Civic Intelligence

Fountain Inn Nursing & Rehabilitation Center Inc

990 • Fiscal year 2017 • EIN 47-2180518

Jan 01, 2017 to Dec 31, 2017 • Filed on Oct 08, 2018

485 North Keller Road No 250Maitland, FL 32751

(407) 975-3000

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

41st percentile

0.17x

Higher debt load relative to assets than 41% of similar nonprofits.

2017 filings • 501(c)3 • $25M-$50M nonprofits • Source year 2017

Liabilities / Revenue

96th percentile

7.80x

Higher debt load relative to revenue than 96% of similar nonprofits.

2017 filings • 501(c)3 • $25M-$50M nonprofits • Source year 2017

Net Margin

99th percentile

95%

Higher net margin than 99% of similar nonprofits.

2017 filings • 501(c)3 • $25M-$50M nonprofits • Source year 2017

Top Officer Pay

97th percentile

$1,555,017

Higher top officer pay than 97% of similar nonprofits.

Top officer pay equals 267.1% of source-year revenue.

2017 filings • 501(c)3 • $25M-$50M nonprofits • Source year 2017

Asset Growth

100th percentile

25653%

Faster asset growth than 100% of similar nonprofits.

2017 filings • 501(c)3 • $25M-$50M nonprofits • Annualized from 2016 to 2017

Revenue Growth

100th percentile

74449%

Faster revenue growth than 100% of similar nonprofits.

2017 filings • 501(c)3 • $25M-$50M nonprofits • Annualized from 2016 to 2017

Assets

Up

$26,409,049

Up $26,306,503 (+25653%) from 2016

Net Assets

Up

$21,866,152

Up $21,763,606 (+21223%) from 2016

Liabilities

Up

$4,542,897

Up $4,542,897 from 2016

Revenue

Up

$582,229

Up $581,448 (+74449%) from 2016

Expenses

Up

$29,120

Up $28,533 (+4861%) from 2016

Net Income

Up

$553,109

Up $552,915 (+285008%) from 2016

Historical Trend

Balance Sheet Trend

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$40M$30M$20M$10M$0Assets 2016: $102,546Liabilities 2016: $0Net Assets 2016: $102,5462016Assets 2017: $26,409,049Liabilities 2017: $4,542,897Net Assets 2017: $21,866,1522017Assets 2018: $29,512,475Liabilities 2018: $9,551,797Net Assets 2018: $19,960,6782018Assets 2019: $30,806,704Liabilities 2019: $1,342,686Net Assets 2019: $29,464,0182019Assets 2020: $30,625,935Liabilities 2020: $1,611,715Net Assets 2020: $29,014,2202020Assets 2021: $28,990,803Liabilities 2021: $1,891,629Net Assets 2021: $27,099,1742021Assets 2022: $26,663,207Liabilities 2022: $1,776,697Net Assets 2022: $24,886,5102022Assets 2023: $24,218,449Liabilities 2023: $1,310,759Net Assets 2023: $22,907,6902023Assets 2024: $0Liabilities 2024: $0Net Assets 2024: $02024

Highlighted filing

2017

Assets$26,409,049
Liabilities$4,542,897
Net Assets$21,866,152

Operations Trend

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$20M$15M$10M$5.0M$0-$5.0MRevenue 2016: $781Expenses 2016: $587Net Income 2016: $1942016Revenue 2017: $582,229Expenses 2017: $29,120Net Income 2017: $553,1092017Revenue 2018: $418,563Expenses 2018: $2,231,569Net Income 2018: -$1,813,0062018Revenue 2019: $9,238,233Expenses 2019: $11,755,048Net Income 2019: -$2,516,8152019Revenue 2020: $14,378,987Expenses 2020: $14,909,614Net Income 2020: -$530,6272020Revenue 2021: $13,554,642Expenses 2021: $15,491,115Net Income 2021: -$1,936,4732021Revenue 2022: $14,933,529Expenses 2022: $16,993,206Net Income 2022: -$2,059,6772022Revenue 2023: $4,890,526Expenses 2023: $7,345,243Net Income 2023: -$2,454,7172023Revenue 2024: $1,097,808Expenses 2024: $77,035Net Income 2024: $1,020,7732024

Highlighted filing

2017

Revenue$582,229
Expenses$29,120
Net Income$553,109
Jump To
Filing Snapshot
Filing Period
Jan 1, 2017 to Dec 31, 2017
Signed
Oct 8, 2018
Return Version
2017v2.3
Gross Receipts
$582,229
Mission and Program Overview

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 Adventist Health System (AHS). AHS 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, AHS cares for and nurtures people: our employees, our communities, our healthcare professionals, and those who trust us for care and healing.

Future Operation of Home for the Aged/Healthcare Delivery. Inactive in Current Year.

Balance Sheet Detail
LineBeginningEndChange
Assets
Land, Buildings, and Equipment, Net$0$19,430,233▲ $19,430,233
Savings and Temporary Cash Investments$102,185$6,916,667▲ $6,814,482
Total Assets$102,546$26,409,049▲ $26,306,503
Other Assets Total$361$62,149▲ $61,788
Liabilities
Accounts Payable and Accrued Expenses-$2,352,487-
Other Liabilities$0$2,190,410▲ $2,190,410
Total Liabilities$0$4,542,897▲ $4,542,897
Net Assets / Fund Balance
Unrestricted Net Assets$102,546$21,866,152▲ $21,763,606
Total Net Assets Fund Balance$102,546$21,866,152▲ $21,763,606
Total Liabilities and Net Assets / Fund Balance$102,546$26,409,049▲ $26,306,503

Asset Categories

AssetBook ValueDepreciationBasis
Other Land Buildings$19,430,233-$19,430,233
Compensation and Service Providers

Employees

NameTitleOtherTotal
Anderson RogerDirector$200$200
Evans G ThomasDirector$200$200
McDonald Raymond AndrewDirector$200$200

Board Members and Trustees

NameTitle
Johnson Sandra KBoard Chairman (Beginning 1/17)
Seifert LewisDirector (Beginning 1/17)
Givens Michelle RDirector/Pres.
Johnson Kent RCFO
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$0
Investment Income
$582,229
Other Revenue
$0
Change in Net Assets
$553,109
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$29,120
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Salaries, Compensation, and Employee Benefits$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Fees for Service Investment Mgmnt Fees-$29,120-$29,120
Total Functional Expenses$0$29,120$0$29,120
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Due to Shcc$2,190,410
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
No
Other officer compensation reviewed
No
Conflict-of-interest policy
Yes
Audited financial statements prepared
Yes
Key decisions subject to board approval
Yes
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section A, line 6

Fountain Inn Nursing and Rehabilitation Center, Inc. (the filing organization) has one member. The sole member of the filing organization is Sunbelt Health Care Centers, Inc. Sunbelt Health Care Centers, Inc. (SHCC) is a Tennessee, 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 SHCC. The Board of Directors of the filing organization are appointed by the sole member, SHCC, 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

SHCC, 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 appoint and remove the Directors and all officers and administrators of the filing organization; b) to adopt, amend, restate, and repeal the Articles of Incorporation or Bylaws of the filing organization; c) to set limits and terms for the borrowing of funds; d) to approve or disapprove the annual operating and capital budgets of the filing organization; and e) to direct the placement of funds and capital of the filing organization.

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 Directors 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 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 Interests 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, other officers and key employees are not compensated by the filing organization. Such individuals are compensated by the related top-tier parent organization of the filing organization. Please see the discussion concerning the process followed by the related top-tier parent organization 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 Adventist Health System (AHS). The audited consolidated financial statements of AHS and of the AHS "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 AHS on a consolidated basis and for the grouping of AHS 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 and officers 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 within Adventist Health System.

Part VIII, Lines 7A and 7C:

The amounts shown in Part VIII, Lines 7a and 7c of the Form 990 represent an allocated share of capital gain/(loss) from a system wide, corporate administered, investment program.

Filing and Contact Details

Filer

Filer Name
Fountain Inn Nursing &
EIN
47-2180518
Phone
4079753000
Address
485 North Keller Road No 250, Maitland, FL 32751

Signing Officer

Name
Lynn C Addiscott
Title
Officer/Asst. Secretary
Phone
4073572317
Signed
2018-10-08

Organization Details

Principal Officer
Michelle Givens
Formed
2014
Legal Domicile
Fl
Voting Board Members
6
Independent Board Members
3
Employees
0
Volunteers
3
Supplemental Narrative

Additional Explanations

Form 990, Part XI, line 9:

Equity Transfer from Related Organization 21,000,000.

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.

Financial Statement Notes

Part X, Line 2:

The filing organization is a subsidiary organization within Adventist Health System (AHS). The consolidated financial statements of AHS contain the following FIN 48 (ASC 740) footnote: Please note that dollar amounts are in thousands. Healthcare Corporation and its affiliated organizations, other than North American Health Services, Inc. and its subsidiary (NAHS), are exempt from state and federal income taxes. Accordingly, Healthcare Corporation and its tax-exempt affiliates are not subject to federal, state or local income taxes except for any net unrelated business taxable income. NAHS is a wholly owned, for-profit subsidiary of Healthcare Corporation. NAHS and its subsidiary are subject to federal and state income taxes. NAHS files a consolidated federal income tax return and, where appropriate, consolidated state income tax returns. All taxable income was fully offset by net operating loss carryforwards for federal income tax purposes; as such, there is no provision for current federal or state income tax for the years ended December 31, 2017 and 2016. NAHS also has temporary deductible differences of approximately $55,700 and $59,100 at December 31, 2017 and 2016, respectively, primarily as a result of net operating loss carryforwards. At December 31, 2017, NAHS had net operating loss carryforwards of approximately $56,400, expiring beginning in 2022 through 2026. Deferred taxes have been provided for these amounts, resulting in a net deferred tax asset of approximately $14,100 and $22,500 at December 31, 2017 and 2016, respectively. A full valuation allowance has been provided at December 31, 2017 and 2016 to offset the deferred tax asset since Healthcare Corporation has determined that it is more likely than not that the benefit of the net operating loss carryforwards will not be realized in future years. On December 22, 2017, the United States enacted tax reform legislation commonly known as the Tax Cuts and Jobs Act (Act), resulting in significant modifications to existing law. NAHS remeasured its deferred tax assets and liabilities based on the rates at which they are expected to reverse in the future, which is generally 21%. Additionally, NAHS had a corresponding decrease to its valuation allowance resulting in no net tax expense impact. The Income Taxes Topic of the ASC (ASC 740) prescribes the accounting for uncertainty in income tax positions recognized in financial statements. ASC 740 prescribes a recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken, or expected to be taken, in a tax return. There were no material uncertain tax positions as of December 31, 2017 and 2016.

Raw XML AppendixShowing 400 of 1,940 raw XML fields

This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.

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IRS990ScheduleD/SupplementalInformationDetail/ExplanationTxt0The filing organization is a subsidiary organization within Adventist Health System (AHS). The consolidated financial statements of AHS contain the following FIN 48 (ASC 740) footnote: Please note that dollar amounts are in thousands. Healthcare Corporation and its affiliated organizations, other than North American Health Services, Inc. and its subsidiary (NAHS), are exempt from state and federal income taxes. Accordingly, Healthcare Corporation and its tax-exempt affiliates are not subject to federal, state or local income taxes except for any net unrelated business taxable income. NAHS is a wholly owned, for-profit subsidiary of Healthcare Corporation. NAHS and its subsidiary are subject to federal and state income taxes. NAHS files a consolidated federal income tax return and, where appropriate, consolidated state income tax returns. All taxable income was fully offset by net operating loss carryforwards for federal income tax purposes; as such, there is no provision for current federal or state income tax for the years ended December 31, 2017 and 2016. NAHS also has temporary deductible differences of approximately $55,700 and $59,100 at December 31, 2017 and 2016, respectively, primarily as a result of net operating loss carryforwards. At December 31, 2017, NAHS had net operating loss carryforwards of approximately $56,400, expiring beginning in 2022 through 2026. Deferred taxes have been provided for these amounts, resulting in a net deferred tax asset of approximately $14,100 and $22,500 at December 31, 2017 and 2016, respectively. A full valuation allowance has been provided at December 31, 2017 and 2016 to offset the deferred tax asset since Healthcare Corporation has determined that it is more likely than not that the benefit of the net operating loss carryforwards will not be realized in future years. On December 22, 2017, the United States enacted tax reform legislation commonly known as the Tax Cuts and Jobs Act (Act), resulting in significant modifications to existing law. NAHS remeasured its deferred tax assets and liabilities based on the rates at which they are expected to reverse in the future, which is generally 21%. Additionally, NAHS had a corresponding decrease to its valuation allowance resulting in no net tax expense impact. The Income Taxes Topic of the ASC (ASC 740) prescribes the accounting for uncertainty in income tax positions recognized in financial statements. ASC 740 prescribes a recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken, or expected to be taken, in a tax return. There were no material uncertain tax positions as of December 31, 2017 and 2016.
IRS990ScheduleD/SupplementalInformationDetail/FormAndLineReferenceDesc0Part X, Line 2:
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IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm0Johnson Sandra K
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm1Givens Michelle R
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm2Seifert Lewis
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm3Johnson Kent R
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt0Board Chairman (Beginning 1/17)
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt1Director/Pres.
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt2Director (Beginning 1/17)
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt3CFO
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IRS990ScheduleJ/SupplementalInformationDetail/ExplanationTxt0The individual who serves as the CEO of the filing organization is compensated by Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) for that individual's role in serving as the CEO of the entire nursing home division of Adventist Health System. 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 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 of the community, 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. 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 AHS and each of its affiliated entities. The following principles guide the establishment of individual executive compensation: - The salary of the President/CEO of AHS will not exceed the 40th 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.
IRS990ScheduleJ/SupplementalInformationDetail/ExplanationTxt1The CEO and CFO of the filing organization are compensated by and on the payroll of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the parent organization of a healthcare system known as Adventist Health System (AHS). In recognition of the contribution that each executive makes to the success of AHS, AHS provides to eligible executives participation in the AHS Executive FLEX Benefit Program (the Plan). The purpose of the Plan is to offer eligible executives an opportunity to elect from among a variety of supplemental benefits, including a split dollar life insurance policy and long-term care insurance, to individually tailor a benefits program appropriate to each executive's needs. The Plan provides eligible participants a pre-determined benefits allowance credit that is equal to a percentage of the executive's base pay from which is deducted the cost of mandatory and elective employee benefits. The pre-determined benefits allowance credit percentage is approved by the AHSSHC Board Compensation Committee, an independent committee of the Board of Directors of AHSSHC. Any funds that remain after the cost of mandatory and elective benefits are subtracted from the annual pre-determined benefits allowance are contributed, at the employee's option, 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 documents define an employee who is eligible to participate in the Plan to generally include the Chief Executive Officers of AHS entities and Vice Presidents of all AHS entities whose base salary is at least $243,000. 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 is forfeited by the executive upon a voluntary separation. In addition to the Plan, AHS has instituted a defined benefit, non-tax-qualified deferred compensation plan for certain executives who have provided lengthy service to AHS and/or to other Seventh-day Adventist Church hospitals or health care institutions. Participation in the plan is offered to AHS executives on a prorata schedule beginning with 20 years of service as an employee of AHS and/or another hospital or health care institution controlled by the Seventh-day Adventist Church and who satisfy certain other qualifying criteria. This supplemental executive retirement plan (SERP) 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 AHS 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 the SERP and by the individual's year of entry to the AHS Executive FLEX Benefit Program. Additionally, in 2017 AHS adopted a Senior Executive Death Benefit (SEDB) Plan in recognition of the considerable age and service requirements in the SERP. The SEDB Plan provides a benefit in an amount equal to the amount the executive's benefit would have been under the SERP Plan assuming that, on the date of the executive's death (and not before), the executive satisfied the last of the eligibility requirements of the SERP Plan with present value recognizing an early benefit commenceme
IRS990ScheduleJ/SupplementalInformationDetail/FormAndLineReferenceDesc0Part I, Line 3
IRS990ScheduleJ/SupplementalInformationDetail/FormAndLineReferenceDesc1Part I, Line 4b
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IRS990/ScheduleORequiredInd01
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0Fountain Inn Nursing and Rehabilitation Center, Inc. (the filing organization) has one member. The sole member of the filing organization is Sunbelt Health Care Centers, Inc. Sunbelt Health Care Centers, Inc. (SHCC) is a Tennessee, 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.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1The sole member of the filing organization is SHCC. The Board of Directors of the filing organization are appointed by the sole member, SHCC, who has the right to elect, appoint or remove any member of the Board of Directors of the filing organization.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2SHCC, 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 appoint and remove the Directors and all officers and administrators of the filing organization; b) to adopt, amend, restate, and repeal the Articles of Incorporation or Bylaws of the filing organization; c) to set limits and terms for the borrowing of funds; d) to approve or disapprove the annual operating and capital budgets of the filing organization; and e) to direct the placement of funds and capital of the filing organization.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3The 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.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt4The 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 conflicts of interest, 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 Interests 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.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt5The filing organization's CEO, other officers and key employees are not compensated by the filing organization. Such individuals are compensated by the related top-tier parent organization of the filing organization. Please see the discussion concerning the process followed by the related top-tier parent organization in determining executive compensation in our response to Schedule J, Line 3.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt6The filing organization is a part of the system of healthcare organizations known as Adventist Health System (AHS). The audited consolidated financial statements of AHS and of the AHS "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 AHS on a consolidated basis and for the grouping of AHS subsidiaries comprising the "Obligated Group". The filing organization does not generally make its governing documents or conflict of interest policy available to the public.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt7For those Board of Director members and officers 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 within Adventist Health System.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt8The amounts shown in Part VIII, Lines 7a and 7c of the Form 990 represent an allocated share of capital gain/(loss) from a system wide, corporate administered, investment program.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt9Equity Transfer from Related Organization 21,000,000.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt10The 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.
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0Form 990, Part VI, Section A, line 6
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1Form 990, Part VI, Section A, line 7a
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2Form 990, Part VI, Section A, line 7b
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3Form 990, Part VI, Section B, line 11b
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc4Form 990, Part VI, Section B, line 12c
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc5Form 990, Part VI, Section B, line 15
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc6Form 990, Part VI, Section C, line 19
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc7Part VII, Section A
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc8Part VIII, Lines 7a and 7c:
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc9Form 990, Part XI, line 9:
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc10Part X, Line 2
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