ADVENTIST HEALTH SYSTEM GEORGIA INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: ADVENTIST HEALTH SYSTEM GEORGIA INC (EIN 58-1425000)
Tax period: 2012-01-01 to 2012-12-31
Filed: 2013-11-14
IRS object ID: 201323189349305142
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule F
Schedule H
Schedule I
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-11-14T15:12:20-06:00	Timestamp
Tax Period End Date	2012-12-31	TaxPeriodEndDate
Return Type	990	ReturnType
Tax Period Begin Date	2012-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	581425000	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	ADVENTIST HEALTH SYSTEM GEORGIA INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	ADVE	NameControl
Phone	7066027800	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1035 RED BUD ROAD	AddressLine1
City	CALHOUN	City
State	GA	State
ZIP Code	30701	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	LYNN C ADDISCOTT	Name
Title	ASSISTANT SECRETARY	Title
Phone	4079751492	Phone
Date Signed	2013-11-14	DateSigned

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

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

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	PETE WEBER	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	1035 RED BUD ROAD	AddressLine1
City	CALHOUN	City
State	GA	State
ZIP Code	30701	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	99059855	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Group Exemption Number	1071	GroupExemptionNumber
Organization501c3	X	Organization501c3
Web Site	WWW.GORDONHOSPITAL.COM	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1981	YearFormation
State Legal Domicile	GA	StateLegalDomicile
Activity Or Mission Description	THE PROVISION OF MEDICAL CARE TO THE COMMUNITY THROUGH THE OPERATION OF A 69 BED HOSPITAL.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	12	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	5	NbrIndependentVotingMembers
Total Nbr Employees	905	TotalNbrEmployees
Total Nbr Volunteers	35	TotalNbrVolunteers
Total Gross UBI	100242	TotalGrossUBI
Net Unrelated Business Txbl Income	-777	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	7657	ContributionsGrantsPriorYear
Contributions Grants Current Year	12964	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	88202424	ProgramServiceRevenuePriorYear
Program Service Revenue CY	95898310	ProgramServiceRevenueCY
Investment Income Prior Year	1274932	InvestmentIncomePriorYear
Investment Income Current Year	1565147	InvestmentIncomeCurrentYear
Other Revenue Prior Year	0	OtherRevenuePriorYear
Other Revenue Current Year	1528013	OtherRevenueCurrentYear
Total Revenue Prior Year	89485013	TotalRevenuePriorYear
Total Revenue Current Year	99004434	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	189882	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	271375	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	42419641	SalariesEtcPriorYear
Salaries Etc Current Year	48711684	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	36579995	OtherExpensePriorYear
Other Expenses Current Year	38528055	OtherExpensesCurrentYear
Total Expenses Prior Year	79189518	TotalExpensesPriorYear
Total Expenses Current Year	87511114	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	10295495	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	11493320	RevenuesLessExpensesCY
Total Assets BOY	142328661	TotalAssetsBOY
Total Assets EOY	158400291	TotalAssetsEOY
Total Liabilities BOY	52463451	TotalLiabilitiesBOY
Total Liabilities EOY	56807006	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	89865210	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	101593285	NetAssetsOrFundBalancesEOY
Mission Description	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.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	79771770	Expense
Grants	271375	Grants
Revenue	97326081	Revenue
Description	OPERATION OF A 69-BED ACUTE CARE HOSPITAL. THERE WERE 4,839 PATIENT ADMISSIONS DURING THE CURRENT YEAR RESULTING IN 18,786 PATIENT DAYS, AND 67,494 OUTPATIENT VISITS.	Description
Total Program Service Expense	79771770	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	0	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	1	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	1	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	1	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	1	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	0	RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	149	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	905	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	12	NbrVotingGoverningBodyMembers
Number Independent Voting Members	5	NumberIndependentVotingMembers
Family Or Business Relationship	1	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	1	InvestmentInJointVenture
Written Policy Or Procedure	1	WrittenPolicyOrProcedure
States Where Copy Of Return Is Filed	GA	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

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

Field	Value	IRS element (for citing)
Telephone Number	7066027800	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1035 RED BUD ROAD	AddressLine1
City	CALHOUN	City
State	GA	State
ZIP Code	30701	ZIPCode

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

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Average Hours Per Week RelatedAverageHoursPerWeekRelated	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee	FormerFormer
RICHARD REINER
CHAIRMAN/DIRECTOR	0.20	50.00	X	0	1681892	62430
BRENT BOX MD
DIRECTOR	61.60	0.00	X	422531	0	42178
PETE WEBER
CEO/DIR/SECRETARY	50.00	0.00	X	0	920635	89134	X
EDWARD WRIGHT
VICE CHAIR/DIRECTOR	0.20	3.00	X	792	1071	0
DAVID LANCE
DIRECTOR	0.20	0.00	X	1020	0	0
DARLA MORGAN MD
DIRECTOR (END 12/12)	0.70	0.00	X	5542	0	0
DEBRA MOYER
DIRECTOR	0.20	0.00	X	906	0	0
JEFF BROWN
DIRECTOR	0.20	0.00	X	0	0	0
PAUL LEBLANC MD
DIRECTOR	1.40	0.00	X	9846	0	0
STEVEN FEHLENBERG
DIRECTOR	0.20	0.00	X	906	0	0
JOE JOYAVE MD
DIRECTOR	0.80	0.00	X	5050	0	0
LAVERNE KEIZER MD
DIRECTOR	0.50	0.00	X	2756	0	0
CORY REEVES
CFO	50.00	0.00		0	243457	36910	X
AMELIA D JORDON
CNO	50.00	0.00		0	216339	40208		X
STEVE HANNAH
COO	50.00	0.00		0	271610	39522		X
STEPHEN KING MD
PHYSICIAN	50.00	0.00		760329	0	40400			X
DANIEL AHN MD
PHYSICIAN	45.00	0.00		740842	0	39213			X
ANDREW HESTER MD
PHYSICIAN	50.00	0.00		428012	0	36082			X
CYNTHIA WHITE BROWN MD
PHYSICIAN	46.50	0.00		427913	0	40444			X
EDUARDO ROJAS MD
PHYSICIAN	42.00	0.00		407176	0	17101			X
CARLENE JAMERSON
FORMER CEO	0.00	50.00		0	716707	117211				X
SAM HUENERGARDT
FORMER COO	0.00	50.00		0	332984	58391				X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	3213621	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	4384695	TotalReportableCompFrmRltdOrgs
Total Other Compensation	659224	TotalOtherCompensation
Number Individuals GT100 K	42	NumberIndividualsGT100K
Formers Listed	1	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
AUREUS NURSING LLC
PO BOX 3037	OMAHA	NE	68103	NURSING STAFFING AGENCY	378667
NW GA SURGICAL ASSOCIATES
PO BOX 128	CALHOUN	GA	30703	CALL COVERAGE	366000
BRASFIELD & GORRIE LLC
1990 VAUGHN RD 100	KENNESAW	GA	30144	CONSTRUCTION SERVICES OF RADIATION THERA	362468
SIEMENS MEDICAL SOLUTIONS USA INC
DEPT ST 40065	ATLANTA	GA	31192	EQUIPMENT SERVICE CONTRACT	329487
JAMES S GOODLET JR MD
185 BLAIR VALLEY DRIVE	MARIETTA	GA	30060	PHYSICIAN COVERAGE FOR CLINICS	318370

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	26	NumberOfContractorsGT100K
All Other Contributions	12964	AllOtherContributions
Total Contributions	12964	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
NET PATIENT REVENUE	900099	94926974	94926974
COUNTY SUBSIDY-EMS	621910	318276	318276
MEDICAL OFFICE BUILDING	531120	232874	232874
CAFETERIA REVENUE	900099	221516	221516
LAB REVENUE	621500	11500		11500

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	187170	TotalRevenueColumn
Related Or Exempt Function Income	98428	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	88742	UnrelatedBusinessRevenue

Field	Value	IRS element (for citing)
Total Program Service Revenue	95898310	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	646247	TotalRevenueColumn
Exclusion	$646,247	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	972321	Securities
Other	2000	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	0	Securities
Other	55421	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	972321	Securities
Other	-53421	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	918900	TotalRevenueColumn
Exclusion	$918,900	ExclusionAmount

Other Revenue Misc OtherRevenueMisc

Field	Value	IRS element (for citing)
Description	EHR REVENUE	Description
Business Code	900099	BusinessCode
Total Revenue Column	1528013	TotalRevenueColumn
Related Or Exempt Function Income	1528013	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Other Revenue	1528013	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	99004434	TotalRevenueColumn
Related Or Exempt Function Income	97326081	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	100242	UnrelatedBusinessRevenue
Exclusion	$1,565,147	ExclusionAmount

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

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	271375	Total
Program Services	271375	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	2345718	Total
Management And General	2345718	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	33987852	Total
Program Services	33987852	ProgramServices

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	1121141	Total
Program Services	1083125	ProgramServices
Management And General	38016	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	8746379	Total
Program Services	8547796	ProgramServices
Management And General	198583	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	2510594	Total
Program Services	2425263	ProgramServices
Management And General	85331	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	78905	Total
Management And General	78905	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	28382	Total
Management And General	28382	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	9210124	Total
Program Services	6483449	ProgramServices
Management And General	2726675	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	641419	Total
Management And General	641419	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	2018972	Total
Program Services	1305323	ProgramServices
Management And General	713649	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	2907490	Total
Program Services	2526315	ProgramServices
Management And General	381175	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	2164973	Total
Program Services	2164973	ProgramServices

Travel Travel

Field	Value	IRS element (for citing)
Total	301572	Total
Management And General	301572	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	49584	Total
Management And General	49584	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	1606182	Total
Program Services	1606182	ProgramServices

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	5026520	Total
Program Services	5026520	ProgramServices

Insurance Insurance

Field	Value	IRS element (for citing)
Total	1023494	Total
Program Services	1000844	ProgramServices
Management And General	22650	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
MEDICAL SUPPLIES	10430270	10430270
REPAIRS & MAINTENANCE	1823661	1823661
GA NET REVENUE TAX	916974	916974
PURCHASED SERVICES	49115		49115

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	250418	Total
Program Services	171848	ProgramServices
Management And General	78570	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	87511114	Total
Program Services	79771770	ProgramServices
Management And General	7739344	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	3576	BOY
EOY	4225	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	78723162	BOY
EOY	85810086	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	12516866	BOY
EOY	13861903	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
BOY	30155	BOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	1472291	BOY
EOY	1417663	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	1779666	BOY
EOY	1808363	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	95554856	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	43949882	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	46965923	BOY
EOY	51604974	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	262779	BOY
EOY	286676	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	574243	BOY
EOY	3606401	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	142328661	BOY
EOY	158400291	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	6334298	BOY
EOY	7646920	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	73768	BOY
EOY	116540	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	46055385	BOY
EOY	49043546	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	52463451	BOY
EOY	56807006	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	89806016	BOY
EOY	101469231	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	59194	BOY
EOY	124054	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	89865210	BOY
EOY	101593285	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	142328661	BOY
EOY	158400291	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	11493320	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	-2690	ReconciliationUnrealizedInvest
Reconcilation Other Changes	237445	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Consolidated	X	FinancialStatementConsolidated

Field	Value	IRS element (for citing)
Audit Committee	1	AuditCommittee
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

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

Contributor Address US ContributorAddressUS

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

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	0	GrantsOtherOrganizations
Direct Contact Legislators	0	DirectContactLegislators
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	1	OtherActivities
Other Activities	$8,215	OtherActivitiesAmount
Total Lobbying Expenditures IIB	8215	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	EXPLANATION OF LOBBYING ACTIVITIES:	Identifier
Return Reference	PART II-B, LINE 1:	ReturnReference
Explanation	AMERICAN HOSPITAL ASSOCIATION DUES GEORGIA HOSPITAL ASSOCIATION DUES	Explanation

Schedule D IRS990ScheduleD

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	2210909	OtherCostOrOtherBasis
Book Value	2210909	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	49374821	OtherCostOrOtherBasis
Depreciation	17722640	Depreciation
Book Value	31652181	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	43099545	OtherCostOrOtherBasis
Depreciation	25711413	Depreciation
Book Value	17388132	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	869581	OtherCostOrOtherBasis
Depreciation	515829	Depreciation
Book Value	353752	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	51604974	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescription	AmountAmount
DUE TO AFFILIATED	$1,233,370
PAYABLE TO THIRD PARTIES	$5,373,364
CREDIT BALANCES IN A/R	$337,442
OTHER CURRENT LIABILITIES	$72,896
INTERCO. ALLOC. OF TE BOND PROCEEDS	$42,026,474

Field	Value	IRS element (for citing)
Total Of Amounts	49043546	TotalOfAmounts
Footnote In Part XIII	X	FootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

Field	Value	IRS element (for citing)
Identifier	DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:	Identifier
Return Reference	PART X, LINE 2:	ReturnReference
Explanation	THE FILING ORGANIZATION IS A SUBSIDIARY ORGANIZATION WITHIN ADVENTIST HEALTH SYSTEM (AHS). THE CONSOLIDATED FINANCIAL STATEMENTS OF AHS CONTAIN THE FOLLOWING FIN 48 FOOTNOTE: PLEASE NOTE THAT DOLLAR AMOUNTS ARE IN THOUSANDS. HEALTHCARE CORPORATION AND ITS AFFILIATED ORGANIZATIONS, OTHER THAN NORTH AMERICAN HEALTH SERVICES, INC. AND ITS SUBSIDIARIES (NAHS), ARE EXEMPT FROM STATE AND FEDERAL INCOME TAXES. ACCORDINGLY, HEALTHCARE CORPORATION AND ITS TAX-EXEMPT AFFILIATES ARE NOT SUBJECT TO FEDERAL, STATE, OR LOCAL INCOME TAXES EXCEPT FOR ANY NET UNRELATED BUSINESS TAXABLE INCOME. FOR THE YEARS ENDED DECEMBER 31, 2012 AND 2011, UNRELATED BUSINESS INCOME ACTIVITIES CONDUCTED BY HEALTHCARE CORPORATION AND ITS TAX-EXEMPT AFFILIATES DID NOT GENERATE A MATERIAL AMOUNT OF COMBINED FEDERAL, STATE AND LOCAL INCOME TAX. NAHS IS A WHOLLY OWNED, FOR-PROFIT SUBSIDIARY OF HEALTHCARE CORPORATION. NAHS AND ITS SUBSIDIARIES ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. NAHS FILES A CONSOLIDATED FEDERAL INCOME TAX RETURN AND, WHERE APPROPRIATE, CONSOLIDATED STATE INCOME TAX RETURNS. FOR THE YEARS ENDED DECEMBER 31, 2012 AND 2011, NAHS GENERATED TAXABLE INCOME OF APPROXIMATELY $2,400 AND $1,000, RESPECTIVELY. THIS TAXABLE INCOME WAS FULLY OFFSET BY NET OPERATING LOSS CARRYFORWARDS FOR FEDERAL INCOME TAX PURPOSES. ALTHOUGH ONE STATE IN WHICH NAHS CONDUCTS BUSINESS HAS SUSPENDED THE UTILIZATION OF NET OPERATING LOSS CARRYFORWARDS FOR THE YEAR ENDED DECEMBER 31, 2012, NO MATERIAL STATE INCOME TAX LIABILITY RESULTED. ACCORDINGLY, THERE IS NO PROVISION FOR CURRENT FEDERAL OR STATE INCOME TAX FOR THE YEARS ENDED DECEMBER 31, 2012 AND 2011. NAHS ALSO HAS TEMPORARY DEDUCTIBLE DIFFERENCES OF APPROXIMATELY $64,800 AND $67,500 AT DECEMBER 31, 2012 AND 2011, RESPECTIVELY, PRIMARILY AS A RESULT OF NET OPERATING LOSS CARRYFORWARDS. AT DECEMBER 31, 2012, NAHS HAD NET OPERATING LOSS CARRYFORWARDS OF APPROXIMATELY $64,300 OF WHICH $21,000 WILL EXPIRE IN 2023, WITH THE REMAINING $43,300 EXPIRING BEGINNING IN 2018 THROUGH 2026. SOME OF THESE NET OPERATING LOSSES ARE SUBJECT TO THE SEPARATE RETURN LIMITATION YEAR RULES. DEFERRED TAXES HAVE BEEN PROVIDED FOR THESE AMOUNTS, RESULTING IN A NET DEFERRED TAX ASSET OF APPROXIMATELY $24,600 AND $25,600 AT DECEMBER 31, 2012 AND 2011, RESPECTIVELY. A FULL VALUATION ALLOWANCE HAS BEEN PROVIDED AT DECEMBER 31, 2012 AND 2011, RESPECTIVELY, TO OFFSET THE DEFERRED TAX ASSET SINCE HEALTHCARE CORPORATION HAS DETERMINED THAT IT IS MORE LIKELY THAN NOT THAT THE BENEFIT OF THE NET OPERATING LOSS CARRYFORWARDS WILL NOT BE REALIZED IN FUTURE YEARS. THE INCOME TAXES TOPIC OF THE ASC (ASC 740) PRESCRIBES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAX POSITIONS RECOGNIZED IN FINANCIAL STATEMENTS. ASC 740 PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN.	Explanation

Schedule F IRS990ScheduleF

Accts Actvs Out US Table AcctsActvsOutUSTable

Field	Value	IRS element (for citing)
Region	CENTRAL AMERICA AND THE CARIBBEAN	Region
Number Of Offices	0	NumberOfOffices
Number Of Employees	0	NumberOfEmployees
Type Of Activities Conducted	PROGRAM SERVICES	TypeOfActivitiesConducted
Specific Services Provided	MEDICAL CLINICS AND EVANGELISTIC MEETINGS	SpecificServicesProvided
Total Expenditures	15013	TotalExpenditures

Field	Value	IRS element (for citing)
Subtotal Number Of Offices	0	SubtotalNumberOfOffices
Subtotal Number Of Employees	0	SubtotalNumberOfEmployees
Cont Number Of Offices	0	ContNumberOfOffices
Cont Number Of Employees	0	ContNumberOfEmployees
Total Number Of Offices	0	TotalNumberOfOffices
Total Number Of Employees	0	TotalNumberOfEmployees
Subtotal Amount Spent	15013	SubtotalAmountSpent
Cont Amount Spent	0	ContAmountSpent
Total Amount Spent	15013	TotalAmountSpent
Transfer To Foreign Corp	0	TransferToForeignCorp
Interest In Foreign Trust	0	InterestInForeignTrust
Own Foreign Corp	0	OwnForeignCorp
Passive Foreign Invest Co	0	PassiveForeignInvestCo
Foreign Partnership	0	ForeignPartnership
Boycott Countries	0	BoycottCountries

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	1	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent400	X	Pcent400
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	1	ExpensesExceededBudget
Unable To Provide Care	0	UnableToProvideCare
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	7813880	TotalCommunityBenefitExpense
Net Community Benefit Expense	7813880	NetCommunityBenefitExpense
Percent Of Total Expense	0.08930	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	15601244	TotalCommunityBenefitExpense
Direct Offsetting Revenue	16246571	DirectOffsettingRevenue
Net Community Benefit Expense	-645327	NetCommunityBenefitExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	23415124	TotalCommunityBenefitExpense
Direct Offsetting Revenue	16246571	DirectOffsettingRevenue
Net Community Benefit Expense	7168553	NetCommunityBenefitExpense
Percent Of Total Expense	0.08930	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	833851	TotalCommunityBenefitExpense
Net Community Benefit Expense	833851	NetCommunityBenefitExpense
Percent Of Total Expense	0.00950	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	183468	TotalCommunityBenefitExpense
Direct Offsetting Revenue	33241	DirectOffsettingRevenue
Net Community Benefit Expense	150227	NetCommunityBenefitExpense
Percent Of Total Expense	0.00170	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1017319	TotalCommunityBenefitExpense
Direct Offsetting Revenue	33241	DirectOffsettingRevenue
Net Community Benefit Expense	984078	NetCommunityBenefitExpense
Percent Of Total Expense	0.01120	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	24432443	TotalCommunityBenefitExpense
Direct Offsetting Revenue	16279812	DirectOffsettingRevenue
Net Community Benefit Expense	8152631	NetCommunityBenefitExpense
Percent Of Total Expense	0.10050	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$12,748,243	BadDebtExpenseAmount
Amount Attributable To	2514011	AmountAttributableTo
Amount Reimbursed By Medicare	23423514	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	20734519	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	2688995	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

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

Address Address

Field	Value	IRS element (for citing)
Address Line1	1035 RED BUD ROAD	AddressLine1
City	CALHOUN	City
State	GA	State
ZIP Code	30701	ZIPCode

Field	Value	IRS element (for citing)
Website Address	WWW.GORDONHOSPITAL.COM	WebsiteAddress
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Er24 Hours	X	Er24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	ADVENTIST HEALTH SYSTEM GEORGIA INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
Eligibility Criteria Explained	1	EligibilityCriteriaExplained
Uses FPG Free	1	UsesFPGFree
FPG Free Percent	200.000000000000	FPGFreePercent
Uses FPG Discounted	1	UsesFPGDiscounted
FPG Discount Percent	400.000000000000	FPGDiscountPercent
Explains Basis	1	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Medical Indigency	X	MedicalIndigency
Insurance Status	X	InsuranceStatus
Uninsured Discount	X	UninsuredDiscount
Medicaid Medicare	X	MedicaidMedicare
State Regulation	X	StateRegulation
Explains Application Method	1	ExplainsApplicationMethod
Includes Publicity Measures	1	IncludesPublicityMeasures
Available On Request	X	AvailableOnRequest
Other Publicity	X	OtherPublicity
Actions On Nonpayment	1	ActionsOnNonpayment
Collection Activities	0	CollectionActivities
Nondiscrim Emergency Care Policy	1	NondiscrimEmergencyCarePolicy
Used Other Method	X	UsedOtherMethod
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	0	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	9	NumberOfOtherFacilities

Other Facilities OtherFacilities (9 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
GORDON HOME CARE
104 HOSPITAL COURT	CALHOUN	GA	30701	HOME HEALTH SERVICES
AMBULANCE SERVICE
101 PROFESSIONAL COURT	CALHOUN	GA	30701	AMBULANCE SERVICE
NORTH GA ORTHOPEDIC & SPORTS MEDICINE
106 HOSPITAL COURT	CALHOUN	GA	30701	PHYSICIAN CLINIC - ORTHOPEDIC
GORDON ADULT & PEDIATRIC MEDICAL ASSOC
815 CURTIS PARKWAY SE	CALHOUN	GA	30701	PHYSICIAN CLINIC - INTERNAL & PEDIATRIC
GORDON HEALTH DEPOT
824 GI MADDOX PARKWAY	CHATSWORTH	GA	30705	PHYSICIAN CLINIC - FAMILY PRACTICE
GORDON URGENT CARE - CALHOUN
100 HOSPITAL COURT	CALHOUN	GA	30701	PHYSICIAN CLINIC - FAMILY PRACTICE
NORTHWEST GEORGIA OB GYN
110 HOSPITAL COURT	CALHOUN	GA	30701	PHYSICIAN CLINIC - OB GYN
GORDON URGENT CARE - ADAIRSVILLE
7427 HIGHWAY 140NW	ADAIRSVILLE	GA	30103	PHYSICIAN CLINIC - FAMILY PRACTICE
CHATSWORTH CLINIC
1289 GI MADDOX PARKWAY	CHATSWORTH	GA	30705	PHYSICIAN CLINIC - FAMILY PRACTICE

Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)

ExplanationExplanation	Return ReferenceReturnReference	IdentifierIdentifier
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 23 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 ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (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 8: COSTING METHODOLOGY:MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST-TO-CHARGE RATIO.
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: $ 2,688,995- DIFFERENCE IN COSTING METHODOLOGY: (5,067,227)- UNREIMBURSED COSTS INCURRED FOR SERVICES PROVIDED TO MEDICARE PATIENTS THAT ARE NOT INCLUDED IN THE ORGANIZATION'S MEDICARE COST REPORT: (834,217) -------------TOTAL SURPLUS/(SHORTFALL) COSTS OF SERVING ALL MEDICARE PATIENTS PER THE FILING ORGANIZATION'S COMMUNITY BENEFIT REPORTING: $(3,212,449)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 8 AND 9. 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: THE FILING ORGANIZATION 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.		ADVENTIST HEALTH SYSTEM GEORGIA, INC.
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.		ADVENTIST HEALTH SYSTEM GEORGIA, INC.
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: GORDON HOSPITAL 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: ADVENTIST HEALTH SYSTEM GEORGIA, INC., D/B/A GORDON HOSPITAL (THE HOSPITAL), IS A 69-BED COMMUNITY HOSPITAL THAT SERVES THE RESIDENTS OF CALHOUN, GORDON COUNTY AND SURROUNDING AREAS IN GEORGIA. THE HOSPITAL'S PRIMARY MARKET HAS A POPULATION OF APPROXIAMTELY 54,354, WITH AN ESTIMATED 6,547 OVER THE AGE OF 65. GORDON HOSPITAL PROVIDES THE FOLLOWING SERVICES TO ITS COMMUNITY: A 24-HOUR EMERGENCY CENTER, AMBULANCE SERVICE, REHABILITATION SERVICES, INTENSIVE AND PROGRESSIVE CARE UNITS, CANCER RESOURCE CENTER, RADIOLOGY, INTERVENTIONAL RADIOLOGY, LAB, CARDIOPULMONARY, SLEEP DISORDERS CENTER, NEW BEGINNINGS MATERNITY CENTER, URGENT CARE CENTERS, ORTHOPEDIC SURGERY, OPTHALMOLOGY SURGERY, AND PASTORAL CARE. IN 2009, THE HOSPITAL OPENED A NEW DIAGNOSTIC CARDIAC CATHETERIZATION LAB. THE HOSPITAL IS THE ONLY HOSPITAL IN NORTHWEST GEORGIA TO BE AN ACCREDITED BREAST IMAGING CENTER OF EXCELLENCE. IN NOVEMBER 2012, THE HOSPITAL OPENED A RADIATION ONCOLOGY CENTER THAT FOR THE FIRST TIME PROVIDES THIS SERVICE WITHIN THE COMMUNITY. APPROXIMATELY 4 UNRELATED HOSPITALS ARE EACH ABOUT 20 MILES AWAY FROM GORDON HOSPITAL. THE WEIGHTED AVERAGE HOUSEHOLD INCOME, BASED ON POPULATION, IN THE PRIMARY MARKET IS APPROXIMATELY $41,390. HIGH SCHOOL GRADUATES ACCOUNT FOR APPROXIMATELY 74% OF GORDON COUNTY, WITH AN ESTIMATED 12% HAVING A BACHELOR'S DEGREE OR HIGHER. IT IS ESTIMATED THAT 16% OF THE INDIVIDUALS RESIDING IN GORDON COUNTY LIVE BELOW THE POVERTY LEVEL AND THE UNEMPLOYMENT RATE IS ABOUT 7%.APPROXIMATELY 59% OF THE HOSPITAL'S PATIENTS ARE COVERED BY MEDICARE AND MEDICAID. MEDICARE PATIENTS COMPRISE ABOUT 42% OF THE HOSPITAL'S PATIENTS. APPROXIMATELY 17% OF THE HOSPITAL'S PATIENTS ARE COVERED BY THE MEDICAID PROGRAM, 11% REPRESENTING SELF-PAY, WITH THE REMAINING 30% IN COMMERCIAL PAYORS. APPROXIMATELY 68% OF THE HOSPITAL'S IN-PATIENTS ARE ADMITTED THROUGH THE HOSPITAL'S EMERGENCY DEPARTMENT.
PART VI, LINE 5: THE PROVISION OF COMMUNITY BENEFIT IS CENTRAL TO GORDON HOSPITAL'S MISSION OF SERVICE AND COMPASSION. RESTORING AND PROMOTING THE HEALTH AND QUALITY OF LIFE OF THOSE IN THE COMMUNITIES SERVED BY THE HOSPITAL IS A FUNCTION OF "EXTENDING THE HEALING MINISTRY OF CHRIST" AND EMBODIES THE HOSPITAL'S COMMITMENT TO ITS VALUES AND PRINCIPLES. THE HOSPITAL COMMITS SUBSTANTIAL RESOURCES TO PROVIDE A BROAD RANGE OF SERVICES TO BOTH THE UNDERPRIVILEGED AS WELL AS THE BROADER COMMUNITY. IN ADDITION TO THE COMMUNITY BENEFIT INFORMATION PROVIDED IN PARTS I, II AND III OF THIS SCHEDULE H, THE HOSPITAL CAPTURES AND REPORTS THE BENEFITS PROVIDED TO ITS COMMUNITY THROUGH FAITH-BASED CARE. EXAMPLES OF SUCH BENEFITS INCLUDE THE COST ASSOCIATED WITH CHAPLAINCY CARE PROGRAMS AND MISSION PEER REVIEWS AND MISSION CONFERENCES. DURING THE CURRENT YEAR, HOSPITAL PROVIDED $143,005 OF BENEFIT WITH RESPECT TO THE FAITH-BASED AND SPIRITUAL NEEDS OF THE COMMUNITY IN CONJUNCTION WITH ITS OPERATION OF A COMMUNITY HOSPITAL. THE HOSPITAL ALSO PROVIDES BENEFITS TO ITS COMMUNITY'S INFRASTRUCTURE BY INVESTING IN CAPITAL IMPROVEMENTS TO ENSURE THAT FACILITIES AND TECHNOLOGY PROVIDE THE BEST POSSIBLE CARE TO THE COMMUNITY. DURING THE CURRENT YEAR, THE HOSPITAL EXPENDED $10,030,573 IN NEW CAPITAL IMPROVEMENTS. AS A FAITH-BASED MISSION-DRIVEN COMMUNITY HOSPITAL, THE HOSPITAL IS CONTINUALLY INVOLVED IN MONITORING ITS COMMUNITY, IDENTIFYING UNMET HEALTH CARE NEEDS AND DEVELOPING SOLUTIONS AND PROGRAMS TO ADDRESS THOSE NEEDS. IN ACCORDANCE WITH ITS CONSERVATIVE APPROACH TO FISCAL RESPONSIBILITY, SURPLUS FUNDS OF THE HOSPITAL ARE CONTINUALLY BEING INVESTED IN RESOURCES THAT IMPROVE THE AVAILABILITY AND QUALITY OF DELIVERY OF HEALTH CARE SERVICES AND PROGRAMS TO ITS COMMUNITY.
PART VI, LINE 6: GORDON HOSPITAL IS A PART OF A FAITH-BASED HEALTHCARE SYSTEM OF ORGANIZATIONS WHOSE PARENT IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). THE SYSTEM IS KNOWN AS ADVENTIST HEALTH SYSTEM (AHS). AHSSHC IS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). AHSSHC AND ITS SUBSIDIARY ORGANIZATIONS OPERATE 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 HOSPITALS 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.GORDON HOSPITAL DOES PARTICIPATE IN A COMMUNITY BENEFIT REPORT SURVEY FACILIATED BY THE GEORGIA HOSPITAL ASSOCIATION.	PART VI, LINE 7:

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	1	RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Non Cash AssistanceAmountOfNonCashAssistance	Method Of ValuationMethodOfValuation	Description Of Non Cash AssistanceDescriptionOfNonCashAssistance	Purpose Of GrantPurposeOfGrant	Amount Of Cash GrantAmountOfCashGrant
SUNSYSTEM DEVELOPMENT CORPORATION DBA GORDON HOSPITAL FOUNDATION
1035 RED BUD ROAD	CALHOUN	GA	30701	592219301	501(C)(3)	240429	COST	GENERAL ADMINISTRATIVE SUPPORT	PROVISION OF GENERAL ADMINISTRATIVE SUPPORT
NORTHWEST GEORGIA REGIONAL CANCER COALITION INC
96 E CALLAHAN ST	ROME	GA	30161	020657616	501(C)(3)				GENERAL SUPPORT	7500

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	2	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	0	TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	PROCEDURE FOR MONITORING GRANTS IN THE U.S.:	Identifier
Return Reference	PART I, LINE 2:	ReturnReference
Explanation	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.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Travel For Companions	X	TravelForCompanions
Idemnification Gross Up Payments	X	IdemnificationGrossUpPayments
Discretionary Spending Account	X	DiscretionarySpendingAccount
Written Policy Re T And E Expenses	1	WrittenPolicyReTAndEExpenses
Substantiation Required	1	SubstantiationRequired
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	1	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	1	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)

TitleTitle	Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
RICHARD REINER
CHAIRMAN/DIRECTOR	0	871778	0	266769	0	543345	0	13599	0	48831	0	1744322	0	0
BRENT BOX MD
DIRECTOR	404291	0	12764	0	5476	0	13599	0	28579	0	464709	0	0	0
PETE WEBER
CEO/DIR/SECRETARY	0	359453	0	129878	0	431304	0	60633	0	28501	0	1009769	0	44269
CORY REEVES
CFO	0	174400	0	56310	0	12747	0	13075	0	23835	0	280367	0	0
AMELIA D JORDON
CNO	0	154709	0	47627	0	14003	0	7144	0	33064	0	256547	0	0
STEVE HANNAH
COO	0	198375	0	53558	0	19677	0	12864	0	26658	0	311132	0	0
STEPHEN KING MD
PHYSICIAN	755871	0	0	0	4458	0	13599	0	26801	0	800729	0	0	0
DANIEL AHN MD
PHYSICIAN	396147	0	340033	0	4662	0	13599	0	25614	0	780055	0	0	0
ANDREW HESTER MD
PHYSICIAN	416124	0	0	0	11888	0	8599	0	27483	0	464094	0	0	0
CYNTHIA WHITE BROWN MD
PHYSICIAN	311654	0	111953	0	4306	0	13599	0	26845	0	468357	0	0	0
EDUARDO ROJAS MD
PHYSICIAN	360365	0	45000	0	1811	0	8906	0	8195	0	424277	0	0	0
CARLENE JAMERSON
FORMER CEO	0	355441	0	111830	0	249436	0	48771	0	68440	0	833918	0	33340
SAM HUENERGARDT
FORMER COO	0	277317	0	25000	0	30667	0	28175	0	30216	0	391375	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
PART I, LINE 1A	AS DISCUSSED IN OUR RESPONSE TO FORM 990, 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 ------------------------------------------------------- RICHARD REINER $ 182,872 $ 167,651 $255,540 $ 0 PETER WEBER $ 47,035 $ 49,188 $343,581 $ 0 CARLENE JAMERSON $ 52,172 $ 33,567 $171,993 $ 0 SAM HUENERGARDT $ 14,577 $ 0 $ 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.
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.	SUPPLEMENTAL INFORMATION

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (5 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
JUDY FEHLENBERG
SPOUSE OF BOARD MEMBER	22810	EMPLOYEE COMPENSATION	0
NORTHWEST GEORGIA SURGICAL ASSOCIATES PC
33% OWNED BY BOARD MEMBER FAMILY MEMBER	366000	CONTRACTED ON-CALL SERVICES	0
CALHOUN OBGYN ASSOCIATES
50% OWNED BY BOARD MEMBER	41965	LEASE AGREEMENT	0
CALHOUN ANESTHESIA PC
33% OWNED BY BOARD MEMBER	651559	PROFESSIONAL SERVICE AGREEMENT	0
OWASA FAMILY MEDICINE PC
25% OWNED BY BOARD MEMBER	150000	PROFESSIONAL SERVICE AGREEMENT	0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 2	DARLA MORGAN, MD AND STEVE FEHLENBERG - BUSINESS RELATIONSHIP
FORM 990, PART VI, SECTION A, LINE 6	ADVENTIST HEALTH SYSTEM GEORGIA, INC. (THE FILING ORGANIZATION) HAS ONE MEMBER. THE SOLE MEMBER OF THE FILING ORGANIZATION IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION. ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION. (AHSSHC) IS A FLORIDA, NOT-FOR-PROFIT CORPORATION THAT IS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3). THERE ARE NO OTHER CLASSES OF MEMBERSHIP IN THE FILING ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7A	THE SOLE MEMBER OF THE FILING ORGANIZATION IS AHSSHC. THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION ARE APPOINTED BY THE SOLE MEMBER, AHSSHC, WHO HAS THE RIGHT TO ELECT, APPOINT OR REMOVE ANY MEMBER OF THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7B	AHSSHC, AS THE SOLE MEMBER OF THE FILING ORGANIZATION, HAS CERTAIN RESERVED POWERS AS SET FORTH IN THE BYLAWS OF THE FILING ORGANIZATION. THESE RESERVED POWERS INCLUDE THE FOLLOWING: A) TO APPROVE AND DISAPPROVE THE EXECUTIVE AND/OR ADMINISTRATIVE LEADERSHIP OF THE FILING ORGANIZATION, AND THEIR SALARIES; B) TO ADOPT, AMEND, RESTATE, AND REPEAL THE ARTICLES OF INCORPORATION OR BYLAWS OF THE FILING ORGANIZATION, AND THE MEDICAL STAFF BYLAWS; C) TO SET LIMITS AND TERMS FOR THE BORROWING OF FUNDS; D) TO APPROVE OR DISAPPROVE MAJOR BUILDING PROGRAMS AND/OR PURCHASE OR SALE OF PERSONAL PROPERTY OR REAL PROPERTY EQUAL TO OR IN EXCESS OF ONE MILLION DOLLARS; E) TO APPROVE OR DISAPPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE FILING ORGANIZATION; F) TO DIRECT THE PLACEMENT OF FUNDS AND CAPITAL OF THE FILING ORGANIZATION; G) TO ESTABLISH GENERAL GUIDING POLICIES, TO IMPLEMENT QUALITY ASSESSMENT, IMPROVEMENT AND UTILIZATION REVIEW PROGRAMS; H) TO APPROVE THE APPOINTMENT OF AN AUDITING FIRM AND ELECTION OF THE FISCAL YEAR FOR THE FILING ORGANIZATION; AND I) TO ESTABLISH A PROCESS FOR ADDRESSING PATIENT GRIEVANCES.
FORM 990, PART VI, SECTION B, LINE 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 DIRECTOR MEMBERS WHO DEVOTE LESS THAN FULL-TIME TO THE FILING ORGANIZATION (BASED UPON THE AVERAGE NUMBER OF HOURS PER WEEK SHOWN IN COLUMN (B) ON PAGE 7 OF THE RETURN) THE COMPENSATION AMOUNTS SHOWN IN COLUMNS (E) AND (F) ON PAGE 7 WERE PROVIDED IN CONJUNCTION WITH THAT PERSON'S RESPONSIBILITIES AND ROLES IN SERVING IN AN EXECUTIVE LEADERSHIP POSITION WITHIN ADVENTIST HEALTH SYSTEM.
FORM 990, PART IX, LINE 11G	PAYMENTS TO HEALTHCARE PROFESSIONAL : PROGRAM SERVICE EXPENSES 2,715,230. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,715,230. PROFESSIONAL FEES : PROGRAM SERVICE EXPENSES 1,870,727. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,870,727. PURCHASED MEDICAL SERVICES : PROGRAM SERVICE EXPENSES 1,066,444. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,066,444. ENVIRONMENTAL SERVICES : PROGRAM SERVICE EXPENSES 583,189. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 583,189. RECRUITING : PROGRAM SERVICE EXPENSES 92,288. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 92,288. TRANSCRIPTION SERVICES : PROGRAM SERVICE EXPENSES 155,571. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 155,571. AHS MANAGEMENT FEES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 992,522. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 992,522. BILLING & COLLECTION SERVICES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 768,518. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 768,518. EHR MANAGEMENT FEES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 965,635. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 965,635.	OTHER FEES
FORM 990, PART XI, LINE 9:	TEMPORARILY RESTRICTED NET GIFTS 951,209. TRANSFER TO TAX-EXEMPT PARENT -738,038. ALLOCATION FROM TAX-EXEMPT PARENT WITH RESPECT TO DEBT 103,557. TRANSFER TO TAX-EXEMPT RELATED ORGANIZATION -79,283.	CHANGES IN NET ASSETS OR FUND BALANCES:
PART X, LINE 2	THE AMOUNTS SHOWN ON LINE 2 OF PART X OF THIS RETURN INCLUDE THE FILING ORGANIZATION'S INTEREST IN A CENTRAL INVESTMENT POOL MAINTAINED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION, THE FILING ORGANIZATION'S TOP-TIER PARENT. THE INVESTMENTS IN THE CENTRAL INVESTMENT POOL ARE RECORDED AT MARKET VALUE.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (107 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg	Direct Controlling Entity NADirectControllingEntityNA
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		0	N/A
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	TX	76028	452793120	SUPPORT OPERATION OF HOSPITAL	TX	501(C)(3)	509(A)(3) TYPE I	ADVENTIST HLTH SYSTEMSUNBELT INC	0
IN-MOTION REHAB INC
602 COURTLAND STREET STE 200	ORLANDO	FL	32804	208023411	THERAPY SERVICES TO TAX EXEMPT NURSING HOMES	KS	501(C)(3)	509(A)(3) TYPE II	SUNBELT HLTH CARE CENTERS INC	0
JELLICO COMMUNITY HOSPITAL INC
188 HOSPITAL LANE	JELLICO	TN	37762	620924706	OPERATION OF HOSPITAL & RELATED SERVICES	TN	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	0
LA GRANGE MEMORIAL HOSPITAL FOUNDATION
5101 S WILLOW SPRINGS RD	LA GRANGE	IL	60525	300247776	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	IL	501(C)(3)	170(B)(1)(A)(VI)	MIDWEST HLTH FOUNDATION	0
MEMORIAL HLTH SYSTEMS FOUNDATION INC
770 WEST GRANADA BLVD	ORMOND BEACH	FL	32174	311771522	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	FL	501(C)(3)	170(B)(1)(A)(VI)	MEMORIAL HLTH SYSTEMS INC	0
MEMORIAL HLTH SYSTEMS INC
301 MEMORIAL MEDICAL PARKWAY	DAYTONA BEACH	FL	32117	590973502	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HLTH SYSTEMSUNBELT INC	0
MEMORIAL HOSPITAL FLAGLER INC
60 MEMORIAL MEDICAL PARKWAY	PALM COAST	FL	32164	592951990	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	170(B)(1)(A)(III)	MEMORIAL HLTH SYSTEMS INC	0
MEMORIAL HOSPITAL - WEST VOLUSIA INC
701 WEST PLYMOUTH AVENUE	DELAND	FL	32720	593256803	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	170(B)(1)(A)(III)	MEMORIAL HLTH SYSTEMS INC	0
MEMORIAL HOSPITAL INC
210 MARIE LANGDON DRIVE	MANCHESTER	KY	40962	610594620	OPERATION OF HOSPITAL & RELATED SERVICES	KY	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	0
MERRIAM HLTH CARE PROPERTIES INC
9700 WEST 62ND STREET	MERRIAM	KS	66203	364595806	LEASE TO RELATED ORGANIZATION	KS	501(C)(3)	509(A)(3) TYPE III-F	SUNBELT HLTH CARE CENTERS INC	0
METROPLEX ADVENTIST HOSPITAL INC
2201 S CLEAR CREEK ROAD	KILLEEN	TX	76549	742225672	OPERATION OF HOSPITAL & RELATED SERVICES	TX	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	0
METROPLEX CLINIC PHYSICIANS INC
2201 S CLEAR CREEK ROAD	KILLEEN	TX	76549	113762050	PHYSICIAN HLTHCARE SERVICES TO THE COMMUNITY	TX	501(C)(3)	170(B)(1)(A)(III)	METROPLEX ADVENTIST HOSPITAL INC	0
METROPLEX HOSPITAL INC (1023-123112)
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	461256516	FUTURE OPERATION OF HOSPITAL & RELATED SVCS	FL	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	0
MIDWEST HLTH FOUNDATION
120 NORTH OAK STREET	HINSDALE	IL	60521	352230515	SUPPORT OF SUBSIDIARY FOUNDATIONS	IL	501(C)(3)	509(A)(3) TYPE II		0	N/A
MILLS HLTH & REHAB CENTER INC
500 BECK LANE	MAYFIELD	KY	42066	205782320	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	KY	501(C)(3)	509(A)(2)	SUNBELT HLTH CARE CENTERS INC	0
MISSION STRATEGIES INC
602 COURTLAND STREET STE 200	ORLANDO	FL	32804	205982365	PROVISION OF SUPPORT TO THE NURSING HOME DIVISION	KS	501(C)(3)	509(A)(3) TYPE II	SUNBELT HLTH CARE CENTERS INC	0
MISSION STRATEGIES OF GEORGIA INC
3949 S COBB DRIVE	SMYRNA	GA	30080	900866024	PROVISION OF SUPPORT TO THE NURSING HOME DIVISION	GA	501(C)(3)	509(A)(3) TYPE II	SUNBELT HLTH CARE CENTERS INC	0
MISSOURI ADVENTIST HLTH INC
9100 W 74TH STREET	SHAWNEE MISSION	KS	66204	431224729	SUPPORT HLTH CARE SERVICES	MO	501(C)(3)	509(A)(3) TYPE III-O	ADVENTIST HLTH MID-AMERICA INC	0
NORTH REGIONAL EMS INC
188 HOSPITAL LANE	JELLICO	TN	37762	262653616	EMS SERVICES	TN	501(C)(3)	509(A)(2)	JELLICO COMMUNITY HOSPITAL INC	0
ORMOND BEACH MEMORIAL HOSPITAL AUXILIARY INC
301 MEMORIAL MEDICAL PARKWAY	DAYTONA BEACH	FL	32117	591721962	VOLUNTEER SUPPORT SERVICES	FL	501(C)(3)	509(A)(3) TYPE III-F	MEMORIAL HLTH SYSTEMS INC	0
OVERLAND PARK NURSING & REHAB CENTER INC
6501 WEST 75TH STREET	OVERLAND PARK	KS	66204	205774821	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	KS	501(C)(3)	509(A)(2)	SUNBELT HLTH CARE CENTERS INC	0
PARAGON HLTH CARE PROPERTIES INC
950 HIGHPOINT DRIVE	HOPKINSVILLE	KY	42240	510605686	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	509(A)(3) TYPE III-F	SUNBELT HLTH CARE CENTERS INC	0
PASCO-PINELLAS HILLSBOROUGH COMMUNITY HLTH SYSTEM INC
2400 BEDFORD ROAD	ORLANDO	FL	32803	208488713	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	170(B)(1)(A)(III)		0	N/A
PORTERCARE ADVENTIST HLTH SYSTEM (630 YEAR END)
2525 S DOWNING STREET	DENVER	CO	80210	840438224	OPERATION OF HOSPITAL & RELATED SERVICES	CO	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	0
PORTLAND NURSING & REHAB CENTER INC
215 HIGHLAND CIRCLE DRIVE	PORTLAND	TN	37148	205774842	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	TN	501(C)(3)	509(A)(2)	SUNBELT HLTH CARE CENTERS INC	0
PRINCETON HLTH & REHAB CENTER INC
1333 WEST MAIN	PRINCETON	KY	42445	205782272	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	KY	501(C)(3)	509(A)(2)	SUNBELT HLTH CARE CENTERS INC	0
PRINCETON PROFESSIONAL SERVICES INC
601 E ROLLINS STREET	ORLANDO	FL	32803	591191045	PROVISION OF HLTHCARE SERVICES	FL	501(C)(3)	509(A)(2)	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	0
QUALITY CIRCLE FOR HLTHCARE INC
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	263789368	HLTHCARE QUALITY SERVICES	FL	501(C)(3)	509(A)(3) TYPE III-F	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	0
RESOURCE PERSONNEL INC
602 COURTLAND STREET STE 200	ORLANDO	FL	32804	208040875	PROVIDE ADMINISTRATIVE SUPPORT TO TAX EXEMPT NURSING HOMES	FL	501(C)(3)	509(A)(3) TYPE II	SUNBELT HLTH CARE CENTERS INC	0
ROCKY MOUNTAIN ADVENTIST HLTHCARE FOUNDATION (630 YEAR END)
2525 SOUTH DOWNING STREET	DENVER	CO	80210	840745018	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	CO	501(C)(3)	170(B)(1)(A)(VI)	PORTERCARE ADVENTIST HLTH SYSTEM	0
ROLLINS BEDFORD CORP
602 COURTLAND STREET STE 200	ORLANDO	FL	32804	370908840	INACTIVE	FL	501(C)(3)	509(A)(3) TYPE II	SUNBELT HLTH CARE CENTERS INC	0
ROLLINS BROOK COMMUNITY CARE CORP (1120-123112)
2201 S CLEAR CREEK ROAD	KILLEEN	TX	76549	461656773	INACTIVE	TX	501(C)(3)		METROPLEX ADVENTIST HOSPITAL INC	0
RUSSELLVILLE HLTH CARE PROPERTIES INC
683 EAST THIRD STREET	RUSSELLVILLE	KY	42276	510605691	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	509(A)(3) TYPE III-F	SUNBELT HLTH CARE CENTERS INC	0
SAN MARCOS HLTH CARE PROPERTIES INC
1900 MEDICAL PARKWAY	SAN MARCOS	TX	78666	510605693	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	509(A)(3) TYPE III-F	SUNBELT HLTH CARE CENTERS INC	0
SAN MARCOS NURSING & REHAB CENTER INC
1900 MEDICAL PARKWAY	SAN MARCOS	TX	78666	205782224	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	TX	501(C)(3)	509(A)(2)	SUNBELT HLTH CARE CENTERS INC	0
SHAWNEE MISSION HLTH CARE INC
6501 WEST 75TH STREET	OVERLAND PARK	KS	66204	480952508	LEASE TO RELATED ORGANIZATION	KS	501(C)(3)	509(A)(3) TYPE III-F	SUNBELT HLTH CARE CENTERS INC	0
SHAWNEE MISSION MEDICAL CENTER INC
9100 W 74TH STREET	SHAWNEE MISSION	KS	66204	480637331	OPERATION OF HOSPITAL & RELATED SERVICES	KS	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HLTH MID-AMERICA INC	0
SOUTH CENTRAL NURSING HOMES PROPERTIES INC
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	593686109	MANAGEMENT SUPPORT	GA	501(C)(3)	509(A)(3) TYPE III-O	SOUTH CENTRAL INC	0
SOUTH CENTRAL NURSING HOMES INC
602 COURTLAND STREET	ORLANDO	FL	32804	611242373	MANAGEMENT SUPPORT	KY	501(C)(3)	509(A)(3) TYPE III-O	SOUTH CENTRAL INC	0
SOUTH CENTRAL PROPERTIES III INC
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	593692860	REAL ESTATE	GA	501(C)(2)		SOUTH CENTRAL NURSING HOMES PROPERTIES INC	0
SOUTH CENTRAL PROPERTIES IV INC
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	593692862	REAL ESTATE	GA	501(C)(2)		SOUTH CENTRAL NURSING HOMES PROPERTIES INC	0
SOUTH CENTRAL PROPERTIES VI INC
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	593692857	REAL ESTATE	GA	501(C)(2)		SOUTH CENTRAL NURSING HOMES PROPERTIES INC	0
SOUTH CENTRAL PROPERTIES INC
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	593651692	REAL ESTATE	GA	501(C)(2)		SOUTH CENTRAL NURSING HOMES PROPERTIES INC	0
SOUTH CENTRAL INC
602 COURTLAND STREET	ORLANDO	FL	32804	593689740	MANAGEMENT SUPPORT	GA	501(C)(3)	509(A)(3) TYPE III-F		0	N/A
SOUTH PASCO HLTH CARE PROPERTIES INC
38250 A AVENUE	ZEPHYRHILLS	FL	33542	510605679	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	509(A)(3) TYPE III-F	SUNBELT HLTH CARE CENTERS INC	0
SOUTHWEST VOLUSIA HLTH SERVICES INC
1055 SAXON BLVD	ORANGE CITY	FL	327638468	593281591	MEDICAL OFFICE BUILDING FOR HOSPITAL	FL	501(C)(3)	509(A)(3) TYPE I	SOUTHWEST VOLUSIA HLTHCARE CORP	0
SOUTHWEST VOLUSIA HLTHCARE CORP
1055 SAXON BLVD	ORANGE CITY	FL	327638468	593149293	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HLTH SYSTEMSUNBELT INC	0
SPECIALTY PHYSICIANS OF CENTRAL TEXAS INC
1301 WONDER WORLD DRIVE	SAN MARCOS	TX	78666	208814408	PHYSICIAN HLTHCARE SERVICES TO THE COMMUNITY	TX	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HLTH SYSTEMSUNBELT INC	0
SPRING VIEW HLTH & REHAB CENTER INC
718 GOODWIN LANE	LEITCHFIELD	KY	42754	205782288	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	KY	501(C)(3)	509(A)(2)	SUNBELT HLTH CARE CENTERS INC	0
SUNBELT HLTH & REHAB CENTER - APOPKA INC
305 EAST OAK STREET	APOPKA	FL	32703	205774856	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	FL	501(C)(3)	509(A)(2)	SUNBELT HLTH CARE CENTERS INC	0
SUNBELT HLTH CARE CENTERS INC
602 COURTLAND STREET STE 200	ORLANDO	FL	32804	581473135	MANAGEMENT SERVICES	TN	501(C)(3)	509(A)(3) TYPE II	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	0
SUNSYSTEM DEVELOPMENT CORP
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	592219301	FUND RAISING FOR AFFILIATED TAX-EXEMPT HOSPITALS	FL	501(C)(3)	170(B)(1)(A)(VI)	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	0
TARPON SPRINGS HOSPITAL FOUNDATION INC
1395 S PINELLAS AVE	TARPON SPRINGS	FL	34689	590898901	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	170(B)(1)(A)(III)	UNIVERSITY COMMUNITY HOSPITAL INC	0
TARRANT COUNTY HLTH CARE PROPERTIES INC
301 HUGULEY BLVD	BURLESON	TX	76028	510605677	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	509(A)(3) TYPE III-F	SUNBELT HLTH CARE CENTERS INC	0
TAYLOR CREEK HLTH CARE PROPERTIES INC
718 GOODWIN LANE	LEITCHFIELD	KY	42754	510605678	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	509(A)(3) TYPE III-F	SUNBELT HLTH CARE CENTERS INC	0
TEXAS HLTH HUGULEY INC (11-43012)
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	452694620	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HLTH SYSTEMSUNBELT INC	0
THE VOLUNTEER AUXILIARY OF FLORIDA HOSPITAL - FLAGLER INC
60 MEMORIAL MEDICAL PARKWAY	PALM COAST	FL	32164	592486582	VOLUNTEER SUPPORT SERVICES	FL	501(C)(3)	509(A)(3) TYPE III-F	MEMORIAL HOSPITAL FLAGLER INC	0
TRINITY NURSING & REHAB CENTER INC
9700 WEST 62ND STREET	MERRIAM	KS	66203	205774890	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	KS	501(C)(3)	509(A)(2)	SUNBELT HLTH CARE CENTERS INC	0
UNIVERSITY COMMUNITY HOSPITAL AUXILIARY INC
3100 E FLETCHER AVE	TAMPA	FL	33613	237011345	VOLUNTEER SUPPORT SERVICES	FL	501(C)(3)	509(A)(3) TYPE III-F	UNIVERSITY COMMUNITY HOSPITAL INC	0
UNIVERSITY COMMUNITY HOSPITAL FOUNDATION INC
3100 E FLETCHER AVE	TAMPA	FL	33613	592554889	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	FL	501(C)(3)	509(A)(3) TYPE I	UNIVERSITY COMMUNITY HOSPITAL INC	0
UNIVERSITY COMMUNITY HOSPITAL SPECIALTY CARE INC
3100 E FLETCHER AVE	TAMPA	FL	33613	593231322	INACTIVE	FL	501(C)(3)	509(A)(3)	UNIVERSITY COMMUNITY HOSPITAL INC	0
UNIVERSITY COMMUNITY HOSPITAL INC
3100 E FLETCHER AVE	TAMPA	FL	33613	591113901	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	0
WEST KENTUCKY HLTH CARE PROPERTIES INC
500 BECK LANE	MAYFIELD	KY	42066	510605676	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	509(A)(3) TYPE III-F	SUNBELT HLTH CARE CENTERS INC	0
ZEPHYR HAVEN HLTH & REHAB CENTER INC
38250 A AVENUE	ZEPHYRHILLS	FL	33542	205774930	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	FL	501(C)(3)	509(A)(2)	SUNBELT HLTH CARE CENTERS INC	0
ZEPHYRHILLS HLTH & REHAB CENTER INC
7350 DAIRY ROAD	ZEPHYRHILLS	FL	33540	205774967	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	FL	501(C)(3)	509(A)(2)	SUNBELT HLTH CARE CENTERS INC	0

Form990 Schedule R Part III Form990ScheduleRPartIII (9 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Direct Controlling Entity NADirectControllingEntityNA
APPALACHIAN THERAPY SERVICES LLC
100 HOSPITAL DRIVE	HENDERSONVILLE	NC	28792	202463851	THERAPY STAFFING	NC	N/A
CLEAR CREEK MOB LTD
2201 S CLEAR CREEK RD	KILLEEN	TX	76549	742609195	REAL ESTATE	TX	N/A
FLORIDA HOSPITAL DMERT LLC
2450 MAITLAND CENTER PKWY STE 200	MAITLAND	FL	32751	202392253	MEDICAL EQUIPMENT	FL	N/A
FLORIDA HOSPITAL HOME INFUSION
2450 MAITLAND CENTER PKWY STE 200	MAITLAND	FL	32751	593142824	HOME INFUSION SERVICES	FL	N/A
HUGULEY SURGERY CTR LLP (11-4112)
15305 DALLAS PKWY STE 1600 LB 28	ADDISON	TX	75001	200910694	OUTPATIENT SURGERY	TX	N/A
KCCCSMMC CANCER CENTER LLC
9100 W 74TH STREET	SHAWNEE MISSION	KS	66204	270909763	EQUIPMENT RENTAL	KS	N/A
PAHSUSP SURGERY CENTERS LLC
15305 DALLAS PKWY STE 1600 LB 28	ADDISON	TX	75010	263057950	MEDICAL SERVICES	CO	N/A
SHAWNEE MISSION OPEN MRI LLC
9100 W 74TH STREET BOX 2923	SHAWNEE MISSION	KS	66201	270011796	IMAGING & TESTING	KS	N/A
SKYLAND MRI LLC (11-12012)
100 HOSPITAL DRIVE	HENDERSONVILLE	NC	28792	043646559	IMAGING & TESTING	KS	N/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (30 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Direct Controlling Entity NADirectControllingEntityNA	Type Of EntityTypeOfEntity	Controlled OrgControlledOrg	Address Line1AddressForeign/AddressLine1	Province Or StateAddressForeign/ProvinceOrState	CountryAddressForeign/Country	Legal Domicile Foreign CountryLegalDomicileForeignCountry
ALTAMONTE MEDICAL PLAZA CONDOMINIUM ASSOCIATION INC
601 EAST ROLLINS STREET	ORLANDO	FL	32803	592855792	CONDO ASSOCIATION	FL	N/A	C	0
APOPKA MEDICAL PLAZA CONDOMINIUM ASSOCIATION INC
601 EAST ROLLINS STREET	ORLANDO	FL	32803	593000857	CONDO ASSOCIATION	FL	N/A	C	0
ARAPAHOE MEDICAL BUILDING I INC (7111-12512)
2525 S DOWNING STREET	DENVER	CO	80210	841574506	REAL ESTATE LEASING	CO	N/A	C	0
ARAPAHOE MEDICAL BUILDING II INC (7111-12512)
2525 S DOWNING STREET	DENVER	CO	80210	841574507	REAL ESTATE LEASING	CO	N/A	C	0
CC MOB INC
2201 S CLEAR CREEK ROAD	KILLEEN	TX	76549	742616875	REAL ESTATE RENTAL	TX	N/A	C	0
CENTRAL TEXAS MEDICAL ASSOCIATES
1301 WONDER WORLD DRIVE	SAN MARCOS	TX	78666	742729873	PHYSICIAN CLINICS	TX	N/A	C	0
CENTRAL TEXAS PROVIDER'S NETWORK
1301 WONDER WORLD DRIVE	SAN MARCOS	TX	78666	742827652	PHYSICIAN HOSPITAL ORG.	TX	N/A	C	0
FLORIDA HOSPITAL FLAGLER MEDICAL OFFICES ASSOCIATION INC
60 MEMORIAL MEDICAL PARKWAY	PALM COAST	FL	32164	262158309	CONDO ASSOCIATION	FL	N/A	C	0
FLORIDA HOSPITAL HEALTHCARE SYSTEM INC
602 COURTLAND STREET	ORLANDO	FL	32804	593215680	PHO/TPA	FL	N/A	C	0
FLORIDA HOSPITAL WESLEY CHAPEL INC (11-51512)
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	203965753	INACTIVE	FL	N/A	C	0
FLORIDA MEDICAL PLAZA CONDO ASSOCIATION INC
601 EAST ROLLINS STREET	ORLANDO	FL	32803	592855791	CONDO ASSOCIATION	FL	N/A	C	0
FLORIDA MEMORIAL HEALTH NETWORK INC
770 W GRANADA BLVD STE 317	ORMOND BEACH	FL	32174	593403558	PHYSICIAN HOSPITAL ORG.	FL	N/A	C	0
HARVARD PARK EAST INC (7111-12512)
2525 S DOWNING STREET	DENVER	CO	80210	841574365	REAL ESTATE LEASING	CO	N/A	C	0
HELEN ELLIS MEMORIAL HOSPITAL REAL ESTATE CORP (11-101912)
1395 S PINELLAS AVE	TARPON SPRINGS	FL	34689	593375731	REAL ESTATE RENTAL	FL	N/A	C	0
HUGULEY ALLIANCE FOUNDATION
11801 SOUTH FREEWAY	FORT WORTH	TX	76115	752642209	INACTIVE	TX	N/A	C	0
HUGULEY MEDICAL ASSOCIATES INC (11-43012)
11801 SOUTH FREEWAY	BURLESON	TX	76028	752547668	PHYSICIAN CLINICS	TX	N/A	C	0
KISSIMMEE MULTISPECIALTY CLINIC CONDOMINIUM ASSOCIATION INC
201 HILDA STREET SUITE 30	KISSIMMEE	FL	34741	593539564	CONDO ASSOCIATION	FL	N/A	C	0
MIDWEST MANAGEMENT SERVICES INC
9100 WEST 74TH STREET	SHAWNEE MISSION	KS	66204	480901551	REAL ESTATE RENTAL	KS	N/A	C	0
METROPLEX ADVENTIST HOSPITAL CRNA
2201 S CLEAR CREEK ROAD	KILLEEN	TX	76549	260760794	SUPPORT HOSPITAL - PROVIDE ALLIED HEALTH PROFESSIONALS	TX	N/A	C	0
NORTH AMERICAN HEALTH SERVICES INC & SUBS
111 N ORLANDO AVENUE	WINTER PARK	FL	32789	621041820	LESSOR/HOLDING CO.	TN	N/A	C	0
ORMOND PROFESSIONAL CONDO ASSOCIATION (430 YEAR END)
770 W GRANADA BLVD STE 101	ORMOND BEACH	FL	32174	592694434	CONDO ASSOCIATION	FL	N/A	C	0
PARK RIDGE PROPERTY OWNER'S ASSOCIATION INC
1 PARK PLACE NAPLES ROAD	FLETCHER	NC	28732	030380531	CONDO ASSOCIATION	NC	N/A	C	0
PORTER AFFILIATED HLTH SERVICES INC DBA DIVERSIFIED AFFILIATED HLTH SVCS
2525 S DOWNING STREET	DENVER	CO	80210	840956175	HEALTHCARE SERVICES	CO	N/A	C	0
PORTER MEDICAL PLAZA INC (7111-12512)
2525 S DOWNING STREET	DENVER	CO	80210	841574369	REAL ESTATE LEASING	CO	N/A	C	0
SAN MARCOS REGIONAL MRI INC
1301 WONDER WORLD DRIVE	SAN MARCOS	TX	78666	770597968	HOLDING COMPANY	TX	N/A	C	0
THE GARDEN RETIREMENT COMMUNITY INC
602 COURTLAND STREET STE 200	ORLANDO	FL	32804	593414055	REAL ESTATE RENTAL	FL	N/A	C	0
UNIVERSITY COMMUNITY HEALTH INSURANCE COMPANY SPC LTD
					CAPTIVE INSURANCE		N/A	C	0	C/O AON INSURANCE MANAGERS PO BOX	GRAND CAYMAN	CJ	CJ
UCH SERVICES INC
3100 EAST FLETCHER AVE	TAMPA	FL	33613	593508454	MANAGEMENT COMPANY	FL	N/A	C	0
WEST COAST MEDICAL GROUP INC (11-101912)
1395 S PINELLAS AVE	TARPON SPRINGS	FL	34689	593537305	PHYSICIAN CLINICS	FL	N/A	C	0
WINTER PARK MEDICAL OFFICE BUILDING I CONDO ASSOC INC
200 LAKEMONT AVE	WINTER PARK	FL	32792	452228478	PHYSICIAN CLINICS	FL	N/A	C	0

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	1	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	1	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	0	DividendsRelatedOrganization
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	0	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	0	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	1	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	1	PerformOfServicesByOtherOrgs
Sharing Of Facilities	0	SharingOfFacilities
Sharing Of Paid Employees	0	SharingOfPaidEmployees
Reimbursement Paid To Other Org	1	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	0	OtherTransferToOtherOrg
Other Transfer From Other Org	0	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (8 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
EMORY-ADVENTIST INC
L	101862	COST
ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION
M	777335	% OF FACILITIES OPERATING EXPENSE
ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORP DBA AHS INFORMATION SERV
M	2517693	% OF FACILITIES OPERATING EXPENSE
SUNSYSTEM DEVELOPMENT CORP DBA GORDON HOSPITAL FOUNDATION
B	240429	COST
SUNSYSTEM DEVELOPMENT CORP DBA GORDON HOSPITAL FOUNDATION
C	1002212	ACTUAL AMOUNT RECEIVED
ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION
P	4336966	COST
ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION
B	738038	CASH
ADVENTIST HEALTH SYSTEMSUNBELT INC
M	1085752	% OF FACILITIES EHR REVENUE