2012-11-12T14:27:13-06:00 2011-12-31 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2011-01-01 593284221 GENESIS REHABILITATION HOSPITAL INC GENE 9043457600 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 322164252 DOUGLAS M BAER 9043457600 2012-11-08 1 AMY BIBBY P00445891 8282542254 2011 2016-02-24 21:20:13Z BROOKS REHABILITATION HOSPITAL DOUGLAS M BAER 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 322164252 75823769 0 X WWW.BROOKSHEALTH.ORG X 1994 FL OPERATION OF REHABILITATION HOSPITAL AND CLINICS IN JACKSONVILLE, FL AND SURROUNDING AREAS 13 8 693 0 0 0 123493 4828 67674373 72220753 3318297 3477363 164979 120825 71281142 75823769 0 0 0 0 33747746 36486559 0 0 0 31507615 32426120 65255361 68912679 6025781 6911090 87793561 94119627 61166519 61101110 26627042 33018517 X TO ADVANCE THE HEALTH AND WELL-BEING OF PERSONS REQUIRING REHABILITATION THROUGH SUPERIOR OUTCOMES, SERVICE, EDUCATION, AND RESEARCH. 0 0 54296165 72220753 GENESIS REHABILITATION HOSPITAL, INC. (DOING BUSINESS AS BROOKS REHABILITATION HOSPITAL) INCLUDES A FREE-STANDING REHABILITATION FACILITY LICENSED FOR 157 BEDS. THE HOSPITAL IS DEDICATED TO TREATING ADULTS AND CHILDREN WITH BRAIN INJURY, STROKE, SPINAL CORD INJURY, HIP FRACTURE, COMPREHENSIVE ORTHOPEDIC PROBLEMS AND OTHER DISABLING CONDITIONS. BROOKS REHABILITATION HOSPITAL IS ACCREDITED BY THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS (JCAHO) AND "CARF", THE REHABILITATION ACCREDITATION COMMISSION. THE HOSPITAL IS ONE OF FLORIDA'S ONLY STATE DESIGNATED TREATMENT FACILITY FOR BRAIN AND SPINAL CORD INJURY FOR CHILDREN AND ADULTS. 54296165 1 0 0 1 0 0 0 0 0 0 1 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 653 0 1 693 1 0 0 0 0 0 0 0 0 0 0 X 13 8 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X X DOUGLAS M BAER 9043457600 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 X BRUCE M JOHNSON 2.00 X X 0 27600 0 ERNEST N BRODSKY 2.00 X X 0 27300 0 STANLEY W CARTER 2.00 X X 0 5662 0 PAMELA S CHALLY PHD 2.00 X 0 16794 0 JEFFREY JOHNS MD 2.00 X 0 285920 24640 LEE LOMAX 2.00 X 0 0 11521 TREVOR PARIS MD 2.00 X 0 326642 14168 GARY SNEED 2.00 X 0 38567 0 LYNNE SNEED 2.00 X 0 0 0 FORREST TRAVIS 2.00 X 0 18900 0 DOUGLAS M BAER 2.00 X X 0 493762 113383 PATRICIA DEBEAR 40.00 X X 0 230194 15284 MICHAEL SPIGEL 2.00 X X 0 378273 72792 KERRY MAHER MD 40.00 X 153403 0 16500 JOANNE HOERTZ 40.00 X 153267 0 4752 RUSSELL ADDEO 40.00 X 145475 0 14568 VIRGIL WITTMER 40.00 X 143040 0 9107 VICTOR DERIENZO 40.00 X 121159 0 11559 EMILY A DUNN 40.00 X 117858 0 12858 CYNTHIA L BEAULIEU 40.00 X 117226 0 10219 951428 1849614 331351 9 0 1 0 MEMORIAL HOSPITAL OF JACKSONVILLE PO BOX 19055 JACKSONVILLE FL 32245 SUPPORT SERVICES 6338388 SODEXO INC AND AFFILIATES PO BOX 905374 CHARLOTTE NC 28290 CLEANING AND FOOD SERVICES 2605153 FICKLING CONSTRUCTION INC 1703 LAMBERT STREET JACKSONVILLE FL 32206 CONSTRUCTION 654872 OWENS & MINOR 8489 WESTSIDE INDUSTRIAL DR JACKSONVILLE FL 32219 MEDICAL SUPPLIES 464509 MEDLINE INDUSTRIES INC 1 MEDLINE PLACE MUNDELEIN IL 60060 MEDICAL SUPPLIES 464449 27 4828 4828 NET PATIENT SERVICE 621400 70088972 70088972 OTHER PATIENT REVENUE 900099 1803586 1803586 SPEECH THERAPY 621400 328195 328195 72220753 3203267 3203267 274096 274096 OTHER REVENUE 900099 120825 120825 120825 75823769 72220753 0 3598188 306672 153336 153336 27130361 25901308 1229053 1070364 1040014 30350 5922626 4977742 944884 2056536 2022608 33928 9302296 1901530 7400766 17269 948 16321 59796 59796 11088044 10870792 217252 111351 111351 3782681 2129758 1652923 1367109 1365098 2011 36192 31828 4364 33975 30837 3138 2268296 2268296 2761238 2517567 243671 339086 24058 315028 OTHER EXPENSE 835360 793963 41397 BAD DEBT EXPENSE 423427 423427 68912679 54296165 14616514 0 1462836 950765 7565168 7606373 97352 89051 1155916 1168957 60374352 37786675 23474893 22587677 12689964 10395016 40025895 50759706 1321537 562082 87793561 94119627 7993503 8399668 51730636 51082762 1442380 1618680 61166519 61101110 X 26387399 33018517 239643 0 26627042 33018517 87793561 94119627 X 6911090 -519615 X X 0 1 1 X 0 X 0 0 0 0 0 0 0 0 1 11903 11903 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: THE ORGANIZATION IS A MEMBER OF VARIOUS HEALTHCARE ORGANIZATIONS, INCLUDING PRIMARILY THE FLORIDA HOSPITAL ASSOCIATION (FHA) AND THE AMERICAN MEDICAL REHABILITATION PROVIDERS ASSOCIATION (AMRPA), IN ADDITION TO PAYING ANNUAL DUES TO THE FAIR FUND. THESE ORGANIZATIONS UNDERTAKE LOBBYING EFFORTS ON BEHALF OF THEIR MEMBERSHIP BODIES, AND EACH YEAR A PORTION OF DUES PAID TO THESE ORGANIZATIONS IS ALLOCATED TO LOBBYING EXPENDITURES. 280659 280659 41360109 23395972 17964137 2109082 1558659 550423 16365325 12832044 3533281 259177 259177 22587677 DUE FROM AFFILIATES 50759706 C 50759706 LONG-TERM SWAP VALUATION LIABILITY 906138 SWAP VALUATION LIABILITY 712542 1618680 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION RECEIVES CONSOLIDATED FINANCIAL STATEMENTS INCLUDING CORPORATE PARENT AND SUBSIDIARIES. THE FOLLOWING DISCLOSURE APPLIES TO THE SYSTEM AS A WHOLE: BROOKS REHABILITATION HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE IRC. 1 1 X 1 X 1 X 1 1 0 1 1 1696979 0 1696979 0.02480 6583648 4544332 2039316 0.02980 8280627 4544332 3736295 0.05460 8280627 4544332 3736295 0.05460 1 423427 696 35700934 33253826 2447108 X 1 1 1 1 BROOKS REHABILITATION HOSPITAL

3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216

X INPATIENT REHAB FACILITY BROOKS REHABILITATION HOSPITAL 1 1 X X X X X X X X X 09 1 1 1 X X X X X X X X X 0 0 1 200.000000000000 1 400.000000000000 1 X X X X 1 1 X 1 0 0 X X 0 0 8 HEALTH CARE PLAZA OUTPATIENT CLINIC

3901 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216

PHYSICAL, OCCUPATIONAL, COGNITIVE THERAPY ORANGE PARK OUTPATIENT CLINIC

550 WELLS RD 4 ORANGE PARK FL 32073

PHYSICAL, OCCUPATIONAL, SPEECH THERAPY SAN PABLO CLINIC

14286 BEACH BLVD SUITE 34 JACKSONVILLE FL 32250

PHYSICAL, OCCUPATIONAL, SPEECH THERAPY MANDARIN OUTPATIENT CLINIC

11701 SAN JOSE BLVD 210 JACKSONVILLE FL 32223

PHYSICAL, OCCUPATIONAL, SPEECH THERAPY ST AUGUSTINE OUTPATIENT CLINIC

190 SOUTHPARK BLVD 100 ST AUGUSTINE FL 32086

PHYSICAL, OCCUPATIONAL, SPEECH THERAPY WESTSIDE OUTPATIENT CLINIC

7749 NORMANDY CROSSING JACKSONVILLE FL 32221

PHYSICAL, OCCUPATIONAL, SPEECH THERAPY CENTER FOR SPORTS THERAPY AT YMCA

10423 CENTURION PKWY NORTH JACKSONVILLE FL 32256

PHYSICAL, ACQUATIC, SPORTS THERAPY NORTHSIDE OUTPATIENT CLINIC

320 DUNDAS DR 8 JACKSONVILLE FL 32218

PHYSICAL, OCCUPATIONAL, SPEECH THERAPY PART I, LINE 3C: BROOKS PROVIDES FREE CARE TO MEDICALLY AND FINANCIALLY QUALIFIED CHARITY, UNINSURED, AND UNDERINSURED PATIENTS FALLING BELOW 400% OF THE FEDERAL POVERTY INCOME GUIDELINES. BROOKS ALSO PROVIDES FREE CARE TO PATIENTS WHOSE CHARGES FOR CARE ARE CATASTROPHIC. THIS IS DEFINED AS CHARGES THAT EXCEED 25% OF THE FEDERAL POVERTY THRESHOLD. PART I, LINE 7: WORKSHEET 2 OF THE 2011 SCHEDULE H INSTRUCTIONS WAS USED TO COMPUTE A COST-TO-CHARGES RATIO USED TO CALCULATE TOTAL COMMUNITY BENEFIT EXPENSE AT COST FOR THE PURPOSES OF LINE 7, COL (C). PART I, L7 COL(F): THE AMOUNT OF TOTAL EXPENSE ON FORM 990, PART IX, LINE 25 CONTAINS A BAD DEBT EXPENSE OF $423,427 THAT HAS BEEN EXCLUDED FROM THE CALCULATION OF PERCENT OF TOTAL EXPENSE ON LINE 7, COL (F). PART III, LINE 4: BAD DEBT REPORTED ON PART III, LINE 2 IS REPORTED AT GROSS CHARGES. THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE ON BAD DEBT, ALLOWANCE FOR DOUBTFUL ACCOUNTS, OR ACCOUNTS RECEIVABLE.AMOUNTS PRESENTED ON PART III, LINE 3 AS BAD DEBTS ATTRIBUTABLE TO COMMUNITY BENEFIT ARE WRITE-OFFS TO MEDICAID PAYORS. PART III, LINE 8: THE ORGANIZATION USED ITS MEDICARE COST REPORT TO CALCULATE AMOUNTS PRESENTED ON PART III, LINES 5 AND 6. PART III, LINE 9B: THE ORGANIZATION IS A SUB ACUTE CARE FACILITY, AND PATIENTS ENTERING THE FACILITY ARE REFERRED BY OTHER ORGANIZATIONS WHICH HAVE ALREADY PERFORMED FINANCIAL EVALUATIONS IN MOST CASES. IT IS HIGHLY UNLIKELY AND RARE THAT A FULL EVALUATION IS NOT PERFORMED ON THE ORGANIZATION'S PATIENTS PRIOR TO DISCHARGE, AND THEREFORE, THE CHANCE OF THE ORGANIZATION PURSUING COLLECTIONS ON PATIENTS THAT WILL QUALIFY FOR FINANCIAL ASSISTANCE IS LOW; HOWEVER, AS DISCUSSED IN PART VI, LINE 3, IN THE EVENT A PATIENT'S FINANCIAL SITUATION CHANGES OVER THE COURSE OF CARE, THE ORGANIZATION HAS POLICIES IN PLACE TO REQUIRE A REEVALUATION. BROOKS REHABILITATION HOSPITAL PART V, SECTION B, LINE 3: THE PROCESS INCLUDED DATA FROM THE FOLLOWING SOURCES: * CONDUCTED SEVERAL FOCUS GROUPS WITH OVER 50 PARTICIPANTS FOR THE FOLLOWING - ILRS CONSUMERS AND CAREGIVERS - BROOKS/COMMUNITY SUPPORT GROUPS (SURVIVORS AND CAREGIVERS FOR STROKE AND SPINAL CORD INJURY SUPPORT GROUPS) - BROOKS CASE MANAGERS * INTERVIEWS WITH BROOKS' PROGRAM DIRECTORS * SURVEY TO ILRC CONSUMERS * UTILIZED FINDINGS FROM BRAIN INJURY ASSOCIATION OF FLORIDA STRATEGIC PLAN * RESULTS OF STUDY ON PERCEIVED AND ACTUAL NEEDS OF PATIENTS AND CAREGIVERS IN REHAB AND ONCE AT HOME BARBARA LUTZ AT UNIVERSITY OF FLORIDA BROOKS REHABILITATION HOSPITAL PART V, SECTION B, LINE 7: NEEDS ASSESSMENTS IN 2005 AND 2008 IDENTIFIED THE NEED FOR TRANSITIONAL AND/OR AFFORDABLE PERMANENT HOUSING. THE NEEDS ASSESSMENT IN 2008 ALSO IDENTIFIED THE NEEDS CONCERNING ALCOHOL AND DRUG ADDICTION, FOLLOW-UP CASE MANAGMENT FOR PATIENTS POST-REHAB, AND PRIMARY CARE PRACTICES SPECIALIZING IN DISABILITIES. BROOKS REHABILITATION HOSPITAL PART V, SECTION B, LINE 18D: BROOKS REHABILITATION HOSPITAL IS A SUB ACUTE CARE FACILITY AND DOES NOT HAVE EMERGENCY FACILITIES. PART VI, LINE 2: BROOKS REHABILITIATION HOSPITAL CONDUCTS A NETWORK-WIDE COMMUNITY-BASED NEEDS ASSESSMENT EVERY THREE YEARS. OUR LAST ASSESSMENT WAS CONDUCTED IN 2008, AND INCLUDED DATA FROM THE FOLLOWING SOURCES: - FOCUS GROUPS WITH OVER 50 PARTICIPANTS FOR THE FOLLOWING: * ILRS CONSUMERS AND CAREGIVERS * BROOKS/COMMUNITY SUPPORT GROUPS (SURVIVORS AND CAREGIVERS FOR STROKE AND SPINAL CORD INJURY SUPPORT GROUPS) * BROOKS CASE MANAGERS - INTERVIEWS WITH BROOKS' PROGRAM DIRECTORS - SURVEY TO INDENPENDENT LIVING RESOURCE CENTER CONSUMERS - FINDINGS FROM BRAIN INJURY ASSOCIATION OF FLORIDA STRATEGIC PLAN - RESULTS OF STUDY ON PERCEIVED AND ACTUAL NEEDS OF PATIENTS AND CAREGIVERS IN REHAB INCLUDING BARBARA LUTZ AT THE UNIVERSITY OF FLORDA PART VI, LINE 3: PATIENTS ARE EVALUATED IN THE ACUTE CARE SETTING TO DETERMINE ELIGIBILITY FOR CHARITY CARE. ALL HOPSITAL TEAM MEMBERS INCLUDING THE BUSINESS OFFICE TEAM AND CASE MANAGERS UNDERSTAND CHARITY CARE AND WORK WITH THE PATIENTS TO COMPLETE THE NECESSARY DOCUMENTATION, IF APPLICABLE. IN THE EVENT A PATIENT'S FINANCIAL DETERMINATION VARIES AFTER ENTRANCE INTO THE FACILITY, HE IS REEVALUATED BY A CASE MANAGER. PART VI, LINE 4: BROOKS REHABILITATION HOSPITAL IS PHYSICALLY LOCATED IN JACKSONVILLE, FLORIDA. OUR PATIENTS PRIMARILY TRANSFER FROM ONE OF SEVEN ACUTE CARE FACILITIES, HOWEVER, ANNUALLY PATIENTS COME FROM HOSPITALS ALL OVER NORTH CENTRAL FLORIDA AND SOUTHEAST GEORGIA. IN ADDITION, ADMISSIONS COME FROM SKILLED NURSING FACILITIES WITHIN THE SAME REGION. THE JACKSONVILLE COMMUNITY COUNCIL, INC. REPORTED IN 2010, FOR THE THIRD YEAR, NET NEGATIVE JOB GROWTH AND 10.7% UNEMPLOYMENT RATE THAT IS THE HIGHEST IN THE REGION. THE COUNTIES IN JACKSONVILLE'S MSA HAD BOTH A HIGH YOUTH POPULATION AND A GROWING ELDERLY POPULATION. PART VI, LINE 5: BROOKS CHARGES ITS UNINSURED PATIENTS AT THE AVERAGE DISCOUNTED RATE RECEIVED BY PRIVATE INSURERS, MEDICARE, AND MEDICAID. GENEROUS INCOME GUIDELINES ALONG WITH PATIENT-FRIENDLY BILLING PRACTICES ALLOWS BROOKS TO PROVIDE COMPREHENSIVE REHABILITATION SERVICES TO FLORIDA AND GEORGIA RESIDENTS WHO WOULD NOT OTHERWISE HAVE ACCESS TO THIS LEVEL OF CARE. THESE BENEFITS NOT ONLY IMPROVE THE FUNCTIONAL INDEPENDENCE OF OUR PATIENTS, BUT LEAD THEM TO A BETTER QUALITY OF LIFE. PART VI, LINE 6: BROOKS HEALTH SYSTEM, THE PARENT COMPANY OF BROOKS REHABILITATION HOSPITAL, ADMINISTERS SEVERAL COMMUNITY BENEFIT PROGRAMS SUCH AS A SCHOOL REENTRY PROGRAM, AN ADAPTIVE SPORTS PROGRAM, A CLINICAL EDUCATION PROGRAM, A SPORTS OUTREACH PROGRAM, A STROKE WELLNESS PROGRAM, AND OTHER VARIOUS PROGRAMS DESGINED TO MEET THE NEEDS OF THE COMMUNITY. DETAIL INFORMATION REGARDING THESE SPECIFIC PROGRAMS IS DESCRIBED ON THIS SCHEDULE AND CAN ALSO BE FOUND ON THE ORGANIZATION'S WEBSITE. 0 1 0 0 0 1 1 0 0 JEFFREY JOHNS MD 0 213438 0 70884 0 1598 0 16500 0 8140 0 310560 0 0 TREVOR PARIS MD 0 225989 0 98571 0 2082 0 7310 0 6858 0 340810 0 0 DOUGLAS M BAER 0 326994 0 113219 0 53549 0 106500 0 6883 0 607145 0 0 PATRICIA DEBEAR 0 156177 0 52165 0 21852 0 8639 0 6645 0 245478 0 0 MICHAEL SPIGEL 0 256192 0 94693 0 27388 0 67100 0 5692 0 451065 0 0 KERRY MAHER MD 126218 0 26944 0 241 0 16500 0 0 0 169903 0 0 0 JOANNE HOERTZ 135609 0 17420 0 238 0 0 0 4752 0 158019 0 0 0 RUSSELL ADDEO 121146 0 24100 0 229 0 9211 0 5357 0 160043 0 0 0 VIRGIL WITTMER 118174 0 24189 0 677 0 3750 0 5357 0 152147 0 0 0 PART I, LINE 4B IN 2011, GENESIS HEALTH, INC., A RELATED ORGANIZATION, PROVIDED A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN TO CERTAIN KEY EMPLOYEES. THE PLAN IS AN UNFUNDED DEFERRED COMPENSATION PLAN DESCRIBED IN SECTION 457(F) AND IS INTENDED FOR A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES. AT THIS TIME, CONTRIBUTIONS TO AN INDIVIDUAL'S ACCOUNT UNDER THE PLAN ARE SET TO BE 20% OF THE INDIVIDUAL'S ANNUAL BASE SALARY, WITH THE OPTION FOR AS MUCH AS 25% OF ANNUAL BASE SALARY AT THE DISCRETION OF THE BOARD COMPENSATION COMMITTEE. VESTING IN THE PLAN FOR CURRENT MEMBERS OCCURS JANUARY 1, 2022, PROVIDED EMPLOYMENT IS MAINTAINED, AND DISREGARDING ACCELERATION DUE TO DEATH OR DISABILITY. FOR THE CURRENT TAX YEAR, ALLOCATIONS TO THE PLAN FOR LISTED INDIVIDUALS WERE AS FOLLOWS, (LISTED AS A COMPONENT OF PART II, COLUMN (C)): DOUGLAS BAER - $ 68,000 MICHAEL SPIGEL - 50,600 PART I, LINE 6 IN 2011 INCENTIVE COMPENSATION ACCRUALS WERE RECORDED FOR THE SYSTEM CEO AND SYSTEM VICE PRESIDENTS THROUGH A PLAN THAT IS, IN PART, BASED ON THE NET EARNINGS OF THE SYSTEM OR INDIVIDUAL ORGANIZATIONS IN THE SYSTEM. SUPPLEMENTAL INFORMATION PART III PART I, LINE 3: THE ORGANIZATION DOES NOT COMPENSATE ANY OFFICERS OR KEY EMPLOYEES DIRECTLY. CERTAIN BOARD MEMBERS AND MANAGEMENT OFFICIALS ARE COMPENSATED BY BROOKS HEALTH SYSTEM, A RELATED ORGANIZATION. THE BOARD OF BROOKS HEALTH SYSTEM USES THE FOLLOWING METHODS TO DETERMINE EXECUTIVE COMPENSATION: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION STUDY OR SURVEY - APPROVAL BY COMPENSATION COMMITTEE PROGRAM SERVICE STATEMENT FORM 990, PART III, LINE 4A BROOKS TAKES GREAT PRIDE IN THE QUALITY CARE WE OFFER OUR PATIENTS EACH YEAR AS ILLUSTRATED IN OUR CLINICAL OUTCOMES AND PATIENT SATISFACTION SCORES. IN 2011: - OVERALL, BROOKS PATIENTS HAVE A SHORTER STAY AT THE HOSPITAL AND RETURN BACK TO THEIR LIVES AND BACK HOME AFTER TREATMENET.** - 96.1% OF PATIENTS RESPONDED POSITIVELY TO THE QUESTION, "LIKELIHOOD OF RECOMMENDING BROOKS".* - BROOKS RETURNS 65% OF PATIENTS BACK TO THEIR HOMES, WHICH IS MORE THAN OTHER REHABILITATION HOSPITALS NATIONALLY.** - PATIENTS ARE ADMITTED FASTER AND CAN BEGIN THE REHABILITATION PROCESS SOONER AT BROOKS THAN IN OTHER REHABILITATION HOSPITALS ACROSS THE NATION.** SOURCES: * PATIENT SATISFACTION AS MEASURED BY THE PRESS GANEY PATIENT SATISFACTION SURVEY 1/11-12/11. ** OUTCOMES DATA FROM E-REHABDATA 1/11-12-11. BROOKS REHABILITATION HAS CONTINUED TO INCREASE THE AMOUNT OF FREE CARE TO CHARITY, UNDERINSURED, AND UNINSURED PATIENTS EACH YEAR. IN 2011, BROOKS PROVIDED $1,366,497 OF FREE CARE AT COST IN THE HOSPITAL, WHICH WAS EQUIVALENT TO 1,177 PATIENT DAYS. CHARITY CARE AND OTHER FREE CARE PROVIDED TO OUTPATIENTS' VISITS WERE EQUIVALENT TO $652,438 IN COSTS. BROOKS ALSO PROVIDED CARE TO MEDICAID PATIENTS IN THE HOSPITAL AND OUTPATIENT CLINICS. THERE WERE 1,912 MEDICAID DAYS PROVIDED IN 2011, INCLUDING 1,470 MEDICAID HMO DAYS. SINCE THE MEDICAID PROGRAM REIMBURSES AT A RATE SIGNIFICANTLY BELOW THE COST OF CARE, THERE WAS A NET LOSS TO BROOKS IN PROVIDING THIS CARE OF $1,727,593. FORM 990, PART VI, SECTION A, LINE 2 BOARD MEMBERS LYNNE SNEED AND GARY W. SNEED HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS GENESIS HEALTH, INC. (DOING BUSINESS AS BROOKS HEALTH SYSTEM), A FLORIDA NOT-FOR-PROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD SHALL BE COMPOSED OF AT LEAST FIVE DIRECTORS. DIRECTORS SHALL BE SELECTED FOR THEIR ABILITY TO PARTICIPATE EFFECTIVELY IN FULFILLING THE BOARD'S RESPONSIBILITY AND WITH THE PURPOSE AND INTENT OF PROVIDING A BOARD OF DIRECTORS THAT IS REPRESENTATIVE OF THE MAJOR SEGMENTS OF THE COMMUNITY SERVICED BY THE HOSPITAL. THE DIRECTORS OF THE ORGANIZATION SHALL BE DESIGNATED BY THE SOLE MEMBER OF THE ORGANIZATION AND SHALL SERVE FOR TERMS OF TWO YEARS. ONE HALF OF THE DIRECTORS SHALL BE DESIGNATED EACH YEAR. AT LEAST ONE DIRECTOR SHALL BE A PHYSICIAN AND AT LEAST TWO DIRECTORS SHALL BE LAYMEN. FORM 990, PART VI, SECTION A, LINE 7B THE BOARD OF DIRECTORS SHALL NOT, WITHOUT PRIOR APPROVAL OF THE SOLE MEMBER OF THE ORGANIZATION: - APPROVE ANY ANNUAL OR LONG-TERM CAPITAL AND OPERATIONAL BUDGETS OR ANY CHANGES THEREIN EXCEEDING FIVE PERCENT OF THE TOTAL ORIGINAL BUDGET - APPROVE ANY NEW, OR ANY CHANGES TO EXISTING LONG-TERM OR MASTER INSTITUTIONAL PLANS OF THE ORGANIZATION - ENGAGE IN, OR ENTER INTO ANY AGREEMENT PROVIDING FOR, ANY TRANSACTION REQUIRING A CERTIFICATE OF NEED - APPROVE A PLAN OF DISSOLUTION OF THE ORGANIZATION - AGREE TO ANY CONTRACT OR ENGAGE IN ANY TRANSACTION WHERE THE AMOUNT INVOLVED EXCEEDS $100,000 - APPROVE A PLAN OF MERGER OR CONSOLIDATION OF THE ORGANIZATION WITH ANOTHER ORGANIZATION - ORGANIZE OR ACQUIRE, OR AUTHORIZE OR APPROVE THE ORGANIZATION OR ACQUISITION OF, ANY SUBSIDIARY OR AFFILIATE OF THE ORGANIZATION FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM WITH THE GUIDANCE AND ASSITANCE OF MANAGEMENT. THE FORM WAS REVIEWED INTERNALLY AND THEN PRESENTED TO THE AUDIT COMMITTEE FOR REVIEW. THE AUDIT COMMITTEE THEN PREPARED A SUMMARY THAT WAS PRESENTED TO THE BOARD OF DIRECTORS ALONG WITH THE FORM 990 PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR BOARD MEMBERS ARE REQUIRED TO COMPLETE A FORM THAT WILL DISCLOSE ANY RELATIONSHIPS THAT MAY CREATE A CONFLICT OF INTEREST. THE FORMS ARE REVIEWED BY MANAGEMENT AND ANY CONCERNS ARE REFERRED TO THE BOARD IF NECESSARY. FORM 990, PART VI, SECTION B, LINE 15 BROOKS HEALTH USES AN OUTSIDE CONSULTANT FOR ALL OFFICER, EXECUTIVE, AND TOP MANAGEMENT OFFICIAL COMPENSATION DECISIONS. THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS MUST APPROVE ANY AND ALL DECISIONS REGARDING EXECUTIVE PAY. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION'S FORM 990 IS AVAILABLE UPON REQUEST. ADDITIONALLY, RECENT FILINGS OF THE FORM ARE AVAILABLE ON GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. EXPLANATION OF BOARD MEMBER COMPENSATION: FORM 990, PART VII, LINE 1: BOARD MEMBERS JEFFREY JOHNS, MD AND TREVOR PARIS, MD WERE COMPENSATED BY PHYSICAL MEDICINE SPECIALISTS, A RELATED ORGANIZATION, FOR MEDICAL SERVICES PERFORMED FOR THE ORGANIZATION. AVERAGE HOURS PER WEEK FOR RELATED ORGANIZATIONS: FORM 990, PART VII, LINE 1: OFFICERS OF THIS ORGANIZATION RECEIVING COMPENSATION FROM A RELATED ORGANIZATION ARE COMPENSATED BY BROOKS HEALTH SYSTEM. THE SYSTEM PROVIDES MANAGERIAL OVERSIGHT TO ITS SUBSIDIARIES, AND OFFICERS IN PART VII SHOWN AS WORKING TWO HOURS FOR THE FILING ORGANIZATION PERFORM AN AVERAGE OF 40 TO 50 HOURS PER WEEK FOR BROOKS HEALTH SYSTEM. FORM 990 PART VII: AVERAGE HOURS FOR RELATED ORGANIZATIONS: THE FOLLOWING VOTING MEMBERS OF THE GOVERNING BODY SERVED ON THE BOARDS OF RELATED ORGANIZATIONS DURING THE TAX YEAR, REPORTED AS AVERAGE HOURS PER WEEK. GARY W. SNEED - 2 HOURS FOR GENESIS HEALTH, INC. ERNEST BRODSKY - 2 HOURS FOR GENESIS HEALTH, INC. STANLEY W. CARTER - 2 HOURS FOR GENESIS HEALTH, INC. BRUCE M. JOHNSON - 2 HOURS FOR GENESIS HEALTH, INC. 2 HOURS FOR BROOKS HOME CARE ADVANTAGE DOUGLAS M. BAER - 40 HOURS SERVICE TOTAL FOR ALL ENTITIES REPORTED ON SCHEDULE R, PARTS II AND IV PATRICIA DEBEAR - 40 HOURS SERVICE TOTAL FOR ALL ENTITIES REPORTED ON SCHEDULE R, PARTS II AND IV FORM 990, PART X, LINE 20: TAX EXEMPT BONDS: THE ORGANIZATION REPORTS ON ITS BALANCE SHEET AN ALLOCATION OF TAX-EXEMPT BOND LIABILITIES FROM A SERIES 2007 ISSUE REPORTED IN FULL ON THE SCHEDULE K OF GENESIS HEALTH, INC., THE ORGANIZATION'S CORPORATE PARENT AND SOLE MEMBER. THE ORGANIZATION ALSO REPORTS ON ITS BALANCE SHEET AN ALLOCATION OF TAX-EXEMPT BOND LIABILITIES FROM A SERIES 2010 ISSUE REPORTED IN FULL ON THE SCHEDULE K OF BROOKS HEALTH CARE ADVANTAGE, A RELATED ORGANIZATION. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -103,673. NET LOSS ON SWAP VALUATION -415,942. TOTAL TO FORM 990, PART XI, LINE 5: -519,615. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. GENESIS HEALTH INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 592249370 HEALTHCARE FL 501(C)(3) LINE 11A, I N/A 0 PHYSICAL MEDICINE SPECIALISTS INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 593530305 HEALTHCARE / PHYSICIANS FL 501(C)(3) LINE 11A, I GENESIS REHABILITATION HOSPITAL INC 1 BROOKS HOME CARE ADVANTAGE INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 262216181 HEALTHCARE / HOME THERAPY FL 501(C)(3) LINE 9 GENESIS HEALTH INC 0 GENESIS HEALTH DEVELOPMENT INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 592249372 HEALTHCARE / REHAB THERAPY FL 501(C)(3) LINE 9 GENESIS HEALTH INC 0 BROOKS SKILLED NURSING INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 264561148 HEALTHCARE / SKILLED NURSING FL 501(C)(3) LINE 9 GENESIS HEALTH INC 0 BROOKS SKILLED NURSING FACILITY A INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 272153586 HEALTHCARE / SKILLED NURSING FL 501(C)(3) LINE 3 BROOKS SKILLED NURSING INC 0 BROOKS SKILLED NURSING FACILITY B INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 452623130 HEALTHCARE / SKILLED NURSING FL 501(C)(3) PENDING BROOKS SKILLED NURSING INC 0 THE GENESIS HEALTH FOUNDATION INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 592249340 SUPPORT / FUNDRAISING FL 501(C)(3) LINE 7 GENESIS HEALTH INC 0 BROOKS SKILLED NURSING FACILITY HOLDINGS A INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 272187557 REAL ESTATE HOLDING FL 501(C)(3) LINE 11A, I BROOKS SKILLED NURSING INC 0 BROOKS SKILLED NURSING FACILITY HOLDINGS B INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 452623488 REAL ESTATE HOLDING FL 501(C)(3) PENDING BROOKS SKILLED NURSING INC 0 HB REHABILITATIVE SERVICES INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 452622986 HEALTHCARE FL 501(C)(3) PENDING GENESIS HEALTH INC 0 ST AUGUSTINE MOB LTD 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 593397507 REAL ESTATE HOLDING FL N/A GH HOLDINGS INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 593007328 HOLDING COMPANY FL N/A C GH MANAGEMENT INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 592387438 HOLDING COMPANY FL N/A C GENESIS MANAGEMENT SERVICES INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 592183211 MANAGEMENT SERVICES FL N/A C GH MEDICAL SERVICES INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 592742895 MEDICAL SERVICES FL N/A C GH PARTNERSHIP HOLDINGS PPA INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 593075439 INVESTMENT HOLDINGS FL N/A C 0 0 0 1 0 0 0 0 0 0 0 1 1 1 0 0 0 0 PHYSICAL MEDICINE SPECIALISTS INC D 468169 INTERCOMPANY REC.