2023-11-15T15:17:47-06:00 2022-12-31 990 2022-01-01 363208390 ADVENTIST GLENOAKS HOSPITAL ADVE 6305458000 701 WINTHROP AVE GLENDALE HEIGHTS IL 60139 LYNN C ADDISCOTT ASSISTANT SECRETARY 4079751492 2023-11-03 LYNN ADDISCOTT 999009999 0 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z VLADIMIR RADIVOJEVIC 701 WINTHROP AVE GLENDALE HEIGHTS IL 60139 115161219 0 X WWW.UCHICAGOMEDICINEADVENTHEALTH.ORG/ X 1982 IL THE PROVISION OF MEDICAL CARE TO THE COMMUNITY THROUGH THE OPERATION OF A 143 BED HOSPITAL. 19 10 560 38 103741 4517 865189 3384216 105504025 111568194 19495 106718 0 0 106388709 115059128 151489 165081 0 0 43333006 50258062 0 0 0 60730267 65636232 104214762 116059375 2173947 -1000247 76929561 54319438 46990659 20840084 29938902 33479354 X ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION AND ALL ITS SUBSIDIARY ORGANIZATIONS WERE ESTABLISHED BY THE SEVENTH-DAY ADVENTIST CHURCH TO BRING A MINISTRY OF HEALING AND HEALTH TO THE COMMUNITIES SERVED. OUR MISSION IS TO EXTEND THE HEALING MINISTRY OF CHRIST.THE HOSPITAL AND HEALTHCARE SYSTEM WHOSE PARENT IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION IS KNOWN AS ADVENTHEALTH. ADVENTHEALTH SEEKS TO BE WIDELY RESPECTED AS A CONSUMER-FOCUSED ORGANIZATION THAT ENGAGES INDIVIDUALS IN THEIR HEALTH BY DELIVERING WHOLISTIC, BEST PRACTICE CARE ACROSS A CONNECTED, COMPREHENSIVE CONTINUUM OF SERVICES. WITH CHRIST AS OUR EXAMPLE, ADVENTHEALTH CARES FOR AND NURTURES PEOPLE: OUR EMPLOYEES, OUR COMMUNITIES, OUR HEALTHCARE PROFESSIONALS, AND THOSE WHO TRUST US FOR CARE AND HEALING. 0 0 106553082 165081 111464453 OPERATION OF A 143-BED ACUTE CARE HOSPITAL. THERE WERE 4,735 PATIENT ADMISSIONS, 26,440 PATIENT DAYS, AND 39,680 OUTPATIENT VISITS. 106553082 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 1 560 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 19 10 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 IL X BOB HONEST 2242730191 701 WINTHROP AVENUE GLENDALE HEIGHTS IL 60139 X BACON KENNETH DIR/CHAIRMAN 0.30 50.00 X 0 1621638 290272 SNYDER BRENT DIRECTOR 0.30 50.00 X 0 1466962 43282 THORDARSON THOR DIR/PRESIDENT/SEC 5.22 44.78 X 0 1297253 147708 BUCHANAN HERBERT DIRECTOR 5.85 44.15 X 7259 788724 32818 ARQUILLA VENANZIO DIRECTOR 0.30 0.60 X 0 0 0 DENSLOW KENNETH DIRECTOR/VICE CHAIR 0.30 3.70 X 0 5692 0 SCOTT GLYNN DIRECTOR 0.30 2.70 X 0 5363 0 RAMIREZ ELDEN DIRECTOR (BEG 1/22) 0.30 2.70 X 0 5363 0 DE RAMOS DO DAVID DIRECTOR (END 12/22) 0.30 50.00 X 0 232083 38491 AGUILERA RONALD DIRECTOR (END 3/22) 0.30 3.70 X 0 6088 0 MURREY MD SUSAN DIRECTOR 0.30 7.00 X 0 49200 0 EASTMAN LINDA DIRECTOR 0.30 0.60 X 0 0 0 GRAY JR MARSHALL DIRECTOR 0.30 0.60 X 0 0 0 HAWKINS RONNIE DIRECTOR 0.30 0.60 X 0 0 0 HOLDER BILL DIRECTOR 0.30 0.60 X 0 0 0 O'CONNOR PETER DIRECTOR 0.30 0.60 X 0 0 0 WRIGHT JONATHAN DIRECTOR 0.30 0.60 X 0 0 0 DAVARAPALLI MD RAMADEVI DIRECTOR (BEG 1/22) 0.30 50.00 X 0 432824 57036 DIXON SUSAN DIRECTOR (BEG 1/22) 0.30 0.60 X 0 0 0 KOHLI MD MANINDER DIRECTOR (BEG 1/22) 0.30 4.60 X 0 31350 0 CHRISTIAN BRUCE PRES/CEO BOLINGBROOK/GLENOAKS (END 10/22) 25.00 25.00 X 0 1591871 39312 RADIVOJEVIC VLADIMIR COO/CEO 37.50 12.50 X 0 356458 72650 BROWN JARED SR. DIR. FINANCE-BOLING/GLENOAKS 25.00 25.00 X 0 234771 30365 CARROLL MD RICHARD VP/CMO BOLINGBROOK/GO (END 6/22) 25.00 25.00 X 0 501650 26170 PAWLIK RN COLLEEN INTERIM CNO BOLING/GLENOAKS 25.00 25.00 X 0 301083 43398 CALANZA FATIMA RN CHARGE 58.70 0.00 X 58818 130940 29666 THORAKKAL SINOL RN CHARGE 49.20 0.00 X 42931 122793 40823 ALBAUGH JOLENE RN DIR-SURGICAL SVCS 30.00 10.00 X 40398 125102 22676 KNUTSON LISA RN DIR-NURSING 40.00 0.00 X 39268 125537 31532 MAYOL LEIZL RN SPV-HOUSE 40.00 0.00 X 39704 124451 40955 228378 9557196 987154 0 0 1 1 R1RCM INC 39918 TREASURY CENTER CHICAGO IL 60694 REVENUE CYCLE SERVICE 2923624 ALVERNO CLINICAL LABORATORIES LLC 2434 INTERSTATE PLAZA DRIVE HAMMOND IN 46324 LAB SERVICES 2655221 MORRISON HEALTHCARE PO BOX 102289 ATLANTA GA 30368 FOOD SERVICES 2200986 PT SOLUTIONS HOLDINGS LLC PO BOX 441146 KENNESAW GA 30160 THERAPY SERVICES 1896539 AYA HEALTHCARE INC PO BOX 3519 DALLAS TX 75312 AGENCY STAFFING SERVICES 1887126 19 X 26018 3358198 3384216 NET PATIENT REVENUE 622110 101662665 101662665 HEALTH EDUCATION PROGRAM 622110 7915675 7915675 RETAIL PHARMACY 622110 1624783 1535677 89106 CAFETERIA REVENUE 622110 263557 263557 MEDICAL OFFICE BUILDING 622110 43403 28768 14635 58111 58111 111568194 208003 208003 806 102091 0 -102091 806 -101285 -101285 115059128 111464453 103741 106718 X 165081 165081 1979689 1979689 36636694 36636694 1217388 1195474 21914 7658705 7545631 113074 2765586 2715803 49783 16492 16492 46631 46631 17476 17476 30122610 28339718 1782892 28903 28903 1441382 1150049 291333 4581733 4312214 269519 2429597 2429597 45016 1901 43115 474 474 560167 560167 2123452 2123452 1772275 1772275 MEDICAL SUPPLIES 13340097 13340097 STATE INDIGENT TAX ASSE 5540786 5540786 REPAIRS AND MAINTENANCE 413173 413173 UBI INCOME TAX 1925 1925 3154043 83245 3070798 116059375 106553082 9506293 0 2456 2455 5774134 13437920 12035096 1897642 1964141 1073177 938597 32332179 631 31808447 32331548 978317 21957468 7047601 76929561 54319438 5539472 2166788 636917 40814270 18673296 46990659 20840084 X 29019734 33479354 919168 0 29938902 33479354 76929561 54319438 X -1000247 -942833 5483532 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 23211 23211 0 PART II-B, LINE 1: DUES WERE PAID TO THE AMERICAN HOSPITAL ASSOCIATION AND THE ILLINOIS HOSPITAL ASSOCIATION. 26119908 26119908 4100121 4100121 2112150 631 2111519 32331548 OTHER RECEIVABLES 3349640 RECEIVABLE FROM THIRD PARTIES 1263527 RIGHT OF USE ASSET-OPERATING LEASE 2434434 7047601 DUE TO RELATED 8482892 PAYABLE TO THIRD PARTIES 4653031 AR CREDIT BALANCES 727078 DEFERRED REVENUE 1647725 ACCRUED INTEREST PAYABLE 24961 OPERATING LEASE LIABIITY 2384578 OTHER LIABILITIES 753031 18673296 X PART X, LINE 2: THE FILING ORGANIZATION IS A SUBSIDIARY ORGANIZATION WITHIN ADVENTHEALTH. THE CONSOLIDATED FINANCIAL STATEMENTS OF ADVENTHEALTH 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, 2022 AND 2021. NAHS ALSO HAS TEMPORARY DEDUCTIBLE DIFFERENCES OF APPROXIMATELY $18,200 AND $33,000 AT DECEMBER 31, 2022 AND 2021, RESPECTIVELY, PRIMARILY AS A RESULT OF NET OPERATING LOSS CARRYFORWARDS. AT DECEMBER 31, 2022, NAHS HAD NET OPERATING LOSS CARRYFORWARDS OF APPROXIMATELY $10,000, EXPIRING IN 2023 THROUGH 2026. DEFERRED TAXES HAVE BEEN PROVIDED FOR THESE AMOUNTS, RESULTING IN A NET DEFERRED TAX ASSET OF APPROXIMATELY $4,500 AND $8,100 AT DECEMBER 31, 2022 AND 2021, RESPECTIVELY. 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%. A FULL VALUATION ALLOWANCE HAS BEEN PROVIDED AT DECEMBER 31, 2022 AND 2021 TO OFFSET THE DEFERRED TAX ASSET SINCE HEALTHCARE CORPORATION HAS DETERMINED THAT IT IS MORE LIKELY THAN NOT THAT THE BENEFIT OF THE NET OPERATING LOSS CARRYFORWARDS WILL NOT BE REALIZED IN FUTURE YEARS. THE INCOME TAXES TOPIC OF THE ACCOUNTING STANDARDS CODIFICATION (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, 2022 AND 2021. 1 1 X 1 X 250.000000000000 1 X 600.000000000000 1 1 1 0 1 1 3166489 3166489 0.02730 39882417 44691542 0 0.00000 43048906 44691542 3166489 0.02730 12384 12384 0.00010 12091 12091 0.00010 52543 52543 0.00050 144181 144181 0.00120 221199 221199 0.00190 43270105 44691542 3387688 0.02920 1 2144327 33430 18848260 23532843 -4684583 X 1 1 1 1 ADVENTIST GLENOAKS HOSPITAL 701 WINTHROP AVE GLENDALE HEIGHTS IL 60139 WWW.UCHICAGOMEDICINEADVENTHEALTH.ORG 0003814 X X X ADVENTIST GLENOAKS HOSPITAL 1 0 0 1 X X X X X X X X X 22 1 0 0 1 X SEE PART V, PAGE 8 X X 1 20 1 SEE PART V, PAGE 8 0 1 X 250.000000000000 600.000000000000 X X X X X 1 1 X X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X 1 X 0 X X X X 1 X 0 0 ADVENTIST GLENOAKS HOSPITAL PART V, SECTION B, LINE 5: ADVENTIST GLENOAKS HOSPITAL (AGOH OR THE HOSPITAL) IS A 143-BED ACUTE CARE HOSPITAL LOCATED IN DUPAGE COUNTY IN ILLINOIS. AGOH'S PRIMARY SERVICE AREA INCLUDES 42 ZIP CODES ACROSS MAINLY DUPAGE COUNTY. AGOH IS THE ONLY DISPROPORTIONATE SHARE HOSPITAL IN DUPAGE COUNTY. IN CONDUCTING ITS 2022 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), THE HOSPITAL SOLICITED INPUT DIRECTLY FROM THE COMMUNITY AND FROM INDIVIDUALS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY COMMUNITY MEMBERS. THE HOSPITAL PARTNERED WITH THE IMPACT DUPAGE COLLABORATIVE IN CONDUCTING ITS 2022 CHNA. THE IMPACT DUPAGE COLLABORATIVE HAS REPRESENTATION FROM SOCIAL SUPPORT AND COMMUNITY ORGANIZATIONS, HEALTH CARE SYSTEMS, AS WELL AS PUBLIC HEALTH AND EDUCATION INSTITUTIONS. A SMALLER COMMITTEE WAS FORMED BY THE COLLABORATIVE TO LOCALIZE THE DATA COLLECTION AND COMMUNITY INPUT PROCESS FOR THE HOSPITAL. COMMUNITY ORGANIZATIONS INCLUDED IN THE SMALLER COMMITTEE INCLUDED UNITED WAY OF METRO CHICAGO, DUPAGE FEDERATION ON HUMAN SERVICES REFORM, PEOPLE'S RESOURCE CENTER, DUPAGE FOUNDATION, DUPAGE COUNTY HEALTH DEPARTMENT, DUPAGE HEALTH COALITION, DUPAGE COUNTY PUBLIC DEFENDER'S OFFICE, DUPAGE COUNTY, AND PRAIRIE STATE LEGAL SERVICES, INC. AGOH ALSO FORMED A COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE (CHNAC) WHOSE PURPOSE WAS TO SELECT THE NEEDS THE HOSPITAL WOULD ADDRESS RESULTING FROM THE FINDINGS IN THE ASSESSMENT. THE COLLABORATIVE COLLECTED BOTH PRIMARY AND SECONDARY DATA. PRIMARY DATA INCLUDED A COMMUNITY SURVEY, A LOCAL SYSTEM ASSESSMENT, AND A FORCES OF CHANGE ASSESSMENT. AN INTENTIONAL EFFORT WAS MADE TO COLLECT INPUT FROM ALL MEMBERS OF THE HOSPITAL'S COMMUNITY AND TO OBTAIN PERSPECTIVES ACROSS AGE, RACE/ETHNICITY, GENDER, PROFESSION, HOUSEHOLD INCOME, EDUCATION LEVEL, AND GEOGRAPHIC LOCATION. THE COMMUNITY SURVEY WAS PROVIDED IN ENGLISH AND SPANISH TO ANYONE IN DUPAGE COUNTY AND WAS ACCESSIBLE ONLINE THROUGH WEBLINKS AND QR CODES. THE LOCAL SYSTEM ASSESSMENT WAS AN ONLINE SURVEY TARGETING PUBLIC HEALTH, LOCAL HOSPITALS AND HEALTH SYSTEMS, MENTAL AND BEHAVIORAL HEALTH, EDUCATION, HOUSING, PUBLIC SAFETY, LOCAL GOVERNMENT, LOCAL NON-PROFIT AND FAITH-BASED ORGANIZATIONS. THE FORCES OF CHANGE ASSESSMENT WAS A SERIES OF BRAINSTORMING SESSIONS CONDUCTED WITH A NUMBER OF SOCIAL SERVICE ORGANIZATIONS AND THE DUPAGE COUNTY HEALTH DEPARTMENT. ADVENTIST GLENOAKS HOSPITAL PART V, SECTION B, LINE 7D: THE HOSPITAL HAS ADOPTED A POLICY THAT ADDRESSES THE PUBLIC POSTING REQUIREMENTS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT. UNDER THIS POLICY, THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS MUST BE POSTED ON THE HOSPITAL'S WEBSITE AT LEAST UNTIL THE DATE THE HOSPITAL FACILITY HAS MADE WIDELY AVAILABLE ON ITS WEBSITE ITS TWO SUBSEQUENT COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS. THE HOSPITAL WILL ALSO MAKE A PAPER COPY OF ITS COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST AND WITHOUT CHARGE, AT LEAST UNTIL THE DATE THE HOSPITAL FACILITY HAS MADE AVAILABLE FOR PUBLIC INSPECTION ITS TWO SUBSEQUENT COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS. ADVENTIST GLENOAKS HOSPITAL PART V, SECTION B, LINE 11: THE INFORMATION PROVIDED BELOW EXPLAINS HOW ADVENTIST GLENOAKS HOSPITAL (AGOH OR THE HOSPITAL) ADDRESSED IN 2022 THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN ITS 2019 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 BY 12/31/19 AND ADOPTED AN IMPLEMENTATION STRATEGY TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT IN 2020 PRIOR TO MAY 15, 2020. THIS IS THE THIRD-YEAR UPDATE FOR AGOH'S 2020-2022 COMMUNITY HEALTH PLAN/IMPLEMENTATION STRATEGY. FOR THE DEVELOPMENT OF BOTH THE COMMUNITY HEALTH NEEDS ASSESSMENT AND THE COMMUNITY HEALTH PLAN/IMPLEMENTATION STRATEGY, AGOH WORKED TO DEFINE AND ADDRESS THE NEEDS OF LOW-INCOME, MINORITY AND UNDERSERVED POPULATIONS IN ITS SERVICE AREA. THE THIRD-YEAR PROGRESS ON THE COMMUNITY HEALTH PLAN IS NOTED BELOW. THE NARRATIVE DESCRIBES THE PRIORITIZED ISSUES IDENTIFIED IN 2019 AND GIVES AN UPDATE ON THE STRATEGIES ADDRESSING THOSE ISSUES. THERE IS ALSO A DESCRIPTION OF THE IDENTIFIED ISSUES THAT THE HOSPITAL DID NOT ADDRESS. AGOH CHOSE TWO PRIORITIES FOR ITS 2020-2022 COMMUNITY HEALTH PLAN: 1. BEHAVIORAL HEALTH 2. HEALTH STATUS IMPROVEMENTAFFORDABLE HOUSING WAS ALSO PRIORITIZED IN THE 2019 CHNA BUT WAS NOT ADDRESSED IN THE 2020-2022 IMPLEMENTATION STRATEGY AS THERE ARE OTHER SERVICE PROVIDERS IN THE COMMUNITY BETTER RESOURCED TO ADDRESS THIS PRIORITY. THE HOSPITAL WILL WORK COLLABORATIVELY WITH THESE ORGANIZATIONS TO ENSURE OPTIMAL SERVICE COORDINATION AND UTILIZATION. PRIORITY 1: BEHAVIORAL HEALTH 2019 DESCRIPTION OF THE ISSUE:THE BURDEN OF MENTAL ILLNESS IN THE UNITED STATES IS AMONG THE HIGHEST OF ALL DISEASES, AND MENTAL DISORDERS ARE AMONG THE MOST COMMON CAUSES OF DISABILITY FOR ADULTS, CHILDREN, AND ADOLESCENTS. WHEN MENTAL HEALTH DISORDERS ARE UNTREATED, THOSE AFFECTED ARE AT HIGH-RISK FOR MANY UNHEALTHY AND UNSAFE BEHAVIORS, INCLUDING ALCOHOL OR DRUG ABUSE, VIOLENT OR SELF-DESTRUCTIVE BEHAVIOR AND SUICIDE. MENTAL HEALTH DISORDERS ARE THE 11TH LEADING CAUSE OF DEATH IN THE UNITED STATES FOR ALL AGE GROUPS AND THE SECOND LEADING CAUSE OF DEATH AMONG PEOPLE AGED 25 TO 34. DATA FROM THE 2018 IMPACT DUPAGE ASSESSMENT INDICATED A NEED FOR IMMEDIATE IMPROVEMENT IN THE AVAILABILITY OF SERVICES FOR PEOPLE WITH MENTAL HEALTH ISSUES, SUBSTANCE USE DISORDERS, OR BOTH. THE ASSESSMENT ALSO EMPHASIZED THE NEED FOR PREVENTION OF SUBSTANCE USE AT AN EARLY AGE AND THE REDUCTION OF STIGMA SURROUNDING BEHAVIORAL HEALTH. 2022 UPDATE: THE AGOH COMMUNITY HEALTH PLAN HAS ONE DESIRED GOAL STATEMENT UNDER THE BEHAVIORAL HEALTH PRIORITY. 1. IMPROVING MENTAL HEALTH AND DECREASING SUBSTANCE ABUSE.GOAL 1: IMPROVING MENTAL HEALTH AND DECREASING SUBSTANCE ABUSE.OBJECTIVE 1: THE FIRST OBJECTIVE IS A SHARED INITIATIVE BETWEEN ADVENTHEALTH BOLINGBROOK, ADVENTHEALTH GLENOAKS, ADVENTHEALTH HINSDALE AND ADVENTHEALTH LA GRANGE, ALL RELATED HOSPITAL FACILITIES. THE HOSPITALS PARTNERED ON THIS INITIATIVE BECAUSE OF A SHARED CHNA PRIORITY. THE OBJECTIVE, TO INCREASE PERSONS TRAINED IN THE COMMUNITY ON MENTAL HEALTH FIRST AID (MHFA) TO INCREASE IDENTIFICATION OF THOSE IN A CRISIS AND REDUCE STIGMA ASSOCIATED WITH MENTAL HEALTH ISSUES, IS FUNDED AND CONDUCTED THROUGH ALL HOSPITALS. REPORTED OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THIS INITIATIVE PROVIDES A TRAINING FOR COMMUNITY RESIDENTS AND FIRST RESPONDERS TO RECOGNIZE, RESPOND AND SEEK ASSISTANCE FOR SIGNS OF MENTAL ILLNESS AND SUBSTANCE USE DISORDERS.THE HOSPITALS DID NOT MEET THE OBJECTIVE OF INCREASING PERSONS TRAINED IN THE COMMUNITY ON MHFA BECAUSE THERE WAS NOT A FACILITATOR AVAILABLE TO OFFER THE TRAININGS IN 2022. BY THE END OF YEAR THREE, A TOTAL OF SIX INDIVIDUALS WERE TRAINED. PRIORITY 2: HEALTH STATUS IMPROVEMENT2019 DESCRIPTION OF THE ISSUE: DATA FROM THE MOST RECENT CHNA INDICATED A NEED FOR CONTINUED FOCUS ON ISSUES INVOLVING RESIDENTS' ACCESS TO HEALTH AND MOVEMENT TOWARD MORE POSITIVE HEALTH OUTCOMES FOR DUPAGE RESIDENTS. ONE OF THE SOCIAL DETERMINANTS OF HEALTH CLOSELY ASSOCIATED WITH POSITIVE HEALTH OUTCOMES IS THE AVAILABILITY OF AFFORDABLE, HEALTHY FOODS. ACCESS TO HEALTH CARE AND HEALTH INSURANCE ESPECIALLY FOR THE LOW-INCOME PERSONS IN THE DUPAGE COMMUNITY CONTINUES TO BE AN ISSUE. EIGHTY-FIVE PERCENT OF DUPAGE COUNTY REPORTED HAVING A USUAL HEALTH CARE PROVIDER WHILE A TOP "RISKY BEHAVIOR NOTED ON THE LAST ASSESSMENT RESIDENT SURVEY WAS NOT HAVING HEALTH INSURANCE. ASSISTING PATIENTS AND COMMUNITY MEMBERS TO PROGRAMS AND SERVICES THAT CAN IMPROVE THEIR SOCIAL DETERMINANTS OF HEALTH ARE NEEDED.2022 UPDATE: THE AGOH COMMUNITY HEALTH PLAN HAS ONE DESIRED GOAL STATEMENT UNDER THE HEALTH STATUS IMPROVEMENT PRIORITY. 1. INCREASING ACCESS TO CARE AND COMMUNITY RESOURCES. GOAL 1: INCREASING ACCESS TO CARE AND COMMUNITY RESOURCES. OBJECTIVE 1: THE FIRST OBJECTIVE IS A FUNDING INITIATIVE. THIS OBJECTIVE PROVIDES FINANCIAL SUPPORT FOR ISLAMIC CIRCLE OF NORTH AMERICA (ICNA) RELIEF AND NEIGHBORHOOD FAMILY FOOD PANTRIES AND IS FUNDED SOLELY THROUGH THE REPORTING HOSPITAL. THIS SUPPORT INCREASES THE AVAILABILITY OF HEALTHY FOODS WITHIN LOW-INCOME COMMUNITIES. THE HOSPITAL EXCEEDED ITS OBJECTIVE TO PROVIDE FINANCIAL SUPPORT FOR THE ISLAMIC CIRCLE OF NORTH AMERICA (ICNA) RELIEF AND NEIGHBORHOOD FAMILY FOOD PANTRIES TO INCREASE THE AVAILABILITY OF HEALTHY FOODS TO 200 HOUSEHOLDS A MONTH WITH 4,000 INDIVIDUALS SERVED. A TOTAL OF $14,400 WAS PROVIDED TO SUPPORT ICNA RELIEF'S HUNGER PREVENTION PROGRAM. NEARLY ALL THE INDIVIDUALS AND FAMILIES SERVED HAVE BEEN DISPROPORTIONATELY IMPACTED BY THE PANDEMIC AND ITS ECONOMIC EFFECTS DUE TO THEIR LIMITED ENGLISH LANGUAGE SKILLS, HIGHER EDUCATION, IMMIGRATION STATUS, AND SKILL CAPACITY.PATIENTS AND COMMUNITY MEMBERS WHO ARE IDENTIFIED AS HAVING A NEED FOR FOOD ARE OFTEN PROVIDED WITH INFORMATION ABOUT THE AVAILABILITY OF THESE PANTRY LOCATIONS.SEE CONTINUATION ADVENTIST GLENOAKS HOSPITAL PART V, SECTION B, LINE 13H: THE FILING ORGANIZATION'S HOSPITAL FACILITY (OR FACILITIES) IMPLEMENTED A COVID-19 EMERGENCY FINANCIAL HARDSHIP POLICY IN WHICH UNINSURED PATIENTS WHO ARE TREATED FOR COVID-19 RELATED EVALUATION AND/OR TREATMENT WILL NOT BE BILLED. INSURED PATIENTS TESTED FOR COVID-19 ARE NOT EXPECTED TO HAVE OUT-OF-POCKET EXPENSES BASED ON INSURANCE COMMUNITY RESPONSE TO WAIVE PATIENT FINANCIAL RESPONSIBILITY. IF A PAYER UNEXPECTEDLY FAILS TO WAIVE PATIENT RESPONSIBILITY FOR COVID-19 RELATED TESTING, THE FILING ORGANIZATION WILL NOT BALANCE BILL PATIENTS FOR ANY OUT-OF-POCKET EXPENSES RELATED TO COVID-19. IN ADDITION, PATIENTS WITH EXISTING PAYMENT PLANS ARE PROVIDED OPPORTUNITIES FOR REDUCING THEIR MONTHLY PAYMENTS INCLUDING A REQUEST TO DEFER ANY PAYMENT PLAN PAYMENT FOR AN INITIAL PERIOD OF UP TO 120 DAYS. SCHEDULE H, PART V, SECTION B, LINE 11 - CONTINUATION: OBJECTIVE 2: THE SECOND INITIATIVE IS BETWEEN AGOH AND ADVENTIST MIDWEST HEALTH, DBA ADVENTHEALTH HINSDALE. THE HOSPITALS PARTNERED ON THIS INITIATIVE BECAUSE OF A SHARED CHNA PRIORITY. THIS OBJECTIVE PROVIDES FINANCIAL SUPPORT FOR THE SILVER ACCESS PROGRAM OF ACCESS DUPAGE AND IS FUNDED BY BOTH HOSPITALS. THIS OBJECTIVE PROVIDES SUPPORT FOR QUALIFYING RESIDENTS WITH A SUBSIDY FOR THEIR HEALTH INSURANCE PREMIUM TO INCREASE ACCESS TO HEALTH CARE.THE HOSPITALS DID NOT MEET THEIR OBJECTIVE TO PROVIDE FINANCIAL SUPPORT FOR THE SILVER ACCESS PROGRAM OF ACCESS DUPAGE TO SUPPORT QUALIFYING RESIDENTS WITH A SUBSIDY FOR THEIR HEALTH INSURANCE PREMIUM TO INCREASE ACCESS TO HEALTH CARE. APPROXIMATELY 406 INDIVIDUALS WERE HELPED WITH FINANCIAL SUPPORT WITH AGOH CONTRIBUTING $117,681 AND ADVENTHEALTH HINSDALE CONTRIBUTING $90,455. ALTHOUGH THE NUMBER OF INDIVIDUALS SERVED DECREASED FROM 2021 THAT WAS DUE IN PART TO MORE INDIVIDUALS QUALIFYING FOR MEDICAID UNDER THE CORONAVIRUS AID RELIEF ECONOMIC SECURITY ACT. OBJECTIVE 3: THE THIRD OBJECTIVE IS A SHARED INITIATIVE BETWEEN AGOH, ADVENTHEALTH BOLINGBROOK, ADVENTHEALTH LA GRANGE AND ADVENTHEALTH HINSDALE, ALL RELATED HOSPITAL FACILITIES. THE HOSPITALS PARTNERED ON THIS INITIATIVE BECAUSE OF A SHARED CHNA PRIORITY. THIS OBJECTIVE, TO INCREASE PATIENT AND COMMUNITY MEMBERS' CONNECTION TO SERVICES TO REDUCE SOCIAL DETERMINANTS OF HEALTH THROUGH THE PROVISION OF THE COMMUNITY RESOURCE DIRECTORY, IS FUNDED AND DEPLOYED THROUGH ALL HOSPITALS. REPORTED OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THIS INITIATIVE PROVIDES AN ONLINE DIRECTORY OF FREE OR REDUCED COST SERVICES THAT ADDRESS SOCIAL NEEDS OF PATIENTS AND COMMUNITY MEMBERS, INCREASING ACCESS TO COMMUNITY RESOURCES. THE HOSPITAL DID NOT MEET ITS OBJECTIVE OF 200 PATIENT AND COMMUNITY MEMBER CONNECTIONS TO SERVICES THROUGH THE COMMUNITY RESOURCE DIRECTORY. THE COMMUNITY RESOURCE DIRECTORY AS IT WAS BRANDED WAS NOT RETAINED AFTER THE UNWINDING OF THE JOINT VENTURE PARTNERSHIP. HOWEVER, A SOFT INTRODUCTION OF THE ADVENTHEALTH WHOLE HEALTH HUB, A SOCIAL-NEED REFERRAL PLATFORM, WAS MADE. APPROXIMATELY 150 FAMILIES RECEIVED INFORMATION ABOUT THE WHOLE HEALTH HUB TO HELP LOOK FOR COMMUNITY RESOURCES AT A MOBILE FOOD PANTRY.OBJECTIVE 4:THE FOURTH OBJECTIVE IS TO INCREASE COMMUNITY MEMBERS' CONNECTION TO SERVICES TO REDUCE SOCIAL DETERMINANTS OF HEALTH THROUGH THE PROVISION OF THE SOCIAL WORKER IN A LIBRARY PROGRAM. THE SOCIAL WORKER IN A LIBRARY PROGRAM IS CONDUCTED THROUGH AGOH, AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE SOCIAL WORKER IN A LIBRARY PROGRAM PROVIDES A FULL-TIME, LICENSED CLINICAL SOCIAL WORKER AT THE LIBRARY TO CONNECT INDIVIDUALS WHO ARE EXPERIENCING HOMELESSNESS, CHRONIC UNEMPLOYMENT, MENTAL ILLNESS AND OTHER COMPLEX NEEDS WITH APPROPRIATE REFERRALS AND SUPPORT UTILIZING THE COMMUNITY RESOURCE DIRECTORY. THE HOSPITAL DID NOT MEET ITS OBJECTIVE OF REFERRING 90% OF INDIVIDUALS TO APPROPRIATE SOURCES TO INCREASE COMMUNITY MEMBERS' CONNECTION TO SERVICES TO REDUCE SOCIAL DETERMINANTS OF HEALTH THROUGH THE PROVISION OF THE SOCIAL WORKER IN A LIBRARY PROGRAM. THE POSITION OF A SOCIAL WORKER COULD NOT BE FILLED DUE TO A LACK OF APPLICANTS AND FUNDING. COMMUNITY NEEDS NOT ADDRESSED BY AGOHAS NOTED ABOVE, AFFORDABLE HOUSING WAS INITIALLY IDENTIFIED AS A PRIORITIZED NEED, BUT NOT ADDRESSED IN THE IMPLEMENTATION STRATEGY AS IT WAS BELIEVED THAT OTHER COMMUNITY RESOURCES WERE BETTER RESOURCED TO ADDRESS THIS PRIORITY. THE HOSPITAL WILL WORK COLLABORATIVELY WITH THESE ORGANIZATIONS AS APPROPRIATE TO ENSURE OPTIMAL SERVICE COORDINATION AND UTILIZATION. ADDITIONALLY, THE PROVISION OF THE COMMUNITY RESOURCE DIRECTORY TO ASSOCIATES AND PHYSICIANS WILL CONNECT THOSE IN NEED TO FREE OR REDUCED COST SERVICES SUCH AS MEDICAL CARE, FOOD, JOB TRAINING, TRANSPORTATION, HOUSING, LEGAL, AND MORE. SCHEDULE H, PART V, SECTION B, LINE 7A THE CHNA REPORT CAN BE FOUND AT URL:HTTPS://WWW.ADVENTHEALTH.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS SCHEDULE H, PART V, SECTION B, LINE 10A: THE HOSPITAL'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY CAN BE FOUND AT:HTTPS://WWW.ADVENTHEALTH.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS SCHEDULE H, PART V, SECTION B, LINE 16A,B,C: THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE AT:HTTPS://WWW.UCHICAGOMEDICINEADVENTHEALTH.ORG/FINANCIAL-ASSISTANCETHE FINANCIAL ASSISTANCE POLICY APPLICATION CAN BE FOUND AT:HTTPS://WWW.UCHICAGOMEDICINEADVENTHEALTH.ORG/FINANCIAL-ASSISTANCETHE PLAIN LANGUAGE SUMMARY IS AVAILABLE AT:HTTPS://WWW.UCHICAGOMEDICINEADVENTHEALTH.ORG/FINANCIAL-ASSISTANCE PART V, SECTION B, LINE 8 - 10A CHNA IMPLEMENTATION STRATEGY NARRATIVE: THE FILING ORGANIZATION ADOPTED A COMMUNITY HEALTH NEEDS ASSESSMENT REPORT BY 12/31/2022 AND WAS IN THE PROCESS OF DEVELOPING ITS COMMUNITY HEALTH NEEDS IMPLEMENTATION STRATEGY AT THAT TIME. THE FILING ORGANIZATION'S 2023-2025 COMMUNITY HEALTH NEEDS IMPLEMENTATION STRATEGY IS DOCUMENTED IN A WRITTEN REPORT CALLED THE "COMMUNITY HEALTH PLAN". THE COMMUNITY HEALTH PLAN (CHP) DESCRIBES HOW THE FILING ORGANIZATION PLANS TO MEET ITS IDENTIFIED PRIORITIZED HEALTH NEEDS OR IDENTIFIES THE HEALTH NEED AS ONE THE FILING ORGANIZATION DOES NOT INTEND TO SPECIFICALLY ADDRESS AND PROVIDES AN EXPLANATION AS TO WHY THE FILING ORGANIZATION DOES NOT INTEND TO ADDRESS THAT HEALTH NEED. THE FILING ORGANIZATION'S 2023-2025 CHP WAS ADOPTED BY MAY 15, 2023 AND IS POSTED ON THE HOSPITAL FACILITY'S WEBSITE. 2 1 - THERAPEUTIC DAY SCHOOL PHEASANT RIDGE 43 E STEVENSON DRIVE GLENDALE HEIGHTS IL 60139 BEHAVORIAL HEALTH 2 - THERAPEUTIC DAY SCHOOL WEST CAMPUS 940 MOOSEHEART ROAD NORTH AURORA IL 60542 BEHAVORIAL HEALTH PART I, LINE 3C: PERSONS WHO EARN LESS THAN 600% OF THE FEDERAL POVERTY GUIDELINES ARE GIVEN MORE SIGNIFICANT DISCOUNTS, DEPENDING ON THEIR INDIVIDUAL SITUATIONS.FEDERAL POVERTY LEVEL - 0-250% UNINSURED PATIENT DISCOUNT - 100%FEDERAL POVERTY LEVEL - 251-300% UNINSURED PATIENT DISCOUNT - 95%FEDERAL POVERTY LEVEL - 301-400% UNINSURED PATIENT DISCOUNT - 90%FEDERAL POVERTY LEVEL - 401-600% UNINSURED PATIENT DISCOUNT - 85% PART I, LINE 6A: THE FILING ORGANIZATION WAS A WHOLLY OWNED SUBSIDIARY OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC) DURING ITS CURRENT TAX YEAR. DURING THE CURRENT YEAR, AHSSHC SERVED AS A PARENT ORGANIZATION TO 30 TAX-EXEMPT 501(C)(3) HOSPITAL ORGANIZATIONS AND A NUMBER OF OTHER HEALTH CARE FACILITIES THAT OPERATED IN 10 STATES WITHIN THE U.S. THE SYSTEM OF ORGANIZATIONS UNDER THE CONTROL AND OWNERSHIP OF AHSSHC IS KNOWN AS "ADVENTHEALTH".ALL HOSPITAL ORGANIZATIONS WITHIN ADVENTHEALTH COLLECT, CALCULATE, AND REPORT THE COMMUNITY BENEFITS THEY PROVIDE TO THE COMMUNITIES THEY SERVE. ADVENTHEALTH ORGANIZATIONS EXIST SOLELY TO IMPROVE AND ENHANCE THE LOCAL COMMUNITIES THEY SERVE. ADVENTHEALTH 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 ADVENTHEALTH 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 CAN BE ACCESSED ON THE FILING ORGANIZATION'S WEBSITE. PART I, LINE 7: THE AMOUNTS OF COSTS REPORTED IN THE TABLE IN LINE 7 OF PART I OF SCHEDULE H WERE DETERMINED BY UTILIZING A COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES, CONTAINED IN THE SCHEDULE H INSTRUCTIONS. PART III, LINE 2: THE AMOUNT OF BAD DEBT EXPENSE REPORTED ON LINE 2 OF SECTION A OF PART III IS RECORDED IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS ADJUSTMENTS TO REVENUE, NOT BAD DEBT EXPENSE. PART III, LINE 3: METHODOLOGY FOR DETERMINING THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE THAT MAY REPRESENT PATIENTS WHO COULD HAVE QUALIFIED UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY:SELF-PAY PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE BY COMPLETING A FINANCIAL ASSISTANCE APPLICATION FORM (FAA FORM). IF AN INDIVIDUAL DOES NOT SUBMIT A COMPLETE FAA FORM WITHIN 240 DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS SENT TO THE INDIVIDUAL, AN INDIVIDUAL MAY BE CONSIDERED FOR PRESUMPTIVE ELIGIBILITY BASED UPON A SCORING TOOL THAT IS DESIGNED TO CLASSIFY PATIENTS INTO GROUPS OF VARYING ECONOMIC MEANS. THE SCORING TOOL USES ALGORITHMS THAT INCORPORATE DATA FROM CREDIT BUREAUS, DEMOGRAPHIC DATABASES, AND HOSPITAL SPECIFIC DATA TO INFER AND CLASSIFY PATIENTS INTO RESPECTIVE ECONOMIC MEANS CATEGORIES. INDIVIDUALS WHO EARN A CERTAIN SCORE ON THE SCORING TOOL ARE CONSIDERED TO QUALIFY AS ELIGIBLE FOR THE MOST GENEROUS FINANCIAL ASSISTANCE UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. AS DETERMINED BY THE FILING ORGANIZATION, A NOMINAL AMOUNT OF SUCH A PATIENT'S BILL IS WRITTEN OFF AS BAD DEBT EXPENSE, WHILE THE REMAINING PORTION OF THE PATIENT'S BILL IS CONSIDERED NON-STATE CHARITY. THE AMOUNT WRITTEN OFF AS BAD DEBT EXPENSE FOR THOSE PATIENTS WHO POTENTIALLY QUALIFY AS NON-STATE CHARITY USING THE SCORING TOOL IS THE AMOUNT SHOWN ON LINE 3 OF SECTION A OF PART III. RATIONALE FOR INCLUDING CERTAIN BAD DEBTS IN COMMUNITY BENEFIT:THE FILING ORGANIZATION IS DEDICATED TO THE VIEW THAT MEDICALLY NECESSARY HEALTH CARE FOR EMERGENCY AND NON-ELECTIVE PATIENTS SHOULD BE ACCESSIBLE TO ALL, REGARDLESS OF AGE, GENDER, GEOGRAPHIC LOCATION, CULTURAL BACKGROUND, PHYSICIAN MOBILITY, OR ABILITY TO PAY. THE FILING ORGANIZATION TREATS EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF THEIR ABILITY TO PAY OR THE AVAILABILITY OF THIRD-PARTY COVERAGE. BY PROVIDING HEALTH CARE TO ALL WHO REQUIRE EMERGENCY OR NON-ELECTIVE CARE IN A NON-DISCRIMINATORY MANNER, THE FILING ORGANIZATION IS PROVIDING HEALTH CARE TO THE BROAD COMMUNITY IT SERVES. AS A 501(C)(3) HOSPITAL ORGANIZATION, THE FILING ORGANIZATION MAINTAINS A 24/7 EMERGENCY ROOM PROVIDING CARE TO ALL WHOM PRESENT. WHEN A PATIENT'S ARRIVAL AND/OR ADMISSION TO THE FACILITY BEGINS WITHIN THE EMERGENCY DEPARTMENT, TRIAGE AND MEDICAL SCREENING ARE ALWAYS COMPLETED PRIOR TO REGISTRATION STAFF PROCEEDING WITH THE DETERMINATION OF A PATIENT'S SOURCE OF PAYMENT. IF THE PATIENT REQUIRES ADMISSION AND CONTINUED NON-ELECTIVE CARE, THE FILING ORGANIZATION PROVIDES THE NECESSARY CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY. THE FILING ORGANIZATION'S OPERATION OF A 24/7 EMERGENCY DEPARTMENT THAT ACCEPTS ALL INDIVIDUALS IN NEED OF CARE PROMOTES THE HEALTH OF THE COMMUNITY THROUGH THE PROVISION OF CARE TO ALL WHOM PRESENT. CURRENT INTERNAL REVENUE SERVICE GUIDANCE THAT TAX-EXEMPT HOSPITALS MAINTAIN SUCH EMERGENCY ROOMS WAS ESTABLISHED TO ENSURE THAT EMERGENCY CARE WOULD BE PROVIDED TO ALL WITHOUT DISCRIMINATION. THE TREATMENT OF ALL AT THE FILING ORGANIZATION'S EMERGENCY DEPARTMENT IS A COMMUNITY BENEFIT. UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, EVERY EFFORT IS MADE TO OBTAIN A PATIENT'S NECESSARY FINANCIAL INFORMATION TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. HOWEVER, NOT ALL PATIENTS WILL COOPERATE WITH SUCH EFFORTS AND A FINANCIAL ASSISTANCE ELIGIBILITY DETERMINATION CANNOT BE MADE BASED UPON INFORMATION SUPPLIED BY THE INDIVIDUAL. IN THIS CASE, A PATIENT'S PORTION OF A BILL THAT REMAINS UNPAID FOR A CERTAIN STIPULATED TIME PERIOD IS WHOLLY OR PARTIALLY CLASSIFIED AS BAD DEBT. BAD DEBTS ASSOCIATED WITH PATIENTS WHO HAVE RECEIVED CARE THROUGH THE FILING ORGANIZATION'S EMERGENCY DEPARTMENT SHOULD BE CONSIDERED COMMUNITY BENEFIT AS CHARITABLE HOSPITALS EXIST TO PROVIDE SUCH CARE IN PURSUIT OF THEIR PURPOSE OF MEETING THE NEED FOR EMERGENCY MEDICAL CARE SERVICES AVAILABLE TO ALL IN THE COMMUNITY. PART III, LINE 4: FINANCIAL STATEMENT FOOTNOTE RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS:THE FINANCIAL INFORMATION OF THE FILING ORGANIZATION IS INCLUDED IN A CONSOLIDATED AUDITED FINANCIAL STATEMENT FOR THE CURRENT YEAR.THE APPLICABLE FOOTNOTE FROM THE ATTACHED CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ADDRESSES ACCOUNTS RECEIVABLE, THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS, AND THE PROVISION FOR BAD DEBTS CAN BE FOUND ON PAGES 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 THE HOSPITAL FACILITY'S OFFICE OR DEPARTMENT THAT CAN PROVIDE INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY, AS WELL AS CONTACT INFORMATION OF THE 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. SUPPLEMENTAL SCHEDULE TO SCHEDULE H, PART III, SECTION B, LINE 8 RECONCILIATION OF SCHEDULE H REPORTED MEDICARE SURPLUS/(SHORTFALL) TO UNREIMBURSED MEDICARE COSTS ASSOCIATED WITH THE PROVISION OF SERVICESTO ALL MEDICARE BENEFICIARIES:THE MEDICARE REVENUE AND ALLOWABLE COSTS OF CARE REPORTED IN SECTION B OF PART III OF SCHEDULE H ARE BASED UPON THE AMOUNTS REPORTED IN THE FILING ORGANIZATION'S MEDICARE COST REPORT IN ACCORDANCE WITH THE IRS INSTRUCTIONS FOR SCHEDULE H. ON AN ANNUAL BASIS, THE FILING ORGANIZATION ALSO DETERMINES ITS TOTAL UNREIMBURSED COSTS ASSOCIATED WITH PROVIDING SERVICES TO ALL MEDICARE PATIENTS. UNREIMBURSED COSTS ARE CONSIDERED A COMMUNITY BENEFIT TO THE ELDERLY AND ARE COMBINED INTO AN ANNUAL COMMUNITY BENEFIT STATEMENT PREPARED BY ADVENTHEALTH. THE PRIMARY RECONCILING ITEMS BETWEEN THE MEDICARE SURPLUS/(SHORTFALL) SHOWN ON LINE 7 OF SECTION B OF PART III OF SCHEDULE H AND THE FILING ORGANIZATION'S UNREIMBURSED COSTS OF SERVICES PROVIDED TO ALL MEDICARE PATIENTS ARE AS FOLLOWS:- MEDICARE SURPLUS/(SHORTFALL) SHOWN ON LINE 7 OF SECTION B OF SCHEDULE H: $ (4,684,583)- DIFFERENCE IN COSTING METHODOLOGY: 2,572,597- UNREIMBURSED COSTS INCURRED FOR SERVICES PROVIDED TO MEDICARE PATIENTS THAT ARE NOT INCLUDED IN THE ORGANIZATION'S MEDICARE COST REPORT: (9,493,907) -------------TOTAL UNREIMBURSED COSTS OF SERVING ALL MEDICARE PATIENTS PER THE FILING ORGANIZATION'S COMMUNITYBENEFIT REPORTING $ (11,605,893)AS INDICATED ABOVE, THE PRIMARY DIFFERENCES BETWEEN THE MEDICARE SURPLUS/(SHORTFALL) REPORTED ON SCHEDULE H, PART III, SECTION B, LINE 7 AND THE FILING ORGANIZATION'S PORTION OF THE COMPANY'S ANNUAL COMMUNITY BENEFIT STATEMENT IS DUE TO A DIFFERENCE IN THE COSTING METHODOLOGY AND DIFFERENCES IN THE POPULATION OF MEDICARE PATIENTS WITHIN THE CALCULATION. THE COST METHODOLOGY UTILIZED IN CALCULATING ANY MEDICARE SURPLUS/(SHORTFALL) FOR PURPOSES OF THE ANNUAL COMMUNITY BENEFIT REPORTING IS BASED UPON THE COST-TO-CHARGE RATIO OUTLINED IN WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. THE SAME COST-TO-CHARGE RATIO IS USED TO DETERMINE THE COSTS ASSOCIATED WITH SERVICES PROVIDED TO CHARITY CARE PATIENTS AND MEDICAID PATIENTS AS REPORTED IN SCHEDULE H, PART I, LINE 7. IN ADDITION, THE MEDICARE COST REPORT EXCLUDES SERVICES PROVIDED TO MEDICARE PATIENTS FOR PHYSICIAN SERVICES, SERVICES PROVIDED TO PATIENTS ENROLLED IN MEDICARE HMOS, AND CERTAIN SERVICES PROVIDED BY OUTPATIENT DEPARTMENTS OF THE FILING ORGANIZATION THAT ARE REIMBURSED ON A FEE SCHEDULE. THE COMPANY'S OWN COMMUNITY BENEFIT STATEMENT CAPTURES THE UNREIMBURSED COST OF PROVIDING SERVICES TO ALL MEDICARE BENEFICIARIES THROUGHOUT THE ORGANIZATION. PART VI, LINE 2: THE HOSPITAL CONDUCTS COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) EVERY THREE YEARS. ITS 2022 CHNA WAS ADOPTED BY ITS GOVERNING BOARD BY DECEMBER 31, 2022, THE END OF THE HOSPITAL'S TAXABLE YEAR IN WHICH IT CONDUCTED THE CHNA. THE HOSPITAL'S 2022 CHNA COMPLIED WITH THE GUIDANCE SET FORTH BY THE IRS IN FINAL REGULATION SECTION 1.501(R)-3. IN ADDITION TO THE CHNA DISCUSSED ABOVE, A VARIETY OF PRACTICES AND PROCESSES ARE IN PLACE TO ENSURE THAT THE FILING ORGANIZATION IS RESPONSIVE TO THE HEALTH NEEDS OF ITS COMMUNITY.SUCH PRACTICES AND PROCESSES INVOLVE THE FOLLOWING:1. A HOSPITAL OPERATING/COMMUNITY BOARD COMPOSED OF INDIVIDUALS BROADLY REPRESENTATIVE OF THE COMMUNITY, COMMUNITY LEADERS, AND THOSE WITH SPECIALIZED MEDICAL TRAINING AND EXPERTISE;2. POST-DISCHARGE PATIENT FOLLOW-UP RELATED TO THE ON-GOING CARE AND TREATMENT OF PATIENTS WHO SUFFER FROM CHRONIC DISEASES; 3. SPONSORSHIP AND PARTICIPATION IN COMMUNITY HEALTH AND WELLNESS ACTIVITIES THAT REACH A BROAD SPECTRUM OF THE FILING ORGANIZATION'S COMMUNITY; AND 4. COLLABORATION WITH OTHER LOCAL COMMUNITY GROUPS TO ADDRESS THE HEALTH CARE NEEDS OF THE FILING ORGANIZATION'S COMMUNITY. 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 FACILITY ARE TRANSPARENT AND AVAILABLE TO ALL INDIVIDUALS SERVED AT ANY POINT IN THE CARE CONTINUUM. THE FAP, FAA FORM, PLS, AND CONTACT INFORMATION FOR THE HOSPITAL FACILITY'S FINANCIAL COUNSELORS ARE PROMINENTLY AND CONSPICUOUSLY POSTED ON THE FILING ORGANIZATION'S HOSPITAL FACILITY'S WEBSITE. THE WEBSITE INDICATES 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 THE HOSPITAL FACILITY (REFERRED TO BELOW AS LEP DEFINED POPULATIONS). SIGNAGE IS DISPLAYED IN PUBLIC LOCATIONS OF THE FILING ORGANIZATION'S HOSPITAL FACILITY, INCLUDING AT ALL POINTS OF ADMISSION AND REGISTRATION AND THE EMERGENCY DEPARTMENT. THE SIGNAGE CONTAINS THE 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. 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 THE 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: THE FILING ORGANIZATION IS LOCATED IN GLENDALE HEIGHTS, ILLINOIS. IT CURRENTLY OPERATES A HOSPITAL FACILITY AND IS LICENSED FOR 143 BEDS. THE HOSPITAL PROVIDES A FULL RANGE OF SERVICES, INCLUDING EMERGENCY CARE, SURGICAL, ONCOLOGY, OBSTETRICAL, CARDIOLOGY, INTERVENTIONAL RADIOLOGY, BEHAVIORAL HEALTH AND MORE. THE HOSPITAL OPERATES A TWO-CAMPUS THERAPEUTIC DAY SCHOOL WHERE STUDENTS IN 3RD GRADE THROUGH HIGH SCHOOL ARE PROVIDED AN ENVIRONMENT THAT BLENDS ACADEMIC EDUCATION WITH THERAPIES THAT NURTURE EACH STUDENT'S EMOTIONAL GROWTH AND INDEPENDENCE. THE HOSPITAL IS AN ACCREDITED CHEST PAIN CENTER AND CERTIFIED PRIMARY STROKE CENTER. AS THE ONLY DISPROPORTIONATE SHARE HOSPITAL IN DUPAGE COUNTY, THE HOSPITAL IS A SAFETY NET FOR THE MOST VULNERABLE AND UNDERSERVED POPULATIONS - PROVIDING CARE MANY PATIENTS CANNOT ACCESS ELSEWHERE.THE ADVENTIST GLENOAKS HOSPITAL COMMUNITY CONSISTS PRIMARILY OF GLENDALE HEIGHTS AND THE SURROUNDING AREA. WE DEFINE THE PRIMARY SERVICE AREA (PSA) AS THE COLLECTION OF ZIP CODES WHERE APPROXIMATELY 75-80% OF HOSPITAL PATIENTS RESIDE, AND WE FOCUS OUR COMMUNITY HEALTH IMPROVEMENT ON THIS SERVICE AREA. THE SERVICE AREA INCLUDES 42 ZIP CODES ACROSS MAINLY DUPAGE COUNTY AND SMALLER AREAS IN WILL, KANE AND COOK COUNTIES.DURING 2022, THE HOSPITAL'S PATIENT PERCENTAGE POPULATION WAS MADE UP OF THE BELOW PAYORS WITH THE REMAINING PERCENTAGE OF THE PATIENTS BEING COVERED UNDER COMMERCIAL INSURANCE. IN 2022, ABOUT 69.2% OF THE HOSPITAL'S IN-PATIENTS WERE ADMITTED THROUGH THE HOSPITAL'S EMERGENCY DEPARTMENT. - MEDICARE PATIENTS 38.3% - MEDICAID PATIENTS 34.3% - SELF-PAY PATIENTS 3.6% THE DEMOGRAPHIC MAKEUP OF THE HOSPITAL'S DUPAGE COUNTY COMMUNITY IS AS FOLLOWS: - POPULATION 1,226,882 - POPULATION OVER 65 15.5% - POVERTY (BELOW 100% FPL) 6.8% - HIGH SCHOOL GRADUATION RATE 91% - UNINSURED ADULTS 6.6% - FOOD INSECURITY RATE 9.8% - POPULATION WITH LOW FOOD ACCESS 67.8% PART VI, LINE 5: THE PROVISION OF COMMUNITY BENEFIT IS CENTRAL TO ADVENTIST GLENOAKS HOSPITAL'S MISSION OF SERVICE AND COMPASSION. RESTORING AND PROMOTING THE HEALTH AND QUALITY OF LIFE OF THOSE IN THE COMMUNITIES SERVED BY THE HOSPITAL IS A FUNCTION OF "EXTENDING THE HEALING MINISTRY OF CHRIST AND EMBODIES THE HOSPITAL'S COMMITMENT TO ITS VALUES AND PRINCIPLES. THE HOSPITAL 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 HOSPITAL 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. THE HOSPITAL ALSO PROVIDES BENEFITS TO 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 HOSPITAL EXPENDED $2,140,186 IN NEW CAPITAL IMPROVEMENTS. AS A FAITH-BASED MISSION-DRIVEN COMMUNITY HOSPITAL, THE HOSPITAL IS CONTINUALLY INVOLVED IN MONITORING ITS COMMUNITY, 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 HOSPITAL ARE CONTINUALLY BEING INVESTED IN RESOURCES THAT IMPROVE THE AVAILABILITY AND QUALITY OF DELIVERY OF HEALTH CARE SERVICES AND PROGRAMS TO ITS COMMUNITY. PART VI, LINE 6: ADVENTIST GLENOAKS HOSPITAL IS PART OF A FAITH-BASED HEALTHCARE SYSTEM OF ORGANIZATIONS WHOSE PARENT IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). THE SYSTEM IS KNOWN AS ADVENTHEALTH. AHSSHC IS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). AHSSHC AND ITS SUBSIDIARY ORGANIZATIONS OPERATE 49 HOSPITALS THROUGHOUT THE U.S., PRIMARILY IN THE SOUTHEASTERN PORTION OF THE U.S. AHSSHC AND ITS SUBSIDIARIES ALSO OPERATE 10 NURSING HOME FACILITIES AND OTHER ANCILLARY HEALTH CARE PROVIDER FACILITIES, SUCH AS AMBULATORY SURGERY CENTERS AND DIAGNOSTIC IMAGING CENTERS. AS THE PARENT ORGANIZATION OF ADVENTHEALTH, AHSSHC PROVIDES EXECUTIVE LEADERSHIP AND OTHER PROFESSIONAL SUPPORT SERVICES TO ITS SUBSIDIARY ORGANIZATIONS. PROFESSIONAL SUPPORT SERVICES INCLUDE AMONG OTHERS IT, CORPORATE COMPLIANCE, LEGAL, REIMBURSEMENT, RISK MANAGEMENT, AND TAX AS WELL AS TREASURY FUNCTIONS. CERTAIN SUPPORT SERVICES, SUCH AS HUMAN RESOURCES, PAYROLL, A/P, AND SUPPLY CHAIN MANAGEMENT ARE PROVIDED PURSUANT TO A SHARED SERVICES MODEL BY AHSSHC TO ITS SUBSIDIARY ORGANIZATIONS. THE PROVISION OF THESE EXECUTIVE AND SUPPORT SERVICES ON A CENTRALIZED BASIS BY AHSSHC PROVIDES AN APPROPRIATE BALANCE BETWEEN PROVIDING EACH ADVENTHEALTH SUBSIDIARY HOSPITAL ORGANIZATION WITH MISSION-DRIVEN CONSISTENT LEADERSHIP AND SUPPORT WHILE ALLOWING THE HOSPITAL ORGANIZATION TO FOCUS ITS RESOURCES ON MEETING THE SPECIFIC HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES. THE READER OF THIS FORM 990 SHOULD KEEP IN MIND THAT THIS REPORTING ENTITY MAY DIFFER IN CERTAIN AREAS FROM THAT OF A STAND-ALONE HOSPITAL ORGANIZATION DUE TO ITS INCLUSION IN A LARGER SYSTEM OF HEALTHCARE ORGANIZATIONS. AS A PART OF A SYSTEM OF HOSPITAL AND OTHER HEALTH CARE ORGANIZATIONS, THE FILING ORGANIZATION BENEFITS FROM REDUCED COSTS DUE TO SYSTEM EFFICIENCIES, SUCH AS LARGE GROUP PURCHASING DISCOUNTS, AND THE AVAILABILITY OF INTERNAL RESOURCES SUCH AS INTERNAL LEGAL COUNSEL. EACH ADVENTHEALTH SUBSIDIARY PAYS A MANAGEMENT FEE TO AHSSHC FOR THE INTERNAL SERVICES PROVIDED BY AHSSHC. AS A RESULT, MANAGEMENT FEE EXPENSE REPORTED BY AN ADVENTHEALTH SUBSIDIARY ORGANIZATION MAY APPEAR GREATER IN RELATION TO MANAGEMENT FEE EXPENSE THAT MAY BE REPORTED BY A SINGLE STAND-ALONE HOSPITAL. THE SINGLE STAND-ALONE HOSPITAL WOULD LIKELY REPORT COSTS ASSOCIATED WITH MANAGEMENT AND OTHER PROFESSIONAL SERVICES ON VARIOUS EXPENSE LINE ITEMS IN ITS STATEMENT OF REVENUE AND EXPENSE AS OPPOSED TO REPORTING SUCH COSTS IN ONE OVERALL MANAGEMENT FEE EXPENSE. AS THE REPORTING OF THE FORM 990 IS DONE ON AN ENTITY BY ENTITY BASIS, THERE IS NO SINGLE FORM 990 THAT CAPTURES THE PROGRAMS AND OPERATIONS OF ADVENTHEALTH AS A WHOLE. THE READER IS DIRECTED TO VISIT THE WEBSITE OF ADVENTHEALTH AT WWW.ADVENTHEALTH.COM TO LEARN MORE ABOUT THE MISSION AND OPERATIONS OF ADVENTHEALTH. PART VI, LINE 7, REPORTS FILED WITH STATES IL 1 DUPAGE HEALTH COALITION 511 THORNHILL DR SUITE M CAROL STREAM IL 60188 364448208 501(C)(3) 117681 0 MEDICAL CARE ICNA RELIEF USA PROGRAMS INC 8791 144TH STREET JAMAICA NY 11435 043810161 501(C)(3) 10800 0 GENERAL SUPPORT VILLAGE OF GLENDALE HEIGHTS 300 CIVIC CENTER PLAZA GLENDALE HEIGHTS IL 60139 366009547 VILLAGE OF GLENDALE 8600 0 GENERAL SUPPORT ANDREWS UNIVERSITY 4150 ADMINISTRATION DRIVE BERRIEN SPRINGS MI 49104 381627600 501(C)(3) 10000 0 GENERAL SUPPORT ILLINOIS ASSOCIATION OF SEVENTH-DAY ADVENTISTS 619 PLAINFIELD ROAD WILLOWBROOK IL 60527 237311734 501(C)(3) 18000 0 GENERAL SUPPORT 5 0 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. X X X X 1 1 1 1 0 0 0 0 0 0 0 BACON KENNETH DIR/CHAIRMAN 0 1226644 0 338892 0 56102 0 243332 0 46940 0 1911910 0 0 CHRISTIAN BRUCE PRES/CEO BOLINGBROOK/GLENOAKS (END 1 0 352000 0 0 0 1239871 0 16000 0 23312 0 1631183 0 0 SNYDER BRENT DIRECTOR 0 921439 0 281173 0 264350 0 16400 0 26882 0 1510244 0 0 THORDARSON THOR DIR/PRESIDENT/SEC 0 744389 0 0 0 552864 0 118312 0 29396 0 1444961 0 0 BUCHANAN HERBERT DIRECTOR 6049 470117 0 0 1210 318607 122 17133 234 15329 7615 821186 0 0 CARROLL MD RICHARD VP/CMO BOLINGBROOK/GO (END 6/22) 0 255140 0 1273 0 245237 0 2900 0 23270 0 527820 0 0 DAVARAPALLI MD RAMADEVI DIRECTOR (BEG 1/22) 0 349891 0 82933 0 0 0 30904 0 26132 0 489860 0 0 RADIVOJEVIC VLADIMIR COO/CEO 0 291307 0 0 0 65151 0 33188 0 39462 0 429108 0 0 PAWLIK RN COLLEEN INTERIM CNO BOLING/GLENOAKS 0 243851 0 0 0 57232 0 9094 0 34304 0 344481 0 0 DE RAMOS DO DAVID DIRECTOR (END 12/22) 0 198493 0 33590 0 0 0 20687 0 17804 0 270574 0 0 BROWN JARED SR. DIR. FINANCE-BOLING/GLENOAKS 0 207451 0 0 0 27320 0 8412 0 21953 0 265136 0 0 CALANZA FATIMA RN CHARGE 22586 124520 17538 3218 18694 3202 1761 12683 3278 11944 63857 155567 0 0 THORAKKAL SINOL RN CHARGE 22421 116888 8189 2805 12321 3100 1341 13527 5713 20242 49985 156562 0 0 MAYOL LEIZL RN SPV-HOUSE 22503 119409 5417 3277 11784 1765 1250 12832 5922 20951 46876 158234 0 0 KNUTSON LISA RN DIR-NURSING 38938 123077 0 0 330 2460 1223 11005 4996 14308 45487 150850 0 0 ALBAUGH JOLENE RN DIR-SURGICAL SVCS 39445 123448 0 0 953 1654 1109 13172 2253 6142 43760 144416 0 0 PART I, LINE 1A THE FILING ORGANIZATION IS A PART OF THE SYSTEM OF HEALTHCARE ORGANIZATIONS KNOWN AS ADVENTHEALTH. MEMBERS OF THE FILING ORGANIZATION'S EXECUTIVE MANAGEMENT TEAM THAT HOLD THE POSITION OF VICE-PRESIDENT OR ABOVE ARE COMPENSATED BY AND ON THE PAYROLL OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), THE PARENT ORGANIZATION OF THE HEALTHCARE SYSTEM KNOWN AS ADVENTHEALTH. AHSSHC IS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). THE FILING ORGANIZATION REIMBURSES AHSSHC FOR THE SALARY AND BENEFIT COST OF THOSE EXECUTIVES LISTED IN PART VII THAT ARE ON THE PAYROLL OF AHSSHC. AT THE DIRECTION OF AHSSHC, AND IN ACCORDANCE WITH THE RESERVED POWERS IN THE FILING ORGANIZATION'S GOVERNING DOCUMENTS, THE EXECUTIVE TEAM LISTED ON PART VII PROVIDES SERVICES TO THE FILING ORGANIZATION. FIRST-CLASS OR CHARTER TRAVEL: PURSUANT TO THE ADVENTHEALTH SYSTEM-WIDE GENERAL POLICY REGARDING BUSINESS TRAVEL, NO REIMBURSEMENT WILL BE PROVIDED FOR ANY ADDITIONAL COST INCURRED WITH RESPECT TO FIRST-CLASS OR CHARTER AIR TRAVEL BEYOND THE COST OF A REGULAR COACH AIRFARE. AS A MEANS OF PROVIDING ADDITIONAL BUSINESS TRAVEL REIMBURSEMENT FOR THOSE MEMBERS OF THE AHSSHC SENIOR EXECUTIVE MANAGEMENT TEAM THAT TRAVEL FREQUENTLY ON BEHALF OF ADVENTHEALTH, A SPECIAL ANNUAL TRAVEL ALLOWANCE IS PROVIDED FOR THOSE EXECUTIVES. AS ADVENTHEALTH OPERATES 49 HOSPITALS IN 9 STATES, THE SENIOR LEADERSHIP OF AHSSHC TRAVEL EXTENSIVELY AND OFTEN VISIT MULTIPLE HOSPITAL LOCATIONS IN DIFFERENT STATES AS A PART OF A SINGLE BUSINESS TRIP. THE SPECIAL TRAVEL ALLOWANCE CAN PROVIDE REIMBURSEMENTS TO THE EXECUTIVE FOR SUCH ITEMS AS THE PURCHASE OF AIR TRAVEL UPGRADE COUPONS, TO COVER THE COST DIFFERENTIAL BETWEEN COACH AND FIRST-CLASS TRAVEL, OR TO COVER THE COST OF A CHARTER FLIGHT. THE SPECIAL TRAVEL ALLOWANCE BENEFIT WAS ORIGINALLY AUTHORIZED BY AND CODIFIED INTO A POLICY BY THE AHSSHC BOARD COMPENSATION COMMITTEE (THE COMMITTEE), AN INDEPENDENT BODY OF THE AHSSHC BOARD OF DIRECTORS, WHO ALSO APPROVES THE ANNUAL CAP ON THE AMOUNT OF THE ALLOWANCE. THE SPECIAL TRAVEL ALLOWANCE HAS AN ANNUAL CAP OF $24,000 FOR MEMBERS OF THE LEADERSHIP EXECUTIVE TEAM (13 ADVENTHEALTH CABINET MEMBERS AND THE ADVENTHEALTH MULTI-STATE CFO) AND $15,000 FOR ADVENTHEALTH CORPORATE OFFICE SENIOR VICE PRESIDENTS, REGIONAL CEO'S, AND DIVISION CHIEF OFFICERS (GENERALLY 50 - 55 INDIVIDUAL EXECUTIVES). A REGIONAL CEO FOR ADVENTHEALTH IS A MEMBER OF THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION. THE REGIONAL CEO IS CONSIDERED A COMMON LAW EMPLOYEE OF AND IS ON THE PAYROLL OF AHSSHC. WHILE THE SPECIAL TRAVEL ALLOWANCE BENEFIT IS AN AHSSHC COMPENSATION POLICY AND PRACTICE, THE COST OF PROVIDING THIS BENEFIT IS ALLOCATED TO AND EITHER WHOLLY OR PARTIALLY REIMBURSED BY THE FILING ORGANIZATION. ACCORDINGLY, THE FILING ORGANIZATION HAS CHECKED THE BOX IN SCHEDULE J, PART I, LINE 1A FOR FIRST-CLASS OR CHARTER TRAVEL SINCE IT HAS WHOLLY OR PARTIALLY PAID FOR THE COST OF PROVIDING THIS BENEFIT. THOSE EXECUTIVES WHO RECEIVE THE SPECIAL TRAVEL ALLOWANCE ARE RESPONSIBLE FOR TRACKING THE EXPENSES REIMBURSABLE UNDER THE SPECIAL TRAVEL ALLOWANCE AND MUST SUBMIT SUCH EXPENSES ON THEIR ACCOUNTABLE PLAN EXPENSE REPORT. A REPORT ON CHARTER TRAVEL IS PROVIDED TO THE AHSSHC BOARD COMPENSATION COMMITTEE AT EACH MEETING. ANY TAXABLE REIMBURSEMENTS MADE TO EXECUTIVES UNDER THE SPECIAL TRAVEL ALLOWANCE ARRANGEMENT ARE TREATED AS TAXABLE COMPENSATION TO THE EXECUTIVE. TRAVEL FOR COMPANIONS: AHSSHC HAS A CORPORATE EXECUTIVE POLICY THAT PROVIDES A BENEFIT TO ALLOW FOR A TRAVELING AHSSHC EXECUTIVE TO HAVE HIS OR HER SPOUSE ACCOMPANY THE EXECUTIVE ON CERTAIN BUSINESS TRIPS EACH YEAR. TYPICALLY, REIMBURSEMENT IS ONLY PROVIDED TO CERTAIN EXECUTIVE LEADERS AND IS USUALLY LIMITED TO ONE BUSINESS TRIP PER YEAR BEYOND THE ANNUAL ADVENTHEALTH PRESIDENT'S COUNCIL BUSINESS MEETING AND OTHER MEETINGS WHERE THE SPOUSE IS SPECIFICALLY INVITED. THE AHSSHC CORPORATE EXECUTIVE SPOUSAL TRAVEL POLICY WAS ORIGINALLY APPROVED AND REVIEWED BY THE AHSSHC BOARD COMPENSATION COMMITTEE, AN INDEPENDENT BODY OF THE AHSSHC BOARD OF DIRECTORS. ALL SPOUSAL TRAVEL COSTS REIMBURSED TO THE EXECUTIVE ARE CONSIDERED TAXABLE COMPENSATION TO THE EXECUTIVE. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: ADVENTHEALTH HAS A SYSTEM-WIDE POLICY ADDRESSING GROSS-UP PAYMENTS PROVIDED IN CONNECTION WITH EMPLOYER-PROVIDED BENEFITS/OTHER TAXABLE ITEMS. UNDER THE POLICY, CERTAIN TAXABLE BUSINESS-RELATED REIMBURSEMENTS (I.E. TAXABLE BUSINESS-RELATED MOVING EXPENSES, TAXABLE ITEMS PROVIDED IN CONNECTION WITH EMPLOYMENT) PROVIDED TO ANY EMPLOYEE MAY BE GROSSED-UP AT A 25% RATE UPON APPROVAL BY THE FILING ORGANIZATION'S CEO AND CFO. ADDITIONALLY, EMPLOYEES AT THE DIRECTOR LEVEL AND ABOVE ARE ELIGIBLE FOR GROSS-UP PAYMENTS ON GIFTS RECEIVED FOR BOARD OF DIRECTOR SERVICES. DISCRETIONARY SPENDING ACCOUNT: OCCASIONAL DISCRETIONARY SPENDING AMOUNTS ARE PERIODICALLY PROVIDED TO ELIGIBLE EXECUTIVES WHO ATTEND ANNUAL BUSINESS MEETINGS SUCH AS THE ADVENTHEALTH PRESIDENT'S COUNCIL, CFO CONFERENCE OR THE CMO/CNO BUSINESS MEETING. PAYMENTS PROVIDED TO EACH EXECUTIVE ARE CONSIDERED TAXABLE COMPENSATION TO THE EXECUTIVE. PART I, LINE 3 THE FILING ORGANIZATION WAS A COVERED AFFILIATE OF THE JOINT OPERATING COMPANY, ALEXIAN BROTHERS-AHS MIDWEST REGION HEALTH CO. D/B/A AMITA HEALTH (AMITA OR JOC) FOR THE PERIOD FROM JANUARY 1 TO MARCH 31 OF 2022. AS A RESULT OF THE DISAFFILIATION AGREEMENT BETWEEN ALEXIAN BROTHERS HEALTH SYSTEM AND ADVENTIST MIDWEST HEALTH, THE FILING ORGANIZATION'S SOLE MEMBER, THE FILING ORGANIZATION CEASED TO BE A COVERED AFFILIATE OF THE JOC EFFECTIVE APRIL 1, 2022. PLEASE SEE OUR RESPONSE TO FORM 990, PART VI, SECTION A, LINE 4 FOR ADDITIONAL INFORMATION CONCERNING THE DISAFFILIATION AGREEMENT. THE 2022 COMPENSATION OF THE EXECUTIVES LISTED IN PART VII, INCLUDING THE CEO, WAS DETERMINED BY AMITA. UPON THE DISAFFILIATION ON APRIL 1, 2022, THE COMPENSATION OF THE EXECUTIVES LISTED IN PART VII WAS REVIEWED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION, THE FILING ORGANIZATION'S TOP-TIER 501(C)(3) PARENT ORGANIZATION, FOR REASONABLENESS AND APPROPRIATENESS AND LEFT UNCHANGED FOR 2022. AMITA UTILIZED VARIOUS COMPARABILITY DATA IN ESTABLISHING THE 2022 COMPENSATION FOR THOSE EXECUTIVES LISTED IN PART VII THAT PERFORMED SERVICES FOR AMITA DURING THE FIRST QUARTER OF 2022 AND FOR THE FILING ORGANIZATION AND FOR ITS RELATED 501(C)(3) HOSPITAL AND PHYSICIAN PRACTICE ENTITIES FOR CALENDAR YEAR 2022. COMPARABILITY DATA UTILIZED BY AMITA INCLUDED COMPENSATION SURVEYS AND STUDIES AND THE FORMS 990 OF OTHER UNRELATED COMPARABLE ORGANIZATIONS. AMITA ALSO HAD A COMPENSATION COMMITTEE THAT APPROVED ALL RELEVANT EXECUTIVE COMPENSATION, INCLUDING THE COMPENSATION OF THE FILING ORGANIZATION'S CEO FOR 2022. PART I, LINES 4A-B LINE 4A: DURING THE YEAR ENDING DECEMBER 31, 2022, BRUCE CHRISTIAN, CEO AND RICHARD CARROLL, MD, CMO RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $78,225 AND $189,993 RESPECTIVELY. PURSUANT TO THE AHSSHC CORPORATE EXECUTIVE POLICY GOVERNING EXECUTIVE SEVERANCE, SEVERANCE AGREEMENTS FOR EXECUTIVES OPERATING AT THE VICE PRESIDENT LEVEL AND ABOVE ARE ENTERED INTO UPON ELIGIBILITY TO FACILITATE THE TRANSITION TO SUBSEQUENT EMPLOYMENT FOLLOWING AN INVOLUNTARY SEPARATION FROM EMPLOYMENT WITH ADVENTHEALTH. OTHER SEVERANCE PAYMENTS MAY BE MADE TO NON-EXECUTIVE PERSONNEL IN CERTAIN CIRCUMSTANCES. LINE 4B: THOR THORDARSON, KENNETH BACON, RICHARD CARROLL, MD, BRUCE CHRISTIAN, BRENT SNYDER, HERBERT BUCHANAN, AND VLADIMIR RADIVOJEVIC RECEIVED COMPENSATION IN 2022 FROM ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), THE TOP-TIER PARENT OF THE FILING ORGANIZATION AND THE PARENT ORGANIZATION OF A HEALTHCARE SYSTEM KNOWN AS ADVENTHEALTH. IN RECOGNITION OF THE CONTRIBUTION THAT EACH EXECUTIVE MAKES TO THE SUCCESS OF ADVENTHEALTH, ADVENTHEALTH PROVIDES SUPPLEMENTAL EXECUTIVE BENEFIT PLANS TO ELIGIBLE EXECUTIVES. IN 2020, ADVENTHEALTH RESTRUCTURED ITS EXECUTIVE SUPPLEMENTAL RETIREMENT AND BENEFIT PLANS TO REDUCE COMPLEXITY, TO INCREASE PREDICTABILITY OF BENEFITS AND TO CONSOLIDATE MULTIPLE SUPPLEMENTAL EXECUTIVE BENEFIT PLANS INTO ONE PLAN. EFFECTIVE 1/1/2020, A NEW SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP III) WAS ADOPTED AND THE THREE EXISTING PLANS, DESCRIBED BELOW, WERE AMENDED AND RESTATED. THE NEWLY ADOPTED SERP III PLAN, AS WELL AS THE AMENDED AND RESTATED PLANS, WERE REVIEWED AND APPROVED BY THE AHSSHC BOARD COMPENSATION COMMITTEE, AN INDEPENDENT BODY OF THE AHSSHC BOARD OF DIRECTORS. SERP III PLAN: THE SERP III PLAN PROVIDES ELIGIBLE EXECUTIVES A PERCENTAGE OF THEIR BASE PAY, WHICH IS CREDITED TO A DEFERRED COMPENSATION ACCOUNT. THE PLAN ALSO PROVIDES FOR COMPENSATION DEFERRAL AND SELECTION OF LIFE INSURANCE COVERAGE AND LONG-TERM CARE INSURANCE. TO BE ELIGIBLE TO PARTICIPATE IN THE SERP III PLAN, EXECUTIVES MUST BE ON THE AHSSHC CORPORATE PAYROLL AND BE EITHER A CEO OF AN ADVENTHEALTH ENTITY, AN AHSSHC VICE PRESIDENT (VP) OR VP OF AN ADVENTHEALTH ENTITY WITH A BASE SALARY OF AT LEAST $305,000 IN 2022 (ADJUSTED ANNUALLY BY THE SAME PERCENTAGE AS IRC SECTION 401(A)(17) LIMIT INCREASES), OR OTHER LEADER SPECIFICALLY APPROVED BY THE ADVENTHEALTH PRESIDENT. ELIGIBLE EXECUTIVES DO NOT INCLUDE GRANDFATHERED EXECUTIVES, MEANING THOSE EXECUTIVES WHO WOULD SATISFY ALL THE ELIGIBILITY REQUIREMENTS OF THE SERP II PLAN PRIOR TO DEC 31, 2027, HAD THE PLAN NOT BEEN AMENDED AND RESTATED AS OF JAN. 1, 2020. CONTRIBUTION CREDITS WILL BE ESTABLISHED AND MAINTAINED BY CLASS YEAR ACCOUNTS FOR EACH PARTICIPANT USING TIERED CONTRIBUTION CREDIT PERCENTAGES OF ANNUAL BASE COMPENSATION. CONTRIBUTION CREDIT PERCENTAGES RANGE BETWEEN 15% AND 19% OF BASE COMPENSATION. CONTRIBUTION CREDITS WILL BE MADE EACH QUARTER IN 25% INCREMENTS WITH REDUCTIONS IN CONTRIBUTIONS IF THE EXECUTIVE IS ALSO A GRANDFATHERED FLEX PARTICIPANT (SEE BELOW). SERP III PROVIDES FOR A CLASS YEAR VESTING AND PAYMENT SCHEDULE (7 YEARS FOR EACH CLASS YEAR) WITH RESPECT TO AMOUNTS ACCUMULATED IN THE EXECUTIVE'S DEFERRED COMPENSATION ACCOUNT. UPON ATTAINMENT OF A NORMAL RETIREMENT AGE (AGE 62), OR UPON CERTAIN OTHER CIRCUMSTANCES AS DEFINED IN THE SERP III PLAN DOCUMENT, ALL DEFERRED AMOUNTS ARE PAID IMMEDIATELY TO THE PARTICIPANT. FOR ANY EXECUTIVES WORKING BEYOND THE NORMAL RETIREMENT AGE, FUTURE EMPLOYER CONTRIBUTIONS WILL BE MADE QUARTERLY FROM SERP III DIRECTLY TO THE PARTICIPANT AS A TAXABLE CASH BONUS. SERP II PLAN: THE SERP II PLAN IS A DEFINED BENEFIT, NON-TAX-QUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN EXECUTIVES WHO HAVE PROVIDED LENGTHY SERVICE TO ADVENTHEALTH AND/OR TO OTHER SEVENTH-DAY ADVENTIST CHURCH HOSPITALS OR HEALTH CARE INSTITUTIONS. UNDER THE PROVISIONS OF THE SERP II PLAN, BENEFITS ARE PROVIDED TO QUALIFYING EXECUTIVE PARTICIPANTS ON A PRO-RATA SCHEDULE BEGINNING WITH 20 YEARS OF SERVICE AS AN EMPLOYEE OF ADVENTHEALTH AND/OR ANOTHER HOSPITAL OR HEALTH CARE INSTITUTION CONTROLLED BY THE SEVENTH-DAY ADVENTIST CHURCH AND WHO SATISFY CERTAIN OTHER QUALIFYING CRITERIA. ELIGIBLE EMPLOYEES ARE RESTRICTED TO THOSE EXECUTIVES WHO, AS OF JANUARY 1, 2020, SATISFIED, OR IF EMPLOYMENT CONTINUES, WILL SATISFY THE ELIGIBILITY REQUIREMENTS OF SERP II PRIOR TO DECEMBER 31, 2027. THIS SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP II) 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 ADVENTHEALTH 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 SERP II AND BY THE INDIVIDUAL'S YEAR OF ENTRY TO THE ADVENTHEALTH EXECUTIVE FLEX BENEFIT PROGRAM. FLEX PLAN: THE FLEX PLAN WAS ORIGINALLY DESIGNED TO PROVIDE ELIGIBLE EXECUTIVES AN OPPORTUNITY TO SELECT 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. IN 2020, THE FLEX PLAN WAS AMENDED TO EXCLUDE EMPLOYED EXECUTIVES WHO ARE HIRED OR PROMOTED AFTER A CERTAIN DATE FROM BEING ELIGIBLE TO PARTICIPATE IN THE FLEX PLAN EXCEPT FOR CERTAIN INSURANCE COVERAGE FEATURES OF THE PLAN. THE FLEX PLAN PROVIDES ELIGIBLE PARTICIPANTS A PRE-DETERMINED BENEFITS ALLOWANCE CREDIT THAT IS EQUAL TO A PERCENTAGE OF THE EXECUTIVE'S BASE PAY FROM WHICH THE COST OF MANDATORY AND ELECTIVE EMPLOYEE BENEFITS IS DEDUCTED. THE BENEFITS ALLOWANCE CREDIT PERCENTAGE FOR ANY PLAN YEAR SHALL NOT BE GREATER THAN THE MAXIMUM DOLLAR AMOUNT OR THE PERCENTAGE OF COMPENSATION AS DETERMINED BY THE ADVENTHEALTH BENEFITS ADMINISTRATION COMMITTEE. FOR GRANDFATHERED ELIGIBLE EMPLOYEES, THE ANNUAL PRE-DETERMINED FLEX ALLOWANCE IS CONTRIBUTED AND ANY FUNDS THAT REMAIN AFTER THE COST OF MANDATORY AND ELECTIVE BENEFITS ARE SUBTRACTED ARE, AT THE EMPLOYEE'S OPTION, CONTRIBUTED 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 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 WILL BE FORFEITED BY THE EXECUTIVE UPON A VOLUNTARY SEPARATION. WITH RESPECT TO GRANDFATHERED PARTICIPANTS, THE FLEX PLAN DOCUMENTS DEFINE ELIGIBLE EMPLOYEES TO INCLUDE THE CHIEF EXECUTIVE OFFICERS OF ADVENTHEALTH ENTITIES AND VICE PRESIDENTS OF ALL ADVENTHEALTH ENTITIES WHOSE BASE SALARY WAS AT LEAST EQUAL TO THE INTERNAL REVENUE CODE SECTION 401(A)(17) COMPENSATION LIMIT EACH YEAR. FLEX PLAN FLEX PLAN SERP II SERP III CONTR. DISTR.* CONTR./DISTR. CONTR. BACON, KENNETH $ 0 $ 0 $ 0 $ 226,932 CHRISTIAN, BRUCE $ 13,125 $ 0 $ 931,613 $ 0 SNYDER, BRENT $ 150,000 $ 129,500 $ 56,411 $ 0 THORDARSON, THOR $ 0 $ 0 $ 0 $ 98,072 BUCHANAN, HERBERT $ 0 $ 0 $ 0 $ 50,754 CARROLL, RICHARD $ 9,220 $ 9,220 $ 21,047 $ 0 RADIVOJEVIC, VLADIMIR $ 0 $ 0 $ 0 $ 19,327 SERP III DISTR.* BUCHANAN, HERBERT $ 50,754 * INCLUDING INVESTMENT EARNINGS HERBERT BUCHANAN WAS COMPENSATED BY ALEXIAN BROTHERS HEALTH SYSTEM IN JANUARY-MARCH OF 2022 FOR SERVICES PROVIDED TO THE FILING ORGANIZATION. ALEXIAN BROTHERS HEALTH SYSTEM WAS AFFILIATED WITH THE FILING ORGANIZATION FOR THE PERIOD FROM JANUARY 1, - MARCH 31, 2022. PLEASE SEE OUR RESPONSE TO FORM 990, PART VI, SECTION A, LINE 4 FOR A DISCUSSION CONCERNING THE FILING ORGANIZATION'S AFFILIATION WITH ALEXIAN BROTHERS HEALTH SYSTEM THROUGH THE JOINT OPERATING COMPANY KNOWN AS AMITA HEALTH FOR THE PERIOD FROM JANUARY 1, - MARCH 31, 2022. COMPENSATION FOR THIS INDIVIDUAL'S SERVICES PROVIDED TO THE FILING ORGANIZATION IS DISCLOSED IN PART VII, LINE 1A, AND SCHEDULE J, PART II. PART V, LINE 1A: THE PARENT CORPORATION AND SOLE TOP-TIER MEMBER OF ADVENTIST GLENOAKS HOSPITAL (THE FILING ORGANIZATION) IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). AHSSHC IS A FLORIDA, NOT-FOR-PROFIT CORPORATION THAT IS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3). AHSSHC HAS ESTABLISHED A SHARED SERVICE CENTER TO CENTRALIZE THE ACCOUNTS PAYABLE (A/P) FUNCTION FOR ALL AHSSHC SUBSIDIARY ORGANIZATIONS. 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 AHSSHC AS THE PAYOR SUBJECT TO THE INFORMATION REPORTING REQUIREMENTS OF SECTION 6041. THE FACTS AND CIRCUMSTANCES SUPPORT A POSITION THAT AHSSHC, AS A PAYOR ON BEHALF OF ITS SUBSIDIARY ORGANIZATIONS IN A SHARED SERVICE ENVIRONMENT, WILL HAVE SUFFICIENT MANAGEMENT AND OVERSIGHT IN CONNECTION WITH THE SUBSIDIARY ORGANIZATIONS' PAYMENTS TO MEET THE STANDARD SET FORTH IN TREAS. REG. SECTION 1.6041-1(E). AHSSHC WILL NOT MERELY BE MAKING PAYMENTS AT THE DIRECTION OF ITS SUBSIDIARY ORGANIZATIONS. ACCORDINGLY, AHSSHC IS CONSIDERED THE PAYOR SUBJECT TO THE INFORMATION REPORTING REQUIREMENTS OF SECTION 6041. FORM 990, PART VI, SECTION A, LINE 4 APRIL 1, 2022 CHANGES TO BYLAWS: PRIOR TO APRIL 1, 2022, ADVENTIST GLENOAKS HOSPITAL (AGOH OR THE HOSPITAL) WAS A COVERED AFFILIATE OF AN AFFILIATION COMPRISING A REGIONAL HEALTH CARE DELIVERY NETWORK OPERATED AND MANAGED BY ALEXIAN BROTHERS-AHS MIDWEST REGION HEALTH CO., A JOINT OPERATING COMPANY BETWEEN ALEXIAN BROTHERS HEALTH SYSTEM AND ADVENTIST MIDWEST HEALTH (THE JOINT OPERATING COMPANY). THE JOINT OPERATING COMPANY WAS KNOWN AS AMITA HEALTH. THROUGHOUT 2022, THE SOLE MEMBER OF AGOH WAS ADVENTIST MIDWEST HEALTH, A 501(C)(3) ORGANIZATION THAT OPERATES TWO ACUTE-CARE HOSPITALS. THE MEMBERSHIP OF ADVENTIST MIDWEST HEALTH IS HELD DIRECTLY BY ADVENTIST HEALTH SYSTEM/SUNBELT, INC. AND INDIRECTLY BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION, BOTH 501(C)(3) ORGANIZATIONS. THE HEALTHCARE SYSTEM WHOSE PARENT IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION IS KNOWN AS ADVENTHEALTH. EFFECTIVE APRIL 1, 2022, ALEXIAN BROTHERS HEALTH SYSTEM AND ADVENTIST MIDWEST HEALTH EXECUTED A DISAFFILIATION AGREEMENT (THE DISAFFILIATION) WHEREBY IT WAS AGREED THAT THE JOINT OPERATING COMPANY, ALEXIAN BROTHERS-AHS MIDWEST REGION HEALTH CO., WOULD WIND UP ITS AFFAIRS AND DISSOLVE AND THAT THE PARTIES TO THE ORIGINAL AFFILIATION AGREEMENT WOULD NO LONGER BE UNDER THE MANAGEMENT CONTROL OF THE JOINT OPERATING COMPANY. ACCORDINGLY, THE BYLAWS OF THE FILING ORGANIZATION WERE AMENDED EFFECTIVE APRIL 1, 2022, TO REFLECT THE CHANGES RESULTING FROM THE DISAFFILIATION. THE APRIL 1, 2022 BYLAWS WERE REVISED TO EFFECTUATE THE TERMS OF THE DISAFFILIATION AGREEMENT. ACCORDINGLY, ALL RELEVANT SECTIONS OF THE PREVIOUS BYLAWS WERE AMENDED TO REMOVE ALL REFERENCES AND AUTHORITIES, INCLUDING RESERVED POWERS, THAT WERE GRANTED TO THE JOINT OPERATING COMPANY AND ITS BOARD OF DIRECTORS. ALL REFERENCES THROUGHOUT THE BYLAWS TO POTENTIAL LIMITATIONS IMPOSED ON ACTIONS OF THE HOSPITAL THAT MIGHT RESULT FROM INCONSISTENCIES WITH THE JOINT OPERATING COMPANY BYLAWS OR AFFILIATION AGREEMENT WERE REMOVED. PRIOR TO THE APRIL 1, 2022 REVISIONS TO THE BYLAWS, THE BOARD OF DIRECTORS OF AGOH PROVIDED FOR TWO CLASSES OF DIRECTORS - VOTING AND NON-VOTING. THE REVISED BYLAWS PROVIDE FOR ONLY VOTING MEMBERS OF THE BOARD OF DIRECTORS. A QUALIFICATION WAS ADDED TO THOSE REQUIRED FOR BOARD OF DIRECTOR MEMBERS TO NOT BE AN INDIVIDUAL WHO HOLDS AN EXECUTIVE POSITION AT AN INSTITUTION WHICH IS IN DIRECT COMPETITION WITH THE FILING ORGANIZATION AND ITS OPERATIONS. THE BYLAWS WERE ALSO REVISED EFFECTIVE APRIL 1, 2022 TO UPDATE THE POWERS RESERVED TO THE MEMBER. THE FOLLOWING POWERS RESERVED TO THE MEMBER WERE ADDED TO THE APRIL 1, 2022 BYLAW REVISIONS: 1) THE AUTHORITY TO SET LIMITS AND TERMS FOR ALL TYPES OF FINANCIAL TRANSACTIONS EXCEEDING $100,000; 2) THE AUTHORITY TO SECURE NAMING RIGHTS AND TO DIRECT THE PLACEMENT OF FUNDS AND CAPITAL OF THE FILING ORGANIZATION IN EXCESS OF $1,000,000; 3) THE AUTHORITY TO APPROVE OR DISAPPROVE THE IMPLEMENTATION OF NON-TRADITIONAL, NON-HEALTHCARE RELATED ACTIVITIES; 4) THE AUTHORITY TO APPROVE OR DISAPPROVE PERFORMANCE/QUALITY IMPROVEMENT, REVENUE CYCLE AND CASE MANAGEMENT PROGRAMS; 5) THE AUTHORITY TO APPROVE OR DISAPPROVE THE SELECTION OF THE AUDITING FIRM AND ELECTION OF THE FISCAL YEAR; 6) THE AUTHORITY TO APPROVE OR DISAPPROVE THE SELECTION OF THE HOSPITAL'S GROUP PURCHASING ORGANIZATION; 7) THE AUTHORITY TO APPROVE OR DISAPPROVE ANY JOINT VENTURE OR PARTNERSHIP IN WHICH THE AGOH WOULD BE A MEMBER OR PARTNER; 8) THE AUTHORITY TO APPROVE OR DISAPPROVE THE IT SYSTEMS AND OTHER SHARED SERVICES USED; 9) THE AUTHORITY TO REQUIRE ADHERENCE TO THE SYSTEM-WIDE NAMING NOMENCLATURE AND SERVICE STANDARDS ADOPTED BY THE MEMBER; 10) THE AUTHORITY TO SET AND ENFORCE POLICES FOR PHYSICIAN COMPENSATION INCLUDING COMMERCIAL REASONABLENESS AND FAIR MARKET VALUE; AND 11) THE AUTHORITY TO EXERCISE SUCH OTHER POWERS AS ARE NECESSARY IN CONNECTION WITH ALL OTHER LISTED POWERS. A PROVISION WAS ADDED IN THE APRIL 1, 2022 BYLAWS TO PROVIDE THAT ADVENTIST HEALTH SYSTEM/SUNBELT, INC. SHALL RETAIN THE AUTHORITY AND RESPONSIBILITY FOR CORPORATE COMPLIANCE AND SHALL FUNCTION AS THE "GOVERNING AUTHORITY" FOR AGOH FOR THE PURPOSES OF PROVIDING COMPLIANCE OVERSIGHT. DECEMBER 29, 2022 CHANGES TO ARTICLES OF INCORPORATION AND BYLAWS: ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION, ADVENTIST HEALTH SYSTEM/SUNBELT, INC., AND ADVENTIST MIDWEST HEALTH ENTERED INTO AN AFFILIATION AGREEMENT WITH THE UNIVERSITY OF CHICAGO MEDICAL CENTER (UCMC), EFFECTIVE DECEMBER 31, 2022. UCMC IS A 501(C)(3) ACADEMIC HEALTH ORGANIZATION THAT OPERATES HOSPITALS, OUTPATIENT CLINICS AND PHYSICIAN PRACTICES IN THE GREATER CHICAGO AREA AND NORTHWEST INDIANA. UNDER THE AFFILIATION AGREEMENT, UCMC ACQUIRED A 51% MEMBERSHIP INTEREST IN ADVENTIST MIDWEST HEALTH. ADVENTIST MIDWEST HEALTH IS THE SOLE MEMBER OF THE FILING ORGANIZATION. ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION WILL CONTINUE TO MANAGE THE HOSPITAL. AS A RESULT OF THE DECEMBER 31, 2022 AFFILIATION AGREEMENT WITH UCMC, THE GOVERNING DOCUMENTS OF THE FILING ORGANIZATION WERE AMENDED. A SUMMARY OF THE SIGNIFICANT CHANGES TO THE GOVERNING DOCUMENTS FOLLOWS. CHANGES TO THE ARTICLES OF INCORPORATION: THE REVISED ARTICLES OF INCORPORATION ARE EFFECTIVE JANUARY 1, 2023. UNDER THE PURPOSES CLAUSE OF THE ARTICLES OF INCORPORATION, TWO ADDITIONAL PURPOSES WERE ADDED TO PROVIDE THAT THE FILING ORGANIZATION WILL ASSIST IN PROMOTING THE CHARITABLE PURPOSES AND INTERESTS OF ITS SOLE 501(C)(3) MEMBER AND ANY OTHER 501(C)(3) AFFILIATED ORGANIZATIONS WHOSE PURPOSES ARE CONSISTENT WITH THOSE OF THE FILING ORGANIZATION. A REQUIREMENT WAS ADDED TO THE AMENDED ARTICLES OF INCORPORATION TO PROVIDE THAT IN NO EVENT SHALL THE BOARD OF DIRECTORS CONSIST OF FEWER THAN THREE INDIVIDUALS AT ANY TIME. THE DISSOLUTION CLAUSE OF THE AMENDED ARTICLES OF INCORPORATION WAS CHANGED TO PROVIDE THAT THE SECOND-NAMED TRANSFEREES UPON DISPOSITION (IF THE MEMBER WAS NOT A 501(C)(3) ORGANIZATION AT THE TIME OF DISSOLUTION) WOULD BE ADVENTIST HEALTH SYSTEM/SUNBELT, INC. AND THE UNIVERSITY OF CHICAGO MEDICAL CENTER IN ACCORDANCE WITH THEIR RESPECTIVE MEMBERSHIP INTERESTS IN THE FILING ORGANIZATION'S MEMBER AT THE TIME OF DISSOLUTION. CHANGES TO THE BYLAWS: THE REVISED BYLAWS ARE EFFECTIVE JANUARY 1, 2023. THE FORMATION, PURPOSE AND OBJECTIVES SECTION OF THE REVISED BYLAWS WAS AMENDED TO STATE THAT THE FILING ORGANIZATION'S SOLE MEMBER, ADVENTIST MIDWEST HEALTH, IS NOW AFFILIATED WITH THE UNIVERSITY OF CHICAGO MEDICAL CENTER. EXTENSIVE REVISIONS WERE MADE TO THE MEMBER'S RESERVED POWERS TO PROVIDE THAT CERTAIN RESERVED POWERS WERE RETAINED SOLELY BY THE MEMBER WITH CERTAIN OTHER RESERVED POWERS SUBJECT TO THE APPROVAL OF EITHER THE UNIVERSITY OF CHICAGO MEDICAL CENTER, ADVENTIST HEALTH SYSTEM/SUNBELT, INC., OR BOTH. THE RESERVED POWERS RETAINED SOLELY BY THE MEMBER ARE THE FOLLOWING: - APPROVE MATERIAL CHANGES IN THE CATEGORY OF SERVICES OFFERED BY THE FILING ORGANIZATION; - AUTHORITY TO REQUIRE THE FILING ORGANIZATION'S ADHERENCE TO THE SYSTEM-WIDE NAMING NOMENCLATURE AND SERVICE STANDARDS ADOPTED BY THE MEMBER; - AUTHORITY TO SET AND ENFORCE POLICIES FOR PHYSICIAN COMPENSATION INCLUDING COMMERCIAL REASONABLENESS AND FAIR MARKET VALUE; - AUTHORITY TO ADOPT RULES AND REGULATIONS FOR THE MANAGEMENT OF THE FILING ORGANIZATION AS DEEMED PROPER; - APPOINTMENT OF AN INDIVIDUAL PROPOSED BY ADVENTHEALTH TO HOLD THE OFFICE OF PRESIDENT OF THE FILING ORGANIZATION AND THE TERMINATION OF SUCH APPOINTMENT; AND - THE COMPENSATION OF SUCH INDIVIDUAL HOLDING THE OFFICE OF PRESIDENT. FORM 990, PART VI, SECTION A, LINE 4 PART VI, LINE 4 - CONTINUATION THE FOLLOWING RESERVED POWERS ARE RETAINED BY THE MEMBER SUBJECT TO APPROVAL BY THE UNIVERSITY OF CHICAGO MEDICAL CENTER: - THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE FILING ORGANIZATION, ALL UNBUDGETED EXPENDITURES IN EXCESS OF $1 MILLION DOLLARS AND THE FINANCIAL STATEMENTS OF THE FILING ORGANIZATION; - THE INCURRENCE OF ANY CONTRACTUAL OBLIGATION IS EXCESS OF $1 MILLION DOLLARS; - THE STRATEGIC AND OPERATING PLANS OF THE FILING ORGANIZATION; - THE SELECTION, REMOVAL, OR MODIFICATION OF THE AUTHORITY AND RESPONSIBILITIES OF ACCOUNTANTS AND AUDITORS; - BORROWINGS AND CAPITAL LEASES OF MORE THAN $1 MILLION DOLLARS; - THE APPROVAL OR AMENDMENT OF MANAGED CARE PRICING, PRICING STRATEGIES, AND CONTRACTING PARAMETERS; AND - THE CONFESSION OF A JUDGMENT OR SETTLEMENT OF A CLAIM THAT WOULD EXCEED INSURANCE LIMITS. THE FOLLOWING RESERVED POWERS ARE RETAINED BY THE MEMBER SUBJECT TO THE APPROVAL BY ADVENTIST HEALTH SYSTEM/SUNBELT, INC: - CHANGES TO RELIGIOUS AFFILIATION AND ANY CHANGES IN OPERATION POLICIES, PLANS, AND PROCEDURES RELATED TO SUCH RELIGIOUS AFFILIATION OF ANY FACILITY OWNED BY THE FILING ORGANIZATION; - TERMINATION OF THE INDIVIDUAL HOLDING THE OFFICE OF PRESIDENT IF TERMINATION IS RELATED TO THAT PERSON'S MEMBERSHIP STATUS IN THE SEVENTH-DAY ADVENTIST CHURCH; AND - CHANGES TO THE MISSION, VISION, OR VALUES OF THE FILING ORGANIZATION. THE FOLLOWING RESERVED POWERS ARE RETAINED BY THE MEMBER SUBJECT TO THE APPROVAL OF BOTH THE UNIVERSITY OF CHICAGO MEDICAL CENTER AND ADVENTIST HEALTH SYSTEM/SUNBELT, INC.: - AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS - THE FORMATION OF ANY SUBSIDIARY OF THE FILING ORGANIZATION; - ENTERING INTO ANY AFFILIATION AGREEMENT OR JOINT VENTURE AGREEMENT; - ANY CHANGE IN THE NAME OR BRANDING OF THE HOSPITAL; - THE ADDITION OF NEW MEMBERS OF THE FILING ORGANIZATION; - THE APPOINTMENT AND REMOVAL OF ANY MEMBER OF THE BOARD OF DIRECTORS; - DISTRIBUTIONS OF CASH AND OTHER PROPERTY TO THE MEMBER OR OTHERWISE; - THE ADOPTION AND AMENDMENT OF THE QUALITY AND/OR RISK MANAGEMENT PLANS OF THE HOSPITAL; - THE SELECTION OF THE ACCREDITING BODY OF THE HOSPITAL; - THE TRANSFER OF ANY PROPERTY OF THE HOSPITAL IN EXCESS OF $1 MILLION DOLLARS; - ANY SALE, LEASE, TRANSFER, MERGER OR CONSOLIDATION OF THE FILING ORGANIZATION; - THE DISSOLUTION OF THE FILING ORGANIZATION; - THE FILING OF ANY VOLUNTARY PETITION IN BANKRUPTCY; - REQUIRING ANY ADDITIONAL CAPITAL CONTRIBUTIONS FROM THE MEMBER; AND - THE APPOINTMENT OR REMOVAL OF THE CHAIR OF THE BOARD OF DIRECTORS AND ANY OF THE OTHER BOARD OFFICERS. THE REVISED BYLAWS PROVIDE THAT THE BOARD OF DIRECTORS SHALL BE COMPRISED OF AT LEAST TWO UCMC REPRESENTATIVES. A PROVISION WAS ALSO ADDED TO PROVIDE THAT ANY COMMITTEE OF THE BOARD MUST INCLUDE A UCMC REPRESENTATIVE IF THE COMMITTEE HAS RESPONSIBILITIES THAT INCLUDE QUALITY OR COMPLIANCE MATTERS. THE REVISED BYLAWS CONTAIN A MORE DETAILED LISTING OF THE RESPONSIBILITIES OF THE BOARD OF DIRECTORS AND ARE GROUPED INTO THE AREAS OF STRATEGY, GENERAL OPERATIONS, MEDICAL STAFF, SAFETY, QUALITY AND EDUCATION, AND COMMUNITY. THE REVISED BYLAWS PROVIDE THAT THE FISCAL YEAR OF THE FILING ORGANIZATION SHALL END ON JUNE 30 OF EACH YEAR. FORM 990, PART VI, SECTION A, LINE 6 ADVENTIST GLENOAKS HOSPITAL (THE FILING ORGANIZATION) HAS ONE MEMBER. THE SOLE MEMBER OF THE FILING ORGANIZATION IS ADVENTIST MIDWEST HEALTH. ADVENTIST MIDWEST HEALTH IS AN ILLINOIS, 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, AMH. 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. FORM 990, PART VI, SECTION A, LINE 7B PRIOR TO APRIL 1, 2022, ADVENTIST GLENOAKS HOSPITAL (AGOH OR THE HOSPITAL) WAS A COVERED AFFILIATE OF AN AFFILIATION COMPRISING A REGIONAL HEALTH CARE DELIVERY NETWORK OPERATED AND MANAGED BY ALEXIAN BROTHERS-AHS MIDWEST REGION HEALTH CO., A JOINT OPERATING COMPANY BETWEEN ALEXIAN BROTHERS HEALTH SYSTEM AND ADVENTIST MIDWEST HEALTH (THE JOINT OPERATING COMPANY). THE JOINT OPERATING COMPANY WAS KNOWN AS AMITA HEALTH. THROUGHOUT 2022, THE SOLE MEMBER OF AGOH WAS ADVENTIST MIDWEST HEALTH, A 501(C)(3) ORGANIZATION THAT OPERATES TWO ACUTE-CARE HOSPITALS. THE MEMBERSHIP OF ADVENTIST MIDWEST HEALTH IS HELD DIRECTLY BY ADVENTIST HEALTH SYSTEM/SUNBELT, INC. AND INDIRECTLY BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION, BOTH 501(C)(3) ORGANIZATIONS. THE HEALTHCARE SYSTEM WHOSE PARENT IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION IS KNOWN AS ADVENTHEALTH. EFFECTIVE APRIL 1, 2022, ALEXIAN BROTHERS HEALTH SYSTEM AND ADVENTIST MIDWEST HEALTH EXECUTED A DISAFFILIATION AGREEMENT (THE DISAFFILIATION) WHEREBY IT WAS AGREED THAT THE JOINT OPERATING COMPANY, ALEXIAN BROTHERS-AHS MIDWEST REGION HEALTH CO., WOULD WIND UP ITS AFFAIRS AND DISSOLVE AND THAT THE PARTIES TO THE ORIGINAL AFFILIATION AGREEMENT WOULD NO LONGER BE UNDER THE MANAGEMENT CONTROL OF THE JOINT OPERATING COMPANY. ACCORDINGLY, THE BYLAWS OF THE FILING ORGANIZATION WERE AMENDED EFFECTIVE APRIL 1, 2022, TO REFLECT THE CHANGES RESULTING FROM THE DISAFFILIATION. FOR THE PERIOD FROM JANUARY 1 TO MARCH 31 OF 2022, CERTAIN GOVERNANCE POWERS WERE RESERVED TO ADVENTIST MIDWEST HEALTH AS THE MEMBER OF THE FILING ORGANIZATION. THESE RESERVED POWERS INCLUDED THE ALTERATION, RESTATEMENT, OR REPEAL OF THE ARTICLES OF INCORPORATION, BYLAWS, OR MISSION STATEMENT OF THE FILING ORGANIZATION, PROVIDED THAT SUCH ACTIONS WERE NOT INCONSISTENT WITH THE JOINT OPERATING COMPANY BYLAWS OR THE AFFILIATION AGREEMENT. RESERVED POWERS ALSO INCLUDED THE APPOINTMENT OF THE FILING ORGANIZATION'S BOARD OF DIRECTORS, SUBJECT TO THE RATIFICATION OF THE JOINT OPERATING COMPANY BOARD OF DIRECTORS. FOR THE SAME TIME PERIOD, CERTAIN FINANCIAL AUTHORITIES WERE RESERVED TO ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION, AS SPONSOR, THE BOARD OF DIRECTORS OF THE JOINT OPERATING COMPANY, AND BY BOTH MEMBERS OF THE JOINT OPERATING COMPANY. CERTAIN OPERATIONAL AUTHORITIES WERE ALSO RESERVED TO THE BOARD OF DIRECTORS OF THE JOINT OPERATING COMPANY INCLUDING THE DETERMINATION OF THE SERVICES TO BE PROVIDED BY THE FILING ORGANIZATION. BEGINNING APRIL 1, 2022, THE BYLAWS OF THE FILING ORGANIZATION WERE AMENDED. UPON AMENDMENT, THE FOLLOWING RESERVED POWERS WERE HELD BY ADVENTIST MIDWEST HEALTH: - TO APPROVE OR DISAPPROVE SENIOR MANAGEMENT OF THE FILING ORGANIZATION AND SUCH INDIVIDUALS' COMPENSATION; - TO APPROVE OR DISAPPROVE ANY AMENDMENTS TO THE FILING ORGANIZATION'S ARTICLES OF INCORPORATION OR BYLAWS; - TO APPROVE OR DISAPPROVE MATERIAL CHANGES IN THE SERVICES OFFERED BY THE FILING ORGANIZATION; - THE AUTHORITY TO SET LIMITS AND TERMS FOR ALL TYPES OF FINANCIAL TRANSACTIONS EXCEEDING $100,000 FOR ANY SINGLE OR RELATED PROJECTS; - TO APPROVE OR DISAPPROVE CAPITAL EXPENDITURES AND THE SALE, DONATION, OR OTHER TRANSFER OF REAL OR PERSONAL PROPERTY IN EXCESS OF $1,000,000; - TO APPROVE OR DISAPPROVE OPERATING AND CAPITAL BUDGETS AND STRATEGIC PLANS; - THE AUTHORITY TO REQUIRE ADHERENCE TO POLICIES ADOPTED BY THE MEMBER AND ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION; - THE AUTHORITY TO SECURE NAMING RIGHTS AND TO DIRECT THE PLACEMENT OF FUNDS AND CAPITAL OF THE FILING ORGANIZATION IN EXCESS OF $1,000,000; - THE AUTHORITY TO APPROVE OR DISAPPROVE THE IMPLEMENTATION OF NON-TRADITIONAL, NON-HEALTHCARE RELATED ACTIVITIES; - THE AUTHORITY TO APPROVE OR DISAPPROVE PERFORMANCE/QUALITY IMPROVEMENT, REVENUE CYCLE AND CASE MANAGEMENT PROGRAMS; - THE AUTHORITY TO APPROVE OR DISAPPROVE THE SELECTION OF THE AUDITING FIRM AND ELECTION OF THE FISCAL YEAR; - THE AUTHORITY TO APPROVE OR DISAPPROVE THE SELECTION OF THE HOSPITAL'S GROUP PURCHASING ORGANIZATION; - THE AUTHORITY TO APPROVE OR DISAPPROVE ANY JOINT VENTURE OR PARTNERSHIP IN WHICH THE AGOH WOULD BE A MEMBER OR PARTNER; - THE AUTHORITY TO APPROVE OR DISAPPROVE THE IT SYSTEMS AND OTHER SHARED SERVICES USED; - THE AUTHORITY TO REQUIRE ADHERENCE TO THE SYSTEM-WIDE NAMING NOMENCLATURE AND SERVICE STANDARDS ADOPTED BY THE MEMBER; - THE AUTHORITY TO SET AND ENFORCE POLICES FOR PHYSICIAN COMPENSATION INCLUDING COMMERCIAL REASONABLENESS AND FAIR MARKET VALUE; AND - THE AUTHORITY TO EXERCISE SUCH OTHER POWERS AS ARE NECESSARY IN CONNECTION WITH ALL OTHER LISTED POWERS. FORM 990, PART VI, SECTION B, LINE 11B THE FILING ORGANIZATION'S CURRENT YEAR FORM 990 WAS REVIEWED BY THE BOARD MEMBER/PRESIDENT, CEO AND BY THE FINANCE DIRECTOR PRIOR TO ITS FILING WITH THE IRS. THE REVIEW CONDUCTED BY THE BOARD MEMBER/PRESIDENT, CEO AND THE FINANCE DIRECTOR 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 CONFLICTS OF INTEREST, 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 EMPLOYEE ARE NOT COMPENSATED BY THE FILING ORGANIZATION. FOR 2022, THE COMPENSATION PACKAGE FOR THESE INDIVIDUALS WAS INITIALLY DETERMINED BY THE JOINT OPERATING COMPANY, ALEXIAN BROTHERS-AHS MIDWEST REGION HEALTH CO., DBA AMITA HEALTH (AMITA HEALTH OR JOC). AS DISCUSSED IN OUR RESPONSE TO FORM 990, PART VI, SECTION A, LINE 4, THE FILING ORGANIZATION CEASED TO BE A COVERED AFFILIATE OF THE JOC EFFECTIVE APRIL 1, 2022, DUE TO THE DISAFFILIATION AGREEMENT BETWEEN ALEXIAN BROTHERS HEALTH SYSTEM AND ADVENTIST MIDWEST HEALTH, THE FILING ORGANIZATION'S 501(C)(3) SOLE MEMBER. PLEASE SEE THE DISCUSSION CONCERNING THE PROCESS FOLLOWED BY AMITA HEALTH IN DETERMINING 2022 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), OFFICER(S) AND KEY EMPLOYEES 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. 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 7A, B AND C: 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 PROFESSIONALS: PROGRAM SERVICE EXPENSES 10,049,243. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,049,243. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,471,817. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,471,817. PURCHASED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 2,660,738. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,660,738. ENVIRONMENTAL SERVICES: PROGRAM SERVICE EXPENSES 1,859,080. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,859,080. TRANSCRIPTION EXPENSE: PROGRAM SERVICE EXPENSES 7,600. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,600. RECRUITING: PROGRAM SERVICE EXPENSES 10,500. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,500. FOOD SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 3,212,270. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,212,270. MISCELLANEOUS PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 9,068,470. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,068,470. AHS MANAGEMENT FEE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,867,612. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,867,612. BILLING & COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 612. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 612. AH SHARED SERVICES FEE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES -85,332. FUNDRAISING EXPENSES 0. TOTAL EXPENSES -85,332. FORM 990, PART XI, LINE 9: TRANSFER TO RELATED TOP-TIER TAX-EXEMPT PARENT -509,666. NET CHANGE IN INTEREST IN FOUNDATION -990,803. TRANSFER FROM TEMPORARY RESTRICTED 4,562. TRANSFER TO RELATED TAX-EXEMPT ORGANIZATION -297. PREPAID INTERCOMPANY IT COSTS -642,958. CHANGE IN INTERCOMPANY ALLOCATION OF TAX-EXEMPT BONDS 20,587,633. REVERSAL OF PRIOR YEAR PURCHASE ACCOUNTING -12,964,941. ROUNDING 2. FORM 990, PART XII, LINE 3B THE TAXPAYER IS PART OF A CONTROLLED GROUP OF ORGANIZATIONS THAT COMPRISE A CONSOLIDATED FINANCIAL STATEMENT AUDIT. THE CONTROLLED GROUP'S PARENT IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), A 501(C)(3) ORGANIZATION. THE SYSTEM OF HEALTHCARE ENTITIES OWNED AND CONTROLLED BY AHSSHC IS KNOWN AS ADVENTHEALTH. FOR THE YEAR ENDED DECEMBER 31, 2022, ADVENTHEALTH WILL FILE A CONSOLIDATED SINGLE AUDIT WHICH WILL INCLUDE ALL ENTITIES THAT ARE PART OF THE CONTROLLED GROUP. ACCORDINGLY, THE TAXPAYER HAS CHECKED YES TO THE QUESTIONS ON PART XII, LINE 3A AND 3B. ADVENTHEALTH ASHVILLE INC (5922 - 123122) 900 HOPE WAY ALTAMONTE SPRINGS FL 32714 921144574 FUTURE OPERATION OF HOSPITAL & RELATED SERVICES NC 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 ADVENTHEALTH FAMILY MEDICINE RURAL HEALTH CLINICS INC 187 PR 4060 LAMPASAS TX 76550 271858033 OPERATION OF RURAL HEALTH CLINICS & MEDICAL SERVICES FL 501(C)(3) LINE 3 METROPLEX ADVENTIST HOSPITAL INC 1 ADVENTHEALTH FOUNDATION FKA SUNSYSTEM DEVELOPMENT CORP 900 HOPE WAY ALTAMONTE SPRINGS FL 32714 592219301 FUND-RAISING FOR AFFILIATED TAX-EXEMPT HOSPITALS FL 501(C)(3) LINE 7 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 ADVENTHEALTH HOME CARE EAST FLORIDA LLC 770 WEST GRANADA BLVD 319 ORMOND BEACH FL 32174 833768458 INACTIVE FL 501(C)(3) LINE 10 MEMORIAL HLTH SYSTEMS INC 1 ADVENTHEALTH HOSPICE CARE EAST FLORIDA INC 770 WEST GRANADA BLVD 304 ORMOND BEACH FL 32174 833748461 INACTIVE FL 501(C)(3) LINE 10 MEMORIAL HLTH SYSTEMS INC 1 ADVENTHEALTH KANSAS CITY FOUNDATION 7315 E FRONTAGE ROAD MERRIAM KS 66204 480868859 FUND-RAISING FOR TAX-EXEMPT HOSPITALS KS 501(C)(3) LINE 7 SHAWNEE MISSION MEDICAL CENTER INC 1 ADVENTHEALTH NORTH POLK INC 3100 E FLETCHER AVE TAMPA FL 33613 593231322 INACTIVE FL 501(C)(3) LINE 12A, I UNIVERSITY COMMUNITY HOSPITAL INC 1 ADVENTHEALTH PALM COAST PARKWAY INC FKA AH EAST FLORIDA INC 900 HOPE WAY ALTAMONTE SPRINGS FL 32714 882288563 FUTURE OPERATION OF HOSPITAL & RELATED SERVICES FL 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 ADVENTHEALTH POLK NORTH INC 40100 US HIGHWAY 27 N DAVENPORT FL 33837 841793121 OPERATION OF HOSPITAL & RELATED SERVICES FL 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 ADVENTHEALTH POLK SOUTH INC 410 SOUTH 11TH STREET LAKE WALES FL 33853 834672945 OPERATION OF HOSPITAL & RELATED SERVICES FL 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 ADVENTHEALTH RANSOM MEMORIAL INC 1301 S MAIN STREET OTTAWA KS 66067 830976641 OPERATION OF HOSPITAL & RELATED SERVICES KS 501(C)(3) LINE 3 ADVENTIST HLTH MID-AMERICA INC 1 ADVENTHEALTH RIVERVIEW INC 14055 RIVEREDGE DRIVE STE 150 TAMPA FL 33637 870901094 FUTURE OPERATION OF HOSPITAL & RELATED SERVICES FL 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 ADVENTHEALTH SENIOR CARE INC 900 HOPE WAY ALTAMONTE SPRINGS FL 32714 841817046 OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES FL 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 ADVENTHEALTH SOUTH OVERLAND PARK INC 7820 W 165TH STREET OVERLAND PARK KS 66223 364595806 OPERATION OF HOSPITAL & RELATED SERVICES KS 501(C)(3) LINE 3 ADVENTIST HLTH MID-AMERICA INC 1 ADVENTHEALTH UNIVERSITY INC 671 WINYAH DRIVE ORLANDO FL 32803 593069793 EDUCATION/OPERATION OF SCHOOL FL 501(C)(3) LINE 2 ADVENTIST HLTH SYSTEMSUNBELT INC 1 ADVENTHEALTH WEST FLORIDA AMBULATORY SERVICES INC 14055 RIVEREDGE DRIVE STE 250 TAMPA FL 33637 471881744 SUPPORT OF IMAGING CENTER & HOME HEALTH SUBSIDIARIES FL 501(C)(3) LINE 12B, II ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 ADVENTHEALTH WEST FLORIDA IMAGING INC 14055 RIVEREDGE DRIVE STE 250 TAMPA FL 33637 843225135 IMAGING & TESTING FL 501(C)(3) LINE 3 ADVENTHEALTH WEST FLORIDA AMBULATORY SERVICES INC 1 ADVENTIST BOLINGBROOK HOSPITAL 500 REMINGTON BLVD BOLINGBROOK IL 60440 651219504 OPERATION OF HOSPITAL & RELATED SERVICES IL 501(C)(3) LINE 3 ADVENTIST MIDWEST HEALTH 1 ADVENTIST CARE CENTERS - COURTLAND INC 730 COURTLAND STREET ORLANDO FL 32804 205774723 OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY FL 501(C)(3) LINE 10 SUNBELT HLTH CARE CENTERS INC 1 ADVENTIST GLENOAKS HOSPITAL 701 WINTHROP AVENUE GLENDALE HEIGHTS IL 60139 363208390 OPERATION OF HOSPITAL & RELATED SERVICES IL 501(C)(3) LINE 3 ADVENTIST MIDWEST HEALTH 1 ADVENTIST HEALTH MID-AMERICA INC 9100 W 74TH STREET SHAWNEE MISSION KS 66204 521347407 SUPPORT OF AFFILIATED HOSPITAL KS 501(C)(3) LINE 12C, III-FI ADVENTIST HLTH SYSTEMSUNBELT INC 1 ADVENTIST HEALTH PARTNERS INC 5101 S WILLOW SPRINGS RD SUITE B101 LA GRANGE IL 60525 364138353 OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES IL 501(C)(3) LINE 3 ADVENTIST MIDWEST HEALTH 1 ADVENTIST HEALTH SYSTEM GEORGIA INC 1035 RED BUD ROAD NE CALHOUN GA 30701 581425000 OPERATION OF HOSPITAL & RELATED SERVICES GA 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 900 HOPE WAY ALTAMONTE SPRINGS FL 32714 592170012 MANAGEMENT SERVICES FL 501(C)(3) LINE 12A, I N/A 0 ADVENTIST HLTH SYSTEMSUNBELT INC 900 HOPE WAY ALTAMONTE SPRINGS FL 32714 591479658 OPERATION OF HOSPITALS & RELATED SERVICES FL 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 ADVENTIST HLTH SYSTEMTEXAS INC 11801 S FREEWAY BURLESON TX 76028 742578952 LEASING PERSONNEL TO AFFILIATED HOSPITAL TX 501(C)(3) LINE 12C, III-FI ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 ADVENTIST MIDWEST HEALTH 120 NORTH OAK STREET HINSDALE IL 60521 362276984 OPERATION OF HOSPITALS & RELATED SERVICES IL 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEMSUNBELT INC 1 AHP SPECIALTY CARE NFP 5101 S WILLOW SPRINGS RD SUITE B101 LA GRANGE IL 60525 811105774 OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES IL 501(C)(3) LINE 3 ADVENTIST MIDWEST HEALTH 1 AHS MIDWEST MANAGEMENT INC 500 REMINGTON BLVD BOLINGBROOK IL 60440 363354567 OPERATION OF PHYSICIAN PRACTICE MANAGEMENT IL 501(C)(3) LINE 12A, I ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 ALEXIAN BROTHERS-AHS MIDWEST REGION HEALTH CO (11-81722) 2601 NAVISTAR DR BLDG 4 FINANCE LISLE IL 60532 472360513 JOINT OPERATING COMPANY IL 501(C)(3) LINE 12B, II N/A 0 APOPKA HEALTH CARE PROPERTIES INC 305 E OAK STREET APOPKA FL 32703 510605694 LEASE TO RELATED ORGANIZATION GA 501(C)(3) LINE 12C, III-FI SUNBELT HLTH CARE CENTERS INC 1 BERT FISH MEDICAL CENTER AUXILIARY INC 401 PALMETTO STREET NEW SMYRNA BEACH FL 32168 591054892 VOLUNTEER SUPPORT SERVICES FL 501(C)(3) LINE 10 SOUTHEAST VOLUSIA HEALTHCARE CORP 0 BRADFORD HEIGHTS HEALTH & REHAB CENTER INC (11-122222) 485 NORTH KELLER ROAD 250 MAITLAND FL 32751 205782342 INACTIVE - WIND-DOWN KY 501(C)(3) LINE 10 SUNBELT HLTH CARE CENTERS INC 1 BURLESON NURSING & REHAB CENTER INC 301 HUGULEY BLVD BURLESON TX 76028 205782243 OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY TX 501(C)(3) LINE 10 SUNBELT HLTH CARE CENTERS INC 1 CHICKASAW HEALTH CARE PROPERTIES INC 250 S CHICKASAW TRAIL ORLANDO FL 32825 510605681 LEASE TO RELATED ORGANIZATION GA 501(C)(3) LINE 12C, III-FI SUNBELT HLTH CARE CENTERS INC 1 CHIPPEWA VALLEY HOSPITAL & OAKVIEW CARE CENTER INC 1220 THIRD AVENUE WEST DURAND WI 54736 391365168 OPERATION OF HOSPITAL & RELATED SERVICES WI 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEMSUNBELT INC 1 COALITION FOR PHYSICIAN WELL-BEING INC 900 HOPE WAY ALTAMONTE SPRINGS FL 32714 463477012 PROVIDE SUPPORT FOR PHYSICIAN WELL-BEING FL 501(C)(3) LINE 10 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 COURTLAND HEALTH CARE PROPERTIES INC 730 COURTLAND STREET ORLANDO FL 32804 510605682 LEASE TO RELATED ORGANIZATION GA 501(C)(3) LINE 12C, III-FI SUNBELT HLTH CARE CENTERS INC 1 CREEKWOOD PLACE NURSING & REHAB CENTER INC (11-12622) 485 NORTH KELLER ROAD 250 MAITLAND FL 32751 205782260 INACTIVE - 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