2012-11-07T17:19:51-06:00 2011-12-31 990 2011-01-01 300247776 LA GRANGE MEMORIAL HOSPITAL FOUNDATION LAGR 7082452902 5101 S WILLOW SPRINGS RD LA GRANGE IL 60525 BRETT SKEEN 7082452902 2012-10-25 2011 2016-02-25 16:41:14Z BRETT SKEEN 5101 S WILLOW SPRINGS RD LA GRANGE IL 60525 3045866 0 X WWW.KEEPINGYOUWELL.COM X 2004 IL FUNDRAISING FOR TAX-EXEMPT ORGANIZATION. 16 13 0 100 0 0 1201926 2844190 0 0 63657 87415 -37337 -48364 1228246 2883241 1011345 2504294 0 0 0 0 0 0 0 5263 6697 1016608 2510991 211638 372250 1843985 901336 15753 12317 1828232 889019 THE PROMOTION OF PHILANTHROPHY AND GOODWILL FOR ADVENTIST LA GRANGE MEMORIAL HOSPITAL. 0 0 2504294 2504294 FUND RAISING TO PROVIDE CAPITAL EQUIPMENT AND SUPPORT FOR ADVENTIST HEALTH SYSTEM/SUNBELT, INC. D/B/A ADVENTIST LA GRANGE MEMORIAL HOSPITAL, A SECTION 501 (C)(3) ORGANIZATION. 2504294 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 9 0 1 0 0 0 0 0 0 1 1 0 0 0 0 X 16 13 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 IL X BRETT SKEEN 7082452902 5101 S WILLOW SPRINGS ROAD LA GRANGE IL 60525 X THOMAS CAPLIS 1.00 X 0 0 0 BONNY CHEN MD 1.00 X 0 0 0 JEROME HINES MD 1.00 X 0 556111 37621 LUKE SEWALL MD 1.00 X 0 624852 37621 PETER O'CONNOR 1.00 X 0 0 0 DANIEL PANCAKE 1.00 X 0 0 0 JEANNE REILLY 1.00 X 0 0 0 JOHN DIXON 1.00 X 0 0 0 LINDA JOHNSON 1.00 X 0 0 0 WILLIAM KUNKEL 1.00 X 0 0 0 MIKE MARCUCCI 1.00 X 0 0 0 BILL HOLDER 1.00 X 0 0 0 CHRISTOPHER JOYCE 1.00 X 0 0 0 MARTY DUNNE 1.00 X 0 0 0 KEITH RICHARDSON 2.00 X 0 184803 56516 PATRICK WALLACE 1.00 X 0 0 0 RICK WRIGHT 2.00 X 0 478042 58327 PAUL ZIEGELE 2.00 X 0 291439 65575 BRETT SKEEN 50.00 X 0 115813 3664 0 2251060 259324 0 0 1 0 0 311254 10000 2522936 12500 2844190 87415 87415 114261 311254 162625 -48364 -48364 2883241 0 0 39051 2477958 2477958 26336 26336 5362 5362 IN-KIND EXPENSE 1335 1335 2510991 2504294 6697 0 1629172 735095 201785 130517 7500 13028 28224 1843985 901336 312 200 15441 12117 15753 12317 X 229812 312169 1512735 491165 85685 85685 1828232 889019 1843985 901336 X 372250 -1311463 X 0 1 1 X 0 X 586427 604106 1429177 1201926 2844190 6665826 586427 604106 1429177 1201926 2844190 6665826 2970320 3695506 58677 10844 23698 63657 87415 244291 64127 37450 71472 44555 114261 331865 7241982 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 85685 85685 85625 60 85685 85625 85625 85625 85625 1.00000 0 0 0 OBLIGATION FOR CHARITABLE GIFT ANNUNITIES 12117 12117 2883241 2510991 372250 -1311463 -1311463 -939213 2863265 405536 405536 2457729 425512 425512 2883241 2780908 269917 269917 2510991 0 2510991 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: REPRESENTS A SCHOLARSHIP FUND ESTABLISHED TO SUPPORT NURSING SCHOLARSHIPS. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN VALUE - CHARITABLE GIFT ANNUITY -447. RESTRICTED CONTRIBUTIONS 1,150,921. RESTRICTED INTEREST INCOME 9,476. NET ASSETS RELEASED FROM RESTRICTED -2,471,413. TOTAL TO SCHEDULE D, PART XI, LINE 8: -1,311,463. PART XII, LINE 2D - OTHER ADJUSTMENTS: IN-KIND CONTRIBUTIONS 242,914. SPECIAL EVENT EXPENSE 162,622. PART XII, LINE 4B - OTHER ADJUSTMENTS: SPECIAL EVENTS REVENUE RECLASSED FROM FUND BALANCE 425,512. PART XIII, LINE 2D - OTHER ADJUSTMENTS: IN-KIND CONTRIBUTIONS 269,917. GOLF CLASSIC 234149 172908 61241 1000 27382 10102 14550 17088 11093 MUSIC IN THE MOONLIGHT 191366 138346 53020 14225 43455 647 3175 19908 425515 311254 114261 1000 41607 53557 15197 20263 31001 162625 -48364 1 ADVENTIST HEALTH SYSTEMSUNBELT INC DBA ADVENTIST LA GRANGE MEM HOSP 5101 WILLOW SPRINGS RD LA GRANGE IL 60525 591479658 501(C)(3) 2475458 NEW PATIENT CARE CENTER AND GENERAL SUPPORT. 1 0 DISASTER ASSISTANCE 11 13197 NURSING SCHOLARSHIPS 4 13139 GRANTS ARE GENERALLY MADE ONLY TO THE SUPPORTED HOSPITAL ORGANIZATION THAT IS EXEMPT FROM FEDERAL INCOME TAX UNDER 501(C)(3). 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. 0 1 0 0 0 0 0 0 0 JEROME HINES MD 0 556111 0 0 0 0 0 13343 0 24278 0 593732 0 0 LUKE SEWALL MD 0 624852 0 0 0 0 0 13343 0 24278 0 662473 0 0 KEITH RICHARDSON 0 141924 0 0 0 42879 0 16548 0 39968 0 241319 0 0 RICK WRIGHT 0 314424 0 68682 0 94936 0 37885 0 20442 0 536369 0 20513 PAUL ZIEGELE 0 203975 0 37365 0 50099 0 23542 0 42033 0 357014 0 9046 PART I, LINE 4B THE CEO AND CFO OF THE FILING ORGANIZATION'S SUPPORTED HOSPITAL SERVE ON THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION. THESE TWO INDIVIDUALS 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). THE FILING ORGANIZATION'S SUPPORTED HOSPITAL IS A SUBSIDARY OF AHSSHC. 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 $204,000. 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 HOSPITAL 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 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. FLEX PLAN/ FLEX PLAN/ SERP 457(B) CY 457(F) CY 457(F) CY CONTRIB./ DISTRIBUTIONS EMPLOYER DISTRIBUTIONS PAYMENT CONTRIB. ------------------------------------------------------- RICK WRIGHT $41,042 $20,564 $ 0 $ 0 PAUL ZIEGELE $10,199 $ 9,077 $ 0 $ 0 KEITH RICHARDSON $ 9,230 $ 0 $ 0 $ 0 SUPPLEMENTAL INFORMATION PART III PART I, QUESTION 3: AS NOTED IN OUR RESPONSE TO QUESTION 15 OF PART VI OF FORM 990, THE INDIVIDUAL WHO SERVES AS THE EXECUTIVE DIRECTOR OF THE FILING ORGANIZATION IS COMPENSATED BY ADVENTIST HEALTH SYSTEM/SUNBELT, INC., D/B/A ADVENTIST LA GRANGE MEMORIAL HOSPITAL (ALMH) FOR THAT INDIVIDUAL'S ROLE IN SERVING AS THE EXECUTIVE DIRECTOR. COMPENSATION AND BENEFITS PROVIDED TO THIS INDIVIDUAL ARE DETERMINED PURSUANT TO POLICIES, PROCEDURES, AND PROCESSES OF ALMH THAT ARE DESIGNED TO ENSURE THAT ALL EMPLOYEES SERVING IN MANAGEMENT ROLES ARE PROVIDED WITH COMPENSATION REFLECTIVE OF FAIR MARKET VALUE GIVEN THEIR ROLES AND RESPONSIBILITES. ALMH USES THE FOLLOWING TO ESTABLISH COMPENSATION OF THE EXECUTIVE DIRECTOR: - COMPENSATION SURVEY OR STUDY. FORM 990, PART VI, SECTION A, LINE 2 JEROME HINES, MD AND PETER O'CONNOR - BUSINESS RELATIONSHIP WILLIAM KUNKEL AND MIKE MARCUCCI - BUSINESS RELATIONSHIP PETER O'CONNOR AND RICK WRIGHT - BUSINESS RELATIONSHIP PATRICK WALLACE AND MIKE MARCUCCI - BUSINESS RELATIONSHIP FORM 990, PART VI, SECTION A, LINE 4 CHANGES TO THE BY LAWS OF THE FILING ORGANIZATION IN ARTICLE IV, SECTION 2, STATE THAT THE PRESIDENT OF MIDWEST HEALTH FOUNDATION SHALL NO LONGER BE CONSIDERED AN EX-OFFICIO DIRECTOR OF THE FILING ORGANIZATION. IN JULY 2011 LA GRANGE MEMORIAL HOSPITAL FOUNDATION (LMHF) ADOPTED THE FOLLOWING SIGNIFICANT CHANGE TO ITS ARTICLES OF INCORPORATION: THE ARTICLES OF INCORPORATION MAY BE ALTERED, AMENDED OR REPEALED AND RESTATED OR AMENDED ARTICLES OF INCORPORATION MAY BE ADOPTED BY RESOLUTION OF THE BOARD OF DIRECTORS AND THE APPROVAL OF MIDWEST HEALTH FOUNDATION, THE SOLE MEMBER OF LMHF, EXCEPT THAT ANY AMENDMENT TO THE PURPOSE CLAUSE OF THE ARTICLES OF INCORPORATION OR THIS AMENDMENT MAY NOT BE MADE WITHOUT THE APPROVAL OF THE BOARD OF DIRECTORS OR THE EXECUTIVE COMMITTEE OF ADVENTIST HEALTH SYSTEM/SUNBELT, INC. (AHSSI). AHSSI IS THE SOLE MEMBER OF ADVENTIST LA GRANGE MEMORIAL HOSPITAL, LMHF'S SUPPORTED HOSPITAL. FORM 990, PART VI, SECTION A, LINE 6 LA GRANGE MEMORIAL HOSPITAL FOUNDATION (THE FILING ORGANIZATION) HAS ONE MEMBER. THE SOLE MEMBER OF THE FILING ORGANIZATION IS MIDWEST HEALTH FOUNDATION. MIDWEST HEALTH FOUNDATION (MHF) IS A ILLINOIS, NOT-FOR-PROFIT CORPORATION THAT IS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3). THERE ARE NO OTHER CLASSES OF MEMBERSHIP IN THE FILING ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER OF THE FILING ORGANIZATION IS MHF. THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION ARE APPOINTED BY THE SOLE MEMBER, MHF, WHO HAS THE RIGHT TO ELECT, APPOINT OR REMOVE ANY MEMBER OF THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B MHF, AS THE SOLE MEMBER OF THE FILING ORGANIZATION, HAS THE RESERVED POWER TO APPROVE ANY AMENDMENT, RESTATEMENT, OR REPEALING OF THE ARTICLES OF INCORPORATION OR BYLAWS OF THE FILING ORGANIZATION, EXCEPT THAT CHANGES TO ARTICLE 4, THE PURPOSE CLAUSE, OR ARTICLE 6, REGARDING CHANGES TO THE ARTICLES OF INCORPORATION, MAY NOT BE MADE WITHOUT THE APPROVAL OF THE BOARD OF DIRECTORS OR EXECUTIVE COMMITTEE OF ADVENTIST HEALTH SYSTEM/SUNBELT, INC. FORM 990, PART VI, SECTION B, LINE 11 THE FILING ORGANIZATION'S CURRENT YEAR FORM 990 WAS REVIEWED BY THE EXECUTIVE DIRECTOR PRIOR TO ITS FILING WITH THE IRS. THE REVIEW CONDUCTED BY THE EXECUTIVE DIRECTOR DID NOT INCLUDE THE REVIEW OF ANY SUPPORTING WORKPAPERS THAT WERE USED IN PREPARATION OF THE CURRENT YEAR FORM 990, BUT DID INCLUDE A REVIEW OF THE ENTIRE FORM 990 AND ALL SUPPORTING SCHEDULES. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY OF THE FILING ORGANIZATION APPLIES TO MEMBERS OF ITS BOARD OF DIRECTORS (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 (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, IS REQUIRED TO DISCLOSE IN WRITING THE EXISTENCE OF ANY CONFLICT OF INTEREST WITH THE FILING ORGANIZATION OR ANY OF THE CHARITABLE ORGANIZATIONS SUPPORTED BY THE FILING ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 THE FILING ORGANIZATION DOES NOT GENERALLY MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. PART VII, SECTION A FOR THOSE BOARD OF DIRECTOR MEMBERS WHO DEVOTE LESS THAN FULL-TIME TO THE FILING ORGANIZATION (BASED UPON THE AVERAGE NUMBER OF HOURS PER WEEK SHOWN IN COLUMN (B) ON PAGE 7 OF THE RETURN) THE COMPENSATION AMOUNTS SHOWN IN COLUMNS (E) AND (F) ON PAGE 7 WERE PROVIDED IN CONJUNCTION WITH THAT PERSON'S RESPONSIBILITIES AND ROLES IN SERVING IN AN EXECUTIVE LEADERSHIP POSITION WITHIN THE SUPPORTED HOSPITAL AND/OR ITS TAX-EXEMPT BROTHER/SISTER AFFILIATE ORGANIZATION. PART VII, SECTION A, COLUMN (B) THE MEMBERS OF THE BOARD OF DIRECTORS WHO RECEIVED COMPENSATION FROM A RELATED ORGANIZATION AS SHOWN IN COLUMN (E) AND (F) OF SECTION A EACH DEVOTE APPROXIMATELY 50 HOURS PER WEEK IN CONJUNCTION WITH SERVING IN EITHER THEIR RESPECTIVE EXECUTIVE LEADERSHIP POSITION WITHIN ADVENTIST HEALTH SYSTEM OR AS AN EMPLOYED PHYSICIAN OF A TAX-EXEMPT BROTHER/SISTER AFFILIATE ORGANIZATION. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: CHANGE IN VALUE - CHARITABLE GIFT ANNUITY -447. RESTRICTED CONTRIBUTIONS 1,150,921. RESTRICTED INTEREST INCOME 9,476. NET ASSETS RELEASED FROM RESTRICTED -2,471,413. TOTAL TO FORM 990, PART XI, LINE 5: -1,311,463. FORM 990, PART VI, SECTION B, LINE 15: THE EXECUTIVE DIRECTOR OF THE FILING ORGANIZATION IS ON THE PAYROLL OF ADVENTIST HEALTH SYSTEM/SUNBELT, INC., D/B/A ADVENTIST LA GRANGE MEMORIAL HOSPITAL (ALMH). THE COMPENSATION OF THE EXECUTIVE DIRECTOR IS DETERMINED BY ALMH. IN DETERMINING THE COMPENSATION OF THE EXECUTIVE DIRECTOR, ALMH UTILIZES PUBLISHED SALARY SURVEY DATA AND OTHER LOCAL MARKET INFORMATION IN ESTABLISHING ANNUAL COMPENSATION. EXECUTIVE MANAGEMENT OF ALMH REVIEW AND APPROVE ANNUAL COMPENSATION. ADVENTIST BOLINGBROOK HOSPITAL 500 REMINGTON BLVD BOLINGBROOK IL 60440 651219504 OPERATION OF HOSPITAL & RELATED SERVICES IL 501(C)(3) 170(B)(1)(A)(III) ADVENTIST HLTH SYSTEMSUNBELT INC 0 ADVENTIST CARE CENTERS - COURTLAND INC 730 COURTLAND STREET ORLANDO FL 32804 205774723 OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY FL 501(C)(3) 509(A)(2) SUNBELT HLTH CARE CENTERS INC 0 ADVENTIST GLENOAKS HOSPITAL 701 WINTHROP AVENUE GLENDALE HEIGHTS IL 60139 363208390 OPERATION OF HOSPITAL & RELATED SERVICES IL 501(C)(3) 170(B)(1)(A)(III) ADVENTIST HLTH SYSTEMSUNBELT INC 0 ADVENTIST HLTH MID-AMERICA INC 9100 W 74TH STREET SHAWNEE MISSION KS 66204 521347407 HLTHCARE RELATED SERVICES KS 501(C)(3) 509(A)(3) TYPE I ADVENTIST HLTH SYSTEMSUNBELT INC 0 ADVENTIST HLTH PARTNERS INC 1000 REMINGTON BLVD STE 200 BOLINGBROOK IL 60440 364138353 OPERATE OUT-PATIENT PHYSICIAN CLINICS IL 501(C)(3) 170(B)(1)(A)(III) AHS MIDWEST MANAGEMENT INC 0 ADVENTIST HLTH SYSTEM AFFILIATED BENEFIT TRUST 111 N ORLANDO AVENUE WINTER PARK FL 32789 266422966 PROMOTION OF HLTHCARE FL 501(C)(3) 509(A)(3) TYPE I ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 0 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 111 N ORLANDO AVENUE WINTER PARK FL 32789 592170012 MANAGEMENT SERVICES FL 501(C)(3) 509(A)(3) TYPE I N/A 0 ADVENTIST HLTH SYSTEMGEORGIA INC 1035 RED BUD ROAD CALHOUN GA 30701 581425000 OPERATION OF HOSPITAL & RELATED SERVICES GA 501(C)(3) 170(B)(1)(A)(III) ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 0 ADVENTIST HLTH SYSTEMSUNBELT INC 111 N ORLANDO AVENUE WINTER PARK FL 32789 591479658 OPERATION OF HOSPITAL & RELATED SERVICES FL 501(C)(3) 170(B)(1)(A)(III) ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 0 ADVENTIST HLTH SYSTEMTEXAS INC 602 COURTLAND STREET ORLANDO FL 32804 742578952 INACTIVE TX 501(C)(3) 509(A)(2) ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 0 ADVENTIST HINSDALE HOSPITAL 120 NORTH OAK STREET HINSDALE IL 60521 362276984 OPERATION OF HOSPITAL & RELATED SERVICES IL 501(C)(3) 170(B)(1)(A)(III) ADVENTIST HLTH SYSTEMSUNBELT INC 0 AHS MIDWEST MANAGEMENT INC 1000 REMINGTON BLVD STE 200 BOLINGBROOK IL 60440 363354567 OPERATION OF PHYSICIAN PRACTICE MGMT IL 501(C)(3) 509(A)(3) TYPE I ADVENTIST HLTH SYSTEMSUNBELT INC 0 AHSCENTRAL TEXAS INC 1301 WONDER WORLD DRIVE SAN MARCOS TX 78666 742621825 PROVIDE OFFICE SPACE - MEDICAL PROFESSIONALS TX 501(C)(3) 509(A)(3) TYPE III-F ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 0 APOPKA HLTH CARE PROPERTIES INC 305 E OAK STREET APOPKA FL 32703 510605694 LEASE TO RELATED ORGANIZATION GA 501(C)(3) 509(A)(3) TYPE III-F SUNBELT HLTH CARE CENTERS INC 0 BATTLE CREEK ADVENTIST HOSPITAL 1000 REMINGTON BLVD STE 200 BOLINGBROOK IL 60440 381359189 INACTIVE MI 501(C)(3) 170(B)(1)(A)(III) ADVENTIST HLTH SYSTEMSUNBELT INC 0 BERT FISH MEDICAL CENTER INC (10110-63011) 401 PALMETTO STREET NEW SMYRNA BEACH FL 32168 362276984 OPERATION OF HOSPITAL & RELATED SERVICES FL 501(C)(3) 170(B)(1)(A)(III) ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 0 BOLINGBROOK HOSPITAL FOUNDATION 1000 REMINGTON BLVD N ENTRANCE 2ND BOLINGBROOK IL 60440 900494445 FUND-RAISING FOR TAX-EXEMPT HOSPITAL IL 501(C)(3) 170(B)(1)(A)(VI) MIDWEST HLTH FOUNDATION 0 BRADFORD HEIGHTS HLTH & REHAB CENTER INC 950 HIGHPOINT DRIVE HOPKINSVILLE KY 42240 205782342 OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY KY 501(C)(3) 509(A)(2) SUNBELT HLTH CARE CENTERS INC 0 BURLESON NURSING & REHAB CENTER INC 301 HUGULEY BLVD BURLESON TX 76028 205782243 OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY TX 501(C)(3) 509(A)(2) SUNBELT HLTH CARE CENTERS INC 0 CALDWELL HLTH CARE PROPERTIES INC 1333 WEST MAIN PRINCETON KY 42445 510605680 LEASE TO RELATED ORGANIZATION GA 501(C)(3) 509(A)(3) TYPE III-F SUNBELT HLTH CARE CENTERS INC 0 CENTRAL TEXAS HLTHCARE COLLABORATIVE (112-123111) 1301 WONDER WORLD DRIVE SAN MARCOS TX 78666 453739929 SUPPORT OPERATION OF HOSPITAL TX 501(C)(3) 509(A)(3) TYPE I ADVENTIST HLTH SYSTEMSUNBELT INC 0 CEDAR CRAG TERRACE INC (630 YEAR END) RT 5 BOX 900 MANCHESTER KY 40962 611120442 OPERATION OF HOME FOR THE ELDERLY-DISABLED KY 501(C)(3) 170(B)(1)(A)(VI) MEMORIAL HOSPITAL INC 0 CENTRAL TEXAS MEDICAL CENTER FOUNDATION 1301 WONDER WORLD DRIVE SAN MARCOS TX 78666 742259907 FUND-RAISING FOR TAX-EXEMPT HOSPITAL TX 501(C)(3) 170(B)(1)(A)(VI) ADVENTIST HLTH SYSTEMSUNBELT INC 0 CHICKASAW HLTH CARE PROPERTIES INC 250 S CHICKASAW TRAIL ORLANDO FL 32825 510605681 LEASE TO RELATED ORGANIZATION GA 501(C)(3) 509(A)(3) TYPE III-F SUNBELT HLTH CARE CENTERS INC 0 CHIPPEWA VALLEY HOSPITAL & OAKVIEW CARE CENTER INC 1220 THIRD AVENUE WEST DURAND WI 54736 391365168 OPERATION OF HOSPITAL & RELATED SERVICES WI 501(C)(3) 170(B)(1)(A)(III) ADVENTIST HLTH SYSTEMSUNBELT INC 0 COBB MEDICAL ASSOCIATES LLC 3949 SOUTH COBB DRIVE SE SMYRNA GA 300806342 582617089 OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES GA 501(C)(3) 170(B)(1)(A)(III) EMORY-ADVENTIST INC 0 COURTLAND HLTH CARE PROPERTIES INC 730 COURTLAND STREET ORLANDO FL 32804 510605682 LEASE TO RELATED ORGANIZATION GA 501(C)(3) 509(A)(3) TYPE 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