LA GRANGE MEMORIAL HOSPITAL FOUNDATION: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- LA GRANGE MEMORIAL HOSPITAL FOUNDATION (EIN 30-0247776)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-11-09
- IRS object ID
- 201103139349300510
- Schema version
- 2010v3.4
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-11-09T07:48:36-06:00 | Timestamp |
| Tax Period End Date | 2010-12-31 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 300247776 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LA GRANGE MEMORIAL HOSPITAL FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | LAGR | NameControl |
| Phone | 7082456001 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5101 S WILLOW SPRINGS RD | AddressLine1 |
| City | LA GRANGE | City |
| State | IL | State |
| ZIP Code | 60525 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BRETT SKEEN | Name |
| Title | EXECUTIVE DIRECTOR | Title |
| Phone | 7082456001 | Phone |
| Date Signed | 2011-11-08 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | BRETT SKEEN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5101 S WILLOW SPRINGS RD | AddressLine1 |
| City | LA GRANGE | City |
| State | IL | State |
| ZIP Code | 60525 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 1310138 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.KEEPINGYOUWELL.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2004 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | FUNDRAISING FOR TAX-EXEMPT ORGANIZATION. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 60 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1429177 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1201926 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 0 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 23698 | InvestmentIncomePriorYear |
| Investment Income Current Year | 63657 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -53867 | OtherRevenuePriorYear |
| Other Revenue Current Year | -37337 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 1399008 | TotalRevenuePriorYear |
| Total Revenue Current Year | 1228246 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 1111268 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 1011345 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 0 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 15399 | OtherExpensePriorYear |
| Other Expenses Current Year | 5263 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 1126667 | TotalExpensesPriorYear |
| Total Expenses Current Year | 1016608 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 272341 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 211638 | RevenuesLessExpensesCY |
| Total Assets BOY | 1281256 | TotalAssetsBOY |
| Total Assets EOY | 1843985 | TotalAssetsEOY |
| Total Liabilities BOY | 18765 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 15753 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 1262491 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 1828232 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE PROMOTION OF PHILANTHROPHY AND GOODWILL FOR ADVENTIST LA GRANGE MEMORIAL HOSPITAL. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 1014344 | Expense |
| Grants | 1011345 | Grants |
| Description | 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. | Description |
| Total Program Service Expense | 1014344 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 0 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 3 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 1 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IL | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRETT SKEEN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7082452902 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5101 S WILLOW SPRINGS ROAD | AddressLine1 |
| City | LA GRANGE | City |
| State | IL | State |
| ZIP Code | 60525 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer |
|---|---|---|---|---|---|---|
| BONNY CHEN MD | ||||||
| SEC/TREASURER/DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| JEROME HINES MD | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| LUKE SEWALL MD | ||||||
| DIRECTOR | 1.00 | X | 0 | 561278 | 34417 | |
| PETER O'CONNOR | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| DANIEL PANCAKE | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| JEANNE REILLY | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| JERRY BURJAN | ||||||
| DIRECTOR (END 1/10) | 1.00 | X | 0 | 0 | 0 | |
| JOHN DIXON | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| LINDA JOHNSON | ||||||
| CHAIRMAN/DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| MIKE MARCUCCI | ||||||
| VICE-CHAIRMAN/DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| BILL HOLDER | ||||||
| DIRECTOR (BEG 10/10) | 1.00 | X | 0 | 0 | 0 | |
| CHRISTOPHER JOYCE | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| MARTY DUNNE | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| ELIZABETH LIVELY | ||||||
| DIRECTOR (END 11/10) | 1.00 | X | 0 | 140751 | 28752 | |
| RICK WRIGHT | ||||||
| DIRECTOR | 1.00 | X | 0 | 430199 | 62313 | |
| PAUL ZIEGELE | ||||||
| DIRECTOR | 1.00 | X | 0 | 258990 | 49108 | |
| BRETT SKEEN | ||||||
| EXECUTIVE DIRECTOR (BEG 3/10) | 40.00 | 0 | 81641 | 2252 | X | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1472859 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 176842 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Fundraising Events | 163841 | FundraisingEvents |
| Related Organizations | 10000 | RelatedOrganizations |
| All Other Contributions | 1028085 | AllOtherContributions |
| Total Contributions | 1201926 | TotalContributions |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 63657 | TotalRevenueColumn |
| Exclusion | $63,657 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 44555 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 163841 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 81892 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -37337 | TotalRevenueColumn |
| Exclusion | -$37,337 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1228246 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $26,320 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1006531 | Total |
| Program Services | 1006531 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4814 | Total |
| Program Services | 4814 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2264 | Total |
| Management And General | 2264 | ManagementAndGeneral |
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| BAD DEBT EXPENSE | 2499 | 2499 |
| OTHER EXPENSE | 500 | 500 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1016608 | Total |
| Program Services | 1014344 | ProgramServices |
| Management And General | 2264 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 936011 | BOY |
| EOY | 1629172 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 340750 | BOY |
| EOY | 201785 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4495 | BOY |
| EOY | 13028 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1281256 | BOY |
| EOY | 1843985 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 312 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18765 | BOY |
| EOY | 15441 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18765 | BOY |
| EOY | 15753 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 158904 | BOY |
| EOY | 229812 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1017962 | BOY |
| EOY | 1512735 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 85625 | BOY |
| EOY | 85685 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1262491 | BOY |
| EOY | 1828232 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1281256 | BOY |
| EOY | 1843985 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 211638 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 354103 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | 586427 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 604106 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1429177 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1201926 | CurrentTaxYear |
| Total | 3821636 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | 586427 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 604106 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1429177 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1201926 | CurrentTaxYear |
| Total | 3821636 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 2185793 | AmountsSubstContributorsTotal |
| Public Support Total170 | 1635843 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | 58677 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 10844 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 23698 | CurrentTaxYearMinus1Year |
| Current Tax Year | 63657 | CurrentTaxYear |
| Total | 156876 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | 64127 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 37450 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 71472 | CurrentTaxYearMinus1Year |
| Current Tax Year | 44555 | CurrentTaxYear |
| Total | 217604 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 4196116 | TotalSupport |
| First5 Years170 | X | First5Years170 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 85625 | BeginningOfYearBalance |
| Contributions | 60 | Contributions |
| End Of Year Balance | 85685 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 85625 | BeginningOfYearBalance |
| End Of Year Balance | 85625 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 85625 | BeginningOfYearBalance |
| End Of Year Balance | 85625 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
| Total Of Book Value Land Buildings | 0 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OBLIGATION FOR CHARITABLE GIFT ANNUNITIES | Description |
| Amount | $15,441 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 15441 | TotalOfAmounts |
| Total Revenue | 1228246 | TotalRevenue |
| Total Expenses | 1016608 | TotalExpenses |
| Excess Or Deficit For Year | 211638 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -438 | NetUnrealizedGLOnInvestments |
| Other | $354,541 | OtherAmount |
| Total Adjustments | 354103 | TotalAdjustments |
| Excess Or Deficit Per FS | 565741 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 1318474 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 230958 | OtherRevenues |
| Revenue Not Rptd F990 | 230958 | RevenueNotRptdF990 |
| Revenue Subtotal | 1087516 | RevenueSubtotal |
| Other Revenues Not Included | 140730 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 140730 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 1228246 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 1247566 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 230958 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 230958 | ExpensesNotRptdF990 |
| Expenses Subtotal | 1016608 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 1016608 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| 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: | RESTRICTED CONTRIBUTIONS 344,475. RESTRICTED INTEREST INCOME 10,066. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | IN-KIND CONTRIBUTIONS 230,958. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | NET SPECIAL EVENTS REVENUE RECLASSED FROM FUND BALANCE 140,730. | |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | IN-KIND CONTRIBUTIONS 230,958. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GOLF CLASSIC | NameOfEvent1 |
| Gross Receipts Event1 | 208396 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 163841 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 44555 | GrossRevenueEvent1 |
| Cash Prizes Event1 | 1390 | CashPrizesEvent1 |
| Non Cash Prizes Event1 | 12861 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 32188 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 19008 | FoodAndBeverageEvent1 |
| Other Direct Expenses Event1 | 16445 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 208396 | GrossReceiptsTotal |
| Charitable Contributions Total | 163841 | CharitableContributionsTotal |
| Gross Revenue Total Events | 44555 | GrossRevenueTotalEvents |
| Cash Prizes Total Events | 1390 | CashPrizesTotalEvents |
| Non Cash Prizes Total Events | 12861 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 32188 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 19008 | FoodAndBeverageTotalEvents |
| Other Direct Expenses Total Events | 16445 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 81892 | DirectExpenseSummaryEvents |
| Net Income Summary | -37337 | NetIncomeSummary |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADVENTIST HEALTH SYSTEMSUNBELT INC DBA ADVENTIST LA GRANGE MEM HOSP | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5101 WILLOW SPRINGS RD | AddressLine1 |
| City | LA GRANGE | City |
| State | IL | State |
| ZIP Code | 60525 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 591479658 | EINOfRecipient |
| IRC Section | 501(C)(3) | IRCSection |
| Amount Of Cash Grant | 1002531 | AmountOfCashGrant |
| Purpose Of Grant | NEW PATIENT CARE CENTER AND GENERAL SUPPORT. | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | OTHER INFORMATION: | Identifier |
| Return Reference | PART IV: | ReturnReference |
| Explanation | 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. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LUKE SEWALL MD | |||||||||||||
| 0 | 560941 | 0 | 0 | 0 | 337 | 0 | 13343 | 0 | 21074 | 0 | 595695 | 0 | 0 |
| ELIZABETH LIVELY | |||||||||||||
| 0 | 129343 | 0 | 10028 | 0 | 1380 | 0 | 5224 | 0 | 23528 | 0 | 169503 | 0 | 0 |
| RICK WRIGHT | |||||||||||||
| 0 | 298616 | 0 | 65818 | 0 | 65765 | 0 | 41369 | 0 | 20944 | 0 | 492512 | 0 | 0 |
| PAUL ZIEGELE | |||||||||||||
| 0 | 203068 | 0 | 39125 | 0 | 16797 | 0 | 23496 | 0 | 25612 | 0 | 308098 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| 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 PRE-DETERMINED BENEFITS ANNUAL AMOUNT 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. 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 $196,000. 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. 457(F) EMPLOYER SERP CONTRIBUTIONS CONTR./PYMT RICK WRIGHT $37,546 $ 0 PAUL ZIEGELE $10,153 $ 0 | |
| 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. | SUPPLEMENTAL INFORMATION |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (12 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | MIKE MARCUCCI AND PETER O'CONNOR - BUSINESS RELATIONSHIP | |
| FORM 990, PART VI, SECTION A, LINE 4 | IN MARCH OF 2010, THE FILING ORGANIZATION AMENDED ITS BYLAWS TO INCREASE THE NUMBER OF PERMITTED ELECTED DIRECTORS FROM 10 TO 15 TO 16 TO 20. IN ADDITION, THE FOLLOWING CHANGES WERE MADE TO THE BYLAWS IN MARCH, 2010: 1) THE CFO OF ADVENTIST LA GRANGE MEMORIAL HOSPITAL WAS ADDED TO SERVE AS AN EX-OFFICIO MEMBER OF THE BOARD OF DIRECTORS; AND 2) A MEMBER OF THE BOARD OF DIRECTORS MAY BE PERMITTED TO SERVE A THIRD CONSECUTIVE TERM (PRIOR TO AMENDMENT, ONLY 2 CONSECUTIVE TERMS WERE ALLOWED) BY UNANIMOUS VOTE OF THE BOARD OF DIRECTORS. | |
| 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. | |
| 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. | |
| 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 B, LINE 12C | |
| THE FILING ORGANIZATION DOES NOT GENERALLY MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. | FORM 990, PART VI, SECTION C, LINE 19 | |
| 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 | |
| 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. | PART VII, SECTION A, COLUMN (B) | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | NET UNREALIZED LOSSES ON INVESTMENTS: -438. RESTRICTED CONTRIBUTIONS 344,475. RESTRICTED INTEREST INCOME 10,066. TOTAL TO FORM 990, PART XI, LINE 5: 354,103. | FORM 990, PART XI, LINE 5: |
| 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. | FORM 990, PART VI, SECTION B, LINE 15: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (102 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 HEALTH SYSTEMSUNBELT INC | 0 | |
| ADVENTIST CARE CENTERS - COURTLAND INC | |||||||||||
| 730 COURTLAND STREET | ORLANDO | FL | 32804 | 205774723 | OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY | FL | 501(C)(3) | 509(A)(2) | SUNBELT HEALTH 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 HEALTH SYSTEMSUNBELT INC | 0 | |
| ADVENTIST HEALTH MID-AMERICA INC | |||||||||||
| 9100 W 74TH STREET | SHAWNEE MISSION | KS | 66204 | 521347407 | HEALTHCARE RELATED SERVICES | KS | 501(C)(3) | 509(A)(3) TYPE I | ADVENTIST HEALTH SYSTEMSUNBELT INC | 0 | |
| ADVENTIST HEALTH 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 HEALTH SYSTEM AFFILIATED BENEFIT TRUST | |||||||||||
| 111 N ORLANDO AVENUE | WINTER PARK | FL | 32789 | 266422966 | PROMOTION OF HEALTHCARE | FL | 501(C)(3) | 509(A)(3) TYPE I | ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION | 0 | |
| ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION | |||||||||||
| 111 N ORLANDO AVENUE | WINTER PARK | FL | 32789 | 592170012 | MANAGEMENT SERVICES | FL | 501(C)(3) | 509(A)(3) TYPE I | 0 | N/A | |
| ADVENTIST HEALTH 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 HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION | 0 | |
| ADVENTIST HEALTH 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 HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION | 0 | |
| ADVENTIST HEALTH SYSTEMTEXAS INC | |||||||||||
| 602 COURTLAND STREET | ORLANDO | FL | 32804 | 742578952 | INACTIVE | TX | 501(C)(3) | 509(A)(2) | ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION | 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 HEALTH SYSTEMSUNBELT INC | 0 | |
| AHS MIDWEST MANAGEMENT INC | |||||||||||
| 1000 REMINGTON BLVD STE 200 | BOLINGBROOK | IL | 60440 | 363354567 | OPERATION OF OCCUPATIONAL HLTH CLINIC & PHYSICIAN PRACTICE MGMT | IL | 501(C)(3) | 509(A)(3) TYPE I | ADVENTIST HEALTH 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 HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION | 0 | |
| APOPKA HEALTH 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 HEALTH CARE CENTERS INC | 0 | |
| BATTLE CREEK ADVENTIST HOSPITAL | |||||||||||
| 1000 REMINGTON BLVD STE 200 | BOLINGBROOK | IL | 60440 | 381359189 | OPERATION OF HOSPITAL & RELATED SERVICES | MI | 501(C)(3) | 170(B)(1)(A)(III) | ADVENTIST HEALTH 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 HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION | 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 HEALTH FOUNDATION | 0 | |
| BRADFORD HEIGHTS HEALTH & REHAB CENTER INC | |||||||||||
| 950 HIGHPOINT DRIVE | HOPKINSVILLE | KY | 42240 | 205782342 | OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY | KY | 501(C)(3) | 509(A)(2) | SUNBELT HEALTH CARE CENTERS INC | 0 | |
| BURLESON NURSING & REHAB CENTER INC | |||||||||||
| 301 HUGULEY BLVD | BURLESON | TX | 76028 | 205782243 | OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY | TX | 501(C)(3) | 509(A)(2) | SUNBELT HEALTH CARE CENTERS INC | 0 | |
| CALDWELL HEALTH 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 HEALTH CARE CENTERS 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 HEALTH SYSTEMSUNBELT INC | 0 | |
| CHICKASAW HEALTH 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 HEALTH 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 HEALTH 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 HEALTH CARE PROPERTIES INC | |||||||||||
| 730 COURTLAND STREET | ORLANDO | FL | 32804 | 510605682 | LEASE TO RELATED ORGANIZATION | GA | 501(C)(3) | 509(A)(3) TYPE III-F | SUNBELT HEALTH CARE CENTERS INC | 0 | |
| CREEKWOOD PLACE NURSING & REHAB CENTER INC | |||||||||||
| 683 E THIRD STREET | RUSSELLVILLE | KY | 42276 | 205782260 | OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY | KY | 501(C)(3) | 509(A)(2) | SUNBELT HEALTH CARE CENTERS INC | 0 | |
| DAIRY ROAD HEALTH CARE PROPERTIES INC | |||||||||||
| 7350 DAIRY ROAD | ZEPHYRHILLS | FL | 33540 | 510605684 | LEASE TO RELATED ORGANIZATION | GA | 501(C)(3) | 509(A)(3) TYPE III-F | SUNBELT HEALTH CARE CENTERS INC | 0 | |
| EAST ORLANDO HEALTH & REHAB CENTER INC | |||||||||||
| 250 S CHICKASAW TRAIL | ORLANDO | FL | 32825 | 205774748 | OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY | FL | 501(C)(3) | 509(A)(2) | SUNBELT HEALTH CARE CENTERS INC | 0 | |
| EMORY-ADVENTIST INC | |||||||||||
| 3949 SOUTH COBB DRIVE | SMYRNA | GA | 30080 | 582171011 | OPERATION OF HOSPITAL & RELATED SVCS | GA | 501(C)(3) | 170(B)(1)(A)(III) | ADVENTIST HEALTH SYSTEMSUNBELT INC | 0 | |
| FLETCHER HOSPITAL INC | |||||||||||
| 100 HOSPITAL DRIVE | HENDERSONVILLE | NC | 28792 | 560543246 | OPERATION OF HOSPITAL & RELATED SVCS | NC | 501(C)(3) | 170(B)(1)(A)(III) | ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION | 0 | |
| FLNC INC | |||||||||||
| 3355 E SEMORAN BLVD | APOPKA | FL | 32703 | 205774761 | OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY | FL | 501(C)(3) | 509(A)(2) | SUNBELT HEALTH CARE CENTERS INC | 0 | |
| FLORIDA HOSPITAL COLLEGE OF HEALTH SCIENCES INC (630 YEAR END) | |||||||||||
| 671 LAKE WINYAH DRIVE | ORLANDO | FL | 32803 | 593069793 | EDUCATION/OPERATION OF SCHOOL | FL | 501(C)(3) | 170(B)(1)(A)(II) | ADVENTIST HEALTH SYSTEMSUNBELT INC | 0 | |
| FLORIDA HOSPITAL DELAND AUXILIARY INC | |||||||||||
| 701 WEST PLYMOUTH AVENUE | DELAND | FL | 32720 | 593425543 | VOLUNTEER SUPPORT SERVICES | FL | 501(C)(3) | 509(A)(3) TYPE III-F | MEMORIAL HOSPITAL WEST VOLUSIA INC | 0 | |
| FLORIDA HOSPITAL WATERMAN INC | |||||||||||
| 1000 WATERMAN WAY | TAVARES | FL | 32778 | 593140669 | OPERATION OF HOSPITAL & RELATED SERVICES | FL | 501(C)(3) | 170(B)(1)(A)(III) | ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION | 0 | |
| FLORIDA HOSPITAL WESLEY CHAPEL INC | |||||||||||
| 2528 BRUCE B DOWNS BLVD CR 581 S | WESLEY CHAPEL | FL | 33543 | 203965753 | INACTIVE | FL | 501(C)(3) | 509(A)(3) TYPE III-F | ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION | 0 | |
| FLORIDA HOSPITAL ZEPHYRHILLS INC | |||||||||||
| 7050 GALL BLVD | ZEPHYRHILLS | FL | 33541 | 592108057 | OPERATION OF HOSPITAL & RELATED SERVICES | FL | 501(C)(3) | 170(B)(1)(A)(III) | ADVENTIST HEALTH SYSTEMSUNBELT INC | 0 | |
| FLORIDA PHYSICIANS MEDICAL GROUP INC | |||||||||||
| 900 WINDERLEY PLACE | MAITLAND | FL | 32751 | 593214635 | OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES | FL | 501(C)(3) | 170(B)(1)(A)(III) | ADVENTIST HEALTH SYSTEMSUNBELT INC | 0 | |
| FOUNDATION FOR SHAWNEE MISSION MEDICAL CENTER INC | |||||||||||
| 9100 W 74TH STREET | SHAWNEE MISSION | KS | 66204 | 480868859 | FUND-RAISING FOR TAX-EXEMPT HOSPITAL | KS | 501(C)(3) | 509(A)(3) TYPE I | SHAWNEE MISSION MEDICAL CENTER INC | 0 | |
| GLENOAKS HOSPITAL FOUNDATION | |||||||||||
| 701 WINTHROP AVENUE | GLENDALE HEIGHTS | IL | 60139 | 363926044 | FUND-RAISING FOR TAX-EXEMPT HOSPITAL | IL | 501(C)(3) | 170(B)(1)(A)(VI) | MIDWEST HEALTH FOUNDATION | 0 | |
| HAYS MEMORIAL HOSPITAL ASSOCIATION OF SEVENTH-DAY ADVENTISTS | |||||||||||
| 1301 WONDER WORLD DRIVE | SAN MARCOS | TX | 78667 | 741362785 | LEASE OF HOSPITAL PERSONNEL | TX | 501(C)(3) | 509(A)(3) TYPE II | ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION | 0 | |
| HELEN ELLIS MEMORIAL HOSPITAL AUXILIARY INC (51-123110) | |||||||||||
| 1395 S PINELLAS AVE | TARPON SPRINGS | FL | 34689 | 592106043 | FUND-RAISING FOR TAX-EXEMPT HOSPITAL/FOUNDATION | FL | 501(C)(3) | 509(A)(3) TYPE I | TARPON SPRINGS HOSPITAL FOUNDATION INC | 0 | |
| HELEN ELLIS MEMORIAL HOSPITAL FOUNDATION INC (101-123110) | |||||||||||
| 1395 S PINELLAS AVE | TARPON SPRINGS | FL | 34689 | 593690149 | FUND-RAISING FOR TAX-EXEMPT HOSPITAL | FL | 501(C)(3) | 509(A)(3) TYPE I | TARPON SPRINGS HOSPITAL FOUNDATION INC | 0 | |
| HINSDALE HOSPITAL FOUNDATION | |||||||||||
| 7 SALT CREEK LANE SUITE 203 | HINSDALE | IL | 60521 | 521466387 | FUND-RAISING FOR TAX-EXEMPT HOSPITAL | IL | 501(C)(3) | 170(B)(1)(A)(VI) | MIDWEST HEALTH FOUNDATION | 0 | |
| IN-MOTION REHAB INC | |||||||||||
| 602 COURTLAND STREET STE 200 | ORLANDO | FL | 32804 | 208023411 | THERAPY SERVICES TO TAX EXEMPT NURSING HOMES | KS | 501(C)(3) | 509(A)(3) TYPE II | SUNBELT HEALTH CARE CENTERS INC | 0 | |
| JELLICO COMMUNITY HOSPITAL INC | |||||||||||
| 188 HOSPITAL LANE | JELLICO | TN | 37762 | 620924706 | OPERATION OF HOSPITAL & RELATED SERVICES | TN | 501(C)(3) | 170(B)(1)(A)(III) | ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION | 0 | |
| LA GRANGE MEMORIAL HOSPITAL FOUNDATION | |||||||||||
| 5101 S WILLOW SPRINGS RD | LA GRANGE | IL | 60525 | 300247776 | FUND-RAISING FOR TAX-EXEMPT HOSPITAL | IL | 501(C)(3) | 170(B)(1)(A)(VI) | MIDWEST HEALTH FOUNDATION | 0 | |
| MEMORIAL HEALTH SYSTEMS FOUNDATION INC | |||||||||||
| 770 WEST GRANADA BLVD | ORMOND BEACH | FL | 32174 | 311771522 | FUND-RAISING FOR TAX-EXEMPT HOSPITAL | FL | 501(C)(3) | 170(B)(1)(A)(VI) | MEMORIAL HEALTH SYSTEMS INC | 0 | |
| MEMORIAL HEALTH SYSTEMS INC | |||||||||||
| 301 MEMORIAL MEDICAL PARKWAY | DAYTONA BEACH | FL | 32117 | 590973502 | OPERATION OF HOSPITAL & RELATED SERVICES | FL | 501(C)(3) | 170(B)(1)(A)(III) | ADVENTIST HEALTH SYSTEMSUNBELT INC | 0 | |
| MEMORIAL HOSPITAL - FLAGLER INC | |||||||||||
| 60 MEMORIAL MEDICAL PARKWAY | PALM COAST | FL | 32164 | 592951990 | OPERATION OF HOSPITAL & RELATED SERVICES | FL | 501(C)(3) | 170(B)(1)(A)(III) | MEMORIAL HEALTH SYSTEMS INC | 0 | |
| MEMORIAL HOSPITAL - WEST VOLUSIA INC | |||||||||||
| 701 WEST PLYMOUTH AVENUE | DELAND | FL | 32720 | 593256803 | OPERATION OF HOSPITAL & RELATED SERVICES | FL | 501(C)(3) | 170(B)(1)(A)(III) | MEMORIAL HEALTH SYSTEMS INC | 0 | |
| MEMORIAL HOSPITAL INC | |||||||||||
| 210 MARIE LANGDON DRIVE | MANCHESTER | KY | 40962 | 610594620 | OPERATION OF HOSPITAL & RELATED SERVICES | KY | 501(C)(3) | 170(B)(1)(A)(III) | ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION | 0 | |
| MERRIAM HEALTH CARE PROPERTIES INC | |||||||||||
| 9700 WEST 62ND STREET | MERRIAM | KS | 66203 | 364595806 | LEASE TO RELATED ORGANIZATION | KS | 501(C)(3) | 509(A)(3) TYPE III-F | SUNBELT HEALTH CARE CENTERS INC | 0 | |
| METROPLEX ADVENTIST HOSPITAL INC | |||||||||||
| 2201 S CLEAR CREEK ROAD | KILLEEN | TX | 76549 | 742225672 | OPERATION OF HOSPITAL & RELATED SERVICES | TX | 501(C)(3) | 170(B)(1)(A)(III) | ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION | 0 | |
| METROPLEX CLINIC PHYSICIANS INC | |||||||||||
| 2201 S CLEAR CREEK ROAD | KILLEEN | TX | 76549 | 113762050 | PHYSICIAN HEALTHCARE SERVICES TO THE COMMUNITY | TX | 501(C)(3) | 170(B)(1)(A)(III) | METROPLEX ADVENTIST HOSPITAL INC | 0 | |
| MIDWEST HEALTH FOUNDATION | |||||||||||
| 120 NORTH OAK STREET | HINSDALE | IL | 60521 | 352230515 | SUPPORT OF SUBSIDIARY FOUNDATIONS | IL | 501(C)(3) | 509(A)(3) TYPE II | 0 | N/A | |
| MILLS HEALTH & REHAB CENTER INC | |||||||||||
| 500 BECK LANE | MAYFIELD | KY | 42066 | 205782320 | OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY | KY | 501(C)(3) | 509(A)(2) | SUNBELT HEALTH CARE CENTERS INC | 0 | |
| MISSION STRATEGIES INC | |||||||||||
| 602 COURTLAND STREET STE 200 | ORLANDO | FL | 32804 | 205982365 | PROVISION OF SUPPORT TO THE NURSING HOME DIVISION | KS | 501(C)(3) | 509(A)(3) TYPE II | SUNBELT HEALTH CARE CENTERS INC | 0 | |
| MISSOURI ADVENTIST HEALTH INC | |||||||||||
| 9100 W 74TH STREET | SHAWNEE MISSION | KS | 66204 | 431224729 | SUPPORT HEALTH CARE SERVICES | MO | 501(C)(3) | 509(A)(3) TYPE III-O | ADVENTIST HEALTH MID-AMERICA INC | 0 | |
| NORTH REGIONAL EMS INC | |||||||||||
| 188 HOSPITAL LANE | JELLICO | TN | 37762 | 262653616 | EMS SERVICES | TN | 501(C)(3) | 509(A)(2) | JELLICO COMMUNITY HOSPITAL INC | 0 | |
| ORMOND BEACH MEMORIAL HOSPITAL AUXILIARY INC | |||||||||||
| 301 MEMORIAL MEDICAL PARKWAY | DAYTONA BEACH | FL | 32117 | 591721962 | VOLUNTEER SUPPORT SERVICES | FL | 501(C)(3) | 509(A)(3) TYPE III-F | MEMORIAL HEALTH SYSTEMS INC | 0 | |
| OVERLAND PARK NURSING & REHAB CENTER INC | |||||||||||
| 6501 WEST 75TH STREET | OVERLAND PARK | KS | 66204 | 205774821 | OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY | KS | 501(C)(3) | 509(A)(2) | SUNBELT HEALTH CARE CENTERS INC | 0 | |
| PARAGON HEALTH CARE PROPERTIES INC | |||||||||||
| 950 HIGHPOINT DRIVE | HOPKINSVILLE | KY | 42240 | 510605686 | LEASE TO RELATED ORGANIZATION | GA | 501(C)(3) | 509(A)(3) TYPE III-F | SUNBELT HEALTH CARE CENTERS INC | 0 | |
| PORTERCARE ADVENTIST HEALTH SYSTEM (630 YEAR END) | |||||||||||
| 2525 S DOWNING STREET | DENVER | CO | 80210 | 840438224 | OPERATION OF HOSPITAL & RELATED SERVICES | CO | 501(C)(3) | 170(B)(1)(A)(III) | ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION | 0 | |
| PORTLAND NURSING & REHAB CENTER INC | |||||||||||
| 215 HIGHLAND CIRCLE DRIVE | PORTLAND | TN | 37148 | 205774842 | OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY | TN | 501(C)(3) | 509(A)(2) | SUNBELT HEALTH CARE CENTERS INC | 0 | |
| PRINCETON HEALTH & REHAB CENTER INC | |||||||||||
| 1333 WEST MAIN | PRINCETON | KY | 42445 | 205782272 | OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY | KY | 501(C)(3) | 509(A)(2) | SUNBELT HEALTH CARE CENTERS INC | 0 | |
| PRINCETON PROFESSIONAL SERVICES INC | |||||||||||
| 601 E ROLLINS STREET | ORLANDO | FL | 32803 | 591191045 | PROVISION OF HEALTHCARE SERVICES | FL | 501(C)(3) | 509(A)(2) | ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION | 0 | |
| QUALITY CIRCLE FOR HEALTHCARE INC | |||||||||||
| 111 N ORLANDO AVENUE | WINTER PARK | FL | 32789 | 263789368 | HEALTHCARE QUALITY SERVICES | FL | 501(C)(3) | 509(A)(3) TYPE III-F | ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION | 0 | |
| RESOURCE PERSONNEL INC | |||||||||||
| 602 COURTLAND STREET STE 200 | ORLANDO | FL | 32804 | 208040875 | PROVIDE ADMINISTRATIVE SUPPORT TO TAX EXEMPT NURSING HOMES | FL | 501(C)(3) | 509(A)(3) TYPE II | SUNBELT HEALTH CARE CENTERS INC | 0 | |
| ROCKY MOUNTAIN ADVENTIST HEALTHCARE FOUNDATION (630 YEAR END) | |||||||||||
| 2525 SOUTH DOWNING STREET | DENVER | CO | 80210 | 840745018 | FUND-RAISING FOR TAX-EXEMPT HOSPITAL | CO | 501(C)(3) | 170(B)(1)(A)(VI) | PORTERCARE ADVENTIST HEALTH SYSTEM | 0 | |
| ROLLINS BEDFORD CORPORATION | |||||||||||
| 602 COURTLAND STREET STE 200 | ORLANDO | FL | 32804 | 370908840 | INACTIVE | FL | 501(C)(3) | 509(A)(3) TYPE II | SUNBELT HEALTH CARE CENTERS INC | 0 | |
| RUSSELLVILLE HEALTH CARE PROPERTIES INC | |||||||||||
| 683 EAST THIRD STREET | RUSSELLVILLE | KY | 42276 | 510605691 | LEASE TO RELATED ORGANIZATION | GA | 501(C)(3) | 509(A)(3) TYPE III-F | SUNBELT HEALTH CARE CENTERS INC | 0 | |
| SAN MARCOS HEALTH CARE PROPERTIES INC | |||||||||||
| 1900 MEDICAL PARKWAY | SAN MARCOS | TX | 78666 | 510605693 | LEASE TO RELATED ORGANIZATION | GA | 501(C)(3) | 509(A)(3) TYPE III-F | SUNBELT HEALTH CARE CENTERS INC | 0 | |
| SAN MARCOS NURSING & REHAB CENTER INC | |||||||||||
| 1900 MEDICAL PARKWAY | SAN MARCOS | TX | 78666 | 205782224 | OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY | TX | 501(C)(3) | 509(A)(2) | SUNBELT HEALTH CARE CENTERS INC | 0 | |
| SHAWNEE MISSION HEALTH CARE INC | |||||||||||
| 6501 WEST 75TH STREET | OVERLAND PARK | KS | 66204 | 480952508 | LEASE TO RELATED ORGANIZATION | KS | 501(C)(3) | 509(A)(3) TYPE III-F | SUNBELT HEALTH CARE CENTERS INC | 0 | |
| SHAWNEE MISSION MEDICAL CENTER INC | |||||||||||
| 9100 W 74TH STREET | SHAWNEE MISSION | KS | 66204 | 480637331 | OPERATION OF HOSPITAL & RELATED SERVICES | KS | 501(C)(3) | 170(B)(1)(A)(III) | ADVENTIST HEALTH MID-AMERICA INC | 0 | |
| SOUTH CENTRAL NURSING HOMES PROPERTIES INC | |||||||||||
| 111 NORTH ORLANDO AVE | WINTER PARK | FL | 32789 | 593686109 | MANAGEMENT SUPPORT | GA | 501(C)(3) | 509(A)(3) TYPE III-O | SOUTH CENTRAL INC | 0 | |
| SOUTH CENTRAL NURSING HOMES INC | |||||||||||
| 602 COURTLAND STREET | ORLANDO | FL | 32804 | 611242373 | MANAGEMENT SUPPORT | KY | 501(C)(3) | 509(A)(3) TYPE III-O | SOUTH CENTRAL INC | 0 | |
| SOUTH CENTRAL PROPERTIES III INC | |||||||||||
| 111 NORTH ORLANDO AVE | WINTER PARK | FL | 32789 | 593692860 | REAL ESTATE | GA | 501(C)(2) | SOUTH CENTRAL NURSING HOMES PROPERTIES INC | 0 | ||
| SOUTH CENTRAL PROPERTIES IV INC | |||||||||||
| 111 NORTH ORLANDO AVE | WINTER PARK | FL | 32789 | 593692862 | REAL ESTATE | GA | 501(C)(2) | SOUTH CENTRAL NURSING HOMES PROPERTIES INC | 0 | ||
| SOUTH CENTRAL PROPERTIES VI INC | |||||||||||
| 111 NORTH ORLANDO AVE | WINTER PARK | FL | 32789 | 593692857 | REAL ESTATE | GA | 501(C)(2) | SOUTH CENTRAL NURSING HOMES PROPERTIES INC | 0 | ||
| SOUTH CENTRAL PROPERTIES INC | |||||||||||
| 111 NORTH ORLANDO AVE | WINTER PARK | FL | 32789 | 593651692 | REAL ESTATE | GA | 501(C)(2) | SOUTH CENTRAL NURSING HOMES PROPERTIES INC | 0 | ||
| SOUTH CENTRAL INC | |||||||||||
| 602 COURTLAND STREET | ORLANDO | FL | 32804 | 593689740 | MANAGEMENT SUPPORT | GA | 501(C)(3) | 509(A)(3) TYPE III-F | 0 | N/A | |
| SOUTH PASCO HEALTH CARE PROPERTIES INC | |||||||||||
| 38250 A AVENUE | ZEPHYRHILLS | FL | 33542 | 510605679 | LEASE TO RELATED ORGANIZATION | GA | 501(C)(3) | 509(A)(3) TYPE III-F | SUNBELT HEALTH CARE CENTERS INC | 0 | |
| SOUTHWEST VOLUSIA HEALTH SERVICES INC | |||||||||||
| 1055 SAXON BLVD | ORANGE CITY | FL | 327638468 | 593281591 | MEDICAL OFFICE BUILDING FOR HOSPITAL | FL | 501(C)(3) | 509(A)(3) TYPE I | SOUTHWEST VOLUSIA HEALTHCARE CORPORATION | 0 | |
| SOUTHWEST VOLUSIA HEALTHCARE CORPORATION | |||||||||||
| 1055 SAXON BLVD | ORANGE CITY | FL | 327638468 | 593149293 | OPERATION OF HOSPITAL & RELATED SERVICES | FL | 501(C)(3) | 170(B)(1)(A)(III) | ADVENTIST HEALTH SYSTEMSUNBELT INC | 0 | |
| SPECIALTY PHYSICIANS OF CENTRAL TEXAS INC | |||||||||||
| 1301 WONDER WORLD DRIVE | SAN MARCOS | TX | 78666 | 208814408 | PHYSICIAN HEALTHCARE SERVICES TO THE COMMUNITY | TX | 501(C)(3) | 170(B)(1)(A)(III) | ADVENTIST HEALTH SYSTEMSUNBELT INC | 0 | |
| SPRING VIEW HEALTH & REHAB CENTER INC | |||||||||||
| 718 GOODWIN LANE | LEITCHFIELD | KY | 42754 | 205782288 | OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY | KY | 501(C)(3) | 509(A)(2) | SUNBELT HEALTH CARE CENTERS INC | 0 | |
| SUNBELT HEALTH & REHAB CENTER - APOPKA INC | |||||||||||
| 305 EAST OAK STREET | APOPKA | FL | 32703 | 205774856 | OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY | FL | 501(C)(3) | 509(A)(2) | SUNBELT HEALTH CARE CENTERS INC | 0 | |
| SUNBELT HEALTH CARE CENTERS INC | |||||||||||
| 602 COURTLAND STREET STE 200 | ORLANDO | FL | 32804 | 581473135 | MANAGEMENT SERVICES | TN | 501(C)(3) | 509(A)(3) TYPE II | ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION | 0 | |
| SUNSYSTEM DEVELOPMENT CORPORATION | |||||||||||
| 111 N ORLANDO AVENUE | WINTER PARK | FL | 32789 | 592219301 | FUND RAISING FOR AFFILIATED TAX-EXEMPT HOSPITALS | FL | 501(C)(3) | 170(B)(1)(A)(VI) | ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION | 0 | |
| TARPON SPRINGS HOSP FOUNDATION INC (101-123110) | |||||||||||
| 1395 S PINELLAS AVE | TARPON SPRINGS | FL | 34689 | 590898901 | OPERATION OF HOSPITAL & RELATED SERVICES | FL | 501(C)(3) | 170(B)(1)(A)(III) | UNIVERSITY COMMUNITY HOSPITAL INC | 0 | |
| TARRANT COUNTY HEALTH CARE PROPERTIES INC | |||||||||||
| 301 HUGULEY BLVD | BURLESON | TX | 76028 | 510605677 | LEASE TO RELATED ORGANIZATION | GA | 501(C)(3) | 509(A)(3) TYPE III-F | SUNBELT HEALTH CARE CENTERS INC | 0 | |
| TAYLOR CREEK HEALTH CARE PROPERTIES INC | |||||||||||
| 718 GOODWIN LANE | LEITCHFIELD | KY | 42754 | 510605678 | LEASE TO RELATED ORGANIZATION | GA | 501(C)(3) | 509(A)(3) TYPE III-F | SUNBELT HEALTH CARE CENTERS INC | 0 | |
| THE VOLUNTEER AUXILIARY OF FLORIDA HOSPITAL - FLAGLER INC | |||||||||||
| 60 MEMORIAL MEDICAL PARKWAY | PALM COAST | FL | 32164 | 592486582 | VOLUNTEER SUPPORT SERVICES | FL | 501(C)(3) | 509(A)(3) TYPE III-F | MEMORIAL HOSPITAL FLAGLER INC | 0 | |
| TRINITY NURSING & REHAB CENTER INC | |||||||||||
| 9700 WEST 62ND STREET | MERRIAM | KS | 66203 | 205774890 | OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY | KS | 501(C)(3) | 509(A)(2) | SUNBELT HEALTH CARE CENTERS INC | 0 | |
| UNIVERSITY COMMUNITY HOSPITAL AUXILIARY INC(101-123110) | |||||||||||
| 3100 E FLETCHER AVE | TAMPA | FL | 33613 | 237011345 | VOLUNTEER SUPPORT SERVICES | FL | 501(C)(3) | 509(A)(3) TYPE III-F | UNIVERSITY COMMUNITY HOSPITAL INC | 0 | |
| UNIVERSITY COMMUNITY HOSPITAL FOUNDATION INC(101-123110) | |||||||||||
| 3100 E FLETCHER AVE | TAMPA | FL | 33613 | 592554889 | FUND-RAISING FOR TAX-EXEMPT HOSPITAL | FL | 501(C)(3) | 509(A)(3) TYPE I | UNIVERSITY COMMUNITY HOSPITAL INC | 0 | |
| UNIVERSITY COMMUNITY HOSPITAL SPECIALTY CARE INC(101-123110) | |||||||||||
| 3100 E FLETCHER AVE | TAMPA | FL | 33613 | 593231322 | INACTIVE | FL | 501(C)(3) | 509(A)(3) | UNIVERSITY COMMUNITY HOSPITAL INC | 0 | |
| UNIVERSITY COMMUNITY HOSPITAL INC(101-123110) | |||||||||||
| 3100 E FLETCHER AVE | TAMPA | FL | 33613 | 591113901 | OPERATION OF HOSPITAL & RELATED SERVICES | FL | 501(C)(3) | 170(B)(1)(A)(III) | ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION | 0 | |
| WEST KENTUCKY HEALTH CARE PROPERTIES INC | |||||||||||
| 500 BECK LANE | MAYFIELD | KY | 42066 | 510605676 | LEASE TO RELATED ORGANIZATION | GA | 501(C)(3) | 509(A)(3) TYPE III-F | SUNBELT HEALTH CARE CENTERS INC | 0 | |
| ZEPHYR HAVEN HEALTH & REHAB CENTER INC | |||||||||||
| 38250 A AVENUE | ZEPHYRHILLS | FL | 33542 | 205774930 | OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY | FL | 501(C)(3) | 509(A)(2) | SUNBELT HEALTH CARE CENTERS INC | 0 | |
| ZEPHYRHILLS HEALTH & REHAB CENTER INC | |||||||||||
| 7350 DAIRY ROAD | ZEPHYRHILLS | FL | 33540 | 205774967 | OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY | FL | 501(C)(3) | 509(A)(2) | SUNBELT HEALTH CARE CENTERS INC | 0 | |
Form990 Schedule R Part III Form990ScheduleRPartIII (10 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|
| APPALACHIAN THERAPY SERVICES LLC | |||||||
| 100 HOSPITAL DRIVE | HENDERSONVILLE | NC | 28792 | 202463851 | THERAPY STAFFING | NC | N/A |
| CLEAR CREEK MOB LTD | |||||||
| 2201 S CLEAR CREEK RD | KILLEEN | TX | 76549 | 742609195 | REAL ESTATE | TX | N/A |
| FLORIDA HOSPITAL DMERT LLC | |||||||
| 2450 MAITLAND CENTER PKWY STE 200 | MAITLAND | FL | 32751 | 202392253 | MEDICAL EQUIPMENT | FL | N/A |
| FLORIDA HOSPITAL HOME INFUSION | |||||||
| 2450 MAITLAND CENTER PKWY STE 200 | MAITLAND | FL | 32751 | 593142824 | HOME INFUSION SERVICES | FL | N/A |
| KCCCSMMC CANCER CENTER LLC | |||||||
| 9100 W 74TH STREET | SHAWNEE MISSION | KS | 66204 | 270909763 | EQUIPMENT RENTAL | KS | N/A |
| SAN MARCOS MRI LP | |||||||
| 1330 WONDER WORLD DRIVE STE 202 | SAN MARCOS | TX | 78666 | 770597972 | IMAGING & TESTING | TX | N/A |
| SHAWNEE MISSION OPEN MRI LLC | |||||||
| 9100 W 74TH STREET BOX 2923 | SHAWNEE MISSION | KS | 66201 | 270011796 | IMAGING & TESTING | KS | N/A |
| SHAWNEE MISSION PRAIRIE STAR SURGERY CENTER LLC | |||||||
| 23401 PRAIRIE STAR PARKWAY | LENEXA | KS | 66227 | 364634843 | SURGICAL CENTER | KS | N/A |
| SHAWNEE MISSION SURGERY CENTER LLC | |||||||
| PO BOX 2923 | SHAWNEE MISSION | KS | 66201 | 481243914 | SURGICAL SERVICES | KS | N/A |
| SKYLAND MRI LLC | |||||||
| 100 HOSPITAL DRIVE | HENDERSONVILLE | NC | 28792 | 043646559 | IMAGING & TESTING | NC | N/A |
Form990 Schedule R Part IV Form990ScheduleRPartIV (32 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity | Address Line1AddressForeign/AddressLine1 | Province Or StateAddressForeign/ProvinceOrState | CountryAddressForeign/Country | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ADVENTIST HEALTH SYS SUNBELT HEALTHCARE CORP EMPLOYEE BENEFIT TRUST | ||||||||||||
| 111 N ORLANDO AVENUE | WINTER PARK | FL | 32789 | 581318939 | ADMINISTRATION OF SELF-INSURED BENEFIT PLANS | FL | N/A | T | ||||
| AHS SERVICES INC | ||||||||||||
| 11801 SOUTH FREEWAY | FORT WORTH | TX | 76028 | 752049583 | MEDICAL EQUIPMENT | TX | N/A | C | ||||
| ALTAMONTE MEDICAL PLAZA CONDOMINIUM ASSOCIATION INC | ||||||||||||
| 601 EAST ROLLINS STREET | ORLANDO | FL | 32803 | 592855792 | CONDO ASSOCIATION | FL | N/A | C | ||||
| APOPKA MEDICAL PLAZA CONDOMINIUM ASSOCIATION INC | ||||||||||||
| 601 EAST ROLLINS STREET | ORLANDO | FL | 32803 | 593000857 | CONDO ASSOCIATION | FL | N/A | C | ||||
| ARAPAHOE MEDICAL BUILDING I INC (630 YEAR END) | ||||||||||||
| 2525 S DOWNING STREET | DENVER | CO | 80210 | 841574506 | REAL ESTATE LEASING | CO | N/A | C | ||||
| ARAPAHOE MEDICAL BUILDING II INC (630 YEAR END) | ||||||||||||
| 2525 S DOWNING STREET | DENVER | CO | 80210 | 841574507 | REAL ESTATE LEASING | CO | N/A | C | ||||
| CC MOB INC | ||||||||||||
| 2201 S CLEAR CREEK ROAD | KILLEEN | TX | 76549 | 742616875 | REAL ESTATE RENTAL | TX | N/A | C | ||||
| CENTRAL TEXAS MEDICAL ASSOCIATES | ||||||||||||
| 1301 WONDER WORLD DRIVE | SAN MARCOS | TX | 78666 | 742729873 | PHYSICIAN CLINICS | TX | N/A | C | ||||
| CENTRAL TEXAS PROVIDER'S NETWORK | ||||||||||||
| 1301 WONDER WORLD DRIVE | SAN MARCOS | TX | 78666 | 742827652 | PHYSICIAN HOSPITAL ORG. | TX | N/A | C | ||||
| FLORIDA HOSPITAL FLAGLER MEDICAL OFFICE ASSOCIATION INC | ||||||||||||
| 60 MEMORIAL MEDICAL PARKWAY | PALM COAST | FL | 32164 | 262158309 | CONDO ASSOCIATION | FL | N/A | C | ||||
| FLORIDA HOSPITAL HEALTHCARE SYSTEM INC | ||||||||||||
| 602 COURTLAND STREET | ORLANDO | FL | 32804 | 593215680 | PHO/TPA | FL | N/A | C | ||||
| FLORIDA MEDICAL PLAZA CONDO ASSOCIATION INC | ||||||||||||
| 601 EAST ROLLINS STREET | ORLANDO | FL | 32803 | 592855791 | CONDO ASSOCIATION | FL | N/A | C | ||||
| FLORIDA MEMORIAL HEALTH NETWORK INC | ||||||||||||
| 770 W GRANADA BLVD STE 317 | ORMOND BEACH | FL | 32174 | 593403558 | PHYSICIAN HOSPITAL ORG. | FL | N/A | C | ||||
| HARVARD PARK EAST INC (630 YEAR END) | ||||||||||||
| 2525 S DOWNING STREET | DENVER | CO | 80210 | 841574365 | REAL ESTATE LEASING | CO | N/A | C | ||||
| HELEN ELLIS MEMORIAL HOSPITAL REAL ESTATE CORP (101-123110) | ||||||||||||
| 1395 S PINELLAS AVE | TARPON SPRINGS | FL | 34689 | 593375731 | REAL ESTATE RENTAL | FL | N/A | C | ||||
| HUGULEY ALLIANCE FOUNDATION | ||||||||||||
| 11801 SOUTH FREEWAY | FORT WORTH | TX | 76115 | 752642209 | INACTIVE | TX | N/A | C | ||||
| HUGULEY MEDICAL ASSOCIATES INC | ||||||||||||
| 11801 SOUTH FREEWAY | BURLESON | TX | 76028 | 752547668 | PHYSICIAN CLINICS | TX | N/A | C | ||||
| KISSIMMEE MULTISPECIALTY CLINIC CONDOMINIUM ASSOCIATION INC | ||||||||||||
| 201 HILDA STREET SUITE 30 | KISSIMMEE | FL | 34741 | 593539564 | CONDO ASSOCIATION | FL | N/A | C | ||||
| MIDWEST MANAGEMENT SERVICES INC | ||||||||||||
| 9100 WEST 74TH STREET | SHAWNEE MISSION | KS | 66204 | 480901551 | REAL ESTATE RENTAL | KS | N/A | C | ||||
| METROPLEX ADVENTIST HOSPITAL CRNA | ||||||||||||
| 2201 S CLEAR CREEK ROAD | KILLEEN | TX | 76549 | 260760794 | SUPPORT HOSPITAL THROUGH THE PROVISION OF ALLIED HEALTH PROFESSIONALS | TX | N/A | C | ||||
| NORTH AMERICAN HEALTH SERVICES INC & SUBS | ||||||||||||
| 111 N ORLANDO AVENUE | WINTER PARK | FL | 32789 | 621041820 | LESSOR/HOLDING CO. | TN | N/A | C | ||||
| ORMOND PROFESSIONAL CONDO ASSOCIATION (430 YEAR END) | ||||||||||||
| 770 W GRANADA BLVD STE 101 | ORMOND BEACH | FL | 32174 | 592694434 | CONDO ASSOCIATION | FL | N/A | C | ||||
| PARK RIDGE PROPERTY OWNER'S ASSOCIATION INC | ||||||||||||
| 1 PARK PLACE NAPLES ROAD | FLETCHER | NC | 28732 | 030380531 | CONDO ASSOCIATION | NC | N/A | C | ||||
| PORTER AFFILIATED HLTH SERVICES INC DBA DIVERSIFIED AFFILIATED HLTH SVCS | ||||||||||||
| 2525 S DOWNING STREET | DENVER | CO | 80210 | 840956175 | HEALTHCARE SERVICES | CO | N/A | C | ||||
| PORTER MEDICAL PLAZA INC (630 YEAR END) | ||||||||||||
| 2525 S DOWNING STREET | DENVER | CO | 80210 | 841574369 | REAL ESTATE LEASING | CO | N/A | C | ||||
| REFLECTIONS COMMERCIAL CONDOMINIUM ASSOCIATION INC | ||||||||||||
| 875 STERTHAUS AVE | ORMOND BEACH | FL | 32174 | 593519055 | CONDO ASSOCIATION | FL | N/A | C | ||||
| SAN MARCOS REGIONAL MRI INC | ||||||||||||
| 1301 WONDER WORLD DRIVE | SAN MARCOS | TX | 78666 | 770597968 | HOLDING COMPANY | TX | N/A | C | ||||
| SOUTHEAST VOLUSIA MEDICAL SERVICES INC (10110-93011) | ||||||||||||
| 401 PALMETTO STREET | NEW SMYRNA BEACH | FL | 32168 | 593287185 | INACTIVE | FL | N/A | C | ||||
| THE GARDEN RETIREMENT COMMUNITY INC | ||||||||||||
| 602 COURTLAND STREET STE 200 | ORLANDO | FL | 32804 | 593414055 | REAL ESTATE RENTAL | FL | N/A | C | ||||
| UNIVERSITY COMMUNITY HEALTH INSURANCE COMPANY SPC LTD | ||||||||||||
| CAPTIVE INSURANCE | N/A | C | C/O AON INSURANCE MANAGERS PO BOX | GRAND CAYMAN | CJ | CJ | ||||||
| UCH SERVICES INC (101-123110) | ||||||||||||
| 3100 EAST FLETCHER AVE | TAMPA | FL | 33613 | 593508454 | MANAGEMENT COMPANY | FL | N/A | C | ||||
| WEST COAST MEDICAL GROUP INC (101-123110) | ||||||||||||
| 1395 S PINELLAS AVE | TARPON SPRINGS | FL | 34689 | 593537305 | PHYSICIAN CLINICS | FL | N/A | C | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| ADVENTIST HEALTH SYSTEMSUNBELT INC DBA ADVENTIST LA GRANGE MEMORIAL HOS | ||
| B | 1002531 | ACTUAL AMOUNT GIVEN |
| ADVENTIST HEALTH SYSTEMSUNBELT INC DBA ADVENTIST LA GRANGE MEMORIAL HOS | ||
| C | 216732 | ACTUAL AMOUNT RECEIVED |
Comments