2024-05-15T15:43:26-05:00 2023-06-30 990 2023-01-01 362276984 ADVENTIST MIDWEST HEALTH ADVE 6308569000 120 NORTH OAK STREET HINSDALE IL 60521 LYNN C ADDISCOTT ASSISTANT SECRETARY 6308566001 2024-05-15 LYNN ADDISCOTT 999009999 1 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z ADAM MAYCOCK 120 NORTH OAK STREET HINSDALE IL 60521 264562965 0 X WWW.UCHICAGOMEDICINEADVENTHEALTH.ORG X 1904 IL THE PROVISION OF MEDICAL CARE TO THE COMMUNITY THROUGH THE OPERATION OF TWO HOSPITALS. 28 23 127 209 719135 130161 3268474 134567 507737446 262813504 2252044 -146755 218104 41208 513476068 262842524 1247767 472041 0 0 183377785 111255727 0 0 0 340394879 183667638 525020431 295395406 -11544363 -32552882 609877328 585231314 123481637 147796295 486395691 437435019 X ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION AND ALL ITS SUBSIDIARY ORGANIZATIONS WERE ESTABLISHED BY THE SEVENTH-DAY ADVENTIST CHURCH TO BRING A MINISTRY OF HEALING AND HEALTH TO THE COMMUNITIES SERVED. OUR MISSION IS TO EXTEND THE HEALING MINISTRY OF CHRIST. THE TAXPAYER IS OWNED 49% BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (ADVENTHEALTH). EFFECTIVE JANUARY 1, 2023, THE TAXPAYER ENTERED INTO A MASTER MANAGEMENT AGREEMENT WITH ADVENTHEALTH. ADVENTHEALTH SEEKS TO BE WIDELY RESPECTED AS A CONSUMER-FOCUSED ORGANIZATION THAT ENGAGES INDIVIDUALS IN THEIR HEALTH BY DELIVERING WHOLISTIC, BEST PRACTICE CARE ACROSS A CONNECTED, COMPREHENSIVE CONTINUUM OF SERVICES. WITH CHRIST AS OUR EXAMPLE, ADVENTHEALTH CARES FOR AND NURTURES PEOPLE: OUR EMPLOYEES, OUR COMMUNITIES, OUR HEALTHCARE PROFESSIONALS, AND THOSE WHO TRUST US FOR CARE AND HEALING. 0 0 277539092 472041 262112734 OPERATION OF TWO HOSPITALS: UCHICAGO MEDICINE ADVENTHEALTH HINSDALE AND UCHICAGO MEDICINE ADVENTHEALTH LA GRANGE. FOR THE SHORT YEAR BEGINNING JANUARY 1, 2023 THROUGH JUNE 30, 2023, UCHICAGO MEDICINE ADVENTHEALTH HINSDALE, A 261-BED ACUTE CARE HOSPITAL, REPORTED 4,846 ADMISSIONS, 23,360 PATIENT DAYS AND 87,609 OUTPATIENT VISITS; AND UCHICAGO MEDICINE ADVENTHEALTH LA GRANGE, A 177-BED ACUTE CARE HOSPITAL, REPORTED 3,548 ADMISSIONS, 19,489 PATIENT DAYS AND 40,248 OUTPATIENT VISITS. 277539092 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 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 X 0 0 1 127 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 28 23 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 IL X CULLY CHAPMAN 6308566001 120 N OAK STREET HINSDALE IL 60521 ARQUILLA VENANZIO DIRECTOR 0.30 0.60 X 0 0 0 BACON KENNETH DIRECTOR/CHAIRMAN - HOSP. BD. 0.30 0.60 X 0 0 0 BUCHANAN HERBERT DIRECTOR 0.30 50.00 X 0 0 0 DAVARAPALLI MD RAMADEVI DIRECTOR 0.30 50.00 X 0 0 0 DENSLOW KENNETH DIR/VICE CHAIR 0.30 0.60 X 0 0 0 DIXON SUSAN DIRECTOR 0.30 0.60 X 0 0 0 EASTMAN LINDA DIRECTOR 0.30 0.60 X 0 0 0 GRAY JR MARSHALL DIRECTOR 0.30 0.60 X 0 0 0 GRYS D MIN JOHN DIRECTOR (BEG 01/2023) 0.30 0.60 X 0 0 0 HAWKINS RONNIE DIRECTOR 0.30 0.60 X 0 0 0 HOLDER BILL DIRECTOR 0.30 0.60 X 0 0 0 JACKIEWICZ THOMAS DIRECTOR/CHAIR (BEG 01/2023) 0.30 0.60 X 0 0 0 KELLY PAT DIRECTOR (BEG 01/2023) 0.30 0.60 X 0 0 0 KOHLI MD MANINDER DIRECTOR 0.30 9.00 X 0 0 0 MILNER MD ROSS DIRECTOR (BEG 01/2023) 0.30 0.60 X 0 0 0 MOORHEAD MD JOHN DAVID DIRECTOR (BEG 01/2023) 0.30 0.60 X 0 0 0 MURREY MD SUSAN DIRECTOR 0.30 28.90 X 0 0 0 O'CONNOR PETER DIRECTOR 0.30 0.60 X 0 0 0 OTO MD AYTEKIN DIRECTOR (BEG 01/2023) 0.30 0.60 X 0 0 0 PATARI MD SANJAY DIRECTOR (BEG 01/2023) 0.30 0.60 X 0 0 0 RAMIREZ ELDEN DIRECTOR 0.30 0.60 X 0 0 0 RANDOLPH KARSTEN DIRECTOR (BEG 01/2023) 0.30 0.60 X 0 0 0 SAMSTEIN IVAN DIRECTOR (BEG 01/2023) 0.30 0.60 X 0 0 0 SCOTT GLYNN DIRECTOR 0.30 0.60 X 0 0 0 SNYDER BRENT DIRECTOR 0.30 0.60 X 0 0 0 THORDARSON THOR DIR/PRES/SEC/CEO 30.00 20.00 X 0 0 0 VALAITIS MD SANDRA DIRECTOR (BEG 01/2023) 0.30 0.80 X 0 0 0 WRIGHT JONATHAN DIRECTOR 0.30 0.60 X 0 0 0 MAYCOCK ADAM CEO HINSDALE/LA GRANGE 50.00 0.00 X 0 0 0 BEEBE HARMAT CFO HINSDALE/LA GRANGE (BEG 03/2023) 50.00 0.00 X 0 0 0 STILL DANAE CFO HINSDALE/LA GRANGE (END 02/2023) 50.00 0.00 X 0 0 0 0 0 0 0 0 0 0 0 X 134567 134567 NET PATIENT REVENUE 622110 259243919 258824931 418988 PHARMACY 622110 1563573 1281791 281782 PROF. OFFICE BUILDING/EMP. HOUSIN 622110 753173 753173 CAFETERIA REVENUE 622110 728654 728654 RENT FROM EXEMPT AFFILIATES 622110 311276 311276 212909 212909 262813504 1423232 1423232 159965 23373 137122 5008 22843 18365 41208 18365 22843 8324 1578311 0 -1578311 8324 -1569987 -1569987 262842524 262112734 719135 -123912 X 472041 472041 875529 875529 81728291 79676530 2051761 4249725 4100755 148970 17658938 16528768 1130170 6743244 6506866 236378 116992 116992 5957 5957 292100 292100 70502090 65957228 4544862 1133731 1133731 8086395 5610468 2475927 10859390 9743535 1115855 4733491 4733491 198766 198766 42168 42168 334117 334117 13064554 13064554 2842051 2842051 MEDICAL SUPPLIES 53600804 53600804 STATE TAX INDIGENT ASSE 13836059 13836059 REPAIRS & MAINTENANCE 3144367 3144367 UBI TAXES 73311 73311 801295 229509 571786 295395406 277539092 17856314 0 X 6429 6468 156828847 169174272 59139165 59284512 1065483 1119961 14395884 12039274 3204357 3139184 265606710 12977876 256291567 252628834 628749 551256 83391824 1126812 34925023 86160741 609877328 585231314 22442402 13487847 101039235 134308448 123481637 147796295 X 476075966 426529344 10319725 10905675 486395691 437435019 609877328 585231314 X -32552882 5991344 -22399134 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 31929 31929 0 PART II-B, LINE 1: DUES WERE PAID TO THE AMERICAN HOSPITAL ASSOCIATION AND ILLINOIS HOSPITAL ASSOCIATION. 2685040 0 0 2685040 2685040 103974 103974 2685040 2685040 103974 103974 2685040 2685040 103974 103974 2685040 2685040 302541 302541 2685040 1.00000 0 1 1 11804025 11804025 193516015 5820087 187695928 44342627 7098095 37244532 15944043 59694 15884349 252628834 OTHER RECEIVABLES 7688715 RECEIVABLE FROM THIRD PARTIES 57908718 RIGHT OF USE ASSET-OPERATING LEASE 9339488 BENEFICIAL INTEREST IN FOUNDATION 11171949 OTHER ASSETS 51871 86160741 140877 DUE TO RELATED 14914931 PAYABLE TO THIRD PARTIES 81931330 CREDIT BALANCES IN A/R 2507333 ACCRUED INTEREST PAYABLE 36779 DUE TO AFFILIATED 15069937 OPERATING LEASE LIABILITY 10010993 OTHER LIABILITIES 8630690 OTHER DEFERRED REVENUE 1065578 134308448 X PART V, LINE 4: ALL ENDOWMENT FUNDS ARE HELD BY THE FOLLOWING RELATED 501(C)(3) EXEMPT FOUNDATIONS: HINSDALE HOSPITAL FOUNDATION (HHF): FORMED AND MAINTAINED EXCLUSIVELY TO FURTHER THE EXEMPT PURPOSE OF UCHICAGO MEDICINE ADVENTHEALTH HINSDALE. HHF HELD ASSETS IN PERMANENT ENDOWMENT FUNDS DURING THE CURRENT YEAR. HHF'S ENDOWMENT CONSISTS OF THREE INDIVIDUAL FUNDS ESTABLISHED TO SUPPORT THE HOSPITAL'S OPLER CANCER CENTER AND CANCER CENTER NURSE NAVIGATION PROGRAM. MIDWEST HEALTH FOUNDATION (MHF): MAINTAINED TO HOLD ASSETS IN A PERMANENT ENDOWMENT FUND ESTABLISED TO SUPPORT NURSING SCHOLARSHIPS. THE FUND WAS ESTABLISHED BY LA GRANGE MEMORIAL HOSPITAL FOUNDATION, THEN WAS TRANSFERRED TO MHF ON 6/21/19 AS THE RESULT OF A LEGAL MERGER. PART X, LINE 2: THE FINANCIAL INFORMATION OF THE FILING ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENT AUDIT OF THE UNIVERSITY OF CHICAGO MEDICAL CENTER (UCMC) AS OF JANUARY 1, 2023. THE CONSOLIDATED FINANCIAL STATEMENTS OF UCMC CONTAIN THE FOLLOWING FIN 48 (ASC 740) FOOTNOTE: PLEASE NOTE THAT DOLLAR AMOUNTS ARE IN THOUSANDS. THE SYSTEM APPLIES ASC TOPIC 740, INCOME TAXES, WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S FINANCIAL STATEMENTS. ASC TOPIC 740 PRESCRIBES A MORE LIKELY THAN NOT RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN. UNDER ASC TOPIC 740, TAX POSITIONS ARE EVALUATED FOR RECOGNITION, DERECOGNITION, AND MEASUREMENT USING CONSISTENT CRITERIA AND PROVIDE MORE INFORMATION ABOUT THE UNCERTAINTY IN INCOME TAX ASSETS AND LIABILITIES. AS OF JUNE 30, 2023 AND 2022, THE SYSTEM DOES NOT HAVE AN ASSET OR LIABILITY RECORDED FOR UNRECOGNIZED TAX POSITIONS. UCM OBLIGATED GROUP IS COMPRISED OF SUBSIDIARIES THAT ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND, THEREFORE, EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. UCM NON-OBLIGATED GROUPS CONSIST OF SEVERAL NOT-FOR-PROFIT AND TAXABLE ENTITIES. THE TAXABLE ENTITIES INCLUDE UNIVERSITY OF CHICAGO MEDICINE CARE NETWORK, LLC; TRULEN INSURANCE SPC LIMITED; MEDCENTRIX, INC.; INGALLS SAME DAY SURGERY; AND INGALLS PROVIDER GROUP, WHICH ARE TAXABLE ENTITIES UNDER APPLICABLE SECTIONS OF THE CODE. DEFERRED INCOME TAXES ON THE TAXABLE ENTITIES OF THE NON-OBLIGATED GROUPS ARE RECOGNIZED FOR THE TAX CONSEQUENCES OF "TEMPORARY DIFFERENCES" BY APPLYING ENACTED STATUTORY TAX RATES APPLICABLE TO FUTURE YEARS TO DIFFERENCES BETWEEN THE CONSOLIDATED FINANCIAL STATEMENT CARRYING AMOUNTS AND THE TAX BASES OF EXISTING ASSETS AND LIABILITIES. AS OF JUNE 30, 2023 AND 2022, THE UCM NON-OBLIGATED GROUPS HAVE DEFERRED TAX ASSETS PRIMARILY RELATING TO NET OPERATING LOSSES (NOL) OF $18,171 AND $19,234, RESPECTIVELY; HOWEVER, IT HAS A FULL VALUATION ALLOWANCE AS MANAGEMENT BELIEVES THAT IT WAS NOT MORE LIKELY THAN NOT THAT THE RESULTS OF FUTURE OPERATIONS WOULD GENERATE SUFFICIENT TAXABLE INCOME TO REALIZE THE NOL. 1 1 X 1 X 250.000000000000 1 X 600.000000000000 1 1 0 1 1 2429567 2429567 0.00820 44786138 34880651 9905487 0.03350 47215705 34880651 12335054 0.04170 8887765 2452278 6435487 0.02180 113069 113069 0.00040 9000834 2452278 6548556 0.02220 56216539 37332929 18883610 0.06390 138692 138692 0.00050 138692 138692 0.00050 1 4708061 14088 X 1 1 1 HINSDALE SURGICAL CENTER LLC SURGICAL SERVICES 0.28450 0.00000 0.43100 2 1 UCHICAGO MEDICINE ADVENTHEALTH HINSDALE 120 NORTH OAK STREET HINSDALE IL 60521 WWW.UCHICAGOMEDICINEADVENTHEALTH.ORG 0000976 X X X X 2 UCHICAGO MEDICINE ADVENTHEALTH LA GRANGE 5101 S WILLOW SPRINGS ROAD LA GRANGE IL 60525 WWW.UCHICAGOMEDICINEADVENTHEALTH.ORG 0005017 X X X X X UCHICAGO MEDICINE ADVENTHEALTH HINSDALE 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 600.000000000000 X 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 UCHICAGO MEDICINE ADVENTHEALTH LA GRANGE 2 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 600.000000000000 X 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 UCHICAGO MEDICINE ADVENTHEALTH HINSDALE PART V, SECTION B, LINE 5: ADVENTIST MIDWEST HEALTH, DBA UCHICAGO MEDICINE ADVENTHEALTH HINSDALE (AHH OR THE HOSPITAL) IS A 261-BED ACUTE CARE HOSPITAL LOCATED IN THE VILLAGE OF HINSDALE IN DUPAGE COUNTY IN ILLINOIS. BEGINNING ON JANUARY 1, 2023, THE DBA NAME FOR THE HOSPITAL WAS CHANGED TO UCHICAGO MEDICINE ADVENTHEALTH HINSDALE. AHH'S PRIMARY SERVICE AREA INCLUDES 39 ZIP CODES ACROSS MAINLY DUPAGE COUNTY. IN CONDUCTING ITS 2022 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), THE HOSPITAL SOLICITED INPUT DIRECTLY FROM THE COMMUNITY AND FROM INDIVIDUALS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY COMMUNITY MEMBERS. THE HOSPITAL PARTNERED WITH THE IMPACT DUPAGE COLLABORATIVE IN CONDUCTING ITS 2022 CHNA. THE IMPACT DUPAGE COLLABORATIVE HAS REPRESENTATION FROM SOCIAL SUPPORT AND COMMUNITY ORGANIZATIONS, HEALTH CARE SYSTEMS, AS WELL AS PUBLIC HEALTH AND EDUCATION INSTITUTIONS. A SMALLER COMMITTEE WAS FORMED BY THE COLLABORATIVE TO LOCALIZE THE DATA COLLECTION AND COMMUNITY INPUT PROCESS FOR THE HOSPITAL. COMMUNITY ORGANIZATIONS INCLUDED IN THE SMALLER COMMITTEE INCLUDED UNITED WAY OF METRO CHICAGO, DUPAGE FEDERATION ON HUMAN SERVICES REFORM, DUPAGE FOUNDATION, DUPAGE COUNTY HEALTH DEPARTMENT, DUPAGE HEALTH COALITION, DUPAGE COUNTY PUBLIC DEFENDER'S OFFICE, DUPAGE COUNTY, AND PRAIRIE STATE LEGAL SERVICES, INC. AHH ALSO FORMED A COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE (CHNAC) WHOSE PURPOSE WAS TO SELECT THE NEEDS THE HOSPITAL WOULD ADDRESS RESULTING FROM THE FINDINGS IN THE ASSESSMENT. THE COLLABORATIVE COLLECTED BOTH PRIMARY AND SECONDARY DATA. PRIMARY DATA INCLUDED A COMMUNITY SURVEY, A LOCAL SYSTEM ASSESSMENT, AND A FORCES OF CHANGE ASSESSMENT. AN INTENTIONAL EFFORT WAS MADE TO COLLECT INPUT FROM ALL MEMBERS OF THE HOSPITAL'S COMMUNITY AND TO OBTAIN PERSPECTIVES ACROSS AGE, RACE/ETHNICITY, GENDER, PROFESSION, HOUSEHOLD INCOME, EDUCATION LEVEL, AND GEOGRAPHIC LOCATION. THE COMMUNITY SURVEY WAS PROVIDED IN ENGLISH AND SPANISH TO ANYONE IN DUPAGE COUNTY AND WAS ACCESSIBLE ONLINE THROUGH WEBLINKS AND QR CODES. THE LOCAL SYSTEM ASSESSMENT WAS AN ONLINE SURVEY TARGETING PUBLIC HEALTH, LOCAL HOSPITALS AND HEALTH SYSTEMS, MENTAL AND BEHAVIORAL HEALTH, EDUCATION, HOUSING, PUBLIC SAFETY, LOCAL GOVERNMENT, LOCAL NON-PROFIT AND FAITH-BASED ORGANIZATIONS. THE FORCES OF CHANGE ASSESSMENT WAS A SERIES OF BRAINSTORMING SESSIONS CONDUCTED WITH A NUMBER OF SOCIAL SERVICE ORGANIZATIONS AND THE DUPAGE COUNTY HEALTH DEPARTMENT. UCHICAGO MEDICINE ADVENTHEALTH LA GRANGE PART V, SECTION B, LINE 5: ADVENTIST MIDWEST HEALTH, DBA UCHICAGO MEDICINE ADVENTHEALTH LA GRANGE (AHLG OR THE HOSPITAL) IS A 177-BED ACUTE CARE HOSPITAL LOCATED IN THE VILLAGE OF LA GRANGE IN COOK COUNTY IN ILLINOIS. BEGINNING ON JANUARY 1, 2023, THE DBA NAME FOR THE HOSPITAL WAS CHANGED TO UCHICAGO MEDICINE ADVENTHEALTH LA GRANGE. AHLG'S PRIMARY SERVICE AREA INCLUDES 21 ZIP CODES ACROSS COOK AND DUPAGE 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 COLLABORATED WITH THE COOK COUNTY ALLIANCE FOR HEALTH EQUITY IN CONDUCTING ITS 2022 CHNA. THE ALLIANCE FOR HEALTH EQUITY IS A COLLABORATIVE OF HEALTH CARE SYSTEMS AND PROVIDERS, WORKING WITH HEALTH DEPARTMENTS AND COMMUNITY-BASED ORGANIZATIONS WITH A SHARED VISION TO IMPROVE HEALTH EQUITY, WELLNESS, AND QUALITY OF LIFE ACROSS CHICAGO AND COOK COUNTY. A SMALLER COMMITTEE WAS FORMED THROUGH THE ALLIANCE FOR HEALTH EQUITY COLLABORATIVE TO LOCALIZE THE DATA COLLECTION AND COMMUNITY INPUT PROCESS FOR THE COLLABORATING HOSPITALS. THE HEALTH CARE SYSTEMS AND PROVIDERS INCLUDED IN THE SMALLER COMMITTEE WERE ADVOCATE AURORA HEALTH, AMITA HEALTH, ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL, JACKSON PARK HOSPITAL, LOYOLA UNIVERSITY HEALTH SYSTEM, MACNEAL HOSPITAL, MERCY HOSPITAL AND MEDICAL CENTER, NORTHWESTERN MEDICINE, NORWEGIAN AMERICAN HOSPITAL, PALOS HEALTH, ROSELAND COMMUNITY HOSPITAL, RUSH, SINAI HEALTH SYSTEM, SWEDISH HOSPITAL, AND THE UNIVERSITY OF ILLINOIS HOSPITAL & HEALTH SYSTEMS. THE SMALLER COMMITTEE ALSO INCLUDED REPRESENTATIVES FROM THE CHICAGO DEPARTMENT OF PUBLIC HEALTH AND THE COOK COUNTY DEPARTMENT OF PUBLIC HEALTH. AHLG ALSO FORMED A COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE (CHNAC) WHOSE PURPOSE WAS TO SELECT THE NEEDS THE HOSPITAL WOULD ADDRESS RESULTING FROM THE FINDINGS IN THE ASSESSMENT. THE COLLABORATIVE COLLECTED BOTH PRIMARY AND SECONDARY DATA. PRIMARY DATA INCLUDED A COMMUNITY SURVEY, COMMUNITY RESIDENT FOCUS GROUPS, AND A FORCES OF CHANGE ASSESSMENT. AN INTENTIONAL EFFORT WAS MADE TO COLLECT INPUT FROM ALL MEMBERS OF THE HOSPITAL'S COMMUNITY AND TO OBTAIN PERSPECTIVES ACROSS AGE, RACE/ETHNICITY, GENDER, PROFESSION, HOUSEHOLD INCOME, EDUCATION LEVEL, AND GEOGRAPHIC LOCATION. THE COMMUNITY SURVEY WAS PROVIDED IN ENGLISH AND SPANISH TO ANYONE 10 OR OLDER IN THE CHICAGO OR SUBURBAN COOK COUNTY AREA AND WAS ACCESSIBLE ONLINE THROUGH WEBLINKS AND QR CODES. BETWEEN SEPTEMBER OF 2021 AND APRIL OF 2022, 43 FOCUS GROUPS WITH COMMUNITY MEMBERS WERE HELD. PARTICIPANTS WERE 14 YEARS OF AGE OR OLDER AND REPRESENTED A DIVERSE RANGE OF ETHNIC, RACIAL, RELIGIOUS, AND SOCIOECONOMIC BACKGROUNDS. INPUT FROM COMMUNITIES THAT ARE HISTORICALLY MARGINALIZED AND SYSTEMATICALLY EXCLUDED FROM ASSESSMENT AND DECISION-MAKING PROCESSES WAS A FOCUS. THE FORCES OF CHANGE ASSESSMENT WAS A PROCESS OF SOLICITING INPUT FROM PARTICIPANTS TO IDENTIFY TRENDS, FACTORS, OR EVENTS THAT ARE IMPACTING THE HEALTH AND QUALITY OF LIFE FOR THE RESIDENTS OF COOK COUNTY. UCHICAGO MEDICINE ADVENTHEALTH HINSDALE 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. UCHICAGO MEDICINE ADVENTHEALTH LA GRANGE 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. UCHICAGO MEDICINE ADVENTHEALTH HINSDALE PART V, SECTION B, LINE 11: THE FILING ORGANIZATION IS FILING THIS SHORT PERIOD RETURN FOR THE PERIOD FROM JANUARY 1, 2023 THROUGH JUNE 30, 2023, AS IT IS CHANGING ITS TAX YEAR END TO JUNE 30 FROM DECEMBER 31. AS A CALENDAR-YEAR TAXPAYER IN 2022, THE FILING ORGANIZATION COMPLETED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT BY DECEMBER 31, 2022. THE FILING ORGANIZATION'S 2023-2025 IMPLEMENTATION STRATEGY (COMMUNITY HEALTH PLAN) WAS COMPLETED BY MAY 15, 2023. AS THIS SHORT PERIOD RETURN INCLUDES ONLY 46 DAYS IN THE COMMUNITY HEALTH PLAN THREE-YEAR IMPLEMENTATION PERIOD, PART V, SECTION B, LINE 11 IS NOT ABLE TO BE COMPLETED FOR THIS SHORT PERIOD FILING. THE NARRATIVE FOR SCHEDULE H, PART V, SCHEDULE B, LINE 11 FOR THE TAX YEAR BEGINNING JULY 1, 2023 THROUGH JUNE 30, 2024 WILL INCLUDE HOW THE FILING ORGANIZATION HAS ADDRESSED THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN ITS 2022 COMMUNITY HEALTH NEEDS ASSESSMENT FOR THE PERIOD FROM MAY 15, 2023 THROUGH JUNE 30, 2024. UCHICAGO MEDICINE ADVENTHEALTH LA GRANGE PART V, SECTION B, LINE 11: THE FILING ORGANIZATION IS FILING THIS SHORT PERIOD RETURN FOR THE PERIOD FROM JANUARY 1, 2023 THROUGH JUNE 30, 2023, AS IT IS CHANGING ITS TAX YEAR END TO JUNE 30 FROM DECEMBER 31. AS A CALENDAR-YEAR TAXPAYER IN 2022, THE FILING ORGANIZATION COMPLETED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT BY DECEMBER 31, 2022. THE FILING ORGANIZATION'S 2023-2025 IMPLEMENTATION STRATEGY (COMMUNITY HEALTH PLAN) WAS COMPLETED BY MAY 15, 2023. AS THIS SHORT PERIOD RETURN INCLUDES ONLY 46 DAYS IN THE COMMUNITY HEALTH PLAN THREE-YEAR IMPLEMENTATION PERIOD, PART V, SECTION B, LINE 11 IS NOT ABLE TO BE COMPLETED FOR THIS SHORT PERIOD FILING. THE NARRATIVE FOR SCHEDULE H, PART V, SCHEDULE B, LINE 11 FOR THE TAX YEAR BEGINNING JULY 1, 2023 THROUGH JUNE 30, 2024 WILL INCLUDE HOW THE FILING ORGANIZATION HAS ADDRESSED THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN ITS 2022 COMMUNITY HEALTH NEEDS ASSESSMENT FOR THE PERIOD FROM MAY 15, 2023 THROUGH JUNE 30, 2024. SCHEDULE H, PART V, SECTION B, LINE 7A: EACH HOSPITAL FACILITY'S CHNA REPORT IS WIDELY AVAILABLE THROUGH THE FOLLOWING WEBSITE:HTTPS://WWW.UCHICAGOMEDICINEADVENTHEALTH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS SCHEDULE H, PART V, SECTION B, LINE 10A: EACH HOSPITAL FACILITY'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY IS WIDELY AVAILABLE THROUGH THE FOLLOWING WEBSITE: HTTPS://WWW.UCHICAGOMEDICINEADVENTHEALTH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS SCHEDULE H, PART V, SECTION B, LINE 16A,B,C: EACH HOSPITAL'S FINANCIAL ASSISTANCE POLICY CAN BE FOUND AT:HTTPS://WWW.UCHICAGOMEDICINEADVENTHEALTH.ORG/FINANCIAL-ASSISTANCEEACH HOSPITAL FACILITY'S FINANCIAL ASSISTANCE POLICY APPLICATION IS WIDELY AVAILABLE THROUGH THE FOLLOWING WEBSITE:HTTPS://WWW.UCHICAGOMEDICINEADVENTHEALTH.ORG/FINANCIAL-ASSISTANCEEACH HOSPITAL FACILITY'S PLAIN LANGUAGE SUMMARY IS AVAILABLE AT:HTTPS://WWW.UCHICAGOMEDICINEADVENTHEALTH.ORG/FINANCIAL-ASSISTANCE 1 1 - ST THOMAS HOSPICE & PALLIATIVE CARE 119 E OGDEN AVE SUITE 111 HINSDALE IL 60521 HOSPICE CARE PART I, LINE 3C: PERSONS WHO EARN LESS THAN 600% OF THE FEDERAL POVERTY GUIDELINES ARE GIVEN MORE SIGNIFICANT DISCOUNTS, DEPENDING ON THEIR INDIVIDUAL SITUATIONS.FEDERAL POVERTY LEVEL - 0-250% UNINSURED PATIENT DISCOUNT - 100%FEDERAL POVERTY LEVEL - 251-300% UNINSURED PATIENT DISCOUNT - 95%FEDERAL POVERTY LEVEL - 301-400% UNINSURED PATIENT DISCOUNT - 90%FEDERAL POVERTY LEVEL - 401-600% UNINSURED PATIENT DISCOUNT - 85% PART I, LINE 6A: THE FILING ORGANIZATION WAS A PARTIALLY OWNED SUBSIDIARY OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC) DURING ITS CURRENT TAX YEAR. DURING THE CURRENT YEAR, AHSSHC SERVED AS A PARENT ORGANIZATION TO 30 TAX-EXEMPT 501(C)(3) HOSPITAL ORGANIZATIONS AND A NUMBER OF OTHER HEALTH CARE FACILITIES THAT OPERATED IN 10 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 II, COMMUNITY BUILDING ACTIVITIES: THE COSTS OF COMMUNITY BUILDING ACTIVITIES REPORTED ON PART II OF SCHEDULE H PRIMARILY REPRESENT THE COSTS ASSOCIATED WITH COMMERCIALLY SPONSORED RESEARCH. THE ORGANIZATION'S HOSPITALS PARTICIPATE IN CLINICAL DRUG AND DEVICE RESEARCH THAT IS PERFORMED ON PATIENTS WHO HAVE A CONDITION OR DISEASE FOR WHICH THE EVENTUAL COMMERCIAL USE OF A DRUG OR DEVICE IS INTENDED. THIS RESEARCH IS RELATED TO PATIENT CARE AND SERVES TO EXPAND SCIENTIFIC KNOWLEDGE WITH RESPECT TO POTENTIAL TREATMENTS AND CURES FOR VARIOUS DISEASES AND CONDITIONS. PART III, LINE 2: THE AMOUNT OF BAD DEBT EXPENSE REPORTED ON LINE 2 OF SECTION A OF PART III IS RECORDED IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS ADJUSTMENTS TO REVENUE, NOT BAD DEBT EXPENSE. PART III, LINE 3: METHODOLOGY FOR DETERMINING THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE THAT MAY REPRESENT PATIENTS WHO COULD HAVE QUALIFIED UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY:SELF-PAY PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE BY COMPLETING A FINANCIAL ASSISTANCE APPLICATION FORM (FAA FORM). IF AN INDIVIDUAL DOES NOT SUBMIT A COMPLETE FAA FORM WITHIN 240 DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS SENT TO THE INDIVIDUAL, AN INDIVIDUAL MAY BE CONSIDERED FOR PRESUMPTIVE ELIGIBILITY BASED UPON A SCORING TOOL THAT IS DESIGNED TO CLASSIFY PATIENTS INTO GROUPS OF VARYING ECONOMIC MEANS. THE SCORING TOOL USES ALGORITHMS THAT INCORPORATE DATA FROM CREDIT BUREAUS, DEMOGRAPHIC DATABASES, AND HOSPITAL SPECIFIC DATA TO INFER AND CLASSIFY PATIENTS INTO RESPECTIVE ECONOMIC MEANS CATEGORIES. INDIVIDUALS WHO EARN A CERTAIN SCORE ON THE SCORING TOOL ARE CONSIDERED TO QUALIFY AS ELIGIBLE FOR THE MOST GENEROUS FINANCIAL ASSISTANCE UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. AS DETERMINED BY THE FILING ORGANIZATION, A NOMINAL AMOUNT OF SUCH A PATIENT'S BILL IS WRITTEN OFF AS BAD DEBT EXPENSE, WHILE THE REMAINING PORTION OF THE PATIENT'S BILL IS CONSIDERED NON-STATE CHARITY. THE AMOUNT WRITTEN OFF AS BAD DEBT EXPENSE FOR THOSE PATIENTS WHO POTENTIALLY QUALIFY AS NON-STATE CHARITY USING THE SCORING TOOL IS THE AMOUNT SHOWN ON LINE 3 OF SECTION A OF PART III. RATIONALE FOR INCLUDING CERTAIN BAD DEBTS IN COMMUNITY BENEFIT:THE FILING ORGANIZATION IS DEDICATED TO THE VIEW THAT MEDICALLY NECESSARY HEALTH CARE FOR EMERGENCY AND NON-ELECTIVE PATIENTS SHOULD BE ACCESSIBLE TO ALL, REGARDLESS OF AGE, GENDER, GEOGRAPHIC LOCATION, CULTURAL BACKGROUND, PHYSICIAN MOBILITY, OR ABILITY TO PAY. THE FILING ORGANIZATION TREATS EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF THEIR ABILITY TO PAY OR THE AVAILABILITY OF THIRD-PARTY COVERAGE. BY PROVIDING HEALTH CARE TO ALL WHO REQUIRE EMERGENCY OR NON-ELECTIVE CARE IN A NON-DISCRIMINATORY MANNER, THE FILING ORGANIZATION IS PROVIDING HEALTH CARE TO THE BROAD COMMUNITY IT SERVES. AS A 501(C)(3) HOSPITAL ORGANIZATION, THE FILING ORGANIZATION MAINTAINS 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 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 PAGES 14. PLEASE NOTE THAT DOLLAR AMOUNTS ON THE ATTACHED CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE IN THOUSANDS. PART III, LINE 8: PART III, LINE 5 AND 6:LINES 5 AND 6 OF SECTION B OF SCHEDULE H ARE NOT ABLE TO BE COMPLETED FOR THE SHORT-PERIOD FORM 990 BEGINNING JANUARY 1, 2023 AND ENDING ON JUNE 30, 2023. THE FILING ORGANIZATION FILES IT ANNUAL MEDICARE COST REPORT ON A CALENDAR YEAR BASIS. THE MEDICARE COST REPORT FOR THE YEAR ENDED DECEMBER 31, 2023 IS NOT YET FINALIZED FOR THE FILING ORGANIZATION, AS THE DUE DATE OF THE 2023 MEDICARE COST REPORT IS MAY 31, 2023. THE FILING ORGANIZATION WILL INCLUDE THE 2023 MEDICARE COST REPORT DATA IN ITS FORM 990 FOR THE YEAR BEGINNING JULY 1, 2023 AND ENDING ON JUNE 30, 2024. 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 TAKE ACTIONS TO REPORT ADVERSE INFORMATION TO CREDIT REPORTING AGENCIES/BUREAUS 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 REPORTING TO CONSUMER CREDIT REPORTING AGENCIES/BUREAUS (OR CEASES ANY OTHER 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 SUSPEND ANY ADVERSE REPORTING TO CONSUMER CREDIT REPORTING AGENCIES/BUREAUS UNTIL A FINANCIAL ASSISTANCE POLICY ELIGIBILITY DETERMINATION CAN BE MADE. 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 FACILITIES ARE TRANSPARENT AND AVAILABLE TO ALL INDIVIDUALS SERVED AT ANY POINT IN THE CARE CONTINUUM. THE FAP, FAA FORM, PLS, AND CONTACT INFORMATION FOR EACH HOSPITAL FACILITY'S FINANCIAL COUNSELORS ARE PROMINENTLY AND CONSPICUOUSLY POSTED ON EACH OF THE FILING ORGANIZATION'S HOSPITAL FACILITY'S WEBSITES. THE WEBSITES INDICATE 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 EACH HOSPITAL FACILITY (REFERRED TO BELOW AS LEP DEFINED POPULATIONS). SIGNAGE IS DISPLAYED IN PUBLIC LOCATIONS OF THE FILING ORGANIZATION'S HOSPITAL FACILITIES, INCLUDING AT ALL POINTS OF ADMISSION AND REGISTRATION AND THE EMERGENCY DEPARTMENT. THE SIGNAGE CONTAINS EACH 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 EACH HOSPITAL FACILITY'S FAP, FAA FORM AND PLS. PAPER COPIES OF EACH HOSPITAL FACILITY'S FAP, FAA FORM AND PLS ARE AVAILABLE UPON REQUEST AND WITHOUT CHARGE, BOTH IN PUBLIC LOCATIONS IN EACH 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 FACILITIES' FINANCIAL COUNSELORS SEEK TO PROVIDE PERSONAL FINANCIAL COUNSELING TO ALL INDIVIDUALS ADMITTED TO THE HOSPITAL FACILITY WHO ARE CLASSIFIED AS SELF-PAY DURING THE COURSE OF THEIR HOSPITAL STAY OR AT TIME OF DISCHARGE TO EXPLAIN THE FAP AND FAA FORM AND TO PROVIDE INFORMATION CONCERNING OTHER SOURCES OF ASSISTANCE THAT MAY BE AVAILABLE, SUCH AS MEDICAID. A PAPER COPY OF THE HOSPITAL FACILITY'S PLS WILL BE OFFERED TO EVERY PATIENT AS A PART OF THE INTAKE OR DISCHARGE PROCESS. A CONSPICUOUS WRITTEN NOTICE IS INCLUDED ON ALL BILLING STATEMENTS SENT TO PATIENTS THAT NOTIFIES AND INFORMS RECIPIENTS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, INCLUDING THE FOLLOWING: 1) THE TELEPHONE NUMBER OF THE HOSPITAL FACILITY'S OFFICE OR DEPARTMENT THAT CAN PROVIDE INFORMATION ABOUT THE FAP AND THE FAA FORM; AND 2) THE WEBSITE ADDRESS WHERE COPIES OF THE FAP, FAA FORM AND PLS MAY BE OBTAINED. REASONABLE ATTEMPTS ARE MADE TO INFORM INDIVIDUALS ABOUT THE HOSPITAL FACILITY'S FAP IN ALL ORAL COMMUNICATIONS REGARDING THE AMOUNT DUE FOR THE INDIVIDUAL'S CARE. COPIES OF THE PLS ARE DISTRIBUTED TO MEMBERS OF THE COMMUNITY IN A MANNER REASONABLY CALCULATED TO REACH THOSE MEMBERS OF THE COMMUNITY WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE. PART VI, LINE 4: THE FILING ORGANIZATION CURRENTLY OPERATES 2 HOSPITAL FACILITIES, UCHICAGO MEDICINE ADVENTHEALTH HINSDALE AND UCHICAGO MEDICINE ADVENTHEALTH LA GRANGE. BOTH LOCATED IN ILLINOIS, THESE FACILITIES ARE MAJOR HEALTHCARE PROVIDERS IN THE COMMUNITIES THEY SERVE. ADVENTIST MIDWEST HEALTH, DBA UCHICAGO MEDICINE ADVENTHEALTH HINSDALE:UCHICAGO MEDICINE ADVENTHEALTH HINSDALE (AHH), IS LOCATED IN HINSDALE, ILLINOIS. IT CURRENTLY OPERATES A HOSPITAL FACILITY AND IS LICENSED FOR 261 BEDS. IN ADDITION TO OPERATING A HOSPITAL, AHH ALSO OPERATES A CANCER TREATMENT CENTER, 3 IMAGING CENTERS, 7 OUTPATIENT REHABILITATION FACILITIES, 1 BEHAVIORAL HEALTH CENTER, 1 VASCULAR INTERVENTION CENTER, AND 2 FAMILY HEALTH MEDICINE CENTERS. THE AHH COMMUNITY CONSISTS PRIMARILY OF HINSDALE AND THE SURROUNDING AREA. THE AHH PRIMARY SERVICE AREA IS DEFINED AS THE AREA WHICH 75%-80% OF ITS PATIENT POPULATION LIVES. THIS INCLUDES 39 ZIP CODES ACROSS MAINLY DUPAGE COUNTY AND SMALLER AREAS IN WILL, KENDALL, AND COOK COUNTIES. DURING 01/01/2023 - 06/30/2023, THE PATIENT PERCENTAGE POPULATION FOR AHH WAS MADE UP OF THE BELOW PAYORS WITH THE REMAINING PERCENTAGE OF THE PATIENTS BEING COVERED UNDER COMMERCIAL INSURANCE. DURING 1/01/2023 - 06/30/2023, ABOUT 61.9% OF THE HOSPITAL'S IN-PATIENTS WERE ADMITTED THROUGH THE HOSPITAL'S EMERGENCY DEPARTMENT. - MEDICARE PATIENTS 46.2% - MEDICAID PATIENTS 12.8% - SELF-PAY PATIENTS 0.8% THE DEMOGRAPHIC MAKEUP OF THE HOSPITAL'S COMMUNITY IS AS FOLLOWS: - POPULATION 1,176,776 - POPULATION OVER 65 15.2% - POVERTY (BELOW 100% FPL) 8.0% - HIGH SCHOOL GRADUATION RATE 89.5% - UNINSURED ADULTS 7.1% - FOOD INSECURITY RATE 10.4% - POP. WITH LOW FOOD ACCESS 60.0% ADVENTIST MIDWEST HEALTH, DBA UCHICAGO MEDICINE ADVENTHEALTH LA GRANGE:UCHICAGO MEDICINE ADVENTHEALTH LA GRANGE (AHLG) IS A 177-BED FACILITY PROVIDING OUTPATIENT AND INPATIENT PRIMARY CARE, TRAUMA CARE AND WELLNESS SERVICES TO RESIDENTS OF CHICAGO'S WESTERN SUBURBS. THE HOSPITAL IS A LEADER IN OFFERING COMPREHENSIVE ONCOLOGY SERVICES, ORTHOPEDIC SERVICES, ADVANCED CARDIAC CARE, WOMEN'S HEALTH AND MATERNITY CARE, EMERGENCY, GERIATRIC AND MANY OTHER SPECIALTIES THAT CATER TO THE COMMUNITIES IT SERVES. THE AHLG COMMUNITY CONSISTS PRIMARILY OF LA GRANGE AND THE SURROUNDING AREA. THE AHLG PRIMARY SERVICE AREA IS DEFINED AS THE AREA WHICH 75%-80% OF ITS PATIENT POPULATION LIVES. THIS INCLUDES 21 ZIP CODES ACROSS COOK AND DUPAGE COUNTIES. DURING 01/01/2023 - 06/30/2023, THE PATIENT PERCENTAGE POPULATION FOR AHLG WAS MADE UP OF THE BELOW PAYORS WITH THE REMAINING PERCENTAGE OF THE PATIENTS BEING COVERED UNDER COMMERCIAL INSURANCE. DURING 01/01/2023 - 06/30/2023, ABOUT 82.4% OF THE HOSPITAL'S IN-PATIENTS WERE ADMITTED THROUGH THE HOSPITAL'S EMERGENCY DEPARTMENT. - MEDICARE PATIENTS 59.2% - MEDICAID PATIENTS 11.6% - SELF-PAY PATIENTS 1.0% THE DEMOGRAPHIC MAKEUP OF THE HOSPITAL'S COMMUNITY IS AS FOLLOWS: - POPULATION 528,987 - POPULATION OVER 65 15.0% - POVERTY (BELOW 100% FPL) 9.4% - HIGH SCHOOL GRADUATION RATE 85.5% - UNINSURED ADULTS 9.1% - FOOD INSECURITY RATE 11.2% - POP. WITH LOW FOOD ACCESS 46.1% PART VI, LINE 5: THE PROVISION OF COMMUNITY BENEFIT IS CENTRAL TO THE FILING ORGANIZATION'S MISSION OF SERVICE AND COMPASSION. RESTORING AND PROMOTING THE HEALTH AND QUALITY OF LIFE OF THOSE IN THE COMMUNITIES SERVED BY THE FILING ORGANIZATION IS A FUNCTION OF "EXTENDING THE HEALING MINISTRY OF CHRIST AND EMBODIES THE FILING ORGANIZATION'S COMMITMENT TO ITS VALUES AND PRINCIPLES. THE FILING ORGANIZATION 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 FILING ORGANIZATION CAPTURES AND REPORTS THE BENEFITS PROVIDED TO ITS COMMUNITY THROUGH FAITH-BASED CARE. EXAMPLES OF SUCH BENEFITS INCLUDE THE COST ASSOCIATED WITH CHAPLAINCY CARE PROGRAMS AND MISSION PEER REVIEWS AND MISSION CONFERENCES. THE FILING ORGANIZATION 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. AS FAITH-BASED MISSION-DRIVEN COMMUNITY HOSPITALS, THE FILING ORGANIZATION IS CONTINUALLY INVOLVED IN MONITORING ITS COMMUNITIES, 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 FILING ORGANIZATION ARE CONTINUALLY BEING INVESTED IN RESOURCES THAT IMPROVE THE AVAILABILITY AND QUALITY OF DELIVERY OF HEALTH CARE SERVICES AND PROGRAMS TO ITS COMMUNITIES. PART VI, LINE 6: AS EXPLAINED IN OUR RESPONSE TO FORM 990, PART VI, SECTION A, LINE 6, THE FILING ORGANIZATION HAS TWO MEMBERS. THE MEMBERS ARE THE UNIVERSITY OF CHICAGO MEDICAL CENTER AND ADVENTIST HEALTH SYSTEM/SUNBELT, INC. (AHSSI). AHSSI IS A WHOLLY-OWNED SUBSIDIARY OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION. THE FILING ORGANIZATION CAN DRAW UPON THE EXPERTISE AND LEADERSHIP OF BOTH ITS HEALTH SYSTEM MEMBERS IN ITS EFFORT TO CREATE EXCELLENT PATIENT EXPERIENCES AND OFFER A BROAD SPECTRUM OF HEALTH SERVICES NEEDED IN THE COMMUNITY. DURING ITS CURRENT TAX YEAR, THE FILING ORGANIZATION WAS MANAGED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). AHSSHC IS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). AHSSHC AND ITS SUBSIDIARY ORGANIZATIONS OPERATE 50 HOSPITALS THROUGHOUT THE U.S., PRIMARILY IN THE SOUTHEASTERN PORTION OF THE U.S. AHSSHC AND ITS SUBSIDIARIES ALSO OPERATE OTHER ANCILLARY HEALTH CARE PROVIDER FACILITIES, SUCH AS AMBULATORY SURGERY CENTERS AND DIAGNOSTIC IMAGING CENTERS. AHSSHC (MANAGER) PROVIDES MANAGEMENT SERVICES TO THE FILING ORGANIZATION PURSUANT TO A MASTER MANAGEMENT SERVICES AGREEMENT. MANAGEMENT SERVICES PROVIDED INCLUDE THE PROVISION AND LEASING OF PERSONNEL, AND DAY-TO-DAY MANAGEMENT OF THE BUSINESS AFFAIRS AND OPERATIONS OF THE FILING ORGANIZATION'S HOSPITAL FACILITY, INCLUDING REVENUE CYCLE SUPPORT, FINANCIAL OPERATIONS SUPPORT, CLINICAL PROTOCOLS, ACCREDITATION AND CONDITIONS OF PARTICIPATION COMPLIANCE, AND A COMPLIANCE PROGRAM. THE MANAGER ALSO PROVIDES DEVELOPMENT AND FACILITY MANAGEMENT, FINANCE AND ACCOUNTING SERVICES, HUMAN RESOURCES, INTERNAL AUDIT, LEGAL, GOVERNMENT RELATIONS, PURCHASING/MATERIALS MANAGEMENT, INFORMATION, MEDICAL AND PROFESSIONAL MATTERS, AND REGULATORY SERVICES. THE READER OF THIS FORM 990 SHOULD KEEP IN MIND THAT THIS REPORTING ENTITY MAY DIFFER IN CERTAIN AREAS FROM THAT OF A STAND-ALONE HOSPITAL ORGANIZATION DUE TO ITS INCLUSION IN A LARGER SYSTEM OF HEALTHCARE ORGANIZATIONS. AS A PART OF A SYSTEM OF HOSPITAL AND OTHER HEALTH CARE ORGANIZATIONS, THE FILING ORGANIZATION BENEFITS FROM REDUCED COSTS DUE TO SYSTEM EFFICIENCIES, SUCH AS LARGE GROUP PURCHASING DISCOUNTS, AND THE AVAILABILITY OF INTERNAL RESOURCES SUCH AS INTERNAL LEGAL COUNSEL. THE FILING ORGANIZATION PAYS A MANAGEMENT FEE TO AHSSHC FOR THE SERVICES PROVIDED BY AHSSHC. AS A RESULT, MANAGEMENT FEE EXPENSE REPORTED BY THE FILING ORGANIZATION MAY APPEAR GREATER IN RELATION TO MANAGEMENT FEE EXPENSE THAT MAY BE REPORTED BY A SINGLE STAND-ALONE HOSPITAL. THE SINGLE STAND-ALONE HOSPITAL WOULD LIKELY REPORT COSTS ASSOCIATED WITH MANAGEMENT AND OTHER PROFESSIONAL SERVICES ON VARIOUS EXPENSE LINE ITEMS IN ITS STATEMENT OF REVENUE AND EXPENSE AS OPPOSED TO REPORTING SUCH COSTS IN ONE OVERALL MANAGEMENT FEE EXPENSE. AS THE REPORTING OF THE FORM 990 IS DONE ON AN ENTITY BY ENTITY BASIS, THERE IS NO SINGLE FORM 990 THAT CAPTURES THE PROGRAMS AND OPERATIONS OF ADVENTHEALTH OR THE UNIVERSITY OF CHICAGO MEDICAL CENTER AS A WHOLE. THE READER IS DIRECTED TO VISIT THE WEBSITE AT WWW.UCHICAGOMEDICINEADVENTHEALTH.ORG TO LEARN MORE ABOUT THE MISSION AND OPERATIONS OF THE FILING ORGANIZATION. PART VI, LINE 7, REPORTS FILED WITH STATES IL 1 DUPAGE HEALTH COALITION 511 THORNHILL DRIVE STE E CAROL STREAM IL 60188 364448208 501(C)(3) 22613 0 GENERAL SUPPORT HINSDALE ADVENTIST ACADEMY 631 E HICKORY STREET HINSDALE IL 60521 364090219 501(C)(3) 25000 0 GENERAL SUPPORT MIDWEST HEALTH FOUNDATION 120 N OAK STREET HINSDALE IL 60521 352230515 501(C)(3) 0 397754 COST GENERAL ADMINISTRATIVE SUPPORT PROVISION OF GENERAL ADMINISTRATIVE SUPPORT ILLINOIS CONFERENCE OF SEVENTH-DAY ADVENTISTS 619 PLAINFIELD ROAD WILLOWBROOK IL 60527 237311734 501(C)(3) 7375 0 GENERAL SUPPORT ROTARY CLUB OF HINSDALE FOUNDATION INC PO BOX 395 HINSDALE IL 60522 364285727 501(C)(3) 15000 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 501(C)(3), 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, OR TO OTHER 501(C)(3) COMMUNITY ORGANIZATIONS INVOLVED IN HEALTH-RELATED CAUSES. 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. PART V, LINE 1A: EFFECTIVE JANUARY 1, 2023, THE FILING ORGANIZATION ENTERED INTO A MASTER MANAGEMENT AGREEMENT WITH ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). AHSSHC IS A FLORIDA, NOT-FOR-PROFIT CORPORATION THAT IS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3). AHSSHC HAS ESTABLISHED A SHARED SERVICE CENTER TO CENTRALIZE THE ACCOUNTS PAYABLE (A/P) FUNCTION FOR ALL AHSSHC SUBSIDIARY ORGANIZATIONS. THE FILING ORGANIZATION HAS ENTERED "0" IN PART V, LINE 1A BECAUSE THE FILING ORGANIZATION NO LONGER ISSUES FORM 1099 RETURNS, RATHER, ALL SUCH RETURNS ARE FILED BY AND UNDER THE NAME AND EIN OF AHSSHC AS THE PAYOR SUBJECT TO THE INFORMATION REPORTING REQUIREMENTS OF SECTION 6041. THE FACTS AND CIRCUMSTANCES SUPPORT A POSITION THAT AHSSHC, AS A PAYOR ON BEHALF OF ITS SUBSIDIARY ORGANIZATIONS IN A SHARED SERVICE ENVIRONMENT, WILL HAVE SUFFICIENT MANAGEMENT AND OVERSIGHT IN CONNECTION WITH THE SUBSIDIARY ORGANIZATIONS' PAYMENTS TO MEET THE STANDARD SET FORTH IN TREAS. REG. SECTION 1.6041-1(E). AHSSHC WILL NOT MERELY BE MAKING PAYMENTS AT THE DIRECTION OF ITS SUBSIDIARY ORGANIZATIONS. ACCORDINGLY, AHSSHC IS CONSIDERED THE PAYOR SUBJECT TO THE INFORMATION REPORTING REQUIREMENTS OF SECTION 6041. FORM 990, PART VI, SECTION A, LINE 1A THE MEMBERS OF THE BOARD OF DIRECTORS LISTED ON PART VII OF THIS FORM 990 INCLUDE THE FILING ORGANIZATION'S GOVERNING BOARD AND THE MEMBERS OF THE FILING ORGANIZATION'S HOSPITAL BOARD. THE HOSPITAL BOARD IS PRIMARILY RESPONSIBLE FOR MATTERS RELATED TO THE DAY-TO-DAY OPERATIONS OF THE HOSPITAL FACILITY, INCLUDING HOSPITAL-BASED HOME HEALTH CARE AND HOSPITAL-BASED HOSPICE SERVICES, ENSURING THAT THE HOSPITAL(S) FUNCTION IN ACCORDANCE WITH ALL APPLICABLE LAWS, REGULATIONS, AND ACCREDITING BODY STANDARDS, STRATEGY, GENERAL OPERATIONS, MEDICAL STAFF MATTERS, SAFETY, QUALITY AND EDUCATION MATTERS, AND COMMUNITY BENEFIT MATTERS. FORM 990, PART VI, SECTION A, LINE 3 EFFECTIVE JANUARY 1, 2023, THE FILING ORGANIZATION ENTERED INTO A MASTER MANAGEMENT AGREEMENT WITH ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). AHSSHC IS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND SERVES AS THE PARENT ORGANIZATION TO A HEALTH CARE SYSTEM THAT OPERATES 50 HOSPITALS IN THE U.S. ADVENTIST HEALTH SYSTEM/SUNBELT, INC., A DIRECT 501(C)(3) SUBSIDIARY OF AHSSHC, HOLDS A 49% MEMBER INTEREST IN THE FILING ORGANIZATION. UNDER THE MASTER MANAGEMENT AGREEMENT, AHSSHC PROVIDES GENERAL MANAGEMENT OF THE DAY-TO-DAY OPERATIONS OF THE FILING ORGANIZATION'S HOSPITAL FACILITIES, THE HOSPITAL FACILITIES OF THE FILING ORGANIZATION'S TWO SUBSIDIARY HOSPITAL ENTITIES, AND THE SUBSIDIARY PHYSICIAN CLINIC ENTITIES. MANAGEMENT SERVICES MUST BE PROVIDED IN A MANNER THAT IS CONSISTENT WITH THE TENETS OF THE SEVENTH-DAY ADVENTIST CHURCH AND UNDER THE DIRECTION OF THE FILING ORGANIZATION'S GOVERNING BODY. MANAGERIAL SERVICES PROVIDED UNDER THE MASTER MANAGEMENT AGREEMENT INCLUDE THE FOLLOWING: PROVISION OF ALL C-SUITE PERSONNEL; PROVISION OF ALL PERSONNEL NECESSARY FOR OPERATIONS OF THE HOSPITAL; MANAGEMENT OVERSIGHT; OPERATIONS SUPPORT, INCLUDING REVENUE CYCLE, FINANCIAL OPERATIONS, CLINICAL PROTOCOLS, ACCREDITING, AND COMPLIANCE; DEVELOPMENT AND FACILITY MANAGEMENT, INCLUDING STRATEGIC PLANNING, MANAGED CARE, REAL ESTATE, AND CONSTRUCTION AND EQUIPMENT PLANNING; FINANCE AND ACCOUNTING, INCLUDING BUDGET DEVELOPMENT, TREASURY, TAX, ACCOUNTING, INSURANCE AND PAYMENT OF EXPENSES; HUMAN RESOURCES; INTERNAL AUDIT; LEGAL SERVICES; GOVERNMENT RELATIONS; PURCHASING/MATERIALS MANAGEMENT; INFORMATION SERVICES; MEDICAL AND PROFESSIONAL MATTERS; AND REGULATORY ISSUES. FORM 990, PART VI, SECTION A, LINE 6 THE ARTICLES OF INCORPORATION OF THE FILING ORGANIZATION PROVIDE THAT 51% OF THE MEMBERSHIP IN THE FILING ORGANIZATION SHALL BE HELD BY THE UNIVERSITY OF CHICAGO MEDICAL CENTER (UCMC), THE SOLE CLASS A MEMBER, AND 49% OF THE MEMBERSHIP IN THE FILING ORGANIZATION SHALL BE HELD BY ADVENTIST HEALTH SYSTEM/SUNBELT, INC. (AHSSI), THE SOLE CLASS B MEMBER. BOTH UCMC AND AHSSI ARE EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THERE ARE NO OTHER CLASSES OF MEMBERSHIP IN THE FILING ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION IS COMPRISED OF EIGHT DIRECTORS. FOUR DIRECTORS ARE APPOINTED BY THE SOLE CLASS A MEMBER, THE UNIVERSITY OF CHICAGO MEDICAL CENTER, AND FOUR DIRECTORS AS APPOINTED BY THE SOLE CLASS B MEMBER, ADVENTIST HEALTH SYSTEM/SUNBELT, INC. THE MEMBERS APPOINT THE MEMBERS OF THE HOSPITAL BOARD WHICH SHALL CONSIST OF NOT LESS THAN 18 AND NO MORE THAN 23 INDIVIDUALS, AT LEAST 2 OF WHOM SHALL AT ALL TIMES BE APPOINTEES OF THE CLASS A MEMBER. FORM 990, PART VI, SECTION A, LINE 7B CERTAIN GOVERNANCE POWERS ARE RESERVED TO THE MEMBERS OF THE FILING ORGANIZATION. CERTAIN RESERVED MATTERS REQUIRE THE AFFIRMATIVE APPROVAL OF THE UNIVERSITY OF CHICAGO MEDICAL CENTER, THE CLASS A MEMBER, AND CERTAIN MATTERS REQUIRE THE AFFIRMATIVE APPROVAL OF ADVENTIST HEALTH SYSTEM/SUNBELT, INC., THE CLASS B MEMBER. MATTERS REQUIRING AFFIRMATIVE APPROVAL OF THE CLASS A MEMBER: - APPOINTMENT AND COMPENSATION OF AN INDIVIDUAL PROPOSED BY ADVENTHEALTH TO HOLD THE OFFICE OF PRESIDENT/CHIEF EXECUTIVE OFFICER OF THE FILING ORGANIZATION AND THE TERMINATION OF SUCH APPOINTMENT, EXCEPT FOR TERMINATIONS BY THE CLASS B MEMBER AS OUTLINED IN THE REVISED BYLAWS; - THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE FILING ORGANIZATION AND ALL UNBUDGETED EXPENDITURES INDIVIDUALLY OR IN THE AGGREGATE OF RELATED ITEMS OF MORE THAN $5,000,000, CONTRACTUAL OBLIGATIONS IN EXCESS OF $5,000,000, AND THE FINANCIAL STATEMENTS OF THE FILING ORGANIZATION; - THE STRATEGIC AND OPERATING PLANS OF THE FILING ORGANIZATION; - THE SELECTION, REMOVAL AND/OR MODIFICATION OF THE AUTHORITY AND RESPONSIBILITIES OF ACCOUNTANTS AND AUDITORS; - ANY INDEBTEDNESS OR CAPITAL LEASE OF MORE THAN $5,000,000 ON THE BALANCE SHEET OF THE FILING ORGANIZATION AND ITS SUBSIDIARIES; - THE APPROVAL OR AMENDMENT OF MANAGED CARE PRICING, PRICING STRATEGIES, AND CONTRACTING PARAMETERS FOR THOSE MANAGED CARE CONTRACTS TO WHICH THE FILING ORGANIZATION IS A PARTICIPATING PROVIDER; AND - THE CONFESSION OF A JUDGMENT OR SETTLEMENT OF A CLAIM THAT WOULD EXCEED INSURANCE LIMITS. MATTERS REQUIRING AFFIRMATIVE APPROVAL OF THE CLASS B MEMBER: - CHANGES TO THE RELIGIOUS AFFILIATION OF ANY FACILITY OWNED BY THE FILING ORGANIZATION; - CHANGES TO OPERATIONAL POLICIES, PLANS, AND PROCEDURES THAT ARE SPECIFICALLY RELATED TO A FACILITY'S RELIGIOUS AFFILIATION WITH THE SEVENTH-DAY ADVENTIST CHURCH; - THE TERMINATION OF THE PRESIDENT/CEO IF TERMINATION IS RELATED TO THAT PERSON'S MEMBERSHIP IN THE SEVENTH-DAY ADVENTIST CHURCH; - THE SELECTION, REMOVAL, OR MODIFICATION OF THE AUTHORITY AND RESPONSIBILITIES OF ACCOUNTANTS AND AUDITORS; AND - CHANGES TO THE MISSION, VISION, OR VALUES OF THE FILING ORGANIZATION. MATTERS REQUIRING AFFIRMATIVE APPROVAL OF THE CLASS A MEMBER AND THE CLASS B MEMBER: - AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS OR THE GOVERNING DOCUMENTS OF THE ADVENTIST MIDWEST HEALTH SUBSIDIARIES; - THE FORMATION OF ANY SUBSIDIARY OF THE FILING ORGANIZATION; - ENTERING INTO ANY AFFILIATION AGREEMENT OR JOINT VENTURE AGREEMENT; - ANY CHANGE IN THE NAME OR BRANDING OF THE HOSPITAL; - THE ADDITION OF NEW MEMBERS OF THE FILING ORGANIZATION; - THE APPOINTMENT AND REMOVAL OF ANY MEMBER OF THE HOSPITAL BOARD; - DISTRIBUTIONS OF CASH AND OTHER PROPERTY TO THE MEMBERS OR OTHERWISE; - ANY AGREEMENT OR ARRANGEMENT BETWEEN THE FILING ORGANIZATION AND/OR ITS SUBSIDIARIES AND A MEMBER OR MEMBER AFFILIATE INCLUDING THE MANAGEMENT SERVICES AGREEMENT, THE ADMINISTRATIVE SERVICES AGREEMENT, AND THE CLINICAL AFFILIATION AGREEMENT; - TERMINATION OF ANY RELATED PARTY AGREEMENT; - THE ADOPTION AND AMENDMENT OF THE QUALITY AND/OR RISK MANAGEMENT PLANS OF THE HOSPITALS; - THE SELECTION OF THE ACCREDITING BODY OF THE HOSPITALS; - THE TRANSFER OF ANY PROPERTY OF THE HOSPITALS IN EXCESS OF $1 MILLION DOLLARS; - ANY SALE, LEASE, TRANSFER, MERGER OR CONSOLIDATION OF THE FILING ORGANIZATION; - THE DISSOLUTION OF THE FILING ORGANIZATION; - THE FILING OF ANY VOLUNTARY PETITION IN BANKRUPTCY; - REQUIRING ANY ADDITIONAL CAPITAL CONTRIBUTIONS FROM THE MEMBER; AND - THE APPOINTMENT OR REMOVAL OF THE BOARD CHAIR AND ANY OF THE OTHER BOARD OFFICERS. FORM 990, PART VI, SECTION B, LINE 11B THE FILING ORGANIZATION'S CURRENT YEAR FORM 990 WAS REVIEWED BY THE BOARD CHAIRMAN, BOARD FINANCE COMMITTEE CHAIR, CEO, CFO AND MEMBERS OF THE UCHICAGO MEDICINE FINANCE LEADERSHIP TEAM PRIOR TO ITS FILING WITH THE IRS. THE REVIEW CONDUCTED BY THE BOARD CHAIRMAN, BOARD FINANCE COMMITTEE CHAIR, CEO, CFO AND MEMBERS OF THE UCHICAGO MEDICINE FINANCE LEADERSHIP TEAM DID NOT INCLUDE THE REVIEW OF ANY SUPPORTING WORKPAPERS THAT WERE USED IN PREPARATION OF THE CURRENT YEAR FORM 990, BUT DID INCLUDE A REVIEW OF THE ENTIRE FORM 990 AND ALL SUPPORTING SCHEDULES. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY OF THE FILING ORGANIZATION APPLIES TO MEMBERS OF ITS BOARD OF DIRECTORS AND ITS PRINCIPAL OFFICERS (TO BE KNOWN AS INTERESTED PERSONS). IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTERESTS, ANY MEMBER OF THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION OR ANY PRINCIPAL OFFICER OF THE FILING ORGANIZATION (I.E. INTERESTED PERSONS) MUST DISCLOSE THE EXISTENCE OF ANY FINANCIAL INTEREST WITH THE FILING ORGANIZATION AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS CONCERNING THE FINANCIAL INTEREST/ARRANGEMENT TO THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION OR TO ANY MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS THAT IS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. SUBSEQUENT TO ANY DISCLOSURE OF ANY FINANCIAL INTEREST/ARRANGEMENT AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE RELEVANT BOARD MEMBER OR PRINCIPAL OFFICER, THE REMAINING MEMBERS OF THE BOARD OF DIRECTORS OR COMMITTEE WITH BOARD DELEGATED POWERS SHALL DISCUSS, ANALYZE, AND VOTE UPON THE POTENTIAL FINANCIAL INTEREST/ARRANGEMENT TO DETERMINE IF A CONFLICT OF INTEREST EXISTS. ACCORDING TO THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY, AN INTERESTED PERSON MAY MAKE A PRESENTATION TO THE BOARD OF DIRECTORS (OR COMMITTEE WITH BOARD DELEGATED POWERS), BUT AFTER SUCH PRESENTATION, SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN A CONFLICT OF INTEREST. EACH INTERESTED PERSON, AS DEFINED UNDER THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY, SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE FILING ORGANIZATION IS A CHARITABLE ORGANIZATION THAT MUST PRIMARILY ENGAGE IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS EXEMPT PURPOSES. THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY ALSO REQUIRES THAT PERIODIC REVIEWS SHALL BE CONDUCTED TO ENSURE THAT THE FILING ORGANIZATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES. FORM 990, PART VI, SECTION B, LINE 15 THE INDIVIDUAL WHO SERVES AS THE CEO OF THE FILING ORGANIZATION IS APPOINTED AND COMPENSATED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC) AN UNRELATED ENTITY AS DISCLOSED IN OUR RESPONSE TO FORM 990, PART VI, SECTION A, LINE 3. 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. FORM 990, PART VI, SECTION C, LINE 19 THE FINANCIAL STATEMENTS OF THE FILING ORGANIZATION, ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT GENERALLY MADE AVAILABLE TO THE PUBLIC AS A WHOLE. FORM 990, PART VIII, LINES 7A, B AND C: THE AMOUNTS SHOWN IN PART VIII, LINES 7A(I), 7B(I) AND 7C(I) OF THE FORM 990 REPRESENT AN ALLOCATED SHARE OF CAPITAL GAIN/(LOSS) FROM A CENTRAL INVESTMENT PROGRAM MAINTAINED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION, ONE OF THE FILING ORGANIZATION'S TOP TIER PARENTS. FORM 990, PART IX, LINE 11G PAYMENTS TO HEALTHCARE PROFESSIONALS: PROGRAM SERVICE EXPENSES 35,228,719. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 35,228,719. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,425,814. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,425,814. PURCHASED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 8,290,923. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,290,923. ENVIRONMENTAL SERVICES: PROGRAM SERVICE EXPENSES 4,676,468. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,676,468. TRANSCRIPTION SERVICES: PROGRAM SERVICE EXPENSES 13,241. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,241. RECRUITING: PROGRAM SERVICE EXPENSES 1,994. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,994. FOOD SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 4,727,900. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,727,900. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 10,592,169. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,592,169. ADVENTHEALTH MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 3,178,683. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,178,683. AH SHARED SERVICES FEE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,366,179. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,366,179. PART X, LINE 2: THE AMOUNTS SHOWN ON LINE 2 OF PART X OF THIS RETURN INCLUDE THE FILING ORGANIZATION'S INTEREST IN A CENTRAL INVESTMENT POOL MAINTAINED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION, ONE OF THE FILING ORGANIZATION'S TOP-TIER PARENTS. THE INVESTMENTS IN THE CENTRAL INVESTMENT POOL ARE RECORDED AT MARKET VALUE. FORM 990, PART XI, LINE 9: NET CHANGE IN INTEREST IN FOUNDATION -92,023. OTHER 47,961. GIFTS 245,974. CASH FROM TAX-EXEMPT PARENTS 150,000,000. CASH TRANSFERS TO TAX-EXEMPT SUBS -84,043,888. INTERCOMPANY ACCOUNT ADJUSTMENTS -85,176,051. TRANSITION SERVICES AGREEMENT COSTS -2,098,403. PREPAID INTERCOMPANY IT COSTS -1,254,064. RETAINAGE COSTS FOR CIP -28,643. ROUNDING 3. AMH GI ASC LLC 120 N OAK STREET HINSDALE IL 60521 INACTIVE IL 0 0 ADVENTIST MIDWEST HEALTH ADVENTIST BOLINGBROOK HOSPITAL 500 REMINGTON BLVD BOLINGBROOK IL 60440 651219504 OPERATION OF HOSPITAL & RELATED SERVICES IL 501(C)(3) LINE 3 ADVENTIST MIDWEST HEALTH 1 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 1 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 ADVENTIST MIDWEST HEALTH 1 ADVENTIST MIDWEST HEALTH 120 NORTH OAK STREET HINSDALE IL 60521 362276984 OPERATION OF HOSPITALS & RELATED SERVICES IL 501(C)(3) LINE 3 N/A 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 ADVENTIST MIDWEST HEALTH 1 HINSDALE HOSPITAL FOUNDATION 120 NORTH OAK STREET HINSDALE IL 60521 521466387 FUND-RAISING FOR SUPPORTED EXEMPT HOSPITALS IL 501(C)(3) LINE 7 MIDWEST HLTH FOUNDATION 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 AHS MIDWEST MANAGEMENT INC 500 REMINGTON BOULEVARD BOLINGBROOK IL 60440 363354567 EMPLOYEE LEASING IL 501(C)(3) LINE 12C, III-FI ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 ADVENTIST BOLINGBROOK HOSPITAL Q 51183 COST ADVENTIST BOLINGBROOK HOSPITAL P 8150753 COST ADVENTIST GLENOAKS HOSPITAL P 7371830 COST ADVENTIST HEALTH PARTNERS INC P 5276765 COST HINSDALE HOSPITAL FOUNDATION C 134567 ACTUAL AMOUNT RECEIVED MIDWEST HEALTH FOUNDATION B 397754 ACTUAL AMOUNT GIVEN ADVENTIST BOLINGBROOK HOSPITAL R 40638498 ACTUAL AMOUNT GIVEN ADVENTIST GLENOAKS HOSPITAL R 21202695 ACTUAL AMOUNT GIVEN ADVENTIST HEALTH PARTNERS INC R 22202695 ACTUAL AMOUNT GIVEN SCHEDULE R, PART VII: EFFECTIVE JANUARY 1, 2023, THE UNIVERSITY OF CHICAGO MEDICAL CENTER (UCMC) AND ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC) AND ITS WHOLLY-OWNED SUBSIDIARY, ADVENTIST HEALTH SYSTEM/SUNBELT, INC. (AHSSI), ENTERED INTO AN AFFILIATION AGREEMENT (THE AFFILIATION) WHEREBY AHSSI SOLD 51% OF ITS MEMBERSHIP INTEREST IN ADVENTIST MIDWEST HEALTH (AMH) TO UCMC. UCMC, AHSSHC, AHSSI, AND AMH ARE ALL RECOGNIZED AS TAX-EXEMPT ORGANIZATIONS UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). AHSSHC, AHSSI, AND AMH ARE PART OF THE HEALTHCARE SYSTEM KNOWN AS ADVENTHEALTH (AH). THE AFFILIATION BETWEEN UCMC AND AH COMBINES THE EXPERTISE AND RESOURCES OF BOTH ORGANIZATIONS. ALTHOUGH NEITHER UCMC OR AH HAVE CONTROL OVER THE FILING ORGANIZATION AS DEFINED FOR PURPOSES OF SCHEDULE R, THE AFFILIATION BETWEEN THESE TWO HEALTHCARE SYSTEMS IS SIGNIFICANT AND WILL BUILD UPON THE COMPLEMENTARY STRENGTHS OF THE TWO ORGANIZATIONS.