TY 2013 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)	(F) Estimated amount of other compensation from the organization and related organizations
(1) RICHARD REINER........................................................................ VICE PRESIDENT/CHAIRMAN	1.00 .......................50.00	X	X			0	1,662,894	59,355
(2) TERRY SHAW........................................................................ ASST TREASURER/SECRETARY	1.00 .......................50.00	X	X			0	1,692,632	243,317
(3) ROBERT HENDERSCHEDT........................................................................ BOARD MEMBER	1.00 .......................50.00	X				0	1,185,775	164,296
(4) DAN ENDERSON........................................................................ SVP Chief Finance Officer	1.00 .......................0		X			0	0	0
(5) GARY CAMPBELL........................................................................ PRESIDENT/CEO	1.00 .......................0		X			0	0	0
(6) RANDY HAFFNER........................................................................ CEO-PORTER ADVENTIST HOSP	40.00 .......................0		X			849,782	0	241,292
(7) ANDREW GAASCH........................................................................ CFO-PORTER ADVENTIST HOSP	40.00 .......................0			X		345,372	0	47,538
(8) BRETT 58355 SPENST........................................................................ CEO-Littleton Adventist Hospital	40.00 .......................0			X		492,391	0	90,493
(9) CHERYL CURRY........................................................................ CFO-AVISTA ADVENTIST HOSP	40.00 .......................0			X		300,185	0	43,100
(10) DENNIS BARTS........................................................................ CEO - Avista Adventist Hospital	40.00 .......................0			X		246,887	0	10,055
(11) JOHN SACKETT........................................................................ CEO-avista adventist hospital	40.00 .......................0			X		158,484	0	27,328
(12) JONATHAN FISHER........................................................................ CFO -Parker Adventist Hospital	40.00 .......................0			X		214,617	0	35,158
(13) MORRE DEAN........................................................................ CEO-Parker Adventist Hosp	40.00 .......................0			X		480,448	0	122,690
(14) DAVID SCHRIER........................................................................ Physician	40.00 .......................0				X	760,421	0	45,945
(15) JOHN CAMPANA........................................................................ Physician	40.00 .......................0				X	721,337	0	45,019
(16) RAYMOND KIM........................................................................ Physician	40.00 .......................0				X	781,203	0	44,675
(17) ROBERT THOMAS........................................................................ PHYSICIAN	40.00 .......................0				X	941,320	0	40,907

(A) Name and business address	(B) Description of services	(C) Compensation
APP-UNIPATH6116 E WARREN AVEDENVERCO80222	MEDICAL SERVICES	2,715,120
SP III DENER-POTER LLC707 WESTCHESTER AVE 401AWHITE PLAINSNY106043151	CONSTRUCTION	2,547,548
CRITICAL CARE PULMONARY & SLEEP ASSOCIATES274 UNION BLVD SUITE 110LAKEWOODCO80228	PHYSICIAN SERVICES	1,727,102
OBSTETRIX MEDICAL GROUPPO BOX 281034ATLANTAGA30384	MEDICAL SERVICES	1,322,589
SUPPLEMENTAL HEALTH CARE1640 W REDSTONE CENTER DRIVE 200PARK CITYTX84098	TEMPORARY STAFFING	1,140,181
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 50

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	1,290,340	1,290,340
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	296,163,101	236,930,481	59,232,620
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	16,141,022	12,912,818	3,228,204
9	Other employee benefits .......	30,676,511	24,541,209	6,135,302
10	Payroll taxes ...........	20,326,189	16,260,951	4,065,238
11	Fees for services (non-employees):
a	Management ......	82,142,410	65,713,928	16,428,482
b	Legal .........	39,295		39,295
c	Accounting ...........	187,726		187,726
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	101,716,511	78,969,084	22,747,427	0
12	Advertising and promotion ....	3,289,576	2,631,661	657,915
13	Office expenses .......	18,652,269	14,167,969	4,484,300
14	Information technology ......	0
15	Royalties ..	0
16	Occupancy ...........	19,423,607	15,538,886	3,884,721
17	Travel ............	1,253,475	1,002,780	250,695
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	452,792	362,234	90,558
20	Interest ...........	14,716,564	14,716,564
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	53,192,603	42,554,082	10,638,521
23	Insurance ..............	3,533,999	2,827,199	706,800
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	STATE PROVIDER TAX	43,659,239	43,659,239
b	REPAIRS AND MAINTENANCE	12,986,824	10,389,459	2,597,365
c	MEDICAL SUPPLIES	168,013,267	168,013,267
d	BAD DEBTS	49,138,050	39,310,440	9,827,610
e	All other expenses	3,232,551	2,840,907	391,644	0
25	Total functional expenses. Add lines 1 through 24e	940,227,921	794,633,498	145,594,423	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).	0

Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............	654,163	1	2,230,184
2	Savings and temporary cash investments .........	21,593,387	2	39,301,890
3	Pledges and grants receivable, net ...........		3
4	Accounts receivable, net .............	111,801,820	4	125,813,285
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
		0	5	0
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
		0	6	0
7	Notes and loans receivable, net .............	2,570,749	7	4,278,068
8	Inventories for sale or use ..............	17,917,398	8	20,699,843
9	Prepaid expenses and deferred charges ..........	2,591,953	9	3,524,177
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	952,205,959
b	Less: accumulated depreciation .....	10b	362,542,664	568,490,402	10c	589,663,295
11	Investments—publicly traded securities ..........	0	11	0
12	Investments—other securities. See Part IV, line 11 .....	13,894,871	12	15,357,622
13	Investments—program-related. See Part IV, line 11 .....	463,983,942	13	440,699,160
14	Intangible assets ...............	88,149,186	14	88,074,186
15	Other assets. See Part IV, line 11 ...........	74,088,325	15	85,725,716
16	Total assets. Add lines 1 through 15 (must equal line 34)......	1,365,736,196	16	1,415,367,426
	17	Accounts payable and accrued expenses .........	71,719,303	17	81,549,962
18	Grants payable .................		18
19	Deferred revenue ................		19	1,424,064
20	Tax-exempt bond liabilities .............		20
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..........	0	22	0
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....................	396,722,682	25	386,372,562
26	Total liabilities. Add lines 17 through 25.........	468,441,985	26	469,346,588
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	897,190,355	27	945,916,982
28	Temporarily restricted net assets ...........	103,856	28	103,856
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 ...........	897,294,211	33	946,020,838
34	Total liabilities and net assets/fund balances ........	1,365,736,196	34	1,415,367,426

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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.
right arrow

Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

PORTERCARE ADVENTIST HEALTH SYSTEM

Employer identification number

84-0438224

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) 2013

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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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 2013 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2012 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2013. 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—2012. 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—2013. 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—2012. 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) 2013

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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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 2013 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2012 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2012 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2013. 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—2012. 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) 2013

Page 4

Part IV

Supplemental Information. 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) 2013

Additional Data

Software ID:	13000248
Software Version:	2013v3.1

- 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.

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Name of the organization

PORTERCARE ADVENTIST HEALTH SYSTEM

Employer identification number

84-0438224

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 for 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 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 its Form 990PF, Part I, line 2, 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) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 2

Name of organization PORTERCARE ADVENTIST HEALTH SYSTEM

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, RESTRICTEDRESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 3

Name of organization PORTERCARE ADVENTIST HEALTH SYSTEM

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) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 4

Name of organization
PORTERCARE ADVENTIST HEALTH SYSTEM

Employer identification number

84-0438224

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) (2013)

Additional Data

Software ID:	13000248
Software Version:	2013v3.1

- 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. SchCMd Bullet

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

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

PORTERCARE ADVENTIST HEALTH SYSTEM

Employer identification number

84-0438224

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) 2013

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) 2010	(b) 2011	(c) 2012	(d) 2013	(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) 2013

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)? ....

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

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

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

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

Yes

25,861

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

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

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

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

25,861

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

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.

Return Reference	Explanation
Schedule C, Part II-B, Line 1, Description of the activities reported on Lines 1a through 1i	LINE 1F ANNUAL DUES WERE PAID TO COLORADO HEALTH ASSOCIATION, A PORTION OF WHICH WERE ALLOCATED TO LOBBYING. THE AMOUNT THAT REPRESENTS THIS ENTITY'S SHARE OF THE ALLOCATED LOBBYING EXPENSE IS AS FOLLOWS: COLORADO HEALTH ASSOCIATION $25,861

Schedule C (Form 990 or 990EZ) 2013

Additional Data

Software ID:	13000248
Software Version:	2013v3.1

- 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. SchDMd Bullet

Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

PORTERCARE ADVENTIST HEALTH SYSTEM

Employer identification number

84-0438224

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

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

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and 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) 2013

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 ....
b	Contributions ........
c	Net investment earnings, gains, and losses
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

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)

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

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

Part VI

Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	1,247,156	68,299,790		69,546,946
b	Buildings ................		600,426,396	238,477,198	361,949,198
c	Leasehold improvements ............				0
d	Equipment ................		217,400,907	112,101,374	105,299,533
e	Other .................		64,831,710	11,964,092	52,867,618
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......					589,663,295

Schedule D (Form 990) 2013

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. 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. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) AHS INVESTMENT	439,467,197	F
(2) DSRF INVESTMENT	1,231,963	F







Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)	440,699,160

Part IX

Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) INVESTMENT IN UNCONSOLIDATED ORGANIZATIONS				51,886,157
(2) INTERCOMPANY RECEIVABLES				26,471,985
(3) DEPOSITS				868,213
(4) CURRENT PORTION OF AWUIL				2,240,780
(5) DEFERRED FINANCING COSTS				2,276,771
(6) MALPRACTICE RECOVERIES				1,981,810



Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				85,725,716

Part X

Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability		(b) Book value
Federal income taxes		0
INTERCOMPANY PAYABLES		370,758,723
ANNUITIES PAYABLE		92,500
CRT OBLIGATION		486,963
MALPRACTICE		12,812,434
PHYSICIAN LOAN FORGIVENESS		1,703,184
UNCLAIMED PROPERTY		16,030
ENVIRONMENTAL REMEDIATION		394,933
POST EMPLOYMENT BENEFITS		107,795

Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		386,372,562
2. Liability for uncertain tax positions 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) 2013

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
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. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
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

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.

Return Reference	Explanation
Schedule D, Part X, Line 2, FIN 48 (ASC 740) footnote	PORTERCARE ADVENTIST HEALTH SYSTEM'S FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF ADVENTIST HEALTH SYSTEM (AHS), A RELATED ORGANIZATION. AHS'S FIN 48 FOOTNOTE FOR THE YEAR ENDED DECEMBER 31, 2013 IS AS FOLLOWS: "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, 2013 AND 2012, 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, 2013 AND 2012, NAHS GENERATED TAXABLE INCOME OF APPROXIMATELY $500 AND $2,100, 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 SUSPENDED THE UTILIZATION OF NET OPERATING LOSS CARRYFORWARDS FOR THE YEAR ENDED DECEMBER 31, 2013, 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, 2013 AND 2012. NAHS ALSO HAS TEMPORARY DEDUCTIBLE DIFFERENCES OF APPROXIMATELY $65,000 AND $64,800 AT DECEMBER 31, 2013 AND 2012, RESPECTIVELY, PRIMARILY AS A RESULT OF NET OPERATING LOSS CARRYFORWARDS. AT DECEMBER 31, 2013, NAHS HAD NET OPERATING LOSS CARRYFORWARDS OF APPROXIMATELY $64,200, 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 $24,700 AND $24,600 AT DECEMBER 31, 2013 AND 2012, RESPECTIVELY. A FULL VALUATION ALLOWANCE HAS BEEN PROVIDED AT DECEMBER 31, 2013 AND 2012, 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. THERE WERE NO MATERICAL UNCERTAIN TAX POSITION AS OF DECEMBER 31, 2013 AND 2012."

Return Reference

Explanation

Schedule D, Part X, Line 2, FIN 48 (ASC 740) footnote

PORTERCARE ADVENTIST HEALTH SYSTEM'S FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF ADVENTIST HEALTH SYSTEM (AHS), A RELATED ORGANIZATION. AHS'S FIN 48 FOOTNOTE FOR THE YEAR ENDED DECEMBER 31, 2013 IS AS FOLLOWS: "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, 2013 AND 2012, 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, 2013 AND 2012, NAHS GENERATED TAXABLE INCOME OF APPROXIMATELY $500 AND $2,100, 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 SUSPENDED THE UTILIZATION OF NET OPERATING LOSS CARRYFORWARDS FOR THE YEAR ENDED DECEMBER 31, 2013, 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, 2013 AND 2012. NAHS ALSO HAS TEMPORARY DEDUCTIBLE DIFFERENCES OF APPROXIMATELY $65,000 AND $64,800 AT DECEMBER 31, 2013 AND 2012, RESPECTIVELY, PRIMARILY AS A RESULT OF NET OPERATING LOSS CARRYFORWARDS. AT DECEMBER 31, 2013, NAHS HAD NET OPERATING LOSS CARRYFORWARDS OF APPROXIMATELY $64,200, 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 $24,700 AND $24,600 AT DECEMBER 31, 2013 AND 2012, RESPECTIVELY. A FULL VALUATION ALLOWANCE HAS BEEN PROVIDED AT DECEMBER 31, 2013 AND 2012, 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. THERE WERE NO MATERICAL UNCERTAIN TAX POSITION AS OF DECEMBER 31, 2013 AND 2012."

Schedule D (Form 990) 2013

Additional Data

Software ID:	13000248
Software Version:	2013v3.1

- 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.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

PORTERCARE ADVENTIST HEALTH SYSTEM

Employer identification number

84-0438224

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		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(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) ..			14,372,260		14,372,260	1.610 %
b	Medicaid (from Worksheet 3, column a) ....			55,808,726		55,808,726	6.260 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .			9,113,496		9,113,496	1.020 %
d	Total Financial Assistance and Means-Tested Government Programs .	0	0	79,294,482	0	79,294,482	8.890 %
Other Benefits				7,885,544		7,885,544	0.880 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..			7,885,544		7,885,544	0.880 %
f	Health professions education (from Worksheet 5) ..			7,271		7,271	0 %
g	Subsidized health services (from Worksheet 6) ..			2,312,044		2,312,044	0.260 %
h	Research (from Worksheet 7)			4,535		4,535	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8)			1,398,712		1,398,712	0.160 %
j	Total. Other Benefits ..	0	0	11,608,106	0	11,608,106	1.300 %
k	Total. Add lines 7d and 7j .	0	0	90,902,588	0	90,902,588	10.190 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2013

Schedule H (Form 990) 2013

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.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue
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
8	Workforce development
9	Other
10	Total	0	0	0	0

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. ......

49,138,050

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. ......

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).....

213,522,470

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

288,632,419

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

-75,109,949

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 %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2013

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?5 Name, address, primary website address, and state license number							Other (Describe)
1	PARKER ADVENTIST HOSPITAL 9395 CROWN POINT BLVD PARKER,CO80138 WWW.PARKERHOSPITAL.ORG	X	X		X
2	LITTLETON ADVENTIST HOSPITAL 7700 S BROADWAY LITTLETON,CO80122 WWW.MYLITTLETONHOSPITAL.ORG	X	X		X	X	CHILDREN'S ER
3	PORTER ADVENTIST HOSPITAL 2525 S DOWNING ST DENVER,CO80210 WWW.PORTERHOSPITAL.ORG/	X	X	X	X
4	AVISTA ADVENTIST HOSPITAL 100 HEALTH PARK DRIVE LOUISVILLE,CO80027 WWW.AVISTAHOSPITAL.ORG	X	X		X
5	CASTLE ROCK ADVENTIST HOSPITAL 2350 MEADOWS BLVD CASTLE ROCK,CO80109 WWW.CASTLEROCKHOSPITAL.ORG	X	X		X

Schedule H (Form 990) 2013

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)

	PARKER ADVENTIST HOSPITAL
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility 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....................

Yes

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 12

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests 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 ....................

Yes

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

Yes

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

Yes

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

Hospital facility’s website (list url): www.parkerhospital.org

Other website (list url):

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 as of the end of the tax year):

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) 2013

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: 100% 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% 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	Residency
i	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 individual’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 Section C)
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 individual’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 Section C)

Schedule H (Form 990) 2013

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 individuals regarding the individuals’ bills

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

Other (describe in Section C)

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 individual 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 individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	LITTLETON ADVENTIST HOSPITAL
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility 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....................

Yes

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 12

Yes

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

Yes

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

Yes

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

Hospital facility’s website (list url): mylittletonhospital.org

Other website (list url):

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 as of the end of the tax year):

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 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) 2013

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: 100% 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% 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	Residency
i	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 individual’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 Section C)
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 individual’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 Section C)

Schedule H (Form 990) 2013

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 individuals regarding the individuals’ bills

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

Other (describe in Section C)

Policy Relating to Emergency Medical Care

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)

If "Yes," explain in Part VI.

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

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	PORTER ADVENTIST HOSPITAL
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility 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....................

Yes

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 12

Yes

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

Yes

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

Yes

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

Hospital facility’s website (list url): porterhospital.org

Other website (list url):

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 as of the end of the tax year):

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 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) 2013

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: 100% 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% 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	Residency
i	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 individual’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 Section C)
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 individual’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 Section C)

Schedule H (Form 990) 2013

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 individuals regarding the individuals’ bills

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

Other (describe in Section C)

Policy Relating to Emergency Medical Care

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)

If "Yes," explain in Part VI.

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

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	AVISTA ADVENTIST HOSPITAL
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility 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....................

Yes

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 12

Yes

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

Yes

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

Hospital facility’s website (list url): avistahospital.org

Other website (list url):

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 as of the end of the tax year):

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 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) 2013

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: 100% 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% 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	Residency
i	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 individual’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 Section C)
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 individual’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 Section C)

Schedule H (Form 990) 2013

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 individuals regarding the individuals’ bills

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

Other (describe in Section C)

Policy Relating to Emergency Medical Care

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)

If "Yes," explain in Part VI.

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

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	CASTLE ROCK ADVENTIST HOSPITAL
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility 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

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 (list url):

Other website (list url):

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 as of the end of the tax year):

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 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) 2013

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: 100% 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% 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	Residency
i	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 individual’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 Section C)
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 individual’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 Section C)

Schedule H (Form 990) 2013

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 individuals regarding the individuals’ bills

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

Other (describe in Section C)

Policy Relating to Emergency Medical Care

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)

If "Yes," explain in Part VI.

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

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

Page

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines 1j, 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provide separate descriptions for each facility in a facility reporting group, designated by "Facility A," "Facility B," etc.
Form and Line Reference	Explanation
Schedule H, Part V Sec B, Line 3, Community Served by Needs Assessment	(1) - PARKER ADVENTIST HOSPITAL: THE HOSPITAL RETAINED THE CENTER FOR HEALTH ADMINISTRATION AT THE UNIVERSITY OF COLORADO DENVER TO OBTAIN COMMUNITY INPUT. COMMUNITY PERSPECTIVES WERE GATHERED THROUGH TELEPHONE INTERVIEWS DURING FEBRUARY AND MARCH 2012. INTERVIEW QUESTIONS WERE PHRASED IN AN OPEN-ENDED MANNER SO THAT RESPONDENTS COULD IDENTIFY WHATEVER ISSUES WERE MOST IMPORTANT TO THEM. THEY WERE ALSO ASKED FOR IDEAS ON WAYS THAT THE HOSPITAL COULD ASSIST THEM IN IMPROVING THE HEALTH OF THEIR COMMUNITY. RESIDENTS WERE ALSO ASKED FOR IDEAS ON WAYS THAT THE HOSPITAL COULD ASSIST THEM IN IMPROVING THE HEALTH OF THEIR COMMUNITY. THE FOLLOWING ORGANIZATIONS WERE CHOSEN TO PROVIDE INPUT: CITY OF PARKER CROSSROADS COMMUNITY CHURCH PARKER CHAMBER OF COMMERCE PARKER POLICE DEPARTMENT PARKER SENIOR CENTER PARKER TASK FORCE FOOD BANK PONDEROSA HIGH SCHOOL SOUTH METRO FIRE RESCUE AUTHORITY TRI-COUNTY HEALTH DEPARTMENT WOMEN'S CRISIS AND FAMILY OUTREACH CENTER; (1) - LITTLETON ADVENTIST HOSPITAL: COMMUNITY MEMBERS WERE INTERVIEWED FOR THEIR PERSPECTIVES ON THE PREDOMINANT HEALTH ISSUES IN THEIR COMMUNITIES. THEY WERE INTERVIEWED IN EITHER A ONE-ON-ONE INTERVIEW FORMAT, FOCUS GROUP, OR AS PART OF A STEERING COMMITTEE. DATA WAS COLLECTED OVER THE PERIOD FROM JUNE 2011 TO JUNE 2012. THE INTERVIEWEES COMPRISED OF REPRESENTATIVES OF THE FOLLOWING GROUPS: LITTLETON FIRE DEPARTMENT- WAYNE ZYGOWICZ, EMS DIVISION CHIEF TRI-COUNTY DEPARTMENT OF HEALTH- PATTY BOYD, RD MPH, PROGRAM MANAGER ARAPAHOE DOUGLAS MENTAL HEALTH, LISA TRAUDT DOCTORS CARE- BEBE KLEINMAN, EXECUTIVE DIRECTOR HIGHLANDS RANCH COMMUNITY ASSOCIATION - JAMIE NOEBEL, COMMUNITY MANAGER HEALTHY COMMUNITIES GROUP OF CENTURA HEALTH'S SOUTH DENVER OPERATING GROUP -COLORADO WELLNESS - BONNIE THOMAS, OWNER AND NURSE -PORTER ADVENTIST HOSPITAL - DIANNE MCCALLISTER, CHIEF MEDICAL OFFICER -ADVENTIST COMMUNITY SERVICES - MICHAEL BRIGHT, EXECUTIVE DIRECTOR** -LITTLETON ADVENTIST HOSPITAL - KIM MURAMOTO, TRAUMA DIRECTOR -CITY OF LITTLETON - SUSAN THORNTON, EX-MAYOR -LITTLETON ADVENTIST HOSPITAL - RHONDA WARD, CHIEF NURSING OFFICER -EMERGENCY MEDICAL SERVICE - WAYNE ZYGOWICZ, CHIEF -GREATER YOUTH INITIATIVE - KAY WILMESHER -LITTLETON ADVENTIST HOSPITAL - LAWRENCE WOOD, CHIEF MEDICAL OFFICER; (1) - PORTER ADVENTIST HOSPITAL: COMMUNITY MEMBERS WERE INTERVIEWED OVER A PERIOD OF ONE YEAR REGARDING THE NEEDS THEY PERCEIVED IN THEIR COMMUNITY FOR THEIR PERSPECTIVES ON THE PREDOMINANT HEALTH ISSUES IN THEIR COMMUNITIES. THEY WERE INTERVIEWED IN EITHER A ONE-ON-ONE INTERVIEW FORMAT, FOCUS GROUP, OR AS PART OF A STEERING COMMITTEE. THE INTERVIEWEES COMPRISED OF REPRESENTATIVES OF THE FOLLOWING GROUPS: LOCAL FIRE DEPARTMENTS- WAYNE ZYGOWICZ, EMS DIVISION CHIEF COUNTY PUBLIC HEALTH DEPARTMENT- PATTY BOYD, RD, MPH, PROGRAM MANAGER HOME HEALTH / HOSPICE- MELODY WRIGHT, CNO LONG TERM CARE / ASSISTED LIVING- CAMILLE THOMPSON, COO CHRISTIAN LIVING COMMUNITIES MARRY-WELL COLORADO- LAUREN REITSMA, EXECUTIVE DIRECTOR FOR RELATIONSHIP DOCTORS CARE- BEBE KLEINMAN, EXECUTIVE DIRECTOR ADVENTIST COMMUNITY SERVICES- MICHAEL BRIGHT, EXECUTIVE DIRECTOR STOUT STREET CLINIC- CAROL JENKINS, RN; (1) - AVISTA ADVENTIST HOSPITAL: RATHER THAN REPEAT A DUPLICATIVE COMMUNITY ENGAGEMENT WITH THE SAME STAKEHOLDERS, AVISTA CHOSE TO UTILIZE THE COMMUNITY FEEDBACK OBTAINED THROUGH BCPH'S PHIP. PRIMETIME RESEARCH AND EVALUATION CONDUCTED INTERVIEWS WITH THE BCPH PHIP CORE TEAM, AS WELL AS SELECTED BCPH EMPLOYEES AND A VARIETY OF COMMUNITY STAKEHOLDERS. THE INTERVIEWS CONSISTED OF A REVIEW OF A LIST OF 30+ HEALTH OUTCOMES AND WERE FOLLOWED BY A DISCUSSION OF WHAT THE INTERVIEWEE FELT WERE THE MOST IMPORTANT HEALTH OUTCOMES TO PRIORITIZE OVER THE NEXT FIVE YEARS. PRIMETIME RESEARCH AND EVALUATION ALSO COMPLETED THE FORMAL HEALTH SYSTEM CAPACITY ASSESSMENT IN BOULDER COUNTY, WHICH WAS CONDUCTED THROUGH A SERIES OF TEN 3-HOUR MEETINGS HELD DURING THE MONTH OF MAY 2011. EACH MEETING FOCUSED ON ONE OF THE TEN ESSENTIAL PUBLIC HEALTH SERVICES. THESE MEETINGS WERE CONDUCTED THROUGH FACILITATED FOCUS GROUPS CONSISTING OF 6-10 INVITED PARTICIPANTS. THESE PARTICIPANTS' TASKS WERE 1) TO REVIEW THE EVALUATION MEASURES DEVELOPED BY THE NPHPSP FOR THAT SESSION'S ESSENTIAL SERVICE, 2) PARTICIPATE IN THE GROUP DISCUSSION ABOUT THE HEALTH SYSTEM'S CAPACITY AND PERFORMANCE OF THAT PUBLIC HEALTH FUNCTION, 3) COME TO A CONSENSUS ON A RATING SCORE OF THE CURRENT CAPACITY, AND 4) TO EXPRESS CONCERNS AND PROVIDE RECOMMENDATIONS FOR IMPROVEMENT. PARTICIPANTS SELECTED FOR EACH MEETING WERE CHOSEN BASED ON AREA OF EXPERTISE OR INTEREST AND RELATIONSHIP TO THE ESSENTIAL SERVICE TO BE DISCUSSED. INVITATIONS WERE SENT TO A BROAD RANGE OF KEY PARTNERS FROM THE LOCAL PUBLIC HEALTH AGENCY, STATE SERVICE AGENCIES, COMMUNITY BASED ORGANIZATIONS, ACADEMIC INSTITUTIONS, HOSPITALS, SCHOOL SYSTEMS, FOUNDATIONS, LAW ENFORCEMENT AGENCIES, AND NON-PROFIT ORGANIZATIONS. ADDITIONALLY, INVITATIONS WERE SENT TO PEOPLE IN LOCAL GOVERNMENTAL OR QUASI-GOVERNMENTAL ENTITIES INCLUDING FIRST RESPONDERS, ELECTED OFFICIALS, SOCIAL SERVICE PROVIDERS, ADMINISTRATORS, DIVERSITY ADVOCATES, AND OTHERS. INVITATIONS WERE ALSO EXTENDED TO INDIVIDUALS IN THE BUSINESS COMMUNITY, MEDIA, AND JUDICIAL INSTITUTIONS. APPROXIMATELY 70 KEY PARTICIPANTS (6-10 PER MEETING) RESPONDED TO THE REQUEST TO PARTICIPATE IN THE ASSESSMENT SESSIONS.;
Schedule H, Part V Sec B, Line 4, Other Hospital Facilities included in Needs Assessment	(1) - PARKER ADVENTIST HOSPITAL: PORTER ADVENTIST HOSPITAL LITTLETON ADVENTIST HOSPITAL; (1) - LITTLETON ADVENTIST HOSPITAL: PORTER ADVENTIST HOSPITAL PARKER ADVENTIST HOSPITAL; (1) - PORTER ADVENTIST HOSPITAL: LITTLETON ADVENTIST HOSPITAL PARKER ADVENTIST HOSPITAL;
Schedule H, Part V Sec B, Line 7, Needs not addressed in Needs Assessment	(1) - PARKER ADVENTIST HOSPITAL: MANY OF THE HEALTH ISSUES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT AS A SECONDARY HEALTH NEED (SUBSTANCE ABUSE, UNPLANNED PREGNANCIES, SEXUALLY TRANSMITTED INFECTIONS, MOTOR VEHICLE DEATHS, SUICIDE RATES, HEART DISEASE AND STROKE, DIABETES, CANCER, AND POOR ORAL HEALTH) WILL NOT BE ADDRESSED DIRECTLY, AS THEY WILL BE IMPACTED IN A POSITIVE MANNER THROUGH THE INTERVENTIONS RELATED TO THE PRIMARY HEALTH NEEDS (MENTAL HEALTH, ACCESS, AND OBESITY) THE HOSPITAL ADDRESSES. MANY OF THESE ISSUES, AS WELL AS THE OTHER ISSUES IDENTIFIED IN THE CHNA, ARE ALREADY BEING ADDRESSED THROUGH DOCTORS CARE AND ITS REFERRAL NETWORK, WHICH ARE LISTED IN A FUTURE SECTION. THE FOCUS OF THE COMMUNITY BENEFIT TEAM WAS TO SELECT HEALTH ISSUES THAT HAVE A LARGE IMPACT ON THE POPULATION, HAVE AVAILABLE RESOURCES TO ENSURE SUCCESS OF INTERVENTIONS, AND ARE A HIGH PRIORITY IN THEIR COMMUNITY. IT IS ALSO THE UNDERSTANDING OF THE COMMUNITY BENEFIT TEAM TO TRY TO NOT TACKLE EVERYTHING WITH RESULTING MEDIOCRE RESULTS, BUT TO SELECT HEALTH ISSUES THAT CAN BE SUCCESSFULLY ADDRESSED, EVEN IF ON A SMALL SCALE IN THE BEGINNING.; (1) - LITTLETON ADVENTIST HOSPITAL: MANY OF THE HEALTH ISSUES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT AS A SECONDARY HEALTH NEED (SUBSTANCE ABUSE, UNPLANNED PREGNANCIES, SEXUALLY TRANSMITTED INFECTIONS, MOTOR VEHICLE DEATHS, SUICIDE RATES, HEART DISEASE AND STROKE, DIABETES, CANCER, AND POOR ORAL HEALTH) WILL NOT BE ADDRESSED DIRECTLY, BUT WILL BE IMPACTED IN A POSITIVE MANNER THROUGH THE INTERVENTIONS RELATED TO THE PRIMARY HEALTH NEEDS (MENTAL HEALTH, ACCESS, AND OBESITY). MANY OF THESE ISSUES, AS WELL AS THE OTHER ISSUES IDENTIFIED IN THE CHNA, ARE ALREADY BEING ADDRESSED THROUGH DOCTORS CARE AND ITS REFERRAL NETWORK, WHICH ARE LISTED IN A FUTURE SECTION. THE FOCUS OF THE COMMUNITY BENEFIT TEAM WAS TO SELECT HEALTH ISSUES THAT HAVE A LARGE IMPACT ON THE POPULATION, HAVE AVAILABLE RESOURCES TO ENSURE SUCCESS OF INTERVENTIONS, AND ARE A HIGH PRIORITY IN THEIR COMMUNITY. IT IS ALSO THE UNDERSTANDING OF THE COMMUNITY BENEFIT TEAM TO TRY TO NOT TACKLE EVERYTHING WITH RESULTING MEDIOCRE RESULTS, BUT TO SELECT HEALTH ISSUES THAT CAN BE SUCCESSFULLY ADDRESSED, EVEN IF ON A SMALL SCALE IN THE BEGINNING. THE OTHER HEALTH ISSUES ARE AS FOLLOWS: 1. CANCER IN GENERAL, AND COLON CANCER SPECIFICALLY IN ARAPAHOE COUNTY: THIS IS A KEY SERVICE LINE FOR THE ORGANIZATION FOCUSING ON SUPERIOR CLINICAL OUTCOMES BUT ALSO PREVENTION AND SCREENING. ONE EXAMPLE IS MAMMOGRAPHY SCREENINGS SUPPORTED BY THE HOSPITAL FOUNDATION. 2. COMMUNICABLE DISEASE, PNEUMONIA VACCINATIONS IN DOUGLAS COUNTY AND HEPATITIS B INCIDENCE IN ARAPAHOE COUNTY: DOCTORS CARE PARTNERSHIP ADDRESS THESE NEED IN THE UNINSURED AND UNDERINSURED POPULATIONS. 3. DIABETES: CREATION HEALTH GRANT PROGRAM SUPPORTS WEIGHT MANAGEMENT THROUGH HEALTHY EATING AND ACTIVE LIVING IS HAVING AN UPSTREAM IMPACT ON DIABETES 4. HEART DISEASE AND STROKE, INCLUDING HYPERTENSION AND HIGH CHOLESTEROL IN ARAPAHOE COUNTY: A KEY SERVICE LINE INITIATIVE WITHIN THE HOSPITAL PARTNERING WITH PHYSICIANS AND COMMUNITY ORGANIZATIONS TO PROVIDE EDUCATION AND TO SUPPORT LIFESTYLE CHANGE. 5. MATERNAL AND INFANT HEALTH: DOCTORS CARE PARTNERSHIP 6. ORAL HEALTH, INCLUDING INFANT CHECKUPS IN DOUGLAS COUNTY: DENTISTRY FOR KIDS PARTNERSHIP SUPPORT THIS COMMUNITY NEED. 7. OVERALL HEALTH, INCLUDING INFANT MORTALITY RATES IN ARAPAHOE COUNTY: DOCTORS CARE ADDRESSING THESE NEEDS IN THE COMMUNITY. 8 TOBACCO, INCLUDING USE AMONG HIGH SCHOOL STUDENTS IN ARAPAHOE COUNTY: THE HOSPITAL REFERS TO COUNTY AND STATE SERVICES SUCH AS THE TOBACCO FREE COUNTY WEBSITE AND THE STATE OF COLORADO'S MY QUIT PATH CESSATION PORTAL.; (1) - PORTER ADVENTIST HOSPITAL: MANY OF THE HEALTH ISSUES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT AS A SECONDARY HEALTH NEED (SUBSTANCE ABUSE, UNPLANNED PREGNANCIES, SEXUALLY TRANSMITTED INFECTIONS, MOTOR VEHICLE DEATHS, SUICIDE RATES, HEART DISEASE AND STROKE, DIABETES, CANCER, AND POOR ORAL HEALTH) WILL NOT BE ADDRESSED DIRECTLY, BUT WILL HOPEFULLY BE IMPACTED IN A POSITIVE MANNER THROUGH THE INTERVENTIONS RELATED TO THE PRIMARY HEALTH NEEDS (MENTAL HEALTH, ACCESS, OBESITY, INJURY/EQUESTRIAN HEAD INJURIES). MANY OF THESE ISSUES, AS WELL AS THE OTHER ISSUES IDENTIFIED IN THE CHNA, ARE ALREADY BEING ADDRESSED THROUGH DOCTORS CARE AND ITS REFERRAL NETWORK, WHICH ARE LISTED IN A FUTURE SECTION. THE FOCUS OF THE TASK FORCE WAS TO SELECT HEALTH ISSUES THAT HAVE A LARGE IMPACT ON THE POPULATION, HAVE AVAILABLE RESOURCES TO ENSURE SUCCESS OF INTERVENTIONS, AND ARE A HIGH PRIORITY IN THEIR COMMUNITY. IT IS ALSO THE UNDERSTANDING OF THE TASK FORCE TO TRY TO NOT TACKLE EVERYTHING WITH RESULTING MEDIOCRE RESULTS, BUT TO SELECT HEALTH ISSUES THAT CAN BE SUCCESSFULLY ADDRESSED, EVEN IF ON A SMALL SCALE IN THE BEGINNING. THE OTHER HEALTH ISSUES ARE AS FOLLOWS: 1. CANCER IN GENERAL, AND COLON CANCER SPECIFICALLY IN ARAPAHOE COUNTY: THIS IS A KEY SERVICE LINE FOR THE ORGANIZATION FOCUSING ON SUPERIOR CLINICAL OUTCOMES AND ALSO PREVENTION AND SCREENING. ONE EXAMPLE IS MAMMOGRAPHY SCREENINGS SUPPORTED BY THE HOSPITAL FOUNDATION. 2. COMMUNICABLE DISEASE, PNEUMONIA VACCINATIONS IN DOUGLAS COUNTY AND HEPATITIS B INCIDENCE IN ARAPAHOE COUNTY: DOCTORS CARE PARTNERSHIP ADDRESSES THESE NEEDS IN THE UNINSURED AND UNDERINSURED POPULATIONS. 3. DIABETES: CREATION HEALTH GRANT PROGRAM SUPPORTS WEIGHT MANAGEMENT THROUGH HEALTHY EATING AND ACTIVE LIVING; THIS PROGRAM IS HAVING AN UPSTREAM IMPACT ON DIABETES. 4. HEART DISEASE AND STROKE, INCLUDING HYPERTENSION AND HIGH CHOLESTEROL IN ARAPAHOE COUNTY: THIS KEY SERVICE LINE INITIATIVE WITHIN THE HOSPITAL INVOLVES PARTNERING WITH PHYSICIANS AND COMMUNITY ORGANIZATIONS TO PROVIDE EDUCATION AND TO SUPPORT LIFESTYLE CHANGE. 5. MATERNAL AND INFANT HEALTH: DOCTORS CARE PARTNERSHIP SUPPORTS THIS NEED. 6. ORAL HEALTH, INCLUDING INFANT CHECKUPS IN DOUGLAS COUNTY: DENTISTRY FOR KIDS PARTNERSHIP SUPPORTS THIS COMMUNITY NEED. 7. OVERALL HEALTH, INCLUDING INFANT MORTALITY RATES IN ARAPAHOE COUNTY: DOCTORS CARE ADDRESSES THESE NEEDS IN THE COMMUNITY. 8. TOBACCO, INCLUDING USE AMONG HIGH SCHOOL STUDENTS IN ARAPAHOE COUNTY: THE HOSPITAL REFERS TO COUNTY AND STATE SERVICES SUCH AS THE TOBACCO FREE COUNTY WEBSITE AND THE STATE OF COLORADO'S MY QUIT PATH CESSATION.; (1) - AVISTA ADVENTIST HOSPITAL: AS A RESULT OF THE EXTENSIVE PROCESS TO IDENTIFY THE HEALTH NEEDS OF THE COMMUNITY THAT AVISTA ADVENTIST HOSPITAL SERVES, THE COMMUNITY COLLABORATION IDENTIFIED THAT THE GREATEST NEEDS WERE ACCESS TO HEALTH SERVICES, DIABETES, MENTAL HEALTH, SUBSTANCE ABUSE, OBESITY, AND IMMUNIZATIONS. THE TEAM DECIDED TO FOCUS ON TWO OF THOSE NEEDS, ACCESS TO HEALTH SERVICES AND DIABETES, BECAUSE THEY WANTED TO MAKE A MEASURABLE AND LASTING IMPACT IN THOSE AREAS RATHER THAN ONLY SCRATCHING THE SURFACE IN MULTIPLE AREAS AND DILUTING EFFORTS. OTHER NEEDS WERE NOT PRIORITIZED BECAUSE THEY WERE AVAILABLE THROUGH OTHER HEALTH SERVICES ORGANIZATIONS OR WERE PARTIALLY DUPLICATED IN OTHER AREAS PRIORITIZED BY AVISTA.;
Schedule H, Part V Sec B, Line 20d, How amounts charged to FAP-eligible patients were determined	(1) - PARKER ADVENTIST HOSPITAL: PORTERCARE ADVENTIST HEALTH SYSTEM AUTOMATICALLY DISCOUNTS ALL SELF-PAY PATIENT ACCOUNTS BY 30% AND ALSO OFFERS A PROMPT PAY DISCOUNT.; (1) - LITTLETON ADVENTIST: PORTERCARE ADVENTIST HEALTH SYSTEM AUTOMATICALLY DISCOUNTS ALL SELF-PAY PATIENT ACCOUNTS BY 30% AND ALSO OFFERS A PROMPT PAY DISCOUNT.; (1) - PORTER ADVENTIST HOSPITAL: PORTERCARE ADVENTIST HEALTH SYSTEM AUTOMATICALLY DISCOUNTS ALL SELF-PAY PATIENT ACCOUNTS BY 30% AND ALSO OFFERS A PROMPT PAY DISCOUNT.; (1) - AVISTA ADVENTIST HOSPITAL: PORTERCARE ADVENTIST HEALTH SYSTEM AUTOMATICALLY DISCOUNTS ALL SELF PAY PATIENT ACCOUNTS BY 30% AND ALSO OFFERS A PROMPT PAY DISCOUNT. ; (1) - CASTLE ROCK ADVENTIST HOSPITAL: PORTERCARE ADVENTIST HEALTH SYSTEM AUTOMATICALLY DISCOUNTS ALL SELF-PAY PATIENT ACCOUNTS BY 30% AND ALSO OFFERS A PROMPT PAY DISCOUNT.;

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Section D. 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?56
Name and address		Type of Facility (describe)
1	SOUTH DENVER CARDIOLOGY ASSOCIATES 1000 SouthPark Drive LITTLETON,CO80120	EMP PHYSICIANS GROUP
2	MILE HIGH ONCOLOGY 7780 S BROADWAY STE 380 LITTLETON,CO80122	EMP PHYSICIAN GROUP
3	PINNACLE WOMEN'S HEALTHCARE AT PARKER 9397 CROWN CREST BLVD STE 331 PARKER,CO80138	EMP PHYSICIANS GROUP
4	PORTER HOSPICE 1391 SPEER BLVD 600 DENVER,CO80204	ADMIN OFFICE HOME HOSPICE COORDINATION
5	CHATFIELD WOMEN'S CARE 7720 S BROADWAY LITTLETON,CO80122	EMP PHYSICIAN GROUP
6	CENTURA HEALTH AT SOUTHLANDS 6240 SO MAIN ST STE 255 AURORA,CO80016	EMP PHYSICIAN GROUP
7	INTEGRATED OBGYN AT PARKER 9397 CROWN CREST BLVD STE 220 PARKER,CO80138	EMP PHYSICIANS GROUP
8	CENTER FOR ORTHOPEDICS 7720 S BROADWAY LITTLETON,CO80122	EMP PHYSICIAN GROUP
9	CYPRESS HEMOTOLOGY AND ONCOLOGY 2555 S DOWNING ST STE 240 DENVER,CO80210	EMP PHYSICIAN GROUP
10	TIMBERVIEW CLINIC AT PARKER 9399 CROWN CREST BLVD STE 200 PARKER,CO80138	EMP PHYSICIAN GROUP
11	ACCESS FAMILY MEDICINE 19284 COTTONWOOD DRIVE SUITE 201 PARKER,CO80138	EMP PHYSICIAN GROUP
12	RIDGELINE FAMILY MEDICINE 2352 MEADOWS BLVD STE 300 CASTLE ROCK,CO80108	EMP PHYSICIANS GROUP
13	AFFILIATED EAR NOSE AND THROAT PHYSICIANS 8000 E PRENTICE AVE STE D12 GRENWOOD VILLAGE,CO80111	EMP PHYSICIANS GROUP
14	COMPREHENSIVE OBGYN AT PARKER 9397 CREOWN CREST BLVD STE 431 PARKER,CO80138	EMP PHYSICIANS GROUP
15	CLEMENT PARK FAMILY MEDICINE 6901 S PIERCE ST STE 110 LITTLETON,CO80128	EMP PHYSICIANS GROUP
16	ENDOSCOPY CENTER AT PORTER LLC 1001 SOUTH PARK DRIVE LITTLETON,CO80120	DIAGNOSTIC SERVICES
17	COLORADO HEAD AND NECK SPECIALISTS 2555 S DOWNING ST STE 100 DENVER,CO80210	EMP PHYSICIAN GROUP
18	MOUNTAIN VIEW FAMILY PHYSICIANS 2020 ONEIDA ST DENVER,CO80224	EMP PHYSICIAN GROUP
19	COLORADO NEUROVASCULAR SPECIALISTS 7780 S BROADWAY LITTLETON,CO80122	EMP PHYSICIAN GROUP
20	SOUTH SUBURBAN INTERNAL MEDICINE 7750 S BROADWAY LITTLETON,CO80122	EMP PHYSICIAN GROUP
21	BOULDER HOLISTIC MEDICINE 805 S BROADWAY SUITE 103 BOULDER,CO80305	EMP PHYSICIAN GROUP
22	AVISTA FAMILY MEDICINE GUNBARREL 5365 SPINE ROAD SUITE C BOULDER,CO80301	EMP PHYSICIAN GROUP
23	NORTHWEST GASTROENTEROLOGY 80 HEALTH PARK DRIVE LOUISVILLE,CO80027	EMP PHYSICIAN GROUP
24	DIMENSION PAIN MANAGEMENT 400 W 144TH AVE STE 240 WESTMINSTER,CO80023	EMP PHYSICIAN GROUP
25	COLORADO JOINT REPLACEMENT 2535 S DOWNING ST DENVER,CO80210	EMP PHYSICIAN GROUP
26	AVISTA INTERNAL MEDICINE 90 HEALTHPARK DR STE 350 LOUISVILLE,CO80027	EMP PHYSICIAN GROUP
27	COMPREHENSIVE BREAST CARE 2555 S DOWNING ST SUITE 130 DENVER,CO80210	EMP PHYSICIAN GROUP
28	PARKER ENDOCRINOLOGY 9397 CROWN CREST BLVD STE 220 PARKER,CO80138	EMP PHYSICIANS GROUP
29	APOLLO INTERNAL MEDICINE 950 E HARVARD AVE SUITE 530 DENVER,CO80210	EMP PHYSICIAN GROUP
30	PRIMARY CARE (HARVARD PARK) 950 E HARVARD AVE SUITE 660 DENVER,CO80210	EMP PHYSICIAN GROUP
31	CENTURA HEALTH PHYSICIAN GROUP AT CLERMONT PARK 2479 S CLERMONT ST DENVER,CO80222	EMP PHYSICIANS GROUP
32	CYPRESS ONCOLOGY - PKR 9399 CROWN CREST BLVD SUITE 215 PARKER,CO80138	EMP PHYSICIAN GROUP
33	HIGHLANDS RANCH MEDICAL ASSOCIATES 9135 S RIDGELINE BLVD STE 190 HIGHLANDS RANCH,CO80129	EMP PHYSICIANS GROUP
34	AVISTA WOMEN'S HEALTH 611 MITCHELL WAY STE 103 ERIE,CO80516	EMP PHYSICIAN GROUP
35	AVISTA FAMILY MEDICINE (ERIE) 611 MITCHELL WAY ERIE,CO80516	EMP PHYSICIAN GROUP
36	FLATRONS HEART AND VASCULAR 90 HEALTHPARK DRIVE STE 350 LOUISVILLE,CO80027	EMP PHYSICIAN GROUP
37	COLORADO ENT SPECIALISTS 9397 CROWN CREST BLVD STE 431 PARKER,CO80138	EMP PHYSICIAN GROUP
38	ARACEA WOMEN'S CENTER 300 S JACKSON ST DENVER,CO80209	EMP PHYSICIAN GROUP
39	CHATFIELD FAMILY MEDICINE 10789 BRADFORD RD STE 150 LITTLETON,CO80127	EMP PHYSICIAN GROUP
40	CENTER ENDOCRINOLOGY AND DIABETES 7750 S BROADWAY STE 220 LITTLETON,CO80122	EMP PHYSICIAN GROUP
41	PORTER PRIMARY CARE 300 S JACKSON ST DENVER,CO80209	EMP PHYSICIAN GROUP
42	EP CLINIC 2525 S DOWNING ST CARDIAC CATH LAB DENVER,CO80210	EMP PHYSICIAN GROUP
43	CENTURA MEDICAL ASSOCIATES 2525 S DOWNING ST DENVER,CO80210	EMP PHYSICIAN GROUP
44	SOUTH QUEBEC FAMILY MEDICINE 6081 S QUEBEC ST STE 100 CENTENNIAL,CO80111	EMP PHYSICIANS GROUP
45	CASTLE ROCK AFFILIATED ENT 2352 Meadows Blvd CASTLE ROCK,CO80109	EMP PHYSICIANS GROUP
46	CASTLE ROCK ORTHOPEDICS 2352 Meadows Blvd CASTLE ROCK,CO80109	EMP PHYSICIANS GROUP
47	CASTLE ROCK ONCOLOGY 2352 Meadows Blvd CASTLE ROCK,CO80109	EMP PHYSICIANS GROUP
48	RIDGELINE FAMILY MEDICINE AT CASTLE PINES 250 Max Drive CASTLE PINES,CO80109	EMP PHYSICIANS GROUP
49	CHPG RIDGEGATE OBGYN AT CRAH 2352 Meadows Blvd CASTLE ROCK,CO80109	EMP PHYSICIANS GROUP
50	CHPG SENIOR CARE PAHS HOLLY CREEK 5500 East Peakview Ave CENTENNIAL,CO80121	EMP PHYSICIANS GROUP
51	CENTER FOR ENDOCRINOLOGY AND DIABETES 7750 S Broadway LITTLETON,CO80122	EMP PHYSICIANS GROUP
52	CASTLE ROCK HOSPITALISTS 2353 Meadows Blvd CASTLE ROCK,CO80109	EMP PHYSICIANS GROUP
53	SOUTH QUEBEC FAMILY MEDICINE 6081 South Quebec St CENTENNIAL,CO80111	EMP PHYSICIANS GROUP
54	CHPG RIDGEGATE OBGYN AT LONE TREE 10099 Ridgegate Parkway LONE TREE,CO80124	EMP PHYSICIANS GROUP
55	SOUTH SUBURBAN INTERNAL MEDICINE 7750 South Broadway LITTLETON,CO80122	EMP PHYSICIANS GROUP
56	BARIATRIC AND METABOLIC CENTER 9399 CROWN CREST BLVD STE 110 PARKER,CO80138	EMP PHYSICIAN GROUP

Schedule H (Form 990) 2013

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Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.

Form and Line Reference	Explanation
Schedule H, Part V Sec B, Line 3, Community Served by Needs Assessment	(1) - PARKER ADVENTIST HOSPITAL: THE HOSPITAL RETAINED THE CENTER FOR HEALTH ADMINISTRATION AT THE UNIVERSITY OF COLORADO DENVER TO OBTAIN COMMUNITY INPUT. COMMUNITY PERSPECTIVES WERE GATHERED THROUGH TELEPHONE INTERVIEWS DURING FEBRUARY AND MARCH 2012. INTERVIEW QUESTIONS WERE PHRASED IN AN OPEN-ENDED MANNER SO THAT RESPONDENTS COULD IDENTIFY WHATEVER ISSUES WERE MOST IMPORTANT TO THEM. THEY WERE ALSO ASKED FOR IDEAS ON WAYS THAT THE HOSPITAL COULD ASSIST THEM IN IMPROVING THE HEALTH OF THEIR COMMUNITY. RESIDENTS WERE ALSO ASKED FOR IDEAS ON WAYS THAT THE HOSPITAL COULD ASSIST THEM IN IMPROVING THE HEALTH OF THEIR COMMUNITY. THE FOLLOWING ORGANIZATIONS WERE CHOSEN TO PROVIDE INPUT: CITY OF PARKER CROSSROADS COMMUNITY CHURCH PARKER CHAMBER OF COMMERCE PARKER POLICE DEPARTMENT PARKER SENIOR CENTER PARKER TASK FORCE FOOD BANK PONDEROSA HIGH SCHOOL SOUTH METRO FIRE RESCUE AUTHORITY TRI-COUNTY HEALTH DEPARTMENT WOMEN'S CRISIS AND FAMILY OUTREACH CENTER; (1) - LITTLETON ADVENTIST HOSPITAL: COMMUNITY MEMBERS WERE INTERVIEWED FOR THEIR PERSPECTIVES ON THE PREDOMINANT HEALTH ISSUES IN THEIR COMMUNITIES. THEY WERE INTERVIEWED IN EITHER A ONE-ON-ONE INTERVIEW FORMAT, FOCUS GROUP, OR AS PART OF A STEERING COMMITTEE. DATA WAS COLLECTED OVER THE PERIOD FROM JUNE 2011 TO JUNE 2012. THE INTERVIEWEES COMPRISED OF REPRESENTATIVES OF THE FOLLOWING GROUPS: LITTLETON FIRE DEPARTMENT- WAYNE ZYGOWICZ, EMS DIVISION CHIEF TRI-COUNTY DEPARTMENT OF HEALTH- PATTY BOYD, RD MPH, PROGRAM MANAGER ARAPAHOE DOUGLAS MENTAL HEALTH, LISA TRAUDT DOCTORS CARE- BEBE KLEINMAN, EXECUTIVE DIRECTOR HIGHLANDS RANCH COMMUNITY ASSOCIATION - JAMIE NOEBEL, COMMUNITY MANAGER HEALTHY COMMUNITIES GROUP OF CENTURA HEALTH'S SOUTH DENVER OPERATING GROUP -COLORADO WELLNESS - BONNIE THOMAS, OWNER AND NURSE -PORTER ADVENTIST HOSPITAL - DIANNE MCCALLISTER, CHIEF MEDICAL OFFICER -ADVENTIST COMMUNITY SERVICES - MICHAEL BRIGHT, EXECUTIVE DIRECTOR** -LITTLETON ADVENTIST HOSPITAL - KIM MURAMOTO, TRAUMA DIRECTOR -CITY OF LITTLETON - SUSAN THORNTON, EX-MAYOR -LITTLETON ADVENTIST HOSPITAL - RHONDA WARD, CHIEF NURSING OFFICER -EMERGENCY MEDICAL SERVICE - WAYNE ZYGOWICZ, CHIEF -GREATER YOUTH INITIATIVE - KAY WILMESHER -LITTLETON ADVENTIST HOSPITAL - LAWRENCE WOOD, CHIEF MEDICAL OFFICER; (1) - PORTER ADVENTIST HOSPITAL: COMMUNITY MEMBERS WERE INTERVIEWED OVER A PERIOD OF ONE YEAR REGARDING THE NEEDS THEY PERCEIVED IN THEIR COMMUNITY FOR THEIR PERSPECTIVES ON THE PREDOMINANT HEALTH ISSUES IN THEIR COMMUNITIES. THEY WERE INTERVIEWED IN EITHER A ONE-ON-ONE INTERVIEW FORMAT, FOCUS GROUP, OR AS PART OF A STEERING COMMITTEE. THE INTERVIEWEES COMPRISED OF REPRESENTATIVES OF THE FOLLOWING GROUPS: LOCAL FIRE DEPARTMENTS- WAYNE ZYGOWICZ, EMS DIVISION CHIEF COUNTY PUBLIC HEALTH DEPARTMENT- PATTY BOYD, RD, MPH, PROGRAM MANAGER HOME HEALTH / HOSPICE- MELODY WRIGHT, CNO LONG TERM CARE / ASSISTED LIVING- CAMILLE THOMPSON, COO CHRISTIAN LIVING COMMUNITIES MARRY-WELL COLORADO- LAUREN REITSMA, EXECUTIVE DIRECTOR FOR RELATIONSHIP DOCTORS CARE- BEBE KLEINMAN, EXECUTIVE DIRECTOR ADVENTIST COMMUNITY SERVICES- MICHAEL BRIGHT, EXECUTIVE DIRECTOR STOUT STREET CLINIC- CAROL JENKINS, RN; (1) - AVISTA ADVENTIST HOSPITAL: RATHER THAN REPEAT A DUPLICATIVE COMMUNITY ENGAGEMENT WITH THE SAME STAKEHOLDERS, AVISTA CHOSE TO UTILIZE THE COMMUNITY FEEDBACK OBTAINED THROUGH BCPH'S PHIP. PRIMETIME RESEARCH AND EVALUATION CONDUCTED INTERVIEWS WITH THE BCPH PHIP CORE TEAM, AS WELL AS SELECTED BCPH EMPLOYEES AND A VARIETY OF COMMUNITY STAKEHOLDERS. THE INTERVIEWS CONSISTED OF A REVIEW OF A LIST OF 30+ HEALTH OUTCOMES AND WERE FOLLOWED BY A DISCUSSION OF WHAT THE INTERVIEWEE FELT WERE THE MOST IMPORTANT HEALTH OUTCOMES TO PRIORITIZE OVER THE NEXT FIVE YEARS. PRIMETIME RESEARCH AND EVALUATION ALSO COMPLETED THE FORMAL HEALTH SYSTEM CAPACITY ASSESSMENT IN BOULDER COUNTY, WHICH WAS CONDUCTED THROUGH A SERIES OF TEN 3-HOUR MEETINGS HELD DURING THE MONTH OF MAY 2011. EACH MEETING FOCUSED ON ONE OF THE TEN ESSENTIAL PUBLIC HEALTH SERVICES. THESE MEETINGS WERE CONDUCTED THROUGH FACILITATED FOCUS GROUPS CONSISTING OF 6-10 INVITED PARTICIPANTS. THESE PARTICIPANTS' TASKS WERE 1) TO REVIEW THE EVALUATION MEASURES DEVELOPED BY THE NPHPSP FOR THAT SESSION'S ESSENTIAL SERVICE, 2) PARTICIPATE IN THE GROUP DISCUSSION ABOUT THE HEALTH SYSTEM'S CAPACITY AND PERFORMANCE OF THAT PUBLIC HEALTH FUNCTION, 3) COME TO A CONSENSUS ON A RATING SCORE OF THE CURRENT CAPACITY, AND 4) TO EXPRESS CONCERNS AND PROVIDE RECOMMENDATIONS FOR IMPROVEMENT. PARTICIPANTS SELECTED FOR EACH MEETING WERE CHOSEN BASED ON AREA OF EXPERTISE OR INTEREST AND RELATIONSHIP TO THE ESSENTIAL SERVICE TO BE DISCUSSED. INVITATIONS WERE SENT TO A BROAD RANGE OF KEY PARTNERS FROM THE LOCAL PUBLIC HEALTH AGENCY, STATE SERVICE AGENCIES, COMMUNITY BASED ORGANIZATIONS, ACADEMIC INSTITUTIONS, HOSPITALS, SCHOOL SYSTEMS, FOUNDATIONS, LAW ENFORCEMENT AGENCIES, AND NON-PROFIT ORGANIZATIONS. ADDITIONALLY, INVITATIONS WERE SENT TO PEOPLE IN LOCAL GOVERNMENTAL OR QUASI-GOVERNMENTAL ENTITIES INCLUDING FIRST RESPONDERS, ELECTED OFFICIALS, SOCIAL SERVICE PROVIDERS, ADMINISTRATORS, DIVERSITY ADVOCATES, AND OTHERS. INVITATIONS WERE ALSO EXTENDED TO INDIVIDUALS IN THE BUSINESS COMMUNITY, MEDIA, AND JUDICIAL INSTITUTIONS. APPROXIMATELY 70 KEY PARTICIPANTS (6-10 PER MEETING) RESPONDED TO THE REQUEST TO PARTICIPATE IN THE ASSESSMENT SESSIONS.;
Schedule H, Part V Sec B, Line 4, Other Hospital Facilities included in Needs Assessment	(1) - PARKER ADVENTIST HOSPITAL: PORTER ADVENTIST HOSPITAL LITTLETON ADVENTIST HOSPITAL; (1) - LITTLETON ADVENTIST HOSPITAL: PORTER ADVENTIST HOSPITAL PARKER ADVENTIST HOSPITAL; (1) - PORTER ADVENTIST HOSPITAL: LITTLETON ADVENTIST HOSPITAL PARKER ADVENTIST HOSPITAL;
Schedule H, Part V Sec B, Line 7, Needs not addressed in Needs Assessment	(1) - PARKER ADVENTIST HOSPITAL: MANY OF THE HEALTH ISSUES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT AS A SECONDARY HEALTH NEED (SUBSTANCE ABUSE, UNPLANNED PREGNANCIES, SEXUALLY TRANSMITTED INFECTIONS, MOTOR VEHICLE DEATHS, SUICIDE RATES, HEART DISEASE AND STROKE, DIABETES, CANCER, AND POOR ORAL HEALTH) WILL NOT BE ADDRESSED DIRECTLY, AS THEY WILL BE IMPACTED IN A POSITIVE MANNER THROUGH THE INTERVENTIONS RELATED TO THE PRIMARY HEALTH NEEDS (MENTAL HEALTH, ACCESS, AND OBESITY) THE HOSPITAL ADDRESSES. MANY OF THESE ISSUES, AS WELL AS THE OTHER ISSUES IDENTIFIED IN THE CHNA, ARE ALREADY BEING ADDRESSED THROUGH DOCTORS CARE AND ITS REFERRAL NETWORK, WHICH ARE LISTED IN A FUTURE SECTION. THE FOCUS OF THE COMMUNITY BENEFIT TEAM WAS TO SELECT HEALTH ISSUES THAT HAVE A LARGE IMPACT ON THE POPULATION, HAVE AVAILABLE RESOURCES TO ENSURE SUCCESS OF INTERVENTIONS, AND ARE A HIGH PRIORITY IN THEIR COMMUNITY. IT IS ALSO THE UNDERSTANDING OF THE COMMUNITY BENEFIT TEAM TO TRY TO NOT TACKLE EVERYTHING WITH RESULTING MEDIOCRE RESULTS, BUT TO SELECT HEALTH ISSUES THAT CAN BE SUCCESSFULLY ADDRESSED, EVEN IF ON A SMALL SCALE IN THE BEGINNING.; (1) - LITTLETON ADVENTIST HOSPITAL: MANY OF THE HEALTH ISSUES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT AS A SECONDARY HEALTH NEED (SUBSTANCE ABUSE, UNPLANNED PREGNANCIES, SEXUALLY TRANSMITTED INFECTIONS, MOTOR VEHICLE DEATHS, SUICIDE RATES, HEART DISEASE AND STROKE, DIABETES, CANCER, AND POOR ORAL HEALTH) WILL NOT BE ADDRESSED DIRECTLY, BUT WILL BE IMPACTED IN A POSITIVE MANNER THROUGH THE INTERVENTIONS RELATED TO THE PRIMARY HEALTH NEEDS (MENTAL HEALTH, ACCESS, AND OBESITY). MANY OF THESE ISSUES, AS WELL AS THE OTHER ISSUES IDENTIFIED IN THE CHNA, ARE ALREADY BEING ADDRESSED THROUGH DOCTORS CARE AND ITS REFERRAL NETWORK, WHICH ARE LISTED IN A FUTURE SECTION. THE FOCUS OF THE COMMUNITY BENEFIT TEAM WAS TO SELECT HEALTH ISSUES THAT HAVE A LARGE IMPACT ON THE POPULATION, HAVE AVAILABLE RESOURCES TO ENSURE SUCCESS OF INTERVENTIONS, AND ARE A HIGH PRIORITY IN THEIR COMMUNITY. IT IS ALSO THE UNDERSTANDING OF THE COMMUNITY BENEFIT TEAM TO TRY TO NOT TACKLE EVERYTHING WITH RESULTING MEDIOCRE RESULTS, BUT TO SELECT HEALTH ISSUES THAT CAN BE SUCCESSFULLY ADDRESSED, EVEN IF ON A SMALL SCALE IN THE BEGINNING. THE OTHER HEALTH ISSUES ARE AS FOLLOWS: 1. CANCER IN GENERAL, AND COLON CANCER SPECIFICALLY IN ARAPAHOE COUNTY: THIS IS A KEY SERVICE LINE FOR THE ORGANIZATION FOCUSING ON SUPERIOR CLINICAL OUTCOMES BUT ALSO PREVENTION AND SCREENING. ONE EXAMPLE IS MAMMOGRAPHY SCREENINGS SUPPORTED BY THE HOSPITAL FOUNDATION. 2. COMMUNICABLE DISEASE, PNEUMONIA VACCINATIONS IN DOUGLAS COUNTY AND HEPATITIS B INCIDENCE IN ARAPAHOE COUNTY: DOCTORS CARE PARTNERSHIP ADDRESS THESE NEED IN THE UNINSURED AND UNDERINSURED POPULATIONS. 3. DIABETES: CREATION HEALTH GRANT PROGRAM SUPPORTS WEIGHT MANAGEMENT THROUGH HEALTHY EATING AND ACTIVE LIVING IS HAVING AN UPSTREAM IMPACT ON DIABETES 4. HEART DISEASE AND STROKE, INCLUDING HYPERTENSION AND HIGH CHOLESTEROL IN ARAPAHOE COUNTY: A KEY SERVICE LINE INITIATIVE WITHIN THE HOSPITAL PARTNERING WITH PHYSICIANS AND COMMUNITY ORGANIZATIONS TO PROVIDE EDUCATION AND TO SUPPORT LIFESTYLE CHANGE. 5. MATERNAL AND INFANT HEALTH: DOCTORS CARE PARTNERSHIP 6. ORAL HEALTH, INCLUDING INFANT CHECKUPS IN DOUGLAS COUNTY: DENTISTRY FOR KIDS PARTNERSHIP SUPPORT THIS COMMUNITY NEED. 7. OVERALL HEALTH, INCLUDING INFANT MORTALITY RATES IN ARAPAHOE COUNTY: DOCTORS CARE ADDRESSING THESE NEEDS IN THE COMMUNITY. 8 TOBACCO, INCLUDING USE AMONG HIGH SCHOOL STUDENTS IN ARAPAHOE COUNTY: THE HOSPITAL REFERS TO COUNTY AND STATE SERVICES SUCH AS THE TOBACCO FREE COUNTY WEBSITE AND THE STATE OF COLORADO'S MY QUIT PATH CESSATION PORTAL.; (1) - PORTER ADVENTIST HOSPITAL: MANY OF THE HEALTH ISSUES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT AS A SECONDARY HEALTH NEED (SUBSTANCE ABUSE, UNPLANNED PREGNANCIES, SEXUALLY TRANSMITTED INFECTIONS, MOTOR VEHICLE DEATHS, SUICIDE RATES, HEART DISEASE AND STROKE, DIABETES, CANCER, AND POOR ORAL HEALTH) WILL NOT BE ADDRESSED DIRECTLY, BUT WILL HOPEFULLY BE IMPACTED IN A POSITIVE MANNER THROUGH THE INTERVENTIONS RELATED TO THE PRIMARY HEALTH NEEDS (MENTAL HEALTH, ACCESS, OBESITY, INJURY/EQUESTRIAN HEAD INJURIES). MANY OF THESE ISSUES, AS WELL AS THE OTHER ISSUES IDENTIFIED IN THE CHNA, ARE ALREADY BEING ADDRESSED THROUGH DOCTORS CARE AND ITS REFERRAL NETWORK, WHICH ARE LISTED IN A FUTURE SECTION. THE FOCUS OF THE TASK FORCE WAS TO SELECT HEALTH ISSUES THAT HAVE A LARGE IMPACT ON THE POPULATION, HAVE AVAILABLE RESOURCES TO ENSURE SUCCESS OF INTERVENTIONS, AND ARE A HIGH PRIORITY IN THEIR COMMUNITY. IT IS ALSO THE UNDERSTANDING OF THE TASK FORCE TO TRY TO NOT TACKLE EVERYTHING WITH RESULTING MEDIOCRE RESULTS, BUT TO SELECT HEALTH ISSUES THAT CAN BE SUCCESSFULLY ADDRESSED, EVEN IF ON A SMALL SCALE IN THE BEGINNING. THE OTHER HEALTH ISSUES ARE AS FOLLOWS: 1. CANCER IN GENERAL, AND COLON CANCER SPECIFICALLY IN ARAPAHOE COUNTY: THIS IS A KEY SERVICE LINE FOR THE ORGANIZATION FOCUSING ON SUPERIOR CLINICAL OUTCOMES AND ALSO PREVENTION AND SCREENING. ONE EXAMPLE IS MAMMOGRAPHY SCREENINGS SUPPORTED BY THE HOSPITAL FOUNDATION. 2. COMMUNICABLE DISEASE, PNEUMONIA VACCINATIONS IN DOUGLAS COUNTY AND HEPATITIS B INCIDENCE IN ARAPAHOE COUNTY: DOCTORS CARE PARTNERSHIP ADDRESSES THESE NEEDS IN THE UNINSURED AND UNDERINSURED POPULATIONS. 3. DIABETES: CREATION HEALTH GRANT PROGRAM SUPPORTS WEIGHT MANAGEMENT THROUGH HEALTHY EATING AND ACTIVE LIVING; THIS PROGRAM IS HAVING AN UPSTREAM IMPACT ON DIABETES. 4. HEART DISEASE AND STROKE, INCLUDING HYPERTENSION AND HIGH CHOLESTEROL IN ARAPAHOE COUNTY: THIS KEY SERVICE LINE INITIATIVE WITHIN THE HOSPITAL INVOLVES PARTNERING WITH PHYSICIANS AND COMMUNITY ORGANIZATIONS TO PROVIDE EDUCATION AND TO SUPPORT LIFESTYLE CHANGE. 5. MATERNAL AND INFANT HEALTH: DOCTORS CARE PARTNERSHIP SUPPORTS THIS NEED. 6. ORAL HEALTH, INCLUDING INFANT CHECKUPS IN DOUGLAS COUNTY: DENTISTRY FOR KIDS PARTNERSHIP SUPPORTS THIS COMMUNITY NEED. 7. OVERALL HEALTH, INCLUDING INFANT MORTALITY RATES IN ARAPAHOE COUNTY: DOCTORS CARE ADDRESSES THESE NEEDS IN THE COMMUNITY. 8. TOBACCO, INCLUDING USE AMONG HIGH SCHOOL STUDENTS IN ARAPAHOE COUNTY: THE HOSPITAL REFERS TO COUNTY AND STATE SERVICES SUCH AS THE TOBACCO FREE COUNTY WEBSITE AND THE STATE OF COLORADO'S MY QUIT PATH CESSATION.; (1) - AVISTA ADVENTIST HOSPITAL: AS A RESULT OF THE EXTENSIVE PROCESS TO IDENTIFY THE HEALTH NEEDS OF THE COMMUNITY THAT AVISTA ADVENTIST HOSPITAL SERVES, THE COMMUNITY COLLABORATION IDENTIFIED THAT THE GREATEST NEEDS WERE ACCESS TO HEALTH SERVICES, DIABETES, MENTAL HEALTH, SUBSTANCE ABUSE, OBESITY, AND IMMUNIZATIONS. THE TEAM DECIDED TO FOCUS ON TWO OF THOSE NEEDS, ACCESS TO HEALTH SERVICES AND DIABETES, BECAUSE THEY WANTED TO MAKE A MEASURABLE AND LASTING IMPACT IN THOSE AREAS RATHER THAN ONLY SCRATCHING THE SURFACE IN MULTIPLE AREAS AND DILUTING EFFORTS. OTHER NEEDS WERE NOT PRIORITIZED BECAUSE THEY WERE AVAILABLE THROUGH OTHER HEALTH SERVICES ORGANIZATIONS OR WERE PARTIALLY DUPLICATED IN OTHER AREAS PRIORITIZED BY AVISTA.;
Schedule H, Part V Sec B, Line 20d, How amounts charged to FAP-eligible patients were determined	(1) - PARKER ADVENTIST HOSPITAL: PORTERCARE ADVENTIST HEALTH SYSTEM AUTOMATICALLY DISCOUNTS ALL SELF-PAY PATIENT ACCOUNTS BY 30% AND ALSO OFFERS A PROMPT PAY DISCOUNT.; (1) - LITTLETON ADVENTIST: PORTERCARE ADVENTIST HEALTH SYSTEM AUTOMATICALLY DISCOUNTS ALL SELF-PAY PATIENT ACCOUNTS BY 30% AND ALSO OFFERS A PROMPT PAY DISCOUNT.; (1) - PORTER ADVENTIST HOSPITAL: PORTERCARE ADVENTIST HEALTH SYSTEM AUTOMATICALLY DISCOUNTS ALL SELF-PAY PATIENT ACCOUNTS BY 30% AND ALSO OFFERS A PROMPT PAY DISCOUNT.; (1) - AVISTA ADVENTIST HOSPITAL: PORTERCARE ADVENTIST HEALTH SYSTEM AUTOMATICALLY DISCOUNTS ALL SELF PAY PATIENT ACCOUNTS BY 30% AND ALSO OFFERS A PROMPT PAY DISCOUNT. ; (1) - CASTLE ROCK ADVENTIST HOSPITAL: PORTERCARE ADVENTIST HEALTH SYSTEM AUTOMATICALLY DISCOUNTS ALL SELF-PAY PATIENT ACCOUNTS BY 30% AND ALSO OFFERS A PROMPT PAY DISCOUNT.;

Schedule H (Form 990) 2013

Additional Data

Software ID:	13000248
Software Version:	2013v3.1

- 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
lBullet

Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization
PORTERCARE ADVENTIST HEALTH SYSTEM

Employer identification number
84-0438224

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) DOCTORS CARE 191 E ORCHARD RD STE 102NE LITTLETON,CO80121	84-1150815	501(C)(3)	50,000	6,122	BOOK	DRUGS	DONATION FOR 2014
(2) CLINICA CAMPESINA (FAMILY HEALTH SERVICES) 1345 PLAZA COURT NORTH SUITE 1A LAFAYETTE,CO80026	84-0743432	501(C)(3)	165,504				MISSION SUPPORT
(3) DENVER BOTANIC GARDENS 909 YORK STREET DENVER,CO80206	84-0440359	501(C)(3)	8,500				SPONSORSHIP
(4) AMERICAN TRANSPLANT FOUNDATION 333 W HAMPDEN AVE SUITE 305 ENGLEWOOD,CO80110	23-7088947	501(C)(3)	15,000				SPONSORSHIP
(5) ARTHRITIS FOUNDATION 2280 S ALBION STREET DENVER,CO80222	38-3826066	501(C)(3)	17,250				SPONSORSHIP & PT ED
(6) COLORADO WOMENS CHAMBER OF COMMERCE 2150 WEST 29TH AVENUE 250 DENVER,CO80211	84-1145793	501(C)(6)	6,100				MEMBERSHIP
(7) RETREAT & REFRESH STROKE CAMP 425 W GILES PEORIA,IL61614	64-0954851	501(C)(3)	10,600				CAMP SPONSORSHIP
(8) UNIVERSITY OF DENVER 2201 S GAYLORD ST DENVER,CO80208	84-0404231	501(C)(3)	12,500				SPONSORSHIP
(9) COLORADO WELLNESS CONNECTION 4960 E MINERAL CIRCLE CENTENNIAL,CO80122	84-1504515	501(C)(3)	7,391				9HEALTH FAIR 2014
(10) ROCKY MOUNTAIN ADVENTIST HEALTHCARE FOUNDATION 7995 E PRENTICE AVE SUITE 204 GREENWOOD VILLAGE,CO80111	84-0745018	501(C)(3)	18,350				HEART GALA AND WALK
(11) ROCKY MOUNTAIN ADVENTIST HEALTHCARE FOUNDATION 7995 E PRENTICE AVE SUITE 204 GREENWOOD VILLAGE,CO80111	84-0745018	501(C)(3)	9,800				SPONSORSHIP
(12) LIFESOURCE ADVENTIST FELLOWSHIP 6200 WEST HAMPDEN AVE DENVER,CO80227	84-6028596	501(C)(3)	6,280				DONATIONS
(13) ROCKY MOUNTAIN ADVENTIST HEALTHCARE FOUNDATION 7995 E PRENTICE AVE SUITE 204 GREENWOOD VILLAGE,CO80111	84-0745018	501(C)(3)	265,369				MISSION SUPPORT
(14) ROCKY MOUNTAN CONFERENCE OF SEVENTH DAY ADVENTISTS 2520 S DOWNING ST DENVER,CO80210	27-4456014	501(C)(3)	112,310				DONATIONS
(15) UNION COLLEGE 3800 S 48TH STREET LINCOLN,NE68506	47-0405319	501(C)(3)	65,000				DONATIONS
(16) ADVENTIST COMMUNITY SERVICES 5045 W 1ST AVE DENVER,CO80219	84-0527826	501(C)(3)	62,000				CARE VAN
(17) PROJECT CURE 10377 E GEDDES AVE CENTENNIAL,CO80112	84-1568566	501(C)(3)	6,000				SPONSORSHIP

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) 2013

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. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Return Reference

Explanation

Schedule I, Part I, Line 2, Procedures for monitoring use of grant funds

GRANTS ARE MADE AT THE DISCRETION OF THE FACILITY CEOS. THE CEOS MAKE REQUESTS FOR FUNDING, WHICH CAN BE EITHER A DONATION TO A SPECIFIC ENTITY OR AN INVOICE FOR A SPECIFIC EXPENSE. MOST RECIPIENTS OF MONIES ARE 501(C)(3) ENTITIES. AS SUCH, THEY ENSURE THAT ALL MONIES RECEIVED ARE USED FOR THEIR INTENDED PURPOSE ONLY. FOR ALL TUITION REIMBURSEMENTS, RECIPIENTS ARE REQUIRED TO MAINTAIN MINIMUM ACADEMIC STANDARDS AND PROVIDE DOCUMENTATION THAT THEY ARE MEETING THESE STANDARDS. RECIPIENTS MUST SUBMIT WRITTEN SUBSTANTIATION OF ALL EXPENSES INCURRED BEFORE REIMBURSEMENTS WILL BE PAID.

Schedule I (Form 990) 2013

Additional Data

Software ID:	13000248
Software Version:	2013v3.1

- 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, line 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

PORTERCARE ADVENTIST HEALTH SYSTEM

Employer identification number

84-0438224

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
directors, trustees, officers, including 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? ................

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

Yes

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) 2013

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)TERRY SHAWASST TREASURER/SECRETARY	(i) (ii)	0 911,185	0 302,898	0 478,549	0 197,919	0 45,398	0 1,935,949	0 166,425
(2)RICHARD REINERVICE PRESIDENT/CHAIRMAN	(i) (ii)	0 913,142	0 302,898	0 446,854	0 13,850	0 45,505	0 1,722,249	0 0
(3)ROBERT HENDERSCHEDTBOARD MEMBER	(i) (ii)	0 632,650	0 210,247	0 342,878	0 134,358	0 29,938	0 1,350,071	0 92,554
(4)RANDY HAFFNERCEO-PORTER ADVENTIST HOSP	(i) (ii)	492,195 0	218,096 0	139,491 0	213,486 0	27,806 0	1,091,074 0	115,394 0
(5)CHERYL CURRYCFO-AVISTA ADVENTIST HOSP	(i) (ii)	214,567 0	83,964 0	1,654 0	23,502 0	19,598 0	343,285 0	0 0
(6)MORRE DEANCEO-PARKER ADVENTIST HOSP	(i) (ii)	333,337 0	111,284 0	35,827 0	94,292 0	28,398 0	603,138 0	13,129 0
(7)ANDREW GAASCHCFO-PORTER ADVENTIST HOSP	(i) (ii)	260,419 0	84,457 0	496 0	29,463 0	18,075 0	392,910 0	0 0
(8)JOHN SACKETTCEO-AVISTA ADVENTIST HOSPITAL	(i) (ii)	103,601 0	0 0	54,883 0	18,163 0	9,165 0	185,812 0	49,736 0
(9)BRETT 58355 SPENSTCEO-LITTLETON ADVENTIST HOSPITAL	(i) (ii)	347,603 0	105,000 0	39,788 0	71,072 0	19,421 0	582,884 0	0 0
(10)DENNIS BARTSCEO - AVISTA ADVENTIST HOSPITAL	(i) (ii)	129,044 0	35,000 0	82,843 0	5,348 0	4,707 0	256,942 0	0 0
(11)JONATHAN FISHERCFO -PARKER ADVENTIST HOSPITAL	(i) (ii)	166,312 0	47,085 0	1,220 0	17,375 0	17,783 0	249,775 0	0 0
(12)RAYMOND KIMPHYSICIAN	(i) (ii)	707,452 0	72,629 0	1,122 0	20,952 0	23,723 0	825,878 0	0 0
(13)DAVID SCHRIERPHYSICIAN	(i) (ii)	757,937 0	0 0	2,484 0	23,502 0	22,443 0	806,366 0	0 0
(14)ROBERT THOMASPHYSICIAN	(i) (ii)	645,357 0	292,083 0	3,880 0	19,677 0	21,230 0	982,227 0	0 0
(15)TODD MINERPHYSICIAN	(i) (ii)	781,552 0	70,390 0	1,688 0	20,952 0	24,167 0	898,749 0	0 0
(16)JOHN CAMPANAPHYSICIAN	(i) (ii)	593,050 0	126,131 0	2,156 0	23,502 0	21,517 0	766,356 0	0 0

Schedule J (Form 990) 2013

Page 3

Part III

Supplemental Information

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.

Return Reference	Explanation
SCHEDULE J, PART I, REPORTABLE INDIVIDUALS COMPENSATED BY UNRELATED ORGANIZATIONS	ALL KEY EMPLOYEES AND HOSPITAL CEOS ARE COMPENSATED BY CENTURA HEALTH CORPORATION, WHO MANAGES THE DAILY ACTIVITIES OF PORTERCARE ADVENTIST HOSPITALS UNDER A JOINT OPERATING AGREEMENT DATED DECEMBER 8, 1995 BETWEEN THE ADVENTIST HEALTHCARE SYSTEM AND CATHOLIC HEALTH INITIATIVES. AS SUCH, THEIR SALARIES ARE PAID TO THEM BY CENTURA, AN UNRELATED ORGANIZATION, FOR SERVICES RENDERED IN THEIR CAPACITY AS KEY EMPLOYEES OR OFFICERS OF PAHS. ALL OF THEIR REPORTABLE COMPENSATION IS DISCLOSED ON FORM 990, SCHEDULE J, PART II, ROW (I) AND FORM 990, PART VII, COLUMN (D) AS REPORTING ORGANIZATION COMPENSATION. IN ADDITION, THE CEO AND CFO OF PAHS WERE APPOINTED AS SUCH BY THE PAHS BOARD OF DIRECTORS. WHILE THEY ARE OFFICERS OF THESE ENTITIES, A VERY SMALL PORTION OF THEIR TIME IS DIRECTLY RELATED TO THE OPERATIONS OF PAHS. THEY ARE COMPENSATED BY CENTURA, WHICH IS CHARGED WITH MANAGING THE FACILITIES. THEIR RESPECTIVE COMPENSATION IS NOT REPORTED ON THE FILING ORGANIZATION'S 990 BUT IN FACT IS REPORTED IN FULL ON PART VII AND SCHEDULE J OF CENTURA HEALTH CORPORATION'S FORM 990.
Schedule J, Part I, Line 1a, Travel for companions	SENIOR VPS AND HOSPITAL CEOS ARE PAID THROUGH CENTURA HEALTH CORP AND ARE ELIGIBLE FOR THE FOLLOWING BENEFITS: TRAVEL FOR COMPANIONS, HEALTH OR SOCIAL CLUB DUES, AND REIMBURSEMENT UP TO $10,000 FOR PERSONAL SERVICES SUCH AS TAX, FINANCIAL, AND ESTATE PLANNING SERVICES, ALONG WITH TAX GROSS-UP PAYMENTS FOR ANY REIMBURSEMENTS INCLUDED IN TAXABLE COMPENSATION. ALL BENEFITS ARE PROVIDED PURSUANT TO A WRITTEN POLICY GOVERNING PAYMENT AND REIMBURSEMENT, SUBSTANTIATION IS REQUIRED FOR ALL EXPENSES SUBMITTED FOR REIMBURSEMENT, AND REIMBURSEMENTS ARE INCLUDED IN TAXABLE COMPENSATION WHERE APPROPRIATE.
Schedule J, Part I, Line 1a, Tax indemnification and gross-up payments	SEE SCHEDULE J, PART I, LINE 1A - TRAVEL FOR COMPANIONS DISCLOSURE
Schedule J, Part I, Line 1a, Health or social club dues or initiation fees	SEE SCHEDULE J, PART I, LINE 1A - TRAVEL FOR COMPANIONS DISCLOSURE
Schedule J, Part I, Line 1a, Personal services	SEE SCHEDULE J, PART I, LINE 1A - TRAVEL FOR COMPANIONS DISCLOSURE
Schedule J, Part I, Line 3, Arrangement used to establish the top management official's compensation	PORTERCARE ADVENTIST HEALTH SYSTEM'S (PAHS) CEO IS PAID BY CENTURA HEALTH CORPORATION (CENTURA). OUTSIDE CONSULTANTS ARE ENGAGED TO PROVIDE RECOMMENDATIONS TO CENTURA'S COMPENSATION COMMITTEE REGARDING THE COMPENSATION OF FACILITY CEOS. THE CONSULTANT'S RECOMMENDATIONS ARE THEN PRESENTED TO AND APPROVED BY THE COMPENSATION COMMITTEE.
Schedule J, Part I, Line 4b, Supplemental nonqualified retirement plan	CENTURA OFFERS A NON-QUALIFIED RETIREMENT PLAN IN WHICH SENIOR EXECUTIVES (SENIOR VPS AND ABOVE) ARE PROVIDED A 10% OF SALARY ALLOWANCE TO PURCHASE INSURANCE PRODUCTS OR CONTRIBUTED INTO THE DEFERRED COMPENSATION PLAN. IN ADDITION, A PENSION RESTORATION BENEFIT IS PROVIDED WHICH CREDITS PARTICIPANTS WITH A BENEFIT WHICH IS CALCULATED BASED ON THE EXCESS OF THE PARTICIPANT'S COMPENSATION OVER THE MAXIMUM ALLOWED FOR PENSION CONTRIBUTIONS. AMOUNTS DEFERRED ARE NOT REPORTED AS TAXABLE INCOME UNTIL/UNLESS A TRIGGERING EVENT OCCURS. THIS DEFERRED COMPENSATION PLAN HAS A SUBSTANTIAL RISK OF FORFEITURE PROVISION AND AN ELECTED VESTING SCHEDULE. THE FOLLOWING RECEIVED CONTRIBUTIONS TO A NON-QUALIFIED PLAN FOR THE CALENDAR YEAR 2013: MORRE DEAN $48,266 JOHN SACKETT $6,998 RANDALL HAFFNER $132,360 BRETT SPENST $50,120 DENNIS BARTS $5,347 DURING 2013 THE FOLLOWING DISTRIBUTIONS WERE MADE: MORRE DEAN $13,129 JOHN SACKETT $75,154 RANDALL HAFFNER $115,394 IN ADDITION, THREE OF THE BOARD MEMBERS ARE COMPENSATED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHS) AND 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 AHS. ANY FUNDS THAT REMAIN AFTER THE COST OF MANDATORY AND ELECTIVE BENEFITS ARE SUBTRACTED FROM THE PRE-DETERMINED BENEFITS ANNUAL AMOUNT ARE CONTRIBUTED, AT THE EMPLOYEE'S OPTION, TO EITHER AN IRC 457(F) DEFERRED COMPENSATION ACCOUNT OR TO AN IRC 457(B) ELIGIBLE DEFERRED COMPENSATION PLAN. 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 HOSPITAL OR HEALTH CARE INSTITUTIONS. PARTICIPATION IN THE PLAN IS OFFERED TO AHS EXECUTIVES ON A PRORATA SCHEDULE BEGINNING WITH 20 YEARS OF SERVICE AS AN EMPLOYEE OF AHS AND/OR ANOTHER HOSPITAL OR HEALTHCARE INSTITUTION CONTROLLED BY THE SEVENTH-DAY ADVENTIST CHURCH AND WHO SATISFY CERTAIN OTHER QUALIFYING CRITERIA. THIS SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) WAS DESIGNED TO PROVIDE ELIGIBLE EXECUTIVES WITH THE ECONOMIC EQUIVALENT OF AN ANNUAL INCOME BEGINNING AT NORMAL RETIREMENT AGE EQUAL TO 60% OF THE AVERAGE OF THE PARTICIPANT'S THREE HIGHEST YEARS OF BASE SALARY FROM AHS ACTIVE EMPLOYMENT INCLUSIVE OF INCOME FROM ALL OTHER SEVENTH-DAY ADVENTIST CHURCH HEALTHCARE EMPLOYER-FINANCED RETIREMENT INCOME SOURCES AND INVESTMENT INCOME EARNED ON THOSE CONTRIBUTIONS THROUGH SOCIAL SECURITY NORMAL RETIREMENT AGE AS DEFINED IN THE PLAN. 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. 457(F) EMPLOYER CONTRIBUTIONS FOR CALENDAR YEAR 2013 WERE: ROBERT HENDERSCHEDT $120,509 RICHARD REINER $191,096 TERRY SHAW $184,069 457(F) EMPLOYER DISTRIBUTIONS FOR CALENDAR YEAR 2013 WERE: ROBERT HENDERSCHEDT $104,830 RICHARD REINER $173,596 TERRY SHAW $179,354 SERP PAYMENTS FOR CALENDAR YEAR 2013 WERE: ROBERT HENDERSCHEDT $201,948 RICHARD REINER $194,730
Schedule J, Part I, Line 7, Non-fixed payments	PARTICIPANTS IN CENTURA'S INCENTIVE COMPENSATION PLANS INCLUDE DIRECTORS AND ABOVE. PAYOUTS ARE BASED ON METRICS ESTABLISHED AND APPROVED BY CENTURA'S COMPENSATION COMMITTEE. THE METRICS INCLUDE QUANTIFIABLE MEASURES PERTAINING TO FINANCIAL PERFORMANCE, SAFETY AND QUALITY AND ASSOCIATE SATISFACTION WITH EACH METRIC WEIGHTED IN DETERMINING THE OVERALL SCORE. THE INCENTIVE COMPENSATION PAYOUT IS CALCULATED BASED ON THE CUMULATIVE SCORE FOR ALL METRICS AND THE PAYOUT IS BASED ON A COMBINATION OF THE SCORE, THE INDIVIDUAL'S BASE COMPENSATION AMOUNT AND POSITION (E.G. DIRECTOR, VICE PRESIDENT).

Schedule J (Form 990) 2013

Additional Data

Software ID:	13000248
Software Version:	2013v3.1

- 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.
MediumBullet

Information about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

PORTERCARE ADVENTIST HEALTH SYSTEM

Employer identification number

84-0438224

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) 2013

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) HEALTHCARE SUPPORT SERVICES	KEY ON PAHS/BOARD ON HSS	3,394,992	HSS IS A VENDOR OF PAHS		No
(2) TAMMY SMITH	SPOUSE OF KEY EMPLOYEE	78,287	EMPLOYEE COMPENSATION		No
(3) STEPHANIE TRAVER	DAUGHTER OF KEY EMPLOYEE	62,392	EMPLOYEE COMPENSATION		No
(4) DIANE EITEL	SPOUSE OF KEY EMPLOYEE	27,593	EMPLOYEE COMPENSATION		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2013

Additional Data

Software ID:	13000248
Software Version:	2013v3.1

- 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.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

PORTERCARE ADVENTIST HEALTH SYSTEM

Employer identification number

84-0438224

Return Reference	Explanation
Form 990, Part VI, Sec A, Line 1a, Delegate broad authority to a committee	PURSUANT TO ARTICLE IV OF THE BYLAWS OF PORTERCARE ADVENTIST HEALTH SYSTEM, THE BOARD OF TRUSTEES MAY, BY RESOLUTION OR RESOLUTIONS PASSED BY A MAJORITY OF THE TRUSTEES THEREOF, APPOINT AN EXECUTIVE COMMITTEE OR SUCH OTHER COMMITTEES FOR ANY PURPOSE AND DELEGATE TO SUCH COMMITTEES ANY OF THE POWERS AND AUTHORITY OF THE BOARD OF TRUSTEES AS IS PERMITTED BY LAW. COLORADO LAW PRECLUDES A COMMITTEE OF THE BOARD FROM (I) AUTHORIZING DISTRIBUTIONS; (II) APPROVING OR PROPOSING TO THE MEMBER ACTIONS THAT ARTICLES 121-137 OF TITLE 7 OF THE COLORADO REVISED STATUTES REQUIRE TO BE APPROVED BY THE MEMBER; (III) AMENDING THE CORPORATION'S AMENDED AND RESTATED ARTICLES OF INCORPORATION; (IV) ADOPTING, AMENDING OR REPEALING THE BYLAWS; (V) APPROVING A PLAN OF MERGER NOT REQUIRING APPROVAL OF THE MEMBER; OR (VI) APPROVING A SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, OF ITS PROPERTY, WITH OR WITHOUT GOOD WILL, OTHERWISE THAN IN THE USUAL AND REGULAR COURSE OF BUSINESS SUBJECT TO APPROVAL OF THE MEMBER. SUCH COMMITTEES SHALL HAVE THE POWER TO ACT ONLY IN INTERVALS BETWEEN MEETINGS OF THE BOARD OF TRUSTEES AND SHALL, AT ALL TIMES, BE SUBJECT TO THE CONTROL OF THE BOARD OF TRUSTEES. THE BOARD OF TRUSTEES, OR IF THE BOARD DOES NOT ACT, THE COMMITTEES, SHALL ESTABLISH RULES AND REGULATIONS FOR MEETINGS AND SHALL MEET AT SUCH TIMES AS ARE DEEMED NECESSARY, PROVIDED THAT A REASONABLE NOTICE OF ALL MEETINGS SHALL BE GIVEN TO COMMITTEE MEMBERS. NO ACT OF A COMMITTEE SHALL BE VALID UNLESS APPROVED BY THE VOTE OR WRITTEN CONSENT OF A MAJORITY OF ITS MEMBERS. COMMITTEES SHALL KEEP REGULAR MINUTES OF PROCEEDINGS AND REPORT THE SAME TO THE BOARD FROM TIME TO TIME AS THE BOARD MAY REQUIRE.
Form 990, Part VI, Sec A, Line 6, Classes of members or stockholders	THE SOLE CORPORATE MEMBER OF PAHS IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHS), A FLORIDA NONPROFIT CORPORATION.
Form 990, Part VI, Sec A, Line 7a, Members or stockholders electing members of governing body	AHS, THE SOLE CORPORATE MEMBER, HAS THE POWER TO APPOINT OR REMOVE THE MEMBERS OF THE GOVERNING BODY.
Form 990, Part VI, Sec A, Line 7b, Decisions requiring approval by members or stockholders	THE CORPORATE MEMBER, AHS, ACTING THROUGH THE BOARD OF TRUSTEES, MAINTAINS ALL RIGHTS PERMITTED TO BE EXERCISED BY DIRECTORS OF A COLORADO CORPORATION EXCEPT AS LIMITED BY THE ORGANIZATIONS' ARTICLES, BYLAWS, OR AFFILIATION AGREEMENT WITH CATHOLIC HEALTH INITIATIVES (CHI). THE AGREEMENT OF BOTH AHS AND CHI IS REQUIRED FOR CERTAIN SIGNIFICANT DECISIONS INVOLVING CENTURA FACILITIES. IN ADDITION, PURSUANT TO THE AFFILIATION AGREEMENT BETWEEN CHI, CHIC, CENTURA HEALTH CORPORATION, AND PORTERCARE ADVENTIST HEALTH SYSTEM, CERTAIN MATTERS AFFECTING CHIC MUST BE APPROVED BY BOTH PORTERCARE AND CHI. THOSE ITEMS INCLUDE: - THE TRANSFER OF ASSETS VALUED AT OVER $1,000,000 - THE ISSUANCE OF A DEBT INSTRUMENT IN EXCESS OF $250,000 - THE AMENDMENT OF THE ORGANIZING DOCUMENTS - THE ADMISSION OF A NEW SPONSOR - A MERGER OR DISSOLUTION OR REORGANIZATION - SETTLEMENT OF LEGAL PROCEEDINGS IN EXCESS OF $2,000,000 - CAPITAL EXPENDITURES IN EXCESS OF $2,000,000
Form 990, Part VI, Sec B, Line 11b, Review of form 990 by governing body	A DRAFT OF THE FORM 990 IS PROVIDED TO MANAGEMENT, INCLUDING THE CFO, FOR REVIEW. THE RETURN IS E-MAILED TO THE ENTIRE BOARD FOR REVIEW PRIOR TO FILING. AFTER PRESENTATION TO THE BOARD, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE BOARD.
Form 990, Part VI, Sec B, Line 12c, Conflict of interest policy	PORTERCARE ADVENTIST HEALTH SYSTEM HAS ADOPTED CENTURA HEALTH'S CONFLICT OF INTEREST POLICY: 1. CONFLICT OF INTEREST POLICY 1.1 CONSISTENT WITH CENTURA INTEGRITY STANDARDS, IT IS POLICY THAT EACH BOARD OF TRUSTEE MEMBER, CORPORATE OFFICER, AND KEY EMPLOYEE ACT AT ALL TIMES IN A MANNER THAT IS CONSISTENT WITH CENTURA'S MISSION AND VALUES BASED SERVICE TO THE COMMUNITY AND EXERCISE CARE THAT HE OR SHE DOES NOT HAVE ANY PERSONAL INTEREST WHICH MIGHT CONFLICT WITH OR APPEAR TO CONFLICT WITH THE INTEREST OF CENTURA OR WHICH MIGHT INFLUENCE THEIR JUDGMENT OR ACTIONS IN PERFORMING THEIR DUTIES. 1.1.1 IN CONNECTION WITH AN ACTUAL OR POSSIBLE TRANSACTION OR ARRANGEMENT INVOLVING CENTURA, ANY BOARD MEMBER, CORPORATE OFFICER, OR KEY EMPLOYEE WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST MUST DISCLOSE AND BE GIVEN THE OPPORTUNITY TO SHARE ALL MATERIAL FACTS WITH THE BOARD CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. 1.1.2 BOARD MEMBERS, CORPORATE OFFICERS, AND KEY EMPLOYEES ARE ALSO REQUIRED TO DISCLOSE ANY POSSIBLE CONFLICTS ON AN ANNUAL BASIS THROUGH THE CONFLICT OF INTEREST QUESTIONNAIRE. 2. PROCEDURE FOR DISCLOSING AND REVIEWING TRANSACTION OR ARRANGEMENT CONFLICT OF INTERESTS: 2.1 BOARD MEMBERS, CORPORATE OFFICERS, AND KEY EMPLOYEES THAT HAVE A FINANCIAL INTEREST IN ANY ACTUAL OR POSSIBLE TRANSACTION INVOLVING CENTURA ARE REQUIRED TO DISCLOSE THE FINANCIAL INTEREST. 2.1.1 IN ORDER TO DETERMINE IF A CONFLICT OF INTEREST EXISTS, THE INDIVIDUAL WHO IS CONSIDERED TO HAVE A FINANCIAL INTEREST MAY MAKE A PRESENTATION AT THE BOARD OR BOARD COMMITTEE MEETING. AFTER SUCH PRESENTATION, THE INDIVIDUAL SHALL LEAVE THE MEETING FOR DISCUSSION AND A VOTE ON THE ISSUE. 2.1.2 AFTER EXERCISING DUE DILLEGENCE, THE BOARD OR BOARD COMMITTEE SHALL DETERMINE WHETHER CENTURA CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION WITH REASONABLE EFFORTS FROM ANOTHER PERSON OR ENTITY. IF A MORE ADVANTAGEOUS TRANSACTION IS NOT REASONABLY ATTAINABLE, THE BOARD OR BOARD COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED MEMBERS WHETHER THE TRANSACTION IS IN CENTURA'S BEST INTEREST AND IS FAIR. 3. PROCEDURE FOR DISCLOSING AND REVIEWING OTHER CONFLICT OF INTERESTS: 3.1 BOARD MEMBERS, CORPORATE OFFICERS, AND KEY EMPLOYEES SHALL ALSO DISCLOSE IN ADVANCE TO CENTURA LEADERS ANY NON-TRANSACTIONAL ACTIONS OR RELATIONSHIPS THAT HAVE THE POTENTIAL TO CREATE A CONFLICT OF INTEREST. 3.1.1 THE BOARD OR BOARD COMMITTEE SHALL CAREFULLY REVIEW AND SCRUTINIZE ANY CONFLICT OF INTEREST. BY A MAJORITY VOTE OF THE DISINTERESTED MEMBERS, THE BOARD SHALL TAKE WHATEVER ACTION IS DEEMED APPROPRIATE WITH RESPECT TO THE BOARD MEMBER, CORPORATE OFFICER, OR KEY EMPLOYEE UNDER THE CIRCUMSTANCES, INCLUDING POSSIBLE CORRECTIVE ACTION, IN ORDER TO BEST PROTECT THE INTERESTS OF CENTURA. 3.1.2 ON AN ANNUAL BASIS, BOARD MEMBERS, CORPORATE OFFICERS, AND KEY EMPLOYEES WILL ALSO BE SENT AN EMAIL REQUESTING THEY COMPLETE THE BOARD MEMBER AND CORPORATE OFFICER CONFLICT OF INTEREST QUESTIONNAIRE BY THE SPECIFIED DUE DATE IN THE EMAIL. 3.1.3 THE CORPORATE RESPONSIBILITY DEPARTMENT SHALL NOTIFY THE CHAIRPERSON OF THE BOARD OF ANY POTENTIAL CONFLICTS AND THE CHAIRPERSON, OR DESIGNEE, SHALL PERFORM FURTHER INVESTIGATION AS HE OR SHE DEEMS APPROPRIATE. 4. RECORD OF PROCEEDINGS: 4.1 THE MINUTES OF THE BOARD AND BOARD COMMITTEE SHALL CONTAIN: 4.1.1 THE NAMES OF PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST AND THE NATURE OF THE FINANCIAL INTEREST. 4.1.2 THE NAMES OF PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO ANY FINANCIAL INTEREST, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES, AND A RECORD OF THE BOARD OR BOARD COMMITTEE DECISION. 5. VIOLATIONS OF THE CONFLICTS OF INTEREST POLICY: 5.1 IF THE BOARD OR BOARD COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT AN INDIVIDUAL HAS FAILED TO DISCLOSE EITHER AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST, OR ALL MATERIAL FACTS SURROUNDING AN ACTUAL OR POSSIBLE CONFLICT, THE INDIVIDUAL WILL BE GIVEN A CHANCE TO EXPLAIN. 5.1.1 AFTER HEARING THE RESPONSE, THE BOARD WILL CONDUCT SUCH ADDITIONAL INVESTIGATION AS APPROPRIATE. IF THE BOARD DETERMINES THAT THE INDIVIDUAL HAS IN FACT FAILED TO DISCLOSE AS REQUIRED BY THE CONFLICT OF INTEREST POLICY, THE BOARD SHALL TAKE APPROPRIATE DISCIPLINARY OR CORRECTIVE ACTION.
FORM 990, PART VI, LINE 15, PROCESS USED TO ESTABLISH COMPENSATION	OUTSIDE CONSULTANTS ARE ENGAGED TO PROVIDE RECOMMENDATIONS TO CENTURA'S COMPENSATION COMMITTEE REGARDING THE COMPENSATION OF FACILITY CEOS AND CENTURA SENIOR EXECUTIVES. THE CONSULTANT'S RECOMMENDATIONS ARE THEN PRESENTED TO, CONSIDERED BY, AND APPROVED BY THE COMPENSATION COMMITTEE. CENTURA'S HUMAN RESOURCES DEPARTMENT PERFORMS ANALYSES OF THE MARKET TO DETERMINE COMPENSATION RANGES FOR THE REMAINDER OF CENTURA ASSOCIATES WHICH ARE REVIEWED AND APPROVED BY CENTURA'S SENIOR LEADERSHIP.
Form 990, Part VI, Sec B, Line 15b, Process to establish compensation of other employees	SEE ABOVE
FORM 990, PART VI, LINE 16B, JOINT VENTURE POLICY	PORTERCARE ADVENTIST HEALTH SYSTEM HAS NOT FORMALLY ADOPTED A WRITTEN POLICY OR WRITTEN PROCEDURE REGARDING JOINT VENTURES. HOWEVER, ADVENTIST HEALTH SYSTEM'S (AHS) SYSTEM-WIDE JOINT VENTURE MODEL OPERATING AGREEMENT INCORPORATES CONTROLS OVER THE VENTURE SUFFICIENT TO ENSURE THAT (1) THE EXEMPT ORGANIZATIONS, AT ALL TIMES, RETAINS CONTROL OVER THE VENTURE SUFFICIENT TO ENSURE THAT THE PARTNERSHIP FURTHERS THE EXEMPT PURPOSE OF THE ORGANIZATION; (2) IN ANY PARTNERSHIP IN WHICH THE EXEMPT ORGANIZATION IS A PARTNER, ACHIEVEMENT OF EXEMPT PURPOSES IS PRIORITIZED OVER MAXIMIZATION OF PROFITS FOR THE PARTNERS; (3) THE PARTNERSHIP DOES NOT ENGAGE IN ANY ACTIVITIES THAT WOULD JEOPARDIZE THE EXEMPT ORGANIZATION'S EXEMPTION; (4) RETURNS OF CAPITAL, ALLOCATIONS, AND DISTRIBUTIONS MUST BE MADE IN PROPORTION TO THE PARTNERS' RESPECTIVE OWNERSHIP INTERESTS; AND (5) ALL CONTRACTS ENTERED INTO BY THE PARTNERSHIP WITH THE EXEMPT ORGANIZATION MUST BE AT ARM'S LENGTH, WITH PRICES SET AT FAIR MARKET VALUE.
Form 990, Part VI, Sec C, Line 19, Required documents available to the public	THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE ON THE COLORADO SECRETARY OF STATE'S WEBSITE. THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC.
Form 990, Part IX, Line 11g, Other Expenses	OTHER FEES FOR SERVICES - TOTAL EXPENSE: 68302093, PROGRAM SERVICE EXPENSE: 45554666, MANAGEMENT AND GENERAL EXPENSES: 22747427, FUNDRAISING EXPENSES: ; PHYSICIAN FEES - TOTAL EXPENSE: 29418876, PROGRAM SERVICE EXPENSE: 29418876, MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; NURSE FEES - TOTAL EXPENSE: 3995542, PROGRAM SERVICE EXPENSE: 3995542, MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ;
Form 990 , Part XI, Line 9, Other changes in net assets or fund balances	TRANSFERS TO AFFILIATES - -4995200; MINORITY INTEREST DISTRIBUTIONS - -1205529;

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2013

Additional Data

Software ID:	13000248
Software Version:	2013v3.1

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990. MediumBullet

See separate instructions.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

PORTERCARE ADVENTIST HEALTH SYSTEM

Employer identification number

84-0438224

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on 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

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled 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	OPERATION OF HOSPITAL & RELATED SERVICES	IL	501(C)(3)	3	ADVENTIST HLTH SYSTEMSUNBELT INC		No
(2) ADVENTIST CARE CENTERS - COURTLAND INC 730 COURTLAND STREET ORLANDO,FL32804	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	FL	501(C)(3)	9	SUNBELT HLTH CARE CENTERS INC		No
(3) ADVENTIST GLENOAKS HOSPITAL 701 WINTHROP AVENUE GLENDALE HEIGHTS,IL60139	OPERATION OF HOSPITAL & RELATED SERVICES	IL	501(C)(3)	3	ADVENTIST HLTH SYSTEMSUNBELT INC		No
(4) ADVENTIST HINSDALE HOSPITAL 120 NORTH OAK STREET HINSDALE,IL60521	OPERATION OF HOSPITAL & RELATED SERVICES	IL	501(C)(3)	3	ADVENTIST HLTH SYSTEMSUNBELT INC		No
(5) ADVENTIST HEALTH MID-AMERICA INC 9100 W 74TH STREET SHAWNEE MISSION,KS66204	HLTHCARE RELATED SERVICES	KS	501(C)(3)	11	ADVENTIST HLTH SYSTEMSUNBELT INC		No
(6) ADVENTIST HEALTH PARTNERS INC 1000 REMINGTON BLVD STE 200 BOLINGBROOK,IL60440	OPERATE OUT-PATIENT PHYSICIAN CLINICS	IL	501(C)(3)	3	AHS MIDWEST MANAGEMENT INC		No
(7) ADVENTIST HEALTH SYSTEM AFFILIATED BENEFIT TRUST 900 HOPE WAY ALTAMONTE SPRINGS,FL32714	PROMOTION OF HLTHCARE	FL	501(C)(3)	11	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes
(8) ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORP 900 HOPE WAY ALTAMONTE SPRINGS,FL32714	MANAGEMENT SERVICES	FL	501(C)(3)	11	NA		No
(9) ADVENTIST HEALTH SYSTEMGEORGIA INC 1035 RED BUD ROAD CALHOUN,GA30701	OPERATION OF HOSPITAL & RELATED SERVICES	GA	501(C)(3)	3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes
(10) ADVENTIST HEALTH SYSTEMSUNBELT INC 900 HOPE WAY ALTAMONTE SPRINGS,FL32714	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes
(11) ADVENTIST HEALTH SYSTEMTEXAS INC 602 COURTLAND STREET ORLANDO,FL32804	LEASING PERSONNEL TO AFFILIATED HOSPITAL	TX	501(C)(3)	11	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes
(12) ADVENTIST UNIVERSITY OF HEALTH SCIENCES INC (630 YEAR END) 671 LAKE WINYAH DRIVE ORLANDO,FL32803	EDUCATION/OPERATION OF SCHOOL	FL	501(C)(3)	2	ADVENTIST HLTH SYSTEMSUNBELT INC		No
(13) AHS MIDWEST MANAGEMENT INC 1000 REMINGTON BLVD STE 200 BOLINGBROOK,IL60440	OPERATION OF PHYSICIAN PRACTICE MGMT	IL	501(C)(3)	11	ADVENTIST HLTH SYSTEMSUNBELT INC		No
(14) AHSCENTRAL TEXAS INC 1301 WONDER WORLD DRIVE SAN MARCOS,TX78666	PROVIDE OFFICE SPACE - MEDICAL PROFESSIONALS	TX	501(C)(3)	11	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes
(15) APOPKA HEALTH CARE PROPERTIES INC 305 E OAK STREET APOPKA,FL32703	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	11	SUNBELT HLTH CARE CENTERS INC		No
(16) BATTLE CREEK ADVENTIST HOSPITAL 1000 REMINGTON BLVD STE 200 BOLINGBROOK,IL60440	INACTIVE	MI	501(C)(3)	3	ADVENTIST HLTH SYSTEMSUNBELT INC		No
(17) BOLINGBROOK HOSPITAL FOUNDATION 1000 REMINGTON BLVD N 2ND FL BOLINGBROOK,IL60440	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	IL	501(C)(3)	7	MIDWEST HLTH FOUNDATION		No
(18) BRADFORD HEIGHTS HEALTH & REHAB CENTER INC 950 HIGHPOINT DRIVE HOPKINSVILLE,KY42240	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	KY	501(C)(3)	9	SUNBELT HLTH CARE CENTERS INC		No
(19) BURLESON NURSING & REHAB CENTER INC 301 HUGULEY BLVD BURLESON,TX76028	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	TX	501(C)(3)	9	SUNBELT HLTH CARE CENTERS INC		No
(20) CALDWELL HEALTH CARE PROPERTIES INC 1333 WEST MAIN PRINCETON,KY42445	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	11	SUNBELT HLTH CARE CENTERS INC		No
(21) CEDAR CRAG TERRACE INC (630 YEAR END) (11-72213) RT 5 BOX 900 MANCHESTER,KY40962	OPERATION OF HOME FOR THE ELDERLY-DISABLED	KY	501(C)(3)	7	MEMORIAL HOSPITAL INC		No
(22) CENTRAL TEXAS HEALTHCARE COLLABORATIVE 1301 WONDER WORLD DRIVE SAN MARCOS,TX78666	SUPPORT OPERATION OF HOSPITAL	TX	501(C)(3)	11	ADVENTIST HLTH SYSTEMSUNBELT INC		No
(23) CENTRAL TEXAS MEDICAL CENTER FOUNDATION 1301 WONDER WORLD DRIVE SAN MARCOS,TX78666	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	TX	501(C)(3)	7	ADVENTIST HLTH SYSTEMSUNBELT INC		No
(24) CHICKASAW HEALTH CARE PROPERTIES INC 250 S CHICKASAW TRAIL ORLANDO,FL32825	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	11	SUNBELT HLTH CARE CENTERS INC		No
(25) CHIPPEWA VALLEY HOSPITAL & OAKVIEW CARE CENTER INC 1220 THIRD AVENUE WEST DURAND,WI54736	OPERATION OF HOSPITAL & RELATED SERVICES	WI	501(C)(3)	3	ADVENTIST HLTH SYSTEMSUNBELT INC		No
(26) COBB MEDICAL ASSOCIATES LLC 3949 SOUTH COBB DRIVE SE SMYRNA,GA30080	OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES	GA	501(C)(3)	3	EMORY-ADVENTIST INC		No
(27) COURTLAND HEALTH CARE PROPERTIES INC 730 COURTLAND STREET ORLANDO,FL32804	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	11	SUNBELT HLTH CARE CENTERS INC		No
(28) CREEKWOOD PLACE NURSING & REHAB CENTER INC 683 E THIRD STREET RUSSELLVILLE,KY42276	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	KY	501(C)(3)	9	SUNBELT HLTH CARE CENTERS INC		No
(29) DAIRY ROAD HEALTH CARE PROPERTIES INC 7350 DAIRY ROAD ZEPHYRHILLS,FL33540	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	11	SUNBELT HLTH CARE CENTERS INC		No
(30) EAST ORLANDO HEALTH & REHAB CENTER INC 250 S CHICKASAW TRAIL ORLANDO,FL32825	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	FL	501(C)(3)	9	SUNBELT HLTH CARE CENTERS INC		No
(31) EMORY-ADVENTIST INC 3949 SOUTH COBB DRIVE SMYRNA,GA30080	OPERATION OF HOSPITAL & RELATED SVCS	GA	501(C)(3)	3	ADVENTIST HLTH SYSTEMSUNBELT INC		No
(32) FLETCHER HOSPITAL INC 100 HOSPITAL DRIVE HENDERSONVILLE,NC28792	OPERATION OF HOSPITAL & RELATED SVCS	NC	501(C)(3)	3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes
(33) FLNC INC 3355 E SEMORAN BLVD APOPKA,FL32703	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	FL	501(C)(3)	9	SUNBELT HLTH CARE CENTERS INC		No
(34) FLORIDA HOSPITAL HEALTHCARE PARTNERS INC (130-123113) 301 MEMORIAL MEDICAL PARKWAY DAYTONA BEACH,FL32117	OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES	FL	501(C)(3)	3	ADVENTIST HLTH SYSTEMSUNBELT INC		No
(35) FLORIDA HOSPITAL MEDICAL GROUP INC 900 WINDERLEY PLACE MAITLAND,FL32751	OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES	FL	501(C)(3)	3	ADVENTIST HLTH SYSTEMSUNBELT INC		No
(36) FLORIDA HOSPITAL PHYSICIAN GROUP INC (21-123113) 14055 RIVEREDGE DRIVE STE 250 TAMPA,FL33637	OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES	FL	501(C)(3)	3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP		No
(37) FLORIDA HOSPITAL WATERMAN INC 1000 WATERMAN WAY TAVARES,FL32778	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes
(38) FLORIDA HOSPITAL ZEPHYRHILLS INC 7050 GALL BLVD ZEPHYRHILLS,FL33541	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	3	ADVENTIST HLTH SYSTEMSUNBELT INC		No
(39) FOUNDATION FOR SHAWNEE MISSION MEDICAL CENTER INC 9100 W 74TH STREET SHAWNEE MISSION,KS66204	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	KS	501(C)(3)	11	SHAWNEE MISSION MEDICAL CENTER INC		No
(40) GLENOAKS HOSPITAL FOUNDATION 701 WINTHROP AVENUE GLENDALE HEIGHTS,IL60139	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	IL	501(C)(3)	7	MIDWEST HLTH FOUNDATION		No
(41) HELEN ELLIS MEMORIAL HOSPITAL AUXILIARY INC 1395 S PINELLAS AVE TARPON SPRINGS,FL34689	FUND-RAISING FOR TAX-EXEMPT HOSPITAL/FOUNDATION	FL	501(C)(3)	11	TARPON SPRINGS HOSPITAL FOUNDATION INC		No
(42) HELEN ELLIS MEMORIAL HOSPITAL FOUNDATION INC 1395 S PINELLAS AVE TARPON SPRINGS,FL34689	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	FL	501(C)(3)	11	TARPON SPRINGS HOSPITAL FOUNDATION INC		No
(43) HINSDALE HOSPITAL FOUNDATION 7 SALT CREEK LANE SUITE 203 HINSDALE,IL60521	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	IL	501(C)(3)	7	MIDWEST HLTH FOUNDATION		No
(44) IN-MOTION REHAB INC 602 COURTLAND STREET STE 200 ORLANDO,FL32804	THERAPY SERVICES TO TAX EXEMPT NURSING HOMES	KS	501(C)(3)	11	SUNBELT HLTH CARE CENTERS INC		No
(45) JELLICO COMMUNITY HOSPITAL INC 188 HOSPITAL LANE JELLICO,TN37762	OPERATION OF HOSPITAL & RELATED SERVICES	TN	501(C)(3)	3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes
(46) JOHNSON COUNTY COMMUNITY CARE CORPORATION (11-5613) 11801 SOUTH FREEWAY BURLESON,TX76028	SUPPORT OPERATION OF HOSPITAL	TX	501(C)(3)	11	ADVENTIST HLTH SYSTEMSUNBELT INC		No
(47) LA GRANGE MEMORIAL HOSPITAL FOUNDATION 5101 S WILLOW SPRINGS RD LA GRANGE,IL60525	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	IL	501(C)(3)	7	MIDWEST HLTH FOUNDATION		No
(48) MEMORIAL HEALTH SYSTEMS FOUNDATION INC 770 WEST GRANADA BLVD ORMOND BEACH,FL32174	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	FL	501(C)(3)	7	MEMORIAL HLTH SYSTEMS INC		No
(49) MEMORIAL HEALTH SYSTEMS INC 301 MEMORIAL MEDICAL PARKWAY DAYTONA BEACH,FL32117	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	3	ADVENTIST HLTH SYSTEMSUNBELT INC		No
(50) MEMORIAL HOSPITAL - WEST VOLUSIA INC 701 WEST PLYMOUTH AVENUE DELAND,FL32720	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	3	MEMORIAL HLTH SYSTEMS INC		No
(51) MEMORIAL HOSPITAL FLAGLER INC 60 MEMORIAL MEDICAL PARKWAY PALM COAST,FL32164	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	3	MEMORIAL HLTH SYSTEMS INC		No
(52) MEMORIAL HOSPITAL INC 210 MARIE LANGDON DRIVE MANCHESTER,KY40962	OPERATION OF HOSPITAL & RELATED SERVICES	KY	501(C)(3)	3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes
(53) MERRIAM HEALTH CARE PROPERTIES INC 9700 WEST 62ND STREET MERRIAM,KS66203	LEASE TO RELATED ORGANIZATION	KS	501(C)(3)	11	SUNBELT HLTH CARE CENTERS INC		No
(54) METROPLEX ADVENTIST HOSPITAL INC 2201 S CLEAR CREEK ROAD KILLEEN,TX76549	OPERATION OF HOSPITAL & RELATED SERVICES	TX	501(C)(3)	3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes
(55) METROPLEX CLINIC PHYSICIANS INC 2201 S CLEAR CREEK ROAD KILLEEN,TX76549	PHYSICIAN HLTHCARE SERVICES TO THE COMMUNITY	TX	501(C)(3)	3	METROPLEX ADVENTIST HOSPITAL INC		No
(56) METROPLEX HOSPITAL INC 900 HOPE WAY ALTAMONTE SPRINGS,FL32714	FUTURE OPERATION OF HOSPITAL & RELATED SVCS	FL	501(C)(3)	3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP		No
(57) MIDWEST HEALTH FOUNDATION 120 NORTH OAK STREET HINSDALE,IL60521	SUPPORT OF SUBSIDIARY FOUNDATIONS	IL	501(C)(3)	11	NA		No
(58) MILLS HEALTH & REHAB CENTER INC 500 BECK LANE MAYFIELD,KY42066	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	KY	501(C)(3)	9	SUNBELT HLTH CARE CENTERS INC		No
(59) MISSION STRATEGIES OF GEORGIA INC 3949 S COBB DRIVE SMYRNA,GA30080	PROVISION OF SUPPORT TO THE NURSING HOME DIVISION	GA	501(C)(3)	11	SUNBELT HLTH CARE CENTERS INC		No
(60) MISSION STRATEGIES INC 602 COURTLAND STREET STE 200 ORLANDO,FL32804	PROVISION OF SUPPORT TO THE NURSING HOME DIVISION	KS	501(C)(3)	11	SUNBELT HLTH CARE CENTERS INC		No
(61) MISSOURI ADVENTIST HEALTH INC 9100 W 74TH STREET SHAWNEE MISSION,KS66204	SUPPORT HLTH CARE SERVICES	MO	501(C)(3)	11	ADVENTIST HLTH MID-AMERICA INC		No
(62) NORTH REGIONAL EMS INC 188 HOSPITAL LANE JELLICO,TN37762	EMS SERVICES	TN	501(C)(3)	9	JELLICO COMMUNITY HOSPITAL INC		No
(63) ORMOND BEACH MEMORIAL HOSPITAL AUXILIARY INC 301 MEMORIAL MEDICAL PARKWAY DAYTONA BEACH,FL32117	VOLUNTEER SUPPORT SERVICES	FL	501(C)(3)	11	MEMORIAL HLTH SYSTEMS INC		No
(64) OVERLAND PARK NURSING & REHAB CENTER INC 6501 WEST 75TH STREET OVERLAND PARK,KS66204	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	KS	501(C)(3)	9	SUNBELT HLTH CARE CENTERS INC		No
(65) PARAGON HEALTH CARE PROPERTIES INC 950 HIGHPOINT DRIVE HOPKINSVILLE,KY42240	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	11	SUNBELT HLTH CARE CENTERS INC		No
(66) PASCO-PINELLAS HILLSBOROUGH COMMUNITY HEALTH SYSTEM INC 2400 BEDFORD ROAD ORLANDO,FL32803	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP		No
(67) PORTERCARE ADVENTIST HEALTH SYSTEM (630 YEAR END) 2525 S DOWNING STREET DENVER,CO80210	OPERATION OF HOSPITAL & RELATED SERVICES	CO	501(C)(3)	3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes
(68) PORTLAND NURSING & REHAB CENTER INC (11-6513) 215 HIGHLAND CIRCLE DRIVE PORTLAND,TN37148	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	TN	501(C)(3)	9	SUNBELT HLTH CARE CENTERS INC		No
(69) PRINCETON HEALTH & REHAB CENTER INC 1333 WEST MAIN PRINCETON,KY42445	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	KY	501(C)(3)	9	SUNBELT HLTH CARE CENTERS INC		No
(70) PRINCETON PROFESSIONAL SERVICES INC 601 E ROLLINS STREET ORLANDO,FL32803	PROVISION OF HLTHCARE SERVICES	FL	501(C)(3)	9	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes
(71) QUALITY CIRCLE FOR HEALTHCARE INC 900 HOPE WAY ALTAMONTE SPRINGS,FL32714	HLTHCARE QUALITY SERVICES	FL	501(C)(3)	11	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP		No
(72) RESOURCE PERSONNEL INC 602 COURTLAND STREET STE 200 ORLANDO,FL32804	PROVIDE ADMINISTRATIVE SUPPORT TO TAX EXEMPT NURSING HOMES	FL	501(C)(3)	11	SUNBELT HLTH CARE CENTERS INC		No
(73) ROCKY MOUNTAIN ADVENTIST HEALTHCARE FOUNDATION (630 YEAR END) 2525 SOUTH DOWNING STREET DENVER,CO80210	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	CO	501(C)(3)	7	PORTERCARE ADVENTIST HLTH SYSTEM		No
(74) ROLLINS BROOK COMMUNITY CARE CORP 2201 S CLEAR CREEK ROAD KILLEEN,TX76549	INACTIVE	TX	501(C)(3)	N/A	ADVENTIST HLTH SYSTEMSUNBELT INC		No
(75) RUSSELLVILLE HEALTH CARE PROPERTIES INC 683 EAST THIRD STREET RUSSELLVILLE,KY42276	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	11	SUNBELT HLTH CARE CENTERS INC		No
(76) SAN MARCOS HEALTH CARE PROPERTIES INC 1900 MEDICAL PARKWAY SAN MARCOS,TX78666	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	11	SUNBELT HLTH CARE CENTERS INC		No
(77) SAN MARCOS NURSING & REHAB CENTER INC 1900 MEDICAL PARKWAY SAN MARCOS,TX78666	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	TX	501(C)(3)	9	SUNBELT HLTH CARE CENTERS INC		No
(78) SHAWNEE MISSION HEALTH CARE INC 6501 WEST 75TH STREET OVERLAND PARK,KS66204	LEASE TO RELATED ORGANIZATION	KS	501(C)(3)	11	SUNBELT HLTH CARE CENTERS INC		No
(79) SHAWNEE MISSION MEDICAL CENTER INC 9100 W 74TH STREET SHAWNEE MISSION,KS66204	OPERATION OF HOSPITAL & RELATED SERVICES	KS	501(C)(3)	3	ADVENTIST HLTH MID-AMERICA INC		No
(80) SOUTH CENTRAL NURSING HOMES PROPERTIES INC 900 HOPE WAY ALTAMONTE SPRINGS,FL32714	MANAGEMENT SUPPORT	GA	501(C)(3)	11	SOUTH CENTRAL INC		No
(81) SOUTH CENTRAL NURSING HOMES INC 602 COURTLAND STREET ORLANDO,FL32804	MANAGEMENT SUPPORT	KY	501(C)(3)	11	SOUTH CENTRAL INC		No
(82) SOUTH CENTRAL PROPERTIES III INC 900 HOPE WAY ALTAMONTE SPRINGS,FL32714	REAL ESTATE	GA	501(C)(2)	1	SOUTH CENTRAL NURSING HOMES PROPERTIES INC		No
(83) SOUTH CENTRAL PROPERTIES IV INC 900 HOPE WAY ALTAMONTE SPRINGS,FL32714	REAL ESTATE	GA	501(C)(2)	1	SOUTH CENTRAL NURSING HOMES PROPERTIES INC		No
(84) SOUTH CENTRAL PROPERTIES VI INC 900 HOPE WAY ALTAMONTE SPRINGS,FL32714	REAL ESTATE	GA	501(C)(2)	1	SOUTH CENTRAL NURSING HOMES PROPERTIES INC		No
(85) SOUTH CENTRAL PROPERTIES INC 900 HOPE WAY ALTAMONTE SPRINGS,FL32714	REAL ESTATE	GA	501(C)(2)	1	SOUTH CENTRAL NURSING HOMES PROPERTIES INC		No
(86) SOUTH CENTRAL INC 602 COURTLAND STREET ORLANDO,FL32804	MANAGEMENT SUPPORT	GA	501(C)(3)	11	NA		No
(87) SOUTH PASCO HEALTH CARE PROPERTIES INC 38250 A AVENUE ZEPHYRHILLS,FL33542	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	11	SUNBELT HLTH CARE CENTERS INC		No
(88) SOUTHWEST VOLUSIA HEALTH SERVICES INC 1055 SAXON BLVD ORANGE CITY,FL32763	MEDICAL OFFICE BUILDING FOR HOSPITAL	FL	501(C)(3)	11	SOUTHWEST VOLUSIA HLTHCARE CORP		No
(89) SOUTHWEST VOLUSIA HEALTHCARE CORP 1055 SAXON BLVD ORANGE CITY,FL32763	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	3	ADVENTIST HLTH SYSTEMSUNBELT INC		No
(90) SPECIALTY PHYSICIANS OF CENTRAL TEXAS INC 1301 WONDER WORLD DRIVE SAN MARCOS,TX78666	PHYSICIAN HLTHCARE SERVICES TO THE COMMUNITY	TX	501(C)(3)	3	ADVENTIST HLTH SYSTEMSUNBELT INC		No
(91) SPRING VIEW HEALTH & REHAB CENTER INC 718 GOODWIN LANE LEITCHFIELD,KY42754	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	KY	501(C)(3)	9	SUNBELT HLTH CARE CENTERS INC		No
(92) SUNBELT HEALTH & REHAB CENTER - APOPKA INC 305 EAST OAK STREET APOPKA,FL32703	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	FL	501(C)(3)	9	SUNBELT HLTH CARE CENTERS INC		No
(93) SUNBELT HEALTH CARE CENTERS INC 602 COURTLAND STREET STE 200 ORLANDO,FL32804	MANAGEMENT SERVICES	TN	501(C)(3)	11	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes
(94) SUNSYSTEM DEVELOPMENT CORP 900 HOPE WAY ALTAMONTE SPRINGS,FL32714	FUND RAISING FOR AFFILIATED TAX-EXEMPT HOSPITALS	FL	501(C)(3)	7	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes
(95) TARPON SPRINGS HOSPITAL FOUNDATION INC 1395 S PINELLAS AVE TARPON SPRINGS,FL34689	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	3	UNIVERSITY COMMUNITY HOSPITAL INC		No
(96) TARRANT COUNTY HEALTH CARE PROPERTIES INC 301 HUGULEY BLVD BURLESON,TX76028	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	11	SUNBELT HLTH CARE CENTERS INC		No
(97) TAYLOR CREEK HEALTH CARE PROPERTIES INC 718 GOODWIN LANE LEITCHFIELD,KY42754	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	11	SUNBELT HLTH CARE CENTERS INC		No
(98) THE VOLUNTEER AUXILIARY OF FLORIDA HOSPITAL - FLAGLER INC 60 MEMORIAL MEDICAL PARKWAY PALM COAST,FL32164	VOLUNTEER SUPPORT SERVICES	FL	501(C)(3)	11	MEMORIAL HOSPITAL FLAGLER INC		No
(99) TRINITY NURSING & REHAB CENTER INC 9700 WEST 62ND STREET MERRIAM,KS66203	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	KS	501(C)(3)	9	SUNBELT HLTH CARE CENTERS INC		No
(100) UNIVERSITY COMMUNITY HOSPITAL FOUNDATION INC 3100 E FLETCHER AVE TAMPA,FL33613	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	FL	501(C)(3)	11	UNIVERSITY COMMUNITY HOSPITAL INC		No
(101) UNIVERSITY COMMUNITY HOSPITAL SPECIALTY CARE INC 3100 E FLETCHER AVE TAMPA,FL33613	INACTIVE	FL	501(C)(3)	11	UNIVERSITY COMMUNITY HOSPITAL INC		No
(102) UNIVERSITY COMMUNITY HOSPITAL INC 3100 E FLETCHER AVE TAMPA,FL33613	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes
(103) WEST KENTUCKY HEALTH CARE PROPERTIES INC 500 BECK LANE MAYFIELD,KY42066	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	11	SUNBELT HLTH CARE CENTERS INC		No
(104) ZEPHYR HAVEN HEALTH & REHAB CENTER INC 38250 A AVENUE ZEPHYRHILLS,FL33542	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	FL	501(C)(3)	9	SUNBELT HLTH CARE CENTERS INC		No
(105) ZEPHYRHILLS HEALTH & REHAB CENTER INC 7350 DAIRY ROAD ZEPHYRHILLS,FL33540	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	FL	501(C)(3)	9	SUNBELT HLTH CARE CENTERS INC		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2013

Page 2

Part III

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(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 V-UBI 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 V-UBI 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	FLETCHER HOSPITAL INC	N/A								50 %
(2) CLEAR CREEK MOB LTD 2201 S CLEAR CREEK RD KILLEEN,TX76549 74-2609195	REAL ESTATE	TX	CLEAR CREEK MOB INC	N/A								60.8 %
(3) FLORIDA HOSPITAL DMERT LLC 2450 MAITLAND CENTER PKWY STE 200 MAITLAND,FL32751 20-2392253	MEDICAL EQUIPMENT	FL	PRINCETON PROF SERVICES INC	N/A								33.33 %
(4) FLORIDA HOSPITAL HOME INFUSION 2450 MAITLAND CENTER PKWY STE 200 MAITLAND,FL32751 59-3142824	HOME INFUSION SERVICES	FL	PRINCETON PROF SERVSFH WATERMAN	N/A								57 %
(5) KCCCSMMC CANCER CENTER LLC 9100 W 74TH STREET SHAWNEE MISSION,KS66204 27-0909763	EQUIPMENT RENTAL	KS	SHAWNEE MISSION MED CTR INC	N/A								50 %
(6) SHAWNEE MISSION OPEN MRI LLC 9100 W 74TH STREET BOX 2923 SHAWNEE MISSION,KS66201 27-0011796	IMAGING & TESTING	KS	SHAWNEE MISSION MED CTR INC	N/A								60 %
(7) PAHSUSP SURGERY CENTERS LLC 15305 DALLAS PKWY SUITE 1600 LB 28 ADDISON,TX75001 26-3057950	SURGICAL SERVICES	TX	PAHS	RELATED	1,260,889	1,329,167		No	0		No	51 %
(8) ENDOSCOPY CENTER AT PORTER LLC 1001 SOUTH PARK DRIVE LITTLETON,CO80120 20-5855038	DIAGNOSTIC	CO	PAHS	RELATED	68,523	115,542		No	0		No	51 %
(9) SAN MARCOS MRI LP 1330 WONDER WORLD DR STE 202 SAN MARCOS,TX78666 77-0597972	IMAGING & TESTING	TX	ADVENTIST HLTH SYSTEMSUNBELT INC	N/A								60 %

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(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	NA	C CORPORATION
(2) APOPKA MEDICAL PLAZA CONDOMINIUM ASSOCIATION INC 601 EAST ROLLINS STREET ORLANDO,FL32803 59-3000857	CONDO ASSOCIATION	FL	NA	C CORPORATION
(3) CC MOB INC 2201 S CLEAR CREEK ROAD KILLEEN,TX76549 74-2616875	REAL ESTATE RENTAL	TX	NA	C CORPORATION
(4) CENTRAL TEXAS MEDICAL ASSOCIATES 1301 WONDER WORLD DRIVE SAN MARCOS,TX78666 74-2729873	PHYSICIAN CLINICS	TX	NA	C CORPORATION
(5) CENTRAL TEXAS PROVIDER'S NETWORK 1301 WONDER WORLD DRIVE SAN MARCOS,TX78666 74-2827652	PHYSICIAN HOSPITAL ORG.	TX	NA	C CORPORATION
(6) FLORIDA HOSPITAL FLAGLER MEDICAL OFFICES ASSOCIATION INC 60 MEMORIAL MEDICAL PARKWAY PALM COAST,FL32164 26-2158309	CONDO ASSOCIATION	FL	NA	C CORPORATION
(7) FLORIDA HOSPITAL HEALTHCARE SYSTEM INC 602 COURTLAND STREET ORLANDO,FL32804 59-3215680	PHO/TPA	FL	NA	C CORPORATION
(8) FLORIDA MEDICAL PLAZA CONDO ASSOCIATION INC 601 EAST ROLLINS STREET ORLANDO,FL32803 59-2855791	CONDO ASSOCIATION	FL	NA	C CORPORATION
(9) FLORIDA MEMORIAL HEALTH NETWORK INC 770 W GRANADA BLVD STE 317 ORMOND BEACH,FL32174 59-3403558	PHYSICIAN HOSPITAL ORG.	FL	NA	C CORPORATION
(10) HUGULEY ALLIANCE FOUNDATION 11801 SOUTH FREEWAY FORT WORTH,TX76115 75-2642209	INACTIVE	TX	NA	C CORPORATION
(11) KISSIMMEE MULTISPECIALTY CLINIC CONDOMINIUM ASSOCIATION INC 201 HILDA STREET SUITE 30 KISSIMMEE,FL34741 59-3539564	CONDO ASSOCIATION	FL	NA	C CORPORATION
(12) METROPLEX ADVENTIST HOSPITAL CRNA 2201 S CLEAR CREEK ROAD KILLEEN,TX76549 26-0760794	SUPPORT HOSPITAL - PROVIDE ALLIED HEALTH PROFESSIONALS	TX	NA	C CORPORATION
(13) MIDWEST MANAGEMENT SERVICES INC 9100 WEST 74TH STREET SHAWNEE MISSION,KS66204 48-0901551	REAL ESTATE RENTAL	KS	NA	C CORPORATION
(14) NORTH AMERICAN HEALTH SERVICES INC & SUBS 111 N ORLANDO AVENUE WINTER PARK,FL32789 62-1041820	LESSOR/HOLDING CO.	TN	NA	C CORPORATION
(15) ORMOND PROFESSIONAL CONDO ASSOCIATION 770 W GRANADA BLVD STE 101 ORMOND BEACH,FL32174 59-2694434	CONDO ASSOCIATION	FL	NA	C CORPORATION
(16) PARK RIDGE PROPERTY OWNER''''S ASSOCIATION INC 1 PARK PLACE NAPLES ROAD FLETCHER,NC28732	CONDO ASSOCIATION	NC	NA	C CORPORATION
(17) PORTER AFFILIATED HEALTH SERVICES INC DBA DIVERSIFIED AFFILIATED HEALTH SER VICES 2525 S DOWNING STREET DENVER,CO80210 84-0956175	HEALTHCARE SERVICES	CO	NA	C CORPORATION
(18) SAN MARCOS REGIONAL MRI INC 1301 WONDER WORLD DRIVE SAN MARCOS,TX78666 77-0597968	HOLDING COMPANY	TX	NA	C CORPORATION
(19) THE GARDEN RETIREMENT COMMUNITY INC 602 COURTLAND STREET STE 200 ORLANDO,FL32804 59-3414055	REAL ESTATE RENTAL	FL	NA	C CORPORATION
(20) UCH SERVICES INC 3100 EAST FLETCHER AVE TAMPA,FL33613 59-3508454	MANAGEMENT COMPANY	FL	NA	C CORPORATION
(21) UNIVERSITY COMMUNITY HEALTH INSURANCE COMPANY SPC LTD PO BOX 69 GT GRAND CAYMAN CJ	CAPTIVE INSURANCE	CJ	NA	C CORPORATION
(22) WINTER PARK MEDICAL OFFICE BUILDING I CONDO ASSOC INC 200 LAKEMONT AVE WINTER PARK,FL32792 45-2228478	PHYSICIAN CLINICS	FL	NA	C CORPORATION

Schedule R (Form 990) 2013

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on 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 . . . . . . . . . . . . . . . . . . . . . . .

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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

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

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

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

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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

Yes

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

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) ROCKY MOUNTAIN ADVENTIST HEALTHCARE FOUNDATION	C	1,907,712	FMV

Schedule R (Form 990) 2013

Page 4

Part VI

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

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

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(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 V?UBI 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 V?UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2013

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2013

Additional Data

Software ID:	13000248
Software Version:	2013v3.1

1	Briefly describe the organization’s mission or most significant activities: OUR COMPANY, A FAITH BASED ORGANIZATION, INVESTS IN CHARITY CARE, COMMUNITY PROGRAMS AND SPONSORSHIPS DESIGNED TO NURTURE THE HEALTH OF THE PEOPLE OF COLORADO WITH A GOAL TO KEEP THEM HEALTHY.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	3
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	0
5	Total number of individuals employed in calendar year 2013 (Part V, line 2a) ......	5	5,831
6	Total number of volunteers (estimate if necessary) .............	6	1,100
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	2,915,238
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	-435,703

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,049,707	1,914,123
9	Program service revenue (Part VIII, line 2g) .........	960,887,160	972,284,613
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	10,503,137	11,615,849
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	7,242,438	7,985,127
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	979,682,442	993,799,712
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	1,313,703	1,290,340
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)	327,606,654	363,306,823
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)....	557,761,375	575,630,758
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	886,681,732	940,227,921
19	Revenue less expenses. Subtract line 18 from line 12.......	93,000,710	53,571,791
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,365,736,196	1,415,367,426
21	Total liabilities (Part X, line 26).............	468,441,985	469,346,588
22	Net assets or fund balances. Subtract line 21 from line 20.....	897,294,211	946,020,838

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 794,633,498 including grants of $ 1,290,340 ) (Revenue $ 972,284,613 )
	SEE SCHEDULE H

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 expenses794,633,498

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	7,146,077	4,541,301	1,306,287

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)		(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) TODD MINER........................................................................ Physician	40.00 .......................0	X	853,630	0	45,119

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512-514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d		1,907,712
e	Government grants (contributions)1e

f	All other contributions, gifts, grants, and similar amounts not included above1f		6,411

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			1,914,123
			Business Code
2a	PATIENT SERVICES		900099	966,812,773	966,812,773
b	EQUITY CHANGES OF UNCONSOLIDATED ORGS		900099	2,570,726	2,570,726
c	RENTAL INCOME		900099	2,738,299	2,736,549	1,750
d	EDUCATION		611710	115,217	115,217
e	GUEST ROOM FEES		721310	47,595	47,595
f	All other program service revenue .			3	3	0	0
g	Total. Add lines 2a–2f........			972,284,613
3	Investment income (including dividends, interest, and other similar amounts).......			9,848,709		75	9,848,634
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties...........			0
		(i) Real	(ii) Personal
6a	Gross rents	66,037
b	Less: rental expenses	19,315
c	Rental income or (loss)	46,722	0
d	Net rental income or (loss).......			46,722			46,722
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory		11,606,088
b	Less: cost or other basis and sales expenses		9,838,948
c	Gain or (loss)	0	1,767,140
d	Net gain or (loss)..........			1,767,140			1,767,140
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..			0
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...			0
10a	Gross sales of inventory, less returns and allowances .
	a		803,759
b	Less: cost of goods sold ..b		509,972
c	Net income or (loss) from sales of inventory..			293,787			293,787
Miscellaneous Revenue			Business Code
11a	CAFETERIA		722100	4,040,660		115,079	3,925,581
b	PHARMACY SERVICES		446110	2,355,290		2,171,701	183,589
c	RESEARCH		541700	523,636		523,636	0
d	All other revenue ....			725,032	0	102,997	622,035
e	Total. Add lines 11a–11d ......			7,644,618
12	Total revenue. See Instructions......			993,799,712	972,282,863	2,915,238	16,687,488


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			654,163	1	2,230,184
2	Savings and temporary cash investments .........			21,593,387	2	39,301,890
3	Pledges and grants receivable, net ...........				3
4	Accounts receivable, net .............			111,801,820	4	125,813,285
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
				0	5	0
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
				0	6	0
7	Notes and loans receivable, net .............			2,570,749	7	4,278,068
8	Inventories for sale or use ..............			17,917,398	8	20,699,843
9	Prepaid expenses and deferred charges ..........			2,591,953	9	3,524,177
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	952,205,959
b	Less: accumulated depreciation .....	10b	362,542,664	568,490,402	10c	589,663,295
11	Investments—publicly traded securities ..........			0	11	0
12	Investments—other securities. See Part IV, line 11 .....			13,894,871	12	15,357,622
13	Investments—program-related. See Part IV, line 11 .....			463,983,942	13	440,699,160
14	Intangible assets ...............			88,149,186	14	88,074,186
15	Other assets. See Part IV, line 11 ...........			74,088,325	15	85,725,716
16	Total assets. Add lines 1 through 15 (must equal line 34)......			1,365,736,196	16	1,415,367,426
17	Accounts payable and accrued expenses .........			71,719,303	17	81,549,962
18	Grants payable .................				18
19	Deferred revenue ................				19	1,424,064
20	Tax-exempt bond liabilities .............				20
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..........			0	22	0
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....................			396,722,682	25	386,372,562
26	Total liabilities. Add lines 17 through 25.........			468,441,985	26	469,346,588
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			897,190,355	27	945,916,982
28	Temporarily restricted net assets ...........			103,856	28	103,856
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 ...........			897,294,211	33	946,020,838
34	Total liabilities and net assets/fund balances ........			1,365,736,196	34	1,415,367,426