TY 2017 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) Haffner PhD Randall L...................................................................... Board Chairman	5.00 ................. 45.00	X				0	2,395,006	318,699
(2) Houmann Lars D...................................................................... Board Member	1.00 ................. 50.00	X				0	2,430,960	329,576
(3) Rathbun Paul C...................................................................... Board Member (Beg 9/17)	1.00 ................. 50.00	X				0	1,324,061	251,961
(4) Thurber Gary F...................................................................... Board Member	1.00 ................. 5.00	X				0	2,237	0
(5) Campbell Gary...................................................................... President (End 8/17)	5.00 ................. 45.00		X			0	2,388,100	30,400
(6) Banko Peter...................................................................... President (Beg 9/17)	5.00 ................. 45.00		X			0	1,611,258	188,968
(7) Enderson Dan...................................................................... Treasurer/CFO	5.00 ................. 45.00		X			0	955,154	193,574
(8) Dean Morre...................................................................... CEO Porter Adventist Hospital	50.00 ................. 0.00			X		0	945,450	183,003
(9) Gaasch Andrew...................................................................... CFO Porter Adventist Hospital	50.00 ................. 0.00			X		0	376,954	35,358
(10) Spenst Brett...................................................................... CEO Littleton Adventist Hospital	50.00 ................. 0.00			X		0	573,313	112,106
(11) Curry Cheryl...................................................................... CFO Littleton Adventist Hospital	50.00 ................. 0.00			X		0	293,496	35,862
(12) Huenergardt Samuel...................................................................... CEO Parker Adventist Hospital	50.00 ................. 0.00			X		0	462,689	106,453
(13) Fisher Jonathan...................................................................... CFO Parker Adventist Hospital	50.00 ................. 0.00			X		0	227,437	34,411
(14) Yang Charlie...................................................................... Orthopedic Surgeon	50.00 ................. 0.00				X	1,266,984	0	50,795
(15) Miner Todd...................................................................... Orthopedic Surgeon	50.00 ................. 0.00				X	1,242,692	0	42,074
(16) Oliver Christopher...................................................................... Otolaryngology Physician	50.00 ................. 0.00				X	1,152,782	0	43,294
(17) Campana John...................................................................... Otolaryngology Physician	50.00 ................. 0.00				X	1,033,641	0	49,052

(A) Name and business address	(B) Description of services	(C) Compensation
Medix Staffing Solutions Inc 7839 Solution Center Chicago,IL60677	Staffing Services	4,065,170
The Children's Hospital 13123 E 16th Ave Aurora,CO80045	Medical Services	3,471,285
Critical Care Pulmonary and Sleep Associ 274 Union Blvd Ste 110 Lakewood,CO80228	Medical Services	2,110,014
Colorado Cardiovascular Surgical Assoc 950 E Harvard St Ste 550 Denver,CO80210	Medical Services	1,830,572
Colorado Surgical and Critical Care Asso PO Box 205 Sedalia,CO80135	Medical Services	1,697,250
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 126

- 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.
right arrow

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

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 12, 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 (Form 990 or 990-EZ).)

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 agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

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 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

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 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2019

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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. 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—2018. 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—2019. 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—2018. 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) 2019

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. 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—2018. 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) 2019

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d 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 12a or 12b 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 (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) 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 section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

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 9a) 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 9a) 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 section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b 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

Schedule A (Form 990 or 990-EZ) 2019

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

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, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) 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) 2019

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). 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

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) 2019

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

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 2019 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-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

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) 2019

Additional Data

Software ID:
Software Version:

- TIN:

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

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 other 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. Don't 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 isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2

Name of organization Portercare Adventist Health System

Part I Contributors	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
		$	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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 3

Name of organization Portercare Adventist Health System		Employer identification number 84-0438224

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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

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.) $ 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) (2019)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

If the organization answered "Yes" on 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" on 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" on 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 (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

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-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2019

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) 2016	(b) 2017	(c) 2018	(d) 2019	(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) 2019

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 on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(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? ..........................................................

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

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

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

Yes

15,327

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

15,327

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
Part II-B, Line 1i, Lobbying Activities:	Dues were paid to Colorado Health Association, a portion of which were allocated to lobbying.

Schedule C (Form 990 or 990EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

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" on 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" on 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 7/25/06, 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, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, 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" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB 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 FASB 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 on 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 FASB ASC 958 relating to these items:

Revenue included on 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) 2019

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" on 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


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

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" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(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

Term endowment SchDMd Bullet

The percentages on 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" on 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" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	99,832,799		99,832,799
b	Buildings ....	766,876,122	360,871,307	406,004,815
c	Leasehold improvements
d	Equipment ....	364,722,247	234,384,223	130,338,024
e	Other .....	93,545,485	17,250,116	76,295,369
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				712,471,007

Schedule D (Form 990) 2019

Page 3

Part VII

InvestmentsOther Securities.
Complete if the organization answered "Yes" on 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........
(3) Other (A) Share of Parent Centralized Investment Pool	374,844,164	F
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	374,844,164

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on 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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

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

(a) Description				(b) Book value
(1)Investment in Subsidiaries				112,190,217
(2)Deposits				8,833,168
(3)Due from Related				35,566,083
(4)Receivable from Third Parties				5,011,627
(5)Other Assets				1,576,602
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				163,177,697

Part X

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

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	363,699,841
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) 2019

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on 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' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

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

Return Reference

Explanation

Part X, Line 2:

The filing organization is a subsidiary organization within Adventist Health System (AHS). The consolidated financial statements of AHS contain the following FIN 48 (ASC 740) footnote: Please note that dollar amounts are in thousands. Healthcare Corporation and its affiliated organizations, other than North American Health Services, Inc. and its subsidiary (NAHS), are exempt from state and federal income taxes. Accordingly, Healthcare Corporation and its tax-exempt affiliates are not subject to federal, state or local income taxes except for any net unrelated business taxable income. NAHS is a wholly owned, for-profit subsidiary of Healthcare Corporation. NAHS and its subsidiary are subject to federal and state income taxes. NAHS files a consolidated federal income tax return and, where appropriate, consolidated state income tax returns. All taxable income was fully offset by net operating loss carryforwards for federal income tax purposes; as such, there is no provision for current federal or state income tax for the years ended December 31, 2017 and 2016. NAHS also has temporary deductible differences of approximately $55,700 and $59,100 at December 31, 2017 and 2016, respectively, primarily as a result of net operating loss carryforwards. At December 31, 2017, NAHS had net operating loss carryforwards of approximately $56,400, expiring beginning in 2022 through 2026. Deferred taxes have been provided for these amounts, resulting in a net deferred tax asset of approximately $14,100 and $22,500 at December 31, 2017 and 2016, respectively. A full valuation allowance has been provided at December 31, 2017 and 2016 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. On December 22, 2017, the United States enacted tax reform legislation commonly known as the Tax Cuts and Jobs Act (Act), resulting in significant modifications to existing law. NAHS remeasured its deferred tax assets and liabilities based on the rates at which they are expected to reverse in the future, which is generally 21%. Additionally, NAHS had a corresponding decrease to its valuation allowance resulting in no net tax expense impact. The Income Taxes Topic of the ASC (ASC 740) prescribes the accounting for uncertainty in income tax positions recognized in financial statements. ASC 740 prescribes a recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken, or expected to be taken, in a tax return. There were no material uncertain tax positions as of December 31, 2017 and 2016.

Schedule D (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2019

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 25000.0000000000 %

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		(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) . . .	4,892,576		4,892,576	0.420 %
b	Medicaid (from Worksheet 3, column a) . . . . .	186,397,376	116,866,826	69,530,550	5.970 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	191,289,952	116,866,826	74,423,126	6.390 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	1,580,479	55,820	1,524,659	0.130 %
f	Health professions education (from Worksheet 5) . . .
g	Subsidized health services (from Worksheet 6) . . . .	262,077		262,077	0.020 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	216,880		216,880	0.020 %
j	Total. Other Benefits . .	2,059,436	55,820	2,003,616	0.170 %
k	Total. Add lines 7d and 7j .	193,349,388	116,922,646	76,426,742	6.560 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019

Schedule H (Form 990) 2019

Page

Part II

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

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development	538,336	538,336	0.050 %
9	Other
10	Total	538,336	538,336	0.050 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare 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. ......

39,935,737

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).....

203,669,636

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

311,077,569

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

-107,407,933

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 %	(e) Physicians' profit % or stock ownership %
11 Functional Neurosurgical Ambulatory Surgery Center LLC	Surgery Center	51.000 %	49.000 %
23 Crown Point Surgery Center LLC	Surgery Center	26.960 %	33.760 %
34 Flatirons Surgery Center LLC	Surgery Center	25.000 %	49.900 %
46 Harvard Park Surgery Center LLC	Surgery Center	25.000 %	48.500 %
57 South Denver Musculoskeletal Surgical Partners LLC	Surgery Center	25.200 %	49.500 %
68 Summit View Surgery Center LLC	Surgery Center	25.000 %	45.630 %
7
8
9
10
11
12
13

Schedule H (Form 990) 2019

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?5Name, 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)						Facility reporting group
1	Porter Adventist Hospital 2525 S Downing St Denver,CO80210 https://www.centura.org/locations/port 1036	X	X	X	X	A
2	Littleton Adventist Hospital 7700 S Broadway Littleton,CO80122 https://www.centura.org/locations/litt 1034	X	X		X	A
3	Parker Adventist Hospital 9395 Crown Crest Blvd Parker,CO80138 https://www.centura.org/locations/park 1005	X	X		X	A
4	Avista Adventist Hospital 100 Health Park Drive Louisville,CO80027 https://www.centura.org/locations/avis 90831	X	X		X	A
5	Castle Rock Adventist Health Campus 2350 Meadows Blvd Castle Rock,CO80109 https://www.centura.org/locations/cast 01L581	X	X		X	A

Schedule H (Form 990) 2019

Page 4

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)

	Facility Reporting Group A
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 15

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

6 a

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): See Part V, Page 8

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15

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

Yes

If "Yes" (list url): See Part V, Page 8

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

12b

If "Yes" on 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) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	Facility Reporting Group A
Name of hospital facility or letter of facility reporting group

Yes

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 250.000000000000%
and FPG family income limit for eligibility for discounted care of 400.000000000000%

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)

Was widely publicized 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):

See Part V, Page 8

The FAP application form was widely available on a website (list url):

See Part V, Page 8

A plain language summary of the FAP was widely available on a website (list url):
See Part V, Page 8

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)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

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

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	Facility Reporting Group A
Name of hospital facility or letter of facility reporting group

Yes

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 nonpayment?..................................

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

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

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

Did the hospital facility or other authorized 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

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

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 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

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)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

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

	Facility Reporting Group A
Name of hospital facility or letter of facility reporting group

Yes

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 a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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) 2019

Page 8

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, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 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	In order to assess the needs of our community, we created a hospital subcommittee to solicit and take into account input from individuals representing the broad interest of our community. Our hospital subcommittee was made up of key stakeholders and individuals who represented the broader interests of our community. Public health representatives attended every meeting and provided input into the process of narrowing the selection of health issues. Once health needs were prioritized, we determined groups and individuals appropriate for focus groups, being sure to solicit input from underserved or minority groups within the communities we serve. These focus groups helped identify particularly important needs as seen by our communities, identify gaps in knowledge, and understand current external efforts around health needs that could be improved by healthcare participation.
Schedule H, Part V, Section B, Line 7a, Hospital Facility CHNA Website	Facility 1 - Porter Adventist Hospitalhttps://www.centura.org/community-programs/community-benefitFacility 2 - Littleton Adventist Hospitalhttps://www.centura.org/community-programs/community-benefitFacility 3 - Parker Adventist Hospitalhttps://www.centura.org/community-programs/community-benefitFacility 4 - Avista Adentist Hospitalhttps://www.centura.org/community-programs/community-benefitFacility 5 - Castle Rock Adventist Health Campushttps://www.centura.org/community-programs/community-benefit
Schedule H, Part V, Section B, Line 10	Each hospital facility's most recently adopted implementation strategy was made widely available through the following websites:Facility 1 - Porter Adventist Hospitalhttps://www.centura.org/community-programs/community-benefitFacility 2 - Littleton Adventist Hospitalhttps://www.centura.org/community-programs/community-benefitFacility 3 - Parker Adventist Hospitalhttps://www.centura.org/community-programs/community-benefitFacility 4 - Avista Adentist Hospitalhttps://www.centura.org/community-programs/community-benefitFacility 5 - Castle Rock Adventist Health Campushttps://www.centura.org/community-programs/community-benefit
Schedule H, Part V, Section B, Line 11	The information provided below explains how the hospital facility addressed in fiscal year 2018 the significant health needs identified in its fiscal year 2016 Community Health Needs Assessment, and any such needs that were not addressed and the reasons why such needs were not addressed. The hospital facility conducted a Community Health Needs Assessment in fiscal year 2016 and adopted an implementation strategy to address the significant health needs identified in the fiscal year 2016 Community Health Needs Assessment in fiscal year 2016.Facility 1 - Porter Adventist HospitalPorter Adventist Hospital (PAH) initially looked at twenty-one health issues with community stakeholders, including both disease state and health behaviors. Needs included Asthma, Cancer (Breast, Cervical and Colorectal), Diabetes, Heart Disease, Homicide, Infectious Disease (HIV and Chlamydia), Lung Disease, Maternal Infant and Child Health (Infant Mortality, Teen Birth Rate and LBW births), Overweight and Obesity, Oral Health, Prostate Cancer, Substance Abuse, Suicide and Unintentional Injury, Access to Care, and Mental Health. The community narrowed focus by using a form of the Hanlon Method for Prioritizing Health Problems. Each identified need was rated against a) size, b) severity, and c) alignment with PAH and community existing efforts. Total scores were compiled and resulted in the identification of the following prioritized health issues: Suicide Prevention, Healthy Eating and Active Living, Oral Health, Access to Care and Heart Disease. PAH recognizes that focusing on a few health issues leads to greater progress than dispersing efforts across many issues. For each issue, best practices for screening and treatment as well as prevention through environmental and behavioral changes were identified. Suicide Prevention focuses on the identification of people at risk for suicide and connection to available resources along with behavioral health screening. Healthy eating and active living are lifestyle issues to address overweight/obesity, diabetes and cardiovascular disease. Oral health is identified as a focus on dental health and prevention of dental caries. Access to care was identified as both enrollment into coverage and connection with a medical home. Cardiovascular disease was identified as screening and treatment for cardiovascular disease. This, however, morphed over time to focus on prevention of cardiovascular disease through healthy eating and active living. During fiscal year 2018, PAH addressed oral health needs through a partnership with Kids In Need of Dentistry. With a local parish, PAH provided healthy meals to families in need over the holidays. PAH contributed $16,668 to Kids Alive to support mental health needs of children of parents diagnosed with cancer. PAH did not specifically address heart disease; rather, PAH focused efforts toward prevention of heart disease through healthy eating and active living efforts. During fiscal year 2017, PAH addressed obesity/diabetes and behavioral health by providing health coaching, health improvement classes and wellness initiatives to 3,876 people to increase awareness regarding mental and physical wellness. PAH also allocated resources to provide dental services to 14,335 kids in need of such services. PAH staff also trained 238 nurses. PAH had 18,074 encounters with Medicaid patients and patients that received financial assistance to address access to care. PAH did not address the following identified health issues due to limited resources and the availability of other community organizations to address such needs: asthma, cancer, diabetes, homicide, infectious disease, lung disease, maternal infant and child health, and substance abuse. In addition, the following health issues/determinants of education with respect to accessing care for undocumented individuals, the lack of farmer's markets not accepting WIC benefits, the effects of marijuana on tourists, Colorado's lack of affordable housing, and changing the civil commitment statute were not addressed due to limited resources and other organizations that address these needs.Facility 2 - Littleton Adventist HospitalLittleton Adventist Hospital (LAH) initially looked at twenty-one health issues with community stakeholders, including both disease state and health behaviors. Needs included Asthma, Cancer (Breast, Cervical and Colorectal), Diabetes, Heart Disease, Homicide, Infectious Disease (HIV and Chlamydia), Lung Disease, Maternal Infant and Child Health (Infant Mortality, Teen Birth Rate and LBW births), Overweight and Obesity, Oral Health, Prostate Cancer, Substance Abuse, Suicide and Unintentional Injury, Access to Care, and Mental Health. The community narrowed focus by using a form of the Hanlon Method for Prioritizing Health Problems. Each identified need was rated against a) size, b) severity, and c) alignment with LAH and community existing efforts. Total scores were compiled and resulted in the identification of the following prioritized health needs: Mental Health/Suicide Prevention, Healthy Eating and Active Living, and Access to Care. LAH recognizes that focusing on a few health issues leads to greater progress than dispersing efforts across many issues. For each issue, best practices for screening and treatment as well as prevention through environmental and behavioral changes were identified. Mental Health/Suicide Prevention focuses on the screening for mental health issues and suicide risk and referral to resources. Healthy eating and active living are lifestyle issues to address overweight/obesity, diabetes and cardiovascular disease. Access to care was identified as both enrollment into coverage and connection with a medical home. During fiscal year 2018, the following actions were taken with respect to the three prioritized health issues: LAH increased access to care by providing oversight and education to Emergency Medical Services personnel; LAH provided $469,929 toward precepting of health care professionals to improve access to care; and LAH provided Pathways to Health and Wellness programming that reached over 30 community members with the goal of improving the health of each participant's mind, body and spirit. Through healthy eating and active living programming, 593 community members lost 2,827 pounds collectively. LAH also reached 54 community members with Mental Health First Aid training advancing the community's capacity to improve mental health. In fiscal year 2017, LAH's efforts included providing health coaching and health improvement classes to 3,876 people to increase awareness regarding mental and physical wellness. Also, LAH provided resources for the provision of care for over 2,000 medically underserved patients. LAH provided over $1.8 million dollars in resources to train 1,675 nurses and other health care professionals to address access to care. LAH had 11,910 encounters with Medicaid patients and patients that received financial assistance to address access to care.LAH did not address the following identified health issues of asthma, cancer, diabetes, heart disease, homicide, infectious disease, lung disease, maternal infant and child health, oral health, and substance abuse due to limited resources and the availability of other community organizations to address these needs. In addition, the following health issues/determinants of Colorado's lack of affordable housing, changing the civil commitment statute, education for access to care for undocumented individuals, the effects of marijuana on tourists, the shortage of mental health professionals, changing the bike laws and local ordinances regarding bike friendliness were not addressed due to limited resources and other organizations that address these needs.Facility 3 - Parker Adventist Hospital Parker Adventist Hospital (PRK) initially looked at twenty-one health issues with community stakeholders, including both disease state and health behaviors. Needs included Asthma, Cancer (Breast, Cervical and Colorectal), Diabetes, Heart Disease, Homicide, Infectious Disease (HIV and Chlamydia), Lung Disease, Maternal Infant and Child Health (Infant Mortality, Teen Birth Rate and LBW births), Overweight and Obesity, Oral Health, Prostate Cancer, Substance Abuse, Suicide and Unintentional Injury, Access to Care, Mental Health, and Equestrian Safety. The community narrowed focus by using a form of the Hanlon Method for Prioritizing Health Problems. Each identified need was rated against a) size, b) severity, and c) alignment with PRK and community existing efforts. Total scores were compiled and resulted in the identification of the following prioritized health issues: Mental Health/Suicide Prevention, Healthy Eating and Active Living, Access to Care and Equestrian Safety. **See continuation of footnote
Schedule H, Part V, Section B, Line 11 (continued)	PRK recognizes that focusing on a few health issues leads to greater progress than dispersing efforts across many issues. For each issue, best practices for screening and treatment as well as prevention through environmental and behavioral changes were identified. Mental Health/Suicide Prevention focuses on the screening for mental health issues and suicide risk and referral to resources. Healthy eating and active living are lifestyle issues to address overweight/obesity, diabetes and cardiovascular disease. Access to care was identified as both enrollment into health care coverage and connection with a medical home. Equestrian safety is a focus on injury prevention through promotion of the use of helmets. During fiscal year 2018, PKR took the following actions with respect to its prioritized health issues: PRK increased access to care by providing oversight and education to Emergency Medical Services personnel; and PRK conducted Pathways to Health and Wellness programming that reached over 30 community members with the objective of improving the health of mind, body and spirit. Through healthy eating and active living programming, 339 community members lost 1,368 pounds collectively. PRK reached 54 community members with Mental Health First Aid training to help advance the community's capacity to improve mental health. PRK donated helmets and education to 92 community members to prevent head injuries through equestrian safety. In fiscal year 2017, PRK provided health coaching, health improvement classes and wellness initiatives to 5,386 people to increase awareness regarding mental and physical wellness. PRK also provided resources for the provision of care for over 2,000 medically underserved patients. In addition, PRK provided $480,752 in resources to train nurses and other health care professionals to address the demands for health care services in the community. PRK provided fitted helmets and education to community members to promote equestrian safety. PRK also had 10,785 encounters with Medicaid patients and patients that received financial assistance to address access to care. PRK did not address the identified health issues of asthma, cancer, diabetes, heart disease, homicide, infectious disease, lung disease, maternal infant and child health, and oral health due to limited resources and the availability of other community organizations to address these issues. In addition, the following health issues/determinants of Colorado's lack of affordable housing, changing the civil commitment statute, education with respect to accessing care for undocumented individuals, the effects of marijuana on tourists, the shortage of mental health professionals, changing the bike laws and local ordinances regarding bike friendliness were not addressed due to limited resources and other organizations that address these needs.Facility 4 - Avista Adventist HospitalAvista Adventist Hospital (AAH) initially looked at twenty-one health issues with community stakeholders, including both disease state and health behaviors. Needs included Asthma, Cancer (Breast, Cervical and Colorectal), Diabetes, Heart Disease, Homicide, Infectious Disease (HIV and Chlamydia), Lung Disease, Maternal Infant and Child Health (Infant Mortality, Teen Birth Rate and LBW births), Overweight and Obesity, Oral Health, Prostate Cancer, Substance Abuse, Suicide and Unintentional Injury, Access to Care, and Mental Health. The community narrowed focus by using a form of the Hanlon Method for Prioritizing Health Problems. Each identified need was rated against a) size, b) severity, and c) alignment with AAH and community existing efforts. Total scores were compiled and resulted in the identification of the following prioritized health issues: Behavioral Health, Healthy Eating and Active Living, and Access to Care. AAH recognizes that focusing on a few health issues leads to greater progress than dispersing efforts across many issues. For each issue, best practices for screening and treatment as well as prevention through environmental and behavioral changes were identified. Behavioral Health includes both mental health and substance abuse. Healthy eating and active living are lifestyle issues to address overweight/obesity, diabetes and cardiovascular disease. Access to care was identified as both enrollment into coverage and connection with a medical home. During fiscal year 2018, the following actions were taken with respect to the three prioritized health issues: AAH enrolled 1,051 people into available health coverage; AAH partnered with a local Federally Qualified Health Center to invest in technology to enable physicians across the community to provide a system of care for 51,667 lower income community members; AAH supported the overall health and well-being of 47 new mothers through the Creation Health Program; and AAH staff provided 91 hours to address community health needs in partnership with community organizations. In the prior fiscal year, AAH identified and improved access to behavioral health, healthy eating/active living (HEAL)/obesity reduction and prevention and access to care. AAH implemented efforts to address access to health services, diabetes, obesity, mental health, substance abuse and access to care as priority health needs. These efforts included providing $187,084 in resources to assist clinics in increasing access to care for medically underserved community members, including behavioral health services. AAH also provided resources to educate 1,562 families and to educate 157 mothers of newborns regarding healthy eating and active living to address issues related to diabetes and obesity. Additionally, AAH dedicated 43,122 staff hours to training nurses, radiologists, pharmacists and other health care professionals to support availability and access to health care services. AAH also had 8,521 encounters with Medicaid patients and patients that received financial assistance.AAH did not address the identified health issues of asthma, cancer, diabetes, heart disease, homicide, infectious disease, lung disease, maternal infant and child health, and oral health due to limited resources and other organizations that address these needs. In addition, the following health issues/determinants of smoking, homelessness, the lack of farmer's markets not accepting WIC benefits, Colorado's lack of affordable housing, education and access to care for undocumented individuals, and preventable motor vehicle accidents were not addressed due to limited resources and other organizations that address these needs.Facility 5 - Castle Rock Adventist HospitalCastle Rock Adventist Hospital (CRAH) initially looked at twenty-one health issues with community stakeholders, including both disease state and health behaviors. Needs included Asthma, Cancer (Breast, Cervical and Colorectal), Diabetes, Heart Disease, Homicide, Infectious Disease (HIV and Chlamydia), Lung Disease, Maternal Infant and Child Health (Infant Mortality, Teen Birth Rate and LBW births), Overweight and Obesity, Oral Health, Prostate Cancer, Substance Abuse, Suicide and Unintentional Injury, Access to Care, and Mental Health. The community narrowed focus by using a form of the Hanlon Method for Prioritizing Health Problems. Each identified need was rated against a) size, b) severity, and c) alignment with CRAH and community existing efforts. Total scores were compiled and resulted in the identification of the following prioritized health issues: Mental Health/Suicide Prevention, Healthy Eating and Active Living, and Access to Care. CRAH recognizes that focusing on a few health issues leads to greater progress than dispersing efforts across many issues. For each issue, best practices for screening and treatment as well as prevention through environmental and behavioral changes were identified. Mental Health/Suicide Prevention focuses on the screening for mental health issues and suicide risk and referral to resources. Healthy eating and active living are lifestyle issues to address overweight/obesity, diabetes and cardiovascular disease. Access to care was identified as both enrollment into coverage and connection with a medical home. During fiscal year 2018, CRAH increased access to care by providing oversight and education to Emergency Medical Services personnel and CRAH staff dedicated 530 hours to train 40 students to improve access to care in the community. CRAH provided breast feeding education and support to 576 women and prenatal classes to 989 families in the community, with the goal of addressing obesity and nutrition among pregnant women and children. CRAH provided 5,000 pounds of produce to the community through its community gardens. CRAH staff reached 54 community members with Mental Health First Aid training thereby advancing the community's capacity to improve mental health. **See continuation of footnote
Schedule H, Part V, Section B, Line 11 (continued)	In the prior fiscal year, CRAH implemented efforts to address mental health/suicide, healthy eating/active living (HEAL) and access to care as priority health needs. These efforts included providing prenatal classes to 1,286 community members, reaching 2,598 people through a bicycle wellness program, providing breast feeding education to 537 women and providing health coaching and health improvement programs to 3,876 people. Castle Rock also had 6,538 encounters with Medicaid patients and patients that received financial assistance to address access to care.Castle Rock did not address the identified health issues of asthma, cancer, diabetes, heart disease, homicide, infectious disease, lung disease, maternal infant and child health, oral health and substance abuse due to limited resources and the availability of other community programs to address these issues. In addition, the following health issues/determinants of preventable motor vehicle accidents, smoking, homelessness, Colorado's lack of affordable housing, education regarding access to care for undocumented individuals, changing the civil commitment statute, the effects of marijuana on tourists, and the shortage of mental health professionals were not addressed due to limited resources and other organizations that address these needs.
Schedule H, Part V, Section B, Line 16a - c	Each hospital facility's FAP, FAP application form and plain language summary of the FAP was made widely available through the following websites:Facility 1 - Porter Adventist Hospitalhttps://www.centura.org/patients-and-families/billing-and-financial-services/financial-helpFacility 2 - Littleton Adventist Hospitalhttps://www.centura.org/patients-and-families/billing-and-financial-services/financial-helpFactility 3 - Parker Adventist Hospitalhttps://www.centura.org/patients-and-families/billing-and-financial-services/financial-helpFacility 4 - Avista Adventist Hospitalhttps://www.centura.org/patients-and-families/billing-and-financial-services/financial-helpFacility 5 - Castle Rock Adventist Health Campushttps://www.centura.org/patients-and-families/billing-and-financial-services/financial-help

Schedule H (Form 990) 2019

Page 9

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?74
Name and address		Type of Facility (describe)
1	1 - South Denver Cardiology Associates 1000 SouthPark Dr Littleton,CO801205654	HEALTHCARE SERVICES CLINIC
2	2 - Parker Southlands 6069 S Southlands Pkwy Aurora,CO800165316	HEALTHCARE SERVICES CLINIC
3	3 - Porter Place 1001 E Yale Ave Denver,CO80210	NOT-FOR-PROFIT SENIOR LIVING FACILITY
4	4 - Cypress Hemotolgy Oncology And Oncology 2555 S Downing St Ste 240 Denver,CO802105855	HEALTHCARE SERVICES CLINIC
5	5 - Porter Hospice 5020 E Arapahoe Rd Littleton,CO80122	HOSPICE SERVICES
6	6 - Colorado Joint Replacement 2535 S Downing St Ste 100 150 Denver,CO80210	HEALTHCARE SERVICES CLINIC
7	7 - Cypress Hematology At Parker 9399 Crown Crest Blvd Ste 215 Parker,CO801388508	HEALTHCARE SERVICES CLINIC
8	8 - Centura Orthopedic & Spine 9949 S Oswego St Ste 200 Parker,CO801343753	HEALTHCARE SERVICES CLINIC
9	9 - CHPG Ridgegate ObGyn At Lone Tree 9695 S Yosemite St Ste 255B Lone Tree,CO801242890	HEALTHCARE SERVICES CLINIC
10	10 - Colorado ENT Specialists 9399 Crown Crest Blvd Ste 401 Parker,CO801388540	HEALTHCARE SERVICES CLINIC
11	11 - Pinnacle Women's Healthcare At Parker 9397 Crown Crest Blvd Ste 400 Parker,CO801388789	HEALTHCARE SERVICES CLINIC
12	12 - CHPG Neurosurgery One 7780 S Broadway Ste 350 Littleton,CO801222633	HEALTHCARE SERVICES CLINIC
13	13 - Integrated Obgyn At Parker 9397 Crown Crest Blvd Ste 220 Parker,CO801388576	HEALTHCARE SERVICES CLINIC
14	14 - Centura Health Physician Group Porter Hosp 2525 S Downing St Denver,CO802105817	HEALTHCARE SERVICES CLINIC
15	15 - Centura Health Physician Group Parker Adve 2525 S Downing St Denver,CO802105817	HEALTHCARE SERVICES CLINIC
16	16 - Colorado Head And Neck Specialists 2535 S Downing St Ste 480 Denver,CO802105851	HEALTHCARE SERVICES CLINIC
17	17 - NHC Church Ranch And Fsed 7233 Church Ranch Blvd Westminster,CO800214094	HEALTHCARE SERVICES CLINIC
18	18 - Centura Health At Southlands 6069 S Southlands Pkwy Aurora,CO800165316	HEALTHCARE SERVICES CLINIC
19	19 - Primary Care (Harvard Park) 950 E Harvard Ave Ste 200 Denver,CO802107006	HEALTHCARE SERVICES CLINIC
20	20 - CHPG Church Ranch At Avista 7233 Church Ranch Blvd Westminster,CO800214094	HEALTHCARE SERVICES CLINIC
21	21 - CHPG Womens Health At LAH 7720 S Broadway Ste 350 Littleton,CO801222634	HEALTHCARE SERVICES CLINIC
22	22 - Centura Orthopedic & Spine 2352 Meadows Blvd Ste 300 Castle Rock,CO801098419	HEALTHCARE SERVICES CLINIC
23	23 - Chatfield Women'S Care 7720 S Broadway Ste 250 Littleton,CO801222634	HEALTHCARE SERVICES CLINIC
24	24 - Timberview Clinic At Parker 9399 Crown Crest Blvd Ste 200 Parker,CO801388508	HEALTHCARE SERVICES CLINIC
25	25 - Mile High Oncology 7780 S Broadway Ste 380 Littleton,CO801222633	HEALTHCARE SERVICES CLINIC
26	26 - Centura Health Emergency And Urgent Care - 9949 S Oswego St Ste 100 Parker,CO801343753	HEALTHCARE SERVICES CLINIC
27	27 - Ridgeline Family Medicine At Castle Pines 250 Max Drive Ste 102 Castle Pines,CO801089518	HEALTHCARE SERVICES CLINIC
28	28 - Highlands Ranch Emergency And Urgent Care 9205 S Broadway Littleton,CO80129	HEALTHCARE SERVICES CLINIC
29	29 - Ridgeline Family Medicine 2352 Meadows Blvd Ste 300 Castle Rock,CO801098419	HEALTHCARE SERVICES CLINIC
30	30 - Access Family Medicine 15901 E Briarwood Cir Ste 200 Aurora,CO80016	HEALTHCARE SERVICES CLINIC
31	31 - Parker Primary Care 9949 S Oswego St Ste 200 Parker,CO801343753	HEALTHCARE SERVICES CLINIC
32	32 - CHPG Primary Care West Littleton 9670 W Coal Mine Ave Littleton,CO80123	HEALTHCARE SERVICES CLINIC
33	33 - CHPG Internal Medicine Parker 9397 Crown Crest Blvd Ste 420 Parker,CO801388789	HEALTHCARE SERVICES CLINIC
34	34 - Northwest Gastroenterology 80 Health Park Dr Ste 270 Louisville,CO800279584	HEALTHCARE SERVICES CLINIC
35	35 - CHPG Primary Care Southmoor 5570 DTC Parkway Greenwood Village,CO80111	HEALTHCARE SERVICES CLINIC
36	36 - Centura Health Physician Group Porter Orth 2535 S Downing Ste 180 Denver,CO802105863	HEALTHCARE SERVICES CLINIC
37	37 - CHPG Primary Care Highlands 2490 W 26th Ave Ste A120 Denver,CO802115317	HEALTHCARE SERVICES CLINIC
38	38 - Castle Rock Hospitalists 2350 Meadows Blvd Castle Rock,CO801098405	HEALTHCARE SERVICES CLINIC
39	39 - GI At CRAH 2352 Meadows Blvd Ste 300 Castle Rock,CO801098419	HEALTHCARE SERVICES CLINIC
40	40 - Avista Family Medicine Erie 611 Mitchell Way Erie,CO805165443	HEALTHCARE SERVICES CLINIC
41	41 - CHP NHC Meridian 9949 S Oswego St Ste 200 Parker,CO801343753	HEALTHCARE SERVICES CLINIC
42	42 - Precision Spine Center 6825 S Galena Street Suite 314 Littleton,CO80112	HEALTHCARE SERVICES CLINIC
43	43 - Parker Meridian 9949 S Oswego St Ste 200 Parker,CO801343753	HEALTHCARE SERVICES CLINIC
44	44 - Avista Internal Medicine 90 Health Park Dr Ste 350 Louisville,CO800279742	HEALTHCARE SERVICES CLINIC
45	45 - Highlands Ranch Medical Associates 9135 S Ridgeline Blvd Ste 190 Highlands Ranch,CO801292395	HEALTHCARE SERVICES CLINIC
46	46 - Avista Ob Clinic 90 Health Park Dr Ste 350 Louisville,CO800279742	HEALTHCARE SERVICES CLINIC
47	47 - CHPG Colorectal Surgery At Parker 9397 Crown Crest Blvd Ste 201 Parker,CO801388576	HEALTHCARE SERVICES CLINIC
48	48 - South Suburban Internal Medicine 7750 S Broadway Ste 100 Littleton,CO801222630	HEALTHCARE SERVICES CLINIC
49	49 - South Quebec Family Medicine 6081 S Quebec Street Ste 100 Centennial,CO80111	HEALTHCARE SERVICES CLINIC
50	50 - Centura Medical Associates 2525 S Downing St Denver,CO802105817	HEALTHCARE SERVICES CLINIC
51	51 - Grace Family Practice 6909 S Holly Cir Ste 100 Centennial,CO801126300	HEALTHCARE SERVICES CLINIC
52	52 - Aracea Women's Center 2555 S Downing St 1st Floor Denver,CO802105855	HEALTHCARE SERVICES CLINIC
53	53 - Chatfield Family Medicine 10789 Bradford Rd Ste 150 Littleton,CO801276405	HEALTHCARE SERVICES CLINIC
54	54 - Dimension Pain Management 80 Health Park Dr Ste 270 Louisville,CO800274644	HEALTHCARE SERVICES CLINIC
55	55 - Parker Endocrinology 9397 Crown Crest Blvd Ste 431 Parker,CO801388789	HEALTHCARE SERVICES CLINIC
56	56 - Colorado Neurovascular Specialists 7780 S Broadway Ste 340 Littleton,CO801222633	HEALTHCARE SERVICES CLINIC
57	57 - Centura Health Physician Group Gastroenter 2535 S Downing St Ste 360 Denver,CO802105850	HEALTHCARE SERVICES CLINIC
58	58 - Centura Health Physician Group Adventist H 100 Healthpark Dr Louisville,CO800279583	HEALTHCARE SERVICES CLINIC
59	59 - Centura Gastroenterology 9949 S Oswego St Ste 200 Parker,CO801343753	HEALTHCARE SERVICES CLINIC
60	60 - CHPG Urology Castle Rock 2352 Meadows Blvd Ste 300 Castle Rock,CO80109	HEALTHCARE SERVICES CLINIC
61	61 - Centura Health Physician Group Center For 80 Health Park Dr Ste 270 Louisville,CO800274644	HEALTHCARE SERVICES CLINIC
62	62 - Mapleton Hills Medical Plaza 2525 4th St Boulder,CO80304	HEALTHCARE SERVICES CLINIC
63	63 - Bariatric And Metabolic Center 9399 Crown Crest Blvd Ste 110 Parker,CO80138	HEALTHCARE SERVICES CLINIC
64	64 - CHPG Senior Care PAH Holly Creek 5500 East Peakview Ave Centennial,CO80121	HEALTHCARE SERVICES CLINIC
65	65 - Castle Rock Affiliated ENT 2352 Meadows Blvd Ste 300 Castle Rock,CO80109	HEALTHCARE SERVICES CLINIC
66	66 - Flatirons Heart And Vascular 90 Health Park Dr Ste 190 Louisville,CO800279586	HEALTHCARE SERVICES CLINIC
67	67 - CHPG Oncology At Avista 80 Health Park Dr Ste 270 Louisville,CO800274644	HEALTHCARE SERVICES CLINIC
68	68 - Comprehensive Breast Care 2490 W 26th Ave Ste A120 Denver,CO802115317	HEALTHCARE SERVICES CLINIC
69	69 - Cornerstar Women's Health 15901 E Briarwood Cir Ste 200 Aurora,CO80016	HEALTHCARE SERVICES CLINIC
70	70 - PAH Creekside Family Medicine 300 S Jackson St Ste 340 Denver,CO80209	HEALTHCARE SERVICES CLINIC
71	71 - West Littleton NHC 9670 W Coal Mine Ave Littleton,CO80123	HEALTHCARE SERVICES CLINIC
72	72 - Centura Health Physician Group At Clermont 2479 S Clermont St Denver,CO80222	HEALTHCARE SERVICES CLINIC
73	73 - Boulder Holistic Medicine 805 S Broadway Ste 103 Boulder,CO80305	HEALTHCARE SERVICES CLINIC
74	74 - Avista Family Medicine Gunbarrel 5365 Spine Rd Ste C Boulder,CO80301	HEALTHCARE SERVICES CLINIC

Schedule H (Form 990) 2019

Page 10

Part VI

Supplemental Information

Provide the following information.

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

Form and Line Reference	Explanation
Part I, Line 6a:	The filing organization operates as a part of Centura Health Corporation (Centura), a joint operating company that integrally manages a number of hospital and other healthcare provider facilities. All hospital organizations within Centura collect, calculate, and report the community benefits they provide to the communities they serve. Centura organizations exist solely to improve and enhance the local communities they serve. Centura has a system-wide community benefits accounting policy that provides guidelines for its health care provider organizations to capture and report the costs of services provided to the underprivileged and to the broader community. Each Centura hospital facility reports their community benefits to their Board of Directors and strives to communicate their community benefits to their local communities. Additionally, the filing organization's most recently conducted community health needs assessment and associated implementation strategy are posted on the filing organization's website.
Part I, Line 7:	Portercare Adventist Health System does not use a cost accounting system to determine the cost of charity care. The estimated cost of care is calculated as the ratio of each facility's total expenses to total gross revenue. Worksheet 2 was not used to develop the cost to charge ratio. There are no physician clinics included in subsidized health services.
Part II, Community Building Activities:	The costs of community building activities reported on Part II of Schedule H primarily represent the costs associated with providing education for the filing organization's staff physicians and employees. The filing organization's provision of these educational programs/activities to staff physicians and employees provides an opportunity for health care professionals to enhance their skills and expertise and keep up-to-date with the latest advancements in medical procedures and technology. In addition, training opportunities are often provided on-site at the filing organization's hospital facilities, thereby allowing for health care professionals to be more readily available to assist in meeting immediate patient care needs. Education and training provided to each facility's workforce is vital in assisting health care professionals directly involved in patient care with keeping abreast of the latest developments in their respective areas of expertise, learning possible new and innovative ways of delivering care to patients, and understanding the newest technologies available for the treatment of patients.
Part III, Line 2:	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.
Part III, Line 3:	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. Rationale for Including Certain Bad Debts in Community Benefit:The filing organization is dedicated to the view that medically necessary health care for emergency and non-elective patients should be accessible to all, regardless of age, gender, geographic location, cultural background, physician mobility, or ability to pay. The filing organization treats emergency and non-elective patients regardless of their ability to pay or the availability of third-party coverage. By providing health care to all who require emergency or non-elective care in a non-discriminatory manner, the filing organization is providing health care to the broad community it serves. As a 501(c)(3) hospital organization, the filing organization maintains 24/7 emergency rooms providing care to all whom present. When a patient's arrival and/or admission to a facility begins within the Emergency Department, triage and medical screening are always completed prior to registration staff proceeding with the determination of a patient's source of payment. If the patient requires admission and continued non-elective care, the filing organization provides the necessary care regardless of the patient's ability to pay. The filing organization's operation of 24/7 Emergency Departments that accept all individuals in need of care promotes the health of the community through the provision of care to all whom present. Current Internal Revenue Service guidance that tax-exempt hospitals maintain such emergency rooms was established to ensure that emergency care would be provided to all without discrimination. The treatment of all at the filing organization's Emergency Departments is a community benefit. Under the filing organization's Financial Assistance Policy, every effort is made to obtain a patient's necessary financial information to determine eligibility for financial assistance. However, not all patients will cooperate with such efforts and a financial assistance eligibility determination cannot be made based upon information supplied by the individual. In this case, a patient's portion of a bill that remains unpaid for a certain stipulated time period is wholly or partially classified as bad debt. Bad debts associated with patients who have received care through the filing organization's Emergency Departments should be considered community benefit as charitable hospitals exist to provide such care in pursuit of their purpose of meeting the need for emergency medical care services available to all in the community.
Part III, Line 4:	The financial information of the filing organization is included in a consolidated audited financial statement for the current year.The applicable footnote from the attached consolidated audited financial statements that addresses accounts receivable, the allowance for uncollectible accounts, and the provision for bad debts can be found on pages 8-9. Please note that dollar amounts on the attached consolidated audited financial statements are in thousands.
Part III, Line 8:	Costing Methodology: Medicare allowable costs were calculated using a cost-to-charge ratio.Rationale for Including a Medicare Shortfall as Community Benefit:As a 501(c)(3) organization, the filing organization provides emergency and non-elective care to all regardless of ability to pay. All hospital services are provided in a non-discriminatory manner to patients who are covered beneficiaries under the Medicare program. As a public insurance program, Medicare provides a pre-established reimbursement rate/amount to health care providers for the services they provide to patients. In some cases, the reimbursement amount provided to a hospital may exceed its costs of providing a particular service or services to a patient. In other cases, the Medicare reimbursement amount may result in the hospital experiencing a shortfall of reimbursement received over costs incurred. In those cases where an overall shortfall is generated for providing services to all Medicare patients, the shortfall amount should be considered as a benefit to the community. Tax-exempt hospitals are required to accept all Medicare patients regardless of the profitability, or lack thereof, with respect to the services they provide to Medicare patients. The population of individuals covered under the Medicare program is sufficiently large so that the provision of services to the population is a benefit to the community and relieves the burdens of government. In those situations where the provision of services to the total Medicare patient population of a tax-exempt hospital during any year results in a shortfall of reimbursement received over the cost of providing care, the tax-exempt hospital has provided a benefit to a class of persons broad enough to be considered a benefit to the community. Despite a financial shortfall, a tax-exempt hospital must and will continue to accept and care for Medicare patients. Typically, tax-exempt hospitals provide health care services based upon an assessment of the health care needs of their community as opposed to their taxable counterparts where profitability often drives decisions about patient care services that are offered. Patient care provided by tax-exempt hospitals that results in Medicare shortfalls should be considered as providing a benefit to the community and relieving the burdens of government.
Part III, Line 9b:	The hospital filing organization's collection practices are in conformity with the requirements set forth in the 2014 Final Regulations regarding the requirements of Internal Revenue Code Section 501(r)(4) - (r)(6). No extraordinary collection actions (ECA's) are initiated by the hospital filing organization in the 120-day period following the date after the first post-discharge billing statement is sent to the individual (or, if later, the specified deadline given in a written notice of actions that may be taken, as described below). Individuals are provided with at least one written notice (notice of actions that may be taken) and a copy of the filing organization's Plain Language Summary of the Financial Assistance Policy that informs the individual that the hospital filing organization may take actions to report adverse information to credit reporting agencies/bureaus if the individual does not submit a Financial Assistance Application Form (FAA Form) or pay the amount due by a specified deadline. The specified deadline is not earlier than 120 days after the first post-discharge billing statement is sent to the individual and is at least 30 days after the notice is provided. A reasonable attempt is also made to orally notify an individual about the filing organization's Financial Assistance Policy and how the individual may obtain assistance with the Financial Assistance application process. If an individual submits an incomplete FAA Form during the 240-day period following the date on which the first post-discharge billing statement was sent to the individual, the hospital filing organization suspends any reporting to consumer credit reporting agencies/bureaus (or ceases any other ECA's) and provides a written notice to the individual describing what additional information or documentation is needed to complete the FAA Form. This written notice contains contact information including the telephone number and physical location of each hospital facility's office or department that can provide information about the Financial Assistance Policy, as well as contact information of each hospital facility's office or department that can provide assistance with the financial assistance application process or, alternatively, a nonprofit organization or governmental agency that can provide assistance with the financial assistance application process if the hospital facility is unable to do so. If an individual submits a complete FAA Form within a reasonable time-period as set forth in the notice described above, the hospital filing organization will suspend any adverse reporting to consumer credit reporting agencies/bureaus until a financial assistance policy eligibility determination can be made.
Part VI, Line 2:	The hospitals provide several services and resources to the communities they serve beyond the prioritized needs specifically identified in the Community Needs Assessment. They sponsor wellness events such as breast feeding education, asthma screenings, and financially support wellness initiatives of cities and public schools. They also provide 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. They also support, 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.
Part VI, Line 3:	The Financial Assistance Policy (FAP), Financial Assistance Application Form (FAA Form), and the Plain Language Summary of the Financial Assistance Policy (PLS) of the filing organization's hospital facilities are transparent and available to all individuals served at any point in the care continuum. The FAP, FAA Form, PLS, and contact information for each hospital facility's financial counselors are prominently and conspicuously posted on each filing organization's hospital facility's website. The websites indicate that a copy of the FAP, FAA Form, and PLS is available and how to obtain such copies in the primary languages of any populations with limited proficiency in English that constitute the lesser of 1,000 individuals or 5% of the members of the community served by each hospital facility (referred to below as LEP defined populations). Signage is displayed in public locations of each filing organization's hospital facility, including at all points of admission and registration and the Emergency Department. The signage contains each hospital facility's website address where the FAP, FAA Form, and PLS can be accessed and the telephone number and physical location that individuals can call or visit to obtain copies of the FAP, FAA Form and PLS or to obtain more information about the hospital facility's FAP, FAA Form and PLS. Paper copies of the hospital facility's FAP, FAA Form and PLS are available upon request and without charge, both in public locations in the hospital facility and by mail. Paper copies are made available in English and in the primary languages of any LEP defined populations. Each of the filing organization's hospital facility's financial counselors seek to provide personal financial counseling to all individuals admitted to the hospital facility who are classified as self-pay during the course of their hospital stay or at time of discharge to explain the FAP and FAA Form and to provide information concerning other sources of assistance that may be available, such as Medicaid. A paper copy of each hospital facility's PLS will be offered to every patient as a part of the intake or discharge process. A conspicuous written notice is included on all billing statements sent to patients that notifies and informs recipients about the availability of financial assistance under the filing organization's financial assistance policy, including the following: 1) the telephone number of the hospital facility's office or department that can provide information about the FAP and the FAA Form; and 2) the website address where copies of the FAP, FAA Form and PLS may be obtained. Reasonable attempts are made to inform individuals about the hospital facility's FAP in all oral communications regarding the amount due for the individual's care. Copies of the PLS are distributed to members of the community in a manner reasonably calculated to reach those members of the community who are most likely to require financial assistance.
Part VI, Line 4:	Porter Adventist HospitalTo define our community for the CHNA and to analyze demographic and health indicator data, we used the Stark-Law service areas. The Stark-Law service area is defined as the lowest number of contiguous zip codes that accounts for 75% of a hospital's inpatient admissions. These zip codes have a combined population of 1,991,393. The demographic makeup of these communities is as follows: race and ethnicity: white=81.59%; black=5.34%; Asian=3.81%; Native American/Alaskan Native-0.89%; Native Hawaiian/Pacific Islander=0.11%; some other race=4.99%; multiple races=3.26%. 21.8% of the population in our service area reports as Hispanic or Latino. Education level: In our community, 47.6% of the population has an associate's degree or higher, CO average is 44.7% unemployment rate: 3.9%, CO average is 4.0% population with limited English proficiency: 8.5%, CO average is 6.7% high school graduation rate: 68.6%, CO average is 77.6% population living in households with income below 200% of federal poverty level: 29.5%, CO average is 29.6%.Littleton Adventist HospitalTo define our community for the CHNA and to analyze demographic and health indicator data, we used the Stark-Law service areas. The Stark-Law service area is defined as the lowest number of contiguous zip codes that accounts for 75% of a hospital's inpatient admissions. These zip codes have a combined population of 474,343. The demographic makeup of these communities is as follows: race and ethnicity: of the total population in the Littleton Adventist Hospital service area, 90.1 percent are white, 3.8 are Asian, 2.5 are two or more races, and 1.4 percent are black. Education level: 50.7% of our community has an associate's degree or higher, CO average is 44.7% unemployment rate: the unemployment rate is three percent, age 16+. Unemployment rate: 3.6%, CO average is 4.0% population with limited English proficiency: 3.1%, CO average is 6.7% high school graduation rate: 74.8%, CO average is 77.6% population living in households with income below 200% of federal poverty level: 13.8%, CO average is 29.6%.Parker Adventist HospitalTo define our community for the CHNA and to analyze demographic and health indicator data, we used the Stark-Law service areas. The Stark-Law service area is defined as the lowest number of contiguous zip codes that accounts for 75% of a hospital's inpatient admissions. These zip codes have a combined population of 478,802. The demographic makeup of these communities is as follows: race and ethnicity: white: 81%, black 6.4%, Asian 5.1%, multiple races 3.9%, some other race 3%, Native American/Alaskan Native 0.5%, Native Hawaiian/Pacific Islander 0.2%, Hispanic or Latino 12% education level: in our community, 52.6% of the population has an associate's degree or higher. CO average is 44.7% unemployment rate: 3.6%, CO average is 4.0% population with limited English proficiency: 5.4%, CO average is 6.7% high school graduation rate: 74.5%, CO average is 77.6% population living in households with income below 200% of federal poverty level: 17.2%, CO average is 29.6%.Avista Adventist HospitalTo define our community for the CHNA and to analyze demographic and health indicator data, we used the Stark-Law service areas. The Stark-Law service area is defined as the lowest number of contiguous zip codes that account for 75% of a hospital's inpatient admissions. These zip codes have a combined population of 549,657. The demographic makeup of these communities is as follows: race: 84.2% white, 4% black, 2.7% Asian, Native American/Alaskan Native 1%, and 3.3% two or more races. Ethnicity: 23.9% of the service population reports Hispanic or Latino origin. Education level: in the defined service area, 62.3% of the community has associates degree or higher, as compared to the CO state average of 44.7%. Unemployment rate: the unemployment rate is 3.9%, compared to the state average of 4.0%. Population with limited English proficiency: 8.1% of the service area has limited English proficiency, compared to 6.7% across the state of Colorado. High school graduation rate: the reported graduation rate in our service area was 82.4%, higher than the Colorado state average of 77.6%. Population living in households with income below 200% of federal poverty level: over a quarter of the population in our service area, 25.4%, is living in a household with income below 200% of FPL, as compared to the CO state average of 29.6%.Castle Rock Adventist Health CampusTo define our community for the CHNA and to analyze demographic and health indicator data, we used the Stark-Law service areas. The Stark-Law service area is defined as the lowest number of contiguous zip codes that accounts for 75% of a hospital's inpatient admissions. These zip codes have a combined population of 67,170. The demographic makeup of these communities includes: race and ethnicity: white 93.9%, Asian 1.7%, black 0.9%, multiple races 2.1%, some other race 1%, and Hispanic or Latino 9.8% education level: 63.8% of our community has an associate's degree or higher, CO average is 44.7% unemployment rate: 3.2%, CO average is 4.0% population with limited English proficiency: 2.1%, CO average is 6.7% high school graduation rate: 83.1%, CO average is 77.6% population living in households with income below 200% of federal poverty level: 13.7%, CO average is 29.6%.
Part VI, Line 5:	The provision of community benefit is central to Portercare Adventist Health System's mission of service and compassion. Restoring and promoting the health and quality of life of those in the communities served by the filing organization is a function of "extending the healing ministry of Christ by caring for those who are ill and by nuturing the health of the people in our communities and embodies the filing organization's commitment to its values and principles. The filing organization commits substantial resources to provide a broad range of services to both the underprivileged as well as the broader community. In addition to the community benefit and community building information provided in Parts I, II and III of this Schedule H, the filing organization captures and reports the benefits provided to its community through faith-based care. Examples of such benefits include the cost associated with chaplaincy care programs and mission peer reviews and mission conferences. During the current year, the filing organization provided $1,165,760 of benefit with respect to the faith-based and spiritual needs of its communities in conjunction with its operation of community hospitals. The filing organization also provides benefits to each of its community's infrastructure by investing in capital improvements to ensure that facilities and technology provide the best possible care to the community. During the current year, the filing organization expended $87,585,621 in new capital improvements. As faith-based mission-driven community hospitals, the filing organization is continually involved in monitoring its communities, identifying unmet health care needs and developing solutions and programs to address those needs. In accordance with its conservative approach to fiscal responsibility, surplus funds of the filing organization are continually being invested in resources that improve the availability and quality of delivery of health care services and programs to its communities.
Part VI, Line 6:	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.
Part VI, Line 7, Reports Filed With States	CO

Schedule H (Form 990) 2019

Additional Data

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- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

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," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

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" on 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 noncash assistance	(h) Purpose of grant or assistance
(1) AMERISOURCEBERGEN DRUG COMPANY 27550 NETWORK PL CHICAGO,IL606731275	23-2353106		26,368				Mission Trip Donations
(2) CASTLE ROCK COMMUNITY INTER-CHURCH TASK FORCE DBA DOUGLAS ELBERT TASK FORCE 1638 PARK STREET CASTLE ROCK,CO80109	74-2395223	501(c)(3)	7,500				General Support
(3) CASTLE ROCK ECONOMIC DEVELOPMENT COUNCIL 18 S WILCOX ST NBR 202 CASTLE ROCK,CO80104	84-1445735	501(c)(3)	7,500				General Support
(4) CLINICA CAMPESINA FAMILY HEALTH SERVICES 345 PLAZA COURT NORTH LAFAYETTE,CO80026	84-0743432	501(c)(3)	191,400				General Support
(5) COLORADO SEMINARY DBA UNIVERSITY OF DENVER 2199 S UNIVERSITY BLVD DENVER,CO80208	84-0404231	501(c)(3)	12,500				General Support
(6) COLORADO WELLNESS CONNECTION 4960 E MINERAL CIRCLE CENTENNIAL,CO80122	84-1504515		7,953				Health Fair Coordination
(7) DENVER BOTANIC GARDENS INC 909 YORK STREET DENVER,CO80206	84-0440359	501(c)(3)	16,000				General Support
(8) DOCTORS CARE 609 W LITTLETON BLVD 100 LITTLETON,CO80120	84-1150815	501(c)(3)	204,107				General Support
(9) HIGHLANDS RANCH COMMUNITY ASSOCIATION 9568 S UNIVERSITY BLVD HIGHLANDS RANCH,CO80126	84-0869474	501(c)(4)	20,000				General Support
(10) JUSTIN PARKER NEUROLOGICAL INSTITUTE 4743 ARAPAHOE AVE SUITE 202 BOULDER,CO80303	26-3588986	501(c)(3)	10,000				Boulder Neurological Symposium
(11) MILE HIGH ACADEMY 1733 DAD CLARK DRIVE HIGHLANDS RANCH,CO80129	84-0525223	501(c)(3)	21,188				Real World Learning Garden Project
(12) ROCKY MOUNTAIN ADVENTIST HEALTH FOUNDATION 2525 S Downing Street Denver,CO80210	84-0745018	501(c)(3)	27,710	1,210,014	Book	Provision of General Administrative Support	General Support
(13) THE ARTHRITIS FOUNDATION 2280 S ALBION STREET DENVER,CO80222	84-0428040	501(c)(3)	7,500				General Support
(14) ROCKY MOUNTAIN CONFERENCE OF SEVENTH-DAY ADVENTISTS 2520 S DOWNING STREET DENVER,CO80210	27-4456014	501(c)(3)	49,210				General Support
(15) WESTERN WELCOME WEEK INC 709 W LITTLETON BLVD SUITE 203 LITTLETON,CO801202351	74-2271264	501(c)(3)	10,000				General Support

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 2019

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on 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 noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

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

Return Reference

Explanation

Part I, Line 2:

Grants are generally made only to related organizations that are exempt from federal income tax under IRC Section 501(c)(3), or to other local charitable community organizations, or to other 501(c)(3) organizations that are a part of the group exemption ruling issued to the General Conference of Seventh-Day Adventists. Accordingly, the filing organization has not established specific procedures for monitoring the use of grant funds in the United States as the filing organization does not have a grant making program that would necessitate such procedures.

Schedule I (Form 990) 2019

Additional Data

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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" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

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 on 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 on 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 on 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 on 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 on 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," on line 5a or 5b, describe in Part III.

For persons listed on 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," on line 6a or 6b, describe in Part III.

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

Were any amounts reported on 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" on 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) 2019

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 on 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 on 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)
1Haffner PhD Randall L Board Chairman	(i) (ii)	0 ------------- 1,187,115	0 ------------- 415,939	0 ------------- 791,952	0 ------------- 259,249	0 ------------- 59,450	0 ------------- 2,713,705	0 ------------- 142,176
2Houmann Lars D Board Member	(i) (ii)	0 ------------- 1,195,114	0 ------------- 354,332	0 ------------- 881,514	0 ------------- 261,265	0 ------------- 68,311	0 ------------- 2,760,536	0 ------------- 205,694
3Rathbun Paul C Board Member (Beg 9/17)	(i) (ii)	0 ------------- 897,922	0 ------------- 245,766	0 ------------- 180,373	0 ------------- 186,364	0 ------------- 65,597	0 ------------- 1,576,022	0 ------------- 117,794
4Campbell Gary President (End 8/17)	(i) (ii)	0 ------------- 955,973	0 ------------- 1,075,982	0 ------------- 356,145	0 ------------- 9,450	0 ------------- 20,950	0 ------------- 2,418,500	0 ------------- 0
5Banko Peter President (Beg 9/17)	(i) (ii)	0 ------------- 918,985	0 ------------- 638,444	0 ------------- 53,829	0 ------------- 156,936	0 ------------- 32,032	0 ------------- 1,800,226	0 ------------- 0
6Enderson Dan Treasurer/CFO	(i) (ii)	0 ------------- 588,895	0 ------------- 354,008	0 ------------- 12,251	0 ------------- 156,890	0 ------------- 36,684	0 ------------- 1,148,728	0 ------------- 0
7Dean Morre CEO Porter Adventist Hospital	(i) (ii)	0 ------------- 586,308	0 ------------- 348,882	0 ------------- 10,260	0 ------------- 151,911	0 ------------- 31,092	0 ------------- 1,128,453	0 ------------- 0
8Gaasch Andrew CFO Porter Adventist Hospital	(i) (ii)	0 ------------- 335,004	0 ------------- 40,273	0 ------------- 1,677	0 ------------- 6,722	0 ------------- 28,636	0 ------------- 412,312	0 ------------- 0
9Spenst Brett CEO Littleton Adventist Hospital	(i) (ii)	0 ------------- 398,688	0 ------------- 160,274	0 ------------- 14,351	0 ------------- 91,284	0 ------------- 20,822	0 ------------- 685,419	0 ------------- 0
10Curry Cheryl CFO Littleton Adventist Hospital	(i) (ii)	0 ------------- 253,625	0 ------------- 37,519	0 ------------- 2,352	0 ------------- 9,450	0 ------------- 26,412	0 ------------- 329,358	0 ------------- 0
11Huenergardt Samuel CEO Parker Adventist Hospital	(i) (ii)	0 ------------- 351,524	0 ------------- 101,345	0 ------------- 9,820	0 ------------- 77,226	0 ------------- 29,227	0 ------------- 569,142	0 ------------- 0
12Fisher Jonathan CFO Parker Adventist Hospital	(i) (ii)	0 ------------- 201,270	0 ------------- 24,745	0 ------------- 1,422	0 ------------- 8,203	0 ------------- 26,208	0 ------------- 261,848	0 ------------- 0
13Yang Charlie Orthopedic Surgeon	(i) (ii)	1,127,143 ------------- 0	138,676 ------------- 0	1,165 ------------- 0	9,450 ------------- 0	41,345 ------------- 0	1,317,779 ------------- 0	0 ------------- 0
14Miner Todd Orthopedic Surgeon	(i) (ii)	1,110,418 ------------- 0	129,652 ------------- 0	2,622 ------------- 0	9,450 ------------- 0	32,624 ------------- 0	1,284,766 ------------- 0	0 ------------- 0
15Oliver Christopher Otolaryngology Physician	(i) (ii)	543,591 ------------- 0	608,346 ------------- 0	845 ------------- 0	9,450 ------------- 0	33,844 ------------- 0	1,196,076 ------------- 0	0 ------------- 0
16Campana John Otolaryngology Physician	(i) (ii)	563,843 ------------- 0	465,742 ------------- 0	4,056 ------------- 0	9,450 ------------- 0	39,602 ------------- 0	1,082,693 ------------- 0	0 ------------- 0
17Gaines Raymond Otolaryngology Physician	(i) (ii)	707,377 ------------- 0	302,016 ------------- 0	1,077 ------------- 0	9,450 ------------- 0	35,594 ------------- 0	1,055,514 ------------- 0	0 ------------- 0
18Ordelheide Kris Secretary - Former Officer	(i) (ii)	0 ------------- 458,269	0 ------------- 228,628	0 ------------- 12,946	0 ------------- 103,339	0 ------------- 28,937	0 ------------- 832,119	0 ------------- 0
19Barts Dennis CEO Avista - Former Key Emp.	(i) (ii)	0 ------------- 232,816	0 ------------- 134,263	0 ------------- 70,101	0 ------------- 8,860	0 ------------- 13,524	0 ------------- 459,564	0 ------------- 0
20Folkenberg Todd COO Porter - Former Key Emp.	(i) (ii)	0 ------------- 278,324	0 ------------- 123,903	0 ------------- 13,248	0 ------------- 59,439	0 ------------- 31,486	0 ------------- 506,400	0 ------------- 0

Schedule J (Form 990) 2019

Page 3

Part III

Supplemental Information

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

Return Reference

Explanation

Part I, Line 1a

As discussed in Part VI, Section B, Line 15, the filing organization's top management officials are compensated by Centura Health Corporation (CHC). All officers and key employees are compensated by CHC, who manages the daily activities of Portercare Adventist Health System under a joint operating agreement dated December 8, 1995 between Adventist Health System Sunbelt Healthcare Corp. and Catholic Health Initiatives. As such, their salaries are paid to them by CHC, a related 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 (ii) and Form 990, Part VII, column (e) as compensation from related organizations. Travel for companions: CHC provides reimbursement for spousal travel when certain of its executives attend conferences sponsored by Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the tax-exempt top-tier parent of Portercare Adventist Health Systesm (PAHS). All spousal travel costs reimbursed to the executive are considered taxable compensation to the executive. Discretionary spending account: A cash discretionary spending account was provided in the current year to eligible executives in the form of a car allowance of $750 per month to help offset business travel expense. Other discretionary spending accounts may be provided in connection with attendance at conferences but typically do not exceed $300 per participant. Taxable travel and other spending accounts are considered taxable compensation to the executive. Housing allowance or residence for personal use: CHC has a Corporate Executive Policy that addresses assistance to executives who have been relocated by the company during the year. Relocation assistance is administered per CHC policy by an external relocation company. Any taxable reimbursements made to executives in connection with relocation assistance are treated as wages to the executive and are subject to all payroll withholding and reporting requirements.

Part I, Line 4b

As discussed in Line 1 above, the organization's top management officials' compensation is paid by Centura Health Corporation (CHC). All officers and key employees are compensated by CHC, who manages the daily activities of Portercare Adventist Health System (PAHS). As such, their salaries and all associated benefits are paid to them by CHC 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 (ii) and Form 990, Part VII, column (e) as compensation from related organizations. Senior executives on the filing organization's management team that hold the position of Senior Vice-President or Hospital CEO are eligible to participate in the CHC EXECU-FLEX Benefit Plan (the Plan). In recognition of the contribution that each executive makes to the success of CHC, CHC provides for participation in the Plan to the eligible executives. The purpose of the Plan is to offer an opportunity to elect from among a variety of supplemental benefits to individually tailor a benefits program appropriate to each executive's needs. The executive is provided with a Flex allowance equivalent to 10% of base salary to purchase selected benefits and to contribute into a deferred non-qualified supplemental executive retirement plan. The Plan provides for a five-year cliff-vesting schedule with respect to amounts accumulated in the executive's deferred compensation account. CHC contributes into these deferred compensation accounts semi-annually and amounts are subject to a substantial risk of forfeiture with active participation required at time of vesting. In addition, CHC provides a Pension Restoration Benefit (PRB) to restore qualified plan contributions lost on income in excess of the current federal maximum allowable compensation to a qualified plan. The PRB provides contributions by restoring the amount that would have been contributed to the executive's retirement savings plan for compensation in excess of the legislative limits. Benefit amounts are added to the participant's flex allowance each year based on their total compensation from the prior year. The following received contributions to a non-qualified plan for the calendar year 2017: CY Employer CY Employer CY SERP CY PRB SERP Contr. PRB Contr. Distrib. Distrib. Gary Campbell 184,032 157,032 184,032 157,032 Peter Banko 101,197 46,289 Morre Dean 85,444 58,444 Daniel Enderson 87,220 60,220 Brett Spenst 54,417 27,417 Samuel Huenergardt 47,388 20,388 Kris Ordelheide 60,124 34,428 Dennis Barts 40,457 15,707 40,457 15,707 Todd Folkenberg 40,010 13,010 Additionally, Board members of the filing organization, R. Haffner, L. Houmann, and P. Rathbun, are compensated by Adventist Health System Sunbelt Healthcare Corporation (AHS), the parent organization. AHS is exempt from federal income tax under Section 501(c)(3) of the Internal Revenue Code. 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 a split dollar life insurance policy and long-term care insurance, to individually tailor a benefits program appropriate to each executive's needs. The Plan provides eligible participants a pre-determined benefits allowance credit that is equal to a percentage of the executive's base pay from which is deducted the cost of mandatory and elective employee benefits. The pre-determined benefits allowance credit percentage is approved by the AHSSHC Board Compensation Committee, an independent committee of the Board of Directors of AHSSHC. Any funds that remain after the cost of mandatory and elective benefits are subtracted from the annual pre-determined benefits allowance are contributed, at the employee's option, to either an IRC 457(f) deferred compensation account or to an IRC 457(b) eligible deferred compensation plan. Upon attainment of age 65, all previous 457(f) deferred amounts are paid immediately to the participant and any future employer contributions are made quarterly from the Plan directly to the participant. The Plan documents define an employee who is eligible to participate in the Plan to generally include the Chief Executive Officers of AHS entities and Vice Presidents of all AHS entities whose base salary is at least $243,000. The Plan provides for a class year vesting schedule (2 years for each class year) with respect to amounts accumulated in the executive's 457(f) deferred compensation account. Distributions could also be made from the executive's 457(f) deferred compensation account upon attainment of age 65 or upon an involuntary separation. The account is forfeited by the executive upon a voluntary separation. In addition to the Plan, AHS has instituted a defined benefit, non-tax-qualified deferred compensation plan for certain executives who have provided lengthy service to AHS and/or to other Seventh-day Adventist Church hospitals or health care institutions. Participation in the plan is offered to AHS executives on a prorata schedule beginning with 20 years of service as an employee of AHS and/or another hospital or health care institution controlled by the Seventh-day Adventist Church and who satisfy certain other qualifying criteria. This supplemental executive retirement plan (SERP) was designed to provide eligible executives with the economic equivalent of an annual income beginning at normal retirement age equal to 60% of the average of the participant's three, five or seven highest years of base salary from AHS active employment inclusive of income from all other Seventh-day Adventist Church healthcare employer-financed retirement income sources and investment income earned on those contributions through social security normal retirement age as defined in the plan. The number of years included in highest average compensation is determined by the individual's year of entry to the SERP and by the individual's year of entry to the AHS Executive FLEX Benefit Program. Additionally, in 2017 AHS adopted a Senior Executive Death Benefit (SEDB) Plan in recognition of the considerable age and service requirements in the SERP. The SEDB Plan provides a benefit in an amount equal to the amount the executive's benefit would have been under the SERP Plan assuming that, on the date of the executive's death (and not before), the executive satisfied the last of the eligibility requirements of the SERP Plan with present value recognizing an early benefit commencement. An eligible executive becomes a participant in the SEDB Plan if the executive dies prior to termination of employment, provided the executive has not satisfied all of the eligibility requirements of SERP as of the executive's date of death but would have satisfied all of those requirements within five (5) years following death had the executive lived and continued employment. The SEDB Plan was reviewed and approved by the AHSSHC Board Compensation Committee, an independent body of the AHSSHC Board of Directors. Flex Plan Flex Plan SERP 457(b) CY CY Employer CY Contrib./ Distrib. Contrib. Distrib. Payment ------------------------------------------------------- Randall Haffner $ 244,687 $ 159,510 $ 568,287 $ 0 Lars Houmann $ 246,703 $ 217,552 $ 608,036 $ 0 Paul Rathbun $ 171,802 $ 118,469 $ 0 $ 0

Schedule J (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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

Attach to Form 990 or Form 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

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 section 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 the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

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

Part II

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

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






Total ............... $

Part III

Grants or Assistance 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) 2019

Page 2

Part IV

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

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) Baylie Thurber	Family of Board Member	60,823	Employee Compensation		No

Part V

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

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

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

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

Portercare Adventist Health System

Employer identification number

84-0438224

Return Reference	Explanation
Form 990, Part VI, Section A, line 1	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, other 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, Section A, line 6	Portercare Adventist Health System (the filing organization) has one member. The sole member of the filing organization is Adventist Health System Sunbelt Healthcare Corporation. Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) is a Florida, not-for-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). There are no other classes of membership in the filing organization.
Form 990, Part VI, Section A, line 7a	The sole member of the filing organization is AHSSHC. The Board of Directors of the filing organization are appointed by the sole member, AHSSHC, who has the right to elect, appoint or remove any member of the Board of Directors of the filing organization.
Form 990, Part VI, Section A, line 7b	The Corporate member, AHSSHC, acting through the Board of Directors, maintains all rights permitted to be exercised by Directors of a Colorado corporation except as limited by the organization's Articles, Bylaws, or Affiliation Agreement with Catholic Health Initiatives (CHI). The Agreement of both AHSSHC and CHI is required for certain significant decisions involving Centura facilities. In addition, pursuant to the Affiliation Agreement between CHI, Colorado Health Initiatives Colorado (CHIC), Centura Health Corporation, and Portercare Adventist Health System (PAHS), certain matters affecting PAHS must be approved by both PAHS and CHIC. Those items include: - The transfer of assets valued at over $3,000,000 - 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 $5,000,000
Form 990, Part VI, Section B, line 11b	The filing organization's current year Form 990 was reviewed by the Board Chairman, Board Finance Committee Chair, CEO and by the CFO prior to its filing with the IRS. The review conducted by the Board Chairman, Board Finance Committee Chair, CEO and the CFO did not include the review of any supporting workpapers that were used in preparation of the current year Form 990, but did include a review of the entire Form 990 and all supporting schedules.
Form 990, Part VI, Section B, line 12c	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 transactions or arrangements of potential 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 diligence, 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 potential conflicts of interest: 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 potential 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, Section B, line 15	The organization's top management officials' compensation is paid by Centura Health Corporation. All officers and key employees are compensated by Centura Health Corporation, who manages the daily activities of Portercare Adventist Health System under a joint operating agreement dated December 8, 1995 between Adventist Health System Sunbelt Healthcare Corp. and Catholic Health Initiatives. As such, their salaries are paid to them by Centura Health Corporation, a related 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 (ii) and Form 990, Part VII, column (e) as compensation from related organizations. External consultants are engaged to provide market-based compensation studies to make recommendations to Centura Health Corporation's (CHC) Compensation Committee regarding the compensation of the filing organization's CEO and CFO. The Compensation Committee is appointed by the Board of Trustees of CHC. The Board of Trustees may remove at any time, with or without cause, any member of the Compensation Committee; provided the filing organization's members, Portercare Adventist Health System (PAHS) and Catholic Health Initiatives Colorado (CHIC), shall have exclusive authority to appoint or remove, with or without cause, any member it or they appoint to the Compensation Committee. The consultant's recommendations are presented to and deliberated by CHC's Compensation Committee. The Compensation Committee relies upon all available comparable compensation data in finalizing its decision concerning compensation for its senior executive positions. The Compensation Committee deliberations and decisions are documented appropriately. CHC's Human Resources department performs an annual analysis of the market to determine compensation ranges for the remainder of CHC's Executives which are reviewed and approved by CHC's senior leadership.
Form 990, Part VI, Section C, line 19	The organization's governing documents are available on the Colorado Secretary of State's website. The filing organization is a part of the system of healthcare organizations known as Adventist Health System (AHS). The audited consolidated financial statements of AHS and of the AHS "Obligated Group" are filed annually with the Municipal Securities Rulemaking Board (MSRB). The "Obligated Group" is a group of AHSSHC subsidiaries that are jointly and severally liable under a Master Trust Indenture that secures debt primarily issued on a tax-exempt basis. Unaudited quarterly financial statements prepared in accordance with Generally Accepted Accounting Principles (GAAP) are also filed with MSRB for AHS on a consolidated basis and for the grouping of AHS subsidiaries comprising the "Obligated Group". The filing organization does not generally make its conflict of interest policy available to the public.
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. Practices are in place that require the filing organization to perform an analysis and evaluation of its participation in every joint venture in which the filing organization will have an ownership interest. The internal review and analysis ensures that the filing organization will not become a participant in any joint ventures that could potentially threaten the tax-exempt status of the filing organization.
Part V, Line 1a-1b	Pursuant to an Affiliation Agreement between Adventist Health System Sunbelt Healthcare Corporation and Catholic Health Initiatives, Portercare Adventist Health System (the filing organization) is managed by Centura Health Corporation (CHC), a joint operating company. CHC is a Colorado, not-for-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). CHC has established a shared service center to centralize the Accounts Payable (A/P) functions. The facts and circumstances support a position that CHC, as a payor on behalf of its managed organizations in a shared service environment, will have sufficient management and oversight in connection with the managed organizations' payments to meet the standard set forth in Treas. Reg. Section 1.6041-1(e). CHC will not merely be making payments at the direction of its managed organizations. Accordingly, CHC is considered the payor subject to the information reporting requirements of Section 6041. The filing organization has entered "0" in Part V, Line 1a because the filing organization no longer issues Form 1099 returns, rather, all such returns are filed by and under the name and EIN of CHC as the payor subject to the information reporting requirements of Section 6041.
Part VIII, Lines 7a and 7c:	The amounts shown in Part VIII Lines 7a and 7c of the Form 990 represent an allocated share of capital gain/(loss) from a system wide, corporate administered, investment program of Adventist Health System Sunbelt Healthcare Corporation, the filing organizaiton's parent.
Form 990, Part IX, line 11g	Payments to Hlthcare Professionals: Program service expenses 75,047,973. Management and general expenses 0. Fundraising expenses 0. Total expenses 75,047,973. Professional Fees: Program service expenses 68,653,605. Management and general expenses 0. Fundraising expenses 0. Total expenses 68,653,605. Purchased Medical Services: Program service expenses 19,267,321. Management and general expenses 0. Fundraising expenses 0. Total expenses 19,267,321. Environmental Services: Program service expenses 2,339,941. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,339,941. Transcription Services: Program service expenses 670,359. Management and general expenses 0. Fundraising expenses 0. Total expenses 670,359. Recruiting: Program service expenses 1,995,343. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,995,343. Management Fees: Program service expenses 0. Management and general expenses 81,777,931. Fundraising expenses 0. Total expenses 81,777,931. Billing and Collection Services: Program service expenses 0. Management and general expenses 6,762,538. Fundraising expenses 0. Total expenses 6,762,538.
Form 990, Part XI, line 9:	Transfer to Tax-Exempt Parent -11,556,360. Joint Venture Equity Changes -2,037,496.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

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
(1) HealthFit Family Medicine LLC 9100 E Mineral Circle Centennial,CO80112 81-5310593	Medical Services - family practice	CO	-847,576	1,744,544	Portercare Adventist Health System
(2) HealthFit Medical Professionals LLC 9100 E Mineral Circle Centennial,CO80112 47-3561708	Medical Services - family practice	CO	-168,092	303,144	Portercare Adventist Health System
(3) HealthFit Wellness Professionals LLC 9100 E Mineral Circle Centennial,CO80112 81-5325418	Fitness Center	CO	-138,164	15,873	Portercare Adventist Health System
(4) PAHS Emergency and Urgent Care Centers LLC 9100 E Mineral Circle Centennial,CO80112 47-4211060	Urgent Care	CO	-1,917,623	10,442,420	Portercare Adventist Health System

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)	Line 3	Adventist Midwest Health	Yes
(2)Adventist Care Centers - Courtland Inc 730 Courtland Street Orlando,FL32804 20-5774723	Operation of Home for the Aged/Hlthcare Delivery	FL	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes
(3)Adventist GlenOaks Hospital 701 Winthrop Avenue Glendale Heights,IL60139 36-3208390	Operation of Hospital & Related Services	IL	501(c)(3)	Line 3	Adventist Midwest Health	Yes
(4)Adventist Hlth Mid-America Inc 9100 W 74th Street Shawnee Mission,KS66204 52-1347407	Support of Affiliated Hospital	KS	501(c)(3)	Line 12c, III-FI	Adventist Hlth SystemSunbelt Inc	Yes
(5)Adventist Hlth Partners Inc 2601 Navistar Dr Bldg 4 Finance Lisle,IL60532 36-4138353	Operation of Physician Practices & Medical Services	IL	501(c)(3)	Line 3	AHS Midwest Management Inc	Yes
(6)Adventist Hlth System Sunbelt Hlthcare Corp 900 Hope Way Altamonte Springs,FL32714 59-2170012	Management Services	FL	501(c)(3)	Line 12a, I	N/A		No
(7)Adventist Hlth System Georgia Inc 1035 Red Bud Road Calhoun,GA30701 58-1425000	Operation of Hospital & Related Services	GA	501(c)(3)	Line 3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes
(8)Adventist Hlth SystemSunbelt Inc 900 Hope Way Altamonte Springs,FL32714 59-1479658	Operation of Hospital & Related Services	FL	501(c)(3)	Line 3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes
(9)Adventist Hlth SystemTexas Inc 11801 S Freeway Burleson,TX76028 74-2578952	Leasing Personnel to Affiliated Hospital	TX	501(c)(3)	Line 12c, III-FI	Adventist Hlth System Sunbelt Hlthcare Corp	Yes
(10)Adventist Midwest Health 120 North Oak Street Hinsdale,IL60521 36-2276984	Operation of Hospital & Related Services	IL	501(c)(3)	Line 3	Adventist Hlth SystemSunbelt Inc	Yes
(11)Adventist University of Health Sciences Inc (630 Year End) 671 Lake Winyah Drive Orlando,FL32803 59-3069793	Education/Operation of School	FL	501(c)(3)	Line 2	Adventist Hlth SystemSunbelt Inc	Yes
(12)AHP Specialty Care NFP 2601 Navistar Dr Bldg 4 Finance Lisle,IL60532 81-1105774	Operation of Physician Practices & Medical Services	IL	501(c)(3)	Line 3	AHS Midwest Management Inc	Yes
(13)AHS Midwest Management Inc 2601 Navistar Dr Bldg 4 Finance Lisle,IL60532 36-3354567	Operation of Physician Practice Mgmt	IL	501(c)(3)	Line 12a, I	Adventist Midwest Health	Yes
(14)AHSCentral Texas Inc 1301 Wonder World Drive San Marcos,TX78666 74-2621825	Provide Office Space - Medical Professionals	TX	501(c)(3)	Line 12c, III-FI	Adventist Hlth System Sunbelt Hlthcare Corp	Yes
(15)Apopka Hlth Care Properties Inc 305 E Oak Street Apopka,FL32703 51-0605694	Lease to Related Organization	GA	501(c)(3)	Line 12c, III-FI	Sunbelt Hlth Care Centers Inc	Yes
(16)Battle Creek Adventist Hospital 900 Hope Way Altamonte Springs,FL32714 38-1359189	Inactive	MI	501(c)(3)	Line 3	Adventist Hlth SystemSunbelt Inc	Yes
(17)Bolingbrook Hospital Foundation 500 Remington Blvd Bolingbrook,IL60440 90-0494445	Fund-raising for Tax-exempt hospital	IL	501(c)(3)	Line 7	Midwest Hlth Foundation		No
(18)Bradford Heights Hlth & Rehab Center Inc 950 Highpoint Drive Hopkinsville,KY42240 20-5782342	Operation of Home for the Aged/Hlthcare Delivery	KY	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes
(19)Burleson Nursing & Rehab Center Inc 301 Huguley Blvd Burleson,TX76028 20-5782243	Operation of Home for the Aged/Hlthcare Delivery	TX	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes
(20)Caldwell Hlth Care Properties Inc 1333 West Main Princeton,KY42445 51-0605680	Lease to Related Organization	GA	501(c)(3)	Line 12c, III-FI	Sunbelt Hlth Care Centers Inc	Yes
(21)Central Texas Hlthcare Collaborative 1301 Wonder World Drive San Marcos,TX78666 45-3739929	Support Operation of Hospital	TX	501(c)(3)	Line 12a, I	Adventist Hlth SystemSunbelt Inc	Yes
(22)Centura Health Corporation 9100 E Mineral Circle Centennial,CO80112 84-1335382	Joint Operating Company	CO	501(c)(3)	Line 12a, I	N/A		No
(23)Chickasaw Hlth Care Properties Inc 250 S Chickasaw Trail Orlando,FL32825 51-0605681	Lease to Related Organization	GA	501(c)(3)	Line 12c, III-FI	Sunbelt Hlth Care Centers Inc	Yes
(24)Chippewa Valley Hospital & Oakview Care Center Inc 1220 Third Avenue West Durand,WI54736 39-1365168	Operation of Hospital & Related Services	WI	501(c)(3)	Line 3	Adventist Hlth SystemSunbelt Inc	Yes
(25)Courtland Hlth Care Properties Inc 730 Courtland Street Orlando,FL32804 51-0605682	Lease to Related Organization	GA	501(c)(3)	Line 12c, III-FI	Sunbelt Hlth Care Centers Inc	Yes
(26)Creekwood Place Nursing & Rehab Center Inc 107 Boyles Drive Russellville,KY42276 20-5782260	Operation of Home for the Aged/Hlthcare Delivery	KY	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes
(27)Dairy Road Hlth Care Properties Inc 7350 Dairy Road Zephyrhills,FL33540 51-0605684	Lease to Related Organization	GA	501(c)(3)	Line 12c, III-FI	Sunbelt Hlth Care Centers Inc	Yes
(28)East Orlando Hlth & Rehab Center Inc 250 S Chickasaw Trail Orlando,FL32825 20-5774748	Operation of Home for the Aged/Hlthcare Delivery	FL	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes
(29)Emory-Adventist Inc 900 Hope Way Altamonte Springs,FL32714 58-2171011	Inactive	GA	501(c)(3)	Line 3	Adventist Hlth SystemSunbelt Inc	Yes
(30)Fletcher Hospital Inc 100 Hospital Drive Hendersonville,NC28792 56-0543246	Operation of Hospital & Related Svcs	NC	501(c)(3)	Line 3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes
(31)FLNC Inc 3355 E Semoran Blvd Apopka,FL32703 20-5774761	Operation of Home for the Aged/Hlthcare Delivery	FL	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes
(32)Florida Hospital Dade City Inc (816-63018) 13100 Fort King Road Dade City,FL33525 82-2567308	Inactive	FL	501(c)(3)	Line 3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes
(33)Florida Hospital Healthcare Partners Inc 770 West Granada Blvd 101 Ormond Beach,FL32174 46-2354804	Operation of Physician Practices & Medical Services	FL	501(c)(3)	Line 3	Adventist Hlth SystemSunbelt Inc	Yes
(34)Florida Hospital Medical Group Inc 2600 Westhall Lane 4th Floor Maitland,FL32751 59-3214635	Operation of Physician Practices & Medical Services	FL	501(c)(3)	Line 3	Adventist Hlth SystemSunbelt Inc	Yes
(35)Florida Hospital Ocala Inc (1214-63018) 900 Hope Way Altamonte Springs,FL32714 82-4372339	Inactive	FL	501(c)(3)	Line 3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes
(36)Florida Hospital Physician Group Inc 12470 Telecom Dr 100 Tampa,FL33637 46-2021581	Operation of Physician Practices & Medical Services	FL	501(c)(3)	Line 3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes
(37)Florida Hospital Waterman Inc 1000 Waterman Way Tavares,FL32778 59-3140669	Operation of Hospital & Related Services	FL	501(c)(3)	Line 3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes
(38)Florida Hospital Zephyrhills Inc 7050 Gall Blvd Zephyrhills,FL33541 59-2108057	Operation of Hospital & Related Services	FL	501(c)(3)	Line 3	Adventist Hlth SystemSunbelt Inc	Yes
(39)Foundation for Shawnee Mission Medical Center Inc 9100 W 74th Street Shawnee Mission,KS66204 48-0868859	Fund-raising for Tax-exempt hospital	KS	501(c)(3)	Line 7	Shawnee Mission Medical Center Inc	Yes
(40)Fountain Inn Nursing & Rehab Center Inc 485 North Keller Road 250 Maitland,FL32751 47-2180518	Operation of Home for the Aged/Hlthcare Delivery	FL	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes
(41)GlenOaks Hospital Foundation 701 Winthrop Avenue Glendale Heights,IL60139 36-3926044	Fund-raising for Tax-exempt hospital	IL	501(c)(3)	Line 7	Midwest Hlth Foundation		No
(42)Helen Ellis Memorial Hospital Auxiliary Inc 1395 S Pinellas Ave Tarpon Springs,FL34689 59-2106043	Fund-raising for Tax-exempt hospital/foundation	FL	501(c)(3)	Line 12c, III-FI	N/A		No
(43)Helen Ellis Memorial Hospital Foundation Inc 1395 S Pinellas Ave Tarpon Springs,FL34689 59-3690149	Fund-raising for Tax-exempt hospital	FL	501(c)(3)	Line 7	N/A		No
(44)Hinsdale Hospital Foundation 120 North Oak Street Hinsdale,IL60521 52-1466387	Fund-raising for Tax-exempt hospital	IL	501(c)(3)	Line 7	Midwest Hlth Foundation		No
(45)Hospice of the Comforter Inc 480 W Central Parkway Altamonte Springs,FL32714 59-2935928	Operation of Hospice	FL	501(c)(3)	Line 10	The Comforter Health Care Group Inc	Yes
(46)Hospice of the Comforter Foundation Inc 480 W Central Parkway Altamonte Springs,FL32714 27-1858033	Inactive	FL	501(c)(3)	Line 7	The Comforter Health Care Group Inc	Yes
(47)In-Motion Rehab Inc 485 North Keller Road 250 Maitland,FL32751 20-8023411	Therapy services to tax exempt nursing homes	KS	501(c)(3)	Line 12b, II	Sunbelt Hlth Care Centers Inc	Yes
(48)La Grange Memorial Hospital Foundation 5101 S Willow Springs Rd La Grange,IL60525 30-0247776	Fund-raising for Tax-exempt hospital	IL	501(c)(3)	Line 7	Midwest Hlth Foundation		No
(49)Lake County Health Care Properties Inc 485 North Keller Road 250 Maitland,FL32751 81-3923985	Lease to Related Organization	GA	501(c)(3)	Line 12c, III-FI	Sunbelt Hlth Care Centers Inc	Yes
(50)Memorial Hlth Systems Foundation Inc 305 Memorial Medical Pkwy 212 Daytona Beach,FL32117 31-1771522	Fund-raising for Tax-exempt hospital	FL	501(c)(3)	Line 7	N/A		No
(51)Memorial Hlth Systems Inc 301 Memorial Medical Parkway Daytona Beach,FL32117 59-0973502	Operation of Hospital & Related Services	FL	501(c)(3)	Line 3	Adventist Hlth SystemSunbelt Inc	Yes
(52)Memorial Hospital - West Volusia Inc 701 West Plymouth Avenue Deland,FL32720 59-3256803	Operation of Hospital & Related Services	FL	501(c)(3)	Line 3	Memorial Hlth Systems Inc	Yes
(53)Memorial Hospital Flagler Inc 60 Memorial Medical Parkway Palm Coast,FL32164 59-2951990	Operation of Hospital & Related Services	FL	501(c)(3)	Line 3	Memorial Hlth Systems Inc	Yes
(54)Memorial Hospital Inc 210 Marie Langdon Drive Manchester,KY40962 61-0594620	Operation of Hospital & Related Services	KY	501(c)(3)	Line 3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes
(55)Merriam Hlth Care Properties Inc 9700 West 62nd Street Merriam,KS66203 36-4595806	Lease to Related Organization	KS	501(c)(3)	Line 12c, III-FI	Sunbelt Hlth Care Centers Inc	Yes
(56)Metroplex Adventist Hospital Inc 2201 S Clear Creek Road Killeen,TX76549 74-2225672	Operation of Hospital & Related Services	TX	501(c)(3)	Line 3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes
(57)Metroplex Clinic Physicians Inc 2201 S Clear Creek Road Killeen,TX76549 11-3762050	Physician Hlthcare services to the community	TX	501(c)(3)	Line 3	Metroplex Adventist Hospital Inc	Yes
(58)Midwest Hlth Foundation 120 North Oak Street Hinsdale,IL60521 35-2230515	Support of subsidiary Foundations	IL	501(c)(3)	Line 12b, II	N/A		No
(59)Mills Hlth & Rehab Center Inc 500 Beck Lane Mayfield,KY42066 20-5782320	Operation of Home for the Aged/Hlthcare Delivery	KY	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes
(60)Mission Strategies of Georgia Inc 485 North Keller Road 250 Maitland,FL32751 90-0866024	Provision of support to the nursing home division	GA	501(c)(3)	Line 12b, II	Sunbelt Hlth Care Centers Inc	Yes
(61)Missouri Adventist Hlth Inc 9100 W 74th Street Shawnee Mission,KS66204 43-1224729	Support Hlth Care Services	MO	501(c)(3)	Line 12d, III-O	Adventist Hlth Mid-America Inc	Yes
(62)Ormond Beach Memorial Hospital Auxiliary Inc 301 Memorial Medical Parkway Daytona Beach,FL32117 59-1721962	Volunteer support services	FL	501(c)(3)	Line 12c, III-FI	N/A		No
(63)Osceola Health Care Properties Inc 485 North Keller Road 250 Maitland,FL32751 81-3165729	Lease to Related Organization	GA	501(c)(3)	Line 12c, III-FI	Sunbelt Hlth Care Centers Inc	Yes
(64)Overland Park Nursing & Rehab Center Inc 6501 West 75th Street Overland Park,KS66204 20-5774821	Operation of Home for the Aged/Hlthcare Delivery	KS	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes
(65)Paragon Hlth Care Properties Inc 950 Highpoint Drive Hopkinsville,KY42240 51-0605686	Lease to Related Organization	GA	501(c)(3)	Line 12c, III-FI	Sunbelt Hlth Care Centers Inc	Yes
(66)Pasco-Pinellas Hillsborough Community Hlth System Inc 2600 Bruce B Downs Blvd Wesley Chapel,FL33544 20-8488713	Operation of Hospital & Related Services	FL	501(c)(3)	Line 3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes
(67)Portercare Adventist Hlth System (630 Year End) 9100 E Mineral Circle Centennial,CO80112 84-0438224	Operation of Hospital & Related Services	CO	501(c)(3)	Line 3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes
(68)Princeton Hlth & Rehab Center Inc 1333 West Main Princeton,KY42445 20-5782272	Operation of Home for the Aged/Hlthcare Delivery	KY	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes
(69)Princeton Professional Services Inc 601 E Rollins Street Orlando,FL32803 59-1191045	Provision of Hlthcare Services	FL	501(c)(3)	Line 10	Adventist Hlth System Sunbelt Hlthcare Corp	Yes
(70)Quality Circle for Hlthcare Inc 900 Hope Way Altamonte Springs,FL32714 26-3789368	Hlthcare Quality Services	FL	501(c)(3)	Line 12a, I	Adventist Hlth System Sunbelt Hlthcare Corp	Yes
(71)Resource Personnel Inc 485 North Keller Road 250 Maitland,FL32751 20-8040875	Provide administrative support to tax exempt nursing homes	FL	501(c)(3)	Line 12b, II	Sunbelt Hlth Care Centers Inc	Yes
(72)Rocky Mountain Adventist Hlthcare Foundation (630 Year End) 7995 E Prentice Ave 204 Greenwood Village,CO80111 84-0745018	Fund-raising for Tax-exempt hospital	CO	501(c)(3)	Line 7	N/A		No
(73)Rollins Brook Community Care Corp 2201 S Clear Creek Road Killeen,TX76549 46-1656773	Support Operation of Hospital	TX	501(c)(3)	Line 12a, I	Adventist Hlth SystemSunbelt Inc	Yes
(74)Russellville Hlth Care Properties Inc 683 East Third Street Russellville,KY42276 51-0605691	Lease to Related Organization	GA	501(c)(3)	Line 12c, III-FI	Sunbelt Hlth Care Centers Inc	Yes
(75)San Marcos Hlth Care Properties Inc 1900 Medical Parkway San Marcos,TX78666 51-0605693	Lease to Related Organization	GA	501(c)(3)	Line 12c, III-FI	Sunbelt Hlth Care Centers Inc	Yes
(76)San Marcos Nursing & Rehab Center Inc 1900 Medical Parkway San Marcos,TX78666 20-5782224	Operation of Home for the Aged/Hlthcare Delivery	TX	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes
(77)Shawnee Mission Hlth Care Inc 6501 West 75th Street Overland Park,KS66204 48-0952508	Lease to Related Organization	KS	501(c)(3)	Line 12c, III-FI	Sunbelt Hlth Care Centers Inc	Yes
(78)Shawnee Mission Hlth Care Properties Inc 485 North Keller Road 250 Maitland,FL32751 81-3914908	Lease to Related Organization	GA	501(c)(3)	Line 12c, III-FI	Sunbelt Hlth Care Centers Inc	Yes
(79)Shawnee Mission Medical Center Inc 9100 W 74th Street Shawnee Mission,KS66204 48-0637331	Operation of Hospital & Related Services	KS	501(c)(3)	Line 3	Adventist Hlth Mid-America Inc	Yes
(80)South Central Inc 900 Hope Way Altamonte Springs,FL32714 59-3689740	Management Support	GA	501(c)(3)	Line 12c, III-FI	N/A		No
(81)South Pasco Hlth Care Properties Inc 38250 A Avenue Zephyrhills,FL33542 51-0605679	Lease to Related Organization	GA	501(c)(3)	Line 12c, III-FI	Sunbelt Hlth Care Centers Inc	Yes
(82)Southeast Volusia Healthcare Corp 401 Palmetto Street New Smyrna Beach,FL32168 47-3793197	Operation of Hospital & Related Services	FL	501(c)(3)	Line 3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes
(83)Southwest Volusia Hlth Services Inc 1055 Saxon Blvd Orange City,FL32763 59-3281591	Medical Office Building for Hospital	FL	501(c)(3)	Line 12a, I	Southwest Volusia Hlthcare Corp	Yes
(84)Southwest Volusia Hlthcare Corp 1055 Saxon Blvd Orange City,FL32763 59-3149293	Operation of Hospital & Related Services	FL	501(c)(3)	Line 3	Adventist Hlth SystemSunbelt Inc	Yes
(85)Specialty Physicians of Central Texas Inc 1301 Wonder World Drive San Marcos,TX78666 20-8814408	Physician Hlthcare services to the community	TX	501(c)(3)	Line 3	Adventist Hlth SystemSunbelt Inc	Yes
(86)Spring View Hlth & Rehab Center Inc 718 Goodwin Lane Leitchfield,KY42754 20-5782288	Operation of Home for the Aged/Hlthcare Delivery	KY	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes
(87)Sunbelt Hlth & Rehab Center - Apopka Inc 305 East Oak Street Apopka,FL32703 20-5774856	Operation of Home for the Aged/Hlthcare Delivery	FL	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes
(88)Sunbelt Hlth Care Centers Inc 485 North Keller Road 250 Maitland,FL32751 58-1473135	Management Services	TN	501(c)(3)	Line 12b, II	Adventist Hlth System Sunbelt Hlthcare Corp	Yes
(89)SunSystem Development Corp 900 Hope Way Altamonte Springs,FL32714 59-2219301	Fund Raising for Affiliated Tax-Exempt Hospitals	FL	501(c)(3)	Line 7	Adventist Hlth System Sunbelt Hlthcare Corp	Yes
(90)Tarpon Springs Hospital Foundation Inc 1395 S Pinellas Ave Tarpon Springs,FL34689 59-0898901	Operation of Hospital & Related Services	FL	501(c)(3)	Line 3	University Community Hospital Inc	Yes
(91)Tarrant County Hlth Care Properties Inc 301 Huguley Blvd Burleson,TX76028 51-0605677	Lease to Related Organization	GA	501(c)(3)	Line 12c, III-FI	Sunbelt Hlth Care Centers Inc	Yes
(92)Taylor Creek Hlth Care Properties Inc 718 Goodwin Lane Leitchfield,KY42754 51-0605678	Lease to Related Organization	GA	501(c)(3)	Line 12c, III-FI	Sunbelt Hlth Care Centers Inc	Yes
(93)The Comforter Health Care Group Inc 605 Montgomery Road Altamonte Springs,FL32714 27-1857940	Lease to Related Organization	FL	501(c)(3)	Line 12c, III-FI	Adventist Hlth System Sunbelt Hlthcare Corp	Yes
(94)The Volunteer Auxiliary of Florida Hospital - Flagler Inc 60 Memorial Medical Parkway Palm Coast,FL32164 59-2486582	Volunteer support services	FL	501(c)(3)	Line 12c, III-FI	N/A		No
(95)Tri-County Nursing and Rehab Center Inc 485 North Keller Road 250 Maitland,FL32751 47-2219363	Operation of Home for the Aged/Hlthcare Delivery	FL	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes
(96)Trinity Nursing & Rehab Center Inc 9700 West 62nd Street Merriam,KS66203 20-5774890	Operation of Home for the Aged/Hlthcare Delivery	KS	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes
(97)University Community Hospital Foundation Inc 3100 E Fletcher Ave Tampa,FL33613 59-2554889	Fund-raising for Tax-exempt hospital	FL	501(c)(3)	Line 12a, I	N/A		No
(98)University Community Hospital Specialty Care Inc 3100 E Fletcher Ave Tampa,FL33613 59-3231322	Inactive	FL	501(c)(3)	Line 12a, I	University Community Hospital Inc	Yes
(99)University Community Hospital Inc 3100 E Fletcher Ave Tampa,FL33613 59-1113901	Operation of Hospital & Related Services	FL	501(c)(3)	Line 3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes
(100)West Kentucky Hlth Care Properties Inc 500 Beck Lane Mayfield,KY42066 51-0605676	Lease to Related Organization	GA	501(c)(3)	Line 12c, III-FI	Sunbelt Hlth Care Centers Inc	Yes
(101)Zephyr Haven Hlth & Rehab Center Inc 38250 A Avenue Zephyrhills,FL33542 20-5774930	Operation of Home for the Aged/Hlthcare Delivery	FL	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes
(102)Zephyrhills Hlth & Rehab Center Inc 7350 Dairy Road Zephyrhills,FL33540 20-5774967	Operation of Home for the Aged/Hlthcare Delivery	FL	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2019

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) Clear Creek MOB Ltd 2201 S Clear Creek Rd Killeen,TX76549 74-2609195	Real Estate	TX	N/A
(2) Florida Hospital DMERT LLC 500 Winderley Place Ste 324 Maitland,FL32751 20-2392253	Medical Equipment	FL	N/A
(3) Florida Hospital Home Infusion LLP 500 Winderley Place Ste 324 Maitland,FL32751 59-3142824	Home Infusion Services	FL	N/A
(4) Functional Neurosurgical Ambulatory Surgery Ctr LLC 11 W Dry Creek Circle 120 Littleton,CO80120 46-4426708	Surgery Center	CO	Portercare Adventist Health System	Related	60,544	314,388		No			No	51.000 %
(5) PAHSLarkin Ventures LLC (7117 - 1118) 9100 E Mineral Cir Centennial,CO80112 47-4211060	Medical Services	CO	Portercare Adventist Health System	Related	-1,338,219			No			No	87.000 %
(6) Princeton Homecare Services LLC 600 Courtland Street Ste 300 Orlando,FL32804 81-4196648	Operation of Home Health Agency	FL	N/A
(7) San Marcos MRI LP 1330 Wonder World Dr Ste 202 San Marcos,TX78666 77-0597972	Imaging & Testing	TX	N/A

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(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	N/A	C				Yes
(2) Apopka Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando,FL32803 59-3000857	Condo Association	FL	N/A	C				Yes
(3) CC MOB Inc 2201 S Clear Creek Road Killeen,TX76549 74-2616875	Real Estate Rental	TX	N/A	C				Yes
(4) Central Texas Medical Associates 1301 Wonder World Drive San Marcos,TX78666 74-2729873	Inactive	TX	N/A	C				Yes
(5) Central Texas Providers Network 1301 Wonder World Drive San Marcos,TX78666 74-2827652	Physician Hospital Org.	TX	N/A	C				Yes
(6) Florida Hospital Flagler Medical Offices Association Inc 60 Memorial Medical Parkway Palm Coast,FL32164 26-2158309	Condo Association	FL	N/A	C				Yes
(7) Florida Hosp Hlth Village Property Owner's Assoc Inc 550 E Rollins Street 7th Floor Orlando,FL32803 82-1748255	Condo Association	FL	N/A	C				Yes
(8) Florida Hospital Healthcare System Inc 101 Southhall Lane Ste 150 Maitland,FL32751 59-3215680	PHSO	FL	N/A	C				Yes
(9) Florida Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando,FL32803 59-2855791	Condo Association	FL	N/A	C				Yes
(10) Florida Memorial Health Network Inc 770 W Granada Blvd Ste 317 Ormond Beach,FL32174 59-3403558	Physician Hospital Org.	FL	N/A	C				Yes
(11) Kissimmee Multispecialty Clinic Condominium Association Inc 201 Hilda Street Suite 30 Kissimmee,FL34741 59-3539564	Condo Association	FL	N/A	C				Yes
(12) LN Health Partners Inc 550 E Rollins Street 6th Floor Orlando,FL32803 81-3556903	Inactive	FL	N/A	C				Yes
(13) Midwest Management Services Inc 9100 West 74th Street Shawnee Mission,KS66204 48-0901551	Inactive	KS	N/A	C				Yes
(14) North American Health Services Inc & Sub 900 Hope Way Altamonte Springs,FL32714 62-1041820	Lessor/Holding Co.	TN	N/A	C				Yes
(15) Ormond Prof Associates Condo Assoc'n Inc (430 year end) 770 W Granada Blvd Ste 101 Ormond Beach,FL32174 59-2694434	Condo Association	FL	N/A	C				Yes
(16) Park Ridge Property Owner's Association Inc 1 Park Place Naples Road Fletcher,NC28732 03-0380531	Condo Association	NC	N/A	C				Yes
(17) Porter Affiliated Health Services Inc 2525 S Downing Street Denver,CO80210 84-0956175	Healthcare Services	CO	PorterCare Adventist Hlth System	C			100.000 %	Yes
(18) San Marcos Regional MRI Inc 1301 Wonder World Drive San Marcos,TX78666 77-0597968	Holding Company	TX	N/A	C				Yes
(19) The Garden Retirement Community Inc 485 North Keller Road Ste 250 Maitland,FL32751 59-3414055	Real Estate Rental	FL	N/A	C				Yes
(20) Winter Park Medical Office Building I Condo Assoc Inc 601 East Rollins Street Orlando,FL32803 45-2228478	Condo Association	FL	N/A	C				Yes

Schedule R (Form 990) 2019

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

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) Adventist Health System Sunbelt Healthcare Corporation	B	11,340,500	Amount Given
(2) Adventist Health System Sunbelt Healthcare Corporation	C	126,641	Amount Received
(3) Adventist Health System Sunbelt Healthcare Corporation	M	9,241,484	% of Facility's Operating Expense
(4) Adventist Health System Sunbelt Healthcare Corporation	P	4,865,872	Cost
(5) Centura Health Corporation	M	71,760,684	% of Facility's Operating Exp/Rev
(6) Centura Health Corporation	P	36,742,638	Cost
(7) Rocky Mountain Adventist Healthcare Foundation	B	1,237,724	Amount Given
(8) Rocky Mountain Adventist Healthcare Foundation	C	1,924,233	Amount Received

Schedule R (Form 990) 2019

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) 2019

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) 2019

Additional Data

Software ID:
Software Version:

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	4
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 2019 (Part V, line 2a) ......	5	4,600
6	Total number of volunteers (estimate if necessary) .............	6	0
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	683,035
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	-89,739

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	2,626,225	1,952,051
9	Program service revenue (Part VIII, line 2g) .........	1,146,716,616	1,223,629,602
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	7,739,525	8,662,201
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	16,250,344	4,255,952
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,173,332,710	1,238,499,806
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	1,665,289	2,341,746
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)	451,817,473	455,353,094
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)....	671,282,945	706,954,915
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,124,765,707	1,164,649,755
19	Revenue less expenses. Subtract line 18 from line 12.......	48,567,003	73,850,051
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,550,192,020	1,578,342,186
21	Total liabilities (Part X, line 26).............	459,599,953	423,749,307
22	Net assets or fund balances. Subtract line 21 from line 20.....	1,090,592,067	1,154,592,879

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 991,563,756 including grants of $ 2,341,746 ) (Revenue $ 1,227,122,642 )
	Operation of 5 acute care hospitals with 36,022 patient admissions, 144,474 patient days and 265,626 outpatient visits in the current year. In addition to hospital operations, the corporation provides medical care through a number of other activities such as urgent care centers, physician clinics, home health services, hospice services, sleep centers, wound centers, therapy and rehab.

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












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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses991,563,756

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)			(D) Reportable compensation from the organization (W-2/1099-MISC)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) Gaines Raymond........................................................................ Otolaryngology Physician	50.00 .......................0.00	X		1,010,470	0	45,044
(19) Ordelheide Kris........................................................................ Secretary - Former Officer	0.00 .......................50.00		X	0	699,843	132,276
(20) Barts Dennis........................................................................ CEO Avista - Former Key Emp.	50.00 .......................0.00		X	0	437,180	22,384
(21) Folkenberg Todd........................................................................ COO Porter - Former Key Emp.	50.00 .......................0.00		X	0	415,475	90,925

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	5,706,569	15,538,613	2,296,215

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	1,952,051
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		1,952,051

		Business Code
2a	Net Patient Revenue	622110	1,211,377,309	1,211,377,309
b	Cafeteria Revenue	622110	4,491,773	4,489,206	2,567
c	Medical Office Building Rentals	622110	3,348,250	3,348,250
d	Gift Shop Revenue	622110	1,996,510	1,996,510
e	Pharmacy Revenue	622110	1,441,342	868,141	573,201
f	All other program service revenue.		974,418	867,151	107,267
g	Total. Add lines 2a–2f .....		1,223,629,602

3 Investment income (including dividends, interest, and othersimilar amounts) ......			4,205,533			4,205,533
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		107,275	6a
b	Less: rental expenses		27,398	6b
c	Rental income or (loss)		79,877	6c
d	Net rental income or (loss).......			79,877			79,877
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	1,091,997	3,522,080	7a
b	Less: cost or other basis and sales expenses	157,409	0	7b
c	Gain or (loss)	934,588	3,522,080	7c
d	Net gain or (loss).........			4,456,668			4,456,668
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	Equity Earnings Subsidiaries		622110	4,176,075	4,176,075
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			4,176,075
12	Total revenue. See instructions.....			1,238,499,806	1,227,122,642	683,035	8,742,078

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	2,341,746	2,341,746
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 ...........	3,386,532		3,386,532
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........	365,806,321	311,476,806	54,329,515
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	17,769,776	15,012,440	2,757,336
9	Other employee benefits .......	43,730,794	37,000,122	6,730,672
10	Payroll taxes ...........	24,659,671	20,833,230	3,826,441
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	53,156		53,156
c	Accounting ...........	290,591		290,591
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	678,802		678,802
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	256,515,011	167,974,542	88,540,469
12	Advertising and promotion ....	5,495,415		5,495,415
13	Office expenses .......	18,562,366	14,632,635	3,929,731
14	Information technology ......	3,010,305	2,990,857	19,448
15	Royalties ..
16	Occupancy ...........	24,501,418	24,501,418
17	Travel ............	1,267,664	1,267,664		0
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	1,398,877		1,398,877
20	Interest ...........	10,127,901	10,127,901
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	85,998,829	85,998,829
23	Insurance ...	6,158,219	6,003,375	154,844
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	Medical Supplies	202,098,773	202,098,773
b	State Assessment	66,978,290	66,978,290
c	Repairs and Maintenance	18,338,001	18,338,001
d	Dues and Memberships	1,069,049		1,069,049
e	All other expenses	4,412,248	3,987,127	425,121
25	Total functional expenses. Add lines 1 through 24e	1,164,649,755	991,563,756	173,085,999	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).

1	Cash–non-interest-bearing ........			3,508,352	1	7,477,119
2	Savings and temporary cash investments .........			20,653,928	2	25,489,069
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			165,706,521	4	166,070,020
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........			11,087,974	7	10,697,997
8	Inventories for sale or use ............			25,116,347	8	25,422,856
9	Prepaid expenses and deferred charges ......			4,501,156	9	3,943,529
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,324,976,653
b	Less: accumulated depreciation	10b	612,505,646	680,194,381	10c	712,471,007
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....			381,355,664	12	374,844,164
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............			88,663,460	14	88,748,728
15	Other assets. See Part IV, line 11 ...........			169,404,237	15	163,177,697
16	Total assets. Add lines 1 through 15 (must equal line 33)...			1,550,192,020	16	1,578,342,186

17	Accounts payable and accrued expenses .....	66,714,224	17	59,025,587
18	Grants payable ...		18
19	Deferred revenue .........	877,623	19	1,023,879
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 any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			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	392,008,106	25	363,699,841
26	Total liabilities. Add lines 17 through 25..	459,599,953	26	423,749,307

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........		27
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	1,090,592,067	32	1,154,592,879
33	Total liabilities and net assets/fund balances ........	1,550,192,020	33	1,578,342,186