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ADVENTIST HEALTH SYSTEM GEORGIA INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
ADVENTIST HEALTH SYSTEM GEORGIA INC (EIN 58-1425000)
Tax period
2016-01-01 to 2016-12-31
Filed
2018-01-30
IRS object ID
201810309349301361
Schema version
2016v3.0
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2018-01-30T13:48:15-06:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN581425000EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ADVENTIST HEALTH SYSTEM GEORGIA INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlADVEBusinessNameControlTxt
Phone7066027800PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11035 RED BUD ROADAddressLine1Txt
CityCALHOUNCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30701ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLynn C AddiscottPersonNm
Person TitleAssistant SecretaryPersonTitleTxt
Phone4079751492PhoneNum
Signature2018-01-09SignatureDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address204.139.85.142IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-01-09IPDt
IP Tm12:41:03IPTm
IP TimezoneESIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id53982D7F397A57200CCEAC974E09133295FD1DA0AtSubmissionCreationDeviceId
At Submission Filing Device IdF7F973113C6C6A5F5987F0EC85E73F6D0608CD2FAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerPETER WEBERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11035 RED BUD ROADAddressLine1Txt
CityCALHOUNCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30701ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$146,455,562GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Group Exemption1071GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.GORDONHOSPITAL.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1981FormationYr
Legal Domicile StateGALegalDomicileStateCd
Activity Or MissionTHE PROVISION OF MEDICAL CARE TO THE COMMUNITY THROUGH THE OPERATION OF TWO HOSPITALs.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee1399TotalEmployeeCnt
Total Volunteers93TotalVolunteersCnt
Total Gross UBI$100,753TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$87,915NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$93,480PYContributionsGrantsAmt
CY Contributions Grants$393,730CYContributionsGrantsAmt
PY Program Service Revenue$127,445,063PYProgramServiceRevenueAmt
CY Program Service Revenue$144,934,303CYProgramServiceRevenueAmt
PY Investment Income-$754,259PYInvestmentIncomeAmt
CY Investment Income$403,004CYInvestmentIncomeAmt
PY Other Revenue$1,040,173PYOtherRevenueAmt
CY Other Revenue-$118,425CYOtherRevenueAmt
PY Total Revenue$127,824,457PYTotalRevenueAmt
CY Total Revenue$145,612,612CYTotalRevenueAmt
PY Grants And Similar Paid$67,946PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$17,713CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$67,656,466PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$78,666,646CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$55,499,563PYOtherExpensesAmt
CY Other Expenses$61,421,696CYOtherExpensesAmt
PY Total Expenses$123,223,975PYTotalExpensesAmt
CY Total Expenses$140,106,055CYTotalExpensesAmt
PY Revenues Less Expenses$4,600,482PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$5,506,557CYRevenuesLessExpensesAmt
Total Assets BOY$168,140,097TotalAssetsBOYAmt
Total Assets EOY$176,975,843TotalAssetsEOYAmt
Total Liabilities BOY$48,542,677TotalLiabilitiesBOYAmt
Total Liabilities EOY$51,603,698TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$119,597,420NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$125,372,145NetAssetsOrFundBalancesEOYAmt
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 Adventist Health System (AHS). AHS 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, AHS 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$131,509,250ExpenseAmt
Grant$17,713GrantAmt
Revenue$144,715,125RevenueAmt
DescOPERATION OF GORDON HOSPITAL, A 69-BED ACUTE CARE HOSPITAL WITH 4,051 PATIENT ADMISSIONS, 15,855 PATIENT DAYS, AND 75,055 OUTPATIENT VISITS; AND MURRAY MEDICAL CENTER, A 42-BED ACUTE CARE HOSPITAL WITH 509 PATIENT ADMISSIONS, 1,553 PATIENT DAYS, AND 23,238 OUTPATIENT VISITS DURING THE CURRENT YEAR.Desc
Total Program Service Expenses$131,509,250TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
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 MemYes (1)BusinessRlnWithFamMemInd
Business Rln With Officer EntYes (1)BusinessRlnWithOfficerEntInd
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 Document157IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee1399EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
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
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
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 VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldGAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Cory ReevesBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7066027800PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11035 RED BUD ROADAddressLine1Txt
CityCALHOUNCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30701ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Haffner PhD Randall L
Chairman/Dir0.2050.00Yes (X)$0$1,707,541$265,682
Box MD Brent
Director5.9050.00Yes (X)$63,567$0$17,144
Brown Jeff
Director0.200.00Yes (X)$908$0$0
Fehlenberg Steven
Director0.200.00Yes (X)$740$0$0
Joyave MD Joe
Director0.200.00Yes (X)$2,400$0$0
Lance David
Director0.200.00Yes (X)$910$0$0
LeBlanc MD Paul
Director41.800.00Yes (X)$222,072$0$34,516
Miller MD Jacquelin
Director0.200.00Yes (X)$4,160$0$0
Moyer Debra
Director (End 5/16)0.100.00Yes (X)$0$0$0
Parrott MD Max
CMO/Director55.200.00Yes (X)$292,189$0$14,388
Pittman Brittany
Director0.200.00Yes (X)$785$0$0
Weber Peter M
CEO/Dir/Secretary50.000.00Yes (X)$0$872,047$133,422Yes (X)
Wright DMin Edward E
Vice Chair/Director0.200.00Yes (X)$910$0$0
Reeves Cory D
CFO50.000.00$0$388,850$77,019Yes (X)
Nudd Brandon
COO50.000.00$0$213,939$49,388Yes (X)
Jordon Amelia D
CNO50.000.00$0$238,059$47,344Yes (X)
King Stephen
Physician41.600.00$955,971$0$43,084Yes (X)
Lee Hak Joo
Physician41.600.00$735,080$0$45,119Yes (X)
Turner James Eric
Physician41.600.00$656,357$0$43,169Yes (X)
Ahn Daniel S
Physician41.600.00$638,475$0$42,051Yes (X)
Brannon William Anthony David
Physician38.100.00$428,368$0$32,107Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$4,002,892TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,420,436TotReportableCompRltdOrgAmt
Total Other Compensation$844,433TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K84IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
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
PT Solutions Holdings LLC
PO BOX 242278MontgomeryAL36124Physical Therapy Services$2,583,576
Brasfield & Gorrie LLC
1990 Vaughn Road Suite 100KennesawGA30144Construction Services$2,526,236
Medical Services Inc
PO Box 22266ChattanoogaTN37422Billing Service$940,018
Siemens Medical Solutions
51 Valley Steam ParkwayMalvernPA19355Service Contract$477,985
Locum Tenens
PO BOX 405547AtlantaGA30384Hospitalist Services$455,097
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K29CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIIIYes (X)InfoInScheduleOPartVIIIInd
Membership Dues$29,075MembershipDuesAmt
Related Organizations$4,469RelatedOrganizationsAmt
Government Grants$300,300GovernmentGrantsAmt
All Other Contributions$59,886AllOtherContributionsAmt
Total Contributions$393,730TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
Net patient revenue622110$143,968,057$143,867,304$100,753
Cafeteria revenue622110$329,297$329,297
Medical office building622110$232,923$232,923
Medical director revenue622110$114,243$114,243
Gift shop revenue622110$108,071$108,071

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$181,712TotalRevenueColumnAmt
Related Or Exempt Func Income$181,712RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$144,934,303TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,136,452TotalRevenueColumnAmt
Exclusion$1,136,452ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$109,502OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$731,026SecuritiesAmt
Other$111,924OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$731,026SecuritiesAmt
Other-$2,422OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$733,448TotalRevenueColumnAmt
Exclusion-$733,448ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescEHR RevenueDesc
Business622110BusinessCd
Total Revenue Column-$118,425TotalRevenueColumnAmt
Related Or Exempt Func Income-$118,425RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total-$118,425OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$145,612,612TotalRevenueColumnAmt
Related Or Exempt Func Income$144,715,125RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$100,753UnrelatedBusinessRevenueAmt
Exclusion$403,004ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$17,713TotalAmt
Program Services$17,713ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$2,674,757TotalAmt
Program Services$501,850ProgramServicesAmt
Management And General$2,172,907ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$56,901,879TotalAmt
Program Services$56,860,520ProgramServicesAmt
Management And General$41,359ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$2,076,802TotalAmt
Program Services$2,013,023ProgramServicesAmt
Management And General$63,779ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$13,141,663TotalAmt
Program Services$13,050,938ProgramServicesAmt
Management And General$90,725ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$3,871,545TotalAmt
Program Services$3,752,650ProgramServicesAmt
Management And General$118,895ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$11,270TotalAmt
Management And General$11,270ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$54,970TotalAmt
Management And General$54,970ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$292,379TotalAmt
Management And General$292,379ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$13,559,358TotalAmt
Program Services$11,193,711ProgramServicesAmt
Management And General$2,365,647ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$644,689TotalAmt
Management And General$644,689ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,880,547TotalAmt
Program Services$2,795,149ProgramServicesAmt
Management And General$1,085,398ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$4,568,320TotalAmt
Program Services$3,997,738ProgramServicesAmt
Management And General$570,582ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$4,543,792TotalAmt
Program Services$4,538,500ProgramServicesAmt
Management And General$5,292ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$663,679TotalAmt
Management And General$663,679ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$55,747TotalAmt
Management And General$55,747ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,280,644TotalAmt
Program Services$1,280,644ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$8,216,722TotalAmt
Program Services$8,216,722ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,170,146TotalAmt
Program Services$1,117,104ProgramServicesAmt
Management And General$53,042ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Supplies$15,985,806$15,985,806
Repairs & maintenance$4,442,259$4,442,259
GA Net Revenue Tax$1,519,804$1,519,804
Licenses & Permits$187,499$187,499

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$344,065TotalAmt
Program Services$225,119ProgramServicesAmt
Management And General$118,946ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$140,106,055TotalAmt
Program Services$131,509,250ProgramServicesAmt
Management And General$8,596,805ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$6,700BOYAmt
EOY$7,291EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$59,123,687BOYAmt
EOY$68,006,750EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$18,694,421BOYAmt
EOY$20,518,684EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,960,621BOYAmt
EOY$2,792,463EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,896,315BOYAmt
EOY$2,900,307EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$145,240,103LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$66,525,759LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$81,534,427BOYAmt
EOY$78,714,344EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$37,509EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$4,923,926BOYAmt
EOY$3,998,495EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$168,140,097BOYAmt
EOY$176,975,843EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$9,971,438BOYAmt
EOY$9,349,108EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$119,812BOYAmt
EOY$191,676EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$38,451,427BOYAmt
EOY$42,062,914EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$48,542,677BOYAmt
EOY$51,603,698EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$119,588,779BOYAmt
EOY$125,372,145EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$8,641BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$119,597,420BOYAmt
EOY$125,372,145EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$168,140,097BOYAmt
EOY$176,975,843EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$5,506,557ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$1,220,176NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$952,008OtherChangesInNetAssetsAmt
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 B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

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$11,097OtherActivitiesAmt
Total Lobbying Expenditures$11,097TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationMember dues paid to the American Hospital Association and the Georgia Hospital Association that represent lobbying activities conducted by these two associations.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,428,153OtherCostOrOtherBasisAmt
Book Value$3,428,153BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$84,524,256OtherCostOrOtherBasisAmt
Depreciation$27,357,299DepreciationAmt
Book Value$57,166,957BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$56,044,880OtherCostOrOtherBasisAmt
Depreciation$38,416,275DepreciationAmt
Book Value$17,628,605BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,242,814OtherCostOrOtherBasisAmt
Depreciation$752,185DepreciationAmt
Book Value$490,629BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$78,714,344TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
Credit balances in A/R$1,222,251
Due to related$573,376
Accrued interest payable$637,298
Leases payable$1,375,178
Interco. Alloc. of TE Bond Proceeds$38,254,811
FieldValueIRS element (for citing)
Total Liability$42,062,914TotalLiabilityAmt
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 Adventist Health System (AHS). The consolidated financial statements of AHS contain the following FIN 48 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, 2016 and 2015. NAHS also has temporary deductible differences of approximately $59,100 and $62,700 at December 31, 2016 and 2015, respectively, primarily as a result of net operating loss carryforwards. At December 31, 2016, NAHS had net operating loss carryforwards of approximately $59,600, expiring beginning in 2022 through 2026. Deferred taxes have been provided for these amounts, resulting in a net deferred tax asset of approximately $22,500 and $23,800 at December 31, 2016 and 2015, respectively. A full valuation allowance has been provided at December 31, 2016 and 2015 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, 2016 and 2015.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$10,361,729TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$10,361,729NetCommunityBenefitExpnsAmt
Total Expense0.07400TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$21,951,858TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$14,881,151DirectOffsettingRevenueAmt
Net Community Benefit Expns$7,070,707NetCommunityBenefitExpnsAmt
Total Expense0.05050TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$32,313,587TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$14,881,151DirectOffsettingRevenueAmt
Net Community Benefit Expns$17,432,436NetCommunityBenefitExpnsAmt
Total Expense0.12450TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,732,778TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,732,778NetCommunityBenefitExpnsAmt
Total Expense0.01240TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,732,778TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,732,778NetCommunityBenefitExpnsAmt
Total Expense0.01240TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$34,046,365TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$14,881,151DirectOffsettingRevenueAmt
Net Community Benefit Expns$19,165,214NetCommunityBenefitExpnsAmt
Total Expense0.13690TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$14,050,719BadDebtExpenseAmt
Bad Debt Expense Attributable$2,176,932BadDebtExpenseAttributableAmt
Reimbursed By Medicare$29,150,019ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$28,022,425CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$1,127,594MedicareSurplusOrShortfallAmt

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 Facilities2HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNumAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdWebsite AddressWebsiteAddressTxtState LicenseStateLicenseNumLicensed HospitalLicensedHospitalIndGeneral Medical And SurgicalGeneralMedicalAndSurgicalIndEmergency Room24 HrsEmergencyRoom24HrsInd
Gordon Hospital
11035 Red Bud RoadCalhounGA30701www.gordonhospital.com064-334Yes (X)Yes (X)Yes (X)
Murray Medical Center
2707 Old Dalton Ellijay RoadChatsworthGA30705www.murraymedical.org105-706Yes (X)Yes (X)Yes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (2 entries)

FacilityFacilityNumFirst Licensed CY Or PYFirstLicensedCYOrPYIndTax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYIndCHNA ConductedCHNAConductedIndCommunity DefinitionCommunityDefinitionIndCommunity DemographicsCommunityDemographicsIndExisting ResourcesExistingResourcesIndHow Data ObtainedHowDataObtainedIndCommunity Health NeedsCommunityHealthNeedsIndOther Health IssuesOtherHealthIssuesIndCommunity Hlth Needs Id ProcessCommunityHlthNeedsIdProcessIndConsulting ProcessConsultingProcessIndPrior CHNA ImpactPriorCHNAImpactIndCHNA ConductedCHNAConductedYrTake Into Account Others InputTakeIntoAccountOthersInputIndCHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsIndCHNA Conducted With Non FcltsCHNAConductedWithNonFcltsIndCHNA Report Widely AvailableCHNAReportWidelyAvailableIndRpt Available On Own WebsiteRptAvailableOnOwnWebsiteIndOwn Website URLOwnWebsiteURLTxtPaper Copy Public InspectionPaperCopyPublicInspectionIndRpt Available Thru Other MethodRptAvailableThruOtherMethodIndImplementation Strategy AdoptImplementationStrategyAdoptIndImplementation Strategy AdptImplementationStrategyAdptYrStrategy Posted WebsiteStrategyPostedWebsiteIndStrategy Website URLStrategyWebsiteURLTxtOrganization Incur Excise TaxOrganizationIncurExciseTaxIndElig Criteria ExplainedEligCriteriaExplainedIndFPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntIndFPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePctAsset Level CriteriaAssetLevelCriteriaIndMedical Indigency CriteriaMedicalIndigencyCriteriaIndInsurance Status CriteriaInsuranceStatusCriteriaIndUnderinsurance Stat CriteriaUnderinsuranceStatCriteriaIndExplained BasisExplainedBasisIndApp Financial Asst ExplnAppFinancialAsstExplnIndDescribed InfoDescribedInfoIndDescribed Suprt DocDescribedSuprtDocIndProvided Hospital ContactProvidedHospitalContactIndProvided Nonprofit ContactProvidedNonprofitContactIndIncludes Publicity MeasuresIncludesPublicityMeasuresIndFAP Available On WebsiteFAPAvailableOnWebsiteIndFAP Available On Website URLFAPAvailableOnWebsiteURLTxtFAP App Available On WebsiteFAPAppAvailableOnWebsiteIndFAP App Available On Website URLFAPAppAvailableOnWebsiteURLTxtFAP Summary On WebsiteFAPSummaryOnWebsiteIndFAP Summary On Website URLFAPSummaryOnWebsiteURLTxtFAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeIndFAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgIndFAP Sum Avlbl On Request No ChrgFAPSumAvlblOnRequestNoChrgIndNotified FAP Copy Bill DisplayNotifiedFAPCopyBillDisplayIndCommuntity Notified FAPCommuntityNotifiedFAPIndFAP TranslatedFAPTranslatedIndFAP Actions On NonpaymentFAPActionsOnNonpaymentIndPermit No ActionsPermitNoActionsIndCollection ActivitiesCollectionActivitiesIndProvided Written NoticeProvidedWrittenNoticeIndMade Effort Orally NotifyMadeEffortOrallyNotifyIndProcessed FAP ApplicationProcessedFAPApplicationIndMade Presumptive Elig DetermMadePresumptiveEligDetermIndNondis Emergency Care PolicyNondisEmergencyCarePolicyIndLook Back Medicare PrivateLookBackMedicarePrivateIndAmounts Generally BilledAmountsGenerallyBilledIndGross ChargesGrossChargesInd
Gordon Hospital
100Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)16Yes (1)00Yes (1)Yes (X)See StatementYes (X)Yes (X)Yes (1)14Yes (1)See Statement0Yes (1)Yes (X)200.000000000000Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)See StatmentYes (X)See StatementYes (X)See StatementYes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)0Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)00
Murray Medical Center
20Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)16Yes (1)00Yes (1)Yes (X)See StatementYes (X)Yes (X)00Yes (1)Yes (X)200.000000000000Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)See Part V, Page 8Yes (X)See Part V, Page 8Yes (X)See Part V, Page 8Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)0Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)00

Supplemental Information SupplementalInformationGrp (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Gordon HospitalPart V, Section B, Line 5: Adventist Health System Georgia, Inc., dba Gordon Hospital (GH or the Hospital), serves Gordon County residents in northwest Georgia. GH is a 69-bed community hospital located in Calhoun, Georgia and is the only hospital located within Gordon County. The Hospital's primary service area includes all zip codes within Gordon County. The population of Gordon County is approximately 56,574 with an average per capita income of approximately $30,872. The 2016 Community Health Needs Assessment (CHNA) for the Hospital was built on input from people representing the broad community, as well as low-income, minority and other medically underserved populations. The Hospital conducted a community survey throughout 2016. It solicited community members to complete the survey at multiple locations including drug stores, community events, the Health Department, and health fairs. There were 351 surveys completed representative of a cross section of both ethnic populations and income levels.As a part of its efforts to ensure broad community-based input into the CHNA process, the Hospital established a Community Health Needs Assessment Committee (CHNAC). The CHNAC was intended to represent the needs of the general community, with a particular focus on including representatives of the medically underserved, low-income and minority populations. Committee members included both internal and community stakeholders. Each member brought a unique perspective of the community, available services and expertise in their field. Community members of the CHNAC represented the following organizations: -Family Connection of Gordon County; -Gordon County Boys & Girls Club;-The local Chamber of Commerce; and-The Gordon County Health Department.
Murray Medical CenterPart V, Section B, Line 5: Adventist health System Georgia, Inc, DBA Murray Medical Center (MMC or the Hospital), serves Murray County residents in northwest Georgia. MMC is a 42-bed community hospital located in Chatsworth, Georgia and is the only hospital located within Murray County. The Hospital's primary service area included all zip codes within Murray County. The population of Murray County is approximately 39,565 with an average per capita income of approximately $26,057.The 2016 Community Health Needs Assessment (CHNA) for the Hospital was built on input from people representing the broad community, as well as low-income, minority and other medically underserved populations. The Hospital conducted a community survey throughout 2016. It solicited community members to complete the survey at multiple locations including drug stores, community events, the Health Department, and health fairs. There were 207 surveys completed representative of a cross section of both ethnic populations and income levels.As part of its efforts to ensure broad community-based input into the CHNA process, the Hospital established a Community Health Needs Assessment Committee (CHNAC). The CHNAC was intended to represent the needs of the general community, with a particular focus on including representatives of the medically underserved, low-income and minority populations. Committee members included both internal and community stakeholders. Each member brought a unique perspective of the community, available services and expertise in their field. Community members of the CHNAC represented the following organizations:- Murray Health Department;- Murray Senior Center;- Corner Drugs, a local business;- Murray County Chamber of Commerce;- Murray Boys & Girls Club; and- Gladden Middle School.
Gordon HospitalPart 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.
Murray Medical CenterPart 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.
Murray Medical CenterPart V, Section B, Line 2: Effective May 1, 2015, the filing organization entered into a leasing arrangement whereby the operating assets of murray medical center, a 42-bed acute-care hospital located in Chatsworth, GA, were leased by the filing organization from the Murray County Memorial Hospital Authority. Prior to May 1, 2015, Murray Medical Center was operated as a governmental hospital, and to the best knowledge of the filing organization, was not also recognized as exempt from federal income tax under internal revenue code (IRC) Section 501(c)(3). Accordingly, Murray Medical Center did not conduct a Community Health Needs Assessment pursuant to IRC Section 501(r) while owned and operated by the Murray County Memorial Hospital Authority.Treas. Reg. Section 1.501(r)-3(d) provides an exception for acquired, new and terminated hospital facilities with respect to meeting the requirements of IRC Section 501(r)(3). Acquired facilities must conduct a Community Health Needs Assessment by the last day of the organization's second taxable year beginning after the date on which the hospital facility was acquired. Accordingly, Murray Medical Center has completed its first Community Health Needs Assessment in 2016 and will adopt its first implementation strategy before May 15, 2017.
Gordon HospitalPart V, Section B, Line 11: Gordon Hospital is part of the Southeast Region of Adventist Health Systems. The Region includes four hospital facilities. This is the third-year update for Gordon Hospital's 2013-2016 Community Health Plan/Implementation Strategy. The Hospital developed this Plan and posted it in May 2014 as part of its 2013 Community Health Needs Assessment process. For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, Gordon Hospital made a particular effort to define and address the needs of low-income, minority and underserved populations in our service area. The 2013 Community Health Needs Assessment used primary data interviews and surveys; and hospital prevalence data to help the Hospital determine the health needs of the community we serve. 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 2013-2016 Community Health Plan. The three-year progress on the community Health Plan is noted below. The narrative describes the issues identified in 2013 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. Gordon Hospital is located in Calhoun, Georgia. Because the community is very small (16,000 people), special events, seminars and screenings continue to be effective tools to reach the community. In most cases, participation in hospital-sponsored events was at least double the original goal. Priority: Cancer 2013 Description of the Issue: Cancer (including all types) ranked number 1 in our community survey in Gordon County. The State of Georgia's age adjusted cancer deaths/100,000 is 181.8 vs. the U.S. National average at 178.4. The Healthy People 2020 goal is 160.6. Although the latest CDC showed that Gordon County's cancer rates have stabilized, they are not meeting the HP2020 goals. Therefore, the Community Health Needs Assessment Committee (comprised of community members including those representing low-income, minority and other underserved populations) believed Cancer to be a high priority for our community.2016 Update: Because cancer was identified as a top need, Gordon Hospital held free events and screenings related to breast cancer, melanoma, prostate, oral/head/neck cancers, and smoking cessation; 130 people were screened (the goal was 100). The hospital reached 511 people (the goal was 100) at cancer education programs that included underserved populations, many of whom receive free cancer treatment at the hospital's Harris Radiation Therapy Center. 116 low-cost mammograms were offered in cooperation with the Health Department (the goal was 100). Priority: Access to Health Care2013 Description of the Issue: Another priority identified by community feedback is the lack of affordable health care available in zip code 30139, which is the community of Fairmount in Gordon County. A privately-owned clinic shut its doors for financial reasons and the community was left with no medical coverage. This area is composed largely of seniors who have little to no public transportation, and most physicians are located 25-30 minutes away. The Needs Assessment committee saw a need to bring health care access to that area of our county. 2016 Update: Gordon Hospital opened a primary care clinic in Fairmount; it had over 2,000 patient visits in 2016. In addition, the hospital accepts referrals from free and sliding fee scale clinics operated by the Health Department; the clinics are 14-19 miles from Fairmount. Priority: Heart Disease and Stroke 2013 Description of the Issue: The hospital's Needs Assessment committee also chose heart disease and stroke as priority issues. Cardiovascular disease is the number one killer in the state of Georgia. For Georgia, the age-adjusted death rate per 100,000 is 49.7. It is 42.2 nationally, and the Healthy People 2020 goal is 33.8. This ranked very high in our survey data, as well as within our local industry sector (manufacturing, heavy and light industry, and flooring plants). Employee Health nurses at the various plants were more concerned with employees having heart attacks than with getting hurt on the job. By choosing this priority and focusing on healthy eating, we hope to reduce the incidence of obesity and diabetes for our county as well.2016 Update: Gordon Hospital held many community outreach and education efforts, including 1,267 free monthly blood pressure screenings (the goal was 650) throughout the community at locations such as Walmart. Patients were referred to their family physicians or a Health Department clinic. The hospital's two CREATION Health educational programs (based on the tenants of choice, rest, environment, activity, trust, interpersonal relationships, outlook and nutrition) had 24 graduates. Our weekly CREATION Health Farmers Market averaged 25 vendors and 155 attendees per week during the months of June, July and August. Gordon Hospital had planned to educate 200 fifth-graders in Gordon County on healthy eating, the need for physical activity, and the dangers of tobacco. We changed the format to a health-focused Back-to-School-Blast at which we saw 728 elementary school students (plus their parents), including many from low-income families. Priority: Respiratory Disease and Smoking 2013 Description of the issue: The final priority that the Needs Assessment committee chose is respiratory disease and smoking. From our interviews, we have seen an increase in teen smoking, which in turn leads to higher incidences of respiratory diseases. This priority emerged in both our community survey as well as our internal data. According to the Centers for Disease Control and Prevention, Georgia's percentage of smokers is 17.6%. The Healthy People goal is 12%. The committee believed these two items were intertwined and could be addressed together.2016 Update: The focus of the Breathe Free tobacco cessation program (offered at no cost) has moved from one of graduation to participation. This allows attendees to be exposed to options for tobacco cessation and help them determine their readiness to quit. In 2016, Gordon Hospital held 10 Breathe Free classes with 123 attendees. The hospital also held lung disease/COPD seminars targeted at low-income populations in Gordon County; 1,239 people participated (the goal was 100). Priorities Considered but Not Selected 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:Substance Abuse (drugs) ranked high in our community surveys. The hospital supports existing community programs including the Drugs Don't Work Program, Red Ribbon Week, Family Intervention Specialists, and Drug Take Back Program. We do not offer drug rehabilitation services but can help community partners work upstream to prevent or decrease addictions.Maternal, Infant and Child Health and unprotected sexual activity ranked high in our survey. Community programs are offered through the Boys and Girls Club, the Teen Health Task Force, and Family Intervention Specialists. The hospital works with the Healthy Families program after a child is born. This issue of unprotected sexual activity is not within the hospital's areas of expertise; the Health Department handles this issue.
Murray Medical CenterPart V, Section B, Line 11: ADVENTIST HEALTH SYSTEM GEORGIA, INC., DBA MURRAY MEDICAL CENTER (MMC OR THE HOSPITAL), FORMED A COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE (CHNAC) TO REVIEW THE PRIMARY AND SECONDARY DATA COLLECTED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS AND TO FORMULATE THE DETERMINATION OF THE HEALTH PRIORITIES OF MMC USING A SYSTEMATIC APPROACH THAT RELIED HEAVILY ON A DECISION TREE PRIORITY SELECTION PROCESS. THE DECISION TREE FORMAT ASSISTED THE CHNAC IN FOCUSING ON THOSE NEEDS THAT THE HOSPITAL WOULD HAVE THE ABILITY TO INFLUENCE THROUGH THE IMPLEMENTATION OR EXPANSION OF PROGRAMS, SERVICES, OR OTHER ACTIONS, AND THAT MAY BE THE FOCUS OF OTHER COMMUNITY RESOURCES/ORGANIZATIONS WHO ARE ALREADY ADDRESSING THE NEED IN SOME WAY. THE CHNAC USED A PRIORITY SELECTION REPORT TOOL TO ASSIST IN THE REVIEW OF DATA COLLECTED AND PRIORITIZATION OF THE TOP AREAS OF SIGNIFICANT COMMUNITY NEED FOR THE HOSPITAL'S COMMUNITY. THE CHNAC CHOSE THE FOLLOWING THREE PRIORITIES:1. CANCER - NUMBER ONE HEALTH PROBLEM/CONDITION IN THE HOSPITAL'S COMMUNITY. THE CHNAC DETERMINED THAT MMC WAS IN A POSITION TO HELP THE COMMUNITY WITH CANCER DUE TO ITS PARTNERSHIP WITH GORDON HOSPITAL AND THE HARRIS RADIATION CENTER. 2. HIGH BLOOD PRESSURE/CHOLESTEROL & HEART DISEASE - ALL THREE OF THESE HEALTH PROBLEMS/CONDITIONS RANKED HIGH IN THE CHNA. THE CHNAC DETERMINED THAT MMC CAN USE ITS CREATION HEALTH PROGRAMS TO OFFER EDUCATIONAL COMMUNITY EVENTS TO HEIGHTEN AWARENESS OF THE LIFE STYLE CHANGES THAT WILL HELP IN ADDRESSING THESE CONDITIONS.3. DIABETES - THE CHNAC NOTED THAT A NUMBER OF THE BEHAVIOR/RISK FACTORS ON THE MMC COMMUNITY SURVEY ARE DIRECTLY RELATED TO DIABETES. MMC WILL DEVELOP IMPLEMENTATION STRATEGIES TO ADDRESS THESE FACTORS.THE FOLLOWING IDENTIFIED HEALTH NEEDS WERE NOT SELECTED FOR TOP PRIORITY:TEEN PREGNANCY - THERE ARE PROGRAMS IN PLACE THrOUGH THE BOYS & GIRLS CLUB AND OTHER AGENCIES FOR TEEN PREGNANCY ISSUES. MENTAL HEALTH - THE HOSPITAL DOES NOT OFFER MENTAL HEALTH SERVICES. HOWEVER, MENTAL HEALTH SERVICES ARE AVAILABLE IN MURRAY COUNTY.IMMUNIZATIONS (ADULTS & CHILDREN) - THE HOSPITAL WILL SUPPORT THE HEALTH DEPARTMENT IN ITS IMMUNIZATION EFFORTS.ASTHMA (CHILDREN) - ALTHOUGH THERE WAS A SMALL PERCENTAGE OF COMMUNITY RESPONDENTS WHO INDICATED THAT ASTHMA IN CHILDREN WAS A COMMUNITY HEALTH CONCERN, THE CHNAC DETERMINED THAT THE LIMITED RESOURCES OF THE HOSPITAL WOULD BE BETTER USED AT THIS TIME TO FOCUS ON PRIORITIES THAT HAD A BROADER IMPACT ON THE COMMUNITY.
Part V, Section B, Line 7AURL for Gordon Hospital's CHNA: www.gordonhospital.com/about-us/community-benefitURL for Murray Medical Center CHNA: http://www.murraymedical.org/about-us/community-benefit
Part V, Section B, Line 10AURL for Gordon hospital's most recently adopted implementation strategy: www.gordonhospital.com/about-us/community-benefit
Part V, Section B, Line 8-10AGordon Hospital: The filing organization adopted a Community Health Needs Assessment Report by 12/31/16 and was in the process of developing its Community Health Needs Implementation Strategy. The filing organization's 2017 Community Health Needs Implementation Strategy will be documented in a written report called the "Community Health Plan". The Community Health Plan (CHP) will describe how the filing organization plans to meet its identified prioritized health needs or will identify the health need as one the filing organization does not intend to specifically address and provide an explanation as to why the filing organization does not intend to address that health need. In accordance with Final Regulation Section 1.501(r)-3(c)(5), the filing organization's 2017 CHP was adopted no later than May 15, 2017 and is also posted on the hospital facility's website.As the hospital facility's 2017 Community Health Needs Implementation Strategy was not adopted by the end of the hospital organization's taxable year of December 31, 2016, Schedule H, Part V, Section B, line 9 indicates that 2014 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 Implementation Strategy since this is the most recently adopted Implementation Strategy.Murray Medical Center: Effective May 1, 2015, the filing organization entered in to a leasing arrangement whereby the operating assets of Murray Medical Center were leased by the filing organization From the Murray County Memorial Hospital Authority. Prior to May 1, 2015, Murray medical Center was operated as a governmental hospital, and to the best knowledge of the filing organization, was not also recognized as exempt from federal income tax under internal revenue code (IRC) section 501(c)(3). Accordingly, Murray medical Center did not conduct a Community Health Needs Assessment pursuant to IRC Section 501(r) while owned and operated by the Murray County Memorial Hospital authority.Murray Medical Center adopted its first Community Health Needs Assessment Report by 12/31/16 and was in the process of developing its Community Health Needs Implementation Strategy. The filing organization's 2017 Community Health Needs Implementation Strategy will be documented in a written report called the "Community Health Plan". The Community Health Plan (CHP) will describe how the filing organization plans to meet its identified prioritized health needs or will identify the health need as one the filing organization does not intend to specifically address and provide an explanation as to why the filing organization does not intend to address that health need. In accordance with Final Regulation Section 1.501(r)-3(c)(5), the filing organization's first CHP was adopted no later than May 15, 2017 and is posted on the hospital facility's website.As the hospital facility's 2017 Community Health Needs Implementation Strategy was not adopted by the end of the hospital organization's taxable year of December 31, 2016, Schedule H, Part V, Section B, line 8 indicates that an implementation strategy was not adopted to meet the significant health needs identified through its most recently conducted Community Health Needs Assessment.
Part V, Line 16A, 16B, and 16C:Part V, 16A, FAP website:Gordon Hospitalwww.gordonhospital.com/patients-visitors/after-my-stay/financial-assistance/Murray Medical Centerwww.murraymedical.org/patients-visitors/financial-assistance/Part V, 16B, FAP Application Website:Gordon Hospitalwww.gordonhospital.com/patients-visitors/after-my-stay/financial-assistance/Murray Medical Centerwww.murraymedical.org/patients-visitors/financial-assistance/Part V, 16C, FAP Plain Language Summary website:Gordon Hospitalwww.gordonhospital.com/patients-visitors/after-my-stay/financial-assistance/Murray Medical Centerwww.murraymedical.org/patients-visitors/financial-assistance/
FieldValueIRS element (for citing)
Facility19FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (19 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - Gordon Hospital Owasa Family Medicine
109 Hospital CourtCalhounGA30701Physician clinic - Family Practice
2 - Gordon Home Care
104 Hospital CourtCalhounGA30701Home Health Services
3 - Gordon Hospital Internal & Family Medici
400 Timms RdCalhounGA30701Physician clinic - Family Practice
4 - North Georgia Orthopedic & Sports Medici
106 Hospital CourtCalhounGA30701Physician clinic - Orthopedic
5 - Ambulance Service
101 Professional CourtCalhounGA30701Ambulance Service
6 - Gordon Health Depot
824 GI Maddox ParkwayChatsworthGA30705Physician clinic - Family Practice
7 - Gordon Urgent Care - Calhoun
100 Hospital CourtCalhounGA30701Physician clinic - Family Practice
8 - Gordon Adult & Pediatric Medical Assoc
815 Curtis Parkway SECalhounGA30701Physician Clinic - Internal & Pediatric
9 - Ambulance Service
104 Hospital DrChatsworthGA30705Ambulance Service
10 - Gordon Hospital Adairsville Family Medic
6000 Joe Frank Harris Pkwy NWAdairsvilleGA30103Physician clinic - Family Practice
11 - Northwest GEORGIA OB GYN
110 Hospital CourtCalhounGA30701Physician clinic - OB GYN
12 - North Georgia Cancer Center
100 Willowbrook WayCalhounGA30701Physician Clinic
13 - Gordon Primary Care
105 Willowbrook WayCalhounGA30701Physician Clinic - Family Practice
14 - Gordon Hospital Cook Family Practice
100 Hospital CourtChatsworthGA30705Physician Clinic - Family Practice
15 - Gordon Hospital Fairmount Family Medicin
2712 Hwy 411FairmountGA30139Physician clinic - Family Practice
16 - Gordon Neurology
400 Timms RdCalhounGA30701Physician Clinic - Neurologist
17 - Northwest Georgia Endocrinology
400 Timms RdCalhounGA30701Physician Clinic - Endocrinology
18 - Gordon Urgent Care - Adairsville
7427 Highway 140 NWAdairsvilleGA30103Physician clinic - Family Practice
19 - Murray Primary Care
106 Hospital Court Suite 2ChatsworthGA30705Physician Clinic - Family Practice

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 22 tax-exempt 501(c)(3) hospital organizations that operated 44 hospitals in ten states within the U.S. The system of organizations under the control and ownership of AHSSHC is known as "Adventist Health System" (AHS).All hospital organizations within AHS collect, calculate, and report the community benefits they provide to the communities they serve. AHS organizations exist solely to improve and enhance the local communities they serve. AHS has a system-wide community benefits accounting policy that provides guidelines for its health care provider organizations to capture and report the costs of services provided to the underprivileged and to the broader community. Each AHS 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 organizations most recently conducted community health needs assessment and associated implementation strategy are posted 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 page 8. 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.
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 BReconciliation 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 Adventist Health System. The primary reconciling items between the Medicare surplus/(shortfall) shown on line 7 of Section B of Part III of Schedule H and the filing organization's unreimbursed costs of services provided to Medicare patients as reported in the AHS Community Benefit Report are as follows:- Medicare surplus/(shortfall) shown on line 7 of Section B of Schedule H: $ 1,127,594- Difference in costing methodology: (8,016,712)- Unreimbursed costs incurred for services provided to Medicare patients that are not included in the organization's Medicare cost report: (6,646,467) -------------Total surplus/(shortfall) costs of serving all Medicare patients per the filing organization's community benefit reporting: $(13,535,585)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:As reported in Schedule H, Part V, Section B, the filing organization's hospitals conducted community health needs assessments (CHNA) during 2013 and 2016. The 2016 CHNAs were adopted by its governing board by December 31, 2016, the end of the filing organization's taxable year in which it conducted the CHNAs. The filing organization's 2016 CHNAs complied with the guidance set forth by the IRS in Final Regulation Section 1.501(r)-3. In addition to the CHNAs 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 communities.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 communities; and 4.Collaboration with other local community groups to address the health care needs of the filing organization's communities.
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 facilities 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 facilities' financial counselors are prominently and conspicuously posted on the filing organization's hospital facilities' websites. The websites indicate 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 facilities, including at all points of admission and registration and the Emergency Department. The signage contains the hospital facilities' 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 facilities' FAP, FAA Form and PLS. Paper copies of the hospital facilities' 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 facilities' 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:Adventist Health System Georgia, Inc., d/b/a Gordon Hospital (the Hospital), is a 69-bed community hospital that serves the residents of Calhoun, Gordon County and surrounding areas in Georgia. The Hospital's primary market has a population of approxiamtely 56,574. Gordon Hospital provides the following services to its community: a 24-hour Emergency Center, Ambulance Service, Rehabilitation Services, Intensive and Progressive Care Units, Cancer Resource Center, Radiology, Interventional Radiology, Lab, Cardiopulmonary, Sleep Disorders Center, New Beginnings Maternity Center, Urgent Care Centers, Orthopedic Surgery, Opthalmology Surgery, diagnostic cardiac catheterization lab, and Pastoral Care. The Hospital is the only hospital in Northwest Georgia to be an accredited Breast Imaging Center of Excellence. In November 2012, the Hospital opened a Radiation Oncology Center that for the first time provides this service within the community. There are four unrelated hospitals approximately 20 miles away from Gordon Hospital. The per capita income income in the primary market is approximately $30,872. High school graduates account for approximately 74% of Gordon County, with an estimated 11.7% having a bachelor's degree or higher. The unemployment rate is about 5.7%.Approximately 58.3% of the Hospital's patients during 2016 were covered by Medicare and Medicaid. Medicare patients comprise about 43.7% of the Hospital's patients. Approximately 14.6% of the Hospital's patients are covered by the Medicaid program, 9.8% representing self-pay, with the remaining 31.9% in commercial payors. Approximately 65.6% of the Hospital's in-patients are admitted through the Hospital's emergency department.Adventist Health System Georgia, Inc., dba Murray Medical Center (MMC), is a 42-bed community hospital that serves the residents of chatsworth, murray county and surrounding areas in Georgia. The Hospital's services include: 24-hour emergency department, imaging services, laboratory, ambulance services, orthopedics, respiratory therapy, physical therapy, sports medicine, and surgical services. Murray county's population is approximately 39,565. The per capita income, based on population, in murray county is approximately $26,057. High school graduates account for approximately 72.4% of Murray county with 8.6% holding at least a bachelor's degree. The unemploymnet rate is 7.4%. Approximately 57.6% of MMC's patients were covered by medicare and medicaid. Medicare patients comprised about 39.8% of these patients and approximately 17.8% were covered by the medicaid program. 19.2% of MMC's patients were self-pay, with the remaining 23.2% in commercial payors. Approximately 87.8% of MMC's in-patients were admitted through MMC's emergency department.
Part VI, Line 5:The provision of community benefit is central to the filing organization's mission of service and compassion. Restoring and promoting the health and quality of life of those in the communities served by the filing organization is a function of "extending the healing ministry of Christ and embodies the organization's commitment to its values and principles. The filing organization commits substantial resources to provide a broad range of services to both the underprivileged as well as the broader community. In addition to the community benefit and community building information provided in Parts I, II and III of this Schedule H, the filing organization captures and reports the benefits provided to its communities through faith-based care. Examples of such benefits include the cost associated with chaplaincy care programs and mission peer reviews and mission conferences. During the current year, the filing organization provided $113,391 of benefit with respect to the faith-based and spiritual needs of the communities in conjunction with its operation of community hospitals. The filing organization also provides benefits to its communities' infrastructure by investing in capital improvements to ensure that facilities and technology provide the best possible care to the community. During the current year, the filing organization expended $5,921,920 in new capital improvements. As faith-based mission-driven community hospitals, the filing organization is continually involved in monitoring its communities, 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 filing organization are continually being invested in resources that improve the availability and quality of delivery of health care services and programs to the communities it serves.
Part VI, Line 6:Adventist Health System Georgia, Inc. is a part of a faith-based healthcare system of organizations whose parent is Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). The system is known as Adventist Health System (AHS). AHSSHC is an organization exempt from federal income tax under IRC Section 501(c)(3). AHSSHC and its subsidiary organizations operate 44 hospitals in 10 states throughout the U.S., primarily in the Southeastern portion of the U.S. AHSSHC and its subsidiaries also operate 16 nursing home facilities and other ancillary health care provider facilities, such as ambulatory surgery centers and diagnostic imaging centers. As the parent organization of the AHS system, AHSSHC provides executive leadership and other professional support services to its subsidiary organizations. Professional support services include among others corporate compliance, legal, human resources, reimbursement, risk management, and tax as well as treasury functions. The provision of these executive and support services on a centralized basis by AHSSHC provides an appropriate balance between providing each AHS subsidiary hospital organization with mission-driven consistent leadership and support while allowing the hospital organization to focus its resources on meeting the specific health care needs of the community it serves. The reader of this Form 990 should keep in mind that this reporting entity may differ in certain areas from that of a stand-alone hospital organization due to its inclusion in a larger system of healthcare organizations. As a part of a system of hospital and other health care organizations, the filing organization benefits from reduced costs due to system efficiencies, such as large group purchasing discounts, and the availability of internal resources such as internal legal counsel. Each AHS subsidiary pays a management fee to AHSSHC for the internal services provided by AHSSHC. As a result, management fee expense reported by a AHS subsidiary organization may appear greater in relation to management fee expense that may be reported by a single stand-alone hospital. The single stand-alone hospital would likely report costs associated with management and other professional services on various expense line items in its statement of revenue and expense as opposed to reporting such costs in one overall management fee expense. As the reporting of the Form 990 is done on an entity by entity basis, there is no single Form 990 that captures the programs and operations of AHS as a whole. The reader is directed to visit the web-site of AHS at www.adventisthealthsystem.com to learn more about the mission and operations of AHS.
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 SectionIRCSectionDescNon Cash AssistanceNonCashAssistanceAmtValuation Method UsedValuationMethodUsedDescNon Cash AssistanceNonCashAssistanceDescPurpose Of GrantPurposeOfGrantTxtCash GrantCashGrantAmt
SunSystem Development Corporation dba Gordon Hospital Foundation
1035 Red Bud RoadCalhounGA30701592219301501(c)(3)$87,394CostGeneral Administrative SupportProvision of General Administrative Support
Northwest Georgia Regional Cancer Coalition
96 E Callahan Street Suite 479-01RomeGA30161020657616501(c)(3)General Support$7,500
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt

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)
Travel For CompanionsYes (X)TravelForCompanionsInd
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Discretionary Spending AcctYes (X)DiscretionarySpendingAcctInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Severance Payment0SeverancePaymentInd
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 OrgYes (1)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 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
Haffner PhD Randall L
Chairman/Dir$0$1,013,441$0$257,210$0$436,890$0$216,000$0$49,682$0$1,973,223$0$0
LeBlanc MD Paul
Director$201,995$0$13,454$0$6,623$0$11,649$0$22,867$0$256,588$0$0$0
Parrott MD Max
CMO/Director$265,737$0$23,137$0$3,315$0$14,388$0$0$0$306,577$0$0$0
Weber Peter M
CEO/Dir/Secretary$0$482,991$0$159,729$0$229,327$0$85,006$0$48,416$0$1,005,469$0$59,789
Reeves Cory D
CFO$0$289,918$0$66,441$0$32,491$0$34,995$0$42,024$0$465,869$0$9,482
Nudd Brandon
COO$0$173,990$0$26,986$0$12,963$0$10,641$0$38,747$0$263,327$0$0
Jordon Amelia D
CNO$0$182,705$0$37,876$0$17,478$0$9,600$0$37,744$0$285,403$0$0
King Stephen
Physician$850,949$0$96,169$0$8,853$0$14,388$0$28,696$0$999,055$0$0$0
Lee Hak Joo
Physician$727,339$0$0$0$7,741$0$14,388$0$30,731$0$780,199$0$0$0
Turner James Eric
Physician$648,597$0$0$0$7,760$0$14,388$0$28,781$0$699,526$0$0$0
Ahn Daniel S
Physician$410,061$0$219,214$0$9,200$0$14,388$0$27,663$0$680,526$0$0$0
Brannon William Anthony David
Physician$423,578$0$0$0$4,790$0$14,387$0$17,720$0$460,475$0$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 1aThe filing organization is a part of the system of healthcare organizations known as Adventist Health System (AHS). Members of the filing organization's executive management team that hold the position of Vice-President or above are compensated by and on the payroll of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the parent organization of AHS. AHSSHC is exempt from federal income tax under IRC Section 501(c)(3). The filing organization reimburses AHSSHC for the salary and benefit cost of those executives on the payroll of AHSSHC that provide services and are on the management team of the filing organization. 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 Vice Presidents and above and is usually limited to one business trip per year beyond the annual AHS 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: AHS has a system-wide policy addressing gross-up payments provided in connection with employer-provided benefits/other taxable items. Under the policy, certain taxable business-related reimbursements (i.e. taxable business-related moving expenses, taxable items provided in connection with employment) provided to any employee may be grossed-up at a 25% rate upon approval of the filing organization's CEO and CFO. Additionally, employees at the Director level and above are eligible for gross-up payments on gifts received for board of director services. Discretionary spending account: A nominal discretionary spending amount was provided in the current year to all eligible executives who attend the annual AHS President's Council business meeting ($500 per executive) or the annual AHS CFO Conference, or CMO/CNO business meeting ($300 per executive). Other discretionary spending accounts may be provided in connection with other AHS sponsored conferences but typically do not exceed $200 per participant. With respect to the AHS President's Council meeting, eligible executives may include AHSSHC Vice Presidents and above and all AHSSHC subsidiary organization CEOs and Regional CFOs. The payment provided to each executive was considered taxable compensation to the executive.
Part I, Line 3The individual who serves as the CEO of the filing organization is compensated by Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) for that individual's role in serving as the CEO. Compensation and benefits provided to this individual are determined pursuant to policies, procedures, and processes of AHSSHC that are designed to ensure compliance with the intermediate sanctions laws as set forth in IRC Section 4958. AHSSHC 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 AHS and each of its affiliated entities. The following principles guide the establishment of individual executive compensation: - The salary of the President/CEO of AHS will not exceed the 40th percentile of comparable salaries paid by similarly situated organizations; and - Other executive salaries shall be established using market medians. The compensation philosophy, policies, and practices of AHSSHC are consistent with the organization's faith-based mission and conform to applicable laws, regulations, and business practices. As a faith-based organization sponsored by the Seventh-day Adventist Church (the Church), AHSSHC's philosophy and principles with respect to its executive compensation practices reflect the conservative approach of the Church's mission of service and were developed in counsel with the Church's leadership.
Part I, Line 4bAs discussed in Line 1a above, executives on the filing organization's management team that hold the position of Vice-President or above are compensated by and on the payroll of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the parent organization of a healthcare system known as Adventist Health System (AHS). In recognition of the contribution that each executive makes to the success of AHS, AHS provides to eligible executives participation in the AHS Executive FLEX Benefit Program (the Plan). The purpose of the Plan is to offer eligible executives an opportunity to elect from among a variety of supplemental benefits, including deferred compensation benefits taxable under Internal Revenue Code (IRC) Section 457(f), to individually tailor a benefits program appropriate to each executive's needs. The Plan provides eligible participants a pre-determined benefits allowance credit that is equal to a percentage of the executive's base pay from which is deducted the cost of mandatory and elective employee benefits. The pre-determined benefits allowance credit percentage is approved by the 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 AHS entities and Vice Presidents of all AHS entities whose base salary is at least $236,000. The Plan provides for a class year vesting schedule (2 years for each class year) with respect to amounts accumulated in the executive's 457(f) deferred compensation account. Distributions could also be made from the executive's 457(f) deferred compensation account upon attainment of age 65 or upon an involuntary separation. The account is forfeited by the executive upon a voluntary separation. In addition to the Plan, AHS has instituted a defined benefit, non-tax-qualified deferred compensation plan for certain executives who have provided lengthy service to AHS and/or to other Seventh-Day Adventist Church hospitals or health care institutions. Participation in the plan is offered to AHS executives on a prorata schedule beginning with 20 years of service as an employee of AHS and/or another hospital or health care institution controlled by the Seventh-Day Adventist Church and who satisfy certain other qualifying criteria. This supplemental executive retirement plan (SERP) was designed to provide eligible executives with the economic equivalent of an annual income beginning at normal retirement age equal to 60% of the average of the participant's three, five or seven highest years of base salary from AHS active employment inclusive of income from all other Seventh-Day Adventist Church healthcare employer-financed retirement income sources and investment income earned on those contributions through social security normal retirement age as defined in the plan. 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 AHS Executive FLEX Benefit Program. Flex Plan Flex Plan/ SERP 457(b) CY CY Employer CY Contrib./ Distributions Contrib. Distributions* Payment ------------------------------------------------------- Peter Weber $ 68,593 $ 56,563 $144,164 $ 0 Cory Reeves $ 20,608 $ 9,239 $ 0 $ 0 Randall Haffner $ 201,612 $ 0 $409,583 $ 0 *Including Investment Earnings
Part I, Line 6The filing organization's physician compensation formula is designed to result in total compensation that would be reasonable for each physician. The filing organization utilizes national survey productivity, cost, and compensation data in formulating all aspects of the compensation plan. Physician compensation contractual agreements include a ceiling or reasonable maximum on the amount a physician may earn. The filing organization's employed physicians enter into a written agreement that requires the physicians to provide medical care to individuals who are referred by the filing organization. The filing organization's compensation arrangement does not use a method of compensation that is based upon a percentage of the organization's net income. Under the compensation arrangement, physician base salary, including any additional compensation based on a percentage of the practice/location net revenue, is documented as being within a range of Fair Market Value.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
Judy Fehlenberg
Relative of board member$54,930Employee compensation0
JEMGLEN LLLP
50% owned by Board Member$266,922Lease Agreement0
Northwest Georgia Medical Park LLC
45% owned by board members$621,687Lease Agreement0
Brooke Fehlenberg
Relative of Board Member$57,412Employee compensation0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 2Brent Box and Max Parrott - Business Relationship
Form 990, Part VI, Section A, line 6Adventist Health System Georgia, Inc. (the filing organization) 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 and disapprove the executive and/or administrative leadership of the filing organization, and their salaries; b) to adopt, amend, restate, and repeal the Articles of Incorporation or Bylaws of the filing organization, and the Medical Staff Bylaws; c) to set limits and terms for the borrowing of funds; d) to approve or disapprove major building programs and/or purchase or sale of personal property or real property equal to or in excess of One Million dollars; e) to approve or disapprove the annual operating and capital budgets of the filing organization; f) to direct the placement of funds and capital of the filing organization; g) to establish general guiding policies, to implement quality assessment, improvement and utilization review programs; h) to approve the appointment of an auditing firm and election of the fiscal year for the filing organization; and i) to establish a process for addressing patient grievances.
Form 990, Part VI, Section B, line 11bThe filing organization's current year Form 990 was reviewed by the Board Chairman, Board Finance Committee Chair, CEO and by the CFO prior to its filing with the IRS. The review conducted by the Board Chairman, Board Finance Committee Chair, CEO and the CFO did not include the review of any supporting workpapers that were used in preparation of the current year Form 990, but did include a review of the entire Form 990 and all supporting schedules.
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 conflict of interests, any member of the Board of Directors of the filing organization or any principal officer of the filing organization (i.e. Interested Persons) must disclose the existence of any financial interest with the filing organization and must be given the opportunity to disclose all material facts concerning the financial interest/arrangement to the Board of Directors of the filing organization or to any members of a committee with board delegated powers that is considering the proposed transaction or arrangement. Subsequent to any disclosure of any financial interest/arrangement and all material facts, and after any discussion with the relevant Board member or principal officer, the remaining members of the Board of Directors or committee with board delegated powers shall discuss, analyze, and vote upon the potential financial interest/arrangement to determine if a conflict of interest exists. According to the filing organization's Conflict of Interest Policy, an Interested Person may make a presentation to the Board of Directors (or committee with board delegated powers), but after such presentation, shall leave the meeting during the discussion of, and the vote on, the transaction or arrangement that results in a conflict of interest. Each Interested Person, as defined under the filing organization's Conflict of Interest Policy, shall annually sign a statement which affirms that such person has received a copy of the Conflict of Interests policy, has read and understands the policy, has agreed to comply with the policy, and understands that the filing organization is a charitable organization that must primarily engage in activities which accomplish one or more of its exempt purposes. The filing organization's Conflict of Interest Policy also requires that periodic reviews shall be conducted to ensure that the filing organization operates in a manner consistent with its charitable purposes.
Form 990, Part VI, Section B, line 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 Adventist Health System (AHS). The audited consolidated financial statements of AHS and of the AHS "Obligated Group" are filed annually with the Municipal Securities Rulemaking Board (MSRB). The "Obligated Group" is a group of AHSSHC subsidiaries that are jointly and severally liable under a Master Trust Indenture that secures debt primarily issued on a tax-exempt basis. Unaudited quarterly financial statements prepared in accordance with Generally Accepted Accounting Principles (GAAP) are also filed with MSRB for AHS on a consolidated basis and for the grouping of AHS subsidiaries comprising the "Obligated Group". The filing organization does not generally make its governing documents or conflict of interest policy available to the public.
Part VII, Section AFor those Board of Director members who devote less than full-time to the filing organization (based upon the average number of hours per week shown in column (B) on page 7 of the return) the compensation amounts shown in columns (E) and (F) on page 7 were provided in conjunction with that person's responsibilities and roles in serving in an executive leadership position within Adventist Health System.
Part VIII, Lines 7b and 7c:The amounts shown in Part VIII Lines 7b and 7c of the Form 990 represent 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 1,633,507. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,633,507. Professional Fees : Program service expenses 7,081,800. Management and general expenses 0. Fundraising expenses 0. Total expenses 7,081,800. Purchased Medical Services : Program service expenses 1,177,975. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,177,975. Environmental Services : Program service expenses 985,021. Management and general expenses 0. Fundraising expenses 0. Total expenses 985,021. Transcription Services : Program service expenses 263,561. Management and general expenses 0. Fundraising expenses 0. Total expenses 263,561. Recruiting : Program service expenses 51,847. Management and general expenses 0. Fundraising expenses 0. Total expenses 51,847. AHS Management Fees : Program service expenses 0. Management and general expenses 1,416,912. Fundraising expenses 0. Total expenses 1,416,912. Billing & Collection Services : Program service expenses 0. Management and general expenses 1,013,869. Fundraising expenses 0. Total expenses 1,013,869. EHR Management Fees : Program service expenses 0. Management and general expenses -65,134. Fundraising expenses 0. Total expenses -65,134.
Form 990, Part XI, line 9:Transfer to tax-exempt parent -1,245,621. Transfer to/from affiliate -79,441. Allocation from tax-exempt parent with respect to debt 105,916. Release from restricted 256,814. gifts 10,327. Rounding -3.
Part X, Line 2The 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 (101 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
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
3040 Salt Creek LaneArlington HeightsIL60005364138353Operation 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)
Adventist University of Health Sciences Inc (630 Year End)
671 Lake Winyah DriveOrlandoFL32803593069793Education/Operation of SchoolFL501(c)(3)Line 2Adventist Hlth SystemSunbelt IncYes (1)
AHP Specialty Care NFP
3040 Salt Creek LaneArlington HeightsIL60005811105774Operation of Physician Practices & Medical ServicesIL501(c)(3)Line 3AHS Midwest Management IncYes (1)
AHS Midwest Management Inc
1000 Remington Blvd Ste 200BolingbrookIL60440363354567Operation 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
1000 Remington Blvd Ste 200BolingbrookIL60440381359189InactiveMI501(c)(3)Line 3Adventist Hlth SystemSunbelt IncYes (1)
Bolingbrook Hospital Foundation
1000 Remington Blvd N Entrance 2ndBolingbrookIL60440900494445Fund-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 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 Ln 4th FloorMaitlandFL32751593214635Operation of Physician Practices & Medical ServicesFL501(c)(3)Line 3Adventist Hlth SystemSunbelt IncYes (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)
Foundation for Shawnee Mission Medical Center Inc
9100 W 74th StreetShawnee MissionKS66204480868859Fund-raising for Tax-exempt hospitalKS501(c)(3)Line 7Shawnee Mission Medical Center 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
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-FI0
Helen Ellis Memorial Hospital Foundation Inc
1395 S Pinellas AveTarpon SpringsFL34689593690149Fund-raising for Tax-exempt hospitalFL501(c)(3)Line 7Tarpon Springs Hospital Foundation Inc0
Hinsdale Hospital Foundation
7 Salt Creek Lane Suite 203HinsdaleIL60521521466387Fund-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)
Hospice of the Comforter Foundation Inc
480 W Central ParkwayAltamonte SpringsFL32714271858033Fund Raising for Affiliated Tax-Exempt HospiceFL501(c)(3)Line 7The 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
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
770 West Granada BlvdOrmond BeachFL32174311771522Fund-raising for Tax-exempt hospitalFL501(c)(3)Line 70
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-FI0
Osceola Health Care Properties Inc (620-123116)
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 70
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(98-123116)
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 Central Inc
900 Hope WayAltamonte SpringsFL32714593689740Management SupportGA501(c)(3)Line 12c, III-FI0N/A
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)
Takoma Regional Hospital Inc (630 Year End)(7115-123116)
401 Takoma AveGreenevilleTN37743510603966Operation of Hospital & Related ServicesTN501(c)(3)Line 3Adventist Hlth SystemSunbelt IncYes (1)
Takoma Regional Hospital Foundation Inc
401 Takoma AveGreenevilleTN37743471334302Fund Raising for Affiliated Tax-Exempt HospitalTN501(c)(3)Line 7Takoma Regional Hospital IncYes (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-FI0
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, I0
University Community Hospital Specialty Care Inc
3100 E Fletcher AveTampaFL33613593231322InactiveFL501(c)(3)Line 12a, IUniversity Community Hospital IncYes (1)
University Community Hospital Inc
3100 E Fletcher AveTampaFL33613591113901Operation of Hospital & Related ServicesFL501(c)(3)Line 3Adventist Hlth System Sunbelt Hlthcare CorpYes (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 (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACd
Clear Creek MOB Ltd
2201 S Clear Creek RdKilleenTX76549742609195Real EstateTXN/A
Endoscopy Center at Porter LLC (11-32916)
1001 South Park DriveLittletonCO80120205855038Medical ServicesCON/A
Florida Hospital DMERT LLC
500 Winderley Place Ste 324MaitlandFL32751202392253Medical EquipmentFLN/A
Florida Hospital Home Infusion LLP
500 Winderley Place Ste 324MaitlandFL32751593142824Home Infusion ServicesFLN/A
Functional Neurosurgical Ambulatory Surgery Center LLC
777 S Williams StDenverCO80209464426708Surgery CenterCON/A
PAHSLarkin Ventures LLC
9100 E Mineral CirCentennialCO80112474211060Medical ServicesCON/A
PAHSUSP Surgery Centers LLC
15305 Dallas Pkwy Ste 1600 LB 28AddisonTX75010263057950Medical ServicesCON/A
San Marcos MRI LP
1330 Wonder World Dr Ste 202San MarcosTX78666770597972Imaging & TestingTXN/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 Condo Association Inc
601 East Rollins StreetOrlandoFL32803592855791Condo AssociationFLN/ACYes (1)
Florida Memorial Health Network Inc
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 (815-123116)
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 Aff Hlth Svcs Inc dba Diversified Aff Hlth Svcs
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 OrgYes (1)PerformOfServicesForOthOrgInd
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 Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (11 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Fletcher Hospital Inc
P$1,658,024Cost
Fletcher Hospital Inc
Q$1,170,519Cost
Memorial Hospital Inc
L$105,118Cost
Takoma Regional Hospital Inc
L$138,313Cost
Adventist Health System Sunbelt Healthcare Corporation
M$900,151% of facilities operating expense
Adventist Health System Sunbelt Healthcare Corporation dba AHS IS
M$3,716,553% of facilities operating expense
Adventist Health System Sunbelt Healthcare Corporation
P$9,005,127Cost
Adventist Health System Sunbelt Healthcare Corporation
B$1,325,062Amount Given
Adventist Health SystemSunbelt Inc
M-$65,134% of facilities EHR Revenue
SunSystem Development Corporation dba Gordon Hospital Foundation
C$161,796Amount Received
SunSystem Development Corporation dba Gordon Hospital Foundation
B$87,374Amount Given