MEMORIAL HEALTH SYSTEMS INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
MEMORIAL HEALTH SYSTEMS INC (EIN 59-0973502)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-14
IRS object ID
201133189349300243
Schema version
2010v3.4
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-11-14T10:50:54-06:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN590973502EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MEMORIAL HEALTH SYSTEMS INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMEMONameControl
Phone3866766000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1301 MEMORIAL MEDICAL PARKWAYAddressLine1
CityDAYTONA BEACHCity
StateFLState
ZIP Code32117ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameLYNN C ADDISCOTTName
TitleASSISTANT SECRETARYTitle
Phone4079751492Phone
Date Signed2011-11-11DateSigned
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeXAddressChange

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1FLORIDA HOSPITAL MEMORIAL MEDICAL CEBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonMARK LAROSENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1301 MEMORIAL MEDICAL PARKWAYAddressLine1
CityDAYTONA BEACHCity
StateFLState
ZIP Code32117ZIPCode
FieldValueIRS element (for citing)
Gross Receipts238658466GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.FLORIDAHOSPITALMEMORIAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1961YearFormation
State Legal DomicileFLStateLegalDomicile
Activity Or Mission DescriptionMEDICAL CARE TO THE COMMUNITY THROUGH THE OPERATION OF TWO HOSPITALS WITH A TOTAL OF 396 BEDS.ActivityOrMissionDescription
Nbr Voting Members Governing Body17NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees2035TotalNbrEmployees
Total Nbr Volunteers281TotalNbrVolunteers
Total Gross UBI613517TotalGrossUBI
Net Unrelated Business Txbl Income27299NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year451971ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year224739708ProgramServiceRevenuePriorYear
Program Service Revenue CY235236913ProgramServiceRevenueCY
Investment Income Prior Year5112713InvestmentIncomePriorYear
Investment Income Current Year3094051InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year230304392TotalRevenuePriorYear
Total Revenue Current Year238330964TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year68000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY132561GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year93012033SalariesEtcPriorYear
Salaries Etc Current Year96592176SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year131419691OtherExpensePriorYear
Other Expenses Current Year137719358OtherExpensesCurrentYear
Total Expenses Prior Year224499724TotalExpensesPriorYear
Total Expenses Current Year234444095TotalExpensesCurrentYear
Revenues Less Expenses Prior Year5804668RevenuesLessExpensesPriorYear
Revenues Less Expenses CY3886869RevenuesLessExpensesCY
Total Assets BOY439629318TotalAssetsBOY
Total Assets EOY436644817TotalAssetsEOY
Total Liabilities BOY199125367TotalLiabilitiesBOY
Total Liabilities EOY193027149TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY240503951NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY243617668NetAssetsOrFundBalancesEOY
Mission DescriptionADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION AND ALL OF ITS SUBSIDIARY ORGANIZATIONS WERE ESTABLISHED BY THE SEVENTH-DAY ADVENTIST CHURCH TO BRING A MINISTRY OF HEALING AND HEALTH TO THE COMMUNITIES SERVED. OUR MISSION IS TO EXTEND THE HEALING MINISTRY OF CHRIST.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense216904097Expense
Grants132561Grants
Revenue234623396Revenue
DescriptionOPERATION OF 2 ACUTE CARE HOSPITALS WITH 12,867 PATIENT ADMISSIONS AND 60,790 PATIENT DAYS IN THE CURRENT YEAR. BOTH HOSPITALS ARE LOCATED IN ORMOND BEACH AND DAYTONA BEACH, FLORIDA. IN ADDITION, THE CORPORATION OPERATES AN INTEGRATED HEALTHCARE DELIVERY SYSTEM.Description
Total Program Service Expense216904097TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements1ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached0FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096199NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees2035NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members17NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledFLStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1NIGEL HINDSBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3862313901TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1301 MEMORIAL MEDICAL PARKWAYAddressLine1
CityDAYTONA BEACHCity
StateFLState
ZIP Code32117ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (28 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
MICHAEL SCHULTZ
DIRECTOR1.00X01753215138723
RICK BANKER
DIRECTOR1.00X2500
RICHARD C BROWN
DIRECTOR1.00X2500
DAVID BURT
DIRECTOR1.00X2500
PAUL CLARE
DIRECTOR1.00X2500
SURESH DESAI MD
DIRECTOR3.00X2091700
JOSEPH GRUBER
DIRECTOR1.00X2500
JOEL D JOHNSON
DIRECTOR1.00X062258084230
SANDRA K JOHNSON
DIRECTOR1.00X099737581340
MARK LAROSE
CEO/DIRECTOR50.00X048430282891X
NANCY LOHMAN
DIRECTOR1.00X132300
DAVID OTTATI
DIRECTOR1.00X2535359458422
ANDREW RITTER MD
DIRECTOR1.00X2500
JULIE SCHNEIDER MD
DIRECTOR50.00X934623021843
LEWIS SEIFERT
DIRECTOR1.00X046347986033
DARYL TOL
CHAIRMAN/DIR BEG 6/101.00X2542456280284
ELIZABETH WEAGRAFF
DIRECTOR1.00X2528975462055
NIGEL HINDS
CFO (BEG 7/10)50.00024399736513X
DEBORA THOMAS
CFO (END 7/10)50.002535148163678X
DARLINDA COPELAND
COO50.00031094343151X
MICHELE GOEB-BURKETT
CNO50.00021329240482X
RONALD JIMENEZ
CMO50.00032832453462X
ROBERT MARTIN MD
PHYSICIAN40.001040201027727X
ROBERT HEWES MD
PHYSICIAN40.00729535022774X
CHRISTIAN BIRKEDAL MD
PHYSICIAN40.00682667038470X
DINDI REDDY MD
PHYSICIAN40.00646465034850X
BRENT BRANDON MD
PHYSICIAN40.00501644023060X
DANIEL WOLCOTT
FORMER KEY EMPLOYEE0.00034362468538X
FieldValueIRS element (for citing)
Total Reportable Comp From Org4557625TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs7180522TotalReportableCompFrmRltdOrgs
Total Other Compensation1148526TotalOtherCompensation
Number Individuals GT100 K49NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
SHERIDAN HEALTHCARE
PO BOX 452197SUNRISEFL33323MEDICAL SERVICES2995425
SPACE COAST HOSPITAL SERVICES
1895 MURRELL ROADROCKLEDGEFL32955LINEN SERVICE616232
SECURITAS SECURITY
PO BOX 403412ATLANTAGA30384SECURITY SERVICE581903
COASTAL CARDIOVASCULAR
588 STERTHAUS AVEORMOND BEACHFL32174PERFUSION SERVICE364137
EAST COAST DIALYSIS
7061 CYPRESS ROADPLANTATIONFL33317DIALYSIS SERVICE342055
FieldValueIRS element (for citing)
Number Of Contractors GT100 K33NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
NET PATIENT REVENUE90009922982555922977781347746
MANAGEMENT FEES56100030620582496287565771
CAFETERIA REVENUE90009911456261145626
MEDICAL OFFICE BUILDIN53112010796731079673
GIFT SHOP REVENUE9000991931019310

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column104687TotalRevenueColumn
Related Or Exempt Function Income104687RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue235236913TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column829791TotalRevenueColumn
Exclusion$829,791ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities2271158Securities
Other320604Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other327502Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities2271158Securities
Other-6898Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column2264260TotalRevenueColumn
Exclusion$2,264,260ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column238330964TotalRevenueColumn
Related Or Exempt Function Income234623396RelatedOrExemptFunctionIncome
Unrelated Business Revenue613517UnrelatedBusinessRevenue
Exclusion$3,094,051ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total132561Total
Program Services132561ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1904682Total
Management And General1904682ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total73214421Total
Program Services73214421ProgramServices

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2563701Total
Program Services2509827ProgramServices
Management And General53874ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total13025220Total
Program Services12760096ProgramServices
Management And General265124ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total5884152Total
Program Services5760502ProgramServices
Management And General123650ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total461833Total
Management And General461833ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total83600Total
Management And General83600ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total13559552Total
Program Services10511755ProgramServices
Management And General3047797ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total1244298Total
Management And General1244298ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total56208524Total
Program Services54898717ProgramServices
Management And General1309807ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total7626578Total
Program Services6508466ProgramServices
Management And General1118112ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total6054316Total
Program Services6054316ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total373674Total
Management And General373674ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total195588Total
Management And General195588ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total8463276Total
Program Services8463276ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total18474428Total
Program Services18474428ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total4061743Total
Program Services865628ProgramServices
Management And General3196115ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT EXPENSE86058478605847
REPAIRS & MAINTENANCE54373935437393
PURCHASED SERVICES44014244589813942443
STATE TAX INDIGENT ASSE22145942214594
UNRELATED BUSINESS INCO2067020670

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total232020Total
Program Services33289ProgramServices
Management And General198731ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total234444095Total
Program Services216904097ProgramServices
Management And General17539998ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY4960BOY
EOY4061EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY92439631BOY
EOY91793563EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY27301453BOY
EOY25455796EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY5048338BOY
EOY4576943EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY4945941BOY
EOY5842533EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis410184249LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec123102434LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY287820749BOY
EOY287081815EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY5386001BOY
EOY5302705EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY16682245BOY
EOY16587401EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY439629318BOY
EOY436644817EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY13447088BOY
EOY10017307EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY185678279BOY
EOY183009842EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY199125367BOY
EOY193027149EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY236392720BOY
EOY239454096EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1285496BOY
EOY1337837EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2825735BOY
EOY2825735EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY240503951BOY
EOY243617668EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY439629318BOY
EOY436644817EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses3886869ReconcilationRevenueExpenses
Reconcilation Other Changes-773152ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$26,542OtherActivitiesAmount
Total Lobbying Expenditures IIB26542TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF OTHER LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1I:ReturnReference
ExplanationAMERICAN HOSPITAL ASSOCIATION DUES AND FLORIDA HOSPITAL ASSOCIATION DUESExplanation

Schedule D IRS990ScheduleD

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

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis23464070OtherCostOrOtherBasis
Book Value23464070BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis290240874OtherCostOrOtherBasis
Depreciation71846437Depreciation
Book Value218394437BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis94159454OtherCostOrOtherBasis
Depreciation50380192Depreciation
Book Value43779262BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2319851OtherCostOrOtherBasis
Depreciation875805Depreciation
Book Value1444046BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings287081815TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescriptionAmountAmount
PAYABLE TO THIRD PARTIES$5,862,516
DUE TO AFFILIATED$244,680
CREDIT BALANCES IN A/R$340,071
OTHER LIABILITIES$3,131,213
INTERCO. ALLOC. OF TE BOND PROCEEDS$169,944,250
LEASES PAYABLE$3,487,112
FieldValueIRS element (for citing)
Total Of Amounts183009842TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF HOW ORGANIZATION REPORTS CONSERVATION EASEMENTS:PART II, LINE 9:THE FILING ORGANIZATION HAS RECORDED THE LAND CONSERVATION EASEMENT ON ITS FINANCIAL STATEMENTS AS A PROPERTY, PLANT, AND EQUIPMENT ASSET. THE CONSERVATION EASEMENT GENERATES NO REVENUE AND THE FILING ORGANIZATION DID NOT INCUR ANY EXPENSE IN THE CURRENT YEAR RELATED TO THE MAINTENANCE AND MONITORING OF THE CONSERVATION EASEMENT.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE HOSPITAL IS PART OF A CONSOLIDATED AUDITED FINANCIAL STATEMENT. THE CONSOLIDATED AUDITED FINANCIAL STATEMENT INCLUDES THE FOLLOWING FIN 48 FOOTNOTE - THE DIVISION FOLLOWS THE INCOME TAXES TOPIC OF THE ASC (ASC 740), WHICH PRESCRIBES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAX POSITIONS RECOGNIZED IN FINANCIAL STATEMENTS. ASC 740 PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense8842002TotalCommunityBenefitExpense
Net Community Benefit Expense8842002NetCommunityBenefitExpense
Percent Of Total Expense0.03920PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense20566759TotalCommunityBenefitExpense
Direct Offsetting Revenue8792898DirectOffsettingRevenue
Net Community Benefit Expense11773861NetCommunityBenefitExpense
Percent Of Total Expense0.05210PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense29408761TotalCommunityBenefitExpense
Direct Offsetting Revenue8792898DirectOffsettingRevenue
Net Community Benefit Expense20615863NetCommunityBenefitExpense
Percent Of Total Expense0.09130PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense61431TotalCommunityBenefitExpense
Net Community Benefit Expense61431NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense20066TotalCommunityBenefitExpense
Direct Offsetting Revenue11011DirectOffsettingRevenue
Net Community Benefit Expense9055NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense31470TotalCommunityBenefitExpense
Net Community Benefit Expense31470NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense112967TotalCommunityBenefitExpense
Direct Offsetting Revenue11011DirectOffsettingRevenue
Net Community Benefit Expense101956NetCommunityBenefitExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense29521728TotalCommunityBenefitExpense
Direct Offsetting Revenue8803909DirectOffsettingRevenue
Net Community Benefit Expense20717819NetCommunityBenefitExpense
Percent Of Total Expense0.09170PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense1477TotalCommunityBuildingExpense
Net Community Building Expense1477NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense51040TotalCommunityBuildingExpense
Net Community Building Expense51040NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense52517TotalCommunityBuildingExpense
Net Community Building Expense52517NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$2,586,782BadDebtExpenseAmount
Amount Attributable To514199AmountAttributableTo
Amount Reimbursed By Medicare78753326AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare80585179CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-1831853MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities2NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalEr24 HoursEr24Hours
FLORIDA HOSPITAL MEMORIAL MEDICAL CENTER
1301 MEMORIAL MEDICAL PARKWAYDAYTONA BEACHFL32117XXX
FLORIDA HOSPITAL OCEANSIDE
2264 SOUTH ATLANTIC AVEORMOND BEACHFL32176XXX

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1NA FOR 2010BusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities25NumberOfOtherFacilities

Other Facilities OtherFacilities (25 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
FHMMC CANCER CARE CENTER
224 MEMORIAL MEDICAL PKWYDAYTONA BEACHFL32117ONCOLOGY SERVICES
FLORIDA MEMORIAL HOSPITAL IMAGING CENTER
335 CLYDE MORRIS BLVDORMOND BEACHFL32174DIAGNOSTIC IMAGING
HEMATOLOGY ONCOLOGY ASSOCIATES
345 CLYDE MORRIS BLVD 490ORMOND BEACHFL32174ONCOLOGY SERVICES
PRACTICE OF DR MARTIN
305 MEMORIAL MEDICAL PKWY 206DAYTONA BEACHFL32117PHYSICIAN SERVICES
FLORIDA WOMEN'S HEALTH CENTER
335 CLYDE MORRIS BLVD 240ORMOND BEACHFL32174WOMEN'S HEALTH SERVICES
PRACTICE OF DR BIRKEDAL
305 MEMORIAL MEDICAL PKWY 205DAYTONA BEACHFL32117PHYSICIAN SERVICES
FHMMC REHABILITATION SVCS OUTPATIENT CTR
907 STERTHAUS AVENUEORMOND BEACHFL32174REHABILITATIVE SERVICES
COASTAL BARIATRICS
305 MEMORIAL MEDICAL PKWY 101DAYTONA BEACHFL32117WOUND CARE SERVICES
PRACTICE OF DR MURRPHY
305 MEMORIAL MEDICAL PKWY 206DAYTONA BEACHFL32117PHYSICIAN SERVICES
PRACTICE OF DR RASMUSSEN
305 MEMORIAL MEDICAL PKWY 209DAYTONA BEACHFL32117PHYSICIAN SERVICES
PRACTICE OF DR LEVINE
305 MEMORIAL MEDICAL PKWY 207DAYTONA BEACHFL32117PHYSICIAN SERVICES
MEMORIAL FAMILY CARE - DAYTONA
1130 BEVILLE ROADDAYTONA BEACHFL32114FAMILY PHYSICIAN SERVICES
PRACTICE OF DR WINDHAM
305 MEMORIAL MEDICAL PKWY 205DAYTONA BEACHFL32117PHYSICIAN SERVICES
MEMORIAL MEDLAB
290 N CLYDE MORRIS BLVDORMOND BEACHFL32174LAB SERVICES
PRACTICE OF DR COHEN
55 N OLD KINGS ROADORMOND BEACHFL32174PHYSICIAN SERVICES
PORT ORANGE REHABILITATIVE SERVICES
851 DUNLAWTON AVEPORT ORANGEFL32127REHABILITATIVE SERVICES
EHRINGER MEDICAL CENTER
1182 OCEAN SHORE BLVDORMOND BEACHFL32176FAMILY PHYSICIAN SERVICES
PRACTICE OF DR CASIMIRO
290 N CLYDE MORRIS BLVDORMOND BEACHFL32174PHYSICIAN SERVICES
MEMORIAL FAMILY CARE
700 STERTHAUS AVEORMOND BEACHFL32174FAMILY PHYSICIAN SERVICES
PRACTICE OF DR WALKINS
1130 BEVILLE ROADDAYTONA BEACHFL32114PHYSICIAN SERVICES
MEDLAB-DAYTONA
1130 BEVILLE ROADDAYTONA BEACHFL32114LAB SERVICES
PRACTICE OF DR MODAD
305 MEMORIAL MEDICAL PKWY 209DAYTONA BEACHFL32117PHYSICIAN SERVICES
PRACTICE OF DR GONTCHAROVA
394 SOUTH ATLANTIC AVEORMOND BEACHFL32176PHYSICIAN SERVICES
FHMMC CARDIAC REHAB
305 MEMORIAL MEDICAL PKWY 306DAYTONA BEACHFL32117REHABILITATIVE SERVICES
MEDLAB-NORTH ORMOND
700 STERTHAUS AVEORMOND BEACHFL32174LAB SERVICES

Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)

ExplanationExplanationReturn ReferenceReturnReference
PART I, LINE 6A: THE FILING ORGANIZATION IS A WHOLLY OWNED SUBSIDIARY OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). AHSSHC SERVES AS THE PARENT ORGANIZATION TO 21 TAX-EXEMPT 501(C)(3) HOSPITAL ORGANIZATIONS THAT OPERATE 43 HOSPITALS IN TEN STATES WITHIN THE U.S. THE SYSTEM OF ORGANIZATIONS UNDER THE CONTROL AND OWNERSHIP OF AHSSHC IS KNOWN AS "ADVENTIST HEALTH SYSTEM" (AHS).ALL HOSPITAL ORGANIZATIONS WITHIN AHS COLLECT, CALCULATE, AND REPORT THE COMMUNITY BENEFITS THEY PROVIDE TO THE COMMUNITIES THEY SERVE. AHS ORGANIZATIONS EXIST SOLELY TO IMPROVE AND ENHANCE THE LOCAL COMMUNITIES THEY SERVE. AHS HAS A SYSTEM-WIDE COMMUNITY BENEFITS ACCOUNTING POLICY THAT PROVIDES GUIDELINES FOR ITS HEALTH CARE PROVIDER ORGANIZATIONS TO CAPTURE AND REPORT THE COSTS OF SERVICES PROVIDED TO THE UNDERPRIVILEGED AND TO THE BROADER COMMUNITY. ON AN ANNUAL BASIS, THE COMMUNITY BENEFITS OF ALL AHS ORGANIZATIONS ARE CONSOLIDATED AND REPORTED IN THE AHS ANNUAL REPORT DOCUMENT.
PART I, LINE 7: THE AMOUNTS OF COSTS REPORTED IN THE TABLE IN LINE 7 OF PART I OF SCHEDULE H WERE DETERMINED BY UTILIZING A COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES, CONTAINED IN THE SCHEDULE H INSTRUCTIONS.
PART I, L7 COL(F): BAD DEBT EXPENSE OF $8,605,847 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.
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. METHODOLOGY FOR DETERMINING THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE THAT MAY REPRESENT PATIENTS WHO COULD HAVE QUALIFIED UNDER THE FILING ORGANIZATION'S CHARITY CARE POLICY:SELF-PAY PATIENTS ARE REQUIRED TO COMPLETE A PATIENT FINANCIAL ASSISTANCE APPLICATION SHORT FORM (PFAA). IF THE PFAA IS NOT COMPLETED AFTER REASONABLE ATTEMPTS TO OBTAIN IT ARE EXHAUSTED, PATIENT INFORMATION IS PROCESSED THROUGH A SCORER PRODUCT. THE SCORER PRODUCT UTILIZES PUBLICLY AVAILABLE DATA, SUCH AS CREDIT REPORTS, TO ASSESS AN INDIVIDUAL PATIENT'S FINANCIAL VIABILITY. PATIENTS WHO EARN A CERTAIN SCORE ON THE SCORER PRODUCT ARE CONSIDERED TO QUALIFY AS NON-STATE CHARITY PATIENTS. AN AMOUNT UP TO $1,000 OF SUCH A PATIENT'S BILL IS WRITTEN OFF AS BAD DEBT EXPENSE, WHILE THE REMAINING PORTION OF THE PATIENT'S BILL IS CONSIDERED TO BE NON-STATE CHARITY. THE AMOUNT WRITTEN OFF AS BAD DEBT EXPENSE FOR THOSE PATIENTS WHO POTENTIALLY QUALIFY AS NON-STATE CHARITY USING THE SCORER PRODUCT IS THE AMOUNT SHOWN ON LINE 3 OF SECTION A OF PART III. RATIONALE FOR INCLUDING CERTAIN BAD DEBTS IN COMMUNITY BENEFIT:THE FILING ORGANIZATION IS DEDICATED TO THE VIEW THAT MEDICALLY NECESSARY HEALTH CARE FOR EMERGENCY AND NON-ELECTIVE PATIENTS SHOULD BE ACCESSIBLE TO ALL, REGARDLESS OF AGE, GENDER, GEOGRAPHIC LOCATION, CULTURAL BACKGROUND, PHYSICIAN MOBILITY, OR ABILITY TO PAY. THE FILING ORGANIZATION TREATS EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF THEIR ABILITY TO PAY OR THE AVAILABILITY OF THIRD-PARTY COVERAGE. BY PROVIDING HEALTH CARE TO ALL WHO REQUIRE EMERGENCY OR NON-ELECTIVE CARE IN A NON-DISCRIMINATORY MANNER, THE FILING ORGANIZATION IS PROVIDING HEALTH CARE TO THE BROAD COMMUNITY IT SERVES. AS A 501(C)(3) HOSPITAL ORGANIZATION, THE FILING ORGANIZATION MAINTAINS A 24/7 EMERGENCY ROOM PROVIDING CARE TO ALL WHOM PRESENT. WHEN A PATIENT'S ARRIVAL AND/OR ADMISSION TO THE FACILITY BEGINS WITHIN THE EMERGENCY DEPARTMENT, TRIAGE AND MEDICAL SCREENING ARE ALWAYS COMPLETED PRIOR TO REGISTRATION STAFF PROCEEDING WITH THE DETERMINATION OF A PATIENT'S SOURCE OF PAYMENT. IF THE PATIENT REQUIRES ADMISSION AND CONTINUED NON-ELECTIVE CARE, THE FILING ORGANIZATION PROVIDES THE NECESSARY CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY. THE FILING ORGANIZATION'S OPERATION OF A 24/7 EMERGENCY DEPARTMENT THAT ACCEPTS ALL INDIVIDUALS IN NEED OF CARE PROMOTES THE HEALTH OF THE COMMUNITY THROUGH THE PROVISION OF CARE TO ALL WHOM PRESENT. CURRENT INTERNAL REVENUE SERVICE GUIDANCE THAT TAX-EXEMPT HOSPITALS MAINTAIN SUCH EMERGENCY ROOMS WAS ESTABLISHED TO ENSURE THAT EMERGENCY CARE WOULD BE PROVIDED TO ALL WITHOUT DISCRIMINATION. THE TREATMENT OF ALL AT THE FILING ORGANIZATION'S EMERGENCY DEPARTMENT IS A COMMUNITY BENEFIT. UNDER THE FILING ORGANIZATION'S CHARITY CARE POLICY, EVERY EFFORT IS MADE TO OBTAIN A PATIENT'S NECESSARY FINANCIAL INFORMATION TO DETERMINE ELIGIBILITY FOR CHARITY CARE. HOWEVER, NOT ALL PATIENTS WILL COOPERATE WITH SUCH EFFORTS AND A CHARITY CARE ELIGIBILITY DETERMINATION CAN NOT BE MADE. IN THIS CASE, A PATIENT'S PORTION OF A BILL THAT REMAINS UNPAID FOR A CERTAIN STIPULATED TIME PERIOD IS WHOLLY OR PARTIALLY CLASSIFIED AS BAD DEBT. BAD DEBTS ASSOCIATED WITH PATIENTS WHO HAVE RECEIVED CARE THROUGH THE FILING ORGANIZATION'S EMERGENCY DEPARTMENT SHOULD BE CONSIDERED TO BE COMMUNITY BENEFIT AS CHARITABLE HOSPITALS EXIST TO PROVIDE SUCH CARE IN PURSUIT OF THEIR PURPOSE OF MEETING THE NEED FOR EMERGENCY MEDICAL CARE SERVICES AVAILABLE TO ALL IN THE COMMUNITY. FINANCIAL STATEMENT FOOTNOTE RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS:THE FINANCIAL INFORMATION OF THE FILING ORGANIZATION IS INCLUDED IN A CONSOLIDATED AUDITED FINANCIAL STATEMENT FOR THE CURRENT YEAR. THE APPLICABLE FOOTNOTE FROM THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ADDRESSES ACCOUNTS RECEIVABLE, THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS, AND THE PROVISION FOR BAD DEBTS IS AS FOLLOWS:THE DIVISION SERVES CERTAIN PATIENTS WHOSE MEDICAL CARE COSTS ARE NOT PAID AT ESTABLISHED RATES. THESE PATIENTS INCLUDE THOSE SPONSORED UNDER GOVERNMENT PROGRAMS SUCH AS MEDICARE AND MEDICAID, THOSE SPONSORED UNDER PRIVATE CONTRACTUAL AGREEMENTS, CHARITY PATIENTS, AND OTHER UNINSURED PATIENTS WHO HAVE LIMITED ABILITY TO PAY.PATIENT SERVICE REVENUE IS REPORTED AT ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED. THE DIVISION IS SUBJECT TO RETROACTIVE REVENUE ADJUSTMENTS DUE TO FUTURE AUDITS, REVIEWS, AND INVESTIGATIONS. RETROACTIVE ADJUSTMENTS ARE CONSIDERED IN THE RECOGNITION OF REVENUE ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED, AND SUCH AMOUNTS ARE ADJUSTED IN FUTURE PERIODS AS ADJUSTMENTS BECOME KNOWN OR AS YEARS ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS, AND INVESTIGATIONS. ADJUSTMENTS TO REVENUE RELATED TO PRIOR PERIODS INCREASED PATIENT SERVICE REVENUE BY APPROXIMATELY $16,200,000 FOR THE YEAR ENDED DECEMBER 31, 2010.REVENUE FROM THE MEDICARE AND MEDICAID PROGRAMS REPRESENTS APPROXIMATELY 36% OF THE DIVISION'S PATIENT SERVICE REVENUE FOR THE YEAR ENDED DECEMBER 31, 2010. LAWS AND REGULATIONS GOVERNING THE MEDICARE AND MEDICAID PROGRAMS ARE EXTREMELY COMPLEX AND SUBJECT TO INTERPRETATION. AS A RESULT, THERE IS AT LEAST A REASONABLE POSSIBILITY THAT RECORDED ESTIMATES WILL CHANGE BY A MATERIAL AMOUNT IN THE NEAR TERM. THE DIVISION GRANTS CREDIT WITHOUT COLLATERAL TO ITS PATIENTS, MOST OF WHOM ARE LOCAL RESIDENTS AND ARE INSURED UNDER THIRD-PARTY PAYOR ARRANGEMENTS. TO THE EXTENT THE DIVISION REALIZES ADDITIONAL LOSSES RESULTING FROM HIGHER CREDIT RISK FOR PATIENTS WHO ARE NOT IDENTIFIED AS MEETING OR DO NOT MEET THE CHARITY DEFINITION DESCRIBED BELOW, SUCH ADDITIONAL LOSSES ARE INCLUDED IN THE PROVISION FOR BAD DEBTS. OTHER THAN THE ACCOUNTS RECEIVABLE RELATED TO THE MEDICARE AND MEDICAID PROGRAMS, THERE ARE NO SIGNIFICANT CONCENTRATIONS OF ACCOUNTS RECEIVABLE DUE FROM AN INDIVIDUAL PAYOR AT DECEMBER 31, 2010.THE PROVISION FOR BAD DEBTS IS BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON THE PAYOR COMPOSITION AND AGING OF ACCOUNTS RECEIVABLE AS WELL AS RETROSPECTIVE REVIEWS OF SUBSEQUENT CASH COLLECTIONS. THE RESULTS OF THESE REVIEWS ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN ESTIMATED ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE DIVISION'S POLICIES.
PART III, LINE 8: COSTING METHODOLOGY:MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST-TO-CHARGE RATIO.RATIONALE FOR INCLUDING A MEDICARE SHORTFALL AS COMMUNITY BENEFIT:AS A 501(C)(3) ORGANIZATION, THE FILING ORGANIZATION PROVIDES EMERGENCY AND NON-ELECTIVE CARE TO ALL REGARDLESS OF ABILITY TO PAY. ALL HOSPITAL SERVICES ARE PROVIDED IN A NON-DISCRIMINATORY MANNER TO PATIENTS WHO ARE COVERED BENEFICIARIES UNDER THE MEDICARE PROGRAM. AS A PUBLIC INSURANCE PROGRAM, MEDICARE PROVIDES A PRE-ESTABLISHED REIMBURSEMENT RATE/AMOUNT TO HEALTH CARE PROVIDERS FOR THE SERVICES THEY PROVIDE TO PATIENTS. IN SOME CASES, THE REIMBURSEMENT AMOUNT PROVIDED TO A HOSPITAL MAY EXCEED ITS COSTS OF PROVIDING A PARTICULAR SERVICE OR SERVICES TO A PATIENT. IN OTHER CASES, THE MEDICARE REIMBURSEMENT AMOUNT MAY RESULT IN THE HOSPITAL EXPERIENCING A SHORTFALL OF REIMBURSEMENT RECEIVED OVER COSTS INCURRED. IN THOSE CASES WHERE AN OVERALL SHORTFALL IS GENERATED FOR PROVIDING SERVICES TO ALL MEDICARE PATIENTS, THE SHORTFALL AMOUNT SHOULD BE CONSIDERED AS A BENEFIT TO THE COMMUNITY. TAX-EXEMPT HOSPITALS ARE REQUIRED TO ACCEPT ALL MEDICARE PATIENTS REGARDLESS OF THE PROFITABILITY, OR LACK THEREOF, WITH RESPECT TO THE SERVICES THEY PROVIDE TO MEDICARE PATIENTS. THE POPULATION OF INDIVIDUALS COVERED UNDER THE MEDICARE PROGRAM IS SUFFICIENTLY LARGE SO THAT THE PROVISION OF SERVICES TO THE POPULATION IS A BENEFIT TO THE COMMUNITY AND RELIEVES THE BURDENS OF GOVERNMENT. IN THOSE SITUATIONS WHERE THE PROVISION OF SERVICES TO THE TOTAL MEDICARE PATIENT POPULATION OF A TAX-EXEMPT HOSPITAL DURING ANY YEAR RESULTS IN A SHORTFALL OF REIMBURSEMENT RECEIVED OVER THE COST OF PROVIDING CARE, THE TAX-EXEMPT HOSPITAL HAS PROVIDED A BENEFIT TO A CLASS OF PERSONS BROAD ENOUGH TO BE CONSIDERED A BENEFIT TO THE COMMUNITY. DESPITE A FINANCIAL SHORTFALL, A TAX-EXEMPT HOSPITAL MUST AND WILL CONTINUE TO ACCEPT AND CARE FOR MEDICARE PATIENTS. TYPICALLY, TAX-EXEMPT HOSPITALS PROVIDE HEALTH CARE SERVICES BASED UPON AN ASSESSMENT OF THE HEALTH CARE NEEDS OF THEIR COMMUNITY AS OPPOSED TO THEIR TAXABLE COUNTERPARTS WHERE PROFITABILITY OFTEN DRIVES DECISIONS ABOUT PATIENT CARE SERVICES THAT ARE OFFERED. PATIENT CARE PROVIDED BY TAX-EXEMPT HOSPITALS THAT RESULTS IN MEDICARE SHORTFALLS SHOULD BE CONSIDERED AS PROVIDING A BENEFIT TO THE COMMUNITY AND RELIEVING THE BURDENS OF GOVERNMENT.
PART III, LINE 9B: 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 DOES NOT MAKE ANY PAYMENTS FOR THREE CONSECUTIVE MONTHS, THE ACCOUNT MAY BE REFERRED FOR FURTHER COLLECTION ACTIVITY. THE FILING ORGANIZATION DOES NOT PURSUE COLLECTION OF AMOUNTS FROM PATIENTS DETERMINED TO QUALIFY FOR A 100% REDUCTION IN CHARGES UNDER ITS CHARITY CARE POLICY.
RECONCILIATION OF SCHEDULE H REPORTED MEDICARE SURPLUS/(SHORTFALL) TO UNREIMBURSED MEDICARE COSTS ASSOCIATED WITH THE PROVISION OF SERVICESTO ALL MEDICARE BENEFICIARIES:THE MEDICARE REVENUE AND ALLOWABLE COSTS OF CARE REPORTED IN SECTION B OF PART III OF SCHEDULE H ARE BASED UPON THE AMOUNTS REPORTED IN THE FILING ORGANIZATION'S MEDICARE COST REPORT IN ACCORDANCE WITH THE IRS INSTRUCTIONS FOR SCHEDULE H. ON AN ANNUAL BASIS, THE FILING ORGANIZATION ALSO DETERMINES ITS TOTAL UNREIMBURSED COSTS ASSOCIATED WITH PROVIDING SERVICES TO ALL MEDICARE PATIENTS. UNREIMBURSED COSTS ARE REPORTED AS A COMMUNITY BENEFIT TO THE ELDERLY AND ARE INCLUDED IN THE CONSOLIDATED ADVENTIST HEALTH SYSTEM (AHS OR THE COMPANY) COMMUNITY BENEFITS REPORT CONTAINED IN THE AHS ANNUAL REPORT DOCUMENT. THE PRIMARY RECONCILING ITEMS BETWEEN THE MEDICARE SURPLUS/(SHORTFALL) SHOWN ON LINE 7 OF SECTION B OF PART III OF SCHEDULE H AND THE FILING ORGANIZATION'S UNREIMBURSED COSTS OF SERVICES PROVIDED TO MEDICARE PATIENTS AS REPORTED IN THE AHS COMMUNITY BENEFIT REPORT ARE AS FOLLOWS:- MEDICARE SURPLUS/(SHORTFALL) SHOWN ON LINE 7 OF SECTION B OF SCHEDULE H: $ (1,831,853)- DIFFERENCE IN COSTING METHODOLOGY: (3,828,987)- UNREIMBURSED COSTS INCURRED FOR SERVICES PROVIDED TO MEDICARE PATIENTS THAT ARE NOT INCLUDED IN THE ORGANIZATION'S MEDICARE COST REPORT: (4,448,289) -------------TOTAL UNREIMBURSED COSTS OF SERVING ALL MEDICARE PATIENTS PER THE FILING ORGANIZATION'S COMMUNITY BENEFIT REPORTING: $(10,109,129)AS INDICATED ABOVE, THE PRIMARY DIFFERENCES BETWEEN THE MEDICARE SURPLUS/(SHORTFALL) REPORTED ON SCHEDULE H, PART III, SECTION B, LINE 7 AND THE FILING ORGANIZATION'S PORTION OF THE COMPANY'S ANNUAL COMMUNITY BENEFIT STATEMENT IS DUE TO A DIFFERENCE IN THE COSTING METHODOLOGY AND DIFFERENCES IN THE POPULATION OF MEDICARE PATIENTS WITHIN THE CALCULATION. THE COST METHODOLOGY UTILIZED IN CALCULATING ANY MEDICARE SURPLUS/(SHORTFALL) FOR PURPOSES OF THE ANNUAL COMMUNITY BENEFIT REPORTING IS BASED UPON THE COST-TO-CHARGE RATIO OUTLINED IN WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. THE SAME COST-TO-CHARGE RATIO IS USED TO DETERMINE THE COSTS ASSOCIATED WITH SERVICES PROVIDED TO CHARITY CARE PATIENTS AND MEDICAID PATIENTS AS REPORTED IN SCHEDULE H, PART I, LINE 7. IN ADDITION, THE MEDICARE COST REPORT EXCLUDES SERVICES PROVIDED TO MEDICARE PATIENTS FOR PHYSICIAN SERVICES, SERVICES PROVIDED TO PATIENTS ENROLLED IN MEDICARE HMOS, AND CERTAIN SERVICES PROVIDED BY OUTPATIENT DEPARTMENTS OF THE FILING ORGANIZATION THAT ARE REIMBURSED ON A FEE SCHEDULE. THE COMPANY'S OWN COMMUNITY BENEFIT STATEMENT CAPTURES THE UNREIMBURSED COST OF PROVIDING SERVICES TO ALL MEDICARE BENEFICIARIES THROUGHOUT THE ORGANIZATION.SUPPLEMENTAL SCHEDULE TO SCHEDULE H, PART III, SECTION B
PART VI, LINE 7: THE ANNUAL COMMUNITY BENEFIT REPORT CONTAINED IN THE ANNUAL REPORT PREPARED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC) ON BEHALF OF THE ENTIRE AHS SYSTEM OF HEALTHCARE ORGANIZATION IS NOT FILED WITH ANY STATE AGENCIES.
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.
PART VI, LINE 3: THE FILING ORGANIZATION HAS A PROCESS IN PLACE WHEREBY PATIENTS ARE INFORMED ABOUT THE HOSPITAL'S CHARITY CARE POLICY AND OTHER FORMS OF FINANCIAL ASSISTANCE, SUCH AS SELF-PAY DISCOUNTS. SIGNAGE IS POSTED IN THE EMERGENCY ROOM INDICATING THAT FINANCIAL ASSISTANCE IS AVAILABLE FOR THOSE SELF-PAY PATIENTS MEETING ELIGIBILITY REQUIREMENTS. AFTER EMTALA MEDICAL SCREENING AND STABILIZATION REQUIREMENTS ARE MET, REGISTRATION PERSONNEL WILL SECURE FINANCIAL INFORMATION ON AS MANY SELF-PAY PATIENTS AS POSSIBLE AT THE TIME OF SERVICE. FOR THOSE WHO APPEAR TO QUALIFY FOR MEDICAID OR UNDER THE HOSPITAL'S CHARITY CARE POLICY, THE FINANCIAL COUNSELORS WILL CONTINUE TO WORK WITH THOSE PATIENTS UNTIL FINAL ACCOUNT RESOLUTION IS ACHIEVED. ALL OTHER SELF-PAY PATIENTS ARE COVERED UNDER THIS PROCESS. AT ANY TIME DURING THE PROCESS THAT DATA IS PROVIDED SHOWING THAT A PATIENT QUALIFIES FOR ASSISTANCE UNDER THE CHARITY CARE POLICY THE DISCOUNTS EXTENDED UNDER THAT POLICY WILL BE APPLIED.AS PART OF THE BILLING PROCESS, THE HOSPITAL INCLUDES THE APPLICATION FOR CHARITY CARE ASSISTANCE ALONG WITH THE INITIAL PATIENT BILL. THE HOSPITAL'S CHARITY CARE APPLICATION IS ALSO AVAILABLE TO PATIENTS ON THE HOSPITAL'S WEB-SITE IN BOTH AN ENGLISH AND SPANISH VERSION. ADDITIONALLY, THE HOSPITAL'S FINANCIAL COUNSELORS ARE AVAILABLE TO WORK WITH EVERY PATIENT DURING THE FIRST 120 DAYS OF THE BILLING PROCESS TO ASSIST THE PATIENT WITH COMPLETING CHARITY CARE APPLICATIONS AND INVESTIGATING OTHER POTENTIAL SOURCES OF THIRD-PARTY ASSISTANCE. THE DETERMINATION OF A PATIENT'S ELIGIBILITY FOR CHARITY CARE IS MADE ON A CASE-BY-CASE BASIS. VARIOUS FACTORS ARE CONSIDERED IN THAT DETERMINATION. EACH INDIVIDUAL PATIENT WHO IS IDENTIFIED AS POTENTIALLY BEING ELIGIBLE TO RECEIVE CHARITY CARE IS SEEN BY A FINANCIAL COUNSELOR AT THE HOSPITAL. THE FINANCIAL COUNSELOR WILL WORK WITH THE PATIENT TO MAKE SURE THAT OTHER SOURCES OF ASSISTANCE (PUBLIC OR OTHERWISE) HAVE BEEN SOUGHT TO THE FULLEST EXTENT POSSIBLE. WHEN OTHER FORMS OF ASSISTANCE ARE NOT AVAILABLE OR HAVE BEEN EXHAUSTED, THE HOSPITAL WILL GATHER CERTAIN FINANCIAL INFORMATION FROM THE PATIENT TO DETERMINE THE PATIENT'S ABILITY TO PAY BASED UPON LEVEL OF INCOME.
PART VI, LINE 4: THE FILING ORGANIZATION OPERATES 2 HOSPITALS IN VOLUSIA COUNTY, FLORIDA; FLORIDA HOSPITAL MEMORIAL MEDICAL CENTER (MEMORIAL), A 277-BED FACILITY AND FLORIDA HOSPITAL OCEANSIDE (OCEANSIDE), A 119-BED FACILITY. ADDITIONALLY, THE FILING ORGANIZATION SERVES ITS COMMUNITIES WITH PHYICIAN PRACTICES, IMAGING SERVICES, AND LABORATORY SERVICES THROUGHOUT EAST CENTRAL FLORIDA. MORE THAN 400 PHYSICIANS HOLD PRIVILEGES AT THE FILING ORGANIZATION'S FACILITIES AND COMBINED, THE FILING ORGANIZATION EMPLOYS MORE THAN 1,700 INDIVIDUALS. THERE IS AN AFFILIATE HOSPITAL AND TWO OTHER HOSPITALS WITHIN A RADIUS OF 20 MILES OR LESS FROM MEMORIAL AND OCEANSIDE. APPROXIMATELY 59% OF THE FILING ORGANIZATION'S PATIENTS DURING 2010 WERE MEDICARE PATIENTS, ABOUT 9% WERE MEDICAID PATIENTS, 5% WERE SELF-PAY, AND THE REMAINING PERCENTAGE WERE PATIENTS COVERED UNDER COMMERCIAL INSURANCE. FOR 2010, ABOUT 53% OF THE HOSPITAL'S IN-PATIENTS WER ADMITTED THROUGH THE HOSPITAL'S EMERGENCY DEPARTMENT.MEMORIAL IS VOLUSIA COUNTY'S NEWEST AND MOST COMPREHENSIVE FACILITY. ITS NEW FACILITY FEATURES THE AREA'S ONLY ENDOVASCULAR/HYBRID OPERATING ROOM WHERE PATIENTS ARE DIAGNOSED AND TREATED IN ONE LOCATION FOR A VARIETY OF HEART AND ENDOVASCULAR CONDITIONS; THE AREA'S ONLY SIEMENS SOMOTOM 64-SLICE CT SCANNER FOR FASTER, PAINLESS DIAGNOSES OF HEART CONDITIONS AND STROKES USING 50 PERCENT LESS RADIATION; AND A NEWLY EXPANDED EMERGENCY DEPARTMENT FEATURING "NO WAIT" SERVICES. MEMORIAL SERVES A POPULATION OF APPROXIMATELY 297,000 PEOPLE IN THE HOSPITAL'S PRIMARY MARKET. DAYTONA BEACH IS THE REGIONAL COMMERCIAL AND CULTURAL HUB OF DELTONA-DAYTONA BEACH-ORMOND BEACH AREA. THE CITY IS AN INTEGRAL SEGMENT OF THE INTERSTATE HIGHWAY 4 CORRIDOR WITH SPECIALIZED INDUSTRIES IN AEROSPACE, AUTOMOTIVE, AND MANUFACTURING. THE WEIGHTED AVERAGE HOUSEHOLD INCOME, BASED ON POPULATION, IN THE PRIMARY MARKET IS APPROXIMATELY $57,000, WITH AN ESTIMATED 71,000 OVER THE AGE OF 65. HIGH SCHOOL GRADUATES ACCOUNT FOR APPROXIMATELY 87% OF VOLUSIA COUNTY WITH AN ESTIMATED 21% HAVING A BACHELOR'S DEGREE OR HIGHER. IT IS ESTIMATED THAT 13% OF THE INDIVIDUALS RESIDING IN VOLUSIA COUNTY LIVE BELOW THE POVERTY LEVEL AND THE UNEMPLOYMENT RATE IS ABOUT 12%.OCEANSIDE HAS A LONG HISTORY OF COMMUNITY SUPPORT AND SERVICES WHICH INCLUDES MEDICAL/SURGICAL CARE AND THE OPERATION OF PENINSULA REHABILITATION CENTER, VOLUSIA COUNTY'S ONLY INPATIENT REHABILITATION CENTER. IT ALSO OFFERS AN OUTPATIENT REHAB UNIT, IMAGING SERVICES, LABORATORY SERVICES, AND CARDIOPULMONARY SERVICES.
PART VI, LINE 6: THE PROVISION OF COMMUNITY BENEFIT IS CENTRAL TO THE FILING ORGANIZATION'S MISSION OF SERVICE AND COMPASSION. RESTORING AND PROMOTING THE HEALTH AND QUALITY OF LIFE OF THOSE IN THE COMMUNITIES SERVED BY THE FILING ORGANIZATION IS A FUNCTION OF "EXTENDING THE HEALING MINISTRY OF CHRIST" AND EMBODIES THE FIING ORGANIZATION'S COMMITMENT TO ITS VALUES AND PRINCIPLES. THE FILING ORGANIZATION COMMITS SUBSTANTIAL RESOURCES TO PROVIDE A BROAD RANGE OF SERVICES TO BOTH THE UNDERPRIVILEGED AS WELL AS THE BROADER COMMUNITY. IN ADDITION TO THE COMMUNITY BENEFIT INFORMATION PROVIDED IN PARTS I, II AND III OF THIS SCHEDULE H, THE HOSPITAL CAPTURES AND REPORTS THE BENEFITS PROVIDED TO ITS COMMUNITY THROUGH FAITH-BASED CARE. EXAMPLES OF SUCH BENEFITS INCLUDE THE COST ASSOCIATED WITH CHAPLAINCY CARE PROGRAMS AND MISSION PEER REVIEWS AND MISSION CONFERENCES. DURING THE CURRENT YEAR, THE FILING ORGANIZATION PROVIDED $329,001 OF BENEFIT WITH RESPECT TO THE FAITH-BASED AND SPIRITUAL NEEDS OF THE COMMUNITY IN CONJUNCTION WITH ITS OPERATION OF 2 COMMUNITY HOSPITALS. THE FILING ORGANIZATION ALSO PROVIDES BENEFITS TO ITS COMMUNITY'S INFRASTRUCTURE BY INVESTING IN CAPITAL IMPROVEMENTS TO ENSURE THAT FACILITIES AND TECHNOLOGY PROVIDE THE BEST POSSIBLE CARE TO THE COMMUNITY. DURING THE CURRENT YEAR, THE FILING ORGANIZATION EXPENDED $18,647,619 IN NEW CAPITAL IMPROVEMENTS. AS A FAITH-BASED MISSION-DRIVEN COMMUNITY HOSPITAL, THE FILING ORGANIZATION IS CONTINUALLY INVOLVED IN MONITORING ITS COMMUNITY, IDENTIFYING UNMET HEALTH CARE NEEDS AND DEVELOPING SOLUTIONS AND PROGRAMS TO ADDRESS THOSE NEEDS. IN ACCORDANCE WITH ITS CONSERVATIVE APPROACH TO FISCAL RESPONSIBILITY, SURPLUS FUNDS OF THE HOSPITAL ARE CONTINUALLY BEING INVESTED IN RESOURCES THAT IMPROVE THE AVAILABILITY AND QUALITY OF DELIVERY OF HEALTH CARE SERVICES AND PROGRAMS TO ITS COMMUNITY.
PART VI, LINE 7: THE FILING ORGANIZATION IS A PART OF A FAITH-BASED HEALTHCARE SYSTEM OF ORGANIZATIONS WHOSE PARENT IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). THE SYSTEM IS KNOWN AS ADVENTIST HEALTH SYSTEM (AHS). AHSSHC IS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SEC. 501(C)(3). AHSSHC AND ITS SUBSIDIARY ORGANIZATIONS OPERATE 43 HOSPITALS IN 10 STATES THROUGHOUT THE U.S., PRIMARILY IN THE SOUTHEASTERN PORTION OF THE U.S. AHSSHC AND ITS SUBSIDIARIES ALSO OPERATE 16 NURSING HOME FACILITIES AND OTHER ANCILLARY HEALTH CARE PROVIDER FACILITIES, SUCH AS AMBULATORY SURGERY CENTERS AND DIAGNOSTIC IMAGING CENTERS. AS THE PARENT ORGANIZATION OF THE AHS SYSTEM, AHSSHC PROVIDES EXECUTIVE LEADERSHIP AND OTHER PROFESSIONAL SUPPORT SERVICES TO ITS SUBSIDIARY ORGANIZATIONS. PROFESSIONAL SUPPORT SERVICES INCLUDE AMONG OTHERS CORPORATE COMPLIANCE, LEGAL, HUMAN RESOURCES, REIMBURSEMENT, RISK MANAGEMENT, AND TAX AS WELL AS TREASURY FUNCTIONS. THE PROVISION OF THESE EXECUTIVE AND SUPPORT SERVICES ON A CENTRALIZED BASIS BY AHSSHC PROVIDES AN APPROPRIATE BALANCE BETWEEN PROVIDING EACH AHS SUBSIDIARY HOSPITAL ORGANIZATION WITH MISSION-DRIVEN CONSISTENT LEADERSHIP AND SUPPORT WHILE ALLOWING THE HOSPITAL ORGANIZATION TO FOCUS ITS RESOURCES ON MEETING THE SPECIFIC HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES. THE READER OF THIS FORM 990 SHOULD KEEP IN MIND THAT THIS REPORTING ENTITY MAY DIFFER IN CERTAIN AREAS FROM THAT OF A STAND-ALONE HOSPITAL ORGANIZATION DUE TO ITS INCLUSION IN A LARGER SYSTEM OF HEALTHCARE ORGANIZATIONS. AS A PART OF A SYSTEM OF HOSPITAL AND OTHER HEALTH CARE ORGANIZATIONS, THE FILING ORGANIZATION BENEFITS FROM REDUCED COSTS DUE TO SYSTEM EFFICIENCIES, SUCH AS LARGE GROUP PURCHASING DISCOUNTS, AND THE AVAILABILITY OF INTERNAL RESOURCES SUCH AS INTERNAL LEGAL COUNSEL. EACH AHS SUBSIDIARY PAYS A MANAGEMENT FEE TO AHSSHC FOR THE INTERNAL SERVICES PROVIDED BY AHSSHC. AS A RESULT, MANAGEMENT FEE EXPENSE REPORTED BY A AHS SUBSIDIARY ORGANIZATION MAY APPEAR GREATER IN RELATION TO MANAGEMENT FEE EXPENSE THAT MAY BE REPORTED BY A SINGLE STAND-ALONE HOSPITAL. THE SINGLE STAND-ALONE HOSPITAL WOULD LIKELY REPORT COSTS ASSOCIATED WITH MANAGEMENT AND OTHER PROFESSIONAL SERVICES ON VARIOUS EXPENSE LINE ITEMS IN ITS STATEMENT OF REVENUE AND EXPENSE AS OPPOSED TO REPORTING SUCH COSTS IN ONE OVERALL MANAGEMENT FEE EXPENSE. AS THE REPORTING OF THE FORM 990 IS DONE ON AN ENTITY BY ENTITY BASIS, THERE IS NO SINGLE FORM 990 THAT CAPTURES THE PROGRAMS AND OPERATIONS OF AHS AS A WHOLE. THE READER IS DIRECTED TO VISIT THE WEB-SITE OF AHS AT WWW.ADVENTISTHEALTHSYSTEM.COM TO LEARN MORE ABOUT THE MISSION AND OPERATIONS OF AHS AND TO ACCESS AHS'S ANNUAL REPORT THAT CONTAINS FINANCIAL DATA AS WELL AS COMMUNITY BENEFIT REPORTING FOR THE ENTIRE SYSTEM.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistancePurpose Of GrantPurposeOfGrantAmount Of Cash GrantAmountOfCashGrant
MEMORIAL HEALTH SYSTEMS FOUNDATION INC
770 WEST GRANADA BLVD 302ORMOND BEACHFL32174311771522501(C)(3)107561COSTGENERAL ADMINISTRATIVE SUPPORTPROVISION OF GENERAL ADMINISTRATIVE SUPPORT
COMMUNITY CULTURAL FOUNDATION INC
212 SOUTH BEACH STREETDAYTONA BEACHFL32115260740459501(C)(3)GENERAL SUPPORT25000
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: GRANTS ARE GENERALLY MADE ONLY TO RELATED ORGANIZATIONS THAT ARE EXEMPT FROM FEDERAL INCOME TAX UNDER 501(C)(3) OR TO OTHER 501(C)(3) ORGANIZATIONS WITHIN THE COMMUNITY. ACCORDINGLY, THE FILING ORGANIZATION HAS NOT ESTABLISHED SPECIFIC PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE UNITED STATES AS THE FILING ORGANIZATION DOES NOT HAVE A GRANT MAKING PROGRAM THAT WOULD NECESSITATE SUCH PROCEDURES.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Discretionary Spending AccountXDiscretionarySpendingAccount
Housing Allowance Or ResidenceXHousingAllowanceOrResidence
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org1CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (20 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
MICHAEL SCHULTZ
054045501511990106156101045980341250189193800
JOEL D JOHNSON
03024240717500248406044876039354070681000
SANDRA K JOHNSON
037018508969505374950431060382340107871500
MARK LAROSE
0362624087500034178066821016070056719300
DAVID OTTATI
026015806201525314210281680302542541201600
JULIE SCHNEIDER MD
298761063426801594013343085000956466000
LEWIS SEIFERT
0342444079592041443055365030668054951200
DARYL TOL
032755106899325280180481550321292550484600
ELIZABETH WEAGRAFF
021964805220525179010249520371032535180900
NIGEL HINDS
0192711034000017286012326024187028051000
DEBORA THOMAS
026774205000025337390228030408752541515900
DARLINDA COPELAND
0251829033309025805019829023322035409400
MICHELE GOEB-BURKETT
0174062025096014134010782029700025377400
RONALD JIMENEZ
0258808035631033885017282036180038178600
ROBERT MARTIN MD
5419460497486076901334301438401067928000
ROBERT HEWES MD
536208018660006727013343094310752309000
CHRISTIAN BIRKEDAL MD
291503039099101730133430251270721137000
DINDI REDDY MD
48985801449000117070133430215070681315000
BRENT BRANDON MD
4953250006319084430146170524704000
DANIEL WOLCOTT
0222755036076084793024131044407041216200

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART I, LINE 1AAS DISCUSSED IN OUR RESPONSE TO SECTION B, PART VI, QUESTION 15A & B, THE FILING ORGANIZATION IS A PART OF THE SYSTEM OF HEALTHCARE ORGANIZATIONS KNOWN AS ADVENTIST HEALTH SYSTEM (AHS). MEMBERS OF THE FILING ORGANIZATION'S EXECUTIVE MANAGEMENT TEAM THAT HOLD THE POSITION OF VICE-PRESIDENT OR ABOVE ARE COMPENSATED BY AND ON THE PAYROLL OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), THE PARENT ORGANIZATION OF AHS. AHSSHC IS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). THE FILING ORGANIZATION REIMBURSES AHSSHC FOR THE SALARY AND BENEFIT COST OF THOSE EXECUTIVES ON THE PAYROLL OF AHSSHC THAT PROVIDE SERVICES AND ARE ON THE MANAGEMENT TEAM OF THE FILING ORGANIZATION. FOR ADMINISTRATIVE EASE, EXECUTIVE EMPLOYEES ON THE PAYROLL OF AHSSHC WHO PROVIDE SERVICES AT AHS SUBSIDIARY ORGANIZATIONS RECEIVE REIMBURSEMENTS OF TRAVEL AND OTHER BUSINESS-RELATED EXPENSES FROM THE SUBSIDIARY ORGANIZATION. TRAVEL FOR COMPANIONS: AHSSHC HAS A CORPORATE EXECUTIVE POLICY THAT PROVIDES A BENEFIT TO ALLOW FOR A TRAVELING AHSSHC EXECUTIVE TO HAVE HIS OR HER SPOUSE ACCOMPANY THE EXECUTIVE ON TWO BUSINESS TRIPS EACH YEAR. TYPICALLY, REIMBURSEMENT IS ONLY PROVIDED TO VICE PRESIDENTS AND ABOVE AND IS LIMITED TO ONE BUSINESS TRIP PER YEAR AND THE ANNUAL AHS PRESIDENT'S COUNCIL BUSINESS MEETING. THE AHSSHC CORPORATE EXECUTIVE SPOUSAL TRAVEL POLICY WAS ORIGINALLY APPROVED AND REVIEWED BY THE AHSSHC BOARD STRATEGY & COMPENSATION COMMITTEE, AN INDEPENDENT BODY OF THE AHSSHC BOARD OF DIRECTORS. ALL SPOUSAL TRAVEL COSTS REIMBURSED TO THE EXECUTIVE ARE CONSIDERED TAXABLE COMPENSATION TO THE EXECUTIVE. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: AHS HAS A SYSTEM-WIDE POLICY ADDRESSING GROSS-UP PAYMENTS PROVIDED IN CONNECTION WITH EMPLOYER-PROVIDED BENEFITS/OTHER TAXABLE ITEMS. UNDER THE POLICY, CERTAIN TAXABLE BUSINESS-RELATED REIMBURSEMENTS (I.E. TAXABLE BUSINESS-RELATED MOVING EXPENSES, TAXABLE ITEMS PROVIDED IN CONNECTION WITH EMPLOYMENT) PROVIDED TO ANY EMPLOYEE MAY BE GROSSED-UP AT A 25% RATE UPON APPROVAL OF THE FILING ORGANIZATION'S CEO AND CFO. ADDITIONALLY, EMPLOYEES AT THE DIRECTOR LEVEL AND ABOVE ARE ELIGIBLE FOR GROSS-UP PAYMENTS ON GIFTS RECEIVED FOR BOARD OF DIRECTOR SERVICES. DISCRETIONARY SPENDING ACCOUNT: A NOMINAL DISCRETIONARY SPENDING AMOUNT WAS PROVIDED IN THE CURRENT YEAR TO ALL ELIGIBLE EXECUTIVES WHO ATTEND THE ANNUAL AHS PRESIDENT'S COUNCIL BUSINESS MEETING ($500 PER EXECUTIVE). ELIGIBLE EXECUTIVES INCLUDE ALL AHSSHC VICE PRESIDENTS AND ABOVE AND ALL AHSSHC SUBSIDIARY ORGANIZATION CEOS AND REGIONAL CFOS. THE PAYMENT PROVIDED TO EACH EXECUTIVE WAS CONSIDERED TAXABLE COMPENSATION TO THE EXECUTIVE. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE: AHSSHC HAS A CORPORATE EXECUTIVE POLICY THAT ADDRESSES ASSISTANCE TO EXECUTIVES WHO HAVE BEEN RELOCATED BY THE COMPANY DURING THE YEAR. RELOCATION ASSISTANCE PROVIDED TO EXECUTIVES MAY INCLUDE RELOCATION ALLOWANCES TO ASSIST WITH DUPLICATE HOUSING EXPENSES. RELOCATION ASSISTANCE IS ADMINISTERED PER AHSSHC POLICY BY AN EXTERNAL RELOCATION COMPANY. ANY TAXABLE REIMBURSEMENTS MADE TO EXECUTIVES IN CONNECTION WITH RELOCATION ASSISTANCE ARE TREATED AS WAGES TO THE EXECUTIVE AND ARE SUBJECT TO ALL PAYROLL WITHHOLDING AND REPORTING REQUIREMENTS. HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES: AHSSHC HAS A CORPORATE EXECUTIVE POLICY THAT ADDRESSES BUSINESS DEVELOPMENT EXPENDITURES. UNDER THIS POLICY, CERTAIN AHS ELIGIBLE EXECUTIVES MAY BE REIMBURSED FOR MEMBER DUES AND USAGE CHARGES FOR A COUNTRY CLUB OR OTHER SOCIAL CLUB UPON AUTHORIZATION. CLUB MEMBERSHIPS MUST BE RECOMMENDED BY THE CEO OF THE AHS HOSPITAL ORGANIZATION AND APPROVED BY THE CHAIRMAN OF THE BOARD OF DIRECTORS OF THE ORGANIZATION. IN ADDITION, THE PROPOSED MEMBERSHIP MUST BE APPROVED ANNUALLY BY THE AHSSHC BOARD STRATEGY & COMPENSATION COMMITTEE, AN INDEPENDENT COMMITTEE OF THE BOARD OF DIRECTORS OF AHSSHC. ELIGIBLE EXECUTIVES ARE LIMITED TO CERTAIN SENIOR LEVEL EXECUTIVES (HOSPITAL ORGANIZATION CEOS, THE CEO OF THE NURSING HOME DIVISION OF AHS, SENIOR VICE PRESIDENTS AT THREE LARGE HOSPITAL ORGANIZATIONS, REGIONAL CEOS AND CFOS AND THE PRESIDENT AND SENIOR VICE PRESIDENTS OF AHSSHC). IN THE CURRENT YEAR, FOR THIS FILING ORGANIZATION, ONE EXECUTIVE WAS ELIGIBLE TO RECEIVE REIMBURSEMENT FOR CLUB FEES. EACH AHS EXECUTIVE WHO IS APPROVED FOR A CLUB MEMBERSHIP MUST SUBMIT AN ANNUAL REPORT TO THE AHSSHC BOARD STRATEGY & COMPENSATION COMMITTEE THAT DESCRIBES HOW THE MEMBERSHIP BENEFITED THEIR ORGANIZATION DURING THE PRECEDING YEAR.
PART I, LINE 4BAS DISCUSSED IN LINE 1A ABOVE, EXECUTIVES ON THE FILING ORGANIZATION'S MANAGEMENT TEAM THAT HOLD THE POSITION OF VICE-PRESIDENT OR ABOVE ARE COMPENSATED BY AND ON THE PAYROLL OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), THE PARENT ORGANIZATION OF A HEALTHCARE SYSTEM KNOWN AS ADVENTIST HEALTH SYSTEM (AHS). IN RECOGNITION OF THE CONTRIBUTION THAT EACH EXECUTIVE MAKES TO THE SUCCESS OF AHS, AHS PROVIDES TO ELIGIBLE EXECUTIVES PARTICIPATION IN THE AHS EXECUTIVE FLEX BENEFIT PROGRAM (THE PLAN). THE PURPOSE OF THE PLAN IS TO OFFER ELIGIBLE EXECUTIVES AN OPPORTUNITY TO ELECT FROM AMONG A VARIETY OF SUPPLEMENTAL BENEFITS, INCLUDING DEFERRED COMPENSATION BENEFITS TAXABLE UNDER INTERNAL REVENUE CODE (IRC) SECTION 457(F), TO INDIVIDUALLY TAILOR A BENEFITS PROGRAM APPROPRIATE TO EACH EXECUTIVE'S NEEDS. THE PLAN PROVIDES ELIGIBLE PARTICIPANTS A PRE-DETERMINED BENEFITS ALLOWANCE CREDIT THAT IS EQUAL TO A PERCENTAGE OF THE EXECUTIVE'S BASE PAY FROM WHICH IS DEDUCTED THE COST OF MANDATORY AND ELECTIVE EMPLOYEE BENEFITS. THE PRE-DETERMINED BENEFITS ALLOWANCE CREDIT PERCENTAGE IS APPROVED BY THE AHS BOARD STRATEGY & COMPENSATION COMMITTEE, AN INDEPENDENT COMMITTEE OF THE BOARD OF DIRECTORS OF AHSSHC. ANY FUNDS THAT REMAIN AFTER THE COST OF MANDATORY AND ELECTIVE BENEFITS ARE SUBTRACTED FROM THE 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 MICHAEL H. SCHULTZ $91,255 $995,981 MARK E. LAROSE $53,478 $ 0 DEBORA H. THOMAS $18,979 $ 0 SANDRA K. JOHNSON $46,263 $497,066 DAVID A. OTTATI $14,825 $ 0 JOEL D. JOHNSON $31,533 $231,742 LEWIS A. SEIFERT $42,022 $ 0 DARLINDA G. COPELAND $22,986 $ 0 ELIZABETH WEAGRAFF $11,609 $ 0 DARYL TOL $34,812 $ 0 RONALD JIMENEZ $20,439 $ 0 NIGEL HINDS $ 3,942 $ 0 DANIEL WOLCOTT $11,138 $ 0
PART I, LINE 6THE FILING ORGANIZATION'S PHYSICIAN COMPENSATION FORMULA IS DESIGNED TO RESULT IN TOTAL COMPENSATION THAT WOULD BE REASONABLE FOR EACH PHYSICIAN. SINCE IMPLEMENTING THE PRODUCTIVITY-BASED INCENTIVE COMPENSATION MODEL, THE FINANCIAL LOSSES FROM THE OPERATIONS OF ORGANIZATION'S PHYSICIAN PRACTICES HAVE SIGNIFICANTLY DECREASED, AND ESTABLISHED PHYSICIAN PRACTICES HAVE GENERALLY BECOME PROFITABLE. 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 EMPLOYED PHYSICIANS ENTER INTO A WRITTEN AGREEMENT THAT REQUIRES THE PHYSICIANS TO PROVIDE MEDICAL CARE TO INDIVIDUALS WHO ARE REFERRED BY THE FILING ORGANIZATION. PURSUANT TO THE AGREEMENT, AN INDIVIDUAL MAY NOT BE REJECTED AS A PATIENT BY A PHYSICIAN DUE TO RACE, SEX, AGE, COLOR, CREED, NATIONAL ORIGIN OR INABILITY TO PAY. THE FILING ORGANIZATION'S COMPENSATION ARRANGEMENT DOES NOT USE A METHOD OF COMPENSATION THAT IS BASED UPON A PERCENTAGE OF THE ORGANIZATION'S NET INCOME. RATHER, UNDER THE COMPENSATION ARRANGEMENT, PHYSICIAN BASE SALARY IS SET BASED ON FAIR MARKET VALUE BENCHMARKS, AND ANY ADDITIONAL COMPENSATION IS BASED ON A PERCENTAGE OF THE PRACTICE/LOCATION NET REVENUE.
PART IIIPART I, QUESTION 3: AS NOTED IN OUR RESPONSE TO QUESTION 15 OF PART VI OF FORM 990, THE INDIVIDUAL WHO SERVES AS THE CEO OF THE FILING ORGANIZATION IS COMPENSATED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC) FOR THAT INDIVIDUAL'S ROLE IN SERVING AS THE 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.SUPPLEMENTAL INFORMATION

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
TREVOR COPELAND
FAMILY MEMBER OF BOARD MEMBER26852EMPLOYEE COMPENSATION0
RONALD THOMAS
FAMILY MEMBER OF BOARD MEMBER14845EMPLOYEE COMPENSATION0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 6MEMORIAL HEALTH SYSTEMS, 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 7ATHE 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 7BAHSSI, 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, AMEND, RESTATE, AND REPEAL THE ARTICLES OF INCORPORATION OR BYLAWS OF THE FILING ORGANIZATION; C) TO SET LIMITS AND TERMS FOR THE BORROWING OF FUNDS; D) TO APPROVE OR DISAPPROVE THE PURCHASE OR SALE OF PERSONAL PROPERTY OR REAL PROPERTY EQUAL TO OR IN EXCESS OF CERTAIN DOLLAR AMOUNT THRESHOLDS; 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; G) TO ESTABLISH GENERAL GUIDING POLICIES, TO IMPLEMENT QUALITY ASSESSMENT, IMPROVEMENT AND UTILIZATION REVIEW PROGRAMS; AND H) TO APPROVE THE APPOINTMENT OF AN AUDITING FIRM AND ELECTION OF THE FISCAL YEAR FOR THE FILING ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 11THE FILING ORGANIZATION'S CURRENT YEAR FORM 990 WAS REVIEWED BY THE BOARD CHAIRMAN, BOARD FINANCE COMMITTEE CHAIR, CEO AND BY THE CFO PRIOR TO ITS FILING WITH THE IRS. THE REVIEW CONDUCTED BY THE BOARD CHAIRMAN, BOARD FINANCE COMMITTEE CHAIR, 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.
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 12C
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, CFO OR VICE PRESIDENT 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 B, LINE 15
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.FORM 990, PART VI, SECTION C, LINE 19
FOR THOSE BOARD OF TRUSTEE MEMBERS WHO DEVOTE LESS THAN FULL-TIME TO THE FILING ORGANIZATION (BASED UPON THE AVERAGE NUMBER OF HOURS PER WEEK SHOWN IN COLUMN (B) ON PAGE 7 OF THE RETURN) THE COMPENSATION AMOUNTS SHOWN IN COLUMNS (E) AND (F) ON PAGE 7 WERE PROVIDED IN CONJUNCTION WITH THAT PERSON'S RESPONSIBILITIES AND ROLES IN SERVING IN AN EXECUTIVE LEADERSHIP POSITION WITHIN ADVENTIST HEALTH SYSTEM.PART VII, SECTION A
THE MEMBERS OF THE BOARD OF DIRECTORS WHO RECEIVED COMPENSATION FROM A RELATED ORGANIZATION AS SHOWN IN COLUMN (E) AND (F) OF SECTION A EACH DEVOTE APPROXIMATELY 50 HOURS PER WEEK IN CONJUNCTION WITH SERVING IN THEIR RESPECTIVE EXECUTIVE LEADERSHIP POSITION WITHIN ADVENTIST HEALTH SYSTEM.PART VII, SECTION A, COLUMN (B)
CHANGES IN NET ASSETS OR FUND BALANCES:TRANSFER TO TAX-EXEMPT PARENT CORPORATION -1,308,843. ALLOCATIONS WITH RESPECT TO TAX-EXEMPT DEBT 213,409. UNREALIZED LOSS ON DSRF FUNDS -26,927. GIFTS - TEMPORARILY RESTRICTED 296,868. CHANGE IN INVESTMENT IN RELATED FOUNDATION - TEMPORARILY RESTRICTED 52,341. TOTAL TO FORM 990, PART XI, LINE 5: -773,152.FORM 990, PART XI, LINE 5:
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.PART X, LINE 2

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (102 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
ADVENTIST BOLINGBROOK HOSPITAL
500 REMINGTON BLVDBOLINGBROOKIL60440651219504OPERATION OF HOSPITAL & RELATED SERVICESIL501(C)(3)170(B)(1)(A)(III)ADVENTIST HEALTH SYSTEMSUNBELT INC0
ADVENTIST CARE CENTERS - COURTLAND INC
730 COURTLAND STREETORLANDOFL32804205774723OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERYFL501(C)(3)509(A)(2)SUNBELT HEALTH CARE CENTERS INC0
ADVENTIST GLENOAKS HOSPITAL
701 WINTHROP AVENUEGLENDALE HEIGHTSIL60139363208390OPERATION OF HOSPITAL & RELATED SERVICESIL501(C)(3)170(B)(1)(A)(III)ADVENTIST HEALTH SYSTEMSUNBELT INC0
ADVENTIST HEALTH MID-AMERICA INC
9100 W 74TH STREETSHAWNEE MISSIONKS66204521347407HEALTHCARE RELATED SERVICESKS501(C)(3)509(A)(3) TYPE IADVENTIST HEALTH SYSTEMSUNBELT INC0
ADVENTIST HEALTH PARTNERS INC
1000 REMINGTON BLVD STE 200BOLINGBROOKIL60440364138353OPERATE OUT-PATIENT PHYSICIAN CLINICSIL501(C)(3)170(B)(1)(A)(III)AHS MIDWEST MANAGEMENT INC0
ADVENTIST HEALTH SYSTEM AFFILIATED BENEFIT TRUST
111 N ORLANDO AVENUEWINTER PARKFL32789266422966PROMOTION OF HEALTHCAREFL501(C)(3)509(A)(3) TYPE IADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION0
ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION
111 N ORLANDO AVENUEWINTER PARKFL32789592170012MANAGEMENT SERVICESFL501(C)(3)509(A)(3) TYPE I0N/A
ADVENTIST HEALTH SYSTEMGEORGIA INC
1035 RED BUD ROADCALHOUNGA30701581425000OPERATION OF HOSPITAL & RELATED SERVICESGA501(C)(3)170(B)(1)(A)(III)ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION0
ADVENTIST HEALTH SYSTEMSUNBELT INC
111 N ORLANDO AVENUEWINTER PARKFL32789591479658OPERATION OF HOSPITAL & RELATED SERVICESFL501(C)(3)170(B)(1)(A)(III)ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION0
ADVENTIST HEALTH SYSTEMTEXAS INC
602 COURTLAND STREETORLANDOFL32804742578952INACTIVETX501(C)(3)509(A)(2)ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION0
ADVENTIST HINSDALE HOSPITAL
120 NORTH OAK STREETHINSDALEIL60521362276984OPERATION OF HOSPITAL & RELATED SERVICESIL501(C)(3)170(B)(1)(A)(III)ADVENTIST HEALTH SYSTEMSUNBELT INC0
AHS MIDWEST MANAGEMENT INC
1000 REMINGTON BLVD STE 200BOLINGBROOKIL60440363354567OPERATION OF OCCUPATIONAL HLTH CLINIC & PHYSICIAN PRACTICE MGMTIL501(C)(3)509(A)(3) TYPE IADVENTIST HEALTH SYSTEMSUNBELT INC0
AHSCENTRAL TEXAS INC
1301 WONDER WORLD DRIVESAN MARCOSTX78666742621825PROVIDE OFFICE SPACE - MEDICAL PROFESSIONALSTX501(C)(3)509(A)(3) TYPE III-FADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION0
APOPKA HEALTH CARE PROPERTIES INC
305 E OAK STREETAPOPKAFL32703510605694LEASE TO RELATED ORGANIZATIONGA501(C)(3)509(A)(3) TYPE III-FSUNBELT HEALTH CARE CENTERS INC0
BATTLE CREEK ADVENTIST HOSPITAL
1000 REMINGTON BLVD STE 200BOLINGBROOKIL60440381359189OPERATION OF HOSPITAL & RELATED SERVICESMI501(C)(3)170(B)(1)(A)(III)ADVENTIST HEALTH SYSTEMSUNBELT INC0
BERT FISH MEDICAL CENTER INC (10110-63011)
401 PALMETTO STREETNEW SMYRNA BEACHFL32168362276984OPERATION OF HOSPITAL & RELATED SERVICESFL501(C)(3)170(B)(1)(A)(III)ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION0
BOLINGBROOK HOSPITAL FOUNDATION
1000 REMINGTON BLVD N ENTRANCE 2NDBOLINGBROOKIL60440900494445FUND-RAISING FOR TAX-EXEMPT HOSPITALIL501(C)(3)170(B)(1)(A)(VI)MIDWEST HEALTH FOUNDATION0
BRADFORD HEIGHTS HEALTH & REHAB CENTER INC
950 HIGHPOINT DRIVEHOPKINSVILLEKY42240205782342OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERYKY501(C)(3)509(A)(2)SUNBELT HEALTH CARE CENTERS INC0
BURLESON NURSING & REHAB CENTER INC
301 HUGULEY BLVDBURLESONTX76028205782243OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERYTX501(C)(3)509(A)(2)SUNBELT HEALTH CARE CENTERS INC0
CALDWELL HEALTH CARE PROPERTIES INC
1333 WEST MAINPRINCETONKY42445510605680LEASE TO RELATED ORGANIZATIONGA501(C)(3)509(A)(3) TYPE III-FSUNBELT HEALTH CARE CENTERS INC0
CENTRAL TEXAS MEDICAL CENTER FOUNDATION
1301 WONDER WORLD DRIVESAN MARCOSTX78666742259907FUND-RAISING FOR TAX-EXEMPT HOSPITALTX501(C)(3)170(B)(1)(A)(VI)ADVENTIST HEALTH SYSTEMSUNBELT INC0
CHICKASAW HEALTH CARE PROPERTIES INC
250 S CHICKASAW TRAILORLANDOFL32825510605681LEASE TO RELATED ORGANIZATIONGA501(C)(3)509(A)(3) TYPE III-FSUNBELT HEALTH CARE CENTERS INC0
CHIPPEWA VALLEY HOSPITAL & OAKVIEW CARE CENTER INC
1220 THIRD AVENUE WESTDURANDWI54736391365168OPERATION OF HOSPITAL & RELATED SERVICESWI501(C)(3)170(B)(1)(A)(III)ADVENTIST HEALTH SYSTEMSUNBELT INC0
COBB MEDICAL ASSOCIATES LLC
3949 SOUTH COBB DRIVE SESMYRNAGA300806342582617089OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICESGA501(C)(3)170(B)(1)(A)(III)EMORY-ADVENTIST INC0
COURTLAND HEALTH CARE PROPERTIES INC
730 COURTLAND STREETORLANDOFL32804510605682LEASE TO RELATED ORGANIZATIONGA501(C)(3)509(A)(3) TYPE III-FSUNBELT HEALTH CARE CENTERS INC0
CREEKWOOD PLACE NURSING & REHAB CENTER INC
683 E THIRD STREETRUSSELLVILLEKY42276205782260OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERYKY501(C)(3)509(A)(2)SUNBELT HEALTH CARE CENTERS INC0
DAIRY ROAD HEALTH CARE PROPERTIES INC
7350 DAIRY ROADZEPHYRHILLSFL33540510605684LEASE TO RELATED ORGANIZATIONGA501(C)(3)509(A)(3) TYPE III-FSUNBELT HEALTH CARE CENTERS INC0
EAST ORLANDO HEALTH & REHAB CENTER INC
250 S CHICKASAW TRAILORLANDOFL32825205774748OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERYFL501(C)(3)509(A)(2)SUNBELT HEALTH CARE CENTERS INC0
EMORY-ADVENTIST INC
3949 SOUTH COBB DRIVESMYRNAGA30080582171011OPERATION OF HOSPITAL & RELATED SVCSGA501(C)(3)170(B)(1)(A)(III)ADVENTIST HEALTH SYSTEMSUNBELT INC0
FLETCHER HOSPITAL INC
100 HOSPITAL DRIVEHENDERSONVILLENC28792560543246OPERATION OF HOSPITAL & RELATED SVCSNC501(C)(3)170(B)(1)(A)(III)ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION0
FLNC INC
3355 E SEMORAN BLVDAPOPKAFL32703205774761OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERYFL501(C)(3)509(A)(2)SUNBELT HEALTH CARE CENTERS INC0
FLORIDA HOSPITAL COLLEGE OF HEALTH SCIENCES INC (630 YEAR END)
671 LAKE WINYAH DRIVEORLANDOFL32803593069793EDUCATION/OPERATION OF SCHOOLFL501(C)(3)170(B)(1)(A)(II)ADVENTIST HEALTH SYSTEMSUNBELT INC0
FLORIDA HOSPITAL DELAND AUXILIARY INC
701 WEST PLYMOUTH AVENUEDELANDFL32720593425543VOLUNTEER SUPPORT SERVICESFL501(C)(3)509(A)(3) TYPE III-FMEMORIAL HOSPITAL WEST VOLUSIA INC0
FLORIDA HOSPITAL WATERMAN INC
1000 WATERMAN WAYTAVARESFL32778593140669OPERATION OF HOSPITAL & RELATED SERVICESFL501(C)(3)170(B)(1)(A)(III)ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION0
FLORIDA HOSPITAL WESLEY CHAPEL INC
2528 BRUCE B DOWNS BLVD CR 581 SWESLEY CHAPELFL33543203965753INACTIVEFL501(C)(3)509(A)(3) TYPE III-FADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION0
FLORIDA HOSPITAL ZEPHYRHILLS INC
7050 GALL BLVDZEPHYRHILLSFL33541592108057OPERATION OF HOSPITAL & RELATED SERVICESFL501(C)(3)170(B)(1)(A)(III)ADVENTIST HEALTH SYSTEMSUNBELT INC0
FLORIDA PHYSICIANS MEDICAL GROUP INC
900 WINDERLEY PLACEMAITLANDFL32751593214635OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICESFL501(C)(3)170(B)(1)(A)(III)ADVENTIST HEALTH SYSTEMSUNBELT INC0
FOUNDATION FOR SHAWNEE MISSION MEDICAL CENTER INC
9100 W 74TH STREETSHAWNEE MISSIONKS66204480868859FUND-RAISING FOR TAX-EXEMPT HOSPITALKS501(C)(3)509(A)(3) TYPE ISHAWNEE MISSION MEDICAL CENTER INC0
GLENOAKS HOSPITAL FOUNDATION
701 WINTHROP AVENUEGLENDALE HEIGHTSIL60139363926044FUND-RAISING FOR TAX-EXEMPT HOSPITALIL501(C)(3)170(B)(1)(A)(VI)MIDWEST HEALTH FOUNDATION0
HAYS MEMORIAL HOSPITAL ASSOCIATION OF SEVENTH-DAY ADVENTISTS
1301 WONDER WORLD DRIVESAN MARCOSTX78667741362785LEASE OF HOSPITAL PERSONNELTX501(C)(3)509(A)(3) TYPE IIADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION0
HELEN ELLIS MEMORIAL HOSPITAL AUXILIARY INC (51-123110)
1395 S PINELLAS AVETARPON SPRINGSFL34689592106043FUND-RAISING FOR TAX-EXEMPT HOSPITAL/FOUNDATIONFL501(C)(3)509(A)(3) TYPE ITARPON SPRINGS HOSPITAL FOUNDATION INC0
HELEN ELLIS MEMORIAL HOSPITAL FOUNDATION INC (101-123110)
1395 S PINELLAS AVETARPON SPRINGSFL34689593690149FUND-RAISING FOR TAX-EXEMPT HOSPITALFL501(C)(3)509(A)(3) TYPE ITARPON SPRINGS HOSPITAL FOUNDATION INC0
HINSDALE HOSPITAL FOUNDATION
7 SALT CREEK LANE SUITE 203HINSDALEIL60521521466387FUND-RAISING FOR TAX-EXEMPT HOSPITALIL501(C)(3)170(B)(1)(A)(VI)MIDWEST HEALTH FOUNDATION0
IN-MOTION REHAB INC
602 COURTLAND STREET STE 200ORLANDOFL32804208023411THERAPY SERVICES TO TAX EXEMPT NURSING HOMESKS501(C)(3)509(A)(3) TYPE IISUNBELT HEALTH CARE CENTERS INC0
JELLICO COMMUNITY HOSPITAL INC
188 HOSPITAL LANEJELLICOTN37762620924706OPERATION OF HOSPITAL & RELATED SERVICESTN501(C)(3)170(B)(1)(A)(III)ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION0
LA GRANGE MEMORIAL HOSPITAL FOUNDATION
5101 S WILLOW SPRINGS RDLA GRANGEIL60525300247776FUND-RAISING FOR TAX-EXEMPT HOSPITALIL501(C)(3)170(B)(1)(A)(VI)MIDWEST HEALTH FOUNDATION0
MEMORIAL HEALTH SYSTEMS FOUNDATION INC
770 WEST GRANADA BLVDORMOND BEACHFL32174311771522FUND-RAISING FOR TAX-EXEMPT HOSPITALFL501(C)(3)170(B)(1)(A)(VI)MEMORIAL HEALTH SYSTEMS INC0
MEMORIAL HEALTH SYSTEMS INC
301 MEMORIAL MEDICAL PARKWAYDAYTONA BEACHFL32117590973502OPERATION OF HOSPITAL & RELATED SERVICESFL501(C)(3)170(B)(1)(A)(III)ADVENTIST HEALTH SYSTEMSUNBELT INC0
MEMORIAL HOSPITAL - FLAGLER INC
60 MEMORIAL MEDICAL PARKWAYPALM COASTFL32164592951990OPERATION OF HOSPITAL & RELATED SERVICESFL501(C)(3)170(B)(1)(A)(III)MEMORIAL HEALTH SYSTEMS INC1
MEMORIAL HOSPITAL - WEST VOLUSIA INC
701 WEST PLYMOUTH AVENUEDELANDFL32720593256803OPERATION OF HOSPITAL & RELATED SERVICESFL501(C)(3)170(B)(1)(A)(III)MEMORIAL HEALTH SYSTEMS INC1
MEMORIAL HOSPITAL INC
210 MARIE LANGDON DRIVEMANCHESTERKY40962610594620OPERATION OF HOSPITAL & RELATED SERVICESKY501(C)(3)170(B)(1)(A)(III)ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION0
MERRIAM HEALTH CARE PROPERTIES INC
9700 WEST 62ND STREETMERRIAMKS66203364595806LEASE TO RELATED ORGANIZATIONKS501(C)(3)509(A)(3) TYPE III-FSUNBELT HEALTH CARE CENTERS INC0
METROPLEX ADVENTIST HOSPITAL INC
2201 S CLEAR CREEK ROADKILLEENTX76549742225672OPERATION OF HOSPITAL & RELATED SERVICESTX501(C)(3)170(B)(1)(A)(III)ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION0
METROPLEX CLINIC PHYSICIANS INC
2201 S CLEAR CREEK ROADKILLEENTX76549113762050PHYSICIAN HEALTHCARE SERVICES TO THE COMMUNITYTX501(C)(3)170(B)(1)(A)(III)METROPLEX ADVENTIST HOSPITAL INC0
MIDWEST HEALTH FOUNDATION
120 NORTH OAK STREETHINSDALEIL60521352230515SUPPORT OF SUBSIDIARY FOUNDATIONSIL501(C)(3)509(A)(3) TYPE II0N/A
MILLS HEALTH & REHAB CENTER INC
500 BECK LANEMAYFIELDKY42066205782320OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERYKY501(C)(3)509(A)(2)SUNBELT HEALTH CARE CENTERS INC0
MISSION STRATEGIES INC
602 COURTLAND STREET STE 200ORLANDOFL32804205982365PROVISION OF SUPPORT TO THE NURSING HOME DIVISIONKS501(C)(3)509(A)(3) TYPE IISUNBELT HEALTH CARE CENTERS INC0
MISSOURI ADVENTIST HEALTH INC
9100 W 74TH STREETSHAWNEE MISSIONKS66204431224729SUPPORT HEALTH CARE SERVICESMO501(C)(3)509(A)(3) TYPE III-OADVENTIST HEALTH MID-AMERICA INC0
NORTH REGIONAL EMS INC
188 HOSPITAL LANEJELLICOTN37762262653616EMS SERVICESTN501(C)(3)509(A)(2)JELLICO COMMUNITY HOSPITAL INC0
ORMOND BEACH MEMORIAL HOSPITAL AUXILIARY INC
301 MEMORIAL MEDICAL PARKWAYDAYTONA BEACHFL32117591721962VOLUNTEER SUPPORT SERVICESFL501(C)(3)509(A)(3) TYPE III-FMEMORIAL HEALTH SYSTEMS INC0
OVERLAND PARK NURSING & REHAB CENTER INC
6501 WEST 75TH STREETOVERLAND PARKKS66204205774821OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERYKS501(C)(3)509(A)(2)SUNBELT HEALTH CARE CENTERS INC0
PARAGON HEALTH CARE PROPERTIES INC
950 HIGHPOINT DRIVEHOPKINSVILLEKY42240510605686LEASE TO RELATED ORGANIZATIONGA501(C)(3)509(A)(3) TYPE III-FSUNBELT HEALTH CARE CENTERS INC0
PORTERCARE ADVENTIST HEALTH SYSTEM (630 YEAR END)
2525 S DOWNING STREETDENVERCO80210840438224OPERATION OF HOSPITAL & RELATED SERVICESCO501(C)(3)170(B)(1)(A)(III)ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION0
PORTLAND NURSING & REHAB CENTER INC
215 HIGHLAND CIRCLE DRIVEPORTLANDTN37148205774842OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERYTN501(C)(3)509(A)(2)SUNBELT HEALTH CARE CENTERS INC0
PRINCETON HEALTH & REHAB CENTER INC
1333 WEST MAINPRINCETONKY42445205782272OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERYKY501(C)(3)509(A)(2)SUNBELT HEALTH CARE CENTERS INC0
PRINCETON PROFESSIONAL SERVICES INC
601 E ROLLINS STREETORLANDOFL32803591191045PROVISION OF HEALTHCARE SERVICESFL501(C)(3)509(A)(2)ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION0
QUALITY CIRCLE FOR HEALTHCARE INC
111 N ORLANDO AVENUEWINTER PARKFL32789263789368HEALTHCARE QUALITY SERVICESFL501(C)(3)509(A)(3) TYPE III-FADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION0
RESOURCE PERSONNEL INC
602 COURTLAND STREET STE 200ORLANDOFL32804208040875PROVIDE ADMINISTRATIVE SUPPORT TO TAX EXEMPT NURSING HOMESFL501(C)(3)509(A)(3) TYPE IISUNBELT HEALTH CARE CENTERS INC0
ROCKY MOUNTAIN ADVENTIST HEALTHCARE FOUNDATION (630 YEAR END)
2525 SOUTH DOWNING STREETDENVERCO80210840745018FUND-RAISING FOR TAX-EXEMPT HOSPITALCO501(C)(3)170(B)(1)(A)(VI)PORTERCARE ADVENTIST HEALTH SYSTEM0
ROLLINS BEDFORD CORPORATION
602 COURTLAND STREET STE 200ORLANDOFL32804370908840INACTIVEFL501(C)(3)509(A)(3) TYPE IISUNBELT HEALTH CARE CENTERS INC0
RUSSELLVILLE HEALTH CARE PROPERTIES INC
683 EAST THIRD STREETRUSSELLVILLEKY42276510605691LEASE TO RELATED ORGANIZATIONGA501(C)(3)509(A)(3) TYPE III-FSUNBELT HEALTH CARE CENTERS INC0
SAN MARCOS HEALTH CARE PROPERTIES INC
1900 MEDICAL PARKWAYSAN MARCOSTX78666510605693LEASE TO RELATED ORGANIZATIONGA501(C)(3)509(A)(3) TYPE III-FSUNBELT HEALTH CARE CENTERS INC0
SAN MARCOS NURSING & REHAB CENTER INC
1900 MEDICAL PARKWAYSAN MARCOSTX78666205782224OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERYTX501(C)(3)509(A)(2)SUNBELT HEALTH CARE CENTERS INC0
SHAWNEE MISSION HEALTH CARE INC
6501 WEST 75TH STREETOVERLAND PARKKS66204480952508LEASE TO RELATED ORGANIZATIONKS501(C)(3)509(A)(3) TYPE III-FSUNBELT HEALTH CARE CENTERS INC0
SHAWNEE MISSION MEDICAL CENTER INC
9100 W 74TH STREETSHAWNEE MISSIONKS66204480637331OPERATION OF HOSPITAL & RELATED SERVICESKS501(C)(3)170(B)(1)(A)(III)ADVENTIST HEALTH MID-AMERICA INC0
SOUTH CENTRAL NURSING HOMES PROPERTIES INC
111 NORTH ORLANDO AVEWINTER PARKFL32789593686109MANAGEMENT SUPPORTGA501(C)(3)509(A)(3) TYPE III-OSOUTH CENTRAL INC0
SOUTH CENTRAL NURSING HOMES INC
602 COURTLAND STREETORLANDOFL32804611242373MANAGEMENT SUPPORTKY501(C)(3)509(A)(3) TYPE III-OSOUTH CENTRAL INC0
SOUTH CENTRAL PROPERTIES III INC
111 NORTH ORLANDO AVEWINTER PARKFL32789593692860REAL ESTATEGA501(C)(2)SOUTH CENTRAL NURSING HOMES PROPERTIES INC0
SOUTH CENTRAL PROPERTIES IV INC
111 NORTH ORLANDO AVEWINTER PARKFL32789593692862REAL ESTATEGA501(C)(2)SOUTH CENTRAL NURSING HOMES PROPERTIES INC0
SOUTH CENTRAL PROPERTIES VI INC
111 NORTH ORLANDO AVEWINTER PARKFL32789593692857REAL ESTATEGA501(C)(2)SOUTH CENTRAL NURSING HOMES PROPERTIES INC0
SOUTH CENTRAL PROPERTIES INC
111 NORTH ORLANDO AVEWINTER PARKFL32789593651692REAL ESTATEGA501(C)(2)SOUTH CENTRAL NURSING HOMES PROPERTIES INC0
SOUTH CENTRAL INC
602 COURTLAND STREETORLANDOFL32804593689740MANAGEMENT SUPPORTGA501(C)(3)509(A)(3) TYPE III-F0N/A
SOUTH PASCO HEALTH CARE PROPERTIES INC
38250 A AVENUEZEPHYRHILLSFL33542510605679LEASE TO RELATED ORGANIZATIONGA501(C)(3)509(A)(3) TYPE III-FSUNBELT HEALTH CARE CENTERS INC0
SOUTHWEST VOLUSIA HEALTH SERVICES INC
1055 SAXON BLVDORANGE CITYFL327638468593281591MEDICAL OFFICE BUILDING FOR HOSPITALFL501(C)(3)509(A)(3) TYPE ISOUTHWEST VOLUSIA HEALTHCARE CORPORATION0
SOUTHWEST VOLUSIA HEALTHCARE CORPORATION
1055 SAXON BLVDORANGE CITYFL327638468593149293OPERATION OF HOSPITAL & RELATED SERVICESFL501(C)(3)170(B)(1)(A)(III)ADVENTIST HEALTH SYSTEMSUNBELT INC0
SPECIALTY PHYSICIANS OF CENTRAL TEXAS INC
1301 WONDER WORLD DRIVESAN MARCOSTX78666208814408PHYSICIAN HEALTHCARE SERVICES TO THE COMMUNITYTX501(C)(3)170(B)(1)(A)(III)ADVENTIST HEALTH SYSTEMSUNBELT INC0
SPRING VIEW HEALTH & REHAB CENTER INC
718 GOODWIN LANELEITCHFIELDKY42754205782288OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERYKY501(C)(3)509(A)(2)SUNBELT HEALTH CARE CENTERS INC0
SUNBELT HEALTH & REHAB CENTER - APOPKA INC
305 EAST OAK STREETAPOPKAFL32703205774856OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERYFL501(C)(3)509(A)(2)SUNBELT HEALTH CARE CENTERS INC0
SUNBELT HEALTH CARE CENTERS INC
602 COURTLAND STREET STE 200ORLANDOFL32804581473135MANAGEMENT SERVICESTN501(C)(3)509(A)(3) TYPE IIADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION0
SUNSYSTEM DEVELOPMENT CORPORATION
111 N ORLANDO AVENUEWINTER PARKFL32789592219301FUND RAISING FOR AFFILIATED TAX-EXEMPT HOSPITALSFL501(C)(3)170(B)(1)(A)(VI)ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION0
TARPON SPRINGS HOSP FOUNDATION INC (101-123110)
1395 S PINELLAS AVETARPON SPRINGSFL34689590898901OPERATION OF HOSPITAL & RELATED SERVICESFL501(C)(3)170(B)(1)(A)(III)UNIVERSITY COMMUNITY HOSPITAL INC0
TARRANT COUNTY HEALTH CARE PROPERTIES INC
301 HUGULEY BLVDBURLESONTX76028510605677LEASE TO RELATED ORGANIZATIONGA501(C)(3)509(A)(3) TYPE III-FSUNBELT HEALTH CARE CENTERS INC0
TAYLOR CREEK HEALTH CARE PROPERTIES INC
718 GOODWIN LANELEITCHFIELDKY42754510605678LEASE TO RELATED ORGANIZATIONGA501(C)(3)509(A)(3) TYPE III-FSUNBELT HEALTH CARE CENTERS INC0
THE VOLUNTEER AUXILIARY OF FLORIDA HOSPITAL - FLAGLER INC
60 MEMORIAL MEDICAL PARKWAYPALM COASTFL32164592486582VOLUNTEER SUPPORT SERVICESFL501(C)(3)509(A)(3) TYPE III-FMEMORIAL HOSPITAL FLAGLER INC0
TRINITY NURSING & REHAB CENTER INC
9700 WEST 62ND STREETMERRIAMKS66203205774890OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERYKS501(C)(3)509(A)(2)SUNBELT HEALTH CARE CENTERS INC0
UNIVERSITY COMMUNITY HOSPITAL AUXILIARY INC(101-123110)
3100 E FLETCHER AVETAMPAFL33613237011345VOLUNTEER SUPPORT SERVICESFL501(C)(3)509(A)(3) TYPE III-FUNIVERSITY COMMUNITY HOSPITAL INC0
UNIVERSITY COMMUNITY HOSPITAL FOUNDATION INC(101-123110)
3100 E FLETCHER AVETAMPAFL33613592554889FUND-RAISING FOR TAX-EXEMPT HOSPITALFL501(C)(3)509(A)(3) TYPE IUNIVERSITY COMMUNITY HOSPITAL INC0
UNIVERSITY COMMUNITY HOSPITAL SPECIALTY CARE INC(101-123110)
3100 E FLETCHER AVETAMPAFL33613593231322INACTIVEFL501(C)(3)509(A)(3)UNIVERSITY COMMUNITY HOSPITAL INC0
UNIVERSITY COMMUNITY HOSPITAL INC(101-123110)
3100 E FLETCHER AVETAMPAFL33613591113901OPERATION OF HOSPITAL & RELATED SERVICESFL501(C)(3)170(B)(1)(A)(III)ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION0
WEST KENTUCKY HEALTH CARE PROPERTIES INC
500 BECK LANEMAYFIELDKY42066510605676LEASE TO RELATED ORGANIZATIONGA501(C)(3)509(A)(3) TYPE III-FSUNBELT HEALTH CARE CENTERS INC0
ZEPHYR HAVEN HEALTH & REHAB CENTER INC
38250 A AVENUEZEPHYRHILLSFL33542205774930OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERYFL501(C)(3)509(A)(2)SUNBELT HEALTH CARE CENTERS INC0
ZEPHYRHILLS HEALTH & REHAB CENTER INC
7350 DAIRY ROADZEPHYRHILLSFL33540205774967OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERYFL501(C)(3)509(A)(2)SUNBELT HEALTH CARE CENTERS INC0

Form990 Schedule R Part III Form990ScheduleRPartIII (10 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNA
APPALACHIAN THERAPY SERVICES LLC
100 HOSPITAL DRIVEHENDERSONVILLENC28792202463851THERAPY STAFFINGNCN/A
CLEAR CREEK MOB LTD
2201 S CLEAR CREEK RDKILLEENTX76549742609195REAL ESTATETXN/A
FLORIDA HOSPITAL DMERT LLC
2450 MAITLAND CENTER PKWY STE 200MAITLANDFL32751202392253MEDICAL EQUIPMENTFLN/A
FLORIDA HOSPITAL HOME INFUSION
2450 MAITLAND CENTER PKWY STE 200MAITLANDFL32751593142824HOME INFUSION SERVICESFLN/A
KCCCSMMC CANCER CENTER LLC
9100 W 74TH STREETSHAWNEE MISSIONKS66204270909763EQUIPMENT RENTALKSN/A
SAN MARCOS MRI LP
1330 WONDER WORLD DRIVE STE 202SAN MARCOSTX78666770597972IMAGING & TESTINGTXN/A
SHAWNEE MISSION OPEN MRI LLC
9100 W 74TH STREET BOX 2923SHAWNEE MISSIONKS66201270011796IMAGING & TESTINGKSN/A
SHAWNEE MISSION PRAIRIE STAR SURGERY CENTER LLC
23401 PRAIRIE STAR PARKWAYLENEXAKS66227364634843SURGICAL CENTERKSN/A
SHAWNEE MISSION SURGERY CENTER LLC
PO BOX 2923SHAWNEE MISSIONKS66201481243914SURGICAL SERVICESKSN/A
SKYLAND MRI LLC
100 HOSPITAL DRIVEHENDERSONVILLENC28792043646559IMAGING & TESTINGNCN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (32 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Share Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipAddress Line1AddressForeign/AddressLine1Province Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountry
ADVENTIST HEALTH SYS SUNBELT HEALTHCARE CORP EMPLOYEE BENEFIT TRUST
111 N ORLANDO AVENUEWINTER PARKFL32789581318939ADMINISTRATION OF SELF-INSURED BENEFIT PLANSFLN/AT
AHS SERVICES INC
11801 SOUTH FREEWAYFORT WORTHTX76028752049583MEDICAL EQUIPMENTTXN/AC
ALTAMONTE MEDICAL PLAZA CONDOMINIUM ASSOCIATION INC
601 EAST ROLLINS STREETORLANDOFL32803592855792CONDO ASSOCIATIONFLN/AC
APOPKA MEDICAL PLAZA CONDOMINIUM ASSOCIATION INC
601 EAST ROLLINS STREETORLANDOFL32803593000857CONDO ASSOCIATIONFLN/AC
ARAPAHOE MEDICAL BUILDING I INC (630 YEAR END)
2525 S DOWNING STREETDENVERCO80210841574506REAL ESTATE LEASINGCON/AC
ARAPAHOE MEDICAL BUILDING II INC (630 YEAR END)
2525 S DOWNING STREETDENVERCO80210841574507REAL ESTATE LEASINGCON/AC
CC MOB INC
2201 S CLEAR CREEK ROADKILLEENTX76549742616875REAL ESTATE RENTALTXN/AC
CENTRAL TEXAS MEDICAL ASSOCIATES
1301 WONDER WORLD DRIVESAN MARCOSTX78666742729873PHYSICIAN CLINICSTXN/AC
CENTRAL TEXAS PROVIDER'S NETWORK
1301 WONDER WORLD DRIVESAN MARCOSTX78666742827652PHYSICIAN HOSPITAL ORG.TXN/AC
FLORIDA HOSPITAL FLAGLER MEDICAL OFFICE ASSOCIATION INC
60 MEMORIAL MEDICAL PARKWAYPALM COASTFL32164262158309CONDO ASSOCIATIONFLN/AC
FLORIDA HOSPITAL HEALTHCARE SYSTEM INC
602 COURTLAND STREETORLANDOFL32804593215680PHO/TPAFLN/AC
FLORIDA MEDICAL PLAZA CONDO ASSOCIATION INC
601 EAST ROLLINS STREETORLANDOFL32803592855791CONDO ASSOCIATIONFLN/AC
FLORIDA MEMORIAL HEALTH NETWORK INC
770 W GRANADA BLVD STE 317ORMOND BEACHFL32174593403558PHYSICIAN HOSPITAL ORG.FLCMEMORIAL HEALTH SYSTEMS INC1110495724802260.56000
HARVARD PARK EAST INC (630 YEAR END)
2525 S DOWNING STREETDENVERCO80210841574365REAL ESTATE LEASINGCON/AC
HELEN ELLIS MEMORIAL HOSPITAL REAL ESTATE CORP (101-123110)
1395 S PINELLAS AVETARPON SPRINGSFL34689593375731REAL ESTATE RENTALFLN/AC
HUGULEY ALLIANCE FOUNDATION
11801 SOUTH FREEWAYFORT WORTHTX76115752642209INACTIVETXN/AC
HUGULEY MEDICAL ASSOCIATES INC
11801 SOUTH FREEWAYBURLESONTX76028752547668PHYSICIAN CLINICSTXN/AC
KISSIMMEE MULTISPECIALTY CLINIC CONDOMINIUM ASSOCIATION INC
201 HILDA STREET SUITE 30KISSIMMEEFL34741593539564CONDO ASSOCIATIONFLN/AC
MIDWEST MANAGEMENT SERVICES INC
9100 WEST 74TH STREETSHAWNEE MISSIONKS66204480901551REAL ESTATE RENTALKSN/AC
METROPLEX ADVENTIST HOSPITAL CRNA
2201 S CLEAR CREEK ROADKILLEENTX76549260760794SUPPORT HOSPITAL THROUGH THE PROVISION OF ALLIED HEALTH PROFESSIONALSTXN/AC
NORTH AMERICAN HEALTH SERVICES INC & SUBS
111 N ORLANDO AVENUEWINTER PARKFL32789621041820LESSOR/HOLDING CO.TNN/AC
ORMOND PROFESSIONAL CONDO ASSOCIATION (430 YEAR END)
770 W GRANADA BLVD STE 101ORMOND BEACHFL32174592694434CONDO ASSOCIATIONFLCMEMORIAL HEALTH SYSTEMS INC39471310.79900
PARK RIDGE PROPERTY OWNER'S ASSOCIATION INC
1 PARK PLACE NAPLES ROADFLETCHERNC28732030380531CONDO ASSOCIATIONNCN/AC
PORTER AFFILIATED HLTH SERVICES INC DBA DIVERSIFIED AFFILIATED HLTH SVCS
2525 S DOWNING STREETDENVERCO80210840956175HEALTHCARE SERVICESCON/AC
PORTER MEDICAL PLAZA INC (630 YEAR END)
2525 S DOWNING STREETDENVERCO80210841574369REAL ESTATE LEASINGCON/AC
REFLECTIONS COMMERCIAL CONDOMINIUM ASSOCIATION INC
875 STERTHAUS AVEORMOND BEACHFL32174593519055CONDO ASSOCIATIONFLN/AC
SAN MARCOS REGIONAL MRI INC
1301 WONDER WORLD DRIVESAN MARCOSTX78666770597968HOLDING COMPANYTXN/AC
SOUTHEAST VOLUSIA MEDICAL SERVICES INC (10110-93011)
401 PALMETTO STREETNEW SMYRNA BEACHFL32168593287185INACTIVEFLN/AC
THE GARDEN RETIREMENT COMMUNITY INC
602 COURTLAND STREET STE 200ORLANDOFL32804593414055REAL ESTATE RENTALFLN/AC
UNIVERSITY COMMUNITY HEALTH INSURANCE COMPANY SPC LTD
CAPTIVE INSURANCEN/ACC/O AON INSURANCE MANAGERS PO BOXGRAND CAYMANCJCJ
UCH SERVICES INC (101-123110)
3100 EAST FLETCHER AVETAMPAFL33613593508454MANAGEMENT COMPANYFLN/AC
WEST COAST MEDICAL GROUP INC (101-123110)
1395 S PINELLAS AVETARPON SPRINGSFL34689593537305PHYSICIAN CLINICSFLN/AC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org1SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (18 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
MEMORIAL HOSPITAL FLAGLER INC
A220536FMV RENTAL RATE
MEMORIAL HOSPITAL FLAGLER INC
K5374729COST
MEMORIAL HOSPITAL FLAGLER INC
P261137COST
MEMORIAL HOSPITAL FLAGLER INC
O959944COST
MEMORIAL HOSPITAL FLAGLER INC
Q4315224COST
MEMORIAL HOSPITAL FLAGLER INC
R374103COST
FLORIDA MEMORIAL HEALTH NETWORK INC
P505731COST
MEMORIAL HOSPITAL WEST VOLUSIA INC
O353380COST
MEMORIAL HOSPITAL WEST VOLUSIA INC
K988993COST
SOUTHWEST VOLUSIA HEALTHCARE CORPORATION
K746501COST
ADVENTIST HEALTH SYSTEMSUNBELT INC DBA FLORIDA HOSPITAL
P135503COST
ADVENTIST HEALTH SYSTEMSUNBELT INC DBA FLORIDA HOSPITAL
L404704COST
MEMORIAL HEALTH SYSTEMS FOUNDATION INC
P151292COST
MEMORIAL HEALTH SYSTEMS FOUNDATION INC
B107561ACTUAL AMOUNT GIVEN
MEMORIAL HEALTH SYSTEMS FOUNDATION INC
C264812ACTUAL AMOUNT RECEIVED
ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION
B1308843ACTUAL AMOUNT GIVEN
ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION
L2124613% OF FACILITY'S OPERATING EXP.
ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION
O9626154COST

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