MEMORIAL HOSPITAL FLAGLER INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization: MEMORIAL HOSPITAL FLAGLER INC (EIN 59-2951990)
Tax period: 2014-01-01 to 2014-12-31
Filed: 2015-11-15
IRS object ID: 201533199349301413
Schema version: 2014v5.0
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2015-11-15T21:31:13-06:00	ReturnTs
Tax Period End	2014-12-31	TaxPeriodEndDt
Return Type	990	ReturnTypeCd
Tax Period Begin	2014-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	592951990	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MEMORIAL HOSPITAL FLAGLER INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	MEMO	BusinessNameControlTxt
Phone	3865862000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	60 MEMORIAL MEDICAL PARKWAY	AddressLine1Txt
City	PALM COAST	CityNm
State Abbreviation	FL	StateAbbreviationCd
ZIP	32164	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	LYNN C ADDISCOTT	PersonNm
Person Title	ASSISTANT SECRETARY	PersonTitleTxt
Phone	4079751492	PhoneNum
Signature	2015-11-15	SignatureDt

Field	Value	IRS element (for citing)
Tax	2014	TaxYr
Build TS	2016-04-25 22:37:26Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	FLORIDA HOSPITAL FLAGLER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	KEN MATTISON	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	60 MEMORIAL MEDICAL PARKWAY	AddressLine1Txt
City	PALM COAST	CityNm
State Abbreviation	FL	StateAbbreviationCd
ZIP	32164	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$170,248,054	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.FLORIDAHOSPITAL.COM/FLAGLER	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1989	FormationYr
Legal Domicile State	FL	LegalDomicileStateCd
Activity Or Mission	THE PROVISION OF MEDICAL CARE TO THE COMMUNITY THROUGH THE OPERATION OF A 99 BED HOSPITAL.	ActivityOrMissionDesc
Voting Members Governing Body	18	VotingMembersGoverningBodyCnt
Voting Members Independent	7	VotingMembersIndependentCnt
Total Employee	1145	TotalEmployeeCnt
Total Volunteers	273	TotalVolunteersCnt
Total Gross UBI	$150,738	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$86,966	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$0	PYContributionsGrantsAmt
CY Contributions Grants	$0	CYContributionsGrantsAmt
PY Program Service Revenue	$159,923,271	PYProgramServiceRevenueAmt
CY Program Service Revenue	$167,508,911	CYProgramServiceRevenueAmt
PY Investment Income	$3,286,435	PYInvestmentIncomeAmt
CY Investment Income	$2,091,869	CYInvestmentIncomeAmt
PY Other Revenue	$1,441,516	PYOtherRevenueAmt
CY Other Revenue	$640,007	CYOtherRevenueAmt
PY Total Revenue	$164,651,222	PYTotalRevenueAmt
CY Total Revenue	$170,240,787	CYTotalRevenueAmt
PY Grants And Similar Paid	$13,000	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$16,250	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$71,900,313	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$74,091,109	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$69,053,628	PYOtherExpensesAmt
CY Other Expenses	$67,609,422	CYOtherExpensesAmt
PY Total Expenses	$140,966,941	PYTotalExpensesAmt
CY Total Expenses	$141,716,781	CYTotalExpensesAmt
PY Revenues Less Expenses	$23,684,281	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$28,524,006	CYRevenuesLessExpensesAmt
Total Assets BOY	$290,854,768	TotalAssetsBOYAmt
Total Assets EOY	$319,009,416	TotalAssetsEOYAmt
Total Liabilities BOY	$89,568,818	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$90,519,810	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$201,285,950	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$228,489,606	NetAssetsOrFundBalancesEOYAmt
Mission	ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION AND ALL OF 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.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$134,248,325	ExpenseAmt
Grant	$16,250	GrantAmt
Revenue	$167,998,180	RevenueAmt
Desc	PROVISION OF MEDICAL CARE TO BOTH INPATIENTS AND OUTPATIENTS. DURING THE CURRENT YEAR, THE HOSPITAL HAD 7,341 PATIENT ADMISSIONS WHICH RESULTED IN 31,752 PATIENT DAYS AND 105,057 OUTPATIENT VISITS. THE HOSPITAL IS AN 99-BED ACUTE CARE HOSPITAL LOCATED IN FLAGLER COUNTY, FLORIDA.	Desc
Total Program Service Expenses	$134,248,325	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	Yes (1)	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	0	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (1)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	Yes (1)	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	153	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	1145	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	18	GoverningBodyVotingMembersCnt
Independent Voting Member	7	IndependentVotingMemberCnt
Family Or Business Rln	Yes (1)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	0	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (1)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	FL	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JERMAINE BUCKNOR	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	3865864210	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	60 MEMORIAL MEDICAL PARKWAY	AddressLine1Txt
City	PALM COAST	CityNm
State Abbreviation	FL	StateAbbreviationCd
ZIP	32164	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
DENNIS ALTER MD
DIRECTOR	0.50	50.00	Yes (X)	$150	$980,543	$35,009
MICHAEL CHIUMENTO
DIRECTOR	0.50	0.00	Yes (X)	$150	$0	$0
BOB DEVORE
DIRECTOR	0.50	0.00	Yes (X)	$150	$0	$0
TED HAMILTON MD
DIRECTOR	0.50	50.00	Yes (X)	$150	$607,754	$88,772
LARS HOUMANN
CHAIRMAN/DIR (BEG 2/14)	0.50	50.00	Yes (X)	$0	$1,539,933	$235,399
SANDRA JOHNSON
DIRECTOR	0.50	50.00	Yes (X)	$0	$655,675	$108,271
ROGER LEVERTON
DIRECTOR	0.50	0.00	Yes (X)	$150	$0	$0
KENNETH MATTISON
DIRECTOR/CEO	50.00	0.00	Yes (X)	$150	$543,501	$91,500	Yes (X)
HOLSEY MOORMAN
DIRECTOR	0.50	0.00	Yes (X)	$150	$0	$0
EDWARD NOSEWORTHY
DIRECTOR	0.50	50.00	Yes (X)	$0	$541,705	$94,242
BRUCE PAGE
DIRECTOR (END 12/14)	0.50	0.00	Yes (X)	$150	$0	$0
TONY PAPANDREA
DIRECTOR	0.50	0.00	Yes (X)	$150	$0	$0
TERRANCE REGAN MD
DIRECTOR	4.30	0.00	Yes (X)	$28,350	$0	$0
BARBARA REVELS
DIRECTOR	0.50	0.00	Yes (X)	$150	$0	$0
MICHAEL SCHULTZ
CHAIRMAN (END 2/14)	0.50	50.00	Yes (X)	$0	$1,317,204	$162,798
LEWIS SEIFERT
DIRECTOR	0.50	50.00	Yes (X)	$0	$738,971	$136,360
DARYL TOL
CHAIRMAN/DIRECTOR	6.00	44.00	Yes (X)	$150	$715,857	$135,372
DEBORA THOMAS
DIRECTOR	6.00	44.00	Yes (X)	$150	$442,557	$88,385
GLENN ZIMMET DO
DIRECTOR (BEG 1/14)	3.80	0.00	Yes (X)	$24,925	$0	$0
VALERIE ZIESMER
CFO (END 1/14)	50.00	0.00		$0	$345,782	$52,762	Yes (X)
JERMAINE BUCKNOR
CFO (BEG 2/14)	50.00	0.00		$150	$216,799	$63,093	Yes (X)
JOANNE KING
COO	50.00	0.00		$150	$182,007	$35,598		Yes (X)
ROBERT DAVIS
CNO (BEG 4/14)	50.00	0.00		$150	$161,712	$34,687		Yes (X)
RONALD THOMAS MD
CMO (BEG 10/14)	50.00	0.00		$150	$264,404	$18,234		Yes (X)
VENKATARAM THOTA MD
PHYSICIAN	44.00	0.00		$334,586	$0	$30,365			Yes (X)
SATAR SHETH
PHARMACIST	45.00	0.00		$151,195	$0	$20,851			Yes (X)
GUY WARREN WAGNER
PHARMACIST	44.00	0.00		$128,486	$0	$24,392			Yes (X)
KAREN MCFADDEN
DIRECTOR OF HOME HEALTH	40.00	0.00		$125,844	$0	$19,124			Yes (X)
DAVID STACEY
PHARMACIST / PRN	41.00	0.00		$124,907	$0	$5,856			Yes (X)
DAVID OTTATI
FORMER CEO	0.00	50.00		$0	$532,198	$103,122				Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$920,693	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$9,786,602	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,584,192	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	16	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
SHERIDAN HEALTHCORP INC
PO BOX 452197	SUNRISE	FL	33323	ANESTHESIA/PHYSICIAN SERVICES	$1,391,534
ADVENTIST HEALTH SYSTEMSUNBELT INC DB
601 E ROLLINS STREET	ORLANDO	FL	32803	LAB & MARKETING SERVICES	$939,560
BE SMITH INTERIM SERVICES INC
PO BOX 219241 DEPT 300	KANSAS CITY	MO	64121	MEDICAL STAFFING SERVICES	$742,324
FLORIDA LINEN SERVICES
1407 SW 8TH STREET	POMPANO BEACH	FL	33069	LAUNDRY SERVICES	$461,466
MED HOLDING LLC
PO BOX 538449	ATLANTA	GA	30353	COLLECTION SERVICES	$455,478

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	24	CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT REVENUE	900099	$163,797,321	$163,797,321
MANAGEMENT FEES	900099	$1,938,369	$1,938,369
MEDICAL OFFICE BUILDING	531120	$1,135,623	$1,135,623
CAFETERIA REVENUE	900099	$458,371	$458,371
LAB REVENUE	621500	$150,738		$150,738

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$28,489	TotalRevenueColumnAmt
Related Or Exempt Func Income	$28,489	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$167,508,911	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,615,832	TotalRevenueColumnAmt
Exclusion	$1,615,832	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$466,099	SecuritiesAmt
Other	$17,205	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$7,267	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$466,099	SecuritiesAmt
Other	$9,938	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$476,037	TotalRevenueColumnAmt
Exclusion	$476,037	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	EHR REVENUE	Desc
Business	900099	BusinessCd
Total Revenue Column	$640,007	TotalRevenueColumnAmt
Related Or Exempt Func Income	$640,007	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$640,007	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$170,240,787	TotalRevenueColumnAmt
Related Or Exempt Func Income	$167,998,180	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$150,738	UnrelatedBusinessRevenueAmt
Exclusion	$2,091,869	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$16,250	TotalAmt
Program Services	$16,250	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$1,645,978	TotalAmt
Management And General	$1,645,978	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$56,965,804	TotalAmt
Program Services	$56,965,804	ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$1,726,841	TotalAmt
Program Services	$1,700,034	ProgramServicesAmt
Management And General	$26,807	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$10,166,672	TotalAmt
Program Services	$10,031,482	ProgramServicesAmt
Management And General	$135,190	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$3,585,814	TotalAmt
Program Services	$3,530,148	ProgramServicesAmt
Management And General	$55,666	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$113,776	TotalAmt
Management And General	$113,776	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$52,655	TotalAmt
Management And General	$52,655	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$17,213,158	TotalAmt
Program Services	$14,486,137	ProgramServicesAmt
Management And General	$2,727,021	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$676,967	TotalAmt
Management And General	$676,967	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$3,046,218	TotalAmt
Program Services	$2,313,387	ProgramServicesAmt
Management And General	$732,831	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$4,324,539	TotalAmt
Program Services	$3,746,986	ProgramServicesAmt
Management And General	$577,553	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$3,796,479	TotalAmt
Program Services	$3,788,183	ProgramServicesAmt
Management And General	$8,296	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$453,442	TotalAmt
Management And General	$453,442	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$30,084	TotalAmt
Management And General	$30,084	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$2,986,652	TotalAmt
Program Services	$2,986,652	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$7,972,824	TotalAmt
Program Services	$7,972,824	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$2,029,057	TotalAmt
Program Services	$1,972,236	ProgramServicesAmt
Management And General	$56,821	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$19,794,157	$19,794,157
REPAIRS & MAINTENANCE	$3,443,365	$3,443,365
STATE TAX INDIGENT ASSE	$1,469,924	$1,469,924
UNRELATED BUSINESS INCO	$21,500		$21,500

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$184,625	TotalAmt
Program Services	$30,756	ProgramServicesAmt
Management And General	$153,869	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$141,716,781	TotalAmt
Program Services	$134,248,325	ProgramServicesAmt
Management And General	$7,468,456	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$4,449	BOYAmt
EOY	$4,049	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$170,412,443	BOYAmt
EOY	$201,070,927	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$17,736,161	BOYAmt
EOY	$21,547,240	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$2,813,100	BOYAmt
EOY	$2,523,927	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$2,470,193	BOYAmt
EOY	$2,788,268	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$141,666,968	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$65,356,680	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$79,644,095	BOYAmt
EOY	$76,310,288	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
EOY	$50,000	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$14,568,648	BOYAmt
EOY	$14,523,608	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$3,205,679	BOYAmt
EOY	$191,109	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$290,854,768	BOYAmt
EOY	$319,009,416	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$8,416,317	BOYAmt
EOY	$9,604,002	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$139,542	BOYAmt
EOY	$179,458	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$81,012,959	BOYAmt
EOY	$80,736,350	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$89,568,818	BOYAmt
EOY	$90,519,810	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$201,256,930	BOYAmt
EOY	$228,489,606	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$29,020	BOYAmt
EOY	$0	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$201,285,950	BOYAmt
EOY	$228,489,606	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$290,854,768	BOYAmt
EOY	$319,009,416	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$28,524,006	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$599	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$1,319,751	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$4,792	OtherActivitiesAmt
Total Lobbying Expenditures	$4,792	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	AMERICAN HOSPITAL ASSOCIATION AND FLORIDA HOSPITAL ASSOCIATION DUES.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Protection Natural Habitat	Yes (X)	ProtectionNaturalHabitatInd
States Easements Held	1	StatesEasementsHeldCnt
Written Policy Monitoring	0	WrittenPolicyMonitoringInd
Staff Hours Spent Enforcement	0.00	StaffHoursSpentEnforcementCnt
Expenses Incurred Enforcement	$0	ExpensesIncurredEnforcementAmt
Section170h Rqr Stsfd	0	Section170hRqrStsfdInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$7,311,502	OtherCostOrOtherBasisAmt
Book Value	$7,311,502	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$56,989,019	OtherCostOrOtherBasisAmt
Depreciation	$17,089,058	DepreciationAmt
Book Value	$39,899,961	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$70,623,517	OtherCostOrOtherBasisAmt
Depreciation	$44,975,114	DepreciationAmt
Book Value	$25,648,403	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$6,742,930	OtherCostOrOtherBasisAmt
Depreciation	$3,292,508	DepreciationAmt
Book Value	$3,450,422	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$76,310,288	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDesc	AmtAmt
OTHER CURRENT LIABILITIES	$132,270
CREDIT BALANCES IN A/R	$2,115,479
INTERCO. ALLOC. OF TE BOND PROCEEDS	$71,027,687
DUE TO THIRD PARTIES	$5,971,995
DUE TO RELATED	$1,488,919

Field	Value	IRS element (for citing)
Total Liability	$80,736,350	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

PART II, LINE 9:

THE FILING ORGANIZATION HAS RECORDED THE LAND CONSERVATION EASEMENT ON ITS FINANCIAL STATEMENTS AS A PROPERTY, PLANT, AND EQUIPMENT ASSET. THE CONSERVATION EASEMENT GENERATES NO REVENUE AND THE FILING ORGANIZATION DID NOT INCUR ANY EXPENSE RELATED TO THE MAINTENANCE AND MONITORING OF THE CONSERVATION EASEMENT.

PART X, LINE 2:

THE HOSPITAL IS PART OF A CONSOLIDATED AUDITED FINANCIAL STATEMENT. THE CONSOLIDATED AUDITED FINANCIAL STATEMENT INCLUDES THE FOLLOWING FIN 48 FOOTNOTE - THE DIVISION FOLLOWS THE INCOME TAXES TOPIC OF THE ACCOUNTING STANDARD CODIFICATION (ASC) (ASC 740), WHICH 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, 2014.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	0	FPGReferenceDiscountedCareInd
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (1)	ExpensesExceedBudgetInd
Unable To Provide Care	0	UnableToProvideCareInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,595,754	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$5,595,754	NetCommunityBenefitExpnsAmt
Total Expense	0.03950	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$15,109,795	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$10,712,647	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,397,148	NetCommunityBenefitExpnsAmt
Total Expense	0.03100	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$20,705,549	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$10,712,647	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$9,992,902	NetCommunityBenefitExpnsAmt
Total Expense	0.07050	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$251,006	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$251,006	NetCommunityBenefitExpnsAmt
Total Expense	0.00180	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$251,006	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$251,006	NetCommunityBenefitExpnsAmt
Total Expense	0.00180	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$20,956,555	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$10,712,647	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$10,243,908	NetCommunityBenefitExpnsAmt
Total Expense	0.07230	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$24,285	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$24,285	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$24,285	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$24,285	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$9,020,247	BadDebtExpenseAmt
Bad Debt Expense Attributable	$766,454	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$58,970,412	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$53,019,030	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$5,951,382	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	FLORIDA HOSPITAL - FLAGLER	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	60 MEMORIAL MEDICAL PARKWAY	AddressLine1Txt
City	PALM COAST	CityNm
State Abbreviation	FL	StateAbbreviationCd
ZIP	32164	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.FLORIDAHOSPITAL.COM/FLAGLER	WebsiteAddressTxt
State License	4465	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	MEMORIAL HOSPITAL FLAGLER INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
CHNA Conducted	13	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	0	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	0	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE STATEMENT	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	14	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	SEE STATEMENT	StrategyWebsiteURLTxt
Strategy Attached	0	StrategyAttachedInd
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.000000000000	FPGFamilyIncmLmtFreeCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
FAP Notice Displayed	Yes (X)	FAPNoticeDisplayedInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified Before Discharge	Yes (X)	FAPNotifiedBeforeDischargeInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Other Method Used	Yes (X)	OtherMethodUsedInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
MEMORIAL HOSPITAL FLAGLER, INC.	PART V, SECTION B, LINE 5: MEMORIAL HOSPITAL FLAGLER, INC. D/B/A FLORIDA HOSPITAL FLAGLER, (FHF OR THE HOSPITAL) OPERATES A 99-BED ACUTE-CARE HOSPITAL IN FLAGLER COUNTY, FLORIDA. THE PRIMARY SERVICE AREA (PSA) FOR FHF IS ALL OF FLAGLER COUNTY, WHICH INCLUDES APPROXIMATELY 100,000 INDIVIDUALS. APPROXIMATELY 77% OF THE RESIDENTS IN FLAGLER COUNTY ARE WHITE, APPROXIMATELY 10% ARE AFRICAN-AMERICAN, AND APPROXIMATELY 9% ARE HISPANIC. APPROXIMATELY 16.5% OF THE POPULATION WITHIN THE PSA IS UNINSURED. IN CONDUCTING ITS 2013 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), THE HOSPITAL GATHERED PRIMARY AND SECONDARY DATA FROM A NUMBER OF SOURCES WITH AN INTENT TO MAKE SURE THAT INPUT WAS SOLICITED FROM THOSE REPRESENTING THE MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS. COMMUNITY ORGANIZATIONS WERE IDENTIFIED IN ORDER TO GATHER STAKEHOLDER INPUT THROUGH INTERVIEWS AND SURVEYS. STAKEHOLDERS INCLUDED REPRESENTATIVES FROM THE FLAGLER COUNTY HEALTH DEPARTMENT, UNITED WAY, LOCAL CHURCHES, SCHOOLS AND GOVERNMENT. THE IDENTIFIED REPRESENTATIVES REFLECTED A COMPREHENSIVE VIEW OF ALL OF FLAGLER COUNTY'S RESIDENTS, INCLUSIVE OF ALL AGES, ETHNICITIES, AND ECONOMIC STATUS. 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. EACH MEMBER OF THE CHNAC BROUGHT KNOWLEDGE AND EXPERIENCE IN WORKING WITH PEOPLE AND FAMILIES IN THE HOSPITAL'S COMMUNITY, AS WELL AS A UNIQUE PERSPECTIVE ON HEALTH CONCERNS IN THE COMMUNITY. UNDERSERVED POPULATIONS, INCLUDING THE MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS WERE ESPECIALLY REPRESENTED THROUGH PARTICIPATION FROM THE FLAGLER COUNTY HEALTH DEPARTMENT, A FREE HEALTH CLINIC, GRACE TABERNACLE CHURCH, THE FLAGLER COUNTY SCHOOL DISTRICT, AND THE UNITED WAY.
MEMORIAL HOSPITAL FLAGLER, INC.	PART 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 REPORT MUST BE POSTED ON THE HOSPITAL'S WEBSITE BY THE END OF THE YEAR IN WHICH IT IS CONDUCTED. THE HOSPITAL WILL MAKE A COPY OF ITS COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AVAILABLE UPON REQUEST. THE HOSPITAL WILL ALSO MAKE A PAPER COPY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AVAILABLE FOR PUBLIC INSPECTION AT THE HOSPITAL FACILITY.
MEMORIAL HOSPITAL FLAGLER, INC.	PART V, SECTION B, LINE 11: PRIORITY 1: PROMOTING HEALTH AND WELLNESS, CHRONIC DISEASE: CARDIOVASCULAR DISEASE BASED ON SEVERAL HEALTH ISSUES THAT WERE REVEALED BY OUR RESEARCH, THE HOSPITAL AND COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEES CHOSE HEALTH AND WELLNESS AS A FINAL PRIORITY. SOME ISSUES THAT WERE APPARENT INCLUDE OBESITY (POOR EATING HABITS AND UNHEALTHY BEHAVIORS), SMOKING RATES, AND CHRONIC DISEASE (CANCER, HEART DISEASE, DIABETES, ETC.).INTERVENTIONS INCLUDE: - OFFER CREATION HEALTH LIFESTYLE SEMINARS AND EXPANDED PROGRAMS TO THE COMMUNITY. CREATION HEALTH IS A FAITH-BASED WELLNESS PLAN THAT FOCUSES ON EIGHT PRINCIPLES: CHOICE, REST, ENVIRONMENT, ACTIVITY, TRUST, INTERPERSONAL RELATIONSHIPS, OUTLOOK AND NUTRITION. - CHANGE YOUR LIFE WELLNESS PROGRAM FOR 3,100 HOSPITAL EMPLOYEES AND COMMUNITY MEMBERS (INCLUDING SCHOLARSHIPS FOR LOW-INCOME PEOPLE) CENTERED ON THE EIGHT CORE PRINCIPLES OF CREATION HEALTH: EVENTS, PHYSICAL CHALLENGES, EDUCATION, ONLINE REPORTING AND PRIZES - PROVIDE FREE COMMUNITY CHOLESTEROL AND OTHER SCREENINGS FOR AT LEAST 500 PEOPLE - PROVIDE WEEKLY BLOOD PRESSURE SCREENINGS FOR AT LEAST 350 PEOPLE - OFFER 10 FREE CARDIAC SEMINARS TO THE COMMUNITY FOR AT LEAST 400 PEOPLE. PRIORITY 2: PROMOTING HEALTH AND WELLNESS, CHRONIC DISEASE: DIABETESAS NOTED IN PRIORITY 1, THE HOSPITAL AND COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEES CHOSE HEALTH AND WELLNESS AS A FINAL PRIORITY. SOME ISSUES THAT WERE APPARENT INCLUDE OBESITY (POOR EATING HABITS AND UNHEALTHY BEHAVIORS), SMOKING RATES, AND CHRONIC DISEASE (CANCER, HEART DISEASE, DIABETES, ETC.).INTERVENTIONS INCLUDE: - OFFER CREATION HEALTH LIFESTYLE SEMINARS AND EXPANDED PROGRAMS TO THE COMMUNITY. CREATION HEALTH IS A FAITH-BASED WELLNESS PLAN THAT FOCUSES ON EIGHT PRINCIPLES: CHOICE, REST, ENVIRONMENT, ACTIVITY, TRUST, INTERPERSONAL RELATIONSHIPS, OUTLOOK AND NUTRITION. - CHANGE YOUR LIFE WELLNESS PROGRAM FOR 3,100 HOSPITAL EMPLOYEES AND COMMUNITY MEMBERS (INCLUDING SCHOLARSHIPS FOR LOW-INCOME PEOPLE) CENTERED ON THE EIGHT CORE PRINCIPLES OF CREATION HEALTH: EVENTS, PHYSICAL CHALLENGES, EDUCATION, ONLINE REPORTING AND PRIZES - PROVIDE FREE BLOOD SUGAR SCREENINGS - OFFER DIABETES EDUCATION AND SUPPORT GROUPS. PRIORITY 3: ACCESS TO HEALTH AND WELLNESS: WELLNESS PROGRAMS AS NOTED IN PRIORITIES 1 AND 2, THE HOSPITAL AND COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEES CHOSE HEALTH AND WELLNESS AS A FINAL PRIORITY. SOME ISSUES THAT WERE APPARENT INCLUDE OBESITY (POOR EATING HABITS AND UNHEALTHY BEHAVIORS), SMOKING RATES, AND CHRONIC DISEASE (CANCER, HEART DISEASE, DIABETES, ETC.). - OFFER CREATION HEALTH LIFESTYLE SEMINARS AND EXPANDED PROGRAMS TO THE COMMUNITY. CREATION HEALTH IS A FAITH-BASED WELLNESS PLAN THAT FOCUSES ON EIGHT PRINCIPLES: CHOICE, REST, ENVIRONMENT, ACTIVITY, TRUST, INTERPERSONAL RELATIONSHIPS, OUTLOOK AND NUTRITION. - CHANGE YOUR LIFE WELLNESS PROGRAM FOR 3,100 HOSPITAL EMPLOYEES AND COMMUNITY MEMBERS (INCLUDING SCHOLARSHIPS FOR LOW-INCOME PEOPLE) CENTERED ON THE EIGHT CORE PRINCIPLES OF CREATION HEALTH: EVENTS, PHYSICAL CHALLENGES, EDUCATION, ONLINE REPORTING AND PRIZES - OFFER HOSPITAL SUPPORT GROUPS AND MEETING SPACE FOR COMMUNITY SUPPORT GROUP MEETINGS - DIABETES - PROSTATE CANCER - BREAST CANCER - HEAD & NECK CANCER - CANCER CAREGIVERS - LUPUS - STROKE - STEP-PARENTS - DOMESTIC VIOLENCE - MULTIPLE MYELOMA SURVIVORS - PARKINSON'S DISEASE - GAMBLERS ANONYMOUS - OVEREATERS ANONYMOUS.PRIORITY 4: ACCESS TO HEALTH AND WELLNESS: HEALTH CARE SERVICESACCESS TO HEALTH CARE EMERGED AS A PRIORITY FOR OUR COMMUNITY BENEFIT PLANS BECAUSE OUR DATA SHOWED THAT THERE ARE HIGH RATES OF RESIDENTS WITHOUT ACCESS TO HEALTH CARE (ESPECIALLY PRIMARY CARE) AND RESIDENTS WITHOUT INSURANCE. LIMITED ACCESS TO HEALTH CARE SERVICES AGGRAVATE OTHER ISSUES IDENTIFIED THROUGH OUR RESEARCH INCLUDING CHRONIC DISEASE, MENTAL HEALTH ISSUES, AND MATERNAL AND CHILD HEALTH. INTERVENTIONS INCLUDE: - PROVIDE AT LEAST 250 LAB VOUCHERS TO THE FLAGLER FREE CLINIC THAT SERVES UNINSURED PATIENTS - WORK WITH THE COMMUNITY TO DEVELOP AN AFFORDABLE MEDICAL HOME THROUGH A FEDERALLY QUALIFIED HEALTH CENTER OR RURAL HEALTH CENTER IN FLAGLER COUNTY - INCREASE THE NUMBER OF HEALTH AND WELLNESS RESOURCES LISTED IN THE COUNTY'S 2-1-1 DATABASE BY AT LEAST 100 - INCREASE REFERRALS BY STAFF TO 2-1-1 BY 25% - INCREASE WEB REFERRALS TO 2-1-1 BY 25%.PRIORITY 5: ACCESS TO HEALTH AND WELLNESS: ADULT TOBACCO USE AND ABUSE PROGRAMSTHE RATE OF SMOKING IN FLAGLER COUNTY ADULTS WHO ARE CURRENT SMOKERS (2010) FALLS IN THE THIRD QUARTILE IN THE STATE. INTERVENTIONS INCLUDE: - "TOOLS TO QUIT" SMOKING CESSATION PROGRAMS TO AT LEAST 100 PEOPLE INCLUDING IN UNDERSERVED AREAS - SUPPORT OF THE TOBACCO FREE FLAGLER COUNTY PARTNERSHIP, A COMMUNITY COALITION WHOSE GOAL IS TO PREVENT YOUTH INITIATION AND REDUCE THE USE OF TOBACCO PRODUCTS.PRIORITIES CONSIDERED BUT NOT SELECTED COMMUNICABLE DISEASESFLORIDA HOSPITAL FLAGLER DID NOT SELECT COMMUNICABLE DISEASE" AS A PRIORITY AT THIS TIME. WE DETERMINED THAT THERE ARE GROUPS ALREADY ADDRESSING THIS ISSUE: THE HEALTH DEPARTMENT, DIGGS MIRACLE CARE AND THE OUTREACH COMMUNITY CARE NETWORK. IN ADDITION, THE HOSPITAL DOES NOT HAVE THE CAPACITY TO EFFECTIVELY ADDRESS THIS ISSUE. INJURIESWE ALSO DETERMINED WE ARE NOT THE BEST COMMUNITY PARTNER TO ADDRESS INJURY, WHICH WAS IDENTIFIED AS A TOP PRIORITY THROUGH SECONDARY DATA. MULTIPLE COMMUNITY GROUPS ARE WORKING ON ISSUES LIKE UNINTENTIONAL INJURY, VIOLENCE AND DOMESTIC VIOLENCE IN OUR COMMUNITY. THESE GROUPS INCLUDE THE SCHOOL SYSTEMS, DOMESTIC ABUSE SHELTERS, AND GOVERNMENTAL GROUPS.MATERNAL AND CHILD HEALTH MATERNAL AND CHILD HEALTH ISSUES WERE NOT SELECTED AS A DIRECT EFFORT. WE BELIEVE OUR EFFORTS AROUND HEALTH AND WELLNESS AND INCREASING HEALTH CARE ACCESS SHOULD HAVE A POSITIVE IMPACT ON THESE ISSUES. THE HOSPITAL MATERNITY PROGRAM OFFERS NEW MOTHER AND PARENT SUPPORT AND EDUCATION. THE HEALTH DEPARTMENT OFFERS PRENATAL CARE FOR LOW-INCOME WOMEN, AND THE HEALTHY START COALITION OF VOLUSIA/FLAGLER OFFERS SUPPORT PROGRAMS, ESPECIALLY FOR HIGH-RISK MOTHERS. THE TEEN OUTREACH PROGRAM (TOP) IN THE COUNTY SCHOOL SYSTEM - A POSITIVE YOUTH DEVELOPMENT CURRICULUM THAT ENCOURAGES HEALTHY BEHAVIOR, LIFE SKILLS AND A SENSE OF PURPOSE - HAS A GOAL OF REDUCING TEEN PREGNANCIES.
MEMORIAL HOSPITAL FLAGLER, INC.	PART V, SECTION B, LINE 22D: IN DETERMINING THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO FINANCIAL ASSISTANCE POLICY-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE, THE HOSPITAL USED THE FOLLOWING METHODOLOGY IN 2014:THE HOSPITAL IDENTIFIED ALL COMMERCIAL PAYORS THAT HAD ANY ACTIVITY WITH THE HOSPITAL DURING THE TAXABLE YEAR. FOR THOSE IDENTIFIED COMMERCIAL PAYORS, AN AVERAGE OF THE NEGOTIATED COMMERCIAL INSURANCE RATES WAS DETERMINED. THE AVERAGE OF ALL OF THE NEGOTIATED COMMERCIAL INSURANCE RATES FOR THOSE IDENTIFIED COMMERCIAL PAYORS DETERMINED THE MAXIMUM AMOUNT THAT COULD BE CHARGED TO PATIENTS ELIGIBLE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY.
SCHEDULE H, PART V, SECTION B, LINE 7A:	THE CHNA REPORT CAN BE FOUND AT URL:HTTPS://WWW.FLORIDAHOSPITAL.COM/SITES/DEFAULT/FILES/PDF/FLORIDA_HOSPITAL_FLAGLER_2013_CHNA.PDF
SCHEDULE H, PART V, SECTION B, LINE 10A:	THE HOSPITAL'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY CAN BE FOUND AT:HTTPS://WWW.FLORIDAHOSPITAL.COM/COMMUNITY-BENEFIT
SCHEDULE H, PART V, SECTION B, LINE 16A,B,C:	THE FINANCIAL ASSISTANCE POLICY CAN BE FOUND AT URL:HTTPS://WWW.FLORIDAHOSPITAL.COM/SITES/DEFAULT/FILES/FINANCIAL_ASSISTANCE_POLICY_FINAL_FORMAT_FOR_WEB_1_30_14.PDFTHE FINANCIAL ASSISTANCE POLICY APPLICATION CAN BE FOUND AT:HTTPS://WWW.FLORIDAHOSPITAL.COM/SITES/DEFAULT/FILES/FH_FLAGLER_FINANCIAL_ASSISTANCE_APPLICATION.PDFTHE PLAIN LANGUAGE SUMMARY IS AVAILABLE AT:HTTPS://WWW.FLORIDAHOSPITAL.COM/SITES/DEFAULT/FILES/FLAGLER.PDF
PART V, SECTION B, LINE 16	FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY
MEMORIAL HOSPITAL FLAGLER, INC. PART V, SECTION B, LINE 16A WEBSITE:	SEE STATEMENT
MEMORIAL HOSPITAL FLAGLER, INC. PART V, SECTION B, LINE 16B WEBSITE:	SEE STATEMENT
MEMORIAL HOSPITAL FLAGLER, INC. PART V, SECTION B, LINE 16C WEBSITE:	SEE STATEMENT

Field	Value	IRS element (for citing)
Facility	46	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (46 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt	Address Line2USAddress/AddressLine2Txt
FLORIDA HOSPITAL FLAGLER TOWN CENTER SUR
120 CYPRESS EDGE DRIVE 102	PALM COAST	FL	32164	SURGICAL SERVICES
FLORIDA HOSPITAL MEMORIAL HOSPICE
770 W GRANADA BLVD 304	ORMOND BEACH	FL	32174	HOSPICE ADMINISTRATIVE OFFICE
PALM COAST PARKWAY CT
120 CYPRESS EDGE DRIVE	PALM COAST	FL	32164	CT SERVICES
PALM COAST PARKWAY MRI
120 CYPRESS EDGE DRIVE	PALM COAST	FL	32164	IMAGING SERVICES
FLORIDA HOSPITAL MEMORIAL HOME HEALTH
770 W GRANADA BLVD 319	ORMOND BEACH	FL	32174	HOME CARE SERVICES
HCP - ALTER GAY AND KEEN MDS
21 HOSPITAL DRIVE SUITE 110	PALM COAST	FL	32164	ORTHOPEDIC SERVICES
PALM COAST PARKWAY LABORATORY
120 CYPRESS EDGE DRIVE	PALM COAST	FL	32164	LABORATORY SERVICES
PALM COAST PARKWAY PHYSICAL THERAPY
120 CYPRESS EDGE DRIVE	PALM COAST	FL	32164	PHYSICAL THERAPY
PALM COAST PARKWAY ULTRASOUND
120 CYPRESS EDGE DRIVE	PALM COAST	FL	32164	ULTRASOUND SERVICES
PALM COAST PARKWAY RADIOLOGY
120 CYPRESS EDGE DRIVE	PALM COAST	FL	32174	RADIOLOGY SERVICES
FLORIDA HOSPITAL HOSPICE - MEMORIAL
301 MEMORIAL MEDICAL PARKWAY	DAYTONA BEACH	FL	32117	HOSPICE CARE SERVICES
HCP - MCKINLEY JOSEPH MD
3 PINE CONE CIRCLE SUITE 105	PALM COAST	FL	32137	GASTROENTEROLOGY SERVICES
STUART F MEYER HOSPICE HOUSE
150 MEMORIAL PARKWAY	PALM COAST	FL	32164	HOSPICE CARE SERVICES
HCP - JOINER THOMAS A MD
61 MEMORIAL MEDICAL PARKWAY 2811	PALM COAST	FL	32164	FAMILY PRACTICE SERVICES
HCP - KURIAN KIZHAKE MD
61 MEMORIAL MEDICAL PARKWAY SUITE	PALM COAST	FL	32164	CARDIOLOGY SERVICES	3808
HCP - COMBS WALLACE MD
120 PINNACLES DRIVE SUITE 1	PALM COAST	FL	32164	GASTROENTEROLOGY SERVICES
HCP - BOWER STEVEN C MD
61 MEMORIAL MEDICAL PARKWAY SUITE	PALM COAST	FL	32164	SURGICAL SERVICES	3807
HCP - SIDDIQUI REHANA MD
61 MEMORIAL MEDICAL PARKWAY SUITE	PALM COAST	FL	32164	GENERAL PRACTICE SERVICES	3812
PALM COAST PARKWAY SPEECH THERAPY
120 CYPRESS EDGE DRIVE	PALM COAST	FL	32164	SPEECH THERAPY
PROMPT CARE
120 CYPRESS EDGE DRIVE SUITE 102	PALM COAST	FL	32164	URGENT CARE & FAMILY PRACTICE
PALM COAST PARKWAY OCCUPATIONAL THERAPY
120 CYPRESS EDGE DRIVE	PALM COAST	FL	32164	OCCUPATIONAL THERAPY
HCP - BOLLA JOHN D MD
61 MEMORIAL MEDICAL PARKWAY SUITE	PALM COAST	FL	32164	FAMILY PRACTICE SERVICES	3803
PALM COAST PARKWAY WOMEN'S CENTER
120 CYPRESS EDGE DRIVE	PALM COAST	FL	32164	WOMEN'S HEALTH SERVICES
HCP - DAVIS MICHAEL DO DBA PEDIATRICS
61 MEMORIAL MEDICAL PARKWAY SUITE	PALM COAST	FL	32164	PEDIATRIC SERVICES	3811
HCP - PETERSON DARREN L MD
61 MEMORIAL MEDICAL PARKWAY 2815	PALM COAST	FL	32164	GENERAL SURGERY SERVICES
HCP - TUCKER ANTHONY MD
120 CYPRESS EDGE DRIVE SUITE 202	PALM COAST	FL	32164	ENT SERVICES
HCP - PALM COAST FAMILY PRACTICE
42A CAROLINE STREET	BUNNELL	FL	32110	FAMILY PRACTICE SERVICES
HCP - GARCIA-GUERRA JOSE MD
61 MEMORIAL MEDICAL PARKWAY SUITE	PALM COAST	FL	32164	NEUROLOGICAL SERVICES	2808
HCP - SHAMS SAFWAN MD
61 MEMORIAL MEDICAL PARKWAY SUITE	PALM COAST	FL	32164	GASTROENTEROLOGY SERVICES	1800A
HCP - WARD JEFFERY J DO
61 MEMORIAL MEDICAL PARKWAY SUITE	PALM COAST	FL	32164	FAMILY PRACTICE SERVICES	3813
HCP - TURCHIN SERGEY MD
120 CYPRESS EDGE DRIVE SUITE 209	PALM COAST	FL	32164	INTERNAL MEDICINE SERVICES
HCP - CEBALLOS JECEBU MD
61 MEMORIAL MEDICAL PARKWAY SUITE	PALM COAST	FL	32164	FAMILY PRACTICE SERVICES	2806
HCP - KARRAFFA DAVID MD
120 CYPRESS EDGE DRIVE SUITE 206	PALM COAST	FL	32164	HEALTHCARE -NEPHROLOGY SERVICES
HCP - OLIVIER CHAMION MD
120 CYPRESS EDGE DRIVE	PALM COAST	FL	32164	INFECTIOUS DISEASE SERVICES
FLORIDA HOSPITAL HOSPICE - ORLANDO
901 NORTH LAKE DESTINY ROAD SUITE	MAITLAND	FL	32751	HOSPICE ADMINISTRATIVE OFFICE	400
HCP - WALSH JOHN A MD
61 MEMORIAL MEDICAL PARKWAY SUITE	PALM COAST	FL	32164	SURGERY, CARDIOVASCULAR/THORACIC SERVICES	1800B
HCP - OGLESBY ALLAN C MD
61 MEMORIAL MEDICAL PARKWAY SUITE	PALM COAST	FL	32164	INTERNAL MEDICINE SERVICES	3805
HCP - AHMED TANAM MD
120 CYPRESS EDGE DRIVE SUITE 207	PALM COAST	FL	32164	FAMILY PRACTICE SERVICES
HCP - BURNS LAWRENCE W MD
61 MEMORIAL MEDICAL PARKWAY SUITE	PALM COAST	FL	32164	INTERNAL MEDICINE/PULMONOLOGY SERVICES	3817
HCP - CASHIO RICHARD MD
61 MEMORIAL MEDICAL PARKWAY SUITE	PALM COAST	FL	32164	SURGICAL, PLASTIC, & RECONSTRUCTIVE SERVICES	2802
HCP - HOSKOTE JAIDEEP MD
120 CYPRESS EDGE DRIVE SUITE 201	PALM COAST	FL	32164	NEPHROLOGY SERVICES
HCP - MACLSAAC GREGORY MD
120 CYPRESS EDGE DRIVE SUITE 210	PALM COAST	FL	32137	FAMILY PRACTICE SERVICES
FAMILY FOCUS MEDICAL CENTER
61 MEMORIAL MEDICAL PARKWAY SUITE	PALM COAST	FL	32164	FAMILY PRACTICE SERVICES	2802
FLORIDA HOSPITAL HOSPICE - FISH
190 N CHARLES RICHARD BEALL BLVD	DEBARY	FL	32713	HOSPICE ADMINISTRATIVE OFFICE
HCP - BLAIR-BRITT LORAY MD
61 MEMORIAL MEDICAL PARKWAY 3802	PALM COAST	FL	32164	FAMILY PRACTICE SERVICES
HCP - SCRENOCK JONATHAN MD
120 CYPRESS EDGE DRIVE SUITE 204	PALM COAST	FL	32164	FAMILY PRACTICE SERVICES

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 6A:	THE FILING ORGANIZATION IS A WHOLLY OWNED SUBSIDIARY OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). AHSSHC SERVES AS A PARENT ORGANIZATION TO 24 TAX-EXEMPT 501(C)(3) HOSPITAL ORGANIZATIONS THAT OPERATE 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. ON AN ANNUAL BASIS, THE COMMUNITY BENEFITS OF ALL AHS ORGANIZATIONS ARE CONSOLIDATED AND REPORTED IN THE AHS ANNUAL REPORT DOCUMENT (EIN 59-2170012).
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 II, COMMUNITY BUILDING ACTIVITIES:	MEMORIAL HOSPITAL FLAGLER, INC. (THE HOSPITAL) IS INVOLVED WITH AND SUPPORTIVE OF VARIOUS OTHER COMMUNITY AGENCIES IN ITS SERVICE AREA THAT WORK COLLABORATIVELY TO HELP THOSE IN NEED AND TO IMPROVE THE HEALTH AND SAFETY OF THE RESIDENTS OF THE COMMUNITY. THE HOSPITAL PARTICIPATES WITH A NUMBER OF OTHER COMMUNITY ORGANIZATIONS TO ADDRESS THE HEALTHCARE NEEDS OF THE COMMUNITY. THE HOSPITAL PROVIDES SUPPLIES AND CASH DONATIONS TO A LOCAL COMMUNITY FREE CLINIC ORGANIZATION. THE HOSPITAL ALSO PARTICIPATES IN COMMUNITY EVENTS, SUCH AS THE RELY FOR LIFE, AMERICAN CANCER SOCIETY, AND HEARTWALK.
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 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 NON-STATE CHARITY PATIENTS. AN AMOUNT UP TO $1,000 OF SUCH A PATIENT'S BILL IS WRITTEN OFF AS BAD DEBT EXPENSE, WHILE THE REMAINING PORTION OF THE PATIENT'S BILL IS CONSIDERED TO BE 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 TO BE COMMUNITY BENEFIT AS CHARITABLE HOSPITALS EXIST TO PROVIDE SUCH CARE IN PURSUIT OF THEIR PURPOSE OF MEETING THE NEED FOR EMERGENCY MEDICAL CARE SERVICES AVAILABLE TO ALL IN THE COMMUNITY.
PART III, LINE 4:	FINANCIAL STATEMENT FOOTNOTE RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS:THE FINANCIAL INFORMATION OF THE FILING ORGANIZATION IS INCLUDED IN A CONSOLIDATED AUDITED FINANCIAL STATEMENT FOR THE CURRENT YEAR.THE APPLICABLE FOOTNOTE FROM THE ATTACHED CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ADDRESSES ACCOUNTS RECEIVABLE, THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS, AND THE PROVISION FOR BAD DEBTS CAN BE FOUND ON PAGES 6 AND 7. 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 2012 PROPOSED 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 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) 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 THAT 120 DAYS AFTER THE FIRST BILLING STATEMENT IS SENT TO THE INDIVIDUAL AND IS AT LEAST 30 DAYS AFTER THE NOTICE IS PROVIDED. IF AN INDIVIDUAL SUBMITS AN INCOMPLETE FAA FORM DURING THE 240-DAY PERIOD FOLLOWING THE DATE ON WHICH THE FIRST BILLING STATEMENT WAS SENT TO THE INDIVIDUAL, THE HOSPITAL FILING ORGANIZATION SUSPENDS ANY REPORTING TO CONSUMER CREDIT REPORTING AGENCIES/BUREAUS AND PROVIDES A WRITTEN NOTICE TO THE INDIVIDUAL DESCRIBING WHAT ADDITIONAL INFORMATION OR DOCUMENTATION IS NEEDED TO COMPETE THE FAA FORM. THIS WRITTEN NOTICE INCLUDES A COPY OF THE HOSPITAL FILING ORGANIZATION'S PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY (PLS) AND INFORMS THE INDIVIDUAL THAT THE HOSPITAL FILING ORGANIZATION MAY ENGAGE IN ADVERSE REPORTING TO CONSUMER CREDIT REPORTING AGENCIES/BUREAUS IF THE FAA FORM IS NOT COMPLETED BY A SPECIFIED DEADLINE WHICH IS NO EARLIER THAN THE 240-DAY PERIOD FOLLOWING THE DATE ON WHICH THE FIRST BILLING STATEMENT WAS SENT TO THE INDIVIDUAL OR, IF LATER, 30 DAYS AFTER THE WRITTEN NOTICE IS PROVIDED. IF AN INDIVIDUAL SUBMITS A COMPETE FAA FORM WITHIN THE 240-DAY PERIOD AFTER THE FIRST BILLING STATEMENT IS SENT, 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.
PART VI, LINE 2:	AS REPORTED IN SCHEDULE H, PART V, SECTION B, LINES 1-8, THE HOSPITAL CONDUCTED ITS INITIAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING 2013. ITS INITIAL CHNA WAS ADOPTED BY ITS GOVERNING BOARD BY DECEMBER 31, 2013, THE END OF THE HOSPITAL'S TAXABLE YEAR IN WHICH IT CONDUCTED THE CHNA. THE HOSPITAL'S INITIAL CHNA COMPLIED WITH THE GUIDANCE SET FORTH BY THE IRS IN PROPOSED REGULATION SECTION 1.501(R)-3. IN ADDITION TO THE CHNA DISCUSSED ABOVE, A VARIETY OF PRACTICES AND PROCESSES ARE IN PLACE TO ENSURE THAT THE FILING ORGANIZATION IS RESPONSIVE TO THE HEALTH NEEDS OF ITS COMMUNITY.SUCH PRACTICES AND PROCESSES INVOLVE THE FOLLOWING:1. A HOSPITAL OPERATING/COMMUNITY BOARD COMPOSED OF INDIVIDUALS BROADLY REPRESENTATIVE OF THE COMMUNITY, COMMUNITY LEADERS, AND THOSE WITH SPECIALIZED MEDICAL TRAINING AND EXPERTISE;2. POST-DISCHARGE PATIENT FOLLOW-UP RELATED TO THE ON-GOING CARE AND TREATMENT OF PATIENTS WHO SUFFER FROM CHRONIC DISEASES; 3. SPONSORSHIP AND PARTICIPATION IN COMMUNITY HEALTH AND WELLNESS ACTIVITIES THAT REACH A BROAD SPECTRUM OF THE FILING ORGANIZATION'S COMMUNITY; AND 4. COLLABORATION WITH OTHER LOCAL COMMUNITY GROUPS TO ADDRESS THE HEALTH CARE NEEDS OF THE FILING ORGANIZATION'S COMMUNITY.
PART VI, LINE 3:	THE FINANCIAL ASSISTANCE POLICY (FAP) OF THE FILING ORGANIZATION'S HOSPITAL FACILITY IS TRANSPARENT AND AVAILABLE TO ALL INDIVIDUALS SERVED AT ANY POINT IN THE CARE CONTINUUM. THE FAP, THE FINANCIAL ASSISTANCE APPLICATION FORM (FAA FORM), THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY (PLS), AND CONTACT INFORMATION FOR THE HOSPITAL FACILITY'S FINANCIAL COUNSELORS ARE PROMINENTLY AND CONSPICUOUSLY POSTED ON THE FILING ORGANIZATION'S HOSPITAL FACILITY'S WEBSITE. SIGNAGE IS DISPLAYED IN THE FILING ORGANIZATION'S HOSPITAL FACILITY AT ALL POINTS OF ADMISSION AND REGISTRATION, INCLUDING THE EMERGENCY DEPARTMENT. THE SIGNAGE CONTAINS THE HOSPITAL FACILITY'S WEBSITE ADDRESS WHERE THE FAP AND THE FAA FORM CAN BE ACCESSED AND THE TELEPHONE NUMBER AND PHYSICAL LOCATION THAT INDIVIDUALS CAN CALL OR VISIT WITH ANY QUESTIONS ABOUT THE FAP OR THE APPLICATION PROCESS. PAPER COPIES OF THE HOSPITAL FACILITY'S FAP, FAA FORM AND PLS ARE AVAILABLE UPON REQUEST AND WITHOUT CHARGE, BOTH IN PUBLIC LOCATIONS IN THE HOSPITAL FACILITY AND BY MAIL. THE FILING ORGANIZATION'S HOSPITAL FACILITY'S FINANCIAL COUNSELORS SEEK TO PROVIDE PERSONAL FINANCIAL COUNSELING TO ALL INDIVIDUALS ADMITTED TO THE HOSPITAL FACILITY WHO ARE CLASSIFIED AS SELF-PAY DURING THE COURSE OF THEIR HOSPITAL STAY OR AT TIME OF DISCHARGE TO EXPLAIN THE FAP AND FAA FORM AND TO PROVIDE INFORMATION CONCERNING OTHER SOURCES OF ASSISTANCE THAT MAY BE AVAILABLE, SUCH AS MEDICAID. A COPY OF THE HOSPITAL FACILITY'S PLS AND FAA FORM IS DISTRIBUTED TO EVERY INDIVIDUAL BEFORE DISCHARGE FROM THE HOSPITAL FACILITY. ADDITIONALLY, A COPY OF THE PLS IS INCLUDED WITH AT LEAST THREE BILLING STATEMENTS THAT ARE SENT TO THE INDIVIDUAL DURING THE 120-DAY PERIOD AFTER THE FIRST BILLING STATEMENT IS SENT. INDIVIDUALS ARE INFORMED ABOUT THE HOSPITAL FACILITY'S FAP IN ALL ORAL COMMUNICATIONS REGARDING THE AMOUNT DUE FOR THE INDIVIDUAL'S CARE.
PART VI, LINE 4:	MEMORIAL HOSPITAL FLAGLER (THE HOSPITAL) IS A 99-BED ACUTE CARE FACILITY THAT PROVIDES QUALITY HEALTH CARE SERVICES TO THE RESIDENTS OF PALM COAST AND SURROUNDING FLAGLER COUNTY IN THE STATE OF FLORIDA. IN 2002, THE HOSPITAL OPENED ITS NEW FACILITY, EQUIPPED WITH CARE CENTERS FOR HEART, CANCER AND WOMEN'S HEALTH. THE HOSPITAL IS THE SOLE PROVIDER OF EMERGENCY HOSPITAL SERVICES IN FLAGLER COUNTY. THE HOSPITAL IS LOCATED IN A RURAL COMMUNITY LOCATED BETWEEN TWO LARGER CITIES. THE HOSPITAL IS A CRUCIAL COMMUNITY AND REGIONAL ASSET. MEDICARE HAS DESIGNATED FLORIDA HOSPITAL FLAGLER AS A MEDICARE DEPENDENT HOSPITAL AS IT IS LOCATED IN A RURAL AREA. THE NEAREST OTHER HOSPITAL IS 15 MILES AWAY AND THIS FACILITY IS OWNED BY AN AFFILIATE. THE HOSPITAL CURRENTLY OFFERS MOST HOSPITAL SERVICES INCLUDING CANCER, HOME HEALTH AND HOSPICE PROGRAMS. THE HOSPITAL IS ALSO THE THIRD LARGEST EMPLOYER IN FLAGLER COUNTY.THE HOSPITAL'S PRIMARY MARKET HAS A POPULATION OF APPROXIMATELY 98,000, WITH AN ESTIMATED 24,500 OVER THE AGE OF 65. THE WEIGHTED AVERAGE HOUSEHOLD INCOME, BASED ON POPULATION, IN THE PRIMARY MARKET IS APPROXIMATELY $46,330. HIGH SCHOOL GRADUATES ACCOUNT FOR APPROXIMATELY 89% OF FLAGLER COUNTY, WITH AN ESTIMATED 21% HAVING A BACHELOR'S DEGREE OR HIGHER. IT IS ESTIMATED THAT 11% OF THE INDIVDUALS RESIDING IN FLAGLER COUNTY LIVE BELOW THE POVERTY LEVEL AND THE UNEMPLOYMENT RATE IS ABOUT 7%.APPROXIMATELY 72% OF THE HOSPITAL'S PATIENTS ARE COVERED BY MEDICARE OR MEDICAID. MEDICARE PATIENTS COMPRISE ABOUT 62% OF THE HOSPITAL'S PATIENTS. APPROXIMATELY 10% OF THE HOSPITAL'S PATIENTS ARE COVERED BY THE MEDICAID PROGRAM, WITH 6% REPRESENTING SELF-PAY AND THE REMAINING ARE COMMERCIAL PAYORS. APPROXIMATELY 90% OF THE HOSPITAL'S IN-PATIENTS ARE ADMITTED THROUGH THE HOSPITAL'S EMERGENCY DEPARTMENT.
PART VI, LINE 5:	THE PROVISION OF COMMUNITY BENEFIT IS CENTRAL TO MEMORIAL HOSPITAL FLAGLER'S MISSION OF SERVICE AND COMPASSION. RESTORING AND PROMOTING THE HEALTH AND QUALITY OF LIFE OF THOSE IN THE COMMUNITIES SERVED BY THE HOSPITAL IS A FUNCTION OF "EXTENDING THE HEALING MINISTRY OF CHRIST" AND EMBODIES THE HOSPITAL'S COMMITMENT TO ITS VALUES AND PRINCIPLES. THE HOSPITAL COMMITS SUBSTANTIAL RESOURCES TO PROVIDE A BROAD RANGE OF SERVICES TO BOTH THE UNDERPRIVILEGED AS WELL AS THE BROADER COMMUNITY. IN ADDITION TO THE COMMUNITY BENEFIT INFORMATION PROVIDED IN PARTS I, II AND III OF THIS SCHEDULE H, THE HOSPITAL CAPTURES AND REPORTS THE BENEFITS PROVIDED TO ITS COMMUNITY THROUGH FAITH-BASED CARE. EXAMPLES OF SUCH BENEFITS INCLUDE THE COST ASSOCIATED WITH CHAPLAINCY CARE PROGRAMS AND MISSION PEER REVIEWS AND MISSION CONFERENCES. DURING THE CURRENT YEAR, THE HOSPITAL PROVIDED $351,214 OF BENEFIT WITH RESPECT TO THE FAITH-BASED AND SPIRITUAL NEEDS OF THE COMMUNITY IN CONJUNCTION WITH ITS OPERATION OF A COMMUNITY HOSPITAL. THE HOSPITAL ALSO PROVIDES BENEFITS TO ITS COMMUNITY'S INFRASTRUCTURE BY INVESTING IN CAPITAL IMPROVEMENTS TO ENSURE THAT FACILITIES AND TECHNOLOGY PROVIDE THE BEST POSSIBLE CARE TO THE COMMUNITY. DURING THE CURRENT YEAR, THE HOSPITAL EXPENDED $5,094,719 IN NEW CAPITAL IMPROVEMENTS. AS A FAITH-BASED MISSION-DRIVEN COMMUNITY HOSPITAL, THE HOSPITAL IS CONTINUALLY INVOLVED IN MONITORING ITS COMMUNITY, IDENTIFYING UNMET HEALTH CARE NEEDS AND DEVELOPING SOLUTIONS AND PROGRAMS TO ADDRESS THOSE NEEDS. IN ACCORDANCE WITH ITS CONSERVATIVE APPROACH TO FISCAL RESPONSIBILITY, SURPLUS FUNDS OF THE HOSPITAL ARE CONTINUALLY BEING INVESTED IN RESOURCES THAT IMPROVE THE AVAILABILITY AND QUALITY OF DELIVERY OF HEALTH CARE SERVICES AND PROGRAMS TO ITS COMMUNITY.
PART VI, LINE 6:	THE HOSPITAL 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 AND TO ACCESS AHS'S ANNUAL REPORT THAT CONTAINS FINANCIAL DATA AS WELL AS COMMUNITY BENEFIT REPORTING FOR THE ENTIRE SYSTEM.
PART VI, LINE 7:	THE ANNUAL COMMUNITY BENEFIT REPORT CONTAINED IN THE ANNUAL REPORT PREPARED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC) ON BEHALF OF THE ENTIRE AHS SYSTEM OF HEALTHCARE ORGANIZATIONS IS NOT FILED WITH ANY STATE AGENCIES.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
BETHUNE-COOKMAN UNIVERSITY
640 MARY MCLEOD BETHUNE	DAYTONA BEACH	FL	32114	590704726	501(C)(3)	$10,000	GENERAL SUPPORT
FLORIDA STATE UNIVERSITY FOUNDATION
1200 W ISB BLDG 600 SUITE 101	DAYTONA BEACH	FL	32114	596152180	501(C)(3)	$6,250	GENERAL SUPPORT

Field	Value	IRS element (for citing)
Total501c3 Org	2	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	GRANTS 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

Field	Value	IRS element (for citing)
Travel For Companions	Yes (X)	TravelForCompanionsInd
Idemnification Gross Up Pmts	Yes (X)	IdemnificationGrossUpPmtsInd
Discretionary Spending Acct	Yes (X)	DiscretionarySpendingAcctInd
Housing Allowance Or Residence	Yes (X)	HousingAllowanceOrResidenceInd
Written Policy Ref T And E Expnss	Yes (1)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (1)	SubstantiationRequiredInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (1)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (19 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DENNIS ALTER MD
DIRECTOR	$0	$516,148	$0	$462,067	$150	$2,328	$0	$14,105	$0	$20,904	$150	$1,015,552	$0	$0
TED HAMILTON MD
DIRECTOR	$0	$377,568	$0	$92,889	$150	$137,297	$0	$14,105	$0	$74,667	$150	$696,526	$0	$39,488
LARS HOUMANN
CHAIRMAN/DIR (BEG 2/14)	$0	$937,569	$0	$320,728	$0	$281,636	$0	$204,363	$0	$31,036	$0	$1,775,332	$0	$175,971
SANDRA JOHNSON
DIRECTOR	$0	$433,574	$0	$123,124	$0	$98,977	$0	$57,096	$0	$51,175	$0	$763,946	$0	$34,102
KENNETH MATTISON
DIRECTOR/CEO	$0	$361,810	$0	$98,544	$150	$83,147	$0	$49,545	$0	$41,955	$150	$635,001	$0	$34,476
EDWARD NOSEWORTHY
DIRECTOR	$0	$332,621	$0	$86,736	$0	$122,348	$0	$59,240	$0	$35,002	$0	$635,947	$0	$38,752
MICHAEL SCHULTZ
CHAIRMAN (END 2/14)	$0	$680,160	$0	$212,115	$0	$424,929	$0	$118,966	$0	$43,832	$0	$1,480,002	$0	$114,908
LEWIS SEIFERT
DIRECTOR	$0	$498,252	$0	$133,548	$0	$107,171	$0	$94,223	$0	$42,137	$0	$875,331	$0	$72,738
DARYL TOL
CHAIRMAN/DIRECTOR	$0	$492,319	$0	$134,465	$150	$89,073	$0	$89,323	$0	$46,049	$150	$851,229	$0	$65,638
DEBORA THOMAS
DIRECTOR	$0	$321,893	$0	$78,059	$150	$42,605	$0	$36,226	$0	$52,159	$150	$530,942	$0	$9,850
VALERIE ZIESMER
CFO (END 1/14)	$0	$224,022	$0	$40,684	$0	$81,076	$0	$17,789	$0	$34,973	$0	$398,544	$0	$4,163
JERMAINE BUCKNOR
CFO (BEG 2/14)	$0	$175,605	$0	$0	$150	$41,194	$0	$10,287	$0	$52,806	$150	$279,892	$0	$0
JOANNE KING
COO	$0	$149,703	$0	$20,964	$150	$11,340	$0	$9,521	$0	$26,077	$150	$217,605	$0	$0
ROBERT DAVIS
CNO (BEG 4/14)	$0	$146,823	$0	$0	$150	$14,889	$0	$7,648	$0	$27,039	$150	$196,399	$0	$0
RONALD THOMAS MD
CMO (BEG 10/14)	$0	$59,826	$0	$0	$150	$204,578	$0	$0	$0	$18,234	$150	$282,638	$0	$0
VENKATARAM THOTA MD
PHYSICIAN	$189,354	$0	$144,944	$0	$288	$0	$14,105	$0	$16,260	$0	$364,951	$0	$0	$0
SATAR SHETH
PHARMACIST	$110,217	$0	$10,430	$0	$30,548	$0	$7,261	$0	$13,590	$0	$172,046	$0	$0	$0
GUY WARREN WAGNER
PHARMACIST	$105,706	$0	$479	$0	$22,301	$0	$6,484	$0	$17,908	$0	$152,878	$0	$0	$0
DAVID OTTATI
FORMER CEO	$0	$378,907	$0	$81,431	$0	$71,860	$0	$57,516	$0	$45,606	$0	$635,320	$0	$30,836

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 1A	THE 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. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE: AHSSHC HAS A CORPORATE EXECUTIVE POLICY THAT ADDRESSES ASSISTANCE TO EXECUTIVES WHO HAVE BEEN RELOCATED BY THE COMPANY DURING THE YEAR. RELOCATION ASSISTANCE PROVIDED TO EXECUTIVES MAY INCLUDE RELOCATION ALLOWANCES TO ASSIST WITH DUPLICATE HOUSING EXPENSES. RELOCATION ASSISTANCE IS ADMINISTERED PER AHSSHC POLICY BY AN EXTERNAL RELOCATION COMPANY. ANY TAXABLE REIMBURSEMENTS MADE TO EXECUTIVES IN CONNECTION WITH RELOCATION ASSISTANCE ARE TREATED AS WAGES TO THE EXECUTIVE AND ARE SUBJECT TO ALL PAYROLL WITHHOLDING AND REPORTING REQUIREMENTS.
PART I, LINE 3	THE 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 4B	AS DISCUSSED IN LINE 1A ABOVE, EXECUTIVES ON THE FILING ORGANIZATION'S MANAGEMENT TEAM THAT HOLD THE POSITION OF VICE-PRESIDENT OR ABOVE ARE COMPENSATED BY AND ON THE PAYROLL OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), THE PARENT ORGANIZATION OF A HEALTHCARE SYSTEM KNOWN AS 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 AHS 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 $224,000. 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 ------------------------------------------------------- TED HAMILTON $ 56,296 $ 56,296 $ 49,649 $ 0 LARS HOUMANN $190,258 $207,319 $ 36,491 $ 0 SANDRA JOHNSON $ 60,491 $ 40,169 $ 21,376 $ 0 KENNETH MATTISON $ 52,267 $ 45,750 $ 0 $ 0 EDWARD NOSEWORTHY $ 45,135 $ 47,739 $ 55,623 $ 0 DAVID OTTATI $ 43,411 $ 41,450 $ 0 $ 0 MICHAEL SCHULTZ $122,361 $139,877 $166,686 $ 0 LEWIS SEIFERT $ 80,118 $ 73,668 $ 0 $ 0 DARYL TOL $ 75,218 $ 66,756 $ 0 $ 0 DEBORA THOMAS $ 39,621 $ 9,852 $ 0 $ 0 RONALD THOMAS, MD $ 0 $ 6,197 $ 0 $ 0 VALERIE ZIESMER $ 21,184 $ 4,812 $ 0 $ 0 *INCLUDING INVESTMENT EARNINGS

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
BILL TOL
FAMILY OF BOARD MEMBER	$59,027	EMPLOYEE COMPENSATION	0
DENNIS ALTER MD PA DBA ALTER ORTH
100% OWNED BY BOARD MEMBER	$139,217	OFFICE SPACE LEASE	0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2	BRUCE PAGE AND MICHAEL CHIUMENTO - BUSINESS RELATIONSHIP MICHAEL CHIUMENTO AND TONY PAPANDREA - BUSINESS RELATIONSHIP
FORM 990, PART VI, SECTION A, LINE 6	MEMORIAL HOSPITAL - FLAGLER, INC. (THE FILING ORGANIZATION) HAS ONE MEMBER. THE SOLE MEMBER OF THE FILING ORGANIZATION IS MEMORIAL HEALTH SYSTEMS, INC. MEMORIAL HEALTH SYSTEMS, INC. (MHS) 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 7A	THE SOLE MEMBER OF THE FILING ORGANIZATION IS MHS. THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION ARE APPOINTED BY THE SOLE MEMBER, MHS, WHO HAS THE RIGHT TO ELECT, APPOINT OR REMOVE ANY MEMBER OF THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7B	MHS, 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 BYLAWS OF THE FILING ORGANIZATION; C) TO SET LIMITS AND TERMS FOR THE BORROWING OF FUNDS IN EXCESS OF AN ESTABLISHED AMOUNT; D) TO APPROVE OR DISAPPROVE MATERIAL CHANGES IN SERVICES OFFERED AND/OR PURCHASE OR SALE OF PERSONAL PROPERTY OR REAL PROPERTY EQUAL TO OR IN EXCESS OF AN ESTABLISHED AMOUNT; 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 CASE MANAGEMENT; 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 11	THE 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 12C	THE CONFLICT OF INTEREST POLICY OF THE FILING ORGANIZATION APPLIES TO MEMBERS OF ITS BOARD OF DIRECTORS AND ITS PRINCIPAL OFFICERS (TO BE KNOWN AS INTERESTED PERSONS). IN CONNECTION WITH ANY ACTUAL OR POSSIBLE 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 15	THE 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 19	THE FILING ORGANIZATION IS A PART OF THE SYSTEM OF HEALTHCARE ORGANIZATIONS KNOWN AS ADVENTIST HEALTH SYSTEM (AHS). EACH YEAR, AHS PUBLISHES AN ANNUAL REPORT DOCUMENT THAT INCLUDES A FINANCIAL REPORT FOR THE RELEVANT YEAR AS WELL AS A COMMUNITY BENEFIT REPORT. THE FINANCIAL REPORT AND COMMUNITY BENEFIT REPORT ARE PRESENTED ON A CONSOLIDATED BASIS AND REPRESENT ALL OF THE ACTIVITIES, RESULTS OF OPERATIONS, AND FINANCIAL POSITION AT YEAR-END OF THE ENTIRE AHS SYSTEM. IN ADDITION, 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 A	FOR THOSE BOARD OF DIRECTOR MEMBERS WHO DEVOTE LESS THAN FULL-TIME TO THE FILING ORGANIZATION (BASED UPON THE AVERAGE NUMBER OF HOURS PER WEEK SHOWN IN COLUMN (B) ON PAGE 7 OF THE RETURN) THE COMPENSATION AMOUNTS SHOWN IN COLUMNS (E) AND (F) ON PAGE 7 WERE PROVIDED IN CONJUNCTION WITH THAT PERSON'S RESPONSIBILITIES AND ROLES IN SERVING IN AN EXECUTIVE LEADERSHIP POSITION WITHIN ADVENTIST HEALTH SYSTEM.
FORM 990, PART IX, LINE 11G	PAYMENTS TO HEALTHCARE PROFESSIONALS : PROGRAM SERVICE EXPENSES 6,112,777. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,112,777. PROFESSIONAL FEES : PROGRAM SERVICE EXPENSES 1,645,391. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,645,391. PURCHASED MEDICAL SERVICES : PROGRAM SERVICE EXPENSES 945,318. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 945,318. ENVIRONMENTAL SERVICES : PROGRAM SERVICE EXPENSES 508,990. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 508,990. RECRUITING : PROGRAM SERVICE EXPENSES 34,499. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 34,499. FOOD SERVICE CONTRACTS : PROGRAM SERVICE EXPENSES 322,036. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 322,036. MISCELLANEOUS PURCHASED SERVICES : PROGRAM SERVICE EXPENSES 4,917,126. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,917,126. AHS MANAGEMENT FEES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,566,864. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,566,864. BILLING & COLLECTION SERVICES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 818,367. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 818,367. EHR MANAGEMENT FEES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 341,790. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 341,790.
FORM 990, PART XI, LINE 9:	ALLOCATIONS FROM TAX-EXEMPT PARENT WITH RESPECT TO DEBT 60,423. TRANSFER TO TAX-EXEMPT PARENT -1,380,175. ROUNDING 1.
PART X, LINE 2	THE AMOUNTS SHOWN ON LINE 2 OF PART X OF THIS RETURN INCLUDE THE FILING ORGANIZATION'S INTEREST IN A CENTRAL INVESTMENT POOL MAINTAINED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION, THE FILING ORGANIZATION'S TOP-TIER PARENT. THE INVESTMENTS IN THE CENTRAL INVESTMENT POOL ARE RECORDED AT MARKET VALUE.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (103 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd
ADVENTIST BOLINGBROOK HOSPITAL
500 REMINGTON BLVD	BOLINGBROOK	IL	60440	651219504	OPERATION OF HOSPITAL & RELATED SERVICES	IL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
ADVENTIST CARE CENTERS - COURTLAND INC
730 COURTLAND STREET	ORLANDO	FL	32804	205774723	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	FL	501(C)(3)	LINE 9	SUNBELT HLTH CARE CENTERS INC	Yes (1)
ADVENTIST GLENOAKS HOSPITAL
701 WINTHROP AVENUE	GLENDALE HEIGHTS	IL	60139	363208390	OPERATION OF HOSPITAL & RELATED SERVICES	IL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
ADVENTIST HLTH MID-AMERICA INC
9100 W 74TH STREET	SHAWNEE MISSION	KS	66204	521347407	HLTHCARE RELATED SERVICES	KS	501(C)(3)	LINE 11A, I	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
ADVENTIST HLTH PARTNERS INC
1000 REMINGTON BLVD STE 200	BOLINGBROOK	IL	60440	364138353	OPERATE OUT-PATIENT PHYSICIAN CLINICS	IL	501(C)(3)	LINE 3	AHS MIDWEST MANAGEMENT INC	Yes (1)
ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	592170012	MANAGEMENT SERVICES	FL	501(C)(3)	LINE 11A, I		0	N/A
ADVENTIST HLTH SYSTEM GEORGIA INC
1035 RED BUD ROAD	CALHOUN	GA	30701	581425000	OPERATION OF HOSPITAL & RELATED SERVICES	GA	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
ADVENTIST HLTH SYSTEMSUNBELT INC
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	591479658	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
ADVENTIST HLTH SYSTEMTEXAS INC
11801 S FREEWAY	BURLESON	TX	36028	742578952	LEASING PERSONNEL TO AFFILIATED HOSPITAL	TX	501(C)(3)	LINE 11C, III-FI	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
ADVENTIST HINSDALE HOSPITAL
120 NORTH OAK STREET	HINSDALE	IL	60521	362276984	OPERATION OF HOSPITAL & RELATED SERVICES	IL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
ADVENTIST UNIVERSITY OF HEALTH SCIENCES INC (630 YEAR END)
671 LAKE WINYAH DRIVE	ORLANDO	FL	32803	593069793	EDUCATION/OPERATION OF SCHOOL	FL	501(C)(3)	LINE 2	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
AHS MIDWEST MANAGEMENT INC
1000 REMINGTON BLVD STE 200	BOLINGBROOK	IL	60440	363354567	OPERATION OF PHYSICIAN PRACTICE MGMT	IL	501(C)(3)	LINE 11A, I	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
AHSCENTRAL TEXAS INC
1301 WONDER WORLD DRIVE	SAN MARCOS	TX	78666	742621825	PROVIDE OFFICE SPACE - MEDICAL PROFESSIONALS	TX	501(C)(3)	LINE 11C, III-FI	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
APOPKA HLTH CARE PROPERTIES INC
305 E OAK STREET	APOPKA	FL	32703	510605694	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 11C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
BATTLE CREEK ADVENTIST HOSPITAL
1000 REMINGTON BLVD STE 200	BOLINGBROOK	IL	60440	381359189	INACTIVE	MI	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
BOLINGBROOK HOSPITAL FOUNDATION
1000 REMINGTON BLVD N ENTRANCE 2ND	BOLINGBROOK	IL	60440	900494445	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	IL	501(C)(3)	LINE 7	MIDWEST HLTH FOUNDATION	0
BRADFORD HEIGHTS HLTH & REHAB CENTER INC
950 HIGHPOINT DRIVE	HOPKINSVILLE	KY	42240	205782342	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	KY	501(C)(3)	LINE 9	SUNBELT HLTH CARE CENTERS INC	Yes (1)
BURLESON NURSING & REHAB CENTER INC
301 HUGULEY BLVD	BURLESON	TX	76028	205782243	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	TX	501(C)(3)	LINE 9	SUNBELT HLTH CARE CENTERS INC	Yes (1)
CALDWELL HLTH CARE PROPERTIES INC
1333 WEST MAIN	PRINCETON	KY	42445	510605680	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 11C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
CENTRAL TEXAS HLTHCARE COLLABORATIVE
1301 WONDER WORLD DRIVE	SAN MARCOS	TX	78666	453739929	SUPPORT OPERATION OF HOSPITAL	TX	501(C)(3)	LINE 11A, I	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
CENTRAL TEXAS MEDICAL CENTER FOUNDATION
1301 WONDER WORLD DRIVE	SAN MARCOS	TX	78666	742259907	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	TX	501(C)(3)	LINE 7		0
CHICKASAW HLTH CARE PROPERTIES INC
250 S CHICKASAW TRAIL	ORLANDO	FL	32825	510605681	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 11C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
CHIPPEWA VALLEY HOSPITAL & OAKVIEW CARE CENTER INC
1220 THIRD AVENUE WEST	DURAND	WI	54736	391365168	OPERATION OF HOSPITAL & RELATED SERVICES	WI	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
COBB MEDICAL ASSOCIATES LLC
3949 SOUTH COBB DRIVE SE	SMYRNA	GA	30080	582617089	OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES	GA	501(C)(3)	LINE 3	EMORY-ADVENTIST INC	Yes (1)
COURTLAND HLTH CARE PROPERTIES INC
730 COURTLAND STREET	ORLANDO	FL	32804	510605682	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 11C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
CREEKWOOD PLACE NURSING & REHAB CENTER INC
683 E THIRD STREET	RUSSELLVILLE	KY	42276	205782260	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	KY	501(C)(3)	LINE 9	SUNBELT HLTH CARE CENTERS INC	Yes (1)
DAIRY ROAD HLTH CARE PROPERTIES INC
7350 DAIRY ROAD	ZEPHYRHILLS	FL	33540	510605684	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 11C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
EAST ORLANDO HLTH & REHAB CENTER INC
250 S CHICKASAW TRAIL	ORLANDO	FL	32825	205774748	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	FL	501(C)(3)	LINE 9	SUNBELT HLTH CARE CENTERS INC	Yes (1)
EMORY-ADVENTIST INC
3949 SOUTH COBB DRIVE	SMYRNA	GA	30080	582171011	OPERATION OF HOSPITAL & RELATED SVCS	GA	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
FLETCHER HOSPITAL INC
100 HOSPITAL DRIVE	HENDERSONVILLE	NC	28792	560543246	OPERATION OF HOSPITAL & RELATED SVCS	NC	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
FLNC INC
3355 E SEMORAN BLVD	APOPKA	FL	32703	205774761	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	FL	501(C)(3)	LINE 9	SUNBELT HLTH CARE CENTERS INC	Yes (1)
FLORIDA HOSPITAL HEALTHCARE PARTNERS INC
770 WEST GRANADA BLVD 101	ORMOND BEACH	FL	32174	462354804	OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
FLORIDA HOSPITAL MEDICAL GROUP INC
2600 WESTHALL LN	MAITLAND	FL	32751	593214635	OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
FLORIDA HOSPITAL PHYSICIAN GROUP INC
14055 RIVEREDGE DRIVE STE 250	TAMPA	FL	33637	462021581	OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
FLORIDA HOSPITAL WATERMAN INC
1000 WATERMAN WAY	TAVARES	FL	32778	593140669	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
FLORIDA HOSPITAL ZEPHYRHILLS INC
7050 GALL BLVD	ZEPHYRHILLS	FL	33541	592108057	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
FOUNDATION FOR SHAWNEE MISSION MEDICAL CENTER INC
9100 W 74TH STREET	SHAWNEE MISSION	KS	66204	480868859	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	KS	501(C)(3)	LINE 11A, I	SHAWNEE MISSION MEDICAL CENTER INC	Yes (1)
FOUNTAIN INN NURSING & REHAB CENTER INC(1024-123114)
602 COURTLAND ST STE 200	ORLANDO	FL	32804	472180518	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	FL	501(C)(3)	LINE 9	SUNBELT HLTH CARE CENTERS INC	Yes (1)
GLENOAKS HOSPITAL FOUNDATION
701 WINTHROP AVENUE	GLENDALE HEIGHTS	IL	60139	363926044	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	IL	501(C)(3)	LINE 7	MIDWEST HLTH FOUNDATION	0
HELEN ELLIS MEMORIAL HOSPITAL AUXILIARY INC
1395 S PINELLAS AVE	TARPON SPRINGS	FL	34689	592106043	FUND-RAISING FOR TAX-EXEMPT HOSPITAL/FOUNDATION	FL	501(C)(3)	LINE 11C, III-FI		0
HELEN ELLIS MEMORIAL HOSPITAL FOUNDATION INC
1395 S PINELLAS AVE	TARPON SPRINGS	FL	34689	593690149	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	FL	501(C)(3)	LINE 11C, III-FI		0
HINSDALE HOSPITAL FOUNDATION
7 SALT CREEK LANE SUITE 203	HINSDALE	IL	60521	521466387	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	IL	501(C)(3)	LINE 7	MIDWEST HLTH FOUNDATION	0
HOSPICE OF THE COMFORTER INC
480 W CENTRAL PARKWAY	ALTAMONTE SPRINGS	FL	32714	592935928	OPERATION OF HOSPICE	FL	501(C)(3)	LINE 9	THE COMFORTER HEALTH CARE GROUP INC	Yes (1)
HOSPICE OF THE COMFORTER FOUNDATION INC
480 W CENTRAL PARKWAY	ALTAMONTE SPRINGS	FL	32714	271858033	FUND RAISING FOR AFFILIATED TAX-EXEMPT HOSPICE	FL	501(C)(3)	LINE 7	THE COMFORTER HEALTH CARE GROUP INC	Yes (1)
IN-MOTION REHAB INC
602 COURTLAND STREET STE 200	ORLANDO	FL	32804	208023411	THERAPY SERVICES TO TAX EXEMPT NURSING HOMES	KS	501(C)(3)	LINE 11B, II	SUNBELT HLTH CARE CENTERS INC	Yes (1)
JELLICO COMMUNITY HOSPITAL INC
188 HOSPITAL LANE	JELLICO	TN	37762	620924706	OPERATION OF HOSPITAL & RELATED SERVICES	TN	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
LA GRANGE MEMORIAL HOSPITAL FOUNDATION
5101 S WILLOW SPRINGS RD	LA GRANGE	IL	60525	300247776	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	IL	501(C)(3)	LINE 7	MIDWEST HLTH FOUNDATION	0
LAKE COUNTY HEALTH CARE PROPERTIES INC(1017-123114)
602 COURTLAND ST STE 200	ORLANDO	FL	32804	472179868	LEASE TO RELATED ORGANIZATION	FL	501(C)(3)	LINE 11C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
MEMORIAL HLTH SYSTEMS FOUNDATION INC
770 WEST GRANADA BLVD	ORMOND BEACH	FL	32174	311771522	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	FL	501(C)(3)	LINE 7		0
MEMORIAL HLTH SYSTEMS INC
301 MEMORIAL MEDICAL PARKWAY	DAYTONA BEACH	FL	32117	590973502	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
MEMORIAL HOSPITAL - WEST VOLUSIA INC
701 WEST PLYMOUTH AVENUE	DELAND	FL	32720	593256803	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	LINE 3	MEMORIAL HLTH SYSTEMS INC	Yes (1)
MEMORIAL HOSPITAL FLAGLER INC
60 MEMORIAL MEDICAL PARKWAY	PALM COAST	FL	32164	592951990	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	LINE 3	MEMORIAL HLTH SYSTEMS INC	Yes (1)
MEMORIAL HOSPITAL INC
210 MARIE LANGDON DRIVE	MANCHESTER	KY	40962	610594620	OPERATION OF HOSPITAL & RELATED SERVICES	KY	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
MERRIAM HLTH CARE PROPERTIES INC
9700 WEST 62ND STREET	MERRIAM	KS	66203	364595806	LEASE TO RELATED ORGANIZATION	KS	501(C)(3)	LINE 11C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
METROPLEX ADVENTIST HOSPITAL INC
2201 S CLEAR CREEK ROAD	KILLEEN	TX	76549	742225672	OPERATION OF HOSPITAL & RELATED SERVICES	TX	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
METROPLEX CLINIC PHYSICIANS INC
2201 S CLEAR CREEK ROAD	KILLEEN	TX	76549	113762050	PHYSICIAN HLTHCARE SERVICES TO THE COMMUNITY	TX	501(C)(3)	LINE 3	METROPLEX ADVENTIST HOSPITAL INC	Yes (1)
METROPLEX HOSPITAL INC
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	461256516	FUTURE OPERATION OF HOSPITAL & RELATED SVCS	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
MIDWEST HLTH FOUNDATION
120 NORTH OAK STREET	HINSDALE	IL	60521	352230515	SUPPORT OF SUBSIDIARY FOUNDATIONS	IL	501(C)(3)	LINE 11B, II		0	N/A
MILLS HLTH & REHAB CENTER INC
500 BECK LANE	MAYFIELD	KY	42066	205782320	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	KY	501(C)(3)	LINE 9	SUNBELT HLTH CARE CENTERS INC	Yes (1)
MISSION STRATEGIES OF GEORGIA INC
3949 S COBB DRIVE	SMYRNA	GA	30080	900866024	PROVISION OF SUPPORT TO THE NURSING HOME DIVISION	GA	501(C)(3)	LINE 11B, II	SUNBELT HLTH CARE CENTERS INC	Yes (1)
MISSOURI ADVENTIST HLTH INC
9100 W 74TH STREET	SHAWNEE MISSION	KS	66204	431224729	SUPPORT HLTH CARE SERVICES	MO	501(C)(3)	LINE 11D, III-O	ADVENTIST HLTH MID-AMERICA INC	Yes (1)
NORTH REGIONAL EMS INC
188 HOSPITAL LANE	JELLICO	TN	37762	262653616	EMS SERVICES	TN	501(C)(3)	LINE 9	JELLICO COMMUNITY HOSPITAL INC	Yes (1)
ORMOND BEACH MEMORIAL HOSPITAL AUXILIARY INC
301 MEMORIAL MEDICAL PARKWAY	DAYTONA BEACH	FL	32117	591721962	VOLUNTEER SUPPORT SERVICES	FL	501(C)(3)	LINE 11C, III-FI		0
OVERLAND PARK NURSING & REHAB CENTER INC
6501 WEST 75TH STREET	OVERLAND PARK	KS	66204	205774821	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	KS	501(C)(3)	LINE 9	SUNBELT HLTH CARE CENTERS INC	Yes (1)
PARAGON HLTH CARE PROPERTIES INC
950 HIGHPOINT DRIVE	HOPKINSVILLE	KY	42240	510605686	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 11C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
PASCO-PINELLAS HILLSBOROUGH COMMUNITY HLTH SYSTEM INC
2600 BRUCE B DOWNS BLVD	WESLEY CHAPEL	FL	33544	208488713	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
PORTERCARE ADVENTIST HLTH SYSTEM (630 YEAR END)
2525 S DOWNING STREET	DENVER	CO	80210	840438224	OPERATION OF HOSPITAL & RELATED SERVICES	CO	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
PRINCETON HLTH & REHAB CENTER INC
1333 WEST MAIN	PRINCETON	KY	42445	205782272	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	KY	501(C)(3)	LINE 9	SUNBELT HLTH CARE CENTERS INC	Yes (1)
PRINCETON PROFESSIONAL SERVICES INC
601 E ROLLINS STREET	ORLANDO	FL	32803	591191045	PROVISION OF HLTHCARE SERVICES	FL	501(C)(3)	LINE 9	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
QUALITY CIRCLE FOR HLTHCARE INC
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	263789368	HLTHCARE QUALITY SERVICES	FL	501(C)(3)	LINE 11A, I	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
RESOURCE PERSONNEL INC
602 COURTLAND STREET STE 200	ORLANDO	FL	32804	208040875	PROVIDE ADMINISTRATIVE SUPPORT TO TAX EXEMPT NURSING HOMES	FL	501(C)(3)	LINE 11B, II	SUNBELT HLTH CARE CENTERS INC	Yes (1)
ROCKY MOUNTAIN ADVENTIST HLTHCARE FOUNDATION (630 YEAR END)
7995 E PRENTICE AVE 204	GREENWOOD VILLAGE	CO	80111	840745018	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	CO	501(C)(3)	LINE 7		0
ROLLINS BROOK COMMUNITY CARE CORP
2201 S CLEAR CREEK ROAD	KILLEEN	TX	76549	461656773	INACTIVE	TX	501(C)(3)	LINE 11A, I	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
RUSSELLVILLE HLTH CARE PROPERTIES INC
683 EAST THIRD STREET	RUSSELLVILLE	KY	42276	510605691	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 11C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
SAN MARCOS HLTH CARE PROPERTIES INC
1900 MEDICAL PARKWAY	SAN MARCOS	TX	78666	510605693	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 11C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
SAN MARCOS NURSING & REHAB CENTER INC
1900 MEDICAL PARKWAY	SAN MARCOS	TX	78666	205782224	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	TX	501(C)(3)	LINE 9	SUNBELT HLTH CARE CENTERS INC	Yes (1)
SHAWNEE MISSION HLTH CARE INC
6501 WEST 75TH STREET	OVERLAND PARK	KS	66204	480952508	LEASE TO RELATED ORGANIZATION	KS	501(C)(3)	LINE 11C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
SHAWNEE MISSION MEDICAL CENTER INC
9100 W 74TH STREET	SHAWNEE MISSION	KS	66204	480637331	OPERATION OF HOSPITAL & RELATED SERVICES	KS	501(C)(3)	LINE 3	ADVENTIST HLTH MID-AMERICA INC	Yes (1)
SOUTH CENTRAL INC
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	593689740	MANAGEMENT SUPPORT	GA	501(C)(3)	LINE 11C, III-FI		0	N/A
SOUTH PASCO HLTH CARE PROPERTIES INC
38250 A AVENUE	ZEPHYRHILLS	FL	33542	510605679	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 11C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
SOUTHWEST VOLUSIA HLTH SERVICES INC
1055 SAXON BLVD	ORANGE CITY	FL	32763	593281591	MEDICAL OFFICE BUILDING FOR HOSPITAL	FL	501(C)(3)	LINE 11A, I	SOUTHWEST VOLUSIA HLTHCARE CORP	Yes (1)
SOUTHWEST VOLUSIA HLTHCARE CORP
1055 SAXON BLVD	ORANGE CITY	FL	32763	593149293	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
SPECIALTY PHYSICIANS OF CENTRAL TEXAS INC
1301 WONDER WORLD DRIVE	SAN MARCOS	TX	78666	208814408	PHYSICIAN HLTHCARE SERVICES TO THE COMMUNITY	TX	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
SPRING VIEW HLTH & REHAB CENTER INC
718 GOODWIN LANE	LEITCHFIELD	KY	42754	205782288	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	KY	501(C)(3)	LINE 9	SUNBELT HLTH CARE CENTERS INC	Yes (1)
SUNBELT HLTH & REHAB CENTER - APOPKA INC
305 EAST OAK STREET	APOPKA	FL	32703	205774856	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	FL	501(C)(3)	LINE 9	SUNBELT HLTH CARE CENTERS INC	Yes (1)
SUNBELT HLTH CARE CENTERS INC
602 COURTLAND STREET STE 200	ORLANDO	FL	32804	581473135	MANAGEMENT SERVICES	TN	501(C)(3)	LINE 11B, II	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
SUNSYSTEM DEVELOPMENT CORP
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	592219301	FUND RAISING FOR AFFILIATED TAX-EXEMPT HOSPITALS	FL	501(C)(3)	LINE 7	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
TAKOMA REGIONAL HOSPITAL INC (630 YEAR END)
401 TAKOMA AVE	GREENEVILLE	TN	37743	510603966	OPERATION OF HOSPITAL & RELATED SERVICES	TN	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
TAKOMA REGIONAL HOSPITAL FOUNDATION INC (710-123114)
401 TAKOMA AVE	GREENEVILLE	TN	37743	471334302	FUND RAISING FOR AFFILIATED TAX-EXEMPT HOSPITAL	TN	501(C)(3)	LINE 7	TAKOMA REGIONAL HOSPITAL INC	Yes (1)
TARPON SPRINGS HOSPITAL FOUNDATION INC
1395 S PINELLAS AVE	TARPON SPRINGS	FL	34689	590898901	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	LINE 3	UNIVERSITY COMMUNITY HOSPITAL INC	Yes (1)
TARRANT COUNTY HLTH CARE PROPERTIES INC
301 HUGULEY BLVD	BURLESON	TX	76028	510605677	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 11C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
TAYLOR CREEK HLTH CARE PROPERTIES INC
718 GOODWIN LANE	LEITCHFIELD	KY	42754	510605678	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 11C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
THE COMFORTER HEALTH CARE GROUP INC
605 MONTGOMERY ROAD	ALTAMONTE SPRINGS	FL	32714	271857940	LEASE TO RELATED ORGANIZATION	FL	501(C)(3)	LINE 11C, III-FI	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
THE VOLUNTEER AUXILIARY OF FLORIDA HOSPITAL - FLAGLER INC
60 MEMORIAL MEDICAL PARKWAY	PALM COAST	FL	32164	592486582	VOLUNTEER SUPPORT SERVICES	FL	501(C)(3)	LINE 11C, III-FI		0
TRI-COUNTY NURSING AND REHAB CENTER INC(1030-123114)
602 COURTLAND ST STE 200	ORLANDO	FL	32804	472219363	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	FL	501(C)(3)	LINE 9	SUNBELT HLTH CARE CENTERS INC	Yes (1)
TRINITY NURSING & REHAB CENTER INC
9700 WEST 62ND STREET	MERRIAM	KS	66203	205774890	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	KS	501(C)(3)	LINE 9	SUNBELT HLTH CARE CENTERS INC	Yes (1)
UNIVERSITY COMMUNITY HOSPITAL FOUNDATION INC
3100 E FLETCHER AVE	TAMPA	FL	33613	592554889	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	FL	501(C)(3)	LINE 11A, I		0
UNIVERSITY COMMUNITY HOSPITAL SPECIALTY CARE INC
3100 E FLETCHER AVE	TAMPA	FL	33613	593231322	INACTIVE	FL	501(C)(3)	LINE 11A, I	UNIVERSITY COMMUNITY HOSPITAL INC	Yes (1)
UNIVERSITY COMMUNITY HOSPITAL INC
3100 E FLETCHER AVE	TAMPA	FL	33613	591113901	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
WEST FLORIDA HEALTH HOME CARE INC FKA SOUTH CENT NURS HOME PROP(11-1114)
PO BOX 1289	TAMPA	FL	33601	593686109	WILL BE OPERATING HOME HEALTH AGENCY	GA	501(C)(3)	LINE 11D, III-O	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
WEST KENTUCKY HLTH CARE PROPERTIES INC
500 BECK LANE	MAYFIELD	KY	42066	510605676	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 11C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
ZEPHYR HAVEN HLTH & REHAB CENTER INC
38250 A AVENUE	ZEPHYRHILLS	FL	33542	205774930	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	FL	501(C)(3)	LINE 9	SUNBELT HLTH CARE CENTERS INC	Yes (1)
ZEPHYRHILLS HLTH & REHAB CENTER INC
7350 DAIRY ROAD	ZEPHYRHILLS	FL	33540	205774967	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	FL	501(C)(3)	LINE 9	SUNBELT HLTH CARE CENTERS INC	Yes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (8 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd
APPALACHIAN THERAPY SERVICES LLC
100 HOSPITAL DRIVE	HENDERSONVILLE	NC	28792	202463851	THERAPY STAFFING	NC	N/A
CLEAR CREEK MOB LTD
2201 S CLEAR CREEK RD	KILLEEN	TX	76549	742609195	REAL ESTATE	TX	N/A
ENDOSCOPY CENTER AT PORTER LLC
1001 SOUTH PARK DRIVE	LITTLETON	CO	80120	205855038	MEDICAL SERVICES	CO	N/A
FLORIDA HOSPITAL DMERT LLC
2450 MAITLAND CENTER PKWY STE 200	MAITLAND	FL	32751	202392253	MEDICAL EQUIPMENT	FL	N/A
FLORIDA HOSPITAL HOME INFUSION LLP
2450 MAITLAND CENTER PKWY STE 200	MAITLAND	FL	32751	593142824	HOME INFUSION SERVICES	FL	N/A
PAHSUSP SURGERY CENTERS LLC
15305 DALLAS PKWY STE 1600 LB 28	ADDISON	TX	75010	263057950	MEDICAL SERVICES	CO	N/A
SAN MARCOS MRI LP
1330 WONDER WORLD DR STE 202	SAN MARCOS	TX	78666	770597972	IMAGING & TESTING	TX	N/A
SHAWNEE MISSION OPEN MRI LLC
9100 W 74TH STREET BOX 2923	SHAWNEE MISSION	KS	66201	270011796	IMAGING & TESTING	KS	N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (19 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct
ALTAMONTE MEDICAL PLAZA CONDOMINIUM ASSOCIATION INC
601 EAST ROLLINS STREET	ORLANDO	FL	32803	592855792	CONDO ASSOCIATION	FL	N/A	C	Yes (1)
APOPKA MEDICAL PLAZA CONDOMINIUM ASSOCIATION INC
601 EAST ROLLINS STREET	ORLANDO	FL	32803	593000857	CONDO ASSOCIATION	FL	N/A	C	Yes (1)
CC MOB INC
2201 S CLEAR CREEK ROAD	KILLEEN	TX	76549	742616875	REAL ESTATE RENTAL	TX	N/A	C	Yes (1)
CENTRAL TEXAS MEDICAL ASSOCIATES
1301 WONDER WORLD DRIVE	SAN MARCOS	TX	78666	742729873	PHYSICIAN CLINICS	TX	N/A	C	Yes (1)
CENTRAL TEXAS PROVIDER'S NETWORK
1301 WONDER WORLD DRIVE	SAN MARCOS	TX	78666	742827652	PHYSICIAN HOSPITAL ORG.	TX	N/A	C	Yes (1)
FLORIDA HOSPITAL FLAGLER MEDICAL OFFICES ASSOCIATION INC
60 MEMORIAL MEDICAL PARKWAY	PALM COAST	FL	32164	262158309	CONDO ASSOCIATION	FL		C	Yes (1)	MEMORIAL HOSPITAL-FLAGLER INC	$8,872	$56,661	0.91280
FLORIDA HOSPITAL HEALTHCARE SYSTEM INC
602 COURTLAND STREET	ORLANDO	FL	32804	593215680	PHO/TPA	FL	N/A	C	Yes (1)
FLORIDA MEDICAL PLAZA CONDO ASSOCIATION INC
601 EAST ROLLINS STREET	ORLANDO	FL	32803	592855791	CONDO ASSOCIATION	FL	N/A	C	Yes (1)
FLORIDA MEMORIAL HEALTH NETWORK INC
770 W GRANADA BLVD STE 317	ORMOND BEACH	FL	32174	593403558	PHYSICIAN HOSPITAL ORG.	FL		C	Yes (1)	MHS MHF MHWV OR SWVHC	$26,806	$286,177	0.25000
HUGULEY ALLIANCE FOUNDATION (11-8414)
11801 SOUTH FREEWAY	FORT WORTH	TX	76115	752642209	INACTIVE	TX	N/A	C	Yes (1)
KISSIMMEE MULTISPECIALTY CLINIC CONDOMINIUM ASSOCIATION INC
201 HILDA STREET SUITE 30	KISSIMMEE	FL	34741	593539564	CONDO ASSOCIATION	FL	N/A	C	Yes (1)
MIDWEST MANAGEMENT SERVICES INC
9100 WEST 74TH STREET	SHAWNEE MISSION	KS	66204	480901551	REAL ESTATE RENTAL	KS	N/A	C	Yes (1)
NORTH AMERICAN HEALTH SERVICES INC & SUBS
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	621041820	LESSOR/HOLDING CO.	TN	N/A	C	Yes (1)
ORMOND PROF ASSOCIATES CONDO ASSOC'N INC (430 YR END)
770 W GRANADA BLVD STE 101	ORMOND BEACH	FL	32174	592694434	CONDO ASSOCIATION	FL	N/A	C	Yes (1)
PARK RIDGE PROPERTY OWNER'S ASSOCIATION INC
1 PARK PLACE NAPLES ROAD	FLETCHER	NC	28732	030380531	CONDO ASSOCIATION	NC	N/A	C	Yes (1)
PORTER AFFILIATED HLTH SERVICES INC DBA DIVERSIFIED AFFILIATED HLTH SVCS
2525 S DOWNING STREET	DENVER	CO	80210	840956175	HEALTHCARE SERVICES	CO	N/A	C	Yes (1)
SAN MARCOS REGIONAL MRI INC
1301 WONDER WORLD DRIVE	SAN MARCOS	TX	78666	770597968	HOLDING COMPANY	TX	N/A	C	Yes (1)
THE GARDEN RETIREMENT COMMUNITY INC
602 COURTLAND STREET STE 200	ORLANDO	FL	32804	593414055	REAL ESTATE RENTAL	FL	N/A	C	Yes (1)
WINTER PARK MEDICAL OFFICE BUILDING I CONDO ASSOC INC
200 LAKEMONT AVE	WINTER PARK	FL	32792	452228478	PHYSICIAN CLINICS	FL	N/A	C	Yes (1)

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (1)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	0	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	0	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (1)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	0	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (1)	SharingOfFacilitiesInd
Paid Employees Sharing	0	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (14 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
MEMORIAL HEALTH SYSTEMS INC
P	$1,388,901	COST
MEMORIAL HEALTH SYSTEMS INC
K	$339,574	COST
MEMORIAL HEALTH SYSTEMS INC
N	$2,083,760	COST
SOUTHWEST VOLUSIA HEALTHCARE CORPORATION
K	$149,949	COST
FLORIDA HOSPITAL MEDICAL GROUP INC
P	$331,102	COST
ADVENTIST HEALTH SYSTEMSUNBELT INC DBA FLORIDA HOSPITAL
P	$468,786	COST
ADVENTIST HEALTH SYSTEMSUNBELT INC DBA FLORIDA HOSPITAL
M	$939,560	COST
ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION
M	$1,385,475	% OF FACILITY'S OPERATING EXP.
ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION DBA AHS IS
M	$3,820,010	% OF FACILITY'S OPERATING EXP.
ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION
P	$5,158,018	COST
ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION
B	$1,380,175	ACTUAL AMOUNT GIVEN
SUNSYSTEM DEVELOPMENT CORP DBA FLORIDA HOSPITAL FLAGLER FOUNDATION
Q	$95,501	COST
FLORIDA MEMORIAL HEALTH NETWORK INC
P	$445,743	COST
ADVENTIST HEALTH SYSTEMSUNBELT INC
M	$341,790	% OF FACILITY'S EHR REVENUE