TY 2010 Form 990

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (check all that apply)
(1) MARTIN W COLE JR CHAIRMAN	2.00	X
(2) DAVID NEWCOMER IV CHAIRMAN-ELECT	2.00	X
(3) KENT E CRIPPIN FORMER CHAIRMAN	2.00	X
(4) JULIE KELLY SECRETARY	2.00	X
(5) ROBERT THOMAS JR TREASURER	2.00	X
(6) GREGG AMOS DIRECTOR	2.00	X
(7) FRANKLIN BICHLMEIER MD DIRECTOR	2.00	X
(8) RICHARD BOND DIRECTOR	2.00	X
(9) STEPHEN BUBB MD DIRECTOR	2.00	X
(10) JAMES BUTLER JR DIRECTOR	2.00	X
(11) TERRY CALAWAY DIRECTOR	2.00	X
(12) CHARLES CARLSEN EDD DIRECTOR	2.00	X
(13) ROBERT CURTIS DIRECTOR	2.00	X
(14) BARBARA CUSICK DIRECTOR	2.00	X
(15) SISTER OLIVE LOUISE DALLAVIS DIRECTOR	2.00	X
(16) HARRIET DARLING DIRECTOR	2.00	X
(17) BETHANY DERROUGH DIRECTOR	2.00	X

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (check all that apply)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(18) MARK GILMAN DIRECTOR	2.00	X		0	0
(19) JAMES HOLLAND DIRECTOR	2.00	X		0	0
(20) DAVID LINDSTROM DIRECTOR	2.00	X		0	0
(21) RODNEY MARTIN DIRECTOR	2.00	X		0	0
(22) LAURA MCCONWELL DIRECTOR	2.00	X		0	0
(23) PATRICK MCANANY DIRECTOR (ENDED 02/10)	2.00	X		0	0
(24) RICHARD MCEACHEN DIRECTOR	2.00	X		0	0
(25) BARBARA MCGRATH MD DIRECTOR	2.00	X		0	0
(26) JASON MESCHKE DIRECTOR	2.00	X		0	0
(27) TERRI OLSEN DIRECTOR	2.00	X		0	0
(28) R NICHOLAS PFLUMM DIRECTOR	2.00	X		0	0
(29) LYLE PISHNY DIRECTOR	2.00	X		0	0
(30) LEAH RIDGWAY MD DIRECTOR	2.00	X		0	0
(31) TWYLA RIST DIRECTOR	2.00	X		0	0
(32) JOHN ROBINSON MD DIRECTOR	2.00	X		0	0
(33) TIMOTHY RODGERS DIRECTOR	2.00	X		0	0
(34) DIANE RUGGIERO DIRECTOR	2.00	X		0	0
(35) RICHARD SHULL DIRECTOR	2.00	X		0	0
(36) CYNTHIA SMITH DIRECTOR	2.00	X		0	0
(37) SAMUEL TURNER SR DIRECTOR	2.00	X		558,520	110,289
(38) JOHN VRATIL DIRECTOR	2.00	X		0	0
(39) SALLY WINSHIP DIRECTOR	2.00	X		0	0
(40) LOUIS GEHRING EXECUTIVE DIRECTOR	40.00		X	138,662	21,571

Part X Balance Sheet
	1	Cashnon-interest-bearing ..........		1
2	Savings and temporary cash investments .......	1,879,492	2	1,837,976
3	Pledges and grants receivable, net .........	1,554,789	3	3,719,226
4	Accounts receivable, net .........		4
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........		5
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........		6
7	Notes and loans receivable, net .............		7
8	Inventories for sale or use ..............		8
9	Prepaid expenses and deferred charges ............		9
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a
b	Less: accumulated depreciation. .....	10b		3,500	10c
11	Investments—publicly traded securities ..........	5,812,952	11	6,600,179
12	Investments—other securities. See Part IV, line 11 ......		12
13	Investments—program-related. See Part IV, line 11 ..		13
14	Intangible assets .........		14
15	Other assets. See Part IV, line 11 ...........	868,417	15	904,822
16	Total assets. Add lines 1 through 15 (must equal line 34)...	10,119,150	16	13,062,203
	17	Accounts payable and accrued expenses .	162,375	17	277,606
18	Grants payable ..........		18
19	Deferred revenue ..........		19
20	Tax-exempt bond liabilities ..........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ....		24
25	Other liabilities. Complete Part X of Schedule D.....	15,099	25	17,314
26	Total liabilities. Add lines 17 through 25.....	177,474	26	294,920
		Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....	212,736	27	217,070
28	Temporarily restricted net assets .....	9,728,940	28	12,550,213
29	Permanently restricted net assets .....		29
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances .....	9,941,676	33	12,767,283
34	Total liabilities and net assets/fund balances .....	10,119,150	34	13,062,203

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization

FOUNDATION FOR SHAWNEE MISSION
MEDICAL CENTER INC

Employer identification number

48-0868859

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches. section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in

section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. Seesection 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Other

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

and (iii) below, the governing body of the the supported organization? ................

11g(i)

(ii) a family member of a person described in (i) above? ......................

11g(ii)

(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................

11g(iii)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))	(iv) Is the organization in col. (i) listed in your governing document?		(v) Did you notify the organization in col. (i) of your support?		(vi) Is the organization in col. (i) organized in the U.S.?		(vii) Amount of support?
(i) Name of supported organization	(ii) EIN		Yes	No	Yes	No	Yes	No	(vii) Amount of support?
(1) SHAWNEE MISSION MEDICAL CENTER INC	480637331	3	Yes		Yes		Yes		1,739,197

Total									1,739,197

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2010

Page 2

Part II

Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3..
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public Support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11	Total support (Add lines 7 through 10).

Gross receipts from related activities, etc. (See instructions.) ..................

First Five Years If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.......................................... right arrow

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f)) .........

Public Support Percentage for 2009 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2010. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ...................... right arrow

33 1/3% support test—2009. If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2010. If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization .................................................. right arrow

10%-facts-and-circumstances test—2009. If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly
supported organization .............................................. right arrow

Private Foundation If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions ................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2010

Page 3

Part III

Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public Support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13	Total support (Add lines 9, 10c, 11 and 12.).

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f)) .........

Public support percentage from 2009 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f)) ......

Investment income percentage from 2009 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2010. If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .......... right arrow

33 1/3% support tests—2009. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private Foundation If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2010

Page 4

Part IV

Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

OMB No. 1545-0047

2010

Name of organization

FOUNDATION FOR SHAWNEE MISSION
MEDICAL CENTER INC

Employer identification number

48-0868859

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ, that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ, that received from any one contributor,
during the year, aggregate contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ, that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not aggregate to more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year. ......................... Arrow Bullet

Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Name of organization FOUNDATION FOR SHAWNEE MISSION MEDICAL CENTER INC
Schedule B (Form 990, 990-EZ, or 990-PF) (2010) Page 1 of 1 of Part I
Part I	Contributors (see Instructions)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Name of organization FOUNDATION FOR SHAWNEE MISSION MEDICAL CENTER INC
Schedule B (Form 990, 990-EZ, or 990-PF) (2010) Page 1 of 1 of Part II
Part II	Noncash Property (see Instructions)
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Page 1 of 1 of Part III

Name of organization
FOUNDATION FOR SHAWNEE MISSION
MEDICAL CENTER INC

Employer identification number

48-0868859

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

FOUNDATION FOR SHAWNEE MISSION
MEDICAL CENTER INC

Employer identification number

48-0868859

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .......
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) ...
4	Aggregate value at end of year .......

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or pleasure) Preservation of an historically importantly land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06 ........	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................

Yes No

In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:

(i)

Revenues included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 52283D

Schedule D (Form 990) 2010

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIV and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

If “Yes,” explain the arrangement in Part XIV.

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current Year	(b)Prior Year	(c)Two Years Back
1a	Beginning of year balance ....	4,358,060	4,807,101	5,247,540
b	Contributions ........	304,011	274,321	288,761
c	Investment earnings or losses ...	-42,024	-126,979	-484,260
d	Grants or scholarships .....	649	1,711	117,239
e	Other expenditures for facilities and programs ........	412,927	414,623	127,601
f	Administrative expenses ....	546	49	100
g	End of year balance ......	4,205,925	4,538,060	4,807,101

Provide the estimated percentage of the year end balance held as:

Board designated or quasi-endowment: SchDMd Bullet

36.000 %

Permanent endowment: SchDMd Bullet

64.000 %

Term endowment: SchDMd Bullet

0 %

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

Yes

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIV the intended uses of the organization's endowment funds.

Part VI

InvestmentsLand, Buildings, and Equipment. See Form 990, Part X, line 10.

Description of investment		(d) Book value
1a	Land .................
b	Buildings ................
c	Leasehold improvements ............
d	Equipment ................
e	Other .................
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........		0

Schedule D (Form 990) 2010

Page 3

Part VII

InvestmentsOther Securities. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)		(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)

Part VIII

InvestmentsProgram Related. See Form 990, Part X, line 13.

(a) Description of investment type		(b) Book value	(c) Method of valuation: Cost or end-of-year market value









Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) UNITRUSTS				786,097
(2) LIFE INSURANCE				118,725







Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........				904,822

Part X

Other Liabilities. See Form 990, Part X, line 25.

1.(a) Description of Liability		(b) Amount
Federal Income Taxes
ANNUITY LIABILITIES		17,314








Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)		17,314
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).

Schedule D (Form 990) 2010

Page 4

Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1	Total revenue (Form 990, Part VIII, column (A), line 12) ....................	1
2	Total expenses (Form 990, Part IX, column (A), line 25) .....................	2
3	Excess or (deficit) for the year. Subtract line 2 from line 1 .............	3
4	Net unrealized gains (losses) on investments ..........................	4
5	Donated services and use of facilities .............................	5
6	Investment expenses ...................................	6
7	Prior period adjustments ..................................	7
8	Other (Describe in Part XIV) .................................	8
9	Total adjustments (net). Add lines 4 - 8 .............................	9
10	Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 .........	10

Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIV): ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIV): ...........	4b
c	Add lines 4a and 4b.......................		4c
5	Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ......		5

Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements .............		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIV): ............	2d
e	Add lines 2a through 2d......................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIV): ............	4b
c	Add lines 4a and 4b.......................		4c
5	Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ......		5

Part XIV

Supplemental Information

Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.

Identifier	Return Reference	Explanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:	PART V, LINE 4:	FOUNDATION FOR SHAWNEE MISSION MEDICAL CENTER, INC. (THE FOUNDATION) IS A SUPPORTING ORGANIZATION OF SHAWNEE MISSION MEDICAL CENTER, INC. (SMMC) A RELATED TAX-EXEMPT HOSPITAL THAT IS ALSO EXEMPT UNDER IRC SECTION 501(C)(3). THE FOUNDATION'S ENDOWMENTS CONSISTS OF FUNDS ESTABLISHED TO PURCHASE EQUIPMENT FOR THE LEE ANN BRITIAN INFANT DEVELOPMENT CENTER.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:	PART X:	THE FILING ORGANIZATION IS A SUBSIDIARY ORGANIZATION WITHIN ADVENTIST HEALTH SYSTEM (AHS). THE CONSOLIDATED FINANCIAL STATEMENTS OF AHS CONTAIN THE FOLLOWING FIN 48 FOOTNOTE - 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.

Schedule D (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19,
or if the organization entered more than $15,000 on Form 990-EZ, line 6a.
right arrow

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization
FOUNDATION FOR SHAWNEE MISSION
MEDICAL CENTER INC

Employer identification number

48-0868859

Part I

Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and e-mail solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

Yes

If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.

(i) Name and address of individual or entity (fundraiser)	(ii) Activity	(iii) Did fundraiser have custody or control of contributions?		(iv) Gross receipts from activity	(v) Amount paid to (or retained by) fundraiser listed in col. (i)	(vi) Amount paid to (or retained by) organization
	(ii) Activity	Yes	No	(iv) Gross receipts from activity		(vi) Amount paid to (or retained by) organization
HARTSOOK COMPANIES PO BOX 410046 KANSAS CITY, MO64141	CAMPAIGN CONSULTING SERVICES		No	0	104,034	0
Total .................					104,034

List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2010

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.

		(a) Event #1 TINY TIM FANTASY (event type)	(d) Total Events (Add col. (a) through col. (c))
1	Gross receipts . . .	175,029	175,029
2	Less: Charitable contributions . . .	86,976	86,976
3	Gross income (line 1 minus line 2) . . .	88,053	88,053
4	Cash prizes . . .
5	Non-cash prizes . .
6	Rent/facility costs . .
7	Food and beverages . .	56,043	56,043
8	Entertainment . . .	1,795	1,795
9	Other direct expenses .	58,891	58,891
10	Direct expense summary. Add lines 4 through 9 in column (d) ...........		116,729
11	Net income summary. Combine lines 3 and 10 in column (d)............		-28,676

Part III

Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

(a) Bingo

(b) Pull tabs/Instant
bingo/progressive bingo

(c) Other gaming

(d) Total gaming (Add col. (a) through col. (c))

Gross revenue . . . .

Cash prizes . . . .

Non-cash prizes . . .

Rent/facility costs . . .

Other direct expenses . .

Volunteer labor . . .

	Yes
	No

	Yes
	No

	Yes
	No

Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow

Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow

Enter the state(s) in which the organization operates gaming activities:

Is the organization licensed to operate gaming activities in each of these states? ............

YesNo

If "No," Explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....

YesNo

If "Yes," Explain:

Does the organization operate gaming activities with nonmembers? .................

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? ...........................

YesNo

Schedule G (Form 990 or 990-EZ) 2010

Page 3

Indicate the percentage of gaming activity operated in:

The organization's facility ......................

13a

An outside facility ........................

13b

Provide the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? ......................................

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? ............................

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Complete this part to provide additional information for responses to quuestion on Schedule G (see instructions.)

Identifier	ReturnReference	Explanation

Schedule G (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization
FOUNDATION FOR SHAWNEE MISSION
MEDICAL CENTER INC

Employer identification number
48-0868859

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet

(a) Name and address of organization or government	(b) EIN	(c) IRC Code section if applicable	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) SHAWNEE MISSION MEDICAL CENTER INC9100 W 74TH STREET SHAWNEE MISSION,KS66204	48-0637331	501(C)(3)	1,739,197	GENERAL HOSPITAL SUPPORT

Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image

Enter total number of other organizations ................................ . Bullet Image

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2010

Page 2

Part III

Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.

(a)Type of grant or assistance	(b)Number of recipients	(c)Amount of cash grant
(1) ASSISTANCE TO EMPLOYEES IN NEED WITH HOUSEHOLD EXPENSES	25	17,427

Part IV

Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.

Identifier	Return Reference	Explanation
PROCEDURE FOR MONITORING GRANTS IN THE U.S.:	PART I, LINE 2:	SCHEDULE I, PART I, LINE 2: GRANTS ARE GENERALLY MADE ONLY TO THE SUPPORTED HOSPITAL ORGANIZATION THAT IS EXEMPT FROM FEDERAL INCOME TAX UNDER 501(C)(3). 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.

Schedule I (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

FOUNDATION FOR SHAWNEE MISSION
MEDICAL CENTER INC

Employer identification number

48-0868859

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....

Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ...............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? ........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 50053T

Schedule J (Form 990) 2010

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.

(A) Name		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported in prior Form 990 or Form 990-EZ
(A) Name		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
(1) SAMUEL TURNER SR	(i) (ii)	0 402,614	0 100,842	0 55,064	0 76,783	0 33,506	0 668,809	0 0
(2) LOUIS GEHRING	(i) (ii)	0 122,896	0 10,381	0 5,385	0 6,689	0 14,882	0 160,233	0 0

Schedule J (Form 990) 2010

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.

Identifier	Return Reference	Explanation
	PART I, LINE 4B	THE CEO OF THE FILING ORGANIZATION'S SUPPORTED HOSPITAL SERVES ON THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION. THIS INDIVIDUAL IS 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). THE FILING ORGANIZATION'S SUPPORTED HOSPITAL IS A SUBSIDIARY OF AHSSHC. 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 PRE-DETERMINED BENEFITS ANNUAL AMOUNT 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. 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 $196,000. 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 HOSPITAL 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 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. 457(F) EMPLOYER SERP CONTRIBUTIONS CONTR./PYMT SAMUEL TURNER, SR. $63,440 $0
SUPPLEMENTAL INFORMATION	PART III	PART I, QUESTION 3: AS NOTED IN OUR RESPONSE TO QUESTION 15 OF PART VI OF FORM 990, THE INDIVIDUAL WHO SERVES AS THE EXECUTIVE DIRECTOR OF THE FILING ORGANIZATION IS COMPENSATED BY SHAWNEE MISSION MEDICAL CENTER, INC. (SMMC) FOR THAT INDIVIDUAL'S ROLE IN SERVING AS THE EXECUTIVE DIRECTOR. COMPENSATION AND BENEFITS PROVIDED TO THIS INDIVIDUAL ARE DETERMINED PURSUANT TO POLICIES, PROCEDURES, AND PROCESSES OF SMMC THAT ARE DESIGNED TO ENSURE THAT ALL EMPLOYEES SERVING IN MANAGEMENT ROLES ARE PROVIDED COMPENSATION REFLECTIVE OF FAIR MARKET VALUE GIVEN THEIR ROLES AND RESPONSIBILITIES. SMMC USES THE FOLLOWING TO ESTABLISH COMPENSATION OF THE EXECUTIVE DIRECTOR: - COMPENSATION SURVEY OR STUDY

Schedule J (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

NonCash Contributions

Complete if the organization answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

FOUNDATION FOR SHAWNEE MISSION
MEDICAL CENTER INC

Employer identification number

48-0868859

Part I

Types of Property

	(a) Check if applicable	(b) Number of Contributions or items contributed	(c) Contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	4	26,795	SELLING PRICE
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....	X	13	0
19 Food inventory ...
20 Drugs and medical supplies .	X	1	0
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( JEWELRY )	X	15	0
26 Other ( )
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that it

must hold for at least three years from the date of the initial contribution, and which is not required to be used

for exempt purposes for the entire holding period? ..................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell non-cash

contributions? ............................

32a

If "Yes," describe in Part II.

If the organization did not report revenues in column (c) for a type of property for which column (a) is checked,

describe in Part II.

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 51227J

Schedule M (Form 990) 2010

Page 2

Part II

Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33. Also complete this part for any additional information.

Identifier	Return Reference	Explanation
METHOD FOR DETERMINING NUMBER OF CONTRIBUTORS:	PART I, COLUMN (B):	THE NUMBER OF CONTRIBUTIONS REPORTED IN COLUMN (B) OF SCHEDULE M, PART I REPRESENTS THE NUMBER OF ITEMS RECEIVED BY THE FILING ORGANIZATION DURING THE CURRENT YEAR WITH THE EXCEPTION OF PUBLICLY TRADED SECURITIES WHICH IS REPORTED BY THE NUMBER OF CONTRIBUTIONS.
NON REPORTING OF REVENUE:	PART I, LINE 33:	FOR THOSE ITEMS THAT WERE NOT INCLUDED IN PART VIII LINE 1G, REVENUE WAS RECOGNIZED AS PART OF THE SPECIAL FUND-RAISING EVENTS REPORTED ON PART VIII LINE 8.

Schedule M (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization

FOUNDATION FOR SHAWNEE MISSION
MEDICAL CENTER INC

Employer identification number

48-0868859

Identifier	Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 2		RICHARD SHULL AND RICHARD BOND - BUSINESS RELATIONSHIP RICHARD SHULL AND JAMES BUTLER, JR. - BUSINESS RELATIONSHIP RICHARD SHULL AND JAMES HOLLAND - BUSINESS RELATIONSHIP RICHARD SHULL AND PATRICK MCANANY - BUSINESS RELATIONSHIP RICHARD SHULL AND TIMOTHY RODGERS - BUSINESS RELATIONSHIP JAMES BUTLER, JR. AND BARBARA MCGRATH, MD - BUSINESS RELATIONSHIP JAMES BUTLER, JR. AND PATRICK MCANANY - BUSINESS RELATIONSHIP LOUIS GEHRING AND TIMOTHY RODGERS - BUSINESS RELATIONSHIP MARK GILMAN AND TIMOTHY RODGERS - BUSINESS RELATIONSHIP PATRICK MCANANY AND TIMOTHY RODGERS - BUSINESS RELATIONSHIP TIMOTHY RODGERS AND CHARLES CARLSEN, ED.D. - BUSINESS RELATIONSHIP TIMOTHY RODGERS AND DIANE RUGGIERO - BUSINESS RELATIONSHIP TIMOTHY RODGERS AND LYLE PISHNY - BUSINESS RELATIONSHIP TIMOTHY RODGERS AND ROBERT CURTIS - BUSINESS RELATIONSHIP TIMOTHY RODGERS AND TERRI OLSEN - BUSINESS RELATIONSHIP
FORM 990, PART VI, SECTION B, LINE 11		THE FILING ORGANIZATION'S CURRENT YEAR FORM 990 WAS REVIEWED BY THE EXECUTIVE DIRECTOR AND THE CEO (A BOARD MEMBER) AND CFO OF THE SUPPORTED HOSPITAL PRIOR TO ITS FILING WITH THE IRS. THE REVIEW CONDUCTED BY THE EXECUTIVE DIRECTOR AND THE CEO (A BOARD MEMBER) AND CFO OF THE SUPPORTED HOSPITAL 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 (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 (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, IS REQUIRED TO DISCLOSE IN WRITING THE EXISTENCE OF ANY CONFLICT OF INTEREST WITH THE FILING ORGANIZATION OR ANY OF THE CHARITABLE ORGANIZATIONS SUPPORTED BY THE FILING ORGANIZATION.
	FORM 990, PART VI, SECTION B, LINE 15	THE EXECUTIVE DIRECTOR OF THE FILING ORGANIZATION IS ON THE PAYROLL OF SHAWNEE MISSION MEDICAL CENTER, INC. (SMMC). THE COMPENSATION OF THE EXECUTIVE DIRECTOR IS DETERMINED BY SMMC. IN DETERMINING THE COMPENSATION OF THE EXECUTIVE DIRECTOR, SMMC UTILIZES PUBLISHED SALARY SURVEY DATA AND OTHER LOCAL MARKET INFORMATION IN ESTABLISHING ANNUAL COMPENSATION. EXECUTIVE MANAGEMENT OF SMMC REVIEW AND APPROVE ANNUAL COMPENSATION.
	FORM 990, PART VI, SECTION C, LINE 19	THE FILING ORGANIZATION DOES NOT GENERALLY MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.
CHANGES IN NET ASSETS OR FUND BALANCES:	FORM 990, PART XI, LINE 5:	NET UNREALIZED GAINS ON INVESTMENTS: 716,545.
	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 THE SUPPORTED HOSPITAL AND/OR ITS TAX-EXEMPT BROTHER/SISTER AFFILIATE ORGANIZATION.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

FOUNDATION FOR SHAWNEE MISSION
MEDICAL CENTER INC

Employer identification number

48-0868859

Part I

Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)

(a) Name, address, and EIN of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled organization
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) ADVENTIST BOLINGBROOK HOSPITAL 500 REMINGTON BLVD BOLINGBROOK,IL60440 65-1219504	OPERATION OF HOSPITAL & RELATED SERVICES	IL	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HEALTH SYSTEMSUNBELT INC		No
(2) ADVENTIST CARE CENTERS - COURTLAND INC 730 COURTLAND STREET ORLANDO,FL32804 20-5774723	OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY	FL	501(C)(3)	509(A)(2)	SUNBELT HEALTH CARE CENTERS INC		No
(3) ADVENTIST GLENOAKS HOSPITAL 701 WINTHROP AVENUE GLENDALE HEIGHTS,IL60139 36-3208390	OPERATION OF HOSPITAL & RELATED SERVICES	IL	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HEALTH SYSTEMSUNBELT INC		No
(4) ADVENTIST HEALTH MID-AMERICA INC 9100 W 74TH STREET SHAWNEE MISSION,KS66204 52-1347407	HEALTHCARE RELATED SERVICES	KS	501(C)(3)	509(A)(3) TYPE I	ADVENTIST HEALTH SYSTEMSUNBELT INC		No
(5) ADVENTIST HEALTH PARTNERS INC 1000 REMINGTON BLVD STE 200 BOLINGBROOK,IL60440 36-4138353	OPERATE OUT-PATIENT PHYSICIAN CLINICS	IL	501(C)(3)	170(B)(1)(A)(III)	AHS MIDWEST MANAGEMENT INC		No
(6) ADVENTIST HEALTH SYSTEM AFFILIATED BENEFIT TRUST 111 N ORLANDO AVENUE WINTER PARK,FL32789 26-6422966	PROMOTION OF HEALTHCARE	FL	501(C)(3)	509(A)(3) TYPE I	ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION		No
(7) ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION 111 N ORLANDO AVENUE WINTER PARK,FL32789 59-2170012	MANAGEMENT SERVICES	FL	501(C)(3)	509(A)(3) TYPE I	N/A		No
(8) ADVENTIST HEALTH SYSTEMGEORGIA INC 1035 RED BUD ROAD CALHOUN,GA30701 58-1425000	OPERATION OF HOSPITAL & RELATED SERVICES	GA	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION		No
(9) ADVENTIST HEALTH SYSTEMSUNBELT INC 111 N ORLANDO AVENUE WINTER PARK,FL32789 59-1479658	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION		No
(10) ADVENTIST HEALTH SYSTEMTEXAS INC 602 COURTLAND STREET ORLANDO,FL32804 74-2578952	INACTIVE	TX	501(C)(3)	509(A)(2)	ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION		No
(11) ADVENTIST HINSDALE HOSPITAL 120 NORTH OAK STREET HINSDALE,IL60521 36-2276984	OPERATION OF HOSPITAL & RELATED SERVICES	IL	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HEALTH SYSTEMSUNBELT INC		No
(12) AHS MIDWEST MANAGEMENT INC 1000 REMINGTON BLVD STE 200 BOLINGBROOK,IL60440 36-3354567	OPERATION OF OCCUPATIONAL HLTH CLINIC & PHYSICIAN PRACTICE MGMT	IL	501(C)(3)	509(A)(3) TYPE I	ADVENTIST HEALTH SYSTEMSUNBELT INC		No
(13) AHSCENTRAL TEXAS INC 1301 WONDER WORLD DRIVE SAN MARCOS,TX78666 74-2621825	PROVIDE OFFICE SPACE - MEDICAL PROFESSIONALS	TX	501(C)(3)	509(A)(3) TYPE III-F	ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION		No
(14) APOPKA HEALTH CARE PROPERTIES INC 305 E OAK STREET APOPKA,FL32703 51-0605694	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	509(A)(3) TYPE III-F	SUNBELT HEALTH CARE CENTERS INC		No
(15) BATTLE CREEK ADVENTIST HOSPITAL 1000 REMINGTON BLVD STE 200 BOLINGBROOK,IL60440 38-1359189	OPERATION OF HOSPITAL & RELATED SERVICES	MI	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HEALTH SYSTEMSUNBELT INC		No
(16) BERT FISH MEDICAL CENTER INC (10110-63011) 401 PALMETTO STREET NEW SMYRNA BEACH,FL32168 36-2276984	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION		No
(17) BOLINGBROOK HOSPITAL FOUNDATION 1000 REMINGTON BLVD N ENTRANCE 2ND BOLINGBROOK,IL60440 90-0494445	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	IL	501(C)(3)	170(B)(1)(A)(VI)	MIDWEST HEALTH FOUNDATION		No
(18) BRADFORD HEIGHTS HEALTH & REHAB CENTER INC 950 HIGHPOINT DRIVE HOPKINSVILLE,KY42240 20-5782342	OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY	KY	501(C)(3)	509(A)(2)	SUNBELT HEALTH CARE CENTERS INC		No
(19) BURLESON NURSING & REHAB CENTER INC 301 HUGULEY BLVD BURLESON,TX76028 20-5782243	OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY	TX	501(C)(3)	509(A)(2)	SUNBELT HEALTH CARE CENTERS INC		No
(20) CALDWELL HEALTH CARE PROPERTIES INC 1333 WEST MAIN PRINCETON,KY42445 51-0605680	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	509(A)(3) TYPE III-F	SUNBELT HEALTH CARE CENTERS INC		No
(21) CENTRAL TEXAS MEDICAL CENTER FOUNDATION 1301 WONDER WORLD DRIVE SAN MARCOS,TX78666 74-2259907	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	TX	501(C)(3)	170(B)(1)(A)(VI)	ADVENTIST HEALTH SYSTEMSUNBELT INC		No
(22) CHICKASAW HEALTH CARE PROPERTIES INC 250 S CHICKASAW TRAIL ORLANDO,FL32825 51-0605681	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	509(A)(3) TYPE III-F	SUNBELT HEALTH CARE CENTERS INC		No
(23) CHIPPEWA VALLEY HOSPITAL & OAKVIEW CARE CENTER INC 1220 THIRD AVENUE WEST DURAND,WI54736 39-1365168	OPERATION OF HOSPITAL & RELATED SERVICES	WI	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HEALTH SYSTEMSUNBELT INC		No
(24) COBB MEDICAL ASSOCIATES LLC 3949 SOUTH COBB DRIVE SE SMYRNA,GA300806342 58-2617089	OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES	GA	501(C)(3)	170(B)(1)(A)(III)	EMORY-ADVENTIST INC		No
(25) COURTLAND HEALTH CARE PROPERTIES INC 730 COURTLAND STREET ORLANDO,FL32804 51-0605682	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	509(A)(3) TYPE III-F	SUNBELT HEALTH CARE CENTERS INC		No
(26) CREEKWOOD PLACE NURSING & REHAB CENTER INC 683 E THIRD STREET RUSSELLVILLE,KY42276 20-5782260	OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY	KY	501(C)(3)	509(A)(2)	SUNBELT HEALTH CARE CENTERS INC		No
(27) DAIRY ROAD HEALTH CARE PROPERTIES INC 7350 DAIRY ROAD ZEPHYRHILLS,FL33540 51-0605684	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	509(A)(3) TYPE III-F	SUNBELT HEALTH CARE CENTERS INC		No
(28) EAST ORLANDO HEALTH & REHAB CENTER INC 250 S CHICKASAW TRAIL ORLANDO,FL32825 20-5774748	OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY	FL	501(C)(3)	509(A)(2)	SUNBELT HEALTH CARE CENTERS INC		No
(29) EMORY-ADVENTIST INC 3949 SOUTH COBB DRIVE SMYRNA,GA30080 58-2171011	OPERATION OF HOSPITAL & RELATED SVCS	GA	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HEALTH SYSTEMSUNBELT INC		No
(30) FLETCHER HOSPITAL INC 100 HOSPITAL DRIVE HENDERSONVILLE,NC28792 56-0543246	OPERATION OF HOSPITAL & RELATED SVCS	NC	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION		No
(31) FLNC INC 3355 E SEMORAN BLVD APOPKA,FL32703 20-5774761	OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY	FL	501(C)(3)	509(A)(2)	SUNBELT HEALTH CARE CENTERS INC		No
(32) FLORIDA HOSPITAL COLLEGE OF HEALTH SCIENCES INC (630 YEAR END) 671 LAKE WINYAH DRIVE ORLANDO,FL32803 59-3069793	EDUCATION/OPERATION OF SCHOOL	FL	501(C)(3)	170(B)(1)(A)(II)	ADVENTIST HEALTH SYSTEMSUNBELT INC		No
(33) FLORIDA HOSPITAL DELAND AUXILIARY INC 701 WEST PLYMOUTH AVENUE DELAND,FL32720 59-3425543	VOLUNTEER SUPPORT SERVICES	FL	501(C)(3)	509(A)(3) TYPE III-F	MEMORIAL HOSPITAL WEST VOLUSIA INC		No
(34) FLORIDA HOSPITAL WATERMAN INC 1000 WATERMAN WAY TAVARES,FL32778 59-3140669	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION		No
(35) FLORIDA HOSPITAL WESLEY CHAPEL INC 2528 BRUCE B DOWNS BLVD CR 581 S WESLEY CHAPEL,FL33543 20-3965753	INACTIVE	FL	501(C)(3)	509(A)(3) TYPE III-F	ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION		No
(36) FLORIDA HOSPITAL ZEPHYRHILLS INC 7050 GALL BLVD ZEPHYRHILLS,FL33541 59-2108057	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HEALTH SYSTEMSUNBELT INC		No
(37) FLORIDA PHYSICIANS MEDICAL GROUP INC 900 WINDERLEY PLACE MAITLAND,FL32751 59-3214635	OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES	FL	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HEALTH SYSTEMSUNBELT INC		No
(38) FOUNDATION FOR SHAWNEE MISSION MEDICAL CENTER INC 9100 W 74TH STREET SHAWNEE MISSION,KS66204 48-0868859	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	KS	501(C)(3)	509(A)(3) TYPE I	SHAWNEE MISSION MEDICAL CENTER INC		No
(39) GLENOAKS HOSPITAL FOUNDATION 701 WINTHROP AVENUE GLENDALE HEIGHTS,IL60139 36-3926044	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	IL	501(C)(3)	170(B)(1)(A)(VI)	MIDWEST HEALTH FOUNDATION		No
(40) HAYS MEMORIAL HOSPITAL ASSOCIATION OF SEVENTH-DAY ADVENTISTS 1301 WONDER WORLD DRIVE SAN MARCOS,TX78667 74-1362785	LEASE OF HOSPITAL PERSONNEL	TX	501(C)(3)	509(A)(3) TYPE II	ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION		No
(41) HELEN ELLIS MEMORIAL HOSPITAL AUXILIARY INC (51-123110) 1395 S PINELLAS AVE TARPON SPRINGS,FL34689 59-2106043	FUND-RAISING FOR TAX-EXEMPT HOSPITAL/FOUNDATION	FL	501(C)(3)	509(A)(3) TYPE I	TARPON SPRINGS HOSPITAL FOUNDATION INC		No
(42) HELEN ELLIS MEMORIAL HOSPITAL FOUNDATION INC (101-123110) 1395 S PINELLAS AVE TARPON SPRINGS,FL34689 59-3690149	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	FL	501(C)(3)	509(A)(3) TYPE I	TARPON SPRINGS HOSPITAL FOUNDATION INC		No
(43) HINSDALE HOSPITAL FOUNDATION 7 SALT CREEK LANE SUITE 203 HINSDALE,IL60521 52-1466387	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	IL	501(C)(3)	170(B)(1)(A)(VI)	MIDWEST HEALTH FOUNDATION		No
(44) IN-MOTION REHAB INC 602 COURTLAND STREET STE 200 ORLANDO,FL32804 20-8023411	THERAPY SERVICES TO TAX EXEMPT NURSING HOMES	KS	501(C)(3)	509(A)(3) TYPE II	SUNBELT HEALTH CARE CENTERS INC		No
(45) JELLICO COMMUNITY HOSPITAL INC 188 HOSPITAL LANE JELLICO,TN37762 62-0924706	OPERATION OF HOSPITAL & RELATED SERVICES	TN	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION		No
(46) LA GRANGE MEMORIAL HOSPITAL FOUNDATION 5101 S WILLOW SPRINGS RD LA GRANGE,IL60525 30-0247776	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	IL	501(C)(3)	170(B)(1)(A)(VI)	MIDWEST HEALTH FOUNDATION		No
(47) MEMORIAL HEALTH SYSTEMS FOUNDATION INC 770 WEST GRANADA BLVD ORMOND BEACH,FL32174 31-1771522	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	FL	501(C)(3)	170(B)(1)(A)(VI)	MEMORIAL HEALTH SYSTEMS INC		No
(48) MEMORIAL HEALTH SYSTEMS INC 301 MEMORIAL MEDICAL PARKWAY DAYTONA BEACH,FL32117 59-0973502	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HEALTH SYSTEMSUNBELT INC		No
(49) MEMORIAL HOSPITAL - FLAGLER INC 60 MEMORIAL MEDICAL PARKWAY PALM COAST,FL32164 59-2951990	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	170(B)(1)(A)(III)	MEMORIAL HEALTH SYSTEMS INC		No
(50) MEMORIAL HOSPITAL - WEST VOLUSIA INC 701 WEST PLYMOUTH AVENUE DELAND,FL32720 59-3256803	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	170(B)(1)(A)(III)	MEMORIAL HEALTH SYSTEMS INC		No
(51) MEMORIAL HOSPITAL INC 210 MARIE LANGDON DRIVE MANCHESTER,KY40962 61-0594620	OPERATION OF HOSPITAL & RELATED SERVICES	KY	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION		No
(52) MERRIAM HEALTH CARE PROPERTIES INC 9700 WEST 62ND STREET MERRIAM,KS66203 36-4595806	LEASE TO RELATED ORGANIZATION	KS	501(C)(3)	509(A)(3) TYPE III-F	SUNBELT HEALTH CARE CENTERS INC		No
(53) METROPLEX ADVENTIST HOSPITAL INC 2201 S CLEAR CREEK ROAD KILLEEN,TX76549 74-2225672	OPERATION OF HOSPITAL & RELATED SERVICES	TX	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION		No
(54) METROPLEX CLINIC PHYSICIANS INC 2201 S CLEAR CREEK ROAD KILLEEN,TX76549 11-3762050	PHYSICIAN HEALTHCARE SERVICES TO THE COMMUNITY	TX	501(C)(3)	170(B)(1)(A)(III)	METROPLEX ADVENTIST HOSPITAL INC		No
(55) MIDWEST HEALTH FOUNDATION 120 NORTH OAK STREET HINSDALE,IL60521 35-2230515	SUPPORT OF SUBSIDIARY FOUNDATIONS	IL	501(C)(3)	509(A)(3) TYPE II	N/A		No
(56) MILLS HEALTH & REHAB CENTER INC 500 BECK LANE MAYFIELD,KY42066 20-5782320	OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY	KY	501(C)(3)	509(A)(2)	SUNBELT HEALTH CARE CENTERS INC		No
(57) MISSION STRATEGIES INC 602 COURTLAND STREET STE 200 ORLANDO,FL32804 20-5982365	PROVISION OF SUPPORT TO THE NURSING HOME DIVISION	KS	501(C)(3)	509(A)(3) TYPE II	SUNBELT HEALTH CARE CENTERS INC		No
(58) MISSOURI ADVENTIST HEALTH INC 9100 W 74TH STREET SHAWNEE MISSION,KS66204 43-1224729	SUPPORT HEALTH CARE SERVICES	MO	501(C)(3)	509(A)(3) TYPE III-O	ADVENTIST HEALTH MID-AMERICA INC		No
(59) NORTH REGIONAL EMS INC 188 HOSPITAL LANE JELLICO,TN37762 26-2653616	EMS SERVICES	TN	501(C)(3)	509(A)(2)	JELLICO COMMUNITY HOSPITAL INC		No
(60) ORMOND BEACH MEMORIAL HOSPITAL AUXILIARY INC 301 MEMORIAL MEDICAL PARKWAY DAYTONA BEACH,FL32117 59-1721962	VOLUNTEER SUPPORT SERVICES	FL	501(C)(3)	509(A)(3) TYPE III-F	MEMORIAL HEALTH SYSTEMS INC		No
(61) OVERLAND PARK NURSING & REHAB CENTER INC 6501 WEST 75TH STREET OVERLAND PARK,KS66204 20-5774821	OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY	KS	501(C)(3)	509(A)(2)	SUNBELT HEALTH CARE CENTERS INC		No
(62) PARAGON HEALTH CARE PROPERTIES INC 950 HIGHPOINT DRIVE HOPKINSVILLE,KY42240 51-0605686	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	509(A)(3) TYPE III-F	SUNBELT HEALTH CARE CENTERS INC		No
(63) PORTERCARE ADVENTIST HEALTH SYSTEM (630 YEAR END) 2525 S DOWNING STREET DENVER,CO80210 84-0438224	OPERATION OF HOSPITAL & RELATED SERVICES	CO	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION		No
(64) PORTLAND NURSING & REHAB CENTER INC 215 HIGHLAND CIRCLE DRIVE PORTLAND,TN37148 20-5774842	OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY	TN	501(C)(3)	509(A)(2)	SUNBELT HEALTH CARE CENTERS INC		No
(65) PRINCETON HEALTH & REHAB CENTER INC 1333 WEST MAIN PRINCETON,KY42445 20-5782272	OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY	KY	501(C)(3)	509(A)(2)	SUNBELT HEALTH CARE CENTERS INC		No
(66) PRINCETON PROFESSIONAL SERVICES INC 601 E ROLLINS STREET ORLANDO,FL32803 59-1191045	PROVISION OF HEALTHCARE SERVICES	FL	501(C)(3)	509(A)(2)	ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION		No
(67) QUALITY CIRCLE FOR HEALTHCARE INC 111 N ORLANDO AVENUE WINTER PARK,FL32789 26-3789368	HEALTHCARE QUALITY SERVICES	FL	501(C)(3)	509(A)(3) TYPE III-F	ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION		No
(68) RESOURCE PERSONNEL INC 602 COURTLAND STREET STE 200 ORLANDO,FL32804 20-8040875	PROVIDE ADMINISTRATIVE SUPPORT TO TAX EXEMPT NURSING HOMES	FL	501(C)(3)	509(A)(3) TYPE II	SUNBELT HEALTH CARE CENTERS INC		No
(69) ROCKY MOUNTAIN ADVENTIST HEALTHCARE FOUNDATION (630 YEAR END) 2525 SOUTH DOWNING STREET DENVER,CO80210 84-0745018	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	CO	501(C)(3)	170(B)(1)(A)(VI)	PORTERCARE ADVENTIST HEALTH SYSTEM		No
(70) ROLLINS BEDFORD CORPORATION 602 COURTLAND STREET STE 200 ORLANDO,FL32804 37-0908840	INACTIVE	FL	501(C)(3)	509(A)(3) TYPE II	SUNBELT HEALTH CARE CENTERS INC		No
(71) RUSSELLVILLE HEALTH CARE PROPERTIES INC 683 EAST THIRD STREET RUSSELLVILLE,KY42276 51-0605691	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	509(A)(3) TYPE III-F	SUNBELT HEALTH CARE CENTERS INC		No
(72) SAN MARCOS HEALTH CARE PROPERTIES INC 1900 MEDICAL PARKWAY SAN MARCOS,TX78666 51-0605693	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	509(A)(3) TYPE III-F	SUNBELT HEALTH CARE CENTERS INC		No
(73) SAN MARCOS NURSING & REHAB CENTER INC 1900 MEDICAL PARKWAY SAN MARCOS,TX78666 20-5782224	OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY	TX	501(C)(3)	509(A)(2)	SUNBELT HEALTH CARE CENTERS INC		No
(74) SHAWNEE MISSION HEALTH CARE INC 6501 WEST 75TH STREET OVERLAND PARK,KS66204 48-0952508	LEASE TO RELATED ORGANIZATION	KS	501(C)(3)	509(A)(3) TYPE III-F	SUNBELT HEALTH CARE CENTERS INC		No
(75) SHAWNEE MISSION MEDICAL CENTER INC 9100 W 74TH STREET SHAWNEE MISSION,KS66204 48-0637331	OPERATION OF HOSPITAL & RELATED SERVICES	KS	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HEALTH MID-AMERICA INC		No
(76) SOUTH CENTRAL NURSING HOMES PROPERTIES INC 111 NORTH ORLANDO AVE WINTER PARK,FL32789 59-3686109	MANAGEMENT SUPPORT	GA	501(C)(3)	509(A)(3) TYPE III-O	SOUTH CENTRAL INC		No
(77) SOUTH CENTRAL NURSING HOMES INC 602 COURTLAND STREET ORLANDO,FL32804 61-1242373	MANAGEMENT SUPPORT	KY	501(C)(3)	509(A)(3) TYPE III-O	SOUTH CENTRAL INC		No
(78) SOUTH CENTRAL PROPERTIES III INC 111 NORTH ORLANDO AVE WINTER PARK,FL32789 59-3692860	REAL ESTATE	GA	501(C)(2)		SOUTH CENTRAL NURSING HOMES PROPERTIES INC		No
(79) SOUTH CENTRAL PROPERTIES IV INC 111 NORTH ORLANDO AVE WINTER PARK,FL32789 59-3692862	REAL ESTATE	GA	501(C)(2)		SOUTH CENTRAL NURSING HOMES PROPERTIES INC		No
(80) SOUTH CENTRAL PROPERTIES VI INC 111 NORTH ORLANDO AVE WINTER PARK,FL32789 59-3692857	REAL ESTATE	GA	501(C)(2)		SOUTH CENTRAL NURSING HOMES PROPERTIES INC		No
(81) SOUTH CENTRAL PROPERTIES INC 111 NORTH ORLANDO AVE WINTER PARK,FL32789 59-3651692	REAL ESTATE	GA	501(C)(2)		SOUTH CENTRAL NURSING HOMES PROPERTIES INC		No
(82) SOUTH CENTRAL INC 602 COURTLAND STREET ORLANDO,FL32804 59-3689740	MANAGEMENT SUPPORT	GA	501(C)(3)	509(A)(3) TYPE III-F	N/A		No
(83) SOUTH PASCO HEALTH CARE PROPERTIES INC 38250 A AVENUE ZEPHYRHILLS,FL33542 51-0605679	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	509(A)(3) TYPE III-F	SUNBELT HEALTH CARE CENTERS INC		No
(84) SOUTHWEST VOLUSIA HEALTH SERVICES INC 1055 SAXON BLVD ORANGE CITY,FL327638468 59-3281591	MEDICAL OFFICE BUILDING FOR HOSPITAL	FL	501(C)(3)	509(A)(3) TYPE I	SOUTHWEST VOLUSIA HEALTHCARE CORPORATION		No
(85) SOUTHWEST VOLUSIA HEALTHCARE CORPORATION 1055 SAXON BLVD ORANGE CITY,FL327638468 59-3149293	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HEALTH SYSTEMSUNBELT INC		No
(86) SPECIALTY PHYSICIANS OF CENTRAL TEXAS INC 1301 WONDER WORLD DRIVE SAN MARCOS,TX78666 20-8814408	PHYSICIAN HEALTHCARE SERVICES TO THE COMMUNITY	TX	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HEALTH SYSTEMSUNBELT INC		No
(87) SPRING VIEW HEALTH & REHAB CENTER INC 718 GOODWIN LANE LEITCHFIELD,KY42754 20-5782288	OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY	KY	501(C)(3)	509(A)(2)	SUNBELT HEALTH CARE CENTERS INC		No
(88) SUNBELT HEALTH & REHAB CENTER - APOPKA INC 305 EAST OAK STREET APOPKA,FL32703 20-5774856	OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY	FL	501(C)(3)	509(A)(2)	SUNBELT HEALTH CARE CENTERS INC		No
(89) SUNBELT HEALTH CARE CENTERS INC 602 COURTLAND STREET STE 200 ORLANDO,FL32804 58-1473135	MANAGEMENT SERVICES	TN	501(C)(3)	509(A)(3) TYPE II	ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION		No
(90) SUNSYSTEM DEVELOPMENT CORPORATION 111 N ORLANDO AVENUE WINTER PARK,FL32789 59-2219301	FUND RAISING FOR AFFILIATED TAX-EXEMPT HOSPITALS	FL	501(C)(3)	170(B)(1)(A)(VI)	ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION		No
(91) TARPON SPRINGS HOSP FOUNDATION INC (101-123110) 1395 S PINELLAS AVE TARPON SPRINGS,FL34689 59-0898901	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	170(B)(1)(A)(III)	UNIVERSITY COMMUNITY HOSPITAL INC		No
(92) TARRANT COUNTY HEALTH CARE PROPERTIES INC 301 HUGULEY BLVD BURLESON,TX76028 51-0605677	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	509(A)(3) TYPE III-F	SUNBELT HEALTH CARE CENTERS INC		No
(93) TAYLOR CREEK HEALTH CARE PROPERTIES INC 718 GOODWIN LANE LEITCHFIELD,KY42754 51-0605678	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	509(A)(3) TYPE III-F	SUNBELT HEALTH CARE CENTERS INC		No
(94) THE VOLUNTEER AUXILIARY OF FLORIDA HOSPITAL - FLAGLER INC 60 MEMORIAL MEDICAL PARKWAY PALM COAST,FL32164 59-2486582	VOLUNTEER SUPPORT SERVICES	FL	501(C)(3)	509(A)(3) TYPE III-F	MEMORIAL HOSPITAL FLAGLER INC		No
(95) TRINITY NURSING & REHAB CENTER INC 9700 WEST 62ND STREET MERRIAM,KS66203 20-5774890	OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY	KS	501(C)(3)	509(A)(2)	SUNBELT HEALTH CARE CENTERS INC		No
(96) UNIVERSITY COMMUNITY HOSPITAL AUXILIARY INC(101-123110) 3100 E FLETCHER AVE TAMPA,FL33613 23-7011345	VOLUNTEER SUPPORT SERVICES	FL	501(C)(3)	509(A)(3) TYPE III-F	UNIVERSITY COMMUNITY HOSPITAL INC		No
(97) UNIVERSITY COMMUNITY HOSPITAL FOUNDATION INC(101-123110) 3100 E FLETCHER AVE TAMPA,FL33613 59-2554889	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	FL	501(C)(3)	509(A)(3) TYPE I	UNIVERSITY COMMUNITY HOSPITAL INC		No
(98) UNIVERSITY COMMUNITY HOSPITAL SPECIALTY CARE INC(101-123110) 3100 E FLETCHER AVE TAMPA,FL33613 59-3231322	INACTIVE	FL	501(C)(3)	509(A)(3)	UNIVERSITY COMMUNITY HOSPITAL INC		No
(99) UNIVERSITY COMMUNITY HOSPITAL INC(101-123110) 3100 E FLETCHER AVE TAMPA,FL33613 59-1113901	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	170(B)(1)(A)(III)	ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION		No
(100) WEST KENTUCKY HEALTH CARE PROPERTIES INC 500 BECK LANE MAYFIELD,KY42066 51-0605676	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	509(A)(3) TYPE III-F	SUNBELT HEALTH CARE CENTERS INC		No
(101) ZEPHYR HAVEN HEALTH & REHAB CENTER INC 38250 A AVENUE ZEPHYRHILLS,FL33542 20-5774930	OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY	FL	501(C)(3)	509(A)(2)	SUNBELT HEALTH CARE CENTERS INC		No
(102) ZEPHYRHILLS HEALTH & REHAB CENTER INC 7350 DAIRY ROAD ZEPHYRHILLS,FL33540 20-5774967	OPERATION OF HOME FOR THE AGED/HEALTHCARE DELIVERY	FL	501(C)(3)	509(A)(2)	SUNBELT HEALTH CARE CENTERS INC		No

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2010

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) APPALACHIAN THERAPY SERVICES LLC 100 HOSPITAL DRIVE HENDERSONVILLE,NC28792 20-2463851	THERAPY STAFFING	NC	N/A
(2) CLEAR CREEK MOB LTD 2201 S CLEAR CREEK RD KILLEEN,TX76549 74-2609195	REAL ESTATE	TX	N/A
(3) FLORIDA HOSPITAL DMERT LLC 2450 MAITLAND CENTER PKWY STE 200 MAITLAND,FL32751 20-2392253	MEDICAL EQUIPMENT	FL	N/A
(4) FLORIDA HOSPITAL HOME INFUSION 2450 MAITLAND CENTER PKWY STE 200 MAITLAND,FL32751 59-3142824	HOME INFUSION SERVICES	FL	N/A
(5) KCCCSMMC CANCER CENTER LLC 9100 W 74TH STREET SHAWNEE MISSION,KS66204 27-0909763	EQUIPMENT RENTAL	KS	N/A
(6) SAN MARCOS MRI LP 1330 WONDER WORLD DRIVE STE 202 SAN MARCOS,TX78666 77-0597972	IMAGING & TESTING	TX	N/A
(7) SHAWNEE MISSION OPEN MRI LLC 9100 W 74TH STREET BOX 2923 SHAWNEE MISSION,KS66201 27-0011796	IMAGING & TESTING	KS	N/A
(8) SHAWNEE MISSION PRAIRIE STAR SURGERY CENTER LLC 23401 PRAIRIE STAR PARKWAY LENEXA,KS66227 36-4634843	SURGICAL CENTER	KS	N/A
(9) SHAWNEE MISSION SURGERY CENTER LLC PO BOX 2923 SHAWNEE MISSION,KS66201 48-1243914	SURGICAL SERVICES	KS	N/A
(10) SKYLAND MRI LLC 100 HOSPITAL DRIVE HENDERSONVILLE,NC28792 04-3646559	IMAGING & TESTING	NC	N/A

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)
(1) ADVENTIST HEALTH SYS SUNBELT HEALTHCARE CORP EMPLOYEE BENEFIT TRUST 111 N ORLANDO AVENUE WINTER PARK,FL32789 58-1318939	ADMINISTRATION OF SELF-INSURED BENEFIT PLANS	FL	N/A	T
(2) AHS SERVICES INC 11801 SOUTH FREEWAY FORT WORTH,TX76028 75-2049583	MEDICAL EQUIPMENT	TX	N/A	C
(3) ALTAMONTE MEDICAL PLAZA CONDOMINIUM ASSOCIATION INC 601 EAST ROLLINS STREET ORLANDO,FL32803 59-2855792	CONDO ASSOCIATION	FL	N/A	C
(4) APOPKA MEDICAL PLAZA CONDOMINIUM ASSOCIATION INC 601 EAST ROLLINS STREET ORLANDO,FL32803 59-3000857	CONDO ASSOCIATION	FL	N/A	C
(5) ARAPAHOE MEDICAL BUILDING I INC (630 YEAR END) 2525 S DOWNING STREET DENVER,CO80210 84-1574506	REAL ESTATE LEASING	CO	N/A	C
(6) ARAPAHOE MEDICAL BUILDING II INC (630 YEAR END) 2525 S DOWNING STREET DENVER,CO80210 84-1574507	REAL ESTATE LEASING	CO	N/A	C
(7) CC MOB INC 2201 S CLEAR CREEK ROAD KILLEEN,TX76549 74-2616875	REAL ESTATE RENTAL	TX	N/A	C
(8) CENTRAL TEXAS MEDICAL ASSOCIATES 1301 WONDER WORLD DRIVE SAN MARCOS,TX78666 74-2729873	PHYSICIAN CLINICS	TX	N/A	C
(9) CENTRAL TEXAS PROVIDER'S NETWORK 1301 WONDER WORLD DRIVE SAN MARCOS,TX78666 74-2827652	PHYSICIAN HOSPITAL ORG.	TX	N/A	C
(10) FLORIDA HOSPITAL FLAGLER MEDICAL OFFICE ASSOCIATION INC 60 MEMORIAL MEDICAL PARKWAY PALM COAST,FL32164 26-2158309	CONDO ASSOCIATION	FL	N/A	C
(11) FLORIDA HOSPITAL HEALTHCARE SYSTEM INC 602 COURTLAND STREET ORLANDO,FL32804 59-3215680	PHO/TPA	FL	N/A	C
(12) FLORIDA MEDICAL PLAZA CONDO ASSOCIATION INC 601 EAST ROLLINS STREET ORLANDO,FL32803 59-2855791	CONDO ASSOCIATION	FL	N/A	C
(13) FLORIDA MEMORIAL HEALTH NETWORK INC 770 W GRANADA BLVD STE 317 ORMOND BEACH,FL32174 59-3403558	PHYSICIAN HOSPITAL ORG.	FL	N/A	C
(14) HARVARD PARK EAST INC (630 YEAR END) 2525 S DOWNING STREET DENVER,CO80210 84-1574365	REAL ESTATE LEASING	CO	N/A	C
(15) HELEN ELLIS MEMORIAL HOSPITAL REAL ESTATE CORP (101-123110) 1395 S PINELLAS AVE TARPON SPRINGS,FL34689 59-3375731	REAL ESTATE RENTAL	FL	N/A	C
(16) HUGULEY ALLIANCE FOUNDATION 11801 SOUTH FREEWAY FORT WORTH,TX76115 75-2642209	INACTIVE	TX	N/A	C
(17) HUGULEY MEDICAL ASSOCIATES INC 11801 SOUTH FREEWAY BURLESON,TX76028 75-2547668	PHYSICIAN CLINICS	TX	N/A	C
(18) KISSIMMEE MULTISPECIALTY CLINIC CONDOMINIUM ASSOCIATION INC 201 HILDA STREET SUITE 30 KISSIMMEE,FL34741 59-3539564	CONDO ASSOCIATION	FL	N/A	C
(19) MIDWEST MANAGEMENT SERVICES INC 9100 WEST 74TH STREET SHAWNEE MISSION,KS66204 48-0901551	REAL ESTATE RENTAL	KS	N/A	C
(20) METROPLEX ADVENTIST HOSPITAL CRNA 2201 S CLEAR CREEK ROAD KILLEEN,TX76549 26-0760794	SUPPORT HOSPITAL THROUGH THE PROVISION OF ALLIED HEALTH PROFESSIONALS	TX	N/A	C
(21) NORTH AMERICAN HEALTH SERVICES INC & SUBS 111 N ORLANDO AVENUE WINTER PARK,FL32789 62-1041820	LESSOR/HOLDING CO.	TN	N/A	C
(22) ORMOND PROFESSIONAL CONDO ASSOCIATION (430 YEAR END) 770 W GRANADA BLVD STE 101 ORMOND BEACH,FL32174 59-2694434	CONDO ASSOCIATION	FL	N/A	C
(23) PARK RIDGE PROPERTY OWNER'S ASSOCIATION INC 1 PARK PLACE NAPLES ROAD FLETCHER,NC28732 03-0380531	CONDO ASSOCIATION	NC	N/A	C
(24) PORTER AFFILIATED HLTH SERVICES INC DBA DIVERSIFIED AFFILIATED HLTH SVCS 2525 S DOWNING STREET DENVER,CO80210 84-0956175	HEALTHCARE SERVICES	CO	N/A	C
(25) PORTER MEDICAL PLAZA INC (630 YEAR END) 2525 S DOWNING STREET DENVER,CO80210 84-1574369	REAL ESTATE LEASING	CO	N/A	C
(26) REFLECTIONS COMMERCIAL CONDOMINIUM ASSOCIATION INC 875 STERTHAUS AVE ORMOND BEACH,FL32174 59-3519055	CONDO ASSOCIATION	FL	N/A	C
(27) SAN MARCOS REGIONAL MRI INC 1301 WONDER WORLD DRIVE SAN MARCOS,TX78666 77-0597968	HOLDING COMPANY	TX	N/A	C
(28) SOUTHEAST VOLUSIA MEDICAL SERVICES INC (10110-93011) 401 PALMETTO STREET NEW SMYRNA BEACH,FL32168 59-3287185	INACTIVE	FL	N/A	C
(29) THE GARDEN RETIREMENT COMMUNITY INC 602 COURTLAND STREET STE 200 ORLANDO,FL32804 59-3414055	REAL ESTATE RENTAL	FL	N/A	C
(30) UNIVERSITY COMMUNITY HEALTH INSURANCE COMPANY SPC LTD C/O AON INSURANCE MANAGERS PO BOX GRAND CAYMAN CJ	CAPTIVE INSURANCE	CJ	N/A	C
(31) UCH SERVICES INC (101-123110) 3100 EAST FLETCHER AVE TAMPA,FL33613 59-3508454	MANAGEMENT COMPANY	FL	N/A	C
(32) WEST COAST MEDICAL GROUP INC (101-123110) 1395 S PINELLAS AVE TARPON SPRINGS,FL34689 59-3537305	PHYSICIAN CLINICS	FL	N/A	C

Schedule R (Form 990) 2010

Page 3

Part V

Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)

Note. Complete line 1 if any entity is listed in Parts II, III or IV.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .

l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .

m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of other organization	(b) Transaction type(a-r)	(c) Amount involved	(d) Method of determining amount involved
(1) SHAWNEE MISSION MEDICAL CENTER INC	B	1,739,197	ACTUAL AMOUNT GIVEN
(2) SHAWNEE MISSION MEDICAL CENTER INC	O	1,817,901	COST
(3) SHAWNEE MISSION MEDICAL CENTER INC	C	747,110	COST
(4)
(5)
(6)

Schedule R (Form 990) 2010

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Are all partners section 501(c)(3) organizations?		(e) Share of end-of-year assets	(f) Disproprtionate allocations?		(g) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(h) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(e) Share of end-of-year assets	Yes	No	(g) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2010

Page 5

Part VII

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule R (see instructions).

Identifier	Return Reference	Explanation

Additional Data

Software ID:
Software Version:

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	2,380,586	4,733,258
9	Program service revenue (Part VIII, line 2g) .........	9,330	9,670
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	-224,689	121,011
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	-32,568	-28,555
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	2,132,659	4,835,384
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	2,016,669	1,756,624
14	Benefits paid to or for members (Part IX, column (A), line 4) ....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	468,053	472,728
16a	Professional fundraising fees (Part IX, column (A), line 11e)....	77,742	104,034
b	Total fundraising expenses (Part IX, column (D), line 25) 104,034
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	293,021	392,936
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	2,855,485	2,726,322
19	Revenue less expenses. Subtract line 18 from line 12......	-722,826	2,109,062
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16)............	10,119,150	13,062,203
21	Total liabilities (Part X, line 26)............	177,474	294,920
22	Net assets or fund balances. Subtract line 21 from line 20 .....	9,941,676	12,767,283

Sign Here

	Signature of officer	Date

	Type or print name and title.

Paid Preparer's Use Only	Preparer's signature	Date	Check if self- employed	Preparer’s taxpayer identification number (see instructions)
	Firm’s name (or yours if self-employed), address, and ZIP + 4			EIN
				Phone no.


4a	(Code: ) (Expenses $ 1,826,512 including grants of $ 1,756,624 ) (Revenue $ 9,670 )
	ACHIEVEMENTS TO SUPPORT SHAWNEE MISSION MEDICAL CENTER AND HEALTH CARE NEEDS OF THE COMMUNITY, INCLUDING FUNDRAISING ACTIVITIES AND GRANT REQUEST MONITORING.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services. (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses$ 1,826,512

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	0	697,182	131,860

1	Briefly describe the organization’s mission or most significant activities: FUNDRAISING FOR TAX-EXEMPT HOSPITAL ORGANIZATION
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ....	3	38
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	37
5	Total number of individuals employed in calendar year 2010 (Part V, line 2a) ...	5	0
6	Total number of volunteers (estimate if necessary) ....	6	200
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ..	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 ..	7b	0

(A) Name and business address	(B) Description of services	(C) Compensation





2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization 0

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a		29,336
b	Membership dues....1b
c	Fundraising events....1c		175,029
d	Related organizations...1d		757,110
e	Government grants (contributions)1e

f	All other contributions, gifts, grants, and similar amounts not included above1f		3,771,783
g	Noncash contributions included in lines 1a-1f:$ 26,795
h	Total. Add lines 1a-1f.......			4,733,258
			Business Code
2a	REVENUE FROM INFANT DE		900,099	9,670	9,670
b
c
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			9,670
3	Investment income (including dividends, interest
	and other similar amounts).....			143,234			143,234
4	Income from investment of tax-exempt bond proceeds..
5	Royalties............
		(i) Real	(ii) Personal
6a	Gross Rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss).......
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	1,602,351	181
b	Less: cost or other basis and sales expenses	1,620,815	3,940
c	Gain or (loss)	-18,464	-3,759
d	Net gain or (loss)..........			-22,223			-22,223
8a	Gross income from fundraising events (not including $ 86,976 of contributions reported on line 1c). See Part IV, line 18 ...
	a		88,053
b	Less: direct expenses ...b		116,729
c	Net income or (loss) from fundraising events..			-28,676			-28,676
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Miscellaneous Revenue			Business Code
11a	MISCELLANEOUS		900,099	121			121
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			121
12	Total revenue. See Instructions....			4,835,384	9,670	0	92,456


			(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........			1
2	Savings and temporary cash investments .......		1,879,492	2	1,837,976
3	Pledges and grants receivable, net .........		1,554,789	3	3,719,226
4	Accounts receivable, net .........			4
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........			5
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........			6
7	Notes and loans receivable, net .............			7
8	Inventories for sale or use ..............			8
9	Prepaid expenses and deferred charges ............			9
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a
b	Less: accumulated depreciation. .....	10b	3,500	10c
11	Investments—publicly traded securities ..........		5,812,952	11	6,600,179
12	Investments—other securities. See Part IV, line 11 ......			12
13	Investments—program-related. See Part IV, line 11 ..			13
14	Intangible assets .........			14
15	Other assets. See Part IV, line 11 ...........		868,417	15	904,822
16	Total assets. Add lines 1 through 15 (must equal line 34)...		10,119,150	16	13,062,203
17	Accounts payable and accrued expenses .		162,375	17	277,606
18	Grants payable ..........			18
19	Deferred revenue ..........			19
20	Tax-exempt bond liabilities ..........			20
21	Escrow or custodial account liability. Complete Part IV of Schedule D..			21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........			22
23	Secured mortgages and notes payable to unrelated third parties ..			23
24	Unsecured notes and loans payable to unrelated third parties ....			24
25	Other liabilities. Complete Part X of Schedule D.....		15,099	25	17,314
26	Total liabilities. Add lines 17 through 25.....		177,474	26	294,920
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....		212,736	27	217,070
28	Temporarily restricted net assets .....		9,728,940	28	12,550,213
29	Permanently restricted net assets .....			29
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....			30
31	Paid-in or capital surplus, or land, building or equipment fund .....			31
32	Retained earnings, endowment, accumulated income, or other funds			32
33	Total net assets or fund balances .....		9,941,676	33	12,767,283
34	Total liabilities and net assets/fund balances .....		10,119,150	34	13,062,203