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Nonprofiteer
← SOUTHWEST VOLUSIA HEALTH SERVICES INC

Form 990 for tax year 2022

Filed by SOUTHWEST VOLUSIA HEALTH SERVICES INC.

Totals

Total revenue
$1,455,692
Total expenses
$238,197
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$1,363,465
Investment income
$92,227
Other revenue
$0
Total assets, end of year
$9,905,626
Total liabilities, end of year
$1,313
Net assets or fund balances, end of year
$9,904,313
Program services expenses (Part IX)
$222,236
Management and general expenses
$15,961
Fundraising expenses
$0
Program service expenses (Part III)
$222,236

Program services were 93.3% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

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.

Revenue

Part VIII, the statement of revenue.

  • 2a · Program service revenue: Rental - Medical Office Building

    total $1,363,465 · related or exempt $1,363,465

  • 3 · Investment income

    total $222,399 · excluded $222,399

  • 7b · Less cost or other basis and sales expenses

    securities $130,172

  • 7c · Gain or loss

    securities -$130,172

  • 7d · Net gain or loss

    total -$130,172 · excluded -$130,172

Functional expenses

Part IX, the statement of functional expenses.

  • 11f · Fees: investment management

    total $22,282 · management and general $22,282

  • 11g · Fees: other

    total $870 · program services $870

  • 13 · Office expenses

    total $2,013 · management and general $2,013

  • 16 · Occupancy

    total $60,656 · program services $60,656

  • 22 · Depreciation, depletion and amortization

    total $158,647 · program services $158,647

  • 24a · Other expenses: Repairs & maintenance

    total $2,063 · program services $2,063

  • 24b · Other expenses: Insurance reimbursement

    total -$8,334 · management and general -$8,334

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $7,621,402 · end of year $7,058,288

  • 10a · Land, buildings and equipment: cost or other basis

    $8,578,988

  • 10b · Land, buildings and equipment: accumulated depreciation

    $6,628,735

  • 10c · Land, buildings and equipment, net

    beginning of year $2,108,900 · end of year $1,950,253

  • 15 · Other assets

    beginning of year $116,701 · end of year $897,085

  • 17 · Accounts payable and accrued expenses

    beginning of year $6,433 · end of year $1,421

  • 19 · Deferred revenue

    beginning of year -$3,921 · end of year -$108

  • 25 · Other liabilities

    beginning of year -$44,494 · end of year $0

  • 27 · Net assets without donor restrictions

    beginning of year $9,888,985 · end of year $9,904,313

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)

Lease of space to staff physicians of supported tax-exempt hospital.

  • Provides leased office space for physicians on the Medical staff of Southwest Volusia Healthcare Corp d/b/a AdventHealth Fish Memorial. Southwest Volusia Healthcare Corp. is a related exempt organization under IRC Sec 501(c)(3).

    Expenses $222,236 · Revenue $1,363,465

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

Listed in Part VII

  • Banks David

    Director/AH Chief Strategy

    Total calculated
    $2,853,096
    From this org
    $0
    From related orgs
    $2,647,274
    Other
    $205,822
    Hours/week
    0.1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,285,224 related
    Bonus
    $0 + $396,123 related
    Other
    $0 + $965,927 related
    Deferred
    $0 + $166,400 related
    Nontaxable benefits
    $0 + $39,422 related
    Filer's total
    $0 + $2,853,096 related

  • Gregory PhD Audrey

    Dir/Chair/CEO CFN Region

    Total calculated
    $1,567,088
    From this org
    $0
    From related orgs
    $1,335,554
    Other
    $231,534
    Hours/week
    0.1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $890,725 related
    Bonus
    $0
    Other
    $0 + $444,829 related
    Deferred
    $0 + $187,400 related
    Nontaxable benefits
    $0 + $44,134 related
    Filer's total
    $0 + $1,567,088 related

  • Thomas Debora

    Director

    Total calculated
    $918,454
    From this org
    $0
    From related orgs
    $817,018
    Other
    $101,436
    Hours/week
    0.1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $478,627 related
    Bonus
    $0 + $140,091 related
    Other
    $0 + $198,300 related
    Deferred
    $0 + $70,810 related
    Nontaxable benefits
    $0 + $30,626 related
    Filer's total
    $0 + $918,454 related

  • Deininger Robert

    Former CEO

    Total calculated
    $877,151
    From this org
    $0
    From related orgs
    $736,963
    Other
    $140,188
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $547,187 related
    Bonus
    $0 + $123,750 related
    Other
    $0 + $66,026 related
    Deferred
    $0 + $92,862 related
    Nontaxable benefits
    $0 + $47,326 related
    Filer's total
    $0 + $877,151 related

  • Brown Lorenzo

    Director/CEO-Hospital/W.Volusia Mkt

    Total calculated
    $687,604
    From this org
    $0
    From related orgs
    $562,472
    Other
    $125,132
    Hours/week
    0.1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $417,649 related
    Bonus
    $0 + $99,712 related
    Other
    $0 + $45,111 related
    Deferred
    $0 + $67,245 related
    Nontaxable benefits
    $0 + $57,887 related
    Filer's total
    $0 + $687,604 related

  • Weis David

    Director (End 09/22)

    Total calculated
    $640,189
    From this org
    $0
    From related orgs
    $523,042
    Other
    $117,147
    Hours/week
    0.1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $406,063 related
    Bonus
    $0 + $87,239 related
    Other
    $0 + $29,740 related
    Deferred
    $0 + $71,453 related
    Nontaxable benefits
    $0 + $45,694 related
    Filer's total
    $0 + $640,189 related

  • Calla MD Shrish

    Director

    Total calculated
    $504,036
    From this org
    $0
    From related orgs
    $455,111
    Other
    $48,925
    Hours/week
    0.1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $262,418 related
    Bonus
    $0 + $171,727 related
    Other
    $0 + $20,966 related
    Deferred
    $0 + $16,400 related
    Nontaxable benefits
    $0 + $32,525 related
    Filer's total
    $0 + $504,036 related

  • Lunde Eric

    Director (Beg 09/22)

    Total calculated
    $480,613
    From this org
    $0
    From related orgs
    $370,922
    Other
    $109,691
    Hours/week
    0.1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $324,955 related
    Bonus
    $0 + $32,230 related
    Other
    $0 + $13,737 related
    Deferred
    $0 + $66,535 related
    Nontaxable benefits
    $0 + $43,156 related
    Filer's total
    $0 + $480,613 related

  • Glass Kyle

    CFO - Hospital/W.Volusia Mkt

    Total calculated
    $417,502
    From this org
    $0
    From related orgs
    $356,649
    Other
    $60,853
    Hours/week
    0.1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $288,224 related
    Bonus
    $0 + $57,115 related
    Other
    $0 + $11,310 related
    Deferred
    $0 + $16,400 related
    Nontaxable benefits
    $0 + $44,453 related
    Filer's total
    $0 + $417,502 related

  • Ostarly Eric

    Former CFO

    Total calculated
    $311,416
    From this org
    $0
    From related orgs
    $287,630
    Other
    $23,786
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $188,770 related
    Bonus
    $0 + $62,256 related
    Other
    $0 + $36,604 related
    Deferred
    $0 + $8,924 related
    Nontaxable benefits
    $0 + $14,862 related
    Filer's total
    $0 + $311,416 related

  • Desai MD Rohan

    Director (End 12/22)

    Total calculated
    $2,853
    From this org
    $0
    From related orgs
    $2,853
    Other
    $0
    Hours/week
    0.1 + 0.5 related

  • Gupta MD Vishal

    Director

    Total calculated
    $1,978
    From this org
    $0
    From related orgs
    $1,978
    Other
    $0
    Hours/week
    0.1 + 0.3 related

  • Bowman MD Kurt

    Director

    Total calculated
    $1,728
    From this org
    $0
    From related orgs
    $1,728
    Other
    $0
    Hours/week
    0.1 + 0.3 related

  • Foley Doug

    Director

    Total calculated
    $253
    From this org
    $0
    From related orgs
    $253
    Other
    $0
    Hours/week
    0.1 + 0.2 related

  • Northey Patricia

    Director

    Total calculated
    $253
    From this org
    $0
    From related orgs
    $253
    Other
    $0
    Hours/week
    0.1 + 0.2 related

  • Patterson Pat

    Director

    Total calculated
    $253
    From this org
    $0
    From related orgs
    $253
    Other
    $0
    Hours/week
    0.1 + 0.2 related

  • RitcheyJeff

    Director

    Total calculated
    $253
    From this org
    $0
    From related orgs
    $253
    Other
    $0
    Hours/week
    0.1 + 0.2 related

  • Valderrama Carlos

    Director

    Total calculated
    $253
    From this org
    $0
    From related orgs
    $253
    Other
    $0
    Hours/week
    0.1 + 0.2 related

  • Wanamaker John

    Director

    Total calculated
    $253
    From this org
    $0
    From related orgs
    $253
    Other
    $0
    Hours/week
    0.1 + 0.2 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

  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 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 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
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 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. FLEX Plan FLEX Plan SERP II SERP III AHS 457b Contr. Distr.* Contr./Distr. Contr. Distr.* Banks,David $ 150,000 $ 125,363 $ 809,672 $ 0 $ 0 Gregory,Audrey $ 0 $ 0 $ 0 $ 171,000 $ 0 Thomas,Debora $ 74,910 $ 48,092 $ 102,171 $ 0 $ 0 Deininger,Robert $ 78,654 $ 25,469 $ 0 $ 18,308 $ 0 Brown,Lorenzo $ 50,845 $ 28,338 $ 0 $ 0 $ 0 Weis,David $ 45,712 $ 13,071 $ 0 $ 15,441 $ 0 Lunde,Eric $ 0 $ 0 $ 0 $ 50,135 $ 0 Ostarly,Eric $ 3,847 $ 17,571 $ 0 $ 5,078 $ 20,685 * Including Investment Earnings

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
22 January 2024
IRS schema version
2022v5.0
Source object
202430229349301658

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