2022-11-15T08:56:04-06:00 2021-12-31 990 2021-01-01 204600646 ADVENTIST PHYSICIAN SERVICES INC ADVE 3013153030 820 WEST DIAMOND AVE 600 GAITHERSBURG MD 208781419 KRISTEN PULIO SR. VICE PRESIDENT AND CFO 3013153030 2022-11-15 KRISTEN PULIO XXX-XX-XXXX 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z ADVENTIST HEALTHCARE ADVENTIST MEDICAL GROUP TERRY FORDE 820 WEST DIAMOND AVE 600 GAITHERSBURG MD 208781419 16483765 0 X WWW.ADVENTISTHEALTHCARE.COM X 2006 MD WE EXTEND GOD'S CARE THROUGH THE MINISTRY OF PHYSICAL, MENTAL AND SPIRITUAL HEALING. 4 0 0 0 0 0 0 23824 13309492 16459941 0 0 0 0 13309492 16483765 0 0 0 0 19225200 23034401 0 0 0 6515846 7271108 25741046 30305509 -12431554 -13821744 6867140 12232434 62180489 106341875 -55313349 -94109441 X WE EXTEND GOD'S CARE THROUGH THE MINISTRY OF PHYSICAL, MENTAL AND SPIRITUAL HEALING. 0 0 25450695 16459941 ADVENTIST PHYSICIAN SERVICES, INC. D/B/A ADVENTIST HEALTHCARE ADVENTIST MEDICAL GROUP (ADVENTIST MEDICAL GROUP) IS A PREMIER, MULTI-SPECIALTY PHYSICIAN ORGANIZATION COMMITTED TO PROVIDING HIGH QUALITY CARE TO PATIENTS. FOUNDED IN 2006, WE ARE AN INDEPENDENT NOT-FOR-PROFIT ORGANIZATION.TODAY ADVENTIST PHYSICIAN SERVICES (APS) OPERATES UNDER THE NAME ADVENTIST MEDICAL GROUP (AMG). IT EMPLOYS ABOUT 50 COMMUNITY PHYSICIANS IN A VARIETY OF PRIMARY CARE AND MEDICAL SPECIALTIES IN THE AREAS OF BEHAVIORAL HEALTH, ENDOCRINOLOGY AND PHYSIATRY, AS WELL AS PEDIATRIC ORTHOPEDICS TO SERVE ADVENTIST HEALTHCARE'S COMMUNITIES IN....CONTINUES ON SCHEDULE O.MONTGOMERY, FREDERICK, AND PRINCE GEORGE'S COUNTIES IN MARYLAND. AMG PROVIDES ADMINISTRATIVE, FINANCIAL MANAGEMENT, TECHNICAL AND BUSINESS SUPPORT SERVICES THAT ARE ESSENTIAL FOR PHYSICIANS TO PROVIDE QUALITY CARE AND OPERATE SUCCESSFUL PRACTICES.OUR SIZE AND GROUP PRACTICE STRUCTURE ALLOW US TO PROVIDE CARE FOR PATIENTS, WITH MOST OF THE CARE BEING RELATED TO THE CARDIOLOGY SPECIALTY, AND BEHAVIORAL HEALTH AREA AND REHABILITATION AND PRIMARY CARE. WE ARE INTEGRATING WITH OUR OTHER HEALTH SERVICES WITHIN ADVENTIST HEALTHCARE TO DELIVER THE MOST VALUE TO OUR COMMUNITY.IN OCTOBER OF 2021, AMG TOOK OVER THE EMPLOYMENT OF SEVERAL SURGICAL AND MEDICAL SPECIALTIES FROM MANAGEMENT UNDER THE MEDICAL FACULTY ASSOCIATES, WHICH IS A PART OF GEORGE WASHINGTON UNIVERSITY. AMG NOW MANAGES ALL THE PRIMARY CARE AND SPECIALTY CARE PRACTICES UNDER AMG.IN 2021, OUR AMG PHYSICIANS HAD MORE THAN 60,000 AMBULATORY PATIENT ENCOUNTERS, INCLUDING NEW PATIENTS, AND EXISTING PATIENTS. A FEW OF OUR BUSINESS SEGMENTS ALONE ACCOUNTED FOR NEARLY 38,000 VISITS. ADDITIONALLY, OUR APS BEHAVIORAL HEALTH PHYSICIANS PROVIDED CARE FOR THE INPATIENTS AT ADVENTIST HEALTHCARE, INC., D/B/A ADVENTIST HEALTHCARE WASHINGTON ADVENTIST HOSPITAL AND ADVENTIST HEALTHCARE, INC., D/B/A ADVENTIST HEALTHCARE BEHAVIORAL HEALTH & WELLNESS SERVICES' HOSPITALS, SERVING BEHAVIORAL HEALTH UNITS OF 35 AND 100 PLUS BEDS RESPECTIVELY. 25450695 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 4 0 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 0 X KRISTEN PULIO SVP & CFO 3013153030 820 WEST DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781419 JOHN SACKETT EVP & COO, AHC 2.00 48.00 X X 0 1755941 67598 TERRY FORDE PRESIDENT & CEO, AHC 2.00 48.00 X X 0 1671698 62165 JAMES G LEE AHC EVP/CFO,END 10/21; AHC EVP,CSO 3.00 47.00 X X 0 964842 175915 KRISTEN PULIO AHC SVP/CRO;AHC SVP/CFO,STRT 10/2021 2.00 48.00 X X 0 552488 124728 MARTA BRITO PEREZ SVP,POP. HEALTH/POST-ACUTE CARE SVCS 34.00 16.00 X 0 735552 41536 MARY MCNAMARA WARD VP, PHYSICIAN NETWORKS OPS 40.00 X 422427 0 5108 DAVID GREENBLUM ASSOCIATE MEDICAL DIR. - BEHAVIORAL 40.00 X 286156 0 42064 MARK SCHER PHYSICIAN 40.00 X 290983 0 33459 JASMINE SAWHNEY ASSOCIATE MEDICAL DIR. - BEHAVIORAL 40.00 X 267236 0 43059 BINDU KOSHY LEAD PHYSICIAN 40.00 X 272425 0 37198 1539227 5680521 632830 35 0 1 0 GUIDEHOUSE MANAGED SERVICES 4511 PAYSPHERE CIR CHICAGO IL 60674 BILLING & COLLECTIONS 650802 HEARTCARE IMAGING INC 760 N US HIGHWAY 1 TEQUESTA FL 33469 CARDIOLOGY SERVICES 505606 ECLINICALWORKS LLC PO BOX 847950 BOSTON MA 022847950 AMBULATORY CLINICAL SOFTWARE SYSTEMS 312167 LAKSHYA NAIR 14915 BROSCHART RD STE 2200 ROCKVILLE MD 20850 PHYSICIANS SERVICES 299840 RAMESH K THAPAR 604 S FREDERICK AVE 213 GAITHERSBURG MD 20877 PHYSICIAN SERVICES 245555 9 23824 23824 PHYSICIAN SERVICES 900099 16459941 16459941 16459941 16483765 16459941 0 0 X 20300653 17708048 2592605 430782 360114 70668 476911 302308 174603 1826055 1669988 156067 522667 522667 3057836 2933182 124654 293607 2993 290614 288883 264199 24684 197684 4054 193630 1051055 941278 109777 5129 5129 22327 20238 2089 287368 287368 581526 581526 MEDICAL SUPPLIES 352688 352688 RECRUITMENT 244933 69124 175809 COLLECTION FEES/LICENSE 214338 7317 207021 COST ALLOC. FROM PARENT 151067 151067 30305509 25450695 4854814 0 3048924 4140183 1139343 5044026 91638 161697 3198868 573833 2527895 2625035 59340 261493 6867140 12232434 5887876 5213504 120211 357548 56172402 100770823 62180489 106341875 X -55313349 -94127626 18185 -55313349 -94109441 6867140 12232434 X -13821744 -24974348 X 0 1 X 1 1 1 X 23824 23824 6739703 6700227 6349065 13309492 16459941 49558428 6739703 6700227 6349065 13309492 16483765 49582252 0 0 0 49582252 107267 107267 107267 107267 6739703 6807494 6349065 13309492 16483765 49689519 0.99780 0.99720 0.00220 0.00280 X 2068761 278088 1790673 681788 260147 421641 448319 35598 412721 2625035 INTERCOMPANY PAYABLE 100444010 FINANCING & OPERATING LEASE OBLIGATIONS 326813 100770823 X PART X, LINE 2: THE CORPORATION ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD IS MET. MANAGEMENT DETERMINED THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2021 OR 2020. THE CORPORATION'S POLICY IS TO RECOGNIZE INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND PENALTIES IN OPERATING EXPENSES. X X X X X 0 1 0 0 0 0 0 1 0 JOHN SACKETT EVP & COO, AHC 0 573450 0 214511 0 967980 0 26000 0 41598 0 1823539 0 0 TERRY FORDE PRESIDENT & CEO, AHC 0 900426 0 374113 0 397159 0 26000 0 36165 0 1733863 0 188889 JAMES G LEE AHC EVP/CFO,END 10/21; AHC EVP,CSO 0 631246 0 200460 0 133136 0 153557 0 22358 0 1140757 0 113955 MARTA BRITO PEREZ SVP,POP. HEALTH/POST-ACUTE CARE SVCS 0 428611 0 145760 0 161181 0 26000 0 15536 0 777088 0 0 KRISTEN PULIO AHC SVP/CRO;AHC SVP/CFO,STRT 10/2021 0 336043 0 107499 0 108946 0 116347 0 8381 0 677216 0 58928 MARY MCNAMARA WARD VP, PHYSICIAN NETWORKS OPS 228498 0 60448 0 133481 0 4833 0 275 0 427535 0 46462 0 DAVID GREENBLUM ASSOCIATE MEDICAL DIR. - BEHAVIORAL 258192 0 25550 0 2414 0 26000 0 16064 0 328220 0 0 0 MARK SCHER PHYSICIAN 273183 0 15625 0 2175 0 26000 0 7459 0 324442 0 0 0 JASMINE SAWHNEY ASSOCIATE MEDICAL DIR. - BEHAVIORAL 257678 0 9300 0 258 0 19500 0 23559 0 310295 0 0 0 BINDU KOSHY LEAD PHYSICIAN 254673 0 16500 0 1252 0 15660 0 21538 0 309623 0 0 0 PART I, LINE 3 PAY PRACTICE: ADVENTIST HEALTHCARE UTILIZES A SINGLE EMPLOYER ID FOR ALL ITS AFFILIATED ENTITIES FOR EMPLOYMENT PURPOSES. AS SUCH, ACTUAL COMPENSATION AND BENEFITS ARE CHARGED TO THE RESPECTIVE ENTITIES AND THE RESULTING COMPENSATION AND BENEFITS ARE REPORTED ON EACH AFFILIATE IRS FORM 990 AS IF PAID DIRECTLY BY SUCH AFFILIATE. AS APPLICABLE, THE SAME AND NON-ADDITIVE COMPENSATION AND EMPLOYMENT BENEFIT PLAN CONTRIBUTION AMOUNTS WERE ALSO DISCLOSED IN THE ADVENTIST HEALTHCARE INC. RELATED ENTITIES' RETURNS. INDEPENDENT GUIDELINES: WHEN SETTING COMPENSATION FOR THE OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, AND THE HIGHEST COMPENSATED EMPLOYEES, ADVENTIST HEALTHCARE FULLY COMPLIES WITH THE PROCEDURAL SAFEGUARDS EMBODIED IN IRS REGULATIONS. COMPENSATION FOR ADVENTIST HEALTHCARE OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, AND THE HIGHEST COMPENSATED EMPLOYEES IS ENTIRELY SET BY A COMMITTEE OF ADVENTIST HEALTHCARE BOARD OF TRUSTEES. IN SETTING COMPENSATION, THE GOVERNING BOARD COMMITTEE RELIES UPON MARKET COMPARABILITY DATA PROVIDED BY AN INDEPENDENT OUTSIDE COMPENSATION CONSULTANT WHO PROVIDES A SUMMARY OF HEALTH CARE SALARIES AND BENEFITS FOR COMPARABLE SIZED ORGANIZATIONS BOTH NATIONALLY AND IN THE BALTIMORE-WASHINGTON REGION. TO FURTHER ENSURE REASONABLENESS, BOTH COMPENSATION AND BENEFITS ARE TARGETED AT THE 50TH PERCENTILE (OR MEDIAN) OF THE MARKET. PART I, LINE 4B CERTAIN EMPLOYEES RECEIVED COMPENSATION FROM A DISTRIBUTION UNDER AN EXECUTIVE RETENTION 457F PLAN, WHICH BECAME EFFECTIVE ON JANUARY 1, 2015. PRE-TAX CONTRIBUTIONS ARE ACCUMULATED ANNUALLY AND ARE DISTRIBUTED ON JANUARY 1ST OF THE 2ND YEAR, IF STILL EMPLOYED, OR SOONER BASED ON CERTAIN EXCEPTIONS. THERE IS TYPICALLY A 2-YEAR DEFERRAL PERIOD BEFORE PAYMENTS ARE RELEASED. CONTRIBUTIONS ACCUMULATED IN 2019 WERE GENERALLY DISTRIBUTED ON JANUARY 1, 2021 AND CONTRIBUTIONS ACCUMULATED IN 2020 WILL GENERALLY BE DISTRIBUTED ON JANUARY 1, 2022. AMOUNTS LISTED UNDER PART II, COLUMN F INCLUDE PAYOUT AMOUNTS WHICH WERE CONSIDERED DEFERRED COMPENSATION FROM THE 457F PLAN IN OUR PRIOR YEAR RETURNS AND THESE AMOUNTS ARE NOW BEING SHOWN UNDER THE OTHER REPORTABLE INCOME, COLUMN B (III). THE ADVENTIST HEALTHCARE EXECUTIVE RETENTION PLAN PAYS CERTAIN PARTICIPANTS THEIR RETIREMENT PAYMENTS IN DIRECT CASH, RATHER THAN RETENTION BENEFITS OF DEFERRED CASH, AFTER ATTAINING THE PLAN'S RETIREMENT AGE. THE FOLLOWING THREE EXECUTIVES RECEIVED SUPPLEMENTAL RETIREMENT PAYMENTS UNDER THIS PLAN FEATURE: JOHN SACKETT: $137,472 RETIREMENT AGE PAYMENT; MARTA BRITO PEREZ: $104,218 RETIREMENT AGE PAYMENT; MARY MCNAMARA WARD: $64,856 RETIREMENT AGE PAYMENT. THE FOLLOWING EMPLOYEE RECEIVED A PAYOUT OF HIS ENTIRE ACCRUED BENEFIT UNDER THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP), DUE TO HAVING COMPLETED THE NECESSARY YEARS OF SERVICE AND ATTAINING THE NECESSARY AGE FOR VESTING AND PAYMENT. THIS AMOUNT ALSO WAS INCLUDED IN PRIOR YEAR 990 DISCLOSURES WHEN THE AMOUNT ACCRUED (I.E., THIS BENEFIT HAS BEEN REPORTED ON FORM 990 TWICE IN PRIOR YEARS AND IN THIS YEAR). JOHN SACKETT: $685,966. PART I, LINE 7 THE ANNUAL INCENTIVE COMPENSATION INCLUDES PAYMENTS BASED ON SATISFACTION OF PRE-DETERMINED PERFORMANCE TARGETS SUCH AS QUALITY/PATIENT SAFETY GOALS, EMPLOYEE AND PATIENT ENGAGEMENT GOALS, ORGANIZATIONAL GROWTH, AND FINANCIAL PERFORMANCE, AMONG OTHER THINGS. THE ANNUAL INCENTIVE COMPENSATION APPLIES TO DIRECTORS AND ABOVE. SUPPLEMENTAL INFORMATION: OTHER REPORTABLE COMPENSATION INCLUDES RETENTION PAYMENTS AND LUMP-SUM ADJUSTMENTS IN LIEU OF THE ACROSS-THE-BOARD INCREASE (FOR EMPLOYEES WHO ARE AT OR REACH THE RANGE MAXIMUM FOR THEIR POSITION). OTHER REPORTABLE COMPENSATION ALSO INCLUDES LONG-TERM DISABILITY COVERAGE, CELL PHONE ALLOWANCES, CASH-OUT OF UNUSED PAID TIME OFF (PTO) HOURS, IMPUTED VALUE OF LIFE INSURANCE BENEFITS, AND SEVERANCE, AS APPLICABLE. CERTAIN EXECUTIVES CAN ALSO RECEIVE REPORTABLE COMPENSATION THROUGH A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP), ONCE THEY HAVE VESTED IN THE PLAN. NON-TAXABLE BENEFITS INCLUDES PRE-TAX PAYROLL DEDUCTIONS (SUCH AS FLEXIBLE MEDICAL SPENDING, DEPENDENT CARE, AND EMPLOYEE HEALTH BENEFIT PREMIUMS), AND THE EMPLOYER PORTION OF CERTAIN EMPLOYEE BENEFITS SUCH AS HEALTH INSURANCE, DENTAL INSURANCE, VISION INSURANCE, AND LIFE INSURANCE, ETC. FORM 990, PART VI, SECTION A, LINE 6 ADVENTIST HEALTHCARE, INC. IS THE SOLE CORPORATE MEMBER OF ADVENTIST PHYSICIAN SERVICES, INC. WITH THE AUTHORITY TO APPROVE ITS BOARD MEMBERSHIP. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF TRUSTEES OF ADVENTIST HEALTHCARE, INC. APPOINTS THE MEMBERS OF ADVENTIST PHYSICIAN SERVICES, INC.'S GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B THE BOARD OF TRUSTEES APPROVES ALL ACTIONS OF MANAGEMENT. THE ACTIONS OF THE ADVENTIST PHYSICIAN SERVICES, INC.'S GOVERNING BOARD IS SUBJECT TO THE REVIEW OF THE BOARD OF ADVENTIST HEALTHCARE, INC. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING THE FORM 990 WITH THE IRS, IT WAS REVIEWED BY THE ORGANIZATION'S FINANCE DEPARTMENT AND EXECUTIVE MANAGEMENT TEAM. ALSO, PRIOR TO FILING THE FORM 990 WITH THE IRS, ALL MEMBERS OF THE BOARD ARE PROVIDED A COPY OF THE FORM 990 FOR THEIR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C PURSUANT TO THE ORGANIZATION'S CONFLICT OF INTEREST POLICY, EACH FACILITY BOARD MEMBER, OFFICER, DIRECTOR AND ANY EMPLOYEE IN A POSITION THAT REQUIRES COORDINATION AND/OR NEGOTIATION WITH CONTRACTORS OR SUPPLIES, IS REQUIRED ON AN ANNUAL BASIS TO DISCLOSE ANY BUSINESS OR FINANCIAL RELATIONSHIP OUTSIDE OF THE ORGANIZATION. AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST, OR THE PERCEPTION OR APPEARANCE OF A CONFLICT OF INTEREST, OCCURS WHEN A COVERED PERSON IS IN A POSITION TO INFLUENCE A DECISION THAT MAY RESULT IN A PERSONAL GAIN FOR THAT EMPLOYEE, A RELATIVE, OR OTHER PERSON LIVING IN THE SAME HOUSEHOLD, AS A RESULT OF ADVENTIST HEALTHCARE'S BUSINESS ACTIVITIES. A RELATIVE IS DEFINED AS ANY PERSON WHO IS RELATED BY BLOOD OR MARRIAGE, OR WHOSE RELATIONSHIP WITH THE COVERED PERSON IS SIMILAR TO THAT OF PERSONS WHO ARE RELATED BY BLOOD OR MARRIAGE. NO "PRESUMPTION OF GUILT" IS CREATED BY THE MERE EXISTENCE OF A RELATIONSHIP BETWEEN AN ADVENTIST HEALTHCARE EMPLOYEE AND AN OUTSIDE FIRM OR BUSINESS ENDEAVOR, OR OTHER POTENTIAL CONFLICT OF INTEREST. HOWEVER, IF A COVERED PERSON HAS ANY BUSINESS, FINANCIAL, OR OTHER RELATIONSHIP WITH ANY ORGANIZATION WHEREBY THE EXISTENCE OF THAT RELATIONSHIP EITHER CREATES A CONFLICT OF INTEREST OR IS PERCEIVED TO CREATE A CONFLICT OF INTEREST, THE COVERED PERSON MUST DISCLOSE THIS RELATIONSHIP TO THE DESIGNATED SENIOR MANAGER, OR GOVERNING BOARD, AS THE CASE MAY BE, AT THE LOCATION WHERE THE EMPLOYEE IS ASSIGNED. THE SENIOR MANAGER WILL REVIEW THE RELATIONSHIP, MAKE COMMENTS AND RECOMMENDATIONS, AND FORWARD ALL DOCUMENTATION TO THE ORGANIZATIONAL INTEGRITY COMMITTEE FOR A FINAL DECISION. COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY IS MONITORED AND ENFORCED BY THE HUMAN RESOURCES DEPARTMENT, ORGANIZATIONAL INTEGRITY DEPARTMENT AND THE LEGAL DEPARTMENT. FORM 990, PART VI, SECTION B, LINE 15 WHEN SETTING COMPENSATION FOR EXECUTIVES, OFFICERS, KEY EMPLOYEES, AND ALL EMPLOYEES, THE ORGANIZATION FULLY COMPLIES WITH THE PROCEDURAL SAFEGUARDS EMBEDDED IN THE IRS REGULATIONS. COMPENSATION IS ENTIRELY SET BY A COMMITTEE OF THE BOARD OF TRUSTEES. IN SETTING COMPENSATION, THE GOVERNING BOARD COMMITTEE RELIES UPON MARKET COMPARABILITY DATA PROVIDED BY AN INDEPENDENT OUTSIDE COMPENSATION CONSULTANT. TO ENSURE REASONABLENESS, COMPENSATION IS SET AT THE 50TH PERCENTILE OF THE NATURAL MARKET. GENERAL EXPLANATION: EMPLOYEES OF ANY OF THE ADVENTIST HEALTHCARE INC. AND AFFILIATED TAX EXEMPT ENTITIES IN THE STATE OF MARYLAND (INCLUDING ADVENTIST PHYSICIAN SERVICES, INC.) ARE PAID THROUGH A COMMON PAYMASTER, ADVENTIST HEALTHCARE, INC. AND ARE REPORTED ON ITS FORM 941. SALARY AND BENEFIT EXPENSES REPORTED ON THEIR RESPECTIVE RETURNS ARE ACTUAL CHARGES RELATED TO THE EMPLOYEES WORKING ON THE SPECIFIC TAX EXEMPT ENTITY. COMPENSATION INCLUDED REGULAR BASE SALARY, BONUS, PAID TIME OFF CASH OUT (ONLY FOR EMPLOYEES WHO LEAVE OUR ORGANIZATION), TAXABLE RELOCATION ALLOWANCE, HOLIDAY GIFT, RETROACTIVE COMPENSATION ADJUSTMENT, BEREAVEMENT LEAVE, EDUCATION, AND WITHDRAWAL OF DEFERRED COMPENSATION, AS APPLICABLE. THE SAME AND NON-ADDITIVE COMPENSATION AND EMPLOYMENT BENEFIT PLAN CONTRIBUTION AMOUNTS WERE ALSO DISCLOSED IN THE ADVENTIST HEALTHCARE INC.'S RELATED ENTITIES RETURNS. VENDOR PAYMENTS FOR ANY OF THE ADVENTIST HEALTHCARE, INC. AND RELATED ENTITIES IN THE STATE OF MARYLAND ARE MADE THROUGH A COMMON PAYMASTER, ADVENTIST HEALTHCARE, INC. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS, ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACT LABOR AND PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,933,182. MANAGEMENT AND GENERAL EXPENSES 124,654. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,057,836. FORM 990, PART XI, LINE 9: NET ORGANIZATION TRANSFER -819,354. OTHER RESTRICTED NET ASSETS ACTIVITY -24,154,994. APS CORELIFE LLC 820 W DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781419 851413968 PROVIDES WELLNESS AND WEIGHT MANAGEMENT MD 0 0 ADVENTIST PHYSICIAN SERVICES INC CARDIAC ASSOCIATES LLC 820 W DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781419 521532556 CARDIAC SERVICES MD 0 0 ADVENTIST PHYSICIAN SERVICES INC ADVENTIST HEALTHCARE INC 820 W DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781419 521532556 HEALTHCARE SERVICES MD 501(C)(3) LINE 3 MID-ATLANTIC ADVENTIST HEALTHCARE CORPORATION 0 ADVENTIST HEALTHCARE URGENT CARE CENTERS INC 820 W DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781419 461577511 CLINIC - EMERGENCY CARE MD 501(C)(3) LINE 10 ADVENTIST HEALTHCARE INC 0 ADVENTIST HOME HEALTH SERVICES INC 820 W DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781419 520986808 HOME CARE SERVICES MD 501(C)(3) LINE 10 ADVENTIST HEALTHCARE INC 0 ADVENTIST REHABILITATION HOSPITAL OF MARYLAND INC 820 W DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781419 201486678 REHABILITATION HOSPITAL MD 501(C)(3) LINE 3 ADVENTIST HEALTHCARE INC 0 ADVENTIST REHABILITATION INC 820 W DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781419 300780513 REHABILITATION SERVICES MD 501(C)(3) LINE 10 ADVENTIST REHABILITATION HOSPITAL OF MARYLAND INC 0 MID-ATLANTIC ADVENTIST HEALTHCARE CORPORATION 820 W DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781419 521884153 HOLDING COMPANY MD 501(C)(3) LINE 10 N/A 0 REGINALD S LOURIE CENTER FOR INFANTS AND YOUNG CHILDREN 820 W DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781419 521255870 BEHAVIORAL CARE MD 501(C)(3) LINE 10 ADVENTIST HEALTHCARE INC 0 SHADY GROVE ADVENTIST HOSPITAL FOUNDATION INC 820 W DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781419 521216429 FUNDRAISING MD 501(C)(3) LINE 12A, I N/A 0 WASHINGTON ADVENTIST HOSPITAL FOUNDATION INC 820 W DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781419 521692158 FUNDRAISING MD 501(C)(3) LINE 12A, I ADVENTIST HEALTHCARE INC 0 ADVENTIST HEALTHCARE FORT WASHINGTON MEDICAL CENTER INC 820 W DIAMOND AVE SUITE 600 GAITHERSBURG MD 208781419 842670875 ACUTE CARE HOSPITAL MD 501(C)(3) LINE 3 ADVENTIST HEALTHCARE INC 0 SHADY GROVE MEDICAL BUILDING LLC 1650 TYSONS BOULEVARD STE 820 MCLEAN VA 22102 274599411 MEDICAL OFFICE BUILDING MD N/A RELATED 0 0 NEXUS MONTGOMERY REGIONAL PARTNERSHIP LLC 820 WEST DIAMOND AVE SUITE 600 GAITHERSBURG MD 20878 815410250 HEALTHCARE & COMMUNITY SERVICE FOR IMPROVED HEALTH MD N/A RELATED 0 0 CORELIFE ADVENTIST LLC 821 WEST BENFIELD ROAD SUITE 5 SEVERNA PARK MD 21146 841813204 PROVIDES WELLNESS AND WEIGHT MANAGEMENT MD N/A RELATED 0 0 ADVENTIST HEALTHCARE SURGERY CENTER AT NATIONAL HARBOR LLC 251 NATIONAL HARBOR BOULEVARD SUITE OXEN HILL MD 20745 852814304 AMBULATORY SURGICAL SERVICES MD N/A RELATED 0 0 MID-ATLANTIC RADIATION ONCOLOGY LLC 10101 WOODLOCH FOREST DR THE WOODLANDS TX 77380 844560643 RADIATION ONCOLOGY SERVICES MD N/A RELATED 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0