Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private
foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
A For the 2014 calendar year, or tax year beginning 01-01-2014 , and ending 12-31-2014
BCheck if applicable:
CName of organization
Adventist Health SystemSunbelt Inc
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
900 Hope Way
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Altamonte Springs, FL32714
D Employer identification number

59-1479658
E Telephone number

G Gross receipts $ 3,557,749,677
F Name and address of principal officer:
Donald Jernigan
900 Hope Way
Altamonte Springs,FL32714
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.adventisthealthsystem.com
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet1071
K Form of organization:
 
L Year of formation: 1973
M State of legal domicile: FL
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: Operation of 12 acute-care hospitals & related healthcare services.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 24
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 19
5 Total number of individuals employed in calendar year 2014 (Part V, line 2a) ...... 5 26,969
6 Total number of volunteers (estimate if necessary) ............. 6 3,272
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 10,194,656
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 1,171,818
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 6,676,943 19,963,442
9 Program service revenue (Part VIII, line 2g) ......... 3,159,694,997 3,495,776,766
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 35,537,972 19,148,820
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 23,309,569 19,398,813
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 3,225,219,481 3,554,287,841
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 21,415,602 30,961,993
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 1,425,818,817 1,505,976,027
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 1,483,289,786 1,717,937,247
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 2,930,524,205 3,254,875,267
19 Revenue less expenses. Subtract line 18 from line 12....... 294,695,276 299,412,574
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 7,038,810,789 7,381,553,307
21 Total liabilities (Part X, line 26)............. 4,522,366,478 4,595,334,574
22 Net assets or fund balances. Subtract line 21 from line 20..... 2,516,444,311 2,786,218,733
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet
Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2014)
Form 990 (2014)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: Adventist Health System Sunbelt Healthcare Corporation and all of its subsidiary organizations were established by the Seventh-Day Adventist Church to bring a ministry of healing and health to the communities served. Our mission is to extend the healing ministry of Christ.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 2,937,633,891 including grants of $ 30,961,993 ) (Revenue $ 3,502,660,332 )
Operation of 12 acute care hospitals with 159,333 patient admissions, 789,725 patient days and 1,310,198 outpatient visits in the current year. In addition to hospital operations, the corporation provides medical care through a number of other activities such as urgent care centers, physician clinics, home health services, hospice services, sleep centers, wound centers, therapy and rehab.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet2,937,633,891
Form 990 (2014)
Form 990 (2014)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part III
Click to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment
...
7
Yes
 
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment
...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment.........................
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV......... Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IVClick to see attachment
15
Yes
 
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV... Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H.... Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................ Click to see list of attachments
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?
......................
24c
Yes
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I.... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I................... Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II................ Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV .......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV
..................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I
...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
1,902
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
26,969
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?
.........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note.
See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2014)
Form 990 (2014)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
24
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
19
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
No
b
Other officers or key employees of the organization ................
15b
 
No
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
IL
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletTerry Shaw

900 Hope Way
Altamonte Springs,FL32714 (407) 357-2463
Form 990 (2014)
Form 990 (2014)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(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)
(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
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) Carlson Ronald........................................................................
Director
1.00
.......................3.00
X           0 1,093 0
(2) Cauley DMin Michael F........................................................................
Director
1.00
.......................3.00
X           4,950 950 0
(3) Craig Carlos........................................................................
Director
1.00
.......................3.00
X           0 950 0
(4) Davidson James R........................................................................
Director
1.00
.......................3.00
X           613 1,200 0
(5) Griffith Jr Buford........................................................................
Director
1.00
.......................3.00
X           0 1,950 0
(6) Hagele Elaine M........................................................................
Director
1.00
.......................3.00
X           0 2,447 0
(7) Hayes Alta Sue........................................................................
Director
1.00
.......................3.00
X           0 950 0
(8) Houmann Lars D........................................................................
Director
15.00
.......................35.00
X           0 1,539,933 235,399
(9) Jernigan PhD Donald L........................................................................
Director/CEO
1.00
.......................50.00
X   X       0 1,649,011 404,602
(10) Johnson MD Mark........................................................................
Director
1.00
.......................3.00
X           0 950 0
(11) Knutson J Deryl........................................................................
Director
1.00
.......................3.00
X           0 1,950 0
(12) Lemon Thomas L........................................................................
Chairman/Director
1.00
.......................3.00
X           0 1,950 0
(13) Livesay MDiv Donald E........................................................................
Vice Chairman/Director
1.00
.......................3.00
X           0 1,950 0
(14) Moore MDiv Larry R........................................................................
Vice Chairman/Director
1.00
.......................3.00
X           0 1,950 0
(15) Morel Hubert J........................................................................
Director
1.00
.......................3.00
X           3,755 950 0
(16) Pichette Ray........................................................................
Director
1.00
.......................3.00
X           0 950 0
(17) Reiner Richard K........................................................................
Director/Exec VP
1.00
.......................50.00
X           0 1,629,916 134,368
Form 990 (2014)
Form 990 (2014)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(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)
(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
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) Robinson Randy........................................................................
Director
1.00
.......................3.00
X           613 1,950 0
(19) Scott Glynn CW........................................................................
Director
1.00
.......................3.00
X           0 1,950 0
(20) Shaw Terry D........................................................................
Director/Exec VP/CFO/COO
1.00
.......................50.00
X   X       0 1,506,315 257,610
(21) Smith DMin PhD Ron C........................................................................
Vice Chairman/Sec/Dir
1.00
.......................3.00
X           613 1,950 0
(22) Thurber Gary F........................................................................
Director
1.00
.......................3.00
X           0 1,950 0
(23) Webb Gil........................................................................
Director
1.00
.......................3.00
X           0 1,950 0
(24) Werner Thomas L........................................................................
Director
1.00
.......................3.00
X           0 1,450 0
(25) Banks David P........................................................................
Exec VP - FH
50.00
.......................0.00
      X     0 778,474 132,420
(26) Dodds Sheryl D........................................................................
Senior VP - FH
50.00
.......................0.00
      X     0 495,939 71,042
(27) Fulbright Robert D........................................................................
Exec VP - FH
50.00
.......................0.00
      X     0 623,696 127,257
(28) Goodman Todd A........................................................................
Senior VP - FH
50.00
.......................0.00
      X     0 497,444 76,026
(29) Hilliard Douglas W........................................................................
Senior VP - FH
50.00
.......................0.00
      X     0 482,800 97,859
(30) Hurst Jeffery D........................................................................
Senior VP - FH
50.00
.......................0.00
      X     0 461,801 68,989
(31) Moorhead MD John David........................................................................
Senior VP - FH
50.00
.......................0.00
      X     0 733,583 62,332
(32) Owen Terry R........................................................................
Senior VP - FH
50.00
.......................0.00
      X     0 626,776 92,592
(33) Paradis J Brian........................................................................
CEO Division - FH
50.00
.......................0.00
      X     0 1,947,125 164,307
(34) Reed MD Monica P........................................................................
Senior VP - FH
50.00
.......................0.00
      X     0 800,790 133,411
(35) Soler Eddie........................................................................
CFO Divison - FH
50.00
.......................0.00
      X     0 970,057 153,205
(36) Bittner MDHartmuth........................................................................
Medical Director
40.00
.......................0.00
        X   1,155,619 0 26,922
(37) Lee MDKathy........................................................................
Physician
50.00
.......................0.00
        X   785,246 0 28,675
(38) Jones MDPhillip E........................................................................
Physician
50.00
.......................0.00
        X   764,324 0 36,697
(39) Eubanks Jr MDWilliam Stephen........................................................................
Executive Director of Academic Surgery
40.00
.......................0.00
        X   753,377 0 19,077
(40) Wittum MDRoger L........................................................................
Physician
50.00
.......................0.00
        X   690,429 0 29,561
(41) Hamilton Connie A........................................................................
Former key employee
0.00
.......................0.00
          X 0 146,011 7,929
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 4,159,539 14,921,061 2,360,280
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet1,300
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
BRASFIELD & GORRIE LLC

941 W MORSE BLVD STE 200
WINTER PARK,FL32789
Construction Services 52,068,036
CERNER CORPORATION

PO BOX 412702
KANSAS CITY,MO64141
Patient Records & Billing 21,084,914
BARTON MALOW COMPANY

5337 MILLENIA LAKES BLVD STE 235
ORLANDO,FL32839
Construction Services 17,732,061
ROBINS & MORTON

423 S KELLER RD STE 200
ORLANDO,FL32810
Construction Services 14,056,483
KOOSHAREM CORPORATION SELECT STAFFING

24223 NETWORK PL
CHICAGO,IL60673
Staffing 13,065,689
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet488
Form 990 (2014)
Form 990 (2014)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 17,627,354
e Government grants (contributions)1e 2,178,763
f All other contributions, gifts, grants, and
similar amounts not included above
1f
157,325
g Noncash contributions included in lines
1a-1f:$
 
h Total. Add lines 1a-1f.......MediumBullet 19,963,442
 Program Service RevenueAmt Business Code
2a Patient Revenue 900099 3,425,838,202 3,419,003,116 6,835,086  
b Cafeteria/Vending Rev. 900099 19,188,949 18,609,501 579,448  
c Rent from Exemp Affiliates 531120 10,935,161 10,935,161    
d Management Fee 900099 8,781,438 8,097,374 684,064  
e Education 900099 7,782,500 7,782,500    
f All other program service revenue . 23,250,516 22,021,193 1,229,323  
g Total. Add lines 2a–2f........MediumBullet 3,495,776,766
 OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 15,423,921     15,423,921
4 Income from investment of tax-exempt bond proceeds..MediumBullet 246,846     246,846
5 Royalties...........MediumBullet 393,972     393,972
(i) Real (ii) Personal
6a Gross rents 4,361,984 252,232
b Less: rental expenses 1,776,942 43,920
c Rental income or (loss) 2,585,042 208,312
d Net rental income or (loss).......MediumBullet 2,793,354   866,735 1,926,619
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 4,065,875 1,053,152
b Less: cost or other basis and sales expenses 0 1,640,974
c Gain or (loss) 4,065,875 -587,822
d Net gain or (loss)..........MediumBullet 3,478,053     3,478,053
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..MediumBullet      
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...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a Equity earnings from related enti 900099 11,491,076 11,491,076    
b EHR Revenue 900099 4,665,670 4,665,670    
c Investment in Subs 900099 54,741 54,741    
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 16,211,487
12 Total revenue. See Instructions......MediumBullet 3,554,287,841 3,502,660,332 10,194,656 21,469,411
Form 990 (2014)
Form 990 (2014)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ...............
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 domestic organizations and domestic governments. See Part IV, line 21 .... 30,796,924 30,796,924
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ....    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............ 165,069 165,069
4 Benefits paid to or for members ....    
5 Compensation of current officers, directors, trustees, and key employees .... 11,383,801   11,383,801  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages .... 1,119,663,246 1,094,500,746 25,162,500  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 40,321,926 39,405,693 916,233  
9 Other employee benefits ....... 251,672,377 245,883,020 5,789,357  
10 Payroll taxes ........... 82,934,677 81,025,351 1,909,326  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 5,723,340   5,723,340  
c Accounting ........... 622,588   622,588  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) .... 310,123,596 250,742,480 59,381,116  
12 Advertising and promotion .... 20,442,799   20,442,799  
13 Office expenses ....... 106,553,911 79,241,002 27,312,909  
14 Information technology ...... 17,407,138 15,206,394 2,200,744  
15 Royalties ..        
16 Occupancy ........... 65,586,365 65,459,087 127,278  
17 Travel ............ 6,896,294 3,371,635 3,524,659  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 1,345,978 854,758 491,220  
20 Interest ........... 70,673,894 70,673,894    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 166,131,353 166,131,353    
23 Insurance .............. 26,490,711 26,167,348 323,363  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a Medical Supplies 619,012,147 619,012,147    
b Settlements 105,433,065   105,433,065  
c UBI Tax 353,812   353,812  
d Repairs/Maintenance 85,501,003 85,501,003    
e All other expenses 109,639,253 63,495,987 46,143,266  
25 Total functional expenses. Add lines 1 through 24e 3,254,875,267 2,937,633,891 317,241,376 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 MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2014)
Form 990 (2014)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 103,380 1 107,874
2 Savings and temporary cash investments ......... 2,022,267,786 2 2,096,739,949
3 Pledges and grants receivable, net ...........   3  
4 Accounts receivable, net ............. 444,928,441 4 499,819,933
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
  6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use .............. 73,801,169 8 80,835,798
9 Prepaid expenses and deferred charges .......... 23,917,484 9 17,555,966
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 3,946,744,952
b Less: accumulated depreciation ..... 10b 1,928,764,345 1,884,921,993 10c 2,017,980,607
11 Investments—publicly traded securities ..........   11  
12 Investments—other securities. See Part IV, line 11 ..... 277,802,883 12 277,373,392
13 Investments—program-related. See Part IV, line 11 .....   13  
14 Intangible assets ............... 33,144,645 14 32,589,757
15 Other assets. See Part IV, line 11 ........... 2,277,923,008 15 2,358,550,031
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 7,038,810,789 16 7,381,553,307
Liabilities 17 Accounts payable and accrued expenses ......... 253,635,420 17 351,124,411
18 Grants payable .................   18  
19 Deferred revenue ................   19  
20 Tax-exempt bond liabilities ............. 3,967,083,441 20 3,788,766,732
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 301,647,617 25 455,443,431
26 Total liabilities. Add lines 17 through 25......... 4,522,366,478 26 4,595,334,574
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 2,514,344,365 27 2,784,339,068
28 Temporarily restricted net assets ........... 2,099,946 28 1,879,665
29 Permanently restricted net assets ...........   29  
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet 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 ........... 2,516,444,311 33 2,786,218,733
34 Total liabilities and net assets/fund balances ........ 7,038,810,789 34 7,381,553,307
Form 990 (2014)
Form 990 (2014)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
3,554,287,841
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
3,254,875,267
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
299,412,574
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
2,516,444,311
5
Net unrealized gains (losses) on investments ...............
5
-11,367
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
17,585
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-29,644,370
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
2,786,218,733
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? .................
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 13
Form 990, Special Condition Description:
Special Condition Description
Form 990 (2014)
Form 990 (2014)
Page 14
Additional Data


Software ID:  
Software Version:  
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.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number

59-1479658
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
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.)
10
11
a
b
c
d
e
f
Enter the number of supported organizations .............................  
g
Provide the following information about the supported organization(s).
(i)Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total    

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
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) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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 VI.)..            
11 Total support Add lines 7 through 10.  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
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) 2014
Schedule A (Form 990 or 990-EZ) 2014
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) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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 VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations....
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed, (ii) the reasons for each such action, (iii) the authority under the organization's organizing document authorizing such action, and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class benefited by one or more of its supported organizations; or (c) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part II of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9(a)) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 5
Part IV
Supporting Organizations (continued)

Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (1) a written notice describing the type and amount of support provided during the prior tax year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 6
Part V – Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

1.   Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    

Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors (explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    

Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7   Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 7
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity
 
3 Administrative expenses paid to accomplish exempt purposes of supported organizations  
4 Amounts paid to acquire exempt-use assets  
5 Qualified set-aside amounts (prior IRS approval required)  
6 Other distributions (describe in Part VI). See instructions  
7Total annual distributions. Add lines 1 through 6.  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions
 
9 Distributable amount for 2014 from Section C, line 6  
10 Line 8 amount divided by Line 9 amount  

Section E - Distribution Allocations (see instructions) (i)
Excess Distributions
(ii)
Underdistributions
Pre-2014
(iii)
Distributable
Amount for 2014
1 Distributable amount for 2014 from Section C, line
6
 
2 Underdistributions, if any, for years prior to 2014
(reasonable cause required--see instructions)
 
3 Excess distributions carryover, if any, to 2014:
a From 2009.......X
b From 2010.......X
c From 2011.......X
d From 2012.......X
e From 2013.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2014 distributable amount  
i Carryover from 2009 not applied (see
instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2014 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2014 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2014, if any. Subtract lines 3g and 4a from line 2
(if amount greater than zero, see instructions)
 
6 Remaining underdistributions for 2014. Subtract
lines 3h and 4b from line 1 (if amount greater than
zero, see instructions)
 
7 Excess distributions carryover to 2015. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a From 2010.......X
b From 2011.......X
c From 2012.......X
d From 2013.......  
e From 2014.......  
Schedule A (Form 990 or 990-EZ) (2014)
Schedule A (Form 990 or 990-EZ) 2014
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number

59-1479658
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




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
Special Rules
......... 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) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 2
Name of organization
Adventist Health SystemSunbelt Inc
 
Employer identification number

59-1479658
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


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 3
Name of organization
Adventist Health SystemSunbelt Inc
 
Employer identification number

59-1479658
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) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 4
Name of organization
Adventist Health SystemSunbelt Inc
 
Employer identification number

59-1479658
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10)
that total more than $1,000 for the year from any one contributor. 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 (c) Use 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 (c) Use 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 (c) Use 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 (c) Use 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) (2014)

Additional Data


Software ID:  
Software Version:  
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 Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
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) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number

59-1479658
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ...................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
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) 2014

Schedule C (Form 990 or 990-EZ) 2014
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 Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(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? ......................................

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 separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2011 (b) 2012 (c) 2013 (d) 2014 (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) 2014


Schedule C (Form 990 or 990-EZ) 2014
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)
No
Yes
(b)
Amount
1
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:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
Yes
 
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
Yes
 
464,988
j
Total. Add lines 1c through 1i ...............................
464,988
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
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
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
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."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
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? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
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, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
Part II-B, Line 1: The corporation reimbursed traveling expenses and paid fees to retain the services of six consulting firms which performed lobbying activities on behalf of the corporation. The six firms were William Filan, John Andrew Kane, Dick Batchelor, Johnson & Blanton, McKinnon Associates, Inc., and Richard Crotty Consulting Group LLC and were paid a total of $329,518 during the year. Additionaly, dues were paid to the American Hospital Association, Florida Hospital Association, Illinois Hospital Association, Texas Hospital Association, and Association of Organ Procurement who use a portion of the dues to conduct lobbying activities.
Part II-B 1(b) During 2014 salary expense of $22,512 was incurred for paid staff engaged in lobbying activities.
Schedule C (Form 990 or 990EZ) 2014

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet 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.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number

59-1479658
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
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? ............
6
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? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
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.
Held at the End of the 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  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet1
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet0.00
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $ 0
8
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)? .......................................
9
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.
1a
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.
b
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)
Revenue included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
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:
a
Revenue included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
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) 2014

Schedule D (Form 990) 2014
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
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?........
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.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?
b
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 .... 17,122,750 16,590,057 15,730,537 15,221,113 14,810,178
b Contributions ........   79,461 79,402 121,143 30,263
c Net investment earnings, gains, and losses 976,037 808,853 780,118 753,535 720,592
d Grants or scholarships .....         339,920
e Other expenditures for facilities
and programs ........
344,211 355,621   365,254  
f Administrative expenses ....          
g End of year balance ...... 17,754,576 17,122,750 16,590,057 15,730,537 15,221,113
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet81.070 %
b
Permanent endowment SchDMd Bullet18.930 %
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
Yes
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
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 .................   208,903,455 208,903,455
b Buildings ................   1,374,448,717 602,367,295 772,081,422
c Leasehold improvements ............        
d Equipment ................   2,091,881,855 1,265,609,466 826,272,389
e Other .................   271,510,925 60,787,584 210,723,341
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 2,017,980,607
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 3
Part VII
Investments—Other 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.)Small Bullet  
Part VIII
Investments—Program 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








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
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) Funds Held in Trust 242,484,918
(2) Other Current Receivables 3,971,057
(3) Due From Related Parties and Affiliates 124,587,239
(4) Donor Restricted Assets 12,874
(5) Deferred Charges and Costs 19,722,030
(6) Long-term Investments 100,586,052
(7) Other Non-Current Assets 11,542,549
(8) Receivable - Interco Alloc of Tax-Exempt Bond Proceeds 1,837,871,325
(9) Receivable from Third Party 17,588,999
(10) Assets Held for Sale 164,367
(11) Board Deisgnated Funds 18,621
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 2,358,550,031
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  
Accounts Receivable - Credit Balances 15,512,899
Payable to Third Party 100,140,273
Due to Related-Affiliated Entities 9,767,848
Other Current Liabilities 22,895,794
Other Non-Current Liabilities 302,792,153
Notes and Loans Payable 171,468
Leases Payable 4,162,996


Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 455,443,431
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) 2014

Schedule D (Form 990) 2014
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 (losses) 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
Part II, Line 9: The filing organization has recorded the land conservation easement on its financial statements as a Property, Plant, and Equipment Asset. The conservation easement generates no revenue and the filing organization did not incur any expense in 2014 related to the maintenance and monitoring of the conservation easement.
Part V, Line 4: All endowment funds are held by related 501(c)(3) exempt foundations. These endowment funds have been established for a variety of purposes in support of related tax-exempt hospitals. All of the foundation's permanently restricted endowment funds are required to be retained permanently either by explicit donor stipulation or by the Florida Uniform Prudent Management of Institutional Funds Act.
Part X, Line 2: The filing organization is a subsidiary organization within Adventist Health System (AHS). The consolidated financial statements of AHS contain the following FIN 48 footnote: Please note that dollar amounts are in thousands. Healthcare Corporation and its affiliated organizations, other than North American Health Services, Inc. and its subsidiary (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. NAHS is a wholly owned, for-profit subsidiary of Healthcare Corporation. NAHS and its subsidiary are subject to federal and state income taxes. NAHS files a consolidated federal income tax return and, where appropriate, consolidated state income tax returns. All taxable income was fully offset by net operating loss carryforwards for federal income tax purposes; as such, there is no provision for current federal or state income tax for the years ended December 31, 2014 and 2013. NAHS also has temporary deductible differences of approximately $63,600 and $65,000 at December 31, 2014 and 2013, respectively, primarily as a result of net operating loss carryforwards. At December 31, 2014, NAHS had net operating loss carryforwards of approximately $63,400, expiring beginning in 2020 through 2026. Deferred taxes have been provided for these amounts, resulting in a net deferred tax asset of approximately $24,200 and $24,700 at December 31, 2014 and 2013, respectively. A full valuation allowance has been provided at December 31, 2014 and 2013 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 material uncertain tax positions as of December 31, 2014 and 2013.
Schedule D (Form 990) 2014

Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990.Right pointing arrow large image Information about Schedule F (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number

59-1479658
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of its grants
and other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria
used to award the grants or assistance? ...........................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in region (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region
(f) Total expenditures
for and investments
in region
Central America and the Caribbean 0 0 Grantmaking   68,528
Central America and the Caribbean 0 0 Meetings   8,773
Central America and the Caribbean 0 0 Program Services Mission Trip 279,382
East Asia and the Pacific 0 0 Grantmaking   26,104
East Asia and the Pacific 0 0 Meetings   63,844
East Asia and the Pacific 0 0 Program Services Disaster Assistance, Mission Trip 12,669
Europe (including Iceland and Greenland) 0 0 Meetings   54,365
Europe (including Iceland and Greenland) 0 0 Speakers   7,329
Middle East and North Africa 0 0 Grantmaking   1,780
Middle East and North Africa 0 0 Program Services Mission Trip 4,710
North America (which includes Canada and Mexico, but not the U.S.) 0 0 Meetings   13,179
North America (which includes Canada and Mexico, but not the U.S.) 0 0 Program Services Mission Trip-Foundation 23,927
Russia and Neighboring States 0 0 Grantmaking   300
South America 0 0 Grantmaking   20,345
South America 0 0 Meetings   15,809
South America 0 0 Program Services Medical/Dental Clinics, Mission Trip 73,122
South Asia 0 0 Grantmaking   10,000
South Asia 0 0 Meetings   4,333
Sub-Saharan Africa 0 0 Grantmaking   60,300
Sub-Saharan Africa 0 0 Program Services Mission Trip 163,318
3a Sub-total ..... 0 0 520,994
b Total from continuation sheets to Part I ... 0 0 391,123
c Totals (add lines 3a and 3b) 0 0 912,117
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2014
Schedule F (Form 990) 2014
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)
(a)(c) Region (b)(d) Purpose of
grant
(e) Amount of
cash grant
(f) Manner of
cash
disbursement
(g) Amount
of non-cash
assistance
(h) Description
of non-cash
assistance
(i) Method of
valuation
(book, FMV,
appraisal, other)
South America Medical Supplies or Equipment 8,181 Check     Book
Central America and the Caribbean Medical Supplies or Equipment     60,490 Medical Supplies Book
Central America and the Caribbean Medical Supplies or Equipment     5,500 Medical Supplies Book
South America Medical Supplies or Equipment     5,898 Medical Supplies Book
East Asia and the Pacific Disaster Assistance 25,000 Check     Book
Sub-Saharan Africa General Support 60,000 Electronic Funds     Book
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter ....MediumBullet
6
3
Enter total number of other organizations or entities .......................MediumBullet
0
Schedule F (Form 990) 2014
Schedule F (Form 990) 2014Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant
(e) Manner of cash
disbursement
(f) Amount of
non-cash
assistance
(g) Description
of non-cash
assistance
(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2014
Schedule F (Form 990) 2014
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926)......................................
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; do not file with Form 990)............................
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621)...............................................
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see Instructions for Form 5713; do not file with Form 990).....................................
Schedule F (Form 990) 2014
Schedule F (Form 990) 2014
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
ReturnReference Explanation
Part I, Line 2: Foreign grants are generally non-cash donations of medical equipment and supplies to assist foreign health care providers in fulfilling their mission of providing health care services to the populations they serve. The foreign health care providers are often hospitals and/or clinics operated and/or sponsored by or affiliated with the Seventh-Day Adventist Church. The foreign hospitals/clinics may be located in remote and/or underserved villages and townships of developing countries. Grants are typically made to other U.S. charitable organizations or foreign entities recognized as charitable by the foreign country in which they are located. As a result of the nature of the grants as non-cash medical equipment and supplies and the fact that most grants are made indirectly through other U.S. or foreign charitable organizations, the filing organization has not established specific procedures for monitoring the use of grant funds outside the United States.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2014
Additional Data


Software ID:  
Software Version:  



SCHEDULE H (Form 990)
Department of the TreasuryInternal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number

59-1479658
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
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.
3
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.
a
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:
3a
Yes
 
%
b
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: .........
3b
 
No
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used 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.
4
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"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
 
No
c
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? ..............
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
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) ..
    161,772,446   161,772,446 4.970 %
b Medicaid (from Worksheet 3,
column a) ....
    474,803,252 318,233,171 156,570,081 4.810 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) .
           
d Total Financial Assistance
and Means-Tested
Government Programs .
    636,575,698 318,233,171 318,342,527 9.780 %
Other Benefits
    14,033,861 292,920 13,740,941 0.420 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) ..
    37,180,417 10,806,342 26,374,075 0.810 %
g Subsidized health services
(from Worksheet 6) ..
    6,859,175 6,158,465 700,710 0.020 %
h Research (from Worksheet 7)     2,871,677 1,961,696 909,981 0.030 %
i Cash and in-kind
contributions for community
benefit (from Worksheet 8)
    23,821,324   23,821,324 0.730 %
j Total. Other Benefits ..     84,766,454 19,219,423 65,547,031 2.010 %
k Total. Add lines 7d and 7j .     721,342,152 337,452,594 383,889,558 11.790 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
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
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy     26,502,911 5,192,374 21,310,537 0.650 %
8 Workforce development     415,206 8,881 406,325 0.010 %
9 Other            
10 Total     26,918,117 5,201,255 21,716,862 0.660 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
183,557,294
3
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. ......
3
5,289,012
4
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
5
Enter total revenue received from Medicare (including DSH and IME).....
5
715,845,768
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
843,835,187
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-127,989,419
8
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:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
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.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
11 San Marcos MRI LP
 
Imaging Center 55.000 % 0 % 45.000 %
22 Central Texas Ambulatory Endoscopy
 
Endoscopy Center 18.800 % 0 % 81.200 %
33 Surgical Center at Sun'N Lake LLC
 
Ambulatory Surgery 50.000 % 0 % 50.000 %
44 Surgery Management Associates of Kissimmee LLC
 
Management/Admin 30.000 % 0 % 70.000 %
55 Celebration Surgery Management LLC
 
Management/Admin 38.000 % 0 % 62.000 %
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
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?12
Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 Florida Hospital Orlando
601 E Rollins Street
Orlando,FL32803
www.floridahospital.com/orlando
4369
X X X X   X X   Therapy Center, EPS Cath Lab A
2 Florida Hospital Altamonte
601 E Altamonte Drive
Altamonte Springs,FL32701
www.floridahospital.com/altamonte
4369
X X   X     X   Cancer Center, therapy A
3 Florida Hospital Celebration Health
400 Celebration Place
Celebration,FL34747
www.floridahospital.com/celebration-h
4369
X X   X     X   Therapy Center A
4 Florida Hospital East Orlando
7727 Lake Underhill Road
Orlando,FL32822
www.floridahospital.com/east-orlando
4369
X X   X     X     A
5 Winter Park Memorial Hospital
200 N Lakemont Avenue
Winter Park,FL32822
www.floridahospital.com/winter-park-m
4369
X X   X     X     A
6 Florida Hospital Kissimmee
2450 North Orange Blossom Trail
Kissimmee,FL34744
www.floridahospital.com/kissimmee
4369
X X   X     X     A
7 Adventist La Grange Memorial Hospital
5101 S Willow Springs Road
La Grange,IL60525
www.keepingyouwell.com/almh/
0005017
X X   X   X X     C
8 FH Heartland Medical Center
4200 Sun N Lake Blvd
Sebring,FL33872
www.floridahospital.com/heartland
4171
X X         X     A
9 Florida Hospital Apopka
201 N Park Avenue
Apopka,FL32703
www.floridahospital.com/apopka
4369
X X   X     X     A
10 Central Texas Medical Center
1301 Wonder World Dr
San Marcos,TX78666
ctmc.org
000556
X X         X     B
11 FH Heartland Medical Center Lake Placid
1210 US 27 N
Lake Placid,FL33852
www.floridahospital.com/heartland
4171
X X         X   Senior Behavioral Unit A
12 Florida Hospital Wauchula
533 W Carlton Street
Wauchula,FL33873
www.floridahospital.com/heartland
4239
X X     X   X   Skilled Nursing B
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
GROUP A
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
 
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 14
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): See statement
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

GROUP A
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
b
c
d
e
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

GROUP A
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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.
a
b
c
d
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
GROUP B
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
 
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 14
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): See statement
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

GROUP B
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
b
c
d
e
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

GROUP B
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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.
a
b
c
d
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
GROUP C
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
 
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 14
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): See statement
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

GROUP C
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
b
c
d
e
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

GROUP C
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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.
a
b
c
d
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
Part V, Section B Facility Reporting Group A
Facility Reporting Group A consists of: - Facility 1: Florida Hospital Orlando, - Facility 3: Florida Hospital Celebration Health, - Facility 2: Florida Hospital Altamonte, - Facility 4: Florida Hospital East Orlando, - Facility 5: Winter Park Memorial Hospital, - Facility 6: Florida Hospital Kissimmee, - Facility 8: FH Heartland Medical Center, - Facility 9: Florida Hospital Apopka, - Facility 11: FH Heartland Medical Center Lake Placid
GROUP A Part V, Section B, line 16a website: See statement
GROUP A Part V, Section B, line 16b website: See statement
GROUP A Part V, Section B, line 16c website: See statement
Group A-Facility 1 -- Florida Hospital Orlando Part V, Section B, line 5: Florida Hospital (FH) is a 2,500 bed medical complex in Central Florida with seven separate hospital campuses. FH serves the residents of Central Florida (primarily serving the residents of Orange, Osceola, Seminole and Lake Counties) but also draws patients from other parts of the Southeastern United States, the Caribbean and South America. The 7-campus hospital health system is the largest healthcare provider in Central Florida and the nation's largest Medicare provider with FH being the second largest employer in the area. All of the seven campuses of FH operate under a single hospital license. Florida Hospital Orlando (FHO) is a 1,217 acute-care bed hospital and medical center founded in 1908. It is Florida Hospital's flagship hospital and is the largest campus in the Florida Hospital system. FHO has 1,067 acute care beds, 59 adult psychiatric beds, 10 comprehensive medical rehabilitation beds, 28 Level II Neonatal Intensive Care Unit beds, and 53 Level III Neonatal Intensive Care Unit beds. Special services include an adult and pediatric bone marrow transplant program, adult open-heart surgery, as well as organ programs for adult and pediatric kidney transplants and adult liver and pancreas transplants. This campus also serves as a Baker Act receiving center and offers specialty care in the areas of digestive health; hyperbaric medicine and wound care; fetal diagnostics; pain medicine; pediatric hematology/oncology; respiratory care; women's services; and surgical oncology. FHO is also home to institutes for: cancer; diabetes; translational research; cardiology; orthopedics; and neuroscience. Florida Hospital (all campuses) conducted its 2013 Community Health Needs Assessment (CHNA) in two parts: a regional health needs assessment for Orange, Seminole and Osceola Counties in Central Florida, followed by separate assessments focused on and tailored to each of the seven campuses of FH. Three not-for-profit clinical hospitals within Central Florida, namely FH, Orlando Health, and Lakeside Behavioral Health, together with the Florida Department of Health in Orange County, collaborated to conduct the regional tri-county health needs assessment. This was the first ever multi-hospital, public health department joint community health needs assessment. These four organizations also collaborated with other community agencies under the umbrellas of "Healthy Orange Florida" in Orange County, "Healthy Seminole" in Seminole County, and "Community Vision" in Osceola County. Healthy Seminole is an 81-member affiliation of representatives from FH, local government, social service, and educational organizations within Seminole County. The Health Council of East Central Florida, Inc. (the Health Council), a regional quasi-government health planning agency, was contracted with to assist with data collection and analysis. The Health Council conducted over 70 key stakeholder interviews with individuals representing the broad interests of the tri-county area. Key stakeholders for the tri-county assessment included individuals with special knowledge of or interest in public health (i.e., health departments); individuals/organizations serving or representing the interests of medically underserved, low-income, and minority populations; persons who represented the broad interests of residents served by the hospitals; and individuals representing large employers and employee interests. A total of 72 stakeholders representing 44 social service and health care organizations were interviewed and completed a questionnaire aimed at identifying health barriers, assets, resources, and needs within the region. As a part of its efforts to ensure broad community-based input into the CHNA process, FH formed a Community Health Needs Assessment Committee (CHNAC). The CHNAC was comprised of external community members/stakeholders and senior FH leaders. The community members in particular provided strong representation of low-income, minority and underserved populations. Listed below are several examples of community organizations represented on the CHNAC: * Hebni Nutrition Consultant a nutritionist who works in the local African American community;* The University of Central Florida School of Medicine primary care physician training;* Winter Park Health Foundation a local non-profit organization that develops and funds school health and older adult programs; * Orange County Public Schools serves children of all ages and ethnicities, including those who are homeless and/or eligible for free or reduced lunch programs; and * Gracia Anderson Foundation a local non-profit organization that funds social service projects.
Group A-Facility 1 -- Florida Hospital Orlando Part V, Section B, line 6a: The filing organization collaborated with two other not-for-profit hospitals, namely Orlando Health and Lakeside Behavioral Health, to create a Community Health Needs Assessment for Orange, Osceola, and Seminole Counties. The Community Health Needs Assessment describes the health of Central Floridians for the purpose of planning interventions relevant to the community.
Group A-Facility 1 -- Florida Hospital Orlando Part V, Section B, line 6b: The filing collaborated with the Florida Department of Health in Orange County and other community agencies under the umbrellas of "Healthy Orange Florida" in Orange County, "Healthy Seminole" in Seminole County, and "Community Vision" in Osceola County. Healthy Seminole is an 81-member affiliation of representatives from FH, local government, social service, and educational organizations within Seminole County. The Health Council of East Central Florida, Inc. (the Health Council), a regional quasi-government health planning agency, was contracted with to assist with data collection and analysis.
Group A-Facility 1 -- Florida Hospital Orlando Part V, Section B, line 7d: The Hospital has adopted a policy that addresses the public posting requirements of the Community Health Needs Assessment. Under this policy, the Community Health Needs Assessment Report must be posted on the Hospital's website by the end of the year in which it is conducted. The Hospital will make a copy of its Community Health Needs Assessment Report available upon request. The Hospital will also make a paper copy of the Community Health Needs Assessment Report available for public inspection at the Hospital facility.
Group A-Facility 1 -- Florida Hospital Orlando Part V, Section B, line 11: Community Needs Being Addressed by Florida Hospital Orlando Florida Hospital Orlando chose four areas of focus for its 2013-16 Community Health Plan: Obesity, Heart Disease, Mental Health, and Access to Care. The Obesity area addresses the prevention and management of Chronic Diseases such as Heart Disease.A. Obesity Obesity increases the risk for developing health conditions such as heart disease, stroke, diabetes and cancer - and the comorbidities that often accompany these diseases. Additionally, being overweight or obese increases the risk of adverse health outcomes and has significant economic impacts on individuals and the community. These impacts can include a rise in health care spending over time as well as lost earnings and productivity due to illness. Several factors influence the likelihood of obesity including individual behavior, the social and built environment, and genetic heritability. As a result, being overweight or obese is a complex health issue to address. Good nutrition, physical activity, and maintaining a healthy body weight can help manage/prevent obesity and promote overall health and well-being. Florida Hospital Orlando's obesity interventions target both adults and children: - Deploy a Mobile Farmers Market to provide fresh fruits and vegetables along with nutritional educational opportunities, in partnership with both public and private entities.- Support (public and private) school-based gardens in the Orlando metro area- CREATION Health lifestyle seminars and expanded programs are offered at all Florida Hospital locations and in community settings. CREATION Health is a faith-based wellness plan that focuses on eight principles: Choice, Rest, Environment, Activity, Trust, Interpersonal Relationships, Outlook and Nutrition.- CREATION Kids is a child-friendly wellness program that stresses healthy eating and exercise in church and school settings.- Increase opportunities for leisure time physical activity via funding of, and involvement in, 5K races.B. Heart DiseaseHeart Disease is a leading cause of death in Central Florida and across the nation. Risk factors for heart disease include obesity, lack of exercise and smoking. The Florida Heart Institute at Florida Hospital Orlando treats more heart and vascular patients than any other hospital in the U.S., and is a major cardiac referral center for Central, East and West Florida. It offers heart transplantation, surgical and interventional cardiology programs, and a full range of pre- and post-treatment services. Florida Flight 1 is the hospital's Emergency Air-Medical Transport Service that helicopters critically ill cardiac patients from outlying hospitals to the Heart Institute. Heart disease interventions include:- Funding and operations for the Congestive Heart Failure (CHF) clinic serving uninsured patients at the Orlando County Medical Clinic - National and international research studies and clinical trials for new techniques, technologies and procedures- Free and minimal charge screenings/community lectures on disease prevention and recognizing the warning signs of heart disease - Board membership and financial support for research and education programs offered by the American Heart Association - Free online Heart Disease Risk Assessment - Free Quit Smoking Now Smoking Cessation Classes. C. Mental HealthFlorida Hospital Orlando has prioritized mental health as a focus area in its community health programming. While there are strong mental health and substance abuse entities in the community, funding for these services is very limited (as is the case throughout Florida). Mental health and substance abuse providers in Orange County include Aspire Behavioral Health (in- and outpatient mental health and substance abuse services), the Orlando Health Behavioral Group, the Outlook Clinic for Depression & Anxiety, and a large federal SAMHSA grant to coordinate wrap-around services for children in Orange County. Additionally, the Florida Hospital Community Health Impact Council (a grant-making entity) has funded model behavioral health programs for adults and children. Florida Hospital Orlando interventions include:- Outlook Clinic for Depression & Anxiety: free comprehensive behavioral evaluation, treatment and case management for uninsured residents of Orange County - Maturing Minds Clinic: ongoing assessments of patients with dementia to ensure care coordination and to connect patients and families to community resources- Baker Act Receiving Center: emergency psychiatric care for people who are a danger to themselves or others - Major funding for the Aspire Behavioral Health inpatient and outpatient psychiatric centers - Funding for the Central Receiving Center, an alternative (to jail) short-term treatment setting for alcohol or drug-impaired arrestees in cooperation with law enforcement and Aspire Behavioral Health Partners - Financial support for the Mental Health Association of Central Florida - Involvement in the Orange County Government SAMHSA Wrap-Around effort to coordinate preventive mental health services for children. D. Access to careOver 24% of people in Central Florida do not have health insurance, and the State of Florida has not accepted federal Medicaid expansion dollars. A number of Florida Hospital Orlando initiatives educate and link uninsured and underserved community members with free or affordable health care: - Financially support and provide leadership for the Primary Care Access Network (PCAN) of Orange County that cares for 92,000 uninsured patients in 13 FQHC medical homes and 10,000 secondary care patients at the Orange County Medical Clinic- Financially support Shepherd's Hope free clinics - Financially support the Health Care Center for the Homeless - Financially support Grace Medical Home for uninsured people with chronic conditions - Support True Health FQHC and the Orange County Health Department in their efforts to provide primary care to Evans High School students and families - Support Edgewater High School's school health clinic- Financially support the professional development and education of medical and nursing students from Valencia College, Seminole State College, Adventist University, the University of Central Florida (UCF), and the UCF School of Medicine - Increase the availability of free and low-cost mammograms via the mobile mammogram unit - Provide a funding match for the Healthy Start Coalition of Orange County (maternal/infant)- Work with United Global Outreach's Bithlo Transformation Effort to support access to free or low-cost medical, dental, vision and behavioral health care to the community of Bithlo- Participate in LIFT Orlando to enhance the health and wellness of the primarily lower income, African- American residents of the Parramore community. ** see continuation of footnote
Group A-Facility 1 -- Florida Hospital Orlando Part V, Section B, line 22d: In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital used the following methodology in 2014:The Hospital identified all commercial payors that had any activity with the Hospital during the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates was determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determined the maximum amount that could be charged to patients eligible under the Hospital's financial assistance policy.
Group A-Facility 3 -- Florida Hospital Celebration Health Part V, Section B, line 5: Florida Hospital (FH) is a 2,500 bed medical complex in Central Florida with seven separate hospital campuses. FH serves the residents of Central Florida (primarily serving the residents of Orange, Osceola, Seminole and Lake Counties) but also draws patients from other parts of the Southeastern United States, the Caribbean and South America. The 7-campus hospital health system is the largest healthcare provider in Central Florida and the nation's largest Medicare provider with FH being the second largest employer in the area. All of the seven campuses of FH operate under a single hospital license. The Florida Hospital Celebration Health (FHCH) campus is a 203-bed, state-of-the-art hospital that serves as a showcase of innovation and excellence in healthcare. Established in 1997, Florida Hospital Celebration Health was designed to serve as a cornerstone of health in the Disney-planned community of Celebration, Florida. Florida Hospital (all campuses) conducted its 2013 Community Health Needs Assessment (CHNA) in two parts: a regional health needs assessment for Orange, Seminole and Osceola Counties in Central Florida, followed by separate assessments focused on and tailored to each of the seven campuses of FH. Three not-for-profit clinical hospitals within Central Florida, namely FH, Orlando Health, and Lakeside Behavioral Health, together with the Florida Department of Health in Orange County, collaborated to conduct the regional tri-county health needs assessment. This was the first ever multi-hospital, public health department joint community health needs assessment. These four organizations also collaborated with other community agencies under the umbrellas of "Healthy Orange Florida" in Orange County, "Healthy Seminole" in Seminole County, and "Community Vision" in Osceola County. Healthy Seminole is an 81-member affiliation of representatives from FH, local government, social service, and educational organizations within Seminole County. The Health Council of East Central Florida, Inc. (the Health Council), a regional quasi-government health planning agency, was contracted with to assist with data collection and analysis. The Health Council conducted over 70 key stakeholder interviews with individuals representing the broad interests of the tri-county area. Key stakeholders for the tri-county assessment included individuals with special knowledge of or interest in public health (i.e., health departments); individuals/organizations serving or representing the interests of medically underserved, low-income, and minority populations; persons who represented the broad interests of residents served by the hospitals; and individuals representing large employers and employee interests. A total of 72 stakeholders representing 44 social service and health care organizations were interviewed and completed a questionnaire aimed at identifying health barriers, assets, resources, and needs within the region. As a part of its efforts to ensure broad community-based input into the CHNA process, FH formed a Community Health Needs Assessment Committee (CHNAC). The CHNAC was comprised of external community members/stakeholders and senior FH leaders. The community members in particular provided strong representation of low-income, minority and underserved populations. Listed below are several examples of community organizations represented on the CHNAC: * Hebni Nutrition Consultant a nutritionist who works in the local African American community;* The University of Central Florida School of Medicine primary care physician training;* Winter Park Health Foundation a local non-profit organization that develops and funds school health and older adult programs; * Orange County Public Schools serves children of all ages and ethnicities, including those who are homeless and/or eligible for free or reduced lunch programs; and * Gracia Anderson Foundation a local non-profit organization that funds social service projects.
Group A-Facility 3 -- Florida Hospital Celebration Health Part V, Section B, line 6a: The filing organization collaborated with two other not-for-profit hospitals, namely Orlando Health and Lakeside Behavioral Health, to create a Community Health Needs Assessment for Orange, Osceola, and Seminole Counties. The Community Health Needs Assessment describes the health of Central Floridians for the purpose of planning interventions relevant to the community.
Group A-Facility 3 -- Florida Hospital Celebration Health Part V, Section B, line 6b: The filing collaborated with the Florida Department of Health in Orange County and other community agencies under the umbrellas of "Healthy Orange Florida" in Orange County, "Healthy Seminole" in Seminole County, and "Community Vision" in Osceola County. Healthy Seminole is an 81-member affiliation of representatives from FH, local government, social service, and educational organizations within Seminole County. The Health Council of East Central Florida, Inc. (the Health Council), a regional quasi-government health planning agency, was contracted with to assist with data collection and analysis.
Group A-Facility 3 -- Florida Hospital Celebration Health Part V, Section B, line 7d: The Hospital has adopted a policy that addresses the public posting requirements of the Community Health Needs Assessment. Under this policy, the Community Health Needs Assessment Report must be posted on the Hospital's website by the end of the year in which it is conducted. The Hospital will make a copy of its Community Health Needs Assessment Report available upon request. The Hospital will also make a paper copy of the Community Health Needs Assessment Report available for public inspection at the Hospital facility.
Group A-Facility 3 -- Florida Hospital Celebration Health Part V, Section B, line 11: Community Needs Being Addressed by Florida Hospital Celebration Health A. Obesity/DiabetesObesity increases the risk for developing health conditions such as heart disease, stroke, diabetes, and cancer - and the comorbidities that often accompany these diseases. Additionally, being overweight or obese increases the risk of adverse health outcomes and has significant economic impacts on individuals and the community. These impacts can include a rise in health care spending over time as well as lost earnings and productivity due to illness. Several factors influence the likelihood of obesity including individual behavior, the social and built environment, and genetic heritability. As a result, being overweight or obese is a complex health issue to address. Good nutrition, physical activity, and maintaining a healthy body weight can help manage/prevent obesity and promote overall health and well-being. Florida Hospital Celebration Health's obesity/chronic disease interventions target both adults and children: - Partner with local organizations to deliver weekend food to children who qualify for free or reduced lunch - Host and facilitate an annual event to package food items for children and families- Support nutritional education initiatives around the 5-2-1-0 campaign in partner schools- Support the Town of Celebration Marathon and half marathon events the proceeds of which contribute to a scholarship fund for Osceola County High School seniors- Provide education to increase the knowledge of positive behaviors towards healthy eating and exercise through the Mission FIT possible Program- Increase opportunities for leisure time physical activity in social settings through the Annual Healthy 100 sponsored community Run- Support efforts to reduce heart-related conditions through the funding of research and programs through board membership and financial support to the American Heart Association- Provide financial support for operations and case management to the Hope Clinic and Osceola Council on Aging that provide access to primary and secondary care for uninsured and underinsured residents of Osceola County- Increase the likelihood of medication adherence among uninsured patients through enrollment in compassionate drug programs - Increase the availability of free or low cost mammograms through the hospital's mobile mammography unit - Support broad community health planning through Community Vision, Inc.- Support the education and training of medical practitioners in the tri-county region through support of the UCF Medical School and Valencia College Nursing Program - Support the education and training of CNAs in Osceola County - Continue leadership role with the Osceola Health Leadership Council that develops and supports community health initiatives - Offer the CREATION Health faith-based wellness plan that focuses on eight principles: Choice, Rest, Environment, Activity, Trust, Interpersonal Relationships, Outlook and Nutrition. CREATION Health lifestyle seminars and expanded programs are offered at all Florida Hospital locations and in community settings. B. Maternal and Child HealthA number of Florida Hospital Celebration Health initiatives educate and link community members to resources that address maternal and child health. Programming specific to this priority works to: - Reduce cesarean births due to failure to progress through early intervention efforts - Continue to support maternal and child health initiatives in Osceola County by supporting the Healthy Start Coalition- Increase the number of women who are breastfeeding exclusively by the time of discharge via health education and support - Work with the Fetal Infant Mortality Review Committee on the Closing the Gap grant administered by the Florida Department of Health in Osceola County.Community Needs Not Chosen by Florida Hospital Celebration HealthIn developing its Community Health Needs Assessments, Florida Hospital used defined criteria to determine the priority areas to be addressed. The criteria were:a) Acuity of the health issue (how serious is it?)b) Capacity of the hospital to address the issue (does the hospital have the services or other ability to address the issue?)c) Are community partners already addressing this issue? Would the hospital be duplicating those efforts? d) If the hospital were to address the issue, would there be opportunities for collaboration and shared impact?A. Chronic Disease: Cancer & Stroke Cancer and stroke are the most common chronic conditions in the United States. They have many risk factors in common and are frequently related to health behaviors such as obesity and smoking. Florida Hospital Celebration and its community partners - the Department of Health, the Area Health Education Council (AHEC), the American Heart Association, the American Cancer Society, the American Lung Association, etc. - already provide health education and disease management programs. As noted above, the hospital's Obesity interventions focus on health education, exercise, nutrition, stress management, and personal accountability - factors vital to the control of cancer and stroke and the comorbidities that often accompany these diseases. Therefore, Florida Hospital Celebration is addressing the risk factors for these chronic diseases by specifically addressing Obesity.B. AsthmaFlorida Hospital Celebration Health does not have Asthma-specific services, but the hospital actively supports the American Lung Association and provides health education and disease management programs throughout the county. C. DiabetesDiabetes can lead to the development of serious and disabling complications if not properly treated. Complications include heart disease and stroke, high blood pressure, blindness, kidney disease, and limb amputation. According to the American Diabetes Association, it is possible to prevent or delay diabetic complications through a healthy diet, physical activity, and maintaining a healthy weight and glucose levels. Florida Hospital Celebration's diabetes educators help inpatients manage their diabetes, and provide referrals to the Florida Hospital Diabetes Institute at the main campus. The Institute has a number of community outreach programs. D. Heart DiseaseHeart disease, hypertension and Congestive Heart Failure are among the most common chronic conditions in the United States. Risk factors include health behaviors such as obesity and smoking. Efforts to decease heart disease are included in the Obesity initiatives noted above. E. Mental Health and Substance AbuseFlorida Hospital Celebration Health does not offer substance abuse or behavioral/mental health services. Hospital inpatients with behavioral health co-morbidities are transferred to the Med-Psych unit at the Florida Hospital main campus or to the nonprofit Park Place Behavioral Health in Osceola County. Additionally, the Florida Hospital Community Health Impact Council identifies and funds innovative and best practice programs centered on addressing mental health and substance abuse in the tri-county area, including Osceola County.F. Dental CareFlorida Hospital Celebration Health does not provide dental care but supports the Osceola free clinics and FQHCs that provide free and sliding fee scale dental care services to un- and underinsured people.G. Housing Affordability and HomelessnessHousing affordability is a health determinant rather than a core competency of hospitals and other health care providers. While Florida Hospital Celebration Health is not leading out on this issue, Florida Hospital has made a significant financial donation (that garnered community matches) to establish and expand permanent supportive housing efforts in Orange, Osceola and Seminole Counties. (The Osceola efforts are led by Community Vision, Inc.). Florida Hospital also provides leadership to two regional commissions focused on housing issues specific to vulnerable families and individuals, and is active in Habitat for Humanity.** see continuation of footnote
Group A-Facility 3 -- Florida Hospital Celebration Health Part V, Section B, line 22d: In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital used the following methodology in 2014:The Hospital identified all commercial payors that had any activity with the Hospital during the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates was determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determined the maximum amount that could be charged to patients eligible under the Hospital's financial assistance policy.
Group A-Facility 2 -- Florida Hospital Altamonte Part V, Section B, line 5: Florida Hospital (FH) is a 2,500 bed medical complex in Central Florida with seven separate hospital campuses. FH serves the residents of Central Florida (primarily serving the residents of Orange, Osceola, Seminole and Lake Counties) but also draws patients from other parts of the Southeastern United States, the Caribbean and South America. The 7-campus hospital health system is the largest healthcare provider in Central Florida and the nation's largest Medicare provider with FH being the second largest employer in the area. All of the seven campuses of FH operate under a single hospital license. The Florida Hospital Altamonte (FHA) campus is a 362-bed, acute-care community hospital located in Altamonte Springs, Florida. It was established in 1973 as the first satellite campus of Florida Hospital. Since its establishment, Florida Hospital Altamonte has been providing state-of-the-art healthcare to its community, a 15-zip code area surrounding Altamonte Springs, and remains the largest satellite campus in the Florida Hospital system. FHA cares for more than 168,000 patients a year, including 67,000 emergency patients and 20,000 inpatients, with 2,000 baby deliveries and performs approximately 10,000 surgical cases and 79,000 outpatient procedures making it the largest and most comprehensive hospital in Seminole County.Florida Hospital (all campuses) conducted its 2013 Community Health Needs Assessment (CHNA) in two parts: a regional health needs assessment for Orange, Seminole and Osceola Counties in Central Florida, followed by separate assessments focused on and tailored to each of the seven campuses of FH. Three not-for-profit clinical hospitals within Central Florida, namely FH, Orlando Health, and Lakeside Behavioral Health, together with the Florida Department of Health in Orange County, collaborated to conduct the regional tri-county health needs assessment. This was the first ever multi-hospital, public health department joint community health needs assessment. These four organizations also collaborated with other community agencies under the umbrellas of "Healthy Orange Florida" in Orange County, "Healthy Seminole" in Seminole County, and "Community Vision" in Osceola County. Healthy Seminole is an 81-member affiliation of representatives from FH, local government, social service, and educational organizations within Seminole County. The Health Council of East Central Florida, Inc. (the Health Council), a regional quasi-government health planning agency, was contracted with to assist with data collection and analysis. The Health Council conducted over 70 key stakeholder interviews with individuals representing the broad interests of the tri-county area. Key stakeholders for the tri-county assessment included individuals with special knowledge of or interest in public health (i.e., health departments); individuals/organizations serving or representing the interests of medically underserved, low-income, and minority populations; persons who represented the broad interests of residents served by the hospitals; and individuals representing large employers and employee interests. A total of 72 stakeholders representing 44 social service and health care organizations were interviewed and completed a questionnaire aimed at identifying health barriers, assets, resources, and needs within the region. As a part of its efforts to ensure broad community-based input into the CHNA process, FH formed a Community Health Needs Assessment Committee (CHNAC). The CHNAC was comprised of external community members/stakeholders and senior FH leaders. The community members in particular provided strong representation of low-income, minority and underserved populations. Listed below are several examples of community organizations represented on the CHNAC: * Hebni Nutrition Consultant a nutritionist who works in the local African American community;* The University of Central Florida School of Medicine primary care physician training;* Winter Park Health Foundation a local non-profit organization that develops and funds school health and older adult programs; * Orange County Public Schools serves children of all ages and ethnicities, including those who are homeless and/or eligible for free or reduced lunch programs; and * Gracia Anderson Foundation a local non-profit organization that funds social service projects.
Group A-Facility 2 -- Florida Hospital Altamonte Part V, Section B, line 6a: The filing organization collaborated with two other not-for-profit hospitals, namely Orlando Health and Lakeside Behavioral Health, to create a Community Health Needs Assessment for Orange, Osceola, and Seminole Counties. The Community Health Needs Assessment describes the health of Central Floridians for the purpose of planning interventions relevant to the community.
Group A-Facility 2 -- Florida Hospital Altamonte Part V, Section B, line 6b: The filing collaborated with the Florida Department of Health in Orange County and other community agencies under the umbrellas of "Healthy Orange Florida" in Orange County, "Healthy Seminole" in Seminole County, and "Community Vision" in Osceola County. Healthy Seminole is an 81-member affiliation of representatives from FH, local government, social service, and educational organizations within Seminole County. The Health Council of East Central Florida, Inc. (the Health Council), a regional quasi-government health planning agency, was contracted with to assist with data collection and analysis.
Group A-Facility 2 -- Florida Hospital Altamonte Part V, Section B, line 7d: The Hospital has adopted a policy that addresses the public posting requirements of the Community Health Needs Assessment. Under this policy, the Community Health Needs Assessment Report must be posted on the Hospital's website by the end of the year in which it is conducted. The Hospital will make a copy of its Community Health Needs Assessment Report available upon request. The Hospital will also make a paper copy of the Community Health Needs Assessment Report available for public inspection at the Hospital facility.
Group A-Facility 2 -- Florida Hospital Altamonte Part V, Section B, line 11: Community Needs Being Addressed by Florida Hospital Altamonte Florida Hospital Altamonte chose two areas of focus for their 2013-16 Community Health Plan: Obesity and Access to Care. The Obesity area addresses the prevention and management of Chronic Diseases.A. Obesity & Chronic Disease Obesity negatively affects people's quality of life and increases the risk for developing health conditions such as heart disease, stroke, diabetes, and cancer - and the comorbidities that often accompany these diseases. Additionally, being overweight or obese increases the risk of adverse health outcomes and has significant economic impacts on individuals and the community. These impacts can include a rise in health care spending over time as well as lost earnings and productivity due to illness. Several factors influence the likelihood of obesity including individual behavior, the social and built environment, and genetic heritability. As a result, being overweight or obese is a complex health issue to address. Good nutrition, physical activity, and maintaining a healthy body weight can help manage/prevent obesity and promote overall health and well-being. Florida Hospital Altamonte's obesity/chronic disease interventions target both adults and children: - Fund and staff 5k Races to increase opportunities for leisure time physical activity - Provide financial assistance to community walkable areas that facilitate physical activity (e.g., Cranes Roost Park)- Facilitate leisure-time walking programs that increase physical activity in the communities of Eatonville, Maitland and Winter Park - Offer educational programming aimed at increasing quality of life. Focus on nutrition, stress management and exercise: CREATION Health seminars, Project Fit Kids and the Employee Families Performance series - Implement and support positive nutritional and exercise instruction through the Mission FIT Possible program - Provide education and clinical care to families with children who are overweight or obese through the Fit Kids Intensive Medical Program - Create collaborative health education programming with the Department of Children & Families for youth in the foster care system. The goal is to assist these at-risk youth gain knowledge about their health status and ways to integrate healthy behaviors into their daily lives. - Provide free state park admissions to Seminole County residents to increase opportunities for leisure time physical activity - Support efforts to reduce chronic conditions though financial support and board membership of the American Heart Association, American Diabetes Association, and the like- Provide leadership and expertise to the Healthy Seminole Collaboration, a collaboration of community organizations working to reduce obesity in the county - Free 'Quit Smoking Now' smoking cessation classes.B. Access to careA number of Florida Hospital Altamonte initiatives educate and link underserved community members to free or affordable health resources: - Operate a number of clinics for underserved populations: the Community After Hours Clinic, the Congestive Health Failure Clinic, the Lung Clinic and the Outlook Clinic for Depression & Anxiety - Provide free and low-cost mammograms through the Florida Hospital Mobile Mammography unit - Provide financial support to the Health Care Center for the Homeless (FQHC) medical and dental facility at Harvest Time Ministries in Sanford- Provide financial support to the HOPE Team that provides behavioral health services to homeless people living in camps in the woods- Provide financial support (for operations) to the Shepherd's Hope (free) Clinic in Longwood, their Fracture Clinic, and new electronic medical records system - Use hospital staff to recruit volunteer physicians, nurses and ancillary staff, and other employees to donate clinical expertise and diagnostic services to Shepherd's Hope - Provide prescription medications at little to no cost to uninsured or underinsured patients through Discharge Planning and pharmaceutical assistance programs - Provide leadership (via board membership) and financial support to the Kids' House of Seminole and Children's Advocacy Center that provide services to victims of child abuse and their families, as well as prevention programs- Financially support the education of medical and nursing students at Valencia College, Seminole State College, the University of Central Florida, Florida State University, the University of Central Florida, and the Adventist University of Health Sciences- Financially support IDignity, a nonprofit agency that helps homeless people without identification get IDs to help them access necessary services - Provide financial support to the Healthy Start Coalition of Seminole County- Launch a new care coordination system in the Florida Hospital Altamonte emergency department. Develop Community Care Network teams, and establish case management nursing and social work teams to enhance care coordination and community referrals.Community Needs Not Chosen by Florida Hospital Altamonte In developing its Community Health Needs Assessments, Florida Hospital used defined criteria to determine the priority areas to be addressed. The criteria were:1. Acuity of the health issue (how serious is it?)2. Capacity of the hospital to address the issue (does the hospital have the services or other ability to address the issue?)3. Are community partners already addressing this issue? Would the hospital be duplicating those efforts? 4. If the hospital were to address the issue, would there be opportunities for collaboration and shared impact?A. Diabetes, Cancer, Heart Disease, Stroke & AsthmaDiabetes, cancer, heart disease and stroke are the most common chronic conditions in the United States. They have many risk factors in common and are frequently related to health behaviors such as obesity and smoking. Florida Hospital Altamonte and its community partners - the Department of Health, the Area Health Education Council (AHEC), the American Heart Association, the American Cancer Society, the American Lung Association, etc. - already provide any number of health education and disease management programs. As noted above, the Hospital's Obesity interventions focus on health education, exercise, nutrition, stress management, and personal accountability - factors vital to the control of diabetes, cancer, heart disease, stroke, asthma and the comorbidities that often accompany these diseases. Therefore, Florida Hospital Altamonte is addressing the risk factors for these chronic diseases by specifically addressing Obesity.B. Marijuana Use Among Youth, Mental Health & Substance AbuseFlorida Hospital Altamonte does not provide substance abuse or behavioral/mental health services. There are strong mental health and substance abuse assets in Seminole County including Aspire Behavioral Health (in- and outpatient mental health and substance abuse services) and the Orlando Health Behavioral Group, an 80-bed psychiatric hospital at South Seminole Hospital. Additionally, the Florida Hospital Community Health Impact Council (a grant-making entity) funds model behavioral programs for adults and children. C. Maternal and Child Health Florida Hospital Altamonte provides obstetrics services and a variety of pre- and postnatal programs and car seats for parents and children. The Florida Women's Center provides comprehensive and individualized women's medical care from puberty, to family planning and midwifery, to menopause management, to minimally invasive and robotic surgical options. Women and children may qualify for our Financial Assistance Program that includes charity care and/or steep discounts for low-income patients. As noted in the Access to Care section above, Florida Hospital Altamonte also provides financial and board member support to maternal and child health initiatives in Seminole County including the Healthy Start Coalition of Seminole County and Kids' House (the county's sexual abuse treatment center for children).D. Motor Vehicle Collisions The community issue of motor vehicle collisions is a health determinant rather than a core competency of most hospitals including Florida Hospital Altamonte but, as a means of ensuring motor vehicle safety, Florida Hospital provides car seats to new mothers who do not have safety-rated car seats. Additionally, through its partnership with Healthy Central Florida, the Hospital funds and provides leadership for programs that facilitate and encourage safe pedestrianism so that communities can be both healthier and safer.** see continuation of footnote
Group A-Facility 2 -- Florida Hospital Altamonte Part V, Section B, line 22d: In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital used the following methodology in 2014:The Hospital identified all commercial payors that had any activity with the Hospital during the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates was determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determined the maximum amount that could be charged to patients eligible under the Hospital's financial assistance policy.
Group A-Facility 4 -- Florida Hospital East Orlando Part V, Section B, line 5: Florida Hospital (FH) is a 2,500 bed medical complex in Central Florida with seven separate hospital campuses. FH serves the residents of Central Florida (primarily serving the residents of Orange, Osceola, Seminole and Lake Counties) but also draws patients from other parts of the Southeastern United States, the Caribbean and South America. The 7-campus hospital health system is the largest healthcare provider in Central Florida and the nation's largest Medicare provider with FH being the second largest employer in the area. All of the seven campuses of FH operate under a single hospital license. The Florida Hospital East Orlando (FHEO) campus is a 265-bed full-service community hospital and has been serving East Orange County residents since it was acquired in 1990. Florida Hospital (all campuses) conducted its 2013 Community Health Needs Assessment (CHNA) in two parts: a regional health needs assessment for Orange, Seminole and Osceola Counties in Central Florida, followed by separate assessments focused on and tailored to each of the seven campuses of FH. Three not-for-profit clinical hospitals within Central Florida, namely FH, Orlando Health, and Lakeside Behavioral Health, together with the Florida Department of Health in Orange County, collaborated to conduct the regional tri-county health needs assessment. This was the first ever multi-hospital, public health department joint community health needs assessment. These four organizations also collaborated with other community agencies under the umbrellas of "Healthy Orange Florida" in Orange County, "Healthy Seminole" in Seminole County, and "Community Vision" in Osceola County. Healthy Seminole is an 81-member affiliation of representatives from FH, local government, social service, and educational organizations within Seminole County. The Health Council of East Central Florida, Inc. (the Health Council), a regional quasi-government health planning agency, was contracted with to assist with data collection and analysis. The Health Council conducted over 70 key stakeholder interviews with individuals representing the broad interests of the tri-county area. Key stakeholders for the tri-county assessment included individuals with special knowledge of or interest in public health (i.e., health departments); individuals/organizations serving or representing the interests of medically underserved, low-income, and minority populations; persons who represented the broad interests of residents served by the hospitals; and individuals representing large employers and employee interests. A total of 72 stakeholders representing 44 social service and health care organizations were interviewed and completed a questionnaire aimed at identifying health barriers, assets, resources, and needs within the region. As a part of its efforts to ensure broad community-based input into the CHNA process, FH formed a Community Health Needs Assessment Committee (CHNAC). The CHNAC was comprised of external community members/stakeholders and senior FH leaders. The community members in particular provided strong representation of low-income, minority and underserved populations. Listed below are several examples of community organizations represented on the CHNAC: * Hebni Nutrition Consultant a nutritionist who works in the local African American community;* The University of Central Florida School of Medicine primary care physician training;* Winter Park Health Foundation a local non-profit organization that develops and funds school health and older adult programs; * Orange County Public Schools serves children of all ages and ethnicities, including those who are homeless and/or eligible for free or reduced lunch programs; and * Gracia Anderson Foundation a local non-profit organization that funds social service projects.
Group A-Facility 4 -- Florida Hospital East Orlando Part V, Section B, line 6a: The filing organization collaborated with two other not-for-profit hospitals, namely Orlando Health and Lakeside Behavioral Health, to create a Community Health Needs Assessment for Orange, Osceola, and Seminole Counties. The Community Health Needs Assessment describes the health of Central Floridians for the purpose of planning interventions relevant to the community.
Group A-Facility 4 -- Florida Hospital East Orlando Part V, Section B, line 6b: The filing collaborated with the Florida Department of Health in Orange County and other community agencies under the umbrellas of "Healthy Orange Florida" in Orange County, "Healthy Seminole" in Seminole County, and "Community Vision" in Osceola County. Healthy Seminole is an 81-member affiliation of representatives from FH, local government, social service, and educational organizations within Seminole County. The Health Council of East Central Florida, Inc. (the Health Council), a regional quasi-government health planning agency, was contracted with to assist with data collection and analysis.
Group A-Facility 4 -- Florida Hospital East Orlando Part V, Section B, line 7d: The Hospital has adopted a policy that addresses the public posting requirements of the Community Health Needs Assessment. Under this policy, the Community Health Needs Assessment Report must be posted on the Hospital's website by the end of the year in which it is conducted. The Hospital will make a copy of its Community Health Needs Assessment Report available upon request. The Hospital will also make a paper copy of the Community Health Needs Assessment Report available for public inspection at the Hospital facility.
Group A-Facility 4 -- Florida Hospital East Orlando Part V, Section B, line 11: Community Needs Being Addressed by Florida Hospital East Orlando Florida Hospital East Orlando chose five areas of focus for their 2013-2016 Community Health Plan: Obesity, Access to Care, Mental Health, Diabetes, Violent Crime, and Social Determinants of Health/Health Disparities.A. ObesityObesity negatively affects people's quality of life and increases the risk for developing health conditions such as heart disease, stroke, diabetes, and cancer - and the comorbidities that often accompany these diseases. Additionally, being overweight or obese increases the risk of adverse health outcomes and has significant economic impacts on individuals and the community. These impacts can include a rise in health care spending over time as well as lost earnings and productivity due to illness. Several factors influence the likelihood of obesity including individual behavior, the social and built environment, and genetic heritability. As a result, being overweight or obese is a complex health issue to address. Good nutrition, physical activity, and maintaining a healthy body weight can help manage/prevent obesity and promote overall health and well-being. Florida Hospital East Orlando's obesity interventions target both adults and children. The interventions that fall within Florida Hospital East Orlando's programming include: - Increasing opportunities for leisure time physical activity in a social setting for the residents of our Orange County PSA through funding and staffing an Annual 5k known as the Run for Rescue's ASPCA 5k- Offering educational programming aimed at increasing quality of life that focused on nutrition, stress management, and exercise through the Employee Families Performance Workshop Series offered by the Hospital- Implementing and supporting positive nutritional and exercise instruction to within the PSA through our Mission FIT Possible program within the area- Facilitating walking programs that aid in increasing leisure time within targeted communities of the PSA- Increasing the availability of fruits to children and through support of a mobile farmers market that actively travels to regions identified as food deserts - Funding efforts to reduce heart related conditions though the funding of research and programs via financial support and board membership of the American Heart Association- Providing leadership and expertise to a collaborative body composed of Orange County's community organizations aimed at reducing obesity throughout the county via the Healthy Orange Collaboration- Creation Health faith based wellness plan that focuses on eight principles: Choice, Rest, Environment, Activity, Trust, Interpersonal Relationships, Outlook and Nutrition. CREATION Health lifestyle seminars and expanded programs are offered at all Florida Hospital locations and in community settings. B. DiabetesDiabetes can lead to the development of serious and disabling complications if not properly treated. Complications include heart disease and stroke, high blood pressure, blindness, kidney disease, and limb amputation. According to the American Diabetes Association, it is possible to prevent or delay diabetic complications through a healthy diet, physical activity, and maintaining a healthy weight and glucose levels. Florida Hospital East Orlando's diabetes engagement includes: - Continue to offer the Cuidate program based on the Stanford chronic disease self-management program. Because the East Orlando community is nearly 50% Hispanic, the CDC-recommended classes are offered in both Spanish and English.- Continue the Bridge Program intensive case management model that helps uninsured, high-user patients with chronic conditions. The Bridge team helps patients enroll in affordable FQHC Medical Homes, compassionate drug programs, and community resources that improve health, disease management skills, and quality of life.C. Access to CareA number of Florida Hospital East Orlando initiatives educate and link underserved community members to free or affordable health resources: - Operate the Community After Hours Clinic (at Florida hospital) that provide cares to uninsured and underinsured people - Financially support and lead the Primary Care Access Network (PCAN) integrated system of health care for un- and underinsured people in Orange County. PCAN has 92,000 primary care patients in 13 FQHC medical homes, and 10,000 secondary care patients. - Encourage medical home enrollment by making appointments or referring un- and underinsured emergency department and inpatients to PCAN FQHCs - Provide financial support to Shepherd's Hope free clinics - Provide financial support for the Health Care Center for the Homeless- Provide financial support for Grace Medical Home, a chronic care medical home for uninsured people- Increase the availability of free or low-cost mammograms for un- and underinsured women via the mobile mammogram unit and Florida Hospital diagnostics centers - Support the education and training of medical practitioners through the FH Residency programs and Adventist University, and through partnerships with the UCF and FSU Medical Schools.D. Mental Health and Substance AbuseFlorida Hospital has identified mental health as being essential to personal well-being, family and interpersonal relationships, and the ability to contribute to society. Issues of mental health such as depression and anxiety affect people's ability to participate in health-promoting behaviors. Research has shown that mental health and physical health are closely connected because mental health plays a major role in people's ability to maintain good physical health. Currently, there are strong mental health and substance abuse assets in Orange County including Aspire Behavioral Health (in- and outpatient mental health/substance abuse services). Still, such services in Orange County can be hard to access because of funding and capacity issues. Florida Hospital works with local providers to help expand capacity. Specifically, the Hospital:- Provides major funding to Aspire Behavioral Health Center (county mental health) for in- and outpatient mental health and substance abuse services - Offers comprehensive evaluation, treatment, and case management for uninsured residents of Orange County through the Outlook Clinic for Depression & Anxiety. Florida Hospital funds the clinic in partnership with the Mental Health Association, the Orange County Medical Clinic, the UCF School of Social Work, the Primary Care Access Network (PCAN) and Walgreens.- Fund enhanced behavioral health services at FQHCs in East Orlando- Support efforts to provide behavioral health services in low-income, underserved areas such as Bithlo Partners including Aspire Health Partners, United Way and the Harbor House Domestic Violence Center.- Additionally, the Florida Hospital Community Health Impact Council (a grant-making entity) funds some community-based, model behavioral programs for adults and children.E. Violent CrimeHospitals lack the ability to directly address violent crimes, but Florida Hospital provides funding to several organizations that address the effects of violent crime. We view our active involvement in issues of awareness and prevention as especially crucial since Orange County's rates of violent crime exceed the national average. Interventions include:- Funding to Harbor House Domestic Violence Centers- Office and treatment space for the Orange County Victims' Services Center- Trained hospital staff to screen patients for domestic violence issues- Donated space for the Sexual Assault Treatment Center of Orange County.F. Health DisparitiesHealth disparities adversely affect people who have systematically experienced greater obstacles to health based on their: racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion. Within Orange County, black/African-American, Hispanic/Latino families, and the elderly are more than three times more likely to live in poverty than their white neighbors. Further, the Florida Hospital East Orlando community is more than 50% Hispanic and the east part of the county includes the community of Bithlo, one of the poorest communities in Florida. Florida Hospital currently has as a strong internal Diversity program. The hospital has also created a new Committee to better address the disparities in our community; membership includes national health equity scholars. In addition, Hospital staff serve on the board of the Central Florida Partnership on Health Disparities, a 501(c)(3) entity initially founded by Florida Hospital. ** see continuation of footnote
Group A-Facility 4 -- Florida Hospital East Orlando Part V, Section B, line 22d: In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital used the following methodology in 2014:The Hospital identified all commercial payors that had any activity with the Hospital during the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates was determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determined the maximum amount that could be charged to patients eligible under the Hospital's financial assistance policy.
Group A-Facility 5 -- Winter Park Memorial Hospital Part V, Section B, line 5: Florida Hospital (FH) is a 2,500 bed medical complex in Central Florida with seven separate hospital campuses. FH serves the residents of Central Florida (primarily serving the residents of Orange, Osceola, Seminole and Lake Counties) but also draws patients from other parts of the Southeastern United States, the Caribbean and South America. The 7-campus hospital health system is the largest healthcare provider in Central Florida and the nation's largest Medicare provider with FH being the second largest employer in the area. All of the seven campuses of FH operate under a single hospital license. The Winter Park Memorial Hospital (WPMH) campus is a 320-bed acute-care facility that primarily serves the residents of northeastern Orange and southeastern Seminole Counties. WPMH began caring for patients in February 1995 when it first opened its doors to the public. In 2000, Florida Hospital Winter Park Memorial was fully acquired by the Florida Hospital system. Services provided by Winter Park Memorial include: 24-Hour emergency department with Express Care and the area's only senior emergency room; The Baby Place Central Florida's only boutique hospital for women and babies; cancer institute; cardiology; critical care; diagnostic imaging; diabetes education; educational classes and support groups; endoscopy; Longevity Medicine Institute; in and outpatient surgery including minimally invasive and robotic surgery; laboratory; orthopedic institute; pediatrics; rehabilitation & sports medicine; sleep disorders center; and women's health. Every year, WPMH treats more than 150,000 patients.Florida Hospital (all campuses) conducted its 2013 Community Health Needs Assessment (CHNA) in two parts: a regional health needs assessment for Orange, Seminole and Osceola Counties in Central Florida, followed by separate assessments focused on and tailored to each of the seven campuses of FH. Three not-for-profit clinical hospitals within Central Florida, namely FH, Orlando Health, and Lakeside Behavioral Health, together with the Florida Department of Health in Orange County, collaborated to conduct the regional tri-county health needs assessment. This was the first ever multi-hospital, public health department joint community health needs assessment. These four organizations also collaborated with other community agencies under the umbrellas of "Healthy Orange Florida" in Orange County, "Healthy Seminole" in Seminole County, and "Community Vision" in Osceola County. Healthy Seminole is an 81-member affiliation of representatives from FH, local government, social service, and educational organizations within Seminole County. The Health Council of East Central Florida, Inc. (the Health Council), a regional quasi-government health planning agency, was contracted with to assist with data collection and analysis. The Health Council conducted over 70 key stakeholder interviews with individuals representing the broad interests of the tri-county area. Key stakeholders for the tri-county assessment included individuals with special knowledge of or interest in public health (i.e., health departments); individuals/organizations serving or representing the interests of medically underserved, low-income, and minority populations; persons who represented the broad interests of residents served by the hospitals; and individuals representing large employers and employee interests. A total of 72 stakeholders representing 44 social service and health care organizations were interviewed and completed a questionnaire aimed at identifying health barriers, assets, resources, and needs within the region. As a part of its efforts to ensure broad community-based input into the CHNA process, FH formed a Community Health Needs Assessment Committee (CHNAC). The CHNAC was comprised of external community members/stakeholders and senior FH leaders. The community members in particular provided strong representation of low-income, minority and underserved populations. Listed below are several examples of community organizations represented on the CHNAC: * Hebni Nutrition Consultant a nutritionist who works in the local African American community;* The University of Central Florida School of Medicine primary care physician training;* Winter Park Health Foundation a local non-profit organization that develops and funds school health and older adult programs; * Orange County Public Schools serves children of all ages and ethnicities, including those who are homeless and/or eligible for free or reduced lunch programs; and * Gracia Anderson Foundation a local non-profit organization that funds social service projects.
Group A-Facility 5 -- Winter Park Memorial Hospital Part V, Section B, line 6a: The filing organization collaborated with two other not-for-profit hospitals, namely Orlando Health and Lakeside Behavioral Health, to create a Community Health Needs Assessment for Orange, Osceola, and Seminole Counties. The Community Health Needs Assessment describes the health of Central Floridians for the purpose of planning interventions relevant to the community.
Group A-Facility 5 -- Winter Park Memorial Hospital Part V, Section B, line 6b: The filing collaborated with the Florida Department of Health in Orange County and other community agencies under the umbrellas of "Healthy Orange Florida" in Orange County, "Healthy Seminole" in Seminole County, and "Community Vision" in Osceola County. Healthy Seminole is an 81-member affiliation of representatives from FH, local government, social service, and educational organizations within Seminole County. The Health Council of East Central Florida, Inc. (the Health Council), a regional quasi-government health planning agency, was contracted with to assist with data collection and analysis.
Group A-Facility 5 -- Winter Park Memorial Hospital Part V, Section B, line 7d: The Hospital has adopted a policy that addresses the public posting requirements of the Community Health Needs Assessment. Under this policy, the Community Health Needs Assessment Report must be posted on the Hospital's website by the end of the year in which it is conducted. The Hospital will make a copy of its Community Health Needs Assessment Report available upon request. The Hospital will also make a paper copy of the Community Health Needs Assessment Report available for public inspection at the Hospital facility.
Group A-Facility 5 -- Winter Park Memorial Hospital Part V, Section B, line 11: Community Needs Being Addressed by Florida Hospital Winter Park Florida Hospital Winter Park chose three areas of focus for their 2013-16 Community Health Plan: Diabetes, Obesity/Chronic Disease and Access to Care. The Obesity area addresses the prevention and management of Chronic Diseases.A. Obesity & Chronic Disease Obesity negatively affects people's quality of life and increases the risk for developing chronic and acute health conditions such as heart disease, stroke, diabetes, and cancer - and the comorbidities that can accompany them. Being overweight or obese also increases the risk of adverse health outcomes and has significant economic impacts on individuals and the community. These impacts can include a rise in health care spending over time as well as lost earnings and productivity due to illness. Several factors influence the likelihood of obesity including individual behavior, the social and built environment, and genetic heritability. As a result, being overweight or obese is a complex health issue to address. Good nutrition, physical activity, and maintaining a healthy body weight can help manage/prevent obesity and promote overall health and well-being. Florida Hospital Winter Park's obesity/chronic disease interventions target both adults and children.- Partner with Winter Park Health Foundation on the Healthy Central Florida (HCF) initiative that focuses on the Hospital's defined community: Winter Park, Maitland and Eatonville. HCF is a community-based partnership whose goal is to transform our community into the healthiest in the nation. Components include physical activity, healthy eating, personal support systems and the reduction/elimination of smoking. - Create awareness for international Walk to School Day and national Bike to School Day. Support "walking school bus" programs with Healthy Central Florida. - Facilitate walking programs that aid in increasing physical activity during leisure time- Provide opportunities for leisure time physical activity via annual 5k and 10k races- Provide funding to the American Cancer Society and the American Lung Association- CREATION Health lifestyle seminars and expanded programs are offered at all Florida Hospital locations and in community settings. CREATION Health faith based wellness plan that focuses on eight principles: Choice, Rest, Environment, Activity, Trust, Interpersonal Relationships, Outlook and Nutrition. Free 'Quit Smoking Now' smoking cessation classes- Additionally, Florida Hospital Winter Park and its community partners - the Department of Health, the Area Health Education Council (AHEC), the American Heart Association, the American Cancer Society, the American Lung Association, etc. - already provide many health education and disease management programs. B. Access to CareTwenty-four percent of people in Orange County are uninsured. Limited access to health care affects people's ability to reach their full potential and also drives up health costs. Because a lack of insurance coverage is one of the biggest barriers to accessing health care, we fund or staff facilities that focus on providing high quality care to the underinsured and uninsured within the Winter Park community. - Financially support and provide leadership for the Primary Care Access Network (PCAN) of Orange County that cares for 92,000 uninsured patients in 13 FQHC medical homes and 10,000 secondary care patients at the Orange County Medical Clinic. Winter Park residents have easy access to three FQHCs, a Shepherd's Hope free clinic and Grace Medical Home (for chronic conditions).- Financially support Shepherd's Hope free clinics - Financially support the Health Care Center for the Homeless - Financially support the professional development and education of medical and nursing students from Valencia College, Seminole State College, Adventist University, the University of Central Florida and the UCF School of Medicine - Increase the availability of free and low-cost mammograms via the mobile mammogram unit - Provide a funding match for the Healthy Start Coalition of Orange County (maternal/infant).C. DiabetesWinter Park Memorial Hospital's 2013 Needs Assessment showed that Diabetes is the leading cause of death in Orange County and that rates were 40% below Healthy People 2020 targets. Diabetes can lead to the development of serious and disabling complications if not properly treated. Complications include heart disease and stroke, high blood pressure, blindness, kidney disease and limb amputation. In order to address diabetes prevalence, the Hospital has funded and supported extensive health education programs with a focus on nutrition for both children and adults. The Obesity/Chronic Disease focus noted above includes efforts to minimize diabetes in our community. The Florida Hospital Diabetes Institute has implemented a targeted Diabetes program and study in the primarily African-American community of Eatonville (part of the Winter Park service area), which has a 24% rate of adult diabetes. The program offers screenings, diabetic health risk assessments and treatment to help Eatonville residents better control their diabetes. The Hospital also supports the American Diabetes Association Annual 5k and other walks that provide opportunities for leisure time activity.Community Needs Not Chosen by Florida Hospital Winter Park In developing its Community Health Needs Assessments, Florida Hospital used defined criteria to determine the priority areas to be addressed. The criteria were:- Acuity of the health issue (how serious is it?)- Capacity of the hospital to address the issue (does the hospital have the services or other ability to address the issue?)- Are community partners already addressing this issue? Would the hospital be duplicating those efforts? - If the hospital were to address the issue, would there be opportunities for collaboration and shared impact?A. Heart Disease Heart disease, Hypertension and Congestive Heart Failure - with Diabetes - are the most common chronic conditions in the United States. Risk factors include health behaviors such as obesity and smoking. Winter Park Memorial Hospital is less than eight miles from Florida Hospital Orlando, which is addressing the area of Heart Disease. Winter Park residents have access to the free Stanford Chronic Disease Self-Management Program offered in Spanish and English.B. CancerCancer is a major cause of death in Central Florida and the U.S. as a whole. Florida Hospital Winter Park is not focusing on cancer and cancer prevention as a priority because of the many Florida Hospital and community resources already available. The Florida Hospital Cancer Institute provides patient care, education and research at the Orlando campus. In addition, Orlando Health (hospital) offers a full range of cancer services, and groups like the American Cancer and Leukemia Societies provide outreach and education throughout the community - and in partnership with the hospitals. The Hospital receives Susan G. Komen dollars for free mammograms for low-income women, and uses its mobile mammogram unit to reach out to this audience. C. Sexually Transmitted Diseases Florida Hospital Winter Park provides inpatient care but does not provide wrap-around services for HIV/AIDS or STD patients. The Orange County Health Department has STD and HIV/AIDS Clinics, and the Center for Multicultural Wellness and Prevention provides programs that screen for and treat sexually transmitted diseases. In addition, Orange County Government Health Services operates the Ryan White HIV/AIDS Program that provides services to people without sufficient health coverage or financial resources to cope with HIV/AIDS.D. Maternal and Child HealthFlorida Hospital Winter Park provides obstetrics services and the accompanying parent education programs. The nearby Florida Hospital Women's Hospital will open in 2015. The Walt Disney Pavilion at Florida Children's Hospital accepts referrals from other Florida Hospital campuses and from the Hospital's 25 CentraCare Walk-In Urgent Care Centers. Additionally, Florida Hospital Winter Park supports Orange County's Healthy Start Coalition.** see continuation of footnote
Group A-Facility 5 -- Winter Park Memorial Hospital Part V, Section B, line 22d: In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital used the following methodology in 2014:The Hospital identified all commercial payors that had any activity with the Hospital during the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates was determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determined the maximum amount that could be charged to patients eligible under the Hospital's financial assistance policy.
Group A-Facility 6 -- Florida Hospital Kissimmee Part V, Section B, line 5: Florida Hospital (FH) is a 2,500 bed medical complex in Central Florida with seven separate hospital campuses. FH serves the residents of Central Florida (primarily serving the residents of Orange, Osceola, Seminole and Lake Counties) but also draws patients from other parts of the Southeastern United States, the Caribbean and South America. The 7-campus hospital health system is the largest healthcare provider in Central Florida and the nation's largest Medicare provider with FH being the second largest employer in the area. All of the seven campuses of FH operate under a single hospital license. Florida Hospital Kissimmee (FHK) is a not-for-profit hospital with 83 acute care beds and an emergency department and has been part of the Florida Hospital system since 1993. FHK offers comprehensive inpatient and outpatient services including emergency care; cancer treatment including radiation therapy; imaging services including PET, MRI, CT, nuclear, mammography, and ultrasound; a designated primary stroke center; digestive health; and surgical specialties to Osceola County residents. FHK provides holistic care - body, mind and spirit - and is committed to providing a personalized patient experience for all patients.Florida Hospital (all campuses) conducted its 2013 Community Health Needs Assessment (CHNA) in two parts: a regional health needs assessment for Orange, Seminole and Osceola Counties in Central Florida, followed by separate assessments focused on and tailored to each of the seven campuses of FH. Three not-for-profit clinical hospitals within Central Florida, namely FH, Orlando Health, and Lakeside Behavioral Health, together with the Florida Department of Health in Orange County, collaborated to conduct the regional tri-county health needs assessment. This was the first ever multi-hospital, public health department joint community health needs assessment. These four organizations also collaborated with other community agencies under the umbrellas of "Healthy Orange Florida" in Orange County, "Healthy Seminole" in Seminole County, and "Community Vision" in Osceola County. Healthy Seminole is an 81-member affiliation of representatives from FH, local government, social service, and educational organizations within Seminole County. The Health Council of East Central Florida, Inc. (the Health Council), a regional quasi-government health planning agency, was contracted with to assist with data collection and analysis. The Health Council conducted over 70 key stakeholder interviews with individuals representing the broad interests of the tri-county area. Key stakeholders for the tri-county assessment included individuals with special knowledge of or interest in public health (i.e., health departments); individuals/organizations serving or representing the interests of medically underserved, low-income, and minority populations; persons who represented the broad interests of residents served by the hospitals; and individuals representing large employers and employee interests. A total of 72 stakeholders representing 44 social service and health care organizations were interviewed and completed a questionnaire aimed at identifying health barriers, assets, resources, and needs within the region. As a part of its efforts to ensure broad community-based input into the CHNA process, FH formed a Community Health Needs Assessment Committee (CHNAC). The CHNAC was comprised of external community members/stakeholders and senior FH leaders. The community members in particular provided strong representation of low-income, minority and underserved populations. Listed below are several examples of community organizations represented on the CHNAC: * Hebni Nutrition Consultant a nutritionist who works in the local African American community;* The University of Central Florida School of Medicine primary care physician training;* Winter Park Health Foundation a local non-profit organization that develops and funds school health and older adult programs; * Orange County Public Schools serves children of all ages and ethnicities, including those who are homeless and/or eligible for free or reduced lunch programs; and * Gracia Anderson Foundation a local non-profit organization that funds social service projects.
Group A-Facility 6 -- Florida Hospital Kissimmee Part V, Section B, line 6a: The filing organization collaborated with two other not-for-profit hospitals, namely Orlando Health and Lakeside Behavioral Health, to create a Community Health Needs Assessment for Orange, Osceola, and Seminole Counties. The Community Health Needs Assessment describes the health of Central Floridians for the purpose of planning interventions relevant to the community.
Group A-Facility 6 -- Florida Hospital Kissimmee Part V, Section B, line 6b: The filing collaborated with the Florida Department of Health in Orange County and other community agencies under the umbrellas of "Healthy Orange Florida" in Orange County, "Healthy Seminole" in Seminole County, and "Community Vision" in Osceola County. Healthy Seminole is an 81-member affiliation of representatives from FH, local government, social service, and educational organizations within Seminole County. The Health Council of East Central Florida, Inc. (the Health Council), a regional quasi-government health planning agency, was contracted with to assist with data collection and analysis.
Group A-Facility 6 -- Florida Hospital Kissimmee Part V, Section B, line 7d: The Hospital has adopted a policy that addresses the public posting requirements of the Community Health Needs Assessment. Under this policy, the Community Health Needs Assessment Report must be posted on the Hospital's website by the end of the year in which it is conducted. The Hospital will make a copy of its Community Health Needs Assessment Report available upon request. The Hospital will also make a paper copy of the Community Health Needs Assessment Report available for public inspection at the Hospital facility.
Group A-Facility 6 -- Florida Hospital Kissimmee Part V, Section B, line 11: Community Needs Being Addressed by Florida Hospital Kissimmee Florida Hospital Kissimmee chose three areas of focus for its 2013-16 Community Health Plan: Obesity/Heart Disease/Diabetes, Access to Care, and Violent Crime.A. Chronic Disease: Obesity, and DiabetesOverall, Osceola County's health rankings are among the worst in Florida. In particular, Florida Hospital's Community Health Needs Assessment showed that 21.9% of Osceola County residents are obese compared to 27.9% in Orange County and 26.4% in Seminole County. Rates of heart disease and stroke are also far higher than the rest of Central Florida. Obesity increases the risk for chronic health conditions such as heart disease, stroke, diabetes and cancer - and the comorbidities that often accompany these diseases. Additionally, being overweight or obese increases the risk of adverse health outcomes and has significant economic impacts on individuals and the community. These impacts can include a rise in health care spending over time as well as lost earnings and productivity due to illness. Several factors influence the likelihood of obesity including individual behavior, the social and built environment, and genetic heritability. As a result, overweight/obesity is a complex health issue to address. Good nutrition, physical activity, and maintaining a healthy body weight can help manage/prevent obesity and promote overall health and well-being. Florida Hospital Kissimmee's obesity/chronic disease interventions target both adults and children:- Increase opportunities for leisure time physical activity in a social setting through funding and staffing 5K runs including the Annual Healthy 100 Run- Support the Town of Celebration Marathon and half-marathon events, the proceeds of which contribute to a scholarship fund for Osceola County High School seniors- Offer educational programming focused on nutrition, stress management and exercise through the Employee Families Performance Workshop Series - Implement and support positive nutrition and exercise instruction through the Mission FIT Possible program - Offer CREATION Health lifestyle seminars and expanded programs. CREATION Health is a faith-based wellness plan that focuses on eight principles: Choice, Rest, Environment, Activity, Trust, Interpersonal Relationships, Outlook and Nutrition. - Offer CREATION Kids, a child-friendly wellness program that stresses healthy eating and exercise in church and school settings- Partner with local organizations to deliver weekend food to children who qualify for free or reduced lunch per school district- Host and facilitate an annual event to package food items for children and families- Support education initiatives around the 5-2-1-0 campaign in partner schools- Support efforts to reduce heart-related conditions through board membership and financial support to the American Heart Association- Offer free 'Quit Smoking' Smoking Cessation Classes.B. Heart DiseaseHeart disease, hypertension and Congestive Heart Failure - with diabetes - are the most common chronic conditions in the United States. Risk factors include health behaviors such as obesity and smoking. Florida Hospital Kissimmee supports chronic disease management programs at the Osceola Council on Aging, Chronic Care Clinic and the Hope Clinic. In addition, the Obesity interventions noted above address many of the risk factors for heart disease.C. Access to CareAccess to comprehensive, quality health care is important for increasing the quality of life. Osceola County has the highest rate of un-insurance in Central Florida - over 30%. The County is 50% Hispanic and across the nation, Hispanics have much higher rates of un-insurance. Florida Hospital Kissimmee actively supports a number of free/affordable health care resources to County residents: - Provide financial support for the Council on Aging chronic care clinic for uninsured residents - Provide financial support for diabetes program at the Council on Aging Clinic - Provide financial support for the Hope Center Clinic operated by the Health Care Center for the Homeless (FQHC) - Provide financial support for a secondary care referral system for the Hope Clinic and the Council on Aging chronic care clinic- Provide referrals and enrollment assistance for uninsured and underinsured patients to FQHC medical homes in St. Cloud, Kissimmee, Poinciana, and Intercession City- Provide prescription medications at little to no cost to patients though compassionate drug programs- Support the education and training of medical practitioners at UCF Medical School, TECO nursing and other health professions programs, and the Valencia College Nursing program - Provide financial support for the Osceola County Certified Nurse Assistance training program targeted at low-income residents - Continue leadership role with the Osceola Health Leadership Council- Provide financial support for broad community health planning through the hospital's Community Vision, Inc. health endowment. D. Violent CrimeAccording to the Florida Department of Law Enforcement, Osceola County's rate of violent crime exceeds the national average. While hospitals lack the ability to directly address violent crimes, Florida Hospital Kissimmee is engaged with organizations that address the effects of violent crime. Initiatives include:- Providing clinical space for Sexual Assault Nurse Examiners who work directly with victims of sexual assault- Funding domestic violence awareness initiatives including the Harbor House Door Hanger Event. Community Needs Not Chosen by Florida Hospital Kissimmee In developing its Community Health Needs Assessments, Florida Hospital used defined criteria to determine the priority areas to be addressed. The criteria were:A. Acuity of the health issue (how serious is it?)B. Capacity of the hospital to address the issue (does the hospital have the services or other ability to address the issue?)C. Are community partners already addressing this issue? Would the hospital be duplicating those efforts? D. If the hospital were to address the issue, would there be opportunities for collaboration and shared impact?A. Mental Health and Substance AbuseFlorida Hospital Kissimmee does not offer substance abuse or behavioral/mental health services. Hospital inpatients with behavioral health co-morbidities are transferred to the Med-Psych unit at the Florida Hospital main campus or to the nonprofit Park Place Behavioral Health. Additionally, the Florida Hospital Community Health Impact Council board identifies and funds innovative and best practice programs centered on addressing mental health, substance abuse within the tri county area.B. Dental CareFlorida Hospital Kissimmee does not offer dental care but partners with the county's five FQHCs and the Dental Care Access Foundation that provide free and/or sliding fee scale dentistry to people who are uninsured or underinsured.C. Maternal and Child HealthFlorida Hospital Kissimmee does not have Maternal and Child health services, but supports the Healthy Start Coalition of Osceola County financially and through board service. Other Florida Hospital facilities (Winter Park, Orlando and Celebration) provide obstetrics services, and the new Florida Women's Hospital will open in 2015. D. Cancer Florida Hospital Kissimmee does not provide cancer treatment services. Patients in the Kissimmee community are referred to the Cancer Institute at the main Florida Hospital campus or at the Celebration Health Facility. In addition, Florida Hospital Kissimmee supports the Area Health Education Council (AHEC) and provides funding to the American Cancer Society. E. AsthmaFlorida Hospital Kissimmee does not have Asthma-specific community programming but actively supports the American Lung Association and provides health education and disease management programs throughout the county.** see continuation of footnote
Group A-Facility 6 -- Florida Hospital Kissimmee Part V, Section B, line 22d: In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital used the following methodology in 2014:The Hospital identified all commercial payors that had any activity with the Hospital during the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates was determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determined the maximum amount that could be charged to patients eligible under the Hospital's financial assistance policy.
Group A-Facility 8 -- FH Heartland Medical Center Part V, Section B, line 5: Florida Hospital Heartland in Sebring and Florida Hospital Lake Placid (the FHH Hospitals), located in Highlands County, Florida, operate under a single hospital license. Collectively, these two hospitals serve the residents of Highlands County, which includes the cities of Sebring, Lake Placid and Avon Park. Highlands County has an estimated population of 102,000 permanent residents, with an approximate increase of an additional 35,000 seasonal residents during the winter months. Highlands County's residents comprised the fifth-oldest population in the US in 2012. Florida Hospital Heartland in Sebring and Florida Hospital Lake Placid conducted a joint Community Health Needs Assessment (CHNA) in 2013. The CHNA was conducted through a collaborative community health needs assessment process that included the Highlands County Health Department, the Community Health Improvement Planning Committee (CHIP) of Highlands County, Samaritan's Touch free clinics in Sebring, the Highlands County Rural Health Network, Highlands Regional Medical Center, and Central Florida Health Care (a federally qualified health center). The CHNA process included the collection of both primary and secondary data. Primary data consisted of community surveys and direct stakeholder input, particularly with respect to representatives from the CHIC Committee. With respect to the process of gathering and analyzing both primary and secondary health needs assessment data, the collaborative team relied significantly on the CHIP Committee due to its broad representation of the communities served by the FHH Hospitals. The CHIPS Committee is composed of a number of representatives from organizations that serve the medically underserved, low-income populations and those with chronic disease needs. Among others, the following organizations were represented on the CHIC Committee:Highlands County Department of Health;Tri-County Human Services;Salvation Army;Florida Department of Health;Healthy Start Coalition;Children's Services Council; andHeartland Rural Health Network. The CHIP members represent public health, the broad community and people who are low-income, minorities or otherwise undeserved. Their mission is to improve the health of communities through education and the promotion of healthy lifestyles; build partnerships to maximize resources; and provide access to quality health care to all of the people in Highlands County regardless of ability to pay. The FHH Hospitals also established a Community Health Needs Assessment Committee (CHNAC) to analyze the health data collected and prioritize key issues for the FHH Hospitals to address.
Group A-Facility 8 -- FH Heartland Medical Center Part V, Section B, line 6a: Florida Hospital Heartland in Sebring and Florida Hospital Lake Placid conducted a joint Community Health Needs Assessment (CHNA) in 2013. The CHNA was conducted through a collaborative community needs assessment process with the hospitals, Highlands County Health Department, the Community Health Improvement Planning Committee (CHIP) of Highlands County, Samaritan's Touch free clinics in Sebring, the Highlands County Rural Health Network, Highlands Regional Medical Center, and Central Florida Health Care (a federally qualified health center).
Group A-Facility 8 -- FH Heartland Medical Center Part V, Section B, line 6b: Florida Hospital Heartland in Sebring and Florida Hospital Lake Placid conducted a joint Community Health Needs Assessment (CHNA) in 2013. The CHNA was conducted through a collaborative community needs assessment process with the hospitals, Highlands County Health Department, the Community Health Improvement Planning Committee (CHIP) of Highlands County, Samaritan's Touch free clinics in Sebring, the Highlands County Rural Health Network, Highlands Regional Medical Center, and Central Florida Health Care (a federally qualified health center).
Group A-Facility 8 -- FH Heartland Medical Center Part V, Section B, line 7d: The Hospital has adopted a policy that addresses the public posting requirements of the Community Health Needs Assessment. Under this policy, the Community Health Needs Assessment Report must be posted on the Hospital's website by the end of the year in which it is conducted. The Hospital will make a copy of its Community Health Needs Assessment Report available upon request. The Hospital will also make a paper copy of the Community Health Needs Assessment Report available for public inspection at the Hospital facility.
Group A-Facility 8 -- FH Heartland Medical Center Part V, Section B, line 11: Priority 1: Cancer Cancer is the second leading cause of death in the Heartland community. Efforts to promote the importance for early detection are key in reducing the number of cases of Cervical Cancer, Breast Cancer and Prostrate Cancer. Individuals from underserved populations are more likely to be diagnosed with late-stage cancers that might have been treated or cured if diagnosed earlier. Interventions include:- Smoking cessation classes for at least 230 people including underserved populations- Pink Army education efforts re early detection of breast cancer for at least 670 people- Education seminars on the importance of regular checkups with primary care physicians. Priority 2: Heart Disease and StrokeHeart Disease and Stroke are the leading cause of death in the Heartland community. High cholesterol, health attacks, angina, heart disease, and hypertension rates are above the state average for all adults and adult women. Poor eating habits and economic pressures are attributed to these outcomes. As with cancer, heart disease and its risk factors are not being picked up early in people who do not have routine checkups with a primary care physician.Interventions include: - Healthy Heart classes on nutrition, eating habits and stress management - Biometric Indexes for those who attend the Hearty Heart sessions - Health Fairs and cardiac screenings for at least 800 people - Chronic disease self-management programs including efforts on CHF that can reduce readmissions by 1% or more- Stroke education seminars - Cardiac rehabilitation classes - Education seminars on the importance of regular checkups with primary care (as noted in Priority 1).Priority 3: DiabetesThere is a higher-than-state average on hospitalizations and hospitalizations from amputations in the Florida Hospital Heartland service area. Diabetes self-management education is also below the state average, so it is important to educate our community on the importance of managing Diabetes. An individual's socioeconomic status and race or ethnicity plays a major role in their access to education on diabetes, and on the risk factors involved in not being treated. Interventions include:- Community diabetes education program for at least 100 people * Physical activity for at least 50% of the participants * Overall 5% weight loss in overweight or obese patients * Improvement in participant ratings of their quality of life * Instruction on personal foot exams (3x per week at home) * Improvement in medication compliance in 88% pf participants * Adherence to nutritional goals in 60% of participants * Medical nutrition therapy for at least 40 people * Reduce A1c levels in uninsured people through classes and screenings - Gestational diabetes programs - Diabetes self-management training for at least 100 people.Priority 4: Access to Health CareAccess to health care issues can be attributed to the lack of education or understanding of health care systems and the ways treatments and overall care are communicated. Providing community education on how to access health care and improving decision-making skills is important, as are adequate resources for screening and intervention programs through health fairs and screening programs throughout the community. Access to care is effected by socio-economic status, health risk behaviors and limited job opportunities.Interventions include:- Enlist volunteers to educate people on community health care resources- Provide up to $2.5 million in vouchers for lab and imaging services for uninsured patients at the local free clinic- Conduct eight health fairs for insured and uninsured people - Refer patients to the local Federally Qualified Health Center. Priority 5: Chronic Disease Management - Implement free Stanford Chronic Disease Self-Management program that has proven health improvement results for its graduates. - See Heart Disease and Diabetes efforts listed in Priorities 2 and 3 above.Priorities Considered but Not Selected Medical Home Shortage: The community's total number of licensed family physicians is below average with a ratio of 1 primary care physician to 270 people. This issue was not chosen because it is encompassed in the access to health care priority.Motor Vehicle Deaths: The community's rate of motor vehicle accidents is higher that the state average; many are related to alcohol. Motor vehicle deaths that do not involve alcohol are seen as unintentional deaths and may be related to the rural nature of the community. This is not a core competency of the hospital, and there are numerous organizations working to stop drinking and driving. Chronic Lower Respiratory Disease: Hospitalizations for respiratory diseases exceed the state rate. Smoking is the main cause of chronic lower respiratory disease. Florida Hospital offers smoking cessation classes and a Better Breathers Club, and other organizations such as the American Lung Association focus on this disease.Need for Health Promotion: Lifestyle and personal health habits are growing concerns. The community's obesity rate is higher than the expected level for students in middle and high school, as well as in adults. We are addressing this issue in our diabetes, heart disease and chronic disease self-management efforts. In addition, there is a program called ACCESS Florida offered by the Florida Department of Children and Families, which helps families purchase nutritional foods needed to maintain a healthy lifestyle.HIV/AIDS: HIV/AIDS deaths exceed the state average. An alarming 29% of married persons still believe you get HIV from mosquitoes. This is an issue of education, which many groups are focusing on. The local Health Department cares for HIV/AIDS patients. The Highlands County Rural Health Network offers Making a Difference!, aa initiative that empowers adolescents to change their behaviors and reduce their risks of pregnancy, HIV and other sexual transmitted diseases.Maternal-Infant: Pregnancy, Parental Care and Newborn Care fall in as the tenth issue. Even though teen birth rates have decreased from 2010, the area's rates are still above the average. A 15-20 year old has a 57% chance of giving birth, and 30% of mothers began their prenatal care after the first trimester. Florida Hospital Heartland has a Birthing Center that serves women of all incomes and ethnicities. Several community groups are working diligently on teen pregnancy prevention. Healthy Choices Education/Teen Pregnancy Prevention are current initiatives by Highlands County Rural Health Network; their focus is helping reduce STDs and teen pregnancy within the community.Pediatrics: Pediatric Services are limited in this community, due in part to a limited demand driven by the large aging population. Florida Hospital Heartland has a pediatric unit and a one pediatric hospitalist, but no specialists. Families with acute needs travel out of the community - to Tampa, Orlando or Lakeland - for specialty pediatric services. Heartland has a referral agreement with the Florida Hospital for Children in Orlando that provides access to 30 sub-specialties. Due to the limited demand for pediatrics in the community, Florida Hospital Heartland has no current plans to expand the existing pediatric unit.Mental Health/Substance Abuse: There is a local shortage of mental health providers in the community, meaning that the ability to provide effective care is challenging. In the County, the provider-to-patient ratio is four times the state average. Substance abuse is also a growing issue, especially in middle and high school aged population. Marijuana use is above the state average. Florida Hospital Heartland does not provide mental health or substance abuse services. BALANCE Lives in Transition is an organization formed to improve treatment and quality of life for residents. Drug Free Highlands works with the Highlands County School Board and Sheriff's Office to promote a drug-free community.
Group A-Facility 8 -- FH Heartland Medical Center Part V, Section B, line 22d: In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital used the following methodology in 2014:The Hospital identified all commercial payors that had any activity with the Hospital during the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates was determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determined the maximum amount that could be charged to patients eligible under the Hospital's financial assistance policy.
Group A-Facility 9 -- Florida Hospital Apopka Part V, Section B, line 5: Florida Hospital (FH) is a 2,500 bed medical complex in Central Florida with seven separate hospital campuses. FH serves the residents of Central Florida (primarily serving the residents of Orange, Osceola, Seminole and Lake Counties) but also draws patients from other parts of the Southeastern United States, the Caribbean and South America. The 7-campus hospital health system is the largest healthcare provider in Central Florida and the nation's largest Medicare provider with FH being the second largest employer in the area. All of the seven campuses of FH operate under a single hospital license. The Florida Hospital Apopka (FHAP) campus is a 50-bed acute-care community hospital located in Apopka, Florida. Services offered by Florida Hospital Apopka include but are not limited to: rehabilitation services; intensive and progressive care units; 50 acute care beds; a 24-hour emergency department; imaging services; a women's diagnostic center; home health services; cardiac diagnosis services; and a sleep lab. Services not provided at Florida Hospital Apopka are provided at other campuses and ground and air transportation are available to ensure all patients can access the appropriate level of care.Florida Hospital (all campuses) conducted its 2013 Community Health Needs Assessment (CHNA) in two parts: a regional health needs assessment for Orange, Seminole and Osceola Counties in Central Florida, followed by separate assessments focused on and tailored to each of the seven campuses of FH. Three not-for-profit clinical hospitals within Central Florida, namely FH, Orlando Health, and Lakeside Behavioral Health, together with the Florida Department of Health in Orange County, collaborated to conduct the regional tri-county health needs assessment. This was the first ever multi-hospital, public health department joint community health needs assessment. These four organizations also collaborated with other community agencies under the umbrellas of "Healthy Orange Florida" in Orange County, "Healthy Seminole" in Seminole County, and "Community Vision" in Osceola County. Healthy Seminole is an 81-member affiliation of representatives from FH, local government, social service, and educational organizations within Seminole County. The Health Council of East Central Florida, Inc. (the Health Council), a regional quasi-government health planning agency, was contracted with to assist with data collection and analysis. The Health Council conducted over 70 key stakeholder interviews with individuals representing the broad interests of the tri-county area. Key stakeholders for the tri-county assessment included individuals with special knowledge of or interest in public health (i.e., health departments); individuals/organizations serving or representing the interests of medically underserved, low-income, and minority populations; persons who represented the broad interests of residents served by the hospitals; and individuals representing large employers and employee interests. A total of 72 stakeholders representing 44 social service and health care organizations were interviewed and completed a questionnaire aimed at identifying health barriers, assets, resources, and needs within the region. As a part of its efforts to ensure broad community-based input into the CHNA process, FH formed a Community Health Needs Assessment Committee (CHNAC). The CHNAC was comprised of external community members/stakeholders and senior FH leaders. The community members in particular provided strong representation of low-income, minority and underserved populations. Listed below are several examples of community organizations represented on the CHNAC: * Hebni Nutrition Consultant a nutritionist who works in the local African American community;* The University of Central Florida School of Medicine primary care physician training;* Winter Park Health Foundation a local non-profit organization that develops and funds school health and older adult programs; * Orange County Public Schools serves children of all ages and ethnicities, including those who are homeless and/or eligible for free or reduced lunch programs; and * Gracia Anderson Foundation a local non-profit organization that funds social service projects.
Group A-Facility 9 -- Florida Hospital Apopka Part V, Section B, line 6a: The filing organization collaborated with two other not-for-profit hospitals, namely Orlando Health and Lakeside Behavioral Health, to create a Community Health Needs Assessment for Orange, Osceola, and Seminole Counties. The Community Health Needs Assessment describes the health of Central Floridians for the purpose of planning interventions relevant to the community.
Group A-Facility 9 -- Florida Hospital Apopka Part V, Section B, line 6b: The filing collaborated with the Florida Department of Health in Orange County and other community agencies under the umbrellas of "Healthy Orange Florida" in Orange County, "Healthy Seminole" in Seminole County, and "Community Vision" in Osceola County. Healthy Seminole is an 81-member affiliation of representatives from FH, local government, social service, and educational organizations within Seminole County. The Health Council of East Central Florida, Inc. (the Health Council), a regional quasi-government health planning agency, was contracted with to assist with data collection and analysis.
Group A-Facility 9 -- Florida Hospital Apopka Part V, Section B, line 7d: The Hospital has adopted a policy that addresses the public posting requirements of the Community Health Needs Assessment. Under this policy, the Community Health Needs Assessment Report must be posted on the Hospital's website by the end of the year in which it is conducted. The Hospital will make a copy of its Community Health Needs Assessment Report available upon request. The Hospital will also make a paper copy of the Community Health Needs Assessment Report available for public inspection at the Hospital facility.
Group A-Facility 9 -- Florida Hospital Apopka Part V, Section B, line 11: Community Needs Being Addressed by Florida Hospital Apopka Florida Hospital Apopka chose two areas of focus for its 2013-16 Community Health Plan: Obesity/Chronic Disease and Access to Care. A. Obesity/Chronic DiseaseObesity increases the risk for developing health conditions such as heart disease, stroke, diabetes, and cancer - and the comorbidities that often accompany these diseases. Additionally, being overweight or obese increases the risk of adverse health outcomes and has significant economic impacts on individuals and the community. These impacts can include a rise in health care spending over time as well as lost earnings and productivity due to illness. Several factors influence the likelihood of obesity including individual behavior, the social and built environment, and genetic heritability. As a result, being overweight or obese is a complex health issue to address. Good nutrition, physical activity, and maintaining a healthy body weight can help manage/prevent obesity and promote overall health and well-being. Florida Hospital Apopka's obesity/chronic disease interventions target both adults and children: - Provide funding to increase opportunities for health education via community garden curriculum implemented through Head Start- Increase opportunities for leisure time physical activity in a social setting via annual 5k runs- Provide education to increase knowledge of positive behaviors towards healthy eating and exercise via Mission Fit Possible program for Children- Provide education and clinical care to increase knowledge of and positive behaviors toward healthy eating and exercise- Increase the availability of fruits to the diets of the population age 2 and older via the mobile farmers market- Provide education and clinical care to increase knowledge of and positive attitudes towards healthy foods- Promote nature prescription pad pilot to FHMG physicians so that they may "prescribe" exercise via free admissions for up to 8 persons to a state park- Provide support and board membership to the American Heart Association and encourage employee participation in the annual Heart Walk.Additional Chronic disease interventions include:- Heart of Apopka, which uses the Stanford chronic disease self-management program for patients with chronic conditions (free).- Free care for uninsured COPD and asthma patients at the Apopka Lung Clinic operated by the Hospital's Respiratory Care Department.- Increase the access to medication and pulmonary care through the Hospital's Pulmonary Rehab center - CREATION Health faith-based wellness plan that focuses on eight principles: Choice, Rest, Environment, Activity, Trust, Interpersonal Relationships, Outlook and Nutrition. CREATION Health lifestyle seminars and expanded programs are offered at all Florida Hospital locations and in community settings. - Free 'Quit Smoking Now' smoking cessation classes.B. Access to Care A number of Florida Hospital Apopka initiatives educate and link underserved community members to free or affordable health resources: - Operate the Community After Hours Clinic (at Florida Hospital) that provide cares to uninsured and underinsured people - Financially support and lead the Primary Care Access Network (PCAN) integrated system of health care for un- and underinsured people in Orange County. PCAN has 92,000 primary care patients in 13 FQHC medical homes, and 10,000 secondary care patients. - Encourage medical home enrollment by making appointments or referring un- and underinsured emergency department and inpatients to PCAN FQHCs - Provide financial support to Shepherd's Hope free clinics - Provide financial for the Health Care Center for the Homeless- Provide financial support for Grace Medical Home, a chronic care medical home for uninsured people- Operate the Apopka Lung Clinic for uninsured people with chronic respiratory conditions including COPD and asthma- Increase the availability of free or low-cost mammograms for un- and underinsured women via the mobile mammogram unit and Florida Hospital diagnostics centers - Support the education and training of medical practitioners through the FH Residency programs and Adventist University, and through partnerships with the UCF and FSU Medical Schools.Community Needs Not Chosen by Florida Hospital Apopka In developing its Community Health Needs Assessments, Florida Hospital used defined criteria to determine the priority areas to be addressed. The criteria were:1. Acuity of the health issue (how serious is it?)2. Capacity of the hospital to address the issue (does the hospital have the services or other ability to address the issue?)3. Are community partners already addressing this issue? Would the hospital be duplicating those efforts? 4. If the hospital were to address the issue, would there be opportunities for collaboration and shared impact?A. Stroke Stroke is among the most common chronic conditions in the United States and is frequently related to health behaviors such as obesity and smoking. Florida Hospital Apopka and its community partners - the Department of Health, the Area Health Education Council (AHEC), the American Heart Association, the American Cancer Society, the American Lung Association, etc. - already provide health education and disease management programs. As noted above, the hospital's Obesity interventions focus on health education, exercise, nutrition, stress management, and personal accountability - factors vital to the control of diabetes, cancer, heart disease, stroke, asthma and the comorbidities that often accompany these diseases. Therefore, Florida Hospital Apopka is addressing the risk factors for these chronic diseases by specifically addressing Obesity.B. DiabetesDiabetes can lead to the development of serious and disabling complications if not properly treated. Complications include heart disease and stroke, high blood pressure, blindness, kidney disease, and limb amputation. According to the American Diabetes Association, it is possible to prevent or delay diabetic complications through a healthy diet, physical activity, and maintaining a healthy weight and glucose levels. Florida Hospital Apopka does not offer specific diabetes services (other than routine inpatient care), but its diabetes engagement includes the Heart of Apopka program that uses the Stanford chronic disease self-management program that includes diabetes management. Because the Apopka community is nearly 50% Hispanic, the free, CDC-recommended classes are offered in both Spanish and English.C. CancerFlorida Hospital Apopka does not provide cancer treatment services. Patients in the Apopka community are treated at the Cancer Institute at the main Florida Hospital campus. In addition, Florida Hospital Apopka supports the Area Health Education Council (AHEC) and provides funding to the American Cancer Society and the American Lung Association; these partners provide health education and disease management programs throughout the county.D. Heart DiseaseHeart disease, hypertension and Congestive Heart Failure - with Diabetes - are the most common chronic conditions in the United States. Risk factors include health behaviors such as obesity and smoking. The Heart of Apopka program noted above provides education and support for people with or at risk for heart disease through the free Stanford Chronic Disease Self-Management Program offered in Spanish and English. Apopka residents can access the free Florida Hospital congestive heart failure clinic at the Orange County Medical Clinic. The hospital supports efforts to reduce heart related conditions through the funding of research and programs via board membership to the American Heart Association.E. Sexually Transmitted DiseasesFlorida Hospital Apopka provides inpatient care but does not provide wrap-around services for HIV/AIDS or STD patients. The Health Department has STD and HIV/AIDS Clinics, and the Center for Multicultural Wellness and Prevention provides programs that screen for and treat sexually transmitted diseases. In addition, Orange County Government Health Services operates the Ryan White HIV/AIDS Program that provides services to people without sufficient health coverage or financial resources to cope with HIV.** see continuation of footnote
Group A-Facility 9 -- Florida Hospital Apopka Part V, Section B, line 22d: In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital used the following methodology in 2014:The Hospital identified all commercial payors that had any activity with the Hospital during the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates was determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determined the maximum amount that could be charged to patients eligible under the Hospital's financial assistance policy.
Group A-Facility 11 -- FH Heartland Medical Center Lake Placid Part V, Section B, line 5: Florida Hospital Heartland in Sebring and Florida Hospital Lake Placid (the FHH Hospitals), located in Highlands County, Florida, operate under a single hospital license. Collectively, these two hospitals serve the residents of Highlands County, which includes the cities of Sebring, Lake Placid and Avon Park. Highlands County has an estimated population of 102,000 permanent residents, with an approximate increase of an additional 35,000 seasonal residents during the winter months. Highlands County's residents comprised the fifth-oldest population in the US in 2012. Florida Hospital Heartland in Sebring and Florida Hospital Lake Placid conducted a joint Community Health Needs Assessment (CHNA) in 2013. The CHNA was conducted through a collaborative community health needs assessment process that included the Highlands County Health Department, the Community Health Improvement Planning Committee (CHIP) of Highlands County, Samaritan's Touch free clinics in Sebring, the Highlands County Rural Health Network, Highlands Regional Medical Center, and Central Florida Health Care (a federally qualified health center). The CHNA process included the collection of both primary and secondary data. Primary data consisted of community surveys and direct stakeholder input, particularly with respect to representatives from the CHIC Committee. With respect to the process of gathering and analyzing both primary and secondary health needs assessment data, the collaborative team relied significantly on the CHIP Committee due to its broad representation of the communities served by the FHH Hospitals. The CHIPS Committee is composed of a number of representatives from organizations that serve the medically underserved, low-income populations and those with chronic disease needs. Among others, the following organizations were represented on the CHIC Committee:Highlands County Department of Health;Tri-County Human Services;Salvation Army;Florida Department of Health;Healthy Start Coalition;Children's Services Council; andHeartland Rural Health Network. The CHIP members represent public health, the broad community and people who are low-income, minorities or otherwise undeserved. Their mission is to improve the health of communities through education and the promotion of healthy lifestyles; build partnerships to maximize resources; and provide access to quality health care to all of the people in Highlands County regardless of ability to pay. The FHH Hospitals also established a Community Health Needs Assessment Committee (CHNAC) to analyze the health data collected and prioritize key issues for the FHH Hospitals to address.
Group A-Facility 11 -- FH Heartland Medical Center Lake Placid Part V, Section B, line 6a: Florida Hospital Heartland in Sebring and Florida Hospital Lake Placid conducted a joint Community Health Needs Assessment (CHNA) in 2013. The CHNA was conducted through a collaborative community needs assessment process with the hospitals, Highlands County Health Department, the Community Health Improvement Planning Committee (CHIP) of Highlands County, Samaritan's Touch free clinics in Sebring, the Highlands County Rural Health Network, Highlands Regional Medical Center, and Central Florida Health Care (a federally qualified health center).
Group A-Facility 11 -- FH Heartland Medical Center Lake Placid Part V, Section B, line 6b: Florida Hospital Heartland in Sebring and Florida Hospital Lake Placid conducted a joint Community Health Needs Assessment (CHNA) in 2013. The CHNA was conducted through a collaborative community needs assessment process with the hospitals, Highlands County Health Department, the Community Health Improvement Planning Committee (CHIP) of Highlands County, Samaritan's Touch free clinics in Sebring, the Highlands County Rural Health Network, Highlands Regional Medical Center, and Central Florida Health Care (a federally qualified health center).
Group A-Facility 11 -- FH Heartland Medical Center Lake Placid Part V, Section B, line 7d: The Hospital has adopted a policy that addresses the public posting requirements of the Community Health Needs Assessment. Under this policy, the Community Health Needs Assessment Report must be posted on the Hospital's website by the end of the year in which it is conducted. The Hospital will make a copy of its Community Health Needs Assessment Report available upon request. The Hospital will also make a paper copy of the Community Health Needs Assessment Report available for public inspection at the Hospital facility.
Group A-Facility 11 -- FH Heartland Medical Center Lake Placid Part V, Section B, line 11: Because Florida Hospital Lake Placid and Florida Hospital Heartland are both located in Highlands County, and have the same service area, the Community Health Needs Assessment was a joint effort.Priority 1: Cancer Cancer is the second leading cause of death in the Lake Placid community. Efforts to promote the importance for early detection are key in reducing the number of cases of Cervical Cancer, Breast Cancer and Prostrate Cancer. Individuals from underserved populations are more likely to be diagnosed with late-stage cancers that might have been treated or cured if diagnosed earlier. Interventions include:- Smoking cessation classes for at least 230 people including underserved populations- Pink Army education efforts re early detection of breast cancer for at least 670 people- Education seminars on the importance of regular checkups with primary care physicians Priority 2: Heart Disease and StrokeHeart Disease and Stroke are the leading cause of death in the Lake Placid community. High cholesterol, health attacks, angina, heart disease, and hypertension rates are above the state average for all adults and adult women. Poor eating habits and economic pressures are attributed to these outcomes. As with cancer, heart disease and its risk factors are not being picked up early in people who do not have routine checkups with a primary care physician.Interventions include: - Healthy Heart classes on nutrition, eating habits and stress management - Biometric Indexes for those who attend the Hearty Heart sessions - Health Fairs and cardiac screenings for at least 800 people - Chronic disease self-management programs including efforts on CHF that can reduce readmissions by 1% or more- Stroke education seminars - Cardiac rehabilitation classes - Education seminars on the importance of regular checkups with primary care (as noted in Priority 1)Priority 3: DiabetesThere is a higher-than-state average on hospitalizations and hospitalizations from amputations in the Florida Hospital Heartland service area. Diabetes self-management education is also below the state average, so it is important to educate our community on the importance of managing Diabetes. An individual's socioeconomic status and race or ethnicity plays a major role in their access to education on diabetes, and on the risk factors involved in not being treated. Interventions include:- Community diabetes education program for at least 100 people * Physical activity for at least 50% of the participants * Overall 5% weight loss in overweight or obese patients * Improvement in participant ratings of their quality of life * Instruction on personal foot exams (3x per week at home) * Improvement in medication compliance in 88% pf participants * Adherence to nutritional goals in 60% of participants - Medical nutrition therapy for at least 40 people - Reduce A1c levels in uninsured people through classes and screenings - Gestational diabetes programs - Diabetes self-management training for at least 100 people.Priority 4: Access to Health CareAccess to health care issues can be attributed to the lack of education or understanding of health care systems and the ways treatments and overall care are communicated. Providing community education on how to access health care and improving decision-making skills is important, as are adequate resources for screening and intervention programs through health fairs and screening programs throughout the community. Access to care is effected by socio-economic status, health risk behaviors and limited job opportunities.Interventions include:- Enlist volunteers to educate people on community health care resources- Provide up to $2.5 million in vouchers for lab and imaging services for uninsured patients at the local free clinic- Conduct eight health fairs for insured and uninsured people - Refer patients to the local Federally Qualified Health Center. Priority 5: Chronic Disease Management - Implement free Stanford Chronic Disease Self-Management program that has proven health improvement results for its graduates. - See Heart Disease and Diabetes efforts listed in Priorities 2 and 3 above.Priorities Considered but Not Selected Medical Home Shortage: The community's total number of licensed family physicians is below average with a ratio of one primary care physician to 270 people. This issue was not chosen because it is encompassed in the access to health care priority.Motor Vehicle Deaths: The community's rate of motor vehicle accidents is higher that the state average; many are related to alcohol. Motor vehicle deaths that do not involve alcohol are seen as unintentional deaths and may be related to the rural nature of the community. This is not a core competency of the hospital, and there are numerous organizations working to stop drinking and driving.Chronic Lower Respiratory Disease: Hospitalizations for respiratory diseases exceed the state rate. Smoking is the main cause of chronic lower respiratory disease. Florida Hospital offers smoking cessation classes and a Better Breathers Club, and other organizations such as the American Lung Association focus on this disease.Need for Health Promotion: Lifestyle and personal health habits are growing concerns. The community's obesity rate is higher than the expected level for students in middle and high school, as well as in adults. We are addressing this issue in our diabetes, heart disease and chronic disease self-management efforts. In addition, there is a program called ACCESS Florida offered by the Florida Department of Children and Families, which helps families purchase nutritional foods needed to maintain a healthy lifestyle.HIV/AIDS: HIV/AIDS deaths exceed the state average. An alarming 29% of married persons still believe you get HIV from mosquitoes. This is an issue of education, which many groups are focusing on. The local Health Department cares for HIV/AIDS patients. The Highlands County Rural Health Network offers Making a Difference!, an initiative that empowers adolescents to change their behaviors and reduce their risks of pregnancy, HIV and other sexual transmitted diseases.Maternal-Infant: Pregnancy, Parental Care and Newborn Care fall in as the tenth issue. Even though teen birth rates have decreased from 2010, the area's rates are still above the average. A 15-20 year old has a 57% chance of giving birth, and 30% of mothers began their prenatal care after the first trimester. Florida Hospital Heartland has a Birthing Center that serves women of all incomes and ethnicities. Several community groups are working diligently on teen pregnancy prevention. Healthy Choices Education/Teen Pregnancy Prevention in an initiative of the Highlands County Rural Health Network; their focus is helping reduce STDs and teen pregnancy within the community.Pediatrics: Pediatric Services are limited in this community, due in part to a limited demand driven by the large aging population. Florida Hospital Heartland has a pediatric unit and a one pediatric hospitalist, but no specialists. Families with acute needs travel out of the community - to Tampa, Orlando or Lakeland - for specialty pediatric services. Heartland has a referral agreement with the Florida Hospital for Children in Orlando that provides access to 30 sub-specialties. Due to the limited demand for pediatrics in the community, Florida Hospital Heartland has no current plans to expand the existing pediatric unit.Mental Health/Substance Abuse: There is a local shortage of mental health providers in the community, meaning that the ability to provide effective care is challenging. In the county, the provider-to-patient ratio is four times the state average. Substance abuse is also a growing issue, especially in middle and high school aged population. Marijuana use is above the state average. Florida Hospital Heartland does not provide mental health or substance abuse services. BALANCE Lives in Transition is an organization formed to improve treatment and quality of life for residents. Drug Free Highlands works with the Highlands County School Board and Sheriff's Office to promote a drug-free community.
Group A-Facility 11 -- FH Heartland Medical Center Lake Placid Part V, Section B, line 22d: In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital used the following methodology in 2014:The Hospital identified all commercial payors that had any activity with the Hospital during the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates was determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determined the maximum amount that could be charged to patients eligible under the Hospital's financial assistance policy.
Part V, Section B Facility Reporting Group B
Facility Reporting Group B consists of: - Facility 10: Central Texas Medical Center, - Facility 12: Florida Hospital Wauchula
Group B-Facility 10 -- Central Texas Medical Center Part V, Section B, line 5: Central Texas Medical Center (CTMC) is a 170-bed community hospital providing a wide range of complex healthcare services located in San Marcos, Texas. CTMC is one of two hospitals in Hays County and provides a wide range of healthcare services. CTMC's primary service area is identified as the cities of Lockhart, San Marcos, Kyle and Wimberley. The secondary service area is Hays County (location of the cities of San Marcos, Kyle and Wimberley) and Caldwell County (location of the city of Lockhart). Caldwell County is served by one critical access hospital. While the demographics of Hays and Caldwell counties are similar, the cities located in CTMC's primary service area (San Marcos, Kyle, Lockhart and Wimberley) are quite diverse. Wide variations exist in the median household income, percentage of residents below the Federal Poverty Level, ethnicity and education. In conducting its 2013 Community Health Needs Assessment (CHNA), CTMC solicited input from numerous stakeholders from throughout Hays and Caldwell Counties in an effort to gain a thorough understanding of the unique health needs in its primary and secondary service area. Stakeholder organizations were identified as such because they provide resources and/or programs that promote or enhance the health needs of residents in the primary and secondary service areas. Primary data was gathered through interviews and surveys. The goal of this process was to distinguish prevalent health issues impacting residents in the primary and secondary service areas, identify community programs and/or services currently being offered to address the health needs of the population, and recognize gaps that prohibited or limited access to services or disrupt the continuity of care. Many of these organizations offer services that specifically target low-income populations, minority populations, the medically underserved or those with chronic disease needs. As a part of its efforts to ensure broad community-based input into the CHNA process, CTMC established a Community Health Needs Assessment Committee (CHNAC). The CTMC Community Health Needs Assessment Committee is comprised of individuals who represent multiple communities and embody diverse community programs, services and organizations. Each member not only brings a rich understanding of the primary and secondary service areas but are also "subject matter experts" in a variety of areas including public health, mental health, government, education, non-profit, agencies/advocacy groups, faith-based organizations, and the medical community. Community members of the CHNAC represented the following organizations: * Hays County Health Department; * Healthy Communities Collaborative;* Texas State University - San Marcos;* Faith Community Nurses of Hays County (FCNOHC); * San Marcos Consolidated Independent School District (SMCISD); * Women, Infants and Children (WIC) Program; * San Marcos City Council; * Hays County Commissioners Court;* Area Agency on Aging of the Capital Area;;* Schieb (Mental Health Services);* Community Action, Inc. (CAI); * Wimberley EMS; and * Live Oak Health Partners.
Group B-Facility 10 -- Central Texas Medical Center Part V, Section B, line 7d: The Hospital has adopted a policy that addresses the public posting requirements of the Community Health Needs Assessment. Under this policy, the Community Health Needs Assessment Report must be posted on the Hospital's website by the end of the year in which it is conducted. The Hospital will make a copy of its Community Health Needs Assessment Report available upon request. The Hospital will also make a paper copy of the Community Health Needs Assessment Report available for public inspection at the Hospital facility.
Group B-Facility 10 -- Central Texas Medical Center Part V, Section B, line 11: Priority 1: Accessing the right level of care, in the right setting, at the right time: rate of uninsured CTMC interventions include:- Increase capacity at Live Oaks Health Partners Community Clinic for uninsured Hays County residents by adding evening hours to increase patient encounters by at least 475. - Increase the number of uninsured patients receiving prescription assistance at the Live Oaks Health Partners Community Clinic to at least 250 patients. - Add 150 discounted labs and radiology tests for uninsured patients at Live Oaks Health Partners Community Clinic- Collaborate with at least two area school counselors to increase participation (to at least 50 people) in the CTMC Hospital Grief Center's Camp HeartSong and Camp HeartSong Too - Increase the number of supports groups at the CTMC Hospital Grief Center from six to seven per year - Distribute at least 100 vouchers for free mammograms.Priority 2: Timely access (including after-hours care) to Healthcare Professionals, especially primary care; accessing care close to home when care is neededCTMC interventions include:- Build after-hours capacity for uninsured residents of Hays and Caldwell Counties at the Live Oaks Health Partners Community Clinic- Recruit primary care physicians to establish practices in Hays and/or Caldwell Counties (medically underserved areas).Priority 3: Healthier management of lifestyle/making good choices in the areas of nutrition, weight management, exercise, smoking, alcohol use and sexually transmitted infections (STIs).CTMC Interventions include:- Collaborate with churches, civic groups, schools and employers to offer CREATION Health workshops (based on principles of choice, rest, environment, activity, trust, interpersonal relationships, outlook and nutrition)- Increase CREATION Health Fitness Challenge participants from 16 to 32 by adding at least one Challenge and creating a children's component - Collaboration with local community organizations to provide vouchers for free health screenings to residents of Hays and Caldwell Counties at the Hospital's annual HealthCheck screening event. Priority 4: Prevalence and/or enhanced outpatient management of heart disease/congestive heart failure (CHF) and related conditions/risk factors such as hypertensionCTMC Interventions include:- Identify Congestive Health failure (CHF) patients at risk for preventable readmissions and help them manage their disease in outpatient and home settings- Initiate referrals to medical homes for at least 50 percent of unfunded CHF patients in Hays and Caldwell Counties - Develop a "Walk with the Cardiologist" program for residents of Hays and Caldwell Counties- Develop a "Better Breathers Club" in cooperation with the American Lung Association for residents of CTMC's service area who have CHF, COPD (Chronic Obstructive Pulmonary Disease) or related conditions. Priority 5: Prevalence and/or enhanced outpatient management of diabetes; programs to address anticipated growth of diabetes and related conditions.CTMC interventions include: - Offer monthly glucose screenings and Diabetes Risk Assessments to residents of Hays and Caldwell Counties- Provide up to four individual, no-cost, follow-up visits with a Diabetes Educator to all residents of Hays and Caldwell Counties who have participated in CTMC Diabetes Education classes. Priorities Considered but Not SelectedPrevalence of Respiratory Disorders including asthma and COPD and access to programs/services that reduce "rescue care."While this is an important initiative, CTMC does not currently have the infrastructure to support programs that focus on respiratory diseases. There are no engaged pulmonologists on the medical staff. Future programs could include pulmonary rehabilitation and education programs that focus on asthma and those with chronic obstructive pulmonary disease (COPD). CTMC is working with the Lung Association on the Better Breathers program. Timely access to local Mental Health Services including treatment for substance abuse. As noted in the needs assessment, limited resources are available for mental health services. Hill Country Mental Health and Mental Retardation (MHMR) operate the Schieb Center in San Marcos. This center offers a wide array of programs. Qualitative data suggests demand for these services outweighs access. At this time CTMC does not have the expertise or professional staff to address mental health services. Currently, all patients who present at CTMC with behavioral health conditions, including substance abuse, are transferred to another facility once medically stabilized. In 2012, almost 10% of all transfers from CTMC were due to mental health conditions. Prevalence of some cancer-related conditions and timely access to screening services and treatment. CTMC offers screening and related services specifically for breast cancer. We do not, however, offer clinical programs for the treatment of cancer including oncology and radiation services. Significant enhancements to our medical staff membership and service lines would need to be accomplished in order to effectively treat cancer and cancer-related conditions. We will continue to support community screening programs, especially breast cancer screening.Limited transportation resources, especially transportation for healthcare and related services. Unfortunately, Hays and Caldwell Counties have no mass transportation system. There is no bus system or light rail access. The CARTS (Capital Area Rural Transportation System) addresses some transportation challenges but services must be arranged ahead of time and the wait times can be significant. CTMC does not have the infrastructure to address transportation needs that are prevalent throughout the counties we serve. A future goal would be to design targeted health care services that are offered in satellite locations throughout the service area to make access to care closer to home and lessen reliance on transportation services.Reduced Teen Pregnancy Rates; support services including healthcare for pregnant teens. CTMC has a very robust obstetrics program including a neonatal ICU. Teen mothers frequently access these services. CTMC also offers free childbirth education services including breastfeeding/lactation consultation. While we offer a reasonable array of obstetrical-related health care services CTMC is not in the best position to reduce teen pregnancy rates through education and birth control. Other community partners including the Health Departments are working on this issue. Therefore, this is not an identified hospital priority at this time.
Group B-Facility 10 -- Central Texas Medical Center Part V, Section B, line 22d: In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital used the following methodology in 2014:The Hospital identified all commercial payors that had any activity with the Hospital during the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates was determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determined the maximum amount that could be charged to patients eligible under the Hospital's financial assistance policy.
Group B-Facility 12 -- Florida Hospital Wauchula Part V, Section B, line 5: Florida Hospital Wauchula (FHW) is a 25-bed hospital specializing in emergency and outpatient care located in Hardee County, Florida. Florida Hospital Wauchula opened in 1993, a year after the closing of Hardee County's only (other) hospital. Since then, not only has FHW set the pace for healthcare in Hardee County, in 2000 it also became the first Critical Access Hospital (CAH) in the State of Florida. To be designated as a CAH in Florida, a hospital must be located in a rural area and be at least 35 miles from the nearest other hospital. Hardee County is a socio-economically disadvantaged, rural, agricultural county that is also designated as a health professional shortage area by the US Department of Health and Human Services. To ensure that input was solicited from the medically underserved, low-income and minority populations, FHW gathered input from a number of key stakeholder organizations in the community. Input was gathered from the Hardee County Primary Health Care Network, a public/private partnership that provides health care to the working poor. The Hardee County Primary Health Care Network includes Central Florida Health Care, a federally qualified health care center, the Hardee County Health Department, Pioneer Medical Center, FHW, and a pharmacy. The Network provides services to Hardee County residents who have no insurance or are not eligible for Medicare, Medicaid, or other government programs. FHW also gathered input from other key stakeholder organizations/agencies including the Hardee County Health Department and Central Florida Health Care. As noted above, Central Florida Health Care is a federally qualified health care center and provides services to everyone in the community, including undocumented and other underserved populations. Over 51% of the Board of Central Florida Health Care is comprised of clinic users. Florida Hospital Wauchula also established a Community Health Needs Assessment Committee (CHNAC). Input was solicited from all members of the CHNAC. The CHNAC was comprised of community representatives and members of the Florida Hospital Wauchula Board.
Group B-Facility 12 -- Florida Hospital Wauchula Part V, Section B, line 7d: The Hospital has adopted a policy that addresses the public posting requirements of the Community Health Needs Assessment. Under this policy, the Community Health Needs Assessment Report must be posted on the Hospital's website by the end of the year in which it is conducted. The Hospital will make a copy of its Community Health Needs Assessment Report available upon request. The Hospital will also make a paper copy of the Community Health Needs Assessment Report available for public inspection at the Hospital facility.
Group B-Facility 12 -- Florida Hospital Wauchula Part V, Section B, line 11: Priority 1: Cancer Cancer is the leading cause of death within our community. Efforts to promote the importance for early detection are key to reducing the number of severe cases in Cervical Cancer, Breast Cancer and Prostrate Cancer. The three leading cancers for men are lung, prostate, and colorectal. For women, the leading cancers are lung, breast, and colorectal. The 2009-2011 age-adjusted death rate for all cancers for Hardee County Residents is 165.5/100,000 compared to the State of Florida's age-adjusted death rate for all cancers 161.1/100,000. Interventions include:- Screenings and treatment through the Primary Care Network (see Priority 4 below) for people with incomes less than 150% of poverty- Smoking cessation classes for at least 230 people including underserved populations- Pink Army - education efforts re early detection of breast cancer for at least 670 people at 44 events - Pink Army - enlist 180 volunteers to educate the community - Education seminars on the importance of regular checkups with primary care physicians.Priority 2: Diabetes Diabetes has a higher than state average on hospitalizations, and hospitalizations from amputations. With Diabetes self-management education below the state average, the emphasis on educating our public on the importance of managing their Diabetes is crucial. Diabetes is one of the most common chronic diseases among children in the United States. Interventions include:- Community diabetes education program (in cooperation with Florida Hospital Heartland) * Physical activity for at least 50% of the participants * Overall 5% weight loss in overweight or obese patients * Improvement in participant ratings of their quality of life * Instruction on personal foot exams (3x per week at home) * Improvement in medication compliance in 88% pf participants * Adherence to nutritional goals in 60% of participants - Medical nutrition therapy for at least 40 people - Reduce A1c levels in uninsured people through classes and screenings in cooperation with the Hardee County Primary Care Network (see Priority 4 below) for people with incomes less than 150% of poverty.Priority 3: Heart DiseaseHeart Disease and Stroke are the leading cause of death in Florida and the U.S. with high cholesterol, MI, Angina, heart disease, and HTN above the state average for all adults and adult women, and second highest in Hardee County. Poor eating habits and economic pressures are attributed to these outcomes.Interventions (in cooperation with Florida Hospital Heartland) include: - Cardiac screenings and treatment through the Hardee County Primary Care Network for people with incomes less than 150% of poverty- Healthy Heart classes on nutrition, eating habits and stress management - Biometric Indexes for those who attend the Hearty Heart sessions - Health Fairs and cardiac screenings for at least 800 people - Stroke education seminars - Cardiac rehabilitation classes - Education programs and outreach on the importance of routine checkups with a physician - Chronic disease self-management programs. Priority 4: Access to Health Care Access to Health Care is a major issue for Hardee County, with a ratio of 3,237:1 for primary care providers. Not only is there a shortage of providers, but there is a lack of education on how to access health care, treatments and screenings. Access to care is effected by socio-economic status, health risk behaviors (Hardee ranks 56th in Health Factors access to clinical care), and limited job opportunities.Interventions include:- Florida Hospital Wauchula is a founder and an active partner in the Hardee County Primary Care Network, a public/private partnership that provides health care to the working poor (with incomes less than 150% of poverty). It includes Central Florida Health Care (FQHC), Hardee County Health Department, Pioneer Medical Center, Florida Hospital Wauchula, and a pharmacy. Hospitals and other providers donate medical services. Patients pay a small co-payment for services. The program enrolls 1,200 to 1,300 individuals annually.- The Affordable Care Act will help many people get insurance but the State of Florida did not expand Medicaid, leaving the most vulnerable without health coverage. There is the opportunity to work with Central Florida Health Care (FQHC) and Hardee County the Primary Care Network to enhance services.- The hospital enrolls eligible patients in Medicaid.Priority 5: Chronic Disease - Implement free Stanford Chronic Disease Self-Management program that has proven health improvement results for its graduates. - See Heart Disease and Diabetes efforts listed in Priorities 2 and 3 above.Priorities Considered but Not Selected Motor Vehicle Deaths - The community's rate of motor vehicle accidents is higher that the state average; many are related to alcohol. Motor vehicle deaths that do not involve alcohol are seen as unintentional deaths and may be related to the rural nature of the community. This is not a core competency of the hospital, and there are numerous organizations working to stop drinking and driving. Chronic Lower Respiratory Disease - Smoking falls within the education for heart disease and stroke. Florida Hospital Wauchula already offers a five-week program to become tobacco free as well as a Better Breathers Club that teaches ways to cope with COPD.Health Promotion - This issue fell under the umbrella of diabetes, which is being addressed as one of the priorities. Florida Department of Children and Families offers ACCESS Florida, a program that helps individuals and families purchase nutritional foods needed to maintain and promote good health. The Hardee County Department of Health also offers a variety of health promotion programs. HIV/AIDS - Hardee County has an average of two AIDS cases reported annually. This issue already has numerous groups and advocacies working to educate about HIV/AIDS and how they can be treated/cope if they are diagnosed. Making a Difference! is an initiative that empowers adolescents to change their behaviors that will reduce their risks of pregnancy, HIV and other sexually transmitted diseases.Pregnancy/Prenatal Care/Newborn - Florida Hospital Heartland does not offer OB services. While teen birth rates are high, there are numerous organizations making an effort to educate on teen pregnancies and the importance of prenatal care as well as continuing the child's health welfare after birth through regular check-ups with a pediatrician. Healthy Choices Education /Teen Pregnancy Prevention are current initiatives by Highlands County Rural Health Network with their focus on healthy choice education to help reduce STD and teen pregnancy within the community. Healthy Start is another program promoting optimal prenatal health and developmental outcomes for all pregnant women and babies. Pediatric Services - The hospital does not offer pediatric services. The Health Department, Florida Hospital Heartland and Central Florida Family Health Care (FQHC) do.Mental Health/Substance Abuse - Florida Hospital Heartland does not provide mental health services. Currently, there are a number of community-based substance abuse and mental health programs available to help provide stable environments and mentoring for those affected. BALANCE Lives in Transition was formed as a unique support system to improve the treatment and quality of life for residents. They are engaged in a variety of activities to create awareness about behavioral health and promote the promise of recovery for residents of the heartland. Drug Free Highlands works with Highlands County School Board and the Sheriff's Office to promote a drug free community.Immunizations - Immunizations are increasingly available through health departments, drug stores, the local FQHC and primary care physicians. The hospital does not provide immunizations.Dental Care - Dental care was not chosen as a priority due to the scope of resources available and the fact this issue also falls into access to health care. Central Florida Health Care (FQHC) offers dental services for low-income and insured patients.
Group B-Facility 12 -- Florida Hospital Wauchula Part V, Section B, line 22d: In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital used the following methodology in 2014:The Hospital identified all commercial payors that had any activity with the Hospital during the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates was determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determined the maximum amount that could be charged to patients eligible under the Hospital's financial assistance policy.
GROUP B Part V, Section B, line 16a website: See statement
GROUP B Part V, Section B, line 16b website: See statement
GROUP B Part V, Section B, line 16c website: See statement
Part V, Section B Facility Reporting Group C
Facility Reporting Group C consists of: - Facility 7: Adventist La Grange Memorial Hospital
Group C-Facility 7 -- Adventist La Grange Memorial Hospital Part V, Section B, line 5: Adventist La Grange Hospital (the Hospital) is one of four not-for-profit related hospital organizations located in the western and southwestern suburbs of Chicago. Each of these four hospitals is a part of Adventist Health System (AHS). AHS is a health care system primarily consisting of tax-exempt 501(c)(3) hospital organization that operate 44 hospitals in 10 states within the US. The four related hospital organizations located in Chicago, collectively called Adventist Midwest Health (AMH), are clinically integrated, share overlapping communities, and are tied together by common mission, values, and vision. As the four hospitals are located in the same Metropolitan Service Area, the hospitals collaborated in 2013 to conduct a joint Community Health Needs Assessment (CHNA). The four related hospital organizations are Adventist GlenOaks Hospital, Adventist Hinsdale Hospital, Adventist Bolingbrook Hospital, and Adventist Health System/Sunbelt, Inc., dba Adventist La Grange Memorial Hospital. In conducting its 2013 joint CHNA, the four AMH hospitals collected primary and secondary data using a number of data collection methodologies. Adventist GlenOaks Hospital, Adventist Hinsdale Hospital, and Adventist La Grange Memorial Hospital partnered with the Metropolitan Chicago Healthcare Council to conduct its primary research, consisting of telephone surveys, focus groups, and written surveys. A list of recommended participants to be included in the focus groups was provided by the Metropolitan Chicago Healthcare Council. Participants included representatives of public health, individuals who work with low-income, minority or other medically underserved populations, and those who work with persons with chronic disease conditions.
Group C-Facility 7 -- Adventist La Grange Memorial Hospital Part V, Section B, line 6a: The Community Health Needs Assessment conducted by Adventist La Grange Memorial Hospital (the Hospital) was based upon the Hospital's involvement and enrichment of those who live within DuPage County, Illinois. The CHNA was conducted in conjunction with related hospitals in the Chicago Metropolitan area: Adventist Hinsdale HospitalAdventist Bolingbrook HospitalAdventist GlenOaks Hospital
Group C-Facility 7 -- Adventist La Grange Memorial Hospital Part V, Section B, line 7d: The Hospital has adopted a policy that addresses the public posting requirements of the Community Health Needs Assessment. Under this policy, the Community Health Needs Assessment Report must be posted on the Hospital's website by the end of the year in which it is conducted. The Hospital will make a copy of its Community Health Needs Assessment Report available upon request. The Hospital will also make a paper copy of the Community Health Needs Assessment Report available for public inspection at the Hospital facility.
Group C-Facility 7 -- Adventist La Grange Memorial Hospital Part V, Section B, line 11: Priority 1: Access to Healthcare [lack of insurance]Consequences of loss of health insurance include delayed diagnosis, decreased opportunities for effective treatment options at a later stage of diagnosis, greater likelihood of spread of communicable disease and health apathy. It is one of the most pressing health issues in America today, reaching the needs of those with increased health risks and low resource availability. As healthcare reform unfolds, Adventist Midwest Health will be in a unique position to contribute to timely acquisition of health insurance for those with the most substantive healthcare and financial needs through partnership with the Centers for Medicare and Medicaid Services.LaGrange Interventions include:- Health Insurance Exchange enrollment for up to 210 people- Medicaid enrollment for hospital patients - Establish an FQHC (federally qualified health center) at LaGrange in partnership with VNA - Links with community partners such as Aging Care Connections to help chronic care patients avoid preventable readmissions - Free Primary Care for Access DuPage (uninsured) clients at LaGrange Family Medicine Clinics - Provide OB services for underserved women at LaGrange Hospital - Help patients make appointments with local FQHCs- Partner with the American Kidney Foundation on free kidney disease screenings for underserved people at all Adventist Midwest Health facilities - Operate two Physician Residencies and RN-to-BSN program to expand health care workforce.Priority 2: Influenza Vaccination [18-64 years]According to the CDC, routine annual influenza vaccination is recommended for all persons aged > 6 months. The risks related to influenza are highest for those over 65 years of age. However, in Illinois and Adventist Midwest Health Communities, it is the adult population under 65 that falls substantively below the Healthy People 2020 goal for receipt of the vaccination. Further, the CDC reports that although younger adults typically experience a less severe influenza and there is less frequent hospitalization than very young and very old people, it was determined in a study of 18-49 year olds (through one reported economic modeling analysis) to cause five million illnesses, 2.4 million outpatient visits, thirty-two thousand hospitalizations, and 680 deaths. Impact on the individual, the Community, the healthcare system, and the Government (for those individuals receiving government funded care) is high. Further, for those adults aged 18-64 who are not vaccinated, the potential for infecting more vulnerable populations is higher creating more critical impact on individuals and the Government. - Community education on the importance of immunizations - Referrals to Health Department, FQHC and others for free/affordable flu vaccinations. Priority 4: Pneumococcus Vaccine [65 years and older]According to the CDC, invasive disease from pneumococcus is a major cause of illness and death in the United States, with an estimated 43,500 cases and 5,000 deaths among persons of all ages in 2009. Rates of infection do vary, with infants, children and older adults being at highest risk. Eighty-four percent of those who are infected and nearly all deaths occurred in adults. While studies regarding the effectiveness of the pneumococcus vaccine do vary, most are consistent relative to positive benefits obtained by older adults. Individuals with financial need and decreased access to care are less likely than the insured to be vaccinated. Efforts to raise awareness and provide vaccination to those in need leads to potential for preserved health status and decreased risk for pneumonia-related hospitalization or death. A single vaccine in an underprivileged adult who would have otherwise developed pneumonia can save a life and relieve the Government of preventable and costly medical care. Interventions include: - Community education on the importance of immunizations- Referrals to Health Department, FQHC and others for free/affordable pneumonia vaccinations Community education on the importance of immunizations.Priority 5: Hypertension [over 18 y/o)High blood pressure can lead to damage of blood vessels, heart, kidneys, and other organs in the body. Heart disease and stroke, both caused by high blood pressure, are the first and third leading causes of death in the U.S. Twenty-eight percent of adults in Illinois have high blood pressure, but because it is "silent" (signs of high blood pressure are often not perceived), there are many more adults who live life undiagnosed. The poor and those with decreased access to care are less likely to be diagnosed than those with the financial means to receive regular health checkups. The outcome for those left unchecked is escalation of disease, further damaging organ systems that results in decreased quality of life, as well as increased burden on the Government to pay for care that could have been avoided with appropriate screening. Interventions include: - Conduct free health screenings in partnership with local YMCAs- Stanford Chronic Disease Self-Management Program aligned with CREATION Health programs (choice, rest, environment, activity, trust, interpersonal relationships, outlook and nutrition)- Web site education on hypertension at registration areas- System wide CDM efforts including hypertension. Priorities Considered but Not Selected Access to Healthcare: Access to Primary and Secondary Services - Adventist Bolingbrook HospitalRationale: During this assessment period, Adventist Bolingbrook Hospital, in conjunction with VNA, opened a Federally Qualified Health Center on the hospital campus, increasing access to primary and secondary health services for those community members with financial need.Prevention and Management of Chronic Care Issues: Heart Disease [blood cholesterol levels]Rationale: While this tested well on the Impact Analysis Matrix, using the Decision Tree, it was determined that this is a commonly available prevention measure at most surrounding providers. It is frequently a part of community health fairs and routine physician visits.Behavioral Health and Substance Abuse Rationale: Adventist Midwest Health provides comprehensive inpatient programs for behavioral health (Adventist GlenOaks Hospital and Adventist Hinsdale Hospital) and outpatient programs for both behavioral health and substance abuse (Adventist Hinsdale Hospital). Serving the Adventist Midwest Health Community, the Hospitals support County initiatives to bring these necessary services to those in need. Prioritizing Access to Care as one of the selected Health Priorities will assist Adventist Midwest Health in extending services for those who currently lack such access.
Group C-Facility 7 -- Adventist La Grange Memorial Hospital Part V, Section B, line 22d: In determining the maximum amount that can be charged to financial assistance policy-eligible individuals for emergency or other medically necessary care, the Hospital used the following methodology in 2014:The Hospital identified all commercial payors that had any activity with the Hospital during the taxable year. For those identified commercial payors, an average of the negotiated commercial insurance rates was determined. The average of all of the negotiated commercial insurance rates for those identified commercial payors determined the maximum amount that could be charged to patients eligible under the Hospital's financial assistance policy.
GROUP C Part V, Section B, line 16a website: See statement
GROUP C Part V, Section B, line 16b website: See statement
GROUP C Part V, Section B, line 16c website: See statement
Part V, Section B, Line 7a Each hospital facility's CHNA report was made widely available through the following websites:Facility 1 -- Florida Hospital Orlandohttps://www.floridahospital.com/sites/default/files/florida_hospital_orlando_-_2013_chna.pdfFacility 2 -- Florida Hospital Altamontehttps://www.floridahospital.com/sites/default/files/florida_hospital_altamonte_-_2013_chna_0.pdfFacility 3 -- Florida Hospital Celebration Healthhttps://www.floridahospital.com/sites/default/files/florida_hospital_celebration_health_-_2013_chna.pdfFacility 4 -- Florida Hospital East Orlandohttps://www.floridahospital.com/sites/default/files/florida_hospital_east_orlando_-_2013_chna.pdfFacility 5 -- Winter Park Memorial Hospitalhttps://www.floridahospital.com/sites/default/files/florida_hospital_winter_park_memorial_-_2013_chna.pdfFacility 6 -- Florida Hospital Kissimmeehttps://www.floridahospital.com/sites/default/files/florida_hospital_kissimmee_-_2013_chna.pdfFacility 7 -- Adventist La Grange Memorial Hospitalhttp://www.keepingyouwell.com/Portals/33/docs/Community%20Benefits/Adventist%20La%20Grange%20Hospital%202013%20CHNA.pdfFacility 8 -- FH Heartland Medical Centerhttps://www.floridahospital.com/sites/default/files/pdf/florida_hospital_heartland_2013_chna.pdfFacility 9 -- Florida Hospital Apopkahttps://www.floridahospital.com/sites/default/files/florida_hospital_apopka_-_2013_chna.pdfFacility 10 -- Central Texas Medical Centerhttp://www.ctmc.org/Portals/7/docs/Community%20Benefits/CTMC%20CHNA%202013.pdfFacility 11 -- FH Heartland Medical Center Lake Placidhttps://www.floridahospital.com/sites/default/files/pdf/florida_hospital_lake_placid_2013_chna.pdfFacility 12 -- Florida Hospital Wauchulahttps://www.floridahospital.com/sites/default/files/pdf/florida_hospital_wauchula_-_2013_chna.pdf
Part V, Section B, Line 10a Each hospital facility's most recently adopted implementation strategy was made widely available through the following websites:Facility 1 -- Florida Hospital Orlandohttps://www.floridahospital.com/sites/default/files/florida_hospital_orlando_2014-16_community_health_improvement_plan_0.docxFacility 2 -- Florida Hospital Altamontehttps://www.floridahospital.com/sites/default/files/florida_hospital_altamonte_2014-16_community_health_plan.pdfFacility 3 -- Florida Hospital Celebration Healthhttps://www.floridahospital.com/sites/default/files/florida_hospital_celebration_2014-16_community_health_plan.docxFacility 4 -- Florida Hospital East Orlandohttps://www.floridahospital.com/sites/default/files/florida_hospital_east_orlando_2014-16_community_health_improvement_plan_0.docxFacility 5 -- Winter Park Memorial Hospitalhttps://www.floridahospital.com/sites/default/files/florida_hospital_winter_park_memorial_2014-16_community_health_improvement_plan_0.docxFacility 6 -- Florida Hospital Kissimmeehttps://www.floridahospital.com/sites/default/files/florida_hospital_kissimmee_2014-16_community_health_improvement_plan.docxFacility 7 -- Adventist La Grange Memorial Hospitalhttp://www.keepingyouwell.com/Portals/3/docs/About%20Us/Community%20Benefit/ALMH%2014-16%20Community%20Health%20Plan.pdfFacility 8 -- FH Heartland Medical Centerhttps://www.floridahospital.com/sites/default/files/heartland_2014-16_community_health_plan.docxFacility 9 -- Florida Hospital Apopkahttps://www.floridahospital.com/sites/default/files/florida_hospital_apopka_2014-16_community_health_improvement_plan.pdfFacility 10 -- Central Texas Medical Centerhttp://www.ctmc.org/Portals/7/docs/Community%20Benefits/CTMC%202014-16%20Community%20Health%20Plan.pdf Facility 11 -- FH Heartland Medical Center Lake Placidhttps://www.floridahospital.com/sites/default/files/lake_placid_2014-16_community_health_plan.docxFacility 12 -- Florida Hospital Wauchulahttps://www.floridahospital.com/sites/default/files/wauchula_2014-16_community_health_plan.docx
Part V, Section B, Line 16a-16C Each hospital facility's FAP, FAP application form and plain language summary of the FAP was made widely available through the following websites:Facility 1 -- Florida Hospital Orlandohttps://www.floridahospital.com/patient-resources/billing/financial-assistanceFacility 2 -- Florida Hospital Altamontehttps://www.floridahospital.com/patient-resources/billing/financial-assistanceFacility 3 -- Florida Hospital Celebration Healthhttps://www.floridahospital.com/patient-resources/billing/financial-assistanceFacility 4 -- Florida Hospital East Orlandohttps://www.floridahospital.com/patient-resources/billing/financial-assistanceFacility 5 -- Winter Park Memorial Hospitalhttps://www.floridahospital.com/patient-resources/billing/financial-assistanceFacility 6 -- Florida Hospital Kissimmeehttps://www.floridahospital.com/patient-resources/billing/financial-assistanceFacility 7 -- Adventist La Grange Memorial Hospitalhttps://www.keepingyouwell.com/aboutus/financialassistancecharitycare/tabid/6058/default.aspxFacility 8 -- FH Heartland Medical Centerhttps://www.floridahospital.com/patient-resources/billing/financial-assistanceFacility 9 -- Florida Hospital Apopkahttps://www.floridahospital.com/patient-resources/billing/financial-assistanceFacility 10 -- Central Texas Medical Centerhttps://www.ctmc.org/patients-visitors/after-my-stay/financial-assistanceFacility 11 -- FH Heartland Medical Center Lake Placidhttps://www.floridahospital.com/patient-resources/billing/financial-assistanceFacility 12 -- Florida Hospital Wauchulahttps://www.floridahospital.com/patient-resources/billing/financial-assistance
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 1 -- Florida Hospital OrlandoDescription of CHNA Significant Needs ContinuedCommunity Needs Not Chosen by Florida Hospital Orlando In developing its Community Health Needs Assessments, Florida Hospital used the following criteria to determine the priority areas to be addressed:1. Acuity of the health issue (how serious is it?)2. Capacity of the hospital to address the issue (does the hospital have the services or other ability to address the issue?)3. Duplication (Are community partners already addressing this issue? Would the hospital be duplicating those efforts?) 4. Collaboration (If the hospital was to address the issue, would there be opportunities for collaboration and shared impact?).A. Motor Vehicle Accidents The issue of motor vehicle collision is not within the purview of community hospitals. Florida Hospital Orlando does promote and fund safe pedestrianism through its partnership with Healthy Central Florida.B. Single Parent Households Again, the issue of single parent households is not within the purview of Florida Hospital Orlando. Florida Hospital Orlando does financially support regional Healthy Start Coalitions, Florida Hospital Orlando's matching funds help with prenatal and postnatal health education programming for parents and families.C. Violent Crime Orlando/Orange County's rates of violent crime exceed the national average. While hospitals lack the ability to address directly violent crimes, Florida Hospital provides funding to several organizations that address the effects of violent crime. We view our active involvement in issues of awareness and prevention as especially crucial. Interventions include:- Funding to Harbor House Domestic Violence Centers- Office and treatment space for the Orange County Victims' Services Center- Donated space for the Sexual Assault Treatment Center of Orange County- Training hospital staff, especially in the emergency department, to screen patients for domestic violence issues.D. Health LiteracyHealth Literacy was not defined as a priority issue by Florida Hospital Orlando. The Adult Literacy League and others entities including Hispanic Health Initiatives and the Center for Multicultural Wellness & Prevention provide literacy services for the community. In addition, the Hospital provides full translation services that help patients for whom English is not the primary language.E. Maternal and Child HealthBecause of its existing support of the Healthy Start Coalition and other maternal infant initiatives, Florida Hospital Orlando did not choose Maternal and Child Health as a priority area. Florida Hospital facilities (Winter Park, Orlando and Celebration) provide obstetrics services, and the new Florida Women's Hospital will open in 2015. The Walt Disney Pavilion at Florida Children's Hospital accepts referrals from other Florida Hospital campuses and from the hospital's 25 CentraCare Walk-In Urgent Care Centers. F. Sexually Transmitted Diseases Florida Hospital Orlando provides inpatient care but does not provide wrap-around services for HIV/AIDS or STD patients. The Health Department has STD and HIV/AIDS Clinics, and the Center for Multicultural Wellness and Prevention provides programs that screen for and treat sexually transmitted diseases. In addition, Orange County Government Health Services operates the Ryan White HIV/AIDS Program that provides services to people without sufficient health coverage or financial resources to cope with HIV/AIDS.G. DiabetesDiabetes is a major health concern in Central Florida, and the Florida Hospital Diabetes Institute provides treatment, education and research for the community. Rather than a global focus on diabetes, the Hospital is focusing on obesity because it is a risk factor for diabetes, heart disease and cancer. The Diabetes Institute has implemented a targeted Diabetes program and study in the primarily African-American community of Eatonville (near Florida Hospital Orlando), which has a 24% rate of adult diabetes. The program offers screenings, diabetic health risk assessments and treatment to help Eatonville residents better control their diabetes. H. CancerCancer is a major cause of death in Central Florida and the U.S. as a whole. Florida Hospital Orlando is not focusing on cancer and cancer prevention as a priority because of the many hospital and community resources already available. This includes the Florida Hospital Cancer Institute that provides patient care, education and research at the Orlando campus. In addition, Florida Hospital Orlando (Hospital) offers a full range of cancer services, and groups like the American Cancer and Leukemia Societies provide outreach and education throughout the community - and in partnership with the hospitals. The Hospital receives Susan G. Komen dollars to help fund free mammograms for low-income women, and uses its mobile mammogram unit to reach out to this audience. I. Chronic Disease ManagementDiabetes, cancer, and stroke are the most common chronic conditions in the United States. They have many risk factors in common and are frequently related to health behaviors such as obesity and smoking. Florida Hospital Orlando and its community partners provide many health education, disease management and wellness programs. As noted above, the Hospital's obesity interventions focus on health education, exercise, nutrition, stress management, and personal accountability - factors vital to the control of diabetes, cancer, heart disease, stroke, asthma and the comorbidities that often accompany these diseases. The Hospital's Congestive Heart Failure Clinic provides free care to uninsured CHF patients. Two Florida Hospital Lung Clinics provide free care for uninsured people with chronic respiratory conditions including COPD, emphysema and asthma.J. Social Determinants of Health and Health Disparities Although specific health determinants and poverty were not selected as priorities in Florida Hospital's Community Health Needs Assessment, the Hospital supports "place-based" community transformation efforts that address health determinants in geographically specific areas. Florida Hospital is the anchor partner for the Bithlo Transformation Effort led by the nonprofit agency United Global Outreach. UGO and its partners are working to address multiple conditions in this very low-income community (census tract 166.22) of 8,200 people: Education, Housing, Transportation, Health Care, Environment, Basic Needs and Sense of Community. Florida Hospital is a partner in LIFT Orlando, a nonprofit organization of business leaders collaborating with residents to accelerate community transformation in the primarily low-income, African-American community of Parramore in downtown Orlando. Focus areas include cradle-to-career education, mixed income housing, community health and wellness, and long-term economic viability. The Hospital provides funding for IDignity, a nonprofit agency that helps provide IDs to people - including the homeless, precariously housed and low-income - who lack birth certificates, social security numbers or cards, drivers' licenses, state IDs and other personal identification.Florida Hospital is a founder and board member of the Central Florida Partnership on Health Disparities.
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 3 -- Florida Hospital Celebration HealthDescription of CHNA Significant Needs ContinuedH. High UnemploymentHigh Unemployment, while a health determinant, is not a core competency of Florida Hospital. As a means of promoting employment, Florida Hospital does provide leadership to the regional BusinessForce, multiple Chambers of Commerce (including Kissimmee, Celebration and St. Cloud) and Economic Development Commissions (Orange and Osceola) collaboratives that focus on growing a healthy business community. As a means of promoting both access to care and challenging high unemployment, Florida Hospital Celebration supports the education and training of Certified Nursing Assistants in Osceola County. I. Single Parent HouseholdsSingle Parent Households are a health determinant rather than a core competency of hospitals and other health care providers. The Hospital financially supports the Healthy Start Coalition of Osceola County, which offers educational programming and support for parents, including single parents.J. Affordable Health CareAlthough this issue has not been specifically prioritized by the Celebration Health campus, Florida Hospital is an active supporter of health care for the uninsured in Osceola County. Florida Hospital Celebration Health:- Supports the Department of Health network of Federally Qualified Health Centers in the county- Financially supports the Council on Aging's Chronic Care Medical Clinic for uninsured adults of all ages- Financially supports the Hope Center FQHC and secondary care clinic operated by Health Care Centers for the Homeless - Funds a diabetes program targeting uninsured individuals- Funds a Secondary Care referral service for uninsured people - Promotes volunteer opportunities to physicians and other clinical staff for the secondary care clinic.
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 2 -- Florida Hospital AltamonteDescription of CHNA Significant Needs ContinuedE. Housing affordabilityAgain, housing affordability is a health determinant rather than a core competency of hospitals and other health care providers. Florida Hospital Altamonte is not leading out on this issue but did make a significant financial donation (that garnered community matches) to establish and expand permanent supportive housing efforts in Seminole County and surrounding areas. Florida Hospital also provides leadership to two regional commissions focused on issues of housing specific to vulnerable families and individuals, and is active in Habitat for Humanity.
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 4 -- Florida Hospital East OrlandoDescription of CHNA Significant Needs ContinuedCommunity Needs Not Chosen by Florida Hospital East Orlando In developing its Community Health Needs Assessments, Florida Hospital used defined criteria to determine the priority areas to be addressed. The criteria were:1. Acuity of the health issue (how serious is it?)2. Capacity of the hospital to address the issue (does the hospital have the services or other ability to address the issue?)3. Are community partners already addressing this issue? Would the hospital be duplicating those efforts? 4. If the hospital were to address the issue, would there be opportunities for collaboration and shared impact?Based on these criteria, Florida Hospital East Orlando is not addressing:A. Sexually Transmitted DiseasesFlorida Hospital East Orlando provides inpatient care but does not provide wrap-around services for HIV/AIDS or STD patients. The Health Department has STD and HIV/AIDS Clinics, and the Center for Multicultural Wellness and Prevention provides programs that screen for and treat sexually transmitted diseases. In addition, Orange County Government Health Services operates the Ryan White HIV/AIDS Program that provides services to people without sufficient health coverage or financial resources to cope with HIV disease.B. Maternal and Child Health Florida Hospital East Orlando does not have Maternal and Child health services, but supports the Healthy Start Coalition financially and through board service. Other Florida Hospital facilities (Winter Park, Orlando and Celebration) provide obstetrics services, and the new Florida Women's Hospital will open in 2015. The Walt Disney Pavilion at Florida Children's Hospital accepts referrals from other Florida Hospital campuses and from the hospital's 25 CentraCare Walk-In Urgent Care Centers. C. Cancer Florida Hospital East Orlando does not provide cancer treatment services. Patients in the East Orlando community are treated at the Cancer Institute at the main Florida Hospital campus. In addition, Florida Hospital East Orlando supports the Area Health Education Council (AHEC) and provides funding to the American Cancer Society and the American Lung Association; these partners provide health education and disease management programs throughout the county.D. Heart DiseaseHeart disease, hypertension and Congestive Heart Failure - with Diabetes - are the most common chronic conditions in the United States. Risk factors include health behaviors such as obesity and smoking. The Cuidate and Bridge programs noted above provide education and support for people with or at risk for heart disease through the Stanford Chronic Disease Self-Management Program offered in Spanish and English. E. Motor Vehicle CollisionsThe issue of motor vehicle collision is not within the purview of community hospitals. Florida Hospital East Orlando does promote and fund safe pedestrianism through its partnership with Healthy Central Florida.F. Single Parent HouseholdsAgain, the issue of single parent households is not within the purview of Florida Hospital East Orlando. In financially supporting the tri-county Healthy Start Coalitions, Florida Hospital East Orlando helps expectant and new patients access health education and parenting programs for all parents including those from single parent households.
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 5 -- Winter Park Memorial HospitalDescription of CHNA Significant Needs ContinuedE. Substance Abuse and Mental Health Florida Hospital has identified mental health as being essential to personal well-being, family and interpersonal relationships, and the ability to contribute to society. Issues of mental health such as depression and anxiety affect people's ability to participate in health-promoting behaviors. Research has shown that mental health and physical health are closely connected because mental health plays a major role in people's ability to maintain good physical health. Currently, there are strong mental health and substance abuse assets in Orange County including Aspire Behavioral Health (in- and outpatient mental health/substance abuse services). Still, such services in Orange County can be hard to access because of funding and capacity issues. Florida Hospital works with local providers to help expand capacity. While mental health was not a priority chosen, the Hospital participates in the following:- Provide major funding to Aspire Behavioral Health Center (county mental health) for in- and outpatient mental health and substance abuse services - Offer comprehensive evaluation, treatment, and case management for uninsured residents of Orange County through the Outlook Clinic for Depression & Anxiety. Florida Hospital funds the clinic in partnership with the Mental Health Association, the Orange County Medical Clinic, the UCF School of Social Work, the Primary Care Access Network (PCAN) and Walgreens.- Support efforts to provide behavioral health services in low-income, underserved areas such as Bithlo Partners including Aspire Health Partners, United Way and the Harbor House Domestic Violence Center- Participate in the federal SAMHSA grant coalition working to streamline mental health wraparound services for children in Orange County - Additionally, the Florida Hospital Community Health Impact Council (a grant-making entity) funds some community-based, model behavioral programs for adults and children.F. Health LiteracyHealth Literacy was not defined as a priority issue by Winter Park Memorial Hospital. The Adult Literacy League and others entities including Hispanic Health Initiatives and the Center for Multicultural Wellness & Prevention provide literacy services for the community. In addition, the Hospital provides full translation services that help patients for whom English is not the primary language.G. Motor Vehicle Collisions The issue of motor vehicle collisions is a health determinant rather than a core competency of most hospitals including Winter Park Memorial Hospital. As a means of ensuring motor vehicle safety, the Hospital provides car seats to new mothers who do not have safety-rated car seats. Additionally, through its partnership with Healthy Central Florida, the Hospital funds and provides leadership for programs that facilitate and encourage safe pedestrianism so that communities can be both healthier and safer.H. Single Parent HouseholdsThe issue of single parent households is not within the purview of Winter Park Memorial Hospital. In financially supporting regional Healthy Start Coalitions, the Hospital helps the organization provide prenatal and postnatal health education programming for parents.
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 6 -- Florida Hospital KissimmeeDescription of CHNA Significant Needs ContinuedF. Housing Affordability and HomelessnessHousing affordability is a health determinant rather than a core competency of hospitals and other health care providers. Florida Hospital Kissimmee is not leading out on this issue but made a significant financial donation (that garnered a community match) to establish and expand permanent supportive housing efforts in the tri-county area. Florida Hospital also provides leadership to two regional commissions focused on issues of housing specific to vulnerable families and individuals, and is active in Habitat for Humanity. G. High UnemploymentHigh unemployment is a health determinant rather than a core competency of hospitals. As a means of promoting both access to care and creating employment opportunities, Florida Hospital Kissimmee financially supports the education and training of health care professionals at local colleges and trade schools, including TECO and Valencia College in Osceola County. Florida Hospital also provides financial support and leadership to regional Chambers of Commerce (including the Kissimmee, Celebration and St. Cloud Chambers), the Economic Development Commission of Osceola County, and the BusinessForce collaborative that focus on building a healthy business community. H. Single Parent HouseholdsSingle Parent households are a health determinant as opposed to a core competency of hospitals and other health care providers. While the hospital does not have programming specific to single parents, it financially supports the Healthy Start Coalition of Osceola County that provides educational and parenting resources for new parents.
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 9 -- Florida Hospital ApopkaDescription of CHNA Significant Needs ContinuedF. Maternal and Child HealthFlorida Hospital Apopka does not offer Maternal and Child health services, but supports the Healthy Start Coalition financially and through board service. Other Florida Hospital facilities (Winter Park, Orlando and Celebration) provide obstetrics services, and the new Florida Women's Hospital will open in 2015. The Walt Disney Pavilion at Florida Children's Hospital accepts referrals from other Florida Hospital campuses and from the hospital's 25 CentraCare Walk-In Urgent Care Centers. G. Mental Health and Substance AbuseFlorida Hospital Apopka does not provide mental health and substance abuse services. There are strong mental health and substance abuse assets in Orange and Seminole County including Aspire Behavioral Health (in- and outpatient mental health and substance abuse services) and the Orlando Health Behavioral Group, an 80-bed psychiatric hospital at South Seminole Hospital. Additionally, the Florida Hospital Community Health Impact Council (a grant-making entity) funds model behavioral programs for adults and children. Despite not being an explicit initiative prioritized by the campus, Florida Hospital Apopka is addressing issues of mental health by:- Offering comprehensive evaluation, treatment and case management to improve quality of life for residents with mental health diagnosis via the outlook clinic for Depression and Anxiety - created in partnership with the mental health association, FH behavioral health, Orange County Medical Clinic, UCF School of Social Work and Walgreens- Increasing the likelihood of medication adherence among uninsured patients via free or discounted prescription medications.H. Motor Vehicle Collisions The community issue of motor vehicle collisions is a health determinant rather than a core competency of most hospitals including Florida Hospital Apopka. I. Single Parent HouseholdsSingle Parent Households, while a community issue, are a health determinant rather than a core competency of most hospitals including Florida Hospital Apopka. J. Health LiteracyAlthough health literacy was not an issue prioritized by the Apopka campus, the principle of health literacy is embedded into our chronic disease self-management program efforts. We also aim to strengthen the relationship with those community resources including Community Health Centers, a Federally Qualified Health Center (FQHC) in Apopka that offers primary care, dental, and obstetric services. Florida Hospital is also working internally to ensure comprehensive discharge education that emphasizes patients understanding the nature of their condition and has piloted a health navigator program in a local FQHCs to better embed the principle of health literacy into its community health planning.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
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?142
Name and address Type of Facility (describe)
1 Florida Hospital Cancer Institute
2501 N Orange Avenue Suites 139 181
Orlando,FL32804
Cancer Center
2 Florida Hospital Orlando Pathology Lab
2855 N Orange Avenue
Orlando,FL32803
Lab Services
3 Florida Hospital Rehabilitation and Spor
5165 Adanson Street
Orlando,FL32804
Therapy Center
4 Florida Hospital Kissimmee Outpatient Im
2400 N Orange Blossom Trail Suite
106
Kissimmee,FL34744
Outpatient Services
5 Florida Hospital Altamonte Infusion Cent
894 E Altamonte Drive Suite 3000
Altamonte Springs,FL32701
Infusion Center
6 Florida Hospital Cancer Institute - Kiss
1300 West Oak Street
Kissimmee,FL34741
Cancer Center
7 Florida Hospital Altamonte Ambulatory Su
661 E Altamonte Drive Suite 110
Altamonte Springs,FL32701
Outpatient Surgery Center
8 Florida Hospital Kidney Stone Center
2501 N Orange Avenue Suite 121
Orlando,FL32804
Outpatient Services
9 Florida Hospital Altamonte Imaging Cente
661 E Altamonte Drive Suite 112
Altamonte Springs,FL32701
Radiology Services
10 Florida Hospital Kissimmee Infusion Cent
1300 West Oak Street Suite A
Kissimmee,FL34741
Infusion Center
11 Family Health East Orlando Women's Pavil
7975 Lake Underhill Road Suite 100
Orlando,FL32822
Women's Health Clinic
12 FHCC - LAKE BUENA VISTA #2
12500 S Apopka Vineland Rd
Orlando,FL32836
Urgent Care Clinic
13 Florida Hospital Cancer Care Center
2100 Glenwood Drive
Winter Park,FL32792
Radiation Oncology
14 Florida Hospital Altamonte Medical Plaza
661 E Altamonte Drive Suite 110 112
Altamonte Springs,FL32701
Physician Clinics
15 Florida Hospital Endoscopy OP Services
2415 N Orange Ave Suite 201
Orlando,FL32804
OP Services
16 Adventist Paulson Rehab - Willowbrook
619 Plainfield Road
Willowbrook,IL60521
Rehabilitation Center
17 Florida Hospital Transplant Center
2415 N Orange Avenue Suite 600 700
Orlando,FL32804
Organ Tissue/Transplant Center
18 Florida Hospital Medical Plaza
2501 N Orange Avenue
Orlando,FL32804
Physician Clinics
19 FHHMC Cardiology Associates
4638 Sun N Lake Blvd
Sebring,FL33872
Outpatient Phys Clinic
20 La Grange Cancer Treatment Pavillion
1325 Memorial Dr
La Grange,IL60525
Cancer Center/Wound Care Facility
21 Florida Hospital Rehabilitation & Sports
7975 Lake Underhill Road Suite 345
Orlando,FL32822
Therapy Center
22 Florida Hospital Kissimee - OP Endoscopy
2400 North Orange Blossom Trail
Suite 3
Kissimmee,FL34744
Outpatient Services
23 FHCC - SANFORD
4451 West 1st Street
Sanford,FL32771
Urgent Care Clinic
24 Central Texas Ambulatory Endoscopy
1303 Wonder World DR
San Marcos,TX78666
Endoscopy Services
25 Florida Hospital Celebration Health Outp
410 Celebration Place Suite 408
Celebration,FL34747
Outpatient Surgery Center
26 FHCC - WATERFORD
250 N Alafaya Trail Suite 135
Orlando,FL32825
Urgent Care Clinic
27 Florida Hospital Surgery Center East Or
258 S Chickasaw Trail Suite 100
Orlando,FL32825
Outpatient Surgery
28 Surgical Center at Sun N' Lake LLC
4240 Sun N Lake Blvd
Sebring,FL33872
Outpatient Surgery
29 FHCC - WINTER GARDEN
3005 Daniels Road
Winter Garden,FL34787
Urgent Care Clinic
30 FHCC - SOUTH ORANGE
2609 South Orange Ave
Orlando,FL32806
Urgent Care Clinic & Employer Onsite Clinic
31 FHHMC SeaScape Imaging & Laboratory OP C
2950 Alt US 27 S
Sebring,FL33870
Outpatient Imaging Center & Laboratory
32 Florida Hospital Center for Behavioral H
501 E King Street 1st Floor
Orlando,FL32803
Med/Psych
33 Florida Hospital Rehabilitation & Sports
8701 Maitland Summit Blvd
Orlando,FL32810
Therapy Center
34 FHCC - WINTER PARK
3099 Aloma Avenue
Winter Park,FL32792
Urgent Care Clinic
35 Winter Park Memorial Hospital Women's Ce
100 N Edinburgh
Winter Park,FL32792
Women's Health Clinic, Imaging
36 Admin BHS Onsite
2600 Westhall Lane Box 300
Maitland,FL32751
Corporate Services
37 FHCC - ALTAMONTE
440 W Highway 436
Altamonte Springs,FL32714
Urgent Care Clinic
38 FHCC - ORANGE LAKE
8201 W Irlo Bronson Highway
Kissimmee,FL34747
Urgent Care Clinic
39 Loch Haven OBGyn Group
235 E Princeton Street Suite 200
Orlando,FL32804
Physician Clinics
40 Florida Hospital Gamma Knife
2501 N Orange Ave Suite 101 S
Orlando,FL32804
Gamma Knife
41 FHCC - LEE ROAD
2540 Lee Road
Winter Park,FL32789
Urgent Care Clinic
42 CTMC Hospice
1315 IH 35 North
San Marcos,TX78666
Hospice services
43 Adventist La Grange Family Medical Cente
5201 S Willow Springs Road Suite
300
La Grange,IL60525
Family Medical Center
44 Florida Hospital Celebration Women's Ins
410 Celebration Place Suite 201
Celebration,FL34747
Women's services
45 FHCC - HUNTERS CREEK
3293 Greenwald Way North
Kissimmee,FL34741
Urgent Care Clinic
46 FHCC - COLONIAL TOWN
630 North Bumby Ave
Orlando,FL32803
Urgent Care Clinic
47 FHCC - DR PHILLIPS
8014 Conroy-Windermere Rd Suite 104
Orlando,FL32835
Urgent Care Clinic
48 Florida Hospital Altamonte Pain Medicine
711 East Altamonte Drive Suite 100
Altamonte Springs,FL32701
Pain Medicine
49 FH Wauchula Pioneer Medical Center
515 Carlton Street
Wauchula,FL33873
Outpatient Phys Clinic
50 FHCC - CLERMONT
15701 State Road 50 Suite 101
Clermont,FL34711
Urgent Care Clinic
51 FHCC - KISSIMMEE
4320 W Vine Street
Kissimmee,FL34746
Urgent Care Clinic
52 FHCC - AZALEA PARK
509 S Semoran Blvd
Orlando,FL32807
Urgent Care Clinic
53 FHCC - SAND LAKE
2301 Sand Lake Road
Orlando,FL32809
Urgent Care Clinic
54 FHHMC Center Priority Health Care
4200 Sun N Lake Blvd
Sebring,FL33872
Outpatient Phys Clinic
55 Florida Hospital Altamonte Mammography C
661 E Altamonte Drive Suite 130
Altamonte Springs,FL32701
Radiology Services
56 FHCC - OVIEDO
8010 Red Bug Road
Oviedo,FL32765
Urgent Care Clinic
57 FHCC - UNIVERSITY
11550 University Blvd
Orlando,FL32817
Urgent Care Clinic
58 FHCC - MT DORA
9015 US Highway 441
Mount Dora,FL32757
Urgent Care Clinic
59 Florida Hospital Altamonte Imaging Cente
894 E Altamonte Drive Suite 1100
Altamonte Springs,FL32701
Radiology Services
60 Florida Hospital Advanced Nuclear Imagin
328 Spruce Street
Orlando,FL32803
Radiology Services
61 FHCC - LONGWOOD
855 S US Highway 17-92
Longwood,FL32750
Urgent Care Clinic
62 Florida Hospital Rehabilitation & Sports
711 E Altamonte Drive Suite 200
Altamonte Springs,FL32701
Therapy Center
63 Florida Hospital Center for Thrombosis
2566 Lee Road
Winter Park,FL32789
Thrombosis Center
64 Florida Hospital Center for Sleep Disord
501 E King Street 2nd Floor
Orlando,FL32803
Sleep Disorder Center
65 Family Health Center East
7975 Lake Underhill Road Suite 200
Orlando,FL32822
Physician Clinics
66 FHHMC Interventional Cardiology
4240 Sun N Lake Blvd Suite 202
Sebring,FL33872
Outpatient Phys Clinic
67 Florida Hospital Rehabilitation & Sports
615 E Princeton St Suite 104
Orlando,FL32803
Therapy Center
68 FHCC - BRANDON
10222 Bloomingdale Ave
Riverview,FL33578
Urgent Care Clinic
69 FHHMC Family Practice Center
1006 W Pleasant Street
Avon Park,FL33825
Outpatient Phys Clinic
70 FHHMC Heartland Women's Health
37 Ryant Blvd
Sebring,FL33870
Outpatient Phys Clinic
71 Florida Hospital Celebration Health Life
410 Celebration Place Suite 302B
Celebration,FL34747
Education Services
72 San Marcos MRI LP
1330 Wonder World Dr
San Marcos,TX78666
Imaging Services
73 Florida Hospital Rehabilitation & Sports
8000 Red Bug Lake Road Suite 140
Oviedo,FL32765
Therapy Center
74 Family Health Center Winter Park
2950 Aloma Ave Suite 100
Winter Park,FL32792
Physician Clinics, Medicine Specialists, Surgical Specialists
75 Florida Hospital Diabetes Institute
2415 N Orange Ave Suite 501
Orlando,FL32804
Diabetes
76 FHHMC Highlands Surgical Associates
4301 Sun N Lake Blvd Suite 103
Sebring,FL33872
Outpatient Phys Clinic
77 Florida Hospital Sleep Disorder Center -
1925 Mizell Avenue Suite 200
Winter Park,FL32792
Sleep Center
78 FHCC - CONWAY
5810 S Semoran Blvd
Orlando,FL32822
Urgent Care Clinic
79 Florida Hospital Rehab and Sports Medici
100 Waymont Court Suite 120
Lake Mary,FL32746
Therapy/Hearing Center
80 Florida Hospital Kissimmee Clinical Phar
201 Hilda Street Suite 36
Kissimmee,FL34741
Outpatient Services
81 FHHMC Therapy Center
6325 US Hwy 27 N
Sebring,FL33870
Outpatient Physical Therapy
82 Florida Hospital Rehab and Sport Medicin
2005 Mizell Ave
Winter Park,FL32792
Therapy Center
83 FHHMC Wound Care
4143 Sun N Lake Blvd
Sebring,FL33872
Wound Care
84 FHCC - WESLEY CHAPEL
5504 Gateway Boulevard
Wesley Chapel,FL33544
Urgent Care Clinic
85 Florida Hospital Rehabilitation & Sports
2520 N Orange Avenue Suite 100
Orlando,FL32804
Therapy Center
86 FHHMC Priority Health Care
1210 US Highway 27 N
Lake Placid,FL33852
Outpatient Phys Clinic
87 FHHMC Women's Wellness Center Sebring
4240 Sun N Lake Blvd Suite 200
Sebring,FL33872
Outpatient Phys Clinic
88 CTMC Home Health
2007 Medical Parkway
San Marcos,TX78666
Home Health services
89 Celebration Hand Therapy
410 Celebration Place Suite 300
Celebration,FL34747
Therapy Center
90 Florida Hospital Rehabilitation & Sports
201 Hilda Street Suite 12
Kissimmee,FL34741
Therapy Center
91 FHHMC Pulmonary and Critical Care Specia
4409 Sun N Lake Blvd Suite E
Sebring,FL33872
Outpatient Phys Clinic
92 Florida Hospital Cardiac Cath Lab
2501 N Orange Ave Suite 137 N
Orlando,FL32804
Cardiac Cath Lab
93 FHHMC Family Medicine Specialist & OP La
2315 US Highway 27 North
Avon Park,FL33825
Outpatient Phys Clinic & Laboratory
94 CTMC Rehab Services
1340 Wonder World Dr
San Marcos,TX78666
OP Rehab Services
95 Florida Hospital Rehabilitation & Sports
205 N Park Avenue Suite 110
Apopka,FL32703
Therapy Center
96 Florida Hospital Laboratory - Orlando
2501 N Orange Avenue Suite 370
Orlando,FL32804
Lab Services
97 Florida Hospital Urology Surgery Center
1812 N Mills Ave
Orlando,FL32803
Physician Clinics
98 FHCC - PORT ORANGE
1208 Dunlawton Ave
Port Orange,FL32127
Urgent Care Clinic
99 FHHMC Urology Specialist
4215 Sun N Lake Blvd
Sebring,FL33872
Outpatient Phys Clinic
100 Medical Plaza - Florida Hospital Kissimm
2400 North Orange Blossom Trail
Kissimmee,FL34744
Physician Clinics
101 Florida Hospital Rehabilitation and Spor
1603 S Hiawassee Road Suite 105
Orlando,FL32835
Therapy Center
102 FHHMC Sleep Lab
4301 Sun N Lake Blvd
Sebring,FL33872
Sleep Lab
103 Florida Hospital Rehab University of Cen
UCF Health Service/Building 124-Rm
114
Orlando,FL32816
Therapy Center
104 FHHMC Family Medicine Associates
5909 US Hwy 27 N Ste 102
Sebring,FL33870
Outpatient Phys Clinic
105 FHHMC Psychiatric Services
4023 Sun N Lake Blvd
Sebring,FL33872
Outpatient Phys Clinic
106 FHHMC ENT Specialist
4325 Sun N Lake Blvd Suite 102
Sebring,FL33872
Outpatient Phys Clinic
107 FHHMC Complete Family Care
935 Mall Ring Road
Sebring,FL33870
Outpatient Phys Clinic
108 FHHMC CareNow
4421 Sun N Lake Blvd Suite B
Sebring,FL33872
Outpatient Phys Clinic
109 FHHMC Family Care of Lake Placid
201 US Hwy South
Lake Placid,FL33852
Outpatient Phys Clinic
110 FHHMC Seascape Internal Medicine Sebring
2950 Alt US 27 South Suite B
Sebring,FL33870
Outpatient Phys Clinic
111 Eden Spa
2501 N Orange Ave Suite 186
Orlando,FL32804
Therapy
112 Darden Onsite
1000 Darden Center Drive
Orlando,FL32837
Employer Onsite Clinic
113 FHHMC Psychiatric Services
1346 US Highway 27 S
Lake Placid,FL33852
Outpatient Phys Clinic
114 Florida Hospital Sleep Disorder Center -
203 N Park Avenue Suite 106
Apopka,FL32703
Sleep Center
115 FHHMC Highlands Surgical Associates Lake
1352 US 27 North
Lake Placid,FL33852
Outpatient Phys Clinic
116 Florida Hospital Apopka The Women's Cen
205 N Park Avenue Suite 108
Apopka,FL32703
Womens's services
117 Florida Hospital East Infusion Center
7975 Lake Underhill Rd Suite 130
Orlando,FL32822
Infusion Center
118 FHHMC Internal Medicine Specialist
6801 US Hwy 27 North Suite B-2
Sebring,FL33870
Outpatient Phys Clinic
119 Florida Hospital Laboratory - Lucerne Te
1723 Lucerne Terrace
Orlando,FL32806
Lab Services
120 FH Wauchula The Therapy Center
1330 Hwy 17 S
Wauchula,FL33873
Outpatient Physical Therapy
121 FHW Cardiology Associates
463 Carlton Street
Wauchula,FL33873
Outpatient Phys Clinic
122 Siemens Onsite
4400 N Alafaya Trail MC Q1-240
Orlando,FL32826
Employer Onsite Clinic
123 FHHMC Therapy Center Lake Placid
1210 US 27 N
Lake Placid,FL33852
Outpatient Physical Therapy
124 Wyndham Onsite
6277 Sea Harbor Dr
Orlando,FL32821
Employer Onsite Clinic
125 FHHMC Outpatient Laboratory
6801 US Hwy 27 N Suite C -1
Sebring,FL33872
Outpatient Laboratory
126 FHHMC Cardio-Pulmonary
4635 Sun N Lake Blvd
Sebring,FL33872
Cardio Pulmonary Rehab
127 Center for Pediatric & Adolescent Medici
15502 Stoneybrook West Parkway
Suite 2-
Winter Garden,FL34787
Pediatric Center / Outpatient Services
128 FHCC - SOUTH TAMPA
301 North Dale Mabry Hwy
Tampa,FL33609
Urgent Care Clinic
129 Florida Hospital Laboratory - Altamonte
661 East Altamonte Drive Suite 131
Altamonte Springs,FL32701
Lab Services
130 Florida Hospital Women's CenterLactatio
2520 N Orange Avenue Suite 103
Orlando,FL32804
Lactation Center, Birthing Classes
131 Florida Hospital Laboratory - Palm Sprin
631 Palm Springs Drive Suite 113
Altamonte Springs,FL32701
Lab Services
132 Florida Hospital Laboratory - Winter Par
1925 Mizell Ave Suite 100
Winter Park,FL32792
Lab Services
133 JP Morgan Chase Onsite
550 International Parkway Floor 1
Lake Mary,FL32746
Employer Onsite Clinic
134 Florida Hospital Hearing Center East Or
7975 Lake Underhill Road Suite 300
Orlando,FL32822
Hearing Center
135 FH Wauchula Sleep Lab & Wound Care
457 W Carlton St
Wauchula,FL33873
Sleep Lab
136 Florida Hospital Laboratory - Tavares
1769 David Walker Drive
Tavares,FL32778
Lab Services
137 FH Wauchula Hardee Family Medicine
522 W Carlton Street
Wauchula,FL33873
Outpatient Phys Clinic
138 OCG Onsite
450 E South Street
Orlando,FL32802
Employer Onsite Clinic
139 FH Wauchula Womens Wellness Center
526 W Carlton Street
Wauchula,FL33873
Outpatient Phys Clinic
140 FHHMC Diabetes Center
4023 Sun N Lake Blvd
Sebring,FL33872
Diabetes Center
141 Waterman Onsite
1000 Waterman Way
Tavares,FL32778
Employer Onsite Clinic
142 CTMC OP Lab and Radiology
151 Kirkham Circle
Kyle,TX78640
OP lab, rehab & medical imaging
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
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
Part I, Line 6a: The filing organization is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC serves as a parent organization to 24 tax-exempt 501(c)(3) hospital organizations that operate 44 hospitals in ten states within the U.S. The system of organizations under the control and ownership of AHSSHC is known as "Adventist Health System" (AHS).All hospital organizations within AHS collect, calculate, and report the community benefits they provide to the communities they serve. AHS organizations exist solely to improve and enhance the local communities they serve. AHS has a system-wide community benefits accounting policy that provides guidelines for its health care provider organizations to capture and report the costs of services provided to the underprivileged and to the broader community. On an annual basis, the community benefits of all AHS organizations are consolidated and reported in the AHS Annual Report document prepared by Adventist Health System Sunbelt Healthcare Corporation (EIN 59-2170012).
Part I, Line 7: The amounts of costs reported in the table in line 7 of Part I of Schedule H were determined by utilizing a cost-to-charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges, contained in the Schedule H instructions.
Part II, Community Building Activities: The costs of community building activities reported on Part II of Schedule H primarily represent the costs associated with commercially sponsored research conducted by two of the organization's hospitals. These two hospitals participate in clinical drug and device research that is performed on patients who have a condition or disease for which the eventual commercial use of a drug or device is intended. This research is related to patient care and serves to expand scientific knowledge with respect to potential treatments and cures for various diseases and conditions.The remainder of the costs incurred stem from the hospitals' involvement in and support of various other community agencies in its service area that work collaboratively to help those in need and to improve the health and safety of the residents of the community. The organization's hospitals participate with a number of other community organizations to address the healthcare needs of the community. Both cash and in-kind donations are made annually to various local charitable organizations.
Part III, Line 2: The amount of bad debt expense, reported on line 2 of Section A of Part III is recorded in accordance with Healthcare Financial Management Association Statement No. 15. Discounts and payments on patient accounts are recorded as adjustments to revenue, not bad debt expense.
Part III, Line 3: Methodology for Determining the Estimated Amount of Bad Debt Expense that May Represent Patients who Could Have Qualified under the Filing Organization's Financial Assistance Policy:Self-pay patients may apply for financial assistance by completing a Financial Assistance Application Form (FAA Form). If an individual does not submit a complete FAA Form within 240 days after the first billing statement is sent to the individual, an individual may be considered for presumptive eligibility based upon a scoring tool that is designed to classify patients into groups of varying economic means. The scoring tool uses algorithms that incorporate data from credit bureaus, demographic databases, and hospital specific data to infer and classify patients into respective economic means categories. Individuals who earn a certain score on the scoring tool are considered to qualify as non-state charity patients. An amount up to $1,000 of such a patient's bill is written off as bad debt expense, while the remaining portion of the patient's bill is considered to be non-state charity. The amount written off as bad debt expense for those patients who potentially qualify as non-state charity using the scoring tool is the amount shown on line 3 of Section A of Part III. Rationale for Including Certain Bad Debts in Community Benefit: The filing organization is dedicated to the view that medically necessary health care for emergency and non-elective patients should be accessible to all, regardless of age, gender, geographic location, cultural background, physician mobility, or ability to pay. The filing organization treats emergency and non-elective patients regardless of their ability to pay or the availability of third-party coverage. By providing health care to all who require emergency or non-elective care in a non-discriminatory manner, the filing organization is providing health care to the broad community it serves. As a 501(c)(3) hospital organization, the filing organization maintains a 24/7 emergency room providing care to all whom present. When a patient's arrival and/or admission to the facility begins within the Emergency Department, triage and medical screening are always completed prior to registration staff proceeding with the determination of a patient's source of payment. If the patient requires admission and continued non-elective care, the filing organization provides the necessary care regardless of the patient's ability to pay. The filing organization's operation of a 24/7 Emergency Department that accepts all individuals in need of care promotes the health of the community through the provision of care to all whom present. Current Internal Revenue Service guidance that tax-exempt hospitals maintain such emergency rooms was established to ensure that emergency care would be provided to all without discrimination. The treatment of all at the filing organization's Emergency Department is a community benefit. Under the filing organization's Financial Assistance Policy, every effort is made to obtain a patient's necessary financial information to determine eligibility for financial assistance. However, not all patients will cooperate with such efforts and a financial assistance eligibility determination cannot be made based upon information supplied by the individual. In this case, a patient's portion of a bill that remains unpaid for a certain stipulated time period is wholly or partially classified as bad debt. Bad debts associated with patients who have received care through the filing organization's Emergency Department should be considered to be community benefit as charitable hospitals exist to provide such care in pursuit of their purpose of meeting the need for emergency medical care services available to all in the community.
Part III, Line 4: Financial Statement Footnote Related to Accounts Receivable and Allowance for Uncollectible Accounts:The financial information of the filing organization is included in a consolidated audited financial statement for the current year.The applicable footnote from the attached consolidated audited financial statements that addresses accounts receivable, the allowance for uncollectible accounts, and the provision for bad debts can be found on pages 6 and 7. Please note that dollar amounts on the attached consolidated audited financial statements are in thousands.
Part III, Line 8: Costing Methodology: Medicare allowable costs were calculated using a cost-to-charge ratio. Rationale for Including a Medicare Shortfall as Community Benefit:As a 501(c)(3) organization, the filing organization provides emergency and non-elective care to all regardless of ability to pay. All hospital services are provided in a non-discriminatory manner to patients who are covered beneficiaries under the Medicare program. As a public insurance program, Medicare provides a pre-established reimbursement rate/amount to health care providers for the services they provide to patients. In some cases, the reimbursement amount provided to a hospital may exceed its costs of providing a particular service or services to a patient. In other cases, the Medicare reimbursement amount may result in the hospital experiencing a shortfall of reimbursement received over costs incurred. In those cases where an overall shortfall is generated for providing services to all Medicare patients, the shortfall amount should be considered as a benefit to the community. Tax-exempt hospitals are required to accept all Medicare patients regardless of the profitability, or lack thereof, with respect to the services they provide to Medicare patients. The population of individuals covered under the Medicare program is sufficiently large so that the provision of services to the population is a benefit to the community and relieves the burdens of government. In those situations where the provision of services to the total Medicare patient population of a tax-exempt hospital during any year results in a shortfall of reimbursement received over the cost of providing care, the tax-exempt hospital has provided a benefit to a class of persons broad enough to be considered a benefit to the community. Despite a financial shortfall, a tax-exempt hospital must and will continue to accept and care for Medicare patients. Typically, tax-exempt hospitals provide health care services based upon an assessment of the health care needs of their community as opposed to their taxable counterparts where profitability often drives decisions about patient care services that are offered. Patient care provided by tax-exempt hospitals that results in Medicare shortfalls should be considered as providing a benefit to the community and relieving the burdens of government.
Part III, Line 9b: Collection Policies:The hospital filing organization's collection practices are in conformity with the requirements set forth in the 2012 Proposed Regulations regarding the requirements of Internal Revenue Code Section 501(r)(4) - (r)(6). No extraordinary collection actions (ECA's) are initiated by the hospital filing organization in the 120-day period following the date after the first billing statement is sent to the individual (or, if later, the specified deadline given in a written notice of actions that may be taken, as described below). Individuals are provided with at least one written notice (notice of actions that may be taken) that informs the individual that the hospital filing organization may take actions to report adverse information to credit reporting agencies/bureaus if the individual does not submit a Financial Assistance Application Form (FAA Form) or pay the amount due by a specified deadline. The specified deadline is not earlier that 120 days after the first billing statement is sent to the individual and is at least 30 days after the notice is provided. If an individual submits an incomplete FAA Form during the 240-day period following the date on which the first billing statement was sent to the individual, the hospital filing organization suspends any reporting to consumer credit reporting agencies/bureaus and provides a written notice to the individual describing what additional information or documentation is needed to compete the FAA Form. This written notice includes a copy of the hospital filing organization's Plain Language Summary of the Financial Assistance Policy (PLS) and informs the individual that the hospital filing organization may engage in adverse reporting to consumer credit reporting agencies/bureaus if the FAA Form is not completed by a specified deadline which is no earlier than the 240-day period following the date on which the first billing statement was sent to the individual or, if later, 30 days after the written notice is provided. If an individual submits a compete FAA Form within the 240-day period after the first billing statement is sent, the hospital filing organization will suspend any adverse reporting to consumer credit reporting agencies/bureaus until a financial assistance policy eligibility determination can be made.
Supplemental Schedule to Schedule H, Part III, Section B Reconciliation of Schedule H Reported Medicare Surplus/(Shortfall) to Unreimbursed Medicare Costs Associated with the Provision of ServicesTo All Medicare Beneficiaries:The Medicare revenue and allowable costs of care reported in Section B of Part III of Schedule H are based upon the amounts reported in the filing organization's Medicare cost report in accordance with the IRS instructions for Schedule H. On an annual basis, the filing organization also determines its total unreimbursed costs associated with providing services to all Medicare patients. Unreimbursed costs are reported as a community benefit to the elderly and are included in the consolidated Adventist Health System (AHS or the Company) Community Benefits Report contained in the AHS Annual Report document. The primary reconciling items between the Medicare surplus/(shortfall) shown on line 7 of Section B of Part III of Schedule H and the filing organization's unreimbursed costs of services provided to Medicare patients as reported in the AHS Community Benefit Report are as follows:- Medicare surplus/(shortfall) shown on line 7 of Section B of Schedule H: $(127,989,419)- Difference in costing methodology: (4,501,583)- Unreimbursed costs incurred for services provided to Medicare patients that are not included in the organization's Medicare cost report: (98,040,169) -------------Total Unreimbursed costs of serving all Medicare patients per the filing organization's community benefit reporting: $(230,531,171) As indicated above, the primary differences between the Medicare surplus/(shortfall) reported on Schedule H, Part III, Section B, line 7 and the filing organization's portion of the Company's annual community benefit statement is due to a difference in the costing methodology and differences in the population of Medicare patients within the calculation. The cost methodology utilized in calculating any Medicare surplus/(shortfall) for purposes of the annual community benefit reporting is based upon the cost-to-charge ratio outlined in Worksheet 2 of the Schedule H instructions. The same cost-to-charge ratio is used to determine the costs associated with services provided to charity care patients and Medicaid patients as reported in Schedule H, Part I, line 7. In addition, the Medicare cost report excludes services provided to Medicare patients for physician services, services provided to patients enrolled in Medicare HMOs, and certain services provided by outpatient departments of the filing organization that are reimbursed on a fee schedule. The Company's own community benefit statement captures the unreimbursed cost of providing services to all Medicare beneficiaries throughout the organization.
Part VI, Line 2: As reported in Schedule H, Part V, Section B, the filing organization's hospital facilities conducted their initial community health needs assessments (CHNAs) in 2013. The initial CHNAs were adopted by all hospital governing boards by December 31, 2013, the end of the filing organization's taxable year in which the CHNAs were conducted. All of the filing organization's hospital facilities' initial CHNAs complied with the guidance set forth by the IRS in Proposed Regulation Section 1.501(r)-3. In addition to the CHNAs discussed above, a variety of practices and processes are in place to ensure that the filing organization is responsive to the health needs of all of its communities. Such practices and processes involve the following:1. Hospitals' operating/community boards composed of individuals broadly representative of the community, community leaders, and those with specialized medical training and expertise;2. Post-discharge patient follow-up related to the on-going care and treatment of patients who suffer from chronic diseases; 3. Sponsorship and participation in community health and wellness activities that reach a broad spectrum of the filing organization's hospital communities; and 4. Collaboration with other local community groups to address the health care needs of the filing organization's hospital communities.
Part VI, Line 3: The Financial Assistance Policy (FAP) of the filing organization's hospital facilities is transparent and available to all individuals served at any point in the care continuum. The FAP, the Financial Assistance Application Form (FAA Form), the Plain Language Summary of the Financial Assistance Policy (PLS), and contact information for each of the hospital facility's financial counselors are prominently and conspicuously posted on each of the filing organization's hospital facility's website. Signage is displayed in each of the filing organization's hospital facilies at all points of admission and registration, including the Emergency Department. The signage contains the specific hospital facility's website address where the FAP and the FAA Form can be accessed and the telephone number and physical location that individuals can call or visit with any questions about the FAP or the application process. Paper copies of each of the hospital facility's FAP, FAA Form and PLS are available upon request and without charge, both in public locations in the hospital facility and by mail. Each of the filing organization's hospital facilities' financial counselors seek to provide personal financial counseling to all individuals admitted to the hospital facility who are classified as self-pay during the course of their hospital stay or at time of discharge to explain the FAP and FAA Form and to provide information concerning other sources of assistance that may be available, such as Medicaid. A copy of each of the hospital facility's PLS and FAA Form is distributed to every individual before discharge from the hospital facility. Additionally, a copy of the PLS is included with at least three billing statements that are sent to the individual during the 120-day period after the first billing statement is sent. Individuals are informed about each of the hospital facility's FAP in all oral communications regarding the amount due for the individual's care.
Part VI, Line 4: In 2014, the filing organization operated 5 separately licensed hospitals that together encompassed 12 separate campus locations. The hospitals are located in Florida, Illinois and Texas. A description of each of the hospital campuses is described below.Adventist Health System/Sunbelt, Inc. dba Central Texas Medical Center:Central Texas Medical Center (CTMC) is a 170-bed acute-care hospital providing a wide range of healthcare services in San Marcos, Texas and the neighboring communities within Hays and Caldwell counties, Texas. Special services offered at CTMC include a 24/7, Level 4 emergency and trauma center, state-of-the-art medical imaging and laboratory services, a new women's center featuring a Level 2 Neonatal Intensive Care Unit, newly renovated and expanded surgery suites, a Rehabilitation Institute, a center for advanced wound healing and hyperbaric medicine, and a cardiac catheterization lab. As a health resource for their community, CTMC's Creation Health Institute also annually hosts the oldest and largest health screening and fair event in Hays County as well as a number of ongoing classes and workshops ranging in topics from diabetes prevention and management to heart disease, stroke, arthritis, self-help, nutrition and more. CTMC received accreditation as a certified chest pain center from the Society of Chest Pain Centers in 2011. The accreditation enhances CTMC's ability to receive and treat patients suffering from chest pain and/or a possible heart attack. The result is a focus on reduced time from symptom onset to diagnosis and treatment, getting patients treated more quickly during the critical window of time when the integrity of the heart muscle can be preserved, and monitoring of patients whose diagnosis is uncertain to ensure they are not sent home too quickly or admitted unnecessarily. From 2010 through 2013, CTMC was named The Best Hospital in Hays County. In 2012, CTMC became the first operating room along the IH-35 corridor between Austin and San Antonio to be equipped with a da Vinci robotic-assisted surgery suite. In 2014, CTMC received awards and recognitions from the American Heart Association, American Stroke Association, The Joint Commission, Premiere, Inc. and Healogics, Inc. related to the quality of care given to its patients. San Marcos, Texas is located in Hays County, Texas and is in close proximity to Austin and San Antonio. CTMC's primary market has a population of approximately 89,000, with an estimated 8,400 over the age of 65. The weighted average household income, based on population, in the primary market is approximately $39,000. High school graduates account for approximately 87% of Hays County, with an estimated 32% having a bachelor's degree or higher. It is estimated that 18% of the individuals residing in Hays County live below the poverty level and the unemployment rate is about 8%. Approximately 41% of CTMC's patients during 2014 were Medicare patients, about 11% were Medicaid patients, about 14% were self-pay patients and the remaining percentage were patients covered under commercial insurance. In 2014, about 65% of CTMC's in-patients were admitted through the Emergency Department.Adventist Health System/Sunbelt, Inc. dba Florida Hospital Heartland Medical Center:Florida Hospital Heartland Medical Center (FHHMC) is comprised of three separate hospital campuses with a total of 222 beds. Two of the hospital campuses are located in Highlands County, Florida and operate under a single hospital license and the third separately licensed campus is located in Hardee County, Florida. Highlands and Hardee counties are in the south central areas of Florida and are adjacent to each other. *Florida Hospital Heartland Medical Center, Highlands County - The main 147-bed hospital facility is located in north Sebring. The facility provides a wide range of healthcare services including Certified Stroke and Chest Pain Centers, the county's busiest emergency department, ACR-accredited imaging services, surgical services, Blessed Beginnings obstetrics, outpatient psychiatric and Tele ICU. Since 2012, the Heart & Vascular Center has added a third cath lab, expanded the emergency care department and renovated the lab services area. *Florida Hospital Heartland Medical Center Lake Placid, Highlands County - This satellite facility houses 33 medical and surgical beds, the county's only 17-bed inpatient mental health unit and a wide range of services that are highly sophisticated for a small community hospital. This campus also specializes in inpatient geriatric psychiatric services within Highlands and Hardee counties. The need for behavioral health services is extreme in both counties since there is no other program closer than sixty miles. Since 2012, this campus has added a Tele-ICU program and its imaging services are ACR-accredited. *Florida Hospital Wauchula, Hardee County - This campus is licensed for 25 beds and specializes in emergency and outpatient care, while offering excellent medical inpatient services. The inpatient unit is mixed with both acutely ill patients and patients who need short-term rehabilitation (transitional care). This campus offers the only emergency care in Hardee County. In 2000, Florida Hospital Wauchula became the first Critical Access Hospital in the state of Florida. Since 2012, this campus has added the county's only mammography program, updated the lab services area and its imaging services are ACR-accredited. As noted above, Highlands and Hardee counties in Florida are located in the heart of the Florida Peninsula. The Hospital's primary market has a population of approximately 133,000 with an estimated 35,000 over the age of 65. The weighted average household income, based on population, in the primary market is approximately $34,000. High school graduates account for approximately 77% of Highlands County, with an estimated 14% having a bachelor's degree or higher. It is estimated that 16% of the individuals residing in Highlands County live below the poverty level and the unemployment rate is about 10%. Approximately 66% of FHHMC's patients during 2014 were Medicare patients, about 13% were Medicaid patients, about 5% were self-pay patients and the remaining percentage were patients covered under commercial insurance. In 2014, about 60% of FHHMC's in-patients were admitted through the Emergency Department.Adventist Health System/Sunbelt, Inc. dba Florida Hospital (FH):FH is a 2,500 bed medical complex in Central Florida with seven separate hospital campuses that operate under a single hospital license. FH serves the residents of Central Florida (primarily serving the residents of Orange, Osceola, Seminole and Lake County) but also draws patients from other parts of the Southeastern United States, the Caribbean and South America. The 7-campus health system is the largest healthcare provider in Central Florida with more than 1.9 million patient visits per year and is the nation's largest Medicare provider. Florida Hospital is the second largest employer in the area. *** see continuation of footnote
Part VI, Line 5: The provision of community benefit is central to the filing organization's mission of service and compassion. Restoring and promoting the health and quality of life of those in the communities served by the filing organization is a function of "extending the healing ministry of Christ" and embodies the filing organization's commitment to its values and principles. The filing organization commits substantial resources to provide a broad range of services to both the underprivileged as well as the broader community. In addition to the community benefit information provided in Parts I, II and III of this Schedule H, the filing organization captures and reports the benefits provided to its community through faith-based care. Examples of such benefits include the cost associated with chaplaincy care programs and mission peer reviews and mission conferences. During the current year, the filing organization provided $7,551,338 of benefit with respect to the faith-based and spiritual needs of the communities it serves in conjunction with its operation of community hospitals. The filing organization also provides benefits to its communities' infrastructure by investing in capital improvements to ensure that facilities and technology provide the best possible care. During the current year, the filing organization expended $296,401,647 in new capital improvements. As faith-based mission-driven community hospitals, the filing organization is continually involved in monitoring its communities, identifying unmet health care needs and developing solutions and programs to address those needs. In accordance with its conservative approach to fiscal responsibility, surplus funds of the Hospitals are continually being invested in resources that improve the availability and quality of delivery of health care services and programs to its communities.
Part VI, Line 6: The filing organization is a part of a faith-based healthcare system of organizations whose parent is Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). The system is known as Adventist Health System (AHS). AHSSHC is an organization exempt from federal income tax under IRC Section 501(c)(3). AHSSHC and its subsidiary organizations operate 44 hospitals in 10 states throughout the U.S., primarily in the Southeastern portion of the U.S. AHSSHC and its subsidiaries also operate 16 nursing home facilities and other ancillary health care provider facilities, such as ambulatory surgery centers and diagnostic imaging centers. As the parent organization of the AHS system, AHSSHC provides executive leadership and other professional support services to its subsidiary organizations. Professional support services include among others corporate compliance, legal, human resources, reimbursement, risk management, and tax as well as treasury functions. The provision of these executive and support services on a centralized basis by AHSSHC provides an appropriate balance between providing each AHS subsidiary hospital organization with mission-driven consistent leadership and support while allowing the hospital organization to focus its resources on meeting the specific health care needs of the community it serves. The reader of this Form 990 should keep in mind that this reporting entity may differ in certain areas from that of a stand-alone hospital organization due to its inclusion in a larger system of healthcare organizations. As a part of a system of hospital and other health care organizations, the filing organization benefits from reduced costs due to system efficiencies, such as large group purchasing discounts, and the availability of internal resources such as internal legal counsel. Each AHS subsidiary pays a management fee to AHSSHC for the internal services provided by AHSSHC. As a result, management fee expense reported by a AHS subsidiary organization may appear greater in relation to management fee expense that may be reported by a single stand-alone hospital. The single stand-alone hospital would likely report costs associated with management and other professional services on various expense line items in its statement of revenue and expense as opposed to reporting such costs in one overall management fee expense. As the reporting of the Form 990 is done on an entity by entity basis, there is no single Form 990 that captures the programs and operations of AHS as a whole. The reader is directed to visit the web-site of AHS at www.adventisthealthsystem.com to learn more about the mission and operations of AHS and to access AHS's annual report that contains financial data as well as community benefit reporting for the entire system.
Part VI, Line 7 The annual community benefit report contained in the annual report prepared by Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) on behalf of the entire AHS System of healthcare organization is not filed with any state agencies. Certain hospitals within the filing organization file annual community benefit reports with the state in which they are located. Specifically, Central Texas Medical Center files a community benefit report with the State of Texas and Adventist La Grange Memorial Hospital files a community benefit report with the State of Illinois.
Part VI, Line 4 Continuation of Footnote Description of Community Information - ContinuedThe main campus of the FH system is located in Orlando, Florida (Orange County) near the downtown area. The other 6 campuses are located in surrounding communities in the counties of Orange, Osceola, and Seminole. In addition to operating the 7 hospitals, FH also operates 25 full-service urgent care clinics in convenient community settings. A brief description of each of the 7 hospital campuses is described below:*Florida Hospital Orlando (Orange County) - At the core of the FH system, FH Orlando is a 1,217 bed acute-care tertiary hospital. FH Orlando is home to nationally recognized Centers of Excellence for cancer, cardiology, children's health, diabetes, neuroscience, orthopedics, transplant and global robotics. Florida Hospital Orlando houses one of the largest Emergency Departments and cardiac catheterization labs in the country and is one of the busiest hospitals in the nation, providing service excellence to more than 53,000 inpatients and 173,000 outpatients each year. The recent opening of a 15-story patient tower features 200 more beds and 500 new jobs. The campus also includes a state-of-the-art Cardiac Diagnostic Center featuring 15 Cath and electro physiology (EPS) Labs. The cardiology team currently treats 34,000+ individuals for chest pain and performs over 1,500 open heart surgeries each year making them first in the state for the number of surgeries performed.Also located on the Florida Hospital Orlando Campus is the Walt Disney Pavilion at Florida Hospital for Children. The Walt Disney Pavilion is not a stand-alone facility but rather a 7-story, 181-bed tower located on Florida Hospital Orlando's campus. It is a full-service facility served by more than 60 pediatric specialists and a highly trained pediatric team of more than 600 employees. The Walt Disney Pavilion at Florida Hospital for Children delivers a complete range of pediatric health services for younger patients including advanced surgery, oncology, neurosurgery, cardiology and transplant services; full-service pediatrics; and an innovative health and obesity platform.Orlando is located in Orange County, Florida. The Hospital's primary market has a population of approximately 1,822,000 with an estimated 197,000 over the age of 65. The weighted average household income, based on population, in the primary market is approximately $52,000. High school graduates account for approximately 87% of Orange County, with an estimated 30% having a bachelor's degree or higher. It is estimated that 13% of the individuals residing in Orange County live below the poverty level and the unemployment rate is about 8%. Approximately 43% of the Hospital's patients during 2014 were Medicare patients, about 16% were Medicaid patients, about 7% were self-pay patients and the remaining percentage were patients covered under commercial insurance. In 2014, about 72% of the hospital's in-patients were admitted through the hospital's Emergency Department. *Florida Hospital Altamonte (Seminole County) - FH Altamonte is a 362-bed facility, which has recently doubled in size with a new patient tower to better serve a busy community. FH Altamonte was the first "satellite" hospital, built in 1973 on what was then pastureland, miles from the nearest business district. Located north of Orlando in fast-growing Seminole County, Florida Hospital Altamonte is the largest satellite campus within the Florida Hospital health care system. In addition to maternity, pediatric, emergency, medical and surgical services, the hospital operates the Martin Andersen Cancer Center (along with the region's only Cancer Resource Library), a heart catheterization lab, and a comprehensive outpatient program which includes surgery, diagnostics, and medical treatment programs. In 2014, the Mother Baby Unit was expanded to provide a 15 bed CDU, ten new LDR rooms, six triage rooms, a new C-section operating room and a new recovery unit.*Florida Hospital Apopka (Orange County) - In 1975, FH Apopka became the second satellite hospital. For nearly three decades, Florida Hospital Apopka has set the standard in hometown health care by providing high-tech, quality care with a personalized touch. They are situated just 12 miles northwest of Orlando, with a small, yet advanced, 50-bed campus that houses a certified Chest Pain Center and a multitude of inpatient and outpatient services.*Florida Hospital Celebration Health (Osceola County) - FH Celebration Health is a cornerstone of Disney's planned community in Celebration, Florida. Today, this 203-bed acute care hospital delivers a state-of-the-art healing environment to residents of Osceola, Orange, Polk and Lake Counties, as well as to visitors from across the United States and the world. From its creation FH Celebration Health has been about promoting health and wellness as well as healing. Inside the resort-style hospital there is a wellness center, complete with workout area, pool, and rehabilitation facility. FH Celebration Health also houses the Global Robotics Institute, which provides patients with access to some of the most experienced robotic surgeons in the world. The Nicholson Center for Surgical Advancement also is a location where surgeons from around the world travel to learn the latest robotic surgery techniques. In 2011, the new 234,000 square-foot patient tower added 62 beds and will house the Interactive Patient Care Unit, the first of its kind in the nation. In connection with the Institute for Interactive Patient Care, everything from new patient safety technology to changing ways to communicate with patients about their care could be studied as part of the unit. In 2013, a four story medical office building was added in which the Women's Institute is situated. In 2014, a new 5th floor inpatient 32 bed state-of-the art medical/surgical unit was added.*Florida Hospital East Orlando (Orange County) - FH East Orlando is now an innovative local leader that fills a vital need in a fast-growing area. A recent 200,000 square-foot expansion project upgraded the hospital to 265 beds, with a spacious patient tower and 80 new private rooms designed to enhance the holistic care experience. In 2014, a new expanded ED provided 60 new treatment rooms.*Florida Hospital Kissimmee (Osceola County) - FH Kissimmee is an 83-bed community-focused hospital, conveniently located near Walt Disney World. The team located at FH Kissimmee is dedicated to bringing mission-focused, faith-based care to residents and visitors of Osceola and Orange Counties. This facility has recently expanded to include a new medical office building, patient tower, new main entrance, expanded Emergency Department and a parking garage.*Florida Hospital Winter Park (Orange County) - FH Winter Park Memorial Hospital is a 320-bed facility that is a model of community health and wellness. The facility boasts spacious patient care areas and a full spectrum of specialties and services, including the Dr. P. Phillips Baby Place (with Level II NICU), Florida Hospital Orthopedic Institute, and state-of-the-art surgery, recovery and rehabilitation at the Florida Hospital Cancer Institute.Adventist Health System/Sunbelt, Inc. dba Adventist La Grange Memorial Hospital:Adventist La Grange Memorial Hospital (ALMH) is a 204-bed facility providing outpatient and inpatient primary care, trauma care and wellness services to residents of Chicago's western suburbs. The hospital is a leader in offering comprehensive oncology services, orthopedic services, advanced cardiac care, women's health and maternity care, emergency, geriatric and many other specialties that cater to the communities it serves. The communities served by ALMH contain a high senior population. To address the unique needs of its service area, ALMH offers a broad spectrum of services designed to meet the diverse needs of aging adults.La Grange, Illinois is located in Cook County. The Hospital's primary market has a population of approximately 158,000, with an estimated 25,000 over the age of 65. The weighted average household income, based on population, in the primary market is approximately $68,000. High school graduates account for approximately 85% of Cook County, with an estimated 33% having a bachelor's degree or higher. It is estimated that 15% of the individuals residing in Cook County live below the poverty level and the unemployment rate is about 9%.Approximately 54% of the Hospital's patients during 2014 were Medicare patients, about 8% were Medicaid patients, about 2% were self-pay patients and the remaining percentage were patients covered under commercial insurance. In 2014, about 74% of the hospital's in-patients were admitted through the hospital's Emergency Department.
Schedule H (Form 990) 2014
Additional Data


Software ID:  
Software Version:  
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
2014
Open to Public
Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number
59-1479658
Part I
General Information on Grants and Assistance
1
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? ....................................
2
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 Domestic Organizations and Domestic Governments. 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 section
if applicable
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
non-cash assistance
(h) Purpose of grant
or assistance
(1) ADVENTIST CARE CENTERS - COURTLAND INC
730 COURTLAND ST
ORLANDO,FL32804
20-5774723 501(c)(3) 310,302       General Support
(2) ALLIANCE OF THE SPACE COAST INC DBA Florida Abolitionist
PO BOX 536832
ORLANDO,FL32853
59-3178045 501(c)(3) 10,000       General Support
(3) AMERICAN DIABETES ASSOCIATION INC
1701 North Beauregard Street
ALEXANDRIA,VA22311
13-1623888 501(c)(3) 30,000       General Support
(4) American Cancer Society Florida Division Inc
3709 W Jetton Avenue
Tampa,FL33873
59-0657320 501(c)(3) 6,000       General Support
(5) AMERICAN CANCER SOCIETY INC
250 WILLIAMS STREET NW SUITE 400
ATLANTA,GA30303
13-1788491 501(c)(3) 19,050       General Support
(6) AMERICAN HEART ASSOCIATIONGREATER SOUTH AFFILIATE-AR
9900 NINTH ST NORTH
ST PETERSBURG,FL33716
59-0637852 501(c)(3) 117,497       General Support
(7) AMERICAN LUNG ASSOCIATION OF SOUTHEAST INC
851 OUTER RD
ORLANDO,FL32814
59-0662271 501(c)(3) 26,500       General Support
(8) BEACON NETWORK INC
PO BOX 2547
ORLANDO,FL328022547
27-4894580 501(c)(3) 15,000       General Support
(9) BOY SCOUTS OF AMERICA INC CENTRAL FLORIDA COUNCIL
1951 S ORANGE BLOSSOM TR 102
APOPKA,FL32703
59-0624376 501(c)(3) 15,000       General Support
(10) BUILDING US INC
PO BOX 3310
WINTER PARK,FL327903310
45-5420165 501(c)(3) 25,000       General Support
(11) CELEBRATION FOUNDATION INC
610 SYCAMORE ST
CELEBRATION,FL34747
59-3370753 501(c)(3) 36,000       General Support
(12) CENTER FOR CONGREGATIONAL HEALTH INC
MEDICAL CENTER BLVD
WINSTON SALEM,NC27157
23-7426944 501(c)(3) 15,000       General Support
(13) CENTRAL FLORIDA CHAMBER for PERSONS WITH DISABILITIES LLC
3201 E COLONIAL DR UNIT A20
ORLANDO,FL328035174
26-4201627 Other 12,000       General Support
(14) CENTRAL FLORIDA FAMILY HEALTH CENTER INC
2400 STATE ROAD 415
SANFORD,FL32771
59-1741286 501(c)(3) 45,000       General Support
(15) CENTRAL FLORIDA HEALTHCARE COALITION INC DBA FLORIDA HEALTH CARE COALITION
5703 RED BUG LAKE RD STE 118
WINTER SPRINGS,FL32708
59-2500692 501(c)(3) 10,000       General Support
(16) CENTRAL FLORIDA PARTNERSHIP INC
PO BOX 1234
ORLANDO,FL32804
33-1202266 501(c)(6) 106,440       General Support
(17) CENTRAL FLORIDA REGIONAL HEALTH INFORMATION ORGANIZATION INC
3208-C EAST COLONIAL DRIVE
ORLANDO,FL328035127
20-8145032 501(c)(3) 130,879       General Support
(18) CENTRAL FLORIDA YOUNG MEN'S CHRISTIAN ASSOCIATION
433 N MILLS AVENUE
ORLANDO,FL328035721
59-0624430 501(c)(3) 115,500       General Support
(19) CENTRAL TEXAS HEALTHCARE COLLABORATIVE
1301 WONDER WORLD DR
SAN MARCOS,TX78666
45-3739929 501(c)(3) 1,573,475       Provision of Indigent Care
(20) CENTRAL TEXAS MEDICAL CENTER FOUNDATION
1301 WONDER WORLD DR
SAN MARCOS,TX78666
74-2259907 501(c)(3)   84,245 Book Provision of general administrative support General Support
(21) CHANGE 4 KIDS INC
201 S ORANGE AVE STE 960
ORLANDO,FL32801
90-1025013 Other 26,000       General Support
(22) CHRISTIAN SHARING CENTER INC
600 N HWY 17-92
LONGWOOD,FL32750
59-2744535 501(c)(3) 15,000       General Support
(23) CITY OF WINTER PARK
401 S PARK AVE
WINTER PARK,FL32789
59-6000454 Gov't 10,000       General Support
(24) COMMUNITY BASED CARE OF CENTRAL FLORIDA INC
4001 PELEE ST
ORLANDO,FL328173100
01-0631375 501(c)(3) 30,000       General Support
(25) COMMUNITY VISION INC LEADERSHIP ASSOCIATION OF OSCEOLA
111 E MONUMENT AVE UNIT 401
KISSIMMEE,FL34741
59-2896657 501(c)(3) 25,500       General Support
(26) Creation Development Foundation DBA CREATION KIDS VILLAGE
599 CELEBRATION PLACE
CELEBRATION,FL34747
30-0724172 501(c)(3) 15,000       General Support
(27) CROHNS & COLITIS FOUNDATION OF AMERICA
PO BOX 701130
SAINT CLOUD,FL34770
13-6193105 501(c)(3) 7,500       General Support
(28) DOWNTOWN COLLEGE PARK PARTNERSHIP INC
PO BOX 547744
ORLANDO,FL32854
23-7250533 501(c)(3) 15,000       General Support
(29) EAST ORLANDO HEALTH & REHAB CENTER INC
250 SOUTH CHICKASAW TRAIL
ORLANDO,FL32825
20-5774748 501(c)(3) 1,440,600       General Support
(30) EASTER SEALS FLORIDA INC
520 N SEMORAN BLVD STE 280
ORLANDO,FL32807
59-0637848 501(c)(3) 10,000       General Support
(31) EQUIP FOUNDATION INC DBA EQUIP LEADERSHIP INC
2050 Sugarloaf Circle
Duluth,GA30097
33-0686464 501(c)(3) 13,000       General Support
(32) FLNC INC
3355 E SEMORAN BLVD
APOPKA,FL32703
20-5774761 501(c)(3) 2,211,000       General Support
(33) FLORIDA CHAMBER OF COMMERCE INC
PO BOX 11309 136 SOUTH BRONOUGH
STREET
TALLAHASSEE,FL32302
59-0248200 501(c)(6) 200,000       General Support
(34) FLORIDA CHAPTER AMERICAN COLLEGE EMERGENCY PHYSICIANS
3717 S CONWAY RD
ORLANDO,FL32812
23-7147400 501(c)(6) 14,000       General Support
(35) Florida Conference Association of Seventh-Day Adventist dba Better Living C
PO Box 3092
Lake Placid,FL33862
59-6137501 501(c)(3) 7,500       General Support
(36) FLORIDA DIVERSITY INC
PO BOX 2831
ORLANDO,FL32802
46-4503528 501(c)(3) 10,000       General Support
(37) Florida Hospital Waterman Inc
1000 Waterman Way
Tavares,FL32778
59-3140669 501(c)(3) 620,409       General Support
(38) FOREST LAKE ACADEMY
500 EDUCATION LOOP
APOPKA,FL327036176
59-0816443 501(c)(3) 13,500       General Support
(39) FOREST LAKE SDA CHURCH
515 HARLEY LESTER LANE
APOPKA,FL32703
59-2885433 501(c)(3) 11,500       General Support
(40) FOUNDATION FOR EARLY CHILDHOOD DEVELOPMENT INC
PO BOX 540387
ORLANDO,FL32854
86-1076294 501(c)(3) 10,000       General Support
(41) FOUNDATION FOR ORANGE COUNTY PUBLIC SCHOOLS INC
445 W AMELIA ST STE 901
ORLANDO,FL328011153
59-2788435 501(c)(3) 25,000       General Support
(42) FOUNDATION FOR SEMINOLE STATE COLLEGE OF FLORIDA INC
1055 AAA DRIVE STE 209
HEATHROW,FL32746
23-7033822 501(c)(3) 95,333       General Support
(43) FRANKLIN S FRIENDS INC
901 VERSAILLES CIR
MAITLAND,FL32751
46-1111664 501(c)(3) 10,000       General Support
(44) FRIENDS OF THE MENNELLO MUSEUM OF AMERICAN ART INC
900 E PRINCETON STREET
ORLANDO,FL32803
59-3618760 501(c)(3) 11,750       General Support
(45) FRONTLINE OUTREACH INC
300 C R SMITH ST
ORLANDO,FL32805
23-7227148 501(c)(3) 15,000       General Support
(46) GENERAL GROWTH MANAGEMENT INC
110 N WACKER DR
CHICAGO,IL60606
42-1285297 Other 20,000       General Support
(47) GRACE MEDICAL HOME INC
51 PENNSYLVANIA STREET
ORLANDO,FL328062938
28-1817966 501(c)(3) 101,500       General Support
(48) GREATER ORLANDO CHAMBER OF COMMERCE INC DBA ORLANDO REGIONAL CHAMBER OF COM
PO BOX 1234
ORLANDO,FL328021234
59-0272107 501(c)(6) 16,292       General Support
(49) Greater Sebring Chamber of Commerce
227 US 27 North
Sebring,FL33870
59-0532480 501(c)(6) 6,300       General Support
(50) HABITAT FOR HUMANITY OF GREATER ORLANDO AREA INC
4116 SILVER STAR RD
ORLANDO,FL328084636
59-2789167 501(c)(3) 12,500       General Support
(51) HEALTH CARE CENTER FOR THE HOMELESS INC
232 N ORANGE BLOSSOM TRL
ORLANDO,FL32805
59-3185020 501(c)(3) 100,000       General Support
(52) HEALTHY START COALITION OF ORANGE COUNTY INC
600 COURTLAND ST STE 565
ORLANDO,FL32804
59-3125675 501(c)(3) 68,500       General Support
(53) HEALTHY START COALITION OF OSCEOLA COUNTY INC
PO BOX 701995
ST CLOUD,FL34770
59-3212535 501(c)(3) 15,000       General Support
(54) HEART OF FLORIDA UNITED WAY INC
1940 TRAYLOR BLVD
ORLANDO,FL32804
59-0808854 501(c)(3) 15,000       General Support
(55) Heartland Triathlon of Highlands County Inc
1200 Highlands Drive
Lake Placid,FL33852
45-2232127 501(c)(3) 13,000       General Support
(56) HISPANIC BUSINESS INITIATIVE FUND OF FLORIDA INC
3201 E COLONIAL DR UNIT A20
ORLANDO,FL32803
59-3341405 501(c)(3) 36,125       General Support
(57) HISPANIC CHAMBER OF COMMERCE METRO ORLANDO INC
3201 E COLONIAL DRIVE
ORLANDO,FL32803
59-3103840 501(c)(6) 14,500       General Support
(58) HOPE NOW INTERNATIONAL INC
PO BOX 181173
CASSELBERRY,FL327181173
27-4498303 501(c)(3) 10,000       General Support
(59) IVANHOE VILLAGE INC
1605 ALDEN RD
ORLANDO,FL328031861
26-1797406 501(c)(3) 7,000       General Support
(60) JEWISH COMMUNITY CENTER OF GREATER ORLANDO INC
851 N MAITLAND AVENUE
MAITLAND,FL32751
23-7448234 501(c)(3) 6,300       General Support
(61) JOBS PARTNERSHIP OF FLORIDA INC
4900 MILLENIA BLVD STE B
ORLANDO,FL32839
59-3612893 501(c)(3) 50,000       General Support
(62) JUNIOR ACHIEVEMENT OF CENTRAL FLORIDA INC
PO BOX 917197
ORLANDO,FL32891
59-0972112 501(c)(3) 135,000       General Support
(63) KIDS BEATING CANCER INC
615 E PRINCETON ST STE 400
ORLANDO,FL32803
59-3136203 501(c)(3) 7,500       General Support
(64) KINGDOM HARVEST INC DBA COMMUNITY FOOD & OUTREACH
150 W MICHIGAN STREET
ORLANDO,FL32806
11-3697936 501(c)(3) 10,000       General Support
(65) KISSIMMEE OSCEOLA COUNTY CHAMBER OF COMMERCE
1425 E VINE STREET
KISSIMMEE,FL34741
59-0319865 501(c)(6) 12,500       General Support
(66) La Grange Memorial Hospital Foundation
5101 South Willow Springs Road
La Grange,IL60525
30-0247776 501(c)(3) 0 263,313 Book Provision of general administrative support General Support
(67) LAKE NONA INSTITUTE INC
9801 LAKE NONA RD
ORLANDO,FL32827
27-3346737 501(c)(3) 25,000       General Support
(68) LAKESIDE BEHAVIORAL HEALTHCARE INC
1800 MERCY DRIVE STE 302
ORLANDO,FL32808
59-2301233 501(c)(3) 1,089,342       General Support
(69) LEADERSHIP SEMINOLE
1055 AAA DR STE 153
LAKE MARY,FL32746
59-3257486 501(c)(3) 5,500       General Support
(70) LIFEWORK LEADERSHIP
1220 E CONCORD ST
ORLANDO,FL328035453
37-1592618 501(c)(3) 10,000       General Support
(71) LIFT ORLANDO INC
215 EAST CENTRAL BLVD
ORLANDO,FL32801
46-3607865 501(c)(3) 100,000       General Support
(72) MARCH OF DIMES FOUNDATION
341 N MAITLAND AVE STE 115
MAITLAND,FL32751
13-1846366 501(c)(3) 13,000       General Support
(73) MATTHEWS HOPE MINISTRIES INC
1460 DANIELS RD
WINTER GARDEN,FL34787
27-2245867 501(c)(3) 8,000       General Support
(74) MENTAL HEALTH ASSOCIATION OF CENTRAL FLORIDA INC
1525 E ROBINSON ST
ORLANDO,FL32801
59-0816432 501(c)(3) 22,481       General Support
(75) NAMI GREATER ORLANDO INC
237 FERNWOOD BLVD
FERN PARK,FL32730
59-2600149 501(c)(3) 10,000       General Support
(76) NATIONAL KIDNEY FOUNDATION OF FLORIDA INC
1040 WOODCOCK RD STE 119
ORLANDO,FL32803
59-2190073 501(c)(3) 8,000       General Support
(77) NATIONAL PARKINSON FOUNDATION - CENTRAL FLORIDA CHAPTER INC
PO BOX 337
WINTER PARK,FL32790
45-5464483 501(c)(3) 10,000       General Support
(78) OAKWOOD UNIVERSITY
7000 ADVENTIST BLVD NW
HUNTSVILLE,AL35896
63-0366652 501(c)(3) 11,600       General Support
(79) ORLANDO JUNIOR ACADEMY
30 E EVANS STREET
ORLANDO,FL32804
26-2325009 501(c)(3) 50,000       General Support
(80) PRIMARY CARE ACCESS NETWORK INC
101 S WESTMORELAND DR
ORLANDO,FL328052258
46-1817605 501(c)(3) 26,000       General Support
(81) PROFESSIONALS RESOURCE NETWORK INC
PO BOX 16510
FERNANDINA BEACH,FL32035
86-1171352 501(c)(3) 10,000       General Support
(82) RONALD MCDONALD HOUSE CHARITIES OF CENTRAL FLORIDA INC
1030 N ORANGE AV
WINTER PARK,FL327894709
59-3211250 501(c)(3) 20,000       General Support
(83) RUNWAY TO HOPE INC
189 S ORANGE AVE
ORLANDO,FL328013261
27-3272616 501(c)(3) 6,250       General Support
(84) Samaritan Touch Care Center Inc
3015 Herring Avenue
Sebring,FL33870
02-0773338 501(c)(3) 250,000       Medical Care
(85) San Marcos Sights & Sounds of Christmas Inc
630 E Hopkins
San Marcos,TX78666
74-2759206 501(c)(3) 12,000       General Support
(86) SECOND HARVEST FOOD BANK OF CENTRAL FLORIDA
411 MERCY DRIVE
ORLANDO,FL32805
59-2142315 501(c)(3) 15,000       General Support
(87) SHEPHERDS HOPE INC
4851 S APOPKA VINELAND RD
ORLANDO,FL328193128
59-3420727 501(c)(3) 20,000       General Support
(88) South Florida State College
600 W College Drive
Avon Park,FL33825
59-1218159 Gov't 14,083       General Support
(89) SOUTHERN ADVENTIST UNIVERSITY
PO BOX 370
COLLEGEDALE,TN37315
62-0536733 501(c)(3) 400,000       General Support
(90) STRENGTHEN ORLANDO INC
400 SOUTH ORANGE AVE 6TH FLOOR
ORLANDO,FL328013360
27-1964941 501(c)(3) 15,000       General Support
(91) SUNBELT HEALTH & REHAB CENTER - APOPKA INC
305 EAST OAK ST
APOPKA,FL32703
20-5774856 501(c)(3) 310,302       General Support
(92) Sunsystem Development Corporation
900 Hope Way
Altamonte Springs,FL32714
59-2219301 501(c)(3) 14,000 4,606,282 Book Provision of general administrative support General Support
(93) SUSAN G KOMEN BREAST CANCER FOUNDATION
1350 ORANGE AVE STE 260
WINTER PARK,FL32789
75-2854957 501(c)(3) 10,000       General Support
(94) The School Board of Highlands County
426 School Street
Sebring,FL33870
56-6000654 Gov't 11,000       Senior Education
(95) UNITED GLOBAL OUTREACH INC
2301 N ORANGE AVE
ORLANDO,FL328045510
03-0511875 501(c)(3) 100,000       General Support
(96) United Way of Central Florida Inc
PO Box 1357
Highland City,FL33846
59-2116280 501(c)(3) 11,000       General Support
(97) UNIVERSAL ORLANDO FOUNDATION INC
1000 UNIVERSAL STUDIOS PLAZA
ORLANDO,FL32819
59-3510383 501(c)(3) 15,000       General Support
(98) UNIVERSITY OF CENTRAL FLORIDA FOUNDATION INC
12424 RESEARCH PARKWAY STE 140
ORLANDO,FL32826
59-6211832 501(c)(3) 36,000       General Support
(99) US DREAM ACADEMY INC
5950 SYMPHONY WOODS RD
COLUMBIA,MD21044
59-3514841 501(c)(3) 10,000       General Support
(100) WINTER PARK HEALTH FOUNDATION INC
220 EDINBURGH DR
WINTER PARK,FL32792
59-0669460 501(c)(3) 197,217       General Support
(101) WOMEN'S AND GIRL'S CANCER ALLIANCE
1855 W STATE RD 434 282
LONGWOOD,FL32750
06-1639604 501(c)(3) 10,080       General Support
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
92
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
10
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2014

Schedule I (Form 990) 2014
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. 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
Part I, Line 2: Grants are generally made to related organizations that are exempt from Federal Income Tax under 501(c)(3), other 501(c)(3) organizations that are a part of the group exemption ruling issued to the General Conference of Seventh-Day Adventists, or to other local or local affiliate of national charitable organizations whose purposes are healthcare-related. Accordingly, the filing organization has not established specific procedures for monitoring the use of grant funds in the United States as the filing organization does not have a grant making program that would necessitate such procedures.
Schedule I (Form 990) 2014


Additional Data


Software ID:  
Software Version:  


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 Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number

59-1479658
Part I
Questions Regarding Compensation
Yes
No
1a
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.
b
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....
1b
Yes
 
2
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? ..
2
Yes
 
3
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.
4
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:
a
Receive a severance payment or change-of-control payment? ................
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
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:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
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:
a
The organization? ...........................
6a
Yes
 
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
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 ............
7
 
No
8
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 .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
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 in column(B) reported as deferred in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1Houmann Lars DDirector (i)
(ii)
0
...............................
937,569
0
...............................
320,728
0
...............................
281,636
0
...............................
204,363
0
...............................
31,036
0
...............................
1,775,332
0
...............................
175,971
2Jernigan PhD Donald LDirector/CEO (i)
(ii)
0
...............................
1,020,757
0
...............................
347,331
0
...............................
280,923
0
...............................
14,105
0
...............................
390,497
0
...............................
2,053,613
0
...............................
0
3Reiner Richard KDirector/Exec VP (i)
(ii)
0
...............................
939,818
0
...............................
320,728
0
...............................
369,370
0
...............................
14,105
0
...............................
120,263
0
...............................
1,764,284
0
...............................
0
4Shaw Terry DDirector/Exec VP/CFO/COO (i)
(ii)
0
...............................
936,467
0
...............................
320,728
0
...............................
249,120
0
...............................
204,363
0
...............................
53,247
0
...............................
1,763,925
0
...............................
175,971
5Banks David PExec VP - FH (i)
(ii)
0
...............................
522,956
0
...............................
145,817
0
...............................
109,701
0
...............................
86,312
0
...............................
46,108
0
...............................
910,894
0
...............................
76,910
6Dodds Sheryl DSenior VP - FH (i)
(ii)
0
...............................
347,491
0
...............................
83,312
0
...............................
65,136
0
...............................
48,323
0
...............................
22,719
0
...............................
566,981
0
...............................
30,090
7Fulbright Robert DExec VP - FH (i)
(ii)
0
...............................
456,140
0
...............................
96,838
0
...............................
70,718
0
...............................
76,841
0
...............................
50,416
0
...............................
750,953
0
...............................
45,538
8Goodman Todd ASenior VP - FH (i)
(ii)
0
...............................
342,896
0
...............................
83,025
0
...............................
71,523
0
...............................
37,914
0
...............................
38,112
0
...............................
573,470
0
...............................
33,323
9Hilliard Douglas WSenior VP - FH (i)
(ii)
0
...............................
345,982
0
...............................
83,763
0
...............................
53,055
0
...............................
52,766
0
...............................
45,093
0
...............................
580,659
0
...............................
30,699
10Hurst Jeffery DSenior VP - FH (i)
(ii)
0
...............................
322,780
0
...............................
77,771
0
...............................
61,250
0
...............................
35,716
0
...............................
33,273
0
...............................
530,790
0
...............................
18,671
11Moorhead MD John DavidSenior VP - FH (i)
(ii)
0
...............................
497,852
0
...............................
119,546
0
...............................
116,185
0
...............................
8,905
0
...............................
53,427
0
...............................
795,915
0
...............................
67,019
12Owen Terry RSenior VP - FH (i)
(ii)
0
...............................
417,593
0
...............................
120,667
0
...............................
88,516
0
...............................
59,604
0
...............................
32,988
0
...............................
719,368
0
...............................
38,638
13Paradis J BrianCEO Division - FH (i)
(ii)
0
...............................
646,256
0
...............................
221,477
0
...............................
1,079,392
0
...............................
115,560
0
...............................
48,747
0
...............................
2,111,432
0
...............................
115,232
14Reed MD Monica PSenior VP - FH (i)
(ii)
0
...............................
367,752
0
...............................
135,519
0
...............................
297,519
0
...............................
86,743
0
...............................
46,668
0
...............................
934,201
0
...............................
64,397
15Soler EddieCFO Divison - FH (i)
(ii)
0
...............................
569,242
0
...............................
191,731
0
...............................
209,084
0
...............................
115,434
0
...............................
37,771
0
...............................
1,123,262
0
...............................
92,874
16Bittner MDHartmuthMedical Director (i)
(ii)
1,155,003
...............................
0
0
...............................
0
616
...............................
0
8,905
...............................
0
18,017
...............................
0
1,182,541
...............................
0
0
...............................
0
17Lee MDKathyPhysician (i)
(ii)
393,504
...............................
0
379,353
...............................
0
12,389
...............................
0
14,105
...............................
0
14,570
...............................
0
813,921
...............................
0
0
...............................
0
18Jones MDPhillip EPhysician (i)
(ii)
592,074
...............................
0
162,500
...............................
0
9,750
...............................
0
14,105
...............................
0
22,592
...............................
0
801,021
...............................
0
0
...............................
0
19Eubanks Jr MDWilliam StephenExecutive Director of Academic Surge (i)
(ii)
621,121
...............................
0
106,728
...............................
0
25,528
...............................
0
0
...............................
0
19,077
...............................
0
772,454
...............................
0
0
...............................
0
20Wittum MDRoger LPhysician (i)
(ii)
594,998
...............................
0
59,625
...............................
0
35,806
...............................
0
14,105
...............................
0
15,456
...............................
0
719,990
...............................
0
0
...............................
0
21Hamilton Connie AFormer key employee (i)
(ii)
0
...............................
0
0
...............................
0
0
...............................
146,011
0
...............................
7,177
0
...............................
752
0
...............................
153,940
0
...............................
0
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
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
Part I, Line 1a The filing organization is a part of the system of healthcare organizations known as Adventist Health System (AHS). Members of the filing organization's executive management team that hold the position of Vice-President or above are compensated by and on the payroll of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the parent organization of AHS. AHSSHC is exempt from federal income tax under IRC Section 501(c)(3). The filing organization reimburses AHSSHC for the salary and benefit cost of those executives on the payroll of AHSSHC that provide services and are on the management team of the filing organization. First-class or charter travel: Pursuant to the AHS system-wide general policy regarding business travel, no reimbursement will be provided for any additional cost incurred with respect to first-class travel or charter air travel beyond the cost of a regular coach airfare. During the current year, one board member was provided first class travel to a single business meeting. The allowance of first class travel for this individual was approved in advance and authorized via the proper approval process. Travel for companions: AHSSHC has a Corporate Executive Policy that provides a benefit to allow for a traveling AHSSHC executive to have his or her spouse accompany the executive on certain business trips each year. Typically, reimbursement is only provided to Vice Presidents and above and is usually limited to one business trip per year beyond the annual AHS President's Council business meeting and other meetings where the spouse is specifically invited. However, the benefit may also be extended to board members for AHS sponsored business meetings where the spouse is specifically invited. The AHSSHC Corporate Executive Spousal Travel Policy was originally approved and reviewed by the AHSSHC Board Compensation Committee, an independent body of the AHSSHC Board of Directors. All spousal travel costs reimbursed to the executive or board member are considered taxable compensation. Tax Indemnification and gross-up payments: AHS has a system-wide policy addressing gross-up payments provided in connection with employer-provided benefits/other taxable items. Under the policy, certain taxable business-related reimbursements (i.e. taxable business-related moving expenses, taxable items provided in connection with employment) provided to any employee may be grossed-up at a 25% rate upon approval of the filing organization's CEO and CFO. Additionally, employees at the Director level and above are eligible for gross-up payments on gifts received for board of director services. Discretionary spending account: A nominal discretionary spending amount was provided in the current year to all eligible executives who attend the annual AHS President's Council business meeting ($500 per executive) or the annual AHS CFO Conference or CMO/CNO business meeting ($300 per executive). Other discretionary spending accounts may be provided in connection with other AHS sponsored conferences to the executives and board members but typically do not exceed $200 per participant. With respect to the AHS President's Council meeting, eligible executives may include AHSSHC Vice Presidents and above and all AHSSHC subsidiary organization CEOs and Regional CFOs. The payment provided to each executive or board member was considered taxable compensation. Health or social club dues or initiation fees: AHSSHC has a Corporate Executive Policy that addresses business development expenditures. Under this policy, certain AHS eligible executives may be reimbursed for member dues and usage charges for a country club or other social club upon authorization. Club memberships must be recommended by the CEO of the AHS hospital organization and approved by the Chairman of the Board of Directors of the organization. In addition, the proposed membership must be approved annually by the AHSSHC Board Compensation Committee, an independent committee of the Board of Directors of AHSSHC. Eligible executives are limited to certain senior level executives (hospital organization CEOs, the CEO of the nursing home division of AHS, senior vice presidents at three large hospital organizations, regional CEOs and CFOs and the president and senior vice presidents of AHSSHC). In the current year, for this filing organization, four executives were eligible to receive reimbursement for club fees. Each AHS executive who is approved for a club membership must submit an annual report to the AHSSHC Board Compensation Committee that describes how the membership benefited their organization during the preceding year.
Part I, Line 3 The individual who serves as the CEO of the filing organization is compensated by Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) for that individual's role in serving as the CEO. Compensation and benefits provided to this individual are determined pursuant to policies, procedures, and processes of AHSSHC that are designed to ensure compliance with the intermediate sanctions laws as set forth in IRC Section 4958. AHSSHC has taken steps to ensure that processes are in place to satisfy the rebuttable presumption of reasonableness standard as set forth in Treasury Regulation 53.4958-6 with respect to its active executive-level positions. The AHSSHC Board Compensation Committee (the Committee) serves as the governing body for all executive compensation matters. The Committee is composed of certain members of the Board of Directors (the Board) of AHSSHC. Voting members of the Committee include only individuals who serve on the Board as independent representatives of the community, who hold no employment positions with AHSSHC and who do not have relationships with any of the individuals whose compensation is under their review that impacts their best independent judgment as fiduciaries of AHSSHC. The Committee's role is to review and approve all components of the executive compensation plan of AHSSHC. As an independent governing body with respect to executive compensation, it should be noted that the Committee will often confer in executive sessions on matters of compensation policy and policy changes. In such executive sessions, no members of management of AHSSHC are present. The Committee is advised by an independent third party compensation advisor. This advisor prepares all the benchmark studies for the Committee. Compensation levels are benchmarked with a national peer group of other not-for-profit healthcare systems and hospitals of similar size and complexity to AHS and each of its affiliated entities. The following principles guide the establishment of individual executive compensation: - The salary of the President/CEO of AHS will not exceed the 40th percentile of comparable salaries paid by similarly situated organizations; and - Other executive salaries shall be established using market medians. The compensation philosophy, policies, and practices of AHSSHC are consistent with the organization's faith-based mission and conform to applicable laws, regulations, and business practices. As a faith-based organization sponsored by the Seventh-day Adventist Church (the Church), AHSSHC's philosophy and principles with respect to its executive compensation practices reflect the conservative approach of the Church's mission of service and were developed in counsel with the Church's leadership.
Part I, Lines 4a-b During the year ending December 31, 2014, Connie A. Hamilton received severance payments in the amount of $144,100. Pursuant to the AHSSHC Corporate Executive Policy governing executive severance, severance agreements for executives operating at the Vice President level and above are entered into upon eligibility to facilitate the transition to subsequent employment following an involuntary separation from employment with AHS. Executives on the filing organization's management team that hold the position of Vice-President or above are compensated by and on the payroll of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the parent organization of a healthcare system known as Adventist Health System (AHS). In recognition of the contribution that each executive makes to the success of AHS, AHS provides to eligible executives participation in the AHS Executive FLEX Benefit Program (the Plan). The purpose of the Plan is to offer eligible executives an opportunity to elect from among a variety of supplemental benefits, including deferred compensation benefits taxable under Internal Revenue Code (IRC) Section 457(f), to individually tailor a benefits program appropriate to each executive's needs. The Plan provides eligible participants a pre-determined benefits allowance credit that is equal to a percentage of the executive's base pay from which is deducted the cost of mandatory and elective employee benefits. The pre-determined benefits allowance credit percentage is approved by the AHSSHC Board Compensation Committee, an independent committee of the Board of Directors of AHSSHC. Any funds that remain after the cost of mandatory and elective benefits are subtracted from the annual pre-determined benefits allowance are contributed, at the employee's option, to either an IRC 457(f) deferred compensation account or to an IRC 457(b) eligible deferred compensation plan. Upon attainment of age 65, all previous 457(f) deferred amounts are paid immediately to the participant and any future employer contributions are made quarterly from the Plan directly to the participant. The Plan documents define an employee who is eligible to participate in the Plan to generally include the Chief Executive Officers of AHS entities and Vice Presidents of all AHS entities whose base salary is at least $224,000. The Plan provides for a class year vesting schedule (2 years for each class year) with respect to amounts accumulated in the executive's 457(f) deferred compensation account. Distributions could also be made from the executive's 457(f) deferred compensation account upon attainment of age 65 or upon an involuntary separation. The account is forfeited by the executive upon a voluntary separation. In addition to the Plan, AHS has instituted a defined benefit, non-tax-qualified deferred compensation plan for certain executives who have provided lengthy service to AHS and/or to other Seventh-Day Adventist Church hospitals or health care institutions. Participation in the plan is offered to AHS executives on a prorata schedule beginning with 20 years of service as an employee of AHS and/or another hospital or health care institution controlled by the Seventh-Day Adventist Church and who satisfy certain other qualifying criteria. This supplemental executive retirement plan (SERP) was designed to provide eligible executives with the economic equivalent of an annual income beginning at normal retirement age equal to 60% of the average of the participant's three, five or seven highest years of base salary from AHS active employment inclusive of income from all other Seventh-Day Adventist Church healthcare employer-financed retirement income sources and investment income earned on those contributions through social security normal retirement age as defined in the plan. The number of years included in highest average compensation is determined by the individual's year of entry to the SERP and by the individual's year of entry to the AHS Executive FLEX Benefit Program. Flex Plan Flex Plan/ SERP 457(b) CY CY Employer CY Contrib./ Distributions Contrib. Distributions* Payment ------------------------------------------------------- Houmann, Lars D. $ 190,258 $ 207,319 $36,491 $ 0 Jernigan, Ph.D., Donald L. $ 217,482 $ 199,982 $ 0 $ 0 Reiner, Richard K. $ 197,083 $ 179,583 $122,669 $ 0 Shaw, Terry D. $ 190,258 $ 176,733 $ 45,027 $ 0 Banks, David P. $ 86,312 $ 76,937 $ 0 $ 0 Dodds, Sheryl D. $ 51,718 $ 30,098 $ 0 $ 0 Fulbright, Robert D. $ 62,736 $ 45,553 $ 0 $ 0 Goodman, Todd A. $ 41,309 $ 41,539 $ 0 $ 0 Hilliard, Douglas W. $ 38,661 $ 30,709 $ 0 $ 0 Hurst, Jeffery D. $ 39,111 $ 23,719 $ 0 $ 0 Moorhead, MD, John David $ 91,486 $ 73,986 $ 0 $ 0 Owen, Terry R. $ 62,999 $ 52,700 $ 0 $ 0 Paradis, J. Brian $ 118,955 $ 115,272 $921,630 $ 0 Reed, MD, Monica P.$ 72,638 $ 64,419 $112,456 $ 0 Soler, Eddie $ 101,329 $ 126,261 $ 61,129 $ 0 * Including Investment Earnings
Part I, Line 6 The filing organization's physician compensation formula is designed to result in total compensation that would be reasonable for each physician. The filing organization utilizes national survey productivity, cost, and compensation data in formulating all aspects of the compensation plan. Physician compensation contractual agreements include a ceiling or reasonable maximum on the amount a physician may earn. The filing organization's employed physicians enter into a written agreement that requires the physicians to provide medical care to individuals who are referred by the filing organization. The filing organization's compensation arrangement does not use a method of compensation that is based upon a percentage of the organization's net income. Under the compensation arrangement, physician base salary, including any additional compensation based on a percentage of the practice/location net revenue, is documented as being within a range of Fair Market Value.
Schedule J (Form 990) 2014

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990.

SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number
59-1479658
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A Highlands County Health Facilities Authority
 
52-1313569 431022HUD 06-14-2006 205,156,000 2006C, Expand/refurbish facilities, purchase equipment   X   X   X
B Colorado Health Facilities Authority
 
84-0752932 19648AAV7 11-15-2006 249,501,424 2006D&E, Refnd Highland, Tarrant 98 iss 12/17/98, Highland iss 03D 10/7/03   X   X   X
C Colorado Health Facilities Authority
 
84-0752932 19648ACG8 11-15-2006 30,371,450 2006F, Refund 1995 Bonds issued 6/8/1995   X   X   X
D Highlands County Health Facilities Authority
 
52-1313569 431022JZ6 12-20-2006 212,464,496 2006G, Refund Highlands 2002 issued 12/19/02 and Orange 2002 issued 7/10/02   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022KK7 08-08-2007 366,445,000 2007A B C D, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022QZ8 12-16-2008 68,000,000 2008A, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542ABX8 07-08-2009 325,394,417 2009C, Ref 96/05&97/05 iss 1/13/05, 03A 1/16/03, 08B 12/19/08, exp facility   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542ACY5 10-01-2009 102,271,154 2009D, Refund Highlands 07C, 8/8/07 & expand/refurbish facilities/purc equip   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022SP8 11-16-2009 190,752,502 09E & 08B Conv, Ref Orange 91/01 10/11/01, 92/03 5/15/03, 08B 12/19/08   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022SG8 11-16-2009 177,240,000 2005I Conv, Refund Highlands 05I 12/22/05 & expand/refurbish facilities   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   12-17-2010 57,000,000 2010A, Expand/refurbish facilities, purchase equipment   X   X   X
Orange County Health Facilities Authority
 
52-1378595   12-22-2010 25,000,000 2010B, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589   12-22-2010 25,000,000 2010C, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932   12-22-2010 25,000,000 2010D, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   12-30-2010 225,000,000 2010E, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   11-16-2011 80,000,000 2011A, Expand/refurbish facilities   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   03-21-2012 294,985,000 2012A, AR Program - Refund 2009 A-F AR Program   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   07-25-2012 115,015,000 2012B, AR Program - Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542ADG3 08-29-2012 310,952,245 2012A - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022TL6 08-29-2012 348,320,000 2012B-F - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   08-29-2012 125,000,000 2012G&H - Refund Highlands 2005I Conversion Bonds   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022TR3 11-08-2012 232,125,000 2012I - Refunded Volusia 1994-A; Highlands 2004A, 2005E, 2005F, 2005G   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   09-18-2013 485,000,000 2013A B C, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   07-02-2014 110,000,000 2014A&D, Refund 2013C, expand/refurbish facilities, purchase equipment   X   X   X
Orange County Health Facilities Authority
 
52-1378595   07-02-2014 50,000,000 2014B, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589   07-02-2014 30,000,000 2014C, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648AT39 07-23-2014 82,501,800 2014E, Expand/refurbish facilities, purchase equipment   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 27,725,000 28,575,000 3,495,000 28,155,000
2 Amount of bonds legally defeased . . . . . . . . . . . 4,900,000 8,105,000 19,265,000 7,320,000
3 Total proceeds of issue . . . . . . . . . . . . . . 205,156,000 249,501,424 30,371,450 212,464,496
4 Gross proceeds in reserve funds . . . . . . . . . . . .        
5 Capitalized interest from proceeds . . . . . . . . . . .        
6 Proceeds in refunding escrows . . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . . . 2,000,000 2,492,891 306,707 1,856,375
8 Credit enhancement from proceeds . . . . . . . . . . . 5,560,382      
9 Working capital expenditures from proceeds . . . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . . 203,156,000 68,000,000 12,004,967 21,844,721
11 Other spent proceeds . . . . . . . . . . . . . . 247,008,533 247,008,533 30,064,743 210,608,121
12 Other unspent proceeds . . . . . . . . . . . . . . 20,049,236 25,863,825 20,049,236 43,106,374
13 Year of substantial completion . . . . . . . . . . . . 2006 2003 1995 2002
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . .   X   X X     X
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X X     X X  
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X   X     X X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . . X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . . X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0.350 % 0.200 % 0.540 % 0.300 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0.100 %      
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0.450 % 0.200 % 0.540 % 0.300 %
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. 0.140 % 0.140 % 0.370 % 0.370 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . .
X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .   X   X   X   X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X   X   X   X
b Exception to rebate? . . . . . . . . X   X   X   X  
c No rebate due? . . . . . . . .   X   X   X   X
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . .   X   X   X   X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider . . . . . . . . .  
 
 
 
 
 
 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was the hedge terminated? . . . . . .                
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X   X   X   X
b Name of provider . . . . . . . . .  
 
 
 
 
 
 
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
Part III, Line 8c Highlands County Health Facilities Authority 2012A, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c Highlands County Health Facilities Authority 2012B, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c Kansas Development Finance Authority 2012A: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014.
Part III, Line 8c Highlands County Health Facilities Authority 2012B-F: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2013A-C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014A&D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014B: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014E: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Schedule K (Form 990) 2014

Additional Data


Software ID:  
Software Version:  

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990.

SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number
59-1479658
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A Highlands County Health Facilities Authority
 
52-1313569 431022HUD 06-14-2006 205,156,000 2006C, Expand/refurbish facilities, purchase equipment   X   X   X
B Colorado Health Facilities Authority
 
84-0752932 19648AAV7 11-15-2006 249,501,424 2006D&E, Refnd Highland, Tarrant 98 iss 12/17/98, Highland iss 03D 10/7/03   X   X   X
C Colorado Health Facilities Authority
 
84-0752932 19648ACG8 11-15-2006 30,371,450 2006F, Refund 1995 Bonds issued 6/8/1995   X   X   X
D Highlands County Health Facilities Authority
 
52-1313569 431022JZ6 12-20-2006 212,464,496 2006G, Refund Highlands 2002 issued 12/19/02 and Orange 2002 issued 7/10/02   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022KK7 08-08-2007 366,445,000 2007A B C D, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022QZ8 12-16-2008 68,000,000 2008A, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542ABX8 07-08-2009 325,394,417 2009C, Ref 96/05&97/05 iss 1/13/05, 03A 1/16/03, 08B 12/19/08, exp facility   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542ACY5 10-01-2009 102,271,154 2009D, Refund Highlands 07C, 8/8/07 & expand/refurbish facilities/purc equip   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022SP8 11-16-2009 190,752,502 09E & 08B Conv, Ref Orange 91/01 10/11/01, 92/03 5/15/03, 08B 12/19/08   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022SG8 11-16-2009 177,240,000 2005I Conv, Refund Highlands 05I 12/22/05 & expand/refurbish facilities   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   12-17-2010 57,000,000 2010A, Expand/refurbish facilities, purchase equipment   X   X   X
Orange County Health Facilities Authority
 
52-1378595   12-22-2010 25,000,000 2010B, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589   12-22-2010 25,000,000 2010C, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932   12-22-2010 25,000,000 2010D, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   12-30-2010 225,000,000 2010E, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   11-16-2011 80,000,000 2011A, Expand/refurbish facilities   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   03-21-2012 294,985,000 2012A, AR Program - Refund 2009 A-F AR Program   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   07-25-2012 115,015,000 2012B, AR Program - Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542ADG3 08-29-2012 310,952,245 2012A - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022TL6 08-29-2012 348,320,000 2012B-F - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   08-29-2012 125,000,000 2012G&H - Refund Highlands 2005I Conversion Bonds   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022TR3 11-08-2012 232,125,000 2012I - Refunded Volusia 1994-A; Highlands 2004A, 2005E, 2005F, 2005G   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   09-18-2013 485,000,000 2013A B C, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   07-02-2014 110,000,000 2014A&D, Refund 2013C, expand/refurbish facilities, purchase equipment   X   X   X
Orange County Health Facilities Authority
 
52-1378595   07-02-2014 50,000,000 2014B, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589   07-02-2014 30,000,000 2014C, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648AT39 07-23-2014 82,501,800 2014E, Expand/refurbish facilities, purchase equipment   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 27,725,000 28,575,000 3,495,000 28,155,000
2 Amount of bonds legally defeased . . . . . . . . . . . 4,900,000 8,105,000 19,265,000 7,320,000
3 Total proceeds of issue . . . . . . . . . . . . . . 205,156,000 249,501,424 30,371,450 212,464,496
4 Gross proceeds in reserve funds . . . . . . . . . . . .        
5 Capitalized interest from proceeds . . . . . . . . . . .        
6 Proceeds in refunding escrows . . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . . . 2,000,000 2,492,891 306,707 1,856,375
8 Credit enhancement from proceeds . . . . . . . . . . . 5,560,382      
9 Working capital expenditures from proceeds . . . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . . 203,156,000 68,000,000 12,004,967 21,844,721
11 Other spent proceeds . . . . . . . . . . . . . . 247,008,533 247,008,533 30,064,743 210,608,121
12 Other unspent proceeds . . . . . . . . . . . . . . 20,049,236 25,863,825 20,049,236 43,106,374
13 Year of substantial completion . . . . . . . . . . . . 2006 2003 1995 2002
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . .   X   X X     X
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X X     X X  
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X   X     X X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . . X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . . X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0.350 % 0.200 % 0.540 % 0.300 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0.100 %      
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0.450 % 0.200 % 0.540 % 0.300 %
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. 0.140 % 0.140 % 0.370 % 0.370 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . .
X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .   X   X   X   X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X   X   X   X
b Exception to rebate? . . . . . . . . X   X   X   X  
c No rebate due? . . . . . . . .   X   X   X   X
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . .   X   X   X   X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider . . . . . . . . .  
 
 
 
 
 
 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was the hedge terminated? . . . . . .                
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X   X   X   X
b Name of provider . . . . . . . . .  
 
 
 
 
 
 
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
Part III, Line 8c Highlands County Health Facilities Authority 2012A, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c Highlands County Health Facilities Authority 2012B, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c Kansas Development Finance Authority 2012A: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014.
Part III, Line 8c Highlands County Health Facilities Authority 2012B-F: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2013A-C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014A&D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014B: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014E: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Schedule K (Form 990) 2014

Additional Data


Software ID:  
Software Version:  

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990.

SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number
59-1479658
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A Highlands County Health Facilities Authority
 
52-1313569 431022HUD 06-14-2006 205,156,000 2006C, Expand/refurbish facilities, purchase equipment   X   X   X
B Colorado Health Facilities Authority
 
84-0752932 19648AAV7 11-15-2006 249,501,424 2006D&E, Refnd Highland, Tarrant 98 iss 12/17/98, Highland iss 03D 10/7/03   X   X   X
C Colorado Health Facilities Authority
 
84-0752932 19648ACG8 11-15-2006 30,371,450 2006F, Refund 1995 Bonds issued 6/8/1995   X   X   X
D Highlands County Health Facilities Authority
 
52-1313569 431022JZ6 12-20-2006 212,464,496 2006G, Refund Highlands 2002 issued 12/19/02 and Orange 2002 issued 7/10/02   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022KK7 08-08-2007 366,445,000 2007A B C D, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022QZ8 12-16-2008 68,000,000 2008A, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542ABX8 07-08-2009 325,394,417 2009C, Ref 96/05&97/05 iss 1/13/05, 03A 1/16/03, 08B 12/19/08, exp facility   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542ACY5 10-01-2009 102,271,154 2009D, Refund Highlands 07C, 8/8/07 & expand/refurbish facilities/purc equip   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022SP8 11-16-2009 190,752,502 09E & 08B Conv, Ref Orange 91/01 10/11/01, 92/03 5/15/03, 08B 12/19/08   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022SG8 11-16-2009 177,240,000 2005I Conv, Refund Highlands 05I 12/22/05 & expand/refurbish facilities   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   12-17-2010 57,000,000 2010A, Expand/refurbish facilities, purchase equipment   X   X   X
Orange County Health Facilities Authority
 
52-1378595   12-22-2010 25,000,000 2010B, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589   12-22-2010 25,000,000 2010C, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932   12-22-2010 25,000,000 2010D, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   12-30-2010 225,000,000 2010E, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   11-16-2011 80,000,000 2011A, Expand/refurbish facilities   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   03-21-2012 294,985,000 2012A, AR Program - Refund 2009 A-F AR Program   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   07-25-2012 115,015,000 2012B, AR Program - Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542ADG3 08-29-2012 310,952,245 2012A - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022TL6 08-29-2012 348,320,000 2012B-F - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   08-29-2012 125,000,000 2012G&H - Refund Highlands 2005I Conversion Bonds   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022TR3 11-08-2012 232,125,000 2012I - Refunded Volusia 1994-A; Highlands 2004A, 2005E, 2005F, 2005G   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   09-18-2013 485,000,000 2013A B C, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   07-02-2014 110,000,000 2014A&D, Refund 2013C, expand/refurbish facilities, purchase equipment   X   X   X
Orange County Health Facilities Authority
 
52-1378595   07-02-2014 50,000,000 2014B, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589   07-02-2014 30,000,000 2014C, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648AT39 07-23-2014 82,501,800 2014E, Expand/refurbish facilities, purchase equipment   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 27,725,000 28,575,000 3,495,000 28,155,000
2 Amount of bonds legally defeased . . . . . . . . . . . 4,900,000 8,105,000 19,265,000 7,320,000
3 Total proceeds of issue . . . . . . . . . . . . . . 205,156,000 249,501,424 30,371,450 212,464,496
4 Gross proceeds in reserve funds . . . . . . . . . . . .        
5 Capitalized interest from proceeds . . . . . . . . . . .        
6 Proceeds in refunding escrows . . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . . . 2,000,000 2,492,891 306,707 1,856,375
8 Credit enhancement from proceeds . . . . . . . . . . . 5,560,382      
9 Working capital expenditures from proceeds . . . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . . 203,156,000 68,000,000 12,004,967 21,844,721
11 Other spent proceeds . . . . . . . . . . . . . . 247,008,533 247,008,533 30,064,743 210,608,121
12 Other unspent proceeds . . . . . . . . . . . . . . 20,049,236 25,863,825 20,049,236 43,106,374
13 Year of substantial completion . . . . . . . . . . . . 2006 2003 1995 2002
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . .   X   X X     X
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X X     X X  
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X   X     X X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . . X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . . X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0.350 % 0.200 % 0.540 % 0.300 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0.100 %      
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0.450 % 0.200 % 0.540 % 0.300 %
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. 0.140 % 0.140 % 0.370 % 0.370 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . .
X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .   X   X   X   X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X   X   X   X
b Exception to rebate? . . . . . . . . X   X   X   X  
c No rebate due? . . . . . . . .   X   X   X   X
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . .   X   X   X   X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider . . . . . . . . .  
 
 
 
 
 
 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was the hedge terminated? . . . . . .                
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X   X   X   X
b Name of provider . . . . . . . . .  
 
 
 
 
 
 
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
Part III, Line 8c Highlands County Health Facilities Authority 2012A, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c Highlands County Health Facilities Authority 2012B, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c Kansas Development Finance Authority 2012A: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014.
Part III, Line 8c Highlands County Health Facilities Authority 2012B-F: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2013A-C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014A&D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014B: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014E: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Schedule K (Form 990) 2014

Additional Data


Software ID:  
Software Version:  

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990.

SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number
59-1479658
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A Highlands County Health Facilities Authority
 
52-1313569 431022HUD 06-14-2006 205,156,000 2006C, Expand/refurbish facilities, purchase equipment   X   X   X
B Colorado Health Facilities Authority
 
84-0752932 19648AAV7 11-15-2006 249,501,424 2006D&E, Refnd Highland, Tarrant 98 iss 12/17/98, Highland iss 03D 10/7/03   X   X   X
C Colorado Health Facilities Authority
 
84-0752932 19648ACG8 11-15-2006 30,371,450 2006F, Refund 1995 Bonds issued 6/8/1995   X   X   X
D Highlands County Health Facilities Authority
 
52-1313569 431022JZ6 12-20-2006 212,464,496 2006G, Refund Highlands 2002 issued 12/19/02 and Orange 2002 issued 7/10/02   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022KK7 08-08-2007 366,445,000 2007A B C D, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022QZ8 12-16-2008 68,000,000 2008A, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542ABX8 07-08-2009 325,394,417 2009C, Ref 96/05&97/05 iss 1/13/05, 03A 1/16/03, 08B 12/19/08, exp facility   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542ACY5 10-01-2009 102,271,154 2009D, Refund Highlands 07C, 8/8/07 & expand/refurbish facilities/purc equip   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022SP8 11-16-2009 190,752,502 09E & 08B Conv, Ref Orange 91/01 10/11/01, 92/03 5/15/03, 08B 12/19/08   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022SG8 11-16-2009 177,240,000 2005I Conv, Refund Highlands 05I 12/22/05 & expand/refurbish facilities   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   12-17-2010 57,000,000 2010A, Expand/refurbish facilities, purchase equipment   X   X   X
Orange County Health Facilities Authority
 
52-1378595   12-22-2010 25,000,000 2010B, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589   12-22-2010 25,000,000 2010C, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932   12-22-2010 25,000,000 2010D, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   12-30-2010 225,000,000 2010E, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   11-16-2011 80,000,000 2011A, Expand/refurbish facilities   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   03-21-2012 294,985,000 2012A, AR Program - Refund 2009 A-F AR Program   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   07-25-2012 115,015,000 2012B, AR Program - Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542ADG3 08-29-2012 310,952,245 2012A - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022TL6 08-29-2012 348,320,000 2012B-F - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   08-29-2012 125,000,000 2012G&H - Refund Highlands 2005I Conversion Bonds   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022TR3 11-08-2012 232,125,000 2012I - Refunded Volusia 1994-A; Highlands 2004A, 2005E, 2005F, 2005G   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   09-18-2013 485,000,000 2013A B C, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   07-02-2014 110,000,000 2014A&D, Refund 2013C, expand/refurbish facilities, purchase equipment   X   X   X
Orange County Health Facilities Authority
 
52-1378595   07-02-2014 50,000,000 2014B, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589   07-02-2014 30,000,000 2014C, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648AT39 07-23-2014 82,501,800 2014E, Expand/refurbish facilities, purchase equipment   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 27,725,000 28,575,000 3,495,000 28,155,000
2 Amount of bonds legally defeased . . . . . . . . . . . 4,900,000 8,105,000 19,265,000 7,320,000
3 Total proceeds of issue . . . . . . . . . . . . . . 205,156,000 249,501,424 30,371,450 212,464,496
4 Gross proceeds in reserve funds . . . . . . . . . . . .        
5 Capitalized interest from proceeds . . . . . . . . . . .        
6 Proceeds in refunding escrows . . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . . . 2,000,000 2,492,891 306,707 1,856,375
8 Credit enhancement from proceeds . . . . . . . . . . . 5,560,382      
9 Working capital expenditures from proceeds . . . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . . 203,156,000 68,000,000 12,004,967 21,844,721
11 Other spent proceeds . . . . . . . . . . . . . . 247,008,533 247,008,533 30,064,743 210,608,121
12 Other unspent proceeds . . . . . . . . . . . . . . 20,049,236 25,863,825 20,049,236 43,106,374
13 Year of substantial completion . . . . . . . . . . . . 2006 2003 1995 2002
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . .   X   X X     X
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X X     X X  
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X   X     X X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . . X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . . X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0.350 % 0.200 % 0.540 % 0.300 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0.100 %      
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0.450 % 0.200 % 0.540 % 0.300 %
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. 0.140 % 0.140 % 0.370 % 0.370 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . .
X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .   X   X   X   X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X   X   X   X
b Exception to rebate? . . . . . . . . X   X   X   X  
c No rebate due? . . . . . . . .   X   X   X   X
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . .   X   X   X   X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider . . . . . . . . .  
 
 
 
 
 
 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was the hedge terminated? . . . . . .                
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X   X   X   X
b Name of provider . . . . . . . . .  
 
 
 
 
 
 
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
Part III, Line 8c Highlands County Health Facilities Authority 2012A, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c Highlands County Health Facilities Authority 2012B, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c Kansas Development Finance Authority 2012A: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014.
Part III, Line 8c Highlands County Health Facilities Authority 2012B-F: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2013A-C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014A&D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014B: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014E: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Schedule K (Form 990) 2014

Additional Data


Software ID:  
Software Version:  

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990.

SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number
59-1479658
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A Highlands County Health Facilities Authority
 
52-1313569 431022HUD 06-14-2006 205,156,000 2006C, Expand/refurbish facilities, purchase equipment   X   X   X
B Colorado Health Facilities Authority
 
84-0752932 19648AAV7 11-15-2006 249,501,424 2006D&E, Refnd Highland, Tarrant 98 iss 12/17/98, Highland iss 03D 10/7/03   X   X   X
C Colorado Health Facilities Authority
 
84-0752932 19648ACG8 11-15-2006 30,371,450 2006F, Refund 1995 Bonds issued 6/8/1995   X   X   X
D Highlands County Health Facilities Authority
 
52-1313569 431022JZ6 12-20-2006 212,464,496 2006G, Refund Highlands 2002 issued 12/19/02 and Orange 2002 issued 7/10/02   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022KK7 08-08-2007 366,445,000 2007A B C D, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022QZ8 12-16-2008 68,000,000 2008A, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542ABX8 07-08-2009 325,394,417 2009C, Ref 96/05&97/05 iss 1/13/05, 03A 1/16/03, 08B 12/19/08, exp facility   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542ACY5 10-01-2009 102,271,154 2009D, Refund Highlands 07C, 8/8/07 & expand/refurbish facilities/purc equip   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022SP8 11-16-2009 190,752,502 09E & 08B Conv, Ref Orange 91/01 10/11/01, 92/03 5/15/03, 08B 12/19/08   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022SG8 11-16-2009 177,240,000 2005I Conv, Refund Highlands 05I 12/22/05 & expand/refurbish facilities   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   12-17-2010 57,000,000 2010A, Expand/refurbish facilities, purchase equipment   X   X   X
Orange County Health Facilities Authority
 
52-1378595   12-22-2010 25,000,000 2010B, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589   12-22-2010 25,000,000 2010C, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932   12-22-2010 25,000,000 2010D, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   12-30-2010 225,000,000 2010E, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   11-16-2011 80,000,000 2011A, Expand/refurbish facilities   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   03-21-2012 294,985,000 2012A, AR Program - Refund 2009 A-F AR Program   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   07-25-2012 115,015,000 2012B, AR Program - Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542ADG3 08-29-2012 310,952,245 2012A - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022TL6 08-29-2012 348,320,000 2012B-F - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   08-29-2012 125,000,000 2012G&H - Refund Highlands 2005I Conversion Bonds   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022TR3 11-08-2012 232,125,000 2012I - Refunded Volusia 1994-A; Highlands 2004A, 2005E, 2005F, 2005G   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   09-18-2013 485,000,000 2013A B C, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   07-02-2014 110,000,000 2014A&D, Refund 2013C, expand/refurbish facilities, purchase equipment   X   X   X
Orange County Health Facilities Authority
 
52-1378595   07-02-2014 50,000,000 2014B, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589   07-02-2014 30,000,000 2014C, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648AT39 07-23-2014 82,501,800 2014E, Expand/refurbish facilities, purchase equipment   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 27,725,000 28,575,000 3,495,000 28,155,000
2 Amount of bonds legally defeased . . . . . . . . . . . 4,900,000 8,105,000 19,265,000 7,320,000
3 Total proceeds of issue . . . . . . . . . . . . . . 205,156,000 249,501,424 30,371,450 212,464,496
4 Gross proceeds in reserve funds . . . . . . . . . . . .        
5 Capitalized interest from proceeds . . . . . . . . . . .        
6 Proceeds in refunding escrows . . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . . . 2,000,000 2,492,891 306,707 1,856,375
8 Credit enhancement from proceeds . . . . . . . . . . . 5,560,382      
9 Working capital expenditures from proceeds . . . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . . 203,156,000 68,000,000 12,004,967 21,844,721
11 Other spent proceeds . . . . . . . . . . . . . . 247,008,533 247,008,533 30,064,743 210,608,121
12 Other unspent proceeds . . . . . . . . . . . . . . 20,049,236 25,863,825 20,049,236 43,106,374
13 Year of substantial completion . . . . . . . . . . . . 2006 2003 1995 2002
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . .   X   X X     X
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X X     X X  
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X   X     X X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . . X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . . X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0.350 % 0.200 % 0.540 % 0.300 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0.100 %      
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0.450 % 0.200 % 0.540 % 0.300 %
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. 0.140 % 0.140 % 0.370 % 0.370 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . .
X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .   X   X   X   X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X   X   X   X
b Exception to rebate? . . . . . . . . X   X   X   X  
c No rebate due? . . . . . . . .   X   X   X   X
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . .   X   X   X   X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider . . . . . . . . .  
 
 
 
 
 
 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was the hedge terminated? . . . . . .                
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X   X   X   X
b Name of provider . . . . . . . . .  
 
 
 
 
 
 
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
Part III, Line 8c Highlands County Health Facilities Authority 2012A, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c Highlands County Health Facilities Authority 2012B, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c Kansas Development Finance Authority 2012A: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014.
Part III, Line 8c Highlands County Health Facilities Authority 2012B-F: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2013A-C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014A&D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014B: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014E: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Schedule K (Form 990) 2014

Additional Data


Software ID:  
Software Version:  

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990.

SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number
59-1479658
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A Highlands County Health Facilities Authority
 
52-1313569 431022HUD 06-14-2006 205,156,000 2006C, Expand/refurbish facilities, purchase equipment   X   X   X
B Colorado Health Facilities Authority
 
84-0752932 19648AAV7 11-15-2006 249,501,424 2006D&E, Refnd Highland, Tarrant 98 iss 12/17/98, Highland iss 03D 10/7/03   X   X   X
C Colorado Health Facilities Authority
 
84-0752932 19648ACG8 11-15-2006 30,371,450 2006F, Refund 1995 Bonds issued 6/8/1995   X   X   X
D Highlands County Health Facilities Authority
 
52-1313569 431022JZ6 12-20-2006 212,464,496 2006G, Refund Highlands 2002 issued 12/19/02 and Orange 2002 issued 7/10/02   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022KK7 08-08-2007 366,445,000 2007A B C D, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022QZ8 12-16-2008 68,000,000 2008A, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542ABX8 07-08-2009 325,394,417 2009C, Ref 96/05&97/05 iss 1/13/05, 03A 1/16/03, 08B 12/19/08, exp facility   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542ACY5 10-01-2009 102,271,154 2009D, Refund Highlands 07C, 8/8/07 & expand/refurbish facilities/purc equip   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022SP8 11-16-2009 190,752,502 09E & 08B Conv, Ref Orange 91/01 10/11/01, 92/03 5/15/03, 08B 12/19/08   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022SG8 11-16-2009 177,240,000 2005I Conv, Refund Highlands 05I 12/22/05 & expand/refurbish facilities   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   12-17-2010 57,000,000 2010A, Expand/refurbish facilities, purchase equipment   X   X   X
Orange County Health Facilities Authority
 
52-1378595   12-22-2010 25,000,000 2010B, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589   12-22-2010 25,000,000 2010C, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932   12-22-2010 25,000,000 2010D, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   12-30-2010 225,000,000 2010E, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   11-16-2011 80,000,000 2011A, Expand/refurbish facilities   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   03-21-2012 294,985,000 2012A, AR Program - Refund 2009 A-F AR Program   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   07-25-2012 115,015,000 2012B, AR Program - Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542ADG3 08-29-2012 310,952,245 2012A - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022TL6 08-29-2012 348,320,000 2012B-F - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   08-29-2012 125,000,000 2012G&H - Refund Highlands 2005I Conversion Bonds   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022TR3 11-08-2012 232,125,000 2012I - Refunded Volusia 1994-A; Highlands 2004A, 2005E, 2005F, 2005G   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   09-18-2013 485,000,000 2013A B C, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   07-02-2014 110,000,000 2014A&D, Refund 2013C, expand/refurbish facilities, purchase equipment   X   X   X
Orange County Health Facilities Authority
 
52-1378595   07-02-2014 50,000,000 2014B, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589   07-02-2014 30,000,000 2014C, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648AT39 07-23-2014 82,501,800 2014E, Expand/refurbish facilities, purchase equipment   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 27,725,000 28,575,000 3,495,000 28,155,000
2 Amount of bonds legally defeased . . . . . . . . . . . 4,900,000 8,105,000 19,265,000 7,320,000
3 Total proceeds of issue . . . . . . . . . . . . . . 205,156,000 249,501,424 30,371,450 212,464,496
4 Gross proceeds in reserve funds . . . . . . . . . . . .        
5 Capitalized interest from proceeds . . . . . . . . . . .        
6 Proceeds in refunding escrows . . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . . . 2,000,000 2,492,891 306,707 1,856,375
8 Credit enhancement from proceeds . . . . . . . . . . . 5,560,382      
9 Working capital expenditures from proceeds . . . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . . 203,156,000 68,000,000 12,004,967 21,844,721
11 Other spent proceeds . . . . . . . . . . . . . . 247,008,533 247,008,533 30,064,743 210,608,121
12 Other unspent proceeds . . . . . . . . . . . . . . 20,049,236 25,863,825 20,049,236 43,106,374
13 Year of substantial completion . . . . . . . . . . . . 2006 2003 1995 2002
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . .   X   X X     X
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X X     X X  
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X   X     X X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . . X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . . X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0.350 % 0.200 % 0.540 % 0.300 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0.100 %      
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0.450 % 0.200 % 0.540 % 0.300 %
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. 0.140 % 0.140 % 0.370 % 0.370 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . .
X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .   X   X   X   X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X   X   X   X
b Exception to rebate? . . . . . . . . X   X   X   X  
c No rebate due? . . . . . . . .   X   X   X   X
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . .   X   X   X   X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider . . . . . . . . .  
 
 
 
 
 
 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was the hedge terminated? . . . . . .                
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X   X   X   X
b Name of provider . . . . . . . . .  
 
 
 
 
 
 
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
Part III, Line 8c Highlands County Health Facilities Authority 2012A, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c Highlands County Health Facilities Authority 2012B, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c Kansas Development Finance Authority 2012A: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014.
Part III, Line 8c Highlands County Health Facilities Authority 2012B-F: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2013A-C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014A&D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014B: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014E: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Schedule K (Form 990) 2014

Additional Data


Software ID:  
Software Version:  

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990.

SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number
59-1479658
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A Highlands County Health Facilities Authority
 
52-1313569 431022HUD 06-14-2006 205,156,000 2006C, Expand/refurbish facilities, purchase equipment   X   X   X
B Colorado Health Facilities Authority
 
84-0752932 19648AAV7 11-15-2006 249,501,424 2006D&E, Refnd Highland, Tarrant 98 iss 12/17/98, Highland iss 03D 10/7/03   X   X   X
C Colorado Health Facilities Authority
 
84-0752932 19648ACG8 11-15-2006 30,371,450 2006F, Refund 1995 Bonds issued 6/8/1995   X   X   X
D Highlands County Health Facilities Authority
 
52-1313569 431022JZ6 12-20-2006 212,464,496 2006G, Refund Highlands 2002 issued 12/19/02 and Orange 2002 issued 7/10/02   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022KK7 08-08-2007 366,445,000 2007A B C D, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022QZ8 12-16-2008 68,000,000 2008A, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542ABX8 07-08-2009 325,394,417 2009C, Ref 96/05&97/05 iss 1/13/05, 03A 1/16/03, 08B 12/19/08, exp facility   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542ACY5 10-01-2009 102,271,154 2009D, Refund Highlands 07C, 8/8/07 & expand/refurbish facilities/purc equip   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022SP8 11-16-2009 190,752,502 09E & 08B Conv, Ref Orange 91/01 10/11/01, 92/03 5/15/03, 08B 12/19/08   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022SG8 11-16-2009 177,240,000 2005I Conv, Refund Highlands 05I 12/22/05 & expand/refurbish facilities   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   12-17-2010 57,000,000 2010A, Expand/refurbish facilities, purchase equipment   X   X   X
Orange County Health Facilities Authority
 
52-1378595   12-22-2010 25,000,000 2010B, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589   12-22-2010 25,000,000 2010C, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932   12-22-2010 25,000,000 2010D, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   12-30-2010 225,000,000 2010E, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   11-16-2011 80,000,000 2011A, Expand/refurbish facilities   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   03-21-2012 294,985,000 2012A, AR Program - Refund 2009 A-F AR Program   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   07-25-2012 115,015,000 2012B, AR Program - Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542ADG3 08-29-2012 310,952,245 2012A - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022TL6 08-29-2012 348,320,000 2012B-F - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   08-29-2012 125,000,000 2012G&H - Refund Highlands 2005I Conversion Bonds   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022TR3 11-08-2012 232,125,000 2012I - Refunded Volusia 1994-A; Highlands 2004A, 2005E, 2005F, 2005G   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   09-18-2013 485,000,000 2013A B C, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569   07-02-2014 110,000,000 2014A&D, Refund 2013C, expand/refurbish facilities, purchase equipment   X   X   X
Orange County Health Facilities Authority
 
52-1378595   07-02-2014 50,000,000 2014B, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589   07-02-2014 30,000,000 2014C, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648AT39 07-23-2014 82,501,800 2014E, Expand/refurbish facilities, purchase equipment   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 27,725,000 28,575,000 3,495,000 28,155,000
2 Amount of bonds legally defeased . . . . . . . . . . . 4,900,000 8,105,000 19,265,000 7,320,000
3 Total proceeds of issue . . . . . . . . . . . . . . 205,156,000 249,501,424 30,371,450 212,464,496
4 Gross proceeds in reserve funds . . . . . . . . . . . .        
5 Capitalized interest from proceeds . . . . . . . . . . .        
6 Proceeds in refunding escrows . . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . . . 2,000,000 2,492,891 306,707 1,856,375
8 Credit enhancement from proceeds . . . . . . . . . . . 5,560,382      
9 Working capital expenditures from proceeds . . . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . . 203,156,000 68,000,000 12,004,967 21,844,721
11 Other spent proceeds . . . . . . . . . . . . . . 247,008,533 247,008,533 30,064,743 210,608,121
12 Other unspent proceeds . . . . . . . . . . . . . . 20,049,236 25,863,825 20,049,236 43,106,374
13 Year of substantial completion . . . . . . . . . . . . 2006 2003 1995 2002
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . .   X   X X     X
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X X     X X  
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X   X     X X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . . X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . . X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0.350 % 0.200 % 0.540 % 0.300 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0.100 %      
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0.450 % 0.200 % 0.540 % 0.300 %
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. 0.140 % 0.140 % 0.370 % 0.370 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . .
X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .   X   X   X   X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X   X   X   X
b Exception to rebate? . . . . . . . . X   X   X   X  
c No rebate due? . . . . . . . .   X   X   X   X
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . .   X   X   X   X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider . . . . . . . . .  
 
 
 
 
 
 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was the hedge terminated? . . . . . .                
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X   X   X   X
b Name of provider . . . . . . . . .  
 
 
 
 
 
 
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
Part III, Line 8c Highlands County Health Facilities Authority 2012A, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c Highlands County Health Facilities Authority 2012B, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c Kansas Development Finance Authority 2012A: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014.
Part III, Line 8c Highlands County Health Facilities Authority 2012B-F: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2013A-C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014A&D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014B: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014E: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Schedule K (Form 990) 2014

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet 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.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number

59-1479658
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) 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 (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





2
Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
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?
To From Yes No Yes No Yes No
Total ......Small Bullet $  
Part III
Grants or Assistance Benefiting 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) 2014
Schedule L (Form 990 or 990-EZ) 2014
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?
Yes No
(1) Mairilise P Owen Family of board member 104,158 Employee Compensation   No
(2) Karen Tilstra Family of key employee 125,940 Consulting   No
(3) Dan Tilstra Family of key employee 23,908 Professional Services   No
(4) Clifton Scott Family of board member 97,617 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) 2014

Additional Data


Software ID:  
Software Version:  




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 990-EZ 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
2014
Open to Public
Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number

59-1479658
Return Reference Explanation
Form 990, Part VI, Section A, line 2 Lars Houmann and Terry Owen - Family Relationship
Form 990, Part VI, Section A, line 6 Adventist Health System/Sunbelt, Inc. (the filing organization) has one member. The sole member of the filing organization is Adventist Health System Sunbelt Healthcare Corporation. Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) is a Florida, not-for-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). There are no other classes of membership in the filing organization.
Form 990, Part VI, Section A, line 7a The sole member of the filing organization is AHSSHC. The Board of Directors of the filing organization are appointed by the sole member, AHSSHC, who has the right to elect, appoint or remove any member of the Board of Directors of the filing organization.
Form 990, Part VI, Section A, line 7b AHSSHC, as the sole member of the filing organization, has certain reserved powers as set forth in the Bylaws of the filing organization. These reserved powers include the following: a) to approve and disapprove the executive and/or administrative leadership of the filing organization, and their salaries; b) to approve and disapprove the operating Bylaws of the filing organization; c) to set limits and terms for the borrowing of funds; d) to approve or disapprove major building programs and/or purchase or sale of personal property or real property equal to or in excess of One Million dollars; e) to approve or disapprove the annual operating and capital budgets of the filing organization; f) to direct the placement of funds and capital of the filing organization; and g) to establish general guiding policies.
Form 990, Part VI, Section B, line 11 The filing organization's current year Form 990 was reviewed by the Chief Financial Executive prior to its filing with the IRS. The review conducted by the Chief Financial Executive did not include the review of any supporting workpapers that were used in preparation of the current year Form 990, but did include a review of the entire Form 990 and all supporting schedules.
Form 990, Part VI, Section B, line 12c The Conflict of Interest Policy of the filing organization applies to members of its Board of Directors and its principal officers (to be known as Interested Persons). In connection with any actual or possible conflict of interests, any member of the Board of Directors of the filing organization or any principal officer of the filing organization (i.e. Interested Persons) must disclose the existence of any financial interest with the filing organization and must be given the opportunity to disclose all material facts concerning the financial interest/arrangement to the Board of Directors of the filing organization or to any members of a committee with board delegated powers that is considering the proposed transaction or arrangement. Subsequent to any disclosure of any financial interest/arrangement and all material facts, and after any discussion with the relevant Board member or principal officer, the remaining members of the Board of Directors or committee with board delegated powers shall discuss, analyze, and vote upon the potential financial interest/arrangement to determine if a conflict of interest exists. According to the filing organization's Conflict of Interest Policy, an Interested Person may make a presentation to the Board of Directors (or committee with board delegated powers), but after such presentation, shall leave the meeting during the discussion of, and the vote on, the transaction or arrangement that results in a conflict of interest. Each Interested Person, as defined under the filing organization's Conflict of Interest Policy, shall annually sign a statement which affirms that such person has received a copy of the Conflict of Interests policy, has read and understands the policy, has agreed to comply with the policy, and understands that the filing organization is a charitable organization that must primarily engage in activities which accomplish one or more of its exempt purposes. The filing organization's Conflict of Interest Policy also requires that periodic reviews shall be conducted to ensure that the filing organization operates in a manner consistent with its charitable purposes.
Form 990, Part VI, Section B, line 15 The filing organization's CEO, other officers and key employees are not compensated by the filing organization. Such individuals are compensated by the related top-tier parent organization of the filing organization. Please see the discussion concerning the process followed by the related top-tier parent organization in determining executive compensation in our response to Schedule J, Line 3.
Form 990, Part VI, Section C, line 19 The filing organization is a part of the system of healthcare organizations known as Adventist Health System (AHS). Each year, AHS publishes an annual report document that includes a financial report for the relevant year as well as a community benefit report. The financial report and community benefit report are presented on a consolidated basis and represent all of the activities, results of operations, and financial position at year-end of the entire AHS system. In addition, the audited consolidated financial statements of AHS and of the AHS "Obligated Group" are filed annually with the Municipal Securities Rulemaking Board (MSRB). The "Obligated Group" is a group of AHSSHC subsidiaries that are jointly and severally liable under a Master Trust Indenture that secures debt primarily issued on a tax-exempt basis. Unaudited quarterly financial statements prepared in accordance with Generally Accepted Accounting Principles (GAAP) are also filed with MSRB for AHS on a consolidated basis and for the grouping of AHS subsidiaries comprising the "Obligated Group". The filing organization does not generally make its governing documents or conflict of interest policy available to the public.
Part VII, Section A For those Board of Director members who devote less than full-time to the filing organization (based upon the average number of hours per week shown in column (B) on page 7 of the return) the compensation amounts shown in columns (E) and (F) on page 7 for Don Jernigan, Lars Houmann, Richard Reiner, and Terry Shaw, were provided in conjunction with that person's responsibilities and roles in serving in an executive leadership position within Adventist Health System (AHS). Don Jernigan, Richard Reiner,and Terry Shaw devote approximately 50 hours per week in conjunction with serving in their respective executive leadership position within AHS. Lars Houmann devotes approximately 35 hours a week to the filing organization and the remainder of time is devoted to his leadership position within AHS.
Form 990, Part XI, line 9: Transfer to tax-exempt affiliates -37,716,898. Transfer to tax-exempt parent -15,960,203. Donated Property 2,203,971. SWAP loss amortization 4,611,957. Allocations from Tax-exempt Parent with respect to Debt 5,623,517. Transfer for expenses -301,668. Gifts 11,218,012. Other -31,122. Interest in Foundation 708,066. Rounding -2.
Part X, Line 2 The amounts shown on line 2 of Part X of this return include the filing organization's interest in a central investment pool maintained by Adventist Health System Sunbelt Healthcare Corporation, the filing organization's top-tier parent. The investments in the central investment pool are recorded at market value.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet
Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number

59-1479658
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" 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?
Yes No
(1) Adventist Bolingbrook Hospital
500 Remington Blvd

Bolingbrook,IL60440
65-1219504
Operation of Hospital & Related Services IL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc
 
Yes
 
(2) Adventist Care Centers - Courtland Inc
730 Courtland Street

Orlando,FL32804
20-5774723
Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 9 Sunbelt Hlth Care Centers Inc
 
Yes
 
(3) Adventist GlenOaks Hospital
701 Winthrop Avenue

Glendale Heights,IL60139
36-3208390
Operation of Hospital & Related Services IL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc
 
Yes
 
(4) Adventist Hlth Mid-America Inc
9100 W 74th Street

Shawnee Mission,KS66204
52-1347407
Hlthcare Related Services KS 501(c)(3) Line 11a, I Adventist Hlth SystemSunbelt Inc
 
Yes
 
(5) Adventist Hlth Partners Inc
1000 Remington Blvd Ste 200

Bolingbrook,IL60440
36-4138353
Operate out-patient physician clinics IL 501(c)(3) Line 3 AHS Midwest Management Inc
 
Yes
 
(6) Adventist Hlth System Sunbelt Hlthcare Corp
900 Hope Way

Altamonte Springs,FL32714
59-2170012
Management Services FL 501(c)(3) Line 11a, I N/A
 
No
(7) Adventist Hlth System Georgia Inc
1035 Red Bud Road

Calhoun,GA30701
58-1425000
Operation of Hospital & Related Services GA 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(8) Adventist Hlth SystemSunbelt Inc
900 Hope Way

Altamonte Springs,FL32714
59-1479658
Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(9) Adventist Hlth SystemTexas Inc
11801 S Freeway

Burleson,TX36028
74-2578952
Leasing Personnel to Affiliated Hospital TX 501(c)(3) Line 11c, III-FI Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(10) ADVENTIST HINSDALE HOSPITAL
120 North Oak Street

Hinsdale,IL60521
36-2276984
Operation of Hospital & Related Services IL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc
 
Yes
 
(11) Adventist University of Health Sciences Inc (630 Year End)
671 Lake Winyah Drive

Orlando,FL32803
59-3069793
Education/Operation of School FL 501(c)(3) Line 2 Adventist Hlth SystemSunbelt Inc
 
Yes
 
(12) AHS Midwest Management Inc
1000 Remington Blvd Ste 200

Bolingbrook,IL60440
36-3354567
Operation of Physician Practice Mgmt IL 501(c)(3) Line 11a, I Adventist Hlth SystemSunbelt Inc
 
Yes
 
(13) AHSCentral Texas Inc
1301 Wonder World Drive

San Marcos,TX78666
74-2621825
Provide Office Space - Medical Professionals TX 501(c)(3) Line 11c, III-FI Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(14) Apopka Hlth Care Properties Inc
305 E Oak Street

Apopka,FL32703
51-0605694
Lease to Related Organization GA 501(c)(3) Line 11c, III-FI Sunbelt Hlth Care Centers Inc
 
Yes
 
(15) Battle Creek Adventist Hospital
1000 Remington Blvd Ste 200

Bolingbrook,IL60440
38-1359189
Inactive MI 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc
 
Yes
 
(16) Bolingbrook Hospital Foundation
1000 Remington Blvd N Entrance 2nd

Bolingbrook,IL60440
90-0494445
Fund-raising for Tax-exempt hospital IL 501(c)(3) Line 7 Midwest Hlth Foundation
 
 
No
(17) Bradford Heights Hlth & Rehab Center Inc
950 Highpoint Drive

Hopkinsville,KY42240
20-5782342
Operation of Home for the Aged/Hlthcare Delivery KY 501(c)(3) Line 9 Sunbelt Hlth Care Centers Inc
 
Yes
 
(18) Burleson Nursing & Rehab Center Inc
301 Huguley Blvd

Burleson,TX76028
20-5782243
Operation of Home for the Aged/Hlthcare Delivery TX 501(c)(3) Line 9 Sunbelt Hlth Care Centers Inc
 
Yes
 
(19) Caldwell Hlth Care Properties Inc
1333 West Main

Princeton,KY42445
51-0605680
Lease to Related Organization GA 501(c)(3) Line 11c, III-FI Sunbelt Hlth Care Centers Inc
 
Yes
 
(20) Central Texas Hlthcare Collaborative
1301 Wonder World Drive

San Marcos,TX78666
45-3739929
Support Operation of Hospital TX 501(c)(3) Line 11a, I Adventist Hlth SystemSunbelt Inc
 
Yes
 
(21) Central Texas Medical Center Foundation
1301 Wonder World Drive

San Marcos,TX78666
74-2259907
Fund-raising for Tax-exempt hospital TX 501(c)(3) Line 7  
 
No
(22) Chickasaw Hlth Care Properties Inc
250 S Chickasaw Trail

Orlando,FL32825
51-0605681
Lease to Related Organization GA 501(c)(3) Line 11c, III-FI Sunbelt Hlth Care Centers Inc
 
Yes
 
(23) Chippewa Valley Hospital & Oakview Care Center Inc
1220 Third Avenue West

Durand,WI54736
39-1365168
Operation of Hospital & Related Services WI 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc
 
Yes
 
(24) Cobb Medical Associates LLC
3949 South Cobb Drive SE

Smyrna,GA30080
58-2617089
Operation of Physician Practices & Medical Services GA 501(c)(3) Line 3 Emory-Adventist Inc
 
Yes
 
(25) Courtland Hlth Care Properties Inc
730 Courtland Street

Orlando,FL32804
51-0605682
Lease to Related Organization GA 501(c)(3) Line 11c, III-FI Sunbelt Hlth Care Centers Inc
 
Yes
 
(26) Creekwood Place Nursing & Rehab Center Inc
683 E Third Street

Russellville,KY42276
20-5782260
Operation of Home for the Aged/Hlthcare Delivery KY 501(c)(3) Line 9 Sunbelt Hlth Care Centers Inc
 
Yes
 
(27) Dairy Road Hlth Care Properties Inc
7350 Dairy Road

Zephyrhills,FL33540
51-0605684
Lease to Related Organization GA 501(c)(3) Line 11c, III-FI Sunbelt Hlth Care Centers Inc
 
Yes
 
(28) East Orlando Hlth & Rehab Center Inc
250 S Chickasaw Trail

Orlando,FL32825
20-5774748
Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 9 Sunbelt Hlth Care Centers Inc
 
Yes
 
(29) Emory-Adventist Inc
3949 South Cobb Drive

Smyrna,GA30080
58-2171011
Operation of Hospital & Related Svcs GA 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc
 
Yes
 
(30) Fletcher Hospital Inc
100 Hospital Drive

Hendersonville,NC28792
56-0543246
Operation of Hospital & Related Svcs NC 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(31) FLNC Inc
3355 E Semoran Blvd

Apopka,FL32703
20-5774761
Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 9 Sunbelt Hlth Care Centers Inc
 
Yes
 
(32) FLORIDA HOSPITAL HEALTHCARE PARTNERS INC
770 West Granada Blvd 101

Ormond Beach,FL32174
46-2354804
Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc
 
Yes
 
(33) Florida Hospital Medical Group Inc
2600 Westhall Ln

Maitland,FL32751
59-3214635
Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc
 
Yes
 
(34) Florida Hospital Physician Group Inc
14055 Riveredge Drive Ste 250

Tampa,FL33637
46-2021581
Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(35) Florida Hospital Waterman Inc
1000 Waterman Way

Tavares,FL32778
59-3140669
Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(36) Florida Hospital Zephyrhills Inc
7050 Gall Blvd

Zephyrhills,FL33541
59-2108057
Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc
 
Yes
 
(37) Foundation for Shawnee Mission Medical Center Inc
9100 W 74th Street

Shawnee Mission,KS66204
48-0868859
Fund-raising for Tax-exempt hospital KS 501(c)(3) Line 11a, I Shawnee Mission Medical Center Inc
 
Yes
 
(38) Fountain Inn Nursing & Rehab Center Inc(1024-123114)
602 Courtland St Ste 200

Orlando,FL32804
47-2180518
Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 9 Sunbelt Hlth Care Centers Inc
 
Yes
 
(39) GlenOaks Hospital Foundation
701 Winthrop Avenue

Glendale Heights,IL60139
36-3926044
Fund-raising for Tax-exempt hospital IL 501(c)(3) Line 7 Midwest Hlth Foundation
 
 
No
(40) Helen Ellis Memorial Hospital Auxiliary Inc
1395 S Pinellas Ave

Tarpon Springs,FL34689
59-2106043
Fund-raising for Tax-exempt hospital/foundation FL 501(c)(3) Line 11c, III-FI  
 
No
(41) Helen Ellis Memorial Hospital Foundation Inc
1395 S Pinellas Ave

Tarpon Springs,FL34689
59-3690149
Fund-raising for Tax-exempt hospital FL 501(c)(3) Line 11c, III-FI  
 
No
(42) Hinsdale Hospital Foundation
7 Salt Creek Lane Suite 203

Hinsdale,IL60521
52-1466387
Fund-raising for Tax-exempt hospital IL 501(c)(3) Line 7 Midwest Hlth Foundation
 
 
No
(43) Hospice of the Comforter Inc
480 W Central Parkway

Altamonte Springs,FL32714
59-2935928
Operation of Hospice FL 501(c)(3) Line 9 The Comforter Health Care Group Inc
 
Yes
 
(44) Hospice of the Comforter Foundation Inc
480 W Central Parkway

Altamonte Springs,FL32714
27-1858033
Fund Raising for Affiliated Tax-Exempt Hospice FL 501(c)(3) Line 7 The Comforter Health Care Group Inc
 
Yes
 
(45) In-Motion Rehab Inc
602 Courtland Street Ste 200

Orlando,FL32804
20-8023411
Therapy services to tax exempt nursing homes KS 501(c)(3) Line 11b, II Sunbelt Hlth Care Centers Inc
 
Yes
 
(46) Jellico Community Hospital Inc
188 Hospital Lane

Jellico,TN37762
62-0924706
Operation of Hospital & Related Services TN 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(47) La Grange Memorial Hospital Foundation
5101 S Willow Springs Rd

La Grange,IL60525
30-0247776
Fund-raising for Tax-exempt hospital IL 501(c)(3) Line 7 Midwest Hlth Foundation
 
 
No
(48) Lake County Health Care Properties Inc(1017-123114)
602 Courtland St Ste 200

Orlando,FL32804
47-2179868
Lease to Related Organization FL 501(c)(3) Line 11c, III-FI Sunbelt Hlth Care Centers Inc
 
Yes
 
(49) Memorial Hlth Systems Foundation Inc
770 West Granada Blvd

Ormond Beach,FL32174
31-1771522
Fund-raising for Tax-exempt hospital FL 501(c)(3) Line 7  
 
No
(50) Memorial Hlth Systems Inc
301 Memorial Medical Parkway

Daytona Beach,FL32117
59-0973502
Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc
 
Yes
 
(51) Memorial Hospital - West Volusia Inc
701 West Plymouth Avenue

Deland,FL32720
59-3256803
Operation of Hospital & Related Services FL 501(c)(3) Line 3 Memorial Hlth Systems Inc
 
Yes
 
(52) Memorial Hospital Flagler Inc
60 Memorial Medical Parkway

Palm Coast,FL32164
59-2951990
Operation of Hospital & Related Services FL 501(c)(3) Line 3 Memorial Hlth Systems Inc
 
Yes
 
(53) Memorial Hospital Inc
210 Marie Langdon Drive

Manchester,KY40962
61-0594620
Operation of Hospital & Related Services KY 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(54) Merriam Hlth Care Properties Inc
9700 West 62nd Street

Merriam,KS66203
36-4595806
Lease to Related Organization KS 501(c)(3) Line 11c, III-FI Sunbelt Hlth Care Centers Inc
 
Yes
 
(55) Metroplex Adventist Hospital Inc
2201 S Clear Creek Road

Killeen,TX76549
74-2225672
Operation of Hospital & Related Services TX 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(56) Metroplex Clinic Physicians Inc
2201 S Clear Creek Road

Killeen,TX76549
11-3762050
Physician Hlthcare services to the community TX 501(c)(3) Line 3 Metroplex Adventist Hospital Inc
 
Yes
 
(57) Metroplex Hospital Inc
900 Hope Way

Altamonte Springs,FL32714
46-1256516
Future Operation of Hospital & Related Svcs FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(58) Midwest Hlth Foundation
120 North Oak Street

Hinsdale,IL60521
35-2230515
Support of subsidiary Foundations IL 501(c)(3) Line 11b, II N/A
 
No
(59) Mills Hlth & Rehab Center Inc
500 Beck Lane

Mayfield,KY42066
20-5782320
Operation of Home for the Aged/Hlthcare Delivery KY 501(c)(3) Line 9 Sunbelt Hlth Care Centers Inc
 
Yes
 
(60) Mission Strategies of Georgia Inc
3949 S Cobb Drive

Smyrna,GA30080
90-0866024
Provision of support to the nursing home division GA 501(c)(3) Line 11b, II Sunbelt Hlth Care Centers Inc
 
Yes
 
(61) Missouri Adventist Hlth Inc
9100 W 74th Street

Shawnee Mission,KS66204
43-1224729
Support Hlth Care Services MO 501(c)(3) Line 11d, III-O Adventist Hlth Mid-America Inc
 
Yes
 
(62) North Regional EMS Inc
188 Hospital Lane

Jellico,TN37762
26-2653616
EMS Services TN 501(c)(3) Line 9 Jellico Community Hospital Inc
 
Yes
 
(63) Ormond Beach Memorial Hospital Auxiliary Inc
301 Memorial Medical Parkway

Daytona Beach,FL32117
59-1721962
Volunteer support services FL 501(c)(3) Line 11c, III-FI  
 
No
(64) Overland Park Nursing & Rehab Center Inc
6501 West 75th Street

Overland Park,KS66204
20-5774821
Operation of Home for the Aged/Hlthcare Delivery KS 501(c)(3) Line 9 Sunbelt Hlth Care Centers Inc
 
Yes
 
(65) Paragon Hlth Care Properties Inc
950 Highpoint Drive

Hopkinsville,KY42240
51-0605686
Lease to Related Organization GA 501(c)(3) Line 11c, III-FI Sunbelt Hlth Care Centers Inc
 
Yes
 
(66) Pasco-Pinellas Hillsborough Community Hlth System Inc
2600 Bruce B Downs Blvd

Wesley Chapel,FL33544
20-8488713
Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(67) Portercare Adventist Hlth System (630 Year End)
2525 S Downing Street

Denver,CO80210
84-0438224
Operation of Hospital & Related Services CO 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(68) Princeton Hlth & Rehab Center Inc
1333 West Main

Princeton,KY42445
20-5782272
Operation of Home for the Aged/Hlthcare Delivery KY 501(c)(3) Line 9 Sunbelt Hlth Care Centers Inc
 
Yes
 
(69) Princeton Professional Services Inc
601 E Rollins Street

Orlando,FL32803
59-1191045
Provision of Hlthcare Services FL 501(c)(3) Line 9 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(70) Quality Circle for Hlthcare Inc
900 Hope Way

Altamonte Springs,FL32714
26-3789368
Hlthcare Quality Services FL 501(c)(3) Line 11a, I Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(71) Resource Personnel Inc
602 Courtland Street Ste 200

Orlando,FL32804
20-8040875
Provide administrative support to tax exempt nursing homes FL 501(c)(3) Line 11b, II Sunbelt Hlth Care Centers Inc
 
Yes
 
(72) Rocky Mountain Adventist Hlthcare Foundation (630 Year End)
7995 E Prentice Ave 204

Greenwood Village,CO80111
84-0745018
Fund-raising for Tax-exempt hospital CO 501(c)(3) Line 7  
 
No
(73) Rollins Brook Community Care Corp
2201 S Clear Creek Road

Killeen,TX76549
46-1656773
Inactive TX 501(c)(3) Line 11a, I Adventist Hlth SystemSunbelt Inc
 
Yes
 
(74) Russellville Hlth Care Properties Inc
683 East Third Street

Russellville,KY42276
51-0605691
Lease to Related Organization GA 501(c)(3) Line 11c, III-FI Sunbelt Hlth Care Centers Inc
 
Yes
 
(75) San Marcos Hlth Care Properties Inc
1900 Medical Parkway

San Marcos,TX78666
51-0605693
Lease to Related Organization GA 501(c)(3) Line 11c, III-FI Sunbelt Hlth Care Centers Inc
 
Yes
 
(76) San Marcos Nursing & Rehab Center Inc
1900 Medical Parkway

San Marcos,TX78666
20-5782224
Operation of Home for the Aged/Hlthcare Delivery TX 501(c)(3) Line 9 Sunbelt Hlth Care Centers Inc
 
Yes
 
(77) Shawnee Mission Hlth Care Inc
6501 West 75th Street

Overland Park,KS66204
48-0952508
Lease to Related Organization KS 501(c)(3) Line 11c, III-FI Sunbelt Hlth Care Centers Inc
 
Yes
 
(78) Shawnee Mission Medical Center Inc
9100 W 74th Street

Shawnee Mission,KS66204
48-0637331
Operation of Hospital & Related Services KS 501(c)(3) Line 3 Adventist Hlth Mid-America Inc
 
Yes
 
(79) South Central Inc
900 Hope Way

Altamonte Springs,FL32714
59-3689740
Management Support GA 501(c)(3) Line 11c, III-FI N/A
 
No
(80) South Pasco Hlth Care Properties Inc
38250 A Avenue

Zephyrhills,FL33542
51-0605679
Lease to Related Organization GA 501(c)(3) Line 11c, III-FI Sunbelt Hlth Care Centers Inc
 
Yes
 
(81) Southwest Volusia Hlth Services Inc
1055 Saxon Blvd

Orange City,FL32763
59-3281591
Medical Office Building for Hospital FL 501(c)(3) Line 11a, I Southwest Volusia Hlthcare Corp
 
Yes
 
(82) Southwest Volusia Hlthcare Corp
1055 Saxon Blvd

Orange City,FL32763
59-3149293
Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc
 
Yes
 
(83) Specialty Physicians of Central Texas Inc
1301 Wonder World Drive

San Marcos,TX78666
20-8814408
Physician Hlthcare services to the community TX 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc
 
Yes
 
(84) Spring View Hlth & Rehab Center Inc
718 Goodwin Lane

Leitchfield,KY42754
20-5782288
Operation of Home for the Aged/Hlthcare Delivery KY 501(c)(3) Line 9 Sunbelt Hlth Care Centers Inc
 
Yes
 
(85) Sunbelt Hlth & Rehab Center - Apopka Inc
305 East Oak Street

Apopka,FL32703
20-5774856
Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 9 Sunbelt Hlth Care Centers Inc
 
Yes
 
(86) Sunbelt Hlth Care Centers Inc
602 Courtland Street Ste 200

Orlando,FL32804
58-1473135
Management Services TN 501(c)(3) Line 11b, II Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(87) SunSystem Development Corp
900 Hope Way

Altamonte Springs,FL32714
59-2219301
Fund Raising for Affiliated Tax-Exempt Hospitals FL 501(c)(3) Line 7 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(88) Takoma Regional Hospital Inc (630 Year End)
401 Takoma Ave

Greeneville,TN37743
51-0603966
Operation of Hospital & Related Services TN 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc
 
Yes
 
(89) TAKOMA REGIONAL HOSPITAL Foundation INC (710-123114)
401 Takoma Ave

Greeneville,TN37743
47-1334302
Fund Raising for Affiliated Tax-Exempt Hospital TN 501(c)(3) Line 7 Takoma Regional Hospital Inc
 
Yes
 
(90) Tarpon Springs Hospital Foundation Inc
1395 S Pinellas Ave

Tarpon Springs,FL34689
59-0898901
Operation of Hospital & Related Services FL 501(c)(3) Line 3 University Community Hospital Inc
 
Yes
 
(91) Tarrant County Hlth Care Properties Inc
301 Huguley Blvd

Burleson,TX76028
51-0605677
Lease to Related Organization GA 501(c)(3) Line 11c, III-FI Sunbelt Hlth Care Centers Inc
 
Yes
 
(92) Taylor Creek Hlth Care Properties Inc
718 Goodwin Lane

Leitchfield,KY42754
51-0605678
Lease to Related Organization GA 501(c)(3) Line 11c, III-FI Sunbelt Hlth Care Centers Inc
 
Yes
 
(93) The Comforter Health Care Group Inc
605 Montgomery Road

Altamonte Springs,FL32714
27-1857940
Lease to Related Organization FL 501(c)(3) Line 11c, III-FI Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(94) The Volunteer Auxiliary of Florida Hospital - Flagler Inc
60 Memorial Medical Parkway

Palm Coast,FL32164
59-2486582
Volunteer support services FL 501(c)(3) Line 11c, III-FI  
 
No
(95) TRI-COUNTY NURSING AND REHAB Center Inc(1030-123114)
602 Courtland St Ste 200

Orlando,FL32804
47-2219363
Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 9 Sunbelt Hlth Care Centers Inc
 
Yes
 
(96) Trinity Nursing & Rehab Center Inc
9700 West 62nd Street

Merriam,KS66203
20-5774890
Operation of Home for the Aged/Hlthcare Delivery KS 501(c)(3) Line 9 Sunbelt Hlth Care Centers Inc
 
Yes
 
(97) University Community Hospital Foundation Inc
3100 E Fletcher Ave

Tampa,FL33613
59-2554889
Fund-raising for Tax-exempt hospital FL 501(c)(3) Line 11a, I  
 
No
(98) University Community Hospital Specialty Care Inc
3100 E Fletcher Ave

Tampa,FL33613
59-3231322
Inactive FL 501(c)(3) Line 11a, I University Community Hospital Inc
 
Yes
 
(99) University Community Hospital Inc
3100 E Fletcher Ave

Tampa,FL33613
59-1113901
Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(100) West Florida Health Home Care Inc fka South Cent Nurs Home Prop(11-1114)
PO Box 1289

Tampa,FL33601
59-3686109
Will be operating Home Health Agency GA 501(c)(3) Line 11d, III-O Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(101) West Kentucky Hlth Care Properties Inc
500 Beck Lane

Mayfield,KY42066
51-0605676
Lease to Related Organization GA 501(c)(3) Line 11c, III-FI Sunbelt Hlth Care Centers Inc
 
Yes
 
(102) Zephyr Haven Hlth & Rehab Center Inc
38250 A Avenue

Zephyrhills,FL33542
20-5774930
Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 9 Sunbelt Hlth Care Centers Inc
 
Yes
 
(103) Zephyrhills Hlth & Rehab Center Inc
7350 Dairy Road

Zephyrhills,FL33540
20-5774967
Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 9 Sunbelt Hlth Care Centers Inc
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
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


Yes No Yes No
(1) Appalachian Therapy Services LLC

100 Hospital Drive
Hendersonville,NC28792
20-2463851
Therapy Staffing NC N/A
                 
(2) Clear Creek MOB Ltd

2201 S Clear Creek Rd
Killeen,TX76549
74-2609195
Real Estate TX N/A
                 
(3) Endoscopy Center at Porter LLC

1001 South Park Drive
Littleton,CO80120
20-5855038
Medical Services CO N/A
                 
(4) Florida Hospital DMERT LLC

2450 Maitland Center Pkwy Ste 200
Maitland,FL32751
20-2392253
Medical Equipment FL N/A
                 
(5) FLORIDA HOSPITAL HOME INFUSION LLP

2450 Maitland Center Pkwy Ste 200
Maitland,FL32751
59-3142824
Home Infusion Services FL N/A
                 
(6) PAHSUSP Surgery Centers LLC

15305 Dallas Pkwy Ste 1600 LB 28
Addison,TX75010
26-3057950
Medical Services CO N/A
                 
(7) San Marcos MRI LP

1330 Wonder World Dr Ste 202
San Marcos,TX78666
77-0597972
Imaging & Testing TX Adventist Hlth SystemSunbelt Inc
 
Related 13,258 281,209   No     No 55.000 %
(8) Shawnee Mission Open MRI LLC

9100 W 74th Street Box 2923
Shawnee Mission,KS66201
27-0011796
Imaging & Testing KS N/A
                 
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) Altamonte Medical Plaza Condominium Association Inc

601 East Rollins Street
Orlando,FL32803
59-2855792
Condo Association FL Adventist Hlth SystemSunbelt Inc
 
C 132,822 41,241 59.000 % Yes  
(2) Apopka Medical Plaza Condominium Association Inc

601 East Rollins Street
Orlando,FL32803
59-3000857
Condo Association FL Adventist Hlth SystemSunbelt Inc
 
C 30,403 20,803 89.000 % Yes  
(3) CC MOB Inc

2201 S Clear Creek Road
Killeen,TX76549
74-2616875
Real Estate Rental TX N/A
C       Yes  
(4) Central Texas Medical Associates

1301 Wonder World Drive
San Marcos,TX78666
74-2729873
Physician Clinics TX Adventist Hlth SystemSunbelt Inc
 
C     100.000 % Yes  
(5) Central Texas Provider's Network

1301 Wonder World Drive
San Marcos,TX78666
74-2827652
Physician Hospital Org. TX Adventist Hlth SystemSunbelt Inc
 
C 51,165 40,819 100.000 % Yes  
(6) Florida Hospital Flagler Medical Offices Association Inc

60 Memorial Medical Parkway
Palm Coast,FL32164
26-2158309
Condo Association FL N/A
C       Yes  
(7) Florida Hospital Healthcare System Inc

602 Courtland Street
Orlando,FL32804
59-3215680
PHO/TPA FL Adventist Hlth SystemSunbelt Inc
 
C 13,283,337 38,617,374 100.000 % Yes  
(8) Florida Medical Plaza Condo Association Inc

601 East Rollins Street
Orlando,FL32803
59-2855791
Condo Association FL Adventist Hlth SystemSunbelt Inc
 
C 489,156 234,638 78.000 % Yes  
(9) Florida Memorial Health Network Inc

770 W Granada Blvd Ste 317
Ormond Beach,FL32174
59-3403558
Physician Hospital Org. FL N/A
C       Yes  
(10) HUGULEY ALLIANCE FOUNDATION (11-8414)

11801 South Freeway
Fort Worth,TX76115
75-2642209
Inactive TX Adventist Hlth SystemSunbelt Inc
 
C     100.000 % Yes  
(11) Kissimmee Multispecialty Clinic Condominium Association Inc

201 Hilda Street Suite 30
Kissimmee,FL34741
59-3539564
Condo Association FL Adventist Hlth SystemSunbelt Inc
 
C 56,998   54.400 % Yes  
(12) Midwest Management Services Inc

9100 West 74th Street
Shawnee Mission,KS66204
48-0901551
Real Estate Rental KS N/A
C       Yes  
(13) North American Health Services Inc & Subs

900 Hope Way
Altamonte Springs,FL32714
62-1041820
Lessor/Holding Co. TN N/A
C       Yes  
(14) ORMOND PROF Associates CONDO ASSOC'N Inc (430 YR END)

770 W Granada Blvd Ste 101
Ormond Beach,FL32174
59-2694434
Condo Association FL N/A
C       Yes  
(15) Park Ridge Property Owner's Association Inc

1 Park Place Naples Road
Fletcher,NC28732
03-0380531
Condo Association NC N/A
C       Yes  
(16) Porter Affiliated Hlth Services Inc dba Diversified Affiliated Hlth Svcs

2525 S Downing Street
Denver,CO80210
84-0956175
Healthcare Services CO N/A
C       Yes  
(17) San Marcos Regional MRI Inc

1301 Wonder World Drive
San Marcos,TX78666
77-0597968
Holding Company TX Adventist Hlth SystemSunbelt Inc
 
C 484 12,327 100.000 % Yes  
(18) The Garden Retirement Community Inc

602 Courtland Street Ste 200
Orlando,FL32804
59-3414055
Real Estate Rental FL N/A
C       Yes  
(19) Winter Park Medical Office Building I Condo Assoc Inc

200 Lakemont Ave
Winter Park,FL32792
45-2228478
Physician Clinics FL Adventist Hlth SystemSunbelt Inc
 
C 161,503 19,119 52.000 % Yes  
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
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
No
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 . . . . . . . . . . . . . . . . . . . . . . .
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
Yes
 
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
Yes
 
2
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) Adventist Health System Sunbelt Healthcare Corporation

B 15,960,203 Actual Amount Given
(2) Adventist Health System Sunbelt Healthcare Corporation

C 342,192 Actual Amount Received
(3) Adventist Health System Sunbelt Healthcare Corporation

M 49,367,232 % of Facility's Operating Exp
(4) Adventist Health System Sunbelt Healthcare Corporation

P 175,335,946 Cost
(5) Adventist Health System Sunbelt Healthcare Corporation

Q 89,500,000 Cost
(6) Adventist Health System Sunbelt Healthcare Corporation dba AHSIS

M 15,532,465 % of Facility's Operating Exp
(7) Adventist Health System Sunbelt Healthcare Corp dba Sunbelt Medical Mgmt

A 87,354 FMV Rental Rate
(8) Adventist Health System Sunbelt Healthcare Corp dba Sunbelt Medical Mgmt

P 212,739 Cost
(9) Adventist Health System Sunbelt Healthcare Corp dba Sunbelt Medical Mgmt

Q 618,937 Cost
(10) Adventist Bolingbrook Hospital

L 372,977 Cost
(11) Adventist Bolingbrook Hospital

P 107,300 Cost
(12) Adventist Bolingbrook Hospital

Q 220,617 Cost
(13) Adventist Care Centers Courtland Inc

B 310,302 Actual Amount Given
(14) Adventist GlenOaks Hospital

L 182,337 Cost
(15) Adventist GlenOaks Hospital

P 55,997 Cost
(16) Adventist GlenOaks Hospital

Q 75,128 Cost
(17) Adventist Health Midwest Management Inc

L 56,000 Cost Plus Appropriate %
(18) Adventist Health Partners Inc

L 358,121 Cost Plus Appropriate %
(19) Adventist Health Partners Inc

A 417,530 FMV Rental Rate
(20) Adventist Health Partners Inc

P 4,513,147 Cost
(21) Adventist Health Partners Inc

Q 224,352 Cost
(22) Adventist Health System Georgia Inc

L 220,438 Cost
(23) Adventist Midwest Health fka Adventist Hinsdale Hospital

L 5,640,881 Cost
(24) Adventist Midwest Health fka Adventist Hinsdale Hospital

P 15,121,681 Cost
(25) Adventist Midwest Health fka Adventist Hinsdale Hospital

Q 3,476,207 Cost
(26) Adventist University of Health Sciences Inc

A 2,199,732 FMV Rental Rate
(27) Adventist University of Health Sciences Inc

P 1,631,968 Cost
(28) Adventist University of Health Sciences Inc

Q 19,134,146 Cost
(29) Adventist University of Health Sciences Inc

R 4,670,391 Cost
(30) AHS Midwest Management Inc

P 933,172 Cost
(31) AHSCentral Texas Inc

K 138,947 Cost
(32) Central Texas Healthcare Collaborative

B 1,573,475 Actual Amount Given
(33) Central Texas Medical Center Foundation

B 84,245 Actual Amount Given
(34) Central Texas Medical Center Foundation

C 173,647 Actual Amount Received
(35) Central Texas Providers Network

Q 60,340 Cost
(36) East Orlando Health & Rehab Center Inc

B 1,440,600 Actual Amount Given
(37) Emory-Adventist Inc

A 125,889 FMV Interest Rate
(38) Emory-Adventist Inc

H 63,000 FMV
(39) Emory-Adventist Inc

R 11,737,060 Loan Forgiveness
(40) Emory-Adventist Inc

S 7,111,740 Principal Loan Amount
(41) Fletcher Hospital Inc

L 397,506 Cost
(42) FLNC Inc

B 2,211,000 Actual Amount Given
(43) Florida Hospital DMERT LLC

M 114,487 Cost Plus Appropriate %
(44) Florida Hospital Healthcare System Inc

A 230,863 FMV Rental Rate
(45) Florida Hospital Healthcare System Inc

Q 11,740,670 Cost
(46) Florida Hospital Home Infusion LLP

M 265,807 Cost Plus Appropriate %
(47) Florida Hospital Medical Group Inc

A 7,288,906 FMV Rental Rate
(48) Florida Hospital Medical Group Inc

B 4,532,869 Actual Amount Given
(49) Florida Hospital Medical Group Inc

K 559,885 FMV Rental Rate
(50) Florida Hospital Medical Group Inc

L 2,297,641 Cost Plus Appropriate %
(51) Florida Hospital Medical Group Inc

M 51,677,087 Cost Plus Appropriate %
(52) Florida Hospital Medical Group Inc

P 2,772,725 Cost
(53) Florida Hospital Medical Group Inc

Q 7,929,365 Cost
(54) Florida Hospital Medical Group Inc dba FRILM LLC

A 405,564 FMV Rental Rate
(55) Florida Hospital Medical Group Inc dba FRILM LLC

M 164,071 Cost Plus Appropriate %
(56) Florida Hospital Medical Group Inc dba FRILM LLC

P 313,288 Cost
(57) Florida Hospital Medical Group Inc dba FRILM LLC

Q 1,130,777 Cost
(58) Florida Hospital Waterman Inc

B 620,409 Actual Amount Given
(59) Florida Hospital Waterman Inc

L 675,880 Cost
(60) Florida Hospital Waterman Inc

Q 118,674 Cost
(61) Florida Hospital Zephyrhills Inc

L 358,610 Cost
(62) Hospice of the Comforter Inc

B 13,493,162 Actual Amount Given
(63) Hospice of the Comforter Inc

K 203,120 Cost
(64) Hospice of the Comforter Inc

Q 552,232 Cost
(65) Jellico Community Hospital Inc

L 383,206 Cost
(66) La Grange Memorial Hospital Foundation

B 263,313 Actual Amount Given
(67) La Grange Memorial Hospital Foundation

C 137,021 Actual Amount Received
(68) Memorial Health Systems Inc

L 1,099,312 Cost
(69) Memorial Health Systems Inc

P 64,981 Cost
(70) Memorial Hospital - Flagler Inc

L 690,497 Cost
(71) Memorial Hospital - West Volusia Inc

L 666,954 Cost
(72) Memorial Hospital Inc

L 216,941 Cost
(73) Metroplex Hospital

P 82,086 Cost
(74) North American Health Services Inc dba Elm Creek Property Management

P 53,043 Cost
(75) Pasco-Pinellas Hillsborough Community Health System Inc

C 308,773 Actual Amount Received
(76) Pasco-Pinellas Hillsborough Community Health System Inc

L 1,613,881 Cost
(77) Pasco-Pinellas Hillsborough Community Health System Inc

S 1,039,000 Cost
(78) Princeton Professional Services Inc (PPS)

A 239,770 FMV Rental Rate
(79) Princeton Professional Services Inc (PPS)

M 282,471 Cost Plus Appropriate %
(80) San Marcos MRI LP

A 7,420 FMV Rental Rate
(81) Shawnee Mission Medical Center Inc

L 475,963 Cost
(82) Southwest Volusia Healthcare Corporation

L 682,128 Cost
(83) Southwest Volusia Healthcare Corporation

P 86,994 Cost
(84) Southwest Volusia Healthcare Corporation

Q 226,570 Cost
(85) Specialty Physicians of Central Texas Inc

B 3,450,000 Actual Amount Given
(86) Specialty Physicians of Central Texas Inc

S 315,589 Cost
(87) Sunbelt Health & Rehab Center Apopka Inc

B 310,302 Actual Amount Given
(88) Sunbelt Health Care Centers Inc

A 326,642 FMV Rental Rate
(89) Sunbelt Health Care Centers Inc

P 153,714 Cost
(90) SunSystem Development Corporation

B 4,620,282 Actual Amount Given
(91) SunSystem Development Corporation

C 27,372,690 Actual Amount Received
(92) SunSystem Development Corporation

Q 4,020,923 Cost
(93) SunSystem Development Corporation

R 5,805,592 Cost
(94) Tarpon Springs Hospital Foundation Inc

L 189,689 Cost
(95) Texas Health Huguley

P 945,098 Cost
(96) University Community Hospital Inc

B 5,900,000 Actual Amount Given
(97) University Community Hospital Inc

L 1,824,905 Cost
(98) University Community Hospital Inc

P 66,990 Cost
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(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?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
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) 2014
Additional Data


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