Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
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Total |
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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. | ||||||
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 | ||||||
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.) | ||||||
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.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 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) |
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| 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): |
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| 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 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
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2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
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| 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. | ||
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8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
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| 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 | ||||
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2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
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| 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) |
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| 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. | ||||
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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. |
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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. |
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7 Excess distributions carryover to 2020. Add lines 3j and 4c. |
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| 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..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| PART III, LINE 4A - CONTINUATION FOR AMITA HEALTH HINSDALE | AMITA HEALTH HINSDALE CLINICAL INSTITUTES AMITA HEALTH CANCER INSTITUTE & OUTPATIENT CENTER: AMITA HEALTH HINSDALE INCLUDES THE AMITA HEALTH CANCER INSTITUTE & OUTPATIENT CENTER (THE CENTER), WHICH OPENED IN HINSDALE IN FEBRUARY 2016. THE 54,000-SQUARE-FOOT CENTER PROVIDES A CENTRALIZED LOCATION FOR PATIENTS ON THEIR JOURNEY FROM DIAGNOSIS TO RECOVERY, CONSOLIDATING INTO ONE FACILITY A COMPREHENSIVE RANGE OF SERVICES FORMERLY SCATTERED ACROSS AMITA HEALTH HINSDALE AND AMITA HEALTH LA GRANGE. PATIENTS VISITING THE CENTER CAN SEE THEIR PHYSICIAN, HAVE LAB WORK PERFORMED, AND RECEIVE CHEMOTHERAPY AND RADIATION TREATMENTS IN A COMFORTING, HEALING ENVIRONMENT FEATURING STATE-OF-THE-ART TECHNOLOGY. HAVING A COMPREHENSIVE ARRAY OF SERVICES UNDER ONE ROOF FACILITATES COORDINATION OF TREATMENT AMONG MULTIDISCIPLINARY TEAM MEMBERS WHILE SAVING TIME AND REDUCING STRESS FOR PATIENTS. THE CENTER'S DESIGN AND ITS EMPHASIS ON PATIENT CONVENIENCE REFLECT THE INPUT OF CANCER SURVIVORS, PHYSICIANS AND ASSOCIATES CALLED UPON FOR THEIR IDEAS AS PLANS FOR THE FACILITY WERE DEVELOPED. THE FACILITY'S FIRST FLOOR IS DEDICATED TO CANCER TREATMENT, AND ITS SECOND FLOOR OFFERS OUTPATIENT IMAGING SERVICES, SUCH AS MAMMOGRAPHY, ULTRASOUND AND X-RAY. THE FACILITY HAS SEPARATE ENTRANCES FOR THE TWO DIFFERENT GROUPS OF PATIENTS IT SERVES. THE CENTER FEATURES TWO LINEAR ACCELERATORS FOR RADIATION TREATMENT AND 28 CHEMOTHERAPY INFUSION CHAIRS, INCLUDING 17 IN PRIVATE ROOMS, FOUR IN SEMI-PRIVATE ROOMS, AND SEVEN IN COMMUNITY ROOMS DESIGNED TO FOSTER PATIENT-TO-PATIENT SUPPORT AND COMMUNICATION. THE CENTER ALSO HAS 21 EXAM ROOMS FOR DOCTOR-PATIENT CONSULTATIONS, A TESTING LABORATORY AND A PHARMACY SPECIALIZING IN CHEMOTHERAPY. ANOTHER CONVENIENCE IS THE CENTER'S WELLNESS HOUSE OFFICE. WELLNESS HOUSE IS A NOT-FOR-PROFIT ORGANIZATION THAT OFFERS AN EXTENSIVE ARRAY OF SUPPORT SERVICES FOR PEOPLE LIVING WITH CANCER. THE OFFICE REFLECTS THE CENTER'S FOCUS ON PROVIDING "ADJACENCIES, OR CLOSELY RELATED SERVICES, IN ONE CONVENIENT SETTING. OTHER ADJACENCIES OFFERED AT THE FACILITY INCLUDE NUTRITION COUNSELING AND GENETIC COUNSELING. AMITA HEALTH HINSDALE SERVICES DIAGNOSTIC SERVICES: AMITA HEALTH HINSDALE'S DIAGNOSTIC SERVICES INCLUDE THE LATEST TECHNOLOGY AND PRACTICES, WHICH ARE ACCREDITED BY NATIONALLY AND STATE RECOGNIZED AGENCIES AND ASSOCIATIONS, SUCH AS THE ILLINOIS EMERGENCY MANAGEMENT AGENCY, THE AMERICAN COLLEGE OF RADIOLOGY, THE COLLEGE OF AMERICAN PATHOLOGISTS, THE CLINICAL LABORATORY IMPROVEMENT AMENDMENTS AND THE JOINT COMMISSION. DIAGNOSTIC SERVICES OFFERED INCLUDE: -- DIAGNOSTIC IMAGING (GENERAL X-RAY, CT, MRI, PET, ULTRASOUND, NUCLEAR MEDICINE) -- BREAST-CARE SERVICES (SCREENING AND 3-D DIAGNOSTIC MAMMOGRAPHY, BREAST BIOPSY ULTRASOUND, STEREOTACTIC BREAST BIOPSY, BONE DENSITOMETRY, GENETIC COUNSELING, MAMMACARE BREAST SELF-EXAMINATION INSTRUCTIONS) -- CARDIOLOGY (CARDIAC CATHETERIZATION, ELECTROPHYSIOLOGY, ELECTROCARDIOGRAMS [EKGS], STRESS TESTING, ECHOCARDIOGRAPHY, HOLTER MONITORING OF ARRHYTHMIAS) -- PULMONARY DIAGNOSTICS (ARTERIAL BLOOD GAS ANALYSIS) -- GASTROENTEROLOGY (COLONOSCOPY, BRONCHOSCOPY) -- LABORATORY/PATHOLOGY (CHEMISTRY, MICROBIOLOGY, HEMATOLOGY, HISTOLOGY, CYTOLOGY, PHLEBOTOMY, TRANSFUSION SERVICES) EMERGENCY DEPARTMENT: EMERGENCY MEDICAL CARE IS PROVIDED 24/7 FOR ALL AGES AND TYPES OF PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY FOR SUCH SERVICES. OUTPATIENT SERVICES PERFORMED IN 2019: -- 2,638 OUTPATIENT SURGERIES -- 31,433 EMERGENCY ROOM VISITS. |
| PART III, LINE 4A - AMITA HEALTH LA GRANGE | AMITA HEALTH ADVENTIST MEDICAL CENTER LA GRANGE (AMITA HEALTH LA GRANGE, OR THE HOSPITAL) IS A 198-BED ACUTE-CARE HOSPITAL IN LA GRANGE, ILLINOIS, THAT HAS SERVED THE HEALTHCARE NEEDS OF THE LA GRANGE COMMUNITY AND SURROUNDING AREAS SINCE 1955. LOCATED AT 5101 SOUTH WILLOW SPRINGS ROAD, AMITA HEALTH LA GRANGE IS A FULL-SERVICE HOSPITAL THAT INCLUDES A MEDICAL OFFICE BUILDING ON ITS CAMPUS IN LA GRANGE, AS WELL AS THE AMITA HEALTH CANCER INSTITUTE & OUTPATIENT CENTER IN HINSDALE. IN ADDITION TO CANCER CARE, OTHER SPECIALTY CARE AND SERVICES OFFERED BY THE HOSPITAL INCLUDE CLINICAL RESEARCH TRIALS, EMERGENCY SERVICES, ENDOCRINOLOGY, GERIATRICS, GASTROENTEROLOGY, HEART AND VASCULAR, HOME HEALTH, HOSPICE, IMAGING, INTERVENTIONAL RADIOLOGY, LAB SERVICES, NEUROLOGY, OBSTETRICS, ORTHOPEDICS, PASTORAL CARE, PEDIATRICS, PHYSICAL REHABILITATION, RHEUMATOLOGY, SLEEP DISORDERS, SURGICAL SERVICES, UROLOGY, WOMEN'S CARE AND WOUND CARE. THE HOSPITAL HAS AN IMAGING FACILITY IN WESTCHESTER, ILLINOIS, AND OPERATES AN OUTPATIENT PHYSICAL REHABILITATION SITE IN WILLOWBROOK, ILLINOIS, IN PARTNERSHIP WITH PT SOLUTIONS. THE HOSPITAL HAS A 16-BED ACUTE INPATIENT REHABILITATION UNIT THAT INCLUDES AN APARTMENT WHERE THERAPISTS TRAIN PATIENTS TO RESUME DAILY LIVING ACTIVITIES. A 2016 EXPANSION AND RENOVATION OF THE HOSPITAL'S EMERGENCY DEPARTMENT INCREASED THE NUMBER OF TREATMENT BAYS FROM 16 TO 23. EACH BAY IS A PRIVATE ROOM ENCLOSED WITH SOLID WALLS AND A DOOR, INSTEAD OF THE THIN CURTAINS THAT HAD SEPARATED BAYS IN THE OLD EMERGENCY DEPARTMENT. THE NEW EMERGENCY DEPARTMENT ALSO FEATURES A FAST-TRACK AREA FOR PATIENTS WITH MORE-MINOR EMERGENCIES TO DECREASE WAIT TIMES FOR THOSE PATIENTS AND TO FREE UP EXAM ROOMS FOR MORE-SERIOUS CASES. THROUGH THE YEARS, AMITA HEALTH LA GRANGE HAS BUILT NUMEROUS PARTNERSHIPS WITH COMMUNITY ORGANIZATIONS TO ADDRESS LOCAL HEALTHCARE NEEDS. ADDRESSING THE NEEDS OF OLDER ADULTS IS A KEY FOCUS FOR THE HOSPITAL, WHICH SERVES A LARGE MEDICARE POPULATION. AMITA HEALTH LA GRANGE HAS A SPECIAL COLLABORATIVE RELATIONSHIP WITH SISTER HOSPITAL AMITA HEALTH ADVENTIST MEDICAL CENTER HINSDALE (AMITA HEALTH HINSDALE) IN HINSDALE, ILLINOIS. ABOUT TWO MILES SEPARATE THE HOSPITALS, AND BECAUSE OF THEIR PROXIMITY TO EACH OTHER, THEY HAVE WORKED TO INTEGRATE THEIR SERVICES AND TO WORK COLLABORATIVELY INSTEAD OF COMPETING AGAINST EACH OTHER. THE HOSPITALS SHARE THE SAME SENIOR MANAGEMENT TEAM, DEPARTMENT LEADERS, AND MEDICAL STAFF, AND THEY PARTNERED TO DEVELOP THE AMITA HEALTH CANCER INSTITUTE AND OUTPATIENT CENTER, WHICH OPENED IN 2016 IN HINSDALE. THE INTEGRATION PROCESS HAS REDUCED OPERATING COSTS FOR THE TWO HOSPITALS, AND THEY HAVE REINVESTED THE SAVINGS TO EXPAND AND ENHANCE SERVICES. THE TWO HOSPITALS ALSO OPERATE A FAMILY-PRACTICE RESIDENCY PROGRAM IN WHICH MEDICAL-SCHOOL GRADUATES SERVE THEIR RESIDENCIES, DOING CLINICAL ROTATIONS, CARING FOR 18,000 PATIENTS ANNUALLY -- INCLUDING MANY MEDICAID RECIPIENTS -- AT A PRIMARY-CARE CLINIC AT AMITA HEALTH HINSDALE, AND PROVIDING OBSTETRICAL SERVICES AT A DUPAGE COUNTY HEALTH DEPARTMENT CLINIC IN WESTMONT. THE PROGRAM IS A CONSISTENT SOURCE OF FAMILY-PRACTICE PHYSICIANS FOR THE COMMUNITY. AMITA HEALTH LA GRANGE IS CERTIFIED BY THE JOINT COMMISSION AND THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION AS A PRIMARY STROKE CENTER AND HAS RECEIVED NATIONAL QUALITY APPROVAL FROM THE JOINT COMMISSION. THE BLUE CROSS AND BLUE SHIELD ASSOCIATION HAS AWARDED ITS BLUE DISTINCTION CENTER+ DESIGNATION TO THE HOSPITAL FOR DELIVERING SAFE, HIGH-QUALITY AND COST-EFFICIENT MATERNITY CARE. IN DECEMBER 2017, AMITA HEALTH LA GRANGE EARNED A FIVE-STAR RATING - THE HIGHEST POSSIBLE - IN RATINGS POSTED ON THE CENTERS FOR MEDICARE & MEDICAID SERVICES' HOSPITAL COMPARE WEBSITE. THE HOSPITAL EARNED AN "A," THE HIGHEST POSSIBLE SCORE, IN THE SPRING 2017 AND FALL 2017 EDITIONS OF THE LEAPFROG GROUP'S BIANNUAL HOSPITAL SAFETY GRADE STUDY. IN ADDITION, AMITA HEALTH LA GRANGE WAS RATED AS HIGH-PERFORMING IN TWO ADULT PROCEDURES/CONDITIONS (CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND HEART FAILURE) IN U.S. NEWS & WORLD REPORT'S 2017-2018 BEST HOSPITALS REPORT. ALSO IN 2017, AMINO, A SAN FRANCISCO-BASED HEALTHCARE DATA COMPANY, RANKED AMITA HEALTH LA GRANGE 11TH IN THE COMPANY'S RANKINGS OF THE CHICAGO AREA'S TOP 12 BEST VALUE HOSPITALS. IN 2019, AMITA HEALTH LA GRANGE TREATED 7,936 INPATIENTS AND PERFORMED 1,886 INPATIENT SURGERIES. THE HOSPITAL'S MEDICAL STAFF INCLUDES 773 PHYSICIANS REPRESENTING MORE THAN 67 MEDICAL AND SURGICAL SPECIALTIES. AMITA HEALTH LA GRANGE PROVIDES CARE FOR ALL, INCLUDING THE FINANCIALLY DISADVANTAGED, UNINSURED, UNDERINSURED, HOMELESS AND THOSE WHO RECEIVE PUBLIC AID. IN 2019, AMITA HEALTH LA GRANGE PROVIDED $2,104,592 OF CHARITY CARE AT COST. THIS WAS IN ADDITION TO $5,290,299 IN COMMUNITY EDUCATION COSTS, INCLUDING THE HOSPITAL'S RESIDENCY PROGRAM, $86,000 IN OTHER COMMUNITY BENEFITS SERVICES, $927,048 OF BAD DEBT EXPENSE AT COST, AND $5,166,981 OF UNREIMBURSED MEDICAID AT COST. ABOUT ADVENTIST MIDWEST HEALTH THE TOP-TIER PARENT OF THE FILING ORGANIZATION, ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION, OWNS A REGIONAL HEALTH SYSTEM WHICH INCLUDES A NETWORK OF FOUR NOT-FOR-PROFIT HOSPITALS AND THEIR OUTPATIENT-BASED HEALTHCARE FACILITIES OPERATING IN CHICAGO'S WESTERN SUBURBS. THE FOUR NOT-FOR-PROFIT CHICAGO HOSPITALS TAKE A HOLISTIC APPROACH TO WELLNESS, ADDRESSING THE PHYSICAL, MENTAL, SOCIAL AND SPIRITUAL NEEDS OF THE PEOPLE IT SERVES. THE FOUR HOSPITALS AND OTHER FACILITIES ARE INTEGRAL TO THE FABRIC OF THEIR COMMUNITIES. THE HOSPITALS PARTNER WITH LOCAL CIVIC ORGANIZATIONS AND BUSINESSES TO BRING STATE-OF-THE-ART TREATMENTS AND PREVENTIVE HEALTHCARE SERVICES CLOSE TO WHERE PEOPLE LIVE AND WORK. AS PART OF ADVENTHEALTH, THE LARGEST, NOT-FOR-PROFIT PROTESTANT HOSPITAL SYSTEM IN THE NATION, THE FILING ORGANIZATION IS GROUNDED IN CHRISTIAN VALUES AND COMMITTED TO EXTENDING THE HEALING MINISTRY OF CHRIST. THE FILING ORGANIZATION WELCOMES PATIENTS FROM ANY RELIGIOUS DENOMINATION AS WELL AS PATIENTS WHO DO NOT ASCRIBE TO ANY RELIGION. IN FEBRUARY 2015, AMH AND ALEXIAN BROTHERS HEALTH SYSTEM (ABHS) FORMED A JOINT OPERATING COMPANY (JOC). A JOC ALLOWS SEPARATE OWNERS TO INTEGRATE OPERATIONS TO ACHIEVE A COMMON GOAL WHILE MAINTAINING SEPARATE OWNERSHIP OF ASSETS. IT ALSO ALLOWS AMH AND ABHS TO WORK IN UNISON WHILE PRESERVING THE ADVENTIST AND CATHOLIC IDENTITIES AND MISSION PRIORITIES THAT DEFINE AMH AND ABHS, RESPECTIVELY. IN APRIL 2015, ALEXIAN BROTHERS-AHS MIDWEST REGION HEALTH CO., D/B/A AMITA HEALTH, WAS ANNOUNCED AS THE NEW NAME OF THE JOC. THE NAME AMITA IS INSPIRED BY THE MEANING IT HAS IN SEVERAL LANGUAGES -- FRIENDSHIP IN ITALIAN, HONESTY AND TRUTH IN HEBREW, AND SPIRITUAL LIGHT AND BOUNDLESSNESS IN HINDI. THE NAME REFLECTS AMITA HEALTH'S FAITH-BASED CALL TO HEALING, ITS CORE VALUES, AND THE COMPASSION AND DEDICATION THAT ITS CAREGIVERS SHOW EVERY DAY TO PATIENTS, THEIR FAMILIES AND EACH OTHER. |
| FORM 990, PART VI, SECTION A, LINE 6 | ADVENTIST MIDWEST HEALTH (THE FILING ORGANIZATION) HAS ONE MEMBER. THE SOLE MEMBER OF THE FILING ORGANIZATION IS ADVENTIST HEALTH SYSTEM/SUNBELT, INC. (AHSSI). AHSSI 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 MEMBERS OF THE BOARD OF DIRECTORS (GOVERNING BOARD) OF THE FILING ORGANIZATION ARE APPOINTED BY THE CORPORATE MEMBER, ADVENTIST HEALTH SYSTEM/SUNBELT, INC. THE CORPORATE MEMBER IS ENTITLED TO ELECT NOT LESS THAN EIGHTEEN (18) AND NO MORE THAN TWENTY THREE (23) VOTING MEMBERS TO THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION PURSUANT TO THE PROVISIONS OF THE BYLAWS, SUBJECT TO THE RATIFICATION OF THE AMITA HEALTH BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FILING ORGANIZATION IS ONE OF TWO MEMBERS AND IS A COVERED AFFILIATE OF THE JOC KNOWN AS AMITA HEALTH. THE OTHER MEMBER OF AMITA HEALTH IS ALEXIAN BROTHERS HEALTH SYSTEM. THE SOLE MEMBER OF THE FILING ORGANIZATION IS ADVENTIST HEALTH SYSTEM/SUNBELT, INC. (AHSSI). THE TOP-TIER PARENT OF AMH IS AHSSHC (SPONSOR). THE GOVERNING DOCUMENTS OF THE FILING ORGANIZATION PROVIDE FOR CERTAIN RESERVED POWERS TO EXERCISE FINANCIAL, MANAGERIAL, AND OPERATIONAL AUTHORITIES OVER THE FILING ORGANIZATION BY AHSSHC, AS SPONSOR, BY AHSSI AS MEMBER, BY BOTH MEMBERS OF THE JOC, NAMELY, AMH AND ALEXIAN BROTHERS HEALTH SYSTEM (MEMBERS), AND BY THE BOARD OF DIRECTORS OF THE JOC. CERTAIN GOVERNANCE POWERS ARE RESERVED TO AHSSI AS THE MEMBER OF THE FILING ORGANIZATION. THESE RESERVED POWERS INCLUDE THE ALTERATION, RESTATEMENT OR REPEAL OF THE ARTICLES OF INCORPORATION, BYLAWS OR MISSION STATEMENT OF THE FILING ORGANIZATION, PROVIDED THAT SUCH ACTIONS ARE NOT INCONSISTENT WITH THE JOC BYLAWS OR THE AFFILIATION AGREEMENT AND THE APPOINTMENT OF THE FILING ORGANIZATION'S BOARD OF DIRECTORS, SUBJECT TO THE RATIFICATION OF THE JOC BOARD OF DIRECTORS. FINANCIAL AUTHORITIES RESERVED TO THE SPONSOR, THE BOARD OF DIRECTORS OF THE JOC, AND BY BOTH MEMBERS OF THE JOC INCLUDE THE APPROVAL OF ANY DISPOSITION OF THE FILING ORGANIZATION'S ASSETS AND ANY INTERNAL TRANSFER OF THE FILING ORGANIZATION'S ASSETS. THE SPONSOR, THE BOARD OF DIRECTORS OF THE JOC, AND BOTH MEMBERS OF THE JOC MAY APPROVE SUCH DISPOSITIONS OR TRANSFERS UP TO ESTABLISHED ASSET DOLLAR VALUES AS SET FORTH IN THE BYLAWS OF THE FILING ORGANIZATION. ANNUAL OPERATING AND CAPITAL BUDGETS OF THE FILING ORGANIZATION MUST BE RATIFIED BY BOTH SPONSORS OF THE JOC. THE BOARD OF DIRECTORS OF THE JOC MUST APPROVE ANY CAPITAL EXPENDITURE TO BE MADE BY THE FILING ORGANIZATION IN EXCESS OF $10 MILLION. OPERATIONAL AUTHORITIES RESERVED TO THE BOARD OF DIRECTORS OF THE JOC INCLUDE THE DETERMINATION OF THE SERVICES TO BE PROVIDED BY THE FILING ORGANIZATION, INCLUDING THE AUTHORITY TO DIRECT THE EXPANSION, REDUCTION AND CONSOLIDATION OF CLINICAL PROGRAMS, PATIENT CARE SERVICES AND ADMINISTRATIVE CAPABILITIES OR OTHER MAJOR CHANGES IN THE OPERATION OF THE FILING ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FILING ORGANIZATION'S CURRENT YEAR FORM 990 WAS REVIEWED BY THE BOARD CHAIRMAN, CEO AND BY THE CFO PRIOR TO ITS FILING WITH THE IRS. THE REVIEW CONDUCTED BY THE BOARD CHAIRMAN, 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 | THE CONFLICT OF INTEREST POLICY OF THE FILING ORGANIZATION APPLIES TO MEMBERS OF ITS BOARD OF DIRECTORS AND ITS PRINCIPAL OFFICERS (TO BE KNOWN AS INTERESTED PERSONS). IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTERESTS, ANY MEMBER OF THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION OR ANY PRINCIPAL OFFICER OF THE FILING ORGANIZATION (I.E. INTERESTED PERSONS) MUST DISCLOSE THE EXISTENCE OF ANY FINANCIAL INTEREST WITH THE FILING ORGANIZATION AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS CONCERNING THE FINANCIAL INTEREST/ARRANGEMENT TO THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION OR TO ANY MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS THAT IS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. SUBSEQUENT TO ANY DISCLOSURE OF ANY FINANCIAL INTEREST/ARRANGEMENT AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE RELEVANT BOARD MEMBER OR PRINCIPAL OFFICER, THE REMAINING MEMBERS OF THE BOARD OF DIRECTORS OR COMMITTEE WITH BOARD DELEGATED POWERS SHALL DISCUSS, ANALYZE, AND VOTE UPON THE POTENTIAL FINANCIAL INTEREST/ARRANGEMENT TO DETERMINE IF A CONFLICT OF INTEREST EXISTS. ACCORDING TO THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY, AN INTERESTED PERSON MAY MAKE A PRESENTATION TO THE BOARD OF DIRECTORS (OR COMMITTEE WITH BOARD DELEGATED POWERS), BUT AFTER SUCH PRESENTATION, SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN A CONFLICT OF INTEREST. EACH INTERESTED PERSON, AS DEFINED UNDER THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY, SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE FILING ORGANIZATION IS A CHARITABLE ORGANIZATION THAT MUST PRIMARILY ENGAGE IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS EXEMPT PURPOSES. THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY ALSO REQUIRES THAT PERIODIC REVIEWS SHALL BE CONDUCTED TO ENSURE THAT THE FILING ORGANIZATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE FILING ORGANIZATION'S CEO, OTHER OFFICERS AND KEY EMPLOYEES ARE ON THE PAYROLL OF THE FILING ORGANIZATION, HOWEVER THE COMPENSATION PACKAGE OF THESE EXECUTIVES IS DETERMINED BY THE JOINT OPERATING COMPANY, ALEXIAN BROTHERS-AHS MIDWEST REGION HEALTH CO. DBA AMITA HEALTH. AS NOTED IN OUR RESPONSE TO PART VI, SECTION A, LINE 7B, THE FILING ORGANIZATION IS A COVERED AFFILIATE IN THE JOC KNOWN AS AMITA HEALTH. PLEASE SEE THE DISCUSSION CONCERNING THE PROCESS FOLLOWED BY AMITA HEALTH IN DETERMINING EXECUTIVE COMPENSATION IN OUR RESPONSE TO SCHEDULE J, LINE 3. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE FILING ORGANIZATION IS A PART OF THE SYSTEM OF HEALTHCARE ORGANIZATIONS KNOWN AS ADVENTHEALTH. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS OF ADVENTHEALTH AND OF THE ADVENTHEALTH "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 ADVENTHEALTH ON A CONSOLIDATED BASIS AND FOR THE GROUPING OF ADVENTHEALTH SUBSIDIARIES COMPRISING THE "OBLIGATED GROUP". THE FILING ORGANIZATION DOES NOT GENERALLY MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. |
| PART VII, SECTION A | FOR THOSE BOARD OF DIRECTOR MEMBERS (NOT INCLUDING PHYSICIAN MEMBERS OF THE BOARD) WHO DEVOTE LESS THAN FULL-TIME TO THE FILING ORGANIZATION (BASED UPON THE AVERAGE NUMBER OF HOURS PER WEEK SHOWN IN COLUMN (B) ON PAGE 7 OF THE RETURN) THE COMPENSATION AMOUNTS SHOWN IN COLUMNS (E) AND (F) ON PAGE 7 WERE PROVIDED IN CONJUNCTION WITH THAT PERSON'S RESPONSIBILITIES AND ROLES IN SERVING IN AN EXECUTIVE LEADERSHIP POSITION WITHIN ADVENTHEALTH OR AMITA HEALTH. PHYSICIAN MEMBERS OF THE BOARD OF DIRECTORS RECEIVED COMPENSATION FROM RELATED ORGANIZATIONS AS A RESULT OF PROVIDING VARIOUS MEDICAL SERVICES TO THOSE RELATED ENTITIES. |
| PART VIII, LINES 7B AND 7C: | THE AMOUNT SHOWN IN PART VIII, LINE 7C(I) OF THE FORM 990 REPRESENTS AN ALLOCATED SHARE OF CAPITAL GAIN/(LOSS) FROM A SYSTEM WIDE, CORPORATE ADMINISTERED, INVESTMENT PROGRAM. |
| FORM 990, PART IX, LINE 11G | PAYMENTS TO HEALTHCARE PROFESSIONAL: PROGRAM SERVICE EXPENSES 14,925,292. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,925,292. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,948,492. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,948,492. PURCHASED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 7,942,409. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,942,409. ENVIRONMENTAL SERVICES: PROGRAM SERVICE EXPENSES 7,604,608. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,604,608. RECRUITING: PROGRAM SERVICE EXPENSES 18,894. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 18,894. FOOD SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 7,517,282. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,517,282. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 42,798,495. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,798,495. AHS MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 16,483,716. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,483,716. |
| PART X, LINE 2 | THE AMOUNTS SHOWN ON LINE 2 OF PART X OF THIS RETURN INCLUDE THE FILING ORGANIZATION'S INTEREST IN A CENTRAL INVESTMENT POOL MAINTAINED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION, THE FILING ORGANIZATION'S TOP-TIER PARENT. THE INVESTMENTS IN THE CENTRAL INVESTMENT POOL ARE RECORDED AT MARKET VALUE. |
| FORM 990, PART XI, LINE 9: | ASC 842 LEASE ACCOUNTING ADJUSTMENT 805,507. ALLOCATIONS TO TAX-EXEMPT PARENT WITH RESPECT TO DEBT -614,017. INTEREST IN FOUNDATION 1,870,711. TRANSFER TO TAX-EXEMPT PARENT -6,252,630. TRANSFER FOR EXPENSES -280,486. ADJUSTMENT RELATED TO STEP-UP BASIS 90,640. |
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