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SOUTHEAST VOLUSIA HEALTHCARE CORPORATION: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
SOUTHEAST VOLUSIA HEALTHCARE CORPORATION (EIN 47-3793197)
Tax period
2019-01-01 to 2019-12-31
Filed
2020-11-06
IRS object ID
202033119349301073
Schema version
2019v5.1
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

FieldValueIRS element (for citing)
Return2020-11-06T10:05:08-06:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2019-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN473793197EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Southeast Volusia Healthcare CorporationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSOUTBusinessNameControlTxt
Phone3864245000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 Palmetto StreetAddressLine1Txt
CityNew Smyrna BeachCityNm
State AbbreviationFLStateAbbreviationCd
ZIP32168ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLynn C AddiscottPersonNm
Person TitleAssistant SecretaryPersonTitleTxt
Phone4073572349PhoneNum
Signature2020-11-06SignatureDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address204.139.85.142IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-11-06IPDt
IP Tm08:04:09IPTm
IP TimezoneESIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device Id1CF6776BA0A2965D553CEF3953E0B36AE7F0CCCBAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1AdventHealth New Smyrna BeachBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerDennis Hernandez MDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 Palmetto StreetAddressLine1Txt
CityNew Smyrna BeachCityNm
State AbbreviationFLStateAbbreviationCd
ZIP32168ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$122,101,198GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Group Exemption1071GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.adventhealth.com/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2015FormationYr
Legal Domicile StateFLLegalDomicileStateCd
Activity Or MissionThe provision of medical care to the community served through the operation of a 109 bed hospital.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent2VotingMembersIndependentCnt
Total Employee853TotalEmployeeCnt
Total Volunteers117TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$4,052PYContributionsGrantsAmt
CY Contributions Grants$11,275CYContributionsGrantsAmt
PY Program Service Revenue$112,343,205PYProgramServiceRevenueAmt
CY Program Service Revenue$121,718,393CYProgramServiceRevenueAmt
PY Investment Income$314,958PYInvestmentIncomeAmt
CY Investment Income$304,742CYInvestmentIncomeAmt
PY Other Revenue$392PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$112,662,607PYTotalRevenueAmt
CY Total Revenue$122,034,410CYTotalRevenueAmt
PY Grants And Similar Paid$32,685PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$153,823CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$50,353,499PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$46,921,403CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$65,094,977PYOtherExpensesAmt
CY Other Expenses$75,489,093CYOtherExpensesAmt
PY Total Expenses$115,481,161PYTotalExpensesAmt
CY Total Expenses$122,564,319CYTotalExpensesAmt
PY Revenues Less Expenses-$2,818,554PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$529,909CYRevenuesLessExpensesAmt
Total Assets BOY$77,955,124TotalAssetsBOYAmt
Total Assets EOY$94,230,083TotalAssetsEOYAmt
Total Liabilities BOY$10,146,962TotalLiabilitiesBOYAmt
Total Liabilities EOY$28,639,465TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$67,808,162NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$65,590,618NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionAdventist 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 hospital 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 Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$115,042,254ExpenseAmt
Grant$153,823GrantAmt
Revenue$121,718,393RevenueAmt
DescOperation of a 109-bed acute care hospital located in Volusia County. In the current year there were 5,448 patient admissions, 23,347 patient days, 71,668 outpatient visits, and 30,962 physician practice patient visits.Desc
Total Program Service Expenses$115,042,254TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee853EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member2IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Cory DomayerBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3865864301PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 Palmetto StreetAddressLine1Txt
CityNew Smyrna BeachCityNm
State AbbreviationFLStateAbbreviationCd
ZIP32168ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Tol Daryl L
Former Director/Reg. CEO0.0050.00Yes (X)$0$1,857,791$292,832
Ottati David A
Chairman/Dir/AH Cen FL Region CEO4.5045.50$0$1,023,245$176,638Yes (X)Yes (X)
Noseworthy Gordon E
Director0.3050.00$0$788,900$109,290Yes (X)
Thomas Debora H
Reg CFO (end 11/2019)/Former Ofcr4.5045.50Yes (X)$0$752,719$107,941
Blair Judy M
Director (End 6/2019)0.3050.00$0$704,695$26,941Yes (X)
Celano Patricia
Reg CCO (end 9/2019)/Former Key Empl4.5045.50Yes (X)$0$509,195$92,483
Mattison Kenneth R
Former Director/CEO0.0050.00Yes (X)$0$557,016$25,568
Prince Stacy W
Director (Beg 1/2019)0.3050.00$0$409,978$76,573Yes (X)
Hernandez MD Dennis A
Sec./Hospital Facility CEO50.000.00$0$406,541$61,297Yes (X)
Harrell Steven W
COO - Hospital Facility50.000.00$0$349,604$37,814Yes (X)
Rathbun Mark B
CFO - Hospital Facility50.000.00$0$257,552$47,027Yes (X)
Lynch Dawn J
Director/CNO50.000.00$554$214,682$32,666Yes (X)
Templeman David R
AHNSB Director - Pharmacy45.000.00$174,966$0$23,829Yes (X)
Duncan Karen M
AHNSB EF Exec Director IP Services50.000.00$160,857$0$22,440Yes (X)
Evolga Nancy K
AHNSB Director - Human Resources45.000.00$158,777$0$23,307Yes (X)
Thomas Marlene
AHNSB EF-Exec Dir OP Svcs/Bus Dev50.000.00$145,352$0$22,637Yes (X)
Papa Agnes V
AHNSB Director - Rehab Svc45.000.00$138,178$0$29,164Yes (X)
Rao MD Surya
Director (Beg 1/2019)5.750.00$44,880$0$0Yes (X)
Storch Glenn D
Director1.000.00$26,187$0$0Yes (X)
Driver Pat
Director0.300.00$598$0$0Yes (X)
Harrison Stanley
Director (Beg 9/2019)0.300.00$598$0$0Yes (X)
Denys Deborah
Director (End 6/2019)0.300.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$850,947TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$7,831,918TotReportableCompRltdOrgAmt
Total Other Compensation$1,208,447TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K22IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Volusia Anesthesiology Associates
2411 Old Samsula RoadPort OrangeFL32128Anesthesiology Service Contract$1,691,361
AMN Healthcare Inc
2735 Collections CenterChicagoIL60693Medical Staffing Services$1,292,541
Sodexho Inc & Affiliates
7100 Commerce Way Ste 280BrentwoodTN37027Environmental Engineering & Transport Se$1,268,126
The Robins and Morton Group
423 S Keller Road Ste 200OrlandoFL32810Construction Services$747,132
Diversified Clinical Services Inc
28525 Network PlaceChicagoIL60673Medical Staffing Services$665,524
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K35CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIIIYes (X)InfoInScheduleOPartVIIIInd
All Other Contributions$11,275AllOtherContributionsAmt
Noncash Contributions$0NoncashContributionsAmt
Total Contributions$11,275TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Revenue622110$116,741,497$116,741,497
Reimb of exp-TE Affiliate622110$2,896,058$2,896,058
Support Pmts from Exempt Affiliat622110$558,878$558,878
Cafeteria Revenue622110$521,988$521,988
Medical Office Building622110$453,680$453,680

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$546,292TotalRevenueColumnAmt
Related Or Exempt Func Income$546,292RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$121,718,393TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$232,433TotalRevenueColumnAmt
Exclusion$232,433ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$116,416SecuritiesAmt
Other$22,681OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$66,788OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$116,416SecuritiesAmt
Other-$44,107OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$72,309TotalRevenueColumnAmt
Exclusion$72,309ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$122,034,410TotalRevenueColumnAmt
Related Or Exempt Func Income$121,718,393RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$304,742ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$153,823TotalAmt
Program Services$153,823ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,586,793TotalAmt
Program Services$71,067ProgramServicesAmt
Management And General$1,515,726ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$33,487,398TotalAmt
Program Services$33,487,398ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,156,487TotalAmt
Program Services$1,133,030ProgramServicesAmt
Management And General$23,457ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$8,059,043TotalAmt
Program Services$7,824,873ProgramServicesAmt
Management And General$234,170ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,631,682TotalAmt
Program Services$2,578,125ProgramServicesAmt
Management And General$53,557ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$34,022TotalAmt
Management And General$34,022ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$45,491TotalAmt
Management And General$45,491ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$37,488TotalAmt
Management And General$37,488ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$29,160,859TotalAmt
Program Services$25,614,028ProgramServicesAmt
Management And General$3,546,831ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$229,907TotalAmt
Management And General$229,907ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,862,062TotalAmt
Program Services$3,289,064ProgramServicesAmt
Management And General$572,998ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$4,618,130TotalAmt
Program Services$4,133,601ProgramServicesAmt
Management And General$484,529ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,992,875TotalAmt
Program Services$2,992,875ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$120,133TotalAmt
Management And General$120,133ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$54,013TotalAmt
Management And General$54,013ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$116,702TotalAmt
Program Services$116,702ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$5,194,994TotalAmt
Program Services$5,194,994ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,130,685TotalAmt
Program Services$741,665ProgramServicesAmt
Management And General$389,020ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
Medical Supplies$23,674,294$23,674,294
Repairs & Maintenance$2,906,758$2,906,758
State Tax Indigent Asse$1,098,269$1,098,269

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$212,411TotalAmt
Program Services$31,688ProgramServicesAmt
Management And General$180,723ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$122,564,319TotalAmt
Program Services$115,042,254ProgramServicesAmt
Management And General$7,522,065ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,991BOYAmt
EOY$2,191EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$6,658,580BOYAmt
EOY$20,006,879EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$12,309,736BOYAmt
EOY$11,778,415EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$2,717,936BOYAmt
EOY$2,418,702EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,972,751BOYAmt
EOY$2,458,952EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$69,714,249LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$15,665,313LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$49,085,848BOYAmt
EOY$54,048,936EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$5,208,282BOYAmt
EOY$3,516,008EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$77,955,124BOYAmt
EOY$94,230,083EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,863,069BOYAmt
EOY$5,510,412EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,283,893BOYAmt
EOY$23,129,053EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$10,146,962BOYAmt
EOY$28,639,465EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$67,778,162BOYAmt
EOY$65,590,618EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$30,000BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$67,808,162BOYAmt
EOY$65,590,618EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$77,955,124BOYAmt
EOY$94,230,083EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$529,909ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$722,025NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$2,409,660OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$4,924OtherActivitiesAmt
Total Lobbying Expenditures$4,924TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationAmerican Hospital Association and Florida Hospital Association DuesExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,015,162OtherCostOrOtherBasisAmt
Book Value$6,015,162BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$33,428,079OtherCostOrOtherBasisAmt
Depreciation$5,376,670DepreciationAmt
Book Value$28,051,409BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$20,578,527OtherCostOrOtherBasisAmt
Depreciation$10,122,205DepreciationAmt
Book Value$10,456,322BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,692,481OtherCostOrOtherBasisAmt
Depreciation$166,438DepreciationAmt
Book Value$9,526,043BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$54,048,936TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)

DescDescAmtAmt
Due to Related$3,063,763
Payable to Third Parties$694,201
Credit Balances in A/R$202,804
Other Liabilities$862,184
Interco Alloc of TE Bond Proceeds$15,652,994
Due to Affiliated$72,352
Operating Lease Liability$2,580,755
FieldValueIRS element (for citing)
Total Liability$23,129,053TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart X, Line 2:FormAndLineReferenceDesc
ExplanationThe 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, 2019 and 2018. NAHS also has temporary deductible differences of approximately $46,500 and $53,000 at December 31, 2019 and 2018, respectively, primarily as a result of net operating loss carryforwards. At December 31, 2019, NAHS had net operating loss carryforwards of approximately $47,500, expiring beginning in 2022 through 2026. Deferred taxes have been provided for these amounts, resulting in a net deferred tax asset of approximately $11,400 and $13,400 at December 31, 2019 and 2018, 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, 2019 and 2018 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 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, 2019 and 2018. On December 22, 2017, the United States enacted tax reform legislation commonly known as the Tax Cuts and Jobs Act (Act), resulting in significant modifications to existing law. Certain provisions impact tax-exempt organizations, including revisions to taxes on unrelated business activities, excise taxes on compensation of certain employees, and various other provisions. While final regulations on these provisions have not yet been promulgated, the impact of these provisions on the consolidated financial statements is not expected to be significant.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted Care0FPGReferenceDiscountedCareInd
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically Available0ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,825,930TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,426,849DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,399,081NetCommunityBenefitExpnsAmt
Total Expense0.01140TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,808,719TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,146,701DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,662,018NetCommunityBenefitExpnsAmt
Total Expense0.04620TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,634,649TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,573,550DirectOffsettingRevenueAmt
Net Community Benefit Expns$7,061,099NetCommunityBenefitExpnsAmt
Total Expense0.05760TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$97,748TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$97,748NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$97,748TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$97,748NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,732,397TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,573,550DirectOffsettingRevenueAmt
Net Community Benefit Expns$7,158,847NetCommunityBenefitExpnsAmt
Total Expense0.05840TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$3,961,281BadDebtExpenseAmt
Bad Debt Expense Attributable$492,091BadDebtExpenseAttributableAmt
Reimbursed By Medicare$27,906,388ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$33,703,746CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$5,797,358MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1AdventHealth New Smyrna BeachBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 Palmetto StreetAddressLine1Txt
CityNew Smyrna BeachCityNm
State AbbreviationFLStateAbbreviationCd
ZIP32168ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.adventhealth.com/hospital/adventheWebsiteAddressTxt
State License4054StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Southeast Volusia Healthcare CorporationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted19CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSee Part V, Page 8OwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt17ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSee Part V, Page 8StrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSee Part V, Page 8FAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSee Part V, Page 8FAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSee Part V, Page 8FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Southeast Volusia Healthcare CorporationPart V, Section B, Line 5: Southeast Volusia Healthcare Corporation, d/b/a AdventHealth New Smyrna Beach (AdventHealth NSB or the Hospital) operates a hospital in Volusia County, Florida with a total of 109 licensed beds. For over 50 years, AdventHealth New Smyrna Beach has served the Southeast Volusia area and surrounding communities by providing the following comprehensive healthcare services:- Cancer Care- Community Health Clinic- Diabetes Education- 24-Hour Emergency Care- Heart Care- General Surgery- Imaging Services- Intensive Care Unit- Lab Services- Orthopedic Care- Outpatient Services- Sports and Rehabilitation Care- Speech Therapy- Surgical Care- Wound CareA Community Health Needs Assessment Committee (CHNAC) was formed to help AdventHealth New Smyrna Beach conduct a comprehensive assessment of the community. The committee included representation from the Hospital, public health officials and the broad community as well as representation from low-income, minority and other underserved populations. Members were strategically chosen, who represented organizations that serve low income, minority, and underserved populations. The following organization were represented by members of the CHNAC:- Azalea Health, Federally Qualifed Health Center- Bethune Cookman University - A historically black university.- Coummunity Partnership for Children - An organization focused on family preservation services, foster care, therapeutic services, adoption and mentoring.- County of Volusia - Represented by the Director of Community Services, an elected county council member, and the Public Protection Director, who oversees EMS, 911 and the county jail.- Daytona Beach Chamber of Commerce- Department of Children and Families- Early Learning Coalition of Flagler & Volusia- Family Health Source Medical Centers, Federallly Qualified Health Center- Florida Department of Health in Volusia County- Halifax Health - A community hospital.- Healthy Start Coalition of Flagler/Volusia- LSF (Lutheran Services Florida) Health Systems, Inc. - An organization that manages the state funded system of behavioral health care for people who face poverty and are without insurance.- Team Volusia Economic Development Corporate- United Way of Volusia-Flagler- Volusia County Schools- Volusia/Flagler Behavioral Health Consortium - An organization that helps increase access to behavioral health services for children, adults and families.- Volusia/Flagler Coalition for the HomelessCommunity input was gathered through community surveys. There were 2,608 surveys completed for Volusia County. The Taxpayer also gathered input through sixteen focus groups conducted across Volusia County focused on youth, college students, older adults, impoverished communities, Spanish speakers, maternal and child health groups and professional groups.
Southeast Volusia Healthcare CorporationPart V, Section B, Line 7d: The Hospital has adopted a policy that addresses the public posting requirements of the Community Health Needs Assessment. Under this policy, the Community Health Needs Assessment Reports must be posted on the Hospital's website at least until the date the Hospital facility has made widely available on its website its two subsequent Community Health Needs Assessment Reports. The Hospital will also make a paper copy of its Community Health Needs Assessment Report available for public inspection upon request and without charge, at least until the date the Hospital facility has made available for public inspection its two subsequent Community Health Needs Assessment Reports.
Southeast Volusia Healthcare CorporationPart V, Section B, Line 11: Southeast Volusia Healthcare Corporation d/b/a AdventHealth New Smyrna Beach, will be referred to in this document as AdventHealth New Smyrna Beach or "the Hospital." The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. In January 2019, every wholly-owned entity of AHSSHC adopted the AdventHealth system brand. Our identity has been unified to represent the full continuum of care our system offers. Any reference to our 2016 Community Health Needs Assessment (CHNA) or 2017 Community Health Plan (CHP) will utilize our new name for consistency.AdventHealth New Smyrna Beach is part of the Central Florida Division - North Region. The Central Florida Division - North Region includes six hospital facilities.The information provided below explains how the hospital facility addressed in 2019 the significant health needs identified in its 2016 Community Health Needs Assessment, and any such needs that were not addressed and the reasons why such needs were not addressed. The hospital facility conducted a Community Health Needs Assessment in 2016 and adopted an implementation strategy to address the significant health needs identified in the 2016 Community Health Needs Assessment in 2017 prior to May 15, 2017. For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth New Smyrna Beach worked to define and address the needs of low-income, minority and underserved populations in its service area. The 2016 Community Health Needs Assessment used primary data interviews and surveys; secondary data from local, regional and national health-related sources; and Hospital prevalence data to help the Hospital determine the health needs of the community it serves. Once the data was gathered, the primary issues identified in the Needs Assessment were prioritized by community and Hospital stakeholders, who then selected key issues for the Hospital to address in its 2017-2019 Community Health Plan. The third-year progress on the Community Health Plan is noted below. The narrative describes the issues identified in 2016 and gives an update on the strategies addressing those issues. There is also a description of the identified issues that the Hospital is not addressing.AdventHealth New Smyrna Beach chose five areas of focus for their 2017-2019 Community Health Plan: 1. Adult Behavioral Health2. Youth Behavioral Health3. Chronic Disease: Cardiovascular and Diabetes 4. Health Eating and Physical Activity5. Barriers to Accessing Health Care ServicesPriority 1: Adult Behavioral Health2016 Description of the Issue: Behavioral health is a term that covers the full range of mental and emotional well-being - from coping with daily life challenges to the often-complex treatment of mental illnesses, such as depression or personality disorder, as well as substance use disorder and other addictive behaviors. Now more than ever, health experts across all fields are recognizing the important link between good behavioral health and good overall health. According to the 2,000+ respondents of the Volusia/Flagler Community Health Survey, Behavioral Health related issues were the top three unhealthy behaviors. Volusia County residents were most concerned about drug abuse (56 percent), mental health/stress (47 percent) and alcohol abuse (45 percent). Injuries and deaths from alcohol-suspected motor vehicle crashes in the counties were higher than state rates. Death rates from chronic liver disease and cirrhosis have increased for all Volusia County residents (15.4 per 100,000 in 2012-14). The percentage of Volusia County residents who self-reported being current smokers was 10.7 percent higher than the Florida percentage. The highest percentage of smokers were adults with less than a high school education and the lowest was adults aged 65 and older. The percentage of Volusia residents who reported having "poor mental health days" on 14 or more of the past 30 days was higher than the Florida percentage. Women reported a higher percentage of these days than men. According to the 2,000+ respondents of the Volusia/Flagler Community Health Survey, "Mental health/counseling and "substance abuse services-drug and alcohol" were the top two health services that were difficult to obtain in Volusia County.2019 Update: Many partner organizations focused on Adult Mental Health strategies as part of the countywide Community Health Improvement Plan. AdventHealth New Smyrna Beach implemented Smoking Cessation classes to address this Health Priority. Smoking Cessation Classes were hosted at the Hospital throughout the year. Toolkits were distributed with education materials for providers and patients, which included smoking cessation class information. Fifty-eight adults completed smoking cessation education classes in 2019, slightly less than the target goal of 65. One of the biggest challenges to increasing participation is raising awareness of the availability of this program as well as identifying participants willing and ready to address and change their behavior. Priority 2: Youth Behavioral Health2016 Description of the Issue: It is estimated that 50 percent of mental health conditions manifest themselves during adolescence. Preventing mental and/or substance use disorders and related problems in children, adolescents, and young adults is critical to Americans' behavioral and physical health. In 2012-14 the Volusia County suicide rate was 8.5 per 100,000 - higher than the state rate of 4.9. Despite a decline in high school students using alcohol in the last 30 days, Volusia County's rate has been consistently higher than the state rate with 29.6% of high schoolers reporting alcohol use. Volusia County rates for smoking and marijuana use are also consistently higher than the state rate.2019 Update: As with Adult Behavioral Health, Youth Behavioral Health is being addressed by other community partners supporting the countywide Community Health Improvement Plan. AdventHealth New Smyrna Beach implemented one prevention-oriented strategy focused on school-aged youth in partnership with the American Diabetes Association. Increased physical activity is a proven strategy to improve both physical and mental health. The Morning Mile program was designed to encourage physical activity among youth. AdventHealth New Smyrna Beach partnered with a local school during the 2018-19 school year to initiate this program. Two hundred and eighty students participated in the program in 2019, less than the target of 349 students. The greatest challenge faced by the Morning Mile program is engaging students in the morning during a limited timeframe that also includes breakfast for the students.Priorities 3 & 4: Cardiovascular and Diabetes; Healthy Eating and Physical Activity2016 Description of the Issue: Cardiovascular and DiabetesChronic diseases and conditions - such as heart disease, stroke, cancer and diabetes - are among the most common, costly and preventable of all health problems. These conditions shorten lives, reduce quality of life and create considerable burden for caregivers. In 2013, the percentage of Volusia County adults self-reporting that they had ever been told they had high blood cholesterol was higher than the Florida percentage. The Volusia County rate for hospitalizations from strokes (274.0 per 100,000) decreased slightly over the last five years reported, but rates for African-Americans remained high. The age-adjusted diabetes death rate for Volusia County (27.4 per 100,000) increased over the reported year and was consistently higher than the Florida rate. Healthy Eating and Physical ActivityRegular physical activity and healthy eating can help people manage their weight as well as reduce their risk for chronic disease. The percentage of Volusia County adults who self-reported eating five or more servings of fruits and vegetables per day was lower than the Florida percentage in 2013. Forty-nine percent of adults self-reported being inactive or insufficiently active - with over 33.7 percent of the population being overweight and 24.4 percent being obese. Eighty-two percent of Volusia County adults reported that their overall health was "good or "excellent". (Continued)
Schedule H, Part V, Section B, Line 7a and 10a:Line 7a:The CHNA Report can be found at URL:https://www.adventhealth.com/community-health-needs-assessmentsLine 10a:The hospital's most recently adopted implementation strategy can be found at URL:https://www.adventhealth.com/community-health-needs-assessments
Schedule H, Part V, Section B, Line 16a, 16b, and 16c:The Financial Assistance Policy can be found at URL:https://www.adventhealth.com/legal/financial-assistanceThe Financial Assistance Policy Application can be found at:https://www.adventhealth.com/legal/financial-assistanceThe Plain Language Summary is available at:https://www.adventhealth.com/legal/financial-assistance
Schedule H, Part V, Section B, Line 8 -10a:The filing organization adopted a Community Health Needs Assessment Report by 12/31/2019 and was in the process of developing its Community Health Needs Implementation Strategy at that time. The filing organization's 2020-2022 Community Health Needs Implementation Strategy is documented in a written report called the "Community Health Plan". The Community Health Plan (CHP) describes how the filing organization plans to meet its identified prioritized health needs or identifies the health need as one the filing organization does not intend to specifically address and provides an explanation as to why the filing organization does not intend to address that health need. The filing organization's 2020-2022 CHP was adopted by May 15, 2020 and is posted on the hospital facility's website.As the hospital facility's 2020-2022 Community Health Needs Implementation Strategy was not adopted by the end of the hospital organization's taxable year of December 31, 2019, Schedule H, Part V, Section B, line 9 indicates that 2017 was the tax year in which the hospital facility last adopted an implementation strategy. Schedule H, Part V, Section B, Line 10a reflects the website address for the hospital facility's 2014-2016, 2017-2019, and 2020-2022 Implementation Strategies.
Part V, Section B, Line 11 (Continued):2019 Update: AdventHealth New Smyrna Beach implemented several distinct strategies focused on the priorities of Cardiovascular Disease, Diabetes and Healthy Eating and Physical Activity. In 2019, six sessions of CREATION Health, an eight-week, faith-based wellness plan with lifestyle seminars and training based on 8 principles: Choice, Rest, Environment, Activity, Trust, Interpersonal relations, Outlook and Nutrition, were offered with 134 individuals attending. AdventHealth New Smyrna Beach also provided educational seminars covering other health topics of interest to 680 individuals, exceeding the target of 400. Outreach activities reached 26,142 individuals through 30 events and over 640 individuals received free health screenings such as cholesterol and HbA1C (blood sugar) screenings and blood pressure screenings, surpassing all targets set for 2019.AdventHealth New Smyrna Beach also successfully implemented Community Care, a community-based care coordination program for high risk patients with a history of preventable Emergency Department (ED) visits and inpatient admissions. The program targets the underserved patients in the community to increase quality and coordination of care to help improve health outcomes. Seventy-four new individuals were enrolled and served through community care - exceeding the 2019 target for this program. AdventHealth New Smyrna Beach recognizes the benefit of individualized coordination of care to improve health outcomes for the underserved. An ongoing challenge will be to continue finding creative ways to meet individuals needs with limited resources. Currently there is not one system to track what programs are currently available in the community, changes to funding, or qualifications for specific programs. This leads to additional challenges when connecting the underserved to the necessary resources. Priority 5: Barriers to Accessing Health Care Services2016 Description of the Issue: Access to comprehensive quality health care services is important for the achievement of health equity and for increasing the quality of a healthy life for everyone. According to the Volusia/Flagler Community Health Survey, the top three barriers to getting health care were: lack of evening and/or weekend services (22.6 percent), inability to pay for doctor/hospital visits (21.8 percent), and long waits for appointments (21.3 percent). In 2013, 79.8 percent of Volusia County adults had some type of health care coverage and 74.8 percent reported having a personal doctor.2019 Update: To address access to health care services, AdventHealth New Smyrna Beach partnered with United Way of Volusia and Flagler Counties to increase access to health resource information through promotion of the 2-1-1 call center/website resource. There were over 2,000 web hits for health or wellness resources in 2019. United Way continues to work on 2-1-1 system improvements with a focus on health and wellness resources. The Hospital originally intended to provide meeting space for support groups as part of their implementation plan but was unable to meet this goal due to a lack of available space. Community Needs Not Chosen by AdventHealth New Smyrna Beach:The primary and secondary data in the Community Health Needs Assessment identified multiple community issues. Hospital and community stakeholders used the following criteria to narrow the larger list to the priority areas noted above:1. How acute is the need? (based on data and community concern)2. What is the trend? Is the need getting worse?3. Does the Hospital provide services that relate to the priority? 4. Is someone else - or multiple groups - in the community already working on this issue? 5. If the Hospital were to address this issue, are there opportunities to work with community partners? Based on this prioritization process, the Hospital did not choose the following community issues:- Aging-related Issues: Due to The Council on Aging having a strong approach to serving vulnerable seniors throughout Volusia County, the issue was not chosen by the Hospital.- Child/Adolescent Issues: Volusia County Schools, in partnership with other organizations, implement strategies to ensure youth in the K-12 education system are having their health needs met. - Chronic Disease: Cancer/Respiratory Diseases: The data reviewed did not support the prioritization of cancer or respiratory diseases and instead a focus was placed on strategies to impact cardiovascular diseases and diabetes. Many of those strategies implemented, along with strategies to promote healthy eating and physical activity, will also have a positive effect on all chronic diseases.- Communicable & Infectious Diseases: The data trends and comparison to the state rates did not warrant prioritization of this issue. The Florida Department of Health-Volusia takes a leadership role in communicable and infectious disease prevention and surveillance.- Crime, Domestic Violence & Child Abuse: Significant community institutions focus on these social determinants of health, so the issue was not prioritized for AdventHealth strategies. - Early Childhood: The Early Learning Coalition of Flagler and Volusia Counties, in partnership with Early Steps and other community programs, have comprehensive strategies in place to ensure children under age five are healthy and ready to enter kindergarten. This issue was not selected as a community priority for additional focus.- Women's Health, Prenatal Care and Birth Outcomes: Although some of the data reviewed was concerning, the Healthy Start Coalition of Flagler and Volusia Counties has developed strategies to impact this population. - Social and Economic Issues: Although this issue was not identified as a priority issue, all strategies implemented are viewed through the lens of social determinant of health to ensure that vulnerable populations have access to resources offered OR are the target population for services and resources.
FieldValueIRS element (for citing)
Facility7FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxtAddress Line2USAddress/AddressLine2Txt
1 - AdventHealth Medical Group Gen Surgery
600 Palmetto StreetNew Smyrna BeachFL32168General Surgery
2 - AdventHealth Medical Group Orthopedics
600 Palmetto StreetNew Smyrna BeachFL32168Orthopedics
3 - AdventHealth Medical Group Internal Med
125 Florida Memorial Pkwy SuiteNew Smyrna BeachFL32168Internal Medicine2600
4 - AdventHealth Medical Group Family Med
125 Florida Memorial Pkwy SuiteNew Smyrna BeachFL32168Family Medicine2500
5 - AdventHealth Medical Group Family Med
125 Florida Memorial Pkwy SuiteNew Smyrna BeachFL32168Family Medicine2700
6 - AdventHealth Medical Group Family Med
125 Florida Memorial Pkwy SuiteNew Smyrna BeachFL32168Family Medicine2500A
7 - AdventHealth Medical Group Family Med
125 Florida Memorial Pkwy SuiteNew Smyrna BeachFL32168Family Medicine2300

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 6a:The filing organization was a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) during its current tax year. During the current year, AHSSHC served as a parent organization to 27 tax-exempt 501(c)(3) hospital organizations and a number of other health care facilities that operated in 10 states within the U.S. The system of organizations under the control and ownership of AHSSHC is known as "AdventHealth".All hospital organizations within AdventHealth collect, calculate, and report the community benefits they provide to the communities they serve. AdventHealth organizations exist solely to improve and enhance the local communities they serve. AdventHealth has a system-wide community benefits accounting policy that provides guidelines for its health care provider organizations to capture and report the costs of services provided to the underprivileged and to the broader community. Each AdventHealth hospital facility reports their community benefits to their Board of Directors and strives to communicate their community benefits to their local communities. Additionally, the filing organization's most recently conducted community health needs assessment and associated implementation strategy can be accessed on the filing organization's website.
Part I, Line 7:The amounts of costs reported in the table in line 7 of Part I of Schedule H were determined by utilizing a cost-to-charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges, contained in the Schedule H instructions.
Part III, Line 2:The amount of bad debt expense reported on line 2 of Section A of Part III is recorded in accordance with Healthcare Financial Management Association Statement No. 15. Discounts and payments on patient accounts are recorded as adjustments to revenue, not bad debt expense.
Part III, Line 3:Methodology for Determining the Estimated Amount of Bad Debt Expense that May Represent Patients who could Have Qualified under the Filing Organization's Financial Assistance Policy:Self-pay patients may apply for financial assistance by completing a Financial Assistance Application Form (FAA Form). If an individual does not submit a complete FAA Form within 240 days after the first post-discharge billing statement is sent to the individual, an individual may be considered for presumptive eligibility based upon a scoring tool that is designed to classify patients into groups of varying economic means. The scoring tool uses algorithms that incorporate data from credit bureaus, demographic databases, and hospital specific data to infer and classify patients into respective economic means categories. Individuals who earn a certain score on the scoring tool are considered to qualify as eligible for the most generous financial assistance under the filing organization's Financial Assistance Policy. As determined by the filing organization, a nominal amount of such a patient's bill is written off as bad debt expense, while the remaining portion of the patient's bill is considered non-state charity. The amount written off as bad debt expense for those patients who potentially qualify as non-state charity using the scoring tool is the amount shown on line 3 of Section A of Part III. Rationale for Including Certain Bad Debts in Community Benefit:The filing organization is dedicated to the view that medically necessary health care for emergency and non-elective patients should be accessible to all, regardless of age, gender, geographic location, cultural background, physician mobility, or ability to pay. The filing organization treats emergency and non-elective patients regardless of their ability to pay or the availability of third-party coverage. By providing health care to all who require emergency or non-elective care in a non-discriminatory manner, the filing organization is providing health care to the broad community it serves. As a 501(c)(3) hospital organization, the filing organization maintains a 24/7 emergency room providing care to all whom present. When a patient's arrival and/or admission to the facility begins within the Emergency Department, triage and medical screening are always completed prior to registration staff proceeding with the determination of a patient's source of payment. If the patient requires admission and continued non-elective care, the filing organization provides the necessary care regardless of the patient's ability to pay. The filing organization's operation of a 24/7 Emergency Department that accepts all individuals in need of care promotes the health of the community through the provision of care to all whom present. Current Internal Revenue Service guidance that tax-exempt hospitals maintain such emergency rooms was established to ensure that emergency care would be provided to all without discrimination. The treatment of all at the filing organization's Emergency Department is a community benefit. Under the filing organization's Financial Assistance Policy, every effort is made to obtain a patient's necessary financial information to determine eligibility for financial assistance. However, not all patients will cooperate with such efforts and a financial assistance eligibility determination cannot be made based upon information supplied by the individual. In this case, a patient's portion of a bill that remains unpaid for a certain stipulated time period is wholly or partially classified as bad debt. Bad debts associated with patients who have received care through the filing organization's Emergency Department should be considered community benefit as charitable hospitals exist to provide such care in pursuit of their purpose of meeting the need for emergency medical care services available to all in the community.
Part III, Line 4:Financial Statement Footnote Related to Accounts Receivable and Allowance for Uncollectible Accounts:The financial information of the filing organization is included in a consolidated audited financial statement for the current year.The applicable footnote from the attached consolidated audited financial statements that addresses accounts receivable, the allowance for uncollectible accounts, and the provision for bad debts can be found on pages 8 and 9. Please note that dollar amounts on the attached consolidated audited financial statements are in thousands.
Part III, Line 8:Costing Methodology: Medicare allowable costs were calculated using a cost-to-charge ratio.Rationale for Including a Medicare Shortfall as Community Benefit:As a 501(c)(3) organization, the filing organization provides emergency and non-elective care to all regardless of ability to pay. All hospital services are provided in a non-discriminatory manner to patients who are covered beneficiaries under the Medicare program. As a public insurance program, Medicare provides a pre-established reimbursement rate/amount to health care providers for the services they provide to patients. In some cases, the reimbursement amount provided to a hospital may exceed its costs of providing a particular service or services to a patient. In other cases, the Medicare reimbursement amount may result in the hospital experiencing a shortfall of reimbursement received over costs incurred. In those cases where an overall shortfall is generated for providing services to all Medicare patients, the shortfall amount should be considered as a benefit to the community. Tax-exempt hospitals are required to accept all Medicare patients regardless of the profitability, or lack thereof, with respect to the services they provide to Medicare patients. The population of individuals covered under the Medicare program is sufficiently large so that the provision of services to the population is a benefit to the community and relieves the burdens of government. In those situations where the provision of services to the total Medicare patient population of a tax-exempt hospital during any year results in a shortfall of reimbursement received over the cost of providing care, the tax-exempt hospital has provided a benefit to a class of persons broad enough to be considered a benefit to the community. Despite a financial shortfall, a tax-exempt hospital must and will continue to accept and care for Medicare patients. Typically, tax-exempt hospitals provide health care services based upon an assessment of the health care needs of their community as opposed to their taxable counterparts where profitability often drives decisions about patient care services that are offered. Patient care provided by tax-exempt hospitals that results in Medicare shortfalls should be considered as providing a benefit to the community and relieving the burdens of government.
Part III, Line 9b:The hospital filing organization's collection practices are in conformity with the requirements set forth in the 2014 Final Regulations regarding the requirements of Internal Revenue Code Section 501(r)(4) (r)(6). No extraordinary collection actions (ECA's) are initiated by the hospital filing organization in the 120-day period following the date after the first post-discharge billing statement is sent to the individual (or, if later, the specified deadline given in a written notice of actions that may be taken, as described below). Individuals are provided with at least one written notice (notice of actions that may be taken) and a copy of the filing organization's Plain Language Summary of the Financial Assistance Policy that informs the individual that the hospital filing organization may take actions to report adverse information to credit reporting agencies/bureaus if the individual does not submit a Financial Assistance Application Form (FAA Form) or pay the amount due by a specified deadline. The specified deadline is not earlier than 120 days after the first post-discharge billing statement is sent to the individual and is at least 30 days after the notice is provided. A reasonable attempt is also made to orally notify an individual about the filing organization's Financial Assistance Policy and how the individual may obtain assistance with the Financial Assistance application process. If an individual submits an incomplete FAA Form during the 240-day period following the date on which the first post-discharge billing statement was sent to the individual, the hospital filing organization suspends any reporting to consumer credit reporting agencies/bureaus (or ceases any other ECA's) and provides a written notice to the individual describing what additional information or documentation is needed to complete the FAA Form. This written notice contains contact information including the telephone number and physical location of the hospital facility's office or department that can provide information about the Financial Assistance Policy, as well as contact information of the hospital facility's office or department that can provide assistance with the financial assistance application process or, alternatively, a nonprofit organization or governmental agency that can provide assistance with the financial assistance application process if the hospital facility is unable to do so. If an individual submits a complete FAA Form within a reasonable time-period as set forth in the notice described above, the hospital filing organization will suspend any adverse reporting to consumer credit reporting agencies/bureaus until a financial assistance policy eligibility determination can be made.
Supplemental Schedule to Schedule H, Part III, Section B, Line 8:Reconciliation of Schedule H Reported Medicare Surplus/(Shortfall) to Unreimbursed Medicare Costs Associated with the Provision of ServicesTo All Medicare Beneficiaries:The Medicare revenue and allowable costs of care reported in Section B of Part III of Schedule H are based upon the amounts reported in the filing organization's Medicare cost report in accordance with the IRS instructions for Schedule H. On an annual basis, the filing organization also determines its total unreimbursed costs associated with providing services to all Medicare patients. Unreimbursed costs are considered a community benefit to the elderly and are combined into an annual Community Benefit Statement prepared by AdventHealth. The primary reconciling items between the Medicare surplus/(shortfall) shown on line 7 of Section B of Part III of Schedule H and the filing organization's unreimbursed costs of services provided to all Medicare patients are as follows:- Medicare surplus/(shortfall) shown on line 7 of Section B of Schedule H: $ (5,797,358)- Difference in costing methodology: 939,559- Unreimbursed costs incurred for services provided to Medicare patients that are not included in the organization's Medicare cost report: (8,724,031) -------------Total Unreimbursed costs of serving all Medicare patients per the filing organization's communitybenefit reporting $ (13,581,830)As indicated above, the primary differences between the Medicare surplus/(shortfall) reported on Schedule H, Part III, Section B, line 7 and the filing organization's portion of the Company's annual community benefit statement is due to a difference in the costing methodology and differences in the population of Medicare patients within the calculation. The cost methodology utilized in calculating any Medicare surplus/(shortfall) for purposes of the annual community benefit reporting is based upon the cost-to-charge ratio outlined in Worksheet 2 of the Schedule H instructions. The same cost-to-charge ratio is used to determine the costs associated with services provided to charity care patients and Medicaid patients as reported in Schedule H, Part I, line 7. In addition, the Medicare cost report excludes services provided to Medicare patients for physician services, services provided to patients enrolled in Medicare HMOs, and certain services provided by outpatient departments of the filing organization that are reimbursed on a fee schedule. The Company's own community benefit statement captures the unreimbursed cost of providing services to all Medicare beneficiaries throughout the organization.
Part VI, Line 2:The Hospital conducts community health needs assessments (CHNA) every three years. Its 2019 CHNA was adopted by its governing board by December 31, 2019, the end of the Hospital's taxable year in which it conducted the CHNA. The Hospital's 2019 CHNA complied with the guidance set forth by the IRS in Final Regulation Section 1.501(r)-3. In addition to the CHNA discussed above, a variety of practices and processes are in place to ensure that the filing organization is responsive to the health needs of its community.Such practices and processes involve the following:1. A hospital operating/community board composed of individuals broadly representative of the community, community leaders, and those with specialized medical training and expertise;2. Post-discharge patient follow-up related to the on-going care and treatment of patients who suffer from chronic diseases; 3. Sponsorship and participation in community health and wellness activities that reach a broad spectrum of the filing organization's community; and 4. Collaboration with other local community groups to address the health care needs of the filing organization's community.
Part VI, Line 3:The Financial Assistance Policy (FAP), Financial Assistance Application Form (FAA Form), and the Plain Language Summary of the Financial Assistance Policy (PLS) of the filing organization's hospital facility are transparent and available to all individuals served at any point in the care continuum. The FAP, FAA Form, PLS, and contact information for the hospital facility's financial counselors are prominently and conspicuously posted on the filing organization's hospital facility's website. The website indicates that a copy of the FAP, FAA Form, and PLS is available and how to obtain such copies in the primary languages of any populations with limited proficiency in English that constitute the lesser of 1,000 individuals or 5% of the members of the community served by the hospital facility (referred to below as LEP defined populations). Signage is displayed in public locations of the filing organization's hospital facility, including at all points of admission and registration and the Emergency Department. The signage contains the hospital facility's website address where the FAP, FAA Form, and PLS can be accessed and the telephone number and physical location that individuals can call or visit to obtain copies of the FAP, FAA Form and PLS or to obtain more information about the hospital facility's FAP, FAA Form and PLS. Paper copies of the hospital facility's FAP, FAA Form and PLS are available upon request and without charge, both in public locations in the hospital facility and by mail. Paper copies are made available in English and in the primary languages of any LEP defined populations. The filing organization's hospital facility's financial counselors seek to provide personal financial counseling to all individuals admitted to the hospital facility who are classified as self-pay during the course of their hospital stay or at time of discharge to explain the FAP and FAA Form and to provide information concerning other sources of assistance that may be available, such as Medicaid. A paper copy of the hospital facility's PLS will be offered to every patient as a part of the intake or discharge process. A conspicuous written notice is included on all billing statements sent to patients that notifies and informs recipients about the availability of financial assistance under the filing organization's financial assistance policy, including the following: 1) the telephone number of the hospital facility's office or department that can provide information about the FAP and the FAA Form; and 2) the website address where copies of the FAP, FAA Form and PLS may be obtained. Reasonable attempts are made to inform individuals about the hospital facility's FAP in all oral communications regarding the amount due for the individual's care. Copies of the PLS are distributed to members of the community in a manner reasonably calculated to reach those members of the community who are most likely to require financial assistance.
Part VI, Line 4:AdventHealth New Smyrna Beach is a faith-based, not-for-profit healthcare organization with a mission of extending the healing ministry of Christ with skill and compassion. It is a 109-bed full-service hospital providing inpatient and outpatient services as well as 24-hour emergency and critical care. It is a member of AdventHealth, the largest Protestant not-for-profit hospital system in the nation and works to provide exceptional, patient-focused care to the Edgewater, New Smyrna Beach, and Oak Hill communities. The hospital is fully accredited by the Joint Commission on Accreditation of Healthcare Organizations.During 2019, the Hospital's patient percentage population was made up of the below payors with the remaining percentage of the patients being covered under commercial insurance. In 2019, about 91% of the Hospital's in-patients were admitted through the Hospital's Emergency Department. - Medicare Patients 63.5% - Medicaid Patients 6.7% - Self-Pay Patients 6.8% The demographic makeup of the Hospital's community is as follows: - Population 61,122 - Population Over 65 24.0% - Poverty (Below 100% FPL) 11.4% - Unemployment Rate 7.1% - Violent Crime Rate (Per 100,000 Pop.) 426.5 - Pop. Age 25+ with No High School Diploma 8.8% - Uninsured Adults 17.7% - Uninsured Children 6.0% - Food Insecurity Rate 16.2% - Pop. with Low Food Access 45.6%
Part VI, Line 5:The provision of community benefit is central to AdventHealth New Smyrna Beach's mission of service and compassion. Restoring and promoting the health and quality of life of those in the communities served by the Hospital is a function of "extending the healing ministry of Christ and embodies the Hospital's commitment to its values and principles. The Hospital commits substantial resources to provide a broad range of services to both the underprivileged as well as the broader community. In addition to the community benefit and community building information provided in Parts I, II and III of this Schedule H, the Hospital captures and reports the benefits provided to its community through faith-based care. Examples of such benefits include the cost associated with chaplaincy care programs and mission peer reviews and mission conferences. During the current year, Hospital provided $246,515 of benefit with respect to the faith-based and spiritual needs of the community in conjunction with its operation of a community hospital. The Hospital also provides benefits to its community's infrastructure by investing in capital improvements to ensure that facilities and technology provide the best possible care to the community. During the current year, the Hospital expended $10,158,082 in new capital improvements. As a faith-based mission-driven community hospital, the Hospital is continually involved in monitoring its community, identifying unmet health care needs and developing solutions and programs to address those needs. In accordance with its conservative approach to fiscal responsibility, surplus funds of the Hospital are continually being invested in resources that improve the availability and quality of delivery of health care services and programs to its community.
Part VI, Line 6:The filing organization is a part of a faith-based healthcare system of organizations whose parent is Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). The system is known as AdventHealth. AHSSHC is an organization exempt from federal income tax under IRC Section 501(c)(3). AHSSHC and its subsidiary organizations operate 47 hospitals throughout the U.S., primarily in the Southeastern portion of the U.S. AHSSHC and its subsidiaries also operate 12 nursing home facilities and other ancillary health care provider facilities, such as ambulatory surgery centers and diagnostic imaging centers. As the parent organization of AdventHealth, AHSSHC provides executive leadership and other professional support services to its subsidiary organizations. Professional support services include among others IT, corporate compliance, legal, reimbursement, risk management, and tax as well as treasury functions. Certain support services, such as human resources, payroll, A/P, and supply chain management are provided pursuant to a shared services model by AHSSHC to its subsidiary organizations. The provision of these executive and support services on a centralized basis by AHSSHC provides an appropriate balance between providing each AdventHealth subsidiary hospital organization with mission-driven consistent leadership and support while allowing the hospital organization to focus its resources on meeting the specific health care needs of the community it serves. The reader of this Form 990 should keep in mind that this reporting entity may differ in certain areas from that of a stand-alone hospital organization due to its inclusion in a larger system of healthcare organizations. As a part of a system of hospital and other health care organizations, the filing organization benefits from reduced costs due to system efficiencies, such as large group purchasing discounts, and the availability of internal resources such as internal legal counsel. Each AdventHealth subsidiary pays a management fee to AHSSHC for the internal services provided by AHSSHC. As a result, management fee expense reported by an AdventHealth subsidiary organization may appear greater in relation to management fee expense that may be reported by a single stand-alone hospital. The single stand-alone hospital would likely report costs associated with management and other professional services on various expense line items in its statement of revenue and expense as opposed to reporting such costs in one overall management fee expense. As the reporting of the Form 990 is done on an entity by entity basis, there is no single Form 990 that captures the programs and operations of AdventHealth as a whole. The reader is directed to visit the web-site of AdventHealth at www.adventhealth.com to learn more about the mission and operations of AdventHealth.
Part VI, Line 7:The filing organization does not file an annual community benefit report with any state agencies.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtValuation Method UsedValuationMethodUsedDescNon Cash AssistanceNonCashAssistanceDescPurpose Of GrantPurposeOfGrantTxt
SunSystem Development Corp dba AdventHealth New Smyrna Beach Foundation
401 Palmetto StreetNew Smyrna BeachFL32168592219301501(c)(3)$0$141,323CostGeneral Administrative SupportProvision of General Administrative Support
Atlantic Center for the Arts Inc
1414 Art Center AvenueNew Smyrna BeachFL32168591998321501(c)(3)$12,500$0CostGeneral Support
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 2:FormAndLineReferenceDesc
ExplanationGrants are generally made only to related organizations that are exempt from federal income tax under IRC Section 501(c)(3), or to other local charitable community organizations, or to other 501(c)(3) organizations that are a part of the group exemption ruling issued to the General Conference of Seventh-Day Adventists. Accordingly, the filing organization has not established specific procedures for monitoring the use of grant funds in the United States as the filing organization does not have a grant making program that would necessitate such procedures.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
First Class Or Charter TravelYes (X)FirstClassOrCharterTravelInd
Travel For CompanionsYes (X)TravelForCompanionsInd
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Discretionary Spending AcctYes (X)DiscretionarySpendingAcctInd
Housing Allowance Or ResidenceYes (X)HousingAllowanceOrResidenceInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Tol Daryl L
Former Director/Reg. CEO$0$1,189,540$0$429,693$0$238,558$0$239,265$0$53,567$0$2,150,623$0$172,752
Ottati David A
Chairman/Dir/AH Cen FL Region CEO$0$702,036$0$219,618$0$101,591$0$134,895$0$41,743$0$1,199,883$0$79,455
Noseworthy Gordon E
Director$0$464,195$0$123,829$0$200,876$0$85,947$0$23,343$0$898,190$0$63,344
Thomas Debora H
Reg CFO (end 11/2019)/Former Ofcr$0$447,751$0$123,751$0$181,217$0$71,009$0$36,932$0$860,660$0$31,797
Blair Judy M
Director (End 6/2019)$0$51,342$0$111,116$0$542,237$0$4,342$0$22,599$0$731,636$0$117,646
Celano Patricia
Reg CCO (end 9/2019)/Former Key Empl$0$385,530$0$86,584$0$37,081$0$52,298$0$40,185$0$601,678$0$26,428
Mattison Kenneth R
Former Director/CEO$0$0$0$109,805$0$447,211$0$3,493$0$22,075$0$582,584$0$0
Prince Stacy W
Director (Beg 1/2019)$0$323,207$0$60,497$0$26,274$0$50,655$0$25,918$0$486,551$0$18,616
Hernandez MD Dennis A
Sec./Hospital Facility CEO$0$348,271$0$27,684$0$30,586$0$27,108$0$34,189$0$467,838$0$0
Harrell Steven W
COO - Hospital Facility$0$254,342$0$46,442$0$48,820$0$15,087$0$22,727$0$387,418$0$13,416
Rathbun Mark B
CFO - Hospital Facility$0$217,539$0$37,615$0$2,398$0$13,571$0$33,456$0$304,579$0$0
Lynch Dawn J
Director/CNO$0$180,081$0$28,022$554$6,579$0$10,140$0$22,526$554$247,348$0$0
Templeman David R
AHNSB Director - Pharmacy$150,916$0$10,536$0$13,514$0$8,617$0$15,212$0$198,795$0$0$0
Duncan Karen M
AHNSB EF Exec Director IP Services$75,802$0$9,157$0$75,898$0$4,963$0$17,477$0$183,297$0$0$0
Evolga Nancy K
AHNSB Director - Human Resources$138,857$0$9,730$0$10,190$0$7,517$0$15,790$0$182,084$0$0$0
Thomas Marlene
AHNSB EF-Exec Dir OP Svcs/Bus Dev$127,658$0$10,219$0$7,475$0$6,859$0$15,778$0$167,989$0$0$0
Papa Agnes V
AHNSB Director - Rehab Svc$123,766$0$8,544$0$5,868$0$6,703$0$22,461$0$167,342$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 1aThe filing organization is a part of the system of healthcare organizations known as AdventHealth. Members of the filing organization's executive management team that hold the position of Vice-President or above are compensated by and on the payroll of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the parent organization of the healthcare system known as AdventHealth. AHSSHC is exempt from federal income tax under IRC Section 501(c)(3). The filing organization reimburses AHSSHC for the salary and benefit cost of those executives on the payroll of AHSSHC. At the direction of AHSSHC, and in accordance with the reserved powers in the filing organization's governing documents, the executive team listed on Part VII provides services to the filing organization. First-class or charter travel: Pursuant to the AdventHealth system-wide general policy regarding business travel, no reimbursement will be provided for any additional cost incurred with respect to first-class or charter air travel beyond the cost of a regular coach airfare. As a means of providing additional business travel reimbursement for those members of the AHSSHC senior executive management team that travel frequently on behalf of AdventHealth, a special annual travel allowance is provided for those executives. As AdventHealth operates 47 hospitals in 9 states, the senior leadership of AHSSHC travel extensively and often visit multiple hospital locations in different states as a part of a single business trip. The special travel allowance can provide reimbursements to the executive for such items as the purchase of air travel upgrade coupons, to cover the cost differential between coach and first-class travel, or to cover the cost of a charter flight. The special travel allowance benefit was originally authorized by and codified into a policy by the AHSSHC Board Compensation Committee (the Committee), an independent body of the AHSSHC Board of Directors, who also approves the annual cap on the amount of the allowance. The special travel allowance has an annual cap of $24,000 for members of the Leadership Executive Team (AdventHealth Cabinet - 13 members) and $15,000 for AdventHealth Corporate Office Senior Vice Presidents, Regional CEO's and Division Chief Officers (generally 20-30 individual executives). A Regional CEO for AdventHealth is a member of the Board of Directors of the filing organization. The Regional CEO is considered a common law employee of and is on the payroll of AHSSHC. While the special travel allowance benefit is an AHSSHC compensation policy and practice, the cost of providing this benefit is allocated to and reimbursed in part by the filing organization. Accordingly, the filing organization has checked the box in Schedule J, Part I, line 1a for first-class or charter travel since it has partially paid for the cost of providing this benefit. Those executives who receive the special travel allowance are responsible for tracking the expenses reimbursable under the special travel allowance and must submit such expenses on their accountable plan expense report. Any taxable reimbursements made to executives under the special travel allowance arrangement are treated as taxable compensation to the executive. Travel for companions: AHSSHC has a Corporate Executive Policy that provides a benefit to allow for a traveling AHSSHC executive to have his or her spouse accompany the executive on certain business trips each year. Typically, reimbursement is only provided to certain executive leaders and is usually limited to one business trip per year beyond the annual AdventHealth President's Council business meeting and other meetings where the spouse is specifically invited. The AHSSHC Corporate Executive Spousal Travel Policy was originally approved and reviewed by the AHSSHC Board Compensation Committee, an independent body of the AHSSHC Board of Directors. All spousal travel costs reimbursed to the executive are considered taxable compensation to the executive. Tax Indemnification and gross-up payments: AdventHealth has a system-wide policy addressing gross-up payments provided in connection with employer-provided benefits/other taxable items. Under the policy, certain taxable business-related reimbursements (i.e. taxable business-related moving expenses, taxable items provided in connection with employment) provided to any employee may be grossed-up at a 25% rate upon approval by the filing organization's CEO and CFO. Additionally, employees at the Director level and above are eligible for gross-up payments on gifts received for board of director services. Discretionary spending account: Nominal discretionary spending amounts are periodically provided to eligible executives who attend annual business meetings such as the AdventHealth CFO Conference or the CMO/CNO business meeting ($300 or less per executive). Payments provided to each executive are considered taxable compensation to the executive. Housing allowance or residence for personal use: AHSSHC has a Corporate Executive Policy that addresses assistance to executives who have been relocated by the company during the year. Relocation assistance provided to executives may include relocation allowances to assist with duplicate housing expenses. Relocation assistance is administered per AHSSHC policy by an external relocation company. Any taxable reimbursements made to executives in connection with relocation assistance are treated as wages to the executive and are subject to all payroll withholding and reporting requirements.
Part I, Line 3The individual who serves as the CEO of the filing organization is appointed and compensated by Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). 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 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 of the community, who hold no employment positions with AHSSHC and who do not have relationships with any of the individuals whose compensation is under their review that impacts their best independent judgment as fiduciaries of AHSSHC. The Committee's role is to review and approve all components of the executive compensation plan of AHSSHC. As an independent governing body with respect to executive compensation, it should be noted that the Committee will often confer in executive sessions on matters of compensation policy and policy changes. In such executive sessions, no members of management of AHSSHC are present. The Committee is advised by an independent third-party compensation advisor. This advisor prepares all the benchmark studies for the Committee. Compensation levels are benchmarked with a national peer group of other not-for-profit healthcare systems and hospitals of similar size and complexity to 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, Lines 4a-bPart I, Line 4a: During the year ending December 31, 2019, Judy M. Blair and Kenneth R. Mattison received severance payments in the amount of $393,620 and $400,456, respectively. Pursuant to the AHSSHC Corporate Executive Policy governing executive severance, severance agreements for executives operating at the Vice President level and above are entered into upon eligibility to facilitate the transition to subsequent employment following an involuntary separation from employment with AdventHealth. Part I, Line 4b: As discussed in Line 1a above, executives on the filing organization's management team that hold the position of Vice-President or above are compensated by and on the payroll of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the parent organization of a healthcare system known as AdventHealth. In recognition of the contribution that each executive makes to the success of AdventHealth, AdventHealth provides to eligible executives participation in the AdventHealth Executive FLEX Benefit Program (the Plan). The purpose of the Plan is to offer eligible executives an opportunity to elect from among a variety of supplemental benefits, including a split dollar life insurance policy and long-term care insurance, to individually tailor a benefits program appropriate to each executive's needs. The Plan provides eligible participants a pre-determined benefits allowance credit that is equal to a percentage of the executive's base pay from which is deducted the cost of mandatory and elective employee benefits. The pre-determined benefits allowance credit percentage is approved by the AHSSHC Board Compensation Committee, an independent committee of the Board of Directors of AHSSHC. Any funds that remain after the cost of mandatory and elective benefits are subtracted from the annual pre-determined benefits allowance are contributed, at the employee's option, to either an IRC 457(f) deferred compensation account or to an IRC 457(b) eligible deferred compensation plan. 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 documents define an employee who is eligible to participate in the Plan to generally include the Chief Executive Officers of AdventHealth entities and Vice Presidents of all AdventHealth entities whose base salary is at least $260,000. The Plan provides for a class year vesting schedule (2 years for each class year) with respect to amounts accumulated in the executive's 457(f) deferred compensation account. Distributions could also be made from the executive's 457(f) deferred compensation account upon attainment of age 65 or upon an involuntary separation. The account is forfeited by the executive upon a voluntary separation. In addition to the Plan, AdventHealth has instituted 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. Participation in the plan is offered to AdventHealth executives 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. This supplemental executive retirement plan (SERP) was designed to provide eligible executives with the economic equivalent of an annual income beginning at normal retirement age equal to 60% of the average of the participant's three, 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 the SERP and by the individual's year of entry to the AdventHealth Executive FLEX Benefit Program. Additionally, AdventHealth has adopted a Senior Executive Death Benefit (SEDB) Plan in recognition of the considerable age and service requirements in the SERP. The SEDB Plan provides a benefit in an amount equal to the amount the executive's benefit would have been under the SERP Plan assuming that, on the date of the executive's death (and not before), the executive satisfied the last of the eligibility requirements of the SERP Plan with present value recognizing an early benefit commencement. An eligible executive becomes a participant in the SEDB Plan if the executive dies prior to termination of employment, provided the executive has not satisfied all of the eligibility requirements of SERP as of the executive's date of death but would have satisfied all of those requirements within five (5) years following death had the executive lived and continued employment. The SEDB Plan was reviewed and approved by the AHSSHC Board Compensation Committee, an independent body of the AHSSHC Board of Directors. Flex Plan Flex Plan/ SERP 457(b) CY CY Employer CY Contrib./ Distr.* Contrib. Distr.* Payment --------------------------------------------------------------------------- Tol, Daryl L. $243,179 $177,443 $ 0 $ 0 Ottati, David A. $119,809 $ 84,913 $ 0 $ 0 Noseworthy, Gordon E.$ 70,860 $ 65,617 $103,214 $ 0 Thomas, Debora H. $ 55,923 $ 32,527 $127,807 $ 0 Blair, Judy M. $ 4,342 $126,559 $ 0 $ 0 Celano, Patricia $ 40,348 $ 26,513 $ 0 $ 0 Prince, Stacy W. $ 35,569 $ 18,915 $ 0 $ 0 Hernandez, Dennis A. $ 31,021 $ 0 $ 0 $ 0 Harrell, Steven W. $ 18,331 $ 20,030 $ 0 $ 0 * Including Investment Earnings

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part V, Line 1a:The parent corporation and sole top-tier member of Southeast Volusia Healthcare Corporation (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 6Southeast Volusia Healthcare Corporation (SEVHC) has one member. The sole member of the filing organization is Adventist Health System Sunbelt Healthcare Corporation. Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) is a Florida, not-for-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). There are no other classes of membership in the filing organization.
Form 990, Part VI, Section A, line 7aThe sole member of the filing organization is AHSSHC. The Board of Directors of the filing organization are appointed by the sole member, AHSSHC, 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 7bAHSSHC, as the sole member of the filing organization, has certain reserved powers as set forth in the Bylaws of the filing organization. These reserved powers include the following: a) to approve or disapprove the executive and/or administrative leadership of the Hospital and their salaries; b) to adopt, amend, restate, and repeal the Articles of Incorporation or Bylaws of the filing organization and the medical staff Bylaws; c) to set limits and terms for the borrowing of funds; d) to approve or disapprove the annual operating and capital budgets of the filing organization; e) to direct the placement of funds and capital of the filing organization; f) to approve or disapprove certain purchases or sales of personal property or real property equal to or in excess of established dollar thresholds; g) to establish general guiding policies, to implement quality assessment, improvement and utilization review programs; and h) to approve the appointment of an auditing firm and election of the fiscal year for the filing organization.
Form 990, Part VI, Section B, line 11bThe filing organization's current year Form 990 was reviewed by the Board Chairman, the Board Finance Committee Chair, the CEO, and the CFO prior to its filing with the IRS. The review conducted by the Board Chairman, the Board Finance Committee Chair, the CEO, and the CFO did not include the review of any supporting workpapers that were used in preparation of the current year Form 990, but did include a review of the entire Form 990 and all supporting schedules.
Form 990, Part VI, Section B, line 12cThe 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 15The filing organization's CEO, other officers and key employees 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 19The 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.
Form 990, Part VII, Section A:For those Board of Director members (not including physician members of the board), officer(s) and key employees 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. Physician members of the Board of Directors received compensation from related organizations as a result of providing various medical services to those related entities.
Form 990, Part VIII, Lines 7a, b and c:The amounts shown in Part VIII, Lines 7a(i) and 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 11gPayments to Healthcare Professionals: Program service expenses 7,305,369. Management and general expenses 0. Fundraising expenses 0. Total expenses 7,305,369. Purchased Medical Services: Program service expenses 11,767,987. Management and general expenses 0. Fundraising expenses 0. Total expenses 11,767,987. Environmental Services: Program service expenses 775,422. Management and general expenses 0. Fundraising expenses 0. Total expenses 775,422. Transcription Services: Program service expenses 64,330. Management and general expenses 0. Fundraising expenses 0. Total expenses 64,330. Recruiting: Program service expenses 17,963. Management and general expenses 0. Fundraising expenses 0. Total expenses 17,963. Food Service Contracts: Program service expenses 401,019. Management and general expenses 0. Fundraising expenses 0. Total expenses 401,019. Miscellaneous Purchased Services: Program service expenses 5,281,938. Management and general expenses 0. Fundraising expenses 0. Total expenses 5,281,938. AdventHealth Management Fees: Program service expenses 0. Management and general expenses 1,534,255. Fundraising expenses 0. Total expenses 1,534,255. Billing & Collection Services: Program service expenses 0. Management and general expenses 940,515. Fundraising expenses 0. Total expenses 940,515. AdventHealth Shared Service Fee: Program service expenses 0. Management and general expenses 1,072,061. Fundraising expenses 0. Total expenses 1,072,061.
Form 990, Part XI, line 9:Transfer to Tax-Exempt Parent -578,960. Transfer to/from Affiliate -1,291,410. ASC 842 Lease Accounting Adjustments -539,292. Rounding 2.
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.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (111 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
AdventHealth Family Medicine Rural Health Clinics Inc fka Hospice of the C
187 PR 4060LampasasTX76550271858033Operation of Rural Health Clinics & Medical ServicesFL501(c)(3)Line 3Metroplex Adventist Hospital IncYes (1)
AdventHealth Foundation Shawnee Mission
9100 W 74th StreetShawnee MissionKS66204480868859Fund-raising for Tax-exempt hospitalKS501(c)(3)Line 7Shawnee Mission Medical Center IncYes (1)
AdventHealth Home Care East Florida LLC (218-123119)
770 West Granada Blvd 319Ormond BeachFL32174833768458InactiveFL501(c)(3)Line 12a, IMemorial Hlth Systems IncYes (1)
AdventHealth Hospice Care East Florida Inc (218-123119)
770 West Granada Blvd 304Ormond BeachFL32174833748461InactiveFL501(c)(3)Line 12a, IMemorial Hlth Systems IncYes (1)
AdventHealth North Polk Inc fka University Community Hospital Specialty Ca
3100 E Fletcher AveTampaFL33613593231322InactiveFL501(c)(3)Line 12a, IUniversity Community Hospital IncYes (1)
AdventHealth Osceola South Inc (416-123119)
900 Hope WayAltamonte SpringsFL32714841817046InactiveFL501(c)(3)Line 3Adventist Hlth System Sunbelt Hlthcare CorpYes (1)
AdventHealth Polk North Inc (418-123119)
40100 US Highway 27 NDavenportFL33837841793121Operation of Hospital & Related ServicesFL501(c)(3)Line 3Adventist Hlth System Sunbelt Hlthcare CorpYes (1)
AdventHealth Polk South Inc (415-123119)
410 South 11th StreetLake WalesFL33853834672945Operation of Hospital & Related ServicesFL501(c)(3)Line 3Adventist Hlth System Sunbelt Hlthcare CorpYes (1)
AdventHealth Ransom Memorial Inc
1301 S Main StreetOttawaKS66067830976641Operation of Hospital & Related ServicesKS501(c)(3)Line 3Adventist Hlth Mid-America IncYes (1)
AdventHealth University Inc
671 Lake Winyah DriveOrlandoFL32803593069793Education/Operation of SchoolFL501(c)(3)Line 2Adventist Hlth SystemSunbelt IncYes (1)
AdventHealth West FL Ambulatory Svcs Inc fka West FL Hlth Inc
14055 Riveredge DriveTampaFL33637471881744InactiveFL501(c)(3)Line 10Adventist Hlth System Sunbelt Hlthcare CorpYes (1)
AdventHealth West Florida Imaging Inc (924-123119)
14055 Riveredge Drive Ste 250TampaFL33637843225135Imaging & TestingFL501(c)(3)Line 12a, IAdventHealth West Florida Ambulatory Services IncYes (1)
Adventist Bolingbrook Hospital
500 Remington BlvdBolingbrookIL60440651219504Operation of Hospital & Related ServicesIL501(c)(3)Line 3Adventist Midwest HealthYes (1)
Adventist Care Centers - Courtland Inc
730 Courtland StreetOrlandoFL32804205774723Operation of Home for the Aged/Hlthcare DeliveryFL501(c)(3)Line 10Sunbelt Hlth Care Centers IncYes (1)
Adventist GlenOaks Hospital
701 Winthrop AvenueGlendale HeightsIL60139363208390Operation of Hospital & Related ServicesIL501(c)(3)Line 3Adventist Midwest HealthYes (1)
Adventist Hlth Mid-America Inc
9100 W 74th StreetShawnee MissionKS66204521347407Support of Affiliated HospitalKS501(c)(3)Line 12c, III-FIAdventist Hlth SystemSunbelt IncYes (1)
Adventist Hlth Partners Inc
2601 Navistar Dr Bldg 4 FinanceLisleIL60532364138353Operation of Physician Practices & Medical ServicesIL501(c)(3)Line 3AHS Midwest Management IncYes (1)
Adventist Hlth System Sunbelt Hlthcare Corp
900 Hope WayAltamonte SpringsFL32714592170012Management ServicesFL501(c)(3)Line 12a, I0N/A
Adventist Hlth System Georgia Inc
1035 Red Bud RoadCalhounGA30701581425000Operation of Hospital & Related ServicesGA501(c)(3)Line 3Adventist Hlth System Sunbelt Hlthcare CorpYes (1)
Adventist Hlth SystemSunbelt Inc
900 Hope WayAltamonte SpringsFL32714591479658Operation of Hospital & Related ServicesFL501(c)(3)Line 3Adventist Hlth System Sunbelt Hlthcare CorpYes (1)
Adventist Hlth SystemTexas Inc
11801 S FreewayBurlesonTX76028742578952Leasing Personnel to Affiliated HospitalTX501(c)(3)Line 12c, III-FIAdventist Hlth System Sunbelt Hlthcare CorpYes (1)
Adventist Midwest Health
120 North Oak StreetHinsdaleIL60521362276984Operation of Hospital & Related ServicesIL501(c)(3)Line 3Adventist Hlth SystemSunbelt IncYes (1)
AHP Specialty Care NFP
2601 Navistar Dr Bldg 4 FinanceLisleIL60532811105774Operation of Physician Practices & Medical ServicesIL501(c)(3)Line 3AHS Midwest Management IncYes (1)
AHS Midwest Management Inc
2601 Navistar Dr Bldg 4 FinanceLisleIL60532363354567Operation of Physician Practice MgmtIL501(c)(3)Line 12a, IAdventist Midwest HealthYes (1)
AHSCentral Texas Inc
1301 Wonder World DriveSan MarcosTX78666742621825Provide Office Space - Medical ProfessionalsTX501(c)(3)Line 12c, III-FIAdventist Hlth System Sunbelt Hlthcare CorpYes (1)
Apopka Hlth Care Properties Inc
305 E Oak StreetApopkaFL32703510605694Lease to Related OrganizationGA501(c)(3)Line 12c, III-FISunbelt Hlth Care Centers IncYes (1)
Battle Creek Adventist Hospital
900 Hope WayAltamonte SpringsFL32714381359189InactiveMI501(c)(3)Line 3Adventist Hlth SystemSunbelt IncYes (1)
Bert Fish Medical Center Auxiliary Inc
401 Palmetto StreetNew Smyrna BeachFL32168591054892Volunteer support servicesFL501(c)(3)Line 100N/A
Bolingbrook Hospital Foundation (1119-62119)
500 Remington BlvdBolingbrookIL60440900494445Fund-raising for Tax-exempt hospitalIL501(c)(3)Line 7Midwest Hlth Foundation0
Bradford Heights Hlth & Rehab Center Inc
950 Highpoint DriveHopkinsvilleKY42240205782342Operation of Home for the Aged/Hlthcare DeliveryKY501(c)(3)Line 10Sunbelt Hlth Care Centers IncYes (1)
Burleson Nursing & Rehab Center Inc
301 Huguley BlvdBurlesonTX76028205782243Operation of Home for the Aged/Hlthcare DeliveryTX501(c)(3)Line 10Sunbelt Hlth Care Centers IncYes (1)
Caldwell Hlth Care Properties Inc
1333 West MainPrincetonKY42445510605680Lease to Related OrganizationGA501(c)(3)Line 12c, III-FISunbelt Hlth Care Centers IncYes (1)
Central Texas Hlthcare Collaborative
1301 Wonder World DriveSan MarcosTX78666453739929Support Operation of HospitalTX501(c)(3)Line 12a, IAdventist Hlth SystemSunbelt IncYes (1)
Chickasaw Hlth Care Properties Inc
250 S Chickasaw TrailOrlandoFL32825510605681Lease to Related OrganizationGA501(c)(3)Line 12c, III-FISunbelt Hlth Care Centers IncYes (1)
Chippewa Valley Hospital & Oakview Care Center Inc
1220 Third Avenue WestDurandWI54736391365168Operation of Hospital & Related ServicesWI501(c)(3)Line 3Adventist Hlth SystemSunbelt IncYes (1)
Courtland Hlth Care Properties Inc
730 Courtland StreetOrlandoFL32804510605682Lease to Related OrganizationGA501(c)(3)Line 12c, III-FISunbelt Hlth Care Centers IncYes (1)
Creekwood Place Nursing & Rehab Center Inc
107 Boyles DriveRussellvilleKY42276205782260Operation of Home for the Aged/Hlthcare DeliveryKY501(c)(3)Line 10Sunbelt Hlth Care Centers IncYes (1)
Dairy Road Hlth Care Properties Inc
7350 Dairy RoadZephyrhillsFL33540510605684Lease to Related OrganizationGA501(c)(3)Line 12c, III-FISunbelt Hlth Care Centers IncYes (1)
East Orlando Hlth & Rehab Center Inc
250 S Chickasaw TrailOrlandoFL32825205774748Operation of Home for the Aged/Hlthcare DeliveryFL501(c)(3)Line 10Sunbelt Hlth Care Centers IncYes (1)
Emory-Adventist Inc
900 Hope WayAltamonte SpringsFL32714582171011InactiveGA501(c)(3)Line 3Adventist Hlth SystemSunbelt IncYes (1)
Fletcher Hospital Inc
100 Hospital DriveHendersonvilleNC28792560543246Operation of Hospital & Related SvcsNC501(c)(3)Line 3Adventist Hlth System Sunbelt Hlthcare CorpYes (1)
FLNC Inc
3355 E Semoran BlvdApopkaFL32703205774761Operation of Home for the Aged/Hlthcare DeliveryFL501(c)(3)Line 10Sunbelt Hlth Care Centers IncYes (1)
Florida Hospital Dade City Inc
13100 Fort King RoadDade CityFL33525822567308Operation of Hospital & Related SvcsFL501(c)(3)Line 3Adventist Hlth System Sunbelt Hlthcare CorpYes (1)
Florida Hospital Healthcare Partners Inc
770 West Granada Blvd 101Ormond BeachFL32174462354804Operation of Physician Practices & Medical ServicesFL501(c)(3)Line 3Adventist Hlth SystemSunbelt IncYes (1)
Florida Hospital Medical Group Inc
2600 Westhall Lane 4th FloorMaitlandFL32751593214635Operation of Physician Practices & Medical ServicesFL501(c)(3)Line 3Adventist Hlth SystemSunbelt IncYes (1)
Florida Hospital Ocala Inc
1500 SW 1st AvenueOcalaFL34471824372339Operation of Hospital & Related SvcsFL501(c)(3)Line 3Adventist Hlth System Sunbelt Hlthcare CorpYes (1)
Florida Hospital Physician Group Inc
12470 Telecom Dr 100TampaFL33637462021581Operation of Physician Practices & Medical ServicesFL501(c)(3)Line 3Adventist Hlth System Sunbelt Hlthcare CorpYes (1)
Florida Hospital Waterman Inc
1000 Waterman WayTavaresFL32778593140669Operation of Hospital & Related ServicesFL501(c)(3)Line 3Adventist Hlth System Sunbelt Hlthcare CorpYes (1)
Florida Hospital Zephyrhills Inc
7050 Gall BlvdZephyrhillsFL33541592108057Operation of Hospital & Related ServicesFL501(c)(3)Line 3Adventist Hlth SystemSunbelt IncYes (1)
Florida Radiology Imaging at Lake Mary LLC
2600 Westhall Lane 4th FloorMaitlandFL32751550789387Imaging & TestingFL501(c)(3)Line 3Florida Hospital Medical Group IncYes (1)
Fountain Inn Nursing & Rehab Center Inc
485 North Keller Road 250MaitlandFL32751472180518Operation of Home for the Aged/Hlthcare DeliveryFL501(c)(3)Line 10Sunbelt Hlth Care Centers IncYes (1)
GlenOaks Hospital Foundation (11-62119)
701 Winthrop AvenueGlendale HeightsIL60139363926044Fund-raising for Tax-exempt hospitalIL501(c)(3)Line 7Midwest Hlth Foundation0
Helen Ellis Memorial Hospital Auxiliary Inc
1395 S Pinellas AveTarpon SpringsFL34689592106043Fund-raising for Tax-exempt hospital/foundationFL501(c)(3)Line 12c, III-FI0N/A
Helen Ellis Memorial Hospital Foundation Inc
1395 S Pinellas AveTarpon SpringsFL34689593690149Fund-raising for Tax-exempt hospitalFL501(c)(3)Line 70N/A
Hinsdale Hospital Foundation
120 North Oak StreetHinsdaleIL60521521466387Fund-raising for Tax-exempt hospitalIL501(c)(3)Line 7Midwest Hlth Foundation0
Hospice of the Comforter Inc
480 W Central ParkwayAltamonte SpringsFL32714592935928Operation of HospiceFL501(c)(3)Line 10The Comforter Health Care Group IncYes (1)
In-Motion Rehab Inc
485 North Keller Road 250MaitlandFL32751208023411Therapy services to tax exempt nursing homesKS501(c)(3)Line 12b, IISunbelt Hlth Care Centers IncYes (1)
La Grange Memorial Hospital Foundation (11-62119)
5101 S Willow Springs RdLa GrangeIL60525300247776Fund-raising for Tax-exempt hospitalIL501(c)(3)Line 7Midwest Hlth Foundation0
Lake County Health Care Properties Inc
485 North Keller Road 250MaitlandFL32751813923985Lease to Related OrganizationGA501(c)(3)Line 12c, III-FISunbelt Hlth Care Centers IncYes (1)
Memorial Hlth Systems Foundation Inc
305 Memorial Medical Pkwy 212Daytona BeachFL32117311771522Fund-raising for Tax-exempt hospitalFL501(c)(3)Line 70N/A
Memorial Hlth Systems Inc
301 Memorial Medical ParkwayDaytona BeachFL32117590973502Operation of Hospital & Related ServicesFL501(c)(3)Line 3Adventist Hlth SystemSunbelt IncYes (1)
Memorial Hospital - West Volusia Inc
701 West Plymouth AvenueDelandFL32720593256803Operation of Hospital & Related ServicesFL501(c)(3)Line 3Memorial Hlth Systems IncYes (1)
Memorial Hospital Flagler Inc
60 Memorial Medical ParkwayPalm CoastFL32164592951990Operation of Hospital & Related ServicesFL501(c)(3)Line 3Memorial Hlth Systems IncYes (1)
Memorial Hospital Inc
210 Marie Langdon DriveManchesterKY40962610594620Operation of Hospital & Related ServicesKY501(c)(3)Line 3Adventist Hlth System Sunbelt Hlthcare CorpYes (1)
Merriam Hlth Care Properties Inc
9700 West 62nd StreetMerriamKS66203364595806Lease to Related OrganizationKS501(c)(3)Line 12c, III-FISunbelt Hlth Care Centers IncYes (1)
Metroplex Adventist Hospital Inc
2201 S Clear Creek RoadKilleenTX76549742225672Operation of Hospital & Related ServicesTX501(c)(3)Line 3Adventist Hlth System Sunbelt Hlthcare CorpYes (1)
Metroplex Clinic Physicians Inc
2201 S Clear Creek RoadKilleenTX76549113762050Physician Hlthcare services to the communityTX501(c)(3)Line 3Metroplex Adventist Hospital IncYes (1)
Midwest Hlth Foundation
120 North Oak StreetHinsdaleIL60521352230515Support of subsidiary foundationsIL501(c)(3)Line 12b, II0N/A
Mills Hlth & Rehab Center Inc
500 Beck LaneMayfieldKY42066205782320Operation of Home for the Aged/Hlthcare DeliveryKY501(c)(3)Line 10Sunbelt Hlth Care Centers IncYes (1)
Mission Strategies of Georgia Inc
485 North Keller Road 250MaitlandFL32751900866024Provision of support to the nursing home divisionGA501(c)(3)Line 12b, IISunbelt Hlth Care Centers IncYes (1)
Missouri Adventist Hlth Inc
9100 W 74th StreetShawnee MissionKS66204431224729Support Hlth Care ServicesMO501(c)(3)Line 12d, III-OAdventist Hlth Mid-America IncYes (1)
Ormond Beach Memorial Hospital Auxiliary Inc
301 Memorial Medical ParkwayDaytona BeachFL32117591721962Volunteer support servicesFL501(c)(3)Line 12c, III-FI0N/A
Osceola Health Care Properties Inc
485 North Keller Road 250MaitlandFL32751813165729Lease to Related OrganizationGA501(c)(3)Line 12c, III-FISunbelt Hlth Care Centers IncYes (1)
Overland Park Nursing & Rehab Center Inc
6501 West 75th StreetOverland ParkKS66204205774821Operation of Home for the Aged/Hlthcare DeliveryKS501(c)(3)Line 10Sunbelt Hlth Care Centers IncYes (1)
Paragon Hlth Care Properties Inc
950 Highpoint DriveHopkinsvilleKY42240510605686Lease to Related OrganizationGA501(c)(3)Line 12c, III-FISunbelt Hlth Care Centers IncYes (1)
Pasco-Pinellas Hillsborough Community Hlth System Inc
2600 Bruce B Downs BlvdWesley ChapelFL33544208488713Operation of Hospital & Related ServicesFL501(c)(3)Line 3Adventist Hlth System Sunbelt Hlthcare CorpYes (1)
Portercare Adventist Hlth System (630 Year End)
9100 E Mineral CircleCentennialCO80112840438224Operation of Hospital & Related ServicesCO501(c)(3)Line 3Adventist Hlth System Sunbelt Hlthcare CorpYes (1)
Princeton Hlth & Rehab Center Inc
1333 West MainPrincetonKY42445205782272Operation of Home for the Aged/Hlthcare DeliveryKY501(c)(3)Line 10Sunbelt Hlth Care Centers IncYes (1)
Princeton Professional Services Inc
601 E Rollins StreetOrlandoFL32803591191045Provision of Hlthcare ServicesFL501(c)(3)Line 10Adventist Hlth System Sunbelt Hlthcare CorpYes (1)
Quality Circle for Hlthcare Inc
900 Hope WayAltamonte SpringsFL32714263789368Hlthcare Quality ServicesFL501(c)(3)Line 12a, IAdventist Hlth System Sunbelt Hlthcare CorpYes (1)
Resource Personnel Inc
485 North Keller Road 250MaitlandFL32751208040875Provide administrative support to tax exempt nursing homesFL501(c)(3)Line 12b, IISunbelt Hlth Care Centers IncYes (1)
Rocky Mountain Adventist Hlthcare Foundation (630 Year End)
7995 E Prentice Ave 204Greenwood VillageCO80111840745018Fund-raising for Tax-exempt hospitalCO501(c)(3)Line 70N/A
Rollins Brook Community Care Corp
2201 S Clear Creek RoadKilleenTX76549461656773Support Operation of HospitalTX501(c)(3)Line 12a, IAdventist Hlth SystemSunbelt IncYes (1)
Russellville Hlth Care Properties Inc
683 East Third StreetRussellvilleKY42276510605691Lease to Related OrganizationGA501(c)(3)Line 12c, III-FISunbelt Hlth Care Centers IncYes (1)
San Marcos Hlth Care Properties Inc
1900 Medical ParkwaySan MarcosTX78666510605693Lease to Related OrganizationGA501(c)(3)Line 12c, III-FISunbelt Hlth Care Centers IncYes (1)
San Marcos Nursing & Rehab Center Inc
1900 Medical ParkwaySan MarcosTX78666205782224Operation of Home for the Aged/Hlthcare DeliveryTX501(c)(3)Line 10Sunbelt Hlth Care Centers IncYes (1)
Shawnee Mission Hlth Care Inc
6501 West 75th StreetOverland ParkKS66204480952508Lease to Related OrganizationKS501(c)(3)Line 12c, III-FISunbelt Hlth Care Centers IncYes (1)
Shawnee Mission Hlth Care Properties Inc
485 North Keller Road 250MaitlandFL32751813914908Lease to Related OrganizationGA501(c)(3)Line 12c, III-FISunbelt Hlth Care Centers IncYes (1)
Shawnee Mission Medical Center Inc
9100 W 74th StreetShawnee MissionKS66204480637331Operation of Hospital & Related ServicesKS501(c)(3)Line 3Adventist Hlth Mid-America IncYes (1)
South Pasco Hlth Care Properties Inc
38250 A AvenueZephyrhillsFL33542510605679Lease to Related OrganizationGA501(c)(3)Line 12c, III-FISunbelt Hlth Care Centers IncYes (1)
Southeast Volusia Healthcare Corp
401 Palmetto StreetNew Smyrna BeachFL32168473793197Operation of Hospital & Related ServicesFL501(c)(3)Line 3Adventist Hlth System Sunbelt Hlthcare CorpYes (1)
Southwest Volusia Hlth Services Inc
1055 Saxon BlvdOrange CityFL32763593281591Medical Office Building for HospitalFL501(c)(3)Line 12a, ISouthwest Volusia Hlthcare CorpYes (1)
Southwest Volusia Hlthcare Corp
1055 Saxon BlvdOrange CityFL32763593149293Operation of Hospital & Related ServicesFL501(c)(3)Line 3Adventist Hlth SystemSunbelt IncYes (1)
Specialty Physicians of Central Texas Inc
1301 Wonder World DriveSan MarcosTX78666208814408Physician Hlthcare services to the communityTX501(c)(3)Line 3Adventist Hlth SystemSunbelt IncYes (1)
Spring View Hlth & Rehab Center Inc
718 Goodwin LaneLeitchfieldKY42754205782288Operation of Home for the Aged/Hlthcare DeliveryKY501(c)(3)Line 10Sunbelt Hlth Care Centers IncYes (1)
Sunbelt Hlth & Rehab Center - Apopka Inc
305 East Oak StreetApopkaFL32703205774856Operation of Home for the Aged/Hlthcare DeliveryFL501(c)(3)Line 10Sunbelt Hlth Care Centers IncYes (1)
Sunbelt Hlth Care Centers Inc
485 North Keller Road 250MaitlandFL32751581473135Management ServicesTN501(c)(3)Line 12b, IIAdventist Hlth System Sunbelt Hlthcare CorpYes (1)
SunSystem Development Corp
900 Hope WayAltamonte SpringsFL32714592219301Fund Raising for Affiliated Tax-Exempt HospitalsFL501(c)(3)Line 7Adventist Hlth System Sunbelt Hlthcare CorpYes (1)
Tarpon Springs Hospital Foundation Inc
1395 S Pinellas AveTarpon SpringsFL34689590898901Operation of Hospital & Related ServicesFL501(c)(3)Line 3University Community Hospital IncYes (1)
Tarrant County Hlth Care Properties Inc
301 Huguley BlvdBurlesonTX76028510605677Lease to Related OrganizationGA501(c)(3)Line 12c, III-FISunbelt Hlth Care Centers IncYes (1)
Taylor Creek Hlth Care Properties Inc
718 Goodwin LaneLeitchfieldKY42754510605678Lease to Related OrganizationGA501(c)(3)Line 12c, III-FISunbelt Hlth Care Centers IncYes (1)
The Comforter Health Care Group Inc
605 Montgomery RoadAltamonte SpringsFL32714271857940Lease to Related OrganizationFL501(c)(3)Line 12c, III-FIAdventist Hlth System Sunbelt Hlthcare CorpYes (1)
The Volunteer Auxiliary of Florida Hospital - Flagler Inc
60 Memorial Medical ParkwayPalm CoastFL32164592486582Volunteer support servicesFL501(c)(3)Line 12c, III-FI0N/A
Tri-County Nursing and Rehab Center Inc
485 North Keller Road 250MaitlandFL32751472219363Operation of Home for the Aged/Hlthcare DeliveryFL501(c)(3)Line 10Sunbelt Hlth Care Centers IncYes (1)
Trinity Nursing & Rehab Center Inc
9700 West 62nd StreetMerriamKS66203205774890Operation of Home for the Aged/Hlthcare DeliveryKS501(c)(3)Line 10Sunbelt Hlth Care Centers IncYes (1)
University Community Hospital Foundation Inc
3100 E Fletcher AveTampaFL33613592554889Fund-raising for Tax-exempt hospitalFL501(c)(3)Line 12a, I0N/A
University Community Hospital Inc
3100 E Fletcher AveTampaFL33613591113901Operation of Hospital & Related ServicesFL501(c)(3)Line 3Adventist Hlth System Sunbelt Hlthcare CorpYes (1)
West Florida Health Home Care Inc
13601 Bruce B Downs Blvd Ste 110TampaFL33613593686109Home Health ServicesGA501(c)(3)Line 10West Florida Health IncYes (1)
West Kentucky Hlth Care Properties Inc
500 Beck LaneMayfieldKY42066510605676Lease to Related OrganizationGA501(c)(3)Line 12c, III-FISunbelt Hlth Care Centers IncYes (1)
Zephyr Haven Hlth & Rehab Center Inc
38250 A AvenueZephyrhillsFL33542205774930Operation of Home for the Aged/Hlthcare DeliveryFL501(c)(3)Line 10Sunbelt Hlth Care Centers IncYes (1)
Zephyrhills Hlth & Rehab Center Inc
7350 Dairy RoadZephyrhillsFL33540205774967Operation of Home for the Aged/Hlthcare DeliveryFL501(c)(3)Line 10Sunbelt Hlth Care Centers IncYes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACd
Clear Creek MOB Ltd (1119-3519)
2201 S Clear Creek RdKilleenTX76549742609195Real EstateTXN/A
Florida Hospital DMERT LLC
500 Winderley Place Ste 324MaitlandFL32751202392253Medical EquipmentFLN/A
Florida Hospital Home Infusion LLP
500 Winderley Place Ste 226MaitlandFL32751593142824Home Infusion ServicesFLN/A
Heart of Florida Surgery Center LLC
410 Lionel Way 100DavenportFL33837812235296Surgery CenterDEN/A
Functional Neurosurgical Ambulatory Surgery Ctr LLC
11 W Dry Creek Circle 120LittletonCO80120464426708Surgery CenterCON/A
PAHS OnPoint Urgent Care LLC (382019 - 12312019)
9100 E Mineral CircleCentennialCO80112832465331Urgent Care CenterCON/A
Princeton Homecare Services LLC
1050 Forrer BlvdKetteringOH45420814196648Operation of Home Health AgencyFLN/A
San Marcos MRI LP
1330 Wonder World Dr Ste 202San MarcosTX78666770597972Imaging & TestingTXN/A
The Bariatric Center of Kansas City LLC
9100 W 74th StreetMerriamKS66204823025378Surgery CenterKSN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (20 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
Altamonte Medical Plaza Condominium Association Inc
601 East Rollins StreetOrlandoFL32803592855792Condo AssociationFLN/ACYes (1)
Apopka Medical Plaza Condominium Association Inc
601 East Rollins StreetOrlandoFL32803593000857Condo AssociationFLN/ACYes (1)
CC MOB Inc
2201 S Clear Creek RoadKilleenTX76549742616875Real Estate RentalTXN/ACYes (1)
Central Texas Medical Associates
1301 Wonder World DriveSan MarcosTX78666742729873InactiveTXN/ACYes (1)
Central Texas Providers Network
1301 Wonder World DriveSan MarcosTX78666742827652Physician Hospital Org.TXN/ACYes (1)
Florida Hospital Flagler Medical Offices Association Inc
60 Memorial Medical ParkwayPalm CoastFL32164262158309Condo AssociationFLN/ACYes (1)
Florida Hosp Hlth Village Property Owner's Assoc Inc
550 E Rollins Street 7th FloorOrlandoFL32803821748255Condo AssociationFLN/ACYes (1)
Florida Hospital Healthcare System Inc
101 Southhall Lane Ste 150MaitlandFL32751593215680PHSOFLN/ACYes (1)
Florida Medical Plaza Condominium Association Inc
601 East Rollins StreetOrlandoFL32803592855791Condo AssociationFLN/ACYes (1)
Florida Memorial Health Network Inc (11 - 102419)
770 W Granada Blvd Ste 317Ormond BeachFL32174593403558Physician Hospital Org.FLN/ACYes (1)
Kissimmee Multispecialty Clinic Condominium Association Inc
201 Hilda Street Suite 30KissimmeeFL34741593539564Condo AssociationFLN/ACYes (1)
LN Health Partners Inc
550 E Rollins Street 6th FloorOrlandoFL32803813556903InactiveFLN/ACYes (1)
Midwest Management Services Inc
9100 West 74th StreetShawnee MissionKS66204480901551InactiveKSN/ACYes (1)
North American Health Services Inc & Sub
900 Hope WayAltamonte SpringsFL32714621041820Lessor/Holding Co.TNN/ACYes (1)
Ormond Prof Associates Condo Assoc'n Inc (430 year end)
770 W Granada Blvd Ste 101Ormond BeachFL32174592694434Condo AssociationFLN/ACYes (1)
Park Ridge Property Owner's Association Inc
1 Park Place Naples RoadFletcherNC28732030380531Condo AssociationNCN/ACYes (1)
Porter Affiliated Health Services Inc
2525 S Downing StreetDenverCO80210840956175Healthcare ServicesCON/ACYes (1)
San Marcos Regional MRI Inc
1301 Wonder World DriveSan MarcosTX78666770597968Holding CompanyTXN/ACYes (1)
The Garden Retirement Community Inc
485 North Keller Road Ste 250MaitlandFL32751593414055Real Estate RentalFLN/ACYes (1)
Winter Park Medical Office Building I Condo Assoc Inc
601 East Rollins StreetOrlandoFL32803452228478Condo AssociationFLN/ACYes (1)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (13 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Florida Memorial Health Network
P$3,468,797Cost
Memorial Hospital - Flagler Inc
P$5,153,605Cost
Memorial Health Systems Inc
Q$3,872,734Cost
SunSystem Development Corp dba AdventHealth New Smyrna Beach Foundation
B$141,323Amount Given
Florida Hospital Healthcare Partners Inc
Q$2,758,804Cost
Southwest Volusia Healthcare Corporation
Q$51,293Cost
Adventist Health System Sunbelt Healthcare Corporation
M$996,452% of Facility's Oper. Exp.
Adventist Health System Sunbelt Healthcare Corporation - Shared Services
M$1,072,061% of Facility's Oper. Exp.
Adventist Health System Sunbelt Healthcare Corporation dba AIT
M$4,318,687% of Facility's Oper. Exp.
Adventist Health System Sunbelt Healthcare Corporation
P$4,159,672Cost
Adventist Health System Sunbelt Healthcare Corporation - Insurance Alloc
P$507,046Cost
Adventist Health System Sunbelt Healthcare Corporation
B$578,960Amount Given
Adventist Health System Sunbelt Healthcare Corporation
R$811,794Amount Given