corporate Executive Policy governing executive severance, severance agreements for executives operating at the Vice President level and above are entered into upon eligibility to facilitate the transition to subsequent employment following an involuntary separation from employment with AHS. As discussed in Line 1a above, executives on the filing organization's management team that hold the position of Vice-President or above are compensated by and on the payroll of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the parent organization of a healthcare system known as Adventist Health System (AHS). In recognition of the contribution that each executive makes to the success of AHS, AHS provides to eligible executives participation in the AHS Executive FLEX Benefit Program (the Plan). The purpose of the Plan is to offer eligible executives an opportunity to elect from among a variety of supplemental benefits, including deferred compensation benefits taxable under Internal Revenue Code (IRC) Section 457(f), to individually tailor a benefits program appropriate to each executive's needs. The Plan provides eligible participants a pre-determined benefits allowance credit that is equal to a percentage of the executive's base pay from which is deducted the cost of mandatory and elective employee benefits. The pre-determined benefits allowance credit percentage is approved by the AHS Board Strategy & 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 $210,000. 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 ------------------------------------------------------- Houmann, Lars D. $ 175,971 $ 161,469 $ 25,617 $ 0 Jernigan, Ph.D., Donald L. $ 202,164 $ 185,164 $394,589 $ 0 Reiner, Richard K. $ 182,872 $ 167,651 $255,540 $ 0 Shaw, Terry D. $ 175,971 $ 171,709 $ 0 $ 0 Banks, David P. $ 76,910 $ 62,347 $ 0 $ 0 Cummings, Jr., Desmond $ 80,177 $ 80,177 $ 26,942 $ 0 Dodds, Sheryl D. $ 47,090 $ 20,482 $ 0 $ 0 Fulbright, Robert D$ 45,538 $ 28,237 $ 0 $ 0 Goodman, Todd A. $ 33,323 $ 24,800 $ 0 $ 0 Hilliard, Douglas W$ 30,699 $ 23,099 $ 0 $ 0 Hurst, Jeffry D. $ 35,671 $ 10,533 $ 0 $ 0 Moorhead, MD, John David $ 84,019 $ 51,110 $ 0 $ 0 Owen, Terry R. $ 55,638 $ 37,085 $170,398 $ 0 Paradis, J. Brian $ 115,232 $ 89,831 $ 0 $ 0 Reed, MD, Monica P.$ 64,397 $ 55,128 $ 0 $ 0 Soler, Eddie $ 92,874 $ 67,314 $ 0 $ 0 Grim-Marcarelli, Karen $ 24,478 $ 4,825 $ 72,638 $ 0 Hamilton, Connie A.$ 0 $ 37,050 $ 0 $ 0 Herrin, Arlene K. $ 26,972 $ 23,085 $ 0 $ 0 * Including Investment Earnings
Part I, Line 6The 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. Rather, under the compensation arrangement, physician base salary is set based on Fair Market Value benchmarks, and any additional compensation is based on a percentage of the practice/location net revenue.
Part IIIPart I, Question 3: As noted in our response to question 15 of Part VI of Form 990, 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 system-wide CEO of AHS. 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 uses all of the following to establish compensation of the CEO: - Compensation committee; - Independent compensation consultant; - Compensation survey or study; and - Approval by the board or compensation committee.Supplemental Information

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
Highlands County Health Facilities Authority
A521313569431022FR82005-10-18649430862005A, Refund FL 1993A&B, TN 1993 and Tarrant 1993 all issued 10/20/1993000
Highlands County Health Facilities Authority
B521313569431022GN62005-10-181064100632005B, Refund Orange 2000, Tenn 2000, and Tarrant 2000 all issued 8/31/2000000
Highlands County Health Facilities Authority
C521313569431022HG02005-10-18634345352005C, Refund Colorado 2001 issued 3/28/2001000
Highlands County Health Facilities Authority
D521313569431022HH82005-10-181022200002005D, Expand/refurbish facilities, purchase equipment000

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Bond ReferenceBondReferenceCdAmount RetiredAmountRetiredAmount Bond DefeasedAmountBondDefeasedTotal ProceedsTotalProceedsIssuance Costs From ProceedsIssuanceCostsFromProceedsOther Spent ProceedsOtherSpentProceedsYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindCapital ExpendituresCapitalExpenditures
A191850001510000649430869267096401637719931011
B1548000016155000106410063153245010487761320000111
C1195000634345359289336250560220010111
D12255000102220000150000020050011100720000

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyEngage Bond Counsel ContractsEngageBondCounselContractsAny Research AgreementsAnyResearchAgreementsEngage Bond Counsel ResearchEngageBondCounselResearchBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A001111001
B001111001
C001111001
D001111001

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqs
A001000001
B001000001
C001000001
D001000001

Form990 Schedule K Part V Form990ScheduleKPartV (4 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A1
B1
C1
D1

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierPart III, Line 8cIdentifier
Return ReferenceEntity 6, Rows C & DReturnReference
ExplanationHighlands County Health Facilities Authority 2012A, AR Program & 2012B, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
Highlands County Health Facilities Authority
A521313569431022HUD2006-06-142051560002006C, Expand/refurbish facilities, purchase equipment000
Colorado Health Facilities Authority
B84075293219648AAV72006-11-152495014242006D&E, Refnd Highland, Tarrant 98 iss 12/17/98, Highland iss 03D 10/7/03000
Colorado Health Facilities Authority
C84075293219648ACG82006-11-15303714502006F, Refund 1995 Bonds issued 6/8/1995000
Highlands County Health Facilities Authority
D521313569431022JZ62006-12-202124644962006G, Refund Highlands 2002 issued 12/19/02 and Orange 2002 issued 7/10/02000

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Bond ReferenceBondReferenceCdAmount Bond DefeasedAmountBondDefeasedTotal ProceedsTotalProceedsIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindAmount RetiredAmountRetiredOther Spent ProceedsOtherSpentProceeds
A4900000205156000200000020315600020060011
B81050002495014242492891200301119870000247008533
C192650003037145030670719951011268000030064743
D732000021246449618563752002011116840000210608121

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyEngage Bond Counsel ContractsEngageBondCounselContractsAny Research AgreementsAnyResearchAgreementsEngage Bond Counsel ResearchEngageBondCounselResearchPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUseBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers
A0011110.001000.00100001
B0111110.002000010.00200
C001111001
D0111110.003000010.00300

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqs
A001000001
B001000001
C001000001
D001000001

Form990 Schedule K Part V Form990ScheduleKPartV (4 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A1
B1
C1
D1

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
Highlands County Health Facilities Authority
A521313569431022KK72007-08-083664450002007A B C D, Expand/refurbish facilities, purchase equipment000
Highlands County Health Facilities Authority
B521313569431022QZ82008-12-16680000002008A, Expand/refurbish facilities, purchase equipment000
Orange County Health Facilities Authority
C5213785952009-04-0850000002009A, Expand/refurbish facilities, purchase equipment000
Kansas Development Finance Authority
D4810665892009-04-0850000002009B, Expand/refurbish facilities, purchase equipment000

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Bond ReferenceBondReferenceCdAmount RetiredAmountRetiredTotal ProceedsTotalProceedsCredit EnhancementCreditEnhancementCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
A259500000366445000556038236088461820070011
B12250000680000006800000020080011
C36845475000000500000020080011
D36274505000000500000020080011

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyEngage Bond Counsel ContractsEngageBondCounselContractsAny Research AgreementsAnyResearchAgreementsEngage Bond Counsel ResearchEngageBondCounselResearchPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersTotal Private Business UseTotalPrivateBusinessUseBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A0111110.002000.00200001
B001111001
C001111001
D001111001

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqs
A001010001
B011000001
C011010001
D011010001

Form990 Schedule K Part V Form990ScheduleKPartV (4 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A1
B1
C1
D1

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
Kansas Development Finance Authority
A48106658948542ABX82009-07-083253944172009C, Ref 96/05&97/05 iss 1/13/05, 03A 1/16/03, 08B 12/19/08, exp facility000
Kansas Development Finance Authority
B48106658948542ACY52009-10-011022711542009D, Refund Highlands 07C, 8/8/07 & expand/refurbish facilities/purc equip000
Highlands County Health Facilities Authority
C521313569431022SP82009-11-1619075250209E & 08B Conv, Ref Orange 91/01 10/11/01, 92/03 5/15/03, 08B 12/19/08000
Highlands County Health Facilities Authority
D521313569431022SG82009-11-161772400002005I Conv, Refund Highlands 05I 12/22/05 & expand/refurbish facilities000

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Bond ReferenceBondReferenceCdAmount RetiredAmountRetiredTotal ProceedsTotalProceedsCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
A166150003253944171200496731338945020091011
B7375000102271154218447218042643320091011
C1007000019075250219075250220081011
D125000000178936632169663217724000020051011

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyEngage Bond Counsel ContractsEngageBondCounselContractsAny Research AgreementsAnyResearchAgreementsEngage Bond Counsel ResearchEngageBondCounselResearchPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersTotal Private Business UseTotalPrivateBusinessUseBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A0111110.001000.00100001
B001111001
C0111110.001000.00100001
D0111110.009000.00900001

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqs
A011000001
B011000001
C011000001
D011010001

Form990 Schedule K Part V Form990ScheduleKPartV (4 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A1
B1
C1
D1

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
Highlands County Health Facilities Authority
A5213135692010-12-17570000002010A, Expand/refurbish facilities, purchase equipment000
Orange County Health Facilities Authority
B5213785952010-12-22250000002010B, Expand/refurbish facilities, purchase equipment000
Kansas Development Finance Authority
C4810665892010-12-22250000002010C, Expand/refurbish facilities, purchase equipment000
Colorado Health Facilities Authority
D8407529322010-12-22250000002010D, Expand/refurbish facilities, purchase equipment000

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Bond ReferenceBondReferenceCdTotal ProceedsTotalProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindAmount RetiredAmountRetired
A570000005700000020100011
B2500000025000000201000111000000
C2500000025000000201000111000000
D2500000025000000201000111000000

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyEngage Bond Counsel ContractsEngageBondCounselContractsAny Research AgreementsAnyResearchAgreementsEngage Bond Counsel ResearchEngageBondCounselResearchBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A001111001
B001111001
C001111001
D001111001

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqs
A011010001
B011010001
C011010001
D011010001

Form990 Schedule K Part V Form990ScheduleKPartV (4 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A1
B1
C1
D1

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
Highlands County Health Facilities Authority
A5213135692010-12-302250000002010E, Expand/refurbish facilities, purchase equipment000
Highlands County Health Facilities Authority
B5213135692011-11-16800000002011A, Expand/refurbish facilities000
Highlands County Health Facilities Authority
C5213135692012-03-212949850002012A, AR Program - Refund 2009 A-F AR Program000
Highlands County Health Facilities Authority
D5213135692012-07-251150150002012B, AR Program - Expand/refurbish facilities, purchase equipment000

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Bond ReferenceBondReferenceCdAmount RetiredAmountRetiredTotal ProceedsTotalProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindOther Spent ProceedsOtherSpentProceeds
A900000022500000022500000020100011
B180000800000008000000020110011
C29498500020041011294985000
D11501500011501500020120011

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyEngage Bond Counsel ContractsEngageBondCounselContractsAny Research AgreementsAnyResearchAgreementsEngage Bond Counsel ResearchEngageBondCounselResearchBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrsPrcntge Bond Financed PropPrcntgeBondFinancedPropRemedial Action TakenRemedialActionTaken
A001111001
B001111001
C0011110110.000800
D0011110110.000800

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqs
A011010001
B011010001
C011010001
D011010001

Form990 Schedule K Part V Form990ScheduleKPartV (4 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A1
B1
C1
D1

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
Kansas Development Finance Authority
A48106658948542ADG32012-08-293109522452012A - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C000
Highlands County Health Facilities Authority
B521313569431022TL62012-08-293483200002012B-F - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C000
Highlands County Health Facilities Authority
C5213135692012-08-291250000002012G&H - Refund Highlands 2005I Conversion Bonds000
Highlands County Health Facilities Authority
D521313569431022TR32012-11-082321250002012I - Refunded Volusia 1994-A; Highlands 2004A, 2005E, 2005F, 2005G000

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Bond ReferenceBondReferenceCdTotal ProceedsTotalProceedsOther Spent ProceedsOtherSpentProceedsYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
A31095224531095224520081011
B34832000034832000020081011
C12500000012500000020051011
D23212500023212500020051011

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyEngage Bond Counsel ContractsEngageBondCounselContractsAny Research AgreementsAnyResearchAgreementsEngage Bond Counsel ResearchEngageBondCounselResearchPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersTotal Private Business UseTotalPrivateBusinessUseBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A0111110.005000.00500001
B0111110.005000.00500001
C0111110.009000.00900001
D0111110.002000.00200001

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqs
A011010001
B011010001
C011010001
D011010001

Form990 Schedule K Part V Form990ScheduleKPartV (4 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A1
B1
C1
D1

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
Linda Knutson
Family of board member50059Employee Compensation0
Jenola Bradwell
Family of board member62434Employee Compensation0
Karen Tilstra
Family of key employee113530Consulting0
Clifton Scott
Family of board member58270Employee Compensation0

Schedule M IRS990ScheduleM

Real Estate Commercial RealEstateCommercial

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F9900NoncashContribsRptdF990

Other Non Cash Contributions Table OtherNonCashContributionsTable

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
DescriptionMedical EquipmentDescription
Number Of Contributions2NumberOfContributions
Noncash Contribs Rptd F99012368NoncashContribsRptdF990
Method Of Determining RevenuesCost of donated propertyMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Number Of8283 Received0NumberOf8283Received
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGifts
Third Parties Used1ThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Third Party Use:Part I, Line 32b:The filing organization's supporting foundations conduct fund-raising activities on behalf of the filing organization, generally including the soliciting, processing, and selling of non-cash contributions.
Non Reporting of Revenue:Part I, Line 33:Pursuant to the filing organization's Net Assets Accounting Policy, gifts of significant donated property are recorded by the filing organization to the unrestricted net assets (equity) account. Accordingly, donated property (such as furniture and fixtures) are recorded directly to equity accounts and are not recorded in the income statement.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section A, line 2Lars Houmann and Terry Owen - Family Relationship
Form 990, Part VI, Section A, line 6Adventist Health System/Sunbelt, 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 7aThe 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 7bAHSSHC, 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 approve and disapprove the operating 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/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; and g) to establish general guiding policies.
Form 990, Part VI, Section B, line 11The filing organization's current year Form 990 was reviewed by the Senior Vice President of Finance prior to its filing with the IRS. The review conducted by the Senior Vice President of Finance 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 12cThe 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 15The top-tier parent of the filing organization is Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the parent organization of a healthcare system, known as Adventist Health System, that operates hospitals, nursing home facilities, and other healthcare provider organizations. AHSSHC is exempt from federal income tax under IRC Section 501(c)(3) pursuant to a group ruling issued to the General Conference of Seventh-day Adventists. The individuals who serve as the CEO, CFO or key employees of the filing organization are compensated by AHSSHC. Compensation and benefits provided to these individuals is 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 Strategy and 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.
Form 990, Part VI, Section C, line 19As discussed in our response to Question 15a & b in Section B of this Part VI, 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 AFor 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 for Don Jernigan, Lars Houmann, Richard Reiner, and Terry Shaw, were provided in conjunction with that person's responsibilities and roles in serving in an executive leadership position within Adventist Health System (AHS). Don Jernigan, Richard Reiner,and Terry Shaw devote approximately 50 hours per week in conjunction with serving in their respective executive leadership position within AHS. Lars Houmann devotes approximately 35 hours a week to the filing organization and the remainder of time is devoted to his leadership position within AHS.Columns (E) & (F)
Form 990, Part XI, line 9:Transfer to tax-exempt affiliates -52,239,627. Transfer to tax-exempt parent -15,672,193. Donated Property 3,150,375. Income on restricted fund balance 14,767. SWAP loss amortization 3,696,663. Allocations from Tax-exempt Parent with respect to Debt 78,693,889. Transfer for expenses -933,752. Gifts 4,766,891. Other -135,536. Interest in Foundation 343,277. Net assets received upon transfer of membership interest in THH (51%) 27,900,000. Investment in Texas Health Huguley (49%) 32,915,860. Transfer of assets to Texas Health Huguley -54,111,672. Transfer of permanently restricted to Texas Health Huguley -1,413,027. Transfer from Restricted 10,160. Partnership income recorded for tax 87,318. Rounding 1.Changes in Net Assets or Fund Balances:
Part X, Line 2The 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.Savings and temporary cash investments

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1Florida Radiology Imaging at Lake Mary LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1875 Concourse Parkway 150AddressLine1
CityMaitlandCity
StateFLState
ZIP Code32751ZIPCode
FieldValueIRS element (for citing)
EIN550789387EIN
Primary ActivitiesImaging & TestingPrimaryActivities
Legal Domicile StateFLLegalDomicileState
Total Income16835998TotalIncome
EOY Assets7551380EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Adventist Health SystemSunbelt IncBusinessNameLine1

Form990 Schedule R Part II Form990ScheduleRPartII (107 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
Adventist Bolingbrook Hospital
500 Remington BlvdBolingbrookIL60440651219504Operation of Hospital & Related ServicesIL501(c)(3)170(b)(1)(A)(iii)Adventist Hlth SystemSunbelt Inc1
Adventist Care Centers - Courtland Inc
730 Courtland StreetOrlandoFL32804205774723Operation of Home for the Aged/Hlthcare DeliveryFL501(c)(3)509(a)(2)Sunbelt Hlth Care Centers Inc0
Adventist GlenOaks Hospital
701 Winthrop AvenueGlendale HeightsIL60139363208390Operation of Hospital & Related ServicesIL501(c)(3)170(b)(1)(A)(iii)Adventist Hlth SystemSunbelt Inc1
Adventist Hlth Mid-America Inc
9100 W 74th StreetShawnee MissionKS66204521347407Hlthcare Related ServicesKS501(c)(3)509(a)(3) Type IAdventist Hlth SystemSunbelt Inc1
Adventist Hlth Partners Inc
1000 Remington Blvd Ste 200BolingbrookIL60440364138353Operate out-patient physician clinicsIL501(c)(3)170(b)(1)(A)(iii)AHS Midwest Management Inc0
Adventist Hlth System Affiliated Benefit Trust
900 Hope WayAltamonte SpringsFL32714266422966Promotion of HlthcareFL501(c)(3)509(a)(3) Type IAdventist Hlth System Sunbelt Hlthcare Corp0
Adventist Hlth System Sunbelt Hlthcare Corp
900 Hope WayAltamonte SpringsFL32714592170012Management ServicesFL501(c)(3)509(a)(3) Type I0N/A
Adventist Hlth SystemGeorgia Inc
1035 Red Bud RoadCalhounGA30701581425000Operation of Hospital & Related ServicesGA501(c)(3)170(b)(1)(A)(iii)Adventist Hlth System Sunbelt Hlthcare Corp0
Adventist Hlth SystemSunbelt Inc
900 Hope WayAltamonte SpringsFL32714591479658Operation of Hospital & Related ServicesFL501(c)(3)170(b)(1)(A)(iii)Adventist Hlth System Sunbelt Hlthcare Corp0
Adventist Hlth SystemTexas Inc
602 Courtland StreetOrlandoFL32804742578952Leasing Personnel to Affiliated HospitalTX501(c)(3)509(a)(3) Type IIIAdventist Hlth System Sunbelt Hlthcare Corp0
Adventist Hinsdale Hospital
120 North Oak StreetHinsdaleIL60521362276984Operation of Hospital & Related ServicesIL501(c)(3)170(b)(1)(A)(iii)Adventist Hlth SystemSunbelt Inc1
Adventist University of Health Sciences Inc (630 Year End)
671 Lake Winyah DriveOrlandoFL32803593069793Education/Operation of SchoolFL501(c)(3)170(b)(1)(A)(ii)Adventist Hlth SystemSunbelt Inc1
AHS Midwest Management Inc
1000 Remington Blvd Ste 200BolingbrookIL60440363354567Operation of Physician Practice MgmtIL501(c)(3)509(a)(3) Type IAdventist Hlth SystemSunbelt Inc1
AHSCentral Texas Inc
1301 Wonder World DriveSan MarcosTX78666742621825Provide Office Space - Medical ProfessionalsTX501(c)(3)509(a)(3) Type III-FAdventist Hlth System Sunbelt Hlthcare Corp0
Apopka Hlth Care Properties Inc
305 E Oak StreetApopkaFL32703510605694Lease to Related OrganizationGA501(c)(3)509(a)(3) Type III-FSunbelt Hlth Care Centers Inc0
Battle Creek Adventist Hospital
1000 Remington Blvd Ste 200BolingbrookIL60440381359189InactiveMI501(c)(3)170(b)(1)(A)(iii)Adventist Hlth SystemSunbelt Inc1
Bolingbrook Hospital Foundation
1000 Remington Blvd N Entrance 2ndBolingbrookIL60440900494445Fund-raising for Tax-exempt hospitalIL501(c)(3)170(b)(1)(A)(vi)Midwest Hlth Foundation0
Bradford Heights Hlth & Rehab Center Inc
950 Highpoint DriveHopkinsvilleKY42240205782342Operation of Home for the Aged/Hlthcare DeliveryKY501(c)(3)509(a)(2)Sunbelt Hlth Care Centers Inc0
Burleson Nursing & Rehab Center Inc
301 Huguley BlvdBurlesonTX76028205782243Operation of Home for the Aged/Hlthcare DeliveryTX501(c)(3)509(a)(2)Sunbelt Hlth Care Centers Inc0
Caldwell Hlth Care Properties Inc
1333 West MainPrincetonKY42445510605680Lease to Related OrganizationGA501(c)(3)509(a)(3) Type III-FSunbelt Hlth Care Centers Inc0
Central Texas Hlthcare Collaborative
1301 Wonder World DriveSan MarcosTX78666453739929Support Operation of HospitalTX501(c)(3)509(a)(3) Type IAdventist Hlth SystemSunbelt Inc1
Cedar Crag Terrace Inc (630 Year End)
Rt 5 Box 900ManchesterKY40962611120442Operation of Home for the elderly-disabledKY501(c)(3)170(b)(1)(A)(vi)Memorial Hospital Inc0
Central Texas Medical Center Foundation
1301 Wonder World DriveSan MarcosTX78666742259907Fund-raising for Tax-exempt hospitalTX501(c)(3)170(b)(1)(A)(vi)Adventist Hlth SystemSunbelt Inc1
Chickasaw Hlth Care Properties Inc
250 S Chickasaw TrailOrlandoFL32825510605681Lease to Related OrganizationGA501(c)(3)509(a)(3) Type III-FSunbelt Hlth Care Centers Inc0
Chippewa Valley Hospital & Oakview Care Center Inc
1220 Third Avenue WestDurandWI54736391365168Operation of Hospital & Related ServicesWI501(c)(3)170(b)(1)(A)(iii)Adventist Hlth SystemSunbelt Inc1
Cobb Medical Associates LLC
3949 South Cobb Drive SESmyrnaGA300806342582617089Operation of Physician Practices & Medical ServicesGA501(c)(3)170(b)(1)(A)(iii)Emory-Adventist Inc0
Courtland Hlth Care Properties Inc
730 Courtland StreetOrlandoFL32804510605682Lease to Related OrganizationGA501(c)(3)509(a)(3) Type III-FSunbelt Hlth Care Centers Inc0
Creekwood Place Nursing & Rehab Center Inc
683 E Third StreetRussellvilleKY42276205782260Operation of Home for the Aged/Hlthcare DeliveryKY501(c)(3)509(a)(2)Sunbelt Hlth Care Centers Inc0
Dairy Road Hlth Care Properties Inc
7350 Dairy RoadZephyrhillsFL33540510605684Lease to Related OrganizationGA501(c)(3)509(a)(3) Type III-FSunbelt Hlth Care Centers Inc0
East Orlando Hlth & Rehab Center Inc
250 S Chickasaw TrailOrlandoFL32825205774748Operation of Home for the Aged/Hlthcare DeliveryFL501(c)(3)509(a)(2)Sunbelt Hlth Care Centers Inc0
Emory-Adventist Inc
3949 South Cobb DriveSmyrnaGA30080582171011Operation of Hospital & Related SvcsGA501(c)(3)170(b)(1)(A)(iii)Adventist Hlth SystemSunbelt Inc1
Fletcher Hospital Inc
100 Hospital DriveHendersonvilleNC28792560543246Operation of Hospital & Related SvcsNC501(c)(3)170(b)(1)(A)(iii)Adventist Hlth System Sunbelt Hlthcare Corp0
FLNC Inc
3355 E Semoran BlvdApopkaFL32703205774761Operation of Home for the Aged/Hlthcare DeliveryFL501(c)(3)509(a)(2)Sunbelt Hlth Care Centers Inc0
Florida Hospital Waterman Inc
1000 Waterman WayTavaresFL32778593140669Operation of Hospital & Related ServicesFL501(c)(3)170(b)(1)(A)(iii)Adventist Hlth System Sunbelt Hlthcare Corp0
Florida Hospital Zephyrhills Inc
7050 Gall BlvdZephyrhillsFL33541592108057Operation of Hospital & Related ServicesFL501(c)(3)170(b)(1)(A)(iii)Adventist Hlth SystemSunbelt Inc1
Florida Hospital Medical Group Inc
900 Winderley PlaceMaitlandFL32751593214635Operation of Physician Practices & Medical ServicesFL501(c)(3)170(b)(1)(A)(iii)Adventist Hlth SystemSunbelt Inc1
Foundation for Shawnee Mission Medical Center Inc
9100 W 74th StreetShawnee MissionKS66204480868859Fund-raising for Tax-exempt hospitalKS501(c)(3)509(a)(3) Type IShawnee Mission Medical Center Inc0
GlenOaks Hospital Foundation
701 Winthrop AvenueGlendale HeightsIL60139363926044Fund-raising for Tax-exempt hospitalIL501(c)(3)170(b)(1)(A)(vi)Midwest Hlth Foundation0
Hays Memorial Hospital Association of Seventh-Day Adventists
1301 Wonder World DriveSan MarcosTX78667741362785Lease of Hospital PersonnelTX501(c)(3)509(a)(3) Type IIAdventist Hlth System Sunbelt Hlthcare Corp0
Helen Ellis Memorial Hospital Auxiliary Inc
1395 S Pinellas AveTarpon SpringsFL34689592106043Fund-raising for Tax-exempt hospital/foundationFL501(c)(3)509(a)(3) Type ITarpon Springs Hospital Foundation Inc0
Helen Ellis Memorial Hospital Foundation Inc
1395 S Pinellas AveTarpon SpringsFL34689593690149Fund-raising for Tax-exempt hospitalFL501(c)(3)509(a)(3) Type ITarpon Springs Hospital Foundation Inc0
Hinsdale Hospital Foundation
7 Salt Creek Lane Suite 203HinsdaleIL60521521466387Fund-raising for Tax-exempt hospitalIL501(c)(3)170(b)(1)(A)(vi)Midwest Hlth Foundation0
Huguley Community Care Corp
11801 South FreewayBurlesonTX76028452793120Support Operation of HospitalTX501(c)(3)509(a)(3) Type IAdventist Hlth SystemSunbelt Inc1
In-Motion Rehab Inc
602 Courtland Street Ste 200OrlandoFL32804208023411Therapy services to tax exempt nursing homesKS501(c)(3)509(a)(3) Type IISunbelt Hlth Care Centers Inc0
Jellico Community Hospital Inc
188 Hospital LaneJellicoTN37762620924706Operation of Hospital & Related ServicesTN501(c)(3)170(b)(1)(A)(iii)Adventist Hlth System Sunbelt Hlthcare Corp0
La Grange Memorial Hospital Foundation
5101 S Willow Springs RdLa GrangeIL60525300247776Fund-raising for Tax-exempt hospitalIL501(c)(3)170(b)(1)(A)(vi)Midwest Hlth Foundation0
Memorial Hlth Systems Foundation Inc
770 West Granada BlvdOrmond BeachFL32174311771522Fund-raising for Tax-exempt hospitalFL501(c)(3)170(b)(1)(A)(vi)Memorial Hlth Systems Inc0
Memorial Hlth Systems Inc
301 Memorial Medical ParkwayDaytona BeachFL32117590973502Operation of Hospital & Related ServicesFL501(c)(3)170(b)(1)(A)(iii)Adventist Hlth SystemSunbelt Inc1
Memorial Hospital Flagler Inc
60 Memorial Medical ParkwayPalm CoastFL32164592951990Operation of Hospital & Related ServicesFL501(c)(3)170(b)(1)(A)(iii)Memorial Hlth Systems Inc0
Memorial Hospital - West Volusia Inc
701 West Plymouth AvenueDelandFL32720593256803Operation of Hospital & Related ServicesFL501(c)(3)170(b)(1)(A)(iii)Memorial Hlth Systems Inc0
Memorial Hospital Inc
210 Marie Langdon DriveManchesterKY40962610594620Operation of Hospital & Related ServicesKY501(c)(3)170(b)(1)(A)(iii)Adventist Hlth System Sunbelt Hlthcare Corp0
Merriam Hlth Care Properties Inc
9700 West 62nd StreetMerriamKS66203364595806Lease to Related OrganizationKS501(c)(3)509(a)(3) Type III-FSunbelt Hlth Care Centers Inc0
Metroplex Adventist Hospital Inc
2201 S Clear Creek RoadKilleenTX76549742225672Operation of Hospital & Related ServicesTX501(c)(3)170(b)(1)(A)(iii)Adventist Hlth System Sunbelt Hlthcare Corp0
Metroplex Clinic Physicians Inc
2201 S Clear Creek RoadKilleenTX76549113762050Physician Hlthcare services to the communityTX501(c)(3)170(b)(1)(A)(iii)Metroplex Adventist Hospital Inc0
Metroplex Hospital Inc (1023-123112)
900 Hope WayAltamonte SpringsFL32714461256516Future Operation of Hospital & Related SvcsFL501(c)(3)170(b)(1)(A)(iii)Adventist Hlth System Sunbelt Hlthcare Corp0
Midwest Hlth Foundation
120 North Oak StreetHinsdaleIL60521352230515Support of subsidiary FoundationsIL501(c)(3)509(a)(3) Type II0N/A
Mills Hlth & Rehab Center Inc
500 Beck LaneMayfieldKY42066205782320Operation of Home for the Aged/Hlthcare DeliveryKY501(c)(3)509(a)(2)Sunbelt Hlth Care Centers Inc0
Mission Strategies Inc
602 Courtland Street Ste 200OrlandoFL32804205982365Provision of support to the nursing home divisionKS501(c)(3)509(a)(3) Type IISunbelt Hlth Care Centers Inc0
Mission Strategies of Georgia Inc
3949 S Cobb DriveSmyrnaGA30080900866024Provision of support to the nursing home divisionGA501(c)(3)509(a)(3) Type IISunbelt Hlth Care Centers Inc0
Missouri Adventist Hlth Inc
9100 W 74th StreetShawnee MissionKS66204431224729Support Hlth Care ServicesMO501(c)(3)509(a)(3) Type III-OAdventist Hlth Mid-America Inc0
North Regional EMS Inc
188 Hospital LaneJellicoTN37762262653616EMS ServicesTN501(c)(3)509(a)(2)Jellico Community Hospital Inc0
Ormond Beach Memorial Hospital Auxiliary Inc
301 Memorial Medical ParkwayDaytona BeachFL32117591721962Volunteer support servicesFL501(c)(3)509(a)(3) Type III-FMemorial Hlth Systems Inc0
Overland Park Nursing & Rehab Center Inc
6501 West 75th StreetOverland ParkKS66204205774821Operation of Home for the Aged/Hlthcare DeliveryKS501(c)(3)509(a)(2)Sunbelt Hlth Care Centers Inc0
Paragon Hlth Care Properties Inc
950 Highpoint DriveHopkinsvilleKY42240510605686Lease to Related OrganizationGA501(c)(3)509(a)(3) Type III-FSunbelt Hlth Care Centers Inc0
Pasco-Pinellas Hillsborough Community Hlth System Inc
2400 Bedford RoadOrlandoFL32803208488713Operation of Hospital & Related ServicesFL501(c)(3)170(b)(1)(A)(iii)0N/A
Portercare Adventist Hlth System (630 Year End)
2525 S Downing StreetDenverCO80210840438224Operation of Hospital & Related ServicesCO501(c)(3)170(b)(1)(A)(iii)Adventist Hlth System Sunbelt Hlthcare Corp0
Portland Nursing & Rehab Center Inc
215 Highland Circle DrivePortlandTN37148205774842Operation of Home for the Aged/Hlthcare DeliveryTN501(c)(3)509(a)(2)Sunbelt Hlth Care Centers Inc0
Princeton Hlth & Rehab Center Inc
1333 West MainPrincetonKY42445205782272Operation of Home for the Aged/Hlthcare DeliveryKY501(c)(3)509(a)(2)Sunbelt Hlth Care Centers Inc0
Princeton Professional Services Inc
601 E Rollins StreetOrlandoFL32803591191045Provision of Hlthcare ServicesFL501(c)(3)509(a)(2)Adventist Hlth System Sunbelt Hlthcare Corp0
Quality Circle for Hlthcare Inc
900 Hope WayAltamonte SpringsFL32714263789368Hlthcare Quality ServicesFL501(c)(3)509(a)(3) Type III-FAdventist Hlth System Sunbelt Hlthcare Corp0
Resource Personnel Inc
602 Courtland Street Ste 200OrlandoFL32804208040875Provide administrative support to tax exempt nursing homesFL501(c)(3)509(a)(3) Type IISunbelt Hlth Care Centers Inc0
Rocky Mountain Adventist Hlthcare Foundation (630 Year End)
2525 South Downing StreetDenverCO80210840745018Fund-raising for Tax-exempt hospitalCO501(c)(3)170(b)(1)(A)(vi)PorterCare Adventist Hlth System0
Rollins Bedford Corp
602 Courtland Street Ste 200OrlandoFL32804370908840InactiveFL501(c)(3)509(a)(3) Type IISunbelt Hlth Care Centers Inc0
Rollins Brook Community Care Corp (1120-123112)
2201 S Clear Creek RoadKilleenTX76549461656773InactiveTX501(c)(3)Metroplex Adventist Hospital Inc0
Russellville Hlth Care Properties Inc
683 East Third StreetRussellvilleKY42276510605691Lease to Related OrganizationGA501(c)(3)509(a)(3) Type III-FSunbelt Hlth Care Centers Inc0
San Marcos Hlth Care Properties Inc
1900 Medical ParkwaySan MarcosTX78666510605693Lease to Related OrganizationGA501(c)(3)509(a)(3) Type III-FSunbelt Hlth Care Centers Inc0
San Marcos Nursing & Rehab Center Inc
1900 Medical ParkwaySan MarcosTX78666205782224Operation of Home for the Aged/Hlthcare DeliveryTX501(c)(3)509(a)(2)Sunbelt Hlth Care Centers Inc0
Shawnee Mission Hlth Care Inc
6501 West 75th StreetOverland ParkKS66204480952508Lease to Related OrganizationKS501(c)(3)509(a)(3) Type III-FSunbelt Hlth Care Centers Inc0
Shawnee Mission Medical Center Inc
9100 W 74th StreetShawnee MissionKS66204480637331Operation of Hospital & Related ServicesKS501(c)(3)170(b)(1)(A)(iii)Adventist Hlth Mid-America Inc0
South Central Nursing Homes Properties Inc
900 Hope WayAltamonte SpringsFL32714593686109Management SupportGA501(c)(3)509(a)(3) Type III-OSouth Central Inc0
South Central Nursing Homes Inc
602 Courtland StreetOrlandoFL32804611242373Management SupportKY501(c)(3)509(a)(3) Type III-OSouth Central Inc0
South Central Properties III Inc
900 Hope WayAltamonte SpringsFL32714593692860Real EstateGA501(c)(2)South Central Nursing Homes Properties Inc0
South Central Properties IV Inc
900 Hope WayAltamonte SpringsFL32714593692862Real EstateGA501(c)(2)South Central Nursing Homes Properties Inc0
South Central Properties VI Inc
900 Hope WayAltamonte SpringsFL32714593692857Real EstateGA501(c)(2)South Central Nursing Homes Properties Inc0
South Central Properties Inc
900 Hope WayAltamonte SpringsFL32714593651692Real EstateGA501(c)(2)South Central Nursing Homes Properties Inc0
South Central Inc
602 Courtland StreetOrlandoFL32804593689740Management SupportGA501(c)(3)509(a)(3) Type III-F0N/A
South Pasco Hlth Care Properties Inc
38250 A AvenueZephyrhillsFL33542510605679Lease to Related OrganizationGA501(c)(3)509(a)(3) Type III-FSunbelt Hlth Care Centers Inc0
Southwest Volusia Hlth Services Inc
1055 Saxon BlvdOrange CityFL327638468593281591Medical Office Building for HospitalFL501(c)(3)509(a)(3) Type ISouthwest Volusia Hlthcare Corp0
Southwest Volusia Hlthcare Corp
1055 Saxon BlvdOrange CityFL327638468593149293Operation of Hospital & Related ServicesFL501(c)(3)170(b)(1)(A)(iii)Adventist Hlth SystemSunbelt Inc1
Specialty Physicians of Central Texas Inc
1301 Wonder World DriveSan MarcosTX78666208814408Physician Hlthcare services to the communityTX501(c)(3)170(b)(1)(A)(iii)Adventist Hlth SystemSunbelt Inc1
Spring View Hlth & Rehab Center Inc
718 Goodwin LaneLeitchfieldKY42754205782288Operation of Home for the Aged/Hlthcare DeliveryKY501(c)(3)509(a)(2)Sunbelt Hlth Care Centers Inc0
Sunbelt Hlth & Rehab Center - Apopka Inc
305 East Oak StreetApopkaFL32703205774856Operation of Home for the Aged/Hlthcare DeliveryFL501(c)(3)509(a)(2)Sunbelt Hlth Care Centers Inc0
Sunbelt Hlth Care Centers Inc
602 Courtland Street Ste 200OrlandoFL32804581473135Management ServicesTN501(c)(3)509(a)(3) Type IIAdventist Hlth System Sunbelt Hlthcare Corp0
SunSystem Development Corp
900 Hope WayAltamonte SpringsFL32714592219301Fund Raising for Affiliated Tax-Exempt HospitalsFL501(c)(3)170(b)(1)(A)(vi)Adventist Hlth System Sunbelt Hlthcare Corp0
Tarpon Springs Hospital Foundation Inc
1395 S Pinellas AveTarpon SpringsFL34689590898901Operation of Hospital & Related ServicesFL501(c)(3)170(b)(1)(A)(iii)University Community Hospital Inc0
Tarrant County Hlth Care Properties Inc
301 Huguley BlvdBurlesonTX76028510605677Lease to Related OrganizationGA501(c)(3)509(a)(3) Type III-FSunbelt Hlth Care Centers Inc0
Taylor Creek Hlth Care Properties Inc
718 Goodwin LaneLeitchfieldKY42754510605678Lease to Related OrganizationGA501(c)(3)509(a)(3) Type III-FSunbelt Hlth Care Centers Inc0
Texas Hlth Huguley Inc (11-43012)
900 Hope WayAltamonte SpringsFL32714452694620Operation of Hospital & Related ServicesFL501(c)(3)170(b)(1)(A)(iii)Adventist Hlth SystemSunbelt Inc1
The Volunteer Auxiliary of Florida Hospital - Flagler Inc
60 Memorial Medical ParkwayPalm CoastFL32164592486582Volunteer support servicesFL501(c)(3)509(a)(3) Type III-FMemorial Hospital Flagler Inc0
Trinity Nursing & Rehab Center Inc
9700 West 62nd StreetMerriamKS66203205774890Operation of Home for the Aged/Hlthcare DeliveryKS501(c)(3)509(a)(2)Sunbelt Hlth Care Centers Inc0
University Community Hospital Auxiliary Inc
3100 E Fletcher AveTampaFL33613237011345Volunteer support servicesFL501(c)(3)509(a)(3) Type III-FUniversity Community Hospital Inc0
University Community Hospital Foundation Inc
3100 E Fletcher AveTampaFL33613592554889Fund-raising for Tax-exempt hospitalFL501(c)(3)509(a)(3) Type IUniversity Community Hospital Inc0
University Community Hospital Specialty Care Inc
3100 E Fletcher AveTampaFL33613593231322InactiveFL501(c)(3)509(a)(3)University Community Hospital Inc0
University Community Hospital Inc
3100 E Fletcher AveTampaFL33613591113901Operation of Hospital & Related ServicesFL501(c)(3)170(b)(1)(A)(iii)Adventist Hlth System Sunbelt Hlthcare Corp0
West Kentucky Hlth Care Properties Inc
500 Beck LaneMayfieldKY42066510605676Lease to Related OrganizationGA501(c)(3)509(a)(3) Type III-FSunbelt Hlth Care Centers Inc0
Zephyr Haven Hlth & Rehab Center Inc
38250 A AvenueZephyrhillsFL33542205774930Operation of Home for the Aged/Hlthcare DeliveryFL501(c)(3)509(a)(2)Sunbelt Hlth Care Centers Inc0
Zephyrhills Hlth & Rehab Center Inc
7350 Dairy RoadZephyrhillsFL33540205774967Operation of Home for the Aged/Hlthcare DeliveryFL501(c)(3)509(a)(2)Sunbelt Hlth Care Centers Inc0

Form990 Schedule R Part III Form990ScheduleRPartIII (9 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNABusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
Appalachian Therapy Services LLC
100 Hospital DriveHendersonvilleNC28792202463851Therapy StaffingNCN/A
Clear Creek MOB Ltd
2201 S Clear Creek RdKilleenTX76549742609195Real EstateTXN/A
Florida Hospital DMERT LLC
2450 Maitland Center Pkwy Ste 200MaitlandFL32751202392253Medical EquipmentFLN/A
Florida Hospital Home Infusion
2450 Maitland Center Pkwy Ste 200MaitlandFL32751593142824Home Infusion ServicesFLN/A
Huguley Surgery Ctr LLP (11-4112)
15305 Dallas Pkwy Ste 1600 LB 28AddisonTX75001200910694Outpatient SurgeryTXAdventist Hlth SysSunbeltIncdba Huguley Mem Med CtrUnrelated147276000.64100
KCCCSMMC Cancer Center LLC
9100 W 74th StreetShawnee MissionKS66204270909763Equipment RentalKSN/A
PAHSUSP Surgery Centers LLC
15305 Dallas Pkwy Ste 1600 LB 28AddisonTX75010263057950Medical ServicesCON/A
Shawnee Mission Open MRI LLC
9100 W 74th Street Box 2923Shawnee MissionKS66201270011796Imaging & TestingKSN/A
Skyland MRI LLC (11-12012)
100 Hospital DriveHendersonvilleNC28792043646559Imaging & TestingKSN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (30 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipControlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNAAddress Line1AddressForeign/AddressLine1Province Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountry
Altamonte Medical Plaza Condominium Association Inc
601 East Rollins StreetOrlandoFL32803592855792Condo AssociationFLAdventist Hlth SystemSunbelt IncC119895520120.580001
Apopka Medical Plaza Condominium Association Inc
601 East Rollins StreetOrlandoFL32803593000857Condo AssociationFLAdventist Hlth SystemSunbelt IncC27833107890.890001
Arapahoe Medical Building I Inc (7111-12512)
2525 S Downing StreetDenverCO80210841574506Real Estate LeasingCOC0N/A
Arapahoe Medical Building II Inc (7111-12512)
2525 S Downing StreetDenverCO80210841574507Real Estate LeasingCOC0N/A
CC MOB Inc
2201 S Clear Creek RoadKilleenTX76549742616875Real Estate RentalTXC0N/A
Central Texas Medical Associates
1301 Wonder World DriveSan MarcosTX78666742729873Physician ClinicsTXAdventist Hlth SystemSunbelt IncC1.000001
Central Texas Provider's Network
1301 Wonder World DriveSan MarcosTX78666742827652Physician Hospital Org.TXAdventist Hlth SystemSunbelt IncC338051242021.000001
Florida Hospital Flagler Medical Offices Association Inc
60 Memorial Medical ParkwayPalm CoastFL32164262158309Condo AssociationFLC0N/A
Florida Hospital Healthcare System Inc
602 Courtland StreetOrlandoFL32804593215680PHO/TPAFLAdventist Hlth SystemSunbelt IncC133626876508773271.000001
Florida Hospital Wesley Chapel Inc (11-51512)
900 Hope WayAltamonte SpringsFL32714203965753InactiveFLC0N/A
Florida Medical Plaza Condo Association Inc
601 East Rollins StreetOrlandoFL32803592855791Condo AssociationFLAdventist Hlth SystemSunbelt IncC530818333760.780001
Florida Memorial Health Network Inc
770 W Granada Blvd Ste 317Ormond BeachFL32174593403558Physician Hospital Org.FLC0N/A
Harvard Park East Inc (7111-12512)
2525 S Downing StreetDenverCO80210841574365Real Estate LeasingCOC0N/A
Helen Ellis Memorial Hospital Real Estate Corp (11-101912)
1395 S Pinellas AveTarpon SpringsFL34689593375731Real Estate RentalFLC0N/A
Huguley Alliance Foundation
11801 South FreewayFort WorthTX76115752642209InactiveTXAdventist Hlth SystemSunbelt IncC1361911.000001
Huguley Medical Associates Inc (11-43012)
11801 South FreewayBurlesonTX76028752547668Physician ClinicsTXAdventist Hlth SystemSunbelt IncC129084435032541.000001
Kissimmee Multispecialty Clinic Condominium Association Inc
201 Hilda Street Suite 30KissimmeeFL34741593539564Condo AssociationFLAdventist Hlth SystemSunbelt IncC43474299790.544001
Midwest Management Services Inc
9100 West 74th StreetShawnee MissionKS66204480901551Real Estate RentalKSC0N/A
Metroplex Adventist Hospital CRNA
2201 S Clear Creek RoadKilleenTX76549260760794Support hospital - provide allied health professionalsTXC0N/A
North American Health Services Inc & Subs
111 N Orlando AvenueWinter ParkFL32789621041820Lessor/Holding Co.TNC0N/A
Ormond Professional Condo Association (430 Year End)
770 W Granada Blvd Ste 101Ormond BeachFL32174592694434Condo AssociationFLC0N/A
Park Ridge Property Owner's Association Inc
1 Park Place Naples RoadFletcherNC28732030380531Condo AssociationNCC0N/A
Porter Affiliated Hlth Services Inc dba Diversified Affiliated Hlth Svcs
2525 S Downing StreetDenverCO80210840956175Healthcare ServicesCOC0N/A
Porter Medical Plaza Inc (7111-12512)
2525 S Downing StreetDenverCO80210841574369Real Estate LeasingCOC0N/A
San Marcos Regional MRI Inc
1301 Wonder World DriveSan MarcosTX78666770597968Holding CompanyTXAdventist Hlth SystemSunbelt IncC302173481.000001
The Garden Retirement Community Inc
602 Courtland Street Ste 200OrlandoFL32804593414055Real Estate RentalFLC0N/A
University Community Health Insurance Company SPC Ltd
Captive InsuranceC0N/AC/O AON Insurance Managers PO BoxGrand CaymanCJCJ
UCH Services Inc
3100 East Fletcher AveTampaFL33613593508454Management CompanyFLC0N/A
West Coast Medical Group Inc (11-101912)
1395 S Pinellas AveTarpon SpringsFL34689593537305Physician ClinicsFLC0N/A
Winter Park Medical Office Building I Condo Assoc Inc
200 Lakemont AveWinter ParkFL32792452228478Physician ClinicsFLAdventist Hlth SystemSunbelt IncC13763237220.520001
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org1PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (86 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Adventist Health System Sunbelt Healthcare Corporation
B15672193Actual Amount Given
Adventist Health System Sunbelt Healthcare Corporation
M21632553% of Facility's Operating Exp
Adventist Health System Sunbelt Healthcare Corporation dba AHSIS
M19481435% of Facility's Operating Exp
Adventist Health System Sunbelt Healthcare Corporation
P138787765Cost
Adventist Health System Sunbelt Healthcare Corporation
Q1500000Cost
Adventist Health System Sunbelt Healthcare Corp dba Sunbelt Medical Mgmt
J84791Cost
Adventist Health System Sunbelt Healthcare Corp dba Sunbelt Medical Mgmt
P290947Cost
Adventist Health System Sunbelt Healthcare Corp dba Sunbelt Medical Mgmt
Q325814Cost
Adventist Bolingbrook Hospital
L988040Cost
Adventist Bolingbrook Hospital
P127858Cost
Adventist Bolingbrook Hospital
Q80095Cost
Adventist Care Centers Courtland Inc
B218100Actual Amount Given
Adventist GlenOaks Hospital
L1727393Cost
Adventist GlenOaks Hospital
Q85877Cost
Adventist Health Partners Inc
J124244FMV Rental Rate
Adventist Health Partners Inc
L499753Cost
Adventist Health Partners Inc
P2088736Cost
Adventist Health System Georgia Inc
L1085752Cost
Adventist Hinsdale Hospital
L1509050Cost
Adventist Hinsdale Hospital
P23544882Cost
Adventist Hinsdale Hospital
Q5577417Cost
Adventist University of Health Sciences
J2199732Cost
Adventist University of Health Sciences
M4670391Cost
Adventist University of Health Sciences
P557018Cost
Adventist University of Health Sciences
Q15927668Cost
AHS Midwest Management Inc
B4215557Actual Amount Given
AHS Midwest Management Inc
P218108Cost
AHSCentral Texas Inc
K121497Cost
AHSTexas Inc
R1967751Cost
Central Texas Healthcare Collaborative
B1047149Actual Amount Given
Central Texas Medical Center Foundation
B77441Actual Amount Given
Central Texas Medical Center Foundation
C787188Actual Amount Received
Central Texas Providers Network
Q74140Cost
East Orlando Health & Rehab Center Inc
B1404864Actual Amount Given
East Orlando Health & Rehab Center Inc
Q104211Cost
Emory-Adventist Inc
A657618FMV Interest Rate
Emory-Adventist Inc
S950400Principal Loan Amount
Fletcher Hospital Inc
L1059179Cost
FLNC Inc
B2199240Actual Amount Given
Florida Hospital Healthcare System Inc
A246586FMV Rental Rate
Florida Hospital Healthcare System Inc
M101686024Claims Reimb Plus FMV Fee
Florida Hospital Healthcare System Inc
Q8613458Cost
Florida Hospital Medical Group Inc
J4605221FMV Rental Rate
Florida Hospital Medical Group Inc
K357887Cost
Florida Hospital Medical Group Inc
L796341Cost
Florida Hospital Medical Group Inc
M47977172Cost Plus Appropriate %
Florida Hospital Medical Group Inc
P5189070Cost
Florida Hospital Medical Group Inc
Q6759944Cost
Florida Hospital Waterman Inc
B257365Actual Amount Given
Florida Hospital Waterman Inc
L2135272Cost
Florida Hospital Waterman Inc
Q205674Cost
Florida Hospital Zephyrhills Inc
L1673525Cost
Florida Hospital Zephyrhills Inc
P84574Cost
Huguley Medical Associates Inc
A198030FMV Rental Rate
Huguley Medical Associates Inc
Q72184Cost
Huguley Medical Associates Inc
R3260529Cost
Jellico Community Hospital Inc
L1117833Cost
Johnson County Community Care Corporation
B519514Actual Amount Given
La Grange Memorial Hospital Foundation
B293533Actual Amount Given
La Grange Memorial Hospital Foundation
C1103350Actual Amount Received
Memorial Health Systems Inc
C410000Actual Amount Received
Memorial Health Systems Inc
L2032416Cost
Memorial Health Systems Inc
P1455172Cost
Memorial Health Systems Inc
Q103212Cost
Memorial Hospital - Flagler Inc
L1618763Cost
Memorial Hospital - Flagler Inc
Q66777Cost
Memorial Hospital - West Volusia Inc
L1791904Cost
Memorial Hospital - West Volusia Inc
Q135371Cost
Memorial Hospital Inc
L1377211Cost
Metroplex Adventist Hospital Inc
Q284844Cost
Princeton Professional Services Inc
J232774Cost Plus Appropriate Margin
Shawnee Mission Medical Center Inc
L1699427Cost
South Central Nursing Homes Inc
C2500000Actual Amount Received
Southwest Volusia Healthcare Corporation
L1746955Cost
Southwest Volusia Healthcare Corporation
Q170597Cost
Specialty Physicians of Central Texas Inc
B2000000Actual Amount Given
Specialty Physicians of Central Texas Inc
Q935853Cost
Sunbelt Health & Rehab Center Apopka Inc
B450000Actual Amount Given
Sunbelt Health Care Centers Inc
J293561Cost
Sunsystem Development Corporation
B4845715Actual Amount Given
Sunsystem Development Corporation
C6264728Actual Amount Received
Sunsystem Development Corporation
Q2965843Cost
Sunsystem Development Corporation
R4969235Cost
Tarpon Springs Hospital Foundation
L68998Cost
University Community Hospital Inc
L3778411Cost
University Community Hospital Inc
Q54946Cost

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