2025-11-17T09:43:38-06:00 2024-12-31 990 2024-01-01 590898901 Tarpon Springs Hospital Foundation Inc TARP 7279425000 1395 South Pinellas Avenue Tarpon Springs FL 346893790 Lynn Addiscott Assistant Secretary 4073572317 2025-10-24 0 2024 2025-03-06 01:10:19Z AdventHealth North Pinellas Andrew Santos 1395 South Pinellas Avenue Tarpon Springs FL 346893790 190224060 0 X www.adventhealth.com/hospital X 1970 FL The provision of medical care to the community through the operation of one general acute care hospital with a total of 168 beds. 13 8 1044 88 0 0 0 4739334 165294881 185416719 92299 68007 0 0 165387180 190224060 518321 529996 0 0 76932216 75870419 0 0 0 95867500 116239309 173318037 192639724 -7930857 -2415664 124980186 131427817 119646137 129085085 5334049 2342732 X Adventist Health System Sunbelt Healthcare Corporation and all its subsidiary organizations were established by the Seventh-Day Adventist Church to bring a ministry of healing and health to the communities served. Our mission is to extend the healing ministry of Christ.The hospital and healthcare system whose parent is Adventist Health System Sunbelt Healthcare Corporation is known as AdventHealth. AdventHealth seeks to be widely respected as a consumer-focused organization that engages individuals in their health by delivering wholistic, best practice care across a connected, comprehensive continuum of services. With Christ as our example, AdventHealth cares for and nurtures people: our employees, our communities, our healthcare professionals, and those who trust us for care and healing. 0 0 177772009 529996 185416719 Operation of acute care hospital totaling 168 beds with 6,591 patient admissions resulting in 31,267 patient days in the current year and 69,572 outpatient visits. 177772009 1 1 0 1 0 0 0 0 0 1 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 1 0 1 0 0 0 0 1 1 1 0 0 1 X 0 0 1 1044 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X Minh Dang-Do 7279425000 1395 South Pinellas Avenue Tarpon Springs FL 346893790 X Didenko Vadym Dir/CFO West FL Division 2.50 47.50 X 0 1197089 159128 Wangsness Erik Director/ Chairman 0.50 50.00 X 0 873374 128021 Quattlebaum Ryan Dir/Pres/CEO (end 12/24) 50.00 0.00 X X 0 510558 107972 Arnold MD Paul Director 0.50 0.00 X 1000 0 0 Carson MD Thomas Director 0.50 16.00 X 1000 110465 1656 Kouskoutis N Michael Dir/Vice Chairman 0.50 0.00 X 1000 0 0 Pawson Jonathan Director (end 11/24) 0.50 0.00 X 1000 0 0 Schiefer Mark Director 0.50 0.00 X 1000 0 0 Newmyer Jason Director 0.50 50.00 X 0 497401 108505 Mayo Darrell Director (end 7/24) 0.50 0.00 X 0 0 0 Davis MD Rodrigo Director 0.50 0.00 X 1000 0 0 Pappas Rosanne Director 0.50 0.00 X 1000 0 0 Pienado Jonathan Director 0.50 0.00 X 1000 0 0 Sprowls Shannon Director 0.50 0.00 X 1000 0 0 Makombe MD Scheri-lyn Director (beg 9/24) 0.50 0.00 X 1000 0 0 Crunk Dan CFO 50.00 0.00 X 0 347439 43614 Longley MD Michael CMO 50.00 0.00 X 0 564484 104445 Segur Jennifer CNO (end 3/24) 50.00 0.00 X 0 329461 35734 Grzanowski Macye CNO (beg 4/24) 50.00 0.00 X 82866 143502 29380 Malone George Pharmacy Director 40.00 0.00 X 208233 20967 43921 Allgire Michele Clinical Pharmacist 40.00 0.00 X 198640 0 11016 Radden April HR Dir - HRBP 40.00 0.00 X 173863 0 17189 Campbell Jarrod Clinical Pharmacist 40.00 0.00 X 170774 0 15451 Hanson Stephanie Exec Dir Operations 40.00 0.00 X 162269 0 33925 Bergherm Bruce Former Officer 0.00 50.00 X 0 1761749 39509 Dunkel Jason Former Officer 0.00 50.00 X 0 723793 103127 Heinrich Caleb Former Officer 0.00 50.00 X 0 205123 40054 McGuinness Robin Former Key Employee 2.50 47.50 X 0 821684 102832 1006645 8107089 1125479 110 1 1 0 North Pinellas Anesthesia Assoc PA 7032 Collections Center Drive Chicago IL 60693 Anesthesia Services 3567786 PT Solutions Holdings LLC PO Box 724557 Atlanta GA 31139 Medical Professional Services 2000698 Jackson & Locum Coker 2655 Northwinds Pkwy Alpharetta GA 30009 Medical Professional Services 755271 Crothall Healthcare Inc 13028 Collections Center Drive Chicago IL 60693 Environmental Services 681517 Pioneer Medical Group LLC 13067 Telecom Parkway N Tampa FL 33637 Medical Professional Services 446750 40 X 161584 1500000 3077750 4739334 Net patient revenue 622110 184783372 184783372 Cafeteria revenue 622110 488733 488733 Reimbursement of expenses 622110 105272 105272 Gift shop revenue 622110 4233 4233 35109 35109 185416719 43947 43947 10586 13474 0 0 10586 13474 24060 24060 190224060 185416719 0 68007 X 529996 529996 2054436 2054436 54939380 54939380 1850923 1800759 50164 12952823 12654073 298750 4072857 3962474 110383 9211 9211 64191 64191 2353 2353 46814152 38863707 7950445 1217097 1217097 4279160 2717386 1561774 7450610 6831753 618857 5272332 5272332 85723 309 85414 465169 465169 3052053 3052053 6773872 6773872 3299580 3201636 97944 Medical Supplies 22725402 22725402 State Tax Indigent Asse 8582182 8582182 Repairs & maintenance 5857818 5857818 288404 6877 281527 192639724 177772009 14867715 0 601 151 0 22699299 21154465 0 4274580 4832720 8324959 12969611 131280927 50992663 81648276 80288264 8032471 12182606 124980186 131427817 9927794 11365928 109718343 117719157 119646137 129085085 X 1241155 -1226812 4092894 3569544 5334049 2342732 124980186 131427817 X -2415664 -561 -575092 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 5860 5860 0 Part II-B, Line 1: Dues paid to American Hospital Association and Florida Hospital Association. 4092894 779235 467622 1770207 3569544 3699461 2444495 471710 2522772 4092894 6358697 1851374 -574797 3935813 3699461 4252762 3196867 -1097710 -6778 6358697 2842624 1265831 157251 12944 4252762 1.00000 0.00000 0.00000 0 1 1 5620845 5620845 50769724 13663508 37106216 67264181 36782063 30482118 7626177 547092 7079085 80288264 Other receivables 767479 Receivable from third parties 5788888 Right of Use Asset-Operating Lease 2056695 Interest in Foundation 3569544 12182606 Due to related 60485322 Payable to third parties 3075570 Credit balances in A/R 3581064 Accrued interest payable 203077 Leases payable 3255189 Other liabilities 1873134 Interco Alloc of TE Bond Proceeds 43194114 Operating Lease Liability 2051687 117719157 X Part V, Line 4: Helen Ellis Memorial Hospital Foundation, Inc. (HEMHF), a related organization formed and maintained exclusively to further the exempt purpose of AdventHealth North Pinellas (the Hospital) held assets in temporary endowment funds during the current tax year. HEMHF's endowment consists of individual donor restricted endowment funds where the assets have been designated for endowment established to support various purposes benefiting the Hospital and its patients. Part X, Line 2: The filing organization is a subsidiary organization within AdventHealth. The consolidated financial statements of AdventHealth contain the following FIN 48 (ASC 740) footnote: Please note that dollar amounts are in thousands. Healthcare Corporation and its affiliated organizations, other than North American Health Services, Inc. and its subsidiary (NAHS), are exempt from state and federal income taxes. Accordingly, Healthcare Corporation and its tax-exempt affiliates are not subject to federal, state, or local income taxes except for any net unrelated business taxable income. NAHS is a wholly owned, for-profit subsidiary of Healthcare Corporation. NAHS and its subsidiary are subject to federal and state income taxes. NAHS files a consolidated federal income tax return and, where appropriate, consolidated state income tax returns. The provision for federal and state income tax for the years ended December 31, 2024 and 2023 is approximately $1,619 and $1,140, respectively. The Income Taxes Topic of the Accounting Standards Codification (ASC) 740, Income Taxes (ASC 740) prescribes the accounting for uncertainty in income tax positions recognized in financial statements. ASC 740 prescribes a recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken, or expected to be taken, in a tax return. There were no material uncertain tax positions as of December 31, 2024 and 2023. 1 1 X 1 X 250.000000000000 1 X 1 1 0 1 0 7363995 7363995 0.03820 23976324 14427149 9549175 0.04960 31340319 14427149 16913170 0.08780 95411 95411 0.00050 66496 66496 0.00030 161907 161907 0.00080 31502226 14427149 17075077 0.08860 209770 209770 0.00110 209770 209770 0.00110 1 9399810 537021 24708501 30892324 -6183823 X 1 1 1 1 AdventHealth North Pinellas 1395 South Pinellas Avenue Tarpon Springs FL 34689 www.adventhealth.com/hospital/adventhe 4333 X X X AdventHealth North Pinellas 1 0 0 1 X X X X X X X X X 22 1 0 0 1 X See Part V, Page 8 X X 1 23 1 See Part V, Page 8 0 1 X 250.000000000000 400.000000000000 X X X X 1 1 X X X X 1 X See Part V, Page 8 X See Part V, Page 8 X See Part V, Page 8 X X X X X X 1 X 0 X X X X 1 X 0 0 AdventHealth North Pinellas Part V, Section B, Line 5: Tarpon Springs Hospital Foundation, Inc. d/b/a AdventHealth North Pinellas (AHNP or the Hospital) is a 168-bed hospital located in Pinellas County in Florida. AHWC's primary service area includes seven zip codes across Pinellas and Pasco Counties. 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 local community organizations and stakeholders, including those in public health, to form the All4HealthFL Collaborative. The All4HealthFL Collaborative is a regional effort of local hospital systems and public health departments that work to improve community health. The Collaborative collected input directly from the community and from community stakeholders through a community survey and focus groups. The Collaborative met several times in 2021 and 2022 and reviewed primary and secondary data and helped to define the top health priority needs in the community. AHNP also formed a Community Health Needs Assessment Committee (CHNAC) that included representatives from organizations that serve low-income, low-access individuals and communities. The purpose of the CHNAC was to select the needs the Hospital would address from the findings in the community health needs assessment. Key CHNAC members that represented low-income and underserved populations were from the following organizations-Florida Department of Health in Pinellas County, UF/IFAS Extension of Pinellas, the Phoenix, National Alliance on Mental Illness Pinellas, Citizens Alliance for Progress, Mount Moriah AME Church, Tarpon Spring Elementary, St. Pete College, Live Tampa Bay, Peace4Tarpon, Tarpon Springs Shepherd Center, and the Gulfcoast North Area Health Education Center. AdventHealth North Pinellas 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. AdventHealth North Pinellas Part V, Section B, Line 11: Tarpon Springs Hospital Foundation, Inc. dba AdventHealth North Pinellas, will be referred to in this document as AdventHealth North Pinellas or "The Hospital". The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. This is the second-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, AdventHealth North Pinellas 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 second-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. Access to Health and Social Services2. Behavioral Health (Mental Health and Substance Misuse)Priority 1: Access to Health and Social Services2022 Description of the Priority:Thirty-six percent (36%) of community survey respondents ranked Access to Health Care as a pressing quality of life issue. Focus group participants cited barriers such as transportation, cost of care and prescriptions, lack of providers who speak their language, trust issues with the health care system and inconvenient appointment times. Inadequate health insurance coverage is one of the largest barriers to health care access and the unequal distribution of coverage contributes to disparities in health. The percentage of adults (aged 18-64) without health insurance in Pinellas County is 18.7%. Pinellas is in the worst 25% of all counties in the nation.2024 Update:Goal 1.1: Promote the attainment and maintenance of health through health education and access to care Objective 1.1.1: By December 31, 2025, the percentage of adults in the AdventHealth Food is Health program who report redeeming at least five produce vouchers to access nutritious food for their families from a baseline of 57% to 68%. This initiative and the reported outcomes are shared across multiple facilities in the West Florida Division.The AdventHealth Food is Health program provides series-based nutrition education and culturally appropriate, nutritious foods to participants in low income/low access areas in the Hospital's community. The program involves collaborations from a variety of community partners, including subject matter experts providing education, mobile produce vendors, and sites in the community where classes are held. AdventHealth sponsors the cost of produce for participants and assists with coordinating classes.Team members managing this program experienced challenges accurately calculating the percent of program attendees redeeming at least five produce vouchers. This was due to limited attendance data being tracked and shared by educational partners. Instead, the Hospital will track and report the pounds of produce distributed to program attendees. By the end of 2024, a total of 95,242 lbs. of produce were distributed to 2,064 community members throughout the West Florida Division. The Hospital completed classes with the Tarpon Springs Boys and Girls club, Chasco Elementary School, Achieve Center and Mt. Moriah Church for a total of 212 participants toward this division wide metric. Objective 1.1.2: By December 31, 2025, increase the number of community members trained in Hospital sponsored American Heart Association (AHA) Hands-Only CPR classes for adults and youth from a baseline of 573 to 4,200 people trained (Division-wide). This initiative and the reported outcomes are shared across multiple facilities in the West Florida Division.By the end of 2024, the Hospitals in partnership with the American Heart Association and their nursing teams held Hands-Only CPR demonstrations for 7,254 community members. These demonstrations were held at health fairs and free community events. Additionally, AdventHealth North Pinellas staff provided CPR training to youth during the Spring Fun Festival at the Tarpon Springs Boys & Girls Club.Objective 1.1.3: By December 31, 2025, increase number of participants in Hospital-sponsored access to care programs from a baseline of 75 participants to 150 participants. This initiative is focused on providing support to community organizations with programs increasing access to care (ex. health screening events). The outcomes below are specific to the reporting Hospital.By the end of 2024, the Hospital provided access to a total of 735 participants in partnership with Premier Community Healthcare, a nonprofit organization that provides primary care services for people with Medicare/Medicaid as well as those without insurance. The Hospital also provided free Bariatric support groups for anyone in the community to attend. Additionally, the Hospital donated $3000 to Salvation Army to support their Hope Crest program that provides a safe place for single mothers to live while furthering their education. AdventHealth North Pinellas staff also donated their time to help build beds for Sleep in Heavenly Peace, which is an organization that provides free beds for children that cannot afford them.See Continuation 2 Continuation of Part V, Section B, Line 11 - continuation 2 Priority 2: Behavioral Health: (Mental Health and Substance Misuse)2022 Description of the Priority: According to community survey respondents, 32% have been diagnosed with a depressive disorder or anxiety disorder. Forty-one percent (41%) of the community and public health experts surveyed ranked mental health as the most pressing issue in Pinellas County. Substance use emerged as a top concern, reflected in both primary and secondary data sources. Illegal drug use/abuse of prescription medications/alcohol abuse were ranked as important health issues to address by 30% of survey respondents. One of the most concerning trends is with drug overdose deaths, which have increased significantly over the past few years, currently at a rate of 32.5 (per 100,000 population). Pinellas County also sees a higher percentage of adults who currently smoke with 19.7% of adults in Pinellas County compared to 14.8% for the state of Florida.2024 Update:Goal 2.1: Reduce the impact of mental, emotional, and behavioral health disorders. Objective 2.1.1: By December 31, 2025, increase number of participants who attend Hospital sponsored Mental Health First Aid certification classes from a baseline of 258 participants to 700 participants (Division-wide). Mental Health First Aid teaches individuals how to help someone who may be experiencing a mental health or substance use challenge. The training helps individuals identify, understand and respond to signs of addiction and mental illnesses. This initiative and the reported outcomes are shared across multiple facilities in the West Florida Division.The Hospitals contracted with Safe and Sound Hillsborough to teach Mental Health First Aid classes in the community. Safe and Sound Hillsborough is a collaborative of community and professional stakeholders transforming the way local policy makers address violence in the community. The goal is to shift policy from a public safety to a public health model and develop a comprehensive prevention and intervention approach. By the end of 2024, a total of 307 people were trained with most classes offered virtually. Of all Mental Health First Aid participants surveyed, 91.4% indicated they felt confident or strongly confident in having a supportive conversation with anyone about a mental health or substance use challenge after completing the class. In 2024, there were no in-person classes held in Pinellas. However, virtual classes are open to any community members seeking training in Tampa Bay.Objective 2.1.2: By December 31, 2025, increase number of participants in Hospital-sponsored behavioral health education programs from a baseline of 5 participants to 100 participants. The outcomes below are specific to the reporting Hospital.By the end of 2024, the Hospital sponsored programs for a total of 187 individuals. This included a $1,000 sponsorship to the Alliance for Health Communities to support peer counselors and substance misuse support groups for 50 community members. Additionally, the Hospital donated $13,000 to the Shepherd Center, a nonprofit organization that provides essential services, including mental health care, to individuals experiencing homelessness covering services for 41 community members.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. Immunizations and Infectious Disease: There are opportunities to impact through prevention education, however, the Hospital did not perceive the ability to have a measurable impact on the issue within the three years allotted for the Community Health Plan with the current resources available.2. Heart Disease and Stroke: The Hospital did not select this as a priority as there are already several other community organizations actively addressing this need in the community who are better positioned to make an impact.3. Cancer: Cancer was not selected as a priority as there are others already addressing this need.4. Exercise, Nutrition and Weight: Although Exercise, Nutrition and Weight was selected as one of the top three health priorities of concern for the county, the CHNAC did not select it as one of the top two priorities to address because the Hospital is not positioned to directly address this. Schedule H, Part V, Section B, Line 7a: The CHNA report can be found at URL:https://www.adventhealth.com/community-health-needs-assessments Schedule H, Part V, Section B, Line 10a: The most recently adopted implementation strategy can be found at:https://www.adventhealth.com/community-health-needs-assessments Schedule H, Part V, Section B, Line 16a,b,c: The Financial Assistance Policy can be found at URL:https://www.adventhealth.com/legal/financial-assistanceThe Financial Assistance Policy application can be found at:https://www.adventhealth.com/legal/financial-assistanceThe plain language summary is available at:https://www.adventhealth.com/legal/financial-assistance 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. Alternatively, a patient may also qualify for a 100% reduction from charges when the unpaid portion of a patient's bill exceeds 25% of the individual's annual household income and the patient's total annual household income does not exceed 400% of FPG. 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 wholly or partially owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) during its current tax year. During the current year, AHSSHC served as a parent organization to 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. 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:Uninsured and insured patients may apply for financial assistance by completing a Financial Assistance Application Form (FAA Form). If an uninsured individual does not submit a completed FAA Form within 240 days of receiving their first post-discharge billing statement, they may still be considered for presumptive eligibility. This determination can be made through the use of third-party scoring tools, which classify patients into groups based on economic means. Using the scoring results, individuals may be deemed eligible for financial assistance. In such cases, a percentage of their account balance can be discounted in accordance with the filing organization's Financial Assistance Policy. Depending on the determination, a nominal portion of the patient's bill may be written off as bad debt expense, while the remaining balance is classified as charity. The amount categorized as bad debt expense for patients who qualify under presumptive eligibility guidelines is reported on line 3 of Section A in Part III. The filing organization recognizes that some patients may face barriers that prevent them from completing an application within the 240-day financial assistance period. These barriers may include lack of cooperation or extenuating circumstances beyond the patient's control. To address such situations, the filing organization partners with an Internal Revenue Code Section 501(c)(3) third-party organization to forgive debt once a patient's account has completed the bad debt process. This ensures that individuals facing genuine hardship still have access to financial relief, even if they are unable to comply fully with the formal FAA process. Rationale for Including Certain Bad Debts in Community Benefit:The filing organization is dedicated to the view that medically necessary health care for emergency and non-elective patients should be accessible to all, regardless of age, gender, geographic location, cultural background, physician mobility, or ability to pay. The filing organization treats emergency and non-elective patients regardless of their ability to pay or the availability of third-party coverage. By providing health care to all who require emergency or non-elective care in a non-discriminatory manner, the filing organization is providing health care to the broad community it serves. As a 501(c)(3) hospital organization, the filing organization maintains a 24/7 emergency room providing care to all whom present. When a patient's arrival and/or admission to the facility begins within the Emergency Department, triage and medical screening are always completed prior to registration staff proceeding with the determination of a patient's source of payment. If the patient requires admission and continued non-elective care, the filing organization provides the necessary care regardless of the patient's ability to pay. The filing organization's operation of a 24/7 Emergency Department that accepts all individuals in need of care promotes the health of the community through the provision of care to all whom present. Current Internal Revenue Service guidance that tax-exempt hospitals maintain such emergency rooms was established to ensure that emergency care would be provided to all without discrimination. The treatment of all at the filing organization's Emergency Department is a community benefit. Under the filing organization's Financial Assistance Policy, every effort is made to obtain a patient's necessary financial information to determine eligibility for financial assistance. However, not all patients will cooperate with such efforts and a financial assistance eligibility determination cannot be made based upon information supplied by the individual. In this case, a patient's portion of a bill that remains unpaid for a certain stipulated time period is wholly or partially classified as bad debt. Bad debts associated with patients who have received care through the filing organization's Emergency Department should be considered to be community benefit as charitable hospitals exist to provide such care in pursuit of their purpose of meeting the need for emergency medical care services available to all in the community. Part III, Line 4: Financial Statement Footnote Related to Accounts Receivable and Allowance for Uncollectible Accounts:The financial information of the filing organization is included in a consolidated audited financial statement for the current year.The applicable footnote from the attached consolidated audited financial statements that addresses accounts receivable, the allowance for uncollectible accounts, and the provision for bad debts can be found on page 8 - 10. Please note that dollar amounts on the attached consolidated audited financial statements are in thousands. Part III, Line 8: Costing Methodology:Medicare allowable costs were calculated using a cost-to-charge ratio.Rationale for Including a Medicare Shortfall as Community Benefit:As a 501(c)(3) organization, the filing organization provides emergency and non-elective care to all regardless of ability to pay. All hospital services are provided in a non-discriminatory manner to patients who are covered beneficiaries under the Medicare program. As a public insurance program, Medicare provides a pre-established reimbursement rate/amount to health care providers for the services they provide to patients. In some cases, the reimbursement amount provided to a hospital may exceed its costs of providing a particular service or services to a patient. In other cases, the Medicare reimbursement amount may result in the hospital experiencing a shortfall of reimbursement received over costs incurred. In those cases where an overall shortfall is generated for providing services to all Medicare patients, the shortfall amount should be considered as a benefit to the community. Tax-exempt hospitals are required to accept all Medicare patients regardless of the profitability, or lack thereof, with respect to the services they provide to Medicare patients. The population of individuals covered under the Medicare program is sufficiently large so that the provision of services to the population is a benefit to the community and relieves the burdens of government. In those situations where the provision of services to the total Medicare patient population of a tax-exempt hospital during any year results in a shortfall of reimbursement received over the cost of providing care, the tax-exempt hospital has provided a benefit to a class of persons broad enough to be considered a benefit to the community. Despite a financial shortfall, a tax-exempt hospital must and will continue to accept and care for Medicare patients. Typically, tax-exempt hospitals provide health care services based upon an assessment of the health care needs of their community as opposed to their taxable counterparts where profitability often drives decisions about patient care services that are offered. Patient care provided by tax-exempt hospitals that results in Medicare shortfalls should be considered as providing a benefit to the community and relieving the burdens of government. Part III, Line 9b: The hospital filing organization's collection practices are in conformity with the requirements set forth in the 2014 Final Regulations regarding the requirements of Internal Revenue Code Section 501(r)(4)-(r)(6). No extraordinary collection actions (ECA's) are initiated by the hospital filing organization in the 120-day period following the date after the first post-discharge billing statement is sent to the individual (or, if later, the specified deadline given in a written notice of actions that may be taken, as described below). Individuals are provided with at least one written notice (notice of actions that may be taken) and a copy of the filing organization's Plain Language Summary of the Financial Assistance Policy that informs the individual that the hospital filing organization may engage in certain specific ECAs, including the selling of debt to a third party, 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 ECA's and provides a written notice to the individual describing what additional information or documentation is needed to complete the FAA Form. This written notice contains contact information including the telephone number and physical location of the hospital facility's office or department that can provide information about the Financial Assistance Policy, as well as contact information of the hospital facility's office or department that can provide assistance with the financial assistance application process or, alternatively, a nonprofit organization or governmental agency that can provide assistance with the financial assistance application process if the hospital facility is unable to do so. If an individual submits a complete FAA Form within a reasonable time-period as set forth in the notice described above, the hospital filing organization will take all available measures to reverse any ECAs against the individual and will notify the individual in writing within 60 days after receiving the complete FAA Form of the eligibility determination and the basis for the determination. Supplemental Schedule to Schedule H, Part III, Section B Reconciliation of Schedule H Reported Medicare Surplus/(Shortfall) to Unreimbursed Medicare Costs Associated with the Provision of ServicesTo All Medicare Beneficiaries:The Medicare revenue and allowable costs of care reported in Section B of Part III of Schedule H are based upon the amounts reported in the filing organization's Medicare cost report in accordance with the IRS instructions for Schedule H. On an annual basis, the filing organization also determines its total unreimbursed costs associated with providing services to all Medicare patients. Unreimbursed costs are considered a community benefit to the elderly and are combined into an annual Community Benefit Statement prepared by AdventHealth. The primary reconciling items between the Medicare surplus/(shortfall) shown on line 7 of Section B of Part III of Schedule H and the filing organization's unreimbursed costs of services provided to Medicare patients are as follows:- Medicare surplus/(shortfall) shown on line 7 of Section B of Schedule H: $ (6,183,823)- Difference in costing methodology: (2,713,144)- Unreimbursed costs incurred for services provided to Medicare patients that are not included in the organization's Medicare cost report: (27,147,551) -------------Total Unreimbursed costs of serving all Medicare patients per the filing organization's community benefit reporting: $ (36,044,518)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 may, upon patient request, provide personal financial counseling to patients who are classified as uninsured 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: AdventHealth North Pinellas (AHNP), a 168-bed facility, situated on the west coast of central Florida along the Anclote River where the river meets the Gulf of Mexico, serves the residents of North Pinellas and surrounding communities with vital healthcare services. A Medical Staff of more than 430 physicians, including primary care and specialists, have privileges at AHNP. These doctors bring a tremendous resource of medical expertise to the hospital and the communities it serves.AdventHealth North Pinellas is a crucial community asset. In addition to operating a hospital facility, AHNP also operates 2 wound healing institutes, and 1 sleep center. AdventHealth North Pinellas also owns and operates a full service emergency room (ER) location in nearby Palm Harbor, Florida (Pinellas County). The Palm Harbor ER features 24 beds and overnight observation care, on-site imaging, lab and pharmacy services. It offers adult and pediatric emergency care. During 2024, the Hospital's patient percentage population was made up of the below payors with the remaining percentage of the patients being covered under commercial insurance. In 2024, about 88.6% of the Hospital's in-patients were admitted through the Hospital's Emergency Department. - Medicare Patients 57.2% - Medicaid Patients 9.5% - Self-Pay Patients 4.5% The demographic makeup of the Hospital's service area is as follows: - Population 154,351 - Population Over 65 26.8% - Poverty (Below 100% FPL) 12% - High School Graduation Rate 91.3% - Uninsured Adults 12.1% - Food Insecurity Rate 16.5% - Pop. with Low Food Access 72.5% Part VI, Line 5: The provision of community benefit is central to AdventHealth North Pinellas'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. During the current year, the Hospital provided $377,420 of benefit with respect to the faith-based and spiritual needs of the community in conjunction with its operation of a community hospital. 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 $5,407,861 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 is a part of a faith-based healthcare system of organizations whose parent is Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). The system is known as AdventHealth. AHSSHC is an organization exempt from federal income tax under IRC Section 501(c)(3). AHSSHC and its subsidiary organizations operate 51 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. As the parent organization of AdventHealth, AHSSHC provides executive leadership and other professional support services to its subsidiary organizations. Professional support services include among others IT, corporate compliance, legal, reimbursement, risk management, and tax as well as treasury functions. Certain support services, such as human resources, payroll, A/P, and supply chain management are provided pursuant to a shared services model by AHSSHC to its subsidiary organizations. The provision of these executive and support services on a centralized basis by AHSSHC provides an appropriate balance between providing each AdventHealth subsidiary hospital organization with mission-driven consistent leadership and support while allowing the hospital organization to focus its resources on meeting the specific health care needs of the community it serves. The reader of this Form 990 should keep in mind that this reporting entity may differ in certain areas from that of a stand-alone hospital organization due to its inclusion in a larger system of healthcare organizations. As a part of a system of hospital and other health care organizations, the filing organization benefits from reduced costs due to system efficiencies, such as large group purchasing discounts, and the availability of internal resources such as internal legal counsel. 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 as a whole. The reader is directed to visit the website of AdventHealth at www.adventhealth.com to learn more about the mission and operations of the filing organization. Part VI, Line 7: The filing organization does not file an annual community benefit report with any state agencies. 1 Saint Nicholas Greek Orthodox Cathedral 17 E Tarpon Ave Tarpon Springs FL 34689 830371578 501(c)(3) 10000 0 General Support Helen Ellis Memorial Hospital Foundation Inc 1395 S Pinellas Ave Tarpon Springs FL 34689 593690149 501(c)(3) 0 266996 Book Administrative Support General Support Tarpon Springs Shepherd Center 304 S Pinellas Ave Tarpon Springs FL 34689 593070882 501(c)(3) 13000 0 General Support Young Men's Christian Association of the Suncoast Inc 2469 Enterprise Rd Clearwater FL 33763 590810731 501(c)(3) 60000 0 General Support Generations Christian Church at Trinity Inc 1540 Little Rd Trinity FL 34655 591713769 501(c)(3) 180000 0 General Support 5 0 Part I, Line 2: Grants are generally made only to related organizations that are exempt from federal income tax under IRC Section 501(c)(3), or to other local charitable community organizations, or to other 501(c)(3) organizations that are a part of the group exemption ruling issued to the General Conference of Seventh-Day Adventists. Accordingly, the filing organization has not established specific procedures for monitoring the use of grant funds in the United States as the filing organization does not have a grant making program that would necessitate such procedures. X X X X 1 1 0 1 0 0 0 0 0 0 0 Bergherm Bruce Former Officer 0 710394 0 518285 0 533070 0 18516 0 20993 0 1801258 0 0 Didenko Vadym Dir/CFO West FL Division 0 600577 0 441797 0 154715 0 124373 0 34755 0 1356217 0 77515 Wangsness Erik Director/ Chairman 0 459255 0 267920 0 146199 0 90054 0 37967 0 1001395 0 46878 McGuinness Robin Former Key Employee 0 410486 0 297589 0 113609 0 81828 0 21004 0 924516 0 36475 Dunkel Jason Former Officer 0 418282 0 215813 0 89698 0 63734 0 39393 0 826920 0 17810 Longley MD Michael CMO 0 367042 0 91993 0 105449 0 69758 0 34687 0 668929 0 32050 Quattlebaum Ryan Dir/Pres/CEO (end 12/24) 0 319777 0 112786 0 77995 0 74234 0 33738 0 618530 0 0 Newmyer Jason Director 0 311724 0 144981 0 40696 0 68708 0 39797 0 605906 0 0 Crunk Dan CFO 0 264056 0 57787 0 25596 0 16880 0 26734 0 391053 0 0 Segur Jennifer CNO (end 3/24) 0 246304 0 55858 0 27299 0 17396 0 18338 0 365195 0 0 Malone George Pharmacy Director 166662 20967 36294 0 5277 0 0 9936 33985 0 242218 30903 0 0 Grzanowski Macye CNO (beg 4/24) 58286 138092 23531 0 1049 5410 3443 6682 6648 12607 92957 162791 0 0 Heinrich Caleb Former Officer 0 178487 0 24094 0 2542 0 9468 0 30586 0 245177 0 0 Allgire Michele Clinical Pharmacist 195518 0 0 0 3122 0 7619 0 3397 0 209656 0 0 0 Hanson Stephanie Exec Dir Operations 127475 0 28355 0 6439 0 6816 0 27109 0 196194 0 0 0 Radden April HR Dir - HRBP 152755 0 20410 0 698 0 845 0 16344 0 191052 0 0 0 Campbell Jarrod Clinical Pharmacist 169919 0 0 0 855 0 6581 0 8870 0 186225 0 0 0 Part I, Line 1a The filing organization is a part of the system of healthcare organizations known as AdventHealth. Members of the filing organization's executive management team that hold the position of Vice-President or above are compensated by and on the payroll of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the parent organization of the healthcare system known as AdventHealth. AHSSHC is exempt from federal income tax under IRC Section 501(c)(3). The filing organization reimburses AHSSHC for the salary and benefit cost of those executives listed in Part VII that are on the payroll of AHSSHC. At the direction of AHSSHC, and in accordance with the reserved powers in the filing organization's governing documents, the executive team listed on Part VII provides services to the filing organization. First-class or charter travel: Pursuant to the AdventHealth system-wide general policy regarding business travel, no reimbursement will be provided for any additional cost incurred with respect to first-class or charter air travel beyond the cost of a regular coach airfare. As a means of providing additional business travel reimbursement for those members of the AHSSHC senior executive management team that travel frequently on behalf of AdventHealth, a special annual travel allowance is provided for those executives. As AdventHealth operates 51 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 or to cover the cost differential between coach and first-class travel. 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 $33,500 for Senior and System Executive Vice Presidents (generally 18 AdventHealth Executive Vice Presidents) and the Multi-State CFO, $20,000 for System Senior Vice Presidents, Regional CEO's and Division Chief Officers (generally 50-60 individual executives) and $7,500 for other executives whose role requires extensive travel (currently 4), as approved by the AdventHealth CEO. The AdventHealth System CEO does not have an annual cap. The Regional CEO, CFO and CNO are considered common law employees of and are on the payroll of AHSSHC. While the special travel allowance benefit is an AHSSHC compensation policy and practice, the cost of providing this benefit is allocated to and either wholly or partially reimbursed by the filing organization. Accordingly, the filing organization has checked the box in Schedule J, Part I, line 1a for first-class or charter travel since it has wholly or partially paid for the cost of providing this benefit. Those executives who receive the special travel allowance are responsible for tracking the expenses reimbursable under the special travel allowance and must submit such expenses on their accountable plan expense report. A report on charter travel is provided to the AHSSHC Board Compensation Committee at each meeting. Any taxable reimbursements made to executives under the special travel allowance arrangement are treated as taxable compensation to the executive. Travel for companions: AHSSHC has a Corporate Executive Policy that provides a benefit to allow for a traveling AHSSHC executive to have his or her spouse accompany the executive on certain business trips each year. Typically, reimbursement is only provided to certain executive leaders and is usually limited to one business trip per year beyond the annual AdventHealth President's Council business meeting and other meetings where the spouse is specifically invited. The AHSSHC Corporate Executive Spousal Travel Policy was originally approved and reviewed by the AHSSHC Board Compensation Committee, an independent body of the AHSSHC Board of Directors. All spousal travel costs reimbursed to the executive are considered taxable compensation to the executive. Tax Indemnification and gross-up payments: AdventHealth has a system-wide policy addressing gross-up payments provided in connection with employer-provided benefits/other taxable items. Under the policy, certain taxable business-related reimbursements (i.e. taxable business-related moving expenses, taxable items provided in connection with employment) provided to any employee may be grossed-up at a 25% rate upon approval by the filing organization's CEO and CFO. Additionally, employees at the Director level and above are eligible for gross-up payments on gifts received for board of director services. Discretionary spending account: Occasional discretionary spending amounts are periodically provided to eligible executives who attend annual business meetings such as the AdventHealth President's Council, CFO Conference or the CMO/CNO business meeting. Payments provided to each executive are considered taxable compensation to the executive. Part I, Line 3 The individual who serves as the CEO of the filing organization is appointed and compensated by Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). 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, Line 4b As discussed in Line 1a above, executives on the filing organization's management team that hold the position of Vice-President or above are compensated by and on the payroll of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the parent organization of the healthcare system known as AdventHealth. In recognition of the contribution that each executive makes to the success of AdventHealth, AdventHealth provides supplemental executive retirement benefit plans to eligible executives. As the supplemental executive retirement benefit plans were updated in 2020 and certain individuals still participate as grand-fathered participants in certain plans, the narrative below discusses all plans in which there were any participants in 2024. The SERP III plan effectively replaces the prior SERP II plan, the Executive Flex Benefit Program Plan, and the Senior Executive Death Benefit Plan for qualified executives except for certain grandfathered executive employees. SERP III Plan: The SERP III plan provides eligible executives a percentage of their base pay, which is credited to a deferred compensation account. The plan also provides for compensation deferral and selection of life insurance coverage and long-term care insurance. To be eligible to participate in the SERP III plan, executives must be on the AHSSHC corporate payroll and be either a CEO of an AdventHealth entity, an AHSSHC Vice President (VP) or VP of an AdventHealth entity with a base salary of at least $345,000 in 2024 (adjusted annually by the same percentage as IRC Section 401(a)(17) limit increases), or other leader specifically approved by the AdventHealth President. Eligible executives do not include grandfathered executives, meaning those executives who would satisfy all the eligibility requirements of the SERP II plan prior to Dec 31, 2027, had the plan not been amended and restated as of Jan. 1, 2020. Contribution credits will be established and maintained by class year accounts for each participant using tiered contribution credit percentages of annual base compensation. Contribution credit percentages range between 15% and 19% of base compensation. Contribution credits will be made each quarter in 25% increments with reductions in contributions if the executive is also a grandfathered FLEX participant (see below). SERP III provides for a class year vesting and payment schedule (7 years for each class year) with respect to amounts accumulated in the executive's deferred compensation account. Upon attainment of a normal retirement age (age 62), or upon certain other circumstances as defined in the SERP III plan document, all deferred amounts are paid immediately to the participant. For any executives working beyond the normal retirement age, future employer contributions will be made quarterly from SERP III directly to the participant as a taxable cash bonus. SERP II Plan: The SERP II plan is a defined benefit, non-tax-qualified deferred compensation plan for certain executives who have provided lengthy service to AdventHealth and/or to other Seventh-day Adventist Church hospitals or health care institutions. Under the provisions of the SERP II plan, benefits are provided to qualifying executive participants on a pro-rata schedule beginning with 20 years of service as an employee of AdventHealth and/or another hospital or health care institution controlled by the Seventh-day Adventist Church and who satisfy certain other qualifying criteria. Eligible employees are restricted to those executives who, as of January 1, 2020, satisfied, or if employment continues, will satisfy the eligibility requirements of SERP II prior to December 31, 2027. This supplemental executive retirement plan (SERP II) was designed to provide eligible executives with the economic equivalent of an annual income beginning at normal retirement age equal to 60% of the average of the participant's three, five or seven highest years of base salary from AdventHealth active employment inclusive of income from all other Seventh-day Adventist Church healthcare employer-financed retirement income sources and investment income earned on those contributions through social security normal retirement age as defined in the plan. The number of years included in highest average compensation is determined by the individual's year of entry to SERP II and by the individual's year of entry to the AdventHealth Executive FLEX Benefit Program. FLEX Plan: The Flex Plan was originally designed to provide eligible executives an opportunity to select from among a variety of supplemental benefits, including a split dollar life insurance policy and long-term care insurance, to individually tailor a benefits program appropriate to each executive's needs. In 2020, the Flex Plan was amended to exclude employed executives who are hired or promoted after a certain date from being eligible to participate in the Flex Plan except for certain insurance coverage features of the plan. The Flex Plan provides eligible participants a pre-determined benefits allowance credit that is equal to a percentage of the executive's base pay from which the cost of mandatory and elective employee benefits is deducted. The benefits allowance credit percentage for any plan year shall not be greater than the maximum dollar amount or the percentage of compensation as determined by the AdventHealth Benefits Administration Committee. For grandfathered eligible employees, the annual pre-determined Flex allowance is contributed and any funds that remain after the cost of mandatory and elective benefits are subtracted are, at the employee's option, contributed to either an IRC 457(f) deferred compensation account or to an IRC 457(b) eligible deferred compensation plan. Upon attainment of age 65, all previous 457(f) deferred amounts are paid immediately to the participant and any future employer contributions are made quarterly from the Plan directly to the participant. The Plan provides for a class year vesting schedule (2 years for each class year) with respect to amounts accumulated in the executive's 457(f) deferred compensation account. Distributions could also be made from the executive's 457(f) deferred compensation account upon attainment of age 65 or upon an involuntary separation. The account will be forfeited by the executive upon a voluntary separation. With respect to grandfathered participants, the Flex Plan documents define eligible employees to include the Chief Executive Officers of AdventHealth entities and Vice Presidents of all AdventHealth entities whose base salary was at least equal to the Internal Revenue Code Section 401(a)(17) compensation limit each year. FLEX Plan FLEX Plan SERP II SERP III SERP III Contr. Distr.* Contr/Distr Contr. Distr.* Bruce Bergherm $138,882 $ 115,882 $268,344 $ 0 $ 0 Vadym Didenko $105,857 $ 82,133 $ 0 $ 0 $ 0 Erik Wangsness $ 71,538 $ 49,616 $ 0 $ 0 $ 0 Robin McGuinness $ 63,312 $ 38,574 $ 0 $ 3,971 $ 3,971 Jason Dunkel $ 54,731 $ 18,797 $ 0 $ 13,487 $ 0 Michel Longley, MD $ 46,410 $ 33,981 $ 0 $ 16,832 $ 0 Ryan Quattlebaum $ 0 $ 0 $ 0 $ 55,718 $ 0 Jason Newmyer $ 0 $ 0 $ 0 $ 50,192 $ 0 * Including Investment Earnings Christine Longley Family of Key Employee 123401 Employee Compensation 0 X In-Kind Services 1 0 Cost of Services 0 1 0 Part I, Line 33: Pursuant to the filing organization's Net Assets Accounting Policy, gifts of donated property are recorded by the filing organization to the appropriate net assets (equity) account. Accordingly, donated property reported on line 25 is primarily recorded directly to equity accounts and are not recorded in the income statement. Schedule M, Part I, Column (b): The number of contributions reported in column (b) of Schedule M, Part I represents the number of contributions received by the filing organization during the current year. Part V, Line 1a The parent corporation and sole top-tier member of Tarpon Springs Hospital Foundation, Inc. (the filing organization) is Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is a Florida, not-for-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). AHSSHC has established a shared service center to centralize the Accounts Payable (A/P) function for all AHSSHC subsidiary organizations. The filing organization has entered "0" in Part V, Line 1a because the filing organization no longer issues Form 1099 returns, rather, all such returns are filed by and under the name and EIN of AHSSHC as the payor subject to the information reporting requirements of Section 6041. The facts and circumstances support a position that AHSSHC, as a payor on behalf of its subsidiary organizations in a shared service environment, will have sufficient management and oversight in connection with the subsidiary organizations' payments to meet the standard set forth in Treas. Reg. Section 1.6041-1(e). AHSSHC will not merely be making payments at the direction of its subsidiary organizations. Accordingly, AHSSHC is considered the payor subject to the information reporting requirements of Section 6041. Form 990, Part VI, Section A, line 6 Tarpon Springs Hospital Foundation, Inc., d/b/a AdventHealth North Pinellas (the filing organization) has one member. The sole member of the filing organization is University Community Hospital, Inc. (UCH). UCH is a Florida non-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) is the sole member of UCH. AHSSHC is the parent organization of a healthcare system that operates hospitals and other healthcare provider organizations. AHSSHC is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). Form 990, Part VI, Section A, line 7a The Board of Directors of the filing organization is to consist of not less than 12 members. One half of the Board of Directors shall be composed of individuals who (i) have demonstrated knowledge and/or expertise in business or health care; (ii) are familiar with the communities served by the Hospital and/or are residents of the community served by the Hospital; and (iii) have a proven history of being able to participate effectively with others in order to fulfill the general stewardship responsibilities of a Director (the "Community Appointees"). The remaining one half of the Board of Directors are appointed to the Board by UCH as the Member. Form 990, Part VI, Section A, line 7b UCH, as the sole member of the filing organization, has certain reserved powers as set forth in the Bylaws of the filing organization. These reserved powers include the following: a) Approval of the selection of and removal of senior management of the filing organization; b) Approval of the filing organization's Articles of Incorporation; c) Approval of any material changes in services at the health care facilities; d) Approval of major building programs and purchases or sales of property in excess of $500,000 and sales/purchases of less than $500,000 when the filing organization's net revenues are not available for such purpose; e) Appointment of the Member Appointees and approval of the Community Appointees to the Board of Directors; and f) Approval of all operating and capital budgets and strategic plans of the filing organization. Adventist Health System Sunbelt Healthcare Corporation, as the 501(c)(3) top-tier member of the filing organization, has the following reserved powers: a) The authority to set limits and terms for all types of financial transactions exceeding $100,000; and b) The authority to secure naming rights and to direct the placement of funds and capital and the making of gifts, sponsorships, donations, loans, and transfers of funds or other assets by the filing organization in excess of $100,000. 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 and by the CFO prior to its filing with the IRS. The review conducted by the Board Chairman, Board Finance Committee Chair, CEO and the 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 Trustees/Directors, its officers, executive employees, physician employees, and officers of the medical staff (to be known as Interested Persons). In connection with any actual or possible conflicts of interest, any member of the Board of Trustees/Directors of the filing organization or any other Interested Person of the filing organization 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 Trustees/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 Interested Person, the remaining members of the Board of Trustees/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 Trustees/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 the related top-tier parent organization of the filing organization. Please see the discussion concerning the process followed by the related top-tier parent organization in determining executive compensation in our response to Schedule J, Line 3. Form 990, Part VI, Section C, line 19 The filing organization is a part of the system of healthcare organizations known as AdventHealth. The audited consolidated financial statements of AdventHealth and of the AdventHealth "Obligated Group" are filed annually with the Municipal Securities Rulemaking Board (MSRB). The "Obligated Group" is a group of AHSSHC subsidiaries that are jointly and severally liable under a Master Trust Indenture that secures debt primarily issued on a tax-exempt basis. Unaudited quarterly financial statements prepared in accordance with Generally Accepted Accounting Principles (GAAP) are also filed with MSRB for AdventHealth on a consolidated basis and for the grouping of AdventHealth subsidiaries comprising the "Obligated Group". The filing organization does not generally make its governing documents or conflict of interest policy available to the public. Part VII, Section A For those Board of Director members who devote less than full-time to the filing organization (based upon the average number of hours per week shown in column (B) on page 7 of the return) the compensation amounts shown in columns (E) and (F) on page 7 were provided in conjunction with that person's responsibilities and roles in serving in an executive leadership position as an employee of Adventist Health System Sunbelt Healthcare Corporation. Part VIII, Lines 7a, b and c: The amounts shown in Part VIII, Line 7, column (i) of the Form 990 represent an allocated share of capital gain/(loss) from a system wide, corporate administered, investment program. Form 990, Part IX, line 11g Payments to Healthcare Professionals: Program service expenses 19,392,953. Management and general expenses 0. Fundraising expenses 0. Total expenses 19,392,953. Professional Fees: Program service expenses 6,027,439. Management and general expenses 0. Fundraising expenses 0. Total expenses 6,027,439. Purchased Medical Services: Program service expenses 1,897,793. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,897,793. Environmental Services: Program service expenses 597,689. Management and general expenses 0. Fundraising expenses 0. Total expenses 597,689. Recruiting: Program service expenses 32,312. Management and general expenses 0. Fundraising expenses 0. Total expenses 32,312. Miscellaneous Purchased Services: Program service expenses 10,915,521. Management and general expenses 0. Fundraising expenses 0. Total expenses 10,915,521. AdventHealth Management Fees: Program service expenses 0. Management and general expenses 5,160,083. Fundraising expenses 0. Total expenses 5,160,083. Billing & Collection Services: Program service expenses 0. Management and general expenses 937,435. Fundraising expenses 0. Total expenses 937,435. AdventHealth Shared Services Fees: Program service expenses 0. Management and general expenses 1,852,927. Fundraising expenses 0. Total expenses 1,852,927. Form 990, Part XI, line 9: Transfer from Foundation 254,572. Transfer to Tax-Exempt Top-Tier Parent -482,427. Transfer to/from Tax-Exempt Parent with respect to debt 15,112. Pension Liability Adjustment 161,000. Change in Foundation Interest -523,350. Rounding 1. Part XII, Line 3b OMB Circular A-133 Audit Although the taxpayer is not required to undergo an audit as set forth in the Single Audit Act and OMB Circular A-133, the taxpayer is part of a controlled group of organizations that comprise a consolidated financial statement audit. The controlled group's parent is Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), a 501(c)(3) organization. The system of healthcare entities owned and controlled by AHSSHC is known as AdventHealth. For the year ended December 31, 2024, AdventHealth will file a consolidated Single Audit which will include all entities that are part of the controlled group. AdventHealth Bond Clinic fka AdventHealth PCP Network Inc (722 - 1231 900 Hope Way Altamonte Springs FL 32714 333559943 Operation of Medical Clinics & Health Care Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 AdventHealth Family Medicine Rural Health Clinics Inc 187 PR 4060 Lampasas TX 76550 271858033 Operation of Rural Health Clinics & Medical Services FL 501(c)(3) Line 3 Metroplex Adventist Hospital Inc 1 AdventHealth Foundation Inc 900 Hope Way Altamonte Springs FL 32714 592219301 Fund-Raising for Affiliated Tax-Exempt Hospitals FL 501(c)(3) Line 7 Adventist Hlth System Sunbelt Hlthcare Corp 1 AdventHealth Home Health and Hospice Inc fka Hospice of the Comforter Inc 2600 Westhall Lane 2nd Floor Maitland FL 32751 592935928 Operation of Home Health & Hospice Services FL 501(c)(3) Line 10 The Comforter Health Care Group Inc 1 AdventHealth Kansas City Foundation 7315 E Frontage Road Merriam KS 66204 480868859 Fund-raising for Tax-exempt Hospital KS 501(c)(3) Line 7 Shawnee Mission Medical Center Inc 1 AdventHealth Palm Coast Parkway Inc 1 AdventHealth Way Palm Coast FL 32137 882288563 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 AdventHealth Polk North Inc 40100 US Highway 27 N Davenport FL 33837 841793121 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 AdventHealth Polk South Inc 410 South 11th Street Lake Wales FL 33853 834672945 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 AdventHealth Port Charlotte Inc (112124 - 12312024) 2500 Harbor Blvd Port Charlotte FL 33952 332257010 Future Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 AdventHealth Primary Care Network Inc 900 Hope Way Altamonte Springs FL 32714 932208118 Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 AdventHealth Primary Health Division Inc (930 - 12312024) 900 Hope Way Altamonte Springs FL 32714 335016341 Inactive FL 501(c)(3) Line 12a, I Adventist Hlth SystemSunbelt Inc 1 AdventHealth Ransom Memorial Inc 1301 S Main Street Ottawa KS 66067 830976641 Operation of Hospital & Related Services KS 501(c)(3) Line 3 Adventist Hlth Mid-America Inc 1 AdventHealth Riverview Inc 9330 US Highway 301 S Riverview FL 33637 870901094 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 AdventHealth Senior Care Inc 900 Hope Way Altamonte Springs FL 32714 841817046 Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 AdventHealth South Overland Park Inc 7820 W 165th Street Overland Park KS 66223 364595806 Operation of Hospital & Related Services KS 501(c)(3) Line 3 Adventist Hlth Mid-America Inc 1 AdventHealth Team Member Services Inc (1021 - 12312024) 900 Hope Way Altamonte Springs FL 32714 331797512 Future Professional Employer Organization FL 501(c)(3) Line 12c, III-FI Adventist Hlth System Sunbelt Hlthcare Corp 1 AdventHealth University Inc 671 Winyah Drive Orlando FL 32803 593069793 Education/Operation of School FL 501(c)(3) Line 2 Adventist Hlth SystemSunbelt Inc 1 AdventHealth West Florida Ambulatory Services Inc 14055 Riveredge Drive Ste 250 Tampa FL 33637 471881744 Support of Imaging Center & Home Health Subsidiaries FL 501(c)(3) Line 12b, II Adventist Hlth System Sunbelt Hlthcare Corp 1 AdventHealth West Florida Imaging Inc 14055 Riveredge Drive Ste 250 Tampa FL 33637 843225135 Imaging & Testing FL 501(c)(3) Line 3 AdventHealth West Florida Ambulatory Services Inc 1 Adventist Care Centers - Courtland Inc (11 - 872024) 900 Hope Way Altamonte Springs FL 32714 205774723 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Adventist Health Mid-America Inc 9100 W 74th Street Shawnee Mission KS 66204 521347407 Support of Affiliated Hospital KS 501(c)(3) Line 12c, III-FI Adventist Hlth SystemSunbelt Inc 1 Adventist Health System Georgia Inc 1035 Red Bud Road NE Calhoun GA 30701 581425000 Operation of Hospitals & Related Services GA 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Adventist Hlth System Sunbelt Hlthcare Corp 900 Hope Way Altamonte Springs FL 32714 592170012 Management Services FL 501(c)(3) Line 12a, I N/A 0 Adventist Hlth SystemSunbelt Inc 900 Hope Way Altamonte Springs FL 32714 591479658 Operation of Hospitals & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Adventist Hlth SystemTexas Inc 11801 S Freeway Burleson TX 76028 742578952 Employee Leasing of Personnel to Affiliated Hospitals TX 501(c)(3) Line 12c, III-FI Adventist Hlth System Sunbelt Hlthcare Corp 1 AHS Midwest Management Inc 5101 S Willow Springs Rd La Grange IL 60525 363354567 Employee Leasing of Personnel to Supported Hospitals IL 501(c)(3) Line 12c, III-FI Adventist Hlth System Sunbelt Hlthcare Corp 1 Apopka Health Care Properties Inc (11 - 2172024) 900 Hope Way Altamonte Springs FL 32714 510605694 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Burleson Nursing & Rehab Center Inc (11 - 10152024) 900 Hope Way Altamonte Springs FL 32714 205782243 Operation of Home for the Aged/Hlthcare Delivery TX 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Chickasaw Health Care Properties Inc (11 - 2172024) 900 Hope Way Altamonte Springs FL 32714 510605681 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Chippewa Valley Hospital & Oakview Care Center Inc 1220 Third Avenue West Durand WI 54736 391365168 Operation of Hospital & Related Services WI 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Coalition For Physician Well-Being Inc 900 Hope Way Altamonte Springs FL 32714 463477012 Provide support for Physician well-being FL 501(c)(3) Line 10 Adventist Hlth System Sunbelt Hlthcare Corp 1 Courtland Health Care Properties Inc (11 - 2172024) 900 Hope Way Altamonte Springs FL 32714 510605682 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Dairy Road Health Care Properties Inc (11 - 2172024) 900 Hope Way Altamonte Springs FL 32714 510605684 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 East Orlando Health & Rehab Center Inc (11 - 10152024) 900 Hope Way Altamonte Springs FL 32714 205774748 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Fletcher Hospital Inc 100 Hospital Drive Hendersonville NC 28792 560543246 Operation of Hospitals & Related Services NC 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 FLNC Inc (11 - 872024) 900 Hope Way Altamonte Springs FL 32714 205774761 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Florida Hospital Dade City Inc 13100 Fort King Road Dade City FL 33525 822567308 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Florida Hospital Healthcare Partners Inc 770 West Granada Blvd 101 Ormond Beach FL 32174 462354804 Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Florida Hospital Medical Group Inc 2600 Westhall Lane 4th Floor Maitland FL 32751 593214635 Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Florida Hospital Ocala Inc 1500 SW 1st Avenue Ocala FL 34471 824372339 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Florida Hospital Physician Group Inc 14055 Riveredge Drive Ste 250 Tampa FL 33637 462021581 Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Florida Hospital Waterman Inc 1000 Waterman Way Tavares FL 32778 593140669 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Florida Hospital Zephyrhills Inc 7050 Gall Blvd Zephyrhills FL 33541 592108057 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Florida Radiology Imaging at Lake Mary LLC 2600 Westhall Lane 4th Floor Maitland FL 32751 550789387 Imaging & Testing FL 501(c)(3) Line 3 Florida Hospital Medical Group Inc 1 Fountain Inn Nursing & Rehab Center Inc (11 - 9242024) 900 Hope Way Altamonte Springs FL 32714 472180518 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Helen Ellis Memorial Hospital Auxiliary Inc (11 - 1142024) 1395 S Pinellas Ave Tarpon Springs FL 34689 592106043 Fund-raising for Tax-Exempt Hospital/Foundation FL 501(c)(3) Line 12c, III-FI N/A 0 Helen Ellis Memorial Hospital Foundation Inc 1395 S Pinellas Ave Tarpon Springs FL 34689 593690149 Fund-raising for Tax-Exempt Hospital FL 501(c)(3) Line 7 N/A 0 Lake County Health Care Properties Inc (11 - 2172024) 900 Hope Way Altamonte Springs FL 32714 813923985 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Memorial Health Systems Foundation Inc 305 Memorial Medical Pkwy 212 Daytona Beach FL 32117 311771522 Fund-raising for Tax-Exempt Hospital FL 501(c)(3) Line 7 N/A 0 Memorial Health Systems Inc 301 Memorial Medical Parkway Daytona Beach FL 32117 590973502 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Memorial Hospital - West Volusia Inc 701 West Plymouth Avenue Deland FL 32720 593256803 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Memorial Hlth Systems Inc 1 Memorial Hospital Flagler Inc 60 Memorial Medical Parkway Palm Coast FL 32164 592951990 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Memorial Hlth Systems Inc 1 Memorial Hospital Inc 210 Marie Langdon Drive Manchester KY 40962 610594620 Operation of Hospital & Related Services KY 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Metroplex Adventist Hospital Inc 2201 S Clear Creek Road Killeen TX 76549 742225672 Operation of Hospitals & Related Services TX 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Metroplex Clinic Physicians Inc 2201 S Clear Creek Road Killeen TX 76549 113762050 Operation of Physician Practices & Medical Services TX 501(c)(3) Line 3 Metroplex Adventist Hospital Inc 1 Mission Strategies of Georgia Inc 900 Hope Way Altamonte Springs FL 32714 900866024 Provision of support to the nursing home division GA 501(c)(3) Line 12b, II Sunbelt Hlth Care Centers Inc 1 Osceola Health Care Properties Inc (11 - 2172024) 900 Hope Way Altamonte Springs FL 32714 813165729 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Overland Park Nursing & Rehab Center Inc (11 - 6172024) 900 Hope Way Altamonte Springs FL 32714 205774821 Operation of Home for the Aged/Hlthcare Delivery KS 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 PAHS Service Corporation 6061 S Willow Drive Greenwood Village CO 80111 923398616 Employee Leasing of Personnel to Related Hospitals CO 501(c)(3) Line 12a, I Portercare Adventist Health System 1 Pasco-Pinellas Hillsborough Community Hlth System Inc 2600 Bruce B Downs Blvd Wesley Chapel FL 33544 208488713 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Portercare Adventist Health System 6061 S Willow Drive Greenwood Village CO 80111 840438224 Operation of Hospitals & Related Services CO 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Princeton Homecare Services LLC 602 Courtland Street 310 Orlando FL 32804 814196648 Home Health Care Services FL 501(c)(3) Line 10 Princeton Prof Services Inc 1 Princeton Professional Services Inc 601 E Rollins Street Orlando FL 32803 591191045 Operation of ASC's and other Healthcare Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Quality Circle for Healthcare Inc 900 Hope Way Altamonte Springs FL 32714 263789368 Healthcare Quality Services FL 501(c)(3) Line 12a, I Adventist Hlth System Sunbelt Hlthcare Corp 1 Redmond Park Hospital LLC 501 Redmond Road NW Rome GA 30165 581123037 Operation of Hospital & Related Services GA 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Resource Personnel Inc (11 - 872024) 900 Hope Way Altamonte Springs FL 32714 208040875 Provide administrative support to tax exempt nursing homes FL 501(c)(3) Line 12b, II Sunbelt Hlth Care Centers Inc 1 Rocky Mountain Adventist Hlthcare Foundation 950 E Harvard Avenue Ste 230 Denver CO 80210 840745018 Fund-raising for Tax-Exempt Hospital CO 501(c)(3) Line 7 Portercare Adventist Health System 1 Rollins Brook Community Care Corp 2201 S Clear Creek Road Killeen TX 76549 461656773 Support Operation of Hospital TX 501(c)(3) Line 12a, I Adventist Hlth SystemSunbelt Inc 1 San Marcos Nursing & Rehab Center Inc 900 Hope Way Altamonte Springs FL 32714 205782224 Inactive - In wind down TX 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Shawnee Mission Hlth Care Properties Inc (11 - 822024) 900 Hope Way Altamonte Springs FL 32714 813914908 Inactive - In wind down GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Shawnee Mission Health Care Inc (11 - 6172024) 900 Hope Way Altamonte Springs FL 32714 480952508 Lease to Related Organization KS 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Shawnee Mission Medical Center Inc 9100 W 74th Street Shawnee Mission KS 66204 480637331 Operation of Hospital & Related Services KS 501(c)(3) Line 3 Adventist Hlth Mid-America Inc 1 South Pasco Health Care Properties Inc (11 - 2172024) 900 Hope Way Altamonte Springs FL 32714 510605679 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Southeast Volusia Healthcare Corp 401 Palmetto Street New Smyrna Beach FL 32168 473793197 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Southwest Volusia Health Services Inc 1055 Saxon Blvd Orange City FL 32763 593281591 Medical Office Building for Hospital FL 501(c)(3) Line 12a, I Southwest Volusia Hlthcare Corp 1 Southwest Volusia Healthcare Corp 1055 Saxon Blvd Orange City FL 32763 593149293 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Sunbelt Health & Rehab Center - Apopka Inc 900 Hope Way Altamonte Springs FL 32714 205774856 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Sunbelt Health Care Centers Inc 900 Hope Way Altamonte Springs FL 32714 581473135 Management Services TN 501(c)(3) Line 12b, II Adventist Hlth System Sunbelt Hlthcare Corp 1 Tarpon Springs Hospital Foundation Inc 1395 S Pinellas Ave Tarpon Springs FL 34689 590898901 Operation of Hospital & Related Services FL 501(c)(3) Line 3 University Community Hospital Inc 1 Tarrant County Health Care Properties Inc (11 - 2172024) 900 Hope Way Altamonte Springs FL 32714 510605677 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 The Comforter Health Care Group Inc 605 Montgomery Road Altamonte Springs FL 32714 271857940 Support Services to Related Hospice FL 501(c)(3) Line 12c, III-FI Adventist Hlth System Sunbelt Hlthcare Corp 1 Tri-County Nursing and Rehab Center Inc (11 - 872024) 900 Hope Way Altamonte Springs FL 32714 472219363 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 University Community Hospital Foundation Inc 3100 E Fletcher Ave Tampa FL 33613 592554889 Fund-raising for Tax-exempt hospital FL 501(c)(3) Line 7 N/A 0 University Community Hospital Inc 3100 E Fletcher Ave Tampa FL 33613 591113901 Operation of Hospitals & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 West Florida Health Home Care Inc 12903 N Telecom Parkway Temple Terrace FL 33637 593686109 Home Health Services GA 501(c)(3) Line 10 AdventHealth West Florida Ambulatory Services Inc 1 Zephyr Haven Health & Rehab Center Inc (11 - 872024) 900 Hope Way Altamonte Springs FL 32714 205774930 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Zephyrhills Health & Rehab Center Inc (11 - 872024) 900 Hope Way Altamonte Springs FL 32714 205774967 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 AdventHealth Surgery Center Daytona Beach LLC 103 Memorial Medical Pkwy Ste 300 Daytona Beach FL 32117 922967648 Surgery Center FL N/A 0 0 AdventHealth Surgery Center Innovation Tower LLC 265 E Rollins Street Orlando FL 32804 882744377 Surgery Center FL N/A 0 0 AHH MOB II LLC 10800 Farley Ste 380 Overland Park KS 66210 560543246 Operation of Medical Office Building MO N/A 0 0 Fletcher Hospital Surgical Ventures LLC 9131 Anson Way Ste 304 Raleigh NC 27615 861482646 Indirect Interest in Surgery Center NC N/A 0 0 Florida Hospital DMERT LLC 500 Winderley Place Ste 324 Maitland FL 32751 202392253 Medical Equipment FL N/A 0 1 Florida Hospital Home Infusion LLP 500 Winderley Place Ste 226 Maitland FL 32751 593142824 Home Infusion Services FL N/A 0 1 Functional Neurosurgical Ambulatory Surgery Ctr LLC 11 W Dry Creek Circle 120 Littleton CO 80120 464426708 Surgery Center CO N/A 0 0 M&O Daytona MOB I LLC 1125 Sanctuary Parkway Ste 410 Alpharetta GA 30009 883063262 Operation of Medical Office Building DE N/A 0 0 M&O Orlando MOB I LLC 1125 Sanctuary Parkway Ste 410 Alpharetta GA 30009 844259138 Operation of Medical Office Building DE N/A 0 0 Nationwide ASC Holdings LLC (522 - 123124) 569 Brookwood Village Ste 901 Birmingham AL 35209 993267709 Holding Co. FL N/A 0 1 OnPoint OBGYN LLC 7780 S Broadway 280 Littleton CO 80122 873522453 Healthcare Services CO N/A 0 0 Orange City Surgical LLC 1053 Medical Center Drive Ste 201 Orange City FL 32763 208105013 Surgery Center FL N/A 0 0 PAHS OnPoint Imaging LLC 9205 S Broadway Highlands Ranch CO 80129 833275105 Imaging Center CO N/A 0 0 PAHS OnPoint Urgent Care LLC 9100 E Mineral Circle Centennial CO 80112 832465331 Urgent Care Center CO N/A 0 0 SCA - Alliance LLC 569 Brookwood Village Ste 901 Birmingham AL 35209 471807383 Indirect Interest in Surgery Center DE N/A 0 0 SCA-Central Florida LLC 569 Brookwood Village Ste 901 Birmingham AL 35209 471535510 Indirect Interest in Surgery Center DE N/A 0 0 Surgery Center of Rome LP 501 Redmond Road NW Rome GA 30165 200390305 Surgery Center GA N/A 0 0 The Bariatric Center of Kansas City LLC 9100 W 74th Street Merriam KS 66204 823025378 Surgery Center KS N/A 0 0 Urgent Care Centers of Brevard County LLC 2600 Westhall Lane Ste 200 Maitland FL 32751 844261523 Urgent Care Centers FL N/A 0 1 AdventHealth Asheville Inc 100 Hospital Drive Hendersonville NC 28792 921144574 Inactive NC N/A C 1 AdventHealth Hospice Care East Florida Inc 770 West Granada Blvd 304 Ormond Beach FL 32174 833748461 Inactive FL N/A C 1 AdventHealth at Overland Park-College MOB Condominium Assoc 9119 W 74th Street Ste 260 Merriam KS 66204 874353752 Condo Association KS N/A C 1 AdventHealth City Center North Owners' Assoc Inc 9119 W 74th Street Ste 260 Merriam KS 66204 991471046 Maintenance Association KS N/A C 1 AdventHealth Primary Care Inc (1124-62424) 900 Hope Way Altamonte Springs FL 32714 593231322 Inactive FL N/A C 1 AdventHealth Value Based Bundle Management LLC 2600 Lucien Way Maitland FL 32751 873487910 Medical Contracting and Billing FL N/A C 1 Altamonte Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando FL 32803 592855792 Condo Association FL N/A C 1 Battle Creek Adventist Hospital 900 Hope Way Altamonte Springs FL 32714 381359189 Inactive MI N/A C 1 Florida Hospital Flagler Medical Offices Association Inc 60 Memorial Medical Parkway Palm Coast FL 32164 262158309 Condo Association FL N/A C 1 Florida Hosp Hlth Village Property Owner's Assoc Inc 550 E Rollins Street 7th Floor Orlando FL 32803 821748255 Condo Association FL N/A C 1 Florida Hospital Healthcare System Inc 2600 Lucien Way Maitland FL 32751 593215680 PHSO / CIN FL N/A C 1 Florida Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando FL 32803 592855791 Condo Association FL N/A C 1 Gateway Center Association of Altamonte Springs Inc 900 Hope Way Altamonte Springs FL 32714 464685345 Maintenance Association FL N/A C 1 Kissimmee Multispecialty Clinic Condominium Association Inc 201 Hilda Street Suite 30 Kissimmee FL 34741 593539564 Condo Association FL N/A C 1 Midwest Management Services Inc 9100 West 74th Street Shawnee Mission KS 66204 480901551 Inactive KS N/A C 1 North American Health Services Inc & Sub 900 Hope Way Altamonte Springs FL 32714 621041820 Holding Co. TN N/A C 1 Ormond Prof Associates Condo Assoc Inc (430 year end) 770 W Granada Blvd Ste 101 Ormond Beach FL 32174 592694434 Condo Association FL N/A C 1 Park Ridge Property Owner's Association Inc 1 Park Place Naples Road Fletcher NC 28732 030380531 Condo Association NC N/A C 1 Park Ridge Condominium #1 Unit Owners Association Inc 1 Park Place Naples Road Fletcher NC 28732 010584623 Condo Association NC N/A C 1 Redmond Park Health Services Inc 501 Redmond Rd NW Rome GA 30165 621330078 Holding Company GA N/A C 1 Surgicare of Rome Inc 501 Redmond Rd NW Rome GA 30165 200376307 Holding Company GA N/A C 1 The Garden Retirement Community Inc 900 Hope Way Altamonte Springs FL 32714 593414055 Real Estate Rental FL N/A C 1 Winter Park Medical Office Building I Condo Assoc Inc 601 East Rollins Street Orlando FL 32803 452228478 Condo Association FL N/A C 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 Florida Hospital Zephyrhills Inc P 56615 Cost Helen Ellis Memorial Hospital Foundation Inc C 404610 Actual Amount Received Helen Ellis Memorial Hospital Foundation Inc B 266996 Actual Amount Given Adventist Health System Sunbelt Healthcare Corp B 482427 Actual Amount Given AdventHealth Foundation C 161584 Actual Amount Received Adventist Health System Sunbelt Healthcare Corp M 3379181 % of facility's operating exp. Adventist Health System Sunbelt Healthcare Corp-Shared Services M 1852927 % of facility's operating exp. Adventist Health System Sunbelt Healthcare Corp dba AH Info Technology M 6416663 % of facility's operating exp. University Community Hospital Inc P 8251086 Cost Adventist Health System Sunbelt Healthcare Corp P 9196475 Cost Florida Hospital Physician Group Inc P 12259880 Cost