2024-05-23T12:39:21-05:00 2023-06-30 990 2023-01-01 811105774 AHP Specialty Care NFP AHPS 2242730190 5101 S Willow Springs Rd B1013 La Grange IL 60525 Lynn C Addiscott Assistant Secretary 4079751492 2024-05-22 Lynn Addiscott 999009999 0 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z Kathleen Ragusa 5101 S Willow Springs Rd B1013 La Grange IL 60525 3459961 0 X www.uchicagomedicineadventhealth.org X 2015 IL Operate out-patient physician clinics. 8 0 0 0 0 0 0 0 3055350 3459961 0 0 0 0 3055350 3459961 0 0 0 0 0 0 0 0 0 5369981 3558328 5369981 3558328 -2314631 -98367 332314 1373541 18508515 19648109 -18176201 -18274568 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 taxpayer's parent is Adventist Midwest Health, which is owned 49% by Adventist Health System Sunbelt Healthcare Corporation (AdventHealth). Effective January 1, 2023, the taxpayer (or the taxpayer's parent) entered into a Master Management Agreement with 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 3378342 0 3459961 Operation of out-patient specialty physician clinics in the greater Chicagoland metropolitan area including the western portions of Cook County, DuPage County, and Will County. During the current year there were 15,074 patient encounters. 3378342 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 8 0 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 IL X Michael Speelman 2242730190 5101 S Willow Springs Rd Suite La Grange IL 60525 X Ragusa Kathleen Director/President 0.10 50.00 X X 0 0 0 Maycock Adam Director 0.10 50.00 X 0 0 0 Liu MD John Director 0.10 50.00 X 0 0 0 Lewis MD Greg Director 0.10 50.00 X 0 0 0 Kuhlman MD Geoffrey Director 0.10 50.00 X 0 0 0 Buchanan MD Herbert Director/Secretary 0.10 50.00 X 0 0 0 Valaitis MD Sandra Beg 123 Director 0.10 1.00 X 0 0 0 Radivojevic Vladimir Beg 123 Director 0.10 50.00 X 0 0 0 Nelson MD Kenneth Chairperson 0.10 50.00 X 0 0 0 0 0 0 0 0 0 0 0 Net Patient Revenue 621111 1755598 1755598 Subsidy Rev.-Affilates 621111 1693113 1693113 11250 11250 3459961 3459961 3459961 0 0 X 3349470 3226924 122546 45 45 85765 30541 55224 4 4 1530 1530 1283 1283 108893 108893 Dues and Subscriptions 10450 10450 Licenses & Permits 888 888 3558328 3378342 179986 0 0 332314 1373541 0 0 332314 1373541 0 18508515 19648109 18508515 19648109 X -18176201 -18274568 -18176201 -18274568 332314 1373541 -98367 0 X X 0 1 X 1 0 1 X 0 Due to Related 19648109 19648109 X Part X, Line 2: The financial information of the filing organization is included in the consolidated financial statement audit of The University of Chicago Medical Center (UCMC) as of January 1, 2023. The consolidated financial statements of UCMC contain the following FIN 48 (ASC 740) footnote: Please note that dollar amounts are in thousands. The System applies ASC Topic 740, Income Taxes, which clarifies the accounting for uncertainty in income taxes recognized in a company's financial statements. ASC Topic 740 prescribes a more likely than not recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken or expected to be taken. Under ASC Topic 740, tax positions are evaluated for recognition, derecognition, and measurement using consistent criteria and provide more information about the uncertainty in income tax assets and liabilities. As of June 30, 2023 and 2022, the System does not have an asset or liability recorded for unrecognized tax positions. UCM Obligated Group is comprised of subsidiaries that are not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code (the Code) and, therefore, exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. UCM Non-Obligated Groups consist of several not-for-profit and taxable entities. The taxable entities include University of Chicago Medicine Care Network, LLC; Trulen Insurance SPC Limited; Medcentrix, Inc.; Ingalls Same Day Surgery; and Ingalls Provider Group, which are taxable entities under applicable sections of the Code. Deferred income taxes on the taxable entities of the Non-Obligated Groups are recognized for the tax consequences of "temporary differences" by applying enacted statutory tax rates applicable to future years to differences between the consolidated financial statement carrying amounts and the tax bases of existing assets and liabilities. As of June 30, 2023 and 2022, the UCM Non-Obligated Groups have deferred tax assets primarily relating to net operating losses (NOL) of $18,171 and $19,234, respectively; however, it has a full valuation allowance as management believes that it was not more likely than not that the results of future operations would generate sufficient taxable income to realize the NOL. Form 990, Part V, Line 1a: Effective January 1, 2023, the filing organization (or the filing organization's parent) entered into a Master Management Agreement with 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 3 Effective January 1, 2023, the filing organization (or the filing organization's parent) entered into a Master Management Agreement with Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is exempt from federal income tax under Internal Revenue Code Section 501(c)(3) and serves as the parent organization to a health care system that operates 50 hospitals in the U.S. Adventist Health System/Sunbelt, Inc., a direct 501(c)(3) subsidiary of AHSSHC, holds a 49% member interest in the filing organization. Under the Master Management Agreement, AHSSHC provides general management of the day-to-day operations of the filing organization's hospital facility(s), the hospital facilities of the filing organization's two related hospital entities, and the subsidiary physician clinic entities. Management services must be provided in a manner that is consistent with the tenets of the Seventh-day Adventist Church and under the direction of the filing organization's governing body. Managerial services provided under the Master Management Agreement include the following: Provision of all C-Suite personnel; Provision of all personnel necessary for operations of the hospital; Management oversight; Operations support, including revenue cycle, financial operations, clinical protocols, accrediting, and compliance; Development and facility management, including strategic planning, managed care, real estate, and construction and equipment planning; Finance and accounting, including budget development, treasury, tax, accounting, insurance and payment of expenses; Human Resources; Internal Audit; Legal Services; Government relations; Purchasing/Materials Management; Information Services; Medical and Professional Matters; and Regulatory Issues. Form 990, Part VI, Section A, line 6 AHP Specialty Care, NFP (the filing organization) has one member. The sole member of the filing organization is Adventist Midwest Health, an Illinois, not-for-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). Form 990, Part VI, Section A, line 7a The sole member of the filing organization is Adventist Midwest Health. The Board of Directors of the filing organization are appointed by the sole member, Adventist Midwest Health, who has the right to appoint and remove any member of the Board of Directors of the filing organization. Form 990, Part VI, Section A, line 7b Certain reserved powers are 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. 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; - 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 filing organization; - the selection of the accrediting body of the filing organization; - the transfer of any property of the filing organization 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. Form 990, Part VI, Section B, line 11b The filing organization's current year Form 990 was reviewed by the President and Region CFO prior to its filing with the IRS. The review conducted by the President and the Region CFO did not include the review of any supporting workpapers that were used in preparation of the current year Form 990, but did include a review of the entire Form 990 and all supporting schedules. Form 990, Part VI, Section B, line 12c The Conflict of Interest Policy of the filing organization applies to members of its Board of Directors and its principal officers (to be known as Interested Persons). In connection with any actual or possible 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 individual who serves as the CEO of the filing organization is appointed and compensated by Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) an unrelated entity as disclosed in our response to Form 990, Part VI, Section A, Line 3. Compensation and benefits provided to this individual are determined pursuant to policies, procedures, and processes of AHSSHC that are designed to ensure compliance with the intermediate sanctions laws as set forth in IRC Section 4958. AHSSHC has taken steps to ensure that processes are in place to satisfy the rebuttable presumption of reasonableness standard as set forth in Treasury Regulation Section 53.4958-6 with respect to its active executive-level positions. The AHSSHC Board Compensation Committee (the Committee) serves as the governing body for all executive compensation matters. The Committee is composed of certain members of the Board of Directors (the Board) of AHSSHC. Voting members of the Committee include only individuals who serve on the Board as independent representatives, who hold no employment positions with AHSSHC and who do not have relationships with any of the individuals whose compensation is under their review that impacts their best independent judgment as fiduciaries of AHSSHC. The Committee's role is to review and approve all components of the executive compensation plan of AHSSHC. As an independent governing body with respect to executive compensation, it should be noted that the Committee will often confer in executive sessions on matters of compensation policy and policy changes. In such executive sessions, no members of management of AHSSHC are present, other than the Chief People Officer, who remains at the request of the Chairman/committee to provide assistance/information as needed. The Committee is advised by an independent third-party compensation advisor. This advisor prepares all the benchmark studies for the Committee. Compensation levels are benchmarked with a national peer group of other not-for-profit healthcare systems and hospitals of similar size and complexity to AdventHealth and each of its affiliated entities. The following principles guide the establishment of individual executive compensation: - The salary of the President/CEO of AdventHealth will not exceed the 50th percentile of comparable salaries paid by similarly situated organizations; and - Other executive salaries shall be established using market medians. The compensation philosophy, policies, and practices of AHSSHC are consistent with the organization's faith-based mission and conform to applicable laws, regulations, and business practices. Form 990, Part VI, Section C, line 19 The financial statements of the filing organization, it's governing documents and conflict of interest policy are not generally made available to the public as a whole. Form 990, Part IX, line 11g Payments to Healthcare Professionals: Program service expenses 67,815. Management and general expenses 0. Fundraising expenses 0. Total expenses 67,815. Misc. Purchased Services: Program service expenses 7,089. Management and general expenses 0. Fundraising expenses 0. Total expenses 7,089. Intercompany Management Fees: Program service expenses 0. Management and general expenses 4,153. Fundraising expenses 0. Total expenses 4,153. Billing Services Physician: Program service expenses 0. Management and general expenses 113,454. Fundraising expenses 0. Total expenses 113,454. AH Shared Services Fee: Program service expenses 0. Management and general expenses 4,939. Fundraising expenses 0. Total expenses 4,939. Leased Personnel: Program service expenses 3,152,020. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,152,020. 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 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 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 Midwest Health 120 North Oak Street Hinsdale IL 60521 362276984 Operation of Hospitals & Related Services IL 501(c)(3) Line 3 N/A 0 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 Hinsdale Hospital Foundation 120 North Oak Street Hinsdale IL 60521 521466387 Fund-Raising for Supported Exempt Hospitals IL 501(c)(3) Line 7 Midwest Hlth Foundation 0 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 AHS Midwest Management Inc 500 Remington Boulevard Bolingbrook IL 60440 363354567 Operation of Physician Practice Management IL 501(c)(3) Line 12a, I Adventist Hlth System Sunbelt Hlthcare Corp 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 Adventist Health Partners Inc P 3558328 Amount Paid Schedule R, Part VII Effective January 1, 2023, The University of Chicago Medical Center (UCMC) and Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) and its wholly-owned subsidiary, Adventist Health System/Sunbelt, Inc. (AHSSI), entered into an Affiliation Agreement (the Affiliation) whereby AHSSI sold 51% of its membership interest in Adventist Midwest Health (AMH) to UCMC. UCMC, AHSSHC, AHSSI, and AMH are all recognized as tax-exempt organizations under Internal Revenue Code Section 501(c)(3). AHSSHC, AHSSI, and AMH are part of the healthcare system known as AdventHealth (AH). The affiliation between UCMC and AH combines the expertise and resources of both organizations. Although neither UCMC or AH have control over the filing organization as defined for purposes of Schedule R, the affiliation between these two healthcare systems is significant and will build upon the complementary strengths of the two organizations.