2025-05-14T08:17:41-05:00 2024-06-30 990 2023-07-01 651219504 ADVENTIST BOLINGBROOK HOSPITAL ADVE 6303125000 500 REMINGTON BLVD BOLINGBROOK IL 60440 LYNN C ADDISCOTT ASSISTANT SECRETARY 4073572317 2025-05-13 0 2023 2025-03-06 01:10:19Z UCHICAGO MEDICINE ADVENTHEALTH BOLIN KEN ROSE 500 REMINGTON BLVD BOLINGBROOK IL 60440 255346719 0 X WWW.UCHICAGOMEDICINEADVENTHEALTH.ORG/ X 2003 IL OPERATION OF A 138-BED ACUTE-CARE HOSPITAL SERVING RESIDENTS IN & AROUND BOLINGBROOK, IL. 22 21 0 85 372832 14641 0 123829 122502325 252649727 -47274 2573163 0 0 122455051 255346719 52500 40750 0 0 44040553 1189594 0 0 0 79926643 243275795 124019696 244506139 -1564645 10840580 284808847 285574027 44278219 33503486 240530628 252070541 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'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 239730669 40750 252276895 OPERATION OF ACUTE CARE HOSPITAL TOTALING 138 BEDS. DURING THE CURRENT YEAR THERE WERE 6,489 ADMISSIONS RESULTING IN 27,879 PATIENT DAYS AND 154,206 OUTPATIENT VISITS. 239730669 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 0 1 1 0 0 0 0 0 0 0 0 0 0 0 X 22 21 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 IL X TRISTAN SHAW 7082452211 500 REMINGTON BLVD BOLINGBROOK IL 60440 BUCHANAN HERBERT DIR END 4/24, CEO END 2/24 12.50 37.50 X X 162900 488698 26727 DAVARAPALLI MD RAMADEVI DIRECTOR (END 12/23) 0.30 50.00 X 0 517469 46728 KOHLI MD MANINDER DIRECTOR 0.20 13.50 X 0 39000 0 MURREY MD SUSAN DIRECTOR (END 3/24) 0.20 9.20 X 0 75550 0 THORDARSON THOR DIR/PRES (END 11/23) 12.50 37.50 X 241722 725165 173900 ARQUILLA VENANZIO DIRECTOR 0.20 0.60 X 0 0 0 BACON KENNETH DIR/CHAIRMAN (END 11/23) 0.30 0.60 X 0 0 0 BANKS DAVID DIR/CHAIRMAN (BEG 11/23-3/24) BEG 5/24 0.20 0.50 X 0 0 0 DENSLOW KENNETH DIRECTOR/VICE CHAIR 0.20 0.60 X 0 0 0 DIXON SUSAN DIRECTOR 0.20 0.60 X 0 0 0 EASTMAN LINDA DIRECTOR 0.20 0.60 X 0 0 0 GRAY JR MARSHALL DIRECTOR 0.20 0.60 X 0 0 0 GRYS D MIN JOHN DIRECTOR 0.20 0.60 X 0 0 0 HAWKINS RONNIE DIRECTOR 0.20 0.60 X 0 0 0 HOLDER BILL DIRECTOR 0.20 0.60 X 0 0 0 JAHN ANDREW DIR/CHAIRMAN (CHAIR 4/24-5/24) 0.20 0.40 X 0 0 0 MILNER MD ROSS DIRECTOR (END 6/24) 0.20 0.60 X 0 0 0 O'CONNOR PETER DIRECTOR 0.20 0.60 X 0 0 0 PATARI MD SANJAY DIRECTOR 0.20 0.60 X 0 0 0 RAMIREZ ELDEN DIRECTOR 0.20 0.60 X 0 0 0 REED MD MONICA DIR/PRES/CEO REG (BEG 2/24) 12.50 37.50 X X 0 0 0 RYAN MD PAUL DIRECTOR 0.20 0.60 X 0 0 0 SCOTT GLYNN DIRECTOR 0.20 0.60 X 0 0 0 SHAYANI MD VAFA DIRECTOR (BEG 1/24) 0.20 0.60 X 0 0 0 SNYDER BRENT DIRECTOR 0.20 0.60 X 0 0 0 VALAITIS MD SANDRA DIRECTOR 0.20 0.80 X 0 0 0 WRIGHT JONATHAN DIRECTOR 0.20 0.60 X 0 0 0 BROWN JARED CFO (END 8/23) 25.00 25.00 X 125570 125570 23846 ROSE KENNETH CEO BOLING/GLENOAKS (BEG 2/24) 37.50 12.50 X 0 0 0 NOSEWORTHY GORDON E CEO-INTERIM (12/23-3/24) 50.00 0.00 X 155250 0 0 SHAW TRISTAN CFO BOLINGBROOK (BEG 8/23) 21.00 29.00 X 86264 162249 49867 SPAGNOLIA RN JENNIFER INTERIM CNO BOLINGBROOK (3/18-4/14/23) 50.00 0.00 X 153731 0 23134 GALLAGHER RN KAREN CNO BOLINGBROOK 50.00 0.00 X 166892 0 20017 KRIKORIAN MD ARMAND CMO BOLING/GLENOAKS 25.00 25.00 X 190939 190939 103518 PAWLIK RN COLLEEN CNO BOLING/GLENOAKS 25.00 25.00 X 50443 50443 7130 CARROLL MD RICHARD FORMER CMO BOLINGBROOK/GLENOAKS 0.00 0.00 X 121440 121440 10228 RADIVOJEVIC VLADIMIR FORMER VP/COO BOLINGBROOK/GLENOAK 0.00 50.00 X 0 408240 101478 1455151 2904763 586573 0 1 1 1 PT SOLUTIONS HOLDINGS LLC PO BOX 441146 KENNESAW GA 30160 THERAPY SERVICES 8493750 CROTHALL HEALTHCARE INC 13028 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 EVS SERVICES 4132706 MORRISON HEALTHCARE PO BOX 102289 ATLANTA GA 30368 FOOD SERVICES 3678635 OBHG ILLINOIS SC 777 LOWNDES HILL RD BLDG 1 GREENVILLE SC 29607 HOSPITALISTS-MEDICAL DIRECTOR FEES 1741927 R1 RCM INC 39918 TREASURY CENTER CHICAGO IL 60694 REVENUE CYCLE SERVICES 1542510 32 X 0 123829 123829 NET PATIENT REVENUE 622110 218612030 218580210 31820 RETAIL PHARMACY 622110 18441437 18107712 333725 SUPPORT PMTS FROM EXEMPT AFFILIAT 622110 14874713 14874713 CAFETERIA REVENUE 622110 447647 447647 HEALTH EDUCATION PROGRAMS 622110 178564 178564 95336 88049 7287 252649727 2525941 2525941 31985 15237 0 0 31985 15237 47222 47222 255346719 252276895 372832 2573163 X 40750 40750 1189594 1189594 80306 80306 82778 82778 145780852 145106957 673895 4961 4961 2599364 1912526 686838 2575321 2373248 202073 4843760 4843760 110916 110916 18028 18028 9153519 9153519 3690450 2095963 1594487 MEDICAL SUPPLIES 63699841 63699841 STATE TAX INDIGENT ASSE 9254272 9254272 REPAIRS & MAINTENANCE 1205434 1205434 UBI TAXES 2640 2640 173353 44399 128954 244506139 239730669 4775470 0 X 3526 3375 67834226 84284915 25617757 27359260 3614369 3739957 682080 794645 167358557 13398081 157394570 153960476 29662319 15431399 284808847 285574027 2404047 2633893 41874172 30869593 44278219 33503486 X 240530628 252070541 240530628 252070541 284808847 285574027 10840580 699333 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 32896 32896 0 PART II-B, LINE 1: DUES TO THE AMERICAN HOSPITAL ASSOCIATION AND ILLINOIS HOSPITAL ASSOCIATION. 5283000 5283000 144604985 6404820 138200165 16899874 6548935 10350939 570698 444326 126372 153960476 OTHER RECEIVABLES 2337139 RECEIVABLE FROM THIRD PARTIES 2539803 DUE FROM AFFILIATED 8793807 RIGHT OF USE ASSET - OPERATING LEAS 1760650 15431399 DUE TO RELATED 5991295 PAYABLE TO THIRD PARTIES 18666369 AR CREDIT BALANCES 1197651 DEFERRED REVENUE 969247 ACCRUED INTEREST PAYABLE 6268 DUE TO AFFILIATED 2235571 OPERATING LEASE LIABILITY 1803192 30869593 X PART X, LINE 2: AS A RESULT OF ITS CONTROLLING MEMBER INTEREST, THE OPERATIONS OF THE FILING ORGANIZATION ARE INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENT AUDIT OF THE UNIVERSITY OF CHICAGO MEDICAL CENTER (UCMC) FOR THE TWELVE-MONTH PERIOD ENDED JUNE 30, 2024. 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, DE-RECOGNITION, AND MEASUREMENT USING CONSISTENT CRITERIA AND PROVIDE MORE INFORMATION ABOUT THE UNCERTAINTY IN INCOME TAX ASSETS AND LIABILITIES. AS OF JUNE 30, 2024 AND 2023, 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, 2024 AND 2023, THE UCM NON-OBLIGATED GROUPS HAVE DEFERRED TAX ASSETS PRIMARILY RELATING TO NET OPERATING LOSSES; 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. 1 1 X 1 X 250.000000000000 1 X 600.000000000000 1 1 1 0 1 1 6025239 6025239 0.02460 51282478 39819093 11463385 0.04690 57307717 39819093 17488624 0.07150 29298 29298 0.00010 132019 132019 0.00050 161317 161317 0.00060 57469034 39819093 17649941 0.07210 1 4517805 157960 27922367 31803200 -3880833 X 1 1 1 1 ADVENTIST BOLINGBROOK HOSPITAL 500 REMINGTON BLVD BOLINGBROOK IL 60440 WWW.UCHICAGOMEDICINEADVENTHEALTH.ORG 0005496 X X X ADVENTIST BOLINGBROOK HOSPITAL 1 0 0 1 X X X X X X X X X 22 1 0 0 1 X PART V, PAGE 8 X X 1 23 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 PART V, PAGE 8 X PART V, PAGE 8 X PART V, PAGE 8 X X X X X X 1 X 0 X X X X 1 X 0 0 ADVENTIST BOLINGBROOK HOSPITAL PART V, SECTION B, LINE 5: ADVENTIST BOLINGBROOK HOSPITAL (ABH OR THE HOSPITAL) IS A 138-BED ACUTE CARE HOSPITAL LOCATED IN WILL COUNTY IN ILLINOIS. ABH'S PRIMARY SERVICE AREA INCLUDES 16 ZIP CODES PRIMARILY IN WILL 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 WILL COUNTY MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) COLLABORATIVE IN CONDUCTING ITS 2022 CHNA. THE MAPP COLLABORATIVE HAS REPRESENTATION FROM ALMOST 100 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 AUNT MARTHA'S HEALTH & WELLNESS, CATHOLIC CHARITIES, EASTERSEALS JOLIET REGION, INC., GREATER JOLIET YMCA, HOLSTEIN HUMAN CAPITAL DEVELOPMENT, NATIONAL HOOKUP OF BLACK WOMEN, NORTHERN ILLINOIS FOOD BANK, SENIOR SERVICES OF WILL COUNTY, SPANISH COMMUNITY CENTER, STEPPINGSTONES, INC. AND UNITED WAY OF WILL COUNTY. THE SMALLER COMMITTEE ALSO INCLUDED REPRESENTATIVES FROM THE WILL COUNTY HEALTH DEPARTMENT AND THE WILL COUNTY COMMUNITY HEALTH CENTER. ABH 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 PUBLIC HEALTH 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 WILL COUNTY AND WAS ACCESSIBLE ONLINE THROUGH WEBLINKS AND QR CODES. THE LOCAL PUBLIC HEALTH ASSESSMENT WAS AN ONLINE SURVEY TARGETING SOCIAL SERVICE AGENCIES, SCHOOLS, GOVERNMENT, FAITH INSTITUTIONS AND ANY AGENCY THAT INFLUENCES HEALTH. THE FORCES OF CHANGE ASSESSMENT WAS AN ONLINE SURVEY DESIGNED TO ELICIT BROAD COMMUNITY INPUT. ADVENTIST BOLINGBROOK 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 BOLINGBROOK HOSPITAL PART V, SECTION B, LINE 11: SEE FOOTNOTE BELOW PART V, SECTION B, LINE 11: THE FILING ORGANIZATION FILED A SHORT PERIOD RETURN FOR THE PERIOD FROM JANUARY 1, 2023 THROUGH JUNE 30, 2023, AS IT CHANGED ITS TAX YEAR END TO JUNE 30 FROM DECEMBER 31. THE TAXPAYER'S SHORT PERIOD RETURN FOR JANUARY 1, 2023 THROUGH JUNE 30, 2023 DID NOT INCLUDE ANY INFORMATION IN RESPONSE TO SCHEDULE H, PART V, SECTION B, LINE 11 AS THE FILING ORGANIZATION'S 2023-2025 IMPLEMENTATION STRATEGY (COMMUNITY HEALTH PLAN) WAS COMPLETED BY MAY 15, 2023 AND SO INCLUDED ONLY 46 DAYS IN THE COMMUNITY HEALTH PLAN THREE-YEAR IMPLEMENTATION PERIOD. THE NARRATIVE FOR SCHEDULE H, PART V, SCHEDULE B, LINE 11 FOR THE TAX YEAR BEGINNING JULY 1, 2023 THROUGH JUNE 30, 2024 INCLUDES HOW THE FILING ORGANIZATION HAS ADDRESSED THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN ITS 2022 COMMUNITY HEALTH NEEDS ASSESSMENT FOR THE PERIOD FROM MAY 15, 2023 THROUGH JUNE 30, 2024. ADVENTIST BOLINGBROOK HOSPITAL DBA UCHICAGO MEDICINE ADVENTHEALTH BOLINGBROOK, WILL BE REFERRED TO IN THIS DOCUMENT AS ADVENTHEALTH BOLINGBROOK OR "THE HOSPITAL". THE HOSPITAL IS A PARTIALLY OWNED SUBSIDIARY OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). AHSSHC PROVIDES MANAGEMENT SERVICES TO THE FILING ORGANIZATION. AHSSHC IS THE 501(C)(3) PARENT ORGANIZATION OF A HOSPITAL AND HEALTHCARE SYSTEM KNOWN AS ADVENTHEALTH. THIS IS THE FIRST-YEAR UPDATE FOR THE HOSPITAL'S 2023-2025 COMMUNITY HEALTH PLAN/IMPLEMENTATION STRATEGY. THE HOSPITAL DEVELOPED THIS PLAN AND POSTED IT IN MAY 2023 AS PART OF ITS 2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. FOR THE DEVELOPMENT OF BOTH THE COMMUNITY HEALTH NEEDS ASSESSMENT AND THE COMMUNITY HEALTH PLAN/IMPLEMENTATION STRATEGY, UCHICAGO MEDICINE ADVENTHEALTH BOLINGBROOK WORKED TO DEFINE AND ADDRESS THE NEEDS OF LOW-INCOME, MINORITY AND UNDERSERVED POPULATIONS IN ITS SERVICE AREA. THE COMMUNITY HEALTH NEEDS ASSESSMENT USED PRIMARY DATA INTERVIEWS AND SURVEYS; SECONDARY DATA FROM LOCAL, REGIONAL, AND NATIONAL HEALTH-RELATED SOURCES; AND HOSPITAL PREVALENCE DATA TO HELP THE HOSPITAL DETERMINE THE HEALTH NEEDS OF THE COMMUNITY IT SERVES. ONCE THE DATA WAS GATHERED, THE HEALTH ISSUES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT WERE PRIORITIZED BY COMMUNITY AND HOSPITAL STAKEHOLDERS, WHO THEN SELECTED KEY PRIORITIES FOR THE HOSPITAL TO ADDRESS IN ITS COMMUNITY HEALTH PLAN. THE FIRST-YEAR PROGRESS ON THE COMMUNITY HEALTH PLAN IS NOTED BELOW. THE NARRATIVE DESCRIBES THE PRIORITIES IDENTIFIED IN 2022 AND GIVES AN UPDATE ON THE STRATEGIES ADDRESSING THOSE PRIORITIZED NEEDS. THERE IS ALSO A DESCRIPTION OF THE IDENTIFIED NEEDS THAT THE HOSPITAL DID NOT PRIORITIZE TO ADDRESS. THE HOSPITAL'S CHOSEN PRIORITIES ARE LISTED BELOW.1. BEHAVIORAL HEALTH AND SUBSTANCE MISUSE2. ACCESS TO CAREPRIORITY 1: BEHAVIORAL HEALTH AND SUBSTANCE MISUSE2022 DESCRIPTION OF THE PRIORITY:DURING THE ASSESSMENT, 47.2% OF COMMUNITY SURVEY RESPONDENTS SHARED DEPRESSION/ANXIETY WERE A PROBLEM IN THEIR HOME. IT WAS ALSO FOUND THAT 5.3% BELIEVED PRESCRIPTION DRUG USE WAS A PROBLEM IN THEIR HOME AND NEARLY 53% BELIEVE IT IS A PROBLEM IN WILL COUNTY. PUBLIC DATA ALSO FOUND THAT 56% OF 12TH GRADERS USE ALCOHOL, WITH 16% REPORTING THEY HAVE ENGAGED IN BINGE DRINKING IN THE LAST TWO WEEKS. AWARENESS AND THE NEED TO ADDRESS BEHAVIORAL HEALTH HAS BEEN GROWING IN THE COUNTRY AND LOCALLY.2023 UPDATE:GOAL 1.1: INCREASE THE PROPORTION OF PEOPLE WHO GET A REFERRAL FOR MENTAL HEALTH AND/ OR SUBSTANCE MISUSE SERVICES AFTER AN EMERGENCY DEPARTMENT VISIT.OBJECTIVE 1.1.1: BY DECEMBER 31, 2025, INCREASE THE PERCENTAGE OF MENTAL HEALTH AND SUBSTANCE MISUSE PATIENTS WHO ARE ASSESSED IN THE EMERGENCY DEPARTMENT AND RECEIVE A REFERRAL FOR COMMUNITY-BASED BEHAVIORAL HEALTH RESOURCES FROM 33.8 % TO 43.8%.IN 2023, THE HOSPITAL SAW A DECREASE IN THE PERCENTAGE OF MENTAL HEALTH AND SUBSTANCE MISUSE PATIENTS BUT WILL CONTINUE TO COLLECT AND REVIEW DATA TO BE ASSESSED DOWN THE LINE. OBJECTIVE 1.1.2: BY DECEMBER 31, 2025, CREATE A LOOP REFERRAL AGREEMENT WITH AT LEAST TWO AGENCIES FOR THE WHOLE HEALTH HUB. THE WHOLE HEALTH HUB IS AN ADVENTHEALTH BRANDED PLATFORM OUR CLINICAL TEAMS USE TO REFER PATIENTS TO NEARBY SOCIAL SERVICES AGENCIES BASED ON THE PATIENT'S INDIVIDUAL NEEDS.IN 2023, THE HOSPITAL REENGAGED WITH LEADERS TO DISCUSS CURRENT COMMUNITY PARTNERS TO DECIDE ON WHO WILL BE REFERRED THROUGH WHOLE HEALTH HUB. GOAL 1.2: INCREASE AWARENESS OF MENTAL HEALTH AND SUBSTANCE MISUSE CHALLENGES TO REDUCE STIGMAOBJECTIVE 1.2.1: BY DECEMBER 31, 2025, 90% OF PARTICIPANTS WILL HAVE A KNOWLEDGE INCREASE AFTER ATTENDING THE COMMUNITY-WIDE MENTAL HEALTH AND SUBSTANCE MISUSE EDUCATIONAL SERIES.IN 2023, THE HOSPITAL DID NOT HOST ANY EDUCATIONAL SERIES. OBJECTIVE 1.2.2: BY DECEMBER 31, 2025, INCREASE KNOWLEDGE AND SKILLS (EX. HOW TO INTERVENE WHEN A PERSON IS EXPERIENCING A MENTAL HEALTH CHALLENGE/CRISIS) OF AT LEAST 90% OF MENTAL HEALTH FIRST AID (MHFA) TRAINING PARTICIPANTS.IN 2023, THE HOSPITAL IN COLLABORATION WITH THE NATIONAL ALLIANCE FOR MENTAL ILLNESS METRO SUBURBAN, OFFERED A MHFA TRAINING TO FAITH LEADERS. TEN PEOPLE WERE TRAINED.PRIORITY 2: ACCESS TO CARE2022 DESCRIPTION OF THE PRIORITY:ACCESS TO CARE IS A KEY DRIVER TO HEALTH. ACCESS CAN BE INFLUENCED BY BOTH COST AND AVAILABILITY. ACCORDING TO 30% OF COMMUNITY SURVEY RESPONDENTS, THEIR HOUSEHOLDS ARE NEVER, RARELY OR ONLY SOMETIMES ABLE TO PAY FOR HEALTH CARE (FAMILY DOCTOR, PRESCRIPTIONS, ETC.). AN IMPORTANT FACTOR IS AVAILABILITY OF CARE AND REQUIRES HAVING AN ADEQUATE NUMBER OF PROVIDERS IN A COMMUNITY. THERE IS A SHORTAGE OF PRIMARY CARE, MENTAL HEALTH AND DENTAL CARE PROVIDERS IN THE COUNTY. THE COUNTY HAS FEWER PROVIDERS BY POPULATION COMPARED TO BOTH THE STATE AND THE NATION. FOR EXAMPLE, THE RATE OF PRIMARY CARE PROVIDERS IN WILL COUNTY IS 1,810:1, COMPARED TO THE IL RATE OF 1,240:1 AND THE NATIONAL RATE OF 1,030:1.2023 UPDATE:GOAL 2.1: INCREASE ACCESS TO COMPREHENSIVE AND HIGH-QUALITY HEALTH CARE SERVICES.OBJECTIVE 2.1.1: BY DECEMBER 31, 2025, HOST 12 ENROLLMENT EVENTS TO GIVE PATIENTS AND COMMUNITY MEMBERS AN OPPORTUNITY TO ENROLL IN HEALTH CARE COVERAGE.IN 2023, THE HOSPITAL DID NOT HAVE THE INTERNAL RESOURCES OR BUDGET AND WILL HAVE TO RELY ON COMMUNITY PARTNERS TO HOST THE EVENTS. PRIORITIES NOT ADDRESSED BY THE HOSPITAL: THE COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED MULTIPLE HEALTH NEEDS THROUGH THE COLLECTION OF PRIMARY AND SECONDARY DATA. AFTER REVIEWING THE DATA, THE HOSPITAL AND COMMUNITY STAKEHOLDERS CONDUCTED A PRIORITIZATION PROCESS. LISTED BELOW ARE THE PRIORITIES NOT ADDRESSED AND THE REASON WHY THEY WERE NOT SELECTED TO BE ADDRESSED.1. STABILIZING THE BUILT ENVIRONMENT: THE HOSPITAL DECIDED THAT HOUSING AND TRANSPORTATION, ALTHOUGH AN IDENTIFIED NEED FOR A MULTITUDE OF REASONS, IS BEING ADDRESSED AS COUNTYWIDE BY OTHER ORGANIZATIONS BETTER POSITIONED TO ADDRESS IT AND THE HOSPITAL COULD NOT MAKE MEANINGFUL CHANGE IN THE TIME ALLOTTED FOR THE NEXT COMMUNITY HEALTH PLAN.2. ACCESS TO FOOD AND NUTRITION: ALTHOUGH ACCESS TO HEALTHY AFFORDABLE FOOD IS A KEY DRIVER OF HEALTH OUTCOMES, THE HOSPITAL DID NOT CHOOSE TO ADDRESS THIS PRIORITY. THE HOSPITAL BELIEVES THAT OTHER ORGANIZATIONS ARE BETTER POSITIONED IN THE COMMUNITY TO ADDRESS THIS NEED DIRECTLY AND WILL SUPPORT THOSE EFFORTS WHEN ABLE. SCHEDULE H, PART V, SECTION B, LINE 7A: THE CHNA REPORT CAN BE FOUND AT URL:HTTPS://WWW.UCHICAGOMEDICINEADVENTHEALTH.ORG/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.UCHICAGOMEDICINEADVENTHEALTH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS SCHEDULE H, PART V, SECTION B, LINE 16A,B,C: THE FINANCIAL ASSISTANCE POLICY CAN BE FOUND AT URL: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 1 1 - UCMC AH CANCER INST - RETAIL PHARMACY 1 SALT CREEK LANE HINSDALE IL 60521 CANCER CENTER - RETAIL PHARMACY PART I, LINE 3C: UNDER THE HOSPITAL FACILITY'S FINANCIAL ASSISTANCE POLICY, AN INDIVIDUAL IS ELIGIBLE FOR A 100% REDUCTION FROM APPLICABLE CHARGES IF THE INDIVIDUAL'S HOUSEHOLD INCOME IS AT OR BELOW 250% OF THE CURRENT FEDERAL POVERTY GUIDELINES (FPG). UNINSURED PATIENTS WITH HOUSEHOLD INCOMES THAT EXCEED 250% OF THE FPG BUT ARE LESS THAN 401% ARE GRANTED A 98% DISCOUNT ON APPLICABLE BALANCES. INSURED PATIENTS WITH OUT-OF-POCKET BALANCES WITH HOUSEHOLD INCOMES BETWEEN 250% AND 400% OF THE FPG MAY RECEIVE A 75% DISCOUNT FROM APPLICABLE CHARGES. UNINSURED PATIENTS WITH HOUSEHOLD INCOMES BETWEEN 401% AND 600% OF THE FPG ARE GRANTED AN 85% DISCOUNT ON APPLICABLE BALANCES. ALTERNATIVELY, A PATIENT MAY ALSO QUALIFY FOR A 100% REDUCTION FROM CHARGES WHEN THE UNPAID PORTION OF A PATIENT'S BILL EXCEEDS 20% OF THE INDIVIDUAL'S ANNUAL HOUSEHOLD INCOME, WHERE THE PATIENT HAS QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE CURRENT FPG WITHIN A 12-MONTH PERIOD, AND THE PATIENT'S HOUSEHOLD INCOME DOES NOT EXCEED 600% OF FPG FOR UNINSURED PATIENTS AND 400% FOR INSURED PATIENTS. MEDICARE RECIPIENTS MAY ALSO BE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY DEPENDING UPON THE INDIVIDUAL'S INCOME AND RESOURCES. RESOURCES ARE GENERALLY DEFINED AS ASSETS SUCH AS MONEY IN CHECKING OR SAVINGS ACCOUNTS, STOCKS, AND BONDS. PART I, LINE 6A: THE FILING ORGANIZATION WAS A PARTIALLY OWNED SUBSIDIARY OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC) DURING ITS CURRENT TAX YEAR. DURING 2024, AHSSHC SERVED AS A PARENT ORGANIZATION TO 33 TAX-EXEMPT 501(C)(3) HOSPITAL ORGANIZATIONS AND OTHER SUBSIDIARY HEALTH CARE ORGANIZATIONS THAT OPERATED IN 12 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. THE FILING ORGANIZATION PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT ON A SEPARATE ENTITY BASIS FOR THE HOSPITAL(S) THAT IT OWNS AND OPERATES. THE SEPARATE ANNUAL COMMUNITY BENEFIT REPORT IS GENERALLY UTILIZED FOR STATE COMMUNITY BENEFIT REPORTING AND/OR FOR OTHER LOCAL COMMUNITY PURPOSES. 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 MEETING CERTAIN SPECIFIED CONDITIONS, SUCH AS SELF-IDENTIFYING AS BEING HOMELESS. PRESUMPTIVE ELIGIBILITY FOR FINANCIAL ASSISTANCE MAY ALSO BE BASED ON THE HOSPITAL'S USE OF INDEPENDENT ELIGIBILITY ASSESSMENT SCORING TOOLS THAT ARE DESIGNED TO ASSIST IN DETERMINING A PATIENT'S ECONOMIC MEANS. SUCH INFORMATION MAY INCLUDE DOCUMENTATION FROM CREDIT REPORTS, OTHER THIRD-PARTY ASSET INFORMATION, AND INCOME VERIFICATION. INDIVIDUALS WHO HAVE BEEN FOUND TO HAVE A PAYMENT CAPABILITY SCORE OF LOW OR UNKNOWN BASED UPON THE INDEPENDENT ELIGIBILITY ASSESSMENT TOOLS 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 MAY BE 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 TOOLS 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 ONE OR MORE 24/7 EMERGENCY ROOM(S) 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 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 13 - 15. PLEASE NOTE THAT DOLLAR AMOUNTS ON THE ATTACHED CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE IN THOUSANDS. PART III, LINE 8: PART III, LINE 8:COSTING METHODOLOGY: MEDICARE ALLOWABLE COSTS ARE 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 ENGAGE IN EXTRAORDINARY COLLECTION ACTIONS 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 EXTRAORDINARY COLLECTIONS ACTIONS 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 TAKE ALL AVAILABLE MEASURES TO REVERSE ANY EXTRAORDINARY COLLECTIONS ACTIONS AGAINST THE INDIVIDUAL. 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 SERVICES TO 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: $ (3,880,833)- DIFFERENCE IN COSTING METHODOLOGY: 3,442,672- UNREIMBURSED COSTS INCURRED FOR SERVICES PROVIDED TO MEDICARE PATIENTS THAT ARE NOT INCLUDED IN THE ORGANIZATION'S MEDICARE COST REPORT: (5,578,847) -------------TOTAL UNREIMBURSED COSTS OF SERVING ALL MEDICARE PATIENTS PER THE FILING ORGANIZATION'S COMMUNITYBENEFIT REPORTING $ (6,017,008)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: UCHICAGO MEDICINE ADVENTHEALTH BOLINGBROK HAS 138 BEDS AND IS ONE OF FOUR HOSPITALS IN COOK, DUPAGE AND WILL COUNTIES THAT COMPOSES THE ADVENTHEALTH GREAT LAKES DIVISION. IN 2022, ADVENTHEALTH PARTNERED WITH UCHICAGO MEDICINE TO BRING TOGETHER ONE OF THE NATION'S TOP ACADEMIC MEDICAL INSTITUTIONS AND A NATIONAL LEADER IN WHOLE-PERSON HEALTHCARE. WITH ADVENTHEALTH'S MISSION OF EXTENDING THE HEALING MINISTRY OF CHRIST, UCHICAGE MEDICINE ADVENTHEALTH BOLINGBROOK PROVIDES WHOLE PERSON CARE TO HEAL THE BODY, MIND AND SPIRIT. IT IS ACTIVE WITHIN THE COMMUNITY BY PARTNERING WITH LOCAL PART DISTRICTS, OFFERING AN ANNUAL FAMILY FUN MOVIE NIGHT EVENT, PROVIDING AN ONSITE COMMUNITY PANTRY, ATTENDING LOCAL EVENTS AND HEALTH FAIRS AND PROVIDING EDUCATIONAL LECTURES. SERVICES OFFERED AT THE HOSPITAL INCLUDE EMERGENCY CARE, HEART & VASCULAR CARE, CANCER CARE, INFUSION THERAPY, INTERVENTIONAL RADIOLOGY, SURGICAL SERVICES, OBSTETRICS, WOMEN'S SERVICES, BARIATRIC AND WEIGHT LOSS, EXECUTIVE HEALTH SERVICES, RHEUMATOLOGY, ORTHOPEDICS, PAIN MANAGEMENT, BEHAVIORAL GERIATRIC CARE, IMAGING AND LAB SERVICES.DURING 7/1/23 - 6/30/24, 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. DURING 7/1/23 - 6/30/24, ABOUT 78.6% OF THE HOSPITAL'S IN-PATIENTS WERE ADMITTED THROUGH THE HOSPITAL'S EMERGENCY DEPARTMENT. - MEDICARE PATIENTS 40.9% - MEDICAID PATIENTS 20.5% - SELF-PAY PATIENTS 3.0%THE DEMOGRAPHIC MAKEUP OF THE HOSPITAL'S COMMUNITY IS AS FOLLOWS: - POPULATION 523,630 - POPULATION OVER 65 13.8% - POVERTY (BELOW 100% FPL) 6.3% - HIGH SCHOOL GRADUATION RATE 92.7% - UNINSURED ADULTS 5.2% - FOOD INSECURITY RATE 9% - POP. WITH LOW FOOD ACCESS 72% PART VI, LINE 5: THE PROVISION OF COMMUNITY BENEFIT IS CENTRAL TO ADVENTIST BOLINGBROOK 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 $7,723,992 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: THE FILING ORGANIZATION HAS TWO TOP-TIER MEMBERS. THE MEMBERS ARE THE UNIVERSITY OF CHICAGO MEDICAL CENTER AND ADVENTIST HEALTH SYSTEM/SUNBELT, INC. (AHSSI). AHSSI IS A WHOLLY-OWNED SUBSIDIARY OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION. THE FILING ORGANIZATION CAN DRAW UPON THE EXPERTISE AND LEADERSHIP OF BOTH ITS HEALTH SYSTEM MEMBERS IN ITS EFFORT TO CREATE EXCELLENT PATIENT EXPERIENCES AND OFFER A BROAD SPECTRUM OF HEALTH SERVICES NEEDED IN THE COMMUNITY. DURING ITS CURRENT TAX YEAR, THE FILING ORGANIZATION WAS MANAGED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). AHSSHC IS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). AHSSHC AND ITS SUBSIDIARY ORGANIZATIONS OPERATE 50 HOSPITALS THROUGHOUT THE U.S., PRIMARILY IN THE SOUTHEASTERN PORTION OF THE U.S. AHSSHC AND ITS SUBSIDIARIES ALSO OPERATE OTHER ANCILLARY HEALTH CARE PROVIDER FACILITIES, SUCH AS AMBULATORY SURGERY CENTERS AND DIAGNOSTIC IMAGING CENTERS. AHSSHC (MANAGER) PROVIDES MANAGEMENT SERVICES TO THE FILING ORGANIZATION PURSUANT TO A MASTER MANAGEMENT SERVICES AGREEMENT. MANAGEMENT SERVICES PROVIDED INCLUDE THE PROVISION AND LEASING OF PERSONNEL, AND DAY-TO-DAY MANAGEMENT OF THE BUSINESS AFFAIRS AND OPERATIONS OF THE FILING ORGANIZATION'S HOSPITAL FACILITY, INCLUDING REVENUE CYCLE SUPPORT, FINANCIAL OPERATIONS SUPPORT, CLINICAL PROTOCOLS, ACCREDITATION AND CONDITIONS OF PARTICIPATION COMPLIANCE, AND A COMPLIANCE PROGRAM. THE MANAGER ALSO PROVIDES DEVELOPMENT AND FACILITY MANAGEMENT, FINANCE AND ACCOUNTING SERVICES, HUMAN RESOURCES, INTERNAL AUDIT, LEGAL, GOVERNMENT RELATIONS, PURCHASING/MATERIALS MANAGEMENT, INFORMATION, MEDICAL AND PROFESSIONAL MATTERS, AND REGULATORY SERVICES. 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. THE FILING ORGANIZATION PAYS A MANAGEMENT FEE TO AHSSHC FOR THE SERVICES PROVIDED BY AHSSHC. AS A RESULT, MANAGEMENT FEE EXPENSE REPORTED BY THE FILING 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 OR THE UNIVERSITY OF CHICAGO MEDICAL CENTER AS A WHOLE. THE READER IS DIRECTED TO VISIT THE WEBSITE AT WWW.UCHICAGOMEDICINEADVENTHEALTH.ORG TO LEARN MORE ABOUT THE MISSION AND OPERATIONS OF THE FILING ORGANIZATION. PART VI, LINE 7, REPORTS FILED WITH STATES IL 1 HINSDALE ADVENTIST ACADEMY 631 E HICKORY STREET HINSDALE IL 60521 364090219 501(C)(3) 25000 0 GENERAL SUPPORT WILL COUNTY CHAMBER OF COMMERCE 203 N OTTAWA ST SUITE 100 JOLIET IL 60432 363772737 501(C)(6) 16250 0 GENERAL SUPPORT 1 1 PART I, LINE 2: GRANTS ARE GENERALLY MADE ONLY TO AFFILIATED 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 THORDARSON THOR DIR/PRES (END 11/23) 203519 610556 27433 82298 10770 32311 38597 115792 4878 14633 285197 855590 0 0 BUCHANAN HERBERT DIR END 4/24, CEO END 2/24 123997 371991 10648 31943 28255 84764 4432 13295 2250 6750 169582 508743 0 0 DAVARAPALLI MD RAMADEVI DIRECTOR (END 12/23) 0 424827 0 84535 0 8107 0 18150 0 28578 0 564197 0 0 RADIVOJEVIC VLADIMIR FORMER VP/COO BOLINGBROOK/GLENOAK 0 343098 0 38893 0 26249 0 69378 0 32100 0 509718 0 0 KRIKORIAN MD ARMAND CMO BOLING/GLENOAKS 188245 188245 0 0 2694 2694 36556 36556 15203 15203 242698 242698 0 0 SHAW TRISTAN CFO BOLINGBROOK (BEG 8/23) 75918 146259 0 0 10346 15990 0 7600 9686 32581 95950 202430 0 0 BROWN JARED CFO (END 8/23) 74026 74026 9095 9095 42449 42449 1368 1368 10555 10555 137493 137493 0 0 CARROLL MD RICHARD FORMER CMO BOLINGBROOK/GLENOAKS 0 0 545 545 120895 120895 0 0 5114 5114 126554 126554 0 0 GALLAGHER RN KAREN CNO BOLINGBROOK 165008 0 0 0 1884 0 7567 0 12450 0 186909 0 0 0 SPAGNOLIA RN JENNIFER INTERIM CNO BOLINGBROOK (3/18-4/14/2 152553 0 0 0 1178 0 4824 0 18310 0 176865 0 0 0 NOSEWORTHY GORDON E CEO-INTERIM (12/23-3/24) 0 0 0 0 155250 0 0 0 0 0 155250 0 0 0 PAWLIK RN COLLEEN CNO BOLING/GLENOAKS 38389 38389 9743 9743 2311 2311 0 0 3565 3565 54008 54008 0 0 PART I, LINE 1A THE FILING ORGANIZATION'S PARENT IS OWNED 49% BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). AHSSHC IS THE PARENT CORPORATION OF THE HEALTHCARE SYSTEM KNOWN AS ADVENTHEALTH. THE REMAINING 51% MEMBER IS THE UNIVERSITY OF CHICAGO MEDICAL CENTER (UCMC). BOTH AHSSHC AND UCMC ARE 501(C)(3) TAX-EXEMPT ORGANIZATIONS. EFFECTIVE JANUARY 1, 2023, THE FILING ORGANIZATION ENTERED INTO A MASTER MANAGEMENT AGREEMENT WITH AHSSHC WHEREBY AHSSHC SUPERVISES AND MANAGES THE DAY-TO-DAY OPERATIONS OF THE FILING ORGANIZATION. PURSUANT TO THE MASTER MANAGEMENT AGREEMENT, AHSSHC, AS MANAGER, PROVIDES THE CHIEF EXECUTIVE OFFICER (CEO), CHIEF OPERATING OFFICER (COO), CHIEF FINANCIAL OFFICER (CFO), CHIEF NURSING OFFICER (CNO), CHIEF MEDICAL OFFICER (CMO), AND THE CEO THE FILING ORGANIZATION. THE CEO OF THE FILING ORGANIZATION IS RESPONSIBLE FOR APPOINTING THE OTHER KEY MEMBERS OF HIS OR HER MANAGEMENT TEAM. THESE APPOINTED MEMBERS OF THE EXECUTIVE MANAGEMENT TEAM ARE SUPPLIED BY AHSSHC AS MANAGER AND ARE W-2 EMPLOYEES OF AHSSHC. AS THE ABOVE ENUMERATED C-SUITE PERSONNEL AND OTHER MEMBERS OF THE EXECUTIVE MANAGEMENT TEAM ARE PROVIDED TO THE FILING ORGANIZATION BY AHSSHC, THE COMPENSATION PRACTICES AND POLICIES OF AHSSHC ARE FOLLOWED BY THE FILING ORGANIZATION AND ITS SUBSIDIARIES. 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 AHSSHC. AS AHSSHC IS NOT CONSIDERED A RELATED ORGANIZATION PURSUANT TO THE FORM 990 DEFINITIONS AND INSTRUCTIONS, COMPENSATION AND BENEFIT INFORMATION FOR THE FILING ORGANIZATION'S EXECUTIVE MANAGEMENT TEAM SHOWN ON PART VII IS BEING REPORTED FOR THAT PORTION OF EACH INDIVIDUAL'S COMPENSATION AND BENEFITS THAT IS PROVIDED IN EXCHANGE FOR SERVICES PROVIDED TO THE FILING ORGANIZATION AND ITS RELATED SUBSIDIARIES. 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 50 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 (15 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 45-55 INDIVIDUAL EXECUTIVES). THE REGIONAL CEO/BOARD MEMBER LISTED ON PART VII OF THE FILING ORGANIZATION'S FORM 990 IS ON THE PAYROLL OF AHSSHC AND IS PROVIDED TO THE FILING ORGANIZATION PURSUANT TO THE MASTER MANAGEMENT SERVICES AGREEMENT. WHILE THE SPECIAL TRAVEL ALLOWANCE BENEFIT IS AN AHSSHC COMPENSATION POLICY AND PRACTICE, THE COST OF PROVIDING THIS BENEFIT IS CHARGED TO AND 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 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 INDIVIDUAL WHO SERVES AS THE CEO OF THE FILING ORGANIZATION IS COMPENSATED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), AN UNRELATED ENTITY AS DISCLOSED IN OUR RESPONSE TO FORM 990, SCHEDULE J, PART I, LINE 1A, FOR THAT INDIVIDUAL'S ROLE IN SERVING AS THE CEO PURSUANT TO THE MASTER MANAGEMENT AGREEMENT BETWEEN AHSSHC AND UCMC. 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. AS A FAITH-BASED ORGANIZATION SPONSORED BY THE SEVENTH-DAY ADVENTIST CHURCH (THE CHURCH), AHSSHC'S PHILOSOPHY AND PRINCIPLES WITH RESPECT TO ITS EXECUTIVE COMPENSATION PRACTICES REFLECT THE CONSERVATIVE APPROACH OF THE CHURCH'S MISSION OF SERVICE AND WERE DEVELOPED IN COUNSEL WITH THE CHURCH'S LEADERSHIP. PART I, LINES 4A-B DURING THE YEAR ENDING DECEMBER 31, 2023, RICHARD CARROLL AND JARED BROWN RECEIVED SEVERANCE PAYMENTS IN THE AMOUNT OF $221,658 AND $72,693 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. INTRODUCTION TO LINE 4B: PURSUANT TO THE AFFILIATION AGREEMENT BETWEEN AHSSHC AND UCMC, THE INDIVIDUALS LISTED IN PART VII INCLUDE INDIVIDUALS WHO ARE COMPENSATED BY AHSSHC AS MANAGER. ACCORDINGLY, THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLANS SPONSORED BY AHSSHC ARE DISCUSSED BELOW. THE OFFICERS AND KEY EMPLOYEES LISTED IN PART VII ARE PROVIDED TO THE FILING ORGANIZATION BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC) PURSUANT TO THE MASTER MANAGEMENT AGREEMENT. THE EXECUTIVE MANAGEMENT TEAM PROVIDED TO THE FILING ORGANIZATION PARTICIPATES IN THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS SPONSORED BY AHSSHC. THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS ARE DESCRIBED BELOW AND INCLUDES ALL PLANS IN WHICH THERE WERE ANY PARTICIPANTS IN 2023. 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. FORM 990, PART I, LINE 4B: 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 III SERP III CONTR. DISTR.* CONTR. DISTR.* THORDARSON,THOR $ 0 $ 0 $ 147,790 $ 0 BUCHANAN, HERBERT $ 0 $ 0 $ 73,311 $ 73,311 RADIVOJEVIC, VALADMIR $ 0 $ 0 $ 51,651 $ 0 KRIKORIAN, ARMAND $ 0 $ 0 $ 55,385 $ 0 * INCLUDING INVESTMENT EARNINGS FORM 990, PART VII, SECTION A, LINE 5: THE CEO, CFO, COO, CMO, AND CNO WERE COMPENSATED BY AHSSHC, AN UNRELATED ORGANIZATION, DURING THE FISCAL YEAR ENDED JUNE 30, 2024, FOR SERVICES PROVIDED TO THE FILING ORGANIZATION. PLEASE SEE OUR RESPONSE TO FORM 990, SCHEDULE J, PART I, LINE 1A FOR A DISCUSSION CONCERNING THE PROVISION OF EXECUTIVE MANAGEMENT PERSONNEL BY AHSSHC AS MANAGER TO THE FILING ORGANIZATION. COMPENSATION FOR THESE EXECUTIVES IS DISCLOSED IN PART VII AND SCHEDULE J, PART II. PART V, LINE 1A: EFFECTIVE JANUARY 1, 2023, 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 6 ADVENTIST BOLINGBROOK HOSPITAL (THE FILING ORGANIZATION) HAS ONE MEMBER. THE SOLE MEMBER OF THE FILING ORGANIZATION IS ADVENTIST MIDWEST HEALTH. ADVENTIST MIDWEST HEALTH (AMH) 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 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; - 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. FORM 990, PART VI, SECTION B, LINE 11B THE FILING ORGANIZATION'S CURRENT YEAR FORM 990 WAS REVIEWED BY THE BOARD CHAIRMAN, BOARD FINANCE COMMITTEE CHAIR, CEO, CFO AND MEMBERS OF THE UCHICAGO MEDICINE FINANCE LEADERSHIP TEAM PRIOR TO ITS FILING WITH THE IRS. THE REVIEW CONDUCTED BY THE BOARD CHAIRMAN, BOARD FINANCE COMMITTEE CHAIR, CEO, CFO AND MEMBERS OF THE UCHICAGO MEDICINE FINANCE LEADERSHIP TEAM 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 EMPLOYEES ARE NOT COMPENSATED BY THE FILING ORGANIZATION. SUCH INDIVIDUALS ARE COMPENSATED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), AN UNRELATED ENTITY. PLEASE SEE THE DISCUSSION CONCERNING THE PROCESS FOLLOWED BY AHSSHC IN DETERMINING EXECUTIVE COMPENSATION IN OUR RESPONSE TO SCHEDULE J, LINE 3. FORM 990, PART VI, SECTION C, LINE 19 THE FINANCIAL STATEMENTS OF THE FILING ORGANIZATION, ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT GENERALLY MADE AVAILABLE TO THE PUBLIC AS A WHOLE. 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 OPERATED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE SYSTEM. FORM 990, PART IX, LINE 11G PAYMENTS TO HEALTHCARE PROFESSIONALS: PROGRAM SERVICE EXPENSES 30,468,779. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 30,468,779. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 5,118,514. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,118,514. PURCHASED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 11,446,635. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,446,635. ENVIRONMENTAL SERVICES: PROGRAM SERVICE EXPENSES 2,774,489. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,774,489. RECRUITING: PROGRAM SERVICE EXPENSES 7,298. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,298. FOOD SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 3,398,368. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,398,368. MISCELLANEOUS PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 9,174,365. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,174,365. AHS MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 751,146. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 751,146. BILLING & COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 427,055. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 427,055. LEASE PERSONNEL COSTS: PROGRAM SERVICE EXPENSES 87,312,733. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 87,312,733. LEASE PERSONNEL COSTS MGMT: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,179,383. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,179,383. MANAGEMENT FEES REBATES: PROGRAM SERVICE EXPENSES -4,594,224. MANAGEMENT AND GENERAL EXPENSES -1,683,689. FUNDRAISING EXPENSES 0. TOTAL EXPENSES -6,277,913. FORM 990, 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, ONE OF THE FILING ORGANIZATION'S TOP-TIER PARENTS. THE INVESTMENTS IN THE CENTRAL INVESTMENT POOL ARE RECORDED AT MARKET VALUE. PART XII: FOR GAAP REPORTING, THE AFFILIATION AGREEMENT BETWEEN UCMC AND ADVENTIST MIDWEST HEALTH AND ITS PARENT ORGANIZATIONS, ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION AND ADVENTIST HEALTH SYSTEM/SUNBELT, INC., WAS ACCOUNTED FOR AS A DECONSOLIDATION UNDER ACCOUNTING STANDARDS CODIFICATION (ASC) 810. PLEASE NOTE THAT THE ATTACHED CONSOLIDATED FINANCIAL STATEMENTS FOR THE UNIVERSITY OF CHICAGO MEDICAL CENTER (UCMC) REFLECT UCMC'S CONTROLLING INTEREST IN THE NET ASSETS AND OPERATIONS OF THE FILING ORGANIZATION. THE CONSOLIDATED FINANCIAL STATEMENTS OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION AND ITS SUBSIDIARY ORGANIZATIONS INCLUDE ITS 49% INTEREST IN THE FILING ORGANIZATION TO ACCOUNT FOR ITS 49% RETAINED NONCONTROLLING INTEREST IN THE FILING ORGANIZATION UNDER THE EQUITY METHOD OF ACCOUNTING. THE APPROXIMATE NET ASSETS INCLUDED IN THE JUNE 30, 2024 FUND BALANCE AS SHOWN IN PART XI, LINE 10 ASSOCIATED WITH THE 49% NONCONTROLLING INTEREST IS $(35,761,000). ADVENTIST BOLINGBROOK HOSPITAL 500 REMINGTON BLVD BOLINGBROOK IL 60440 651219504 HOSPITAL IL 501(C)(3) PUBLIC CHA LINE 3 ADVENTIST MIDWEST HEALTH 1 ADVENTIST GLENOAKS HOSPITAL 701 WINTHROP AVE GLENDALE HEIGHTS IL 60139 363208390 HOSPITAL IL 501(C)(3) PUBLIC CHA LINE 3 ADVENTIST MIDWEST HEALTH 1 ADVENTIST HEALTH PARTNERS INC 5101 S WILLOW SPRINGS RD LA GRANGE IL 60525 364138353 PHYSICIAN PRACTICES IL 501(C)(3) PUBLIC CHA LINE 3 ADVENTIST MIDWEST HEALTH 1 ADVENTIST MIDWEST HEALTH 120 N OAK STREET HINSDALE IL 60521 362276984 2 HOSPITALS IL 501(C)(3) PUBLIC CHA LINE 3 N/A 0 AHP SPECIALTY CARE NFP 5101 S WILLOW SPRINGS RD LA GRANGE IL 60525 811105774 PHYSICIAN PRACTICES IL 501(C)(3) PUBLIC CHA LINE 3 ADVENTIST MIDWEST HEALTH 1 AHS MIDWEST MANAGEMENT INC 500 REMINGTON BLVD BOLINGBROOK IL 60440 363354567 EMPLOYEE LEASING IL 501(C)(3) PUBLIC CHA LINE 12C, III-FI N/A 0 MIDWEST HEALTH FOUNDATION 120 N OAK STREET HINSDALE IL 60521 352230515 FUND-RAISING FOR TAX-EXEMPT HOSPITAL IL 501(C)(3) PUBLIC CHA LINE 7 N/A 0 HINSDALE HOSPITAL FOUNDATION 7 SALT CREEK LN HINSDALE IL 60521 521466387 FUND-RAISING FOR TAX-EXEMPT HOSPITAL IL 501(C)(3) PUBLIC CHA LINE 7 MIDWEST HEALTH FOUNDATION 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 ADVENTIST MIDWEST HEALTH P 46032298 COST ADVENTIST MIDWEST HEALTH Q 48619838 COST ADVENTIST HEALTH PARTNERS INC P 24603466 COST ADVENTIST GLENOAKS HOSPITAL Q 2007609 COST MIDWEST HEALTH FOUNDATION C 123829 ACTUAL AMOUNT RECEIVED ADVENTIST HEALTH PARTNERS INC Q 25089707 COST ADVENTIST GLENOAKS HOSPITAL P 2214708 COST AHS MIDWEST MANAGEMENT INC P 92005364 COST AHS MIDWEST MANAGEMENT INC Q 3950631 COST MIDWEST HEALTH FOUNDATION R 50971 ACTUAL AMOUNT TRANSFERRED 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.