ADVENTIST HEALTHCARE URGENT CARE CENTERS INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- ADVENTIST HEALTHCARE URGENT CARE CENTERS INC (EIN 46-1577511)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-12
- IRS object ID
- 202143169349308364
- Schema version
- 2020v4.1
- 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 | 2021-11-12T14:17:17-06:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 461577511 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADVENTIST HEALTHCARE URGENT | BusinessNameLine1Txt |
| Business Name Line2 | CARE CENTERS INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ADVE | BusinessNameControlTxt |
| Phone | 3013153030 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 820 WEST DIAMOND AVE NO 600 | AddressLine1Txt |
| City | GAITHERSBURG | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 208781419 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAMES G LEE | PersonNm |
| Person Title | EXEC. VICE PRESIDENT & CFO | PersonTitleTxt |
| Phone | 3013153030 | PhoneNum |
| Signature | 2021-11-12 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JAMES | PersonFirstNm |
| Person Last | LEE | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
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 | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TERRY FORDE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 820 WEST DIAMOND AVE NO 600 | AddressLine1Txt |
| City | GAITHERSBURG | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 208781419 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,959,418 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ADVENTISTHEALTHCARE.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2012 | FormationYr |
| Legal Domicile State | MD | LegalDomicileStateCd |
| Activity Or Mission | WE EXTEND GOD'S CARE THROUGH THE MINISTRY OF PHYSICAL, MENTAL AND SPIRITUAL HEALING. | ActivityOrMissionDesc |
| Voting Members Governing Body | 3 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 0 | 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 | $6,535,432 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $7,959,418 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $6,535,432 | PYTotalRevenueAmt |
| CY Total Revenue | $7,959,418 | 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 | $4,506,137 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,141,827 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,717,739 | PYOtherExpensesAmt |
| CY Other Expenses | $3,681,331 | CYOtherExpensesAmt |
| PY Total Expenses | $8,223,876 | PYTotalExpensesAmt |
| CY Total Expenses | $7,823,158 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,688,444 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $136,260 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $14,786,839 | TotalAssetsBOYAmt |
| Total Assets EOY | $14,415,437 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $27,196,330 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $27,238,331 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$12,409,491 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$12,822,894 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | WE EXTEND GOD'S CARE THROUGH THE MINISTRY OF PHYSICAL, MENTAL AND SPIRITUAL HEALING. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $6,101,165 | ExpenseAmt |
| Revenue | $7,959,418 | RevenueAmt |
| Desc | ADVENTIST HEALTHCARE URGENT CARE OFFERS QUALITY, CONVENIENT CARE FOR ADULTS AND CHILDREN AND IS OPEN EVERY DAY FROM 8 A.M. 8 P.M. THE FIRST ADVENTIST HEALTHCARE URGENT CARE CENTER OPENED IN MARCH 2015 IN ROCKVILLE, MD AND TWO NEW LOCATIONS OPENED IN GERMANTOWN, MD AND LAUREL, MD IN 2016. A NEW LOCATION IN TAKOMA PARK OPENED IN AUGUST 2019 AND IS OPEN 24/7. CONDITIONS TREATED AT THE CENTERS INCLUDE A WIDE RANGE OF MILD ILLNESSES AND INJURIES INCLUDING COMMON VIRUSES, INFECTIONS, STOMACH AND DIGESTIVE CONDITIONS, CUTS, BREAKS AND SPRAINS, RASHES AND OTHER SKIN CONDITIONS. COVID-19 TESTING IS ALSO AVAILABLE. ALL SITES HAVE ON-SITE X-RAYS AND LABS. NARRATIVE CONTINUES ON SCHEDULE O.ALSO AVAILABLE ARE COMPREHENSIVE OCCUPATIONAL HEALTH SERVICES INCLUDING WORKERS' COMPENSATION AND DRUG AND ALCOHOL TESTING FOR LOCAL AREA BUSINESSES. | Desc |
| Total Program Service Expenses | $6,101,165 | 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 | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| 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 | 3 | 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 | Yes (1) | LocalChaptersInd |
| Policies Reference Chapters | Yes (1) | PoliciesReferenceChaptersInd |
| 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 | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JAMES G LEE EXEC VP & CFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3013153030 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 820 WEST DIAMOND AVE SUITE 600 | AddressLine1Txt |
| City | GAITHERSBURG | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 208781419 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (9 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 | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| TERRY FORDE | |||||||||
| PRESIDENT & CEO, AHC | 1.25 | 48.75 | Yes (X) | Yes (X) | $0 | $1,575,074 | $308,054 | ||
| JOHN SACKETT | |||||||||
| EVP & COO, AHC | 2.00 | 58.00 | Yes (X) | Yes (X) | $0 | $1,125,840 | $67,261 | ||
| JAMES G LEE | |||||||||
| EVP & CFO, AHC | 5.00 | 45.00 | Yes (X) | Yes (X) | $0 | $856,033 | $169,870 | ||
| EUNMEE SHIM | |||||||||
| PRESIDENT OF FWMC & AHC AMB NETWK | 8.00 | 52.00 | $0 | $665,719 | $146,074 | Yes (X) | |||
| AMRA NASIR | |||||||||
| CLINICAL OPS MEDICAL DIR, PHYSICIAN | 40.00 | $229,850 | $0 | $46,850 | Yes (X) | ||||
| RICHARD SAMUEL | |||||||||
| MEDICAL DIRECTOR, PHYSICIAN | 40.00 | $235,754 | $0 | $11,704 | Yes (X) | ||||
| NANCY NYAKUNDI | |||||||||
| NURSE PRACTITIONER | 40.00 | $167,197 | $0 | $38,674 | Yes (X) | ||||
| VERA OGEMBO | |||||||||
| NURSE PRACTITIONER | 40.00 | $163,879 | $0 | $41,233 | Yes (X) | ||||
| ROBERTA SCHNELLER | |||||||||
| PHYSICIAN ASSISTANT | 40.00 | $148,376 | $0 | $18,534 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $945,056 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,222,666 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $848,254 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 14 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| LOCUM LEADERS LLC | |||||
| 100 MANSELL COURT SUITE 500 | ROSWELL | GA | 30076 | RECRUITING CONSULTING SERVICES | $215,853 |
| QUEST DIAGNOSTICS | |||||
| 14225 NEWBROOK DR | CHANTILLY | VA | 191761303 | CLINICAL LABORATORY SERVICES | $129,675 |
| P&R ENTERPRISES INC | |||||
| 5681 COLUMBIA PIKE SUITE 101 | FALLS CHURCH | VA | 22041 | JANITORIAL SERVICES | $116,236 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OUTPATIENT SERVICES | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $7,959,418 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,959,418 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $7,959,418 | TotalProgramServiceRevenueAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,959,418 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,959,418 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | 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 | $3,507,451 | TotalAmt |
| Program Services | $2,982,058 | ProgramServicesAmt |
| Management And General | $525,393 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $101,972 | TotalAmt |
| Program Services | $84,617 | ProgramServicesAmt |
| Management And General | $17,355 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $187,520 | TotalAmt |
| Program Services | $153,611 | ProgramServicesAmt |
| Management And General | $33,909 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $344,884 | TotalAmt |
| Program Services | $303,824 | ProgramServicesAmt |
| Management And General | $41,060 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $952,732 | TotalAmt |
| Program Services | $764,768 | ProgramServicesAmt |
| Management And General | $187,964 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $184,631 | TotalAmt |
| Program Services | $184,631 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $120,430 | TotalAmt |
| Program Services | $57,604 | ProgramServicesAmt |
| Management And General | $62,826 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,430,494 | TotalAmt |
| Program Services | $1,211,548 | ProgramServicesAmt |
| Management And General | $218,946 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,065 | TotalAmt |
| Program Services | $4,845 | ProgramServicesAmt |
| Management And General | $7,220 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,392 | TotalAmt |
| Management And General | $1,392 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $367,401 | TotalAmt |
| Management And General | $367,401 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,724 | TotalAmt |
| Management And General | $72,724 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $346,581 | $346,581 | |
| COST ALLOC. FROM PARENT | $150,497 | $0 | $150,497 |
| COLLECTION FEES/LICENSE | $41,324 | $7,078 | $34,246 |
| RECRUITING | $1,060 | $1,060 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,823,158 | TotalAmt |
| Program Services | $6,101,165 | ProgramServicesAmt |
| Management And General | $1,721,993 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $650 | BOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $580,228 | BOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,174,930 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,336 | BOYAmt |
| EOY | $89,612 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,352,730 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,619,203 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,100,032 | BOYAmt |
| EOY | $5,733,527 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,042,593 | BOYAmt |
| EOY | $7,417,368 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,786,839 | BOYAmt |
| EOY | $14,415,437 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,939,857 | BOYAmt |
| EOY | $15,719,742 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,242,136 | BOYAmt |
| EOY | $4,129,112 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,014,337 | BOYAmt |
| EOY | $7,389,477 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,196,330 | BOYAmt |
| EOY | $27,238,331 | 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 | -$12,409,491 | BOYAmt |
| EOY | -$12,822,894 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$12,409,491 | BOYAmt |
| EOY | -$12,822,894 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,786,839 | BOYAmt |
| EOY | $14,415,437 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $136,260 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$549,663 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,065,495 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,882,021 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,182,835 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,535,432 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,959,418 | CurrentTaxYearAmt |
| Total | $25,625,201 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,065,495 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,882,021 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,182,835 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,535,432 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,959,418 | CurrentTaxYearAmt |
| Total | $25,625,201 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $25,625,201 | PublicSupportTotal509Amt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,065,495 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,882,021 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,182,835 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,535,432 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,959,418 | CurrentTaxYearAmt |
| Total | $25,625,201 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 1.00000 | PublicSupportCY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,906,015 | OtherCostOrOtherBasisAmt |
| Book Value | $1,906,015 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $963,188 | OtherCostOrOtherBasisAmt |
| Depreciation | $347,143 | DepreciationAmt |
| Book Value | $616,045 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,434,465 | OtherCostOrOtherBasisAmt |
| Depreciation | $808,444 | DepreciationAmt |
| Book Value | $2,626,021 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $884,290 | OtherCostOrOtherBasisAmt |
| Depreciation | $386,986 | DepreciationAmt |
| Book Value | $497,304 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $164,772 | OtherCostOrOtherBasisAmt |
| Depreciation | $76,630 | DepreciationAmt |
| Book Value | $88,142 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,733,527 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| SECURITY DEPOSIT | $200,582 |
| OPERATING LEASE RIGHT-OF-USE ASSET | $7,216,786 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $7,417,368 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| OPERATING LEASE OBLIGATIONS | $7,367,422 |
| LONG-TERM OBLIGATIONS | $22,055 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $7,389,477 | 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 | FIN 48 NOTES: 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 2020 OR 2019. THE CORPORATION'S POLICY IS TO RECOGNIZE INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND PENALTIES IN OPERATING EXPENSES. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| 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 | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TERRY FORDE | ||||||||||||||
| PRESIDENT & CEO, AHC | $0 | $910,479 | $0 | $363,083 | $0 | $301,512 | $0 | $272,570 | $0 | $35,484 | $0 | $1,883,128 | $0 | $189,349 |
| JOHN SACKETT | ||||||||||||||
| EVP & COO, AHC | $0 | $646,430 | $0 | $194,690 | $0 | $284,720 | $0 | $26,000 | $0 | $41,261 | $0 | $1,193,101 | $0 | $100,516 |
| JAMES G LEE | ||||||||||||||
| EVP & CFO, AHC | $0 | $579,230 | $0 | $165,825 | $0 | $110,978 | $0 | $147,781 | $0 | $22,089 | $0 | $1,025,903 | $0 | $71,660 |
| EUNMEE SHIM | ||||||||||||||
| PRESIDENT OF FWMC & AHC AMB NETWK | $0 | $407,395 | $0 | $133,295 | $0 | $125,029 | $0 | $115,594 | $0 | $30,480 | $0 | $811,793 | $0 | $64,375 |
| AMRA NASIR | ||||||||||||||
| CLINICAL OPS MEDICAL DIR, PHYSICIAN | $228,351 | $0 | $0 | $0 | $1,499 | $0 | $25,000 | $0 | $21,850 | $0 | $276,700 | $0 | $0 | $0 |
| RICHARD SAMUEL | ||||||||||||||
| MEDICAL DIRECTOR, PHYSICIAN | $231,984 | $0 | $0 | $0 | $3,770 | $0 | $4,670 | $0 | $7,034 | $0 | $247,458 | $0 | $0 | $0 |
| NANCY NYAKUNDI | ||||||||||||||
| NURSE PRACTITIONER | $163,742 | $0 | $0 | $0 | $3,455 | $0 | $16,941 | $0 | $21,733 | $0 | $205,871 | $0 | $0 | $0 |
| VERA OGEMBO | ||||||||||||||
| NURSE PRACTITIONER | $159,632 | $0 | $0 | $0 | $4,247 | $0 | $19,500 | $0 | $21,733 | $0 | $205,112 | $0 | $0 | $0 |
| ROBERTA SCHNELLER | ||||||||||||||
| PHYSICIAN ASSISTANT | $147,152 | $0 | $0 | $0 | $1,224 | $0 | $3,900 | $0 | $14,634 | $0 | $166,910 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 2018 WERE GENERALLY DISTRIBUTED ON JANUARY 1, 2020 AND CONTRIBUTIONS ACCUMULATED IN 2019 WILL GENERALLY BE DISTRIBUTED ON JANUARY 1, 2021. 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 457(F) PLAN DISCUSSED IMMEDIATELY ABOVE PAYS CERTAIN PARTICIPANTS SUPPLEMENTAL RETIREMENT PAYMENTS IN DIRECT CASH, RATHER THAN RETENTION BENEFITS OF DEFERRED CASH, AFTER ATTAINING THE PLAN'S RETIREMENT AGE. THE FOLLOWING EXECUTIVE RECEIVED A SUPPLEMENTAL RETIREMENT PAYMENT UNDER THIS PLAN FEATURE: JOHN SACKETT: $130,857 EARLY LUMP-SUM. |
| 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 (ONLY FOR EMPLOYEES WHO LEAVE OUR ORGANIZATION), 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. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | SEE BY LAWS, ARTICLE II: THE SOLE MEMBER OF THIS ORGANIZATION IS ADVENTIST HEALTHCARE, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | SEE BY LAWS, ARTICLE II. MEMBERSHIP. THERE SHALL BE A SINGLE CLASS OF CONSTITUENT MEMBERS OF THE CORPORATION (EACH INDIVIDUALLY A "MEMBER AND COLLECTIVELY, THE "MEMBERSHIP") WHICH SHALL CONSIST OF ADVENTIST HEALTHCARE, INC., A NOT-FOR-PROFIT MARYLAND CORPORATION EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE ("IRC") SECTION 501(C)(3). |
| FORM 990, PART VI, SECTION A, LINE 7B | DECISIONS SUBJECT TO APPROVAL. SEE BY LAWS, ARTICLE II, SECTION 2 - RESERVED AUTHORITY AND RESPONSIBILITY. THE FOLLOWING ACTIONS ARE RESERVED TO THE MEMBERSHIP: A. THE ADOPTION, ALTERING, AMENDING OR REPLACING OF THE ARTICLES OF INCORPORATION OR THE BYLAWS OF THE CORPORATION; B. THE LIQUIDATION, DISSOLUTION, WINDING UP, OR ABANDONMENT OF THE CORPORATION; C. DETERMINATION OF THE NUMBER OF DIRECTORS OF THE CORPORATION; D. APPOINTMENT OF MEMBERS OF THE BOARD OF DIRECTORS OF THE CORPORATION; E. REMOVAL OF MEMBERS OF THE BOARD OF DIRECTORS OF THE CORPORATION; F. APPOINTMENT AND REMOVAL OF THE PRESIDENT OF THE CORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | DURING THE PREPARATION PROCESS, EXECUTIVE MANAGEMENT TEAM REVIEWED VARIOUS SECTIONS OF THE DRAFT FORM 990 BASED ON A PLANNED COMPLETION TIME TABLE. IN ADDITION, THE EXECUTIVE COMMITTEE OF THE BOARD REVIEWED CERTAIN KEY SECTIONS OF THE FORM. PRIOR TO FILING, ALL MEMBERS OF THE BOARD ARE PROVIDED A COPY OF THIS FORM 990 THROUGH EMAIL, WHICH IS LINKED TO THE COMPANY'S INTRANET WEBSITE. |
| 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 HEALTHCARE URGENT CARE CENTERS, 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 PURCHASE SERVICES: PROGRAM SERVICE EXPENSES 764,768. MANAGEMENT AND GENERAL EXPENSES 187,964. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 952,732. |
| FORM 990, PART XI, LINE 9: | DISCONTINUED OPERATIONS -549,663. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 HOME HEALTH SERVICES INC | |||||||||||
| 820 W DIAMOND AVE SUITE 600 | GAITHERSBURG | MD | 208781419 | 520986808 | CLINIC - EMERGENCY CARE | MD | 501(C)(3) | LINE 10 | ADVENTIST HEALTHCARE INC | 0 | |
| ADVENTIST PHYSICIAN SERVICES INC | |||||||||||
| 820 W DIAMOND AVE SUITE 600 | GAITHERSBURG | MD | 208781419 | 204600646 | 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 | 0 | N/A | |
| 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 | 0 | N/A | |
| 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 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|---|
| 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | 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 | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |