TARPON SPRINGS HOSPITAL FOUNDATION INC: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- TARPON SPRINGS HOSPITAL FOUNDATION INC (EIN 59-0898901)
- Tax period
- 2009-10-01 to 2010-09-30
- Filed
- 2011-08-15
- IRS object ID
- 201112289349300806
- Schema version
- 2009v1.7
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-08-15T08:40:48-05:00 | Timestamp |
| Tax Period End Date | 2010-09-30 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 590898901 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Tarpon Springs Hospital Foundation Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | TARP | NameControl |
| Phone | 7279425006 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1395 South Pinellas Avenue | AddressLine1 |
| City | Tarpon Springs | City |
| State | FL | State |
| ZIP Code | 346893790 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Bruce Bergherm | Name |
| Title | CEO | Title |
| Phone | 7279425006 | Phone |
| Date Signed | 2011-08-16 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Helen Ellis Memorial Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Bruce Bergherm | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1395 South Pinellas Avenue | AddressLine1 |
| City | Tarpon Springs | City |
| State | FL | State |
| ZIP Code | 346893790 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 68199447 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | www.hemh.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1970 | YearFormation |
| State Legal Domicile | FL | StateLegalDomicile |
| Activity Or Mission Description | The provision of medical care to the community through the operation of one general acute care hospital with a total of 168 beds. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 713 | TotalNbrEmployees |
| Total Nbr Volunteers | 217 | TotalNbrVolunteers |
| Total Gross UBI | 36000 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -3826 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 71872603 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 63627952 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 372283 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1446975 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 143015 | OtherRevenuePriorYear |
| Other Revenue Current Year | 3124520 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 72387901 | TotalRevenuePriorYear |
| Total Revenue Current Year | 68199447 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 650 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 26610574 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 29746272 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 50204860 | OtherExpensePriorYear |
| Other Expenses Current Year | 48116789 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 76815434 | TotalExpensesPriorYear |
| Total Expenses Current Year | 77863711 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -4427533 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -9664264 | RevenuesLessExpensesCY |
| Total Assets BOY | 41082541 | TotalAssetsBOY |
| Total Assets EOY | 43641042 | TotalAssetsEOY |
| Total Liabilities BOY | 33947879 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 46045865 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 7134662 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -2404823 | NetAssetsOrFundBalancesEOY |
| Mission Description | Helen Ellis Memorial Hospital is a not-for-profit community hospital that provides high quality, personal, compassionate, and cost effective care to its patients and community. It is dedicated to excellence in customer service, performance improvement and corporate integrity to meet the health care needs of the community, while promoting health education and wellness. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 65632048 | Expense |
| Grants | 650 | Grants |
| Revenue | 63591952 | Revenue |
| Description | Operation of acute care hospital totaling 168 beds with 5,250 patient admissions resulting in 23,533 patient days in the current year. | Description |
| Total Program Service Expense | 65632048 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | 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 |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 0 | 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 | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Grants To Organizations | 0 | 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 | 1 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 120 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 713 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| 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 | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | 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 | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Deborah Mraovich Controller | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7279425006 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1395 S Pinellas Ave | AddressLine1 |
| City | Tarpon Springs | City |
| State | FL | State |
| ZIP Code | 34689 | ZIPCode |
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 | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| N Michael Kouskoutis | |||||||
| Chairman | 1.00 | X | 0 | 0 | 0 | ||
| Alma Bryant | |||||||
| Vice Chairman | 1.00 | X | 0 | 0 | 0 | ||
| Jack Butcher | |||||||
| Secretary | 1.00 | X | 0 | 0 | 0 | ||
| Thomas Carson MD | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Donald Evans | |||||||
| CEO/President | 50.00 | X | 0 | 263069 | 39651 | X | |
| Bob Hellstern | |||||||
| Interim CFO | 50.00 | X | 258843 | 0 | 0 | X | |
| Marvin Kurtz | |||||||
| Director | 1.00 | X | 0 | 286356 | 23451 | ||
| Thaddeus C Parker IV | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Nicolas Pavouris MD | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Roger Sellew | |||||||
| Treasurer | 1.00 | X | 0 | 0 | 0 | ||
| Norman Stein | |||||||
| Director (ended 09/10) | 1.00 | X | 0 | 608279 | 135532 | ||
| Daniel Vinson | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Dennis Jones MD | |||||||
| Physician | 50.00 | 410561 | 0 | 21010 | X | ||
| Esther Browne-King MD | |||||||
| Physician | 50.00 | 214699 | 0 | 19762 | X | ||
| Maria Desai MD | |||||||
| Physician | 50.00 | 186764 | 0 | 2091 | X | ||
| Ilka Nazario MD | |||||||
| Physician | 50.00 | 148290 | 0 | 7501 | X | ||
| Michael Cadoret | |||||||
| COO/CNO | 50.00 | 118819 | 0 | 19375 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1337976 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1157704 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 268373 | TotalOtherCompensation |
| Number Individuals GT100 K | 15 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Hyperbaric & Wound Care Inc | |||||
| 7171 N Dale Mabry Hwy Suite 402 | Tampa | FL | 33614 | Woundcare & Hyperbaric Mgmnt Services | 618158 |
| Northwood Anesthesia | |||||
| 1501 S Pinellas Avenue Suite N | Tarpon Springs | FL | 34689 | Anesthesiology Services | 600000 |
| LEI Construction Inc | |||||
| 6418 Badger Drive Suite B | Tampa | FL | 33610 | Contractor | 509752 |
| Fawcett Medical Imaging | |||||
| 1395 S Pinellas Avenue | Tarpon Springs | FL | 34689 | Radiology Services | 439594 |
| Millennium Receivable Inc | |||||
| 2919 Swann Avenue Suite 301 | Tampa | FL | 33609 | Outsourcing/Collections Services | 371452 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 13 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| Net Patient Revenue | 900099 | 63509880 | 63509880 | |
| Medical Office Buildin | 531120 | 47714 | 47714 | |
| Management Fees | 561000 | 36000 | 36000 | |
| Medical Staff Fees | 900099 | 14975 | 14975 | |
| Health Education/Scree | 900099 | 10953 | 10953 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 8430 | TotalRevenueColumn |
| Related Or Exempt Function Income | 8430 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 63627952 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1431475 | TotalRevenueColumn |
| Exclusion | $1,431,475 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 15500 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 15500 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 15500 | TotalRevenueColumn |
| Exclusion | $15,500 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | GAAP Business Combinat | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 3124520 | TotalRevenueColumn |
| Exclusion | $3,124,520 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 3124520 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 68199447 | TotalRevenueColumn |
| Related Or Exempt Function Income | 63591952 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 36000 | UnrelatedBusinessRevenue |
| Exclusion | $4,571,495 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 650 | Total |
| Program Services | 650 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 561563 | Total |
| Management And General | 561563 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22788184 | Total |
| Program Services | 19330453 | ProgramServices |
| Management And General | 3457731 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2032416 | Total |
| Program Services | 1704355 | ProgramServices |
| Management And General | 328061 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2603724 | Total |
| Program Services | 2216697 | ProgramServices |
| Management And General | 387027 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1760385 | Total |
| Program Services | 1476234 | ProgramServices |
| Management And General | 284151 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 263421 | Total |
| Management And General | 263421 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 140300 | Total |
| Management And General | 140300 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5437480 | Total |
| Program Services | 3188548 | ProgramServices |
| Management And General | 2248932 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 140039 | Total |
| Management And General | 140039 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16254263 | Total |
| Program Services | 15515792 | ProgramServices |
| Management And General | 738471 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 415635 | Total |
| Program Services | 415635 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6045909 | Total |
| Program Services | 6045909 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28461 | Total |
| Program Services | 28461 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 987000 | Total |
| Program Services | 987000 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2409694 | Total |
| Program Services | 2409694 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 566127 | Total |
| Management And General | 566127 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Bad Debt Expense | 9767161 | 9767161 | |
| Purchased Services | 2949065 | 2949065 | |
| Repairs & Maintenance | 1862289 | 1862289 | |
| State Tax Indigent Asse | 683170 | 683170 | |
| Taxes, Licenses & Fees | 151619 | 151619 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15156 | Total |
| Management And General | 15156 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 77863711 | Total |
| Program Services | 65632048 | ProgramServices |
| Management And General | 12231663 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 609155 | BOY |
| EOY | 1007 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1389119 | BOY |
| EOY | 2087522 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9244366 | BOY |
| EOY | 8760847 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 50880 | BOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1064243 | BOY |
| EOY | 1181384 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1693197 | BOY |
| EOY | 2671133 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 13958784 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 86215 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15349788 | BOY |
| EOY | 13872569 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11681793 | BOY |
| EOY | 15066580 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41082541 | BOY |
| EOY | 43641042 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11200607 | BOY |
| EOY | 8269982 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9374735 | BOY |
| EOY | 5335664 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13372537 | BOY |
| EOY | 32440219 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33947879 | BOY |
| EOY | 46045865 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5998102 | BOY |
| EOY | -4492089 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1136560 | BOY |
| EOY | 2087266 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7134662 | BOY |
| EOY | -2404823 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41082541 | BOY |
| EOY | 43641042 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 0 | FSAudited |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $3,272 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 3272 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part II-B, Line 1i: | Identifier |
| Return Reference | Explanation of Other Lobbying Activities: | ReturnReference |
| Explanation | Dues were paid to the Florida Hospital Association. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1136560 | BeginningOfYearBalance |
| Contributions | 1238334 | Contributions |
| Other Expenditures | 238211 | OtherExpenditures |
| End Of Year Balance | 2136683 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1744004 | BeginningOfYearBalance |
| Contributions | 509582 | Contributions |
| Other Expenditures | 1117026 | OtherExpenditures |
| End Of Year Balance | 1136560 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Endowment EOY Balance | 1.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 1 | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | 0 | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5000000 | OtherCostOrOtherBasis |
| Book Value | 5000000 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 7740063 | OtherCostOrOtherBasis |
| Depreciation | 47396 | Depreciation |
| Book Value | 7692667 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 918611 | OtherCostOrOtherBasis |
| Depreciation | 35814 | Depreciation |
| Book Value | 882797 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 300110 | OtherCostOrOtherBasis |
| Depreciation | 3005 | Depreciation |
| Book Value | 297105 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 13872569 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (5 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Due from Affiliates | 10823510 |
| Other Receivables | 1021359 |
| Funds Held in Trust | 421361 |
| Investment in Captive | 200000 |
| Investment in Foundation | 2600350 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 15066580 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (7 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Payable to Third Parties | $3,539,107 |
| Accrued Pension Liability | $17,287,416 |
| Other Liabilities | $1,049,436 |
| Credit Balance in Accounts Receivable | $1,025,484 |
| Current Portion of Long-Term Debt | $159,863 |
| Due to Affiliated | $2,505,299 |
| Leases Payable | $6,873,614 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 32440219 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Part V, Line 4: | Description of Intended Use of Endowment Funds: | Helen Ellis Memorial Hospital Foundation, Inc. (HEMHF), a related organization formed and maintained exclusively to further the exempt purpose of Helen Ellis Memorial Hospital (the Hospital) held assets in temporary endowment funds during the current tax year. HEMHF's endowment consists of individual donor restricted endowment funds where the assets have been designated for endowment established to support various purposes benefiting the Hospital and its patients. |
| Part X: | Description of Uncertain Tax Positions Under FIN 48: | There is no applicable FIN 48 footnote as there are no audited financial statements that cover the filing organization's tax year from October 1, 2009 to September 30, 2010. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 600.000000000000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2065067 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2065067 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03030 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8154323 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3322244 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4832079 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07100 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10219390 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3322244 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6897146 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10130 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10219390 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3322244 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6897146 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10130 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $2,340,004 | BadDebtExpenseAmount |
| Amount Attributable To | 976229 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 18329656 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 22047115 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -3717459 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV (4 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Er24 HoursEr24Hours | OtherOther |
|---|---|---|---|---|---|---|---|
| Helen Ellis Memorial Hospital | |||||||
| 1395 South Pinellas Avenue | Tarpon Springs | FL | 34689 | X | X | X | |
| Helen Ellis Center for Wound Care | |||||||
| 1501 S Pinellas Avenue Ste J | Tarpon Springs | FL | 34689 | Wound Care Institute | |||
| Sonesta Sleep Center of Helen Ellis | |||||||
| 5500 Rio Vista Drive | Clearwater | FL | 33760 | Sleep Disorders Center | |||
| Helen Ellis Occupational Health | |||||||
| 2508 US Hwy 19 | Holiday | FL | 34691 | Occupational Health | |||
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Income Based Criteria | Part I, Line 3c: Under the filing organization's Financial Assistance Policy, charity care eligibility is limited to those households whose income is no greater than 200% of the Federal Poverty Guidelines (FPG) unless the Hospital charges exceed 25% of the patient's yearly income up to a maximum income level of four times the household FPG income level for a family of four. In 2009, household income levels above $88,200 would have been ineligible for charity care classification. | IncomeBasedCriteria |
| Costing Method Used | Part I, Line 7: The amounts of costs reported in the table in line 7 of Part I of Schedule H were determined by utilizing a cost-to-charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges, contained in the Schedule H instructions. | CostingMethodUsed |
| Percent Of Total Expense Expln | Part I, Line 7f: Bad debt expense of $9,767,161 was included on Form 990, Part IX, line 25, but subtracted for purposes of calculating the percentage of total expenses in column (f) of line 7. | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | Part III, Line 4: Costing Methodology:The amounts of bad debt expense, at cost, reported on line 2 and 3 of Section A of Part III were determined utilizing a ratio of patient care cost to charges as shown on Worksheet A contained in the instructions for Schedule H, Part III, line 3. Discounts and payments on patient accounts are recorded as adjustments to revenue, not bad debt expense. The estimated amount of bad debt expense (at cost) attributable to patients eligible for financial assistance under the filing organization's financial assistance policy was estimated for its tax year ended September 30, 2010. The estimate was based upon a methodology implemented in calendar year 2011 subsequent to the filing organization's joining Adventist Health System (AHS). As noted in other parts of this Form 990, the membership of the filing organization was transferred to Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) effective September 1, 2010 pursuant to a merger and affiliation agreement. The methodology utilized by AHS to determine an estimated amount of bad debt attributable to charity care is based upon the use of a Scorer product. The Scorer product is used in those instances when self-pay patients do not comply with all reasonable attempts to have such patients complete financial assistance applications. The Scorer product utilizes publicly available data, such as credit reports, to assess an individual patient's financial viability. Patients who earn a certain score on the Scorer product are considered to qualify as non-state charity patients. The amount classified as charity care using the Scorer product for the period from January to June of 2011 was used as a basis for estimating the amount of bad debt attributable to charity care for the year ended September 30, 2010. Rationale for Including Certain Bad Debts in Community Benefit:The filing organization is dedicated to the view that medically necessary health care for emergency and non-elective patients should be accessible to all, regardless of age, gender, geographic location, cultural background, physician mobility, or ability to pay. The filing organization treats emergency and non-elective patients regardless of their ability to pay or the availability of third-party coverage. By providing health care to all who require emergency or non-elective care in a non-discriminatory manner, the filing organization is providing health care to the broad community it serves. As a 501(c)(3) hospital organization, the filing organization maintains a 24/7 emergency room providing care to all whom present. When a patient's arrival and/or admission to the facility begins within the Emergency Department, triage and medical screening are always completed prior to registration staff proceeding with the determination of a patient's source of payment. If the patient requires admission and continued non-elective care, the filing organization provides the necessary care regardless of the patient's ability to pay. The filing organization's operation of a 24/7 Emergency Department that accepts all individuals in need of care promotes the health of the community through the provision of care to all whom present. Current Internal Revenue Service guidance that tax-exempt hospitals maintain such emergency rooms was established to ensure that emergency care would be provided to all without discrimination. The treatment of all at the filing organization's Emergency Department is a community benefit. Under the filing organization's Charity Care Policy, every effort is made to obtain a patient's necessary financial information to determine eligibility for charity care. However, not all patients will cooperate with such efforts and a charity care eligibility determination can not be made. In this case, a patient's portion of a bill that remains unpaid for a certain stipulated time period is wholly or partially classified as bad debt. Bad debts associated with patients who have received care through the filing organization's Emergency Department should be considered to be community benefit as charitable hospitals exist to provide such care in pursuit of their purpose of meeting the need for emergency medical care services available to all in the community. Financial Statement Footnote Related to Accounts Receivable and Allowance for Uncollectible Accounts:There is no applicable footnote that describes bad debt expense as there are no audited financial statements that cover the filing organization's tax year from October 1, 2009 to September 30, 2010. | BadDebtFootnote |
| Shortfall As Community Benefit | Part III, Line 8: Costing Methodology:Medicare allowable costs were calculated using a cost-to-charge ratio.Rationale for Including a Medicare Shortfall as Community Benefit:As a 501(c)(3) organization, the filing organization provides emergency and non-elective care to all regardless of ability to pay. All hospital services are provided in a non-discriminatory manner to patients who are covered beneficiaries under the Medicare program. As a public insurance program, Medicare provides a pre-established reimbursement rate/amount to health care providers for the services they provide to patients. In some cases, the reimbursement amount provided to a hospital may exceed its costs of providing a particular service or services to a patient. In other cases, the Medicare reimbursement amount may result in the hospital experiencing a shortfall of reimbursement received over costs incurred. In those cases where an overall shortfall is generated for providing services to all Medicare patients, the shortfall amount should be considered as a benefit to the community. Tax-exempt hospitals are required to accept all Medicare patients regardless of the profitability, or lack thereof, with respect to the services they provide to Medicare patients. The population of individuals covered under the Medicare program is sufficiently large so that the provision of services to the population is a benefit to the community and relieves the burdens of government. In those situations where the provision of services to the total Medicare patient population of a tax-exempt hospital during any year results in a shortfall of reimbursement received over the cost of providing care, the tax-exempt hospital has provided a benefit to a class of persons broad enough to be considered a benefit to the community. Despite a financial shortfall, a tax-exempt hospital must and will continue to accept and care for Medicare patients. Typically, tax-exempt hospitals provide health care services based upon an assessment of the health care needs of their community as opposed to their taxable counterparts where profitability often drives decisions about patient care services that are offered. Patient care provided by tax-exempt hospitals that results in Medicare shortfalls should be considered as providing a benefit to the community and relieving the burdens of government. PART III, SECTION B, LINES 5-7The IRS instructions for Schedule H, Part III, Section B, lines 5-7 specifically indicate to include only those allowable costs and Medicare reimbursements that are reported in the organization's Medicare cost report for the year. This reporting does not take into account those costs and revenues associated with hospital employed physicians who are treating Medicare patients at hospital-owned clinic and physician practice sites. Accordingly, the net result of treating Medicare patients from a financial perspective may differ as reported for financial reporting purposes and community benefit reporting purposes from the surplus or shortfall shown on line 7 of Section B of Part III of Schedule H. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | Part III, Line 9b: At the time of patient registration, non-elective self-pay patients are informed of the minimum discount available under the filing organization's self-pay discount policy. Such patients are also informed of the filing organization's charity care policy and told that they will be required to submit necessary financial data in order to potentially receive any additional discounts. Percentage discounts are applied to a patient's account (from a 100% discount to a 30% discount) based upon the patient's household income as a percentage of the Federal Poverty Guidelines.Under the filing organization's policies, payment plans for partial charity accounts will be individually developed with the patient. Partial charity accounts result when a financial assistance eligibility determination allows for a percentage reduction but leaves the patient with a self-pay balance. If the patient complies with the agreed-upon payment plan, the filing organization does not pursue any collection action with respect to the patient. However, if a patient's balance remains unpaid after collection efforts by the Hospital, an account may be referred for further collection activity. The filing organization does not pursue collection of amounts from patients determined to qualify for a 100% reduction in charges under its Financial Assistance Policy. The patient access representative/financial counselor or medical assistance coordinator will determine the patient payment obligation in accordance with household size and income level as outlined in the filing organization's Financial Assistance Policy. All qualified uninsured patients will receive a discount (from a 100% discount to a 30% discount) based upon the patient's household size & income level. | DebtCollectionPolicy |
| Number Of Facility Type Expln | Part V: The filing organization had no other facilities that were not required to be licensed, registered, or similarly recognized as a health care facility under state law in the current tax year. | NumberOfFacilityTypeExpln |
| General Explanation | Part VI, Line 8:The filing organization does not file a community benefit report with any state. | GeneralExplanation |
| Needs Assessment | Part VI, Line 2: The filing organization does not currently conduct any formal annual health care needs assessment. However, a variety of practices and processes are in place to ensure that the filing organization is responsive to the health needs of its community. Such practices and processes involve the following:1. A hospital operating/community board composed of individuals broadly representative of the community, community leaders, and those with specialized medical training and expertise;2. Post-discharge patient follow-up related to the on-going care and treatment of patients who suffer from chronic diseases; 3. Sponsorship and participation in community health and wellness activities that reach a broad spectrum of the filing organization's community; and 4. Collaboration with other local community groups to address the health care needs of the filing organization's community. | NeedsAssessment |
| Patient Education Assistance | Part VI, Line 3: Helen Ellis Memorial Hospital (the Hospital) has a process in place whereby patients are informed about the Hospital's Financial Assistance Policy and other forms of patient account discounts, such as prompt pay discounts. Signage is posted prominently at all points of admission and registration, including the Emergency Department indicating that financial assistance is available for those self-pay patients meeting eligibility requirements. After EMTALA medical screening and stabilization requirements are met, registration personnel will secure financial information on as many self-pay patients as possible at the time of service. For those who appear to qualify for Medicaid or under the Hospital's Financial Assistance Policy, the financial counselors will continue to work with those patients until final account resolution is achieved. All other self-pay patients are covered under this process. At any time during the process that data is provided showing that a patient qualifies for assistance under the Financial Assistance Policy the discounts extended under that policy will be applied.As part of the billing process, the Hospital advises patients on the initial patient bill that they can contact the Medical Assistance Department of the Hospital to apply for charity care assistance. The Hospital's charity care application is available in both an English and Spanish version. Additionally, the Hospital's financial counselors are available to work with every patient during the billing process to assist the patient with completing charity care applications and investigating other potential sources of third-party assistance. The determination of a patient's eligibility for charity care is made on a case-by-case basis. Various factors are considered in that determination. Each individual patient who is identified as potentially being eligible to receive charity care is seen by a financial counselor at the Hospital. The financial counselor will work with the patient to make sure that other sources of assistance (public or otherwise) have been sought to the fullest extent possible. When other forms of assistance are not available or have been exhausted, the Hospital will gather certain financial information from the patient to determine the patient's ability to pay based upon household size and level of income. | PatientEducationAssistance |
| Community Information | Part VI, Line 4: Helen Ellis Memorial Hospital (HEMH), a 168-bed facility, situated on the west coast of central Florida along the Anclote River where the river meets the Gulf of Mexico, serves the residents of Tarpon Springs and surrounding communities with vital healthcare services. A Medical Staff of 300 physicians, including primary care and specialists, have privileges at HEMH. These doctors bring a tremendous resource of medical expertise to our hospital and the communities we serve.In its ongoing pursuit of providing quality healthcare services, the dedication of HEMH's staff was recognized as a result of the triennial accreditation survey conducted in late 2010 by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Helen Ellis Memorial Hospital achieved full accreditation and was commended for its overall commitment to maintaining high standards of patient care practice.Helen Ellis Memorial Hospital is a crucial community asset. In addition to operating a hospital facility, HEMH also operates 1 wound healing institute, 1 occupational health center, and 2 sleep centers (1 conveniently located at HEMH).Helen Ellis Memorial Hospital is located in the City of Tarpon Springs, Florida (population of approximately 23,000) and primarily serves patients residing in Pinellas County (population of approximately 945,000). Pinellas County is the most densely populated county in Florida, with the smallest land area of 280 square miles. Approximtely 20.7% of the population of Pinellas is 65 years or older, compared to the U.S. overall average of 12.6%. The median household income in Pinellas County is approximately $44,800. Approximately 11.6% of the individuals residing in Pinellas County live below the poverty level. Approximately 42% of the Hospital's patients during the current tax year were Medicare patients, about 17% were Medicaid patients, and the remaining percentage were patients covered under commercial insurance and self-pay patients. | CommunityInformation |
| Other Information | Part VI, Line 6: Helen Ellis Memorial Hospital (HEMH) values the community it serves, and pledges to provide that community with needed educational, preventative, diagnostic, treatment and rehabilitative services. HEMH is continually improving and updating its range of services as necessary to meet community needs. HEMH's community outreach efforts are focused on health education, wellness information, physician referral, and screening services. Each month, HEMH offers a variety of health and wellness classes taught by members of its medical staff and other health care professionals. HEMH also hosts and participates in a variety of screening events, health fairs, and education seminars throughout the year designed to encourage wellness and prevention.Because prevention and early detection are key components of maintaining good health for individuals of all ages, HEMH regularly conducts a variety of free and low-cost health screening events. Such screenings include cholesterol, blood sugar, lipid profiles, blood pressure checks, ALT liver function tests, body fat and osteoporosis screenings. Effective September 1, 2010, HEMH became a part of the system of healthcare organizations known as Adventist Health System, a faith-based non-profit tax-exempt system of hospitals and other healthcare organizations. The parent of the AHS system of healthcare organizations is Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). The provision of community benefit is central to AHS's mission of service and compassion. Restoring and promoting the health and quality of life of those in the communities served by AHS is a function of the System's mission of "extending the healing ministry of Christ". As a member of the AHS system, HEMH will continue to commit substantial resources to provide a broad range of services to its community. | OtherInformation |
| Affiliated Health Care System | Part VI, Line 7: Effective September 1, 2010, Helen Ellis Memorial Hospital became a part of a faith-based healthcare system of organizations whose parent is Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). The system is known as Adventist Health System (AHS). AHSSHC is an organization exempt from federal income tax under IRC Section 501(c)(3). AHSSHC and its subsidiary organizations operate 43 hospital facilities in 10 states throughout the U.S., primarily in the Southeastern portion of the U.S. AHSSHC and its subsidiaries also operate 17 nursing home facilities and other ancillary health care provider facilities, such as ambulatory surgery centers and diagnostic imaging centers. As the parent organization of the AHS system, AHSSHC provides executive leadership and other professional support services to its subsidiary organizations. Professional support services include among others corporate compliance, legal, human resources, reimbursement, risk management, and tax as well as treasury functions. The provision of these executive and support services on a centralized basis by AHSSHC provides an appropriate balance between providing each AHS subsidiary hospital organization with mission-driven consistent leadership and support while allowing the hospital organization to focus it resources on meeting the specific health care needs of the community it serves. As the reporting of the Form 990 is done on an entity by entity basis, there is no single Form 990 that captures the programs and operations of AHS as a whole. The reader is directed to visit the web-site of AHS at www.adventisthealthsystem.com to learn more about the mission and operations of AHS and to access AHS's annual report that contains financial data as well as community benefit reporting for the entire system. | AffiliatedHealthCareSystem |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Housing Allowance Or Residence | X | HousingAllowanceOrResidence |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 1 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 1 | 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 (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Donald Evans | |||||||||||||
| 0 | 262452 | 0 | 0 | 0 | 617 | 0 | 16039 | 0 | 23612 | 0 | 302720 | 0 | 0 |
| Bob Hellstern | |||||||||||||
| 258843 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 258843 | 0 | 0 | 0 |
| Marvin Kurtz | |||||||||||||
| 0 | 286356 | 0 | 0 | 0 | 0 | 0 | 13444 | 0 | 10007 | 0 | 309807 | 0 | 0 |
| Norman Stein | |||||||||||||
| 0 | 598456 | 0 | 0 | 0 | 9823 | 0 | 118316 | 0 | 17216 | 0 | 743811 | 0 | 0 |
| Dennis Jones MD | |||||||||||||
| 410561 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 21010 | 0 | 431571 | 0 | 0 | 0 |
| Esther Browne-King MD | |||||||||||||
| 184699 | 0 | 0 | 0 | 30000 | 0 | 0 | 0 | 19762 | 0 | 234461 | 0 | 0 | 0 |
| Maria Desai MD | |||||||||||||
| 186224 | 0 | 0 | 0 | 540 | 0 | 0 | 0 | 2091 | 0 | 188855 | 0 | 0 | 0 |
| Ilka Nazario MD | |||||||||||||
| 148290 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 7501 | 0 | 155791 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (5 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Part I, Line 1a | Housing allowance or residence for personal use: During the current tax year Helen Ellis Memorial Hospital (HEMH) provided housing to one of its officers, Bob Hellstern, during the time he provided interim CFO services to HEMH. Mr. Hellstern's permanent residence is in the state of Colorado. Accordingly, HEMH provided temporary housing as he was expected to live within the state of Florida while providing services to HEMH. The total fair market value of the housing provided to Mr. Hellstern during the current tax year was $15,108. | |
| Part I, Line 4b: | The sole member of the filing organization is University Community Hospital, Inc. (UCH). UCH is a Florida non-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). In 1995, UCH implemented a Supplemental Employee Retirement Plan (the UCH SERP) for certain key executives. This plan was frozen as of December 31, 2009. During its tax year ended September 30, 2010, 1 of the filing organization's Board of Director Members, Norman Stein, President of UCH through September of 2010, received payments totaling $91,527 from the UCH SERP plan. | |
| Part I, Line 5 | The filing organization's physician compensation formula is designed to result in total compensation that would be reasonable for each physician. The filing organization utilizes national survey productivity, cost, and compensation data in formulating all aspects of the compensation plan. Physician compensation arrangements include a ceiling or reasonable maximum on the amount a physician may earn. Under the compensation arrangement, physician base salary is set based on Fair Market Value benchmarks, and any additional compensation is based on a percentage of the practice/location net collections. | |
| Part I, Line 6 | The filing organization's physician compensation formula is designed to result in total compensation that would be reasonable for each physician. The filing organization utilizes national survey productivity, cost, and compensation data in formulating all aspects of the compensation plan. Physician compensation arrangements include a ceiling or reasonable maximum on the amount a physician may earn. The filing organization's compensation arrangement does not use a method of compensation that is based upon a percentage of the organization's net income. Rather, under the compensation arrangement, physician base salary is set based on Fair Market Value benchmarks, and any additional compensation is based on a percentage of the practice/location net revenue. | |
| Part III | Part I, Question 3: As noted in our response to Question 15 of Part VI of Form 990, the compensation and benefits of the filing organization's CEO were determined pursuant to policies, procedures and processes that were designed to be in compliance with the intermediate sanctions laws as set forth in IRC Section 4958. The filing organization uses all of the following to establish compensation of the CEO: - Compensation committee; - Compensation survey and studies; and - Approval by the board and compensation committee. | Supplemental Information |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Form 990, Part VI, Section A, line 6 | Tarpon Springs Hospital Foundation, Inc., d/b/a Helen Ellis Memorial Hospital (the filing organization) has one member. The sole member of the filing organization is University Community Hospital, Inc. (UCH). UCH is a Florida non-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). Effective September 1, 2010, Adventist Health System Sunbelt Healthcare Corporation became the sole member of UCH. The Board of Trustees and membership of University Community Hospital, Inc. adopted and approved a plan of merger on July 8, 2010 whereby Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) became the sole member of UCH. AHSSHC is the parent organization of a healthcare system that operates hospitals, nursing home facilities and other healthcare provider organizations. AHSSHC is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). |
| Form 990, Part VI, Section A, line 7a | The Board of Directors of the filing organization is to consist of not less than 12 members. One half of the Board of Directors is composed of qualified individuals who are residents of the City of Tarpon Springs, Florida or any other community located in the filing organization's primary service area. These community appointees are nominated to serve on the Board of Directors by the Helen Ellis Memorial Hospital Foundation, Inc. (HEMH Foundation). The HEMH Foundation is a separate supporting organization to the filing organization that is exempt from federal income tax under IRC Section 501(c)(3). These community appointees must be approved by UCH as the member. The remaining one half of the Board of Directors are appointed to the Board by UCH as the member. |
| Form 990, Part VI, Section A, line 7b | UCH, as the sole member of the filing organization, has certain reserved powers as set forth in the Bylaws of the filing organization. These reserved powers include the following: a) Approval of the selection of and removal of, and the compensation level of, senior management of the filing organization; b) Approval of the filing organization's Articles of Incorporation; c) Approval of any material changes in services at the health care facilities; d) Approval of major building programs and purchases or sales of property in excess of $500,000 and sales/purchases of less than $500,000 when the filing organization's net revenues are not available for such purpose; e) Approval of the terms and conditions of borrowing; f) Appointment of one-half of the Board of Directors and approval of the community appointees to the Board of Directors; g) Approval of all operating and capital budgets and strategic plans of the filing organization; and h) To direct the placement of funds and capital of the filing organization. |
| Form 990, Part VI, Section B, line 11 | The filing organization's current tax year Form 990 was reviewed by the President/CEO and CFO of AHSSHC's Florida region and by the CEO and CFO of the filing organization prior to its filing with the IRS. The review conducted by these individuals 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 Trustees/Directors, its officers, executive employees, physician employees, and officers of the medical staff (to be known as Interested Persons). In connection with any actual or possible conflict of interests, any member of the Board of Trustees/Directors of the filing organization or any other Interested Person of the filing organization 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 Trustees/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 Interested Person, the remaining members of the Board of Trustees/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 Trustees/Directors (or committee with board delegated powers), but after such presentation, shall leave the meeting during the discussion of, and the vote on, the transaction or arrangement that results in a conflict of interest. Each Interested Person, as defined under the filing organization's Conflict of Interest Policy, shall annually sign a statement which affirms that such person has received a copy of the Conflict of Interests policy, has read and understands the policy, has agreed to comply with the policy, and understands that the filing organization is a charitable organization that must primarily engage in activities which accomplish one or more of its exempt purposes. The filing organization's Conflict of Interest Policy also requires that periodic reviews shall be conducted to ensure that the filing organization operates in a manner consistent with its charitable purposes. |
| Form 990, Part VI, Section B, line 15 | The sole member of the filing organization is University Community Hospital, Inc. (UCH). UCH is a Florida non-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). The individual who serves as the CEO of the filing organization was compensated by UCH. During the current tax year, there was established an executive compensation committee of the Board of Trustees of University Community Hospital, Inc. (UCH). The executive compensation committee was responsible to determine the compensation package, including the salary, benefits (as defined below), bonus, incentive, and any perquisites and deferred compensation of all employees of Helen Ellis Memorial Hospital (HEMH) who held executive positions (with title Vice President or above). Members and Voting The executive compensation committee was comprised of the Board Officers of UCH. However, whenever the compensation package (or adjustment thereto) of an executive who served Helen Ellis Memorial Hospital (HEMH) was considered, the Chairman and Vice Chairman of the corporate board of HEMH, substituted for and served as members in place of the secretary and treasurer of UCH. Each served as a voting member of the committee, provided that he/she was independent. Independence means that the individual does not have any duties, commitments or outside interests that would deter from his/her ability to faithfully carry out the duties and responsibilities of the executive compensation committee. This includes but is not limited to financial or fiduciary relationships with competing organizations or organizations that have significant business relationships with any University Community Health facility. Any such duties, commitments or outside interests must be fully disclosed and acted upon in accordance with the conflict of interest policy of the Board of Trustees of University Community Hospital and the Board of Directors of the filing organization. In the event any named committee member is unable to serve on the executive compensation committee, in any year, or with respect to addressing the compensation of any individual, the next officer in line, the immediate past Chairman, shall serve for that year or to address the specific individual compensation. A quorum is comprised of all of the committee members. The vote of a majority of the committee members shall constitute action of the committee. Advisors The President of UCH served as an advisor to the committee. He/she was responsible to present the qualifications and performance evaluation of each candidate for compensation and compensation adjustment. The committee held the authority to engage and consult with such other advisors or consultants from within or outside the organization as it deemed appropriate. Meetings The executive compensation committee meets as needed, but not less than annually. Periodic executive session meetings without the presence of advisors or others shall be held at the discretion of the committee or upon request of any committee member. The President of HEMH shall not be present at any time during deliberation, discussion or decision relating to any part of his/her evaluation of performance, salary, benefits, or compensation package (other than to answer questions of the committee). Chair The Chairman of the committee shall be the Chairman of the Board of UCH. Compensation Philosophy It is the philosophy of UCH for HEMH that the compensation of executives of Helen Ellis Memorial Hospital fairly and reasonably reflect the scope and magnitude of individual job duties, education, training, experience, and tenure with Helen Ellis Memorial Hospital. As a not-for-profit entity, the assets of Helen Ellis Memorial Hospital shall be dedicated first to assuring the delivery of healthcare services within the communities served. To achieve this, qualified, competent executives are essential. Therefore, compensation must be competitive and the overall value of the compensation package must be consistent with fair market value. Bonus and/or incentive compensation may be paid to achieve clearly defined corporate goals; reasonable recruitment incentives may be paid to attract qualified competent individuals; and perquisites should be limited to those generally available to all employees and those that are reasonable and necessary to fulfill specific job duties. The target salary and wages component of executive compensation packages was 5% to 10% above the national mean of the compensation packages of like positions (as determined through the fair market value comparison data) unless special circumstances warranted an amount in excess. Such special circumstances must support the additional compensation, and be noted and recorded by the committee in its records. Authority and Responsibility 1. The executive compensation committee had full delegated authority of the Board of Trustees of UCH and HEMH to carry out the following duties in accordance with the compensation philosophy and guidelines in this policy: a. Determine the initial compensation package of all executives. b. Determine periodic adjustments to such compensation packages, including, without limitation, salary increases, bonus or incentive compensation, deferred compensation, perquisites, and benefits. For purposes of this policy, benefits include only those employment benefits and perquisites provided to any executive which are outside the scope of the standard benefits and perquisites offered to employees generally at the director level of Helen Ellis Memorial Hospital. c. Approve all contracts entered into with any executive. Executive Compensation Committee Guidelines 1. Each compensation package for each executive must be consistent with fair market value determined on the basis of: a. The specific job duties and scope of the position. b. The education, training, experience and any special talent or expertise of the individual filling the position. c. The performance of the individual within the position. d. The compensation philosophy in this policy. 2. Fair market value and mean range shall be determined by evaluating salary and compensation data from at least two external, objective nationally recognized sources, comparing similar positions at like organizations including, specifically, not-for-profit organizations, within the United States. If such data is not available, data on the closest comparable position should be obtained. To the extent available, Tampa Bay Region or Florida data should be considered. 3. The executive compensation committee shall maintain minutes of all meetings. Compensation data and other supporting information shall be appended to the minutes at which such information was considered. The minutes should reflect the members present at each meeting, the recusal of any committee member who is not independent or who bears a conflict of interest with respect to any particular compensation package considered, the presence of any substitute member, determinations by the committee that each specific compensation package reviewed is consistent with fair market value and this policy, actions taken by the committee, and the basis for the actions taken. 4. The executive compensation committee must report at least once annually to the full Board of Trustees advising whether approved executive compensation packages are consistent with this policy. |
| Form 990, Part VI, Section C, line 19 | A copy of the filing organization's Governing documents, Conflict of Interest policy, and/or financial statements are available to the public upon request. |
| Page 1, Line 22 | The difference of $(9,539,485) between the fund balance at 9/30/09 of $7,134,662 and $(2,404,823) at 9/30/10 is comprised of the following reconciling items: Revenue less expenses per line 19 of page 1 $(9,664,264) Increase to property, plant & equipment to fair value in connection with business combination (345,361) Transfer from tax-exempt parent 4,078,992 Pension related changes other than periodic pension costs (4,845,905) Change in interest in supporting Foundation 48,134 Net Assets released from restricted 238,213 Increase in temporarily restricted assets 950,706 ----------- $(9,539,485) |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (104 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 | 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| Bert Fish Medical Center Inc (7110-93010) | ||||||||||
| 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 | |
| Bert Fish Medical Center Auxiliary Inc (11109-103010) | ||||||||||
| 401 Palmetto Street | New Smyrna Beach | FL | 32168 | 591054892 | Fund-raising for Tax-exempt hospital/foundation | FL | 501(c)(3) | 509(a)(3) Type I | Bert Fish Medical Center Inc | |
| Bert Fish Medical Center Foundation Inc (10109-93010) | ||||||||||
| 401 Palmetto Street | New Smyrna Beach | FL | 32168 | 593219250 | Fund-raising for Tax-exempt hospital | FL | 501(c)(3) | 509(a)(3) Type I | Bert Fish Medical Center Inc | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| Helen Ellis Memorial Hospital Auxiliary Inc (5109-43010) | ||||||||||
| 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 | |
| Helen Ellis Memorial Hospital Foundation Inc (10109-93010) | ||||||||||
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| Midwest Health Foundation | ||||||||||
| 120 North Oak Street | Hinsdale | IL | 60521 | 352230515 | Support of subsidiary Foundations | IL | 501(c)(3) | 509(a)(3) Type II | 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 | |
| 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 | |
| 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 | |
| North Regional EMS Inc | ||||||||||
| 188 Hospital Lane | Jellico | TN | 37762 | 262653616 | EMS Services | TN | 501(c)(3) | 509(a)(2) | Jellico Community Hospital Inc | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | ||
| 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 | ||
| 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 | ||
| 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 | ||
| South Central Inc | ||||||||||
| 602 Courtland Street | Orlando | FL | 32804 | 593689740 | Management Support | GA | 501(c)(3) | 509(a)(3) Type III-F | 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| Tarpon Springs Hosp Foundation Inc (10109-93010) | ||||||||||
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| 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 | |
| University Community Hospital Auxiliary Inc(10109-93010) | ||||||||||
| 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 | |
| University Community Hospital Foundation Inc(10109-93010) | ||||||||||
| 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 | |
| University Community Hospital Specialty Care Inc(10109-93010) | ||||||||||
| 3100 E Fletcher Ave | Tampa | FL | 33613 | 593231322 | Inactive | FL | 501(c)(3) | 509(a)(3) | University Community Hospital Inc | |
| University Community Hospital Inc(10109-93010) | ||||||||||
| 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 | |
| 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 | |
| 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 | |
| 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 | |
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 | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership | 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 (10109-93010) | ||||||||||||||||
| 1395 S Pinellas Ave | Tarpon Springs | FL | 34689 | 593375731 | Real Estate Rental | FL | C | Tarpon Springs Hospital Foundation | 86270 | 18468 | 1.00000 | |||||
| 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 (10109-93010) | ||||||||||||||||
| 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 (10109-93010) | ||||||||||||||||
| 3100 East Fletcher Ave | Tampa | FL | 33613 | 593508454 | Management Company | FL | N/A | C | ||||||||
| West Coast Medical Group Inc (10109-93010) | ||||||||||||||||
| 1395 S Pinellas Ave | Tarpon Springs | FL | 34689 | 593537305 | Physician Clinics | FL | C | Tarpon Springs Hospital Foundation | 460167 | 211375 | 1.00000 | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | 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 | 1 | 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 | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (12 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| University Community Hospital Inc | |
| E | 2800000 |
| University Community Hospital Inc | |
| N | 1450868 |
| University Community Hospital Inc | |
| C | 4078992 |
| University Community Hospital Inc | |
| L | 1200964 |
| Adventist Health System Sunbelt Healthcare Corp | |
| L | 71161 |
| University Community Health Insurance Company SPC Ltd | |
| R | 1400000 |
| University Community Health Insurance Company SPC Ltd | |
| O | 187500 |
| University Community Health Insurance Company SPC Ltd | |
| L | 402862 |
| Helen Ellis Memorial Hospital Foundation Inc | |
| C | 238211 |
| Helen Ellis Memorial Hospital Real Estate Corporation | |
| K | 18000 |
| West Coast Medical Group | |
| K | 18000 |
| Helen Ellis Memorial Hospital Foundation Inc | |
| P | 115435 |
Comments