2023-11-15T11:11:41-06:00 2022-12-31 990 2022-01-01 480868859 AdventHealth Kansas City Foundation ADVE 9136762055 7315 E Frontage Road Merriam KS 66204 Laurie McCormack EXECUTIVE DIRECTOR 9136762055 2023-11-13 Laurie McCormack 999009999 0 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z Laurie McCormack 7315 E Frontage Road Merriam KS 66204 9183027 0 1071 X www.adventhealthkc.org/foundation X 1978 KS Fundraising for Tax-Exempt Hospital Organization 29 27 0 55 0 0 2265527 8846160 10075 0 476298 287746 -220368 -224109 2531532 8909797 2645743 1639598 0 0 0 0 0 0 0 301880 416231 2947623 2055829 -416091 6853968 19483773 23766739 368542 333307 19115231 23433432 To Inspire Philanthropy that will transform the lives of our patients, our donors, and our community through the healing mission of Shawnee Mission Medical Center, Inc. 0 0 1720216 1639598 0 Achievements to support Shawnee Mission Medical Center, Inc. and health care needs of the community, including fundraising activities and grant request monitoring. 1720216 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 1 0 0 1 1 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 X 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 29 27 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X Mairilise Pothin Owen 9136762153 9100 W 74TH STREET Shawnee Mission KS 66204 X Benjamin Jennifer Director 0.20 0.00 X 0 0 0 Bubb MD Stephen Director 0.20 0.00 X 0 0 0 Butler Jr James Director 0.20 0.00 X 0 0 0 Carlsen EdD Charles Director (End 10/22) 0.20 0.00 X 0 0 0 Cline Steve Director (Beg 1/22) 0.20 0.00 X 0 0 0 Cole Jr Martin Director 2.00 0.00 X 0 0 0 Crable Jennifer Dir/Secretary 0.20 0.00 X 0 0 0 Crippin Kent Dir/Emeritus 0.20 0.00 X 0 0 0 Cusick Barbara Director 0.20 1.00 X 0 525 0 Darling Harriet Dir/Emeritus 0.20 0.00 X 0 0 0 Deves Timothy Director 0.20 0.00 X 0 0 0 Gafney Todd Director/Chair 3.00 0.00 X 0 495 0 Gilman Mark Dir/Emeritus 0.20 0.00 X 0 0 0 Holland James Director (End 12/22) 0.20 0.00 X 0 0 0 Jackson MD Robert Director/Past Chair 0.20 1.00 X 0 0 0 Johnson Sheri Director (Beg 1/22) 0.20 0.00 X 0 0 0 Kelly Julie Director (End 1/22) 0.20 0.00 X 0 0 0 Kim Jay Director 0.20 0.00 X 0 0 0 Knecht Michael AHSM President 5.00 50.00 X X 0 713957 145562 McCormack Laurie Exec Director 40.00 10.00 X X 0 216551 36791 McEachen Richard Director 0.20 0.00 X 0 0 0 McGrath MD Barbara Director 0.20 0.00 X 0 0 0 Migliazzo MD Carl Director/Treasurer 2.00 0.00 X 0 0 0 Newcomer IV David Director 0.20 0.00 X 0 0 0 Pine Julie Director (Beg 1/22) 0.20 0.00 X 0 0 0 Ridgway MD Leah Director 0.20 0.00 X 0 0 0 Rist Twyla Director/ Chair-Elect 0.20 0.00 X 0 0 0 Rodgers Timothy Director 0.20 1.00 X 0 495 0 Saunders Kathy Director 0.20 0.00 X 0 0 0 Shull Richard Dir/Emeritus 0.20 0.00 X 0 0 0 White Ronda Director (Beg 1/22) 0.20 0.00 X 0 0 0 Withrow Nick Director 0.20 0.00 X 0 0 0 0 932023 182353 0 0 1 0 0 X 1082097 288012 7476051 458780 8846160 287666 287666 80 0 80 80 80 49121 1082097 273230 -224109 -224109 8909797 0 0 63637 1523325 1523325 18258 18258 98015 98015 189725 189725 50436 50436 23738 23738 45906 39963 5943 15957 8648 7309 58462 58462 Pledge Write-Off 22400 22400 Women's Health Expenses 9607 9607 2055829 1720216 335613 0 X 493689 5304678 1491950 3362550 1654408 1607226 15344445 12948850 499281 543435 19483773 23766739 368542 333307 368542 333307 X 504942 277063 18610289 23156369 19115231 23433432 19483773 23766739 6853968 -2535767 0 X X 0 1 X 1 1 1 X 3459617 1396370 3508237 2265527 8846160 19475911 3459617 1396370 3508237 2265527 8846160 19475911 7340854 12135057 592726 784958 289255 290783 287666 2245388 34280 0 52926 0 0 87206 21808505 45940 0.55640 0.61380 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6778139 109082 103036 168003 6822254 6639957 9769 178989 50576 6778139 6468663 32918 310064 171688 6639957 6271423 20709 303206 126675 6468663 5860298 28013 514102 130990 6271423 0.26628 0.73373 0.00000 0 0 0 Due to Affiliates 269518 Annuity Liabilities 63789 333307 X Part V, Line 4: AdventHealth Kansas City Foundation (The Foundation) is a supporting organization of Shawnee Mission Medical Center, Inc. (SMMC), a related Tax-Exempt Hospital that is also exempt under IRC Section 501(c)(3). The Foundation's Endowments consist of funds established to provide scholarships and support for the Lee Ann Britain Infant Development Center, Medical Mission, Lectures, Nurse Education and Medical Staff Education. 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 South America 0 0 Grantmaking 98015 0 0 0 0 0 0 98015 0 98015 South America - Argentina, Bolivia, Brazil, Chile, Columbia, Ecuador, General Support 98015 Check 0 Cash 1 0 0 0 0 0 0 0 Part I, Line 2: Foreign Grants are typically made only to the supported hospital organization that is exempt from federal income tax under 501(c)(3) for medical services provided outside the United States. Given that foreign grants are made indirectly, the filing organization has not established specific procedures for monitoring the use of grant funds outside the United States. Part III Accounting Method: TINY TIM 1131218 1082097 49121 77317 128760 67153 1131218 1082097 49121 77317 128760 67153 273230 -224109 1 Shawnee Mission Medical Center Inc 9100 W 74th Street Shawnee Mission KS 66204 480637331 501(c)(3) 1341893 0 General Hospital Support Shawnee Mission Medical Center Inc 9100 W 74th Street Shawnee Mission KS 66204 480637331 501(c)(3) 181431 0 Women's Health Education Seminar 1 0 Food, Clothing, and Shelter 11 12031 0 Other 17 6227 0 Part I, Line 2: Grants are generally made only to the supported hospital organization that is exempt from Federal Income Tax under 501(c)(3). 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. 0 1 0 0 0 0 0 0 0 Knecht Michael AHSM President 0 512681 0 113491 0 87785 0 93312 0 52250 0 859519 0 54462 McCormack Laurie Exec Director 0 190730 0 23938 0 1883 0 11583 0 25208 0 253342 0 0 Part I, Line 3 As noted in our response to question 15 of Part VI of Form 990, the individual who serves as the executive director of the filing organization is compensated by Shawnee Mission Medical Center, Inc. (SMMC) for that individual's role in serving as the executive director. Compensation and benefits provided to this individual are determined pursuant to policies, procedures, and processes of SMMC that are designed to ensure that all employees serving in management roles are provided compensation reflective of fair market value given their roles and responsibilities. SMMC uses the following to establish compensation of the executive director: - Compensation survey or study Part I, Line 4b The individual who serves as the President/CEO of Shawnee Mission Medical Center, Inc., d/b/a Advent Health Shawnee Mission is compensated by and on the payroll of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the parent organization of the healthcare system known as AdventHealth. In recognition of the contribution that each executive makes to the success of AdventHealth, AdventHealth provides supplemental executive retirement benefit plans to eligible executives. As the supplemental executive retirement benefit plans were updated in 2020 and certain individuals still participate as grand-fathered participants in certain plans, the narrative below discusses all plans in which there were any participants in 2022. The SERP III plan effectively replaces the prior SERP II plan, the Executive Flex Benefit Program Plan, and the Senior Executive Death Benefit Plan for qualified executives except for certain grandfathered executive employees. 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. 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. Contributions/Distributions: Flex Plan Flex Plan SERP II SERP III Contr. Distr.* Contr./Distr. Contr. Knecht, Michael $ 72,296 $ 64,648 $ 0 $ 4,617 * Including Investment Earnings X 4 236357 Cost of Donated Property X In- Kind Administrative Expenses 1 222423 Cost of Donated Expe X Donated Auction Items 127 54229 FMV 0 0 0 0 Form 990, Part V, line 1a: The sole member of the filing organization is Shawnee Mission Medical Center, Inc., d/b/a AdventHealth Shawnee Mission (AHSM). The parent corporation and sole top-tier member of AHSM 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 2 Family Relationship - Richard Shull and James Butler Jr. Family Relationship - Richard Shull and Timothy Rodgers Form 990, Part VI, Section A, line 4 The articles of incorporation and the bylaws for AdventHealth Kansas City Foundation were modified in the 2022 tax-year. The same significant changes were made in both organizing documents and are as follows: The name of the filing organization was changed from AdventHealth Foundation Shawnee Mission to AdventHealth Kansas City Foundation. One of the purposes of the filing organization was changed from exclusively fostering the charitable purposes of Shawnee Mission Medical Center, Inc., the sole member of the filing organization, to fostering the charitable purposes of the AdventHealth hospitals located in the Kansas City area, including, but not limited to, (i) Shawnee Mission Medical Center, Inc., d/b/a AdventHealth Shawnee Mission, (ii) AdventHealth South Overland Park, Inc., and (iii) any successor or future AdventHealth hospital located in the Kansas City area. Form 990, Part VI, Section A, line 6 AdventHealth Kansas City Foundation, (the filing organization) has one member. The sole member of the filing organization is Shawnee Mission Medical Center, Inc., d/b/a AdventHealth Shawnee Mission (AHSM). AHSM is a Kansas, not-for-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). There are no other classes of membership in the filing organization. Form 990, Part VI, Section A, line 7a The sole member of the filing organization is AHSM. New members of board of directors of the filing organization must be approved by the governing board of AHSM before they can be presented to the filing organization's board of directors for approval. Form 990, Part VI, Section A, line 7b AHSM, the sole member of the filing organization is required to approve the following actions before they can be approved by the filing organization's board of directors: a. Changes to the bylaws and articles of incorporation of the filing organization; b. Plans to restructure the filing organization; c. Changes to the filing organization's purposes or tax classification; d. The nomination for officers of the filing organization; e. The selection of the Executive Director; and f. The appointment of a Custodian of Securities. Form 990, Part VI, Section B, line 11b The filing organization's current year Form 990 was reviewed by the Executive Director and the CEO (a board member) and CFO of the supported hospital prior to its filing with the IRS. The review conducted by the Executive Director and the CEO (a board member) and CFO of the supported hospital 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 (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 (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, is required to disclose in writing the existence of any conflict of interest with the filing organization or any of the charitable organizations supported by the filing organization. Form 990, Part VI, Section B, line 15 The Executive Director of the filing organization is on the payroll of Shawnee Mission Medical Center, Inc. (SMMC). The compensation of the Executive Director is determined by SMMC. Please see the discussion concerning the process followed by the related top-tier parent organization in determining executive compensation in our response to Schedule J, Line 3. Form 990, Part VI, Section C, line 19 The filing organization does not generally make its governing documents, conflict of interest policy or financial statements available to the public. Part VII, Section A: For those officers 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 as an employee of Adventist Health System Sunbelt Healthcare Corporation. Part VIII, Lines 7a, b and c: The amounts shown in Part VIII, Lines 7a(i), 7b(i) and 7c(i) of the Form 990 includes an allocated share of capital gain/(loss) from a system wide, corporate administered, investment program. Part X, Line 2: The amounts shown on line 2 of Part X of this return include the filing organization's interest in a central investment pool maintained by Adventist Health System Sunbelt Healthcare Corporation, the filing organization's top-tier parent. The investments in the central investment pool are recorded at market value. Part XII, Line 3b: Although the taxpayer is not required to undergo an audit as set forth in the Single Audit Act and OMB Circular A-133, 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 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 - Wind-Down KY 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Dairy Road Health Care Properties Inc 7350 Dairy Road Zephyrhills FL 33540 510605684 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 East Orlando Health & Rehab Center Inc 250 S Chickasaw Trail Orlando FL 32825 205774748 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Fletcher Hospital Inc 100 Hospital Drive Hendersonville NC 28792 560543246 Operation of Hospital & Related Services NC 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 FLNC Inc 3355 E Semoran Blvd Apopka FL 32703 205774761 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Florida Hospital Dade City Inc 13100 Fort King Road Dade City FL 33525 822567308 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Florida Hospital Healthcare Partners Inc 770 West Granada Blvd 101 Ormond Beach FL 32174 462354804 Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Florida Hospital Medical Group Inc 2600 Westhall Lane 4th Floor Maitland FL 32751 593214635 Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Florida Hospital Ocala Inc 1500 SW 1st Avenue Ocala FL 34471 824372339 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Florida Hospital Physician Group Inc 12470 Telecom Dr 100 Tampa FL 33637 462021581 Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Florida Hospital Waterman Inc 1000 Waterman Way Tavares FL 32778 593140669 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Florida Hospital Zephyrhills Inc 7050 Gall Blvd Zephyrhills FL 33541 592108057 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Florida Radiology Imaging at Lake Mary LLC 2600 Westhall Lane 4th Floor Maitland FL 32751 550789387 Imaging & Testing FL 501(c)(3) Line 3 Florida Hospital Medical Group Inc 1 Fountain Inn Nursing & Rehab Center Inc 4501 Waterman Way Tavares FL 32778 472180518 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Helen Ellis Memorial Hospital Auxiliary Inc 1395 S Pinellas Ave Tarpon Springs FL 34689 592106043 Fund-raising for Tax-exempt hospital/foundation FL 501(c)(3) Line 12c, III-FI N/A 0 Helen Ellis Memorial Hospital Foundation Inc 1395 S Pinellas Ave Tarpon Springs FL 34689 593690149 Fund-raising for Tax-exempt hospital FL 501(c)(3) Line 7 N/A 0 Hinsdale Hospital Foundation 120 North Oak Street Hinsdale IL 60521 521466387 Fund-raising for Tax-exempt hospital IL 501(c)(3) Line 7 Midwest Hlth Foundation 0 Hospice of the Comforter Inc 480 W Central Parkway Altamonte Springs FL 32714 592935928 Operation of Hospice FL 501(c)(3) Line 10 The Comforter Health Care Group Inc 1 In-Motion Rehab Inc (11-122722) 485 North Keller Road 250 Maitland FL 32751 208023411 Inactive KS 501(c)(3) Line 12b, II Sunbelt Hlth Care Centers Inc 1 Lake County Health Care Properties Inc (11-122822) 485 North Keller Road 250 Maitland FL 32751 813923985 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Memorial Health Systems Foundation Inc 305 Memorial Medical Pkwy 212 Daytona Beach FL 32117 311771522 Fund-raising for Tax-exempt hospital FL 501(c)(3) Line 7 N/A 0 Memorial Health Systems Inc 301 Memorial Medical Parkway Daytona Beach FL 32117 590973502 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Memorial Hospital - West Volusia Inc 701 West Plymouth Avenue Deland FL 32720 593256803 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Memorial Hlth Systems Inc 1 Memorial Hospital Flagler Inc 60 Memorial Medical Parkway Palm Coast FL 32164 592951990 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Memorial Hlth Systems Inc 1 Memorial Hospital Inc 210 Marie Langdon Drive Manchester KY 40962 610594620 Operation of Hospital & Related Services KY 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Metroplex Adventist Hospital Inc 2201 S Clear Creek Road Killeen TX 76549 742225672 Operation of Hospital & Related Services TX 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Metroplex Clinic Physicians Inc 2201 S Clear Creek Road Killeen TX 76549 113762050 Physician Healthcare services to the community TX 501(c)(3) Line 3 Metroplex Adventist Hospital Inc 1 Midwest Health Foundation 120 North Oak Street Hinsdale IL 60521 352230515 Fund-Raising for Supported Exempt Hospitals IL 501(c)(3) Line 7 N/A 0 Mills Health & Rehab Center Inc(11-12622) 485 North Keller Road 250 Maitland FL 32751 205782320 Inactive - Wind-Down KY 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Mission Strategies of Georgia Inc 485 North Keller Road 250 Maitland FL 32751 900866024 Provision of support to the nursing home division GA 501(c)(3) Line 12b, II Sunbelt Hlth Care Centers Inc 1 Missouri Adventist Health Inc 9100 W 74th Street Shawnee Mission KS 66204 431224729 Support Health Care Services MO 501(c)(3) Line 12d, III-O Adventist Hlth Mid-America Inc 1 Osceola Health Care Properties Inc 485 North Keller Road 250 Maitland FL 32751 813165729 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Overland Park Nursing & Rehab Center Inc 6501 West 75th Street Overland Park KS 66204 205774821 Operation of Home for the Aged/Hlthcare Delivery KS 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Pasco-Pinellas Hillsborough Community Hlth System Inc 2600 Bruce B Downs Blvd Wesley Chapel FL 33544 208488713 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Portercare Adventist Health System (630 YE) 9100 E Mineral Circle Centennial CO 80112 840438224 Operation of Hospitals & Related Services CO 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Princeton Health & Rehab Center Inc (11-12622) 485 North Keller Road 250 Maitland FL 32751 205782272 Inactive - Wind-Down KY 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Princeton Homecare Services LLC (81 - 123122) 602 Courtland Street 310 Orlando FL 32804 814196648 Home Health Care Servcies FL 501(c)(3) Line 10 Princeton Prof Services Inc 1 Princeton Professional Services Inc 601 E Rollins Street Orlando FL 32803 591191045 Provision of Healthcare Services FL 501(c)(3) Line 10 Adventist Hlth System Sunbelt Hlthcare Corp 1 Quality Circle for Healthcare Inc 900 Hope Way Altamonte Springs FL 32714 263789368 Healthcare Quality Services FL 501(c)(3) Line 12a, I Adventist Hlth System Sunbelt Hlthcare Corp 1 Redmond Park Hospital LLC 501 Redmond Road NW Rome GA 30165 581123037 Operation of Hospital & Related Services GA 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Resource Personnel Inc 485 North Keller Road 250 Maitland FL 32751 208040875 Provide administrative support to tax exempt nursing homes FL 501(c)(3) Line 12b, II Sunbelt Hlth Care Centers Inc 1 Rocky Mountain Adventist Hlthcare Foundation (630 YE) 960 E Harvard Avenue Ste 230 Denver CO 80210 840745018 Fund-raising for Tax-exempt hospital CO 501(c)(3) Line 7 N/A 0 Rollins Brook Community Care Corp 2201 S Clear Creek Road Killeen TX 76549 461656773 Support Operation of Hospital TX 501(c)(3) Line 12a, I Adventist Hlth SystemSunbelt Inc 1 San Marcos Nursing & Rehab Center Inc 1900 Medical Parkway San Marcos TX 78666 205782224 Operation of Home for the Aged/Hlthcare Delivery TX 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Shawnee Mission Hlth Care Properties Inc 485 North Keller Road 250 Maitland FL 32751 813914908 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Shawnee Mission Health Care Inc 6501 West 75th Street Overland Park KS 66204 480952508 Lease to Related Organization KS 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Shawnee Mission Medical Center Inc 9100 W 74th Street Shawnee Mission KS 66204 480637331 Operation of Hospital & Related Services KS 501(c)(3) Line 3 Adventist Hlth Mid-America Inc 1 South Pasco Health Care Properties Inc 38250 A Avenue Zephyrhills FL 33542 510605679 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Southeast Volusia Healthcare Corp 401 Palmetto Street New Smyrna Beach FL 32168 473793197 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Southwest Volusia Health Services Inc 1055 Saxon Blvd Orange City FL 32763 593281591 Medical Office Building for Hospital FL 501(c)(3) Line 12a, I Southwest Volusia Hlthcare Corp 1 Southwest Volusia Healthcare Corp 1055 Saxon Blvd Orange City FL 32763 593149293 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Spring View Health & Rehab Center Inc (11-122222) 485 North Keller Road 250 Maitland FL 32751 205782288 Inactive - Wind-Down KY 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Sunbelt Health & Rehab Center - Apopka Inc 305 East Oak Street Apopka FL 32703 205774856 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Sunbelt Health Care Centers Inc 485 North Keller Road 250 Maitland FL 32751 581473135 Management Services TN 501(c)(3) Line 12b, II Adventist Hlth System Sunbelt Hlthcare Corp 1 Tarpon Springs Hospital Foundation Inc 1395 S Pinellas Ave Tarpon Springs FL 34689 590898901 Operation of Hospital & Related Services FL 501(c)(3) Line 3 University Community Hospital Inc 1 Tarrant County Health Care Properties Inc 301 Huguley Blvd Burleson TX 76028 510605677 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 The Comforter Health Care Group Inc 605 Montgomery Road Altamonte Springs FL 32714 271857940 Support Services to Related Hospice FL 501(c)(3) Line 12c, III-FI Adventist Hlth System Sunbelt Hlthcare Corp 1 Tri-County Nursing and Rehab Center Inc 1290 Celebration Blvd Kissimmee FL 34747 472219363 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 University Community Hospital Foundation Inc 3100 E Fletcher Ave Tampa FL 33613 592554889 Fund-raising for Tax-exempt hospital FL 501(c)(3) Line 7 N/A 0 University Community Hospital Inc 3100 E Fletcher Ave Tampa FL 33613 591113901 Operation of Hospitals & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 West Florida Health Home Care Inc 13601 Bruce B Downs Blvd Ste 110 Tampa FL 33613 593686109 Home Health Services GA 501(c)(3) Line 10 AdventHealth West Florida Ambulatory Svcs Inc 1 Zephyr Haven Health & Rehab Center Inc 38250 A Avenue Zephyrhills FL 33542 205774930 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Zephyrhills Health & Rehab Center Inc 7350 Dairy Road Zephyrhills FL 33540 205774967 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Fletcher Hospital Surgical Ventures LLC 9131 Anson Way Ste 304 Raleigh NC 27615 861482646 Indirect Interest in Surgery Center NC N/A 0 0 Florida Hospital DMERT LLC 500 Winderley Place Ste 324 Maitland FL 32751 202392253 Medical Equipment FL N/A 0 1 Florida Hospital Home Infusion LLP 500 Winderley Place Ste 226 Maitland FL 32751 593142824 Home Infusion Services FL N/A 0 1 Functional Neurosurgical Ambulatory Surgery Ctr LLC 11 W Dry Creek Circle 120 Littleton CO 80120 464426708 Surgery Center CO N/A 0 0 M&O Orlando MOB I LLC 1919 N Orange Ave Ste E Orlando FL 32804 844259138 Operation of Medical Office Building DE N/A 0 0 OnPoint OBGYN LLC (21-123122) 7780 S Broadway 280 Littleton CO 80122 873522453 Healthcare Services CO N/A 0 0 PAHS OnPoint Imaging LLC 9205 S Broadway Highlands Ranch CO 80129 833275105 Imaging Center CO N/A 0 0 PAHS OnPoint Urgent Care LLC 9100 E Mineral Circle Centennial CO 80112 832465331 Urgent Care Center CO N/A 0 0 Princeton Homecare Services LLC (11-8122) 602 Courtland Street 310 Orlando FL 32804 814196648 Operation of Home Health Agency FL N/A 0 0 Surgery Center of Rome LP 501 Redmond Road NW Rome GA 30165 200390305 Surgery Center GA N/A 0 0 The Bariatric Center of Kansas City LLC 9100 W 74th Street Merriam KS 66204 823025378 Surgery Center KS N/A 0 0 Urgent Care Centers of Brevard County LLC 2600 Westhall Lane Maitland FL 32751 844261523 Urgent Care Centers FL N/A 0 1 AdventHealth Orlando Network Inc (11 - 41922) 900 Hope Way Altamonte Springs FL 32714 862639185 Inactive FL N/A C 1 AdventHealth Professional Staffing Inc (11 - 12822) 900 Hope Way Altamonte Springs FL 32714 880742779 INACTIVE FL N/A C 1 AdventHealth Tampa Network Inc (11 - 41922) 900 Hope Way Altamonte Springs FL 32714 862666178 Inactive FL N/A C 1 AdventHealth Team Members Inc (11 - 12822) 900 Hope Way Altamonte Springs FL 32714 880763664 INACTIVE FL N/A C 1 AdventHealth Value Based Bundle Management LLC (61-123122) 101 Southhall Lane Ste 150 Maitland FL 32751 873487910 Medical Contracting and Billing FL N/A C 1 Altamonte Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando FL 32803 592855792 Condo Association FL N/A C 1 Apopka Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando FL 32803 593000857 Condo Association FL N/A C 1 Battle Creek Adventist Hospital 900 Hope Way Altamonte Springs FL 32714 381359189 Inactive MI N/A C 1 Florida Hospital Flagler Medical Offices Association Inc 60 Memorial Medical Parkway Palm Coast FL 32164 262158309 Condo Association FL N/A C 1 Florida Hosp Hlth Village Property Owner's Assoc Inc 550 E Rollins Street 7th Floor Orlando FL 32803 821748255 Condo Association FL N/A C 1 Florida Hospital Healthcare System Inc 101 Southhall Lane Ste 150 Maitland FL 32751 593215680 PHSO / CIN FL N/A C 1 Florida Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando FL 32803 592855791 Condo Association FL N/A C 1 Kissimmee Multispecialty Clinic Condominium Association Inc 201 Hilda Street Suite 30 Kissimmee FL 34741 593539564 Condo Association FL N/A C 1 Midwest Management Services Inc 9100 West 74th Street Shawnee Mission KS 66204 480901551 Inactive KS N/A C 1 North American Health Services Inc & Sub 900 Hope Way Altamonte Springs FL 32714 621041820 Holding Co. TN N/A C 1 Ormond Prof Associates Condo Assoc Inc (430 year end) 770 W Granada Blvd Ste 101 Ormond Beach FL 32174 592694434 Condo Association FL N/A C 1 Park Ridge Property Owner's Association Inc 1 Park Place Naples Road Fletcher NC 28732 030380531 Condo Association NC N/A C 1 Park Ridge Condominium #1 Unit Owners Association Inc 1 Park Place Naples Road Fletcher NC 28732 010584623 Condo Association NC N/A C 1 Surgicare of Rome Inc 501 Redmond Rd Rome GA 30165 200376307 Holding Company GA N/A C 1 Redmond Park Health Services Inc 501 Redmond Rd Rome GA 30165 621330078 Holding Company GA N/A C 1 The Garden Retirement Community Inc 485 North Keller Road Ste 250 Maitland FL 32751 593414055 Real Estate Rental FL N/A C 1 Winter Park Medical Office Building I Condo Assoc Inc 601 East Rollins Street Orlando FL 32803 452228478 Condo Association FL N/A C 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 1 Shawnee Mission Medical Center Inc B 1621339 Actual Amount Given Shawnee Mission Medical Center Inc C 282973 Actual Amount Received Shawnee Mission Medical Center Inc M 925458 Cost Shawnee Mission Medical Center Inc P 147579 Cost shawnee Mission Medical Center Inc S 214923 Actual Amount Received