TY 2012 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) Carlson Ronald........................................................................ Director	.10 .......................3.00	X		1,071	0
(2) Cauley DMin Michael F........................................................................ Director	.10 .......................3.00	X		1,071	0
(3) Cazeau Esq RoseMarie........................................................................ Director (end 12/12)	.10 .......................3.00	X		1,071	0
(4) Craig Carlos........................................................................ Director	.10 .......................3.00	X		1,071	0
(5) Davidson James R........................................................................ Director	.10 .......................3.00	X		2,071	0
(6) Griffith Jr Buford........................................................................ Director	.10 .......................3.00	X		1,821	0
(7) Grove Rodney A........................................................................ Director	.10 .......................3.00	X		2,071	0
(8) Hagele Elaine M........................................................................ Director	.10 .......................3.00	X		1,821	0
(9) Hayes Alta Sue........................................................................ Director	.10 .......................3.00	X		1,071	0
(10) Houmann Lars D........................................................................ Director	35.00 .......................15.00	X		1,371,852	242,069
(11) Jernigan PhD Donald L........................................................................ Director/CEO	.10 .......................50.00	X	X	1,976,362	106,120
(12) Johnson MD Mark........................................................................ Director	.10 .......................3.00	X		1,071	0
(13) Knutson J Deryl........................................................................ Director	.10 .......................3.00	X		2,071	0
(14) Lemon Thomas L........................................................................ Vice Chairman/Director	.10 .......................4.00	X		2,850	0
(15) Livesay MDiv Donald E........................................................................ Chairman/Director	.10 .......................4.00	X		2,850	0
(16) Moore MDiv Larry R........................................................................ Vice Chairman/Director	.10 .......................4.00	X		2,850	0
(17) Morel Hubert J........................................................................ Director	.10 .......................3.00	X		1,071	0

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) Pichette Ray........................................................................ Director	.10 .......................3.00	X					0	1,071	0
(19) Reiner Richard K........................................................................ Director	.10 .......................50.00	X					0	1,681,892	62,430
(20) Robinson Randy........................................................................ Director	.10 .......................3.00	X					0	2,071	0
(21) Scott Glynn CW........................................................................ Director	.10 .......................3.00	X					0	2,071	0
(22) Shaw Terry D........................................................................ Director	.10 .......................50.00	X	X				0	1,343,770	234,647
(23) Smith DMin PhD Ron C........................................................................ Vice Chair/Sec/Director	.10 .......................4.00	X					0	2,671	0
(24) Valentine MDiv II Maurice........................................................................ Director (end 9/12)	.10 .......................3.00	X					0	1,321	0
(25) Werner Thomas L........................................................................ Director	.10 .......................3.00	X					0	1,071	0
(26) Banks David P........................................................................ Senior VP - FH	50.00 .......................0.00			X			0	711,547	136,324
(27) Cummings Jr Desmond........................................................................ Exec VP - FH	50.00 .......................0.00			X			0	802,214	30,032
(28) Dodds Sheryl D........................................................................ Senior VP - FH	50.00 .......................0.00			X			0	473,562	58,115
(29) Fulbright Robert D........................................................................ Senior VP - FH	50.00 .......................0.00			X			0	516,148	98,711
(30) Goodman Todd A........................................................................ Senior VP - FH	50.00 .......................0.00			X			0	438,713	82,799
(31) Hilliard Douglas W........................................................................ Senior VP - FH	50.00 .......................0.00			X			0	458,195	79,129
(32) Hurst Jeffry D........................................................................ Senior VP - FH	50.00 .......................0.00			X			0	451,049	53,349
(33) Moorhead MD John David........................................................................ Senior VP - FH	50.00 .......................0.00			X			0	719,614	100,925
(34) Owen Terry R........................................................................ Senior VP - FH	50.00 .......................0.00			X			0	750,567	80,630
(35) Paradis J Brian........................................................................ Exec VP - FH	50.00 .......................0.00			X			0	926,299	174,546
(36) Reed MD Monica P........................................................................ Senior VP - FH	50.00 .......................0.00			X			0	648,656	114,429
(37) Soler Eddie........................................................................ CFO - FL Divison	50.00 .......................0.00			X			0	821,215	140,493
(38) Lee MD Kathy........................................................................ Physician	50.00 .......................0.00				X		894,576	0	26,308
(39) Eubanks Jr MD William Stephen........................................................................ Executive Director of Academic Surgery	50.00 .......................0.00				X		828,534	0	24,754
(40) Bittner MD Hartmuth........................................................................ Medical Director	56.00 .......................0.00				X		814,044	0	21,993
(41) Torres MD Ramon M........................................................................ Physician	50.00 .......................0.00				X		696,531	0	33,179
(42) Jones MD Phillip E........................................................................ Physician	50.00 .......................0.00				X		691,828	0	32,040
(43) Grim-Marcarelli Karen........................................................................ Former key employee	50.00 .......................0.00					X	0	409,451	43,883
(44) Hamilton Connie A........................................................................ Former key employee	50.00 .......................0.00					X	0	407,922	31,155
(45) Herrin Arlene K........................................................................ Former key employee	50.00 .......................0.00					X	0	326,735	53,759

(A) Name and business address	(B) Description of services	(C) Compensation
Brasfield & Gorrie LLC200 Colonial Ctr Pwy Ste 200Lake MaryFL32746	Construction Services	23,409,134
Cerner Corporation2800 Rockcreek ParkwayKansas CityMO64117	Technology Solutions Support	11,284,868
Koosharem Corporation24223 Network PlaceChicagoIL60673	Staffing	9,927,646
Crothall Healthcare Inc13028 Collection Center DrChicagoIL60693	Housekeeping	5,038,118
Hardee Services of Rehab Inc1330 Hwy 17 SouthWauchulaFL33873	Physical Therapy	3,940,658
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 388

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.	(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the United States. See Part IV, line 21	23,324,989	23,324,989
2	Grants and other assistance to individuals in the United States. See Part IV, line 22
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	89,577	89,577
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	10,481,182		10,481,182
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	1,014,789,755	996,359,720	18,430,035
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	35,665,232	34,933,961	731,271
9	Other employee benefits .......	241,586,585	224,807,891	16,778,694
10	Payroll taxes ...........	76,432,936	74,884,216	1,548,720
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	7,109,607		7,109,607
c	Accounting ...........	619,331		619,331
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	247,139,753	219,221,732	27,918,021
12	Advertising and promotion ....	16,718,428		16,718,428
13	Office expenses .......	103,235,818	78,654,716	24,581,102
14	Information technology ......	18,779,905	16,460,410	2,319,495
15	Royalties ..
16	Occupancy ...........	60,472,743	60,348,793	123,950
17	Travel ............	6,087,663	3,073,025	3,014,638
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....	1,312,476	880,046	432,430
20	Interest ...........	70,189,549	58,749,904	11,439,645
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	159,039,466	159,039,466
23	Insurance ..............	42,169,859	40,349,825	1,820,034
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	Medical Supplies	509,526,071	509,526,071
b	Extinguishment of Debt	83,770,648	83,770,648
c	Repairs/Maintenance	66,203,586	66,203,586
d	Assessments	35,029,340	35,029,340
e	All other expenses	36,186,491	5,294,225	30,892,266
25	Total functional expenses. Add lines 1 through 24e	2,865,960,990	2,691,002,141	174,958,849	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response to any question in this Part X ...............
	1	Cashnon-interest-bearing .............	99,490	1	104,616
2	Savings and temporary cash investments .........	1,458,843,277	2	1,559,001,735
3	Pledges and grants receivable, net ...........		3
4	Accounts receivable, net .............	370,664,906	4	421,785,860
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
			5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
			6
7	Notes and loans receivable, net .............		7
8	Inventories for sale or use ..............	69,068,975	8	73,594,192
9	Prepaid expenses and deferred charges ..........	15,053,517	9	29,239,839
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	3,461,478,497
b	Less: accumulated depreciation .....	10b	1,684,128,752	1,773,627,027	10c	1,777,349,745
11	Investments—publicly traded securities ..........		11
12	Investments—other securities. See Part IV, line 11 .....	277,876,782	12	278,044,188
13	Investments—program-related. See Part IV, line 11 .....		13
14	Intangible assets ...............	11,840,997	14	34,901,310
15	Other assets. See Part IV, line 11 ...........	1,936,921,170	15	2,125,977,661
16	Total assets. Add lines 1 through 15 (must equal line 34)......	5,913,996,141	16	6,299,999,146
	17	Accounts payable and accrued expenses .........	195,866,090	17	211,662,358
18	Grants payable .................		18
19	Deferred revenue ................		19
20	Tax-exempt bond liabilities .............	3,588,586,470	20	3,620,560,952
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Loans and other 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 (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................	169,905,951	25	232,589,914
26	Total liabilities. Add lines 17 through 25.........	3,954,358,511	26	4,064,813,224
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	1,956,618,834	27	2,233,704,874
28	Temporarily restricted net assets ...........	3,018,796	28	1,481,048
29	Permanently restricted net assets ...........		29
	Organizations that do not follow SFAS 117 (ASC 958), 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 ...........	1,959,637,630	33	2,235,185,922
34	Total liabilities and net assets/fund balances ........	5,913,996,141	34	6,299,999,146

- 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

2012

Open to Public
Inspection

Name of the organization

Adventist Health SystemSunbelt Inc

Employer identification number

59-1479658

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 described in 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. See section 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 - Non-functionally integrated

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 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	(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 monetary support
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of monetary support


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2012

Page 2

Part II

Support Schedule for Organizations Described in Sections 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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
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 2012 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2011 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2012. 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—2011. If the organization did not check a 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—2012. 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—2011. 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) 2012

Page 3

Part III

Support Schedule for Organizations Described in Section 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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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.)..

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 2012 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2011 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2011 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2012. 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—2011. 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) 2012

Page 4

Part IV

Supplemental Information. Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2012

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

2012

Name of the organization

Adventist Health SystemSunbelt Inc

Employer identification number

59-1479658

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, total 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 total 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 on line H of its
Form 990-EZ or on Part I, 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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 2

Name of organization Adventist Health SystemSunbelt Inc

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total 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) Total 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) Total 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) Total 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) Total 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) Total 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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 3

Name of organization Adventist Health SystemSunbelt Inc

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 4

Name of organization
Adventist Health SystemSunbelt Inc

Employer identification number

59-1479658

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total 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

$
Use duplicate copies of Part III if additional space is needed.

(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) (2012)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public
Inspection

If the organization answered “Yes” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35c (Proxy Tax), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

Adventist Health SystemSunbelt Inc

Employer identification number

59-1479658

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ................................... SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b.. SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2012

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......
b	Total lobbying expenditures to influence a legislative body (direct lobbying) .......
c	Total lobbying expenditures (add lines 1a and 1b) ...................
d	Other exempt purpose expenditures ........................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ......................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2012

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Yes

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Yes

3,240

Other activities? ..........................

Yes

443,034

Total. Add lines 1c through 1i ...............................

446,274

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered “No” OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members .....................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ............................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

Part IV

Supplemental Information

Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.

Identifier	Return Reference	Explanation
Explanation of Lobbying Activities:	Part II-B, Line 1:	The corporation reimbursed traveling expenses and paid fees to retain the services of four consulting firms which performed lobbying activities on behalf of the corporation. The four firms were William Filan, John Andrew Kane, Dick Batchelor, and Johnson & Blanton and were paid a total of $284,944 during the year. Additionaly, dues were paid to the American Hospital Association, Florida Hospital Association, Illinois Hospital Association, Texas Hospital Association, Association of Organ Procurement and the Metropolitan Chicago Healthcare Council who use a portion of the dues to conduct lobbying activities.
Part IV, Supplemental Information:		Part II-B 1(b) During 2012 salary expense of $24,118 was incurred for paid staff engaged in lobbying activities.

Schedule C (Form 990 or 990EZ) 2012

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, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

Adventist Health SystemSunbelt Inc

Employer identification number

59-1479658

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 can 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 education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 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, and not on a historic structure listed in the National Register ....................	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax 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

0.00

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

$ 0

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

Yes No

In Part XIII, 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 (ASC 958), 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 XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), 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 (ASC 958) 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 Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2012

Page 2

Part III

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

Using the organization’s acquisition, 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 XIII.

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 XIII 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 XIII. Check here if the explanation has been provided in Part XIII ........

Part V

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

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....	15,730,537	15,221,113	14,810,178	14,077,615	3,027,408
b	Contributions ........	79,402	121,143	30,263	57,189	79,953
c	Net investment earnings, gains, and losses	780,118	753,535	720,592	696,088
d	Grants or scholarships .....			339,920	117,114
e	Other expenditures for facilities and programs ........		365,254			233,695
f	Administrative expenses ....				-96,400
g	End of year balance ......	16,590,057	15,730,537	15,221,113	14,810,178	2,873,666

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

80.940 %

Permanent endowment SchDMd Bullet

19.060 %

Temporarily restricted endowment SchDMd Bullet

0 %

The percentages in lines 2a, 2b, and 2c should equal 100%.

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)

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

3a(ii)

Yes

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

Yes

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

Part VI

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

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	193,465,472		193,465,472
b	Buildings ................	1,262,084,896	520,591,642	741,493,254
c	Leasehold improvements ............
d	Equipment ................	1,855,192,486	1,109,475,993	745,716,493
e	Other .................	150,735,643	54,061,117	96,674,526
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				1,777,349,745

Schedule D (Form 990) 2012

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) must 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) must 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) Funds Held in Trust				9,892,860
(2) Other Current Receivables				12,544,777
(3) Due From Related Parties and Affiliates				42,173,540
(4) Donor Restricted Assets				12,874
(5) Deferred Charges and Costs				21,893,194
(6) Long-term Investments				60,976,783
(7) Other Non-Current Assets				8,213,023
(8) Receivable - Interco Alloc of Tax-Exempt Bond Proceeds				1,959,372,596
(9) Receivable from Third Party				10,898,014
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				2,125,977,661

Part X

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

1.(a) Description of liability		(b) Book value
Federal income taxes
Accounts Receivable - Credit Balances		7,926,003
Payable to Third Party		72,642,513
Due to Related-Affiliated Entities		33,604,832
Other Current Liabilities		5,576,869
Other Non-Current Liabilities		103,834,580
Notes and Loans Payable - Current		176,725
Leases Payable		8,828,392


Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		232,589,914
2. Fin 48 (ASC 740) Footnote. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII .....................................................

Schedule D (Form 990) 2012

Page 4

Part XI 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 XIII.) ............	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 XIII.) ...........	4b
c	Add lines 4a and 4b.......................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII 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 XIII.) ............	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 XIII.) ............	4b
c	Add lines 4a and 4b.......................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Identifier	Return Reference	Explanation
Description of How Organization Reports Conservation Easements:	Part II, Line 9:	The filing organization has recorded the land conservation easement on its financial statements as a Property, Plant, and Equipment Asset. The conservation easement generates no revenue and the filing organization did not incur any expense in 2012 related to the maintenance and monitoring of the conservation easement.
Description of Intended Use of Endowment Funds:	Part V, Line 4:	All endowment funds are held by related 501(c)(3) exempt foundations. These endowment funds have been established for a variety of purposes in support of related tax-exempt hospitals. All of the foundation's permanently restricted endowment funds are required to be retained permanently either by explicit donor stipulation or by the Florida Uniform Prudent Management of Institutional Funds Act. Part V, line 1a, column (b) Prior year - Explanation for change in opening balance: During the year 2009, management of a related Foundation determined that there were temporarily restricted net assets that should have been classified as unrestricted board-designated endowment funds as of December 31, 2008. This included $11,203,949 of board-designated endowments that should have been released from restriction in fiscal year 2008 or an earlier period. As a result, the related Foundation restated beginning board-designated endowment funds on the statement of activities in its 2009 tax year.
Description of Uncertain Tax Positions Under FIN 48:	Part X, Line 2:	The filing organization is a subsidiary organization within Adventist Health System (AHS). The consolidated financial statements of AHS contain the following FIN 48 footnote: Please note that dollar amounts are in thousands. Healthcare Corporation and its affiliated organizations, other than North American Health Services, Inc. and its subsidiaries (NAHS), are exempt from state and federal income taxes. Accordingly, Healthcare Corporation and its tax-exempt affiliates are not subject to federal, state, or local income taxes except for any net unrelated business taxable income. For the years ended December 31, 2012 and 2011, unrelated business income activities conducted by Healthcare Corporation and its tax-exempt affiliates did not generate a material amount of combined federal, state and local income tax. NAHS is a wholly owned, for-profit subsidiary of Healthcare Corporation. NAHS and its subsidiaries are subject to federal and state income taxes. NAHS files a consolidated federal income tax return and, where appropriate, consolidated state income tax returns. For the years ended December 31, 2012 and 2011, NAHS generated taxable income of approximately $2,400 and $1,000, respectively. This taxable income was fully offset by net operating loss carryforwards for federal income tax purposes. Although one state in which NAHS conducts business has suspended the utilization of net operating loss carryforwards for the year ended December 31, 2012, no material state income tax liability resulted. Accordingly, there is no provision for current federal or state income tax for the years ended December 31, 2012 and 2011. NAHS also has temporary deductible differences of approximately $64,800 and $67,500 at December 31, 2012 and 2011, respectively, primarily as a result of net operating loss carryforwards. At December 31, 2012, NAHS had net operating loss carryforwards of approximately $64,300 of which $21,000 will expire in 2023, with the remaining $43,300 expiring beginning in 2018 through 2026. Some of these net operating losses are subject to the separate return limitation year rules. Deferred taxes have been provided for these amounts, resulting in a net deferred tax asset of approximately $24,600 and $25,600 at December 31, 2012 and 2011, respectively. A full valuation allowance has been provided at December 31, 2012 and 2011, respectively, to offset the deferred tax asset since Healthcare Corporation has determined that it is more likely than not that the benefit of the net operating loss carryforwards will not be realized in future years. The Income Taxes Topic of the ASC (ASC 740) prescribes the accounting for uncertainty in income tax positions recognized in financial statements. ASC 740 prescribes a recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return.

Schedule D (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16. Right pointing arrow large image

Attach to Form 990. Right pointing arrow large image

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization
Adventist Health SystemSunbelt Inc

Employer identification number

59-1479658

Part I

General Information on Activities Outside the United States. Complete if the organization answered “Yes” to Form 990, Part IV, line 14b.

For grantmakers. 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

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of grant funds outside
the United States.

Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region		(d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region)	(e) If activity listed in (d) is a program service, describe specific type of service(s) in region	(f) Total expenditures for and investments in region
	Central America and the Caribbean	Grantmaking		4,235
	Central America and the Caribbean	Meetings		6,904
	Central America and the Caribbean	Program Services	Medical Care Mission Trips	34,262
	East Asia and the Pacific	Meetings		830
	Europe (including Iceland and Greenland)	Grantmaking		10,000
	Europe (including Iceland and Greenland)	Meetings/Conferences		48,742
	Europe (including Iceland and Greenland)	Program Services	Mission Trip Planning	210
	Europe (including Iceland and Greenland)	Program Services	Surgical Care	3,368
	Middle East and North Africa	Urological Society Conference		1,541
	North America (which includes Canada and Mexico, but not the U.S.)	Meetings/Conferences		7,928
	South America	Grantmaking		9,200
	South America	Meetings/Conferences		5,690
	South America	Program Services	Medical/dental clinics	38,567
	South America	Program Services	Surgical Care	2,062
	South America	Program Services	Mission trips and Conferences. Medical supplies and other donated supplies.	80,423
	South Asia	Meetings/Conferences		10,496
	Sub-Saharan Africa	Grant for Mission trip		500
	Sub-Saharan Africa	Program Services	Mission trip ultrasound equipment & PT supplies and items puchased locally	24,922










3a	Sub-total .....			108,551
b	Total from continuation sheets to Part I ...			181,329
c	Totals (add lines 3a and 3b)			289,880

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2012

Schedule F (Form 990) 2012

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered “Yes” to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

(c) Region	(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of of non-cash assistance	(h) Description of non-cash assistance	(i) Method of valuation (book, FMV, appraisal, other)
Central America and the Caribbean	Medical Supplies or Equipment	11,900	Check			Book
South America	Medical Mission Trip	13,550	Check			Book
South America	Medical Supplies or Equipment			5,494	Medical Supplies	Book
Sub-Saharan Africa	Medical Supplies or Equipment			9,566	Medical Supplies	Book
Europe (including Iceland and Greenland)	Sponsorship of German Hospital	10,000	Electronic Funds			Book

Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .... MediumBullet

Enter total number of other organizations or entities ....................... MediumBullet

Schedule F (Form 990) 2012

Schedule F (Form 990) 2012Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.

Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance		(b) Region	(c) Number of recipients	(d) Amount of cash grant	(e) Manner of cash disbursement	(f) Amount of non-cash assistance	(g) Description of non-cash assistance	(h) Method of valuation (book, FMV, appraisal, other)

Schedule F (Form 990) 2012

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2012

Page 5

Part V

Supplemental Information
Complete this part to provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).

Identifier	ReturnReference	Explanation
Procedure for Monitoring Grants Outside the U.S.:		Schedule F, Part I, Line 2: Foreign grants are generally non-cash donations of medical equipment and supplies to assist foreign health care providers in fulfilling their mission of providing health care services to the populations they serve. The foreign health care providers are often hospitals and/or clinics operated and/or sponsored by or affiliated with the Seventh-Day Adventist Church. The foreign hospitals/clinics may be located in remote and/or underserved villages and townships of developing countries. Grants are typically made to other U.S. charitable organizations or foreign entities recognized as charitable by the foreign country in which they are located. As a result of the nature of the grants as non-cash medical equipment and supplies and the fact that most grants are made indirectly through other U.S. or foreign charitable organizations, the filing organization has not established specific procedures for monitoring the use of grant funds outside the United States.

Schedule F (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

Adventist Health SystemSunbelt Inc

Employer identification number

59-1479658

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...

Yes

If "Yes," was it a written policy? .......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: .........

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............

Did the organization prepare a community benefit report during the tax year? ..........

Yes

If "Yes," did the organization make it available to the public? ..............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) ..	155,179,851		155,179,851	5.410 %
b	Medicaid (from Worksheet 3, column a) ....	434,070,792	273,481,625	160,589,167	5.600 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .
d	Total Financial Assistance and Means-Tested Government Programs .	589,250,643	273,481,625	315,769,018	11.010 %
Other Benefits		14,949,141	222,934	14,726,207	0.510 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	14,949,141	222,934	14,726,207	0.510 %
f	Health professions education (from Worksheet 5) ..	44,005,649	10,553,059	33,452,590	1.170 %
g	Subsidized health services (from Worksheet 6) ..	352,627	425	352,202	0.010 %
h	Research (from Worksheet 7)	1,579,642	1,201,099	378,543	0.010 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	16,300,405		16,300,405	0.570 %
j	Total. Other Benefits ..	77,187,464	11,977,517	65,209,947	2.270 %
k	Total. Add lines 7d and 7j .	666,438,107	285,459,142	380,978,965	13.280 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2012

Schedule H (Form 990) 2012

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	19,933,654	5,163,707	14,769,947	0.520 %
8	Workforce development	384,219	40,310	343,909	0.010 %
9	Other	10,450		10,450	0 %
10	Total	20,328,323	5,204,017	15,124,306	0.530 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

96,817,676

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

7,332,132

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

685,288,744

Enter Medicare allowable costs of care relating to payments on line 5.....

779,908,106

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-94,619,362

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
11 Surgical Center at Sun'N Lake LLC	Ambulatory Surgery	50.000 %	0 %	50.000 %
22 Huguley Surgery Center LLP (ended 412)	OP Surgeries	64.100 %	0 %	35.900 %
33 San Marcos MRI LP	Imaging Center	50.000 %	0 %	50.000 %
44 Central Texas Ambulatory Endoscopy	Endoscopy Center	18.800 %	0 %	81.200 %
55 Surgery Management Associates of Kissimmee LLC	Management/Admin	30.000 %	0 %	70.000 %
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2012

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?13 Name, address, and primary website address									Other (Describe)	Facility reporting group
1	Florida Hospital Orlando 601 E Rollins Street Orlando,FL32803 www.floridahospital.com/orlando	X	X	X	X		X	X		A
2	Florida Hospital Celebration Health 400 Celebration Place Celebration,FL34747 www.floridahospital.com/celebration-h	X	X		X			X		A
3	Florida Hospital Altamonte 601 E Altamonte Drive Altamonte Springs,FL32701 www.floridahospitalaltamonte.com	X	X		X			X		A
4	Florida Hospital East Orlando 7727 Lake Underhill Drive Orlando,FL32822 www.floridahospitaleast.com	X	X		X			X		A
5	Winter Park Memorial Hospital 200 N Lakemont Avenue Winter Park,FL32822 www.floridahospital.com/winter-park-m	X	X		X			X		A
6	Adventist La Grange Memorial Hospital 5101 S Willow Springs Road La Grange,IL60525 www.keepingyouwell.com/almh/	X	X		X		X	X		A
7	FH Heartland Medical Center 4200 Sun N Lake Blvd Sebring,FL33872 fhheartland.org	X	X					X		A
8	Florida Hospital Kissimmee 2450 North Orange Blossom Trail Kissimmee,FL34741 www.floridahospital.com/kissimmee	X	X		X			X		A
9	Central Texas Medical Center 1301 Wonder World Dr San Marcos,TX78666 ctmc.org	X	X					X		A
10	Florida Hospital Apopka 201 N Park Avenue Apopka,FL32703 www.floridahospitalapopka.com	X	X		X			X		A
11	FH Heartland Medical Center Lake Placid 1210 US 27 N Lake Placid,FL33852 fhheartland.org	X	X					X	Senior Behavioral Unit	A
12	Florida Hospital Wauchula 533 W Carlton Street Wauchula,FL33873 fhheartland.org	X	X			X		X	Skilled Nursing	A
13	Huguley Memorial Medical Center 11801 South Freeway Fort Worth,TX76115 www.huguley.org	X	X					X	Huguley Home Health Agency	A

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	GROUP A
Name of hospital facility or facility reporting group

For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9....................

If “Yes,” indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20

In conducting its most recent CHNA, did the hospital facility take into account input from representatives of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ....................

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................

Did the hospital facility make its CHNA report widely available to the public? .............

If “Yes,” indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Financial Assistance Policy			Yes	No
9	Did the hospital facility have in place during the tax year a written financial assistance policy that:
	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?	9	Yes
10	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........	10	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 200.000000000000% If "No," explain in Part VI the criteria the hospital facility used.
11	Used FPG to determine eligibility for providing discounted care?.................	11	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 400.000000000000% If "No," explain in Part VI the criteria the hospital facility used.
12	Explained the basis for calculating amounts charged to patients?.................	12	Yes
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Other (describe in Part VI)
13	Explained the method for applying for financial assistance?...................	13	Yes
14	Included measures to publicize the policy within the community served by the hospital facility?.......	14	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
Billing and Collections
15	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?.......	15	Yes
16	Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)
17	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?..........	17		No
	If “Yes,” check all actions in which the hospital facility or a third party engaged:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the patients regarding the patients’ bills

Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Part VI)

Policy Relating to Emergency Medical Care

Yes

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........

Yes

If “No,” indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

During the tax year, did the hospital facility charge any FAP-eligible individuals to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care? ............................

If “Yes,” explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? .........................

If “Yes,” explain in Part VI.

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?138
Name and address		Type of Facility (describe)
1	Florida Hospital Cancer Institute 2501 N Orange Avenue Suites 139 181 Orlando,FL32804	Cancer Center
2	Florida Hospital Rehabilitation and Spor 5165 Adanson Street Orlando,FL32804	Therapy Center
3	Florida Hospital Orlando Pathology Lab 2855 N Orange Avenue Orlando,FL32803	Lab Services
4	Florida Hospital Cancer Institute - Kiss 1300 West Oak Street Kissimmee,FL34741	Cancer Center
5	Florida Hospital Cancer Care Center 2100 Glenwood Drive Winter Park,FL32792	Radiation Oncology
6	Florida Hospital Altamonte Imaging Cente 661 E Altamonte Drive Suite 112 Altamonte Springs,FL32701	MRI/CT
7	Florida Hospital Kidney Stone Center 2501 N Orange Avenue Suite 121 Orlando,FL32804	Outpatient Services
8	Florida Hospital Altamonte Cancer Center 601 E Altamonte Drive Altamonte Springs,FL32701	Cancer Center
9	Florida Hospital Altamonte Ambulatory Su 661 E Altamonte Drive Suite 110 Altamonte Springs,FL32701	Outpatient Surgery Center
10	Florida Hospital Altamonte Medical Plaza 661 E Altamonte Drive Altamonte Springs,FL32701	Physician Clinics
11	Florida Hospital Medical Plaza 2501 N Orange Avenue Orlando,FL32804	Physician Clinics
12	Florida Hospital Transplant Center 2415 N Orange Avenue Suite 700 Orlando,FL32804	Organ Tissue/Transplant Center
13	FRi Princeton 235 E Princeton Street Suite 100 Orlando,FL32804	Imaging Center
14	Florida Hospital Center for Behavioral H 501 E King Street 1st Floor Orlando,FL32803	Med/Psych
15	Florida Hospital Advanced Nuclear Imagin 328 Spruce Street Orlando,FL32803	Radiology Services
16	Florida Hospital Surgery Center East Or 258 S Chickasaw Trail Suite 100 Orlando,FL32825	Outpatient Surgery
17	Florida Hospital Altamonte Imaging Cente 894 E Altamonte Drive Suite 1100 Altamonte Springs,FL32701	Radiology Services
18	FHCC - LAKE BUENA VISTA #2 12500 S Apopka Vineland Rd Orlando,FL32836	Urgent care Clinic
19	Adventist Paulson Rehab - Willowbrook 619 Plainfield Road Willowbrook,IL60521	Rehabilitation Center
20	FRi Lake Mary 775 Primera Blvd Suite 1031 Lake Mary,FL32746	Imaging Center
21	Florida Hospital Gamma Knife 2501 N Orange Ave Suite 101 S Orlando,FL32804	Gamma Knife
22	Loch Haven OBGyn Group 235 E Princeton Street Suite 200 Orlando,FL32804	Physician Clinics
23	Florida Hospital Rehabilitation & Sports 8701 Maitland Summit Blvd Orlando,FL32810	Therapy Center
24	Family Health East Orlando Women's Pavil 7975 Lake Underhill Drive Suite 100 Orlando,FL32822	Women's Health Clinic
25	Surgical Center at Sun N' Lake LLC 4240 Sun n Lake Blvd Sebring,FL33872	Outpatient Surgery
26	Florida Hospital Rehabilitation & Sports 7975 Lake Underhill Drive Suite 300 34 Orlando,FL32822	Therapy Center
27	FHCC - WATERFORD 250 N Alafaya Trail Suite 135 Orlando,FL32825	Urgent care Clinic
28	FHHMC Cardiology Associates 4638 Sun n Lake Blvd Sebring,FL33872	Outpatient Phys Clinic
29	Central Texas Ambulatory Endoscopy 1303 Wonder World DR San Marcos,TX78666	Endoscopy Services
30	Winter Park Memorial Hospital Women's Ce 1925 Mizell Ave Suites 105 107 Winter Park,FL32792	Women's Health Clinic, Imaging
31	FHCC - SANFORD 4451 West 1st Street Sanford,FL32771	Urgent care Clinic
32	Florida Hospital Rehabilitation & Sports 400 Celebration Place Suite 200C Celebration,FL34747	Therapy Center
33	Florida Hospital Center for Thrombosis 2501 N Orange Avenue Suite 786 Orlando,FL32804	Thrombosis Center
34	Florida Hospital Altamonte Mammography C 661 E Altamonte Drive Suite 130 Altamonte Springs,FL32701	Imaging Center
35	FHCC - WINTER PARK 3099 Aloma Avenue Winter Park,FL32792	Urgent care Clinic
36	FRi Oviedo 8000 Red Bug Lake Road Suite 120 Oviedo,FL32765	Imaging Center
37	Florida Hospital Altamonte Pain Medicine 711 East Altamonte Drive Suite 100 Altamonte Springs,FL32701	Pain Medicine
38	FHCC - WINTER GARDEN 3005 Daniels Road Winter Garden,FL34787	Urgent care Clinic
39	FRi Waterford Lake 12301 Lake Underhill Rd Suite 113 Orlando,FL32828	Imaging Center
40	Family Health Center Winter Park 2950 Aloma Ave Suite 100 Winter Park,FL32792	Physician Clinics, Medicine Specialists, Surgical Specialists
41	Florida Hospital Center for Sleep Disord 501 E King Street 2nd Floor Orlando,FL32803	Sleep Disorder Center
42	CTMC Hospice 1315 IH 35 North San Marcos,TX78666	Hospice services
43	FHCC - ORANGE LAKE 8201 W Irlo Bronson Highway Kissimmee,FL34747	Urgent care Clinic
44	FHHMC SeaScape Imaging OP Center 2950 Alt US 27 S Sebring,FL33870	Outpatient Imaging Center
45	FHCC - OnsiteBusiness Health Services 901 N Lake Destiny Road Suite 400 Maitland,FL32750	Onsite Services
46	FHCC - LEE ROAD 2540 Lee Road Winter Park,FL32789	Urgent care Clinic
47	FHCC - ALTAMONTE 440 W Highway 436 Altamonte Springs,FL32714	Urgent care Clinic
48	FH Wauchula Pioneer Medical Center 515 Carlton Street Wauchula,FL33873	Outpatient Phys Clinic
49	FHCC - COLONIAL TOWN 630 North Bumby Ave Orlando,FL32803	Urgent care Clinic
50	FHCC - DR PHILLIPS 8014 Conroy-Windermere Rd Suite 104 Orlando,FL32835	Urgent care Clinic
51	La Grange Cancer Treatment Pavillion 1325 Memorial Dr La Grange,IL60525	Cancer Center/Wound Care Facility
52	FHCC - KISSIMMEE 4320 W Vine Street Kissimmee,FL34746	Urgent care Clinic
53	Florida Hospital Rehabilitation & Sports 711 E Altamonte Drive Suite 200 Altamonte Springs,FL32701	Therapy Center
54	FHCC - RDV 8701 Maitland Summit Blvd Maitland,FL32810	Urgent care Clinic
55	FHCC - HUNTERS CREEK 3293 Greenwald Way North Kissimmee,FL34741	Urgent care Clinic
56	FHCC - SAND LAKE 2301 Sand Lake Road Orlando,FL32809	Urgent care Clinic
57	Florida Hospital Rehabilitation & Sports 8000 Red Bug Lake Road Suite 140 Oviedo,FL32765	Therapy Center
58	FHCC - MT DORA 9015 US Highway 441 Mount Dora,FL32757	Urgent care Clinic
59	Florida Hospital Sleep Disorder Center - 1925 Mizell Avenue Suite 200 Winter Park,FL32792	Sleep Center
60	Adventist La Grange Family Medical Cente 5101 S Willow Springs Road La Grange,IL60525	Family Medical Center
61	FHCC - OVIEDO 8010 Red Bug Road Oviedo,FL32765	Urgent care Clinic
62	FHCC - AZALEA PARK 509 S Semoran Blvd Orlando,FL32807	Urgent care Clinic
63	FHCC - CLERMONT 15701 State Road 50 Suite 101 Clermont,FL34711	Urgent care Clinic
64	Florida Hospital Rehabilitation & Sports 615 E Princeton St Suite 104 Orlando,FL32803	Therapy Center
65	FHHMC Family Practice Center 1006 W Pleasant Street Avon Park,FL33825	Outpatient Phys Clinic
66	FHCC - LONGWOOD 855 S US Highway 17-92 Longwood,FL32750	Urgent care Clinic
67	FHHMC Pulmonary and Critical Care Specia 4409 Sun n Lake Blvd Suite E Sebring,FL33872	Outpatient Phys Clinic
68	Florida Hospital Rehab and Sport Medicin 2005 Mizell Ave Winter Park,FL32792	Therapy Center
69	FHCC - UNIVERSITY 11550 University Blvd Orlando,FL32817	Urgent care Clinic
70	FHHMC Therapy Center 6325 US Hwy 27 N Sebring,FL33870	Outpatient Physical Therapy
71	Huguley Surgery Center LLP 15305 Dallas Pkwy Ste 1600 LB 28 Addison,TX75001	Outpatient Surgery Center
72	Florida Hospital Rehab and Sports Medici 100 Waymont Court Suite 120 Lake Mary,FL32746	Therapy & Hearing Center
73	Medical Plaza - Florida Hospital Kissimm 2400 North Orange Blossom Trail Kissimmee,FL34744	Physician Clinics
74	FHHMC Heartland Women's Health 37 Ryant Blvd Sebring,FL33870	Outpatient Phys Clinic
75	FHHMC Center Priority Health Care 4200 Sun n Lake Blvd Sebring,FL33872	Outpatient Phys Clinic
76	Family Health Center East 7975 Lake Underhill Drive Suite 200 Orlando,FL32822	Physician Clinics
77	San Marcos MRI LP 1330 Wonder World Dr San Marcos,TX78666	Imaging Services
78	FHCC - CONWAY 5810 S Semoran Blvd Orlando,FL32822	Urgent care Clinic
79	FHHMC Interventional Cardiology 6325 US 27 North Suite 202 Sebring,FL33872	Outpatient Phys Clinic
80	Florida Hospital Rehabilitation & Sports 201 Hilda Street Suite 12 Kissimmee,FL34741	Therapy Center
81	Florida Hospital Celebration Health Outp 410 Celebration Place Suite 408 Celebration,FL34747	Outpatient Surgery Center
82	Celebration Hand Therapy 410 Celebration Place Suite 300 Celebration,FL34747	Therapy Center
83	CTMC Home Health 2007 Medical Parkway San Marcos,TX78666	Home Health services
84	FHHMC Wound Care 4143 Sun N Lake Sebring,FL33872	Wound Care
85	Florida Hospital Rehabilitation & Sports 2520 N Orange Avenue Suite 100 Orlando,FL32804	Therapy Center
86	Florida Hospital Rehabilitation & Sports 205 N Park Avenue Suite 110 Apopka,FL32703	Therapy Center
87	Florida Hospital Rehabilitation and Spor 1603 S Hiawassee Road Orlando,FL32835	Therapy Center
88	Florida Hospital Laboratory - Orlando 2501 N Orange Avenue Suite 370 Orlando,FL32804	Lab Services
89	Florida Hospital Diabetes Institute 2415 N Orange Ave Suite 501 Orlando,FL32804	Diabetes
90	CTMC Rehab Services 1340 Wonder World Dr San Marcos,TX78666	OP Rehab Services
91	FHHMC Women's Wellness Center Sebring 4240 Sun n Lake Blvd Sebring,FL33872	Outpatient Phys Clinic
92	FHHMC Center for Infectious Disease 4409 Sun n Lake Blvd Suite E Sebring,FL33870	Outpatient Phys Clinic
93	FHHMC Priority Health Care 1210 US Highway 27 N Lake Placid,FL33852	Outpatient Phys Clinic
94	FHHMC Family Medicine Specialist 2315 US Highway 27 North Avon Park,FL33825	Outpatient Phys Clinic
95	FHHMC Sleep Lab 4301 Sun N Lake Blvd Sebring,FL33872	Sleep Lab
96	Florida Hospital Sleep Disorder Center - 203 N Park Avenue Suite 106 Apopka,FL32703	Sleep Center
97	FHHMC Highlands Surgical Associates 4301 Sun n Lake Blvd Suite 103 Sebring,FL33872	Outpatient Phys Clinic
98	FHHMC Psychiatric Services 4023 Sun n Lake Blvd Sebring,FL33872	Outpatient Phys Clinic
99	FHHMC SeaScape South Laboratory 2950 Alt US 27 S Sebring,FL33870	Outpatient Laboratory
100	Eden Spa 2501 N Orange Ave Suite 186 Orlando,FL32804	Outpatient Therapy & Consumer goods and services
101	FHHMC CareNow 4421 Sun n Lake Blvd Suite B Sebring,FL33872	Outpatient Phys Clinic
102	FH Wauchula The Therapy Center 1330 Hwy 17 S Wauchula,FL33873	Outpatient Physical Therapy
103	Darden Onsite 1000 Darden Center Drive Orlando,FL32837	Employer Onsite Clinic
104	FHHMC Gastroenterology & Women's Wellnes 1352 US 27 North Lake Placid,FL33852	Outpatient Phys Clinic
105	FHHMC Therapy Center Lake Placid 1210 US 27 N Lake Placid,FL33852	Outpatient Physical Therapy
106	Florida Hospital Laboratory - Lucerne Te 1723 Lucerne Terrace Orlando,FL32806	Blood collection stations
107	FH Wauchula Hardee Family Medicine 522 W Carlton Street Wauchula,FL33873	Outpatient Phys Clinic
108	FHHMC Gastroenterology Center Sebring 4421 Sun n Lake Blvd Suite B Sebring,FL33872	Outpatient Phys Clinic
109	Florida Hospital Laboratory - Palm Sprin 631 Palm Springs Drive Suite 113 Altamonte Springs,FL32701	Blood collection stations
110	FHHMC Internal Medicine Specialist 6801 US Hwy 27 North Suite B-2 Sebring,FL33870	Outpatient Phys Clinic
111	Florida Hospital Laboratory - Tavares 1769 David Walker Drive Tavares,FL32778	Blood collection stations
112	FHHMC Pain Management 4145 Sun N Lake Sebring,FL33872	Pain Management
113	Siemens Onsite 4400 N Alafaya Trail MC Q1-240 Orlando,FL32826	Employer Onsite Clinic
114	Wyndham Onsite 6277 Sea Harbor Dr Orlando,FL32821	Employer Onsite Clinic
115	FHHMC Outpatient Laboratory 2315 US Hwy 27 N Avon Park,FL33825	Outpatient Laboratory
116	Florida Hospital Laboratory - Altamonte 661 East Altamonte Drive Suite 131 Altamonte Springs,FL32701	Lab Services
117	FHHMC Psychiatric Services 1346 US Highway 27 S Lake Placid,FL33852	Outpatient Phys Clinic
118	FHHMC Cardio-Pulmonary 4635 Sun N Lake Blvd Sebring,FL33872	Cardio Pulmonary Rehab
119	CTMC OP Lab and Radiology 151 Kirkham Circle Kyle,TX78640	OP lab, rehab & medical imaging
120	Florida Hospital Hearing Center East Or 7975 Lake Underhill Drive Suite 300 Orlando,FL32822	Hearing Center
121	Florida Hospital Laboratory - Winter Par 1925 Mizell Ave Suite 100 Winter Park,FL32792	Lab Services
122	FHHMC Outpatient Laboratory 6801 US Hwy 27 N Suite C -1 Sebring,FL33872	Outpatient Laboratory
123	FHHMC Neurology 4421 Sun n Lake Blvd Suite B Sebring,FL33872	Outpatient Phys Clinic
124	Florida Hospital Women's CenterLactatio 2520 N Orange Avenue Suite 103 Orlando,FL32804	Lactation Center, Birthing Classes
125	FH Wauchula Sleep Lab & Wound Care 457 W Carlton St Wauchula,FL33873	Sleep Lab & Wound Care
126	FHHMC Seascape Internal Medicine Sebring 2950 Alt US 27 South Suite B Sebring,FL33870	Outpatient Phys Clinic
127	Florida Hospital Rehabilitation and Spor 601 E Rollins Street Orlando,FL32803	Therapy Center
128	Waterman Onsite 1000 Waterman Way Tavares,FL32778	Employer Onsite Clinic
129	Florida Hospital Pediatric 615 E Princeton St Suite 540 Orlando,FL32803	EPS Cath Lab
130	Total Healthcare Management 1000 Universal Studios Plaza 3 Orlando,FL32819	Employer Onsite Clinic
131	ALT EDEN SPA 601 E Altamonte Drive Suite 1721 Altamonte Springs,FL32701	Outpatient Therapy & Consumer goods and services
132	FHHMC Highlands Surgical Associates Lake 1352 US 27 North Lake Placid,FL33852	Outpatient Phys Clinic
133	OCG Onsite 450 E South Street Orlando,FL32802	Employer Onsite Clinic
134	FHHMC Family Medicine Center of Lake Pla 1352 US 27 North Lake Placid,FL33852	Outpatient Phys Clinic
135	FHHMC Diabetes Center 4023 Sun N Lake Sebring,FL33872	Diabetes Center
136	FHHMC ENT Specialist 4325 Sun n Lake Blvd Suite 102 Sebring,FL33872	Outpatient Phys Clinic
137	FH Wauchula Womens Wellness Center 526 W Carlton Street Wauchula,FL33873	Outpatient Phys Clinic
138	FHHMC LP Wound Care 1352 US Hwy 27 N Lake Placid,FL33852	Wound Care

Schedule H (Form 990) 2012

Page

Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; Part V, Section A; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any needs assessments reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
8	Facility reporting group(s). If applicable, for each hospital facility in a facility reporting group provide the descriptions required for Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.

Identifier	ReturnReference	Explanation
		Part I, Line 6a: The filing organization is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC serves as a parent organization to 24 tax-exempt 501(c)(3) hospital organizations that operate 43 hospitals in ten states within the U.S. The system of organizations under the control and ownership of AHSSHC is known as "Adventist Health System" (AHS).All hospital organizations within AHS collect, calculate, and report the community benefits they provide to the communities they serve. AHS organizations exist solely to improve and enhance the local communities they serve. AHS has a system-wide community benefits accounting policy that provides guidelines for its health care provider organizations to capture and report the costs of services provided to the underprivileged and to the broader community. On an annual basis, the community benefits of all AHS organizations are consolidated and reported in the AHS Annual Report document prepared by Adventist Health System Sunbelt Healthcare Corporation (EIN 59-2170012).
		Part I, Line 7: The amounts of costs reported in the table in line 7 of Part I of Schedule H were determined by utilizing a cost-to-charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges, contained in the Schedule H instructions.
		Part II: The costs of community building activities reported on Part II of Schedule H primarily represent the costs associated with commercially sponsored research conducted by two of the organization's hospitals. These two hospitals participate in clinical drug and device research that is performed on patients who have a condition or disease for which the eventual commercial use of a drug or device is intended. This research is related to patient care and serves to expand scientific knowledge with respect to potential treatments and cures for various diseases and conditions.The remainder of the costs incurred stem from the hospitals' involvement in and support of various other community agencies in its service area that work collaboratively to help those in need and to improve the health and safety of the residents of the community. The organization's hospitals participate with a number of other community organizations to address the healthcare needs of the community. Both cash and in-kind donations are made annually to various local charitable organizations.
		Part III, Line 8: Costing Methodology: Medicare allowable costs were calculated using a cost-to-charge ratio.Rationale for Including a Medicare Shortfall as Community Benefit:As a 501(c)(3) organization, the filing organization provides emergency and non-elective care to all regardless of ability to pay. All hospital services are provided in a non-discriminatory manner to patients who are covered beneficiaries under the Medicare program. As a public insurance program, Medicare provides a pre-established reimbursement rate/amount to health care providers for the services they provide to patients. In some cases, the reimbursement amount provided to a hospital may exceed its costs of providing a particular service or services to a patient. In other cases, the Medicare reimbursement amount may result in the hospital experiencing a shortfall of reimbursement received over costs incurred. In those cases where an overall shortfall is generated for providing services to all Medicare patients, the shortfall amount should be considered as a benefit to the community. Tax-exempt hospitals are required to accept all Medicare patients regardless of the profitability, or lack thereof, with respect to the services they provide to Medicare patients. The population of individuals covered under the Medicare program is sufficiently large so that the provision of services to the population is a benefit to the community and relieves the burdens of government. In those situations where the provision of services to the total Medicare patient population of a tax-exempt hospital during any year results in a shortfall of reimbursement received over the cost of providing care, the tax-exempt hospital has provided a benefit to a class of persons broad enough to be considered a benefit to the community. Despite a financial shortfall, a tax-exempt hospital must and will continue to accept and care for Medicare patients. Typically, tax-exempt hospitals provide health care services based upon an assessment of the health care needs of their community as opposed to their taxable counterparts where profitability often drives decisions about patient care services that are offered. Patient care provided by tax-exempt hospitals that results in Medicare shortfalls should be considered as providing a benefit to the community and relieving the burdens of government.
		Part III, Line 9b: Collection Policies:At the time of patient registration, non-elective self-pay patients are informed of the minimum discount available under the filing organization's self-pay discount policy. Such patients are also informed of the filing organization's charity care policy and told that they will be required to submit necessary financial data in order to potentially receive any additional discounts. Under the filing organization's financial assistance policy, percentage discounts are applied to a patient's account based upon amounts generally billed to individuals who have insurance covering such care.Under the filing organization's policies, payment plans for partial charity accounts will be individually developed with the patient. Partial charity accounts result when a financial assistance eligibility determination allows for a percentage reduction but leaves the patient with a self-pay balance. If the patient complies with the agreed-upon payment plan, the filing organization does not pursue any collection action with respect to the patient. However, if a patient does not make any payments for three consecutive months, the account may be referred for further collection activity. The filing organization does not pursue collection of amounts from patients determined to qualify for a 100% reduction in charges under its charity care policy.
	Part III, Line 2:	The amount of bad debt expense, reported on line 2 of Section A of Part III is recorded in accordance with Healthcare Financial Management Association Statement No. 15. Discounts and payments on patient accounts are recorded as adjustments to revenue, not bad debt expense.
	Part III, Line 3:	Methodology for Determining the Estimated Amount of Bad Debt Expense that May Represent Patients who Could Have Qualified under the Filing Organization's Charity Care Policy:Self-pay patients are required to complete a Patient Financial Assistance Application Short Form (PFAA). If the PFAA is not completed after reasonable attempts to obtain it are exhausted, patient information is processed through a Scorer product. The Scorer product utilizes publicly available data, such as credit reports, to assess an individual patient's financial viability. Patients who earn a certain score on the Scorer product are considered to qualify as non-state charity patients. An amount up to $1,000 of such a patient's bill is written off as bad debt expense, while the remaining portion of the patient's bill is considered to be non-state charity. The amount written off as bad debt expense for those patients who potentially qualify as non-state charity using the Scorer product is the amount shown on line 3 of Section A of Part III. Rationale for Including Certain Bad Debts in Community Benefit:The filing organization is dedicated to the view that medically necessary health care for emergency and non-elective patients should be accessible to all, regardless of age, gender, geographic location, cultural background, physician mobility, or ability to pay. The filing organization treats emergency and non-elective patients regardless of their ability to pay or the availability of third-party coverage. By providing health care to all who require emergency or non-elective care in a non-discriminatory manner, the filing organization is providing health care to the broad community it serves. As a 501(c)(3) hospital organization, the filing organization maintains a 24/7 emergency room providing care to all whom present. When a patient's arrival and/or admission to the facility begins within the Emergency Department, triage and medical screening are always completed prior to registration staff proceeding with the determination of a patient's source of payment. If the patient requires admission and continued non-elective care, the filing organization provides the necessary care regardless of the patient's ability to pay. The filing organization's operation of a 24/7 Emergency Department that accepts all individuals in need of care promotes the health of the community through the provision of care to all whom present. Current Internal Revenue Service guidance that tax-exempt hospitals maintain such emergency rooms was established to ensure that emergency care would be provided to all without discrimination. The treatment of all at the filing organization's Emergency Department is a community benefit. Under the filing organization's Charity Care Policy, every effort is made to obtain a patient's necessary financial information to determine eligibility for charity care. However, not all patients will cooperate with such efforts and a charity care eligibility determination can not be made. In this case, a patient's portion of a bill that remains unpaid for a certain stipulated time period is wholly or partially classified as bad debt. Bad debts associated with patients who have received care through the filing organization's Emergency Department should be considered to be community benefit as charitable hospitals exist to provide such care in pursuit of their purpose of meeting the need for emergency medical care services available to all in the community.
	Part III, Line 4:	Financial Statement Footnote Related to Accounts Receivable and Allowance for Uncollectible Accounts:The financial information of the filing organization is included in a consolidated audited financial statement for the current year.The applicable footnote from the attached consolidated audited financial statements that addresses accounts receivable, the allowance for uncollectible accounts, and the provision for bad debts can be found on pages 8 and 9. Please note that dollar amounts on the attached consolidated audited financial statements are in thousands.
	Supplemental Schedule to Schedule H, Part III, Section B	Reconciliation of Schedule H Reported Medicare Surplus/(Shortfall) to Unreimbursed Medicare Costs Associated with the Provision of ServicesTo All Medicare Beneficiaries:The Medicare revenue and allowable costs of care reported in Section B of Part III of Schedule H are based upon the amounts reported in the filing organization's Medicare cost report in accordance with the IRS instructions for Schedule H. On an annual basis, the filing organization also determines its total unreimbursed costs associated with providing services to all Medicare patients. Unreimbursed costs are reported as a community benefit to the elderly and are included in the consolidated Adventist Health System (AHS or the Company) Community Benefits Report contained in the AHS Annual Report document. The primary reconciling items between the Medicare surplus/(shortfall) shown on line 7 of Section B of Part III of Schedule H and the filing organization's unreimbursed costs of services provided to Medicare patients as reported in the AHS Community Benefit Report are as follows:- Medicare surplus/(shortfall) shown on line 7 of Section B of Schedule H: $(94,619,362)- Difference in costing methodology: 16,195,295- Unreimbursed costs incurred for services provided to Medicare patients that are not included in the organization's Medicare cost report: (61,483,719) -------------Total Unreimbursed costs of serving all Medicare patients per the filing organization's community benefit reporting: $(139,907,786)As indicated above, the primary differences between the Medicare surplus/(shortfall) reported on Schedule H, Part III, Section B, line 7 and the filing organization's portion of the Company's annual community benefit statement is due to a difference in the costing methodology and differences in the population of Medicare patients within the calculation. The cost methodology utilized in calculating any Medicare surplus/(shortfall) for purposes of the annual community benefit reporting is based upon the cost-to-charge ratio outlined in Worksheet 2 of the Schedule H instructions. The same cost-to-charge ratio is used to determine the costs associated with services provided to charity care patients and Medicaid patients as reported in Schedule H, Part I, line 7. In addition, the Medicare cost report excludes services provided to Medicare patients for physician services, services provided to patients enrolled in Medicare HMOs, and certain services provided by outpatient departments of the filing organization that are reimbursed on a fee schedule. The Company's own community benefit statement captures the unreimbursed cost of providing services to all Medicare beneficiaries throughout the organization.
		Part VI, Line 2: In accordance with IRC Section 501(r)(3), the filing organization's hospitals have adopted and implemented a policy that sets forth the general requirements, processes and procedures with respect to conducting a community health needs assessment and associated implementation strategy. During 2012, the filing organization's hospitals were in the process of planning for their initial Community Health Needs Assessments (CHNA) that are to be completed by 12/31/2013. In addition to the CHNAs that are being conducted, a variety of practices and processes are in place to ensure that the filing organization's hospitals are responsive to the health needs of their communities. Such practices and processes involve the following:1. Hospitals' operating/community boards composed of individuals broadly representative of the community, community leaders, and those with specialized medical training and expertise;2. Post-discharge patient follow-up related to the on-going care and treatment of patients who suffer from chronic diseases; 3. Sponsorship and participation in community health and wellness activities that reach a broad spectrum of the filing organization's hospital communities; and 4. Collaboration with other local community groups to address the health care needs of the filing organization's hospital communities.
		Part VI, Line 3: The filing organization's hospitals have a process in place whereby patients are informed about the Hospital's Charity Care Policy and other forms of financial assistance, such as self-pay discounts. Signage is posted in the Emergency Rooms indicating that financial assistance is available for those self-pay patients meeting eligibility requirements. After EMTALA medical screening and stabilization requirements are met, registration personnel will secure financial information on as many self-pay patients as possible at the time of service. For those who appear to qualify for Medicaid or under the Hospital's Charity Care Policy, the financial counselors will continue to work with those patients until final account resolution is achieved. All other self-pay patients are covered under this process. At any time during the process that data is provided showing that a patient qualifies for assistance under the Charity Care Policy the discounts extended under that policy will be applied.As part of the billing process, the filing organization's Hospitals include the application for charity care assistance along with the initial patient bill. The Hospitals' charity care applications are also available to patients on the Hospitals' web-sites in both an English and Spanish version. Additionally, the Hospitals' financial counselors are available to work with every patient during the first 120 days of the billing process to assist the patient with completing charity care applications and investigating other potential sources of third-party assistance. The determination of a patient's eligibility for charity care is made on a case-by-case basis. Various factors are considered in that determination. Each individual patient who is identified as potentially being eligible to receive charity care is seen by a financial counselor at the Hospital. The financial counselor will work with the patient to make sure that other sources of assistance (public or otherwise) have been sought to the fullest extent possible. When other forms of assistance are not available or have been exhausted, the Hospitals will gather certain financial information from the patient to determine the patient's ability to pay based upon level of income.
		Part VI, Line 4: In 2012, the filing organization operated 5 hospitals that together encompassed 13 separate campus locations. The hospitals are located in Florida, Illinois and Texas. A description of each of the 5 hospitals is described below.Adventist Health System/Sunbelt, Inc. dba Central Texas Medical Center:Central Texas Medical Center (CTMC) is a 178-bed acute-care hospital providing a wide range of healthcare services in San Marcos, Texas and the neighboring communities within Hays and Caldwell counties, Texas. Special services offered at CTMC include a 24/7, Level 4 emergency and trauma center, state-of-the-art medical imaging and laboratory services, a new women's center featuring a Level 2 Neonatal Intensive Care Unit, newly renovated and expanded surgery suites, a Rehabilitation Institute, a center for advanced wound healing and hyperbaric medicine, and a cardiac catheterization lab. As a health resource for their community, CTMC's Institute for Healthy Living also annually hosts the oldest and largest health screening and fair event in Hays County as well as a number of ongoing classes and workshops ranging in topics from diabetes prevention and management to heart disease, stroke, arthritis, self-help, nutrition and more. CTMC received accreditation as a certified chest pain center from the Society of Chest Pain Centers in 2011. The accreditation enhances the hospital's ability to receive and treat patients suffering from chest pain and/or a possible heart attack. The result is a focus on reduced time from symptom onset to diagnosis and treatment, getting patients treated more quickly during the critical window of time when the integrity of the heart muscle can be preserved, and monitoring of patients whose diagnosis is uncertain to ensure they are not sent home too quickly or admitted unnecessarily. In 2010, 2011 and 2012, CTMC was named The Best Hospital in Hays County. In 2012, CTMC became the first operating room along the IH-35 corridor between Austin and San Antonio to be equipped with a da Vinci robotic-assisted surgery suite.San Marcos, Texas is located in Hays County and is in close proximity to Austin and San Antonio. The Hospital's primary market has a population of approximately 89,000, with an estimated 8,400 over the age of 65. The weighted average household income, based on population, in the primary market is approximately $39,000. High school graduates account for approximately 87% of Hays County, with an estimated 32% having a bachelor's degree or higher. It is estimated that 18% of the individuals residing in Hays County live below the poverty level and the unemployment rate is about 8%. Approximately 39% of the Hospital's patients during 2012 were Medicare patients, about 13% were Medicaid patients, about 15% were self-pay patients and the remaining percentage were patients covered under commercial insurance. In 2012, about 66% of the hospital's in-patients were admitted through the hospital's Emergency Department.Adventist Health System/Sunbelt, Inc. dba Florida Hospital Heartland Medical Center:Florida Hospital Heartland Medical Center (FHHMC) is comprised of 3 separate hospital campuses with a total of 222 beds. Two of the hospital campuses are located in Highlands County, Florida and the third campus is located in Hardee County, Florida. Highlands and Hardee counties are in the south central areas of Florida and are adjacent to each other. FHHMC Sebring Campus - The main 147-bed hospital facility is located in Sebring, FL in Highlands County. The Sebring facility provides a wide range of healthcare services including a Stroke Center and vascular surgery center, imaging services (CT scanner/MRI), stroke and cardiac rehabilitation, and a Cardiac Catheterization Lab. A community education center and library are also located on the Sebring campus offering free and low-cost community classes, screenings and a resource information library. In 2009, the hospital began performing percutaneous coronary intervention (PCI) in a new cath lab and a second cath lab was opened in 2010. FHHMC Lake Placid Campus houses 33 medical and surgical beds, Highland County's only 17 bed inpatient mental health unit, an outpatient counseling center, and a wide range of services that are highly sophisticated for a small community hospital. The Lake Placid campus also specializes in inpatient geriatric psychiatric services and outpatient behavioral health counseling centers within Highlands and Hardee counties. The need for behavioral health services is extreme in both counties since there is no other program closer than sixty miles.FHHMC Wauchula Campus is licensed for 25 beds and specializes in emergency and outpatient care, while offering excellent medical inpatient services. The inpatient unit is mixed with both acutely ill patients and patients who need short-term rehabilitation (transitional care). FHHMC Wauchula campus became the first Critical Access Hospital in the State of Florida in the year 2000.As noted above, Highlands and Hardee counties in Florida are located in the heart of the Florida Peninsula. The Hospital's primary market has a population of approximately 133,000 with an estimated 35,000 over the age of 65. The weighted average household income, based on population, in the primary market is approximately $34,000. High school graduates account for approximately 77% of Highlands County, with an estimated 14% having a bachelor's degree or higher. It is estimated that 16% of the individuals residing in Highlands County live below the poverty level and the unemployment rate is about 10%. Approximately 65% of the Hospital's patients during 2012 were Medicare patients, about 13% were Medicaid patients, about 6% were self-pay patients and the remaining percentage were patients covered under commercial insurance. In 2012, about 67% of the hospital's in-patients were admitted through the hospital's Emergency Department.Adventist Health System/Sunbelt, Inc. dba Florida Hospital (FH):FH is a 2,377 bed medical complex in Central Florida with seven separate hospital campuses. FH serves the residents of Central Florida (primarily serving the residents of Orange, Osceola, Seminole and Lake County) but also draws patients from other parts of the Southeastern United States, the Caribbean and South America. The 7-campus health system is the largest healthcare provider in Central Florida and the nation's largest Medicare provider with FH being the second largest employer in the area.The main campus of the FH system is located in Orlando, Florida (Orange County) near the downtown area. The other 6 campuses are located in surrounding communities in the counties of Orange, Osceola, and Seminole. In addition to operating the 7 hospitals, FH also operates 21 full-service urgent care clinics in convenient community settings. A brief description of each of the 7 hospital campuses is described below:Florida Hospital Orlando (Orange County) - At the core of the FH system, FH Orlando is a 1,183 bed acute-care tertiary hospital caring for more than 1.7 million patients a year. FH Orlando is home to nationally recognized Centers of Excellence for cancer, cardiology, children's health, diabetes, neuroscience, orthopedics, transplant and global robotics. Florida Hospital Orlando houses one of the largest Emergency Departments and cardiac catheterization labs in the country and is one of the busiest hospitals in the nation, providing service excellence to more than 53,000 inpatients and 170,000 outpatients each year. The recent opening of a 15-story patient tower features 200 more beds and 500 new jobs. The campus also includes a state-of-the-art Cardiac Diagnostic Center featuring 15 Cath and electro physiology (EPS) Labs. The cardiology team currently treats 25,000+ individuals for chest pain and performs over 1,300 open heart surgeries each year making them first in the state for the number of surgeries performed. Also located on the Florida Hospital Orlando Campus is the Walt Disney Pavilion at Florida Hospital for Children. The Walt Disney Pavilion is not a stand-alone facility but rather a 7-story, 171-bed tower located on Florida Hospital Orlando's campus. It is a full-service facility served by more than 60 pediatric specialists and a highly trained pediatric team of more than 600 employees. The Walt Disney Pavilion at Florida Hospital for Children delivers a complete range of pediatric health services for younger patients including advanced surgery, oncology, neurosurgery, cardiology and transplant services; full-service pediatrics; and an innovative health and obesity platform. *** see continuation of footnote
		Part VI, Line 5: The provision of community benefit is central to the filing organization's mission of service and compassion. Restoring and promoting the health and quality of life of those in the communities served by the filing organization is a function of "extending the healing ministry of Christ" and embodies the filing organization's commitment to its values and principles. The filing organization commits substantial resources to provide a broad range of services to both the underprivileged as well as the broader community. In addition to the community benefit information provided in Parts I, II and III of this Schedule H, the filing organization captures and reports the benefits provided to its community through faith-based care. Examples of such benefits include the cost associated with chaplaincy care programs and mission peer reviews and mission conferences. During the current year, the filing organization provided $7,294,149 of benefit with respect to the faith-based and spiritual needs of the communities it serves in conjunction with its operation of community hospitals. The filing organization also provides benefits to its communities' infrastructure by investing in capital improvements to ensure that facilities and technology provide the best possible care. During the current year, the filing organization expended $194,840,238 in new capital improvements. As faith-based mission-driven community hospitals, the filing organization is continually involved in monitoring its communities, identifying unmet health care needs and developing solutions and programs to address those needs. In accordance with its conservative approach to fiscal responsibility, surplus funds of the Hospitals are continually being invested in resources that improve the availability and quality of delivery of health care services and programs to its communities.
		Part VI, Line 6: The filing organization is a part of a faith-based healthcare system of organizations whose parent is Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). The system is known as Adventist Health System (AHS). AHSSHC is an organization exempt from federal income tax under IRC Sec. 501(c)(3). AHSSHC and its subsidiary organizations operate 43 hospitals in 10 states throughout the U.S., primarily in the Southeastern portion of the U.S. AHSSHC and its subsidiaries also operate 16 nursing home facilities and other ancillary health care provider facilities, such as ambulatory surgery centers and diagnostic imaging centers. As the parent organization of the AHS system, AHSSHC provides executive leadership and other professional support services to its subsidiary organizations. Professional support services include among others corporate compliance, legal, human resources, reimbursement, risk management, and tax as well as treasury functions. The provision of these executive and support services on a centralized basis by AHSSHC provides an appropriate balance between providing each AHS subsidiary hospital organization with mission-driven consistent leadership and support while allowing the hospital organization to focus its resources on meeting the specific health care needs of the communities it serves. The reader of this Form 990 should keep in mind that this reporting entity may differ in certain areas from that of a stand-alone hospital organization due to its inclusion in a larger system of healthcare organizations. As a part of a system of hospital and other health care organizations, the filing organization benefits from reduced costs due to system efficiencies, such as large group purchasing discounts, and the availability of internal resources such as internal legal counsel. Each AHS subsidiary pays a management fee to AHSSHC for the internal services provided by AHSSHC. As a result, management fee expense reported by a AHS subsidiary organization may appear greater in relation to management fee expense that may be reported by a single stand-alone hospital. The single stand-alone hospital would likely report costs associated with management and other professional services on various expense line items in its statement of revenue and expense as opposed to reporting such costs in one overall management fee expense. As the reporting of the Form 990 is done on an entity by entity basis, there is no single Form 990 that captures the programs and operations of AHS as a whole. The reader is directed to visit the web-site of AHS at www.adventisthealthsystem.com to learn more about the mission and operations of AHS and to access AHS's annual report that contains financial data as well as community benefit reporting for the entire system.
	Part VI, Line 7	The annual community benefit report contained in the annual report prepared by Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) on behalf of the entire AHS System of healthcare organization is not filed with any state agencies. Certain hospitals within the filing organization file annual community benefit reports with the state in which they are located. Specifically, Huguley Memorial Medical Center and Central Texas Medical Center file community benefit reports with the State of Texas and Adventist La Grange Memorial Hospital files a community benefit report with the State of Illinois.
Description of Community Information - Continued	Part VI, Line 4 Continuation of Footnote	Orlando is located in Orange County, Florida. The Hospital's primary market has a population of approximately 1,822,000 with an estimated 197,000 over the age of 65. The weighted average household income, based on population, in the primary market is approximately $52,000. High school graduates account for approximately 87% of Orange County, with an estimated 30% having a bachelor's degree or higher. It is estimated that 13% of the individuals residing in Orange County live below the poverty level and the unemployment rate is about 8%. Approximately 42% of the Hospital's patients during 2012 were Medicare patients, about 17% were Medicaid patients, about 7% were self-pay patients and the remaining percentage were patients covered under commercial insurance. In 2012, about 71% of the hospital's in-patients were admitted through the hospital's Emergency Department.Florida Hospital Altamonte (Seminole County) - FH Altamonte is a 340-bed facility, which has recently doubled in size with a new patient tower to better serve a busy community. FH Altamonte was the first "satellite" hospital, built in 1973 on what was then pastureland, miles from the nearest business district. Located north of Orlando in fast-growing Seminole County, Florida Hospital Altamonte is the largest satellite campus within the Florida Hospital health care system. In addition to maternity, pediatric, emergency, medical and surgical services, the hospital operates the Martin Andersen Cancer Center (along with the region's only Cancer Resource Library), a heart catheterization lab, and a comprehensive outpatient program which includes surgery, diagnostics, and medical treatment programs. Florida Hospital Apopka (Orange County) - In 1975, FH Apopka became the second satellite hospital. For nearly three decades, Florida Hospital Apopka has set the standard in hometown health care by providing high-tech, quality care with a personalized touch. They are situated just 12 miles northwest of Orlando, with a small, yet advanced, 50-bed campus that houses a certified Chest Pain Center and a multitude of inpatient and outpatient services.Florida Hospital Celebration Health (Osceola County) - FH Celebration Health is a cornerstone of Disney's planned community in Celebration, Florida. Today, this 174-bed acute care hospital delivers a state-of-the-art healing environment to residents of Osceola, Orange, Polk and Lake Counties, as well as to visitors from across the United States and the world. From its creation FH Celebration Health has been about promoting health and wellness as well as healing. Inside the resort-style hospital there is a wellness center, complete with workout area, pool, rehabilitation facility. FH Celebration Health also houses the Global Robotics Institute, which provides patients with access to some of the most experienced robotic surgeons in the world. The Nicholson Center for Surgical Advancement also is a location where surgeons from around the world travel to learn the latest robotic surgery techniques. In 2011, the new 234,000 square-foot patient tower added 62 beds and will house the Interactive Patient Care Unit, the first of its kind in the nation. In connection with the Institute for Interactive Patient Care, everything from new patient safety technology to changing ways to communicate with patients about their care could be studied as part of the unit. Florida Hospital East Orlando (Orange County) - FH East Orlando is now an innovative local leader that fills a vital need in a fast-growing area. A recent 200,000 square-foot expansion project upgraded the hospital to 225 beds, with a spacious patient tower and 80 new private rooms designed to enhance the holistic care experience.Florida Hospital Kissimmee (Osceola County) - FH Kissimmee is an 83-bed community-focused hospital, conveniently located near Walt Disney World. The team located at FH Kissimmee is dedicated to bringing mission-focused, faith-based care to residents and visitors of Osceola and Orange Counties. This facility has recently expanded to include a new medical office building, patient tower, new main entrance and a parking garage.Florida Hospital Winter Park (Orange County) - FH Winter Park Memorial Hospital is a 322-bed facility that is a model of community health and wellness. The facility boasts spacious patient care areas and a full spectrum of specialties and services, including the Dr. P. Phillips Baby Place (with Level II NICU), Florida Hospital Orthopedic Institute, and state-of-the-art surgery, recovery and rehabilitation at the Florida Hospital Cancer Institute. Adventist Health System/Sunbelt, Inc. dba Huguley Memorial Medical Center:Note: On 5/1/2012, the net assets associated with the operation of Huguley Memorial Medical Center (HMMC) were transferred into Texas Health Huguley, Inc., a 501(c)(3) tax-exempt organization which is owned 49% by Adventist Health System/Sunbelt, Inc. and 51% by Texas Health Resources. Accordingly, only the operations for HMMC for the period 1/1/12 4/30/2012 are included in this return. Huguley Memorial Medical Center (HMMC) is a 223-bed acute-care hospital in Burleson, Texas. The hospital houses two intensive care units, a progressive care unit, an open-heart surgery center, a behavioral health center and a 24/7 emergency department. HMMC has a 16-bed intensive care unit for patients with medical care and respiratory needs and a 12-bed intensive care unit concentrating on cardiovascular patients. A 4-bed dialysis center is available for renal patients with critical needs. Additionally, there is a 33-bed Progressive Care Unit designed to bridge the gap between the Intensive Care Unit and the medical-surgical units. Part of HMMC's primary service area includes a number of smaller communities with limited access to healthcare services. To meet the needs of these residents, HMMC has established multiple primary care clinics throughout its primary service area. In addition, the Mobile Health Services Bus provides health screenings and wellness education services throughout Tarrant and Johnson counties. Burleson, Texas is located in Johnson County and serves the South Fort Worth area. The Hospital's primary market has a population of approximately 212,000, with an estimated 25,000 over the age of 65. The weighted average household income, based on population, in the primary market is approximately $53,000. High school graduates account for approximately 82% of Johnson County, with an estimated 16% having a bachelor's degree or higher. It is estimated that 11% of the individuals residing in Johnson County live below the poverty level and the unemployment rate is about 8%. Approximately 51% of the Hospital's patients during 2012 were Medicare patients, about 14% were Medicaid patients, about 8% were self-pay patients and the remaining percentage were patients covered under commercial insurance. In 2012, about 74% of the hospital's in-patients were admitted through the hospital's Emergency Department.Adventist Health System/Sunbelt, Inc. dba Adventist La Grange Memorial Hospital:Adventist La Grange Memorial Hospital (ALMH) is a 205-bed facility providing outpatient and inpatient primary care, trauma care and wellness services to residents of Chicago's western suburbs. The hospital is a leader in offering comprehensive oncology services, orthopedic services, advanced cardiac care, women's health and maternity care, emergency, geriatric and many other specialties that cater to the communities it serves. The communities served by ALMH contain a high senior population. To address the unique needs of its service area, ALMH offers a broad spectrum of services designed to meet the diverse needs of aging adults. La Grange, Illinois is located in Cook County. The Hospital's primary market has a population of approximately 158,000, with an estimated 25,000 over the age of 65. The weighted average household income, based on population, in the primary market is approximately $68,000. High school graduates account for approximately 85% of Cook County, with an estimated 33% having a bachelor's degree or higher. It is estimated that 15% of the individuals residing in Cook County live below the poverty level and the unemployment rate is about 9%. Approximately 54% of the Hospital's patients during 2012 were Medicare patients, about 7% were Medicaid patients, about 3% were self-pay patients and the remaining percentage were patients covered under commercial insurance. In 2012, about 75% of the hospital's in-patients were admitted through the hospital's Emergency Department.
Part V, Line 8 Facility Reporting Group A		See below
Facility 1 -- Florida Hospital Orlando	Part V, Section B, line 14g:	The filing organization has developed a patient-friendly summary version of its financial assistance policy (FAP). The filing organization's FAP provides that its hospital facility will post the patient-friendly summary version of its FAP on the Hospital's website. In addition, the FAP of the Hospital facility states that signage regarding the availability of the Hospital facility's FAP will be visible at points of admission and registration, including the emergency department.
Facility 1 -- Florida Hospital Orlando	Part V, Section B, line 20d:	In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital uses the following methodology:The Hospital identifies all commercial payors whose volume of activity with the Hospital equals or exceeds $100,000 for the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates is determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determines the maximum amount that can be charged to patients eligible under the Hospital's financial assistance policy.
Facility 2 -- Florida Hospital Celebration Health	Part V, Section B, line 14g:	The filing organization has developed a patient-friendly summary version of its financial assistance policy (FAP). The filing organization's FAP provides that its hospital facility will post the patient-friendly summary version of its FAP on the Hospital's website. In addition, the FAP of the Hospital facility states that signage regarding the availability of the Hospital facility's FAP will be visible at points of admission and registration, including the emergency department.
Facility 2 -- Florida Hospital Celebration Health	Part V, Section B, line 20d:	In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital uses the following methodology:The Hospital identifies all commercial payors whose volume of activity with the Hospital equals or exceeds $100,000 for the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates is determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determines the maximum amount that can be charged to patients eligible under the Hospital's financial assistance policy.
Facility 3 -- Florida Hospital Altamonte	Part V, Section B, line 14g:	The filing organization has developed a patient-friendly summary version of its financial assistance policy (FAP). The filing organization's FAP provides that its hospital facility will post the patient-friendly summary version of its FAP on the Hospital's website. In addition, the FAP of the Hospital facility states that signage regarding the availability of the Hospital facility's FAP will be visible at points of admission and registration, including the emergency department.
Facility 3 -- Florida Hospital Altamonte	Part V, Section B, line 20d:	In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital uses the following methodology:The Hospital identifies all commercial payors whose volume of activity with the Hospital equals or exceeds $100,000 for the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates is determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determines the maximum amount that can be charged to patients eligible under the Hospital's financial assistance policy.
Facility 4 -- Florida Hospital East Orlando	Part V, Section B, line 14g:	The filing organization has developed a patient-friendly summary version of its financial assistance policy (FAP). The filing organization's FAP provides that its hospital facility will post the patient-friendly summary version of its FAP on the Hospital's website. In addition, the FAP of the Hospital facility states that signage regarding the availability of the Hospital facility's FAP will be visible at points of admission and registration, including the emergency department.
Facility 4 -- Florida Hospital East Orlando	Part V, Section B, line 20d:	In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital uses the following methodology:The Hospital identifies all commercial payors whose volume of activity with the Hospital equals or exceeds $100,000 for the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates is determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determines the maximum amount that can be charged to patients eligible under the Hospital's financial assistance policy.
Facility 5 -- Winter Park Memorial Hospital	Part V, Section B, line 14g:	The filing organization has developed a patient-friendly summary version of its financial assistance policy (FAP). The filing organization's FAP provides that its hospital facility will post the patient-friendly summary version of its FAP on the Hospital's website. In addition, the FAP of the Hospital facility states that signage regarding the availability of the Hospital facility's FAP will be visible at points of admission and registration, including the emergency department.
Facility 5 -- Winter Park Memorial Hospital	Part V, Section B, line 20d:	In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital uses the following methodology:The Hospital identifies all commercial payors whose volume of activity with the Hospital equals or exceeds $100,000 for the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates is determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determines the maximum amount that can be charged to patients eligible under the Hospital's financial assistance policy.
Facility 6 -- Adventist La Grange Memorial Hospital	Part V, Section B, line 14g:	The filing organization has developed a patient-friendly summary version of its financial assistance policy (FAP). The filing organization's FAP provides that its hospital facility will post the patient-friendly summary version of its FAP on the Hospital's website. In addition, the FAP of the Hospital facility states that signage regarding the availability of the Hospital facility's FAP will be visible at points of admission and registration, including the emergency department.
Facility 6 -- Adventist La Grange Memorial Hospital	Part V, Section B, line 20d:	In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital uses the following methodology:The Hospital identifies all commercial payors whose volume of activity with the Hospital equals or exceeds $100,000 for the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates is determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determines the maximum amount that can be charged to patients eligible under the Hospital's financial assistance policy.
Facility 7 -- FH Heartland Medical Center	Part V, Section B, line 14g:	The filing organization has developed a patient-friendly summary version of its financial assistance policy (FAP). The filing organization's FAP provides that its hospital facility will post the patient-friendly summary version of its FAP on the Hospital's website. In addition, the FAP of the Hospital facility states that signage regarding the availability of the Hospital facility's FAP will be visible at points of admission and registration, including the emergency department.
Facility 7 -- FH Heartland Medical Center	Part V, Section B, line 20d:	In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital uses the following methodology:The Hospital identifies all commercial payors whose volume of activity with the Hospital equals or exceeds $100,000 for the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates is determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determines the maximum amount that can be charged to patients eligible under the Hospital's financial assistance policy.
Facility 8 -- Florida Hospital Kissimmee	Part V, Section B, line 14g:	The filing organization has developed a patient-friendly summary version of its financial assistance policy (FAP). The filing organization's FAP provides that its hospital facility will post the patient-friendly summary version of its FAP on the Hospital's website. In addition, the FAP of the Hospital facility states that signage regarding the availability of the Hospital facility's FAP will be visible at points of admission and registration, including the emergency department.
Facility 8 -- Florida Hospital Kissimmee	Part V, Section B, line 20d:	In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital uses the following methodology:The Hospital identifies all commercial payors whose volume of activity with the Hospital equals or exceeds $100,000 for the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates is determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determines the maximum amount that can be charged to patients eligible under the Hospital's financial assistance policy.
Facility 9 -- Central Texas Medical Center	Part V, Section B, line 14g:	The filing organization has developed a patient-friendly summary version of its financial assistance policy (FAP). The filing organization's FAP provides that its hospital facility will post the patient-friendly summary version of its FAP on the Hospital's website. In addition, the FAP of the Hospital facility states that signage regarding the availability of the Hospital facility's FAP will be visible at points of admission and registration, including the emergency department.
Facility 9 -- Central Texas Medical Center	Part V, Section B, line 20d:	In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital uses the following methodology:The Hospital identifies all commercial payors whose volume of activity with the Hospital equals or exceeds $100,000 for the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates is determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determines the maximum amount that can be charged to patients eligible under the Hospital's financial assistance policy.
Facility 10 -- Florida Hospital Apopka	Part V, Section B, line 14g:	The filing organization has developed a patient-friendly summary version of its financial assistance policy (FAP). The filing organization's FAP provides that its hospital facility will post the patient-friendly summary version of its FAP on the Hospital's website. In addition, the FAP of the Hospital facility states that signage regarding the availability of the Hospital facility's FAP will be visible at points of admission and registration, including the emergency department.
Facility 10 -- Florida Hospital Apopka	Part V, Section B, line 20d:	In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital uses the following methodology:The Hospital identifies all commercial payors whose volume of activity with the Hospital equals or exceeds $100,000 for the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates is determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determines the maximum amount that can be charged to patients eligible under the Hospital's financial assistance policy.
Facility 11 -- FH Heartland Medical Center Lake Placid	Part V, Section B, line 14g:	The filing organization has developed a patient-friendly summary version of its financial assistance policy (FAP). The filing organization's FAP provides that its hospital facility will post the patient-friendly summary version of its FAP on the Hospital's website. In addition, the FAP of the Hospital facility states that signage regarding the availability of the Hospital facility's FAP will be visible at points of admission and registration, including the emergency department.
Facility 11 -- FH Heartland Medical Center Lake Placid	Part V, Section B, line 20d:	In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital uses the following methodology:The Hospital identifies all commercial payors whose volume of activity with the Hospital equals or exceeds $100,000 for the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates is determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determines the maximum amount that can be charged to patients eligible under the Hospital's financial assistance policy.
Facility 12 -- Florida Hospital Wauchula	Part V, Section B, line 14g:	The filing organization has developed a patient-friendly summary version of its financial assistance policy (FAP). The filing organization's FAP provides that its hospital facility will post the patient-friendly summary version of its FAP on the Hospital's website. In addition, the FAP of the Hospital facility states that signage regarding the availability of the Hospital facility's FAP will be visible at points of admission and registration, including the emergency department.
Facility 12 -- Florida Hospital Wauchula	Part V, Section B, line 20d:	In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital uses the following methodology:The Hospital identifies all commercial payors whose volume of activity with the Hospital equals or exceeds $100,000 for the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates is determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determines the maximum amount that can be charged to patients eligible under the Hospital's financial assistance policy.
Facility 13 -- Huguley Memorial Medical Center	Part V, Section B, line 14g:	The filing organization has developed a patient-friendly summary version of its financial assistance policy (FAP). The filing organization's FAP provides that its hospital facility will post the patient-friendly summary version of its FAP on the Hospital's website. In addition, the FAP of the Hospital facility states that signage regarding the availability of the Hospital facility's FAP will be visible at points of admission and registration, including the emergency department.
Facility 13 -- Huguley Memorial Medical Center	Part V, Section B, line 20d:	In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital uses the following methodology:The Hospital identifies all commercial payors whose volume of activity with the Hospital equals or exceeds $100,000 for the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates is determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determines the maximum amount that can be charged to patients eligible under the Hospital's financial assistance policy.

Schedule H (Form 990) 2012

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

2012

Open to Public
Inspection

Name of the organization
Adventist Health SystemSunbelt Inc

Employer identification number
59-1479658

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. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC Code section if applicable	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of non-cash assistance	(h) Purpose of grant or assistance
(1) ADVENTIST CARE CENTERS - COURTLAND INC 730 COURTLAND ST ORLANDO,FL32804	20-5774723	501(c)(3)	218,100				General Support
(2) AFRICAN AMERICAN CHAMBER OF COMMERCE OF CENTRAL FLORIDA INC 315 E ROBINSON ST STE 100 ORLANDO,FL32801	59-3314330	501(c)(6)	12,500				General Support
(3) AMERICAN ASSOCIATION OF PHYSICIANS OF INDIAN ORIGIN 600 ENTERPRISE DR STE 108 OAK BROOK,IL60523	38-2532505	501(c)(3)	12,000				General Support
(4) AMERICAN CANCER SOCIETY INC FLORIDA DIVISION INC 3709 W Jetton Avenue Tampa,FL33873	59-0657320	501(c)(3)	31,000				General Support
(5) AMERICAN DIABETES ASSOCIATION 1101 N LAKE DESTINY RD STE 415 MAITLAND,FL32751	13-1623888	501(c)(3)	12,500				General Support
(6) AMERICAN HEART ASSOCIATION INC 1101 NORTHCHASE PKWY SE STE 1 MARIETTA,GA30067	13-5613797	501(c)(3)	110,000				General Support
(7) AMERICAN LUNG ASSOCIATION OF THE SOUTHEAST INC 851 OUTER RD ORLANDO,FL32814	59-0662271	501(c)(3)	35,000				General Support
(8) BOY SCOUNTS OF AMERICA INC CENTRAL FLORIDA COUNIL PO BOX 422101 KISSIMMEE,FL34742	59-0624376	501(c)(3)	43,500				General Support
(9) CELEBRATION FOUNDATION INC 610 SYCAMORE ST CELEBRATION,FL34747	59-3370753	501(c)(3)	6,000				General Support
(10) CENTRAL FLORIDA FAMILY HEALTH CENTER INC 2400 STATE ROAD 415 SANFORD,FL32771	59-1741286	501(c)(3)	110,000				General Support
(11) CENTRAL FLORIDA PARTNERSHIP INC 75 S IVANHOE BLVD ORLANDO,FL32804	33-1202266	501(c)(6)	100,000				General Support
(12) CENTRAL FLORIDA YOUNG MEN'S CHRISTIAN ASSOCIATION 433 NORTH MILLS AVENUE ORLANDO,FL32803	59-0624430	501(c)(3)	13,750				General Support
(13) CENTRAL TEXAS HEALTHCARE COLLABORATIVE 1301 WONDER WORLD DR SAN MARCOS,TX78666	45-3739929	501(c)(3)	1,047,149				Provision of Indigent Care
(14) CENTRAL TEXAS MEDICAL CENTER FOUNDATION 1301 WONDER WORLD DR SAN MARCOS,TX78666	74-2259907	501(c)(3)		77,441	Book	Provision of general administrative support	General Support
(15) CHAMBER OF COMMERCE FOR PERSONS WITH DISABILTIES INC 3201 E COLONIAL DR ORLANDO,FL328035174	20-8994529	501(c)(6)	6,000				General Support
(16) CHRISTIAN SERVICE CENTER FOR CENTRAL FLORIDA INC 808 W CENTRAL BLVD ORLANDO,FL32805	59-1353031	501(c)(3)	13,000				General Support
(17) CITY OF ALTAMONTE SPRINGS 150 CRANES ROOST BLVD STE 2200 ALTAMONTE SPRINGS,FL32701	59-6000263	Gov't	30,000				General Support
(18) CITY OF ORLANDO 400 South Orange Avenue ORLANDO,FL32801	59-6000396	Gov't	4,921,000				General Support
(19) CITY OF ORLANDO COMMUTER RAIL SYSTEM 400 South Orange Avenue ORLANDO,FL32801	59-6000396	Gov't	375,812				General Support
(20) CITY OF WINTER PARK 401 S PARK AVE WINTER PARK,FL32789	59-6000454	Gov't	10,000				General Support
(21) COMMUNITY VISION 704 GENERATION PT APT 101 KISSIMMEE,FL347445918	59-2896657	501(c)(3)	12,500				General Support
(22) D12 FOUNDATION INC 711 N MAGNOLIA AVE ORLANDO,FL32803	27-3846066	501(c)(3)	10,000				General Support
(23) DOWN SYNDROME FOUNDATION OF FLORIDA PO BOX 533462 ORLANDO,FL328533462	27-2436041	501(c)(3)	5,250				General Support
(24) DOWNTOWN COLLEGE PARK PARTNERSHIP INC PO BOX 547744 ORLANDO,FL32854	23-7250533	501(c)(3)	13,500				General Support
(25) EAST ORLANDO HEALTH & REHAB CENTER INC 250 S CHICKASAW TRAIL ORLANDO,FL32825	20-5774748	501(c)(3)	1,404,864				General Support
(26) FLNC INC 3355 E SEMORAN BLVD APOPKA,FL32703	20-5774761	501(c)(3)	2,199,240				General Support
(27) FLORIDA CHAMBER OF COMMERCE FOUNDATION INC 136 S BRONOUGH ST TALLAHASSEE,FL323017706	59-6209605	501(c)(3)	25,000				General Support
(28) FLORIDA CHAMBER OF COMMERCE INC PO BOX 11309 136 SOUTH BRONOUGH STREET TALLAHASSEE,FL32302	59-0248200	501(c)(6)	100,000				General Support
(29) Florida Hospital Waterman Inc 1000 Waterman Way Tavares,FL32778	59-3140669	501(c)(3)	239,166				General Support
(30) FLORIDA INTERFAITH INSTITUTE PO BOX 3310 WINTER PARK,FL327903310	45-5420165	501(c)(3)	25,000				General Support
(31) FOREST LAKE ACADEMY 500 EDUCATION LOOP APOPKA,FL327036176	59-0816443	501(c)(3)	6,500				General Support
(32) FOUNDATION FOR EARLY CHILDHOOD DEVELOPMENT PO BOX 540387 ORLANDO,FL328540387	86-1076294	501(c)(3)	20,000				General Support
(33) FOUNDATION FOR WOMEN'S CANCER 230 W MONROE ST CHICAGO,IL606064902	36-3797707	501(c)(3)	15,000				General Support
(34) GET HEALTHY FLORIDA 142 W LAKEVIEW AVE STE 2040 LAKE MARY,FL327462903	20-0463380	Other	35,000				General Support - Flu Shot Event Sponsor
(35) GR8 TO DON8 INC 968 MOSS TREE PL LONGWOOD,FL32750	27-1946207	501(c)(3)	10,000				General Support
(36) GRACE MEDICAL HOME INC 51 PENNSYLVANIA STREET ORLANDO,FL328062938	28-1817966	501(c)(3)	101,500				General Support
(37) HARBOR HOUSE OF CENTRAL FLORIDA INC PO BOX 12434 ORLANDO,FL32801	59-1712936	501(c)(3)	5,500				General Support
(38) HEALTH CARE CENTER FOR THE HOMELESS INC 232 N ORANGE BLOSSOM TRL ORLANDO,FL32805	59-3185020	501(c)(3)	130,000				General Support
(39) HEALTHY START COALITION OF ORANGE COUNTY INC 600 COURTLAND ST STE 565 ORLANDO,FL32804	59-3125675	501(c)(3)	25,000				General Support
(40) HEALTHY START COALITION OF OSCEOLA COUNTY INC PO BOX 701995 ST CLOUD,FL34770	59-3212535	501(c)(3)	7,500				General Support
(41) HEART OF FLORIDA UNITED WAY INC 1940 TRAYLOR BLVD ORLANDO,FL32804	59-0808854	501(c)(3)	79,025				General Support
(42) Heartland Triathlon of Highlands County Inc 1200 Highlands Drive Lake Placid,FL33852	45-2232127	501(c)(3)	13,000				General Support
(43) Highlands County Habitat for Humanity 159 S Commerce Avenue Sebring,FL33870	59-3023727	501(c)(3)	15,000				Construction
(44) HISPANIC BUSINESS INITIATIVE FUND OF FLORIDA INC 3201 E COLONIAL DR UNIT A20 ORLANDO,FL32803	59-3341405	501(c)(3)	33,000				General Support
(45) HISPANIC CHAMBER OF COMMERCE METRO ORLANDO INC 315 E ROBINSON ST STE 465 ORLANDO,FL32801	59-3103840	501(c)(6)	21,000				General Support
(46) HOPE NOW INTERNATIONAL INC PO BOX 181173 CASSELBERRY,FL327181173	27-4498303	501(c)(3)	10,000				General Support
(47) HOSPICE OF THE COMFORTER INC 480 WEST CENTRAL PARKWAY ALTAMONTE SPRINGS,FL32714	59-2935928	501(c)(3)	7,500				General Support
(48) INSTITUTE FOR DIVERSITY IN HEALTH MANAGEMENT INC 75 REMITTANCE DR CHICAGO,IL606751072	58-2094118	501(c)(3)	15,000				General Support
(49) IVANHOE VILLAGE INC 320 E PRINCETON ST ORLANDO,FL32804	26-1797406	501(c)(3)	7,000				General Support
(50) JEWISH NATIONAL FUND (KEREN KAYEMETH LEISRAL) INC 1951 NW 19TH ST BOCA RATON,FL334317344	13-1659627	501(c)(3)	20,000				General Support
(51) Johnson County Community Care Corporation 11801 South Freeway Burleson,TX76028	45-2793120	501(c)(3)	474,032				Indigent Care
(52) JUNIOR ACHIEVEMENT OF CENTRAL FLORIDA INC PO BOX 917197 ORLANDO,FL32891	59-0972112	501(c)(3)	34,000				General Support
(53) KIDS HOUSE OF SEMINOLE INC 5467 NORTH RONALD REGAN BLVD SANFORD,FL32773	59-3415005	501(c)(3)	5,500				General Support
(54) KISSIMMEEOSCEOLA COUNTY CHAMBER OF COMMERCE 1425 E VINE STREET KISSIMMEE,FL34744	59-0319865	501(c)(6)	12,000				General Support
(55) La Grange Memorial Hospital Foundation 5101 South Willow Springs Road La Grange,IL60525	30-0247776	501(c)(3)		293,533	Book	Provision of general administrative support	General Support
(56) LAKESIDE BEHAVIORAL HEALTHCARE INC 1800 MERCY DRIVE STE 302 ORLANDO,FL32808	59-2301233	501(c)(3)	1,199,261				General Support
(57) LIFEWORK LEADERSHIP 301 E PINE STREET STE 150 ORLANDO,FL32801	37-1592618	501(c)(3)	10,000				General Support
(58) MARCH OF DIMES FOUNDATION 341 N MAITLAND AVE STE 115 MAITLAND,FL32751	13-1846366	501(c)(3)	18,000				General Support
(59) METHODIST HEALTHCARE FOUNDATION 1211 UNION AVENUE STE 733 MEMPHIS,TN381046638	23-7320638	501(c)(3)	20,000				General Support
(60) MICHELEE PUPPETS INC 4420 PARKWAY COMMERCE BLVD A ORLANDO,FL32808	59-2616456	501(c)(3)	5,190				General Support
(61) NATIONAL KIDNEY FOUNDATION OF FLORIDA INC 1040 WOODCOCK RD STE 119 ORLANDO,FL328033510	59-2190073	501(c)(3)	16,000				General Support
(62) NEW IMAGE YOUTH CENTER INC 208 S PARRAMORE AVE ORLANDO,FL32805	56-2482818	501(c)(3)	10,000				General Support
(63) ORLANDO HEALTH INC 86 W UNDERWOOD STREET ORLANDO,FL328061110	59-1726273	501(c)(3)	7,000				General Support
(64) ORLANDO JUNIOR ACADEMY 30 E EVANS STREET ORLANDO,FL32804	26-2325009	501(c)(3)	12,600				General Support
(65) ORLANDO SCIENCE CENTER INC 777 E PRINCETON STREET ORLANDO,FL32803	59-0896343	501(c)(3)	7,500				General Support
(66) ORLANDO SHAKESPEARE THEATER INC 812 E ROLLINS ST ORLANDO,FL328031202	59-2931698	501(c)(3)	10,000				General Support
(67) OSCEOLA COUNTY COUNCIL ON AGING INC 700 GENERATION POINT KISSIMMEE,FL34744	59-1595398	501(c)(3)	93,622				General Support
(68) ROLLINS COLLEGE 1000 HOLT AVENUE - 2722 WINTER PARK,FL327894499	59-0624440	501(c)(3)	10,000				General Support
(69) RONALD MCDONALD HOUSE CHARITIES OF CENTRAL FLORIDA INC 1350 N ORANGE AVE WINTER PARK,FL32789	59-3211250	501(c)(3)	10,000				General Support
(70) RUNWAY TO HOPE INC 189 S ORANGE AVE ORLANDO,FL328013261	27-3272616	501(c)(3)	6,250				General Support
(71) Samaritan Touch Care Center Inc 3015 Herring Avenue Sebring,FL33870	02-0773338	501(c)(3)	229,167				Medical care
(72) SANFORD HEALTH PO BOX 1667 SANFORD,FL327721667	31-1527032	501(c)(3)	243,333				General Support - Childhood Diabetes Education
(73) SECOND HARVEST FOOD BANK OF CENTRAL FLORIDA INC 2008 BRENGLE AVENUE ORLANDO,FL32808	59-2142315	501(c)(3)	25,000				General Support
(74) SEMINOLE STATE COLLEGE 100 WELDON BLVD SANFORD,FL327736199	59-1210158	Gov't	7,000				General Support
(75) SHEPHERD'S HOPE INC 4851 S APOPKA VINELAND RD ORLANDO,FL328193128	59-3420727	501(c)(3)	28,000				General Support
(76) SOCIETY FOR THE PREVENTION OF CRUELTY TO ANIMALS OF CENTRAL FLORIDA INC 2727 CONROY RD ORLANDO,FL32839	59-0637883	501(c)(3)	10,500				General Support
(77) South Florida State College 600 W College Drive Avon Park,FL33825	59-1218159	Gov't	23,000				General Support
(78) South Florida State College Foundation Inc 13 E Main Street Avon Park,FL33825	59-3050497	501(c)(3)	7,666				General Support
(79) SOUTHERN ADVENTIST UNIVERSITY PO BOX 370 COLLEGEDALE,TN37315	62-0536733	501(c)(3)	118,000				General Support
(80) STRENGTHEN ORLANDO INC 400 SOUTH ORANGE AVE 6TH FLOOR ORLANDO,FL328013360	27-1964941	501(c)(3)	7,500				General Support
(81) SUNBELT HEALTH & REHAB CENTER - APOPKA INC 305 EAST OAK ST APOPKA,FL32703	20-5774856	501(c)(3)	450,000				General Support
(82) SunSystem Development Corporation 900 HOPE WAY ALTAMONTE SPRINGS,FL32714	59-2219301	501(c)(3)	4,861,894				General Support
(83) SUSAN G KOMEN BREAST CANCER FOUNDATION 1350 ORANGE AVE STE 260 WINTER PARK,FL32789	75-2854957	501(c)(3)	10,000				General Support
(84) SYNECHION INC 6757 ARAPAHO STE 711-238 DALLAS,TX75248	75-2640985	Other	12,000				General Support
(85) The School Board of Highlands County 426 School Street Sebring,FL33870	59-6000654	Gov't	10,000				General Support - Senior Education
(86) US DREAM ACADEMY INC 10400 LITTLE PATUXENT PKWAY SUITE 300 COLUMBIA,MD21044	59-3514841	501(c)(3)	30,000				General Support
(87) UNITED GLOBAL OUTREACH INC 2311 MOUNT VERNON ST ORLANDO,FL32803	03-0511875	501(c)(3)	201,126				General Support
(88) UNIVERSAL ORLANDO FOUNDATION INC 1000 UNIVERSAL STUDIOS PLAZA ORLANDO,FL32819	59-3510383	501(c)(3)	15,000				General Support
(89) UNIVERSITY OF CENTRAL FLORIDA PO BOX 160046 ORLANDO,FL328160046	59-2924021	Gov't	13,750				General Support
(90) UNIVERSITY OF CENTRAL FLORIDA FOUNDATION INC 12424 RESEARCH PARKWAY STE 140 ORLANDO,FL32826	59-6211832	501(c)(3)	55,000				General Support
(91) VALENCIA COLLEGE FOUNDATION INC 190 S ORANGE AVE ORLANDO,FL328013204	23-7442785	501(c)(3)	214,500				General Support
(92) WEST ORANGE CHAMBER OF COMMERCE 12184 W COLONIAL DRIVE WINTER GARDEN,FL347874146	59-0576757	501(c)(6)	8,000				General Support
(93) WINTER PARK HEALTH FOUNDATION INC 220 EDINBURGH DR WINTER PARK,FL32792	59-0669460	501(c)(3)	135,000				General Support
(94) WINTER PARK HISTORICAL ASSOCIATION INC PO BOX 51 WINTER PARK,FL32790	59-1664195	501(c)(3)	5,500				General Support
(95) WINTER PARK YOUTH BASEBALL INC PO BOX 3702 WINTER PARK,FL327903702	27-0647788	501(c)(3)	6,000				General Support

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

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

Cat. No. 50055P

Schedule I (Form 990) 2012

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.
Part III can be duplicated if additional space is needed.

(a)Type of grant or assistance	(b)Number of recipients	(c)Amount of cash grant	(d)Amount of non-cash assistance	(e)Method of valuation (book, FMV, appraisal, other)	(f)Description of non-cash assistance

Part IV

Supplemental Information.

Complete this part to provide the information required in Part I, line 2, Part III, column (b), 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 to related organizations that are exempt from Federal Income Tax under 501(c)(3), other 501(c)(3) organizations that are a part of the group exemption ruling issued to the General Conference of Seventh-Day Adventists, or to other local or local affiliate of national charitable organizations whose purposes are healthcare-related. 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) 2012

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

2012

Open to Public Inspection

Name of the organization

Adventist Health SystemSunbelt Inc

Employer identification number

59-1479658

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 or provision of all of the expenses described above? If "No," complete Part III to explain....

Yes

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? .......

Yes

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

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? ................

Yes

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? ...........................

Yes

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

Cat. No. 50053T

Schedule J (Form 990) 2012

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(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 as deferred in prior Form 990
(A) Name and Title		(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)	(F) Compensation reported as deferred in prior Form 990
(1)Houmann Lars DDirector	(i) (ii)	0 869,760	0 266,769	0 235,323	0 189,569	0 52,500	0 1,613,921	0 158,447
(2)Jernigan PhD Donald LDirector/CEO	(i) (ii)	0 947,487	0 288,129	0 740,746	0 13,599	0 92,521	0 2,082,482	0 0
(3)Reiner Richard KDirector	(i) (ii)	0 871,778	0 266,769	0 543,345	0 13,599	0 48,831	0 1,744,322	0 0
(4)Shaw Terry DDirector	(i) (ii)	0 869,760	0 266,769	0 207,241	0 189,569	0 45,078	0 1,578,417	0 158,447
(5)Banks David PSenior VP - FH	(i) (ii)	0 478,800	0 134,924	0 97,823	0 90,508	0 45,816	0 847,871	0 62,300
(6)Cummings Jr DesmondExec VP - FH	(i) (ii)	0 464,959	0 148,493	0 188,762	0 13,599	0 16,433	0 832,246	0 0
(7)Dodds Sheryl DSenior VP - FH	(i) (ii)	0 322,722	0 99,112	0 51,728	0 43,688	0 14,427	0 531,677	0 20,470
(8)Fulbright Robert DSenior VP - FH	(i) (ii)	0 370,242	0 99,291	0 46,615	0 59,136	0 39,575	0 614,859	0 28,216
(9)Goodman Todd ASenior VP - FH	(i) (ii)	0 305,685	0 95,971	0 37,057	0 46,921	0 35,878	0 521,512	0 22,392
(10)Hilliard Douglas WSenior VP - FH	(i) (ii)	0 308,988	0 96,819	0 52,388	0 44,297	0 34,832	0 537,324	0 23,081
(11)Hurst Jeffry DSenior VP - FH	(i) (ii)	0 298,183	0 91,250	0 61,616	0 27,270	0 26,079	0 504,398	0 10,316
(12)Moorhead MD John DavidSenior VP - FH	(i) (ii)	0 461,871	0 130,317	0 127,426	0 75,617	0 25,308	0 820,539	0 51,075
(13)Owen Terry RSenior VP - FH	(i) (ii)	0 381,058	0 113,486	0 256,023	0 52,236	0 28,394	0 831,197	0 34,002
(14)Paradis J BrianExec VP - FH	(i) (ii)	0 618,569	0 198,313	0 109,417	0 123,831	0 50,715	0 1,100,845	0 89,762
(15)Reed MD Monica PSenior VP - FH	(i) (ii)	0 429,416	0 123,822	0 95,418	0 77,996	0 36,433	0 763,085	0 55,086
(16)Soler EddieCFO - FL Divison	(i) (ii)	0 528,184	0 170,651	0 122,380	0 106,472	0 34,021	0 961,708	0 61,612
(17)Lee MD KathyPhysician	(i) (ii)	366,239 0	452,840 0	75,497 0	13,599 0	12,709 0	920,884 0	0 0
(18)Eubanks Jr MD William StephenExecutive Director of Academic Surge	(i) (ii)	683,365 0	140,076 0	5,093 0	8,599 0	16,155 0	853,288 0	0 0
(19)Bittner MD HartmuthMedical Director	(i) (ii)	779,709 0	56 0	34,279 0	8,599 0	13,394 0	836,037 0	0 0
(20)Torres MD Ramon MPhysician	(i) (ii)	599,997 0	89,773 0	6,761 0	13,599 0	19,580 0	729,710 0	0 0
(21)Jones MD Phillip EPhysician	(i) (ii)	585,728 0	81,250 0	24,850 0	13,599 0	18,441 0	723,868 0	0 0
(22)Grim-Marcarelli KarenFormer key employee	(i) (ii)	0 244,375	0 59,025	0 106,051	0 21,076	0 22,807	0 453,334	0 4,746
(23)Hamilton Connie AFormer key employee	(i) (ii)	0 0	0 68,140	0 339,782	0 13,599	0 17,556	0 439,077	0 51,225
(24)Herrin Arlene KFormer key employee	(i) (ii)	0 234,922	0 57,678	0 34,135	0 35,571	0 18,188	0 380,494	0 23,067

Schedule J (Form 990) 2012

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.

Identifier	Return Reference	Explanation
	Part I, Line 1a	As discussed in our response to Section B, Part VI, Question 15a & b, the filing organization is a part of the system of healthcare organizations known as Adventist Health System (AHS). Members of the filing organization's executive management team that hold the position of Vice-President or above are compensated by and on the payroll of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the parent organization of AHS. AHSSHC is exempt from federal income tax under IRC Section 501(c)(3). The filing organization reimburses AHSSHC for the salary and benefit cost of those executives on the payroll of AHSSHC that provide services and are on the management team of the filing organization. Travel for companions: AHSSHC has a Corporate Executive Policy that provides a benefit to allow for a traveling AHSSHC executive to have his or her spouse accompany the executive on certain business trips each year. Typically, reimbursement is only provided to Vice Presidents and above and is usually limited to one business trip per year beyond the annual AHS President's Council business meeting and other meetings where the spouse is specifically invited. The AHSSHC Corporate Executive Spousal Travel Policy was originally approved and reviewed by the AHSSHC Board Strategy & Compensation Committee, an independent body of the AHSSHC Board of Directors. All spousal travel costs reimbursed to the executive are considered taxable compensation to the executive. Tax Indemnification and gross-up payments: AHS has a system-wide policy addressing gross-up payments provided in connection with employer-provided benefits/other taxable items. Under the policy, certain taxable business-related reimbursements (i.e. taxable business-related moving expenses, taxable items provided in connection with employment) provided to any employee may be grossed-up at a 25% rate upon approval of the filing organization's CEO and CFO. Additionally, employees at the Director level and above are eligible for gross-up payments on gifts received for board of director services. Discretionary spending account: A nominal discretionary spending amount was provided in the current year to all eligible executives who attend the annual AHS President's Council business meeting ($500 per executive) or the annual AHS CFO Conference business meeting ($300 per executive). With respect to the AHS President's council meeting, eligible executives may include AHSSHC Vice Presidents and above and all AHSSHC subsidiary organization CEOs and Regional CFOs. The payment provided to each executive was considered taxable compensation to the executive. Housing allowance or residence for personal use: AHSSHC has a Corporate Executive Policy that addresses assistance to executives who have been relocated by the company during the year. Relocation assistance provided to executives may include relocation allowances to assist with duplicate housing expenses. Relocation assistance is administered per AHSSHC policy by an external relocation company. Any taxable reimbursements made to executives in connection with relocation assistance are treated as wages to the executive and are subject to all payroll withholding and reporting requirements. Health or social club dues or initiation fees: AHSSHC has a Corporate Executive Policy that addresses business development expenditures. Under this policy, certain AHS eligible executives may be reimbursed for member dues and usage charges for a country club or other social club upon authorization. Club memberships must be recommended by the CEO of the AHS hospital organization and approved by the Chairman of the Board of Directors of the organization. In addition, the proposed membership must be approved annually by the AHSSHC Board Strategy & Compensation Committee, an independent committee of the Board of Directors of AHSSHC. Eligible executives are limited to certain senior level executives (hospital organization CEOs, the CEO of the nursing home division of AHS, senior vice presidents at three large hospital organizations, regional CEOs and CFOs and the president and senior vice presidents of AHSSHC). In the current year, for this filing organization, four executives were eligible to receive reimbursement for club fees. Each AHS executive who is approved for a club membership must submit an annual report to the AHSSHC Board Strategy & Compensation Committee that describes how the membership benefited their organization during the preceding year.
	Part I, Lines 4a-b	During the year ending December 31, 2012, Connie A. Hamilton received severance payments in the amount of $288,425. Pursuant to the AHSSHC Corporate Executive Policy governing executive severance, severance agreements for executives operating at the Vice President level and above are entered into upon eligibility to facilitate the transition to subsequent employment following an involuntary separation from employment with AHS. As discussed in Line 1a above, executives on the filing organization's management team that hold the position of Vice-President or above are compensated by and on the payroll of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the parent organization of a healthcare system known as Adventist Health System (AHS). In recognition of the contribution that each executive makes to the success of AHS, AHS provides to eligible executives participation in the AHS Executive FLEX Benefit Program (the Plan). The purpose of the Plan is to offer eligible executives an opportunity to elect from among a variety of supplemental benefits, including deferred compensation benefits taxable under Internal Revenue Code (IRC) Section 457(f), to individually tailor a benefits program appropriate to each executive's needs. The Plan provides eligible participants a pre-determined benefits allowance credit that is equal to a percentage of the executive's base pay from which is deducted the cost of mandatory and elective employee benefits. The pre-determined benefits allowance credit percentage is approved by the AHS Board Strategy & Compensation Committee, an independent committee of the Board of Directors of AHSSHC. Any funds that remain after the cost of mandatory and elective benefits are subtracted from the annual pre-determined benefits allowance are contributed, at the employee's option, to either an IRC 457(f) deferred compensation account or to an IRC 457(b) eligible deferred compensation plan. Upon attainment of age 65, all previous 457(f) deferred amounts are paid immediately to the participant and any future employer contributions are made quarterly from the Plan directly to the participant. The Plan documents define an employee who is eligible to participate in the Plan to generally include the Chief Executive Officers of AHS entities and Vice Presidents of all AHS entities whose base salary is at least $210,000. The Plan provides for a class year vesting schedule (2 years for each class year) with respect to amounts accumulated in the executive's 457(f) deferred compensation account. Distributions could also be made from the executive's 457(f) deferred compensation account upon attainment of age 65 or upon an involuntary separation. The account is forfeited by the executive upon a voluntary separation. In addition to the Plan, AHS has instituted a defined benefit, non-tax-qualified deferred compensation plan for certain executives who have provided lengthy service to AHS and/or to other Seventh-Day Adventist Church hospitals or health care institutions. Participation in the plan is offered to AHS executives on a prorata schedule beginning with 20 years of service as an employee of AHS and/or another hospital or health care institution controlled by the Seventh-Day Adventist Church and who satisfy certain other qualifying criteria. This supplemental executive retirement plan (SERP) was designed to provide eligible executives with the economic equivalent of an annual income beginning at normal retirement age equal to 60% of the average of the participant's three, five or seven highest years of base salary from AHS active employment inclusive of income from all other Seventh-Day Adventist Church healthcare employer-financed retirement income sources and investment income earned on those contributions through social security normal retirement age as defined in the plan. The number of years included in highest average compensation is determined by the individual's year of entry to the SERP and by the individual's year of entry to the AHS Executive FLEX Benefit Program. Flex Plan Flex Plan/ SERP 457(b) CY CY Employer CY Contrib./ Distributions Contrib. Distributions* Payment ------------------------------------------------------- Houmann, Lars D. $ 175,971 $ 161,469 $ 25,617 $ 0 Jernigan, Ph.D., Donald L. $ 202,164 $ 185,164 $394,589 $ 0 Reiner, Richard K. $ 182,872 $ 167,651 $255,540 $ 0 Shaw, Terry D. $ 175,971 $ 171,709 $ 0 $ 0 Banks, David P. $ 76,910 $ 62,347 $ 0 $ 0 Cummings, Jr., Desmond $ 80,177 $ 80,177 $ 26,942 $ 0 Dodds, Sheryl D. $ 47,090 $ 20,482 $ 0 $ 0 Fulbright, Robert D$ 45,538 $ 28,237 $ 0 $ 0 Goodman, Todd A. $ 33,323 $ 24,800 $ 0 $ 0 Hilliard, Douglas W$ 30,699 $ 23,099 $ 0 $ 0 Hurst, Jeffry D. $ 35,671 $ 10,533 $ 0 $ 0 Moorhead, MD, John David $ 84,019 $ 51,110 $ 0 $ 0 Owen, Terry R. $ 55,638 $ 37,085 $170,398 $ 0 Paradis, J. Brian $ 115,232 $ 89,831 $ 0 $ 0 Reed, MD, Monica P.$ 64,397 $ 55,128 $ 0 $ 0 Soler, Eddie $ 92,874 $ 67,314 $ 0 $ 0 Grim-Marcarelli, Karen $ 24,478 $ 4,825 $ 72,638 $ 0 Hamilton, Connie A.$ 0 $ 37,050 $ 0 $ 0 Herrin, Arlene K. $ 26,972 $ 23,085 $ 0 $ 0 * Including Investment Earnings
	Part I, Line 6	The filing organization's physician compensation formula is designed to result in total compensation that would be reasonable for each physician. The filing organization utilizes national survey productivity, cost, and compensation data in formulating all aspects of the compensation plan. Physician compensation contractual agreements include a ceiling or reasonable maximum on the amount a physician may earn. The filing organization's employed physicians enter into a written agreement that requires the physicians to provide medical care to individuals who are referred by the filing organization. The filing organization's compensation arrangement does not use a method of compensation that is based upon a percentage of the organization's net income. Rather, under the compensation arrangement, physician base salary is set based on Fair Market Value benchmarks, and any additional compensation is based on a percentage of the practice/location net revenue.
Supplemental Information	Part III	Part I, Question 3: As noted in our response to question 15 of Part VI of Form 990, the individual who serves as the CEO of the filing organization is compensated by Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) for that individual's role in serving as the system-wide CEO of AHS. Compensation and benefits provided to this individual are determined pursuant to policies, procedures, and processes of AHSSHC that are designed to ensure compliance with the intermediate sanctions laws as set forth in IRC Section 4958. AHSSHC uses all of the following to establish compensation of the CEO: - Compensation committee; - Independent compensation consultant; - Compensation survey or study; and - Approval by the board or compensation committee.

Schedule J (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization
Adventist Health SystemSunbelt Inc

Employer identification number
59-1479658

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	Highlands County Health Facilities Authority	52-1313569	431022FR8	10-18-2005	64,943,086	2005A, Refund FL 1993A&B, TN 1993 and Tarrant 1993 all issued 10/20/1993		X		X		X
B	Highlands County Health Facilities Authority	52-1313569	431022GN6	10-18-2005	106,410,063	2005B, Refund Orange 2000, Tenn 2000, and Tarrant 2000 all issued 8/31/2000		X		X		X
C	Highlands County Health Facilities Authority	52-1313569	431022HG0	10-18-2005	63,434,535	2005C, Refund Colorado 2001 issued 3/28/2001		X		X		X
D	Highlands County Health Facilities Authority	52-1313569	431022HH8	10-18-2005	102,220,000	2005D, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022HUD	06-14-2006	205,156,000	2006C, Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648AAV7	11-15-2006	249,501,424	2006D&E, Refnd Highland, Tarrant 98 iss 12/17/98, Highland iss 03D 10/7/03		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648ACG8	11-15-2006	30,371,450	2006F, Refund 1995 Bonds issued 6/8/1995		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022JZ6	12-20-2006	212,464,496	2006G, Refund Highlands 2002 issued 12/19/02 and Orange 2002 issued 7/10/02		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022KK7	08-08-2007	366,445,000	2007A B C D, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022QZ8	12-16-2008	68,000,000	2008A, Expand/refurbish facilities, purchase equipment		X		X		X
	Orange County Health Facilities Authority	52-1378595		04-08-2009	5,000,000	2009A, Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589		04-08-2009	5,000,000	2009B, Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589	48542ABX8	07-08-2009	325,394,417	2009C, Ref 96/05&97/05 iss 1/13/05, 03A 1/16/03, 08B 12/19/08, exp facility		X		X		X
	Kansas Development Finance Authority	48-1066589	48542ACY5	10-01-2009	102,271,154	2009D, Refund Highlands 07C, 8/8/07 & expand/refurbish facilities/purc equip		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022SP8	11-16-2009	190,752,502	09E & 08B Conv, Ref Orange 91/01 10/11/01, 92/03 5/15/03, 08B 12/19/08		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022SG8	11-16-2009	177,240,000	2005I Conv, Refund Highlands 05I 12/22/05 & expand/refurbish facilities		X		X		X
	Highlands County Health Facilities Authority	52-1313569		12-17-2010	57,000,000	2010A, Expand/refurbish facilities, purchase equipment		X		X		X
	Orange County Health Facilities Authority	52-1378595		12-22-2010	25,000,000	2010B, Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589		12-22-2010	25,000,000	2010C, Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932		12-22-2010	25,000,000	2010D, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569		12-30-2010	225,000,000	2010E, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569		11-16-2011	80,000,000	2011A, Expand/refurbish facilities		X		X		X
	Highlands County Health Facilities Authority	52-1313569		03-21-2012	294,985,000	2012A, AR Program - Refund 2009 A-F AR Program		X		X		X
	Highlands County Health Facilities Authority	52-1313569		07-25-2012	115,015,000	2012B, AR Program - Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589	48542ADG3	08-29-2012	310,952,245	2012A - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022TL6	08-29-2012	348,320,000	2012B-F - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C		X		X		X
	Highlands County Health Facilities Authority	52-1313569		08-29-2012	125,000,000	2012G&H - Refund Highlands 2005I Conversion Bonds		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022TR3	11-08-2012	232,125,000	2012I - Refunded Volusia 1994-A; Highlands 2004A, 2005E, 2005F, 2005G		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	19,185,000		15,480,000		1,195,000		16,840,000
2 Amount of bonds legally defeased . . . . . . . . . . .	1,510,000		16,155,000		19,265,000		12,255,000
3 Total proceeds of issue . . . . . . . . . . . . . .	64,943,086		106,410,063		63,434,535		102,220,000
4 Gross proceeds in reserve funds . . . . . . . . . . . .
5 Capitalized interest from proceeds . . . . . . . . . . .
6 Proceeds in refunding escrows . . . . . . . . . . . .
7 Issuance costs from proceeds . . . . . . . . . . . .	926,709		1,532,450		928,933		1,500,000
8 Credit enhancement from proceeds . . . . . . . . . . .	5,560,382
9 Working capital expenditures from proceeds . . . . . . . . .
10 Capital expenditures from proceeds . . . . . . . . . . .	100,720,000		68,000,000		5,000,000		100,720,000
11 Other spent proceeds . . . . . . . . . . . . . .	64,016,377		104,877,613		62,505,602		210,608,121
12 Other unspent proceeds . . . . . . . . . . . . . .
13 Year of substantial completion . . . . . . . . . . . .	1993		2000		2001		2005
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .	X			X		X		X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X	X		X			X
16 Has the final allocation of proceeds been made? . . . . . . . .	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X		X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2012

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . . . . . . . . . . . . .	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	0%		0%		0%		0%
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .	0%		%		%		%
6 Total of lines 4 and 5 . . . . . . . . . . . . . . .	0%		0%		0%		0%
7 Does the bond issue meet the private security or payment test? . . . . .		X		X		X		X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X		X		X		X
b If “Yes” to line 8a, enter the percentage of bond-financed property sold or disposed of.	0%		%		0%		0%
c If “Yes” to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .		X				X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2?	X		X		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T? . . . . .		X		X		X		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .		X		X		X		X
b Exception to rebate? . . . . . . . .	X		X		X		X
c No rebate due? . . . . . . . . . .		X		X		X		X
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .		X		X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider . . . . . . . . .
c Term of hedge . . . . . . . . . .
d Was the hedge superintegrated? . . . . . .
e Was a hedge terminated? . . . . . . .

Schedule K (Form 990) 2012

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .		X		X		X		X
b Name of provider . . . . . . . . .
c Term of GIC . . . . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .	X		X		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part VI

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

Identifier	Return Reference	Explanation
Part III, Line 8c	Entity 6, Rows C & D	Highlands County Health Facilities Authority 2012A, AR Program & 2012B, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013.

Schedule K (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization
Adventist Health SystemSunbelt Inc

Employer identification number
59-1479658

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	Highlands County Health Facilities Authority	52-1313569	431022FR8	10-18-2005	64,943,086	2005A, Refund FL 1993A&B, TN 1993 and Tarrant 1993 all issued 10/20/1993		X		X		X
B	Highlands County Health Facilities Authority	52-1313569	431022GN6	10-18-2005	106,410,063	2005B, Refund Orange 2000, Tenn 2000, and Tarrant 2000 all issued 8/31/2000		X		X		X
C	Highlands County Health Facilities Authority	52-1313569	431022HG0	10-18-2005	63,434,535	2005C, Refund Colorado 2001 issued 3/28/2001		X		X		X
D	Highlands County Health Facilities Authority	52-1313569	431022HH8	10-18-2005	102,220,000	2005D, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022HUD	06-14-2006	205,156,000	2006C, Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648AAV7	11-15-2006	249,501,424	2006D&E, Refnd Highland, Tarrant 98 iss 12/17/98, Highland iss 03D 10/7/03		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648ACG8	11-15-2006	30,371,450	2006F, Refund 1995 Bonds issued 6/8/1995		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022JZ6	12-20-2006	212,464,496	2006G, Refund Highlands 2002 issued 12/19/02 and Orange 2002 issued 7/10/02		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022KK7	08-08-2007	366,445,000	2007A B C D, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022QZ8	12-16-2008	68,000,000	2008A, Expand/refurbish facilities, purchase equipment		X		X		X
	Orange County Health Facilities Authority	52-1378595		04-08-2009	5,000,000	2009A, Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589		04-08-2009	5,000,000	2009B, Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589	48542ABX8	07-08-2009	325,394,417	2009C, Ref 96/05&97/05 iss 1/13/05, 03A 1/16/03, 08B 12/19/08, exp facility		X		X		X
	Kansas Development Finance Authority	48-1066589	48542ACY5	10-01-2009	102,271,154	2009D, Refund Highlands 07C, 8/8/07 & expand/refurbish facilities/purc equip		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022SP8	11-16-2009	190,752,502	09E & 08B Conv, Ref Orange 91/01 10/11/01, 92/03 5/15/03, 08B 12/19/08		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022SG8	11-16-2009	177,240,000	2005I Conv, Refund Highlands 05I 12/22/05 & expand/refurbish facilities		X		X		X
	Highlands County Health Facilities Authority	52-1313569		12-17-2010	57,000,000	2010A, Expand/refurbish facilities, purchase equipment		X		X		X
	Orange County Health Facilities Authority	52-1378595		12-22-2010	25,000,000	2010B, Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589		12-22-2010	25,000,000	2010C, Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932		12-22-2010	25,000,000	2010D, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569		12-30-2010	225,000,000	2010E, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569		11-16-2011	80,000,000	2011A, Expand/refurbish facilities		X		X		X
	Highlands County Health Facilities Authority	52-1313569		03-21-2012	294,985,000	2012A, AR Program - Refund 2009 A-F AR Program		X		X		X
	Highlands County Health Facilities Authority	52-1313569		07-25-2012	115,015,000	2012B, AR Program - Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589	48542ADG3	08-29-2012	310,952,245	2012A - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022TL6	08-29-2012	348,320,000	2012B-F - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C		X		X		X
	Highlands County Health Facilities Authority	52-1313569		08-29-2012	125,000,000	2012G&H - Refund Highlands 2005I Conversion Bonds		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022TR3	11-08-2012	232,125,000	2012I - Refunded Volusia 1994-A; Highlands 2004A, 2005E, 2005F, 2005G		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	19,185,000		15,480,000		1,195,000		16,840,000
2 Amount of bonds legally defeased . . . . . . . . . . .	1,510,000		16,155,000		19,265,000		12,255,000
3 Total proceeds of issue . . . . . . . . . . . . . .	64,943,086		106,410,063		63,434,535		102,220,000
4 Gross proceeds in reserve funds . . . . . . . . . . . .
5 Capitalized interest from proceeds . . . . . . . . . . .
6 Proceeds in refunding escrows . . . . . . . . . . . .
7 Issuance costs from proceeds . . . . . . . . . . . .	926,709		1,532,450		928,933		1,500,000
8 Credit enhancement from proceeds . . . . . . . . . . .	5,560,382
9 Working capital expenditures from proceeds . . . . . . . . .
10 Capital expenditures from proceeds . . . . . . . . . . .	100,720,000		68,000,000		5,000,000		100,720,000
11 Other spent proceeds . . . . . . . . . . . . . .	64,016,377		104,877,613		62,505,602		210,608,121
12 Other unspent proceeds . . . . . . . . . . . . . .
13 Year of substantial completion . . . . . . . . . . . .	1993		2000		2001		2005
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .	X			X		X		X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X	X		X			X
16 Has the final allocation of proceeds been made? . . . . . . . .	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X		X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2012

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . . . . . . . . . . . . .	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	0%		0%		0%		0%
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .	0%		%		%		%
6 Total of lines 4 and 5 . . . . . . . . . . . . . . .	0%		0%		0%		0%
7 Does the bond issue meet the private security or payment test? . . . . .		X		X		X		X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X		X		X		X
b If “Yes” to line 8a, enter the percentage of bond-financed property sold or disposed of.	0%		%		0%		0%
c If “Yes” to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .		X				X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2?	X		X		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T? . . . . .		X		X		X		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .		X		X		X		X
b Exception to rebate? . . . . . . . .	X		X		X		X
c No rebate due? . . . . . . . . . .		X		X		X		X
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .		X		X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider . . . . . . . . .
c Term of hedge . . . . . . . . . .
d Was the hedge superintegrated? . . . . . .
e Was a hedge terminated? . . . . . . .

Schedule K (Form 990) 2012

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .		X		X		X		X
b Name of provider . . . . . . . . .
c Term of GIC . . . . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .	X		X		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part VI

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

Identifier	Return Reference	Explanation
Part III, Line 8c	Entity 6, Rows C & D	Highlands County Health Facilities Authority 2012A, AR Program & 2012B, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013.

Schedule K (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization
Adventist Health SystemSunbelt Inc

Employer identification number
59-1479658

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	Highlands County Health Facilities Authority	52-1313569	431022FR8	10-18-2005	64,943,086	2005A, Refund FL 1993A&B, TN 1993 and Tarrant 1993 all issued 10/20/1993		X		X		X
B	Highlands County Health Facilities Authority	52-1313569	431022GN6	10-18-2005	106,410,063	2005B, Refund Orange 2000, Tenn 2000, and Tarrant 2000 all issued 8/31/2000		X		X		X
C	Highlands County Health Facilities Authority	52-1313569	431022HG0	10-18-2005	63,434,535	2005C, Refund Colorado 2001 issued 3/28/2001		X		X		X
D	Highlands County Health Facilities Authority	52-1313569	431022HH8	10-18-2005	102,220,000	2005D, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022HUD	06-14-2006	205,156,000	2006C, Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648AAV7	11-15-2006	249,501,424	2006D&E, Refnd Highland, Tarrant 98 iss 12/17/98, Highland iss 03D 10/7/03		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648ACG8	11-15-2006	30,371,450	2006F, Refund 1995 Bonds issued 6/8/1995		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022JZ6	12-20-2006	212,464,496	2006G, Refund Highlands 2002 issued 12/19/02 and Orange 2002 issued 7/10/02		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022KK7	08-08-2007	366,445,000	2007A B C D, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022QZ8	12-16-2008	68,000,000	2008A, Expand/refurbish facilities, purchase equipment		X		X		X
	Orange County Health Facilities Authority	52-1378595		04-08-2009	5,000,000	2009A, Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589		04-08-2009	5,000,000	2009B, Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589	48542ABX8	07-08-2009	325,394,417	2009C, Ref 96/05&97/05 iss 1/13/05, 03A 1/16/03, 08B 12/19/08, exp facility		X		X		X
	Kansas Development Finance Authority	48-1066589	48542ACY5	10-01-2009	102,271,154	2009D, Refund Highlands 07C, 8/8/07 & expand/refurbish facilities/purc equip		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022SP8	11-16-2009	190,752,502	09E & 08B Conv, Ref Orange 91/01 10/11/01, 92/03 5/15/03, 08B 12/19/08		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022SG8	11-16-2009	177,240,000	2005I Conv, Refund Highlands 05I 12/22/05 & expand/refurbish facilities		X		X		X
	Highlands County Health Facilities Authority	52-1313569		12-17-2010	57,000,000	2010A, Expand/refurbish facilities, purchase equipment		X		X		X
	Orange County Health Facilities Authority	52-1378595		12-22-2010	25,000,000	2010B, Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589		12-22-2010	25,000,000	2010C, Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932		12-22-2010	25,000,000	2010D, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569		12-30-2010	225,000,000	2010E, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569		11-16-2011	80,000,000	2011A, Expand/refurbish facilities		X		X		X
	Highlands County Health Facilities Authority	52-1313569		03-21-2012	294,985,000	2012A, AR Program - Refund 2009 A-F AR Program		X		X		X
	Highlands County Health Facilities Authority	52-1313569		07-25-2012	115,015,000	2012B, AR Program - Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589	48542ADG3	08-29-2012	310,952,245	2012A - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022TL6	08-29-2012	348,320,000	2012B-F - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C		X		X		X
	Highlands County Health Facilities Authority	52-1313569		08-29-2012	125,000,000	2012G&H - Refund Highlands 2005I Conversion Bonds		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022TR3	11-08-2012	232,125,000	2012I - Refunded Volusia 1994-A; Highlands 2004A, 2005E, 2005F, 2005G		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	19,185,000		15,480,000		1,195,000		16,840,000
2 Amount of bonds legally defeased . . . . . . . . . . .	1,510,000		16,155,000		19,265,000		12,255,000
3 Total proceeds of issue . . . . . . . . . . . . . .	64,943,086		106,410,063		63,434,535		102,220,000
4 Gross proceeds in reserve funds . . . . . . . . . . . .
5 Capitalized interest from proceeds . . . . . . . . . . .
6 Proceeds in refunding escrows . . . . . . . . . . . .
7 Issuance costs from proceeds . . . . . . . . . . . .	926,709		1,532,450		928,933		1,500,000
8 Credit enhancement from proceeds . . . . . . . . . . .	5,560,382
9 Working capital expenditures from proceeds . . . . . . . . .
10 Capital expenditures from proceeds . . . . . . . . . . .	100,720,000		68,000,000		5,000,000		100,720,000
11 Other spent proceeds . . . . . . . . . . . . . .	64,016,377		104,877,613		62,505,602		210,608,121
12 Other unspent proceeds . . . . . . . . . . . . . .
13 Year of substantial completion . . . . . . . . . . . .	1993		2000		2001		2005
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .	X			X		X		X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X	X		X			X
16 Has the final allocation of proceeds been made? . . . . . . . .	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X		X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2012

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . . . . . . . . . . . . .	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	0%		0%		0%		0%
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .	0%		%		%		%
6 Total of lines 4 and 5 . . . . . . . . . . . . . . .	0%		0%		0%		0%
7 Does the bond issue meet the private security or payment test? . . . . .		X		X		X		X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X		X		X		X
b If “Yes” to line 8a, enter the percentage of bond-financed property sold or disposed of.	0%		%		0%		0%
c If “Yes” to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .		X				X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2?	X		X		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T? . . . . .		X		X		X		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .		X		X		X		X
b Exception to rebate? . . . . . . . .	X		X		X		X
c No rebate due? . . . . . . . . . .		X		X		X		X
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .		X		X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider . . . . . . . . .
c Term of hedge . . . . . . . . . .
d Was the hedge superintegrated? . . . . . .
e Was a hedge terminated? . . . . . . .

Schedule K (Form 990) 2012

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .		X		X		X		X
b Name of provider . . . . . . . . .
c Term of GIC . . . . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .	X		X		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part VI

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

Identifier	Return Reference	Explanation
Part III, Line 8c	Entity 6, Rows C & D	Highlands County Health Facilities Authority 2012A, AR Program & 2012B, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013.

Schedule K (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization
Adventist Health SystemSunbelt Inc

Employer identification number
59-1479658

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	Highlands County Health Facilities Authority	52-1313569	431022FR8	10-18-2005	64,943,086	2005A, Refund FL 1993A&B, TN 1993 and Tarrant 1993 all issued 10/20/1993		X		X		X
B	Highlands County Health Facilities Authority	52-1313569	431022GN6	10-18-2005	106,410,063	2005B, Refund Orange 2000, Tenn 2000, and Tarrant 2000 all issued 8/31/2000		X		X		X
C	Highlands County Health Facilities Authority	52-1313569	431022HG0	10-18-2005	63,434,535	2005C, Refund Colorado 2001 issued 3/28/2001		X		X		X
D	Highlands County Health Facilities Authority	52-1313569	431022HH8	10-18-2005	102,220,000	2005D, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022HUD	06-14-2006	205,156,000	2006C, Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648AAV7	11-15-2006	249,501,424	2006D&E, Refnd Highland, Tarrant 98 iss 12/17/98, Highland iss 03D 10/7/03		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648ACG8	11-15-2006	30,371,450	2006F, Refund 1995 Bonds issued 6/8/1995		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022JZ6	12-20-2006	212,464,496	2006G, Refund Highlands 2002 issued 12/19/02 and Orange 2002 issued 7/10/02		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022KK7	08-08-2007	366,445,000	2007A B C D, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022QZ8	12-16-2008	68,000,000	2008A, Expand/refurbish facilities, purchase equipment		X		X		X
	Orange County Health Facilities Authority	52-1378595		04-08-2009	5,000,000	2009A, Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589		04-08-2009	5,000,000	2009B, Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589	48542ABX8	07-08-2009	325,394,417	2009C, Ref 96/05&97/05 iss 1/13/05, 03A 1/16/03, 08B 12/19/08, exp facility		X		X		X
	Kansas Development Finance Authority	48-1066589	48542ACY5	10-01-2009	102,271,154	2009D, Refund Highlands 07C, 8/8/07 & expand/refurbish facilities/purc equip		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022SP8	11-16-2009	190,752,502	09E & 08B Conv, Ref Orange 91/01 10/11/01, 92/03 5/15/03, 08B 12/19/08		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022SG8	11-16-2009	177,240,000	2005I Conv, Refund Highlands 05I 12/22/05 & expand/refurbish facilities		X		X		X
	Highlands County Health Facilities Authority	52-1313569		12-17-2010	57,000,000	2010A, Expand/refurbish facilities, purchase equipment		X		X		X
	Orange County Health Facilities Authority	52-1378595		12-22-2010	25,000,000	2010B, Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589		12-22-2010	25,000,000	2010C, Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932		12-22-2010	25,000,000	2010D, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569		12-30-2010	225,000,000	2010E, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569		11-16-2011	80,000,000	2011A, Expand/refurbish facilities		X		X		X
	Highlands County Health Facilities Authority	52-1313569		03-21-2012	294,985,000	2012A, AR Program - Refund 2009 A-F AR Program		X		X		X
	Highlands County Health Facilities Authority	52-1313569		07-25-2012	115,015,000	2012B, AR Program - Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589	48542ADG3	08-29-2012	310,952,245	2012A - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022TL6	08-29-2012	348,320,000	2012B-F - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C		X		X		X
	Highlands County Health Facilities Authority	52-1313569		08-29-2012	125,000,000	2012G&H - Refund Highlands 2005I Conversion Bonds		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022TR3	11-08-2012	232,125,000	2012I - Refunded Volusia 1994-A; Highlands 2004A, 2005E, 2005F, 2005G		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	19,185,000		15,480,000		1,195,000		16,840,000
2 Amount of bonds legally defeased . . . . . . . . . . .	1,510,000		16,155,000		19,265,000		12,255,000
3 Total proceeds of issue . . . . . . . . . . . . . .	64,943,086		106,410,063		63,434,535		102,220,000
4 Gross proceeds in reserve funds . . . . . . . . . . . .
5 Capitalized interest from proceeds . . . . . . . . . . .
6 Proceeds in refunding escrows . . . . . . . . . . . .
7 Issuance costs from proceeds . . . . . . . . . . . .	926,709		1,532,450		928,933		1,500,000
8 Credit enhancement from proceeds . . . . . . . . . . .	5,560,382
9 Working capital expenditures from proceeds . . . . . . . . .
10 Capital expenditures from proceeds . . . . . . . . . . .	100,720,000		68,000,000		5,000,000		100,720,000
11 Other spent proceeds . . . . . . . . . . . . . .	64,016,377		104,877,613		62,505,602		210,608,121
12 Other unspent proceeds . . . . . . . . . . . . . .
13 Year of substantial completion . . . . . . . . . . . .	1993		2000		2001		2005
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .	X			X		X		X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X	X		X			X
16 Has the final allocation of proceeds been made? . . . . . . . .	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X		X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2012

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . . . . . . . . . . . . .	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	0%		0%		0%		0%
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .	0%		%		%		%
6 Total of lines 4 and 5 . . . . . . . . . . . . . . .	0%		0%		0%		0%
7 Does the bond issue meet the private security or payment test? . . . . .		X		X		X		X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X		X		X		X
b If “Yes” to line 8a, enter the percentage of bond-financed property sold or disposed of.	0%		%		0%		0%
c If “Yes” to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .		X				X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2?	X		X		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T? . . . . .		X		X		X		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .		X		X		X		X
b Exception to rebate? . . . . . . . .	X		X		X		X
c No rebate due? . . . . . . . . . .		X		X		X		X
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .		X		X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider . . . . . . . . .
c Term of hedge . . . . . . . . . .
d Was the hedge superintegrated? . . . . . .
e Was a hedge terminated? . . . . . . .

Schedule K (Form 990) 2012

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .		X		X		X		X
b Name of provider . . . . . . . . .
c Term of GIC . . . . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .	X		X		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part VI

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

Identifier	Return Reference	Explanation
Part III, Line 8c	Entity 6, Rows C & D	Highlands County Health Facilities Authority 2012A, AR Program & 2012B, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013.

Schedule K (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization
Adventist Health SystemSunbelt Inc

Employer identification number
59-1479658

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	Highlands County Health Facilities Authority	52-1313569	431022FR8	10-18-2005	64,943,086	2005A, Refund FL 1993A&B, TN 1993 and Tarrant 1993 all issued 10/20/1993		X		X		X
B	Highlands County Health Facilities Authority	52-1313569	431022GN6	10-18-2005	106,410,063	2005B, Refund Orange 2000, Tenn 2000, and Tarrant 2000 all issued 8/31/2000		X		X		X
C	Highlands County Health Facilities Authority	52-1313569	431022HG0	10-18-2005	63,434,535	2005C, Refund Colorado 2001 issued 3/28/2001		X		X		X
D	Highlands County Health Facilities Authority	52-1313569	431022HH8	10-18-2005	102,220,000	2005D, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022HUD	06-14-2006	205,156,000	2006C, Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648AAV7	11-15-2006	249,501,424	2006D&E, Refnd Highland, Tarrant 98 iss 12/17/98, Highland iss 03D 10/7/03		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648ACG8	11-15-2006	30,371,450	2006F, Refund 1995 Bonds issued 6/8/1995		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022JZ6	12-20-2006	212,464,496	2006G, Refund Highlands 2002 issued 12/19/02 and Orange 2002 issued 7/10/02		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022KK7	08-08-2007	366,445,000	2007A B C D, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022QZ8	12-16-2008	68,000,000	2008A, Expand/refurbish facilities, purchase equipment		X		X		X
	Orange County Health Facilities Authority	52-1378595		04-08-2009	5,000,000	2009A, Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589		04-08-2009	5,000,000	2009B, Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589	48542ABX8	07-08-2009	325,394,417	2009C, Ref 96/05&97/05 iss 1/13/05, 03A 1/16/03, 08B 12/19/08, exp facility		X		X		X
	Kansas Development Finance Authority	48-1066589	48542ACY5	10-01-2009	102,271,154	2009D, Refund Highlands 07C, 8/8/07 & expand/refurbish facilities/purc equip		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022SP8	11-16-2009	190,752,502	09E & 08B Conv, Ref Orange 91/01 10/11/01, 92/03 5/15/03, 08B 12/19/08		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022SG8	11-16-2009	177,240,000	2005I Conv, Refund Highlands 05I 12/22/05 & expand/refurbish facilities		X		X		X
	Highlands County Health Facilities Authority	52-1313569		12-17-2010	57,000,000	2010A, Expand/refurbish facilities, purchase equipment		X		X		X
	Orange County Health Facilities Authority	52-1378595		12-22-2010	25,000,000	2010B, Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589		12-22-2010	25,000,000	2010C, Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932		12-22-2010	25,000,000	2010D, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569		12-30-2010	225,000,000	2010E, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569		11-16-2011	80,000,000	2011A, Expand/refurbish facilities		X		X		X
	Highlands County Health Facilities Authority	52-1313569		03-21-2012	294,985,000	2012A, AR Program - Refund 2009 A-F AR Program		X		X		X
	Highlands County Health Facilities Authority	52-1313569		07-25-2012	115,015,000	2012B, AR Program - Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589	48542ADG3	08-29-2012	310,952,245	2012A - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022TL6	08-29-2012	348,320,000	2012B-F - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C		X		X		X
	Highlands County Health Facilities Authority	52-1313569		08-29-2012	125,000,000	2012G&H - Refund Highlands 2005I Conversion Bonds		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022TR3	11-08-2012	232,125,000	2012I - Refunded Volusia 1994-A; Highlands 2004A, 2005E, 2005F, 2005G		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	19,185,000		15,480,000		1,195,000		16,840,000
2 Amount of bonds legally defeased . . . . . . . . . . .	1,510,000		16,155,000		19,265,000		12,255,000
3 Total proceeds of issue . . . . . . . . . . . . . .	64,943,086		106,410,063		63,434,535		102,220,000
4 Gross proceeds in reserve funds . . . . . . . . . . . .
5 Capitalized interest from proceeds . . . . . . . . . . .
6 Proceeds in refunding escrows . . . . . . . . . . . .
7 Issuance costs from proceeds . . . . . . . . . . . .	926,709		1,532,450		928,933		1,500,000
8 Credit enhancement from proceeds . . . . . . . . . . .	5,560,382
9 Working capital expenditures from proceeds . . . . . . . . .
10 Capital expenditures from proceeds . . . . . . . . . . .	100,720,000		68,000,000		5,000,000		100,720,000
11 Other spent proceeds . . . . . . . . . . . . . .	64,016,377		104,877,613		62,505,602		210,608,121
12 Other unspent proceeds . . . . . . . . . . . . . .
13 Year of substantial completion . . . . . . . . . . . .	1993		2000		2001		2005
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .	X			X		X		X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X	X		X			X
16 Has the final allocation of proceeds been made? . . . . . . . .	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X		X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2012

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . . . . . . . . . . . . .	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	0%		0%		0%		0%
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .	0%		%		%		%
6 Total of lines 4 and 5 . . . . . . . . . . . . . . .	0%		0%		0%		0%
7 Does the bond issue meet the private security or payment test? . . . . .		X		X		X		X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X		X		X		X
b If “Yes” to line 8a, enter the percentage of bond-financed property sold or disposed of.	0%		%		0%		0%
c If “Yes” to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .		X				X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2?	X		X		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T? . . . . .		X		X		X		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .		X		X		X		X
b Exception to rebate? . . . . . . . .	X		X		X		X
c No rebate due? . . . . . . . . . .		X		X		X		X
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .		X		X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider . . . . . . . . .
c Term of hedge . . . . . . . . . .
d Was the hedge superintegrated? . . . . . .
e Was a hedge terminated? . . . . . . .

Schedule K (Form 990) 2012

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .		X		X		X		X
b Name of provider . . . . . . . . .
c Term of GIC . . . . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .	X		X		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part VI

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

Identifier	Return Reference	Explanation
Part III, Line 8c	Entity 6, Rows C & D	Highlands County Health Facilities Authority 2012A, AR Program & 2012B, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013.

Schedule K (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization
Adventist Health SystemSunbelt Inc

Employer identification number
59-1479658

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	Highlands County Health Facilities Authority	52-1313569	431022FR8	10-18-2005	64,943,086	2005A, Refund FL 1993A&B, TN 1993 and Tarrant 1993 all issued 10/20/1993		X		X		X
B	Highlands County Health Facilities Authority	52-1313569	431022GN6	10-18-2005	106,410,063	2005B, Refund Orange 2000, Tenn 2000, and Tarrant 2000 all issued 8/31/2000		X		X		X
C	Highlands County Health Facilities Authority	52-1313569	431022HG0	10-18-2005	63,434,535	2005C, Refund Colorado 2001 issued 3/28/2001		X		X		X
D	Highlands County Health Facilities Authority	52-1313569	431022HH8	10-18-2005	102,220,000	2005D, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022HUD	06-14-2006	205,156,000	2006C, Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648AAV7	11-15-2006	249,501,424	2006D&E, Refnd Highland, Tarrant 98 iss 12/17/98, Highland iss 03D 10/7/03		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648ACG8	11-15-2006	30,371,450	2006F, Refund 1995 Bonds issued 6/8/1995		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022JZ6	12-20-2006	212,464,496	2006G, Refund Highlands 2002 issued 12/19/02 and Orange 2002 issued 7/10/02		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022KK7	08-08-2007	366,445,000	2007A B C D, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022QZ8	12-16-2008	68,000,000	2008A, Expand/refurbish facilities, purchase equipment		X		X		X
	Orange County Health Facilities Authority	52-1378595		04-08-2009	5,000,000	2009A, Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589		04-08-2009	5,000,000	2009B, Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589	48542ABX8	07-08-2009	325,394,417	2009C, Ref 96/05&97/05 iss 1/13/05, 03A 1/16/03, 08B 12/19/08, exp facility		X		X		X
	Kansas Development Finance Authority	48-1066589	48542ACY5	10-01-2009	102,271,154	2009D, Refund Highlands 07C, 8/8/07 & expand/refurbish facilities/purc equip		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022SP8	11-16-2009	190,752,502	09E & 08B Conv, Ref Orange 91/01 10/11/01, 92/03 5/15/03, 08B 12/19/08		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022SG8	11-16-2009	177,240,000	2005I Conv, Refund Highlands 05I 12/22/05 & expand/refurbish facilities		X		X		X
	Highlands County Health Facilities Authority	52-1313569		12-17-2010	57,000,000	2010A, Expand/refurbish facilities, purchase equipment		X		X		X
	Orange County Health Facilities Authority	52-1378595		12-22-2010	25,000,000	2010B, Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589		12-22-2010	25,000,000	2010C, Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932		12-22-2010	25,000,000	2010D, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569		12-30-2010	225,000,000	2010E, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569		11-16-2011	80,000,000	2011A, Expand/refurbish facilities		X		X		X
	Highlands County Health Facilities Authority	52-1313569		03-21-2012	294,985,000	2012A, AR Program - Refund 2009 A-F AR Program		X		X		X
	Highlands County Health Facilities Authority	52-1313569		07-25-2012	115,015,000	2012B, AR Program - Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589	48542ADG3	08-29-2012	310,952,245	2012A - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022TL6	08-29-2012	348,320,000	2012B-F - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C		X		X		X
	Highlands County Health Facilities Authority	52-1313569		08-29-2012	125,000,000	2012G&H - Refund Highlands 2005I Conversion Bonds		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022TR3	11-08-2012	232,125,000	2012I - Refunded Volusia 1994-A; Highlands 2004A, 2005E, 2005F, 2005G		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	19,185,000		15,480,000		1,195,000		16,840,000
2 Amount of bonds legally defeased . . . . . . . . . . .	1,510,000		16,155,000		19,265,000		12,255,000
3 Total proceeds of issue . . . . . . . . . . . . . .	64,943,086		106,410,063		63,434,535		102,220,000
4 Gross proceeds in reserve funds . . . . . . . . . . . .
5 Capitalized interest from proceeds . . . . . . . . . . .
6 Proceeds in refunding escrows . . . . . . . . . . . .
7 Issuance costs from proceeds . . . . . . . . . . . .	926,709		1,532,450		928,933		1,500,000
8 Credit enhancement from proceeds . . . . . . . . . . .	5,560,382
9 Working capital expenditures from proceeds . . . . . . . . .
10 Capital expenditures from proceeds . . . . . . . . . . .	100,720,000		68,000,000		5,000,000		100,720,000
11 Other spent proceeds . . . . . . . . . . . . . .	64,016,377		104,877,613		62,505,602		210,608,121
12 Other unspent proceeds . . . . . . . . . . . . . .
13 Year of substantial completion . . . . . . . . . . . .	1993		2000		2001		2005
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .	X			X		X		X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X	X		X			X
16 Has the final allocation of proceeds been made? . . . . . . . .	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X		X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2012

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . . . . . . . . . . . . .	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	0%		0%		0%		0%
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .	0%		%		%		%
6 Total of lines 4 and 5 . . . . . . . . . . . . . . .	0%		0%		0%		0%
7 Does the bond issue meet the private security or payment test? . . . . .		X		X		X		X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X		X		X		X
b If “Yes” to line 8a, enter the percentage of bond-financed property sold or disposed of.	0%		%		0%		0%
c If “Yes” to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .		X				X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2?	X		X		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T? . . . . .		X		X		X		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .		X		X		X		X
b Exception to rebate? . . . . . . . .	X		X		X		X
c No rebate due? . . . . . . . . . .		X		X		X		X
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .		X		X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider . . . . . . . . .
c Term of hedge . . . . . . . . . .
d Was the hedge superintegrated? . . . . . .
e Was a hedge terminated? . . . . . . .

Schedule K (Form 990) 2012

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .		X		X		X		X
b Name of provider . . . . . . . . .
c Term of GIC . . . . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .	X		X		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part VI

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

Identifier	Return Reference	Explanation
Part III, Line 8c	Entity 6, Rows C & D	Highlands County Health Facilities Authority 2012A, AR Program & 2012B, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013.

Schedule K (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization
Adventist Health SystemSunbelt Inc

Employer identification number
59-1479658

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	Highlands County Health Facilities Authority	52-1313569	431022FR8	10-18-2005	64,943,086	2005A, Refund FL 1993A&B, TN 1993 and Tarrant 1993 all issued 10/20/1993		X		X		X
B	Highlands County Health Facilities Authority	52-1313569	431022GN6	10-18-2005	106,410,063	2005B, Refund Orange 2000, Tenn 2000, and Tarrant 2000 all issued 8/31/2000		X		X		X
C	Highlands County Health Facilities Authority	52-1313569	431022HG0	10-18-2005	63,434,535	2005C, Refund Colorado 2001 issued 3/28/2001		X		X		X
D	Highlands County Health Facilities Authority	52-1313569	431022HH8	10-18-2005	102,220,000	2005D, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022HUD	06-14-2006	205,156,000	2006C, Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648AAV7	11-15-2006	249,501,424	2006D&E, Refnd Highland, Tarrant 98 iss 12/17/98, Highland iss 03D 10/7/03		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648ACG8	11-15-2006	30,371,450	2006F, Refund 1995 Bonds issued 6/8/1995		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022JZ6	12-20-2006	212,464,496	2006G, Refund Highlands 2002 issued 12/19/02 and Orange 2002 issued 7/10/02		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022KK7	08-08-2007	366,445,000	2007A B C D, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022QZ8	12-16-2008	68,000,000	2008A, Expand/refurbish facilities, purchase equipment		X		X		X
	Orange County Health Facilities Authority	52-1378595		04-08-2009	5,000,000	2009A, Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589		04-08-2009	5,000,000	2009B, Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589	48542ABX8	07-08-2009	325,394,417	2009C, Ref 96/05&97/05 iss 1/13/05, 03A 1/16/03, 08B 12/19/08, exp facility		X		X		X
	Kansas Development Finance Authority	48-1066589	48542ACY5	10-01-2009	102,271,154	2009D, Refund Highlands 07C, 8/8/07 & expand/refurbish facilities/purc equip		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022SP8	11-16-2009	190,752,502	09E & 08B Conv, Ref Orange 91/01 10/11/01, 92/03 5/15/03, 08B 12/19/08		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022SG8	11-16-2009	177,240,000	2005I Conv, Refund Highlands 05I 12/22/05 & expand/refurbish facilities		X		X		X
	Highlands County Health Facilities Authority	52-1313569		12-17-2010	57,000,000	2010A, Expand/refurbish facilities, purchase equipment		X		X		X
	Orange County Health Facilities Authority	52-1378595		12-22-2010	25,000,000	2010B, Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589		12-22-2010	25,000,000	2010C, Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932		12-22-2010	25,000,000	2010D, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569		12-30-2010	225,000,000	2010E, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569		11-16-2011	80,000,000	2011A, Expand/refurbish facilities		X		X		X
	Highlands County Health Facilities Authority	52-1313569		03-21-2012	294,985,000	2012A, AR Program - Refund 2009 A-F AR Program		X		X		X
	Highlands County Health Facilities Authority	52-1313569		07-25-2012	115,015,000	2012B, AR Program - Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589	48542ADG3	08-29-2012	310,952,245	2012A - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022TL6	08-29-2012	348,320,000	2012B-F - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C		X		X		X
	Highlands County Health Facilities Authority	52-1313569		08-29-2012	125,000,000	2012G&H - Refund Highlands 2005I Conversion Bonds		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022TR3	11-08-2012	232,125,000	2012I - Refunded Volusia 1994-A; Highlands 2004A, 2005E, 2005F, 2005G		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	19,185,000		15,480,000		1,195,000		16,840,000
2 Amount of bonds legally defeased . . . . . . . . . . .	1,510,000		16,155,000		19,265,000		12,255,000
3 Total proceeds of issue . . . . . . . . . . . . . .	64,943,086		106,410,063		63,434,535		102,220,000
4 Gross proceeds in reserve funds . . . . . . . . . . . .
5 Capitalized interest from proceeds . . . . . . . . . . .
6 Proceeds in refunding escrows . . . . . . . . . . . .
7 Issuance costs from proceeds . . . . . . . . . . . .	926,709		1,532,450		928,933		1,500,000
8 Credit enhancement from proceeds . . . . . . . . . . .	5,560,382
9 Working capital expenditures from proceeds . . . . . . . . .
10 Capital expenditures from proceeds . . . . . . . . . . .	100,720,000		68,000,000		5,000,000		100,720,000
11 Other spent proceeds . . . . . . . . . . . . . .	64,016,377		104,877,613		62,505,602		210,608,121
12 Other unspent proceeds . . . . . . . . . . . . . .
13 Year of substantial completion . . . . . . . . . . . .	1993		2000		2001		2005
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .	X			X		X		X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X	X		X			X
16 Has the final allocation of proceeds been made? . . . . . . . .	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X		X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2012

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . . . . . . . . . . . . .	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	0%		0%		0%		0%
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .	0%		%		%		%
6 Total of lines 4 and 5 . . . . . . . . . . . . . . .	0%		0%		0%		0%
7 Does the bond issue meet the private security or payment test? . . . . .		X		X		X		X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X		X		X		X
b If “Yes” to line 8a, enter the percentage of bond-financed property sold or disposed of.	0%		%		0%		0%
c If “Yes” to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .		X				X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2?	X		X		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T? . . . . .		X		X		X		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .		X		X		X		X
b Exception to rebate? . . . . . . . .	X		X		X		X
c No rebate due? . . . . . . . . . .		X		X		X		X
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .		X		X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider . . . . . . . . .
c Term of hedge . . . . . . . . . .
d Was the hedge superintegrated? . . . . . .
e Was a hedge terminated? . . . . . . .

Schedule K (Form 990) 2012

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .		X		X		X		X
b Name of provider . . . . . . . . .
c Term of GIC . . . . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .	X		X		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part VI

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

Identifier	Return Reference	Explanation
Part III, Line 8c	Entity 6, Rows C & D	Highlands County Health Facilities Authority 2012A, AR Program & 2012B, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013.

Schedule K (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ. MediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

Adventist Health SystemSunbelt Inc

Employer identification number

59-1479658

Part I

Excess Benefit Transactions (section 501(c)(3) and section 501(c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No






Total ...... $

Part III

Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2012

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) Linda Knutson	Family of board member	50,059	Employee Compensation		No
(2) Jenola Bradwell	Family of board member	62,434	Employee Compensation		No
(3) Karen Tilstra	Family of key employee	113,530	Consulting		No
(4) Clifton Scott	Family of board member	58,270	Employee Compensation		No

Part V

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

Identifier	Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

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

Attach to Form 990.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

Adventist Health SystemSunbelt Inc

Employer identification number

59-1479658

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash 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 .
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 ..	X	1	0
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( Medical Equipment )	X	2	12,368	Cost of donated property
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 noncash

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

32a

Yes

If "Yes," describe in Part II.

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

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) (2012)

Page 2

Part II

Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Identifier	Return Reference	Explanation
Third Party Use:	Part I, Line 32b:	The filing organization's supporting foundations conduct fund-raising activities on behalf of the filing organization, generally including the soliciting, processing, and selling of non-cash contributions.
Non Reporting of Revenue:	Part I, Line 33:	Pursuant to the filing organization's Net Assets Accounting Policy, gifts of significant donated property are recorded by the filing organization to the unrestricted net assets (equity) account. Accordingly, donated property (such as furniture and fixtures) are recorded directly to equity accounts and are not recorded in the income statement.

Schedule M (Form 990) (2012)

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

2012

Open to Public
Inspection

Name of the organization

Adventist Health SystemSunbelt Inc

Employer identification number

59-1479658

Identifier	Return Reference	Explanation
	Form 990, Part VI, Section A, line 2	Lars Houmann and Terry Owen - Family Relationship
	Form 990, Part VI, Section A, line 6	Adventist Health System/Sunbelt, Inc. (the filing organization) has one member. The sole member of the filing organization is Adventist Health System Sunbelt Healthcare Corporation. Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) is a Florida, not-for-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). There are no other classes of membership in the filing organization.
	Form 990, Part VI, Section A, line 7a	The sole member of the filing organization is AHSSHC. The Board of Directors of the filing organization are appointed by the sole member, AHSSHC, who has the right to elect, appoint or remove any member of the Board of Directors of the filing organization.
	Form 990, Part VI, Section A, line 7b	AHSSHC, as the sole member of the filing organization, has certain reserved powers as set forth in the Bylaws of the filing organization. These reserved powers include the following: a) to approve and disapprove the executive and/or administrative leadership of the filing organization, and their salaries; b) to approve and disapprove the operating Bylaws of the filing organization; c) to set limits and terms for the borrowing of funds; d) to approve or disapprove major building programs and/or purchase or sale of personal property or real property equal to or in excess of One Million dollars; e) to approve or disapprove the annual operating and capital budgets of the filing organization; f) to direct the placement of funds and capital of the filing organization; and g) to establish general guiding policies.
	Form 990, Part VI, Section B, line 11	The filing organization's current year Form 990 was reviewed by the Senior Vice President of Finance prior to its filing with the IRS. The review conducted by the Senior Vice President of Finance did not include the review of any supporting workpapers that were used in preparation of the current year Form 990, but did include a review of the entire Form 990 and all supporting schedules.
	Form 990, Part VI, Section B, line 12c	The Conflict of Interest Policy of the filing organization applies to members of its Board of Directors and its principal officers (to be known as Interested Persons). In connection with any actual or possible conflict of interests, any member of the Board of Directors of the filing organization or any principal officer of the filing organization (i.e. Interested Persons) must disclose the existence of any financial interest with the filing organization and must be given the opportunity to disclose all material facts concerning the financial interest/arrangement to the Board of Directors of the filing organization or to any members of a committee with board delegated powers that is considering the proposed transaction or arrangement. Subsequent to any disclosure of any financial interest/arrangement and all material facts, and after any discussion with the relevant Board member or principal officer, the remaining members of the Board of Directors or committee with board delegated powers shall discuss, analyze, and vote upon the potential financial interest/arrangement to determine if a conflict of interest exists. According to the filing organization's Conflict of Interest Policy, an Interested Person may make a presentation to the Board of Directors (or committee with board delegated powers), but after such presentation, shall leave the meeting during the discussion of, and the vote on, the transaction or arrangement that results in a conflict of interest. Each Interested Person, as defined under the filing organization's Conflict of Interest Policy, shall annually sign a statement which affirms that such person has received a copy of the Conflict of Interests policy, has read and understands the policy, has agreed to comply with the policy, and understands that the filing organization is a charitable organization that must primarily engage in activities which accomplish one or more of its exempt purposes. The filing organization's Conflict of Interest Policy also requires that periodic reviews shall be conducted to ensure that the filing organization operates in a manner consistent with its charitable purposes.
	Form 990, Part VI, Section B, line 15	The top-tier parent of the filing organization is Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the parent organization of a healthcare system, known as Adventist Health System, that operates hospitals, nursing home facilities, and other healthcare provider organizations. AHSSHC is exempt from federal income tax under IRC Section 501(c)(3) pursuant to a group ruling issued to the General Conference of Seventh-day Adventists. The individuals who serve as the CEO, CFO or key employees of the filing organization are compensated by AHSSHC. Compensation and benefits provided to these individuals is determined pursuant to policies, procedures, and processes of AHSSHC that are designed to ensure compliance with the intermediate sanctions laws as set forth in IRC Section 4958. AHSSHC has taken steps to ensure that processes are in place to satisfy the rebuttable presumption of reasonableness standard as set forth in Treasury Regulation 53.4958-6 with respect to its active executive-level positions. The AHSSHC Board Strategy and Compensation Committee (the Committee) serves as the governing body for all executive compensation matters. The Committee is composed of certain members of the Board of Directors (the Board) of AHSSHC. Voting members of the Committee include only individuals who serve on the Board as independent representatives of the community, who hold no employment positions with AHSSHC and who do not have relationships with any of the individuals whose compensation is under their review that impacts their best independent judgment as fiduciaries of AHSSHC. The Committee's role is to review and approve all components of the executive compensation plan of AHSSHC. As an independent governing body with respect to executive compensation, it should be noted that the Committee will often confer in executive sessions on matters of compensation policy and policy changes. In such executive sessions, no members of management of AHSSHC are present. The Committee is advised by an independent third party compensation advisor. This advisor prepares all the benchmark studies for the Committee. Compensation levels are benchmarked with a national peer group of other not-for-profit healthcare systems and hospitals of similar size and complexity to AHS and each of its affiliated entities. The following principles guide the establishment of individual executive compensation: - The salary of the President/CEO of AHS will not exceed the 40th percentile of comparable salaries paid by similarly situated organizations; and - Other executive salaries shall be established using market medians. The compensation philosophy, policies, and practices of AHSSHC are consistent with the organization's faith-based mission and conform to applicable laws, regulations, and business practices. As a faith-based organization sponsored by the Seventh-day Adventist Church (the Church), AHSSHC's philosophy and principles with respect to its executive compensation practices reflect the conservative approach of the Church's mission of service and were developed in counsel with the Church's leadership.
	Form 990, Part VI, Section C, line 19	As discussed in our response to Question 15a & b in Section B of this Part VI, the filing organization is a part of the system of healthcare organizations known as Adventist Health System (AHS). Each year, AHS publishes an annual report document that includes a financial report for the relevant year as well as a community benefit report. The financial report and community benefit report are presented on a consolidated basis and represent all of the activities, results of operations, and financial position at year-end of the entire AHS system. In addition, the audited consolidated financial statements of AHS and of the AHS "Obligated Group" are filed annually with the Municipal Securities Rulemaking Board (MSRB). The "Obligated Group" is a group of AHSSHC subsidiaries that are jointly and severally liable under a Master Trust Indenture that secures debt primarily issued on a tax-exempt basis. Unaudited quarterly financial statements prepared in accordance with Generally Accepted Accounting Principles (GAAP) are also filed with MSRB for AHS on a consolidated basis and for the grouping of AHS subsidiaries comprising the "Obligated Group". The filing organization does not generally make its governing documents or conflict of interest policy available to the public.
Columns (E) & (F)	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 for Don Jernigan, Lars Houmann, Richard Reiner, and Terry Shaw, were provided in conjunction with that person's responsibilities and roles in serving in an executive leadership position within Adventist Health System (AHS). Don Jernigan, Richard Reiner,and Terry Shaw devote approximately 50 hours per week in conjunction with serving in their respective executive leadership position within AHS. Lars Houmann devotes approximately 35 hours a week to the filing organization and the remainder of time is devoted to his leadership position within AHS.
Changes in Net Assets or Fund Balances:	Form 990, Part XI, line 9:	Transfer to tax-exempt affiliates -52,239,627. Transfer to tax-exempt parent -15,672,193. Donated Property 3,150,375. Income on restricted fund balance 14,767. SWAP loss amortization 3,696,663. Allocations from Tax-exempt Parent with respect to Debt 78,693,889. Transfer for expenses -933,752. Gifts 4,766,891. Other -135,536. Interest in Foundation 343,277. Net assets received upon transfer of membership interest in THH (51%) 27,900,000. Investment in Texas Health Huguley (49%) 32,915,860. Transfer of assets to Texas Health Huguley -54,111,672. Transfer of permanently restricted to Texas Health Huguley -1,413,027. Transfer from Restricted 10,160. Partnership income recorded for tax 87,318. Rounding 1.
Savings and temporary cash investments	Part X, Line 2	The amounts shown on line 2 of Part X of this return include the filing organization's interest in a central investment pool maintained by Adventist Health System Sunbelt Healthcare Corporation, the filing organization's top-tier parent. The investments in the central investment pool are recorded at market value.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2012

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

2012

Open to Public Inspection

Name of the organization

Adventist Health SystemSunbelt Inc

Employer identification number

59-1479658

Part I

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

(a) Name, address, and EIN (if applicable) 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
(1) Florida Radiology Imaging at Lake Mary LLC 875 Concourse Parkway 150 Maitland,FL32751 55-0789387	Imaging & Testing	FL	16,835,998	7,551,380	Adventist Health SystemSunbelt Inc

Part II

Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" to 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 entity?
(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 Hlth SystemSunbelt Inc	Yes
(2) Adventist Care Centers - Courtland Inc 730 Courtland Street Orlando,FL32804 20-5774723	Operation of Home for the Aged/Hlthcare Delivery	FL	501(c)(3)	509(a)(2)	Sunbelt Hlth 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 Hlth SystemSunbelt Inc	Yes
(4) Adventist Hlth Mid-America Inc 9100 W 74th Street Shawnee Mission,KS66204 52-1347407	Hlthcare Related Services	KS	501(c)(3)	509(a)(3) Type I	Adventist Hlth SystemSunbelt Inc	Yes
(5) Adventist Hlth 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 Hlth System Affiliated Benefit Trust 900 Hope Way Altamonte Springs,FL32714 26-6422966	Promotion of Hlthcare	FL	501(c)(3)	509(a)(3) Type I	Adventist Hlth System Sunbelt Hlthcare Corp		No
(7) Adventist Hlth System Sunbelt Hlthcare Corp 900 Hope Way Altamonte Springs,FL32714 59-2170012	Management Services	FL	501(c)(3)	509(a)(3) Type I	N/A		No
(8) Adventist Hlth 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 Hlth System Sunbelt Hlthcare Corp		No
(9) Adventist Hlth SystemSunbelt Inc 900 Hope Way Altamonte Springs,FL32714 59-1479658	Operation of Hospital & Related Services	FL	501(c)(3)	170(b)(1)(A)(iii)	Adventist Hlth System Sunbelt Hlthcare Corp		No
(10) Adventist Hlth SystemTexas Inc 602 Courtland Street Orlando,FL32804 74-2578952	Leasing Personnel to Affiliated Hospital	TX	501(c)(3)	509(a)(3) Type III	Adventist Hlth System Sunbelt Hlthcare Corp		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 Hlth SystemSunbelt Inc	Yes
(12) Adventist University 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 Hlth SystemSunbelt Inc	Yes
(13) AHS Midwest Management Inc 1000 Remington Blvd Ste 200 Bolingbrook,IL60440 36-3354567	Operation of Physician Practice Mgmt	IL	501(c)(3)	509(a)(3) Type I	Adventist Hlth SystemSunbelt Inc	Yes
(14) 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 Hlth System Sunbelt Hlthcare Corp		No
(15) Apopka Hlth 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 Hlth Care Centers Inc		No
(16) Battle Creek Adventist Hospital 1000 Remington Blvd Ste 200 Bolingbrook,IL60440 38-1359189	Inactive	MI	501(c)(3)	170(b)(1)(A)(iii)	Adventist Hlth SystemSunbelt Inc	Yes
(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 Hlth Foundation		No
(18) Bradford Heights Hlth & Rehab Center Inc 950 Highpoint Drive Hopkinsville,KY42240 20-5782342	Operation of Home for the Aged/Hlthcare Delivery	KY	501(c)(3)	509(a)(2)	Sunbelt Hlth Care Centers Inc		No
(19) Burleson Nursing & Rehab Center Inc 301 Huguley Blvd Burleson,TX76028 20-5782243	Operation of Home for the Aged/Hlthcare Delivery	TX	501(c)(3)	509(a)(2)	Sunbelt Hlth Care Centers Inc		No
(20) Caldwell Hlth 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 Hlth Care Centers Inc		No
(21) Central Texas Hlthcare Collaborative 1301 Wonder World Drive San Marcos,TX78666 45-3739929	Support Operation of Hospital	TX	501(c)(3)	509(a)(3) Type I	Adventist Hlth SystemSunbelt Inc	Yes
(22) Cedar Crag Terrace Inc (630 Year End) Rt 5 Box 900 Manchester,KY40962 61-1120442	Operation of Home for the elderly-disabled	KY	501(c)(3)	170(b)(1)(A)(vi)	Memorial Hospital Inc		No
(23) 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 Hlth SystemSunbelt Inc	Yes
(24) Chickasaw Hlth 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 Hlth Care Centers Inc		No
(25) 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 Hlth SystemSunbelt Inc	Yes
(26) 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
(27) Courtland Hlth 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 Hlth Care Centers Inc		No
(28) Creekwood Place Nursing & Rehab Center Inc 683 E Third Street Russellville,KY42276 20-5782260	Operation of Home for the Aged/Hlthcare Delivery	KY	501(c)(3)	509(a)(2)	Sunbelt Hlth Care Centers Inc		No
(29) Dairy Road Hlth 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 Hlth Care Centers Inc		No
(30) East Orlando Hlth & Rehab Center Inc 250 S Chickasaw Trail Orlando,FL32825 20-5774748	Operation of Home for the Aged/Hlthcare Delivery	FL	501(c)(3)	509(a)(2)	Sunbelt Hlth Care Centers Inc		No
(31) 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 Hlth SystemSunbelt Inc	Yes
(32) 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 Hlth System Sunbelt Hlthcare Corp		No
(33) FLNC Inc 3355 E Semoran Blvd Apopka,FL32703 20-5774761	Operation of Home for the Aged/Hlthcare Delivery	FL	501(c)(3)	509(a)(2)	Sunbelt Hlth Care Centers 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 Hlth System Sunbelt Hlthcare Corp		No
(35) 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 Hlth SystemSunbelt Inc	Yes
(36) Florida Hospital 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 Hlth SystemSunbelt Inc	Yes
(37) 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
(38) 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 Hlth Foundation		No
(39) 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 Hlth System Sunbelt Hlthcare Corp		No
(40) Helen Ellis Memorial Hospital Auxiliary Inc 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
(41) Helen Ellis Memorial Hospital Foundation Inc 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
(42) 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 Hlth Foundation		No
(43) Huguley Community Care Corp 11801 South Freeway Burleson,TX76028 45-2793120	Support Operation of Hospital	TX	501(c)(3)	509(a)(3) Type I	Adventist Hlth SystemSunbelt Inc	Yes
(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 Hlth 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 Hlth System Sunbelt Hlthcare Corp		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 Hlth Foundation		No
(47) Memorial Hlth 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 Hlth Systems Inc		No
(48) Memorial Hlth 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 Hlth SystemSunbelt Inc	Yes
(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 Hlth 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 Hlth 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 Hlth System Sunbelt Hlthcare Corp		No
(52) Merriam Hlth 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 Hlth 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 Hlth System Sunbelt Hlthcare Corp		No
(54) Metroplex Clinic Physicians Inc 2201 S Clear Creek Road Killeen,TX76549 11-3762050	Physician Hlthcare services to the community	TX	501(c)(3)	170(b)(1)(A)(iii)	Metroplex Adventist Hospital Inc		No
(55) Metroplex Hospital Inc (1023-123112) 900 Hope Way Altamonte Springs,FL32714 46-1256516	Future Operation of Hospital & Related Svcs	FL	501(c)(3)	170(b)(1)(A)(iii)	Adventist Hlth System Sunbelt Hlthcare Corp		No
(56) Midwest Hlth 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
(57) Mills Hlth & Rehab Center Inc 500 Beck Lane Mayfield,KY42066 20-5782320	Operation of Home for the Aged/Hlthcare Delivery	KY	501(c)(3)	509(a)(2)	Sunbelt Hlth Care Centers Inc		No
(58) 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 Hlth Care Centers Inc		No
(59) Mission Strategies of Georgia Inc 3949 S Cobb Drive Smyrna,GA30080 90-0866024	Provision of support to the nursing home division	GA	501(c)(3)	509(a)(3) Type II	Sunbelt Hlth Care Centers Inc		No
(60) Missouri Adventist Hlth Inc 9100 W 74th Street Shawnee Mission,KS66204 43-1224729	Support Hlth Care Services	MO	501(c)(3)	509(a)(3) Type III-O	Adventist Hlth Mid-America Inc		No
(61) 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
(62) 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 Hlth Systems Inc		No
(63) Overland Park Nursing & Rehab Center Inc 6501 West 75th Street Overland Park,KS66204 20-5774821	Operation of Home for the Aged/Hlthcare Delivery	KS	501(c)(3)	509(a)(2)	Sunbelt Hlth Care Centers Inc		No
(64) Paragon Hlth 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 Hlth Care Centers Inc		No
(65) Pasco-Pinellas Hillsborough Community Hlth System Inc 2400 Bedford Road Orlando,FL32803 20-8488713	Operation of Hospital & Related Services	FL	501(c)(3)	170(b)(1)(A)(iii)	N/A		No
(66) Portercare Adventist Hlth 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 Hlth System Sunbelt Hlthcare Corp		No
(67) Portland Nursing & Rehab Center Inc 215 Highland Circle Drive Portland,TN37148 20-5774842	Operation of Home for the Aged/Hlthcare Delivery	TN	501(c)(3)	509(a)(2)	Sunbelt Hlth Care Centers Inc		No
(68) Princeton Hlth & Rehab Center Inc 1333 West Main Princeton,KY42445 20-5782272	Operation of Home for the Aged/Hlthcare Delivery	KY	501(c)(3)	509(a)(2)	Sunbelt Hlth Care Centers Inc		No
(69) Princeton Professional Services Inc 601 E Rollins Street Orlando,FL32803 59-1191045	Provision of Hlthcare Services	FL	501(c)(3)	509(a)(2)	Adventist Hlth System Sunbelt Hlthcare Corp		No
(70) Quality Circle for Hlthcare Inc 900 Hope Way Altamonte Springs,FL32714 26-3789368	Hlthcare Quality Services	FL	501(c)(3)	509(a)(3) Type III-F	Adventist Hlth System Sunbelt Hlthcare Corp		No
(71) 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 Hlth Care Centers Inc		No
(72) Rocky Mountain Adventist Hlthcare 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 Hlth System		No
(73) Rollins Bedford Corp 602 Courtland Street Ste 200 Orlando,FL32804 37-0908840	Inactive	FL	501(c)(3)	509(a)(3) Type II	Sunbelt Hlth Care Centers Inc		No
(74) Rollins Brook Community Care Corp (1120-123112) 2201 S Clear Creek Road Killeen,TX76549 46-1656773	Inactive	TX	501(c)(3)		Metroplex Adventist Hospital Inc		No
(75) Russellville Hlth 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 Hlth Care Centers Inc		No
(76) San Marcos Hlth 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 Hlth Care Centers Inc		No
(77) San Marcos Nursing & Rehab Center Inc 1900 Medical Parkway San Marcos,TX78666 20-5782224	Operation of Home for the Aged/Hlthcare Delivery	TX	501(c)(3)	509(a)(2)	Sunbelt Hlth Care Centers Inc		No
(78) Shawnee Mission Hlth 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 Hlth Care Centers Inc		No
(79) 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 Hlth Mid-America Inc		No
(80) South Central Nursing Homes Properties Inc 900 Hope Way Altamonte Springs,FL32714 59-3686109	Management Support	GA	501(c)(3)	509(a)(3) Type III-O	South Central Inc		No
(81) 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
(82) South Central Properties III Inc 900 Hope Way Altamonte Springs,FL32714 59-3692860	Real Estate	GA	501(c)(2)		South Central Nursing Homes Properties Inc		No
(83) South Central Properties IV Inc 900 Hope Way Altamonte Springs,FL32714 59-3692862	Real Estate	GA	501(c)(2)		South Central Nursing Homes Properties Inc		No
(84) South Central Properties VI Inc 900 Hope Way Altamonte Springs,FL32714 59-3692857	Real Estate	GA	501(c)(2)		South Central Nursing Homes Properties Inc		No
(85) South Central Properties Inc 900 Hope Way Altamonte Springs,FL32714 59-3651692	Real Estate	GA	501(c)(2)		South Central Nursing Homes Properties Inc		No
(86) 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
(87) South Pasco Hlth 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 Hlth Care Centers Inc		No
(88) Southwest Volusia Hlth 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 Hlthcare Corp		No
(89) Southwest Volusia Hlthcare Corp 1055 Saxon Blvd Orange City,FL327638468 59-3149293	Operation of Hospital & Related Services	FL	501(c)(3)	170(b)(1)(A)(iii)	Adventist Hlth SystemSunbelt Inc	Yes
(90) Specialty Physicians of Central Texas Inc 1301 Wonder World Drive San Marcos,TX78666 20-8814408	Physician Hlthcare services to the community	TX	501(c)(3)	170(b)(1)(A)(iii)	Adventist Hlth SystemSunbelt Inc	Yes
(91) Spring View Hlth & Rehab Center Inc 718 Goodwin Lane Leitchfield,KY42754 20-5782288	Operation of Home for the Aged/Hlthcare Delivery	KY	501(c)(3)	509(a)(2)	Sunbelt Hlth Care Centers Inc		No
(92) Sunbelt Hlth & Rehab Center - Apopka Inc 305 East Oak Street Apopka,FL32703 20-5774856	Operation of Home for the Aged/Hlthcare Delivery	FL	501(c)(3)	509(a)(2)	Sunbelt Hlth Care Centers Inc		No
(93) Sunbelt Hlth Care Centers Inc 602 Courtland Street Ste 200 Orlando,FL32804 58-1473135	Management Services	TN	501(c)(3)	509(a)(3) Type II	Adventist Hlth System Sunbelt Hlthcare Corp		No
(94) SunSystem Development Corp 900 Hope Way Altamonte Springs,FL32714 59-2219301	Fund Raising for Affiliated Tax-Exempt Hospitals	FL	501(c)(3)	170(b)(1)(A)(vi)	Adventist Hlth System Sunbelt Hlthcare Corp		No
(95) Tarpon Springs Hospital Foundation Inc 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
(96) Tarrant County Hlth 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 Hlth Care Centers Inc		No
(97) Taylor Creek Hlth 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 Hlth Care Centers Inc		No
(98) Texas Hlth Huguley Inc (11-43012) 900 Hope Way Altamonte Springs,FL32714 45-2694620	Operation of Hospital & Related Services	FL	501(c)(3)	170(b)(1)(A)(iii)	Adventist Hlth SystemSunbelt Inc	Yes
(99) 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
(100) Trinity Nursing & Rehab Center Inc 9700 West 62nd Street Merriam,KS66203 20-5774890	Operation of Home for the Aged/Hlthcare Delivery	KS	501(c)(3)	509(a)(2)	Sunbelt Hlth Care Centers Inc		No
(101) University Community Hospital Auxiliary Inc 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
(102) University Community Hospital Foundation Inc 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
(103) University Community Hospital Specialty Care Inc 3100 E Fletcher Ave Tampa,FL33613 59-3231322	Inactive	FL	501(c)(3)	509(a)(3)	University Community Hospital Inc		No
(104) University Community Hospital Inc 3100 E Fletcher Ave Tampa,FL33613 59-1113901	Operation of Hospital & Related Services	FL	501(c)(3)	170(b)(1)(A)(iii)	Adventist Hlth System Sunbelt Hlthcare Corp		No
(105) West Kentucky Hlth 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 Hlth Care Centers Inc		No
(106) Zephyr Haven Hlth & Rehab Center Inc 38250 A Avenue Zephyrhills,FL33542 20-5774930	Operation of Home for the Aged/Hlthcare Delivery	FL	501(c)(3)	509(a)(2)	Sunbelt Hlth Care Centers Inc		No
(107) Zephyrhills Hlth & Rehab Center Inc 7350 Dairy Road Zephyrhills,FL33540 20-5774967	Operation of Home for the Aged/Hlthcare Delivery	FL	501(c)(3)	509(a)(2)	Sunbelt Hlth Care Centers Inc		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2012

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(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?		(k) Percentage ownership
(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) Huguley Surgery Ctr LLP (11-4112) 15305 Dallas Pkwy Ste 1600 LB 28 Addison,TX75001 20-0910694	Outpatient Surgery	TX	Adventist Hlth SysSunbeltIncdba Huguley Mem Med Ctr	Unrelated	147,276			No			No	64.100 %
(6) KCCCSMMC Cancer Center LLC 9100 W 74th Street Shawnee Mission,KS66204 27-0909763	Equipment Rental	KS	N/A
(7) PAHSUSP Surgery Centers LLC 15305 Dallas Pkwy Ste 1600 LB 28 Addison,TX75010 26-3057950	Medical Services	CO	N/A
(8) Shawnee Mission Open MRI LLC 9100 W 74th Street Box 2923 Shawnee Mission,KS66201 27-0011796	Imaging & Testing	KS	N/A
(9) Skyland MRI LLC (11-12012) 100 Hospital Drive Hendersonville,NC28792 04-3646559	Imaging & Testing	KS	N/A

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" to 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)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(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)	(f) Share of total income	(g) Share of end-of-year assets		Yes	No
(1) Altamonte Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando,FL32803 59-2855792	Condo Association	FL	Adventist Hlth SystemSunbelt Inc	C	119,895	52,012	58.000 %	Yes
(2) Apopka Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando,FL32803 59-3000857	Condo Association	FL	Adventist Hlth SystemSunbelt Inc	C	27,833	10,789	89.000 %	Yes
(3) Arapahoe Medical Building I Inc (7111-12512) 2525 S Downing Street Denver,CO80210 84-1574506	Real Estate Leasing	CO	N/A	C					No
(4) Arapahoe Medical Building II Inc (7111-12512) 2525 S Downing Street Denver,CO80210 84-1574507	Real Estate Leasing	CO	N/A	C					No
(5) CC MOB Inc 2201 S Clear Creek Road Killeen,TX76549 74-2616875	Real Estate Rental	TX	N/A	C					No
(6) Central Texas Medical Associates 1301 Wonder World Drive San Marcos,TX78666 74-2729873	Physician Clinics	TX	Adventist Hlth SystemSunbelt Inc	C			100.000 %	Yes
(7) Central Texas Provider's Network 1301 Wonder World Drive San Marcos,TX78666 74-2827652	Physician Hospital Org.	TX	Adventist Hlth SystemSunbelt Inc	C	33,805	124,202	100.000 %	Yes
(8) Florida Hospital Flagler Medical Offices Association Inc 60 Memorial Medical Parkway Palm Coast,FL32164 26-2158309	Condo Association	FL	N/A	C					No
(9) Florida Hospital Healthcare System Inc 602 Courtland Street Orlando,FL32804 59-3215680	PHO/TPA	FL	Adventist Hlth SystemSunbelt Inc	C	133,626,876	50,877,327	100.000 %	Yes
(10) Florida Hospital Wesley Chapel Inc (11-51512) 900 Hope Way Altamonte Springs,FL32714 20-3965753	Inactive	FL	N/A	C					No
(11) Florida Medical Plaza Condo Association Inc 601 East Rollins Street Orlando,FL32803 59-2855791	Condo Association	FL	Adventist Hlth SystemSunbelt Inc	C	530,818	33,376	78.000 %	Yes
(12) Florida Memorial Health Network Inc 770 W Granada Blvd Ste 317 Ormond Beach,FL32174 59-3403558	Physician Hospital Org.	FL	N/A	C					No
(13) Harvard Park East Inc (7111-12512) 2525 S Downing Street Denver,CO80210 84-1574365	Real Estate Leasing	CO	N/A	C					No
(14) Helen Ellis Memorial Hospital Real Estate Corp (11-101912) 1395 S Pinellas Ave Tarpon Springs,FL34689 59-3375731	Real Estate Rental	FL	N/A	C					No
(15) Huguley Alliance Foundation 11801 South Freeway Fort Worth,TX76115 75-2642209	Inactive	TX	Adventist Hlth SystemSunbelt Inc	C		136,191	100.000 %	Yes
(16) Huguley Medical Associates Inc (11-43012) 11801 South Freeway Burleson,TX76028 75-2547668	Physician Clinics	TX	Adventist Hlth SystemSunbelt Inc	C	12,908,443	503,254	100.000 %	Yes
(17) Kissimmee Multispecialty Clinic Condominium Association Inc 201 Hilda Street Suite 30 Kissimmee,FL34741 59-3539564	Condo Association	FL	Adventist Hlth SystemSunbelt Inc	C	43,474	29,979	54.400 %	Yes
(18) Midwest Management Services Inc 9100 West 74th Street Shawnee Mission,KS66204 48-0901551	Real Estate Rental	KS	N/A	C					No
(19) Metroplex Adventist Hospital CRNA 2201 S Clear Creek Road Killeen,TX76549 26-0760794	Support hospital - provide allied health professionals	TX	N/A	C					No
(20) North American Health Services Inc & Subs 111 N Orlando Avenue Winter Park,FL32789 62-1041820	Lessor/Holding Co.	TN	N/A	C					No
(21) Ormond Professional Condo Association (430 Year End) 770 W Granada Blvd Ste 101 Ormond Beach,FL32174 59-2694434	Condo Association	FL	N/A	C					No
(22) Park Ridge Property Owner's Association Inc 1 Park Place Naples Road Fletcher,NC28732 03-0380531	Condo Association	NC	N/A	C					No
(23) Porter Affiliated Hlth Services Inc dba Diversified Affiliated Hlth Svcs 2525 S Downing Street Denver,CO80210 84-0956175	Healthcare Services	CO	N/A	C					No
(24) Porter Medical Plaza Inc (7111-12512) 2525 S Downing Street Denver,CO80210 84-1574369	Real Estate Leasing	CO	N/A	C					No
(25) San Marcos Regional MRI Inc 1301 Wonder World Drive San Marcos,TX78666 77-0597968	Holding Company	TX	Adventist Hlth SystemSunbelt Inc	C	3,021	7,348	100.000 %	Yes
(26) The Garden Retirement Community Inc 602 Courtland Street Ste 200 Orlando,FL32804 59-3414055	Real Estate Rental	FL	N/A	C					No
(27) University Community Health Insurance Company SPC Ltd C/O AON Insurance Managers PO Box Grand Cayman CJ	Captive Insurance	CJ	N/A	C					No
(28) UCH Services Inc 3100 East Fletcher Ave Tampa,FL33613 59-3508454	Management Company	FL	N/A	C					No
(29) West Coast Medical Group Inc (11-101912) 1395 S Pinellas Ave Tarpon Springs,FL34689 59-3537305	Physician Clinics	FL	N/A	C					No
(30) Winter Park Medical Office Building I Condo Assoc Inc 200 Lakemont Ave Winter Park,FL32792 45-2228478	Physician Clinics	FL	Adventist Hlth SystemSunbelt Inc	C	137,632	3,722	52.000 %	Yes

Schedule R (Form 990) 2012

Page 3

Part V

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

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

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 or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

Yes

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

Yes

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

Yes

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

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

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

Yes

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

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

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

Yes

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-s)	(c) Amount involved	(d) Method of determining amount involved
(1) Adventist Health System Sunbelt Healthcare Corporation	B	15,672,193	Actual Amount Given
(2) Adventist Health System Sunbelt Healthcare Corporation	M	21,632,553	% of Facility's Operating Exp
(3) Adventist Health System Sunbelt Healthcare Corporation dba AHSIS	M	19,481,435	% of Facility's Operating Exp
(4) Adventist Health System Sunbelt Healthcare Corporation	P	138,787,765	Cost
(5) Adventist Health System Sunbelt Healthcare Corporation	Q	1,500,000	Cost
(6) Adventist Health System Sunbelt Healthcare Corp dba Sunbelt Medical Mgmt	J	84,791	Cost
(7) Adventist Health System Sunbelt Healthcare Corp dba Sunbelt Medical Mgmt	P	290,947	Cost
(8) Adventist Health System Sunbelt Healthcare Corp dba Sunbelt Medical Mgmt	Q	325,814	Cost
(9) Adventist Bolingbrook Hospital	L	988,040	Cost
(10) Adventist Bolingbrook Hospital	P	127,858	Cost
(11) Adventist Bolingbrook Hospital	Q	80,095	Cost
(12) Adventist Care Centers Courtland Inc	B	218,100	Actual Amount Given
(13) Adventist GlenOaks Hospital	L	1,727,393	Cost
(14) Adventist GlenOaks Hospital	Q	85,877	Cost
(15) Adventist Health Partners Inc	J	124,244	FMV Rental Rate
(16) Adventist Health Partners Inc	L	499,753	Cost
(17) Adventist Health Partners Inc	P	2,088,736	Cost
(18) Adventist Health System Georgia Inc	L	1,085,752	Cost
(19) Adventist Hinsdale Hospital	L	1,509,050	Cost
(20) Adventist Hinsdale Hospital	P	23,544,882	Cost
(21) Adventist Hinsdale Hospital	Q	5,577,417	Cost
(22) Adventist University of Health Sciences	J	2,199,732	Cost
(23) Adventist University of Health Sciences	M	4,670,391	Cost
(24) Adventist University of Health Sciences	P	557,018	Cost
(25) Adventist University of Health Sciences	Q	15,927,668	Cost
(26) AHS Midwest Management Inc	B	4,215,557	Actual Amount Given
(27) AHS Midwest Management Inc	P	218,108	Cost
(28) AHSCentral Texas Inc	K	121,497	Cost
(29) AHSTexas Inc	R	1,967,751	Cost
(30) Central Texas Healthcare Collaborative	B	1,047,149	Actual Amount Given
(31) Central Texas Medical Center Foundation	B	77,441	Actual Amount Given
(32) Central Texas Medical Center Foundation	C	787,188	Actual Amount Received
(33) Central Texas Providers Network	Q	74,140	Cost
(34) East Orlando Health & Rehab Center Inc	B	1,404,864	Actual Amount Given
(35) East Orlando Health & Rehab Center Inc	Q	104,211	Cost
(36) Emory-Adventist Inc	A	657,618	FMV Interest Rate
(37) Emory-Adventist Inc	S	950,400	Principal Loan Amount
(38) Fletcher Hospital Inc	L	1,059,179	Cost
(39) FLNC Inc	B	2,199,240	Actual Amount Given
(40) Florida Hospital Healthcare System Inc	A	246,586	FMV Rental Rate
(41) Florida Hospital Healthcare System Inc	M	101,686,024	Claims Reimb Plus FMV Fee
(42) Florida Hospital Healthcare System Inc	Q	8,613,458	Cost
(43) Florida Hospital Medical Group Inc	J	4,605,221	FMV Rental Rate
(44) Florida Hospital Medical Group Inc	K	357,887	Cost
(45) Florida Hospital Medical Group Inc	L	796,341	Cost
(46) Florida Hospital Medical Group Inc	M	47,977,172	Cost Plus Appropriate %
(47) Florida Hospital Medical Group Inc	P	5,189,070	Cost
(48) Florida Hospital Medical Group Inc	Q	6,759,944	Cost
(49) Florida Hospital Waterman Inc	B	257,365	Actual Amount Given
(50) Florida Hospital Waterman Inc	L	2,135,272	Cost
(51) Florida Hospital Waterman Inc	Q	205,674	Cost
(52) Florida Hospital Zephyrhills Inc	L	1,673,525	Cost
(53) Florida Hospital Zephyrhills Inc	P	84,574	Cost
(54) Huguley Medical Associates Inc	A	198,030	FMV Rental Rate
(55) Huguley Medical Associates Inc	Q	72,184	Cost
(56) Huguley Medical Associates Inc	R	3,260,529	Cost
(57) Jellico Community Hospital Inc	L	1,117,833	Cost
(58) Johnson County Community Care Corporation	B	519,514	Actual Amount Given
(59) La Grange Memorial Hospital Foundation	B	293,533	Actual Amount Given
(60) La Grange Memorial Hospital Foundation	C	1,103,350	Actual Amount Received
(61) Memorial Health Systems Inc	C	410,000	Actual Amount Received
(62) Memorial Health Systems Inc	L	2,032,416	Cost
(63) Memorial Health Systems Inc	P	1,455,172	Cost
(64) Memorial Health Systems Inc	Q	103,212	Cost
(65) Memorial Hospital - Flagler Inc	L	1,618,763	Cost
(66) Memorial Hospital - Flagler Inc	Q	66,777	Cost
(67) Memorial Hospital - West Volusia Inc	L	1,791,904	Cost
(68) Memorial Hospital - West Volusia Inc	Q	135,371	Cost
(69) Memorial Hospital Inc	L	1,377,211	Cost
(70) Metroplex Adventist Hospital Inc	Q	284,844	Cost
(71) Princeton Professional Services Inc	J	232,774	Cost Plus Appropriate Margin
(72) Shawnee Mission Medical Center Inc	L	1,699,427	Cost
(73) South Central Nursing Homes Inc	C	2,500,000	Actual Amount Received
(74) Southwest Volusia Healthcare Corporation	L	1,746,955	Cost
(75) Southwest Volusia Healthcare Corporation	Q	170,597	Cost
(76) Specialty Physicians of Central Texas Inc	B	2,000,000	Actual Amount Given
(77) Specialty Physicians of Central Texas Inc	Q	935,853	Cost
(78) Sunbelt Health & Rehab Center Apopka Inc	B	450,000	Actual Amount Given
(79) Sunbelt Health Care Centers Inc	J	293,561	Cost
(80) Sunsystem Development Corporation	B	4,845,715	Actual Amount Given
(81) Sunsystem Development Corporation	C	6,264,728	Actual Amount Received
(82) Sunsystem Development Corporation	Q	2,965,843	Cost
(83) Sunsystem Development Corporation	R	4,969,235	Cost
(84) Tarpon Springs Hospital Foundation	L	68,998	Cost
(85) University Community Hospital Inc	L	3,778,411	Cost
(86) University Community Hospital Inc	Q	54,946	Cost

Schedule R (Form 990) 2012

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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)	(e) Are all partners section 501(c)(3) organizations?		(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 entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(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

Schedule R (Form 990) 2012

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:

1	Briefly describe the organization’s mission or most significant activities: Operation of 13 acute-care hospitals & related healthcare services.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	24
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	16
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ......	5	24,812
6	Total number of volunteers (estimate if necessary) .............	6	4,404
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	11,980,115
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	49,158

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	6,313,788	8,143,760
9	Program service revenue (Part VIII, line 2g) .........	2,899,300,597	3,052,566,284
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	25,573,839	32,324,587
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	5,264,364	22,908,437
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	2,936,452,588	3,115,943,068
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	14,980,749	23,414,566
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)	1,350,533,428	1,378,955,690
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	1,348,234,659	1,463,590,734
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	2,713,748,836	2,865,960,990
19	Revenue less expenses. Subtract line 18 from line 12.......	222,703,752	249,982,078
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	5,913,996,141	6,299,999,146
21	Total liabilities (Part X, line 26).............	3,954,358,511	4,064,813,224
22	Net assets or fund balances. Subtract line 21 from line 20.....	1,959,637,630	2,235,185,922

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 2,691,002,141 including grants of $ 23,414,566 ) (Revenue $ 3,060,931,959 )
	Operation of 13 acute care hospitals with 158,029 patient admissions, 744,132 patient days and 1,215,547 outpatient visits in the current year. In addition to hospital operations, the corporation provides medical care through a number of other activities such as urgent care centers, physician clinics, home health services, hospice services, sleep centers, wound centers, therapy and rehab.

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 expenses2,691,002,141

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	3,925,513	15,271,941	2,061,819

				(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
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d		6,397,990
e	Government grants (contributions)1e		1,344,621

f	All other contributions, gifts, grants, and similar amounts not included above1f		401,149

g	Noncash contributions included in lines 1a-1f:$		12,368
h	Total. Add lines 1a-1f.......			8,143,760
			Business Code
2a	Patient Revenue		900099	2,972,269,098	2,963,213,008	9,056,090
b	Management Fee		900099	23,610,897	22,861,771	749,126
c	Cafeteria/Vending Rev.		900099	19,646,318	19,210,185	436,133
d	Medical Office Building		531120	10,339,133	10,339,133
e	Education		900099	6,876,123	6,876,123
f	All other program service revenue .			19,824,715	18,875,374	949,341
g	Total. Add lines 2a–2f........			3,052,566,284
3	Investment income (including dividends, interest, and other similar amounts).......			13,567,527			13,567,527
4	Income from investment of tax-exempt bond proceeds..			468,130			468,130
5	Royalties...........			279,441			279,441
		(i) Real	(ii) Personal
6a	Gross rents	4,451,065	209,742
b	Less: rental expenses	1,587,978	198
c	Rental income or (loss)	2,863,087	209,544
d	Net rental income or (loss).......			3,072,631		789,425	2,283,206
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	17,704,540	4,449,404
b	Less: cost or other basis and sales expenses	0	3,865,014
c	Gain or (loss)	17,704,540	584,390
d	Net gain or (loss)..........			18,288,930			18,288,930
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ..
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
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	EHR Revenue		900099	13,690,266	13,690,266
b	Equity earnings from related enti		900099	5,728,259	5,728,259
c	Investment in Subs		900099	137,840	137,840
d	All other revenue ....
e	Total. Add lines 11a–11d ......			19,556,365
12	Total revenue. See Instructions......			3,115,943,068	3,060,931,959	11,980,115	34,887,234


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing .............			99,490	1	104,616
2	Savings and temporary cash investments .........			1,458,843,277	2	1,559,001,735
3	Pledges and grants receivable, net ...........				3
4	Accounts receivable, net .............			370,664,906	4	421,785,860
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6
7	Notes and loans receivable, net .............				7
8	Inventories for sale or use ..............			69,068,975	8	73,594,192
9	Prepaid expenses and deferred charges ..........			15,053,517	9	29,239,839
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	3,461,478,497
b	Less: accumulated depreciation .....	10b	1,684,128,752	1,773,627,027	10c	1,777,349,745
11	Investments—publicly traded securities ..........				11
12	Investments—other securities. See Part IV, line 11 .....			277,876,782	12	278,044,188
13	Investments—program-related. See Part IV, line 11 .....				13
14	Intangible assets ...............			11,840,997	14	34,901,310
15	Other assets. See Part IV, line 11 ...........			1,936,921,170	15	2,125,977,661
16	Total assets. Add lines 1 through 15 (must equal line 34)......			5,913,996,141	16	6,299,999,146
17	Accounts payable and accrued expenses .........			195,866,090	17	211,662,358
18	Grants payable .................				18
19	Deferred revenue ................				19
20	Tax-exempt bond liabilities .............			3,588,586,470	20	3,620,560,952
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Loans and other 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 (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................			169,905,951	25	232,589,914
26	Total liabilities. Add lines 17 through 25.........			3,954,358,511	26	4,064,813,224
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			1,956,618,834	27	2,233,704,874
28	Temporarily restricted net assets ...........			3,018,796	28	1,481,048
29	Permanently restricted net assets ...........				29
	Organizations that do not follow SFAS 117 (ASC 958), 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 ...........			1,959,637,630	33	2,235,185,922
34	Total liabilities and net assets/fund balances ........			5,913,996,141	34	6,299,999,146

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If “Yes,”the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926)......................................	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If “Yes,” the organizationmay be required to file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A).......................................	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471)..............................	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If "Yes," the organization may be required to file Form 8621, Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621)	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865)....................................	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see Instructions for Form 5713)................................................	Yes	No