2024-11-13T08:41:22-06:00 2023-12-31 990 2023-01-01 311771522 MEMORIAL HEALTH SYSTEMS FOUNDATION INC MEMO 3866154144 305 MEMORIAL MEDICAL PKWY 212 DAYTONA BEACH FL 32117 TIM NORTON EXECUTIVE DIRECTOR 3866154144 2024-10-22 0 2023 2024-10-15 13:58:12Z ADVENTHEALTH DAYTONA BEACH FOUNDATION TIM NORTON 305 MEMORIAL MEDICAL PKWY 212 DAYTONA BEACH FL 32117 3905409 0 X WWW.ADVENTHEALTH.COM/ADVENTHEALTH-FOUNDATION X 2000 FL FUND RAISING FOR THE NEEDS OF MEMORIAL HEALTH SYSTEMS, INC. DBA ADVENTHEALTH DAYTONA BEACH. 17 14 0 21 0 0 131470 199577 57895 1458630 384551 269928 50796 52723 624712 1980858 60490 1494396 0 0 0 0 0 0 0 99460 140298 159950 1634694 464762 346164 11460855 11704223 124322 48556 11336533 11655667 FUND-RAISING AND VOLUNTEER ACTIVITY FOR SUPPORTED HOSPITAL. 0 0 1494396 1494396 1458630 THE PRIMARY EXEMPT PURPOSE OF MEMORIAL HEALTH SYSTEMS FOUNDATION, INC. (THE FOUNDATION) IS TO CONDUCT FUND-RAISING ON BEHALF OF MEMORIAL HEALTH SYSTEMS, INC. (MHS), AN IRC SECTION 501(C)(3) ORGANIZATION. 1494396 1 1 0 0 0 0 0 0 1 1 1 0 0 1 0 1 1 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 17 14 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 FL X CORY DOMAYER 3866154144 301 MEMORIAL MEDICAL PKWY DAYTONA BEACH FL 32117 X SCHNEIDER MD JULIE DIRECTOR 0.20 50.00 X 0 1086075 26431 WEIS DAVID DIRECTOR 0.20 50.00 X 0 694873 117174 DOMAYER CFO CORY DIRECTOR 0.20 50.00 X 0 432889 99666 RAND JULIE EXECUTIVE DIRECTOR 50.00 0.00 X 0 168459 17001 ADAMS JOHN PRESIDENT/DIRECTOR 0.20 0.12 X 0 250 0 DAWSON MELINDA CHAIRMAN/DIRECTOR 0.20 0.19 X 0 250 0 FERGUSON JOHN DIRECTOR 0.20 0.15 X 0 250 0 CHITTENDEN OWEN DIRECTOR (END 12/2023) 0.20 0.00 X 0 0 0 DORIS TROY DIRECTOR (END 12/2023) 0.20 0.00 X 0 0 0 GAMMERO DEANA DIRECTOR 0.20 0.00 X 0 0 0 HOSSEINI NIKA DIRECTOR 0.20 0.00 X 0 0 0 KEARNEY CFP ADAM DIRECTOR 0.20 0.00 X 0 0 0 MILLER PAULA DIRECTOR (END 12/2023) 0.20 0.00 X 0 0 0 MILTHORPE KATHRYN DIRECTOR (END 12/2023) 0.20 0.00 X 0 0 0 OLIVARI CPA JOHN DIRECTOR 0.20 0.20 X 0 0 0 SIMPKINS JILL DIRECTOR 0.20 0.00 X 0 0 0 VOGES WILLIAM DIRECTOR (END 12/2023) 0.20 0.00 X 0 0 0 YEOMANS GARY DIRECTOR 0.20 0.00 X 0 0 0 0 2383046 260272 0 0 1 0 0 31386 59813 108378 59813 199577 SATISFACTION OF PROGRAM RESTRICTI 900099 1458630 1458630 1458630 240589 240589 1933379 1904040 29339 29339 29339 73234 31386 20511 52723 52723 1980858 1458630 0 322651 X 1466527 1466527 27869 27869 15000 15000 70604 70604 18570 18570 3046 3046 18284 18284 8175 8175 1125 1125 FOOD COSTS 3233 3233 DUES & SUBSCRIPTIONS 833 833 GIFTS 150 150 1278 1278 1634694 1494396 140298 0 2642349 689487 919894 681011 1020 40817 15200 15200 0 0 6791809 9090957 16681 16106 1089102 1185845 11460855 11704223 16774 19592 107548 28964 124322 48556 X 4263099 5482135 7073434 6173532 11336533 11655667 11460855 11704223 X 346164 1073965 -1100995 X 0 1 X 1 0 X 458611 294345 1000068 2000491 557213 4310728 458611 294345 1000068 2000491 557213 4310728 2218892 2091836 187661 174467 256863 365513 240589 1225093 5535821 0.37790 0.39820 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 3936919 96742 4033661 4216400 -279481 3936919 4109813 106587 4216400 4008737 101076 4109813 3846292 162445 4008737 0.00000 1.00000 0.00000 0 0 15200 15200 0 0 CHARITABLE REMAINDER TRUST RECEIVABLE 16649 BENEFICIAL INTEREST IN PERPETUAL TRUSTS 1169196 1185845 X 3144833 977223 341195 20511 1338929 1805904 70604 104350 174954 1980858 1925798 341195 20511 361706 1564092 70604 -2 70602 1634694 PART IV, LINE 2B: THE FUNDS HELD FOR AGENCIES PRIMARILY CONSIST OF AMOUNTS HELD ON BEHALF OF THE SUPPORTED HOSPITAL ORGANIZATION WITH RESPECT TO A CARDIOPULMONARY GRANT AND ITS EMPLOYEE ASSISTANCE FUND. PART V, LINE 4: MEMORIAL HEALTH SYSTEMS FOUNDATION, INC. (THE FOUNDATION) HAS CERTAIN ENDOWMENTS ESTABLISHED FOR A VARIETY OF PURPOSES IN SUPPORT OF MEMORIAL HEALTH SYSTEMS, INC., A RELATED TAX-EXEMPT HOSPITAL ORGANIZATION THAT IS ALSO EXEMPT UNDER IRC SECTION 501(C)(3). THE FOUNDATION'S ENDOWMENTS CONSIST OF THREE INDIVIDUAL FUNDS ESTABLISHED BY DONORS TO PROVIDE ANNUAL FUNDING FOR SPECIFIC ACTIVITIES AND GENERAL OPERATIONS. ALL OF THE FOUNDATION'S PERMANENTLY RESTRICTED ENDOWMENT FUNDS ARE REQUIRED TO BE RETAINED PERMANENTLY EITHER BY EXPLICIT DONOR STIPULATION OR BY THE FLORIDA UNIFORM PRUDENT MANAGEMENT OF INSTITUTIONAL FUNDS ACT. PART X, LINE 2: THE SEPARATE AUDITED FINANCIAL STATEMENTS OF THE FILING ORGANIZATION CONTAIN THE FOLLOWING FOOTNOTE REGARDING INCOME TAXES: THE FOUNDATION QUALIFIES AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND, THEREFORE, HAS MADE NO PROVISION FOR FEDERAL INCOME TAXES. IN ADDITION, THE FOUNDATION QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 509(A). MANAGEMENT OF THE FOUNDATION CONSIDERS THE LIKELIHOOD OF CHANGES BY TAXING AUTHORITIES IN ITS FILED INCOME TAX RETURNS AND RECOGNIZES A LIABILITY FOR OR DISCLOSES POTENTIAL SIGNIFICANT CHANGES THAT MANAGEMENT BELIEVES ARE MORE LIKELY THAN NOT TO OCCUR, INCLUDING CHANGES TO THE FOUNDATION'S STATUS AS A NOT-FOR-PROFIT ENTITY. MANAGEMENT BELIEVES THE FOUNDATION MET THE REQUIREMENTS TO MAINTAIN ITS TAX-EXEMPT STATUS AND HAS NOT IDENTIFIED ANY UNCERTAIN TAX POSITIONS SUBJECT TO THE UNRELATED BUSINESS INCOME TAX THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE FOUNDATION'S INCOME TAX RETURNS FOR THE PAST THREE YEARS ARE SUBJECT TO EXAMINATION BY TAX AUTHORITIES, AND MAY CHANGE UPON EXAMINATION. THE FOUNDATION'S POLICY IS TO CLASSIFY INCOME TAX RELATED INTEREST AND PENALTIES IN INTEREST EXPENSE AND OTHER EXPENSES, RESPECTIVELY. PART XI, LINE 2D - OTHER ADJUSTMENTS: RECLASS EXPENSE FOR SPECIAL EVENTS 20,511. PART XI, LINE 4B - OTHER ADJUSTMENTS: SPECIAL EVENTS REVENUE - TEMPORARILY RESTRICTED 104,350. PART XII, LINE 2D - OTHER ADJUSTMENTS: RECLASS EXPENSE FOR SPECIAL EVENTS 20,511. PART XII, LINE 4B - OTHER ADJUSTMENTS: ROUNDING -2. GOLF TOURNAMENT 104620 31386 73234 0 0 11424 0 0 9087 104620 31386 73234 11424 9087 20511 52723 1 MEMORIAL HEALTH SYSTEMS INC DBA ADVENTHEALTH DAYTONA BEACH 303 MEMORIAL MEDICAL PKWY DAYTONA BEACH FL 32119 590973502 501(C)(3) 1466527 0 GENERAL SUPPORT 1 0 FOOD, CLOTHING & SHELTER 6 1261 BOOKS AND SUPPLIES 8 2367 TRANSPORTATION FOR MEDICAL PATIENTS 47 21774 MEDICAL TRAININGS INCLUDING SMOKING CESSATION AND DIABETES CARE 15 2466 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) 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 OR TO OTHER 501(C)(3) ORGANIZATIONS THAT SUPPORT THE GOALS AND OBJECTIVES OF THE SUPPORTED HOSPITAL. 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 SCHNEIDER MD JULIE DIRECTOR 0 498936 0 582626 0 4513 0 17727 0 8704 0 1112506 0 0 WEIS DAVID DIRECTOR 0 508461 0 123232 0 63180 0 86035 0 31139 0 812047 0 36086 DOMAYER CFO CORY DIRECTOR 0 338574 0 70213 0 24102 0 69280 0 30386 0 532555 0 0 RAND JULIE EXECUTIVE DIRECTOR 0 153573 0 13161 0 1725 0 7902 0 9099 0 185460 0 0 PART I, LINE 4B THE CEO AND CFO OF THE FILING ORGANIZATION'S SUPPORTED HOSPITAL SERVE ON THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION. THESE INDIVIDUALS ARE COMPENSATED BY AND ON THE PAYROLL OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), 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 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 2023. 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 $330,000 IN 2023 (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. WEIS, DAVID $ 61,443 $ 36,658 $ 0 $ 13,464 DOMAYER, CORY $ 0 $ 0 $ 0 $ 51,553 *INCLUDING INVESTMENT EARNINGS X IN-KIND ADMINISTRATIVE EXPENSES 1 59813 COST 0 0 0 PART I, COLUMN (B): THE NUMBER OF CONTRIBUTIONS REPORTED IN COLUMN (B) OF SCHEDULE M, PART I, REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED BY THE FILING ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE FILING ORGANIZATION'S CURRENT YEAR FORM 990 WAS REVIEWED BY THE EXECUTIVE DIRECTOR OF THE FILING ORGANIZATION, PRIOR TO ITS FILING WITH THE IRS. THE REVIEW CONDUCTED BY THE EXECUTIVE 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 C, LINE 19 THE FILING ORGANIZATION DOES NOT GENERALLY MAKE ITS GOVERNING DOCUMENTS, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. PART VII, SECTION A FOR THOSE BOARD OF DIRECTOR MEMBERS (NOT INCLUDING PHYSICIAN MEMBERS OF THE BOARD), WHO DEVOTE LESS THAN FULL-TIME TO THE FILING ORGANIZATION (BASED UPON THE AVERAGE NUMBER OF HOURS PER WEEK SHOWN IN COLUMN (B) ON PAGE 7 OF THE RETURN) THE COMPENSATION AMOUNTS SHOWN IN COLUMNS (E) AND (F) ON PAGE 7 WERE PROVIDED IN CONJUNCTION WITH THAT PERSON'S RESPONSIBILITIES AND ROLES IN SERVING IN AN EXECUTIVE LEADERSHIP POSITION AS AN EMPLOYEE OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION. PHYSICIAN MEMBERS OF THE BOARD OF DIRECTORS RECEIVED COMPENSATION FROM RELATED ORGANIZATIONS AS A RESULT OF PROVIDING VARIOUS MEDICAL SERVICES TO THOSE RELATED ENTITIES. FORM 990, PART IX, LINE 11G CONSULTING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 18,349. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 18,349. OTHER: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 221. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 221. FORM 990, PART XI, LINE 9: RESTRICTED CONTRIBUTIONS 357,636. TRANSFER OF NET ASSETS FROM RESTRICTED FUND BALANCE -1,458,630. ROUNDING -1. ADVENTHEALTH ASHEVILLE INC 100 HOSPITAL DRIVE HENDERSONVILLE NC 28792 921144574 FUTURE OPERATION OF HOSPITAL & RELATED SERVICES NC 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 0 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 0 ADVENTHEALTH FOUNDATION INC 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 0 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 0 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 0 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 0 ADVENTHEALTH PALM COAST PARKWAY INC 1 ADVENTHEALTH WAY PALM COAST FL 32137 882288563 OPERATION OF HOSPITAL & RELATED SERVICES FL 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 0 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 0 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 0 ADVENTHEALTH PRIMARY CARE NETWORK INC (630-123123) 900 HOPE WAY ALTAMONTE SPRINGS FL 32714 932208118 FUTURE OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES FL 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 0 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 0 ADVENTHEALTH RIVERVIEW INC 9330 US HIGHWAY 301 S TAMPA FL 33637 870901094 FUTURE OPERATION OF HOSPITAL & RELATED SERVICES FL 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 0 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 0 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 0 ADVENTHEALTH UNIVERSITY INC 671 WINYAH DRIVE ORLANDO FL 32803 593069793 EDUCATION/OPERATION OF SCHOOL FL 501(C)(3) LINE 2 ADVENTIST HLTH SYSTEMSUNBELT INC 0 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 0 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 0 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 0 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 0 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 0 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 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