TY 2014 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) RANDY HAFFNER CHAIRMAN	50.00 .......................0	X	X				929,758	0	162,371
(2) ROBERT HENDERSCHEDT BOARD MEMBER	1.00 .......................50.00	X					0	1,024,371	183,750
(3) TERRY SHAW BOARD MEMBER	1.00 .......................50.00	X					0	1,506,315	257,610
(4) KRIS ORDELHEIDE SECRETARY	1.00 .......................0		X				0	0	0
(5) GARY CAMPBELL PRESIDENT/CEO	1.00 .......................0		X				0	0	0
(6) Dan Enderson SVP Chief Finance Officer	1.00 .......................0		X				0	0	0
(7) CHERYL CURRY CFO-Littleton Adventist Hosp	50.00 .......................0			X			313,877	0	34,663
(8) MORRE DEAN CEO-Porter Adventist Hospital	50.00 .......................0			X			494,748	0	107,977
(9) Jonathan Fisher CFO -Parker Adventist Hospital	50.00 .......................0			X			206,547	0	28,173
(10) ANDREW GAASCH CFO-PORTER ADVENTIST HOSP	50.00 .......................0			X			351,249	0	31,292
(11) Brett Spenst CEO-Littleton Adventist Hospital	50.00 .......................0			X			427,491	0	83,012
(12) Douglas Dennis PHYSICIAN	40.00 .......................0				X		1,144,709	0	30,371
(13) Raymond Kim Physician	40.00 .......................0				X		1,549,554	0	39,309
(14) Todd Miner Physician	40.00 .......................0				X		1,410,689	0	39,241
(15) Christopher OLIVER PHYSICIAN	40.00 .......................0				X		932,855	0	35,929
(16) Charlie Yang PHYSICIAN	40.00 .......................0				X		1,158,953	0	37,792
(17) Dennis Barts CEO - Avista Adventist Hospital	50.00 .......................0					X	451,925	0	66,050

(A) Name and business address	(B) Description of services	(C) Compensation
PREMIER EMERGENCY SERVICES PC 550 S WADSWORTH BLVD SUITE 410 LAKEWOOD,CO80226	HEALTHCARE SERVICES	1,334,621
CRITICAL C ARE PULMONARY & SLEEP ASSOCIATES 274 UNION BLVD SUITE 110 LAKEWOOD,CO80228	PHYSICIAN SERVICES	1,189,705
CHER LLC PO BOX 974960 DALLAS,TX75397	HEALTHCARE SERVICES	1,150,386
MORRISON COMMUNITY LIVING PO BOX 102289 ATLANTA,CO30368	FACILITY MANAGEMENT	1,115,787
COLORADO PULMONARY INTENSIVISTS 15 WEST DRY CREEK DR LITTLETON,CO80120	PHYSICIAN SERVICES	1,043,235
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 48

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 ....	1,908,179	1,908,179
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 ............
4	Benefits paid to or for members ....
5	Compensation of current officers, directors, trustees, and key employees ....
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 ....	321,738,706	257,390,965	64,347,741
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	13,783,454	11,026,763	2,756,691
9	Other employee benefits .......	32,245,150	25,796,120	6,449,030
10	Payroll taxes ...........	21,840,767	17,472,614	4,368,153
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	1,354	1,083	271
c	Accounting ...........	211,432	169,146	42,286
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) ....	162,848,493	130,274,920	32,573,573	0
12	Advertising and promotion ....	3,214,466	2,571,573	642,893
13	Office expenses .......	9,612,364	7,689,891	1,922,473
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	22,604,163	18,083,330	4,520,833
17	Travel ............	1,540,325	1,232,260	308,065
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....	504,065	403,252	100,813
20	Interest ...........	14,063,008	11,250,406	2,812,602
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	78,834,974	63,067,979	15,766,995
23	Insurance ..............	4,574,883	3,659,906	914,977
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	Repairs and Maintenance	15,460,884	12,368,707	3,092,177
b	Dues and Subscriptions	1,392,484	1,113,987	278,497
c	Recruitment	144,831	115,865	28,966
d	Restructuring	461,795	369,436	92,359
e	All other expenses	307,620,409	246,096,328	61,524,081	0
25	Total functional expenses. Add lines 1 through 24e	1,014,606,186	812,062,710	202,543,476	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............	2,230,184	1	1,350,704
2	Savings and temporary cash investments .........	39,301,890	2	18,841,179
3	Pledges and grants receivable, net ...........		3
4	Accounts receivable, net .............	125,813,285	4	144,501,814
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
		0	5	77,333
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
		0	6
7	Notes and loans receivable, net .............	4,278,068	7	7,227,592
8	Inventories for sale or use ..............	20,699,843	8	22,878,953
9	Prepaid expenses and deferred charges ..........	3,524,177	9	4,632,646
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,047,202,170
b	Less: accumulated depreciation .....	10b	406,548,747	589,663,295	10c	640,653,423
11	Investments—publicly traded securities ..........	0	11
12	Investments—other securities. See Part IV, line 11 .....	15,357,622	12
13	Investments—program-related. See Part IV, line 11 .....	440,699,160	13	454,733,518
14	Intangible assets ...............	88,074,186	14	88,074,186
15	Other assets. See Part IV, line 11 ...........	85,725,716	15	95,813,170
16	Total assets. Add lines 1 through 15 (must equal line 34)......	1,415,367,426	16	1,478,784,518
	17	Accounts payable and accrued expenses .........	81,549,962	17	102,771,713
18	Grants payable .................		18
19	Deferred revenue ................	1,424,064	19	1,636,044
20	Tax-exempt bond liabilities .............		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........	0	22
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....................	386,372,562	25	376,695,392
26	Total liabilities. Add lines 17 through 25.........	469,346,588	26	481,103,149
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	945,916,982	27	997,577,513
28	Temporarily restricted net assets ...........	103,856	28	103,856
29	Permanently restricted net assets ...........		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	946,020,838	33	997,681,369
34	Total liabilities and net assets/fund balances ........	1,415,367,426	34	1,478,784,518

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
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Attach to Form 990 or Form 990-EZ.
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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

PORTERCARE ADVENTIST HEALTH SYSTEM

Employer identification number

84-0438224

Part I

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

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

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

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

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

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

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

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

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

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

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

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

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

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

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

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

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

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations .............................

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

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


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

Page 2

Part II

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 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)		(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.

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

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

Section C. Computation of Public Support Percentage

Public support percentage for 2014 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2013 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2014. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2013. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2013. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

Schedule A (Form 990 or 990-EZ) 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)		(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)		(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.)..

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

Public support percentage for 2014 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2013 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2014 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2013 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2014. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2013. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

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

Schedule A (Form 990 or 990-EZ) 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

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.

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).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

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.

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.

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.

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....

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.

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).

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?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

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.

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) .

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).

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.

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.

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.

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

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

Has the organization accepted a gift or contribution from any of the following persons?

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

A family member of a person described in (a) above?

11b

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

Page 5

Part IV

Supporting Organizations (continued)

Section B. Type I Supporting Organizations

Yes

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.

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.

Section C. Type II Supporting Organizations

Yes

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).

Section D. All Type III Supporting Organizations

Yes

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?

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).

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.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

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.

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.

Parent of Supported Organizations. Answer (a) and (b) below.

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.

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.

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

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:	14000329
Software Version:	2014v1.0

- TIN:

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

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

OMB No. 1545-0047

2014

Name of the organization

PORTERCARE ADVENTIST HEALTH SYSTEM

Employer identification number

84-0438224

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

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

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

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

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

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Page 2

Name of organization PORTERCARE ADVENTIST HEALTH SYSTEM

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Page 3

Name of organization PORTERCARE ADVENTIST HEALTH SYSTEM

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Page 4

Name of organization
PORTERCARE ADVENTIST HEALTH SYSTEM

Employer identification number

84-0438224

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

(d) Description of how gift is held

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

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

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

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Additional Data

Software ID:	14000329
Software Version:	2014v1.0

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

Complete if the organization is described below. SchCMd Bullet

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

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

PORTERCARE ADVENTIST HEALTH SYSTEM

Employer identification number

84-0438224

Part I-A

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

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

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

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

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

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

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

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 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 Bullet

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

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

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

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

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the 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

Page 3

Part II-B

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

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

(a)

Yes

(b)

Amount

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

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

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

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

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

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

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

Yes

26,104

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

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

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

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

26,104

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

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

Part IV

Supplemental Information

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

Return Reference	Explanation
Schedule C, Part II-B, Line 1 DESCRIPTION OF THE ACTIVITIES REPORTED ON LINES 1A THROUGH 1I	LINE 1F ANNUAL DUES WERE PAID TO COLORADO HEALTH ASSOCIATION, A PORTION OF WHICH WERE ALLOCATED TO LOBBYING. THE AMOUNT THAT REPRESENTS THIS ENTITY'S SHARE OF THE ALLOCATED LOBBYING EXPENSE IS AS FOLLOWS: COLORADO HEALTH ASSOCIATION $26,104

Schedule C (Form 990 or 990EZ) 2014

Additional Data

Software ID:	14000329
Software Version:	2014v1.0

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990.
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

PORTERCARE ADVENTIST HEALTH SYSTEM

Employer identification number

84-0438224

Part I

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

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

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ....................	2d

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

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

(ii)

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

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2014

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No

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


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII .......

Part V

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

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....
b	Contributions ........
c	Net investment earnings, gains, and losses
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

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

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

Yes

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

3a(i)

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

3a(ii)

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

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

Part VI

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

Description of property		(a) Cost or other basis (investment)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	93,840,415		93,840,415
b	Buildings ................	643,193,498	267,435,330	375,758,168
c	Leasehold improvements ............
d	Equipment ................	245,537,541	139,113,417	106,424,124
e	Other .................	64,630,716		64,630,716
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				640,653,423

Schedule D (Form 990) 2014

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

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








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

Part VIII

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

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) AHS INVESTMENT	453,700,942	F
(2) DSRF INVESTMENT	1,032,576	F







Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)	454,733,518

Part IX

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

(a) Description				(b) Book value
(1) Investment in Unconsolidated Organizations				65,937,882
(2) Intercompany Receivables				22,597,670
(3) Deposits				3,465,539
(4) Current Portion of AWUIL				1,785,336
(5) Deferred Financing Costs				2,026,743
(6) Malpractice Recoveries



Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				95,813,170

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
Intercompany Payables		359,646,159
Annuities Payable		62,500
CRT Obligation		436,056
Malpractice		13,693,329
Physician Loan Forgiveness		2,333,507
Unclaimed Property		19,772
Environmental Remediation		410,729
Post Employment Benefits		93,340

Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		376,695,392
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

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

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

PORTERCARE ADVENTIST HEALTH SYSTEM'S FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF ADVENTIST HEALTH SYSTEM (AHS), A RELATED ORGANIZATION. AHS'S FIN 48 FOOTNOTE FOR THE YEAR ENDED DECEMBER 31, 2014 IS AS FOLLOWS: "HEALTHCARE CORPORATION AND ITS AFFILIATED ORGANIZATIONS, OTHER THAN NORTH AMERICAN HEALTH SERVICES, INC. AND ITS SUBSIDIARIES (NAHS), ARE EXEMPT FROM STATE AND FEDERAL INCOME TAXES. ACCORDINGLY, HEALTHCARE CORPORATION AND ITS TAX-EXEMPT AFFILIATES ARE NOT SUBJECT TO FEDERAL, STATE, OR LOCAL INCOME TAXES EXCEPT FOR ANY NET UNRELATED BUSINESS TAXABLE INCOME. NAHS IS A WHOLLY OWNED, FOR-PROFIT SUBSIDIARY OF HEALTHCARE CORPORATION. NAHS AND ITS SUBSIDIARIES ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. NAHS FILES A CONSOLIDATED FEDERAL INCOME TAX RETURN AND, WHERE APPROPRIATE, CONSOLIDATED STATE INCOME TAX RETURNS. 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 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 MATERICAL UNCERTAIN TAX POSITION AS OF DECEMBER 31, 2014 AND 2013."

Schedule D (Form 990) 2014

Additional Data

Software ID:	14000329
Software Version:	2014v1.0

- TIN:

SCHEDULE H (Form 990)

Department of the TreasuryInternal Revenue Service

Hospitals

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

PORTERCARE ADVENTIST HEALTH SYSTEM

Employer identification number

84-0438224

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other %

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

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

Yes

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

If the organization used factors other than FPG in determining eligibility, describe in Part VI the 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.

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

Yes

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

Yes

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

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) ..			9,152,494		9,152,494	0.93 %
b	Medicaid (from Worksheet 3, column a) ....			55,468,485		55,468,485	5.64 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .			0		0	0 %
d	Total Financial Assistance and Means-Tested Government Programs .	0	0	64,620,979	0	64,620,979	6.57 %
Other Benefits				752,858		752,858	0.08 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..			752,858		752,858	0.08 %
f	Health professions education (from Worksheet 5) ..			2,545,948		2,545,948	0.26 %
g	Subsidized health services (from Worksheet 6) ..			52,289		52,289	0.01 %
h	Research (from Worksheet 7)			5,517		5,517	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8)			422,473		422,473	0.04 %
j	Total. Other Benefits ..	0	0	3,779,085	0	3,779,085	0.38 %
k	Total. Add lines 7d and 7j .	0	0	68,400,064	0	68,400,064	6.96 %

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
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	0	0	0	0

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

31,434,400

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

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

Section B. Medicare

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

192,888,066

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

275,065,009

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

-82,176,943

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 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?5 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)								Other (describe)
3	PORTER ADVENTIST HOSPITAL www.porterhospital.org/ 1036	X	X		X	X
4	LITTLETON ADVENTIST HOSPITAL www.mylittletonhospital.org 1034	X	X			X	X	CHILDREN'S ER
1	PARKER ADVENTIST HOSPITAL www.parkerhospital.org 1005	X	X	X		X
2	AVISTA ADVENTIST HOSPITAL www.avistahospital.org 90831	X	X			X
5	CASTLE ROCK ADVENTIST HOSPITAL www.castlerockhospital.org 01L581	X	X			X

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)

	PORTER ADVENTIST HOSPITAL
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

Community Health Needs Assessment

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

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..........

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

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

Yes

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

Yes

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

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

Yes

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

Hospital facility’s website (list url): https://www.porterhospital.org/uploadedFiles/Centura/Content/Community/Community_Benefits/PAH_CHNA_2

Other website (list url): See Supplemental Narrative

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 12

Is the hospital facility's most recently adopted implementation strategy posted on a website? ........

Yes

If "Yes" (list url): https://www.porterhospital.org/uploadedFiles/Centura/Content/Community/Community_Benefits/Porter-Adv

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

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

If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ......

12b

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

Page

Part VFacility Information (continued)

	PORTER ADVENTIST HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Financial Assistance Policy (FAP)

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 1.0%
and FPG family income limit for eligibility for discounted care of 4.0%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

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):

Described the information the hospital facility may require an individual to provide as part of his or her application.

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application.

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process.

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications.

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?.......

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url): https://www.porterhospital.org/financial-help/

The FAP application form was widely available on a website (list url): https://www.centura.org/uploadedFiles/Centura/CNA/Patient_Resources/FA-Application-1112.pdf

A plain language summary of the FAP was widely available on a website (list url):
https://www.centura.org/uploadedFiles/Centura/CNA/Patient_Resources/FA-Application-1112.pdf

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

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

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

	PORTER ADVENTIST HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

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?.........

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

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

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

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

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

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

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

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

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

Other (describe in Section C)

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

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

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)

	LITTLETON ADVENTIST HOSPITAL
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

Community Health Needs Assessment

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

Yes

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

Yes

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

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

Yes

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

Hospital facility’s website (list url): https://www.mylittletonhospital.org/uploadedFiles/Centura/Content/Community/Community_Benefits/LAH_C

Other website (list url): See Supplemental Narrative

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 12

Is the hospital facility's most recently adopted implementation strategy posted on a website? ........

Yes

If "Yes" (list url): https://www.mylittletonhospital.org/uploadedFiles/Centura/Content/Community/Community_Benefits/Littl

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

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

If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ......

12b

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

Page

Part VFacility Information (continued)

	LITTLETON ADVENTIST HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Financial Assistance Policy (FAP)

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 1.0%
and FPG family income limit for eligibility for discounted care of 4.0%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

Described the information the hospital facility may require an individual to provide as part of his or her application.

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application.

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process.

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications.

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?.......

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url): https://www.mylittletonhospital.org/Financial-Help/

The FAP application form was widely available on a website (list url): https://www.centura.org/uploadedFiles/Centura/CNA/Patient_Resources/FA-Application-1112.pdf

A plain language summary of the FAP was widely available on a website (list url):
https://www.centura.org/uploadedFiles/Centura/CNA/Patient_Resources/FA-Application-1112.pdf

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

	LITTLETON ADVENTIST HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

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

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

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

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

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

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

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

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

Other (describe in Section C)

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

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)

	PARKER ADVENTIST HOSPITAL
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

Community Health Needs Assessment

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

Yes

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

Yes

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

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

Yes

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

Hospital facility’s website (list url): https://www.parkerhospital.org/uploadedFiles/Centura/Content/Community/Community_Benefits/PKR_CHNA_2

Other website (list url): See Supplemental Narrative

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 12

Is the hospital facility's most recently adopted implementation strategy posted on a website? ........

Yes

If "Yes" (list url): https://www.parkerhospital.org/uploadedFiles/Centura/Content/Community/Community_Benefits/Parker-Adv

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

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

If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ......

12b

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

Page

Part VFacility Information (continued)

	PARKER ADVENTIST HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Financial Assistance Policy (FAP)

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 1.0%
and FPG family income limit for eligibility for discounted care of 4.0%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

Described the information the hospital facility may require an individual to provide as part of his or her application.

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application.

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process.

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications.

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?.......

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url): https://www.parkerhospital.org/financial-help/

The FAP application form was widely available on a website (list url): https://www.centura.org/uploadedFiles/Centura/CNA/Patient_Resources/FA-Application-1112.pdf

A plain language summary of the FAP was widely available on a website (list url):
https://www.centura.org/uploadedFiles/Centura/CNA/Patient_Resources/FA-Application-1112.pdf

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

	PARKER ADVENTIST HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

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

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

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

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

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

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

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

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

Other (describe in Section C)

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

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)

	AVISTA ADVENTIST HOSPITAL
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

Community Health Needs Assessment

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

Yes

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

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

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

Yes

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

Hospital facility’s website (list url): https://www.avistahospital.org/avh/community/community-benefit/

Other website (list url): https://www.centura.org/community-benefits/

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 12

Is the hospital facility's most recently adopted implementation strategy posted on a website? ........

Yes

If "Yes" (list url): https://www.parkerhospital.org/uploadedFiles/Centura/Content/Community/Community_Benefits/PKR_CHNA_2

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

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

If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ......

12b

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

Page

Part VFacility Information (continued)

	AVISTA ADVENTIST HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Financial Assistance Policy (FAP)

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 1.0%
and FPG family income limit for eligibility for discounted care of 4.0%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

Described the information the hospital facility may require an individual to provide as part of his or her application.

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application.

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process.

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications.

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?.......

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url): https://www.avistahospital.org/financial-help/

The FAP application form was widely available on a website (list url): https://www.centura.org/uploadedFiles/Centura/CNA/Patient_Resources/FA-Application-1112.pdf

A plain language summary of the FAP was widely available on a website (list url):
https://www.centura.org/uploadedFiles/Centura/CNA/Patient_Resources/FA-Application-1112.pdf

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

	AVISTA ADVENTIST HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

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

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

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

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

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

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

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

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

Other (describe in Section C)

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

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)

	CASTLE ROCK ADVENTIST HOSPITAL
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

Community Health Needs Assessment

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

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

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

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

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

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

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

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

Hospital facility’s website (list url):

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

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

Indicate the tax year the hospital facility last adopted an implementation strategy: 20

Is the hospital facility's most recently adopted implementation strategy posted on a website? ........

If "Yes" (list url):

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

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

If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ......

12b

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

Page

Part VFacility Information (continued)

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

Yes

Financial Assistance Policy (FAP)

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 1.0%
and FPG family income limit for eligibility for discounted care of 4.0%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

Described the information the hospital facility may require an individual to provide as part of his or her application.

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application.

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process.

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications.

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?.......

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url): https://www.castlerockhospital.org/financial-help/

The FAP application form was widely available on a website (list url): https://www.centura.org/uploadedFiles/Centura/CNA/Patient_Resources/FA-Application-1112.pdf

A plain language summary of the FAP was widely available on a website (list url):
https://www.centura.org/uploadedFiles/Centura/CNA/Patient_Resources/FA-Application-1112.pdf

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

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

Yes

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

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

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

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

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

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

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

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

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

Other (describe in Section C)

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

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
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - PORTER ADVENTIST HOSPITAL. Community members were interviewed over a period of one year regarding the needs they perceived in their community for their perspectives on the predominant health issues in their communities. They were interviewed in either a one-on-one interview format, focus group, or as part of a Steering Committee. The interviewees comprised of representatives of the following groups: Local Fire Departments- Wayne Zygowicz, EMS Division Chief County Public Health Department- Patty Boyd, RD, MPH, Program Manager Home Health / Hospice- Melody Wright, CNO Long Term Care / Assisted Living- Camille Thompson, COO Christian Living Communities Marry-Well Colorado- Lauren Reitsma, Executive Director for Relationship Doctors Care- BeBe Kleinman, Executive Director Adventist Community Services- Michael Bright, Executive Director Stout Street Clinic- Carol Jenkins, RN
Schedule H, Part V, Section B, Line 6a Facility , 1	Facility , 1 - PORTER ADVENTIST HOSPITAL. Littleton Adventist Hospital Parker Adventist Hospital
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - Porter Adventist Hospital. Many of the needs identified will be indirectly addressed by addressing health outcomes in an upstream manner. For example, substance abuse, suicide, and heart disease will be addressed by targeting the primary health needs of mental health, access to care, and obesity. Many of the issues identified are being addressed by strong community groups. An internal capacity assessment concluded that it would be more fortuitous to support and partner with successful groups already working in the community, instead of using resources to create new strategies, when success programs and strategies already existed. To have the greatest impact on the needs were identified, community benefit resources were carefully planned and allocated towards targeted evidence based strategies known to directly impact and improve the identified needs.
Schedule H, Part V, Section B, Line 22 Facility , 1	Facility , 1 - Porter Adventist Hospital. Portercare Adventist Health System automatically discounts all self-pay patient accounts by 30% and also offers a prompt pay discount.
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - LITTLETON ADVENTIST HOSPITAL. Community members were interviewed for their perspectives on the predominant health issues in their communities. They were interviewed in either a one-on-one interview format, focus group, or as part of a Steering Committee. Data was collected over the period from June 2011 to June 2012. The interviewees comprised of representatives of the following groups: Littleton Fire Department- Wayne Zygowicz, EMS Division Chief Tri-County Department of Health- Patty Boyd, RD MPH, Program Manager Arapahoe Douglas Mental Health, Lisa Traudt Doctors Care- BeBe Kleinman, Executive Director Highlands Ranch Community Association - Jamie Noebel, Community Manager Healthy Communities Group of Centura Health's South Denver Operating Group -Colorado Wellness - Bonnie Thomas, Owner and Nurse -Porter Adventist Hospital - Dianne McCallister, Chief Medical Officer -Adventist Community Services - Michael Bright, Executive Director** -Littleton Adventist Hospital - Kim Muramoto, Trauma Director -City of Littleton - Susan Thornton, Ex-Mayor -Littleton Adventist Hospital - Rhonda Ward, Chief Nursing Officer -Emergency Medical Service - Wayne Zygowicz, Chief -Greater Youth Initiative - Kay Wilmesher -Littleton Adventist Hospital - Lawrence Wood, Chief Medical Officer
Schedule H, Part V, Section B, Line 6a Facility , 1	Facility , 1 - LITTLETON ADVENTIST HOSPITAL. Porter Adventist Hospital Parker Adventist Hospital
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - Littleton Adventist Hospital. Many of the needs identified will be indirectly addressed by addressing health outcomes in an upstream manner. For example, substance abuse, suicide, and heart disease will be addressed by targeting the primary health needs of mental health, access to care, and obesity. Many of the issues identified are being addressed by strong community groups. An internal capacity assessment concluded that it would be more fortuitous to support and partner with successful groups already working in the community, instead of using resources to create new strategies, when successful programs and strategies already existed. To have the greatest impact on the needs that were identified, community benefit resources were carefully planned and allocated towards targeted evidence based strategies known to directly impact and improve the identified needs.
Schedule H, Part V, Section B, Line 22 Facility , 1	Facility , 1 - Littleton Adventist. Portercare Adventist Health System automatically discounts all self-pay patient accounts by 30% and also offers a prompt pay discount.
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - Parker Adventist Hospital. The hospital retained the Center for Health Administration at the University of Colorado Denver to obtain community input. Community perspectives were gathered through telephone interviews during February and March 2012. Interview questions were phrased in an open-ended manner so that respondents could identify whatever issues were most important to them. They were also asked for ideas on ways that the hospital could assist them in improving the health of their community. Residents were also asked for ideas on ways that the hospital could assist them in improving the health of their community. The following organizations were chosen to provide input: City of Parker Crossroads Community Church Parker Chamber of Commerce Parker Police Department Parker Senior Center Parker Task Force Food Bank Ponderosa High School South Metro Fire Rescue Authority Tri-County Health Department Women's Crisis and Family Outreach Center
Schedule H, Part V, Section B, Line 6a Facility , 1	Facility , 1 - PARKER ADVENTIST HOSPITAL. Porter Adventist Hospital Littleton Adventist Hospital
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - Parker Adventist Hospital. Many of the needs identified will be indirectly addressed by addressing health outcomes in an upstream manner. For example, substance abuse, suicide, and heart disease will be addressed by targeting the primary health needs of mental health, access to care, and obesity. Many of the issues identified are being addressed by strong community groups. Rather than create new strategies where there existing successful strategies, Parker Hospital has decided to align its efforts with these successful community groups (e.g. Doctors Care).
Schedule H, Part V, Section B, Line 22 Facility , 1	Facility , 1 - Parker Adventist Hospital. Portercare Adventist Health System automatically discounts all self-pay patient accounts by 30% and also offers a prompt pay discount.
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - AVISTA ADVENTIST HOSPITAL. Rather than repeat a duplicative community engagement with the same stakeholders, Avista chose to utilize the community feedback obtained through BCPH's PHIP. Primetime Research and Evaluation conducted interviews with the BCPH PHIP Core Team, as well as selected BCPH employees and a variety of community stakeholders. The interviews consisted of a review of a list of 30+ health outcomes and were followed by a discussion of what the interviewee felt were the most important health outcomes to prioritize over the next five years. Primetime Research and Evaluation also completed the formal health system capacity assessment in Boulder County, which was conducted through a series of ten 3-hour meetings held during the month of May 2011. Each meeting focused on one of the Ten Essential Public Health Services. These meetings were conducted through facilitated focus groups consisting of 6-10 invited participants. These participants' tasks were 1) to review the evaluation measures developed by the NPHPSP for that session's essential service, 2) participate in the group discussion about the health system's capacity and performance of that public health function, 3) come to a consensus on a rating score of the current capacity, and 4) to express concerns and provide recommendations for improvement. Participants selected for each meeting were chosen based on area of expertise or interest and relationship to the essential service to be discussed. Invitations were sent to a broad range of key partners from the local public health agency, state service agencies, community based organizations, academic institutions, hospitals, school systems, foundations, law enforcement agencies, and non-profit organizations. Additionally, invitations were sent to people in local governmental or quasi-governmental entities including first responders, elected officials, social service providers, administrators, diversity advocates, and others. Invitations were also extended to individuals in the business community, media, and judicial institutions. Approximately 70 key participants (6-10 per meeting) responded to the request to participate in the assessment sessions.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - Avista Adventist Hospital. Key health needs for Avista were identified as access to health services, diabetes, mental health/substance abuse, obesity, and immunizations. After doing an assessment of existing capacity and community efforts, Avista hospital decided to focus on access to services and diabetes. The needs not addressed were already being addressed by strong community organizations, and hospital resources were better used towards creating targeted strategies to impact the prioritized needs. For example, Boulder County Public Health has an extensive immunization program. Instead of duplicating efforts, Avista decided to align and refer to Boulder County for immunizations. Efforts were strategically targeted towards areas where the largest need existed, and where Avista could have the greatest impact.
Schedule H, Part V, Section B, Line 22 Facility , 1	Facility , 1 - Avista Adventist Hospital. Portercare Adventist Health System automatically discounts all self pay patient accounts by 30% and also offers a prompt pay discount.
Schedule H, Part V, Section B, Line 22 Facility , 1	Facility , 1 - Castle Rock Adventist Hospital. Portercare Adventist Health System automatically discounts all self-pay patient accounts by 30% and also offers a prompt pay discount.

Schedule H (Form 990) 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?56
Name and address		Type of Facility (describe)
1	DIMENSION PAIN MANAGEMENT 400 W 144TH AVE STE 240 WESTMINSTER,CO80023	EMP PHYSICIAN GROUP
2	COLORADO HEAD AND NECK SPECIALISTS 2555 S DOWNING ST STE 100 DENVER,CO80210	EMP PHYSICIAN GROUP
3	CLEMENT PARK FAMILY MEDICINE 6901 S PIERCE ST STE 110 LITTLETON,CO80128	EMP PHYSICIANS GROUP
4	MOUNTAIN VIEW FAMILY PHYSICIANS 2020 ONEIDA ST DENVER,CO80224	EMP PHYSICIAN GROUP
5	COLORADO NEUROVASCULAR SPECIALISTS 7780 S BROADWAY LITTLETON,CO80122	EMP PHYSICIAN GROUP
6	ACCESS FAMILY MEDICINE 19284 COTTONWOOD DRIVE SUITE 201 PARKER,CO80138	EMP PHYSICIAN GROUP
7	SOUTH SUBURBAN INTERNAL MEDICINE 7750 S BROADWAY LITTLETON,CO80122	EMP PHYSICIAN GROUP
8	CENTURA HEALTH AT SOUTHLANDS 6240 SO MAIN ST STE 255 AURORA,CO80016	EMP PHYSICIAN GROUP
9	BOULDER HOLISTIC MEDICINE 805 S BROADWAY SUITE 103 BOULDER,CO80305	EMP PHYSICIAN GROUP
10	AVISTA FAMILY MEDICINE GUNBARREL 5365 SPINE ROAD SUITE C BOULDER,CO80301	EMP PHYSICIAN GROUP
11	NORTHWEST GASTROENTEROLOGY 80 HEALTH PARK DRIVE LOUISVILLE,CO80027	EMP PHYSICIAN GROUP
12	RIDGELINE FAMILY MEDICINE 2352 MEADOWS BLVD STE 300 CASTLE ROCK,CO80108	EMP PHYSICIANS GROUP
13	COLORADO JOINT REPLACEMENT 2535 S DOWNING ST DENVER,CO80210	EMP PHYSICIAN GROUP
14	AVISTA INTERNAL MEDICINE 90 HEALTHPARK DR STE 350 LOUISVILLE,CO80027	EMP PHYSICIAN GROUP
15	COMPREHENSIVE BREAST CARE 2555 S DOWNING ST SUITE 130 DENVER,CO80210	EMP PHYSICIAN GROUP
16	CENTER FOR ORTHOPEDICS 7720 S BROADWAY LITTLETON,CO80122	EMP PHYSICIAN GROUP
17	CHATFIELD WOMEN'S CARE 7720 S BROADWAY LITTLETON,CO80122	EMP PHYSICIAN GROUP
18	PARKER ENDOCRINOLOGY 9397 CROWN CREST BLVD STE 220 PARKER,CO80138	EMP PHYSICIANS GROUP
19	APOLLO INTERNAL MEDICINE 950 E HARVARD AVE SUITE 530 DENVER,CO80210	EMP PHYSICIAN GROUP
20	PRIMARY CARE (HARVARD PARK) 950 E HARVARD AVE SUITE 660 DENVER,CO80210	EMP PHYSICIAN GROUP
21	CENTURA HEALTH PHYSICIAN GROUP AT CLERMONT PARK 2479 S CLERMONT ST DENVER,CO80222	EMP PHYSICIANS GROUP
22	PORTER HOSPICE 1391 SPEER BLVD 600 DENVER,CO80204	ADMIN OFFICE HOME HOSPICE COORDINATION
23	PINNACLE WOMEN'S HEALTHCARE AT PARKER 9397 CROWN CREST BLVD STE 331 PARKER,CO80138	EMP PHYSICIANS GROUP
24	COMPREHENSIVE OBGYN AT PARKER 9397 CREOWN CREST BLVD STE 431 PARKER,CO80138	EMP PHYSICIANS GROUP
25	HIGHLANDS RANCH MEDICAL ASSOCIATES 9135 S RIDGELINE BLVD STE 190 HIGHLANDS RANCH,CO80129	EMP PHYSICIANS GROUP
26	AVISTA WOMEN'S HEALTH 611 MITCHELL WAY STE 103 ERIE,CO80516	EMP PHYSICIAN GROUP
27	MILE HIGH ONCOLOGY 7780 S BROADWAY STE 380 LITTLETON,CO80122	EMP PHYSICIAN GROUP
28	CYPRESS HEMOTOLOGY AND ONCOLOGY 2555 S DOWNING ST STE 240 DENVER,CO80210	EMP PHYSICIAN GROUP
29	AVISTA FAMILY MEDICINE (ERIE) 611 MITCHELL WAY ERIE,CO80516	EMP PHYSICIAN GROUP
30	FLATRONS HEART AND VASCULAR 90 HEALTHPARK DRIVE STE 350 LOUISVILLE,CO80027	EMP PHYSICIAN GROUP
31	ENDOSCOPY CENTER AT PORTER LLC 1001 SOUTH PARK DRIVE LITTLETON,CO80120	DIAGNOSTIC SERVICES
32	COLORADO ENT SPECIALISTS 9397 CROWN CREST BLVD STE 431 PARKER,CO80138	EMP PHYSICIAN GROUP
33	CYPRESS ONCOLOGY - PKR 9399 CROWN CREST BLVD SUITE 215 PARKER,CO80138	EMP PHYSICIAN GROUP
34	ARACEA WOMEN'S CENTER 300 S JACKSON ST DENVER,CO80209	EMP PHYSICIAN GROUP
35	South Denver Cardiology Associates 1000 SouthPark Drive LITTLETON,CO80120	EMP PHYSICIANS GROUP
36	CHATFIELD FAMILY MEDICINE 10789 BRADFORD RD STE 150 LITTLETON,CO80127	EMP PHYSICIAN GROUP
37	TIMBERVIEW CLINIC AT PARKER 9399 CROWN CREST BLVD STE 200 PARKER,CO80138	EMP PHYSICIAN GROUP
38	INTEGRATED OBGYN AT PARKER 9397 CROWN CREST BLVD STE 220 PARKER,CO80138	EMP PHYSICIANS GROUP
39	CENTER ENDOCRINOLOGY AND DIABETES 7750 S BROADWAY STE 220 LITTLETON,CO80122	EMP PHYSICIAN GROUP
40	PORTER PRIMARY CARE 300 S JACKSON ST DENVER,CO80209	EMP PHYSICIAN GROUP
41	BARIATRIC AND METABOLIC CENTER 9399 CROWN CREST BLVD STE 110 PARKER,CO80138	EMP PHYSICIAN GROUP
42	EP CLINIC 2525 S DOWNING ST CARDIAC CATH LAB DENVER,CO80210	EMP PHYSICIAN GROUP
43	CENTURA MEDICAL ASSOCIATES 2525 S DOWNING ST DENVER,CO80210	EMP PHYSICIAN GROUP
44	SOUTH QUEBEC FAMILY MEDICINE 6081 S QUEBEC ST STE 100 CENTENNIAL,CO80111	EMP PHYSICIANS GROUP
45	AFFILIATED EAR NOSE AND THROAT PHYSICIANS 8000 E PRENTICE AVE STE D12 GRENWOOD VILLAGE,CO80111	EMP PHYSICIANS GROUP
46	Castle Rock Affiliated ENT 2352 Meadows Blvd Castle Rock,CO80109	EMP PHYSICIANS GROUP
47	Castle Rock Orthopedics 2352 Meadows Blvd Castle Rock,CO80109	EMP PHYSICIANS GROUP
48	Castle Rock Oncology 2352 Meadows Blvd Castle Rock,CO80109	EMP PHYSICIANS GROUP
49	Castle Rock Hospitalists 2353 Meadows Blvd Castle Rock,CO80109	EMP PHYSICIANS GROUP
50	Ridgeline Family Medicine at Castle Pines 250 Max Drive Castle Pines,CO80109	EMP PHYSICIANS GROUP
51	CHPG Ridgegate OBGYN at CRAH 2352 Meadows Blvd Castle Rock,CO80109	EMP PHYSICIANS GROUP
52	CHPG Ridgegate OBGYN at Lone Tree 10099 Ridgegate Parkway Lone Tree,CO80124	EMP PHYSICIANS GROUP
53	CHPG Senior Care PAHS Holly Creek 5500 East Peakview Ave Centennial,CO80121	EMP PHYSICIANS GROUP
54	Center for Endocrinology and Diabetes 7750 S Broadway Littleton,CO80122	EMP PHYSICIANS GROUP
55	South Quebec Family Medicine 6081 South Quebec St Centennial,CO80111	EMP PHYSICIANS GROUP
56	South Suburban Internal Medicine 7750 South Broadway Littleton,CO80122	EMP PHYSICIANS GROUP

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
Schedule H, Part V, Section B, Line 1 CASTLE ROCK ADVENTIST HOSPITAL	CASTLE ROCK ADVENTIST HOSPITAL OPENED IN AUGUST OF 2013. THE COMMUNITY HEALTH NEEDS ASSESSMENT WILL BE COMPLETED IN FY16 AND REPORTED ON THE 2015 FORM 990.
Schedule H, Part V, Section B, Line 16c AVISTA ADVENTIST HOSPITAL	https://www.avistahospital.org/for-patients-and-families/billing-and-financial-services/financial-help/
Schedule H, Part V, Section B, Line 16a PARKER ADVENTIST HOSPITAL	https://www.parkerhospital.org/for-patients-and-families/billing-and-financial-services/financial-help/
Schedule H, Part V, Section B, Line 16b PARKER ADVENTIST HOSPITAL	https://www.parkerhospital.org/for-patients-and-families/billing-and-financial-services/financial-help/
Schedule H, Part V, Section B, Line 16c PARKER ADVENTIST HOSPITAL	https://www.parkerhospital.org/for-patients-and-families/billing-and-financial-services/financial-help/
Schedule H, Part V, Section B, Line 16a AVISTA ADVENTIST HOSPITAL	https://www.avistahospital.org/for-patients-and-families/billing-and-financial-services/financial-help/
Schedule H, Part V, Section B, Line 16b AVISTA ADVENTIST HOSPITAL	https://www.avistahospital.org/for-patients-and-families/billing-and-financial-services/financial-help/
Schedule H, Part V, Section B, Line 7 Parker Adventist Hospital	https://www.centura.org/uploadedFiles/Centura/Content/Community/Community_Benefits/PKR_CHNA_2012_Final.pdf
Schedule H, Part V, Section B, Line 7 Porter Adventist Hospital	https://www.centura.org/uploadedFiles/Centura/Content/Community/Community_Benefits/PAH_CHNA_2012_Final.pdf
Schedule H, Part V, Section B, Line 7 Littleton Adventist Hospital	https://www.centura.org/uploadedFiles/Centura/Content/Community/Community_Benefits/LAH_CHNA_2012_Final.pdf
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation	31433765
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	PORTERCARE ADVENTIST HEALTH SYSTEM DOES NOT USE A COST ACCOUNTING SYSTEM TO DETERMINE THE COST OF CHARITY CARE PROVIDED. THE ESTIMATED COST OF CARE IS CALCULATED BY APPLYING THE RATIO OF EACH FACILITY'S TOTAL EXPENSES TO TOTAL GROSS REVENUE, APPLIED TO THE APPLICABLE GROSS REVENUES (E.G. MEDICARE, MEDICAID). WORKSHEET 2 WAS NOT USED TO DEVELOP THE COST TO CHARGE RATIO.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	Portercare Adventist Health System (PAHS) USES THE OVERALL COST TO GROSS CHARGE RATIO APPLICABLE TO EACH FACILITY TO DETERMINE THE COSTS IN PART III LINES 2 AND 3. PAHS AUTOMATICALLY DISCOUNTS ALL SELF PAY PATIENT ACCOUNTS BY 30% AND ALSO OFFERS A PROMPT PAY DISCOUNT. THIS ALLOWANCE IS NOT INCLUDED IN THE CALCULATION OF THE COST OF BAD DEBTS IN INSTANCES WHERE A PATIENT DOES NOT PAY HIS OR HER BILL.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	Portercare Adventist Health System does not believe that any portion of bad debt expense could reasonably be attributed to patients who qualify for financial assistance since amounts due from those individuals' accounts will be reclassified from bad debt expense to charity care within 30 days following the date that the patient is determined to qualify for charity care.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	PORTERCARE ADVENTIST HEALTH SYSTEM (PAHS) DOES NOT ISSUE SEPARATE AUDITED FINANCIAL STATEMENTS; HOWEVER, PAHS IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF ADVENTIST HEALTH SYSTEM (AHS) AND THEIR FOOTNOTE IS REFERENCED BELOW. BAD DEBT EXPENSE IS REPORTED ON PAHS' INTERNAL FINANCIAL STATEMENTS AS AN EXPENSE. THE AMOUNT REPORTED IS BASED ON THE AMOUNT DEEMED TO NOT BE COLLECTIBLE BY PATIENTS WHO HAVE THE ABILITY TO PAY. FINANCIAL STATEMENT FOOTNOTE RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS: THE SYSTEM'S PATIENT ACCEPTANCE POLICY IS BASED ON ITS MISSION STATEMENT AND ITS CHARITABLE PURPOSES. ACCORDINGLY, THE SYSTEM ACCEPTS PATIENTS IN IMMEDIATE NEED OF CARE, REGARDLESS OF THEIR ABILITY TO PAY. PATIENT SERVICE REVENUE IS REPORTED AT ESTIMATED NET REALIZABLE AMOUNTS FOR SERVICES RENDERED. THE SYSTEM RECOGNIZES PATIENT SERVICE REVENUE ASSOCIATED WITH PATIENTS WHO HAVE THIRD-PARTY PAYOR COVERAGE ON THE BASIS OF CONTRACTUAL RATES FOR THE SERVICES RENDERED. FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, REVENUE IS RECOGNIZED ON THE BASIS OF DISCOUNTED RATES IN ACCORDANCE WITH THE SYSTEM'S POLICY. PATIENT SERVICE REVENUE IS REDUCED BY THE PROVISION FOR BAD DEBTS AND ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THESE AMOUNTS ARE BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS FOR EACH MAJOR PAYOR SOURCE, CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE AND OTHER COLLECTION INDICATORS. MANAGEMENT REGULARLY REVIEWS COLLECTIONS DATA BY MAJOR PAYOR SOURCES IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. ON THE BASIS OF HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF THE SYSTEM'S SELF-PAY PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR SERVICES PROVIDED. THUS, THE SYSTEM RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD SERVICES ARE PROVIDED RELATED TO SELF-PAY PATIENTS. THE SYSTEM'S ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS FOR SELF-PAY PATIENTS WAS 97% OF SELF-PAY ACCOUNTS RECEIVABLE AS OF DECEMBER 31, 2014 AND 2013. FOR RECEIVABLES ASSOCIATED WITH PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE SYSTEM'S POLICIES. FOR ALL PATIENTS OTHER THAN CHARITY PATIENTS, PATIENT SERVICE REVENUE, NET OF CONTRACTUAL ALLOWANCES AND SELF-PAY DISCOUNTS AND BEFORE THE PROVISION FOR BAD DEBTS, RECOGNIZED FROM MAJOR PAYOR SOURCES IS AS FOLLOWS: THIRD PARTY PAYORS, NET OF CONTRACUTAL ALLOWANCES: 2014: $8,074,102 2013: $7,240,083 SELF-PAY PATIENTS, NET OF DISCOUNTS 2014: $396,147 2013: $426,173 THE SYSTEM HAS NOT EXPERIENCED SIGNIFICANT CHANGES IN WRITE-OFF TRENDS AND HAS NOT CHANGED ITS SELF-PAY DISCOUNT OR CHARITY CARE POLICY FOR THE YEARS ENDED DECEMBER 31, 2014 OR 2013. THE SYSTEM HAS DETERMINED, BASED ON AN ASSESSMENT AT THE REPORTING-ENTITY LEVEL, THAT PATIENT SERVICE REVENUE IS PRIMARILY RECORDED PRIOR TO ASSESSING THE PATIENT'S ABILITY TO PAY AND AS SUCH, THE ENTIRE PROVISION FOR BAD DEBTS IS RECORDED AS A DEDUCTION FROM PATIENT SERVICE REVENUE IN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	Cost for each hospital's cost report is pulled from year end trial balances. The cost is then evaluated and all non-allowable cost is removed via adjustments. The remaining allowable cost is then allocated to appropriate patient care and non-patient care cost centers based on Medicare allocation principles. 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.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	Portercare Adventist Health System's debt collection policy provides the performance of a reasonable review of each patient's account prior to turning an account over to a third-party collection agent and prior to instituting any legal action for non-payment. The review of patient accounts is done to assure that the patient or their guarantor is not eligible for assistance through Portercare Adventist Health System's charity care policy, uninsured discount policy or another financial assistance program (i.e. Medicaid). Portercare Adventist Health System requires the following of its third-party collection agencies: * Neither Portercare Adventist Health System hospitals or their collection agencies will request bench or arrest warrants as a result of non-payment; * Neither Portercare Adventist Health System hospitals or their collection agencies will seek liens that would require the sale or foreclosure of a primary residence; and * No Portercare Adventist Health System collection agency may seek court action without hospital approval.
Schedule H, Part V, Section B, Line 16a FAP website	- PARKER ADVENTIST HOSPITAL: Line 16a URL: https://www.parkerhospital.org/financial-help/; - AVISTA ADVENTIST HOSPITAL: Line 16a URL: https://www.avistahospital.org/financial-help/; - PORTER ADVENTIST HOSPITAL: Line 16a URL: https://www.porterhospital.org/financial-help/; - LITTLETON ADVENTIST HOSPITAL: Line 16a URL: https://www.mylittletonhospital.org/Financial-Help/; - CASTLE ROCK ADVENTIST HOSPITAL: Line 16a URL: https://www.castlerockhospital.org/financial-help/;
Schedule H, Part V, Section B, Line 16b FAP Application website	- PARKER ADVENTIST HOSPITAL: Line 16b URL: https://www.centura.org/uploadedFiles/Centura/CNA/Patient_Resources/FA-Application-1112.pdf; - AVISTA ADVENTIST HOSPITAL: Line 16b URL: https://www.centura.org/uploadedFiles/Centura/CNA/Patient_Resources/FA-Application-1112.pdf; - PORTER ADVENTIST HOSPITAL: Line 16b URL: https://www.centura.org/uploadedFiles/Centura/CNA/Patient_Resources/FA-Application-1112.pdf; - LITTLETON ADVENTIST HOSPITAL: Line 16b URL: https://www.centura.org/uploadedFiles/Centura/CNA/Patient_Resources/FA-Application-1112.pdf; - CASTLE ROCK ADVENTIST HOSPITAL: Line 16b URL: https://www.centura.org/uploadedFiles/Centura/CNA/Patient_Resources/FA-Application-1112.pdf;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- PARKER ADVENTIST HOSPITAL: Line 16c URL: https://www.parkerhospital.org/financial-help/; - AVISTA ADVENTIST HOSPITAL: Line 16c URL: https://www.avistahospital.org/financial-help/; - PORTER ADVENTIST HOSPITAL: Line 16c URL: https://www.porterhospital.org/financial-help/; - LITTLETON ADVENTIST HOSPITAL: Line 16c URL: https://www.mylittletonhospital.org/Financial-Help/; - CASTLE ROCK ADVENTIST HOSPITAL: Line 16c URL: https://www.castlerockhospital.org/financial-help/;
Schedule H, Part VI, Line 2 Needs assessment	The hospitals provides several services and resources to the communities it serves beyond the prioritized needs specifically identified in the Community Needs Assessment. It sponsors wellness events such as breast feeding education, asthma screenings, and financially supports wellness initiatives of cities and public schools. It also provides transportation for low income patients and housing at no cost or very low cost for the families of low income patients of the hospitals that are far from their residence. It also supports, financially and through volunteerism, initiatives such as soup kitchens and meals on wheels to provide food and nutrition education to address hunger issues. Hospital staff also volunteer to serve as preceptors for students of local health professional programs and serve on boards of local community organizations that provide social services to populations in need.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	Information concerning financial assistance is included on Centura's website. The website not only lists phone numbers for patients to call to discuss financial assistance, but also includes Centura's policy for charity care and its policies related to uninsured patients. In addition, at the time of registration, uninsured patients are screened to determine if the patients qualify for any Federal, State or County programs. Uninsured patients are also sent a letter requesting that the patient call to determine eligibility for various assistance programs, including charity.
Schedule H, Part VI, Line 4 Community information	Portercare Adventist Health System hospitals provides healthcare services to the direct and surrounding communities where they are located. In addition, due to some of the specialized healthcare services available at these hospital facilities, a number of our patients come from what would be considered outside the immediate geographic area. Many Portercare related hospitals serve the Front Range communities, which have diverse populations and different healthcare needs.
Schedule H, Part VI, Line 5 Promotion of community health	Portercare Adventist Health System hospitals implements several efforts and initiatives to promote the health of the community. It provides financial and volunteer support to clinics that provide care to low income patients. Staff volunteer on the boards of community based organizations that provide essential services to disadvantaged patients. Furthermore, the hospitals provides donations to the initiatives of community based organizations, cities and public schools to support events that promote health and wellness.
Schedule H, Part VI, Line 6 Affiliated health care system	Portercare Adventist Health System is operated as part of Centura Health Corporation ("Centura"). Centura and its affiliated organizations are dedicated to extending the healing ministry of Christ by caring for those who are ill and by nurturing the health of the people in our communities. Specifically, Centura has launched a system-wide strategic plan to improve the quality, consistency, availability, and affordability of health care to communities throughout Colorado. The three main components of this strategy are (1) to continue investing in technology advancements that improve the quality, costs, and coordination of care including the establishment of electronic health records linking our physicians, clinics, hospitals, long-term facilities and home care services; (2) providing wellness care, thereby potentially reducing health care costs by helping patients to maintain good health, growing the level of support and outreach provided to rural communities, and increasing access, affordability and quality of health care; and (3) coordinate and develop systems of care, looking to each facility and entity in Centura to share best practices and improve overall efficiency and communication system-wide from birth to home care.
Schedule H, Part VI, Line 7 State filing of community benefit report	CO

Schedule H (Form 990) 2014

Additional Data

Software ID:	14000329
Software Version:	2014v1.0

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

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

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

Attach to Form 990.
lBullet

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

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization
PORTERCARE ADVENTIST HEALTH SYSTEM

Employer identification number
84-0438224

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

Grants and Other Assistance to 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) Doctors Care 191 E Orchard Rd 102NE Littleton,CO80121	84-1150815	501(c)(3)	0	40,000	Book	Drugs	Donation for 2015
(2) Arthritis Foundation 2280 S Albion St Denver,CO80222	38-3826066	501(c)(3)	19,750				Sponsorship
(3) University of Denver 2201 S Gaylord St Denver,CO80208	84-0404231	501(c)(3)	12,500				Sponsorship
(4) Colorado Wellness Connection 4960 E Mineral Circle Centennial,CO80122	84-1504515	501(c)(3)	7,500				Health Fair
(5) Clinica Campesina 345 Plaza Court N 1A Lafayette,CO80026	84-0743432	501(c)(3)	166,129				Mission Support
(6) Portercare Foundation 7995 E Prentice Ave 204 Greenwood Village,CO80111	84-0745018	501(c)(3)	29,160				Sponsorship
(7) Denver Botanic Gardens 909 York St Denver,CO80206	84-0440359	501(c)(3)	14,750				Sponsorship
(8) Women's Crisis Center PO Box 367 Castle Rock,CO80104	74-2385006	501(c)(3)	7,500				Sponsorship
(9) Classic Bicycle Racing 1515 Arapahoe St Denver,CO80202	27-3045655		6,250				2014 Pro Challenge
(10) Douglas County Libraries Foundation 9292 Ridgeline Blvd Highlands Ranch,CO80129	84-1207775	501(c)(3)	5,175				Sponsorship
(11) Greater Parker Foundation 20120 East Main St Parker,CO80138	26-3664272	501(c)(3)	10,000				Sponsorship
(12) Highlands Ranch Community Association 9568 S University Blvd Highlands Ranch,CO80126	84-0869474	501(c)(3)	6,667				Sponsorship
(13) Littleton Adventist Hospital Dept 1640 Denver,CO80291	84-0438224	501(c)(3)	19,527				Sponsorship
(14) Littleton Public Schools Foundation 5776 S Crocker St Littleton,CO80120	84-1185005	501(c)(3)	15,000				Sponsorship
(15) Parker Chamber of Commerce 19590 East Main St 100 Parker,CO80138	84-0721419	501(c)(6)	6,200				Membership
(16) Parker Task Force PO Box 2645 Parker,CO80134	74-2494265	501(c)(3)	10,000				Sponsorship
(17) The Community Foundation 1123 Spruce St Boulder,CO80302	84-1171836	501(c)(3)	6,000				Sponsorship
(18) Town of Castle Rock 100 N Wilcox Castle Rock,CO80104	84-6000640	501(c)(3)	10,296				Sponsorship
(19) March of Dimes 421 South Tejon 310 Colorado Springs,CO80903	13-1846366	501(c)(3)	7,500				Sponsorship

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 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

Schedule I, Part I, Line 2 Description Of Procedure For Monitoring Use Of Grant Funds

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

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

Schedule I (Form 990) 2014

Additional Data

Software ID:	14000329
Software Version:	2014v1.0

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

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

Attach to Form 990.
SchJMediumBullet

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

PORTERCARE ADVENTIST HEALTH SYSTEM

Employer identification number

84-0438224

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

Yes

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

Yes

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

Yes

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

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

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

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

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

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

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

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

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

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

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

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

Yes

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1RANDY HAFFNER CHAIRMAN	(i) (ii)	591,435 ............................... 0	219,184 ............................... 0	119,139 ............................... 0	140,604 ............................... 0	21,767 ............................... 0	1,092,129 ............................... 0	109,812 ............................... 0
2ROBERT HENDERSCHEDT BOARD MEMBER	(i) (ii)	0 ............................... 650,059	0 ............................... 222,556	0 ............................... 151,756	0 ............................... 138,708	0 ............................... 45,042	0 ............................... 1,208,121	0 ............................... 98,094
3TERRY SHAW BOARD MEMBER	(i) (ii)	0 ............................... 936,467	0 ............................... 320,728	0 ............................... 249,120	0 ............................... 204,363	0 ............................... 53,247	0 ............................... 1,763,925	0 ............................... 175,971
4Dennis Barts CEO - Avista Adventist Hospital	(i) (ii)	318,011 ............................... 0	126,615 ............................... 0	7,299 ............................... 0	53,702 ............................... 0	12,348 ............................... 0	517,975 ............................... 0	12,835 ............................... 0
5CHERYL CURRY CFO-Littleton Adventist Hosp	(i) (ii)	248,095 ............................... 0	63,508 ............................... 0	2,274 ............................... 0	15,600 ............................... 0	19,063 ............................... 0	348,540 ............................... 0	0 ............................... 0
6MORRE DEAN CEO-Porter Adventist Hospital	(i) (ii)	373,371 ............................... 0	74,132 ............................... 0	47,245 ............................... 0	86,482 ............................... 0	21,495 ............................... 0	602,725 ............................... 0	31,506 ............................... 0
7Jonathan Fisher CFO -Parker Adventist Hospital	(i) (ii)	176,013 ............................... 0	29,136 ............................... 0	1,398 ............................... 0	10,089 ............................... 0	18,084 ............................... 0	234,720 ............................... 0	0 ............................... 0
8ANDREW GAASCH CFO-PORTER ADVENTIST HOSP	(i) (ii)	284,365 ............................... 0	66,061 ............................... 0	823 ............................... 0	12,900 ............................... 0	18,392 ............................... 0	382,541 ............................... 0	0 ............................... 0
9Brett Spenst CEO-Littleton Adventist Hospital	(i) (ii)	301,218 ............................... 0	115,089 ............................... 0	11,184 ............................... 0	69,950 ............................... 0	13,062 ............................... 0	510,503 ............................... 0	0 ............................... 0
10Douglas Dennis PHYSICIAN	(i) (ii)	738,413 ............................... 0	400,080 ............................... 0	6,216 ............................... 0	15,600 ............................... 0	14,771 ............................... 0	1,175,080 ............................... 0	0 ............................... 0
11Raymond Kim Physician	(i) (ii)	1,147,849 ............................... 0	400,580 ............................... 0	1,125 ............................... 0	15,600 ............................... 0	23,709 ............................... 0	1,588,863 ............................... 0	0 ............................... 0
12Todd Miner Physician	(i) (ii)	979,666 ............................... 0	429,330 ............................... 0	1,693 ............................... 0	15,600 ............................... 0	23,641 ............................... 0	1,449,930 ............................... 0	0 ............................... 0
13Christopher OLIVER PHYSICIAN	(i) (ii)	932,071 ............................... 0	0 ............................... 0	784 ............................... 0	15,600 ............................... 0	20,329 ............................... 0	968,784 ............................... 0	0 ............................... 0
14Charlie Yang PHYSICIAN	(i) (ii)	758,039 ............................... 0	400,000 ............................... 0	914 ............................... 0	15,600 ............................... 0	22,192 ............................... 0	1,196,745 ............................... 0	0 ............................... 0

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
REPORTABLE INDIVIDUALS COMPENSATED BY UNRELATED ORGANIZATIONS	ALL KEY EMPLOYEES AND HOSPITAL CEOS ARE COMPENSATED BY CENTURA HEALTH CORPORATION, WHO MANAGES THE DAILY ACTIVITIES OF PORTERCARE ADVENTIST HOSPITALS UNDER A JOINT OPERATING AGREEMENT DATED DECEMBER 8, 1995 BETWEEN THE ADVENTIST HEALTHCARE SYSTEM AND CATHOLIC HEALTH INITIATIVES. AS SUCH, THEIR SALARIES ARE PAID TO THEM BY CENTURA, AN UNRELATED ORGANIZATION, FOR SERVICES RENDERED IN THEIR CAPACITY AS KEY EMPLOYEES OR OFFICERS OF PAHS. ALL OF THEIR REPORTABLE COMPENSATION IS DISCLOSED ON FORM 990, SCHEDULE J, PART II, ROW (I) AND FORM 990, PART VII, COLUMN (D) AS REPORTING ORGANIZATION COMPENSATION. IN ADDITION, THE CEO AND CFO OF PAHS WERE APPOINTED AS SUCH BY THE PAHS BOARD OF DIRECTORS. WHILE THEY ARE OFFICERS OF THESE ENTITIES, A VERY SMALL PORTION OF THEIR TIME IS DIRECTLY RELATED TO THE OPERATIONS OF PAHS. THEY ARE COMPENSATED BY CENTURA, WHICH IS CHARGED WITH MANAGING THE FACILITIES. THEIR RESPECTIVE COMPENSATION IS NOT REPORTED ON THE FILING ORGANIZATION'S 990 BUT IN FACT IS REPORTED IN FULL ON PART VII AND SCHEDULE J OF CENTURA HEALTH CORPORATION'S FORM 990.
Schedule J, Part I, Line 1a Travel for companions	SENIOR VPS AND HOSPITAL CEOS ARE PAID THROUGH CENTURA HEALTH CORP AND ARE ELIGIBLE FOR THE FOLLOWING BENEFITS: TRAVEL FOR COMPANIONS, HEALTH OR SOCIAL CLUB DUES, AND REIMBURSEMENT UP TO $10,000 FOR PERSONAL SERVICES SUCH AS TAX, FINANCIAL, AND ESTATE PLANNING SERVICES, ALONG WITH TAX GROSS-UP PAYMENTS FOR ANY REIMBURSEMENTS INCLUDED IN TAXABLE COMPENSATION. ALL BENEFITS ARE PROVIDED PURSUANT TO A WRITTEN POLICY GOVERNING PAYMENT AND REIMBURSEMENT, SUBSTANTIATION IS REQUIRED FOR ALL EXPENSES SUBMITTED FOR REIMBURSEMENT, AND REIMBURSEMENTS ARE INCLUDED IN TAXABLE COMPENSATION WHERE APPROPRIATE.
Schedule J, Part I, Line 1a Tax indemnification and gross-up payments	SEE SCHEDULE J, PART I, LINE 1A - TRAVEL FOR COMPANIONS DISCLOSURE
Schedule J, Part I, Line 1a Health or social club dues or initiation fees	SEE SCHEDULE J, PART I, LINE 1A - TRAVEL FOR COMPANIONS DISCLOSURE
Schedule J, Part I, Line 1a Personal services	SEE SCHEDULE J, PART I, LINE 1A - TRAVEL FOR COMPANIONS DISCLOSURE
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation	Portercare Adventist Health System's (PAHS) CEO IS PAID BY CENTURA HEALTH CORPORATION (CENTURA). OUTSIDE CONSULTANTS ARE ENGAGED TO PROVIDE RECOMMENDATIONS TO CENTURA'S COMPENSATION COMMITTEE REGARDING THE COMPENSATION OF FACILITY CEOS. THE CONSULTANT'S RECOMMENDATIONS ARE THEN PRESENTED TO AND APPROVED BY THE COMPENSATION COMMITTEE.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	CENTURA OFFERS A NON-QUALIFIED RETIREMENT PLAN IN WHICH SENIOR EXECUTIVES (SENIOR VPS AND ABOVE) ARE PROVIDED A 10% OF SALARY ALLOWANCE TO PURCHASE INSURANCE PRODUCTS OR CONTRIBUTED INTO THE DEFERRED COMPENSATION PLAN. IN ADDITION, A PENSION RESTORATION BENEFIT IS PROVIDED WHICH CREDITS PARTICIPANTS WITH A BENEFIT WHICH IS CALCULATED BASED ON THE EXCESS OF THE PARTICIPANT'S COMPENSATION OVER THE MAXIMUM ALLOWED FOR PENSION CONTRIBUTIONS. AMOUNTS DEFERRED ARE NOT REPORTED AS TAXABLE INCOME UNTIL/UNLESS A TRIGGERING EVENT OCCURS. THIS DEFERRED COMPENSATION PLAN HAS A SUBSTANTIAL RISK OF FORFEITURE PROVISION AND AN ELECTED VESTING SCHEDULE. THE FOLLOWING RECEIVED CONTRIBUTIONS TO A NON-QUALIFIED PLAN FOR THE CALENDAR YEAR 2014: Morre Dean $48,191 Brett Spenst $47,725 Dennis Barts $31,801 Randy Haffner $134,104 During 2014 the following Distributions were made: Morre Dean $31,506 Randy Haffner $109,812 IN ADDITION, TWO OF THE BOARD MEMBERS ARE COMPENSATED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHS) AND IN RECOGNITION OF THE CONTRIBUTION THAT EACH EXECUTIVE MAKES TO THE SUCCESS OF AHS, AHS PROVIDES TO ELIGIBLE EXECUTIVES PARTICIPATION IN THE AHS EXECUTIVE FLEX BENEFIT PROGRAM (THE PLAN). THE PURPOSE OF THE PLAN IS TO OFFER ELIGIBLE EXECUTIVES AN OPPORTUNITY TO ELECT FROM AMONG A VARIETY OF SUPPLEMENTAL BENEFITS, INCLUDING DEFERRED COMPENSATION BENEFITS TAXABLE UNDER INTERNAL REVENUE CODE (IRC) SECTION 457(F), TO INDIVIDUALLY TAILOR A BENEFITS PROGRAM APPROPRIATE TO EACH EXECUTIVE'S NEEDS. THE PLAN PROVIDES ELIGIBLE PARTICIPANTS A PRE-DETERMINED BENEFITS ALLOWANCE CREDIT THAT IS EQUAL TO A PERCENTAGE OF THE EXECUTIVE'S BASE PAY FROM WHICH IS DEDUCTED THE COST OF MANDATORY AND ELECTIVE EMPLOYEE BENEFITS. THE PRE-DETERMINED BENEFITS ALLOWANCE CREDIT PERCENTAGE IS APPROVED BY THE AHS BOARD STRATEGY & COMPENSATION COMMITTEE, AN INDEPENDENT COMMITTEE OF THE BOARD OF DIRECTORS OF AHS. ANY FUNDS THAT REMAIN AFTER THE COST OF MANDATORY AND ELECTIVE BENEFITS ARE SUBTRACTED FROM THE PRE-DETERMINED BENEFITS ANNUAL AMOUNT ARE CONTRIBUTED, AT THE EMPLOYEE'S OPTION, TO EITHER AN IRC 457(F) DEFERRED COMPENSATION ACCOUNT OR TO AN IRC 457(B) ELIGIBLE DEFERRED COMPENSATION PLAN. UPON ATTAINMENT OF AGE 65, ALL PREVIOUS 457(F) DEFERRED AMOUNTS ARE PAID IMMEDIATELY TO THE PARTICIPANT AND ANY FUTURE EMPLOYER CONTRIBUTIONS ARE MADE QUARTERLY FROM THE PLAN DIRECTLY TO THE PARTICIPANT. THE PLAN DOCUMENTS DEFINE AN EMPLOYEE WHO IS ELIGIBLE TO PARTICIPATE IN THE PLAN TO GENERALLY INCLUDE THE CHIEF EXECUTIVE OFFICERS OF AHS ENTITIES AND VICE PRESIDENTS OF ALL AHS ENTITIES WHOSE BASE SALARY IS AT LEAST $210,000. THE PLAN PROVIDES FOR A CLASS YEAR VESTING SCHEDULE (2 YEARS FOR EACH CLASS YEAR) WITH RESPECT TO AMOUNTS ACCUMULATED IN THE EXECUTIVE'S 457(F) DEFERRED COMPENSATION ACCOUNT. DISTRIBUTIONS COULD ALSO BE MADE FROM THE EXECUTIVE'S 457(F) DEFERRED COMPENSATION ACCOUNT UPON ATTAINMENT OF AGE 65 OR UPON AN INVOLUNTARY SEPARATION. THE ACCOUNT IS FORFEITED BY THE EXECUTIVE UPON A VOLUNTARY SEPARATION. IN ADDITION TO THE PLAN, AHS HAS INSTITUTED A DEFINED BENEFIT, NON-TAX-QUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN EXECUTIVES WHO HAVE PROVIDED LENGTHY SERVICE TO AHS AND/OR TO OTHER SEVENTH-DAY ADVENTIST CHURCH HOSPITAL OR HEALTH CARE INSTITUTIONS. PARTICIPATION IN THE PLAN IS OFFERED TO AHS EXECUTIVES ON A PRORATA SCHEDULE BEGINNING WITH 20 YEARS OF SERVICE AS AN EMPLOYEE OF AHS AND/OR ANOTHER HOSPITAL OR HEALTHCARE INSTITUTION CONTROLLED BY THE SEVENTH-DAY ADVENTIST CHURCH AND WHO SATISFY CERTAIN OTHER QUALIFYING CRITERIA. THIS SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) WAS DESIGNED TO PROVIDE ELIGIBLE EXECUTIVES WITH THE ECONOMIC EQUIVALENT OF AN ANNUAL INCOME BEGINNING AT NORMAL RETIREMENT AGE EQUAL TO 60% OF THE AVERAGE OF THE PARTICIPANT'S THREE HIGHEST YEARS OF BASE SALARY FROM AHS ACTIVE EMPLOYMENT INCLUSIVE OF INCOME FROM ALL OTHER SEVENTH-DAY ADVENTIST CHURCH HEALTHCARE EMPLOYER-FINANCED RETIREMENT INCOME SOURCES AND INVESTMENT INCOME EARNED ON THOSE CONTRIBUTIONS THROUGH SOCIAL SECURITY NORMAL RETIREMENT AGE AS DEFINED IN THE PLAN. THE NUMBER OF YEARS INCLUDED IN HIGHEST AVERAGE COMPENSATION IS DETERMINED BY THE INDIVIDUAL'S YEAR OF ENTRY TO THE SERP AND BY THE INDIVIDUAL'S YEAR OF ENTRY TO THE AHS EXECUTIVE FLEX BENEFIT PROGRAM. 457(F) EMPLOYER CONTRIBUTIONS FOR CALENDAR YEAR 2014 WERE: ROBERT HENDERSCHEDT $124,603 TERRY SHAW $190,258 457(F) EMPLOYER DISTRIBUTIONS FOR CALENDAR YEAR 2014 WERE: ROBERT HENDERSCHEDT $121,878 TERRY SHAW $176,733 SERP PAYMENTS FOR CALENDAR YEAR 2014 WERE: Terry Shaw $176,733
Schedule J, Part I, Line 7 Non-fixed payments	PARTICIPANTS IN CENTURA'S INCENTIVE COMPENSATION PLANS INCLUDE DIRECTORS AND ABOVE. PAYOUTS ARE BASED ON METRICS ESTABLISHED AND APPROVED BY CENTURA'S COMPENSATION COMMITTEE. THE METRICS INCLUDE QUANTIFIABLE MEASURES PERTAINING TO FINANCIAL PERFORMANCE, SAFETY AND QUALITY AND ASSOCIATE SATISFACTION WITH EACH METRIC WEIGHTED IN DETERMINING THE OVERALL SCORE. THE INCENTIVE COMPENSATION PAYOUT IS CALCULATED BASED ON THE CUMULATIVE SCORE FOR ALL METRICS AND THE PAYOUT IS BASED ON A COMBINATION OF THE SCORE, THE INDIVIDUAL'S BASE COMPENSATION AMOUNT AND POSITION (E.G. DIRECTOR, VICE PRESIDENT).

Schedule J (Form 990) 2014

Additional Data

Software ID:	14000329
Software Version:	2014v1.0

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Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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

Attach to Form 990 or Form 990-EZ.
MediumBullet

Information 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

PORTERCARE ADVENTIST HEALTH SYSTEM

Employer identification number

84-0438224

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

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

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

Part II

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

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No
(1) Christopher Oliver	Employee	Physician Remuneration		X	290,000	77,333		No	Yes		Yes





Total ...... $						77,333

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

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	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person	(c) Amount of transaction	(d) Description of transaction	Yes	No

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:	14000329
Software Version:	2014v1.0

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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

PORTERCARE ADVENTIST HEALTH SYSTEM

Employer identification number

84-0438224

Return Reference	Explanation
Form 990, Part VI, Line 16b JOINT VENTURE POLICY	PORTERCARE ADVENTIST HEALTH SYSTEM HAS NOT FORMALLY ADOPTED A WRITTEN POLICY OR WRITTEN PROCEDURE REGARDING JOINT VENTURES. HOWEVER, ADVENTIST HEALTH SYSTEM'S (AHS) SYSTEM-WIDE JOINT VENTURE MODEL OPERATING AGREEMENT INCORPORATES CONTROLS OVER THE VENTURE SUFFICIENT TO ENSURE THAT (1) THE EXEMPT ORGANIZATIONS, AT ALL TIMES, RETAINS CONTROL OVER THE VENTURE SUFFICIENT TO ENSURE THAT THE PARTNERSHIP FURTHERS THE EXEMPT PURPOSE OF THE ORGANIZATION; (2) IN ANY PARTNERSHIP IN WHICH THE EXEMPT ORGANIZATION IS A PARTNER, ACHIEVEMENT OF EXEMPT PURPOSES IS PRIORITIZED OVER MAXIMIZATION OF PROFITS FOR THE PARTNERS; (3) THE PARTNERSHIP DOES NOT ENGAGE IN ANY ACTIVITIES THAT WOULD JEOPARDIZE THE EXEMPT ORGANIZATION'S EXEMPTION; (4) RETURNS OF CAPITAL, ALLOCATIONS, AND DISTRIBUTIONS MUST BE MADE IN PROPORTION TO THE PARTNERS' RESPECTIVE OWNERSHIP INTERESTS; AND (5) ALL CONTRACTS ENTERED INTO BY THE PARTNERSHIP WITH THE EXEMPT ORGANIZATION MUST BE AT ARM'S LENGTH, WITH PRICES SET AT FAIR MARKET VALUE.
Form 990, Part VI, Line 15 PROCESS USED TO ESTABLISH COMPENSATION	OUTSIDE CONSULTANTS ARE ENGAGED TO PROVIDE RECOMMENDATIONS TO CENTURA'S COMPENSATION COMMITTEE REGARDING THE COMPENSATION OF FACILITY CEOS AND CENTURA SENIOR EXECUTIVES. THE CONSULTANT'S RECOMMENDATIONS ARE THEN PRESENTED TO, CONSIDERED BY, AND APPROVED BY THE COMPENSATION COMMITTEE. CENTURA'S HUMAN RESOURCES DEPARTMENT PERFORMS ANALYSES OF THE MARKET TO DETERMINE COMPENSATION RANGES FOR THE REMAINDER OF CENTURA ASSOCIATES WHICH ARE REVIEWED AND APPROVED BY CENTURA'S SENIOR LEADERSHIP.
Form 990, Part VI, Line 1a Delegate broad authority to a committee	PURSUANT TO ARTICLE IV OF THE BYLAWS OF PORTERCARE ADVENTIST HEALTH SYSTEM, THE BOARD OF TRUSTEES MAY, BY RESOLUTION OR RESOLUTIONS PASSED BY A MAJORITY OF THE TRUSTEES THEREOF, APPOINT AN EXECUTIVE COMMITTEE OR SUCH OTHER COMMITTEES FOR ANY PURPOSE AND DELEGATE TO SUCH COMMITTEES ANY OF THE POWERS AND AUTHORITY OF THE BOARD OF TRUSTEES AS IS PERMITTED BY LAW. COLORADO LAW PRECLUDES A COMMITTEE OF THE BOARD FROM (I) AUTHORIZING DISTRIBUTIONS; (II) APPROVING OR PROPOSING TO THE MEMBER ACTIONS THAT ARTICLES 121-137 OF TITLE 7 OF THE COLORADO REVISED STATUTES REQUIRE TO BE APPROVED BY THE MEMBER; (III) AMENDING THE CORPORATION'S AMENDED AND RESTATED ARTICLES OF INCORPORATION; (IV) ADOPTING, AMENDING OR REPEALING THE BYLAWS; (V) APPROVING A PLAN OF MERGER NOT REQUIRING APPROVAL OF THE MEMBER; OR (VI) APPROVING A SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, OF ITS PROPERTY, WITH OR WITHOUT GOOD WILL, OTHERWISE THAN IN THE USUAL AND REGULAR COURSE OF BUSINESS SUBJECT TO APPROVAL OF THE MEMBER. SUCH COMMITTEES SHALL HAVE THE POWER TO ACT ONLY IN INTERVALS BETWEEN MEETINGS OF THE BOARD OF TRUSTEES AND SHALL, AT ALL TIMES, BE SUBJECT TO THE CONTROL OF THE BOARD OF TRUSTEES. THE BOARD OF TRUSTEES, OR IF THE BOARD DOES NOT ACT, THE COMMITTEES, SHALL ESTABLISH RULES AND REGULATIONS FOR MEETINGS AND SHALL MEET AT SUCH TIMES AS ARE DEEMED NECESSARY, PROVIDED THAT A REASONABLE NOTICE OF ALL MEETINGS SHALL BE GIVEN TO COMMITTEE MEMBERS. NO ACT OF A COMMITTEE SHALL BE VALID UNLESS APPROVED BY THE VOTE OR WRITTEN CONSENT OF A MAJORITY OF ITS MEMBERS. COMMITTEES SHALL KEEP REGULAR MINUTES OF PROCEEDINGS AND REPORT THE SAME TO THE BOARD FROM TIME TO TIME AS THE BOARD MAY REQUIRE.
Form 990, Part VI, Line 6 Classes of members or stockholders	THE SOLE CORPORATE MEMBER OF PAHS IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHS), A FLORIDA NONPROFIT CORPORATION.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	AHS, THE SOLE CORPORATE MEMBER, HAS THE POWER TO APPOINT OR REMOVE THE MEMBERS OF THE GOVERNING BODY.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	THE CORPORATE MEMBER, AHS, ACTING THROUGH THE BOARD OF TRUSTEES, MAINTAINS ALL RIGHTS PERMITTED TO BE EXERCISED BY DIRECTORS OF A COLORADO CORPORATION EXCEPT AS LIMITED BY THE ORGANIZATIONS' ARTICLES, BYLAWS, OR AFFILIATION AGREEMENT WITH CATHOLIC HEALTH INITIATIVES (CHI). THE AGREEMENT OF BOTH AHS AND CHI IS REQUIRED FOR CERTAIN SIGNIFICANT DECISIONS INVOLVING CENTURA FACILITIES. IN ADDITION, PURSUANT TO THE AFFILIATION AGREEMENT BETWEEN CHI, CHIC, CENTURA HEALTH CORPORATION, AND PORTERCARE ADVENTIST HEALTH SYSTEM, CERTAIN MATTERS AFFECTING CHIC MUST BE APPROVED BY BOTH PORTERCARE AND CHI. THOSE ITEMS INCLUDE: - THE TRANSFER OF ASSETS VALUED AT OVER $1,000,000 - THE ISSUANCE OF A DEBT INSTRUMENT IN EXCESS OF $250,000 - THE AMENDMENT OF THE ORGANIZING DOCUMENTS - THE ADMISSION OF A NEW SPONSOR - A MERGER OR DISSOLUTION OR REORGANIZATION - SETTLEMENT OF LEGAL PROCEEDINGS IN EXCESS OF $2,000,000 - CAPITAL EXPENDITURES IN EXCESS OF $2,000,000
Form 990, Part VI, Line 11b Review of form 990 by governing body	A DRAFT OF THE FORM 990 IS PROVIDED TO MANAGEMENT, INCLUDING THE CFO, FOR REVIEW. THE RETURN IS E-MAILED TO THE ENTIRE BOARD FOR REVIEW PRIOR TO FILING. AFTER PRESENTATION TO THE BOARD, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE BOARD.
Form 990, Part VI, Line 12c Conflict of interest policy	PORTERCARE ADVENTIST HEALTH SYSTEM HAS ADOPTED CENTURA HEALTH'S CONFLICT OF INTEREST POLICY: 1. CONFLICT OF INTEREST POLICY 1.1 CONSISTENT WITH CENTURA INTEGRITY STANDARDS, IT IS POLICY THAT EACH BOARD OF TRUSTEE MEMBER, CORPORATE OFFICER, AND KEY EMPLOYEE ACT AT ALL TIMES IN A MANNER THAT IS CONSISTENT WITH CENTURA'S MISSION AND VALUES BASED SERVICE TO THE COMMUNITY AND EXERCISE CARE THAT HE OR SHE DOES NOT HAVE ANY PERSONAL INTEREST WHICH MIGHT CONFLICT WITH OR APPEAR TO CONFLICT WITH THE INTEREST OF CENTURA OR WHICH MIGHT INFLUENCE THEIR JUDGMENT OR ACTIONS IN PERFORMING THEIR DUTIES. 1.1.1 IN CONNECTION WITH AN ACTUAL OR POSSIBLE TRANSACTION OR ARRANGEMENT INVOLVING CENTURA, ANY BOARD MEMBER, CORPORATE OFFICER, OR KEY EMPLOYEE WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST MUST DISCLOSE AND BE GIVEN THE OPPORTUNITY TO SHARE ALL MATERIAL FACTS WITH THE BOARD CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. 1.1.2 BOARD MEMBERS, CORPORATE OFFICERS, AND KEY EMPLOYEES ARE ALSO REQUIRED TO DISCLOSE ANY POSSIBLE CONFLICTS ON AN ANNUAL BASIS THROUGH THE CONFLICT OF INTEREST QUESTIONNAIRE. 2. PROCEDURE FOR DISCLOSING AND REVIEWING TRANSACTION OR ARRANGEMENT CONFLICT OF INTERESTS: 2.1 BOARD MEMBERS, CORPORATE OFFICERS, AND KEY EMPLOYEES THAT HAVE A FINANCIAL INTEREST IN ANY ACTUAL OR POSSIBLE TRANSACTION INVOLVING CENTURA ARE REQUIRED TO DISCLOSE THE FINANCIAL INTEREST. 2.1.1 IN ORDER TO DETERMINE IF A CONFLICT OF INTEREST EXISTS, THE INDIVIDUAL WHO IS CONSIDERED TO HAVE A FINANCIAL INTEREST MAY MAKE A PRESENTATION AT THE BOARD OR BOARD COMMITTEE MEETING. AFTER SUCH PRESENTATION, THE INDIVIDUAL SHALL LEAVE THE MEETING FOR DISCUSSION AND A VOTE ON THE ISSUE. 2.1.2 AFTER EXERCISING DUE DILLEGENCE, THE BOARD OR BOARD COMMITTEE SHALL DETERMINE WHETHER CENTURA CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION WITH REASONABLE EFFORTS FROM ANOTHER PERSON OR ENTITY. IF A MORE ADVANTAGEOUS TRANSACTION IS NOT REASONABLY ATTAINABLE, THE BOARD OR BOARD COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED MEMBERS WHETHER THE TRANSACTION IS IN CENTURA'S BEST INTEREST AND IS FAIR. 3. PROCEDURE FOR DISCLOSING AND REVIEWING OTHER CONFLICT OF INTERESTS: 3.1 BOARD MEMBERS, CORPORATE OFFICERS, AND KEY EMPLOYEES SHALL ALSO DISCLOSE IN ADVANCE TO CENTURA LEADERS ANY NON-TRANSACTIONAL ACTIONS OR RELATIONSHIPS THAT HAVE THE POTENTIAL TO CREATE A CONFLICT OF INTEREST. 3.1.1 THE BOARD OR BOARD COMMITTEE SHALL CAREFULLY REVIEW AND SCRUTINIZE ANY CONFLICT OF INTEREST. BY A MAJORITY VOTE OF THE DISINTERESTED MEMBERS, THE BOARD SHALL TAKE WHATEVER ACTION IS DEEMED APPROPRIATE WITH RESPECT TO THE BOARD MEMBER, CORPORATE OFFICER, OR KEY EMPLOYEE UNDER THE CIRCUMSTANCES, INCLUDING POSSIBLE CORRECTIVE ACTION, IN ORDER TO BEST PROTECT THE INTERESTS OF CENTURA. 3.1.2 ON AN ANNUAL BASIS, BOARD MEMBERS, CORPORATE OFFICERS, AND KEY EMPLOYEES WILL ALSO BE SENT AN EMAIL REQUESTING THEY COMPLETE THE BOARD MEMBER AND CORPORATE OFFICER CONFLICT OF INTEREST QUESTIONNAIRE BY THE SPECIFIED DUE DATE IN THE EMAIL. 3.1.3 THE CORPORATE RESPONSIBILITY DEPARTMENT SHALL NOTIFY THE CHAIRPERSON OF THE BOARD OF ANY POTENTIAL CONFLICTS AND THE CHAIRPERSON, OR DESIGNEE, SHALL PERFORM FURTHER INVESTIGATION AS HE OR SHE DEEMS APPROPRIATE. 4. RECORD OF PROCEEDINGS: 4.1 THE MINUTES OF THE BOARD AND BOARD COMMITTEE SHALL CONTAIN: 4.1.1 THE NAMES OF PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST AND THE NATURE OF THE FINANCIAL INTEREST. 4.1.2 THE NAMES OF PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO ANY FINANCIAL INTEREST, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES, AND A RECORD OF THE BOARD OR BOARD COMMITTEE DECISION. 5. VIOLATIONS OF THE CONFLICTS OF INTEREST POLICY: 5.1 IF THE BOARD OR BOARD COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT AN INDIVIDUAL HAS FAILED TO DISCLOSE EITHER AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST, OR ALL MATERIAL FACTS SURROUNDING AN ACTUAL OR POSSIBLE CONFLICT, THE INDIVIDUAL WILL BE GIVEN A CHANCE TO EXPLAIN. 5.1.1 AFTER HEARING THE RESPONSE, THE BOARD WILL CONDUCT SUCH ADDITIONAL INVESTIGATION AS APPROPRIATE. IF THE BOARD DETERMINES THAT THE INDIVIDUAL HAS IN FACT FAILED TO DISCLOSE AS REQUIRED BY THE CONFLICT OF INTEREST POLICY, THE BOARD SHALL TAKE APPROPRIATE DISCIPLINARY OR CORRECTIVE ACTION.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	See Above
Form 990, Part VI, Line 19 Required documents available to the public	THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE ON THE COLORADO SECRETARY OF STATE'S WEBSITE. THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	Other Miscellaneous Revenue - Total Revenue: 1238217, Related or Exempt Function Revenue: , Unrelated Business Revenue: 85373, Revenue Excluded from Tax Under Sections 512, 513, or 514: 1152844;
Form 990, Part IX, Line 11g Other Fees	Other Fees for Services - Total Expense: XXX-XX-XXXX, Program Service Expense: XXX-XX-XXXX, Management and General Expenses: 32573573, Fundraising Expenses: ;
Form 990, Part IX, Line 11g Other Expenses	All other expenses - Total Expense: XXX-XX-XXXX, Program Service Expense: XXX-XX-XXXX, Management and General Expenses: 61524081, Fundraising Expenses: 0;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	Transfers to Affiliates - -4966616; Minority Interest Distribution - -44671;

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:	14000329
Software Version:	2014v1.0

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

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

PORTERCARE ADVENTIST HEALTH SYSTEM

Employer identification number

84-0438224

Part I

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

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

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) Adventist Bolingbrook Hospital 500 Remington Blvd Bolingbrook,IL60440 65-1219504	Operation of Hospital & Related Services	IL	501(c)(3	3	Adventist Hlth SystemSunbelt Inc		No
(2) Adventist Care Centers - Courtland Inc 730 Courtland Street Orlando,FL32804 20-5774723	Operation of Home for the Aged/Hlthcare Delivery	FL	501(c)(3	9	Sunbelt Hlth Care Centers Inc		No
(3) Adventist GlenOaks Hospital 701 Winthrop Avenue Glendale Heights,IL60139 36-3208390	Operation of Hospital & Related Services	IL	501(c)(3	3	Adventist Hlth SystemSunbelt Inc		No
(4) Adventist Hlth Mid-America Inc 9100 W 74th Street Shawnee Mission,KS66204 52-1347407	Hlthcare Related Services	KS	501(c)(3	Type I	Adventist Hlth SystemSunbelt Inc		No
(5) Adventist Hlth Partners Inc 1000 Remington Bvd St 200 Bolingbrook,IL60440 36-4138353	Operate out-patient physician clinics	IL	501(c)(3	3	AHS Midwest Management Inc		No
(6) Adventist Hlth System Sunbelt Hlthcare Corp 900 Hope Way Altamonte Springs,FL32714 59-2170012	Management Services	FL	501(c)(3	Type I	NA		No
(7) Adventist Hlth System Georgia Inc 1035 Red Bud Road Calhoun,GA30701 58-1425000	Operation of Hospital & Related Services	GA	501(c)(3	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	3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes
(9) Adventist Hlth System Texas Inc 11801 S Freeway Burleson,TX36028 74-2578952	Leasing Personnel to Affiliated Hospital	TX	501(c)(3	Type 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	3	Adventist Hlth SystemSunbelt Inc		No
(11) Adventist University of Health Sciences Inc 671 Lake Winyah Drive Orlando,FL32803 59-3069793	Education/Operation of School	FL	501(c)(3	2	Adventist Hlth SystemSunbelt Inc		No
(12) AHS Midwest Management Inc 1000 Remington Blvd Ste 200 Bolingbrook,IL60440 36-3354567	Operation of Physician Practice Mgmt	IL	501(c)(3	Type I	Adventist Hlth SystemSunbelt Inc		No
(13) AHSCentral Texas Inc 1301 Wonder World Drive San Marcos,TX78666 74-2621825	Provide Office Space - Medical Professionals	TX	501(c)(3	Type 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	Type III-O	Sunbelt Hlth Care Centers Inc		No
(15) Battle Creek Adventist Hospital 1000 Remington Blvd Ste 200 Bolingbrook,IL60440 38-1359189	Inactive	MI	501(c)(3	3	Adventist Hlth SystemSunbelt Inc		No
(16) Bolingbrook Hospital Foundation 1000 Remington Blvd Bolingbrook,IL60440 90-0494445	Fund-raising for Tax-exempt hospital	IL	501(c)(3	7	Midwest Hlth Foundation		No
(17) Bradford Heights Hlth and Rehab Center Inc 950 Highpoint Drive Hopkinsville,KY42240 20-5782342	Operation of Home for the Aged/Hlthcare Delivery	KY	501(c)(3	9	Sunbelt Hlth Care Centers Inc		No
(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	9	Sunbelt Hlth Care Centers Inc		No
(19) Caldwell Hlth Care Properties Inc 1333 West Main Princeton,KY42445 51-0605680	Lease to Related Organization	GA	501(c)(3	Type III-FI	Sunbelt Hlth Care Centers Inc		No
(20) Central Texas Hlthcare Collaborative 1301 Wonder World Drive San Marcos,TX78666 45-3739929	Support Operation of Hospital	TX	501(c)(3	Type I	Adventist Hlth SystemSunbelt Inc		No
(21) Central Texas Medical Center Foundation 1301 Wonder World Drive San Marcos,TX78666 74-2259907	Fund-raising for Tax-exempt hospital	TX	501(c)(3	7	NA		No
(22) Chickasaw Hlth Care Properties Inc 250 S Chickasaw Trail Orlando,FL32825 51-0605681	Lease to Related Organization	GA	501(c)(3	Type III-FI	Sunbelt Hlth Care Centers Inc		No
(23) Chippewa Valley Hospital and Oakview Care Center Inc 1220 Third Avenue West Durand,WI54736 39-1365168	Operation of Hospital & Related Services	WI	501(c)(3	3	Adventist Hlth SystemSunbelt Inc		No
(24) Cobb Medical Associates LLC 3949 South Cobb Drive SE Smyrna,GA30080 58-2617089	Operation of Physician Practices & Medical Services	GA	501(c)(3	3	Emory-Adventist Inc		No
(25) Courtland Hlth Care Properties Inc 730 Courtland Street Orlando,FL32804 51-0605682	Lease to Related Organization	GA	501(c)(3	Type III-FI	Sunbelt Hlth Care Centers Inc		No
(26) Creekwood Place Nursing and Rehab Center Inc 683 E Third Street Russellville,KY42276 20-5782260	Operation of Home for the Aged/Hlthcare Delivery	KY	501(c)(3	9	Sunbelt Hlth Care Centers Inc		No
(27) Dairy Road Hlth Care Properties Inc 7350 Dairy Road Zephyrhills,FL33540 51-0605684	Lease to Related Organization	GA	501(c)(3	Type III-FI	Sunbelt Hlth Care Centers Inc		No
(28) East Orlando Hlth and Rehab Center Inc 250 S Chickasaw Trail Orlando,FL32825 20-5774748	Operation of Home for the Aged/Hlthcare Delivery	FL	501(c)(3	9	Sunbelt Hlth Care Centers Inc		No
(29) Emory Adventist Inc 3949 South Cobb Drive Smyrna,GA30080 58-2171011	Operation of Hospital & Related Svcs	GA	501(c)(3	3	Adventist Hlth SystemSunbelt Inc		No
(30) Fletcher Hospital Inc 100 Hospital Drive Hendersonville,NC28792 56-0543246	Operation of Hospital & Related Svcs	NC	501(c)(3	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	9	Sunbelt Hlth Care Centers Inc		No
(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	3	Adventist Hlth SystemSunbelt Inc		No
(33) Florida Hospital Medical Group Inc 2600 Westhall Ln Maitland,FL32751 59-3214635	Operation of Physician Practices & Medical Services	FL	501(c)(3	3	Adventist Hlth SystemSunbelt Inc		No
(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	3	Adventist Hlth System Sunbelt Hlthcare Corp		No
(35) Florida Hospital Waterman Inc 1000 Waterman Way Tavares,FL32778 59-3140669	Operation of Hospital & Related Services	FL	501(c)(3	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	3	Adventist Hlth SystemSunbelt Inc		No
(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	Type I	Shawnee Mission Medical Center Inc		No
(38) Fountain Inn Nursing & Rehab CenterInc 602 Courtland St Ste 200 Orlando,FL32804 47-2180518	Operation of Home for the Aged/Hlthcare Delivery	FL	501(c)(3	9	Sunbelt Hlth Care Centers Inc		No
(39) GlenOaks Hospital Foundation 701 Winthrop Avenue Glendale Heights,IL60139 36-3926044	Fund-raising for Tax-exempt hospital	IL	501(c)(3	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	Type III-FI	NA		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	Type III-FI	NA		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	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	9	The Comforter Health Care Group Inc		No
(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	7	The Comforter Health Care Group Inc		No
(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	Type II	Sunbelt Hlth Care Centers Inc		No
(46) Jellico Community Hospital Inc 188 Hospital Lane Jellico,TN37762 62-0924706	Operation of Hospital & Related Services	TN	501(c)(3	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	7	Midwest Hlth Foundation		No
(48) Lake County Health Care Properties Inc 602 Courtland St Ste 200 Orlando,FL32804 47-2179868	Lease to Related Organization	FL	501(c)(3	Type III-FI	Sunbelt Hlth Care Centers Inc		No
(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	7	NA		No
(50) Memorial Hlth Systems Inc 301 Memorial Medical Pkwy Daytona Beach,FL32117 59-0973502	Operation of Hospital & Related Services	FL	501(c)(3	3	Adventist Hlth SystemSunbelt Inc		No
(51) Memorial Hospital West Volusia Inc 701 West Plymouth Avenue Deland,FL32720 59-3256803	Operation of Hospital & Related Services	FL	501(c)(3	3	Memorial Hlth Systems Inc		No
(52) Memorial Hospital Flagler Inc 60 Memorial Medical Parkway Palm Coast,FL32164 59-2951990	Operation of Hospital & Related Services	FL	501(c)(3	3	Memorial Hlth Systems Inc		No
(53) Memorial Hospital Inc 210 Marie Langdon Drive Manchester,KY40962 61-0594620	Operation of Hospital & Related Services	KY	501(c)(3	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	Type III-FI	Sunbelt Hlth Care Centers Inc		No
(55) Metroplex Adventist Hospital Inc 2201 S Clear Creek Road Killeen,TX76549 74-2225672	Operation of Hospital & Related Services	TX	501(c)(3	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	3	Metroplex Adventist Hospital Inc		No
(57) Metroplex Hospital Inc 900 Hope Way Altamonte Springs,FL32714 46-1256516	Future Operation of Hospital & Related Svcs	FL	501(c)(3	3	Adventist Hlth System Sunbelt Hlthcare Corp		No
(58) Midwest Hlth Foundation 120 North Oak Street Hinsdale,IL60521 35-2230515	Support of subsidiary Foundations	IL	501(c)(3	Type II	NA		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	9	Sunbelt Hlth Care Centers Inc		No
(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	Type II	Sunbelt Hlth Care Centers Inc		No
(61) Missouri Adventist Hlth Inc 9100 W 74th Street Shawnee Mission,KS66204 43-1224729	Support Hlth Care Services	MO	501(c)(3	Type III-O	Adventist Hlth Mid-America Inc		No
(62) North Regional EMS Inc 188 Hospital Lane Jellico,TN37762 26-2653616	EMS Services	TN	501(c)(3	9	Jellico Community Hospital Inc		No
(63) Ormond Beach Memorial Hospital Auxiliary Inc 301 Memorial Medical Parkway Daytona Beach,FL32117 59-1721962	Volunteer support services	FL	501(c)(3	Type III-FI	NA		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	9	Sunbelt Hlth Care Centers Inc		No
(65) Paragon Hlth Care Properties Inc 950 Highpoint Drive Hopkinsville,KY42240 51-0605686	Lease to Related Organization	GA	501(c)(3	Type III-FI	Sunbelt Hlth Care Centers Inc		No
(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	3	Adventist Hlth System Sunbelt Hlthcare Corp		No
(67) Portercare Adventist Hlth System 2525 S Downing Street Denver,CO80210 84-0438224	Operation of Hospital & Related Services	CO	501(c)(3	3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes
(68) Princeton Hlth and Rehab Center Inc 1333 West Main Princeton,KY42445 20-5782272	Operation of Home for the Aged/Hlthcare Delivery	KY	501(c)(3	9	Sunbelt Hlth Care Centers Inc		No
(69) Princeton Professional Services Inc 601 E Rollins Street Orlando,FL32803 59-1191045	Provision of Hlthcare Services	FL	501(c)(3	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	Type I	Adventist Hlth System Sunbelt Hlthcare Corp		No
(71) Resource Personnel Inc 602 Courtland Street Ste 200 Orlando,FL32804 20-8040875	Provide administrative support to tax exempt nursing homes	FL	501(c)(3	Type II	Sunbelt Hlth Care Centers Inc		No
(72) Rocky Mountain Adventist Hlthcare Foundation 7995 E Prentice Ave 204 Greenwood Village,CO80111 84-0745018	Fund-raising for Tax-exempt hospital	CO	501(c)(3	7	NA		No
(73) Rollins Brook Community Care Corp 2201 S Clear Creek Road Killeen,TX76549 46-1656773	Inactive	TX	501(c)(3	Type I	Adventist Hlth SystemSunbelt Inc		No
(74) Russellville Hlth Care Properties Inc 683 East Third Street Russellville,KY42276 51-0605691	Lease to Related Organization	GA	501(c)(3	Type III-FI	Sunbelt Hlth Care Centers Inc		No
(75) San Marcos Hlth Care Properties Inc 1900 Medical Parkway San Marcos,TX78666 51-0605693	Lease to Related Organization	GA	501(c)(3	Type III-FI	Sunbelt Hlth Care Centers Inc		No
(76) San Marcos Nursing and Rehab Center Inc 1900 Medical Parkway San Marcos,TX78666 20-5782224	Operation of Home for the Aged/Hlthcare Delivery	TX	501(c)(3	9	Sunbelt Hlth Care Centers Inc		No
(77) Shawnee Mission Hlth Care Inc 6501 West 75th Street Overland Park,KS66204 48-0952508	Lease to Related Organization	KS	501(c)(3	Type III-FI	Sunbelt Hlth Care Centers Inc		No
(78) Shawnee Mission Medical Center Inc 9100 W 74th Street Shawnee Mission,KS66204 48-0637331	Operation of Hospital & Related Services	KS	501(c)(3	3	Adventist Hlth Mid-America Inc		No
(79) South Central Inc 900 Hope Way Altamonte Springs,FL32714 59-3689740	Management Support	GA	501(c)(3	Type III-FI	NA		No
(80) South Pasco Hlth Care Properties Inc 38250 A Avenue Zephyrhills,FL33542 51-0605679	Lease to Related Organization	GA	501(c)(3	Type III-FI	Sunbelt Hlth Care Centers Inc		No
(81) Southwest Volusia Hlth Services Inc 1055 Saxon Blvd Orange City,FL32763 59-3281591	Medical Office Building for Hospital	FL	501(c)(3	Type I	Southwest Volusia Hlthcare Corp		No
(82) Southwest Volusia Hlthcare Corp 1055 Saxon Blvd Orange City,FL32763 59-3149293	Operation of Hospital & Related Services	FL	501(c)(3	3	Adventist Hlth SystemSunbelt Inc		No
(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	3	Adventist Hlth SystemSunbelt Inc		No
(84) Spring View Hlth and Rehab Center Inc 718 Goodwin Lane Leitchfield,KY42754 20-5782288	Operation of Home for the Aged/Hlthcare Delivery	KY	501(c)(3	9	Sunbelt Hlth Care Centers Inc		No
(85) Sunbelt Hlth and Rehab Center Apopka Inc 305 East Oak Street Apopka,FL32703 20-5774856	Operation of Home for the Aged/Hlthcare Delivery	FL	501(c)(3	9	Sunbelt Hlth Care Centers Inc		No
(86) Sunbelt Hlth Care Centers Inc 602 Courtland Street Ste 200 Orlando,FL32804 58-1473135	Management Services	TN	501(c)(3	Type 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	7	Adventist Hlth System Sunbelt Hlthcare Corp	Yes
(88) Takoma Regional Hospital Inc 401 Takoma Ave Greeneville,TN37743 51-0603966	Operation of Hospital & Related Services	TN	501(c)(3	3	Adventist Hlth SystemSunbelt Inc		No
(89) TAKOMA REGIONAL HOSPITAL Foundation INC 401 Takoma Ave Greeneville,TN37743 47-1334302	Fund Raising for Affiliated Tax-Exempt Hospital	TN	501(c)(3	7	Takoma Regional Hospital Inc		No
(90) Tarpon Springs Hospital Foundation Inc 1395 S Pinellas Ave Tarpon Springs,FL34689 59-0898901	Operation of Hospital & Related Services	FL	501(c)(3	3	University Community Hospital Inc		No
(91) Tarrant County Hlth Care Properties Inc 301 Huguley Blvd Burleson,TX76028 51-0605677	Lease to Related Organization	GA	501(c)(3	Type III-FI	Sunbelt Hlth Care Centers Inc		No
(92) Taylor Creek Hlth Care Properties Inc 718 Goodwin Lane Leitchfield,KY42754 51-0605678	Lease to Related Organization	GA	501(c)(3	Type III-FI	Sunbelt Hlth Care Centers Inc		No
(93) The Comforter Health Care Group Inc 605 Montgomery Road Altamonte Springs,FL32714 27-1857940	Lease to Related Organization	FL	501(c)(3	Type III-FI	Adventist Hlth System Sunbelt Hlthcare Corp		No
(94) The Volunteer Auxiliary of Florida Hospital Flagler Inc 60 Memorial Medical Parkway Palm Coast,FL32164 59-2486582	Volunteer support services	FL	501(c)(3	Type III-FI	NA		No
(95) TRI-COUNTY NURSING AND REHAB Center Inc 602 Courtland St Ste 200 Orlando,FL32804 47-2219363	Operation of Home for the Aged/Hlthcare Delivery	FL	501(c)(3	9	Sunbelt Hlth Care Centers Inc		No
(96) Trinity Nursing and Rehab Center Inc 9700 West 62nd Street Merriam,KS66203 20-5774890	Operation of Home for the Aged/Hlthcare Delivery	KS	501(c)(3	9	Sunbelt Hlth Care Centers Inc		No
(97) University Community Hospital Foundation Inc 3100 E Fletcher Ave Tampa,FL33613 59-2554889	Fund-raising for Tax-exempt hospital	FL	501(c)(3	Type I	NA		No
(98) University Community Hospital Specialty Care Inc 3100 E Fletcher Ave Tampa,FL33613 59-3231322	Inactive	FL	501(c)(3	Type I	University Community Hospital Inc		No
(99) University Community Hospital Inc 3100 E Fletcher Ave Tampa,FL33613 59-1113901	Operation of Hospital & Related Services	FL	501(c)(3	3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes
(100) West Florida Health Home Care Inc fka South Cent Nurs Home Prop PO Box 1289 Tampa,FL33601 59-3686109	Will be operating Home Health Agency	GA	501(c)(3	Type III-O	Adventist Hlth System Sunbelt Hlthcare Corp		No
(101) West Kentucky Hlth Care Properties Inc 500 Beck Lane Mayfield,KY42066 51-0605676	Lease to Related Organization	GA	501(c)(3	Type III-FI	Sunbelt Hlth Care Centers Inc		No
(102) Zephyr Haven Hlth and Rehab Center Inc 38250 A Avenue Zephyrhills,FL33542 20-5774930	Operation of Home for the Aged/Hlthcare Delivery	FL	501(c)(3	9	Sunbelt Hlth Care Centers Inc		No
(103) Zephyrhills Hlth and Rehab Center Inc 7350 Dairy Road Zephyrhills,FL33540 20-5774967	Operation of Home for the Aged/Hlthcare Delivery	FL	501(c)(3	9	Sunbelt Hlth Care Centers Inc		No

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

Cat. No. 50135Y

Schedule R (Form 990) 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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) Appalachian Therapy Services LLC 100 Hospital Drive Hendersonville,NC28792 20-2463851	Therapy Staffing	NC	Fletcher Hospital Inc	N/A								50 %
(2) Clear Creek MOB Ltd 2201 S Clear Creek Rd Killeen,TX76549 74-2609195	Real Estate	TX	Clear Creek MOB Inc	N/A								61 %
(3) Endoscopy Center at Porter LLC 1001 South Park Drive Littleton,CO80120 20-5855038	Medical Services	CO	Portercare Adventist Health System	Related	27,350	131,570		No	0		No	51 %
(4) Florida Hospital DMERT LLC 2450 Maitland Center Pkwy Ste 200 Maitland,FL32751 20-2392253	Medical Equipment	FL	Princeton Prof Services Inc	N/A								67 %
(5) Florida Hospital Home Infusion 2450 Maitland Center Pkwy Ste 200 Maitland,FL32751 59-3142824	Home Infusion Services	FL	Princeton Prof ServsFH Waterman	N/A								57 %
(6) KCCCSMMC Cancer Center LLC (11-4813) 9100 W 74th Street Shawnee Mission,KS66204 27-0909763	Equipment Rental	KS	Shawnee Mission Med Ctr Inc	N/A								50 %
(7) PAHSUSP Surgery Centers LLC 15305 Dallas Pkwy Ste 1600 LB 28 Addison,TX75010 26-3057950	Medical Services	CO	Portercare Adventist Health System	Related	1,101,609	904,818		No	0		No	51 %
(8) San Marcos MRI LP 1330 Wonder World Dr Ste 202 San Marcos,TX78666 77-0597972	Imaging & Testing	TX	Adventist Hlth SystemSunbelt Inc	N/A								60 %
(9) Shawnee Mission Open MRI LLC 9100 W 74th Street Box 2923 Shawnee Mission,KS66201 27-0011796	Imaging & Testing	KS	Shawnee Mission Med Ctr Inc	N/A								55 %

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) Altamonte Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando,FL32803 59-2855792	Condo Association	FL	NA	C Corporation				No
(2) Apopka Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando,FL32803 59-3000857	Condo Association	FL	NA	C Corporation				No
(3) CC MOB Inc 2201 S Clear Creek Road Killeen,TX76549 74-2616875	Real Estate Rental	TX	NA	C Corporation				No
(4) Central Texas Medical Associates 1301 Wonder World Drive San Marcos,TX78666 74-2729873	Physician Clinics	TX	NA	C Corporation				No
(5) Central Texas Provider's Network 1301 Wonder World Drive San Marcos,TX78666 74-2827652	Physician Hospital Org.	TX	NA	C Corporation				No
(6) Florida Hospital Flagler Medical Offices Association Inc 60 Memorial Medical Parkway Palm Coast,FL32164 26-2158309	Condo Association	FL	NA	C Corporation				No
(7) Florida Hospital Healthcare System Inc 602 Courtland Street Orlando,FL32804 59-3215680	PHO/TPA	FL	NA	C Corporation				No
(8) Florida Medical Plaza Condo Association Inc 601 East Rollins Street Orlando,FL32803 59-2855791	Condo Association	FL	NA	C Corporation				No
(9) Florida Memorial Health Network Inc 770 W Granada Blvd Ste 317 Ormond Beach,FL32174 59-3403558	Physician Hospital Org.	FL	NA	C Corporation				No
(10) HUGULEY ALLIANCE FOUNDATION (11-8414) 11801 South Freeway Fort Worth,TX76115 75-2642209	Inactive	TX	NA	C Corporation				No
(11) Kissimmee Multispecialty Clinic Condominium Association Inc 201 Hilda Street Suite 30 Kissimmee,FL34741 59-3539564	Condo Association	FL	NA	C Corporation				No
(12) Midwest Management Services Inc 9100 West 74th Street Shawnee Mission,KS66204 48-0901551	Real Estate Rental	KS	NA	C Corporation				No
(13) North American Health Services Inc & Subs 900 Hope Way Altamonte Springs,TN32714 62-1041820	Lessor/Holding Co.	TN	NA	C Corporation				No
(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	NA	C Corporation				No
(15) Park Ridge Property Owner's Association Inc 1 Park Place Naples Road Fletcher,NC28732 03-0380531	Condo Association	NC	NA	C Corporation				No
(16) Porter Affiliated Hlth Services Inc dba Diversified Affiliated Hlth Svcs 2525 S Downing Street Denver,CO80210 84-0956175	Healthcare Services	CO	NA	C Corporation				No
(17) San Marcos Regional MRI Inc 1301 Wonder World Drive San Marcos,TX78666 77-0597968	Holding Company	TX	NA	C Corporation				No
(18) The Garden Retirement Community Inc 602 Courtland Street Ste 200 Orlando,FL32804 59-3414055	Real Estate Rental	FL	NA	C Corporation				No
(19) Winter Park Medical Office Building I Condo Assoc Inc 200 Lakemont Ave Winter Park,FL32792 45-2228478	Physician Clinics	FL	NA	C Corporation				No

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

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

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

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

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

Yes

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

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

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

Yes

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

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

Yes

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

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) ROCKY MOUNTAIN ADVENTIST HEALTHCARE FOUNDATION	C	1,440,374	FMV

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

Schedule R (Form 990) 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

Software ID:	14000329
Software Version:	2014v1.0

1	Briefly describe the organization’s mission or most significant activities: OUR COMPANY, A FAITH BASED ORGANIZATION, INVESTS IN CHARITY CARE, COMMUNITY PROGRAMS AND SPONSORSHIPS DESIGNED TO NURTURE THE HEALTH OF THE PEOPLE OF COLORADO WITH A GOAL TO KEEP THEM HEALTHY.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	3
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	0
5	Total number of individuals employed in calendar year 2014 (Part V, line 2a) ......	5	7,150
6	Total number of volunteers (estimate if necessary) .............	6	1,050
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	2,584,764
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	-445,782

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,914,123	1,573,045
9	Program service revenue (Part VIII, line 2g) .........	972,284,613	1,058,455,891
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	11,615,849	2,589,087
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	7,985,127	8,335,265
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	993,799,712	1,070,953,288
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	1,290,340	1,908,179
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)	363,306,823	389,608,077
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	575,630,758	623,089,930
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	940,227,921	1,014,606,186
19	Revenue less expenses. Subtract line 18 from line 12.......	53,571,791	56,347,102
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,415,367,426	1,478,784,518
21	Total liabilities (Part X, line 26).............	469,346,588	481,103,149
22	Net assets or fund balances. Subtract line 21 from line 20.....	946,020,838	997,681,369

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 812,062,710 including grants of $ 1,908,179 ) (Revenue $ 1,058,455,891 )
	SEE SCHEDULE H

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












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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses812,062,710

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	9,372,355	2,530,686	1,137,540

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512-514
1a	Federated campaigns..1a		0
b	Membership dues....1b		0
c	Fundraising events....1c		0
d	Related organizations...1d		1,440,374
e	Government grants (contributions)1e		0

f	All other contributions, gifts, grants, and similar amounts not included above1f		132,671

g	Noncash contributions included in lines 1a-1f:$		0
h	Total. Add lines 1a-1f.......			1,573,045
			Business Code
2a	Patient Services		900099	1,051,960,517	1,051,960,517	0	0
b	Equity changes of unconsolidated orgs		900099	3,711,026	3,711,026	0	0
c	Rental Income		900099	2,586,033	2,586,033	0	0
d	Guest Room Fees		721310	105,415	105,415	0	0
e	Education		611710	92,900	92,900	0	0
f	All other program service revenue .			0	0	0	0
g	Total. Add lines 2a–2f........			1,058,455,891
3	Investment income (including dividends, interest, and other similar amounts).......			2,653,389	0	0	2,653,389
4	Income from investment of tax-exempt bond proceeds..			0	0	0	0
5	Royalties...........			0	0	0	0
		(i) Real	(ii) Personal
6a	Gross rents	65,323	0
b	Less: rental expenses	19,372	0
c	Rental income or (loss)	45,951	0
d	Net rental income or (loss).......			45,951	0	0	45,951
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	0	361,970
b	Less: cost or other basis and sales expenses	0	426,272
c	Gain or (loss)	0	-64,302
d	Net gain or (loss)..........			-64,302	0	0	-64,302
8a	Gross income from fundraising events (not including $ 0 of contributions reported on line 1c). See Part IV, line 18 ..
	a		0
b	Less: direct expenses ...b		0
c	Net income or (loss) from fundraising events..			0		0	0
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a		0
b	Less: direct expenses ...b		0
c	Net income or (loss) from gaming activities...			0	0	0	0
10a	Gross sales of inventory, less returns and allowances .
	a		838,934
b	Less: cost of goods sold ..b		521,972
c	Net income or (loss) from sales of inventory..			316,962	0	0	316,962
Miscellaneous Revenue			Business Code
11a	Cafeteria		722100	4,208,352	0	133,118	4,075,234
b	Pharmacy Services		446110	2,166,644	0	2,007,134	159,510
c	Research		541700	359,139	0	359,139	0
d	All other revenue ....			1,238,217	0	85,373	1,152,844
e	Total. Add lines 11a–11d ......			7,972,352
12	Total revenue. See Instructions......			1,070,953,288	1,058,455,891	2,584,764	8,339,588


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			2,230,184	1	1,350,704
2	Savings and temporary cash investments .........			39,301,890	2	18,841,179
3	Pledges and grants receivable, net ...........				3
4	Accounts receivable, net .............			125,813,285	4	144,501,814
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
				0	5	77,333
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
				0	6
7	Notes and loans receivable, net .............			4,278,068	7	7,227,592
8	Inventories for sale or use ..............			20,699,843	8	22,878,953
9	Prepaid expenses and deferred charges ..........			3,524,177	9	4,632,646
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,047,202,170
b	Less: accumulated depreciation .....	10b	406,548,747	589,663,295	10c	640,653,423
11	Investments—publicly traded securities ..........			0	11
12	Investments—other securities. See Part IV, line 11 .....			15,357,622	12
13	Investments—program-related. See Part IV, line 11 .....			440,699,160	13	454,733,518
14	Intangible assets ...............			88,074,186	14	88,074,186
15	Other assets. See Part IV, line 11 ...........			85,725,716	15	95,813,170
16	Total assets. Add lines 1 through 15 (must equal line 34)......			1,415,367,426	16	1,478,784,518
17	Accounts payable and accrued expenses .........			81,549,962	17	102,771,713
18	Grants payable .................				18
19	Deferred revenue ................			1,424,064	19	1,636,044
20	Tax-exempt bond liabilities .............				20
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........			0	22
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....................			386,372,562	25	376,695,392
26	Total liabilities. Add lines 17 through 25.........			469,346,588	26	481,103,149
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			945,916,982	27	997,577,513
28	Temporarily restricted net assets ...........			103,856	28	103,856
29	Permanently restricted net assets ...........				29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances ...........			946,020,838	33	997,681,369
34	Total liabilities and net assets/fund balances ........			1,415,367,426	34	1,478,784,518