2011-11-14T14:58:50-06:00 2010-12-31 990 2010-01-01 363354567 AHS MIDWEST MANAGEMENT INC AHSM 6303127780 1000 REMINGTON BLVD NO 200 BOLINGBROOK IL 60440 LYNN C ADDISCOTT 6303127780 2011-11-14 2010 2016-03-07 17:11:31Z PAM WILLIAMS 1000 REMINGTON BLVD NO 200 BOLINGBROOK IL 60440 16561107 0 1071 X WWW.KEEPINGYOUWELL.COM X 1984 IL OPERATION OF PHYSICIAN PRACTICE MANAGEMENT SERVICES FOR RELATED TAX-EXEMPT ORGANIZATIONS. 11 0 404 0 403104 0 0 0 14421838 16548068 41979 13039 0 0 14463817 16561107 0 0 0 0 10400398 12414939 0 0 0 5753909 6276050 16154307 18690989 -1690490 -2129882 9917609 15822571 8209574 11422996 1708035 4399575 ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION AND ALL OF ITS SUBSIDIARY ORGANIZATIONS WERE ESTABLISHED BY THE SEVENTH-DAY ADVENTIST CHURCH TO BRING A MINISTRY OF HEALING AND HEALTH TO THE COMMUNITIES SERVED. OUR MISSION IS TO EXTEND THE HEALING MINISTRY OF CHRIST. 0 0 16951975 0 16144964 PROVISION OF MANAGEMENT SERVICES TO PHYSICIAN PRACTICES OF RELATED TAX-EXEMPT ORGANIZATIONS. 16951975 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 40 0 1 404 1 1 1 0 0 0 0 0 0 0 0 0 X 11 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X REBECCA MATHIS 6308566056 1000 REMINGTON BLVD SUITE 200 BOLINGBROOK IL 60440 X DAVID L CRANE 5.00 X 0 881523 150989 RICHARD CARROLL MD 1.00 X 0 390333 71743 JANICE HAGENSICKER 5.00 X X 0 494024 60525 BRINSLEY LEWIS 1.00 X 0 345794 53714 GARY LIPINSKI MD 1.00 X 0 365166 68615 RICK MACE 1.00 X 0 523911 70757 JOHN B RAPP 1.00 X 0 190125 58464 DONALD RUSSELL 1.00 X 0 251492 61195 RONALD WEHTJE 5.00 X X 0 311976 37658 PAM WILLIAMS 20.00 X X 0 365095 51420 THOMAS J WILLIAMS 1.00 X 0 325367 45650 RICK WRIGHT 1.00 X 0 430199 62313 RICHARD HIBBOTT 40.00 X 134091 0 19189 134091 4875005 812232 1 0 1 0 0 MANAGEMENT SERVICES 561000 12855533 12488953 366580 BILLING FEES 561000 3563461 3563461 COLLECTION FEES 561000 36524 36524 92550 92550 16548068 13039 13039 16561107 16144964 403104 13039 10192859 9757785 435074 278670 266775 11895 1113707 1066170 47537 829703 794288 35415 250 250 48226 48226 2051692 1676888 374804 138477 138477 2747396 2262900 484496 163854 84470 79384 405422 405422 42906 42906 21645 21645 132 132 PURCHASED SERVICES 546547 542354 4193 0 REPAIRS & MAINTENANCE 73278 73278 0 0 LICENSES & FEES 18166 0 18166 0 18059 18059 18690989 16951975 1739014 0 4525 5126 227716 33559 117378 206792 125000 26886 16166 784139 763532 42253 20607 9373851 15540321 9917609 15822571 1056240 1514620 7153334 9908376 8209574 11422996 X 1708035 4399575 1708035 4399575 9917609 15822571 X -2129882 4821422 X 0 1 1 X 0 X X X 0 0 0 ADVENTIST HINSDALE HOSPITAL 362276984 3 0 1 0 ADVENTIST GLENOAKS HOSPITAL INC 363208390 3 0 1 0 ADVENTIST HEALTH SYSTEMSUNBELT INC 591479658 3 1 1 0 ADVENTIST BOLINGBROOK HOSPITAL 651219504 3 0 1 0 4 0 784139 763532 20607 20607 DUE FROM AFFILIATED 15512076 DUE FROM ADVENTIST HEALTH NETWORK 28245 15540321 DUE TO AFFILIATED 9908376 9908376 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE FILING ORGANIZATION IS A SUBSIDIARY ORGANIZATION WITHIN ADVENTIST HEALTH SYSTEM (AHS). THE CONSOLIDATED FINANCIAL STATEMENTS OF AHS CONTAIN THE FOLLOWING FIN 48 FOOTNOTE - THE INCOME TAXES TOPIC OF THE ASC (ASC 740) PRESCRIBES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAX POSITIONS RECOGNIZED IN FINANCIAL STATEMENTS. ASC 740 PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. 0 1 0 0 0 0 0 0 0 DAVID L CRANE 0 601950 0 173520 0 106053 0 119760 0 31229 0 1032512 0 0 RICHARD CARROLL MD 0 299816 0 43316 0 47201 0 27442 0 44301 0 462076 0 0 JANICE HAGENSICKER 0 324586 0 76666 0 92772 0 40839 0 19686 0 554549 0 0 BRINSLEY LEWIS 0 241609 0 55968 0 48217 0 25074 0 28640 0 399508 0 0 GARY LIPINSKI MD 0 294226 0 41641 0 29299 0 34306 0 34309 0 433781 0 0 RICK MACE 0 274556 0 62938 0 186417 0 44934 0 25823 0 594668 0 0 JOHN B RAPP 0 151265 0 20651 0 18209 0 6042 0 52422 0 248589 0 0 DONALD RUSSELL 0 213764 0 30306 0 7422 0 24055 0 37140 0 312687 0 0 RONALD WEHTJE 0 218606 0 51870 0 41500 0 8443 0 29215 0 349634 0 0 PAM WILLIAMS 0 286828 0 37726 0 40541 0 31468 0 19952 0 416515 0 0 THOMAS J WILLIAMS 0 254850 0 36477 0 34040 0 24302 0 21348 0 371017 0 0 RICK WRIGHT 0 298616 0 65818 0 65765 0 41369 0 20944 0 492512 0 0 RICHARD HIBBOTT 127482 0 6390 0 219 0 5833 0 13356 0 153280 0 0 0 PART I, LINE 4B EXECUTIVES ON THE FILING ORGANIZATION'S MANAGEMENT TEAM THAT HOLD THE POSITION OF CEO OR CFO ARE COMPENSATED BY AND ON THE PAYROLL OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), THE PARENT ORGANIZATION OF A HEALTHCARE SYSTEM KNOW AS ADVENTIST HEALTH SYSTEM (AHS). IN RECOGNITION OF THE CONTRIBUTION THAT EACH EXECUTIVE MAKES TO THE SUCCESS OF AHS, AHS PROVIDES TO ELIGIBLE EXECUTIVES PARTICIPATION IN THE AHS EXECUTIVE FLEX BENEFIT PROGRAM (THE PLAN). THE PURPOSE OF THE PLAN IS TO OFFER ELIGIBLE EXECUTIVES AN OPPORTUNITY TO ELECT FROM AMONG A VARIETY OF SUPPLEMENTAL BENEFITS, INCLUDING DEFERRED COMPENSATION BENEFITS TAXABLE UNDER INTERNAL REVENUE CODE (IRC) SECTION 457(F), TO INDIVIDUALLY TAILOR A BENEFITS PROGRAM APPROPRIATE TO EACH EXECUTIVE'S NEEDS. THE PLAN PROVIDES ELIGIBLE PARTICIPANTS A PRE-DETERMINED BENEFITS ALLOWANCE CREDIT THAT IS EQUAL TO A PERCENTAGE OF THE EXECUTIVE'S BASE PAY FROM WHICH IS DEDUCTED THE COST OF MANDATORY AND ELECTIVE EMPLOYEE BENEFITS. THE PRE-DETERMINED BENEFITS ALLOWANCE CREDIT PERCENTAGE IS APPROVED BY THE AHS BOARD STRATEGY & COMPENSATION COMMITTEE, AN INDEPENDENT COMMITTEE OF THE BOARD OF DIRECTORS OF AHSSHC. ANY FUNDS THAT REMAIN AFTER THE COST OF MANDATORY AND ELECTIVE BENEFITS ARE SUBTRACTED FROM THE PRE-DETERMINED BENEFITS ANNUAL AMOUNT ARE CONTRIBUTED, AT THE EMPLOYEE'S OPTION, TO EITHER AN IRC 457(F) DEFERRED COMPENSATION ACCOUNT OR TO AN IRC 457(B) ELIGIBLE DEFERRED COMPENSATION PLAN. THE PLAN DOCUMENTS DEFINE AN EMPLOYEE WHO IS ELIGIBLE TO PARTICIPATE IN THE PLAN TO GENERALLY INCLUDE THE CHIEF EXECUTIVE OFFICERS OF AHS ENTITIES AND VICE PRESIDENTS OF ALL AHS ENTITIES WHOSE BASE SALARY IS AT LEAST $196,000. THE PLAN PROVIDES FOR A CLASS YEAR VESTING SCHEDULE (2 YEARS FOR EACH CLASS YEAR) WITH RESPECT TO AMOUNTS ACCUMULATED IN THE EXECUTIVE'S 457(F) DEFERRED COMPENSATION ACCOUNT. DISTRIBUTIONS COULD ALSO BE MADE FROM THE EXECUTIVE'S 457(F) DEFERRED COMPENSATION ACCOUNT UPON ATTAINMENT OF AGE 65 OR UPON AN INVOLUNTARY SEPARATION. THE ACCOUNT IS FORFEITED BY THE EXECUTIVE UPON A VOLUNTARY SEPARATION. IN ADDITION TO THE PLAN, AHS HAS INSTITUTED A DEFINED BENEFIT, NON-TAX-QUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN EXECUTIVES WHO HAVE PROVIDED LENGTHY SERVICE TO AHS AND/OR TO OTHER SEVENTH-DAY ADVENTIST CHURCH HOSPITAL OR HEALTH CARE INSTITUTIONS. PARTICIPATION IN THE PLAN IS OFFERED TO AHS EXECUTIVES ON A PRORATA SCHEDULE BEGINNING WITH 20 YEARS OF SERVICE AS AN EMPLOYEE OF AHS AND/OR ANOTHER HOSPITAL OR HEALTH CARE INSTITUTION CONTROLLED BY THE SEVENTH-DAY ADVENTIST CHURCH AND WHO SATISFY CERTAIN OTHER QUALIFYING CRITERIA. THIS SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) WAS DESIGNED TO PROVIDE ELIGIBLE EXECUTIVES WITH THE ECONOMIC EQUIVALENT OF AN ANNUAL INCOME BEGINNING AT NORMAL RETIREMENT AGE EQUAL TO 60% OF THE AVERAGE OF THE PARTICIPANT'S THREE HIGHEST YEARS OF BASE SALARY FROM AHS ACTIVE EMPLOYMENT INCLUSIVE OF INCOME FROM ALL OTHER SEVENTH-DAY ADVENTIST CHURCH HEALTHCARE EMPLOYER-FINANCED RETIREMENT INCOME SOURCES AND INVESTMENT INCOME EARNED ON THOSE CONTRIBUTIONS THROUGH SOCIAL SECURITY NORMAL RETIREMENT AGE AS DEFINED IN THE PLAN. 457(F) EMPLOYER SERP CONTRIBUTIONS CONTR./PYMT DAVID CRANE $106,417 $0 RICHARD CARROLL, MD $ 30,599 $0 JANICE HAGENSICKER $ 43,996 $0 BRINSLEY LEWIS $ 23,731 $0 GARY LIPINSKI, MD $ 29,213 $0 RICK MACE $ 31,591 $141,155 DONALD RUSSELL $ 10,712 $0 RONALD WEHTJE $ 15,871 $0 PAM WILLIAMS $ 34,625 $0 THOMAS WILLIAMS $ 27,459 $0 RICK WRIGHT $ 37,546 $0 SUPPLEMENTAL INFORMATION PART III PART I, QUESTION 3: AS NOTED IN OUR RESPONSE TO QUESTION 15 OF PART VI OF FORM 990, THE INDIVIDUAL WHO SERVES AS THE CEO OF THE FILING ORGANIZATION AND OF ONE OF THE FILING ORGANIZATION'S SUPPORTED HOSPITALS IS COMPENSATED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC) FOR THAT INDIVIDUAL'S ROLE IN SERVING AS THE CEO. COMPENSATION AND BENEFITS PROVIDED TO THIS INDIVIDUAL ARE DETERMINED PURSUANT TO POLICIES, PROCEDURES, AND PROCESSES OF AHSSHC THAT ARE DESIGNED TO ENSURE COMPLIANCE WITH THE INTERMEDIATE SANCTIONS LAWS AS SET FORTH IN IRC SECTION 4958. AHSSHC USES ALL OF THE FOLLOWING TO ESTABLISH COMPENSATION OF THE CEO: - COMPENSATION COMMITTEE; - INDEPENDENT COMPENSATION CONSULTANT; - COMPENSATION SURVEY OR STUDY; AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. ADVENTIST HEALTH NETWORK NFP 6 OFFICERS ARE MEMBERS OF THE BOARD 494660 MANAGEMENT SERVICES 0 FORM 990, PART VI, SECTION A, LINE 6 AHS MIDWEST MANAGEMENT, INC. (THE FILING ORGANIZATION) HAS ONE MEMBER. THE SOLE MEMBER OF THE FILING ORGANIZATION IS ADVENTIST HEALTH SYSTEM/SUNBELT, INC. ADVENTIST HEALTH SYSTEM/SUNBELT, INC. (AHSSI) IS A FLORIDA, NOT-FOR-PROFIT CORPORATION THAT IS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3). THERE ARE NO OTHER CLASSES OF MEMBERSHIP IN THE FILING ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER OF THE FILING ORGANIZATION IS AHSSI. THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION ARE APPOINTED BY THE SOLE MEMBER, AHSSI, WHO HAS THE RIGHT TO ELECT, APPOINT OR REMOVE ANY MEMBER OF THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B AHSSI, AS THE SOLE MEMBER OF THE FILING ORGANIZATION, HAS CERTAIN RESERVED POWERS AS SET FORTH IN THE BYLAWS OF THE FILING ORGANIZATION. THESE RESERVED POWERS INCLUDE THE FOLLOWING: A) TO APPROVE AND DISAPPROVE THE EXECUTIVE AND/OR ADMINISTRATIVE LEADERSHIP OF THE FILING ORGANIZATION, AND THEIR SALARIES; B) TO ADOPT, APPROVE, OR DISAPPROVE OF THE BYLAWS OF THE FILING ORGANIZATION; C) TO SET LIMITS AND TERMS FOR THE BORROWING OF FUNDS; D) TO APPROVE OR DISAPPROVE MAJOR BUILDING PROGRAMS AND/OR PURCHASE OR SALE OF PERSONAL PROPERTY OR REAL PROPERTY EQUAL TO OR IN EXCESS OF ONE MILLION DOLLARS; E) TO APPROVE OR DISAPPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE FILING ORGANIZATION; F) TO DIRECT THE PLACEMENT OF FUNDS AND CAPITAL OF THE FILING ORGANIZATION; AND G) TO ESTABLISH GENERAL GUIDING POLICIES. FORM 990, PART VI, SECTION B, LINE 11 THE FILING ORGANIZATION'S CURRENT YEAR FORM 990 WAS REVIEWED BY THE BOARD CHAIRMAN, CEO AND BY THE CFO PRIOR TO ITS FILING WITH THE IRS. THE REVIEW CONDUCTED BY THE BOARD CHAIRMAN, CEO AND THE CFO DID NOT INCLUDE THE REVIEW OF ANY SUPPORTING WORKPAPERS THAT WERE USED IN PREPARATION OF THE CURRENT YEAR FORM 990, BUT DID INCLUDE A REVIEW OF THE ENTIRE FORM 990 AND ALL SUPPORTING SCHEDULES. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY OF THE FILING ORGANIZATION APPLIES TO MEMBERS OF ITS BOARD OF DIRECTORS AND ITS PRINCIPAL OFFICERS (TO BE KNOWN AS INTERESTED PERSONS). IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTERESTS, ANY MEMBER OF THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION OR ANY PRINCIPAL OFFICER OF THE FILING ORGANIZATION (I.E. INTERESTED PERSONS) MUST DISCLOSE THE EXISTENCE OF ANY FINANCIAL INTEREST WITH THE FILING ORGANIZATION AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS CONCERNING THE FINANCIAL INTEREST/ARRANGEMENT TO THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION OR TO ANY MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS THAT IS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. SUBSEQUENT TO ANY DISCLOSURE OF ANY FINANCIAL INTEREST/ARRANGEMENT AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE RELEVANT BOARD MEMBER OR PRINCIPAL OFFICER, THE REMAINING MEMBERS OF THE BOARD OF DIRECTORS OR COMMITTEE WITH BOARD DELEGATED POWERS SHALL DISCUSS, ANALYZE, AND VOTE UPON THE POTENTIAL FINANCIAL INTEREST/ARRANGEMENT TO DETERMINE IF A CONFLICT OF INTEREST EXISTS. ACCORDING TO THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY, AN INTERESTED PERSON MAY MAKE A PRESENTATION TO THE BOARD OF DIRECTORS (OR COMMITTEE WITH BOARD DELEGATED POWERS), BUT AFTER SUCH PRESENTATION, SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN A CONFLICT OF INTEREST. EACH INTERESTED PERSON, AS DEFINED UNDER THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY, SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICT OF INTERESTS POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE FILING ORGANIZATION IS A CHARITABLE ORGANIZATION THAT MUST PRIMARILY ENGAGE IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS EXEMPT PURPOSES. THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY ALSO REQUIRES THAT PERIODIC REVIEWS SHALL BE CONDUCTED TO ENSURE THAT THE FILING ORGANIZATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES. FORM 990, PART VI, SECTION B, LINE 15 THE TOP-TIER PARENT OF THE FILING ORGANIZATION IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). AHSSHC IS THE PARENT ORGANIZATION OF A HEALTHCARE SYSTEM, KNOWN AS ADVENTIST HEALTH SYSTEM, THAT OPERATES HOSPITALS, NURSING HOME FACILITIES, AND OTHER HEALTHCARE PROVIDER ORGANIZATIONS. AHSSHC IS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3) PURSUANT TO A GROUP RULING ISSUED TO THE GENERAL CONFERENCE OF SEVENTH-DAY ADVENTISTS. THE INDIVIDUALS WHO SERVE AS THE CEO AND CFO OF THE FILING ORGANIZATION ARE COMPENSATED BY AHSSHC. COMPENSATION AND BENEFITS PROVIDED TO THESE INDIVIDUALS IS DETERMINED PURSUANT TO POLICIES, PROCEDURES, AND PROCESSES OF AHSSHC THAT ARE DESIGNED TO ENSURE COMPLIANCE WITH THE INTERMEDIATE SANCTIONS LAWS AS SET FORTH IN IRC SECTION 4958. AHSSHC HAS TAKEN STEPS TO ENSURE THAT PROCESSES ARE IN PLACE TO SATISFY THE REBUTTABLE PRESUMPTION OF REASONABLENESS STANDARD AS SET FORTH IN TREASURY REGULATION 53.4958-6 WITH RESPECT TO ITS ACTIVE EXECUTIVE-LEVEL POSITIONS. THE AHSSHC BOARD STRATEGY AND COMPENSATION COMMITTEE (THE COMMITTEE) SERVES AS THE GOVERNING BODY FOR ALL EXECUTIVE COMPENSATION MATTERS. THE COMMITTEE IS COMPOSED OF CERTAIN MEMBERS OF THE BOARD OF DIRECTORS (THE BOARD) OF AHSSHC. VOTING MEMBERS OF THE COMMITTEE INCLUDE ONLY INDIVIDUALS WHO SERVE ON THE BOARD AS INDEPENDENT REPRESENTATIVES OF THE COMMUNITY, WHO HOLD NO EMPLOYMENT POSITIONS WITH AHSSHC AND WHO DO NOT HAVE RELATIONSHIPS WITH ANY OF THE INDIVIDUALS WHOSE COMPENSATION IS UNDER THEIR REVIEW THAT IMPACTS THEIR BEST INDEPENDENT JUDGMENT AS FIDUCIARIES OF AHSSHC. THE COMMITTEE'S ROLE IS TO REVIEW AND APPROVE ALL COMPONENTS OF THE EXECUTIVE COMPENSATION PLAN OF AHSSHC. AS AN INDEPENDENT GOVERNING BODY WITH RESPECT TO EXECUTIVE COMPENSATION, IT SHOULD BE NOTED THAT THE COMMITTEE WILL OFTEN CONFER IN EXECUTIVE SESSIONS ON MATTERS OF COMPENSATION POLICY AND POLICY CHANGES. IN SUCH EXECUTIVE SESSIONS, NO MEMBERS OF MANAGEMENT OF AHSSHC ARE PRESENT. THE COMMITTEE IS ADVISED BY AN INDEPENDENT THIRD PARTY COMPENSATION ADVISOR. THIS ADVISOR PREPARES ALL THE BENCHMARK STUDIES FOR THE COMMITTEE. COMPENSATION LEVELS ARE BENCHMARKED WITH A NATIONAL PEER GROUP OF OTHER NOT-FOR-PROFIT HEALTHCARE SYSTEMS AND HOSPITALS OF SIMILAR SIZE AND COMPLEXITY TO AHS AND EACH OF ITS AFFILIATED ENTITIES. THE FOLLOWING PRINCIPLES GUIDE THE ESTABLISHMENT OF INDIVIDUAL EXECUTIVE COMPENSATION: - THE SALARY OF THE PRESIDENT/CEO OF AHS WILL NOT EXCEED THE 40TH PERCENTILE OF COMPARABLE SALARIES PAID BY SIMILARLY SITUATED ORGANIZATIONS; AND - OTHER EXECUTIVE SALARIES SHALL BE ESTABLISHED USING MARKET MEDIANS. THE COMPENSATION PHILOSOPHY, POLICIES, AND PRACTICES OF AHSSHC ARE CONSISTENT WITH THE ORGANIZATION'S FAITH-BASED MISSION AND CONFORM TO APPLICABLE LAWS, REGULATIONS, AND BUSINESS PRACTICES. AS A FAITH-BASED ORGANIZATION SPONSORED BY THE SEVENTH-DAY ADVENTIST CHURCH (THE CHURCH), AHSSHC'S PHILOSOPHY AND PRINCIPLES WITH RESPECT TO ITS EXECUTIVE COMPENSATION PRACTICES REFLECT THE CONSERVATIVE APPROACH OF THE CHURCH'S MISSION OF SERVICE AND WERE DEVELOPED IN COUNSEL WITH THE CHURCH'S LEADERSHIP. FORM 990, PART VI, SECTION C, LINE 19 AS DISCUSSED IN OUR RESPONSE TO QUESTION 15A & B IN SECTION B OF THIS PART VI, THE FILING ORGANIZATION IS A PART OF THE SYSTEM OF HEALTHCARE ORGANIZATIONS KNOWN AS ADVENTIST HEALTH SYSTEM (AHS). EACH YEAR, AHS PUBLISHES AN ANNUAL REPORT DOCUMENT THAT INCLUDES A FINANCIAL REPORT FOR THE RELEVANT YEAR AS WELL AS A COMMUNITY BENEFIT REPORT. THE FINANCIAL REPORT AND COMMUNITY BENEFIT REPORT ARE PRESENTED ON A CONSOLIDATED BASIS AND REPRESENT ALL OF THE ACTIVITIES, RESULTS OF OPERATIONS, AND FINANCIAL POSITION AT YEAR-END OF THE ENTIRE AHS SYSTEM. IN ADDITION, THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS OF AHS AND OF THE AHS "OBLIGATED GROUP" ARE FILED ANNUALLY WITH THE MUNICIPAL SECURITIES RULEMAKING BOARD (MSRB). THE "OBLIGATED GROUP" IS A GROUP OF AHSSHC SUBSIDIARIES THAT ARE JOINTLY AND SEVERALLY LIABLE UNDER A MASTER TRUST INDENTURE THAT SECURES DEBT PRIMARILY ISSUED ON A TAX-EXEMPT BASIS. UNAUDITED QUARTERLY FINANCIAL STATEMENTS PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) ARE ALSO FILED WITH MSRB FOR AHS ON A CONSOLIDATED BASIS AND FOR THE GROUPING OF AHS SUBSIDIARIES COMPRISING THE "OBLIGATED GROUP". THE FILING ORGANIZATION DOES NOT GENERALLY MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. PART VII, SECTION A FOR THOSE BOARD OF DIRECTOR MEMBERS AND OFFICERS WHO DEVOTE LESS THAN FULL-TIME TO THE FILING ORGANIZATION (BASED UPON THE AVERAGE NUMBER OF HOURS PER WEEK SHOWN IN COLUMN (B) ON PAGE 7 OF THE RETURN) THE COMPENSATION AMOUNTS SHOWN IN COLUMNS (E) AND (F) ON PAGE 7 WERE PROVIDED IN CONJUNCTION WITH THAT PERSON'S RESPONSIBILITIES AND ROLES IN SERVING IN AN EXECUTIVE LEADERSHIP POSITION WITHIN ADVENTIST HEALTH SYSTEM. PART VII, SECTION A, COLUMN (B) THE MEMBERS OF THE BOARD OF DIRECTORS AND OFFICERS WHO RECEIVED COMPENSATION FROM A RELATED ORGANIZATION AS SHOWN IN COLUMN (E) AND (F) OF SECTION A EACH DEVOTE APPROXIMATELY 50 HOURS PER WEEK IN CONJUNCTION WITH SERVING IN THEIR RESPECTIVE EXECUTIVE LEADERSHIP POSITION WITHIN ADVENTIST HEALTH SYSTEM. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: TRANSFER FROM TAX-EXEMPT RELATED ORGANIZATIONS 4,800,000. DISCONTINUED BUSINESS 21,930. OTHER ADJUSTMENT -508. TOTAL TO FORM 990, PART XI, LINE 5: 4,821,422. PART X, LINE 2 THE AMOUNTS SHOWN ON LINE 2 OF PART X OF THIS RETURN INCLUDE THE FILING ORGANIZATION'S INTEREST IN A CENTRAL INVESTMENT POOL MAINTAINED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION, THE FILING ORGANIZATION'S TOP-TIER PARENT. THE INVESTMENTS IN THE CENTRAL INVESTMENT POOL ARE RECORDED AT MARKET VALUE. ADVENTIST BOLINGBROOK HOSPITAL 500 REMINGTON BLVD BOLINGBROOK IL 60440 651219504 OPERATION OF HOSPITAL & RELATED SERVICES IL 501(C)(3) 170(B)(1)(A)(III) ADVENTIST HEALTH SYSTEMSUNBELT INC 0 ADVENTIST CARE CENTERS - COURTLAND INC 730 COURTLAND STREET ORLANDO FL 32804 205774723 OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY FL 501(C)(3) 509(A)(2) SUNBELT HEALTH CARE CENTERS INC 0 ADVENTIST GLENOAKS HOSPITAL 701 WINTHROP AVENUE GLENDALE HEIGHTS IL 60139 363208390 OPERATION OF HOSPITAL & RELATED SERVICES IL 501(C)(3) 170(B)(1)(A)(III) ADVENTIST HEALTH SYSTEMSUNBELT INC 0 ADVENTIST HEALTH MID-AMERICA INC 9100 W 74TH STREET SHAWNEE MISSION KS 66204 521347407 HEALTHCARE RELATED SERVICES KS 501(C)(3) 509(A)(3) TYPE I ADVENTIST HEALTH SYSTEMSUNBELT INC 0 ADVENTIST HEALTH PARTNERS INC 1000 REMINGTON BLVD STE 200 BOLINGBROOK IL 60440 364138353 OPERATE OUT-PATIENT PHYSICIAN CLINICS IL 501(C)(3) 170(B)(1)(A)(III) AHS MIDWEST MANAGEMENT INC 1 ADVENTIST HEALTH SYSTEM AFFILIATED BENEFIT TRUST 111 N ORLANDO AVENUE WINTER PARK FL 32789 266422966 PROMOTION OF HEALTHCARE FL 501(C)(3) 509(A)(3) TYPE I ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION 0 ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION 111 N ORLANDO AVENUE WINTER PARK FL 32789 592170012 MANAGEMENT SERVICES FL 501(C)(3) 509(A)(3) TYPE I N/A 0 ADVENTIST HEALTH SYSTEMGEORGIA INC 1035 RED BUD ROAD CALHOUN GA 30701 581425000 OPERATION OF HOSPITAL & RELATED SERVICES GA 501(C)(3) 170(B)(1)(A)(III) ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION 0 ADVENTIST HEALTH SYSTEMSUNBELT INC 111 N ORLANDO AVENUE WINTER PARK FL 32789 591479658 OPERATION OF HOSPITAL & RELATED SERVICES FL 501(C)(3) 170(B)(1)(A)(III) ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION 0 ADVENTIST HEALTH SYSTEMTEXAS INC 602 COURTLAND STREET ORLANDO FL 32804 742578952 INACTIVE TX 501(C)(3) 509(A)(2) ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION 0 ADVENTIST HINSDALE HOSPITAL 120 NORTH OAK STREET HINSDALE IL 60521 362276984 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TN N/A C ORMOND PROFESSIONAL CONDO ASSOCIATION (430 YEAR END) 770 W GRANADA BLVD STE 101 ORMOND BEACH FL 32174 592694434 CONDO ASSOCIATION FL N/A C PARK RIDGE PROPERTY OWNER'S ASSOCIATION INC 1 PARK PLACE NAPLES ROAD FLETCHER NC 28732 030380531 CONDO ASSOCIATION NC N/A C PORTER AFFILIATED HLTH SERVICES INC DBA DIVERSIFIED AFFILIATED HLTH SVCS 2525 S DOWNING STREET DENVER CO 80210 840956175 HEALTHCARE SERVICES CO N/A C PORTER MEDICAL PLAZA INC (630 YEAR END) 2525 S DOWNING STREET DENVER CO 80210 841574369 REAL ESTATE LEASING CO N/A C REFLECTIONS COMMERCIAL CONDOMINIUM ASSOCIATION INC 875 STERTHAUS AVE ORMOND BEACH FL 32174 593519055 CONDO ASSOCIATION FL N/A C SAN MARCOS REGIONAL MRI INC 1301 WONDER WORLD DRIVE SAN MARCOS TX 78666 770597968 HOLDING COMPANY TX N/A C SOUTHEAST VOLUSIA MEDICAL SERVICES INC (10110-93011) 401 PALMETTO STREET NEW SMYRNA BEACH FL 32168 593287185 INACTIVE FL N/A C THE GARDEN RETIREMENT COMMUNITY INC 602 COURTLAND STREET STE 200 ORLANDO FL 32804 593414055 REAL ESTATE RENTAL FL N/A C UNIVERSITY COMMUNITY HEALTH INSURANCE COMPANY SPC LTD C/O AON INSURANCE MANAGERS PO BOX GRAND CAYMAN CJ CAPTIVE INSURANCE CJ N/A C UCH SERVICES INC (101-123110) 3100 EAST FLETCHER AVE TAMPA FL 33613 593508454 MANAGEMENT COMPANY FL N/A C WEST COAST MEDICAL GROUP INC (101-123110) 1395 S PINELLAS AVE TARPON SPRINGS FL 34689 593537305 PHYSICIAN CLINICS FL N/A C 0 0 1 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 ADVENTIST HEALTH PARTNERS INC O 128969 COST ADVENTIST HEALTH PARTNERS INC P 14224992 COST ADVENTIST HEALTH PARTNERS INC L 70563 COST PLUS APPROPRIATE MARGIN ADVENTIST HINSDALE HOSPITAL K 593482 COST PLUS ADVENTIST HLTH SYSTEMSUNBELT INC DBA ADVENTIST LAGRANGE MEMORIAL HOSP K 253685 COST PLUS ADVENTIST BOLINGBROOK HOSPITAL INC K 122078 COST PLUS ADVENTIST GLENOAKS HOSPITAL C 1300000 ACTUAL AMOUNT RECEIVED ADVENTIST HINSDALE HOSPITAL C 1750000 ACTUAL AMOUNT RECEIVED ADVENTIST HLTH SYSTEMSUNBELT INC DBA ADVENTIST LAGRANGE MEMORIAL HOSP C 1750000 ACTUAL AMOUNT RECEIVED