ADVENTHEALTH WEST FLORIDA AMBULATORY SERVICES INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- ADVENTHEALTH WEST FLORIDA AMBULATORY SERVICES INC (EIN 47-1881744)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-11-10
- IRS object ID
- 202323149349302702
- Schema version
- 2022v5.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-11-10T10:53:29-06:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 471881744 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AdventHealth West Florida Ambulatory | BusinessNameLine1Txt |
| Business Name Line2 | Services Inc | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ADVE | BusinessNameControlTxt |
| Phone | 8138034030 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14055 Riveredge Drive 250 | AddressLine1Txt |
| City | Tampa | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33637 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Lynn C Addiscott | PersonNm |
| Person Title | Assistant Secretary | PersonTitleTxt |
| Phone | 4073572317 | PhoneNum |
| Signature | 2023-11-10 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Lynn | PersonFirstNm |
| Person Last | Addiscott | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | David Ottati | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14055 Riveredge Drive 250 | AddressLine1Txt |
| City | Tampa | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33637 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,875,114 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2014 | FormationYr |
| Legal Domicile State | FL | LegalDomicileStateCd |
| Activity Or Mission | To expand the availability of professional medical services to residents and visitors of West Florida; and to promote public health and foster related activities that are consistent with the scientific, educational and charitable purposes. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 41 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,643,171 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $2,873,307 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,833,978 | PYInvestmentIncomeAmt |
| CY Investment Income | $749 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $3,477,149 | PYTotalRevenueAmt |
| CY Total Revenue | $2,874,056 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,408,843 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,963,633 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,301,292 | PYOtherExpensesAmt |
| CY Other Expenses | $11,816,325 | CYOtherExpensesAmt |
| PY Total Expenses | $10,710,135 | PYTotalExpensesAmt |
| CY Total Expenses | $13,779,958 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$7,232,986 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$10,905,902 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $44,113,366 | TotalAssetsBOYAmt |
| Total Assets EOY | $68,104,355 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $20,993,301 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $38,229,604 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $23,120,065 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $29,874,751 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Adventist Health System Sunbelt Healthcare Corporation and all 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.The filing organization and healthcare system whose parent is Adventist Health System Sunbelt Healthcare Corporation is known as AdventHealth. AdventHealth seeks to be widely respected as a consumer-focused organization that engages individuals in their health by delivering wholistic, best practice care across a connected, comprehensive continuum of services. With Christ as our example, AdventHealth cares for and nurtures people: our employees, our communities, our healthcare professionals, and those who trust us for care and healing. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $6,064,991 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $2,873,307 | RevenueAmt |
| Desc | The filing organization provides oversight, support and guidance to its wholly-owned subsidiaries that operate and provide out-patient professional medical services and owns an indirect partnership interest in an ambulatory surgery center. | Desc |
| Total Program Service Expenses | $6,064,991 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 41 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Clay Presswood | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8138034030 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14055 Riveredge Drive 250 | AddressLine1Txt |
| City | Tampa | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33637 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| David Ottati | |||||||||
| Director/Pres/Chairman (Beg 01/22) | 0.20 | 50.00 | Yes (X) | Yes (X) | $0 | $3,686,151 | $220,120 | ||
| Bruce Bergherm | |||||||||
| Secretary/Director | 0.10 | 50.00 | Yes (X) | $0 | $1,410,394 | $49,535 | |||
| Jennifer Wandersleben | |||||||||
| Director (Beg 12/22) | 0.20 | 50.00 | Yes (X) | $0 | $949,270 | $170,444 | |||
| Vadym Didenko | |||||||||
| Treasurer/Director | 0.20 | 50.00 | Yes (X) | $0 | $910,346 | $146,851 | |||
| John Johannessen | |||||||||
| Director | 2.40 | 47.60 | Yes (X) | Yes (X) | $0 | $672,102 | $111,154 | ||
| Robin McGuinness | |||||||||
| Director | 0.20 | 50.00 | Yes (X) | $0 | $633,401 | $89,768 | |||
| Michael Schultz | |||||||||
| Former Officer | 0.00 | 0.00 | $0 | $566,508 | $10,300 | Yes (X) | |||
| Clay Presswood | |||||||||
| Director | 2.40 | 47.60 | Yes (X) | Yes (X) | $0 | $391,754 | $105,016 | ||
| Kirsten Quinlan | |||||||||
| AVP Physician Recruiting | 0.00 | 40.00 | $186,600 | $0 | $18,129 | Yes (X) | |||
| Elin Boyd | |||||||||
| AVP Project Management | 10.00 | 30.00 | $166,898 | $0 | $31,455 | Yes (X) | |||
| Eugenia Evarts | |||||||||
| Director Outpatient Imaging | 10.00 | 30.00 | $162,392 | $0 | $15,773 | Yes (X) | |||
| Jonathan Gilbert | |||||||||
| Director of Finance | 10.00 | 30.00 | $127,507 | $0 | $22,345 | Yes (X) | |||
| Jeffrey McMurray | |||||||||
| HR Director & HRBP | 10.00 | 30.00 | $128,979 | $0 | $14,012 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $772,376 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $9,219,926 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,004,902 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Hunton Brady Architects PA | |||||
| 333 S Garland Ave Suite 100 | Orlando | FL | 32801 | Architecture Services | $837,184 |
| Google Inc | |||||
| 1600 Amphitheatre Pkwy | Mountain View | CA | 94043 | Advertising | $365,934 |
| Blue Crew Services Inc | |||||
| 301 West Platt Suite 205 | Tampa | FL | 33606 | Janitorial Services | $179,870 |
| The Robins & Morton Group | |||||
| 423 S Keller Rd Suite 200 | Orlando | FL | 32810 | Construction Services | $127,624 |
| Crothall Healthcare | |||||
| 13028 Collections Center Dr | Chicago | IL | 60693 | Environmental Services | $101,887 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Info In Schedule O Part VIII | Yes (X) | InfoInScheduleOPartVIIIInd |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Rent from Tax-Exempt A | 531120 | $1,578,221 | $1,578,221 |
| Reimb. from Tax-Exempt | 621511 | $896,445 | $896,445 |
| Ambulatory Surgery Ctr | 621493 | $398,641 | $398,641 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $2,873,307 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,807 | TotalRevenueColumnAmt |
| Exclusion | $1,807 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,058 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$1,058 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,058 | TotalRevenueColumnAmt |
| Exclusion | -$1,058 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,874,056 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,873,307 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $749 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,382,747 | TotalAmt |
| Program Services | $1,236,303 | ProgramServicesAmt |
| Management And General | $146,444 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,358 | TotalAmt |
| Program Services | $73,578 | ProgramServicesAmt |
| Management And General | $6,780 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $356,595 | TotalAmt |
| Program Services | $342,479 | ProgramServicesAmt |
| Management And General | $14,116 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $143,933 | TotalAmt |
| Program Services | $131,650 | ProgramServicesAmt |
| Management And General | $12,283 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $134,536 | TotalAmt |
| Management And General | $134,536 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $181 | TotalAmt |
| Management And General | $181 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,353,931 | TotalAmt |
| Program Services | $728,640 | ProgramServicesAmt |
| Management And General | $6,625,291 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $596,753 | TotalAmt |
| Management And General | $596,753 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $171,115 | TotalAmt |
| Program Services | $47,154 | ProgramServicesAmt |
| Management And General | $123,961 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,666 | TotalAmt |
| Program Services | $43,666 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $468,751 | TotalAmt |
| Program Services | $468,751 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,895 | TotalAmt |
| Program Services | $33,816 | ProgramServicesAmt |
| Management And General | $17,079 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,083 | TotalAmt |
| Management And General | $3,083 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $427,671 | TotalAmt |
| Program Services | $427,671 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,349,646 | TotalAmt |
| Program Services | $2,349,646 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,152 | TotalAmt |
| Management And General | $33,152 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| Repairs & Maint - Build | $164,455 | $164,455 |
| Medical supplies | $16,725 | $16,725 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,765 | TotalAmt |
| Program Services | $457 | ProgramServicesAmt |
| Management And General | $1,308 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,779,958 | TotalAmt |
| Program Services | $6,064,991 | ProgramServicesAmt |
| Management And General | $7,714,967 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $65,323 | BOYAmt |
| EOY | $55,064 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $703,516 | BOYAmt |
| EOY | $568,398 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $56,276,435 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,440,525 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,134,887 | BOYAmt |
| EOY | $52,835,910 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,208,629 | BOYAmt |
| EOY | $2,743,956 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,011 | BOYAmt |
| EOY | $11,901,027 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,113,366 | BOYAmt |
| EOY | $68,104,355 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,328,678 | BOYAmt |
| EOY | $4,218,498 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,664,623 | BOYAmt |
| EOY | $34,011,106 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,993,301 | BOYAmt |
| EOY | $38,229,604 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,120,065 | BOYAmt |
| EOY | $29,874,751 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,120,065 | BOYAmt |
| EOY | $29,874,751 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,113,366 | BOYAmt |
| EOY | $68,104,355 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$10,905,902 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$9,767 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $17,670,355 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type2 | Yes (X) | SupportingOrgType2Ind |
| Supported Organizations | 2 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (2 entries)
| EINEIN | Organization TypeOrganizationTypeCd | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| West Florida Health Home Care Inc | ||||
| 593686109 | 10 | 0 | $0 | $0 |
| AdventHealth West Florida Imaging Inc | ||||
| 843225135 | 3 | 0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 2 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | 0 | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Majority Dir Trst Supported Org | Yes (1) | MajorityDirTrstSupportedOrgInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule A, Part IV, Section A, Line 1 | FormAndLineReferenceDesc |
| Explanation | The governing documents of the filing organization state that its purposes include the expansion of the availability of professional medical services to residents and visitors of West Florida and to promote public health and foster related activities that are in furtherance of the health ministry of the Seventh-day Adventist Church. Currently, the filing organization is the sole member and supporting organization of two 501(c)(3) subsidiaries that provide professional medical and healthcare services, namely home health services and imaging services. In accordance with Treasury Regulation Section 1.509(a)-4(d)(2), the supported organization is operating in support of organizations that are designated by purpose in the filing organization's Articles of Incorporation. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,947,579 | OtherCostOrOtherBasisAmt |
| Book Value | $6,947,579 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $23,408,122 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,360,114 | DepreciationAmt |
| Book Value | $22,048,008 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,813,257 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,066,919 | DepreciationAmt |
| Book Value | $9,746,338 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,107,477 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,492 | DepreciationAmt |
| Book Value | $14,093,985 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $52,835,910 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Other receivables | $810 |
| Right Of Use Asset-Oper Lease | $11,900,217 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $11,901,027 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| Due to Related | $22,030,372 |
| AIP AH Cash Mgmt Interest Exp | $68,110 |
| Operating Lease Liability | $11,872,258 |
| Accrued Interest Payable | $40,366 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $34,011,106 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | The filing organization is a subsidiary organization within AdventHealth. The consolidated financial statements of AdventHealth contain the following FIN 48 (ASC 740) footnote: Please note that dollar amounts are in thousands. Healthcare Corporation and its affiliated organizations, other than North American Health Services, Inc. and its subsidiary (NAHS), are exempt from state and federal income taxes. Accordingly, Healthcare Corporation and its tax-exempt affiliates are not subject to federal, state or local income taxes except for any net unrelated business taxable income. NAHS is a wholly owned, for-profit subsidiary of Healthcare Corporation. NAHS and its subsidiary are subject to federal and state income taxes. NAHS files a consolidated federal income tax return and, where appropriate, consolidated state income tax returns. All taxable income was fully offset by net operating loss carryforwards for federal income tax purposes; as such, there is no provision for current federal or state income tax for the years ended December 31, 2022 and 2021. NAHS also has temporary deductible differences of approximately $18,200 and $33,000 at December 31, 2022 and 2021, respectively, primarily as a result of net operating loss carryforwards. At December 31, 2022, NAHS had net operating loss carryforwards of approximately $10,000, expiring in 2023 through 2026. Deferred taxes have been provided for these amounts, resulting in a net deferred tax asset of approximately $4,500 and $8,100 at December 31, 2022 and 2021, respectively. NAHS remeasured its deferred tax assets and liabilities based on the rates at which they are expected to reverse in the future, which is generally 21%. A full valuation allowance has been provided at December 31, 2022 and 2021 to offset the deferred tax asset since Healthcare Corporation has determined that it is more likely than not that the benefit of the net operating loss carryforwards will not be realized in future years. The Income Taxes Topic of the Accounting Standards Codification (ASC) (ASC 740) prescribes the accounting for uncertainty in income tax positions recognized in financial statements. ASC 740 prescribes a recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken, or expected to be taken, in a tax return. There were no material uncertain tax positions as of December 31, 2022 and 2021. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| David Ottati | ||||||||||||||
| Director/Pres/Chairman (Beg 01/22) | $0 | $990,100 | $0 | $268,500 | $0 | $2,427,551 | $0 | $166,400 | $0 | $53,720 | $0 | $3,906,271 | $0 | $104,040 |
| Bruce Bergherm | ||||||||||||||
| Secretary/Director | $0 | $673,281 | $0 | $174,998 | $0 | $562,115 | $0 | $16,400 | $0 | $33,135 | $0 | $1,459,929 | $0 | $0 |
| Jennifer Wandersleben | ||||||||||||||
| Director (Beg 12/22) | $0 | $649,654 | $0 | $180,378 | $0 | $119,238 | $0 | $114,611 | $0 | $55,833 | $0 | $1,119,714 | $0 | $59,424 |
| Vadym Didenko | ||||||||||||||
| Treasurer/Director | $0 | $606,687 | $0 | $162,689 | $0 | $140,970 | $0 | $93,915 | $0 | $52,936 | $0 | $1,057,197 | $0 | $73,086 |
| John Johannessen | ||||||||||||||
| Director | $0 | $480,082 | $0 | $110,936 | $0 | $81,084 | $0 | $69,162 | $0 | $41,992 | $0 | $783,256 | $0 | $32,224 |
| Robin McGuinness | ||||||||||||||
| Director | $0 | $406,695 | $0 | $94,539 | $0 | $132,167 | $0 | $56,683 | $0 | $33,085 | $0 | $723,169 | $0 | $59,918 |
| Michael Schultz | ||||||||||||||
| Former Officer | $0 | $156,759 | $0 | $397,536 | $0 | $12,213 | $0 | $10,300 | $0 | $0 | $0 | $576,808 | $0 | $0 |
| Clay Presswood | ||||||||||||||
| Director | $0 | $302,798 | $0 | $56,332 | $0 | $32,624 | $0 | $61,641 | $0 | $43,375 | $0 | $496,770 | $0 | $14,147 |
| Kirsten Quinlan | ||||||||||||||
| AVP Physician Recruiting | $163,530 | $0 | $21,038 | $0 | $2,032 | $0 | $9,188 | $0 | $8,941 | $0 | $204,729 | $0 | $0 | $0 |
| Elin Boyd | ||||||||||||||
| AVP Project Management | $147,106 | $0 | $16,739 | $0 | $3,053 | $0 | $8,437 | $0 | $23,018 | $0 | $198,353 | $0 | $0 | $0 |
| Eugenia Evarts | ||||||||||||||
| Director Outpatient Imaging | $143,841 | $0 | $17,210 | $0 | $1,341 | $0 | $7,685 | $0 | $8,088 | $0 | $178,165 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3 | The individual who serves as the President/Board Member of the filing organization is appointed and compensated by Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) for serving as the CEO of the West Florida Division of AdventHealth. AHSSHC is the 501(c)(3) parent organization of the healthcare system known as AdventHealth. 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 has taken steps to ensure that processes are in place to satisfy the rebuttable presumption of reasonableness standard as set forth in Treasury Regulation Section 53.4958-6 with respect to its active executive-level positions. The AHSSHC Board 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, 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, other than the Chief People Officer, who remains at the request of the Chairman/committee to provide assistance/information as needed. 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 AdventHealth and each of its affiliated entities. The following principles guide the establishment of individual executive compensation: - The salary of the President/CEO of AdventHealth will not exceed the 50th 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. |
| Part I, Line 4b | 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 the healthcare system known as AdventHealth. In recognition of the contribution that each executive makes to the success of AdventHealth, AdventHealth provides supplemental executive retirement benefit plans to eligible executives. As the supplemental executive retirement benefit plans were updated in 2020 and certain individuals still participate as grand-fathered participants in certain plans, the narrative below discusses all plans in which there were any participants in 2022. The SERP III plan effectively replaces the prior SERP II plan, the Executive Flex Benefit Program Plan, and the Senior Executive Death Benefit Plan for qualified executives except for certain grandfathered executive employees. SERP III Plan: The SERP III plan provides eligible executives a percentage of their base pay, which is credited to a deferred compensation account. The plan also provides for compensation deferral and selection of life insurance coverage and long-term care insurance. To be eligible to participate in the SERP III plan, executives must be on the AHSSHC corporate payroll and be either a CEO of an AdventHealth entity, an AHSSHC Vice President (VP) or VP of an AdventHealth entity with a base salary of at least $305,000 in 2022 (adjusted annually by the same percentage as IRC Section 401(a)(17) limit increases), or other leader specifically approved by the AdventHealth President. Eligible executives do not include grandfathered executives, meaning those executives who would satisfy all the eligibility requirements of the SERP II plan prior to Dec 31, 2027, had the plan not been amended and restated as of Jan. 1, 2020. Contribution credits will be established and maintained by class year accounts for each participant using tiered contribution credit percentages of annual base compensation. Contribution credit percentages range between 15% and 19% of base compensation. Contribution credits will be made each quarter in 25% increments with reductions in contributions if the executive is also a grandfathered FLEX participant (see below). SERP III provides for a class year vesting and payment schedule (7 years for each class year) with respect to amounts accumulated in the executive's deferred compensation account. Upon attainment of a normal retirement age (age 62), or upon certain other circumstances as defined in the SERP III plan document, all deferred amounts are paid immediately to the participant. For any executives working beyond the normal retirement age, future employer contributions will be made quarterly from SERP III directly to the participant as a taxable cash bonus. SERP II Plan: The SERP II plan is a defined benefit, non-tax-qualified deferred compensation plan for certain executives who have provided lengthy service to AdventHealth and/or to other Seventh-day Adventist Church hospitals or health care institutions. Under the provisions of the SERP II plan, benefits are provided to qualifying executive participants on a pro-rata schedule beginning with 20 years of service as an employee of AdventHealth and/or another hospital or health care institution controlled by the Seventh-day Adventist Church and who satisfy certain other qualifying criteria. Eligible employees are restricted to those executives who, as of January 1, 2020, satisfied, or if employment continues, will satisfy the eligibility requirements of SERP II prior to December 31, 2027. This supplemental executive retirement plan (SERP II) 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, five or seven highest years of base salary from AdventHealth 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. The number of years included in highest average compensation is determined by the individual's year of entry to SERP II and by the individual's year of entry to the AdventHealth Executive FLEX Benefit Program. FLEX Plan: The Flex Plan was originally designed to provide eligible executives an opportunity to select from among a variety of supplemental benefits, including a split dollar life insurance policy and long-term care insurance, to individually tailor a benefits program appropriate to each executive's needs. In 2020, the Flex Plan was amended to exclude employed executives who are hired or promoted after a certain date from being eligible to participate in the Flex Plan except for certain insurance coverage features of the plan. The Flex Plan provides eligible participants a pre-determined benefits allowance credit that is equal to a percentage of the executive's base pay from which the cost of mandatory and elective employee benefits is deducted. The benefits allowance credit percentage for any plan year shall not be greater than the maximum dollar amount or the percentage of compensation as determined by the AdventHealth Benefits Administration Committee. For grandfathered eligible employees, the annual pre-determined Flex allowance is contributed and any funds that remain after the cost of mandatory and elective benefits are subtracted are, at the employee's option, contributed to either an IRC 457(f) deferred compensation account or to an IRC 457(b) eligible deferred compensation plan. Upon attainment of age 65, all previous 457(f) deferred amounts are paid immediately to the participant and any future employer contributions are made quarterly from the Plan directly to the participant. The Plan 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 will be forfeited by the executive upon a voluntary separation. With respect to grandfathered participants, the Flex Plan documents define eligible employees to include the Chief Executive Officers of AdventHealth entities and Vice Presidents of all AdventHealth entities whose base salary was at least equal to the Internal Revenue Code Section 401(a)(17) compensation limit each year. FLEX Plan FLEX Plan SERP II SERP III Contr. Distr.* Contr./Distr. Contr. Ottati,David $ 150,000 $ 140,915 $ 2,256,444 $ 0 Bergherm,Bruce $ 103,125 $ 82,625 $ 386,102 $ 0 Wandersleben,Jennifer $ 108,827 $ 60,800 $ 0 $ 9,884 Didenko,Vadym $ 98,015 $ 101,582 $ 0 $ 0 Johannessen,John $ 66,411 $ 35,363 $ 0 $ 6,851 McGuinness,Robin $ 56,975 $ 57,069 $ 0 $ 4,953 Presswood,Clay $ 19,603 $ 18,568 $ 0 $ 25,638 SERP III Distr.* McGuinness,Robin $ 19,805 * Including Investment Earnings |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part V, Line 1a: | The parent corporation and sole top-tier member of AdventHealth West Florida Ambulatory Services, Inc. (the filing organization) is Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is a Florida, not-for-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). AHSSHC has established a shared service center to centralize the Accounts Payable (A/P) function for all AHSSHC subsidiary organizations. The filing organization has entered "0" in Part V, Line 1a because the filing organization no longer issues Form 1099 returns, rather, all such returns are filed by and under the name and EIN of AHSSHC as the payor subject to the information reporting requirements of Section 6041. The facts and circumstances support a position that AHSSHC, as a payor on behalf of its subsidiary organizations in a shared service environment, will have sufficient management and oversight in connection with the subsidiary organizations' payments to meet the standard set forth in Treas. Reg. Section 1.6041-1(e). AHSSHC will not merely be making payments at the direction of its subsidiary organizations. Accordingly, AHSSHC is considered the payor subject to the information reporting requirements of Section 6041. |
| Form 990, Part VI, Section A, line 6 | AdventHealth West Florida Ambulatory Services, Inc. (the filing organization) has one member. The sole member of the filing organization is Adventist Health System Sunbelt Healthcare Corporation, 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 organizaiton. |
| Form 990, Part VI, Section A, line 7a | The Board of Directors of the filing organization are appointed by the member who has the right to elect, appoint or remove any member of the Board of Directors of the filing organization. |
| Form 990, Part VI, Section A, line 7b | The membership 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) amend the Articles of Incorporation or Bylaws; (b) adopt any annual or long-term capital or operational budget for the Corporation, or any changes exceeding ten percent (10%) of the total annual budget; (c) adopt any new, or any changes to, existing long-term or master strategic plan for the Corporation; (d) authorize the Corporation to enter into any contract or engage in any transaction which is not provided for in an annual or long-term capital or operational budget approved by the Member where the amount involved exceeds one hundred thousand dollars ($100,000.00); (e) approve the incorporation, formation, or dissolution of any subsidiary corporation or other entity that is owned or controlled by the Member (a "Subsidiary"); (f) approve the formation, modification, or dissolution of any partnership, limited liability company, joint venture in which the Corporation or any Subsidiary will be a shareholder, partner, member, joint venture or party to an affiliation; (g) enter into, modify, or terminate any affiliation agreement as to which the Corporation or any Subsidiary will be a party; (h) incur any long-term debt; (i) mortgage or otherwise grant a lien or security interest to be placed upon or a Uniform Commercial Code financing statement to be filed against any of the Corporation's assets; (j) merge the Corporation with or consolidate the Corporation into any other entity; (k) sell, assign or otherwise transfer all or substantially all of the Corporation's assets in one or more related transactions; (l) enter into any contract (regardless of the identity of the party and regardless of nature of the product/service acquired) at less than fair market value; (m) grant membership rights to any person or entity other than the Member; (n) enter into, modify, amend, revise, extend or renew any agreement for the management of the business of the Corporation by any person or entity, or terminate any such agreement; (o) approve the voluntary dissolution of the Corporation; (p) appoint and remove the members of the Corporation's Board of Directors; (q) approve the Corporation entering into a new service line; (r) make any distribution permitted in accordance with Section 617.0505 of the Act, as amended; or (s) make a call for additional contributions. |
| Form 990, Part VI, Section B, line 11b | The filing organization's current year Form 990 was reviewed by the Board Chairman and the CFO of AdventHealth's West Florida Division Non-Acute Services prior to its filing with the IRS. The review conducted by the Board Chairman and the CFO of AdventHealth's West Florida Division Non-Acute Services did not include the review of any supporting workpapers that were used in preparation of the current year Form 990, but did include a review of the entire Form 990 and all supporting schedules. |
| Form 990, Part VI, Section B, line 12c | The Conflict of Interest Policy of the filing organization applies to members of its Board of Directors and its principal officers (to be known as Interested Persons). In connection with any actual or possible conflicts of interest, 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 Interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the filing organization is a charitable organization that must primarily engage in activities which accomplish one or more of its exempt purposes. The filing organization's Conflict of Interest Policy also requires that periodic reviews shall be conducted to ensure that the filing organization operates in a manner consistent with its charitable purposes. |
| Form 990, Part VI, Section B, line 15 | The filing organization's President and other officers are not compensated by the filing organization. Such individuals are compensated by the related top-tier parent organization of the filing organization. Please see the discussion concerning the process followed by the related top-tier parent organization in determining executive compensation in our response to Schedule J, Line 3. |
| Form 990, Part VI, Section C, line 19 | The filing organization is a part of the system of healthcare organizations known as AdventHealth. The audited consolidated financial statements of AdventHealth and of the AdventHealth "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 AdventHealth on a consolidated basis and for the grouping of AdventHealth subsidiaries comprising the "Obligated Group". The filing organization does not generally make its governing documents or conflict of interest policy available to the public. |
| Part VII, Section A, Columns E & F: | For those Board of Director members who devote less than full-time to the filing organization (based upon the average number of hours per week shown in column (B) on page 7 of the return) the compensation amounts shown in columns (E) and (F) on page 7 were provided in conjunction with that person's responsibilities and roles in serving in an executive leadership position as an employee of Adventist Health System Sunbelt Healthcare Corporation. |
| Part VIII, Lines 7a, b and c: | The amount shown in Part VIII, Line 7c(i) of the Form 990 represents an allocated share of capital gain/(loss) from a system wide, corporate administered, investment program. |
| Form 990, Part IX, line 11g | Payments to healthcare professionals: Program service expenses 969. Management and general expenses 0. Fundraising expenses 0. Total expenses 969. Professional fees: Program service expenses 228,215. Management and general expenses 0. Fundraising expenses 0. Total expenses 228,215. Environmental Services: Program service expenses 283,234. Management and general expenses 0. Fundraising expenses 0. Total expenses 283,234. Recruiting: Program service expenses 2,243. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,243. Outsourced Food Services: Program service expenses 1,400. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,400. Miscellaneous purchased services: Program service expenses 212,579. Management and general expenses 0. Fundraising expenses 0. Total expenses 212,579. AdventHealth management fees: Program service expenses 0. Management and general expenses 6,510,261. Fundraising expenses 0. Total expenses 6,510,261. Collection Fees: Program service expenses 0. Management and general expenses 4,788. Fundraising expenses 0. Total expenses 4,788. AdventHealth shared services fees: Program service expenses 0. Management and general expenses 110,242. Fundraising expenses 0. Total expenses 110,242. |
| Form 990, Part X, Line 2: | The amounts shown on line 2 of Part X of this return include the filing organization's interest in a central investment pool maintained by Adventist Health System Sunbelt Healthcare Corporation, the filing organization's top-tier parent. The investments in the central investment pool are recorded at market value. |
| Form 990, Part XI, line 9: | Transfers from tax-exempt affiliates 17,670,355. |
| Form 990, Part XII, Line 3b: | Although the taxpayer is not required to undergo an audit as set forth in the Single Audit Act and OMB Circular A-133, the taxpayer is part of a controlled group of organizations that comprise a consolidated financial statement audit. The controlled group's parent is Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), a 501(c)(3) organization. The system of healthcare entities owned and controlled by AHSSHC is known as AdventHealth. For the year ended December 31, 2022, AdventHealth will file a consolidated Single Audit which will include all entities that are part of the controlled group. Accordingly, the taxpayer has checked yes to the questions on Part XII, line 3a and 3b. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (100 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| AdventHealth Ashville Inc (5922 - 123122) | |||||||||||
| 900 Hope Way | Altamonte Springs | FL | 32714 | 921144574 | Future Operation of Hospital & Related Services | NC | 501(c)(3) | Line 3 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| AdventHealth Family Medicine Rural Health Clinics Inc | |||||||||||
| 187 PR 4060 | Lampasas | TX | 76550 | 271858033 | Operation of Rural Health Clinics & Medical Services | FL | 501(c)(3) | Line 3 | Metroplex Adventist Hospital Inc | Yes (1) | |
| AdventHealth Foundation fka SunSystem Development Corp | |||||||||||
| 900 Hope Way | Altamonte Springs | FL | 32714 | 592219301 | Fund-Raising for Affiliated Tax-Exempt Hospitals | FL | 501(c)(3) | Line 7 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| AdventHealth Home Care East Florida LLC | |||||||||||
| 770 West Granada Blvd 319 | Ormond Beach | FL | 32174 | 833768458 | Inactive | FL | 501(c)(3) | Line 10 | Memorial Hlth Systems Inc | Yes (1) | |
| AdventHealth Hospice Care East Florida Inc | |||||||||||
| 770 West Granada Blvd 304 | Ormond Beach | FL | 32174 | 833748461 | Inactive | FL | 501(c)(3) | Line 10 | Memorial Hlth Systems Inc | Yes (1) | |
| AdventHealth Kansas City Foundation | |||||||||||
| 7315 E Frontage Road | Merriam | KS | 66204 | 480868859 | Fund-raising for Tax-exempt hospitals | KS | 501(c)(3) | Line 7 | Shawnee Mission Medical Center Inc | Yes (1) | |
| AdventHealth North Polk Inc | |||||||||||
| 3100 E Fletcher Ave | Tampa | FL | 33613 | 593231322 | Inactive | FL | 501(c)(3) | Line 12a, I | University Community Hospital Inc | Yes (1) | |
| AdventHealth Palm Coast Parkway Inc fka AH East Florida Inc | |||||||||||
| 900 Hope Way | Altamonte Springs | FL | 32714 | 882288563 | Future Operation of Hospital & Related Services | FL | 501(c)(3) | Line 3 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| AdventHealth Polk North Inc | |||||||||||
| 40100 US Highway 27 N | Davenport | FL | 33837 | 841793121 | Operation of Hospital & Related Services | FL | 501(c)(3) | Line 3 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| AdventHealth Polk South Inc | |||||||||||
| 410 South 11th Street | Lake Wales | FL | 33853 | 834672945 | Operation of Hospital & Related Services | FL | 501(c)(3) | Line 3 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| AdventHealth Ransom Memorial Inc | |||||||||||
| 1301 S Main Street | Ottawa | KS | 66067 | 830976641 | Operation of Hospital & Related Services | KS | 501(c)(3) | Line 3 | Adventist Hlth Mid-America Inc | Yes (1) | |
| AdventHealth Riverview Inc | |||||||||||
| 14055 Riveredge Drive Ste 150 | Tampa | FL | 33637 | 870901094 | Future Operation of Hospital & Related Services | FL | 501(c)(3) | Line 3 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| AdventHealth Senior Care Inc | |||||||||||
| 900 Hope Way | Altamonte Springs | FL | 32714 | 841817046 | Operation of Physician Practices & Medical Services | FL | 501(c)(3) | Line 3 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| AdventHealth South Overland Park Inc | |||||||||||
| 7820 W 165th Street | Overland Park | KS | 66223 | 364595806 | Operation of Hospital & Related Services | KS | 501(c)(3) | Line 3 | Adventist Hlth Mid-America Inc | Yes (1) | |
| AdventHealth University Inc | |||||||||||
| 671 Winyah Drive | Orlando | FL | 32803 | 593069793 | Education/Operation of School | FL | 501(c)(3) | Line 2 | Adventist Hlth SystemSunbelt Inc | Yes (1) | |
| AdventHealth West Florida Ambulatory Services Inc | |||||||||||
| 14055 Riveredge Drive Ste 250 | Tampa | FL | 33637 | 471881744 | Support of Imaging Center & Home Health Subsidiaries | FL | 501(c)(3) | Line 12b, II | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| AdventHealth West Florida Imaging Inc | |||||||||||
| 14055 Riveredge Drive Ste 250 | Tampa | FL | 33637 | 843225135 | Imaging & Testing | FL | 501(c)(3) | Line 3 | AdventHealth West Florida Ambulatory Services Inc | Yes (1) | |
| Adventist Bolingbrook Hospital | |||||||||||
| 500 Remington Blvd | Bolingbrook | IL | 60440 | 651219504 | Operation of Hospital & Related Services | IL | 501(c)(3) | Line 3 | Adventist Midwest Health | Yes (1) | |
| Adventist Care Centers - Courtland Inc | |||||||||||
| 730 Courtland Street | Orlando | FL | 32804 | 205774723 | Operation of Home for the Aged/Hlthcare Delivery | FL | 501(c)(3) | Line 10 | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| Adventist GlenOaks Hospital | |||||||||||
| 701 Winthrop Avenue | Glendale Heights | IL | 60139 | 363208390 | Operation of Hospital & Related Services | IL | 501(c)(3) | Line 3 | Adventist Midwest Health | Yes (1) | |
| Adventist Health Mid-America Inc | |||||||||||
| 9100 W 74th Street | Shawnee Mission | KS | 66204 | 521347407 | Support of Affiliated Hospital | KS | 501(c)(3) | Line 12c, III-FI | Adventist Hlth SystemSunbelt Inc | Yes (1) | |
| Adventist Health Partners Inc | |||||||||||
| 5101 S Willow Springs Rd Suite B101 | La Grange | IL | 60525 | 364138353 | Operation of Physician Practices & Medical Services | IL | 501(c)(3) | Line 3 | Adventist Midwest Health | Yes (1) | |
| Adventist Health System Georgia Inc | |||||||||||
| 1035 Red Bud Road NE | Calhoun | GA | 30701 | 581425000 | Operation of Hospital & Related Services | GA | 501(c)(3) | Line 3 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| Adventist Hlth System Sunbelt Hlthcare Corp | |||||||||||
| 900 Hope Way | Altamonte Springs | FL | 32714 | 592170012 | Management Services | FL | 501(c)(3) | Line 12a, I | 0 | N/A | |
| Adventist Hlth SystemSunbelt Inc | |||||||||||
| 900 Hope Way | Altamonte Springs | FL | 32714 | 591479658 | Operation of Hospitals & Related Services | FL | 501(c)(3) | Line 3 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| Adventist Hlth SystemTexas Inc | |||||||||||
| 11801 S Freeway | Burleson | TX | 76028 | 742578952 | Leasing Personnel to Affiliated Hospital | TX | 501(c)(3) | Line 12c, III-FI | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| Adventist Midwest Health | |||||||||||
| 120 North Oak Street | Hinsdale | IL | 60521 | 362276984 | Operation of Hospitals & Related Services | IL | 501(c)(3) | Line 3 | Adventist Hlth SystemSunbelt Inc | Yes (1) | |
| AHP Specialty Care NFP | |||||||||||
| 5101 S Willow Springs Rd Suite B101 | La Grange | IL | 60525 | 811105774 | Operation of Physician Practices & Medical Services | IL | 501(c)(3) | Line 3 | Adventist Midwest Health | Yes (1) | |
| AHS Midwest Management Inc | |||||||||||
| 500 Remington Blvd | Bolingbrook | IL | 60440 | 363354567 | Operation of Physician Practice Management | IL | 501(c)(3) | Line 12a, I | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| Apopka Health Care Properties Inc | |||||||||||
| 305 E Oak Street | Apopka | FL | 32703 | 510605694 | Lease to Related Organization | GA | 501(c)(3) | Line 12c, III-FI | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| Bert Fish Medical Center Auxiliary Inc | |||||||||||
| 401 Palmetto Street | New Smyrna Beach | FL | 32168 | 591054892 | Volunteer support services | FL | 501(c)(3) | Line 10 | Southeast Volusia Healthcare Corp | 0 | |
| Bradford Heights Health & Rehab Center Inc (11-122222) | |||||||||||
| 485 North Keller Road 250 | Maitland | FL | 32751 | 205782342 | Inactive - Wind-Down | KY | 501(c)(3) | Line 10 | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| Burleson Nursing & Rehab Center Inc | |||||||||||
| 301 Huguley Blvd | Burleson | TX | 76028 | 205782243 | Operation of Home for the Aged/Hlthcare Delivery | TX | 501(c)(3) | Line 10 | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| Chickasaw Health Care Properties Inc | |||||||||||
| 250 S Chickasaw Trail | Orlando | FL | 32825 | 510605681 | Lease to Related Organization | GA | 501(c)(3) | Line 12c, III-FI | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| Chippewa Valley Hospital & Oakview Care Center Inc | |||||||||||
| 1220 Third Avenue West | Durand | WI | 54736 | 391365168 | Operation of Hospital & Related Services | WI | 501(c)(3) | Line 3 | Adventist Hlth SystemSunbelt Inc | Yes (1) | |
| Coalition For Physician Well-Being Inc | |||||||||||
| 900 Hope Way | Altamonte Springs | FL | 32714 | 463477012 | Provide support for Physician well-being | FL | 501(c)(3) | Line 10 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| Courtland Health Care Properties Inc | |||||||||||
| 730 Courtland Street | Orlando | FL | 32804 | 510605682 | Lease to Related Organization | GA | 501(c)(3) | Line 12c, III-FI | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| Creekwood Place Nursing & Rehab Center Inc (11-12622) | |||||||||||
| 485 North Keller Road 250 | Maitland | FL | 32751 | 205782260 | Inactive - Wind-Down | KY | 501(c)(3) | Line 10 | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| Dairy Road Health Care Properties Inc | |||||||||||
| 7350 Dairy Road | Zephyrhills | FL | 33540 | 510605684 | Lease to Related Organization | GA | 501(c)(3) | Line 12c, III-FI | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| East Orlando Health & Rehab Center Inc | |||||||||||
| 250 S Chickasaw Trail | Orlando | FL | 32825 | 205774748 | Operation of Home for the Aged/Hlthcare Delivery | FL | 501(c)(3) | Line 10 | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| Fletcher Hospital Inc | |||||||||||
| 100 Hospital Drive | Hendersonville | NC | 28792 | 560543246 | Operation of Hospital & Related Services | NC | 501(c)(3) | Line 3 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| FLNC Inc | |||||||||||
| 3355 E Semoran Blvd | Apopka | FL | 32703 | 205774761 | Operation of Home for the Aged/Hlthcare Delivery | FL | 501(c)(3) | Line 10 | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| Florida Hospital Dade City Inc | |||||||||||
| 13100 Fort King Road | Dade City | FL | 33525 | 822567308 | Operation of Hospital & Related Services | FL | 501(c)(3) | Line 3 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| Florida Hospital Healthcare Partners Inc | |||||||||||
| 770 West Granada Blvd 101 | Ormond Beach | FL | 32174 | 462354804 | Operation of Physician Practices & Medical Services | FL | 501(c)(3) | Line 3 | Adventist Hlth SystemSunbelt Inc | Yes (1) | |
| Florida Hospital Medical Group Inc | |||||||||||
| 2600 Westhall Lane 4th Floor | Maitland | FL | 32751 | 593214635 | Operation of Physician Practices & Medical Services | FL | 501(c)(3) | Line 3 | Adventist Hlth SystemSunbelt Inc | Yes (1) | |
| Florida Hospital Ocala Inc | |||||||||||
| 1500 SW 1st Avenue | Ocala | FL | 34471 | 824372339 | Operation of Hospital & Related Services | FL | 501(c)(3) | Line 3 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| Florida Hospital Physician Group Inc | |||||||||||
| 12470 Telecom Dr 100 | Tampa | FL | 33637 | 462021581 | Operation of Physician Practices & Medical Services | FL | 501(c)(3) | Line 3 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| Florida Hospital Waterman Inc | |||||||||||
| 1000 Waterman Way | Tavares | FL | 32778 | 593140669 | Operation of Hospital & Related Services | FL | 501(c)(3) | Line 3 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| Florida Hospital Zephyrhills Inc | |||||||||||
| 7050 Gall Blvd | Zephyrhills | FL | 33541 | 592108057 | Operation of Hospital & Related Services | FL | 501(c)(3) | Line 3 | Adventist Hlth SystemSunbelt Inc | Yes (1) | |
| Florida Radiology Imaging at Lake Mary LLC | |||||||||||
| 2600 Westhall Lane 4th Floor | Maitland | FL | 32751 | 550789387 | Imaging & Testing | FL | 501(c)(3) | Line 3 | Florida Hospital Medical Group Inc | Yes (1) | |
| Fountain Inn Nursing & Rehab Center Inc | |||||||||||
| 4501 Waterman Way | Tavares | FL | 32778 | 472180518 | Operation of Home for the Aged/Hlthcare Delivery | FL | 501(c)(3) | Line 10 | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| Helen Ellis Memorial Hospital Auxiliary Inc | |||||||||||
| 1395 S Pinellas Ave | Tarpon Springs | FL | 34689 | 592106043 | Fund-raising for Tax-exempt hospital/foundation | FL | 501(c)(3) | Line 12c, III-FI | 0 | N/A | |
| Helen Ellis Memorial Hospital Foundation Inc | |||||||||||
| 1395 S Pinellas Ave | Tarpon Springs | FL | 34689 | 593690149 | Fund-raising for Tax-exempt hospital | FL | 501(c)(3) | Line 7 | 0 | N/A | |
| Hinsdale Hospital Foundation | |||||||||||
| 120 North Oak Street | Hinsdale | IL | 60521 | 521466387 | Fund-raising for Tax-exempt hospital | IL | 501(c)(3) | Line 7 | Midwest Hlth Foundation | 0 | |
| Hospice of the Comforter Inc | |||||||||||
| 480 W Central Parkway | Altamonte Springs | FL | 32714 | 592935928 | Operation of Hospice | FL | 501(c)(3) | Line 10 | The Comforter Health Care Group Inc | Yes (1) | |
| In-Motion Rehab Inc (11-122722) | |||||||||||
| 485 North Keller Road 250 | Maitland | FL | 32751 | 208023411 | Inactive | KS | 501(c)(3) | Line 12b, II | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| Lake County Health Care Properties Inc (11-122822) | |||||||||||
| 485 North Keller Road 250 | Maitland | FL | 32751 | 813923985 | Lease to Related Organization | GA | 501(c)(3) | Line 12c, III-FI | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| Memorial Health Systems Foundation Inc | |||||||||||
| 305 Memorial Medical Pkwy 212 | Daytona Beach | FL | 32117 | 311771522 | Fund-raising for Tax-exempt hospital | FL | 501(c)(3) | Line 7 | 0 | N/A | |
| Memorial Health Systems Inc | |||||||||||
| 301 Memorial Medical Parkway | Daytona Beach | FL | 32117 | 590973502 | Operation of Hospital & Related Services | FL | 501(c)(3) | Line 3 | Adventist Hlth SystemSunbelt Inc | Yes (1) | |
| Memorial Hospital - West Volusia Inc | |||||||||||
| 701 West Plymouth Avenue | Deland | FL | 32720 | 593256803 | Operation of Hospital & Related Services | FL | 501(c)(3) | Line 3 | Memorial Hlth Systems Inc | Yes (1) | |
| Memorial Hospital Flagler Inc | |||||||||||
| 60 Memorial Medical Parkway | Palm Coast | FL | 32164 | 592951990 | Operation of Hospital & Related Services | FL | 501(c)(3) | Line 3 | Memorial Hlth Systems Inc | Yes (1) | |
| Memorial Hospital Inc | |||||||||||
| 210 Marie Langdon Drive | Manchester | KY | 40962 | 610594620 | Operation of Hospital & Related Services | KY | 501(c)(3) | Line 3 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| Metroplex Adventist Hospital Inc | |||||||||||
| 2201 S Clear Creek Road | Killeen | TX | 76549 | 742225672 | Operation of Hospital & Related Services | TX | 501(c)(3) | Line 3 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| Metroplex Clinic Physicians Inc | |||||||||||
| 2201 S Clear Creek Road | Killeen | TX | 76549 | 113762050 | Physician Healthcare services to the community | TX | 501(c)(3) | Line 3 | Metroplex Adventist Hospital Inc | Yes (1) | |
| Midwest Health Foundation | |||||||||||
| 120 North Oak Street | Hinsdale | IL | 60521 | 352230515 | Fund-Raising for Supported Exempt Hospitals | IL | 501(c)(3) | Line 7 | 0 | N/A | |
| Mills Health & Rehab Center Inc(11-12622) | |||||||||||
| 485 North Keller Road 250 | Maitland | FL | 32751 | 205782320 | Inactive - Wind-Down | KY | 501(c)(3) | Line 10 | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| Mission Strategies of Georgia Inc | |||||||||||
| 485 North Keller Road 250 | Maitland | FL | 32751 | 900866024 | Provision of support to the nursing home division | GA | 501(c)(3) | Line 12b, II | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| Missouri Adventist Health Inc | |||||||||||
| 9100 W 74th Street | Shawnee Mission | KS | 66204 | 431224729 | Support Health Care Services | MO | 501(c)(3) | Line 12d, III-O | Adventist Hlth Mid-America Inc | Yes (1) | |
| Osceola Health Care Properties Inc | |||||||||||
| 485 North Keller Road 250 | Maitland | FL | 32751 | 813165729 | Lease to Related Organization | GA | 501(c)(3) | Line 12c, III-FI | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| Overland Park Nursing & Rehab Center Inc | |||||||||||
| 6501 West 75th Street | Overland Park | KS | 66204 | 205774821 | Operation of Home for the Aged/Hlthcare Delivery | KS | 501(c)(3) | Line 10 | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| Pasco-Pinellas Hillsborough Community Hlth System Inc | |||||||||||
| 2600 Bruce B Downs Blvd | Wesley Chapel | FL | 33544 | 208488713 | Operation of Hospital & Related Services | FL | 501(c)(3) | Line 3 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| Portercare Adventist Health System (630 YE) | |||||||||||
| 9100 E Mineral Circle | Centennial | CO | 80112 | 840438224 | Operation of Hospitals & Related Services | CO | 501(c)(3) | Line 3 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| Princeton Health & Rehab Center Inc (11-12622) | |||||||||||
| 485 North Keller Road 250 | Maitland | FL | 32751 | 205782272 | Inactive - Wind-Down | KY | 501(c)(3) | Line 10 | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| Princeton Homecare Services LLC (81 - 123122) | |||||||||||
| 602 Courtland Street 310 | Orlando | FL | 32804 | 814196648 | Home Health Care Servcies | FL | 501(c)(3) | Line 10 | Princeton Prof Services Inc | Yes (1) | |
| Princeton Professional Services Inc | |||||||||||
| 601 E Rollins Street | Orlando | FL | 32803 | 591191045 | Provision of Healthcare Services | FL | 501(c)(3) | Line 10 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| Quality Circle for Healthcare Inc | |||||||||||
| 900 Hope Way | Altamonte Springs | FL | 32714 | 263789368 | Healthcare Quality Services | FL | 501(c)(3) | Line 12a, I | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| Redmond Park Hospital LLC | |||||||||||
| 501 Redmond Road NW | Rome | GA | 30165 | 581123037 | Operation of Hospital & Related Services | GA | 501(c)(3) | Line 3 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| Resource Personnel Inc | |||||||||||
| 485 North Keller Road 250 | Maitland | FL | 32751 | 208040875 | Provide administrative support to tax exempt nursing homes | FL | 501(c)(3) | Line 12b, II | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| Rocky Mountain Adventist Hlthcare Foundation (630 YE) | |||||||||||
| 960 E Harvard Avenue Ste 230 | Denver | CO | 80210 | 840745018 | Fund-raising for Tax-exempt hospital | CO | 501(c)(3) | Line 7 | 0 | N/A | |
| Rollins Brook Community Care Corp | |||||||||||
| 2201 S Clear Creek Road | Killeen | TX | 76549 | 461656773 | Support Operation of Hospital | TX | 501(c)(3) | Line 12a, I | Adventist Hlth SystemSunbelt Inc | Yes (1) | |
| San Marcos Nursing & Rehab Center Inc | |||||||||||
| 1900 Medical Parkway | San Marcos | TX | 78666 | 205782224 | Operation of Home for the Aged/Hlthcare Delivery | TX | 501(c)(3) | Line 10 | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| Shawnee Mission Hlth Care Properties Inc | |||||||||||
| 485 North Keller Road 250 | Maitland | FL | 32751 | 813914908 | Lease to Related Organization | GA | 501(c)(3) | Line 12c, III-FI | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| Shawnee Mission Health Care Inc | |||||||||||
| 6501 West 75th Street | Overland Park | KS | 66204 | 480952508 | Lease to Related Organization | KS | 501(c)(3) | Line 12c, III-FI | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| Shawnee Mission Medical Center Inc | |||||||||||
| 9100 W 74th Street | Shawnee Mission | KS | 66204 | 480637331 | Operation of Hospital & Related Services | KS | 501(c)(3) | Line 3 | Adventist Hlth Mid-America Inc | Yes (1) | |
| South Pasco Health Care Properties Inc | |||||||||||
| 38250 A Avenue | Zephyrhills | FL | 33542 | 510605679 | Lease to Related Organization | GA | 501(c)(3) | Line 12c, III-FI | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| Southeast Volusia Healthcare Corp | |||||||||||
| 401 Palmetto Street | New Smyrna Beach | FL | 32168 | 473793197 | Operation of Hospital & Related Services | FL | 501(c)(3) | Line 3 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| Southwest Volusia Health Services Inc | |||||||||||
| 1055 Saxon Blvd | Orange City | FL | 32763 | 593281591 | Medical Office Building for Hospital | FL | 501(c)(3) | Line 12a, I | Southwest Volusia Hlthcare Corp | Yes (1) | |
| Southwest Volusia Healthcare Corp | |||||||||||
| 1055 Saxon Blvd | Orange City | FL | 32763 | 593149293 | Operation of Hospital & Related Services | FL | 501(c)(3) | Line 3 | Adventist Hlth SystemSunbelt Inc | Yes (1) | |
| Spring View Health & Rehab Center Inc (11-122222) | |||||||||||
| 485 North Keller Road 250 | Maitland | FL | 32751 | 205782288 | Inactive - Wind-Down | KY | 501(c)(3) | Line 10 | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| Sunbelt Health & Rehab Center - Apopka Inc | |||||||||||
| 305 East Oak Street | Apopka | FL | 32703 | 205774856 | Operation of Home for the Aged/Hlthcare Delivery | FL | 501(c)(3) | Line 10 | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| Sunbelt Health Care Centers Inc | |||||||||||
| 485 North Keller Road 250 | Maitland | FL | 32751 | 581473135 | Management Services | TN | 501(c)(3) | Line 12b, II | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| Tarpon Springs Hospital Foundation Inc | |||||||||||
| 1395 S Pinellas Ave | Tarpon Springs | FL | 34689 | 590898901 | Operation of Hospital & Related Services | FL | 501(c)(3) | Line 3 | University Community Hospital Inc | Yes (1) | |
| Tarrant County Health Care Properties Inc | |||||||||||
| 301 Huguley Blvd | Burleson | TX | 76028 | 510605677 | Lease to Related Organization | GA | 501(c)(3) | Line 12c, III-FI | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| The Comforter Health Care Group Inc | |||||||||||
| 605 Montgomery Road | Altamonte Springs | FL | 32714 | 271857940 | Support Services to Related Hospice | FL | 501(c)(3) | Line 12c, III-FI | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| Tri-County Nursing and Rehab Center Inc | |||||||||||
| 1290 Celebration Blvd | Kissimmee | FL | 34747 | 472219363 | Operation of Home for the Aged/Hlthcare Delivery | FL | 501(c)(3) | Line 10 | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| University Community Hospital Foundation Inc | |||||||||||
| 3100 E Fletcher Ave | Tampa | FL | 33613 | 592554889 | Fund-raising for Tax-exempt hospital | FL | 501(c)(3) | Line 7 | 0 | N/A | |
| University Community Hospital Inc | |||||||||||
| 3100 E Fletcher Ave | Tampa | FL | 33613 | 591113901 | Operation of Hospitals & Related Services | FL | 501(c)(3) | Line 3 | Adventist Hlth System Sunbelt Hlthcare Corp | Yes (1) | |
| West Florida Health Home Care Inc | |||||||||||
| 13601 Bruce B Downs Blvd Ste 110 | Tampa | FL | 33613 | 593686109 | Home Health Services | GA | 501(c)(3) | Line 10 | AdventHealth West Florida Ambulatory Svcs Inc | Yes (1) | |
| Zephyr Haven Health & Rehab Center Inc | |||||||||||
| 38250 A Avenue | Zephyrhills | FL | 33542 | 205774930 | Operation of Home for the Aged/Hlthcare Delivery | FL | 501(c)(3) | Line 10 | Sunbelt Hlth Care Centers Inc | Yes (1) | |
| Zephyrhills Health & Rehab Center Inc | |||||||||||
| 7350 Dairy Road | Zephyrhills | FL | 33540 | 205774967 | Operation of Home for the Aged/Hlthcare Delivery | FL | 501(c)(3) | Line 10 | Sunbelt Hlth Care Centers Inc | Yes (1) | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (12 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| Fletcher Hospital Surgical Ventures LLC | |||||||||
| 9131 Anson Way Ste 304 | Raleigh | NC | 27615 | 861482646 | Indirect Interest in Surgery Center | NC | N/A | 0 | 0 |
| Florida Hospital DMERT LLC | |||||||||
| 500 Winderley Place Ste 324 | Maitland | FL | 32751 | 202392253 | Medical Equipment | FL | N/A | 0 | Yes (1) |
| Florida Hospital Home Infusion LLP | |||||||||
| 500 Winderley Place Ste 226 | Maitland | FL | 32751 | 593142824 | Home Infusion Services | FL | N/A | 0 | Yes (1) |
| Functional Neurosurgical Ambulatory Surgery Ctr LLC | |||||||||
| 11 W Dry Creek Circle 120 | Littleton | CO | 80120 | 464426708 | Surgery Center | CO | N/A | 0 | 0 |
| M&O Orlando MOB I LLC | |||||||||
| 1919 N Orange Ave Ste E | Orlando | FL | 32804 | 844259138 | Operation of Medical Office Building | DE | N/A | 0 | 0 |
| OnPoint OBGYN LLC (21-123122) | |||||||||
| 7780 S Broadway 280 | Littleton | CO | 80122 | 873522453 | Healthcare Services | CO | N/A | 0 | 0 |
| PAHS OnPoint Imaging LLC | |||||||||
| 9205 S Broadway | Highlands Ranch | CO | 80129 | 833275105 | Imaging Center | CO | N/A | 0 | 0 |
| PAHS OnPoint Urgent Care LLC | |||||||||
| 9100 E Mineral Circle | Centennial | CO | 80112 | 832465331 | Urgent Care Center | CO | N/A | 0 | 0 |
| Princeton Homecare Services LLC (11-8122) | |||||||||
| 602 Courtland Street 310 | Orlando | FL | 32804 | 814196648 | Operation of Home Health Agency | FL | N/A | 0 | 0 |
| Surgery Center of Rome LP | |||||||||
| 501 Redmond Road NW | Rome | GA | 30165 | 200390305 | Surgery Center | GA | N/A | 0 | 0 |
| The Bariatric Center of Kansas City LLC | |||||||||
| 9100 W 74th Street | Merriam | KS | 66204 | 823025378 | Surgery Center | KS | N/A | 0 | 0 |
| Urgent Care Centers of Brevard County LLC | |||||||||
| 2600 Westhall Lane | Maitland | FL | 32751 | 844261523 | Urgent Care Centers | FL | N/A | 0 | Yes (1) |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (22 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| AdventHealth Orlando Network Inc (11 - 41922) | |||||||||
| 900 Hope Way | Altamonte Springs | FL | 32714 | 862639185 | Inactive | FL | N/A | C | Yes (1) |
| AdventHealth Professional Staffing Inc (11 - 12822) | |||||||||
| 900 Hope Way | Altamonte Springs | FL | 32714 | 880742779 | INACTIVE | FL | N/A | C | Yes (1) |
| AdventHealth Tampa Network Inc (11 - 41922) | |||||||||
| 900 Hope Way | Altamonte Springs | FL | 32714 | 862666178 | Inactive | FL | N/A | C | Yes (1) |
| AdventHealth Team Members Inc (11 - 12822) | |||||||||
| 900 Hope Way | Altamonte Springs | FL | 32714 | 880763664 | INACTIVE | FL | N/A | C | Yes (1) |
| AdventHealth Value Based Bundle Management LLC (61-123122) | |||||||||
| 101 Southhall Lane Ste 150 | Maitland | FL | 32751 | 873487910 | Medical Contracting and Billing | FL | N/A | C | Yes (1) |
| Altamonte Medical Plaza Condominium Association Inc | |||||||||
| 601 East Rollins Street | Orlando | FL | 32803 | 592855792 | Condo Association | FL | N/A | C | Yes (1) |
| Apopka Medical Plaza Condominium Association Inc | |||||||||
| 601 East Rollins Street | Orlando | FL | 32803 | 593000857 | Condo Association | FL | N/A | C | Yes (1) |
| Battle Creek Adventist Hospital | |||||||||
| 900 Hope Way | Altamonte Springs | FL | 32714 | 381359189 | Inactive | MI | N/A | C | Yes (1) |
| Florida Hospital Flagler Medical Offices Association Inc | |||||||||
| 60 Memorial Medical Parkway | Palm Coast | FL | 32164 | 262158309 | Condo Association | FL | N/A | C | Yes (1) |
| Florida Hosp Hlth Village Property Owner's Assoc Inc | |||||||||
| 550 E Rollins Street 7th Floor | Orlando | FL | 32803 | 821748255 | Condo Association | FL | N/A | C | Yes (1) |
| Florida Hospital Healthcare System Inc | |||||||||
| 101 Southhall Lane Ste 150 | Maitland | FL | 32751 | 593215680 | PHSO / CIN | FL | N/A | C | Yes (1) |
| Florida Medical Plaza Condominium Association Inc | |||||||||
| 601 East Rollins Street | Orlando | FL | 32803 | 592855791 | Condo Association | FL | N/A | C | Yes (1) |
| Kissimmee Multispecialty Clinic Condominium Association Inc | |||||||||
| 201 Hilda Street Suite 30 | Kissimmee | FL | 34741 | 593539564 | Condo Association | FL | N/A | C | Yes (1) |
| Midwest Management Services Inc | |||||||||
| 9100 West 74th Street | Shawnee Mission | KS | 66204 | 480901551 | Inactive | KS | N/A | C | Yes (1) |
| North American Health Services Inc & Sub | |||||||||
| 900 Hope Way | Altamonte Springs | FL | 32714 | 621041820 | Holding Co. | TN | N/A | C | Yes (1) |
| Ormond Prof Associates Condo Assoc Inc (430 year end) | |||||||||
| 770 W Granada Blvd Ste 101 | Ormond Beach | FL | 32174 | 592694434 | Condo Association | FL | N/A | C | Yes (1) |
| Park Ridge Property Owner's Association Inc | |||||||||
| 1 Park Place Naples Road | Fletcher | NC | 28732 | 030380531 | Condo Association | NC | N/A | C | Yes (1) |
| Park Ridge Condominium #1 Unit Owners Association Inc | |||||||||
| 1 Park Place Naples Road | Fletcher | NC | 28732 | 010584623 | Condo Association | NC | N/A | C | Yes (1) |
| Surgicare of Rome Inc | |||||||||
| 501 Redmond Rd | Rome | GA | 30165 | 200376307 | Holding Company | GA | N/A | C | Yes (1) |
| Redmond Park Health Services Inc | |||||||||
| 501 Redmond Rd | Rome | GA | 30165 | 621330078 | Holding Company | GA | N/A | C | Yes (1) |
| The Garden Retirement Community Inc | |||||||||
| 485 North Keller Road Ste 250 | Maitland | FL | 32751 | 593414055 | Real Estate Rental | FL | N/A | C | Yes (1) |
| Winter Park Medical Office Building I Condo Assoc Inc | |||||||||
| 601 East Rollins Street | Orlando | FL | 32803 | 452228478 | Condo Association | FL | N/A | C | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (16 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| AdventHealth West Florida Imaging Inc | ||
| A | $654,302 | FMV |
| Florida Hospital Physician Group Inc | ||
| A | $1,168,700 | FMV |
| Adventist Health System Sunbelt Healthcare Corporation | ||
| M | $94,703 | % of Facility's Oper. Exp. |
| Adventist Health System Sunbelt Healthcare Corporation - Shared Services | ||
| M | $101,354 | % of Facility's Oper. Exp. |
| Adventist Health System Sunbelt Healthcare Corporation | ||
| P | $118,954 | Cost |
| AdventHealth West Florida Imaging Inc | ||
| P | $460,588 | Cost |
| Florida Hospital Physician Group Inc | ||
| Q | $724,467 | Cost |
| University Community Hospital Inc | ||
| Q | $1,292,428 | Cost |
| AdventHealth West Florida Imaging Inc | ||
| Q | $51,540 | Cost |
| West Florida Health Home Care Inc | ||
| Q | $112,383 | Cost |
| Pasco-Pinellas Hillsborough Community Health System Inc | ||
| S | $9,843,245 | Actual Amount Transferred |
| University Community Hospital Inc | ||
| S | $6,754,455 | Actual Amount Transferred |
| Florida Hospital Zephyrhills Inc | ||
| S | $847,917 | Actual Amount Transferred |
| Tarpon Springs Hospital Foundation Inc | ||
| S | $178,579 | Actual Amount Transferred |
| Florida Hospital Physician Group Inc | ||
| P | $431,453 | Cost |
| Florida Hospital Ocala Inc | ||
| Q | $68,283 | Cost |