2013-11-05T17:40:13-06:00 2012-12-31 990 2012-01-01 590973502 MEMORIAL HEALTH SYSTEMS INC MEMO 3866766000 301 MEMORIAL MEDICAL PARKWAY DAYTONA BEACH FL 32117 LYNN C ADDISCOTT 4079751492 2013-11-04 2012 2016-03-07 17:11:31Z FLORIDA HOSPITAL MEMORIAL MEDICAL CENTER DARYL TOL 301 MEMORIAL MEDICAL PARKWAY DAYTONA BEACH FL 32117 250361142 0 X WWW.FLORIDAHOSPITALMEMORIAL.ORG X 1961 FL MEDICAL CARE TO THE COMMUNITY THROUGH THE OPERATION OF TWO HOSPITALS WITH A TOTAL OF 396 BEDS. 18 8 2187 254 38540 21849 0 0 234363158 245872207 1870212 1996583 0 2315873 236233370 250184663 165981 105713 0 0 99777661 106892001 0 0 0 135774686 132937234 235718328 239934948 515042 10249715 434016611 440515926 190151117 187836321 243865494 252679605 ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION AND ALL OF ITS SUBSIDIARY ORGANIZATIONS WERE ESTABLISHED BY THE SEVENTH-DAY ADVENTIST CHURCH TO BRING A MINISTRY OF HEALING AND HEALTH TO THE COMMUNITIES SERVED. OUR MISSION IS TO EXTEND THE HEALING MINISTRY OF CHRIST. 0 0 222035586 105713 248149540 OPERATION 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. 222035586 1 1 0 1 0 0 1 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 161 0 1 2187 1 1 1 0 0 0 0 0 0 0 0 0 X 18 8 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 FL X DEBORA THOMAS 3862313901 301 MEMORIAL MEDICAL PARKWAY DAYTONA BEACH FL 32117 X MICHAEL SCHULTZ 0.60 50.00 X 199 1305933 169103 RICK BANKER 0.60 0.00 X 199 0 0 LONNIE BROWN 0.60 0.00 X 199 0 0 DAVID BURT 0.60 0.00 X 199 0 0 PAUL CLARE 0.60 0.00 X 199 0 0 SURESH DESAI MD 4.70 0.00 X 33621 0 0 CHARLES D HOOD JR 0.60 0.00 X 199 0 0 SANDRA K JOHNSON 0.60 50.00 X 0 590485 99955 MARK LAROSE 8.30 41.70 X X 0 575006 96916 NANCY LOHMAN 0.60 0.00 X 199 0 0 DAVID OTTATI 0.60 50.00 X 199 432475 78624 WILLIAM MCMUNN 0.60 0.00 X 199 0 0 ED NOSEWORTHY 0.60 50.00 X 0 446272 75791 EDDIE SCHATZ JR 0.60 0.00 X 199 0 0 JULIE SCHNEIDER MD 82.60 0.00 X 1199257 0 21432 LEWIS SEIFERT 0.60 50.00 X 199 681597 118449 DARYL TOL 41.70 8.30 X X 0 564953 116809 ELIZABETH WEAGRAFF 0.60 50.00 X 199 344942 64960 DEBORA THOMAS 41.70 8.30 X X 0 401061 57811 NIGEL HINDS 8.30 41.70 X 0 305345 58764 DARLINDA COPELAND 50.00 0.00 X 0 336623 42773 MICHELE GOEB-BURKETT 50.00 0.00 X 0 255075 36417 RONALD JIMENEZ 50.00 0.00 X 0 369639 71518 MICHAEL KELLEY MD 70.00 0.00 X 784833 0 35704 ROBERT MARTIN MD 58.00 0.00 X 742213 0 26444 ROBERT HEWES MD 52.00 0.00 X 735141 0 26165 CHRISTOPHER SUTTON KENT MD 87.00 0.00 X 689367 0 39284 DINDI REDDY MD 50.00 0.00 X 671860 0 36285 4858680 6609406 1273204 66 0 1 0 SHERIDAN HEALTHCORP INC PO BOX 452197 SUNRISE FL 33323 MEDICAL SERVICE 2908124 HURON CONSULTING GROUP 3005 MOMENTUM PLACE CHICAGO IL 60689 CONSULTING SERVICE 1772297 SPACE COAST HOSPITAL SERVICES 1895 MURRELL ROAD ROCKLEDGE FL 32955 LINEN SERVICE 824538 MONTI ELIGIBILITY & DENIAL SOLUTIONS 540 S PINE MEADOW DR DEBARY FL 32713 COLLECTION SERVICE 476130 AMERISOURCE FUNDING INC PO BOX 4738 HOUSTON TX 77210 AGENCY SERVICE 462979 33 NET PATIENT REVENUE 900099 237160180 237121640 38540 MANAGEMENT FEES 561000 5448274 5448274 MEDICAL OFFICE BUILDING 531120 1534409 1534409 CAFETERIA REVENUE 900099 1499518 1499518 HEALTH EDUCATION 900099 170280 170280 59546 59546 245872207 840405 840405 1238936 93721 0 176479 1238936 -82758 1156178 1156178 EHR REVENUE 900099 2315873 2315873 2315873 250184663 248149540 38540 1996583 105713 105713 3489855 3489855 79478109 79478109 2531300 2488711 42589 15191706 14918377 273329 6201031 6096699 104332 703955 703955 56764 56764 16942757 11633239 5309518 927893 927893 5157559 3889570 1267989 8091341 6978473 1112868 5476319 5476319 381189 381189 175825 175825 7238781 7238781 18523850 18523850 3634569 3532367 102202 UNRELATED BUSINESS INCO 9346 9346 MEDICAL SUPPLIES 52569126 52569126 REPAIRS & MAINTENANCE 5602904 5602904 PURCHASED SERVICES 4614474 672766 3941708 2830582 2830582 239934948 222035586 17899362 0 4311 4987 106482950 121912428 26445233 27653963 4634870 5413676 6009911 6780042 337490590 82359235 268926757 255131355 4548297 3502352 281875 233505 16682407 19883618 434016611 440515926 13106544 12370776 0 177044573 175465545 190151117 187836321 X 240453830 249231866 585929 622004 2825735 2825735 243865494 252679605 434016611 440515926 X 10249715 -11610 -1423994 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 10114 10114 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: AMERICAN HOSPITAL ASSOCIATION DUES AND FLORIDA HOSPITAL ASSOCIATION DUES X 0 1 0 0.00 0 19759070 19759070 241473411 37141704 204331707 75224565 44920501 30304064 1033544 297030 736514 255131355 PAYABLE TO THIRD PARTIES 5528719 DUE TO AFFILIATED 1708628 CREDIT BALANCES IN A/R 683930 OTHER LIABILITIES 2162537 INTERCO. ALLOC. OF TE BOND PROCEEDS 165365281 LEASES PAYABLE 16450 175465545 X 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. 1 1 X 1 X 1 X 1 1 0 1 1 9502619 9502619 0.03960 25399134 9132002 16267132 0.06780 34901753 9132002 25769751 0.10740 57993 57993 0.00020 1868 1868 0.00000 59861 59861 0.00020 34961614 9132002 25829612 0.10760 26250 26250 0.00010 48785 48785 0.00020 19442 19442 0.00010 6615 6615 0.00000 17024 17024 0.00010 118116 118116 0.00050 1 10437942 1855039 79791587 75711932 4079655 X 1 1 2 1 FLORIDA HOSPITAL MEMORIAL MEDICAL CENTER

301 MEMORIAL MEDICAL PARKWAY DAYTONA BEACH FL 32117

WWW.FLORIDAHOSPITALMEMORIAL.ORG X X X 2 FLORIDA HOSPITAL OCEANSIDE

264 SOUTH ATLANTIC AVE ORMOND BEACH FL 32176

WWW.FLORIDAHOSPITALMEMORIAL.ORG X X X FLORIDA HOSPITAL MEMORIAL MEDICAL CENTER 1 1 1 200.000000000000 1 400.000000000000 1 X X X X X X X 1 1 X X 1 0 1 X 0 0 FLORIDA HOSPITAL OCEANSIDE 2 1 1 200.000000000000 1 400.000000000000 1 X X X X X X X 1 1 X X 1 0 1 X 0 0 20 FLORIDA MEMORIAL HOSPITAL IMAGING CENTER

335 CLYDE MORRIS BLVD ORMOND BEACH FL 32174

DIAGNOSTIC IMAGING FHMMC CANCER CARE CENTER

224 MEMORIAL MEDICAL PKWY DAYTONA BEACH FL 32117

ONCOLOGY SERVICES WOUND CARE

305 MEMORIAL MEDICAL PKWY 101 DAYTONA BEACH FL 32117

WOUND CARE SERVICES HEMATOLOGY ONCOLOGY ASSOCIATES

345 CLYDE MORRIS BLVD 490 ORMOND BEACH FL 32174

ONCOLOGY SERVICES PRACTICE OF DR MURRPHY MARTIN & KENT

305 MEMORIAL MEDICAL PKWY 206 DAYTONA BEACH FL 32117

PHYSICIAN SERVICES FHMMC AT THE PAVILION-REHAB

5535 S WILLIAMSON BLVD700 PORT ORANGE FL 32128

HEALTHCARE REHABILITATION SERVICES FLORIDA WOMEN'S HEALTH CENTER

335 CLYDE MORRIS BLVD 240 ORMOND BEACH FL 32174

WOMEN'S HEALTH SERVICES PRACTICE OF DR BIRKEDAL

305 MEMORIAL MEDICAL PKWY 205 DAYTONA BEACH FL 32117

PHYSICIAN SERVICES FHMMC REHABILITATION SVCS OUTPATIENT CTR

501 STERTHAUS AVENUE ORMOND BEACH FL 32174

REHABILITATIVE SERVICES PRACTICE OF DR RASMUSSEN

305 MEMORIAL MEDICAL PKWY 209 DAYTONA BEACH FL 32117

PHYSICIAN SERVICES PRACTICE OF DR LEVINE

305 MEMORIAL MEDICAL PKWY 207 DAYTONA BEACH FL 32117

PHYSICIAN SERVICES FHMMC AT THE PAVILION-LAB

5535 S WILLIAMSON BLVD700 PORT ORANGE FL 32128

LAB SERVICES PRACTICE OF DR DAAS

305 MEMORIAL MEDICAL PKWY 203 DAYTONA BEACH FL 32117

PHYSICIAN SERVICES PRACTICE OF DR COHEN

305 MEMORIAL MEDICAL PKWY 208 ORMOND BEACH FL 32174

PHYSICIAN SERVICES FHMMC AT THE PAVILION-RADIOLOGY

5535 S WILLIAMSON BLVD700 PORT ORANGE FL 32128

RADIOLOGY SERVICES FHMMC AT THE PAVILION-DR MANTINEO

5535 S WILLIAMSON BLVD700 PORT ORANGE FL 32128

PHYSICIAN SERVICES PRACTICE OF DR CASIMIRO

290 N CLYDE MORRIS BLVD A-2 ORMOND BEACH FL 32174

PHYSICIAN SERVICES FHMMC CARDIAC REHAB

305 MEMORIAL MEDICAL PKWY 306 DAYTONA BEACH FL 32117

REHABILITATIVE SERVICES MEMORIAL FAMILY CARE DR GONSALVES

335 CLYDE MORRIS BLVD 240 DAYTONA BEACH FL 32174

PHYSICIAN SERVICES MEMORIAL MEDLAB

290 N CLYDE MORRIS BLVD ORMOND BEACH FL 32174

LAB SERVICES 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. SUPPLEMENTAL SCHEDULE TO SCHEDULE H, PART III, SECTION B 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. PART III, LINE 2: THE AMOUNT OF BAD DEBT EXPENSE, REPORTED ON LINE 2 OF SECTION A OF PART III IS RECORDED IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS ADJUSTMENTS TO REVENUE, NOT BAD DEBT EXPENSE. PART III, LINE 3: METHODOLOGY FOR DETERMINING THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE THAT MAY REPRESENT PATIENTS WHO COULD HAVE QUALIFIED UNDER THE FILING ORGANIZATION'S 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 4: FINANCIAL STATEMENT FOOTNOTE RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS:THE FINANCIAL INFORMATION OF THE FILING ORGANIZATION IS INCLUDED IN A CONSOLIDATED AUDITED FINANCIAL STATEMENT FOR THE CURRENT YEAR.THE APPLICABLE FOOTNOTE FROM THE ATTACHED CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ADDRESSES ACCOUNTS RECEIVABLE, THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS, AND THE PROVISION FOR BAD DEBTS CAN BE FOUND ON PAGES 6 AND 7. PLEASE NOTE THAT DOLLAR AMOUNTS ON THE ATTACHED CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE IN THOUSANDS. FLORIDA HOSPITAL MEMORIAL MEDICAL CENTER 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 OCEANSIDE 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 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 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. 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. PART VI, LINE 7: THE ANNUAL COMMUNITY BENEFIT REPORT CONTAINED IN THE ANNUAL REPORT PREPARED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC) ON BEHALF OF THE ENTIRE AHS SYSTEM OF HEALTHCARE ORGANIZATION IS NOT FILED WITH ANY STATE AGENCIES. 1 MEMORIAL HEALTH SYSTEMS FOUNDATION INC 770 WEST GRANADA BLVD 302 ORMOND BEACH FL 32174 311771522 501(C)(3) 88213 COST GENERAL ADMINISTRATIVE SUPPORT PROVISION OF GENERAL ADMINISTRATIVE SUPPORT THE CENTRAL FLORIDA SPORTS COMMISSION INC PO BOX 1234 ORLANDO FL 32802 593152788 501(C)(3) 10000 GENERAL SUPPORT AMERICAN HEART ASSOCIATION PO BOX 4002900 DES MOINES IA 50340 135613797 501(C)(3) 7500 GENERAL SUPPORT 3 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE 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. X X X 1 1 0 1 0 0 0 1 0 0 0 MICHAEL SCHULTZ 0 642188 0 195183 199 468562 0 128507 0 40596 199 1475036 0 91255 SANDRA K JOHNSON 0 390514 0 120945 0 79026 0 47701 0 52254 0 690440 0 29763 MARK LAROSE 0 423408 0 65966 0 85632 0 82864 0 14052 0 671922 0 53478 DAVID OTTATI 0 323487 0 69726 199 39262 0 44434 0 34190 199 511099 0 14825 ED NOSEWORTHY 0 313162 0 62353 0 70757 0 52350 0 23441 0 522063 0 27967 JULIE SCHNEIDER MD 295834 0 902349 0 1074 0 13599 0 7833 0 1220689 0 0 0 LEWIS SEIFERT 0 462337 0 126959 199 92301 0 86337 0 32112 199 800046 0 42022 DARYL TOL 0 447934 0 70129 0 46890 0 79237 0 37572 0 681762 0 34812 ELIZABETH WEAGRAFF 0 220894 0 79653 199 44395 0 28972 0 35988 199 409902 0 11609 DEBORA THOMAS 0 293181 0 49914 0 57966 0 23449 0 34362 0 458872 0 9460 NIGEL HINDS 0 228842 0 42983 0 33520 0 27657 0 31107 0 364109 0 3942 DARLINDA COPELAND 0 265788 0 40542 0 30293 0 26364 0 16409 0 379396 0 6486 MICHELE GOEB-BURKETT 0 199555 0 36809 0 18711 0 13599 0 22818 0 291492 0 0 RONALD JIMENEZ 0 297804 0 42456 0 29379 0 27949 0 43569 0 441157 0 3939 MICHAEL KELLEY MD 261778 0 522391 0 664 0 13599 0 22105 0 820537 0 0 0 ROBERT MARTIN MD 741523 0 0 0 690 0 13599 0 12845 0 768657 0 0 0 ROBERT HEWES MD 496978 0 107442 0 130721 0 13599 0 12566 0 761306 0 0 0 CHRISTOPHER SUTTON KENT MD 688917 0 0 0 450 0 13599 0 25685 0 728651 0 0 0 DINDI REDDY MD 492229 0 135224 0 44407 0 13599 0 22686 0 708145 0 0 0 PART I, LINE 1A AS 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 4B AS DISCUSSED IN LINE 1A ABOVE, EXECUTIVES ON THE FILING ORGANIZATION'S MANAGEMENT TEAM THAT HOLD THE POSITION OF VICE-PRESIDENT OR ABOVE ARE COMPENSATED BY AND ON THE PAYROLL OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), THE PARENT ORGANIZATION OF A HEALTHCARE SYSTEM KNOWN AS ADVENTIST HEALTH SYSTEM (AHS). IN RECOGNITION OF THE CONTRIBUTION THAT EACH EXECUTIVE MAKES TO THE SUCCESS OF AHS, AHS PROVIDES TO ELIGIBLE EXECUTIVES PARTICIPATION IN THE AHS EXECUTIVE FLEX BENEFIT PROGRAM (THE PLAN). THE PURPOSE OF THE PLAN IS TO OFFER ELIGIBLE EXECUTIVES AN OPPORTUNITY TO ELECT FROM AMONG A VARIETY OF SUPPLEMENTAL BENEFITS, INCLUDING DEFERRED COMPENSATION BENEFITS TAXABLE UNDER INTERNAL REVENUE CODE (IRC) SECTION 457(F), TO INDIVIDUALLY TAILOR A BENEFITS PROGRAM APPROPRIATE TO EACH EXECUTIVE'S NEEDS. THE PLAN PROVIDES ELIGIBLE PARTICIPANTS A PRE-DETERMINED BENEFITS ALLOWANCE CREDIT THAT IS EQUAL TO A PERCENTAGE OF THE EXECUTIVE'S BASE PAY FROM WHICH IS DEDUCTED THE COST OF MANDATORY AND ELECTIVE EMPLOYEE BENEFITS. THE PRE-DETERMINED BENEFITS ALLOWANCE CREDIT PERCENTAGE IS APPROVED BY THE AHS BOARD 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 6 THE 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. SUPPLEMENTAL INFORMATION PART III PART 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. GERI MANLEY FAMILY MEMBER OF KEY EMPLOYEE 32798 EMPLOYEE COMPENSATION 0 FORM 990, PART VI, SECTION A, LINE 2 CHARLES 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 6 MEMORIAL 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 7A THE 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 7B AHSSI, 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 11 THE FILING ORGANIZATION'S CURRENT YEAR FORM 990 WAS REVIEWED BY THE BOARD CHAIRMAN, BOARD FINANCE COMMITTEE CHAIR, CEO AND BY THE CFO PRIOR TO ITS FILING WITH THE IRS. THE REVIEW CONDUCTED BY THE BOARD CHAIRMAN, BOARD FINANCE COMMITTEE CHAIR, CEO AND THE CFO DID NOT INCLUDE THE REVIEW OF ANY SUPPORTING WORKPAPERS THAT WERE USED IN PREPARATION OF THE CURRENT YEAR FORM 990, BUT DID INCLUDE A REVIEW OF THE ENTIRE FORM 990 AND ALL SUPPORTING SCHEDULES. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY OF THE FILING ORGANIZATION APPLIES TO MEMBERS OF ITS BOARD OF DIRECTORS AND ITS PRINCIPAL OFFICERS (TO BE KNOWN AS INTERESTED PERSONS). IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTERESTS, ANY MEMBER OF THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION OR ANY PRINCIPAL OFFICER OF THE FILING ORGANIZATION (I.E. INTERESTED PERSONS) MUST DISCLOSE THE EXISTENCE OF ANY FINANCIAL INTEREST WITH THE FILING ORGANIZATION AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS CONCERNING THE FINANCIAL INTEREST/ARRANGEMENT TO THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION OR TO ANY MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS THAT IS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. SUBSEQUENT TO ANY DISCLOSURE OF ANY FINANCIAL INTEREST/ARRANGEMENT AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE RELEVANT BOARD MEMBER OR PRINCIPAL OFFICER, THE REMAINING MEMBERS OF THE BOARD OF DIRECTORS OR COMMITTEE WITH BOARD DELEGATED POWERS SHALL DISCUSS, ANALYZE, AND VOTE UPON THE POTENTIAL FINANCIAL INTEREST/ARRANGEMENT TO DETERMINE IF A CONFLICT OF INTEREST EXISTS. ACCORDING TO THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY, AN INTERESTED PERSON MAY MAKE A PRESENTATION TO THE BOARD OF DIRECTORS (OR COMMITTEE WITH BOARD DELEGATED POWERS), BUT AFTER SUCH PRESENTATION, SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN A CONFLICT OF INTEREST. EACH INTERESTED PERSON, AS DEFINED UNDER THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY, SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICT OF INTERESTS POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE FILING ORGANIZATION IS A CHARITABLE ORGANIZATION THAT MUST PRIMARILY ENGAGE IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS EXEMPT PURPOSES. THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY ALSO REQUIRES THAT PERIODIC REVIEWS SHALL BE CONDUCTED TO ENSURE THAT THE FILING ORGANIZATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES. FORM 990, PART VI, SECTION B, LINE 15 THE 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 19 AS 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 A FOR 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. CHANGES IN NET ASSETS OR FUND BALANCES: 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. PART X, LINE 2 THE AMOUNTS SHOWN ON LINE 2 OF PART X OF THIS RETURN INCLUDE THE FILING ORGANIZATION'S INTEREST IN A CENTRAL INVESTMENT POOL MAINTAINED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION, THE FILING ORGANIZATION'S TOP-TIER PARENT. THE INVESTMENTS IN THE CENTRAL INVESTMENT POOL ARE RECORDED AT MARKET VALUE. ADVENTIST BOLINGBROOK HOSPITAL 500 REMINGTON BLVD BOLINGBROOK IL 60440 651219504 OPERATION OF HOSPITAL & RELATED SERVICES IL 501(C)(3) 170(B)(1)(A)(III) ADVENTIST HLTH SYSTEMSUNBELT INC 0 ADVENTIST CARE CENTERS - COURTLAND INC 730 COURTLAND STREET ORLANDO FL 32804 205774723 OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY FL 501(C)(3) 509(A)(2) SUNBELT HLTH CARE CENTERS INC 0 ADVENTIST GLENOAKS HOSPITAL 701 WINTHROP AVENUE GLENDALE HEIGHTS IL 60139 363208390 OPERATION OF HOSPITAL & RELATED SERVICES IL 501(C)(3) 170(B)(1)(A)(III) ADVENTIST HLTH SYSTEMSUNBELT INC 0 ADVENTIST HLTH MID-AMERICA INC 9100 W 74TH STREET SHAWNEE MISSION KS 66204 521347407 HLTHCARE RELATED SERVICES KS 501(C)(3) 509(A)(3) TYPE I ADVENTIST HLTH SYSTEMSUNBELT INC 0 ADVENTIST HLTH PARTNERS INC 1000 REMINGTON BLVD STE 200 BOLINGBROOK IL 60440 364138353 OPERATE OUT-PATIENT PHYSICIAN CLINICS IL 501(C)(3) 170(B)(1)(A)(III) AHS MIDWEST MANAGEMENT INC 0 ADVENTIST HLTH SYSTEM AFFILIATED BENEFIT TRUST 900 HOPE WAY ALTAMONTE SPRINGS FL 32714 266422966 PROMOTION OF HLTHCARE FL 501(C)(3) 509(A)(3) TYPE I ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 0 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 900 HOPE WAY ALTAMONTE SPRINGS FL 32714 592170012 MANAGEMENT SERVICES FL 501(C)(3) 509(A)(3) TYPE I N/A 0 ADVENTIST HLTH SYSTEMGEORGIA INC 1035 RED BUD ROAD CALHOUN GA 30701 581425000 OPERATION OF HOSPITAL & RELATED SERVICES GA 501(C)(3) 170(B)(1)(A)(III) ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 0 ADVENTIST HLTH SYSTEMSUNBELT INC 900 HOPE WAY ALTAMONTE SPRINGS FL 32714 591479658 OPERATION OF HOSPITAL & RELATED SERVICES FL 501(C)(3) 170(B)(1)(A)(III) ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 0 ADVENTIST HLTH SYSTEMTEXAS INC 602 COURTLAND STREET ORLANDO FL 32804 742578952 LEASING PERSONNEL TO AFFILIATED HOSPITAL TX 501(C)(3) 509(A)(3) TYPE III ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 0 ADVENTIST HINSDALE HOSPITAL 120 NORTH OAK STREET HINSDALE IL 60521 362276984 OPERATION OF HOSPITAL & RELATED SERVICES IL 501(C)(3) 170(B)(1)(A)(III) ADVENTIST HLTH SYSTEMSUNBELT INC 0 ADVENTIST UNIVERSITY OF HEALTH SCIENCES INC (630 YEAR END) 671 LAKE WINYAH DRIVE ORLANDO FL 32803 593069793 EDUCATION/OPERATION OF SCHOOL FL 501(C)(3) 170(B)(1)(A)(II) ADVENTIST HLTH SYSTEMSUNBELT INC 0 AHS MIDWEST MANAGEMENT INC 1000 REMINGTON BLVD STE 200 BOLINGBROOK IL 60440 363354567 OPERATION OF PHYSICIAN PRACTICE MGMT IL 501(C)(3) 509(A)(3) TYPE I ADVENTIST HLTH SYSTEMSUNBELT INC 0 AHSCENTRAL TEXAS INC 1301 WONDER WORLD DRIVE SAN MARCOS TX 78666 742621825 PROVIDE OFFICE SPACE - MEDICAL PROFESSIONALS TX 501(C)(3) 509(A)(3) TYPE III-F ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 0 APOPKA HLTH CARE PROPERTIES INC 305 E OAK STREET APOPKA FL 32703 510605694 LEASE TO RELATED ORGANIZATION GA 501(C)(3) 509(A)(3) TYPE III-F SUNBELT HLTH CARE CENTERS INC 0 BATTLE CREEK ADVENTIST HOSPITAL 1000 REMINGTON BLVD STE 200 BOLINGBROOK IL 60440 381359189 INACTIVE MI 501(C)(3) 170(B)(1)(A)(III) ADVENTIST HLTH SYSTEMSUNBELT INC 0 BOLINGBROOK HOSPITAL FOUNDATION 1000 REMINGTON BLVD N ENTRANCE 2ND BOLINGBROOK IL 60440 900494445 FUND-RAISING FOR TAX-EXEMPT HOSPITAL IL 501(C)(3) 170(B)(1)(A)(VI) MIDWEST HLTH FOUNDATION 0 BRADFORD HEIGHTS HLTH & REHAB CENTER INC 950 HIGHPOINT DRIVE HOPKINSVILLE KY 42240 205782342 OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY KY 501(C)(3) 509(A)(2) SUNBELT HLTH CARE CENTERS INC 0 BURLESON NURSING & REHAB CENTER INC 301 HUGULEY BLVD BURLESON TX 76028 205782243 OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY TX 501(C)(3) 509(A)(2) SUNBELT HLTH CARE CENTERS INC 0 CALDWELL HLTH CARE PROPERTIES INC 1333 WEST MAIN PRINCETON KY 42445 510605680 LEASE TO RELATED ORGANIZATION GA 501(C)(3) 509(A)(3) TYPE III-F SUNBELT HLTH CARE CENTERS INC 0 CENTRAL TEXAS HLTHCARE COLLABORATIVE 1301 WONDER WORLD DRIVE SAN MARCOS TX 78666 453739929 SUPPORT OPERATION OF HOSPITAL TX 501(C)(3) 509(A)(3) TYPE I ADVENTIST HLTH SYSTEMSUNBELT INC 0 CEDAR CRAG TERRACE INC (630 YEAR END) RT 5 BOX 900 MANCHESTER KY 40962 611120442 OPERATION OF HOME FOR THE ELDERLY-DISABLED KY 501(C)(3) 170(B)(1)(A)(VI) MEMORIAL HOSPITAL INC 0 CENTRAL TEXAS MEDICAL CENTER FOUNDATION 1301 WONDER WORLD DRIVE SAN MARCOS TX 78666 742259907 FUND-RAISING FOR TAX-EXEMPT HOSPITAL TX 501(C)(3) 170(B)(1)(A)(VI) ADVENTIST HLTH SYSTEMSUNBELT INC 0 CHICKASAW HLTH CARE PROPERTIES INC 250 S CHICKASAW TRAIL ORLANDO FL 32825 510605681 LEASE TO RELATED ORGANIZATION GA 501(C)(3) 509(A)(3) TYPE III-F SUNBELT HLTH CARE CENTERS INC 0 CHIPPEWA VALLEY HOSPITAL & OAKVIEW CARE CENTER INC 1220 THIRD AVENUE WEST DURAND WI 54736 391365168 OPERATION OF HOSPITAL & RELATED SERVICES WI 501(C)(3) 170(B)(1)(A)(III) ADVENTIST HLTH SYSTEMSUNBELT INC 0 COBB MEDICAL ASSOCIATES LLC 3949 SOUTH COBB DRIVE SE SMYRNA GA 300806342 582617089 OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES GA 501(C)(3) 170(B)(1)(A)(III) EMORY-ADVENTIST INC 0 COURTLAND HLTH CARE PROPERTIES INC 730 COURTLAND STREET ORLANDO FL 32804 510605682 LEASE TO RELATED ORGANIZATION GA 501(C)(3) 509(A)(3) TYPE III-F SUNBELT HLTH CARE CENTERS INC 0 CREEKWOOD PLACE NURSING & REHAB CENTER INC 683 E THIRD STREET RUSSELLVILLE KY 42276 205782260 OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY KY 501(C)(3) 509(A)(2) SUNBELT HLTH CARE CENTERS INC 0 DAIRY ROAD HLTH CARE PROPERTIES INC 7350 DAIRY ROAD ZEPHYRHILLS FL 33540 510605684 LEASE TO RELATED ORGANIZATION GA 501(C)(3) 509(A)(3) TYPE III-F SUNBELT HLTH CARE CENTERS INC 0 EAST ORLANDO HLTH & REHAB CENTER INC 250 S CHICKASAW TRAIL ORLANDO FL 32825 205774748 OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY FL 501(C)(3) 509(A)(2) SUNBELT HLTH CARE CENTERS INC 0 EMORY-ADVENTIST INC 3949 SOUTH COBB DRIVE SMYRNA GA 30080 582171011 OPERATION OF HOSPITAL & RELATED SVCS GA 501(C)(3) 170(B)(1)(A)(III) ADVENTIST HLTH SYSTEMSUNBELT INC 0 FLETCHER HOSPITAL INC 100 HOSPITAL DRIVE HENDERSONVILLE NC 28792 560543246 OPERATION OF HOSPITAL & RELATED SVCS NC 501(C)(3) 170(B)(1)(A)(III) ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 0 FLNC INC 3355 E SEMORAN BLVD APOPKA FL 32703 205774761 OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY FL 501(C)(3) 509(A)(2) SUNBELT HLTH CARE CENTERS INC 0 FLORIDA HOSPITAL WATERMAN INC 1000 WATERMAN WAY TAVARES FL 32778 593140669 OPERATION OF HOSPITAL & RELATED SERVICES FL 501(C)(3) 170(B)(1)(A)(III) ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 0 FLORIDA HOSPITAL ZEPHYRHILLS INC 7050 GALL BLVD ZEPHYRHILLS FL 33541 592108057 OPERATION OF HOSPITAL & RELATED SERVICES FL 501(C)(3) 170(B)(1)(A)(III) ADVENTIST HLTH SYSTEMSUNBELT INC 0 FLORIDA HOSPITAL MEDICAL GROUP INC 900 WINDERLEY PLACE MAITLAND FL 32751 593214635 OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES FL 501(C)(3) 170(B)(1)(A)(III) ADVENTIST HLTH SYSTEMSUNBELT INC 0 FOUNDATION FOR SHAWNEE MISSION MEDICAL CENTER INC 9100 W 74TH STREET SHAWNEE MISSION KS 66204 480868859 FUND-RAISING FOR TAX-EXEMPT HOSPITAL KS 501(C)(3) 509(A)(3) TYPE I SHAWNEE MISSION MEDICAL CENTER INC 0 GLENOAKS HOSPITAL FOUNDATION 701 WINTHROP AVENUE GLENDALE HEIGHTS IL 60139 363926044 FUND-RAISING FOR TAX-EXEMPT HOSPITAL IL 501(C)(3) 170(B)(1)(A)(VI) MIDWEST HLTH FOUNDATION 0 HAYS MEMORIAL HOSPITAL ASSOCIATION OF SEVENTH-DAY ADVENTISTS 1301 WONDER WORLD DRIVE SAN MARCOS TX 78667 741362785 LEASE OF HOSPITAL PERSONNEL TX 501(C)(3) 509(A)(3) TYPE II ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 0 HELEN ELLIS MEMORIAL HOSPITAL AUXILIARY INC 1395 S PINELLAS AVE TARPON SPRINGS FL 34689 592106043 FUND-RAISING FOR TAX-EXEMPT HOSPITAL/FOUNDATION FL 501(C)(3) 509(A)(3) TYPE I TARPON SPRINGS HOSPITAL FOUNDATION INC 0 HELEN ELLIS MEMORIAL HOSPITAL FOUNDATION INC 1395 S PINELLAS AVE TARPON SPRINGS FL 34689 593690149 FUND-RAISING FOR TAX-EXEMPT HOSPITAL FL 501(C)(3) 509(A)(3) TYPE I TARPON SPRINGS HOSPITAL FOUNDATION INC 0 HINSDALE HOSPITAL FOUNDATION 7 SALT CREEK LANE SUITE 203 HINSDALE IL 60521 521466387 FUND-RAISING FOR TAX-EXEMPT HOSPITAL IL 501(C)(3) 170(B)(1)(A)(VI) MIDWEST HLTH FOUNDATION 0 HUGULEY COMMUNITY CARE CORP 11801 SOUTH FREEWAY BURLESON 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