2022-09-15T18:37:55-05:00 2021-12-31 990 2021-01-01 592554889 University Community Hospital Foundation Inc UNIV 8139716000 3100 East Fletcher Avenue Tampa FL 336134688 Roger Joyce Chairman 8139716000 2022-09-06 Roger Joyce 999009999 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z Roger Joyce 3100 East Fletcher Avenue Tampa FL 336134688 11800498 0 X www.adventhealth.com/foundation/adventhealth-foun X 1985 FL Fundraising for Affiliated Tax-Exempt Hospital 10 9 0 54 0 0 0 349507 218307 11450991 0 0 0 0 218307 11800498 1185019 11525759 0 0 0 0 0 0 279775 54758 307519 1239777 11833278 -1021470 -32780 20274310 13727368 97012 46259 20177298 13681109 Fundraising and volunteer activity for related tax-exempt hospital. 0 0 11525759 11525759 11450991 The primary exempt purpose of University Community Hospital Foundation, Inc. is to conduct fundraising on behalf of University Community Hospital, Inc., an IRC Section 501(c)(3) organization. 11525759 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 10 9 1 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 FL X Tyson Davis 8136157853 3100 East Fletcher Avenue Tampa FL 336134688 X Bales-Chubb Denyse Trustee 0.20 50.00 X 0 864904 140422 Joyce Roger Chairman 0.20 0.00 X X 0 0 0 Austin Dan Trustee 0.20 0.00 X 0 0 0 Odisho Dennis Trustee (Beg 05/21) 0.20 0.00 X 0 0 0 Paradise Erica Trustee 0.20 0.00 X 0 0 0 Sharpe Mark Trustee (Beg 01/21) 0.20 0.00 X 0 0 0 Stanislow Jeff Trustee 0.20 0.00 X 0 0 0 Stonesifer MD Kurt Past Chairman 0.20 0.40 X 0 0 0 Weidner David Trustee 0.20 0.00 X 0 0 0 Zubrowski Diana Trustee (Beg 01/21) 0.20 0.00 X 0 0 0 0 864904 140422 0 0 1 0 0 349507 349507 Satisfaction of Program Restricti 900099 11450991 11450991 11450991 11800498 11450991 0 0 X 11509619 11509619 16140 16140 63837 63837 8611 8611 11175 6650 4525 Purchased Services 161682 161682 CGA Write-off 21094 21094 Food Costs 19648 19648 Gifts 11404 11404 10068 10068 11833278 11525759 27744 279775 X 19484631 13664484 61000 61000 0 0 789679 62884 20274310 13727368 97012 46259 97012 46259 X 2660363 7730665 17516935 5950444 20177298 13681109 20274310 13727368 X -32780 -6463409 X 0 0 0 X 2488593 2149391 3221638 1232307 11800498 20892427 2488593 2149391 3221638 1232307 11800498 20892427 5892638 14999789 1872673 1113580 1991285 561529 1252559 6791626 27684053 0.54180 0.35400 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 15221241 3735023 1252560 12390294 7818530 12096996 3156927 561529 594211 15221241 12768809 1909563 1943089 4524465 12096996 10595999 2886156 1124167 1837513 12768809 24197844 792339 1852663 16246847 10595999 0.31050 0.12790 0.56160 0 0 61000 61000 0 0 Due to Affiliates 34814 Charitable Gift Annuity Obligations 11445 46259 Part V, Line 4: University Community Hospital Foundation, Inc. (UCHF) is a supporting organization of University Community Hospital, Inc. (the Hospital), a related tax-exempt hospital that is also exempt under IRC Section 501(c)(3). UCHF endowment consists of individual donor restricted endowment funds where the assets have been designated for endowment. Restricted endowment funds are intended to benefit various programs and departments of the Hospital and its patients. Endowment funds have also been designated by the Board of UCHF to support various Hospital initiatives. Part V, column (d) Three years back and column (e) Four years back: Explanation for change in column (d) lines 1a thru 1g and column (e) lines 1b thru 1g: During 2020, it came to the attention of the Foundation's management that certain assets were mistakenly classified as endowments during years 2017 and 2018. This reclassification resulted in a total decrease of $951,003. 0 University Community Hospital Inc 3100 East Fletcher Avenue Tampa FL 33613 591113901 501(c)(3) 11509619 0 General Support - Capital Projects 1 0 Food, Clothing & Shelter 14 14640 Nursing Scholarships 3 1500 Part I, Line 2 Grants are generally made only to the Foundation's supported hospital organization. Accordingly, the filing organization has not established specific procedures for monitoring the use of grant funds in the United States as the filing organization does not have a grant making program that would necessitate such procedures. 0 1 0 0 0 0 0 0 0 Bales-Chubb Denyse Trustee 0 553353 0 184633 0 126918 0 96699 0 43723 0 1005326 0 69543 Part I, Line 4b The CEO of the filing organization's supported Hospital serves on the board of directors of the filing organization. This individual is compensated by and on the payroll of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the parent organization of the healthcare system known as AdventHealth. In recognition of the contribution that each executive makes to the success of AdventHealth, AdventHealth provides supplemental executive benefit plans to eligible executives. In 2020, AdventHealth restructured its executive supplemental retirement and benefit plans to reduce complexity, to increase predictability of benefits and to consolidate multiple supplemental executive benefit plans into one plan. Effective 1/1/2020, a new supplemental executive retirement plan (SERP III) was adopted and the three existing plans, described below, were amended and restated. The newly adopted SERP III plan, as well as the amended and restated plans, were reviewed and approved by the AHSSHC Board Compensation Committee, an independent body of the AHSSHC Board of Directors. SERP III Plan (Effective 1/1/2020): To recognize the contribution each executive makes to the success of AdventHealth and to recognize the limitations available to executives in qualified retirement plans due to compensation limits set on such plans, AdventHealth adopted a new supplemental executive retirement plan (SERP III) in 2020. 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. 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 $290,000 in 2021 (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 (Amended and Restated in 2020): In 2020, the SERP II plan was amended and restated to provide that 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. 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. 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 (Amended and Restated in 2020): In 2020, the Flex Plan was amended and restated 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. Additionally, a provision was added to place a maximum limit on the amount of a participant's annual Flex allowance to not be greater than a maximum dollar amount or percentage of compensation as established by the AdventHealth Benefits Administration Committee. 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. 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 is 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. Senior Executive Death Benefit Plan (SEDB) (Amended and Restated in 2020): The SEDB plan was originally designed to provide a benefit in an amount equal to the amount the executive's benefit would have been under the SERP II Plan assuming that, on the date of the executive's death (and not before), the executive satisfied the last of the eligibility requirements of the SERP II Plan with present value recognizing an early benefit commencement. In conjunction with the amendment and restatement of the SERP II Plan, the SEDB was similarly amended in 2020 to limit eligible employees to only those who either satisfy the eligibility requirements of SERP II as of January 1 2020, or remain in active employment and will satisfy those requirements prior to December 31, 2027. An eligible executive becomes a participant in the SEDB Plan if the executive dies prior to termination of employment, provided the executive has not satisfied all the eligibility requirements of SERP II as of the executive's date of death but would have satisfied all those requirements within five (5) years following death had the executive lived and continued employment. The SEDB Plan will terminate automatically after December 31, 2027. Contributions/Distributions: FLEX PLAN FLEX PLAN SERP II SERP III 457(B) CONTR. DISTR.* CONTR./DISTR. CONTR. DISTR.* Bales-Chubb, Denyse $96,999 $83,279 $ 0 $ 3,652 $ 0 * Including Investment Earnings Form 990, Part VI, Section A, line 2 Family Relationship - Dennis Odisho and Roger Joyce Family Relationship - Dennis Odisho and Diana Zubrowski Business Relationship - Jeff Stanislow and Dan Austin Form 990, Part VI, Section A, line 7a Trustees are nominated by the filing organization's Board of Trustees and approved by the Board of Directors of University Community Hospital, Inc. (UCH Board). If a Trustee of the filing organization is appointed in this manner, such Trustee may be removed from office by the UCH Board. Form 990, Part VI, Section A, line 7b As discussed in our response to 7a, the filing organization's Board of Trustees are approved and removed by the Board of Directors of University Community Hospital, Inc. In 2010 the filing organization and the filing organization's supported hospital organization entered into a Merger Agreement with Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the supported hospital organization's tax-exempt parent. AHSSHC has the right to provide written consent for the Bylaws or Articles of Incorporation of the filing organization to be altered, amended, revised, repealed, supplemented or restated in any manner that conflicts with the Foundation's rights and obligations as provided for under this Merger Agreement. Form 990, Part VI, Section B, line 11b The filing organization's current year Form 990 was reviewed by the Board Chairman of the filing organization prior to its filing with the IRS. The review conducted by the Board Chairman 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 and its principal officers (to be known as Interested Persons). In connection with any actual or possible conflicts of interest, any member of the Board of Trustees of the filing organization or any principal officer of the filing organization (i.e. Interested Persons) must disclose the existence of any financial interest with the filing organization and must be given the opportunity to disclose all material facts concerning the financial interest/arrangement to the Board of Trustees of the filing organization or to any members of a committee with board delegated powers that is considering the proposed transaction or arrangement. Subsequent to any disclosure of any financial interest/arrangement and all material facts, and after any discussion with the relevant Board member or principal officer, the remaining members of the Board of Trustees 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 (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 C, line 19 The filing organization does not generally make its governing documents, or financials statements available to the public. Part VII, Section A, Columns (E) & (F) For those Board of Trustee 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. Form 990, Part IX, line 11g Other Fees: Program service expenses 0. Management and general expenses 0. Fundraising expenses 63,837. Total expenses 63,837. Part X, Line 2 The amounts shown on line 2 of Part X of this return include the filing organization's interest in a central investment pool maintained by Adventist Health System Sunbelt Healthcare Corporation, the top-tier parent of the filing organization's supported Hospital. The investments in the central investment pool are recorded at market value. Form 990, Part XI, line 9: Temporarily Restricted Gifts 3,735,023. Transfer of Net Assets from Restricted Fund Balance -11,450,991. Temporarily Restricted Investment Income 1,252,559. AdventHealth East Florida Inc (3521 - 123121) 900 Hope Way Altamonte Springs FL 32714 882288563 Future Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 0 AdventHealth Family Medicine Rural Health Clinics Inc 187 PR 4060 Lampasas TX 76550 271858033 Operation of Rural Health Clinics & Medical Services FL 501(c)(3) Line 3 Metroplex Adventist Hospital Inc 0 AdventHealth Kansas City Foundation fka AH Fdn Shawnee Mission 7315 E Frontage Road Merriam KS 66204 480868859 Fund-raising for Tax-exempt hospitals KS 501(c)(3) Line 7 Shawnee Mission Medical Center Inc 0 AdventHealth Home Care East Florida LLC 770 West Granada Blvd 319 Ormond Beach FL 32174 833768458 Inactive FL 501(c)(3) Line 10 Memorial Hlth Systems Inc 0 AdventHealth Hospice Care East Florida Inc 770 West Granada Blvd 304 Ormond Beach FL 32174 833748461 Inactive FL 501(c)(3) Line 10 Memorial Hlth Systems Inc 0 AdventHealth North Polk Inc 3100 E Fletcher Ave Tampa FL 33613 593231322 Inactive FL 501(c)(3) Line 12a, I University Community Hospital Inc 0 AdventHealth Polk North Inc 40100 US Highway 27 N Davenport FL 33837 841793121 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 0 AdventHealth Polk South Inc 410 South 11th Street Lake Wales FL 33853 834672945 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 0 AdventHealth Ransom Memorial Inc 1301 S Main Street Ottawa KS 66067 830976641 Operation of Hospital & Related Services KS 501(c)(3) Line 3 Adventist Hlth Mid-America Inc 0 AdventHealth Riverview Inc (5321 - 123121) 14055 Riveredge Drive Ste 150 Tampa FL 33637 870901094 Future Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 0 AdventHealth Senior Care Inc 900 Hope Way Altamonte Springs FL 32714 841817046 Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 0 AdventHealth South Overland ParkInc 7820 W 165th Street Overland Park KS 66223 364595806 Operation of Hospital & Related Services KS 501(c)(3) Line 3 Adventist Hlth Mid-America Inc 0 AdventHealth University Inc 671 Winyah Drive Orlando FL 32803 593069793 Education/Operation of School FL 501(c)(3) Line 2 Adventist Hlth SystemSunbelt Inc 0 AdventHealth West Florida Ambulatory Services Inc 14055 Riveredge Drive Ste 250 Tampa FL 33637 471881744 Support of Imaging Center & Home Health Subsidiaries FL 501(c)(3) Line 12b, II Adventist Hlth System Sunbelt Hlthcare Corp 0 AdventHealth West Florida Imaging Inc 14055 Riveredge Drive Ste 250 Tampa FL 33637 843225135 Imaging & Testing FL 501(c)(3) Line 3 AdventHealth West Florida Ambulatory Services Inc 0 Adventist Bolingbrook Hospital 500 Remington Blvd Bolingbrook IL 60440 651219504 Operation of Hospital & Related Services IL 501(c)(3) Line 3 Adventist Midwest Health 0 Adventist Care Centers - Courtland Inc 730 Courtland Street Orlando FL 32804 205774723 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 0 Adventist GlenOaks Hospital 701 Winthrop Avenue Glendale Heights IL 60139 363208390 Operation of Hospital & Related Services IL 501(c)(3) Line 3 Adventist Midwest Health 0 Adventist Health Mid-America Inc 9100 W 74th Street Shawnee Mission KS 66204 521347407 Support of Affiliated Hospital KS 501(c)(3) Line 12c, III-FI Adventist Hlth SystemSunbelt Inc 0 Adventist Health Partners Inc 5101 S Willow Springs Rd Suite B101 La Grange IL 60525 364138353 Operation of Physician Practices & Medical Services IL 501(c)(3) Line 3 AHS Midwest Management Inc 0 Adventist Health System Georgia Inc 1035 Red Bud Road NE Calhoun GA 30701 581425000 Operation of Hospital & Related Services GA 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 0 Adventist Hlth System Sunbelt Hlthcare Corp 900 Hope Way Altamonte Springs FL 32714 592170012 Management Services FL 501(c)(3) Line 12a, I N/A 0 Adventist Hlth SystemSunbelt Inc 900 Hope Way Altamonte Springs FL 32714 591479658 Operation of Hospitals & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 0 Adventist Hlth SystemTexas Inc 11801 S Freeway Burleson TX 76028 742578952 Leasing Personnel to Affiliated Hospital TX 501(c)(3) Line 12c, III-FI Adventist Hlth System Sunbelt Hlthcare Corp 0 Adventist Midwest Health 120 North Oak Street Hinsdale IL 60521 362276984 Operation of Hospitals & Related Services IL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 0 AHP Specialty Care NFP 5101 S Willow Springs Rd Suite B101 La Grange IL 60525 811105774 Operation of Physician Practices & Medical Services IL 501(c)(3) Line 3 AHS Midwest Management Inc 0 AHS Midwest Management Inc 5101 S Willow Springs Rd Suite B101 La Grange IL 60525 363354567 Operation of Physician Practice Management IL 501(c)(3) Line 12a, I Adventist Midwest Health 0 Apopka Health Care Properties Inc 305 E Oak Street Apopka FL 32703 510605694 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 0 Bert Fish Medical Center Auxiliary Inc 401 Palmetto Street New Smyrna Beach FL 32168 591054892 Volunteer support services FL 501(c)(3) Line 10 N/A 0 Bradford Heights Health & Rehab Center Inc 485 North Keller Road 250 Maitland FL 32751 205782342 Inactive - Wind-Down KY 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 0 Burleson Nursing & Rehab Center Inc 301 Huguley Blvd Burleson TX 76028 205782243 Operation of Home for the Aged/Hlthcare Delivery TX 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 0 Chickasaw Health Care Properties Inc 250 S Chickasaw Trail Orlando FL 32825 510605681 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 0 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 0 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 0 Courtland Health Care Properties Inc 730 Courtland Street Orlando FL 32804 510605682 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 0 Creekwood Place Nursing & Rehab Center Inc 485 North Keller Road 250 Maitland FL 32751 205782260 Inactive - Wind-Down KY 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 0 Dairy Road Health Care Properties Inc 7350 Dairy Road Zephyrhills FL 33540 510605684 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 0 East Orlando Health & Rehab Center Inc 250 S Chickasaw Trail Orlando FL 32825 205774748 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 0 Emory-Adventist Inc (1121 - 123121) 900 Hope Way Altamonte Springs FL 32714 582171011 Inactive GA 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 0 Fletcher Hospital Inc 100 Hospital Drive Hendersonville NC 28792 560543246 Operation of Hospital & Related Services NC 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 0 FLNC Inc 3355 E Semoran Blvd Apopka FL 32703 205774761 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 0 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 0 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 0 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 0 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 0 Florida Hospital Physician Group Inc 12470 Telecom Dr 100 Tampa FL 33637 462021581 Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 0 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 0 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 0 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 0 Fountain Inn Nursing & Rehab Center Inc 4501 Waterman Way Tavares FL 32778 472180518 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 0 Helen Ellis Memorial Hospital Auxiliary Inc 1395 S Pinellas Ave Tarpon Springs FL 34689 592106043 Fund-raising for Tax-exempt hospital/foundation FL 501(c)(3) Line 12c, III-FI N/A 0 Helen Ellis Memorial Hospital Foundation Inc 1395 S Pinellas Ave Tarpon Springs FL 34689 593690149 Fund-raising for Tax-exempt hospital FL 501(c)(3) Line 7 N/A 0 Hinsdale Hospital Foundation 120 North Oak Street Hinsdale IL 60521 521466387 Fund-raising for Tax-exempt hospital IL 501(c)(3) Line 7 Midwest Hlth Foundation 0 Hospice of the Comforter Inc 480 W Central Parkway Altamonte Springs FL 32714 592935928 Operation of Hospice FL 501(c)(3) Line 10 The Comforter Health Care Group Inc 0 In-Motion Rehab Inc 485 North Keller Road 250 Maitland FL 32751 208023411 Inactive KS 501(c)(3) Line 12b, II Sunbelt Hlth Care Centers Inc 0 Lake County Health Care Properties Inc 485 North Keller Road 250 Maitland FL 32751 813923985 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 0 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 0 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 0 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 0 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 0 Metroplex Adventist Hospital Inc 2201 S Clear Creek Road Killeen TX 76549 742225672 Operation of Hospital & Related Services TX 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 0 Metroplex Clinic Physicians Inc 2201 S Clear Creek Road Killeen TX 76549 113762050 Physician Healthcare services to the community TX 501(c)(3) Line 3 Metroplex Adventist Hospital Inc 0 Midwest Health Foundation 120 North Oak Street Hinsdale IL 60521 352230515 Fund-Raising for Supported Exempt Hospitals IL 501(c)(3) Line 7 N/A 0 Mills Health & Rehab Center Inc 485 North Keller Road 250 Maitland FL 32751 205782320 Inactive - Wind-Down KY 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 0 Mission Strategies of Georgia Inc 485 North Keller Road 250 Maitland FL 32751 900866024 Provision of support to the nursing home division GA 501(c)(3) Line 12b, II Sunbelt Hlth Care Centers Inc 0 Missouri Adventist Health Inc 9100 W 74th Street Shawnee Mission KS 66204 431224729 Support Health Care Services MO 501(c)(3) Line 12d, III-O Adventist Hlth Mid-America Inc 0 Ormond Beach Memorial Hospital Auxiliary Inc(11-123121) 301 Memorial Medical Pkwy Daytona Beach FL 32117 591721962 Volunteer support services FL 501(c)(3) Line 12c, III-FI N/A 0 Osceola Health Care Properties Inc 485 North Keller Road 250 Maitland FL 32751 813165729 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 0 Overland Park Nursing & Rehab Center Inc 6501 West 75th Street Overland Park KS 66204 205774821 Operation of Home for the Aged/Hlthcare Delivery KS 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 0 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 0 Portercare Adventist Health System (630 YE) 9100 E Mineral Circle Centennial CO 80112 840438224 Operation of Hospitals & Related Services CO 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 0 Princeton Health & Rehab Center Inc 485 North Keller Road 250 Maitland FL 32751 205782272 Inactive - Wind-Down KY 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 0 Princeton Professional Services Inc 601 E Rollins Street Orlando FL 32803 591191045 Provision of Healthcare Services FL 501(c)(3) Line 10 Adventist Hlth System Sunbelt Hlthcare Corp 0 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 0 Redmond Park Hospital LLC (10121 - 123121) 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 0 Resource Personnel Inc 485 North Keller Road 250 Maitland FL 32751 208040875 Provide administrative support to tax exempt nursing homes FL 501(c)(3) Line 12b, II Sunbelt Hlth Care Centers Inc 0 Rocky Mountain Adventist Hlthcare Foundation (630 YE) 960 E Harvard Avenue Ste 230 Denver CO 80210 840745018 Fund-raising for Tax-exempt hospital CO 501(c)(3) Line 7 N/A 0 Rollins Brook Community Care Corp 2201 S Clear Creek Road Killeen TX 76549 461656773 Support Operation of Hospital TX 501(c)(3) Line 12a, I Adventist Hlth SystemSunbelt Inc 0 San Marcos Health Care Properties Inc (11 - 123021) 1900 Medical Parkway San Marcos TX 78666 510605693 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 0 San Marcos Nursing & Rehab Center Inc 1900 Medical Parkway San Marcos TX 78666 205782224 Operation of Home for the Aged/Hlthcare Delivery TX 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 0 Shawnee Mission Hlth Care Properties Inc 485 North Keller Road 250 Maitland FL 32751 813914908 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 0 Shawnee Mission Health Care Inc 6501 West 75th Street Overland Park KS 66204 480952508 Lease to Related Organization KS 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 0 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 0 South Pasco Health Care Properties Inc 38250 A Avenue Zephyrhills FL 33542 510605679 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 0 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 0 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 0 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 0 Spring View Health & Rehab Center Inc 485 North Keller Road 250 Maitland FL 32751 205782288 Inactive - Wind-Down KY 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 0 Sunbelt Health & Rehab Center - Apopka Inc 305 East Oak Street Apopka FL 32703 205774856 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 0 Sunbelt Health Care Centers Inc 485 North Keller Road 250 Maitland FL 32751 581473135 Management Services TN 501(c)(3) Line 12b, II Adventist Hlth System Sunbelt Hlthcare Corp 0 SunSystem Development Corp 900 Hope Way Altamonte Springs FL 32714 592219301 Fund-Raising for Affiliated Tax-Exempt Hospitals FL 501(c)(3) Line 7 Adventist Hlth System Sunbelt Hlthcare Corp 0 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 0 Tarrant County Health Care Properties Inc 301 Huguley Blvd Burleson TX 76028 510605677 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 0 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 0 The Volunteer Auxiliary of Florida Hosp Flagler Inc(11-8321) 60 Memorial Medical Pkwy Palm Coast FL 32164 592486582 Volunteer support services FL 501(c)(3) Line 12c, III-FI N/A 0 Tri-County Nursing and Rehab Center Inc 1290 Celebration Blvd Kissimmee FL 34747 472219363 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 0 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 0 West Florida Health Home Care Inc 13601 Bruce B Downs Blvd Ste 110 Tampa FL 33613 593686109 Home Health Services GA 501(c)(3) Line 10 AdventHealth West Florida Ambulatory Svcs Inc 0 Zephyr Haven Health & Rehab Center Inc 38250 A Avenue Zephyrhills FL 33542 205774930 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 0 Zephyrhills Health & Rehab Center Inc 7350 Dairy Road Zephyrhills FL 33540 205774967 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 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 PAHS OnPoint Urgent Care LLC 9100 E Mineral Circle Centennial CO 80112 832465331 Urgent Care Center CO N/A 0 0 Princeton Homecare Services LLC 1050 Forrer Blvd Kettering OH 45420 814196648 Operation of Home Health Agency FL N/A 0 0 San Marcos MRI LP (1121-8121) 1330 Wonder World Dr Ste 202 San Marcos TX 78666 770597972 Imaging & Testing TX N/A 0 0 Surgery Center of Rome LP 900 Hope Way Altamonte Springs FL 32714 200390305 Surgery Center FL N/A 0 0 The Bariatric Center of Kansas City LLC 9100 W 74th Street Merriam KS 66204 823025378 Surgery Center KS N/A 0 0 Urgent Care Centers of Brevard County LLC 2600 Westhall Lane Maitland FL 32751 844261523 Urgent Care Centers FL N/A 0 1 AdventHealth Orlando Network Inc (35 - 123121) 900 Hope Way Altamonte Springs FL 32714 862639185 Inactive FL N/A C 0 AdventHealth Professional Staffing Inc (35 - 123121) 900 Hope Way Altamonte Springs FL 32714 880742779 INACTIVE FL N/A C 0 AdventHealth Tampa Network Inc (35 - 123121) 900 Hope Way Altamonte Springs FL 32714 862666178 Inactive FL N/A C 0 AdventHealth Team Members Inc (35 - 123121) 900 Hope Way Altamonte Springs FL 32714 880763664 INACTIVE FL N/A C 0 Altamonte Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando FL 32803 592855792 Condo Association FL N/A C 0 Apopka Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando FL 32803 593000857 Condo Association FL N/A C 0 Battle Creek Adventist Hospital 900 Hope Way Altamonte Springs FL 32714 381359189 Inactive MI N/A C 0 Central Texas Medical Associates (11-12252021) 1301 Wonder World Drive San Marcos TX 78666 742729873 Inactive TX N/A C 0 Florida Hospital Flagler Medical Offices Association Inc 60 Memorial Medical Parkway Palm Coast FL 32164 262158309 Condo Association FL N/A C 0 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 0 Florida Hospital Healthcare System Inc 101 Southhall Lane Ste 150 Maitland FL 32751 593215680 PHSO / CIN FL N/A C 0 Florida Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando FL 32803 592855791 Condo Association FL N/A C 0 Kissimmee Multispecialty Clinic Condominium Association Inc 201 Hilda Street Suite 30 Kissimmee FL 34741 593539564 Condo Association FL N/A C 0 Midwest Management Services Inc 9100 West 74th Street Shawnee Mission KS 66204 480901551 Inactive KS N/A C 0 North American Health Services Inc & Sub 900 Hope Way Altamonte Springs FL 32714 621041820 Holding Co. TN N/A C 0 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 0 Park Ridge Property Owner's Association Inc 1 Park Place Naples Road Fletcher NC 28732 030380531 Condo Association NC N/A C 0 Porter Affiliated Health Services Inc (11-63021) 2525 S Downing Street Denver CO 80210 840956175 INACTIVE CO N/A C 0 Surgicare of Rome Inc (10121 - 123121) 900 Hope Way Altamonte Springs FL 32714 200376307 Holding Company GA N/A C 0 Redmond Park Health Services Inc (10121 - 123121) 900 Hope Way Altamonte Springs FL 32714 621330078 Holding Company GA N/A C 0 Redmond Physician Practice Company (10121 - 10121) 900 Hope Way Altamonte Springs FL 32714 621662134 Medical Clinics GA N/A C 0 The Garden Retirement Community Inc 485 North Keller Road Ste 250 Maitland FL 32751 593414055 Real Estate Rental FL N/A C 0 Winter Park Medical Office Building I Condo Assoc Inc 601 East Rollins Street Orlando FL 32803 452228478 Condo Association FL N/A C 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 University Community Hospital Inc C 369506 Actual Amount Received University Community Hospital Inc B 11509619 Actual Amount Donated University Community Hospital Inc M 557015 Cost