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Nonprofiteer
← AHS MIDWEST MANAGEMENT INC

Form 990 for tax year 2022

Filed by AHS MIDWEST MANAGEMENT INC.

Totals

Total revenue
$0
Total expenses
$0
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$0
Investment income
$0
Other revenue
$0
Total assets, end of year
$13,647,309
Total liabilities, end of year
$13,647,309
Net assets or fund balances, end of year
$0
Program services expenses (Part IX)
$0
Management and general expenses
$0
Fundraising expenses
$0
Program service expenses (Part III)
not reported

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Balance sheet

Part X, book values.

  • 15 · Other assets

    beginning of year $1,065,226 · end of year $13,647,309

  • 17 · Accounts payable and accrued expenses

    beginning of year $3,962 · end of year $13,647,309

  • 25 · Other liabilities

    beginning of year $62,007,100 · end of year $0

  • 27 · Net assets without donor restrictions

    beginning of year -$60,945,836 · end of year $0

Mission and programs · 2022

Mission

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.

Activities or mission (Part I)

PREVIOUS OPERATION OF PHYSICIAN PRACTICE MANAGEMENT SERVICES FOR RELATED TAX-EXEMPT ORGANIZATIONS.

  • INACTIVE DURING 2022

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Addiscott Lynn

    DIRECTOR (BEG 11/22)

    Total calculated
    $634,482
    From this org
    $0
    From related orgs
    $605,074
    Other
    $29,408
    Hours/week
    0.1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $374,865 related
    Bonus
    $0 + $92,393 related
    Other
    $0 + $137,816 related
    Deferred
    $0 + $16,400 related
    Nontaxable benefits
    $0 + $13,008 related
    Filer's total
    $0 + $634,482 related

  • Buchanan Herbert

    DIR/VICE CHAIR/TREAS (ENDED 10/22)

    Total calculated
    $828,801
    From this org
    $7,259
    From related orgs
    $788,724
    Other
    $32,818
    Hours/week
    0.63 + 49.37 related

    Schedule J breakdown matched by us

    Base
    $6,049 + $470,117 related
    Bonus
    $0
    Other
    $1,210 + $318,607 related
    Deferred
    $122 + $17,133 related
    Nontaxable benefits
    $234 + $15,329 related
    Filer's total
    $7,615 + $821,186 related

  • Chen Yuesha

    DIRECTOR (BEG 03/22, ENDED 04/22)

    Total calculated
    $681,229
    From this org
    $0
    From related orgs
    $607,538
    Other
    $73,691
    Hours/week
    0.1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $375,459 related
    Bonus
    $0
    Other
    $0 + $232,079 related
    Deferred
    $0 + $48,577 related
    Nontaxable benefits
    $0 + $25,114 related
    Filer's total
    $0 + $681,229 related

  • Christian Bruce

    DIRECTOR (ENDED 10/22)

    Total calculated
    $1,631,183
    From this org
    $0
    From related orgs
    $1,591,871
    Other
    $39,312
    Hours/week
    0.1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $352,000 related
    Bonus
    $0
    Other
    $0 + $1,239,871 related
    Deferred
    $0 + $16,000 related
    Nontaxable benefits
    $0 + $23,312 related
    Filer's total
    $0 + $1,631,183 related

  • Johnson Sandra

    DIRECTOR/PRESIDENT (BEG 11/22)

    Total calculated
    $1,112,951
    From this org
    $0
    From related orgs
    $1,055,911
    Other
    $57,040
    Hours/week
    0.1 + 28 related

    Schedule J breakdown matched by us

    Base
    $0 + $608,691 related
    Bonus
    $0 + $271,601 related
    Other
    $0 + $175,619 related
    Deferred
    $0 + $17,895 related
    Nontaxable benefits
    $0 + $39,145 related
    Filer's total
    $0 + $1,112,951 related

  • Llerena MD Reinhold

    VICE PRES/SEC/DIR/CMO (ENDED 03/22)

    Total calculated
    $39,308
    From this org
    $3,861
    From related orgs
    $28,311
    Other
    $7,136
    Hours/week
    1.5 + 11 related

  • Mathis Rebecca

    DIRECTOR (BEG 04/22, ENDED 10/22)

    Total calculated
    $519,316
    From this org
    $0
    From related orgs
    $407,099
    Other
    $112,217
    Hours/week
    0.1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $370,485 related
    Bonus
    $0
    Other
    $0 + $36,614 related
    Deferred
    $0 + $71,093 related
    Nontaxable benefits
    $0 + $41,124 related
    Filer's total
    $0 + $519,316 related

  • Maycock Adam

    DIRECTOR (ENDED 10/22)

    Total calculated
    $696,627
    From this org
    $0
    From related orgs
    $598,002
    Other
    $98,625
    Hours/week
    0.1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $382,427 related
    Bonus
    $0
    Other
    $0 + $215,575 related
    Deferred
    $0 + $59,011 related
    Nontaxable benefits
    $0 + $39,614 related
    Filer's total
    $0 + $696,627 related

  • Palumbo Andrew

    CEO/DIRECTOR (ENDED 03/22)

    Total calculated
    $31,675
    From this org
    $3,042
    From related orgs
    $22,306
    Other
    $6,327
    Hours/week
    1.5 + 11 related

  • Ragusa Kathleen

    DIR/VP/SEC (BEG 03/22, ENDED 10/22)

    Total calculated
    $346,457
    From this org
    $0
    From related orgs
    $324,108
    Other
    $22,349
    Hours/week
    0.1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $244,720 related
    Bonus
    $0
    Other
    $0 + $79,388 related
    Deferred
    $0 + $10,964 related
    Nontaxable benefits
    $0 + $11,385 related
    Filer's total
    $0 + $346,457 related

  • Thordarson Thor

    DIR/CHAIRMAN/PRES (ENDED 10/22)

    Total calculated
    $1,444,961
    From this org
    $0
    From related orgs
    $1,297,253
    Other
    $147,708
    Hours/week
    0.1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $744,389 related
    Bonus
    $0
    Other
    $0 + $552,864 related
    Deferred
    $0 + $118,312 related
    Nontaxable benefits
    $0 + $29,396 related
    Filer's total
    $0 + $1,444,961 related

  • Trimble Tamara

    DIR/SEC (BEG 11/22)

    Total calculated
    $1,024,617
    From this org
    $0
    From related orgs
    $995,063
    Other
    $29,554
    Hours/week
    0.1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $634,011 related
    Bonus
    $0 + $169,365 related
    Other
    $0 + $191,687 related
    Deferred
    $0 + $16,400 related
    Nontaxable benefits
    $0 + $13,154 related
    Filer's total
    $0 + $1,024,617 related

  • Johnson Justin

    VP-FINANCE (ENDED 03/22)

    Total calculated
    $26,287
    From this org
    $2,402
    From related orgs
    $17,617
    Other
    $6,268
    Hours/week
    1.5 + 11 related

  • Nelson MD Kenneth

    PRESIDENT (BEG 04/22, ENDED 10/22)

    Total calculated
    $438,706
    From this org
    $0
    From related orgs
    $392,900
    Other
    $45,806
    Hours/week
    0.1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $270,755 related
    Bonus
    $0 + $34,857 related
    Other
    $0 + $87,288 related
    Deferred
    $0 + $28,302 related
    Nontaxable benefits
    $0 + $17,504 related
    Filer's total
    $0 + $438,706 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 3
THE FILING ORGANIZATION WAS A COVERED AFFILIATE OF THE JOINT OPERATING COMPANY, ALEXIAN BROTHERS-AHS MIDWEST REGION HEALTH CO. D/B/A AMITA HEALTH (AMITA OR JOC) FOR THE PERIOD FROM JANUARY 1 TO MARCH 31 OF 2022. AS A RESULT OF THE DISAFFILIATION AGREEMENT BETWEEN ALEXIAN BROTHERS HEALTH SYSTEM AND ADVENTIST MIDWEST HEALTH, THE FILING ORGANIZATION'S SOLE MEMBER PRIOR TO NOVEMBER 1, 2022, THE FILING ORGANIZATION CEASED TO BE A COVERED AFFILIATE OF THE JOC EFFECTIVE APRIL 1, 2022. PLEASE SEE OUR RESPONSE TO FORM 990, PART VI, SECTION A, LINE 4 FOR ADDITIONAL INFORMATION CONCERNING THE DISAFFILIATION AGREEMENT. THE 2022 COMPENSATION OF THE EXECUTIVES LISTED IN PART VII, INCLUDING THE CEO, WAS DETERMINED BY AMITA. UPON THE DISAFFILIATION ON APRIL 1, 2022, THE COMPENSATION OF THE EXECUTIVES LISTED IN PART VII WAS REVIEWED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION, THE FILING ORGANIZATION'S TOP-TIER 501(C)(3) PARENT ORGANIZATION, FOR REASONABLENESS AND APPROPRIATENESS AND LEFT UNCHANGED FOR 2022. AMITA UTILIZED VARIOUS COMPARABILITY DATA IN ESTABLISHING THE 2022 COMPENSATION FOR THOSE EXECUTIVES LISTED IN PART VII THAT PERFORMED SERVICES FOR AMITA DURING THE FIRST QUARTER OF 2022 AND FOR THE FILING ORGANIZATION AND FOR ITS RELATED 501(C)(3) HOSPITAL AND PHYSICIAN PRACTICE ENTITIES FOR CALENDAR YEAR 2022. COMPARABILITY DATA UTILIZED BY AMITA INCLUDED COMPENSATION SURVEYS AND STUDIES AND THE FORMS 990 OF OTHER UNRELATED COMPARABLE ORGANIZATIONS. AMITA ALSO HAD A COMPENSATION COMMITTEE THAT APPROVED ALL RELEVANT EXECUTIVE COMPENSATION, INCLUDING THE COMPENSATION OF THE FILING ORGANIZATION'S CEO FOR 2022.
PART I, LINES 4A-B
LINE 4A: DURING THE YEAR ENDING DECEMBER 31, 2022, BRUCE CHRISTIAN AND YUESHA CHEN RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $78,225 AND $86,539 RESPECTIVELY. PURSUANT TO THE AHSSHC CORPORATE EXECUTIVE POLICY GOVERNING EXECUTIVE SEVERANCE, SEVERANCE AGREEMENTS FOR EXECUTIVES OPERATING AT THE VICE PRESIDENT LEVEL AND ABOVE ARE ENTERED INTO UPON ELIGIBILITY TO FACILITATE THE TRANSITION TO SUBSEQUENT EMPLOYMENT FOLLOWING AN INVOLUNTARY SEPARATION FROM EMPLOYMENT WITH ADVENTHEALTH. OTHER SEVERANCE PAYMENTS MAY BE MADE TO NON-EXECUTIVE PERSONNEL IN CERTAIN CIRCUMSTANCES. LINE 4B: LYNN ADDISCOTT, HERBERT BUCHANAN, YUESHA CHEN, BRUCE CHRISTIAN, SANDRA JOHNSON, REBECCA MATHIS, ADAM MAYCOCK, KATHLEEN RAGUSA, THOR THORDARSON, AND TAMARA TRIMBLE RECEIVED COMPENSATION IN 2022 FROM ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), THE TOP-TIER PARENT OF THE FILING ORGANIZATION AND THE PARENT ORGANIZATION OF A HEALTHCARE SYSTEM KNOWN AS ADVENTHEALTH. IN RECOGNITION OF THE CONTRIBUTION THAT EACH EXECUTIVE MAKES TO THE SUCCESS OF ADVENTHEALTH, ADVENTHEALTH PROVIDES SUPPLEMENTAL EXECUTIVE 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 2022. 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 $305,000 IN 2022 (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.
PART I, LINE 4B - CONTINUATION
FLEX PLAN FLEX PLAN SERP II SERP III CONTR. DISTR.* CONTR./DISTR. CONTR. ADDISCOTT, LYNN $ 58,256 $ 58,256 $ 20,179 $ 0 BUCHANAN, HERBERT $ 0 $ 0 $ 0 $ 50,754 CHEN, YUESHA $ 0 $ 0 $ 0 $ 31,154 CHRISTIAN, BRUCE $ 13,125 $ 0 $931,613 $ 0 JOHNSON, SANDRA $ 1,495 $ 154,319 $ 0 $ 0 MATHIS, REBECCCA $ 0 $ 0 $ 0 $ 54,693 MAYCOCK, ADAM $ 0 $ 0 $ 0 $ 41,539 THORDARSON, THOR $ 0 $ 0 $ 0 $ 98,072 TRIMBLE, TAMARA $ 122,953 $102,453 $ 0 $ 0 SERP III DISTR.* BUCHANAN, HERBERT $ 50,754 * INCLUDING INVESTMENT EARNINGS HERBERT BUCHANAN, REINHOLD LLERENA, M.D., ANDREW PALUMBO, AND JUSTIN JOHNSON WERE COMPENSATED BY ALEXIAN BROTHERS HEALTH SYSTEM IN JANUARY-MARCH OF 2022 FOR SERVICES PROVIDED TO THE FILING ORGANIZATION. ALEXIAN BROTHERS HEALTH SYSTEM WAS AFFILIATED WITH THE FILING ORGANIZATION FOR THE PERIOD OF JANUARY 1 - MARCH 31, 2022. PLEASE SEE OUR RESPONSE TO FORM 990, PART VI, SECTION A, LINE 4 FOR A DISCUSSION CONCERNING THE FILING ORGANIZATION'S AFFILIATION WITH ALEXIAN BROTHERS HEALTH SYSTEM THROUGH THE JOINT OPERATING COMPANY KNOWN AS AMITA HEALTH FOR THE PERIOD FROM JANUARY 1 - MARCH 31, 2022. COMPENSATION FOR THESE INDIVIDUALS' SERVICES PROVIDED TO THE FILING ORGANIZATION IS DISCLOSED IN PART II.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

  • FLETCHER HOSPITAL SURGICAL VENTURES LLC

    INDIRECT INTEREST IN SURGERY CENTER · NC

  • FLORIDA HOSPITAL DMERT LLC

    MEDICAL EQUIPMENT · FL · general or managing partner

  • FLORIDA HOSPITAL HOME INFUSION LLP

    HOME INFUSION SERVICES · FL · general or managing partner

  • FUNCTIONAL NEUROSURGICAL AMBULATORY SURGERY CTR LLC

    SURGERY CENTER · CO

  • M&O ORLANDO MOB I LLC

    OPERATION OF MEDICAL OFFICE BUILDING · DE

  • ONPOINT OBGYN LLC (21-123122)

    HEALTHCARE SERVICES · CO

  • PAHS ONPOINT IMAGING LLC

    IMAGING CENTER · CO

  • PAHS ONPOINT URGENT CARE LLC

    URGENT CARE CENTER · CO

  • PRINCETON HOMECARE SERVICES LLC (11-8122)

    OPERATION OF HOME HEALTH AGENCY · FL

  • SURGERY CENTER OF ROME LP

    SURGERY CENTER · GA

  • THE BARIATRIC CENTER OF KANSAS CITY LLC

    SURGERY CENTER · KS

  • URGENT CARE CENTERS OF BREVARD COUNTY LLC

    URGENT CARE CENTERS · FL · general or managing partner

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • ADVENTHEALTH ORLANDO NETWORK INC (11 - 41922)

    C · INACTIVE · FL · controlled entity

  • ADVENTHEALTH PROFESSIONAL STAFFING INC (11 - 12822)

    C · INACTIVE · FL · controlled entity

  • ADVENTHEALTH TAMPA NETWORK INC (11 - 41922)

    C · INACTIVE · FL · controlled entity

  • ADVENTHEALTH TEAM MEMBERS INC (11 - 12822)

    C · INACTIVE · FL · controlled entity

  • ADVENTHEALTH VALUE BASED BUNDLE MANAGEMENT LLC (61-123122)

    C · MEDICAL CONTRACTING AND BILLING · FL · controlled entity

  • ALTAMONTE MEDICAL PLAZA CONDOMINIUM ASSOCIATION INC

    C · CONDO ASSOCIATION · FL · controlled entity

  • APOPKA MEDICAL PLAZA CONDOMINIUM ASSOCIATION INC

    C · CONDO ASSOCIATION · FL · controlled entity

  • BATTLE CREEK ADVENTIST HOSPITAL

    C · INACTIVE · MI · controlled entity

  • FLORIDA HOSPITAL FLAGLER MEDICAL OFFICES ASSOCIATION INC

    C · CONDO ASSOCIATION · FL · controlled entity

  • FLORIDA HOSP HLTH VILLAGE PROPERTY OWNER'S ASSOC INC

    C · CONDO ASSOCIATION · FL · controlled entity

  • FLORIDA HOSPITAL HEALTHCARE SYSTEM INC

    C · PHSO / CIN · FL · controlled entity

  • FLORIDA MEDICAL PLAZA CONDOMINIUM ASSOCIATION INC

    C · CONDO ASSOCIATION · FL · controlled entity

  • KISSIMMEE MULTISPECIALTY CLINIC CONDOMINIUM ASSOCIATION INC

    C · CONDO ASSOCIATION · FL · controlled entity

  • MIDWEST MANAGEMENT SERVICES INC

    C · INACTIVE · KS · controlled entity

  • NORTH AMERICAN HEALTH SERVICES INC & SUB

    C · HOLDING CO. · TN · controlled entity

  • ORMOND PROF ASSOCIATES CONDO ASSOC INC (430 YEAR END)

    C · CONDO ASSOCIATION · FL · controlled entity

  • PARK RIDGE PROPERTY OWNER'S ASSOCIATION INC

    C · CONDO ASSOCIATION · NC · controlled entity

  • PARK RIDGE CONDOMINIUM #1 UNIT OWNERS ASSOCIATION INC

    C · CONDO ASSOCIATION · NC · controlled entity

  • SURGICARE OF ROME INC

    C · HOLDING COMPANY · GA · controlled entity

  • REDMOND PARK HEALTH SERVICES INC

    C · HOLDING COMPANY · GA · controlled entity

  • THE GARDEN RETIREMENT COMMUNITY INC

    C · REAL ESTATE RENTAL · FL · controlled entity

  • WINTER PARK MEDICAL OFFICE BUILDING I CONDO ASSOC INC

    C · CONDO ASSOCIATION · FL · controlled entity

Provenance

Return type
form_990
Tax year
2022
Filed
7 November 2023
IRS schema version
2022v5.0
Source object
202343119349303984

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