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MEMORIAL HEALTH SYSTEMS INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
MEMORIAL HEALTH SYSTEMS INC (EIN 59-0973502)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-05
IRS object ID
201303099349302100
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-11-05T17:40:13-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN590973502EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MEMORIAL HEALTH SYSTEMS INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMEMONameControl
Phone3866766000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1301 MEMORIAL MEDICAL PARKWAYAddressLine1
CityDAYTONA BEACHCity
StateFLState
ZIP Code32117ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameLYNN C ADDISCOTTName
TitleASSISTANT SECRETARYTitle
Phone4079751492Phone
Date Signed2013-11-04DateSigned
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1FLORIDA HOSPITAL MEMORIAL MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonDARYL TOLNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1301 MEMORIAL MEDICAL PARKWAYAddressLine1
CityDAYTONA BEACHCity
StateFLState
ZIP Code32117ZIPCode
FieldValueIRS element (for citing)
Gross Receipts250361142GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.FLORIDAHOSPITALMEMORIAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1961YearFormation
State Legal DomicileFLStateLegalDomicile
Activity Or Mission DescriptionMEDICAL CARE TO THE COMMUNITY THROUGH THE OPERATION OF TWO HOSPITALS WITH A TOTAL OF 396 BEDS.ActivityOrMissionDescription
Nbr Voting Members Governing Body18NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees2187TotalNbrEmployees
Total Nbr Volunteers254TotalNbrVolunteers
Total Gross UBI38540TotalGrossUBI
Net Unrelated Business Txbl Income21849NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year234363158ProgramServiceRevenuePriorYear
Program Service Revenue CY245872207ProgramServiceRevenueCY
Investment Income Prior Year1870212InvestmentIncomePriorYear
Investment Income Current Year1996583InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year2315873OtherRevenueCurrentYear
Total Revenue Prior Year236233370TotalRevenuePriorYear
Total Revenue Current Year250184663TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year165981GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY105713GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year99777661SalariesEtcPriorYear
Salaries Etc Current Year106892001SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year135774686OtherExpensePriorYear
Other Expenses Current Year132937234OtherExpensesCurrentYear
Total Expenses Prior Year235718328TotalExpensesPriorYear
Total Expenses Current Year239934948TotalExpensesCurrentYear
Revenues Less Expenses Prior Year515042RevenuesLessExpensesPriorYear
Revenues Less Expenses CY10249715RevenuesLessExpensesCY
Total Assets BOY434016611TotalAssetsBOY
Total Assets EOY440515926TotalAssetsEOY
Total Liabilities BOY190151117TotalLiabilitiesBOY
Total Liabilities EOY187836321TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY243865494NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY252679605NetAssetsOrFundBalancesEOY
Mission DescriptionADVENTIST 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.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense222035586Expense
Grants105713Grants
Revenue248149540Revenue
DescriptionOPERATION OF 2 ACUTE CARE HOSPITALS WITH 13,527 PATIENT ADMISSIONS, 67,022 PATIENT DAYS, AND 108,798 OUTPATIENT VISITS IN THE CURRENT YEAR. BOTH HOSPITALS ARE LOCATED IN ORMOND BEACH AND DAYTONA BEACH, FLORIDA. IN ADDITION, THE CORPORATION OPERATES AN INTEGRATED HEALTHCARE DELIVERY SYSTEM.Description
Total Program Service Expense222035586TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements1ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096161NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees2187NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members18NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledFLStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1DEBORA THOMASBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3862313901TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1301 MEMORIAL MEDICAL PARKWAYAddressLine1
CityDAYTONA BEACHCity
StateFLState
ZIP Code32117ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (28 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
MICHAEL SCHULTZ
CHAIRMAN/DIRECTOR0.6050.00X1991305933169103
RICK BANKER
DIRECTOR (END 12/12)0.600.00X19900
LONNIE BROWN
DIRECTOR (BEG 9/12)0.600.00X19900
DAVID BURT
DIRECTOR0.600.00X19900
PAUL CLARE
DIRECTOR0.600.00X19900
SURESH DESAI MD
DIRECTOR4.700.00X3362100
CHARLES D HOOD JR
DIRECTOR0.600.00X19900
SANDRA K JOHNSON
DIRECTOR0.6050.00X059048599955
MARK LAROSE
CEO (END 2/12)/DIRECTOR8.3041.70X057500696916X
NANCY LOHMAN
DIRECTOR (END 12/12)0.600.00X19900
DAVID OTTATI
DIRECTOR0.6050.00X19943247578624
WILLIAM MCMUNN
DIRECTOR0.600.00X19900
ED NOSEWORTHY
DIRECTOR0.6050.00X044627275791
EDDIE SCHATZ JR
DIRECTOR0.600.00X19900
JULIE SCHNEIDER MD
DIRECTOR82.600.00X1199257021432
LEWIS SEIFERT
DIRECTOR0.6050.00X199681597118449
DARYL TOL
DIRECTOR/CEO41.708.30X0564953116809X
ELIZABETH WEAGRAFF
DIRECTOR0.6050.00X19934494264960
DEBORA THOMAS
REGION CFO/DIRECTOR41.708.30X040106157811X
NIGEL HINDS
CFO (END 2/12)8.3041.70030534558764X
DARLINDA COPELAND
COO50.000.00033662342773X
MICHELE GOEB-BURKETT
CNO50.000.00025507536417X
RONALD JIMENEZ
CMO50.000.00036963971518X
MICHAEL KELLEY MD
PHYSICIAN70.000.00784833035704X
ROBERT MARTIN MD
PHYSICIAN58.000.00742213026444X
ROBERT HEWES MD
PHYSICIAN52.000.00735141026165X
CHRISTOPHER SUTTON KENT MD
PHYSICIAN87.000.00689367039284X
DINDI REDDY MD
PHYSICIAN50.000.00671860036285X
FieldValueIRS element (for citing)
Total Reportable Comp From Org4858680TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs6609406TotalReportableCompFrmRltdOrgs
Total Other Compensation1273204TotalOtherCompensation
Number Individuals GT100 K66NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
SHERIDAN HEALTHCORP INC
PO BOX 452197SUNRISEFL33323MEDICAL SERVICE2908124
HURON CONSULTING GROUP
3005 MOMENTUM PLACECHICAGOIL60689CONSULTING SERVICE1772297
SPACE COAST HOSPITAL SERVICES
1895 MURRELL ROADROCKLEDGEFL32955LINEN SERVICE824538
MONTI ELIGIBILITY & DENIAL SOLUTIONS
540 S PINE MEADOW DRDEBARYFL32713COLLECTION SERVICE476130
AMERISOURCE FUNDING INC
PO BOX 4738HOUSTONTX77210AGENCY SERVICE462979
FieldValueIRS element (for citing)
Number Of Contractors GT100 K33NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
NET PATIENT REVENUE90009923716018023712164038540
MANAGEMENT FEES56100054482745448274
MEDICAL OFFICE BUILDING53112015344091534409
CAFETERIA REVENUE90009914995181499518
HEALTH EDUCATION900099170280170280

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column59546TotalRevenueColumn
Related Or Exempt Function Income59546RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue245872207TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column840405TotalRevenueColumn
Exclusion$840,405ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1238936Securities
Other93721Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities0Securities
Other176479Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1238936Securities
Other-82758Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1156178TotalRevenueColumn
Exclusion$1,156,178ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionEHR REVENUEDescription
Business Code900099BusinessCode
Total Revenue Column2315873TotalRevenueColumn
Related Or Exempt Function Income2315873RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue2315873TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column250184663TotalRevenueColumn
Related Or Exempt Function Income248149540RelatedOrExemptFunctionIncome
Unrelated Business Revenue38540UnrelatedBusinessRevenue
Exclusion$1,996,583ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total105713Total
Program Services105713ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total3489855Total
Management And General3489855ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total79478109Total
Program Services79478109ProgramServices

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2531300Total
Program Services2488711ProgramServices
Management And General42589ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total15191706Total
Program Services14918377ProgramServices
Management And General273329ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total6201031Total
Program Services6096699ProgramServices
Management And General104332ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total703955Total
Management And General703955ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total56764Total
Management And General56764ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total16942757Total
Program Services11633239ProgramServices
Management And General5309518ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total927893Total
Management And General927893ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total5157559Total
Program Services3889570ProgramServices
Management And General1267989ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total8091341Total
Program Services6978473ProgramServices
Management And General1112868ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total5476319Total
Program Services5476319ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total381189Total
Management And General381189ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total175825Total
Management And General175825ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total7238781Total
Program Services7238781ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total18523850Total
Program Services18523850ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total3634569Total
Program Services3532367ProgramServices
Management And General102202ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralProgram ServicesProgramServices
UNRELATED BUSINESS INCO93469346
MEDICAL SUPPLIES5256912652569126
REPAIRS & MAINTENANCE56029045602904
PURCHASED SERVICES46144743941708672766

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2830582Total
Program Services2830582ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total239934948Total
Program Services222035586ProgramServices
Management And General17899362ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY4311BOY
EOY4987EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY106482950BOY
EOY121912428EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY26445233BOY
EOY27653963EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY4634870BOY
EOY5413676EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY6009911BOY
EOY6780042EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis337490590LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec82359235LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY268926757BOY
EOY255131355EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY4548297BOY
EOY3502352EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY281875BOY
EOY233505EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY16682407BOY
EOY19883618EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY434016611BOY
EOY440515926EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY13106544BOY
EOY12370776EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY177044573BOY
EOY175465545EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY190151117BOY
EOY187836321EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY240453830BOY
EOY249231866EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY585929BOY
EOY622004EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2825735BOY
EOY2825735EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY243865494BOY
EOY252679605EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY434016611BOY
EOY440515926EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses10249715ReconcilationRevenueExpenses
Reconciliation Unrealized Invest-11610ReconciliationUnrealizedInvest
Reconcilation Other Changes-1423994ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$10,114OtherActivitiesAmount
Total Lobbying Expenditures IIB10114TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationAMERICAN HOSPITAL ASSOCIATION DUES AND FLORIDA HOSPITAL ASSOCIATION DUESExplanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Protection Of Natural HabitatXProtectionOfNaturalHabitat
Nmbr Easements Modified0NmbrEasementsModified
Nmbr States In Which Easements Held1NmbrStatesInWhichEasementsHeld
Written Policy Monitoring0WrittenPolicyMonitoring
Staff Hours Spent On Enforcement0.00StaffHoursSpentOnEnforcement
Expenses Incurred For Enforcement0ExpensesIncurredForEnforcement

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis19759070OtherCostOrOtherBasis
Book Value19759070BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis241473411OtherCostOrOtherBasis
Depreciation37141704Depreciation
Book Value204331707BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis75224565OtherCostOrOtherBasis
Depreciation44920501Depreciation
Book Value30304064BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1033544OtherCostOrOtherBasis
Depreciation297030Depreciation
Book Value736514BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings255131355TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescriptionAmountAmount
PAYABLE TO THIRD PARTIES$5,528,719
DUE TO AFFILIATED$1,708,628
CREDIT BALANCES IN A/R$683,930
OTHER LIABILITIES$2,162,537
INTERCO. ALLOC. OF TE BOND PROCEEDS$165,365,281
LEASES PAYABLE$16,450
FieldValueIRS element (for citing)
Total Of Amounts175465545TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF HOW ORGANIZATION REPORTS CONSERVATION EASEMENTS: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 IN THE CURRENT YEAR RELATED TO THE MAINTENANCE AND MONITORING OF THE CONSERVATION EASEMENT.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: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 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.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense9502619TotalCommunityBenefitExpense
Net Community Benefit Expense9502619NetCommunityBenefitExpense
Percent Of Total Expense0.03960PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense25399134TotalCommunityBenefitExpense
Direct Offsetting Revenue9132002DirectOffsettingRevenue
Net Community Benefit Expense16267132NetCommunityBenefitExpense
Percent Of Total Expense0.06780PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense34901753TotalCommunityBenefitExpense
Direct Offsetting Revenue9132002DirectOffsettingRevenue
Net Community Benefit Expense25769751NetCommunityBenefitExpense
Percent Of Total Expense0.10740PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense57993TotalCommunityBenefitExpense
Net Community Benefit Expense57993NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense1868TotalCommunityBenefitExpense
Net Community Benefit Expense1868NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense59861TotalCommunityBenefitExpense
Net Community Benefit Expense59861NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense34961614TotalCommunityBenefitExpense
Direct Offsetting Revenue9132002DirectOffsettingRevenue
Net Community Benefit Expense25829612NetCommunityBenefitExpense
Percent Of Total Expense0.10760PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense26250TotalCommunityBuildingExpense
Net Community Building Expense26250NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Total Community Building Expense48785TotalCommunityBuildingExpense
Net Community Building Expense48785NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense19442TotalCommunityBuildingExpense
Net Community Building Expense19442NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense6615TotalCommunityBuildingExpense
Net Community Building Expense6615NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense17024TotalCommunityBuildingExpense
Net Community Building Expense17024NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense118116TotalCommunityBuildingExpense
Net Community Building Expense118116NetCommunityBuildingExpense
Percent Of Total Expense0.00050PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$10,437,942BadDebtExpenseAmount
Amount Attributable To1855039AmountAttributableTo
Amount Reimbursed By Medicare79791587AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare75711932CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall4079655MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities2NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeWebsite AddressWebsiteAddressLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalEr24 HoursEr24Hours
FLORIDA HOSPITAL MEMORIAL MEDICAL CENTER
1301 MEMORIAL MEDICAL PARKWAYDAYTONA BEACHFL32117WWW.FLORIDAHOSPITALMEMORIAL.ORGXXX
FLORIDA HOSPITAL OCEANSIDE
2264 SOUTH ATLANTIC AVEORMOND BEACHFL32176WWW.FLORIDAHOSPITALMEMORIAL.ORGXXX

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (2 entries)

Hospital Facility NumberHospitalFacilityNumberEligibility Criteria ExplainedEligibilityCriteriaExplainedUses FPG FreeUsesFPGFreeFPG Free PercentFPGFreePercentUses FPG DiscountedUsesFPGDiscountedFPG Discount PercentFPGDiscountPercentExplains BasisExplainsBasisIncome LevelIncomeLevelAsset LevelAssetLevelMedical IndigencyMedicalIndigencyInsurance StatusInsuranceStatusUninsured DiscountUninsuredDiscountMedicaid MedicareMedicaidMedicareState RegulationStateRegulationExplains Application MethodExplainsApplicationMethodIncludes Publicity MeasuresIncludesPublicityMeasuresAvailable On RequestAvailableOnRequestOther PublicityOtherPublicityActions On NonpaymentActionsOnNonpaymentCollection ActivitiesCollectionActivitiesNondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicyUsed Other MethodUsedOtherMethodAmounts Generally BilledAmountsGenerallyBilledGross ChargesGrossCharges
FLORIDA HOSPITAL MEMORIAL MEDICAL CENTER
111200.0000000000001400.0000000000001XXXXXXX11XX101X00
FLORIDA HOSPITAL OCEANSIDE
211200.0000000000001400.0000000000001XXXXXXX11XX101X00

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities20NumberOfOtherFacilities

Other Facilities OtherFacilities (20 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
FLORIDA MEMORIAL HOSPITAL IMAGING CENTER
335 CLYDE MORRIS BLVDORMOND BEACHFL32174DIAGNOSTIC IMAGING
FHMMC CANCER CARE CENTER
224 MEMORIAL MEDICAL PKWYDAYTONA BEACHFL32117ONCOLOGY SERVICES
WOUND CARE
305 MEMORIAL MEDICAL PKWY 101DAYTONA BEACHFL32117WOUND CARE SERVICES
HEMATOLOGY ONCOLOGY ASSOCIATES
345 CLYDE MORRIS BLVD 490ORMOND BEACHFL32174ONCOLOGY SERVICES
PRACTICE OF DR MURRPHY MARTIN & KENT
305 MEMORIAL MEDICAL PKWY 206DAYTONA BEACHFL32117PHYSICIAN SERVICES
FHMMC AT THE PAVILION-REHAB
5535 S WILLIAMSON BLVD700PORT ORANGEFL32128HEALTHCARE REHABILITATION SERVICES
FLORIDA WOMEN'S HEALTH CENTER
335 CLYDE MORRIS BLVD 240ORMOND BEACHFL32174WOMEN'S HEALTH SERVICES
PRACTICE OF DR BIRKEDAL
305 MEMORIAL MEDICAL PKWY 205DAYTONA BEACHFL32117PHYSICIAN SERVICES
FHMMC REHABILITATION SVCS OUTPATIENT CTR
501 STERTHAUS AVENUEORMOND BEACHFL32174REHABILITATIVE SERVICES
PRACTICE OF DR RASMUSSEN
305 MEMORIAL MEDICAL PKWY 209DAYTONA BEACHFL32117PHYSICIAN SERVICES
PRACTICE OF DR LEVINE
305 MEMORIAL MEDICAL PKWY 207DAYTONA BEACHFL32117PHYSICIAN SERVICES
FHMMC AT THE PAVILION-LAB
5535 S WILLIAMSON BLVD700PORT ORANGEFL32128LAB SERVICES
PRACTICE OF DR DAAS
305 MEMORIAL MEDICAL PKWY 203DAYTONA BEACHFL32117PHYSICIAN SERVICES
PRACTICE OF DR COHEN
305 MEMORIAL MEDICAL PKWY 208ORMOND BEACHFL32174PHYSICIAN SERVICES
FHMMC AT THE PAVILION-RADIOLOGY
5535 S WILLIAMSON BLVD700PORT ORANGEFL32128RADIOLOGY SERVICES
FHMMC AT THE PAVILION-DR MANTINEO
5535 S WILLIAMSON BLVD700PORT ORANGEFL32128PHYSICIAN SERVICES
PRACTICE OF DR CASIMIRO
290 N CLYDE MORRIS BLVD A-2ORMOND BEACHFL32174PHYSICIAN SERVICES
FHMMC CARDIAC REHAB
305 MEMORIAL MEDICAL PKWY 306DAYTONA BEACHFL32117REHABILITATIVE SERVICES
MEMORIAL FAMILY CARE DR GONSALVES
335 CLYDE MORRIS BLVD 240DAYTONA BEACHFL32174PHYSICIAN SERVICES
MEMORIAL MEDLAB
290 N CLYDE MORRIS BLVDORMOND BEACHFL32174LAB SERVICES

Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)

ExplanationExplanationReturn ReferenceReturnReferenceIdentifierIdentifier
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 43 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 PREPARED BY AHSSHC (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 III, LINE 9B: AT THE TIME OF PATIENT REGISTRATION, NON-ELECTIVE SELF-PAY PATIENTS ARE INFORMED OF THE MINIMUM DISCOUNT AVAILABLE UNDER THE FILING ORGANIZATION'S SELF-PAY DISCOUNT POLICY. SUCH PATIENTS ARE ALSO INFORMED OF THE FILING ORGANIZATION'S CHARITY CARE POLICY AND TOLD THAT THEY WILL BE REQUIRED TO SUBMIT NECESSARY FINANCIAL DATA IN ORDER TO POTENTIALLY RECEIVE ANY ADDITIONAL DISCOUNTS. UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, PERCENTAGE DISCOUNTS ARE APPLIED TO A PATIENT'S ACCOUNT BASED UPON AMOUNTS GENERALLY BILLED TO INDIVIDUALS WHO HAVE INSURANCE COVERING SUCH CARE. UNDER THE FILING ORGANIZATION'S POLICIES, PAYMENT PLANS FOR PARTIAL CHARITY ACCOUNTS WILL BE INDIVIDUALLY DEVELOPED WITH THE PATIENT. PARTIAL CHARITY ACCOUNTS RESULT WHEN A FINANCIAL ASSISTANCE ELIGIBILITY DETERMINATION ALLOWS FOR A PERCENTAGE REDUCTION BUT LEAVES THE PATIENT WITH A SELF-PAY BALANCE. IF THE PATIENT COMPLIES WITH THE AGREED-UPON PAYMENT PLAN, THE FILING ORGANIZATION DOES NOT PURSUE ANY COLLECTION ACTION WITH RESPECT TO THE PATIENT. HOWEVER, IF A PATIENT DOES NOT MAKE ANY PAYMENTS FOR THREE CONSECUTIVE MONTHS, THE ACCOUNT MAY BE REFERRED FOR FURTHER COLLECTION ACTIVITY. THE FILING ORGANIZATION DOES NOT PURSUE COLLECTION OF AMOUNTS FROM PATIENTS DETERMINED TO QUALIFY FOR A 100% REDUCTION IN CHARGES UNDER ITS CHARITY CARE POLICY.
RECONCILIATION OF SCHEDULE H REPORTED MEDICARE SURPLUS/(SHORTFALL) TO UNREIMBURSED MEDICARE COSTS ASSOCIATED WITH THE PROVISION OF SERVICESTO ALL MEDICARE BENEFICIARIES:THE MEDICARE REVENUE AND ALLOWABLE COSTS OF CARE REPORTED IN SECTION B OF PART III OF SCHEDULE H ARE BASED UPON THE AMOUNTS REPORTED IN THE FILING ORGANIZATION'S MEDICARE COST REPORT IN ACCORDANCE WITH THE IRS INSTRUCTIONS FOR SCHEDULE H. ON AN ANNUAL BASIS, THE FILING ORGANIZATION ALSO DETERMINES ITS TOTAL UNREIMBURSED COSTS ASSOCIATED WITH PROVIDING SERVICES TO ALL MEDICARE PATIENTS. UNREIMBURSED COSTS ARE REPORTED AS A COMMUNITY BENEFIT TO THE ELDERLY AND ARE INCLUDED IN THE CONSOLIDATED ADVENTIST HEALTH SYSTEM (AHS OR THE COMPANY) COMMUNITY BENEFITS REPORT CONTAINED IN THE AHS ANNUAL REPORT DOCUMENT. THE PRIMARY RECONCILING ITEMS BETWEEN THE MEDICARE SURPLUS/(SHORTFALL) SHOWN ON LINE 7 OF SECTION B OF PART III OF SCHEDULE H AND THE FILING ORGANIZATION'S UNREIMBURSED COSTS OF SERVICES PROVIDED TO MEDICARE PATIENTS AS REPORTED IN THE AHS COMMUNITY BENEFIT REPORT ARE AS FOLLOWS:- MEDICARE SURPLUS/(SHORTFALL) SHOWN ON LINE 7 OF SECTION B OF SCHEDULE H: $ 4,079,655- DIFFERENCE IN COSTING METHODOLOGY: (9,258,804)- UNREIMBURSED COSTS INCURRED FOR SERVICES PROVIDED TO MEDICARE PATIENTS THAT ARE NOT INCLUDED IN THE ORGANIZATION'S MEDICARE COST REPORT: (11,485,074) -------------TOTAL SURPLUS/(SHORTFALL) COSTS OF SERVING ALL MEDICARE PATIENTS PER THE FILING ORGANIZATION'S COMMUNITY BENEFIT REPORTING: $(16,664,223)AS INDICATED ABOVE, THE PRIMARY DIFFERENCES BETWEEN THE MEDICARE SURPLUS/(SHORTFALL) REPORTED ON SCHEDULE H, PART III, SECTION B, LINE 7 AND THE FILING ORGANIZATION'S PORTION OF THE COMPANY'S ANNUAL COMMUNITY BENEFIT STATEMENT IS DUE TO A DIFFERENCE IN THE COSTING METHODOLOGY AND DIFFERENCES IN THE POPULATION OF MEDICARE PATIENTS WITHIN THE CALCULATION. THE COST METHODOLOGY UTILIZED IN CALCULATING ANY MEDICARE SURPLUS/(SHORTFALL) FOR PURPOSES OF THE ANNUAL COMMUNITY BENEFIT REPORTING IS BASED UPON THE COST-TO-CHARGE RATIO OUTLINED IN WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. THE SAME COST-TO-CHARGE RATIO IS USED TO DETERMINE THE COSTS ASSOCIATED WITH SERVICES PROVIDED TO CHARITY CARE PATIENTS AND MEDICAID PATIENTS AS REPORTED IN SCHEDULE H, PART I, LINE 7. IN ADDITION, THE MEDICARE COST REPORT EXCLUDES SERVICES PROVIDED TO MEDICARE PATIENTS FOR PHYSICIAN SERVICES, SERVICES PROVIDED TO PATIENTS ENROLLED IN MEDICARE HMOS, AND CERTAIN SERVICES PROVIDED BY OUTPATIENT DEPARTMENTS OF THE FILING ORGANIZATION THAT ARE REIMBURSED ON A FEE SCHEDULE. THE COMPANY'S OWN COMMUNITY BENEFIT STATEMENT CAPTURES THE UNREIMBURSED COST OF PROVIDING SERVICES TO ALL MEDICARE BENEFICIARIES THROUGHOUT THE ORGANIZATION.SUPPLEMENTAL SCHEDULE TO SCHEDULE H, PART III, SECTION B
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 2:
METHODOLOGY FOR DETERMINING THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE THAT MAY REPRESENT PATIENTS WHO COULD HAVE QUALIFIED UNDER THE FILING ORGANIZATION'S CHARITY CARE POLICY:SELF-PAY PATIENTS ARE REQUIRED TO COMPLETE A PATIENT FINANCIAL ASSISTANCE APPLICATION SHORT FORM (PFAA). IF THE PFAA IS NOT COMPLETED AFTER REASONABLE ATTEMPTS TO OBTAIN IT ARE EXHAUSTED, PATIENT INFORMATION IS PROCESSED THROUGH A SCORER PRODUCT. THE SCORER PRODUCT UTILIZES PUBLICLY AVAILABLE DATA, SUCH AS CREDIT REPORTS, TO ASSESS AN INDIVIDUAL PATIENT'S FINANCIAL VIABILITY. PATIENTS WHO EARN A CERTAIN SCORE ON THE SCORER PRODUCT 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 SCORER PRODUCT 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 CHARITY CARE POLICY, EVERY EFFORT IS MADE TO OBTAIN A PATIENT'S NECESSARY FINANCIAL INFORMATION TO DETERMINE ELIGIBILITY FOR CHARITY CARE. HOWEVER, NOT ALL PATIENTS WILL COOPERATE WITH SUCH EFFORTS AND A CHARITY CARE ELIGIBILITY DETERMINATION CAN NOT BE MADE. 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 3:
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 4:
PART V, SECTION B, LINE 14G: FLORIDA HOSPITAL MEMORIAL MEDICAL CENTER HAS DEVELOPED A PATIENT-FRIENDLY SUMMARY VERSION OF ITS FINANCIAL ASSISTANCE POLICY (FAP). THE FILING ORGANIZATION'S FAP PROVIDES THAT ITS HOSPITAL FACILITY WILL POST THE PATIENT-FRIENDLY SUMMARY VERSION OF ITS FAP ON THE HOSPITAL'S WEBSITE. IN ADDITION, THE FAP OF THE HOSPITAL FACILITY STATES THAT SIGNAGE REGARDING THE AVAILABILITY OF THE HOSPITAL FACILITY'S FAP WILL BE VISIBLE AT POINTS OF ADMISSION AND REGISTRATION, INCLUDING THE EMERGENCY DEPARTMENT.FLORIDA HOSPITAL MEMORIAL MEDICAL CENTER
PART V, SECTION B, LINE 14G: FLORIDA HOSPITAL OCEANSIDE HAS DEVELOPED A PATIENT-FRIENDLY SUMMARY VERSION OF ITS FINANCIAL ASSISTANCE POLICY (FAP). THE FILING ORGANIZATION'S FAP PROVIDES THAT ITS HOSPITAL FACILITY WILL POST THE PATIENT-FRIENDLY SUMMARY VERSION OF ITS FAP ON THE HOSPITAL'S WEBSITE. IN ADDITION, THE FAP OF THE HOSPITAL FACILITY STATES THAT SIGNAGE REGARDING THE AVAILABILITY OF THE HOSPITAL FACILITY'S FAP WILL BE VISIBLE AT POINTS OF ADMISSION AND REGISTRATION, INCLUDING THE EMERGENCY DEPARTMENT.FLORIDA HOSPITAL OCEANSIDE
PART V, SECTION B, LINE 20D: IN DETERMINING THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO FINANCIAL ASSISTANCE POLICY-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE, THE HOSPITAL USES THE FOLLOWING METHODOLOGY:THE HOSPITAL IDENTIFIES ALL COMMERCIAL PAYORS WHOSE VOLUME OF ACTIVITY WITH THE HOSPITAL EQUALS OR EXCEEDS $100,000 FOR THE TAXABLE YEAR. FOR THOSE IDENTIFIED COMMERCIAL PAYORS, AN AVERAGE OF THE NEGOTIATED COMMERCIAL INSURANCE RATES IS DETERMINED. THE AVERAGE OF ALL OF THE NEGOTIATED COMMERCIAL INSURANCE RATES FOR THOSE IDENTIFIED COMMERCIAL PAYORS DETERMINES THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO PATIENTS ELIGIBLE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY.FLORIDA HOSPITAL MEMORIAL MEDICAL CENTER
PART V, SECTION B, LINE 20D: IN DETERMINING THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO FINANCIAL ASSISTANCE POLICY-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE, THE HOSPITAL USES THE FOLLOWING METHODOLOGY:THE HOSPITAL IDENTIFIES ALL COMMERCIAL PAYORS WHOSE VOLUME OF ACTIVITY WITH THE HOSPITAL EQUALS OR EXCEEDS $100,000 FOR THE TAXABLE YEAR. FOR THOSE IDENTIFIED COMMERCIAL PAYORS, AN AVERAGE OF THE NEGOTIATED COMMERCIAL INSURANCE RATES IS DETERMINED. THE AVERAGE OF ALL OF THE NEGOTIATED COMMERCIAL INSURANCE RATES FOR THOSE IDENTIFIED COMMERCIAL PAYORS DETERMINES THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO PATIENTS ELIGIBLE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY.FLORIDA HOSPITAL OCEANSIDE
PART VI, LINE 2: IN ACCORDANCE WITH IRC SECTION 501(R)(3), THE FILING ORGANIZATION HAS ADOPTED AND IMPLEMENTED A POLICY THAT SETS FORTH THE GENERAL REQUIREMENTS, PROCESSES AND PROCEDURES WITH RESPECT TO CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT AND ASSOCIATED IMPLEMENTATION STRATEGY. DURING 2012, THE FILING ORGANIZATION WAS IN THE PROCESS OF PLANNING FOR THEIR INITIAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) THAT IS TO BE COMPLETED BY 12/31/2013. IN ADDITION TO THE CHNA THAT IS BEING CONDUCTED, 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 ORGANIZATIONS COMMUNITY; AND 4. COLLABORATION WITH OTHER LOCAL COMMUNITY GROUPS TO ADDRESS THE HEALTH CARE NEEDS OF THE FILING ORGANIZATIONS COMMUNITY.
PART VI, LINE 3: THE FILING ORGANIZATION HAS A PROCESS IN PLACE WHEREBY PATIENTS ARE INFORMED ABOUT THE HOSPITAL'S CHARITY CARE POLICY AND OTHER FORMS OF FINANCIAL ASSISTANCE, SUCH AS SELF-PAY DISCOUNTS. SIGNAGE IS POSTED IN THE EMERGENCY ROOM INDICATING THAT FINANCIAL ASSISTANCE IS AVAILABLE FOR THOSE SELF-PAY PATIENTS MEETING ELIGIBILITY REQUIREMENTS. AFTER EMTALA MEDICAL SCREENING AND STABILIZATION REQUIREMENTS ARE MET, REGISTRATION PERSONNEL WILL SECURE FINANCIAL INFORMATION ON AS MANY SELF-PAY PATIENTS AS POSSIBLE AT THE TIME OF SERVICE. FOR THOSE WHO APPEAR TO QUALIFY FOR MEDICAID OR UNDER THE HOSPITAL'S CHARITY CARE POLICY, THE FINANCIAL COUNSELORS WILL CONTINUE TO WORK WITH THOSE PATIENTS UNTIL FINAL ACCOUNT RESOLUTION IS ACHIEVED. ALL OTHER SELF-PAY PATIENTS ARE COVERED UNDER THIS PROCESS. AT ANY TIME DURING THE PROCESS THAT DATA IS PROVIDED SHOWING THAT A PATIENT QUALIFIES FOR ASSISTANCE UNDER THE CHARITY CARE POLICY THE DISCOUNTS EXTENDED UNDER THAT POLICY WILL BE APPLIED.AS PART OF THE BILLING PROCESS, THE HOSPITAL INCLUDES THE APPLICATION FOR CHARITY CARE ASSISTANCE ALONG WITH THE INITIAL PATIENT BILL. THE HOSPITAL'S CHARITY CARE APPLICATION IS ALSO AVAILABLE TO PATIENTS ON THE HOSPITAL'S WEB-SITE IN BOTH AN ENGLISH AND SPANISH VERSION. ADDITIONALLY, THE HOSPITAL'S FINANCIAL COUNSELORS ARE AVAILABLE TO WORK WITH EVERY PATIENT DURING THE FIRST 120 DAYS OF THE BILLING PROCESS TO ASSIST THE PATIENT WITH COMPLETING CHARITY CARE APPLICATIONS AND INVESTIGATING OTHER POTENTIAL SOURCES OF THIRD-PARTY ASSISTANCE. THE DETERMINATION OF A PATIENT'S ELIGIBILITY FOR CHARITY CARE IS MADE ON A CASE-BY-CASE BASIS. VARIOUS FACTORS ARE CONSIDERED IN THAT DETERMINATION. EACH INDIVIDUAL PATIENT WHO IS IDENTIFIED AS POTENTIALLY BEING ELIGIBLE TO RECEIVE CHARITY CARE IS SEEN BY A FINANCIAL COUNSELOR AT THE HOSPITAL. THE FINANCIAL COUNSELOR WILL WORK WITH THE PATIENT TO MAKE SURE THAT OTHER SOURCES OF ASSISTANCE (PUBLIC OR OTHERWISE) HAVE BEEN SOUGHT TO THE FULLEST EXTENT POSSIBLE. WHEN OTHER FORMS OF ASSISTANCE ARE NOT AVAILABLE OR HAVE BEEN EXHAUSTED, THE HOSPITAL WILL GATHER CERTAIN FINANCIAL INFORMATION FROM THE PATIENT TO DETERMINE THE PATIENT'S ABILITY TO PAY BASED UPON LEVEL OF INCOME.
PART VI, LINE 4: THE FILING ORGANIZATION OPERATES 2 HOSPITALS IN VOLUSIA COUNTY, FLORIDA; FLORIDA HOSPITAL MEMORIAL MEDICAL CENTER (MEMORIAL), A 277-BED FACILITY AND FLORIDA HOSPITAL OCEANSIDE (OCEANSIDE), A 119-BED FACILITY. ADDITIONALLY, THE FILING ORGANIZATION SERVES ITS COMMUNITIES WITH PHYICIAN PRACTICES, IMAGING SERVICES, AND LABORATORY SERVICES THROUGHOUT EAST CENTRAL FLORIDA. MORE THAN 400 PHYSICIANS HOLD PRIVILEGES AT THE FILING ORGANIZATION'S FACILITIES AND COMBINED, THE FILING ORGANIZATION EMPLOYS MORE THAN 2,100 INDIVIDUALS. THERE IS AN AFFILIATE HOSPITAL AND TWO OTHER HOSPITALS WITHIN A RADIUS OF 20 MILES OR LESS FROM MEMORIAL AND OCEANSIDE. APPROXIMATELY 59% OF THE FILING ORGANIZATION'S PATIENTS DURING 2012 WERE MEDICARE PATIENTS, ABOUT 10% WERE MEDICAID PATIENTS, 5% WERE SELF-PAY, AND THE REMAINING PERCENTAGE WERE PATIENTS COVERED UNDER COMMERCIAL INSURANCE. FOR 2012, ABOUT 59% OF THE HOSPITAL'S IN-PATIENTS WERE ADMITTED THROUGH THE HOSPITAL'S EMERGENCY DEPARTMENT.MEMORIAL IS VOLUSIA COUNTY'S NEWEST AND MOST COMPREHENSIVE FACILITY. ITS NEW FACILITY FEATURES THE AREA'S ONLY ENDOVASCULAR/HYBRID OPERATING ROOM WHERE PATIENTS ARE DIAGNOSED AND TREATED IN ONE LOCATION FOR A VARIETY OF HEART AND ENDOVASCULAR CONDITIONS; THE AREA'S ONLY SIEMENS SOMOTOM 64-SLICE CT SCANNER FOR FASTER, PAINLESS DIAGNOSES OF HEART CONDITIONS AND STROKES USING 50 PERCENT LESS RADIATION; AND A NEWLY EXPANDED EMERGENCY DEPARTMENT FEATURING "NO WAIT" SERVICES. MEMORIAL SERVES A POPULATION OF APPROXIMATELY 297,000 PEOPLE IN THE HOSPITAL'S PRIMARY MARKET. DAYTONA BEACH IS THE REGIONAL COMMERCIAL AND CULTURAL HUB OF DELTONA-DAYTONA BEACH-ORMOND BEACH AREA. THE CITY IS AN INTEGRAL SEGMENT OF THE INTERSTATE HIGHWAY 4 CORRIDOR WITH SPECIALIZED INDUSTRIES IN AEROSPACE, AUTOMOTIVE, AND MANUFACTURING. THE WEIGHTED AVERAGE HOUSEHOLD INCOME, BASED ON POPULATION, IN THE PRIMARY MARKET IS APPROXIMATELY $41,000, WITH AN ESTIMATED 71,000 OVER THE AGE OF 65. HIGH SCHOOL GRADUATES ACCOUNT FOR APPROXIMATELY 87% OF VOLUSIA COUNTY WITH AN ESTIMATED 21% HAVING A BACHELOR'S DEGREE OR HIGHER. IT IS ESTIMATED THAT 13% OF THE INDIVIDUALS RESIDING IN VOLUSIA COUNTY LIVE BELOW THE POVERTY LEVEL AND THE UNEMPLOYMENT RATE IS ABOUT 7%.OCEANSIDE HAS A LONG HISTORY OF COMMUNITY SUPPORT AND SERVICES WHICH INCLUDES MEDICAL/SURGICAL CARE AND THE OPERATION OF PENINSULA REHABILITATION CENTER, VOLUSIA COUNTY'S ONLY INPATIENT REHABILITATION CENTER. IT ALSO OFFERS AN OUTPATIENT REHAB UNIT, IMAGING SERVICES, LABORATORY SERVICES, AND CARDIOPULMONARY SERVICES.
PART VI, LINE 5: THE PROVISION OF COMMUNITY BENEFIT IS CENTRAL TO THE FILING ORGANIZATION'S MISSION OF SERVICE AND COMPASSION. RESTORING AND PROMOTING THE HEALTH AND QUALITY OF LIFE OF THOSE IN THE COMMUNITIES SERVED BY THE FILING ORGANIZATION IS A FUNCTION OF "EXTENDING THE HEALING MINISTRY OF CHRIST" AND EMBODIES THE FIING ORGANIZATION'S COMMITMENT TO ITS VALUES AND PRINCIPLES. THE FILING ORGANIZATION COMMITS SUBSTANTIAL RESOURCES TO PROVIDE A BROAD RANGE OF SERVICES TO BOTH THE UNDERPRIVILEGED AS WELL AS THE BROADER COMMUNITY. IN ADDITION TO THE COMMUNITY BENEFIT 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 FILING ORGANIZATION PROVIDED $407,799 OF BENEFIT WITH RESPECT TO THE FAITH-BASED AND SPIRITUAL NEEDS OF THE COMMUNITY IN CONJUNCTION WITH ITS OPERATION OF 2 COMMUNITY HOSPITALS. THE FILING ORGANIZATION 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 FILING ORGANIZATION EXPENDED $5,837,740 IN NEW CAPITAL IMPROVEMENTS. AS A FAITH-BASED MISSION-DRIVEN COMMUNITY HOSPITAL, THE FILING ORGANIZATION IS CONTINUALLY INVOLVED IN MONITORING ITS COMMUNITY, IDENTIFYING UNMET HEALTH CARE NEEDS AND DEVELOPING SOLUTIONS AND PROGRAMS TO ADDRESS THOSE NEEDS. IN ACCORDANCE WITH ITS CONSERVATIVE APPROACH TO FISCAL RESPONSIBILITY, SURPLUS FUNDS OF THE HOSPITAL ARE CONTINUALLY BEING INVESTED IN RESOURCES THAT IMPROVE THE AVAILABILITY AND QUALITY OF DELIVERY OF HEALTH CARE SERVICES AND PROGRAMS TO ITS COMMUNITY.
PART VI, LINE 6: THE FILING ORGANIZATION IS A PART OF A FAITH-BASED HEALTHCARE SYSTEM OF ORGANIZATIONS WHOSE PARENT IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). THE SYSTEM IS KNOWN AS ADVENTIST HEALTH SYSTEM (AHS). AHSSHC IS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SEC. 501(C)(3). AHSSHC AND ITS SUBSIDIARY ORGANIZATIONS OPERATE 43 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.
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 ORGANIZATION IS NOT FILED WITH ANY STATE AGENCIES.PART VI, LINE 7:

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistancePurpose Of GrantPurposeOfGrantAmount Of Cash GrantAmountOfCashGrant
MEMORIAL HEALTH SYSTEMS FOUNDATION INC
770 WEST GRANADA BLVD 302ORMOND BEACHFL32174311771522501(C)(3)88213COSTGENERAL ADMINISTRATIVE SUPPORTPROVISION OF GENERAL ADMINISTRATIVE SUPPORT
THE CENTRAL FLORIDA SPORTS COMMISSION INC
PO BOX 1234ORLANDOFL32802593152788501(C)(3)GENERAL SUPPORT10000
AMERICAN HEART ASSOCIATION
PO BOX 4002900DES MOINESIA50340135613797501(C)(3)GENERAL SUPPORT7500
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants3TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: 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.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Discretionary Spending AccountXDiscretionarySpendingAccount
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org1CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (19 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
MICHAEL SCHULTZ
CHAIRMAN/DIRECTOR0642188019518319946856201285070405961991475036091255
SANDRA K JOHNSON
DIRECTOR039051401209450790260477010522540690440029763
MARK LAROSE
CEO (END 2/12)/DIRECTOR04234080659660856320828640140520671922053478
DAVID OTTATI
DIRECTOR032348706972619939262044434034190199511099014825
ED NOSEWORTHY
DIRECTOR03131620623530707570523500234410522063027967
JULIE SCHNEIDER MD
DIRECTOR2958340902349010740135990783301220689000
LEWIS SEIFERT
DIRECTOR0462337012695919992301086337032112199800046042022
DARYL TOL
DIRECTOR/CEO04479340701290468900792370375720681762034812
ELIZABETH WEAGRAFF
DIRECTOR022089407965319944395028972035988199409902011609
DEBORA THOMAS
REGION CFO/DIRECTOR0293181049914057966023449034362045887209460
NIGEL HINDS
CFO (END 2/12)0228842042983033520027657031107036410903942
DARLINDA COPELAND
COO0265788040542030293026364016409037939606486
MICHELE GOEB-BURKETT
CNO0199555036809018711013599022818029149200
RONALD JIMENEZ
CMO0297804042456029379027949043569044115703939
MICHAEL KELLEY MD
PHYSICIAN261778052239106640135990221050820537000
ROBERT MARTIN MD
PHYSICIAN7415230006900135990128450768657000
ROBERT HEWES MD
PHYSICIAN496978010744201307210135990125660761306000
CHRISTOPHER SUTTON KENT MD
PHYSICIAN6889170004500135990256850728651000
DINDI REDDY MD
PHYSICIAN49222901352240444070135990226860708145000

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART I, LINE 1AAS DISCUSSED IN OUR RESPONSE TO SECTION B, PART VI, QUESTION 15A & B, 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 STRATEGY & 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 BUSINESS MEETING ($300 PER EXECUTIVE). WITH RESPECT TO THE AHS PRESIDENT'S COUNCIL MEETING, ELIGIBLE EXECUTIVES MAY INCLUDE AHSSHC VICE PRESIDENTS AND ABOVE AND ALL AHSSHC SUBSIDIARY ORGANIZATION CEOS AND REGIONAL CFOS. THE PAYMENT PROVIDED TO EACH EXECUTIVE WAS CONSIDERED TAXABLE COMPENSATION TO THE EXECUTIVE.
PART I, LINE 4BAS DISCUSSED IN LINE 1A ABOVE, EXECUTIVES ON THE FILING ORGANIZATION'S MANAGEMENT TEAM THAT HOLD THE POSITION OF VICE-PRESIDENT OR ABOVE ARE COMPENSATED BY AND ON THE PAYROLL OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), THE PARENT ORGANIZATION OF A HEALTHCARE SYSTEM KNOWN AS ADVENTIST HEALTH SYSTEM (AHS). IN RECOGNITION OF THE CONTRIBUTION THAT EACH EXECUTIVE MAKES TO THE SUCCESS OF AHS, AHS PROVIDES TO ELIGIBLE EXECUTIVES PARTICIPATION IN THE AHS EXECUTIVE FLEX BENEFIT PROGRAM (THE PLAN). THE PURPOSE OF THE PLAN IS TO OFFER ELIGIBLE EXECUTIVES AN OPPORTUNITY TO ELECT FROM AMONG A VARIETY OF SUPPLEMENTAL BENEFITS, INCLUDING DEFERRED COMPENSATION BENEFITS TAXABLE UNDER INTERNAL REVENUE CODE (IRC) SECTION 457(F), TO INDIVIDUALLY TAILOR A BENEFITS PROGRAM APPROPRIATE TO EACH EXECUTIVE'S NEEDS. THE PLAN PROVIDES ELIGIBLE PARTICIPANTS A PRE-DETERMINED BENEFITS ALLOWANCE CREDIT THAT IS EQUAL TO A PERCENTAGE OF THE EXECUTIVE'S BASE PAY FROM WHICH IS DEDUCTED THE COST OF MANDATORY AND ELECTIVE EMPLOYEE BENEFITS. THE PRE-DETERMINED BENEFITS ALLOWANCE CREDIT PERCENTAGE IS APPROVED BY THE AHS BOARD STRATEGY & 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 $210,000. 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 ------------------------------------------------------- MICHAEL H. SCHULTZ $114,908 $ 97,967 $300,548 $ 0 MARK E. LAROSE $ 69,265 $ 53,519 $ 0 $ 0 DEBORA H. THOMAS $ 26,850 $ 9,465 $ 0 $ 0 SANDRA K. JOHNSON $ 51,102 $ 32,385 $ 0 $ 0 DAVID A. OTTATI $ 30,836 $ 14,836 $ 0 $ 0 LEWIS A. SEIFERT $ 72,738 $ 42,384 $ 0 $ 0 DARLINDA G. COPELAND $ 29,766 $ 6,489 $ 0 $ 0 ELIZABETH WEAGRAFF $ 15,373 $ 11,618 $ 0 $ 0 ED NOSEWORTHY $ 38,752 $ 31,019 $ 0 $ 0 DARYL TOL $ 65,638 $ 35,595 $ 0 $ 0 RONALD JIMENEZ $ 31,350 $ 3,941 $ 0 $ 0 NIGEL HINDS $ 19,058 $ 4,151 $ 0 $ 0 *INCLUDING INVESTMENT EARNINGS
PART I, LINE 6THE FILING ORGANIZATION'S PHYSICIAN COMPENSATION FORMULA IS DESIGNED TO RESULT IN TOTAL COMPENSATION THAT WOULD BE REASONABLE FOR EACH PHYSICIAN. THE FILING ORGANIZATION UTILIZES NATIONAL SURVEY PRODUCTIVITY, COST, AND COMPENSATION DATA IN FORMULATING ALL ASPECTS OF THE COMPENSATION PLAN. PHYSICIAN COMPENSATION CONTRACTUAL AGREEMENTS INCLUDE A CEILING OR REASONABLE MAXIMUM ON THE AMOUNT A PHYSICIAN MAY EARN. THE FILING ORGANIZATION'S EMPLOYED PHYSICIANS ENTER INTO A WRITTEN AGREEMENT THAT REQUIRES THE PHYSICIANS TO PROVIDE MEDICAL CARE TO INDIVIDUALS WHO ARE REFERRED BY THE FILING ORGANIZATION. THE FILING ORGANIZATION'S COMPENSATION ARRANGEMENT DOES NOT USE A METHOD OF COMPENSATION THAT IS BASED UPON A PERCENTAGE OF THE ORGANIZATION'S NET INCOME. RATHER, UNDER THE COMPENSATION ARRANGEMENT, PHYSICIAN BASE SALARY IS SET BASED ON FAIR MARKET VALUE BENCHMARKS, AND ANY ADDITIONAL COMPENSATION IS BASED ON A PERCENTAGE OF THE PRACTICE/LOCATION NET REVENUE.
PART IIIPART I, QUESTION 3: AS NOTED IN OUR RESPONSE TO QUESTION 15 OF PART VI OF FORM 990, 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 USES ALL OF THE FOLLOWING TO ESTABLISH COMPENSATION OF THE CEO: - COMPENSATION COMMITTEE; - INDEPENDENT COMPENSATION CONSULTANT; - COMPENSATION SURVEY OR STUDY; AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.SUPPLEMENTAL INFORMATION

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonGERI MANLEYNamePerson
FieldValueIRS element (for citing)
RelationshipFAMILY MEMBER OF KEY EMPLOYEERelationship
Amount Of Transaction32798AmountOfTransaction
Description Of TransactionEMPLOYEE COMPENSATIONDescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 2CHARLES D. HOOD, JR. AND DAVID BURT - BUSINESS RELATIONSHIP DARYL TOL AND JULIE SCHNEIDER, MD - BUSINESS RELATIONSHIP CHARLES D. HOOD, JR. AND NANCY LOHMAN - BUSINESS RELATIONSHIP CHARLES D. HOOD, JR. AND DARYL TOL - BUSINESS RELATIONSHIP CHARLES D. HOOD, JR. AND SURESH DESAI, MD - BUSINESS RELATIONSHIP DARLINDA COPELAND AND EDDIE SCHATZ, JR. - BUSINESS RELATIONSHIP
FORM 990, PART VI, SECTION A, LINE 6MEMORIAL HEALTH SYSTEMS, INC. (THE FILING ORGANIZATION) HAS ONE MEMBER. THE SOLE MEMBER OF THE FILING ORGANIZATION IS ADVENTIST HEALTH SYSTEM/SUNBELT, INC. ADVENTIST HEALTH SYSTEM/SUNBELT, INC.(AHSSI) IS A FLORIDA, NOT-FOR-PROFIT CORPORATION THAT IS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3). THERE ARE NO OTHER CLASSES OF MEMBERSHIP IN THE FILING ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7ATHE SOLE MEMBER OF THE FILING ORGANIZATION IS AHSSI. THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION ARE APPOINTED BY THE SOLE MEMBER, AHSSI, 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 7BAHSSI, AS THE SOLE MEMBER OF THE FILING ORGANIZATION, HAS CERTAIN RESERVED POWERS AS SET FORTH IN THE BYLAWS OF THE FILING ORGANIZATION. THESE RESERVED POWERS INCLUDE THE FOLLOWING: A) TO APPROVE AND DISAPPROVE THE EXECUTIVE AND/OR ADMINISTRATIVE LEADERSHIP OF THE FILING ORGANIZATION, AND THEIR SALARIES; B) TO ADOPT, AMEND, RESTATE, AND REPEAL THE ARTICLES OF INCORPORATION OR BYLAWS OF THE FILING ORGANIZATION; C) TO SET LIMITS AND TERMS FOR THE BORROWING OF FUNDS; D) TO APPROVE OR DISAPPROVE THE PURCHASE OR SALE OF PERSONAL PROPERTY OR REAL PROPERTY EQUAL TO OR IN EXCESS OF CERTAIN DOLLAR AMOUNT THRESHOLDS; E) TO APPROVE OR DISAPPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE FILING ORGANIZATION; F) TO DIRECT THE PLACEMENT OF FUNDS AND CAPITAL OF THE FILING ORGANIZATION; G) TO ESTABLISH GENERAL GUIDING POLICIES, TO IMPLEMENT QUALITY ASSESSMENT, IMPROVEMENT AND UTILIZATION REVIEW PROGRAMS; H) TO APPROVE THE APPOINTMENT OF AN AUDITING FIRM AND ELECTION OF THE FISCAL YEAR FOR THE FILING ORGANIZATION; AND I) TO ESTABLISH A PROCESS FOR ADDRESSING PATIENT GRIEVANCES.
FORM 990, PART VI, SECTION B, LINE 11THE FILING ORGANIZATION'S CURRENT YEAR FORM 990 WAS REVIEWED BY THE BOARD CHAIRMAN, BOARD FINANCE COMMITTEE CHAIR, CEO AND BY THE CFO PRIOR TO ITS FILING WITH THE IRS. THE REVIEW CONDUCTED BY THE BOARD CHAIRMAN, BOARD FINANCE COMMITTEE CHAIR, CEO AND THE CFO DID NOT INCLUDE THE REVIEW OF ANY SUPPORTING WORKPAPERS THAT WERE USED IN PREPARATION OF THE CURRENT YEAR FORM 990, BUT DID INCLUDE A REVIEW OF THE ENTIRE FORM 990 AND ALL SUPPORTING SCHEDULES.
FORM 990, PART VI, SECTION B, LINE 12CTHE CONFLICT OF INTEREST POLICY OF THE FILING ORGANIZATION APPLIES TO MEMBERS OF ITS BOARD OF DIRECTORS AND ITS PRINCIPAL OFFICERS (TO BE KNOWN AS INTERESTED PERSONS). IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTERESTS, ANY MEMBER OF THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION OR ANY PRINCIPAL OFFICER OF THE FILING ORGANIZATION (I.E. INTERESTED PERSONS) MUST DISCLOSE THE EXISTENCE OF ANY FINANCIAL INTEREST WITH THE FILING ORGANIZATION AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS CONCERNING THE FINANCIAL INTEREST/ARRANGEMENT TO THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION OR TO ANY MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS THAT IS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. SUBSEQUENT TO ANY DISCLOSURE OF ANY FINANCIAL INTEREST/ARRANGEMENT AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE RELEVANT BOARD MEMBER OR PRINCIPAL OFFICER, THE REMAINING MEMBERS OF THE BOARD OF DIRECTORS OR COMMITTEE WITH BOARD DELEGATED POWERS SHALL DISCUSS, ANALYZE, AND VOTE UPON THE POTENTIAL FINANCIAL INTEREST/ARRANGEMENT TO DETERMINE IF A CONFLICT OF INTEREST EXISTS. ACCORDING TO THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY, AN INTERESTED PERSON MAY MAKE A PRESENTATION TO THE BOARD OF DIRECTORS (OR COMMITTEE WITH BOARD DELEGATED POWERS), BUT AFTER SUCH PRESENTATION, SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN A CONFLICT OF INTEREST. EACH INTERESTED PERSON, AS DEFINED UNDER THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY, SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICT OF INTERESTS POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE FILING ORGANIZATION IS A CHARITABLE ORGANIZATION THAT MUST PRIMARILY ENGAGE IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS EXEMPT PURPOSES. THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY ALSO REQUIRES THAT PERIODIC REVIEWS SHALL BE CONDUCTED TO ENSURE THAT THE FILING ORGANIZATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES.
FORM 990, PART VI, SECTION B, LINE 15THE TOP-TIER PARENT OF THE FILING ORGANIZATION IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). AHSSHC IS THE PARENT ORGANIZATION OF A HEALTHCARE SYSTEM, KNOWN AS ADVENTIST HEALTH SYSTEM, THAT OPERATES HOSPITALS, NURSING HOME FACILITIES, AND OTHER HEALTHCARE PROVIDER ORGANIZATIONS. AHSSHC IS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3) PURSUANT TO A GROUP RULING ISSUED TO THE GENERAL CONFERENCE OF SEVENTH-DAY ADVENTISTS. THE INDIVIDUALS WHO SERVE AS THE CEO, CFO OR VICE PRESIDENT OF THE FILING ORGANIZATION ARE COMPENSATED BY AHSSHC. COMPENSATION AND BENEFITS PROVIDED TO THESE INDIVIDUALS IS 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 STRATEGY AND 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.
FORM 990, PART VI, SECTION C, LINE 19AS DISCUSSED IN OUR RESPONSE TO QUESTION 15A & B IN SECTION B OF THIS PART VI, 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 AFOR THOSE BOARD OF TRUSTEE 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 XI, LINE 9:ALLOCATIONS WITH RESPECT TO TAX-EXEMPT DEBT -1,387,253. TRANSFER TO TAX-EXEMPT PARENT CORPORATION -1,220,464. CHANGE IN INVESTMENT IN RELATED FOUNDATION - TEMPORARILY RESTRICTED 36,074. GIFTS - TEMPORARILY RESTRICKTED 65,630. TRANSFER FROM AFFILIATED ORGANIZATION 1,082,019.CHANGES IN NET ASSETS OR FUND BALANCES:
PART X, LINE 2THE AMOUNTS SHOWN ON LINE 2 OF PART X OF THIS RETURN INCLUDE THE FILING ORGANIZATION'S INTEREST IN A CENTRAL INVESTMENT POOL MAINTAINED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION, THE FILING ORGANIZATION'S TOP-TIER PARENT. THE INVESTMENTS IN THE CENTRAL INVESTMENT POOL ARE RECORDED AT MARKET VALUE.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (107 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
ADVENTIST BOLINGBROOK HOSPITAL
500 REMINGTON BLVDBOLINGBROOKIL60440651219504OPERATION OF HOSPITAL & RELATED SERVICESIL501(C)(3)170(B)(1)(A)(III)ADVENTIST HLTH SYSTEMSUNBELT INC0
ADVENTIST CARE CENTERS - COURTLAND INC
730 COURTLAND STREETORLANDOFL32804205774723OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERYFL501(C)(3)509(A)(2)SUNBELT HLTH CARE CENTERS INC0
ADVENTIST GLENOAKS HOSPITAL
701 WINTHROP AVENUEGLENDALE HEIGHTSIL60139363208390OPERATION OF HOSPITAL & RELATED SERVICESIL501(C)(3)170(B)(1)(A)(III)ADVENTIST HLTH SYSTEMSUNBELT INC0
ADVENTIST HLTH MID-AMERICA INC
9100 W 74TH STREETSHAWNEE MISSIONKS66204521347407HLTHCARE RELATED SERVICESKS501(C)(3)509(A)(3) TYPE IADVENTIST HLTH SYSTEMSUNBELT INC0
ADVENTIST HLTH PARTNERS INC
1000 REMINGTON BLVD STE 200BOLINGBROOKIL60440364138353OPERATE OUT-PATIENT PHYSICIAN CLINICSIL501(C)(3)170(B)(1)(A)(III)AHS MIDWEST MANAGEMENT INC0
ADVENTIST HLTH SYSTEM AFFILIATED BENEFIT TRUST
900 HOPE WAYALTAMONTE SPRINGSFL32714266422966PROMOTION OF HLTHCAREFL501(C)(3)509(A)(3) TYPE IADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP0
ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP
900 HOPE WAYALTAMONTE SPRINGSFL32714592170012MANAGEMENT SERVICESFL501(C)(3)509(A)(3) TYPE I0N/A
ADVENTIST HLTH SYSTEMGEORGIA INC
1035 RED BUD ROADCALHOUNGA30701581425000OPERATION OF HOSPITAL & RELATED SERVICESGA501(C)(3)170(B)(1)(A)(III)ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP0
ADVENTIST HLTH SYSTEMSUNBELT INC
900 HOPE WAYALTAMONTE SPRINGSFL32714591479658OPERATION OF HOSPITAL & RELATED SERVICESFL501(C)(3)170(B)(1)(A)(III)ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP0
ADVENTIST HLTH SYSTEMTEXAS INC
602 COURTLAND STREETORLANDOFL32804742578952LEASING PERSONNEL TO AFFILIATED HOSPITALTX501(C)(3)509(A)(3) TYPE IIIADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP0
ADVENTIST HINSDALE HOSPITAL
120 NORTH OAK STREETHINSDALEIL60521362276984OPERATION OF HOSPITAL & RELATED SERVICESIL501(C)(3)170(B)(1)(A)(III)ADVENTIST HLTH SYSTEMSUNBELT INC0
ADVENTIST UNIVERSITY OF HEALTH SCIENCES INC (630 YEAR END)
671 LAKE WINYAH DRIVEORLANDOFL32803593069793EDUCATION/OPERATION OF SCHOOLFL501(C)(3)170(B)(1)(A)(II)ADVENTIST HLTH SYSTEMSUNBELT INC0
AHS MIDWEST MANAGEMENT INC
1000 REMINGTON BLVD STE 200BOLINGBROOKIL60440363354567OPERATION OF PHYSICIAN PRACTICE MGMTIL501(C)(3)509(A)(3) TYPE IADVENTIST HLTH SYSTEMSUNBELT INC0
AHSCENTRAL TEXAS INC
1301 WONDER WORLD DRIVESAN MARCOSTX78666742621825PROVIDE OFFICE SPACE - MEDICAL PROFESSIONALSTX501(C)(3)509(A)(3) TYPE III-FADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP0
APOPKA HLTH CARE PROPERTIES INC
305 E OAK STREETAPOPKAFL32703510605694LEASE TO RELATED ORGANIZATIONGA501(C)(3)509(A)(3) TYPE III-FSUNBELT HLTH CARE CENTERS INC0
BATTLE CREEK ADVENTIST HOSPITAL
1000 REMINGTON BLVD STE 200BOLINGBROOKIL60440381359189INACTIVEMI501(C)(3)170(B)(1)(A)(III)ADVENTIST HLTH SYSTEMSUNBELT INC0
BOLINGBROOK HOSPITAL FOUNDATION
1000 REMINGTON BLVD N ENTRANCE 2NDBOLINGBROOKIL60440900494445FUND-RAISING FOR TAX-EXEMPT HOSPITALIL501(C)(3)170(B)(1)(A)(VI)MIDWEST HLTH FOUNDATION0
BRADFORD HEIGHTS HLTH & REHAB CENTER INC
950 HIGHPOINT DRIVEHOPKINSVILLEKY42240205782342OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERYKY501(C)(3)509(A)(2)SUNBELT HLTH CARE CENTERS INC0
BURLESON NURSING & REHAB CENTER INC
301 HUGULEY BLVDBURLESONTX76028205782243OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERYTX501(C)(3)509(A)(2)SUNBELT HLTH CARE CENTERS INC0
CALDWELL HLTH CARE PROPERTIES INC
1333 WEST MAINPRINCETONKY42445510605680LEASE TO RELATED ORGANIZATIONGA501(C)(3)509(A)(3) TYPE III-FSUNBELT HLTH CARE CENTERS INC0
CENTRAL TEXAS HLTHCARE COLLABORATIVE
1301 WONDER WORLD DRIVESAN MARCOSTX78666453739929SUPPORT OPERATION OF HOSPITALTX501(C)(3)509(A)(3) TYPE IADVENTIST HLTH SYSTEMSUNBELT INC0
CEDAR CRAG TERRACE INC (630 YEAR END)
RT 5 BOX 900MANCHESTERKY40962611120442OPERATION OF HOME FOR THE ELDERLY-DISABLEDKY501(C)(3)170(B)(1)(A)(VI)MEMORIAL HOSPITAL INC0
CENTRAL TEXAS MEDICAL CENTER FOUNDATION
1301 WONDER WORLD DRIVESAN MARCOSTX78666742259907FUND-RAISING FOR TAX-EXEMPT HOSPITALTX501(C)(3)170(B)(1)(A)(VI)ADVENTIST HLTH SYSTEMSUNBELT INC0
CHICKASAW HLTH CARE PROPERTIES INC
250 S CHICKASAW TRAILORLANDOFL32825510605681LEASE TO RELATED ORGANIZATIONGA501(C)(3)509(A)(3) TYPE III-FSUNBELT HLTH CARE CENTERS INC0
CHIPPEWA VALLEY HOSPITAL & OAKVIEW CARE CENTER INC
1220 THIRD AVENUE WESTDURANDWI54736391365168OPERATION OF HOSPITAL & RELATED SERVICESWI501(C)(3)170(B)(1)(A)(III)ADVENTIST HLTH SYSTEMSUNBELT INC0
COBB MEDICAL ASSOCIATES LLC
3949 SOUTH COBB DRIVE SESMYRNAGA300806342582617089OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICESGA501(C)(3)170(B)(1)(A)(III)EMORY-ADVENTIST INC0
COURTLAND HLTH CARE PROPERTIES INC
730 COURTLAND STREETORLANDOFL32804510605682LEASE TO RELATED ORGANIZATIONGA501(C)(3)509(A)(3) TYPE III-FSUNBELT HLTH CARE CENTERS INC0
CREEKWOOD PLACE NURSING & REHAB CENTER INC
683 E THIRD STREETRUSSELLVILLEKY42276205782260OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERYKY501(C)(3)509(A)(2)SUNBELT HLTH CARE CENTERS INC0
DAIRY ROAD HLTH CARE PROPERTIES INC
7350 DAIRY ROADZEPHYRHILLSFL33540510605684LEASE TO RELATED ORGANIZATIONGA501(C)(3)509(A)(3) TYPE III-FSUNBELT HLTH CARE CENTERS INC0
EAST ORLANDO HLTH & REHAB CENTER INC
250 S CHICKASAW TRAILORLANDOFL32825205774748OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERYFL501(C)(3)509(A)(2)SUNBELT HLTH CARE CENTERS INC0
EMORY-ADVENTIST INC
3949 SOUTH COBB DRIVESMYRNAGA30080582171011OPERATION OF HOSPITAL & RELATED SVCSGA501(C)(3)170(B)(1)(A)(III)ADVENTIST HLTH SYSTEMSUNBELT INC0
FLETCHER HOSPITAL INC
100 HOSPITAL DRIVEHENDERSONVILLENC28792560543246OPERATION OF HOSPITAL & RELATED SVCSNC501(C)(3)170(B)(1)(A)(III)ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP0
FLNC INC
3355 E SEMORAN BLVDAPOPKAFL32703205774761OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERYFL501(C)(3)509(A)(2)SUNBELT HLTH CARE CENTERS INC0
FLORIDA HOSPITAL WATERMAN INC
1000 WATERMAN WAYTAVARESFL32778593140669OPERATION OF HOSPITAL & RELATED SERVICESFL501(C)(3)170(B)(1)(A)(III)ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP0
FLORIDA HOSPITAL ZEPHYRHILLS INC
7050 GALL BLVDZEPHYRHILLSFL33541592108057OPERATION OF HOSPITAL & RELATED SERVICESFL501(C)(3)170(B)(1)(A)(III)ADVENTIST HLTH SYSTEMSUNBELT INC0
FLORIDA HOSPITAL MEDICAL GROUP INC
900 WINDERLEY PLACEMAITLANDFL32751593214635OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICESFL501(C)(3)170(B)(1)(A)(III)ADVENTIST HLTH SYSTEMSUNBELT INC0
FOUNDATION FOR SHAWNEE MISSION MEDICAL CENTER INC
9100 W 74TH STREETSHAWNEE MISSIONKS66204480868859FUND-RAISING FOR TAX-EXEMPT HOSPITALKS501(C)(3)509(A)(3) TYPE ISHAWNEE MISSION MEDICAL CENTER INC0
GLENOAKS HOSPITAL FOUNDATION
701 WINTHROP AVENUEGLENDALE HEIGHTSIL60139363926044FUND-RAISING FOR TAX-EXEMPT HOSPITALIL501(C)(3)170(B)(1)(A)(VI)MIDWEST HLTH FOUNDATION0
HAYS MEMORIAL HOSPITAL ASSOCIATION OF SEVENTH-DAY ADVENTISTS
1301 WONDER WORLD DRIVESAN MARCOSTX78667741362785LEASE OF HOSPITAL PERSONNELTX501(C)(3)509(A)(3) TYPE IIADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP0
HELEN ELLIS MEMORIAL HOSPITAL AUXILIARY INC
1395 S PINELLAS AVETARPON SPRINGSFL34689592106043FUND-RAISING FOR TAX-EXEMPT HOSPITAL/FOUNDATIONFL501(C)(3)509(A)(3) TYPE ITARPON SPRINGS HOSPITAL FOUNDATION INC0
HELEN ELLIS MEMORIAL HOSPITAL FOUNDATION INC
1395 S PINELLAS AVETARPON SPRINGSFL34689593690149FUND-RAISING FOR TAX-EXEMPT HOSPITALFL501(C)(3)509(A)(3) TYPE ITARPON SPRINGS HOSPITAL FOUNDATION INC0
HINSDALE HOSPITAL FOUNDATION
7 SALT CREEK LANE SUITE 203HINSDALEIL60521521466387FUND-RAISING FOR TAX-EXEMPT HOSPITALIL501(C)(3)170(B)(1)(A)(VI)MIDWEST HLTH FOUNDATION0
HUGULEY COMMUNITY CARE CORP
11801 SOUTH FREEWAYBURLESONTX76028452793120SUPPORT OPERATION OF HOSPITALTX501(C)(3)509(A)(3) TYPE IADVENTIST HLTH SYSTEMSUNBELT INC0
IN-MOTION REHAB INC
602 COURTLAND STREET STE 200ORLANDOFL32804208023411THERAPY SERVICES TO TAX EXEMPT NURSING HOMESKS501(C)(3)509(A)(3) TYPE IISUNBELT HLTH CARE CENTERS INC0
JELLICO COMMUNITY HOSPITAL INC
188 HOSPITAL LANEJELLICOTN37762620924706OPERATION OF HOSPITAL & RELATED SERVICESTN501(C)(3)170(B)(1)(A)(III)ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP0
LA GRANGE MEMORIAL HOSPITAL FOUNDATION
5101 S WILLOW SPRINGS RDLA GRANGEIL60525300247776FUND-RAISING FOR TAX-EXEMPT HOSPITALIL501(C)(3)170(B)(1)(A)(VI)MIDWEST HLTH FOUNDATION0
MEMORIAL HLTH SYSTEMS FOUNDATION INC
770 WEST GRANADA BLVDORMOND BEACHFL32174311771522FUND-RAISING FOR TAX-EXEMPT HOSPITALFL501(C)(3)170(B)(1)(A)(VI)MEMORIAL HLTH SYSTEMS INC0
MEMORIAL HLTH SYSTEMS INC
301 MEMORIAL MEDICAL PARKWAYDAYTONA BEACHFL32117590973502OPERATION OF HOSPITAL & RELATED SERVICESFL501(C)(3)170(B)(1)(A)(III)ADVENTIST HLTH SYSTEMSUNBELT INC0
MEMORIAL HOSPITAL FLAGLER INC
60 MEMORIAL MEDICAL PARKWAYPALM COASTFL32164592951990OPERATION OF HOSPITAL & RELATED SERVICESFL501(C)(3)170(B)(1)(A)(III)MEMORIAL HLTH SYSTEMS INC1
MEMORIAL HOSPITAL - WEST VOLUSIA INC
701 WEST PLYMOUTH AVENUEDELANDFL32720593256803OPERATION OF HOSPITAL & RELATED SERVICESFL501(C)(3)170(B)(1)(A)(III)MEMORIAL HLTH SYSTEMS INC1
MEMORIAL HOSPITAL INC
210 MARIE LANGDON DRIVEMANCHESTERKY40962610594620OPERATION OF HOSPITAL & RELATED SERVICESKY501(C)(3)170(B)(1)(A)(III)ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP0
MERRIAM HLTH CARE PROPERTIES INC
9700 WEST 62ND STREETMERRIAMKS66203364595806LEASE TO RELATED ORGANIZATIONKS501(C)(3)509(A)(3) TYPE III-FSUNBELT HLTH CARE CENTERS INC0
METROPLEX ADVENTIST HOSPITAL INC
2201 S CLEAR CREEK ROADKILLEENTX76549742225672OPERATION OF HOSPITAL & RELATED SERVICESTX501(C)(3)170(B)(1)(A)(III)ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP0
METROPLEX CLINIC PHYSICIANS INC
2201 S CLEAR CREEK ROADKILLEENTX76549113762050PHYSICIAN HLTHCARE SERVICES TO THE COMMUNITYTX501(C)(3)170(B)(1)(A)(III)METROPLEX ADVENTIST HOSPITAL INC0
METROPLEX HOSPITAL INC (1023-123112)
900 HOPE WAYALTAMONTE SPRINGSFL32714461256516FUTURE OPERATION OF HOSPITAL & RELATED SVCSFL501(C)(3)170(B)(1)(A)(III)ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP0
MIDWEST HLTH FOUNDATION
120 NORTH OAK STREETHINSDALEIL60521352230515SUPPORT OF SUBSIDIARY FOUNDATIONSIL501(C)(3)509(A)(3) TYPE II0N/A
MILLS HLTH & REHAB CENTER INC
500 BECK LANEMAYFIELDKY42066205782320OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERYKY501(C)(3)509(A)(2)SUNBELT HLTH CARE CENTERS INC0
MISSION STRATEGIES INC
602 COURTLAND STREET STE 200ORLANDOFL32804205982365PROVISION OF SUPPORT TO THE NURSING HOME DIVISIONKS501(C)(3)509(A)(3) TYPE IISUNBELT HLTH CARE CENTERS INC0
MISSION STRATEGIES OF GEORGIA INC
3949 S COBB DRIVESMYRNAGA30080900866024PROVISION OF SUPPORT TO THE NURSING HOME DIVISIONGA501(C)(3)509(A)(3) TYPE IISUNBELT HLTH CARE CENTERS INC0
MISSOURI ADVENTIST HLTH INC
9100 W 74TH STREETSHAWNEE MISSIONKS66204431224729SUPPORT HLTH CARE SERVICESMO501(C)(3)509(A)(3) TYPE III-OADVENTIST HLTH MID-AMERICA INC0
NORTH REGIONAL EMS INC
188 HOSPITAL LANEJELLICOTN37762262653616EMS SERVICESTN501(C)(3)509(A)(2)JELLICO COMMUNITY HOSPITAL INC0
ORMOND BEACH MEMORIAL HOSPITAL AUXILIARY INC
301 MEMORIAL MEDICAL PARKWAYDAYTONA BEACHFL32117591721962VOLUNTEER SUPPORT SERVICESFL501(C)(3)509(A)(3) TYPE III-FMEMORIAL HLTH SYSTEMS INC0
OVERLAND PARK NURSING & REHAB CENTER INC
6501 WEST 75TH STREETOVERLAND PARKKS66204205774821OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERYKS501(C)(3)509(A)(2)SUNBELT HLTH CARE CENTERS INC0
PARAGON HLTH CARE PROPERTIES INC
950 HIGHPOINT DRIVEHOPKINSVILLEKY42240510605686LEASE TO RELATED ORGANIZATIONGA501(C)(3)509(A)(3) TYPE III-FSUNBELT HLTH CARE CENTERS INC0
PASCO-PINELLAS HILLSBOROUGH COMMUNITY HLTH SYSTEM INC
2400 BEDFORD ROADORLANDOFL32803208488713OPERATION OF HOSPITAL & RELATED SERVICESFL501(C)(3)170(B)(1)(A)(III)0N/A
PORTERCARE ADVENTIST HLTH SYSTEM (630 YEAR END)
2525 S DOWNING STREETDENVERCO80210840438224OPERATION OF HOSPITAL & RELATED SERVICESCO501(C)(3)170(B)(1)(A)(III)ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP0
PORTLAND NURSING & REHAB CENTER INC
215 HIGHLAND CIRCLE DRIVEPORTLANDTN37148205774842OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERYTN501(C)(3)509(A)(2)SUNBELT HLTH CARE CENTERS INC0
PRINCETON HLTH & REHAB CENTER INC
1333 WEST MAINPRINCETONKY42445205782272OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERYKY501(C)(3)509(A)(2)SUNBELT HLTH CARE CENTERS INC0
PRINCETON PROFESSIONAL SERVICES INC
601 E ROLLINS STREETORLANDOFL32803591191045PROVISION OF HLTHCARE SERVICESFL501(C)(3)509(A)(2)ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP0
QUALITY CIRCLE FOR HLTHCARE INC
900 HOPE WAYALTAMONTE SPRINGSFL32714263789368HLTHCARE QUALITY SERVICESFL501(C)(3)509(A)(3) TYPE III-FADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP0
RESOURCE PERSONNEL INC
602 COURTLAND STREET STE 200ORLANDOFL32804208040875PROVIDE ADMINISTRATIVE SUPPORT TO TAX EXEMPT NURSING HOMESFL501(C)(3)509(A)(3) TYPE IISUNBELT HLTH CARE CENTERS INC0
ROCKY MOUNTAIN ADVENTIST HLTHCARE FOUNDATION (630 YEAR END)
2525 SOUTH DOWNING STREETDENVERCO80210840745018FUND-RAISING FOR TAX-EXEMPT HOSPITALCO501(C)(3)170(B)(1)(A)(VI)PORTERCARE ADVENTIST HLTH SYSTEM0
ROLLINS BEDFORD CORP
602 COURTLAND STREET STE 200ORLANDOFL32804370908840INACTIVEFL501(C)(3)509(A)(3) TYPE IISUNBELT HLTH CARE CENTERS INC0
ROLLINS BROOK COMMUNITY CARE CORP (1120-123112)
2201 S CLEAR CREEK ROADKILLEENTX76549461656773INACTIVETX501(C)(3)METROPLEX ADVENTIST HOSPITAL INC0
RUSSELLVILLE HLTH CARE PROPERTIES INC
683 EAST THIRD STREETRUSSELLVILLEKY42276510605691LEASE TO RELATED ORGANIZATIONGA501(C)(3)509(A)(3) TYPE III-FSUNBELT HLTH CARE CENTERS INC0
SAN MARCOS HLTH CARE PROPERTIES INC
1900 MEDICAL PARKWAYSAN MARCOSTX78666510605693LEASE TO RELATED ORGANIZATIONGA501(C)(3)509(A)(3) TYPE III-FSUNBELT HLTH CARE CENTERS INC0
SAN MARCOS NURSING & REHAB CENTER INC
1900 MEDICAL PARKWAYSAN MARCOSTX78666205782224OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERYTX501(C)(3)509(A)(2)SUNBELT HLTH CARE CENTERS INC0
SHAWNEE MISSION HLTH CARE INC
6501 WEST 75TH STREETOVERLAND PARKKS66204480952508LEASE TO RELATED ORGANIZATIONKS501(C)(3)509(A)(3) TYPE III-FSUNBELT HLTH CARE CENTERS INC0
SHAWNEE MISSION MEDICAL CENTER INC
9100 W 74TH STREETSHAWNEE MISSIONKS66204480637331OPERATION OF HOSPITAL & RELATED SERVICESKS501(C)(3)170(B)(1)(A)(III)ADVENTIST HLTH MID-AMERICA INC0
SOUTH CENTRAL NURSING HOMES PROPERTIES INC
900 HOPE WAYALTAMONTE SPRINGSFL32714593686109MANAGEMENT SUPPORTGA501(C)(3)509(A)(3) TYPE III-OSOUTH CENTRAL INC0
SOUTH CENTRAL NURSING HOMES INC
602 COURTLAND STREETORLANDOFL32804611242373MANAGEMENT SUPPORTKY501(C)(3)509(A)(3) TYPE III-OSOUTH CENTRAL INC0
SOUTH CENTRAL PROPERTIES III INC
900 HOPE WAYALTAMONTE SPRINGSFL32714593692860REAL ESTATEGA501(C)(2)SOUTH CENTRAL NURSING HOMES PROPERTIES INC0
SOUTH CENTRAL PROPERTIES IV INC
900 HOPE WAYALTAMONTE SPRINGSFL32714593692862REAL ESTATEGA501(C)(2)SOUTH CENTRAL NURSING HOMES PROPERTIES INC0
SOUTH CENTRAL PROPERTIES VI INC
900 HOPE WAYALTAMONTE SPRINGSFL32714593692857REAL ESTATEGA501(C)(2)SOUTH CENTRAL NURSING HOMES PROPERTIES INC0
SOUTH CENTRAL PROPERTIES INC
900 HOPE WAYALTAMONTE SPRINGSFL32714593651692REAL ESTATEGA501(C)(2)SOUTH CENTRAL NURSING HOMES PROPERTIES INC0
SOUTH CENTRAL INC
602 COURTLAND STREETORLANDOFL32804593689740MANAGEMENT SUPPORTGA501(C)(3)509(A)(3) TYPE III-F0N/A
SOUTH PASCO HLTH CARE PROPERTIES INC
38250 A AVENUEZEPHYRHILLSFL33542510605679LEASE TO RELATED ORGANIZATIONGA501(C)(3)509(A)(3) TYPE III-FSUNBELT HLTH CARE CENTERS INC0
SOUTHWEST VOLUSIA HLTH SERVICES INC
1055 SAXON BLVDORANGE CITYFL327638468593281591MEDICAL OFFICE BUILDING FOR HOSPITALFL501(C)(3)509(A)(3) TYPE ISOUTHWEST VOLUSIA HLTHCARE CORP0
SOUTHWEST VOLUSIA HLTHCARE CORP
1055 SAXON BLVDORANGE CITYFL327638468593149293OPERATION OF HOSPITAL & RELATED SERVICESFL501(C)(3)170(B)(1)(A)(III)ADVENTIST HLTH SYSTEMSUNBELT INC0
SPECIALTY PHYSICIANS OF CENTRAL TEXAS INC
1301 WONDER WORLD DRIVESAN MARCOSTX78666208814408PHYSICIAN HLTHCARE SERVICES TO THE COMMUNITYTX501(C)(3)170(B)(1)(A)(III)ADVENTIST HLTH SYSTEMSUNBELT INC0
SPRING VIEW HLTH & REHAB CENTER INC
718 GOODWIN LANELEITCHFIELDKY42754205782288OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERYKY501(C)(3)509(A)(2)SUNBELT HLTH CARE CENTERS INC0
SUNBELT HLTH & REHAB CENTER - APOPKA INC
305 EAST OAK STREETAPOPKAFL32703205774856OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERYFL501(C)(3)509(A)(2)SUNBELT HLTH CARE CENTERS INC0
SUNBELT HLTH CARE CENTERS INC
602 COURTLAND STREET STE 200ORLANDOFL32804581473135MANAGEMENT SERVICESTN501(C)(3)509(A)(3) TYPE IIADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP0
SUNSYSTEM DEVELOPMENT CORP
900 HOPE WAYALTAMONTE SPRINGSFL32714592219301FUND RAISING FOR AFFILIATED TAX-EXEMPT HOSPITALSFL501(C)(3)170(B)(1)(A)(VI)ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP0
TARPON SPRINGS HOSPITAL FOUNDATION INC
1395 S PINELLAS AVETARPON SPRINGSFL34689590898901OPERATION OF HOSPITAL & RELATED SERVICESFL501(C)(3)170(B)(1)(A)(III)UNIVERSITY COMMUNITY HOSPITAL INC0
TARRANT COUNTY HLTH CARE PROPERTIES INC
301 HUGULEY BLVDBURLESONTX76028510605677LEASE TO RELATED ORGANIZATIONGA501(C)(3)509(A)(3) TYPE III-FSUNBELT HLTH CARE CENTERS INC0
TAYLOR CREEK HLTH CARE PROPERTIES INC
718 GOODWIN LANELEITCHFIELDKY42754510605678LEASE TO RELATED ORGANIZATIONGA501(C)(3)509(A)(3) TYPE III-FSUNBELT HLTH CARE CENTERS INC0
TEXAS HLTH HUGULEY INC (11-43012)
900 HOPE WAYALTAMONTE SPRINGSFL32714452694620OPERATION OF HOSPITAL & RELATED SERVICESFL501(C)(3)170(B)(1)(A)(III)ADVENTIST HLTH SYSTEMSUNBELT INC0
THE VOLUNTEER AUXILIARY OF FLORIDA HOSPITAL - FLAGLER INC
60 MEMORIAL MEDICAL PARKWAYPALM COASTFL32164592486582VOLUNTEER SUPPORT SERVICESFL501(C)(3)509(A)(3) TYPE III-FMEMORIAL HOSPITAL FLAGLER INC0
TRINITY NURSING & REHAB CENTER INC
9700 WEST 62ND STREETMERRIAMKS66203205774890OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERYKS501(C)(3)509(A)(2)SUNBELT HLTH CARE CENTERS INC0
UNIVERSITY COMMUNITY HOSPITAL AUXILIARY INC
3100 E FLETCHER AVETAMPAFL33613237011345VOLUNTEER SUPPORT SERVICESFL501(C)(3)509(A)(3) TYPE III-FUNIVERSITY COMMUNITY HOSPITAL INC0
UNIVERSITY COMMUNITY HOSPITAL FOUNDATION INC
3100 E FLETCHER AVETAMPAFL33613592554889FUND-RAISING FOR TAX-EXEMPT HOSPITALFL501(C)(3)509(A)(3) TYPE IUNIVERSITY COMMUNITY HOSPITAL INC0
UNIVERSITY COMMUNITY HOSPITAL SPECIALTY CARE INC
3100 E FLETCHER AVETAMPAFL33613593231322INACTIVEFL501(C)(3)509(A)(3)UNIVERSITY COMMUNITY HOSPITAL INC0
UNIVERSITY COMMUNITY HOSPITAL INC
3100 E FLETCHER AVETAMPAFL33613591113901OPERATION OF HOSPITAL & RELATED SERVICESFL501(C)(3)170(B)(1)(A)(III)ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP0
WEST KENTUCKY HLTH CARE PROPERTIES INC
500 BECK LANEMAYFIELDKY42066510605676LEASE TO RELATED ORGANIZATIONGA501(C)(3)509(A)(3) TYPE III-FSUNBELT HLTH CARE CENTERS INC0
ZEPHYR HAVEN HLTH & REHAB CENTER INC
38250 A AVENUEZEPHYRHILLSFL33542205774930OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERYFL501(C)(3)509(A)(2)SUNBELT HLTH CARE CENTERS INC0
ZEPHYRHILLS HLTH & REHAB CENTER INC
7350 DAIRY ROADZEPHYRHILLSFL33540205774967OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERYFL501(C)(3)509(A)(2)SUNBELT HLTH CARE CENTERS INC0

Form990 Schedule R Part III Form990ScheduleRPartIII (9 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNA
APPALACHIAN THERAPY SERVICES LLC
100 HOSPITAL DRIVEHENDERSONVILLENC28792202463851THERAPY STAFFINGNCN/A
CLEAR CREEK MOB LTD
2201 S CLEAR CREEK RDKILLEENTX76549742609195REAL ESTATETXN/A
FLORIDA HOSPITAL DMERT LLC
2450 MAITLAND CENTER PKWY STE 200MAITLANDFL32751202392253MEDICAL EQUIPMENTFLN/A
FLORIDA HOSPITAL HOME INFUSION
2450 MAITLAND CENTER PKWY STE 200MAITLANDFL32751593142824HOME INFUSION SERVICESFLN/A
HUGULEY SURGERY CTR LLP (11-4112)
15305 DALLAS PKWY STE 1600 LB 28ADDISONTX75001200910694OUTPATIENT SURGERYTXN/A
KCCCSMMC CANCER CENTER LLC
9100 W 74TH STREETSHAWNEE MISSIONKS66204270909763EQUIPMENT RENTALKSN/A
PAHSUSP SURGERY CENTERS LLC
15305 DALLAS PKWY STE 1600 LB 28ADDISONTX75010263057950MEDICAL SERVICESCON/A
SHAWNEE MISSION OPEN MRI LLC
9100 W 74TH STREET BOX 2923SHAWNEE MISSIONKS66201270011796IMAGING & TESTINGKSN/A
SKYLAND MRI LLC (11-12012)
100 HOSPITAL DRIVEHENDERSONVILLENC28792043646559IMAGING & TESTINGKSN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (30 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Share Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipAddress Line1AddressForeign/AddressLine1Province Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountry
ALTAMONTE MEDICAL PLAZA CONDOMINIUM ASSOCIATION INC
601 EAST ROLLINS STREETORLANDOFL32803592855792CONDO ASSOCIATIONFLN/AC0
APOPKA MEDICAL PLAZA CONDOMINIUM ASSOCIATION INC
601 EAST ROLLINS STREETORLANDOFL32803593000857CONDO ASSOCIATIONFLN/AC0
ARAPAHOE MEDICAL BUILDING I INC (7111-12512)
2525 S DOWNING STREETDENVERCO80210841574506REAL ESTATE LEASINGCON/AC0
ARAPAHOE MEDICAL BUILDING II INC (7111-12512)
2525 S DOWNING STREETDENVERCO80210841574507REAL ESTATE LEASINGCON/AC0
CC MOB INC
2201 S CLEAR CREEK ROADKILLEENTX76549742616875REAL ESTATE RENTALTXN/AC0
CENTRAL TEXAS MEDICAL ASSOCIATES
1301 WONDER WORLD DRIVESAN MARCOSTX78666742729873PHYSICIAN CLINICSTXN/AC0
CENTRAL TEXAS PROVIDER'S NETWORK
1301 WONDER WORLD DRIVESAN MARCOSTX78666742827652PHYSICIAN HOSPITAL ORG.TXN/AC0
FLORIDA HOSPITAL FLAGLER MEDICAL OFFICES ASSOCIATION INC
60 MEMORIAL MEDICAL PARKWAYPALM COASTFL32164262158309CONDO ASSOCIATIONFLN/AC0
FLORIDA HOSPITAL HEALTHCARE SYSTEM INC
602 COURTLAND STREETORLANDOFL32804593215680PHO/TPAFLN/AC0
FLORIDA HOSPITAL WESLEY CHAPEL INC (11-51512)
900 HOPE WAYALTAMONTE SPRINGSFL32714203965753INACTIVEFLN/AC0
FLORIDA MEDICAL PLAZA CONDO ASSOCIATION INC
601 EAST ROLLINS STREETORLANDOFL32803592855791CONDO ASSOCIATIONFLN/AC0
FLORIDA MEMORIAL HEALTH NETWORK INC
770 W GRANADA BLVD STE 317ORMOND BEACHFL32174593403558PHYSICIAN HOSPITAL ORG.FLC0MHS MHF MHWV OR SWVHC58331518051070.25000
HARVARD PARK EAST INC (7111-12512)
2525 S DOWNING STREETDENVERCO80210841574365REAL ESTATE LEASINGCON/AC0
HELEN ELLIS MEMORIAL HOSPITAL REAL ESTATE CORP (11-101912)
1395 S PINELLAS AVETARPON SPRINGSFL34689593375731REAL ESTATE RENTALFLN/AC0
HUGULEY ALLIANCE FOUNDATION
11801 SOUTH FREEWAYFORT WORTHTX76115752642209INACTIVETXN/AC0
HUGULEY MEDICAL ASSOCIATES INC (11-43012)
11801 SOUTH FREEWAYBURLESONTX76028752547668PHYSICIAN CLINICSTXN/AC0
KISSIMMEE MULTISPECIALTY CLINIC CONDOMINIUM ASSOCIATION INC
201 HILDA STREET SUITE 30KISSIMMEEFL34741593539564CONDO ASSOCIATIONFLN/AC0
MIDWEST MANAGEMENT SERVICES INC
9100 WEST 74TH STREETSHAWNEE MISSIONKS66204480901551REAL ESTATE RENTALKSN/AC0
METROPLEX ADVENTIST HOSPITAL CRNA
2201 S CLEAR CREEK ROADKILLEENTX76549260760794SUPPORT HOSPITAL - PROVIDE ALLIED HEALTH PROFESSIONALSTXN/AC0
NORTH AMERICAN HEALTH SERVICES INC & SUBS
111 N ORLANDO AVENUEWINTER PARKFL32789621041820LESSOR/HOLDING CO.TNN/AC0
ORMOND PROFESSIONAL CONDO ASSOCIATION (430 YEAR END)
770 W GRANADA BLVD STE 101ORMOND BEACHFL32174592694434CONDO ASSOCIATIONFLC0MEMORIAL HLTH SYSTEMS INC87443450.79900
PARK RIDGE PROPERTY OWNER'S ASSOCIATION INC
1 PARK PLACE NAPLES ROADFLETCHERNC28732030380531CONDO ASSOCIATIONNCN/AC0
PORTER AFFILIATED HLTH SERVICES INC DBA DIVERSIFIED AFFILIATED HLTH SVCS
2525 S DOWNING STREETDENVERCO80210840956175HEALTHCARE SERVICESCON/AC0
PORTER MEDICAL PLAZA INC (7111-12512)
2525 S DOWNING STREETDENVERCO80210841574369REAL ESTATE LEASINGCON/AC0
SAN MARCOS REGIONAL MRI INC
1301 WONDER WORLD DRIVESAN MARCOSTX78666770597968HOLDING COMPANYTXN/AC0
THE GARDEN RETIREMENT COMMUNITY INC
602 COURTLAND STREET STE 200ORLANDOFL32804593414055REAL ESTATE RENTALFLN/AC0
UNIVERSITY COMMUNITY HEALTH INSURANCE COMPANY SPC LTD
CAPTIVE INSURANCEN/AC0C/O AON INSURANCE MANAGERS PO BOXGRAND CAYMANCJCJ
UCH SERVICES INC
3100 EAST FLETCHER AVETAMPAFL33613593508454MANAGEMENT COMPANYFLN/AC0
WEST COAST MEDICAL GROUP INC (11-101912)
1395 S PINELLAS AVETARPON SPRINGSFL34689593537305PHYSICIAN CLINICSFLN/AC0
WINTER PARK MEDICAL OFFICE BUILDING I CONDO ASSOC INC
200 LAKEMONT AVEWINTER PARKFL32792452228478PHYSICIAN CLINICSFLN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (19 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
MEMORIAL HOSPITAL FLAGLER INC
Q1329498COST
MEMORIAL HOSPITAL FLAGLER INC
N3167649COST
MEMORIAL HOSPITAL FLAGLER INC
J321649COST
MEMORIAL HOSPITAL FLAGLER INC
O205047COST
FLORIDA MEMORIAL HEALTH NETWORK INC
Q9616041COST
FLORIDA MEMORIAL HEALTH NETWORK INC
S1082019ACTUAL AMOUNT RECEIVED
MEMORIAL HOSPITAL WEST VOLUSIA INC
N2114294COST
MEMORIAL HOSPITAL WEST VOLUSIA INC
Q824478COST
SOUTHWEST VOLUSIA HEALTHCARE CORPORATION
N1232650COST
SOUTHWEST VOLUSIA HEALTHCARE CORPORATION
Q502923COST
SOUTHWEST VOLUSIA HEALTHCARE CORPORATION
O64486COST
MEMORIAL HEALTH SYSTEMS FOUNDATION INC
Q132109COST
MEMORIAL HEALTH SYSTEMS FOUNDATION INC
B88213ACTUAL AMOUNT GIVEN
FLORIDA HOSPITAL ZEPHYRHILLS INC
N197910COST
ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION
B1220464ACTUAL AMOUNT GIVEN
ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION
M2285144% OF FACILITY'S OPERATING EXP.
ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION DBA AHS IS
M7417046% OF FACILITY'S OPERATING EXP.
ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION
P9759688COST
ADVENTIST HEALTH SYSTEMSUNBELT INC
M1522653% OF FACILITY'S EHR REVENUE