SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
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OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
Redmond Park Hospital LLC
 
Employer identification number

58-1123037
Return Reference Explanation
Form 990, Part V, Line 1a: The parent corporation and sole top-tier member of Redmond Park Hospital, LLC (the filing organization) is Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is a Florida, not-for-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). AHSSHC has established a shared service center to centralize the Accounts Payable (A/P) function for all AHSSHC subsidiary organizations. The filing organization has entered "0" in Part V, Line 1a because the filing organization no longer issues Form 1099 returns, rather, all such returns are filed by and under the name and EIN of AHSSHC as the payor subject to the information reporting requirements of Section 6041. The facts and circumstances support a position that AHSSHC, as a payor on behalf of its subsidiary organizations in a shared service environment, will have sufficient management and oversight in connection with the subsidiary organizations' payments to meet the standard set forth in Treas. Reg. Section 1.6041-1(e). AHSSHC will not merely be making payments at the direction of its subsidiary organizations. Accordingly, AHSSHC is considered the payor subject to the information reporting requirements of Section 6041.
Form 990, Part VI, Section A, line 4 Prior to October 1, 2021, Redmond Park Hospital, LLC (the Company or the Hospital) was a disregarded single-member limited liability company of HTI Hospital Holdings, Inc., an entity owned directly or indirectly by HCA Healthcare, Inc. On October 1, 2021, Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), a 501(c)(3) organization, entered into an Equity Interest Purchase Agreement with HTI Hospital Holdings, Inc. whereby AHSSHC acquired an equity interest in Redmond Park Hospital, LLC. Consistent with Revenue Ruling 99-5, the sale of the membership interest in Redmond Park Hospital, LLC by HTI Hospital Holdings, Inc. is treated as an asset sale for federal income tax purposes. The governing documents of Redmond Park Hospital, LLC were amended and restated effective October 1, 2021 to provide that the assets and operations of Redmond Park Hospital, LLC were converted to be consistent with classifying the Company as a 501(c)(3) organization. The Company derives its federal income tax exemption under Internal Revenue Code (IRC) Section 501(c)(3) as a subordinate organization under the group ruling issued to the General Conference of Seventh-day Adventists. The sole member of the Company is AHSSHC, which is the charitable organization parent to the healthcare system known as AdventHealth. Since October 1, 2021, the Company has been operated as an affiliated entity of AdventHealth and its health care operations are part of the system of medical institutions operated in furtherance of the health ministry of the Seventh-day Adventist Church. Article Three of the Company's Restated Articles of Incorporation states that the Articles of Incorporation of the Company were restated effective October 1, 2021. Revised Article Four of the Restated Articles addresses the Management of the Company to provide that the management of the Company is vested in a Board of Managers appointed by AHSSHC, the sole member of the Company. The number of the Board of Managers shall not be less than three. Qualifications for individuals serving on the Board of Managers state that such individuals must be more than 18 years of age, demonstrate an interest in health care matters, and support the Mission and Values of the Company. No less than a majority of the individuals appointed to the Board of Managers shall be members of the Seventh-day Adventist Church. The Officers of the Company shall include a Chair, President, Treasurer, Secretary and one or more Assistant Secretaries. Each Officer shall serve until his or her replacement is appointed or otherwise resigns or is removed by the Member. At the election of the Member, the Member may also appoint three or more individuals to serve as the governing body of the Hospital (the Hospital Operating Board). Such a governing body shall adopt rules consistent with the governing documents of the Company. An Article Five was added to the Restated Articles to provide that the Company is organized solely for scientific, educational, and charitable purposes within the meaning of IRC Section 501(c)(3). Article Six states that the primary purpose of the Company is to own and operate a general acute-care hospital in Rome, GA in support of the system of medical institutions operated in furtherance of the health ministry of the Seventh-day Adventist Church. Additional powers of the Company include the ability to accept, hold, administer, invest and disburse for charitable purposes funds or property given to or earned by it, acquire and develop property, carry on educational activities related to the promotion of health, support scientific research related to health care, and participate in any activity designed to promote the health of the general community served by the Company. Article Seven states that AHSSHC shall be the sole member of the Company. Article Eight was added to the Restated Articles to prohibit the net earnings of the Company from inuring to the benefit of private persons, to prohibit the participation or intervention in any political campaign activities, provide that no substantial part of the activities of the Company shall consist of activities attempting to influence legislation, and to prohibit the Company from carrying on any activities not permitted to be carried on by a limited liability company exempt from federal income tax under Section 501(c)(3). Article Nine was added to provide that upon dissolution of the Company, the assets shall be distributed to the 501(c)(3) Member. Article Ten provides that any amendment to the Company's Articles of Organization and/or Operating Agreement must be approved by the Member. Article Eleven states that the Company adopts AdventHealth's company-wide Conflicts of Interest Policy. The Operating Agreement of the Company was also restated effective October 1, 2021. Article II of the revised Operating Agreement was restated to provide that the Company shall operate in a manner that is supportive of the goals, activities, and policies of the Seventh-day Adventist Church, consistent with its Restated Articles of Organization, and in furtherance of meeting the need of the communities it serves. The purpose and objectives of the Company are to uphold the Company's mission and values as summarized in the Company's mission statement of Extending the Healing Ministry of Christ, and upholding its values of inclusiveness, quality and service excellence, community well-being, high ethical standards, and stewardship. Article III of the revised Operating Agreement provides that AHSSHC shall be the sole member of the Company and may act through its board of directors, a committee authorized by the board, or through an Officer authorized by the Member. Article IV of the revised Operating Agreement provides that the Member shall appoint not less than three individuals to the Board of Managers and that Managers shall be appointed for terms up to one, two, three, or four years. A majority of Managers shall constitute a quorum. Managers shall receive no compensation for their services as Manager. Managers may designate one or more committees including an Executive Committee. The Board of Managers shall exercise control and general management of the affairs and business of the Company other than those powers retained by the Member, specifically including strategy, general operations, medical staff matters, safety, quality and education, and community to include ensuring the Hospital meets all requirements found in IRC Section 501(r). Article V of the revised Operating Agreement addresses Officers of the Company. Officers shall include a Chair, President, Treasurer, Secretary, and one more Assistance Secretaries. Administrative Officers for the Hospital may include a Chief Executive Officer, and one more departmental Senior Vice Presidents, Vice Presidents, and Directors. The Board, in consultation with the Member, shall approve the appointment of the Chief Executive Officer of the Hospital. The Chief Executive Officer shall serve at the pleasure of the Membership. Article VI of the revised Operating Agreement states that the books of the Company may be audited annually by an independent CPA firm. Article VII of the revised Operating Agreement sets forth the reserved powers held by the Member. These reserved powers include the following: a) to approve and disapprove the executive and/or administrative leadership of the filing organization, and their salaries; b) to adopt, amend, restate, and repeal the Articles of Incorporation or Operating Agreement of the filing organization; c) to set limits and terms for the borrowing of funds exceeding $100,000; d) to approve or disapprove the purchase or sale of personal property or real property equal to or in excess of certain dollar amount thresholds; e) to approve or disapprove the annual operating and capital budgets and strategic plans of the filing organization; f) to approve or disapprove capital expenditures in excess of $1,000,000; g) to approve or disapprove performance/quality improvement and case management programs; h) to approve the appointment of an auditing firm and election of the fiscal year for the filing organization; i) to approve or disapprove material changes in services offered by the filing organization; j) the authority to require the filing organization's adherence to policies adopted by the Member: k) the authority to secure naming rights and to direct the placement of funds and capital and the making of gifts, sponsorships, donations, loans and transfers of funds or other assets by the filing organization in excess of $1,000,000; l) to approve or disapprove the sale, purchase, donation, or other conveyance of personal property with a value in excess of $1,000,000 not otherwise approved in the current capital or operating budgets;
Form 990, Part VI, Section A, line 4 (Continued) m) to approve or disapprove the implementation of non-traditional, non-healthcare related activities; n) to approve or disapprove the selection of the filing organization's group purchasing organization(s); o) to approve or disapprove any joint venture or partnership in which the filing organization would be a member or partner; p) to approve the IT systems used by the filing organization; q) the authority to require the filing organization's adherence to the system-wide naming nomenclature adopted by the Member; and r) to set and enforce policies for physician compensation, including commercial reasonableness and fair market value. The Member shall also retain the authority and responsibility for compliance and establishing a compliance program addressing federal, state, and local regulatory matters. Article VIII of the revised Operating Agreement outlines the duties and responsibilities of the Chief Executive Officer. Article VIII also includes a Section addressing matters related to the Medical Staff of the Hospital. The Board of the Hospital shall determine which categories of practitioners are eligible candidates for appointment to the Hospital's medical staff and provides that medical staff practitioners eligible for medical staff appointment shall be organized into a medical staff under medical staff bylaws. The medical staff bylaws and medical staff rules and regulations are subject to final approval by the Board. The revised Operating Agreement also includes a dissolution section which provides that upon dissolution the assets of the Company shall be distributed to the Member. In the event the Member is not in existence or does not qualify for exemption under Section 501(c)(3) at the time of dissolution, the assets of the Company will be turned over to the Southern Union of the General Conference of Seventh-day Adventists, which is organized and operated exclusively for religious and charitable purposes.
Form 990, Part VI, Section A, line 6 Redmond Park Hospital, LLC (the filing organization) has one member. The sole member of the filing organization is Adventist Health System Sunbelt Healthcare Corporation. Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) is a Florida, not-for-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). There are no other classes of membership in the filing organization.
Form 990, Part VI, Section A, line 7a The sole member of the filing organization is AHSSHC. The Board of Directors of the filing organization are appointed by the sole member, AHSSHC, who has the right to elect, appoint or remove any member of the Board of Directors of the filing organization.
Form 990, Part VI, Section A, line 7b AHSSHC, as the sole member of the filing organization, has certain reserved powers as set forth in the Bylaws of the filing organization. These reserved powers include the following: a) to approve and disapprove the executive and/or administrative leadership of the filing organization, and their salaries; b) to adopt, amend, restate, and repeal the Articles of Incorporation or Operating Agreement of the filing organization; c) to set limits and terms for the borrowing of funds exceeding $100,000; d) to approve or disapprove the purchase or sale of personal property or real property equal to or in excess of certain dollar amount thresholds; e) to approve or disapprove the annual operating and capital budgets and strategic plans of the filing organization; f) to approve or disapprove capital expenditures in excess of $1,000,000; g) to approve or disapprove performance/quality improvement and case management programs; h) to approve the appointment of an auditing firm and election of the fiscal year for the filing organization; i) to approve or disapprove material changes in services offered by the filing organization; j) the authority to require the filing organization's adherence to policies adopted by the Member: k) the authority to secure naming rights and to direct the placement of funds and capital and the making of gifts, sponsorships, donations, loans and transfers of funds or other assets by the filing organization in excess of $1,000,000; l) to approve or disapprove the sale, purchase, donation, or other conveyance of personal property with a value in excess of $1,000,000 not otherwise approved in the current capital or operating budgets; m) to approve or disapprove the implementation of non-traditional, non-healthcare related activities; n) to approve or disapprove the selection of the filing organization's group purchasing organization(s); o) to approve or disapprove any joint venture or partnership in which the filing organization would be a member or partner; p) to approve the IT systems used by the filing organization; q) the authority to require the filing organization's adherence to the system-wide naming nomenclature adopted by the Member; and r) to set and enforce policies for physician compensation, including commercial reasonableness and fair market value.
Form 990, Part VI, Section B, line 11b The filing organization's current year Form 990 was reviewed by the Board Chairman, Board Finance Committee Chair, CEO and by the CFO prior to its filing with the IRS. The review conducted by the Board Chairman, Board Finance Committee Chair, CEO and the CFO did not include the review of any supporting workpapers that were used in preparation of the current year Form 990, but did include a review of the entire Form 990 and all supporting schedules.
Form 990, Part VI, Section B, line 12c The Conflict of Interest Policy of the filing organization applies to members of its Board of Trustees and its principal officers (to be known as Interested Persons). In connection with any actual or possible conflicts of interest, any member of the Board of Trustees of the filing organization or any principal officer of the filing organization (i.e. Interested Persons) must disclose the existence of any financial interest with the filing organization and must be given the opportunity to disclose all material facts concerning the financial interest/arrangement to the Board of Trustees of the filing organization or to any members of a committee with board delegated powers that is considering the proposed transaction or arrangement. Subsequent to any disclosure of any financial interest/arrangement and all material facts, and after any discussion with the relevant Board member or principal officer, the remaining members of the Board of Trustees or committee with board delegated powers shall discuss, analyze, and vote upon the potential financial interest/arrangement to determine if a conflict of interest exists. According to the filing organization's Conflict of Interest Policy, an Interested Person may make a presentation to the Board of Trustees (or committee with board delegated powers), but after such presentation, shall leave the meeting during the discussion of, and the vote on, the transaction or arrangement that results in a conflict of interest. Each Interested Person, as defined under the filing organization's Conflict of Interest Policy, shall annually sign a statement which affirms that such person has received a copy of the Conflict of Interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the filing organization is a charitable organization that must primarily engage in activities which accomplish one or more of its exempt purposes. The filing organization's Conflict of Interest Policy also requires that periodic reviews shall be conducted to ensure that the filing organization operates in a manner consistent with its charitable purposes.
Form 990, Part VI, Section B, line 15 The filing organization's CEO is not compensated by the filing organization. This individual is compensated by Adventist Health System Sunbelt Healthare Corporation (AHSSHC), the top-tier tax-exempt parent of the filing organization. Please see the discussion concerning the process followed by AHSSHC in determining executive compensation in our response to Schedule J, Line 3.
Form 990, Part VI, Section C, line 19 The filing organization is a part of the system of healthcare organizations known as AdventHealth. The audited consolidated financial statements of AdventHealth and of the AdventHealth "Obligated Group" are filed annually with the Municipal Securities Rulemaking Board (MSRB). The "Obligated Group" is a group of AHSSHC subsidiaries that are jointly and severally liable under a Master Trust Indenture that secures debt primarily issued on a tax-exempt basis. Unaudited quarterly financial statements prepared in accordance with Generally Accepted Accounting Principles (GAAP) are also filed with MSRB for AdventHealth on a consolidated basis and for the grouping of AdventHealth subsidiaries comprising the "Obligated Group". The filing organization does not generally make its governing documents or conflict of interest policy available to the public.
Part VII, Section A: For those Board of Director members, officer(s) and key employees who devote less than full-time to the filing organization (based upon the average number of hours per week shown in column (B) on page 7 of the return) the compensation amounts shown in columns (E) and (F) on page 7 were provided in conjunction with that person's responsibilities and roles in serving in an executive leadership position as an employee of Adventist Health System Sunbelt Healthcare Corporation.
Part VIII, Lines 7a, b and c: The amounts shown in Part VIII, Lines 7a(i), 7b(i) and 7c(i) of the Form 990 represent an allocated share of capital gain/(loss) from a system wide, corporate administered, investment program.
Form 990, Part IX, line 11g Payments to Healthcare Professionals: Program service expenses 9,346,819. Management and general expenses 0. Fundraising expenses 0. Total expenses 9,346,819. Consulting and Management Fees: Program service expenses 5,336,194. Management and general expenses 0. Fundraising expenses 0. Total expenses 5,336,194. Outside Medical Services: Program service expenses 920,426. Management and general expenses 0. Fundraising expenses 0. Total expenses 920,426. Environmental Services: Program service expenses 81,718. Management and general expenses 0. Fundraising expenses 0. Total expenses 81,718. Transcription: Program service expenses 3,143. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,143. Recruiting Purchased Services: Program service expenses 2,819. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,819. Other Purchased Services: Program service expenses 859,768. Management and general expenses 0. Fundraising expenses 0. Total expenses 859,768. AH Management Fees: Program service expenses 0. Management and general expenses 558,505. Fundraising expenses 0. Total expenses 558,505. AH Shared Services Fee: Program service expenses 0. Management and general expenses 1,449,976. Fundraising expenses 0. Total expenses 1,449,976.
Form 990, Part X, Line 2: The amount shown on line 2 of Part X of this return includes the filing organization's interest in a central investment pool maintained by Adventist Health System Sunbelt Healthcare Corporation, the filing organization's top-tier parent. The investments in the central investment pool are recorded at market value.
Form 990, Part XI, line 9: Value of Net Assets Purchased 644,799,665.
Form 990, Part XII, Line 3b: Although the taxpayer is not required to undergo an audit as set forth in the Single Audit Act and OMB Circular A-133, the taxpayer is part of a controlled group of organizations that comprise a consolidated financial statement audit. The controlled group's parent is Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), a 501(c)(3) organization. The system of healthcare entities owned and controlled by AHSSHC is known as AdventHealth. For the year ended December 31, 2021, AdventHealth will file a consolidated Single Audit which will include all entities that are part of the controlled group. Accordingly, the taxpayer has checked yes to the questions on Part XII, line 3a and 3b.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


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