BROOKS SKILLED NURSING FACILITY A INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- BROOKS SKILLED NURSING FACILITY A INC (EIN 27-2153586)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-12
- IRS object ID
- 201223179349301887
- Schema version
- 2011v1.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-12T14:27:13-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560747981 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIXON HUGHES GOODMAN LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 RIDGEFIELD COURT | AddressLine1 |
| City | ASHEVILLE | City |
| State | NC | State |
| ZIP Code | 28806 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 272153586 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BROOKS SKILLED NURSING FACILITY A INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | BROO | NameControl |
| Phone | 9043465584 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3599 UNIVERSITY BLVD SOUTH | AddressLine1 |
| City | JACKSONVILLE | City |
| State | FL | State |
| ZIP Code | 32216 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DOUGLAS M BAER | Name |
| Title | CHAIRMAN | Title |
| Phone | 9043465584 | Phone |
| Date Signed | 2012-11-06 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | AMY BIBBY | Name |
| PTIN | P00445891 | PTIN |
| Phone | 8282542254 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | X | AddressChange |
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAN MARCO TERRACE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | BRIAN FULLER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3599 UNIVERSITY BLVD SOUTH | AddressLine1 |
| City | JACKSONVILLE | City |
| State | FL | State |
| ZIP Code | 32216 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 5215071 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.BROOKSHEALTH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2010 | YearFormation |
| State Legal Domicile | FL | StateLegalDomicile |
| Activity Or Mission Description | OPERATION OF SAN MARCO TERRACE, A NURSING AND REHABILITATION FACILITY | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 5 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 1 | NbrIndependentVotingMembers |
| Total Nbr Employees | 124 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 54 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 3029359 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 5144521 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 0 | InvestmentIncomePriorYear |
| Investment Income Current Year | 0 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 70550 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 3029413 | TotalRevenuePriorYear |
| Total Revenue Current Year | 5215071 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 1681175 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 2676348 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1574135 | OtherExpensePriorYear |
| Other Expenses Current Year | 2753063 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 3255310 | TotalExpensesPriorYear |
| Total Expenses Current Year | 5429411 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -225897 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -214340 | RevenuesLessExpensesCY |
| Total Assets BOY | 4698288 | TotalAssetsBOY |
| Total Assets EOY | 8202605 | TotalAssetsEOY |
| Total Liabilities BOY | 4924185 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 8642842 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -225897 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -440237 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | TO ADVANCE THE HEALTH AND WELL-BEING OF PERSONS REQUIRING REHABILITATION THROUGH SUPERIOR OUTCOMES, SERVICE, EDUCATION, AND RESEARCH | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 3270459 | Expense |
| Revenue | 5144521 | Revenue |
| Description | BROOKS SKILLED NURSING FACILITY A, INC. IS A 501(C)(3) NON-PROFIT ORGANIZATION CREATED BY BROOKS HEALTH SYSTEM OF JACKSONVILLE, FLORIDA TO OPERATE THE SAN MARCO TERRACE.SAN MARCO TERRACE, OWNED AND OPERATED BY BROOKS REHABILITATION VIA BROOKS SKILLED NURSING FACILITY A, IS AN AWARD-WINNING NURSING AND REHABILITATION FACILITY LOCATED IN THE HEART OF ST. AUGUSTINE. ONE OF ONLY A FEW FACILITIES IN NORTHEAST FLORIDA AWARDED THE 5-STAR QUALITY RATING BY MEDICARE, SAN MARCO TERRACE IS AMONG THE TOP 10% OF ALL SKILLED NURSING AND REHABILITATION FACILITIES IN THE UNITED STATES. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | LEARN MORE ABOUT SAN MARCO TERRACE AT:HTTP://WWW.BROOKSHEALTH.ORG/SKILLED-NURSING/SAN-MARCO-TERRACE/ | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 3270459 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 117 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 124 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 5 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 1 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DOUGLAS M BAER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9043457600 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3599 UNIVERSITY BLVD SOUTH | AddressLine1 |
| City | JACKSONVILLE | City |
| State | FL | State |
| ZIP Code | 32216 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (6 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| DOUGLAS M BAER | |||||||
| CHAIRMAN | 2.00 | X | X | 0 | 493762 | 113383 | |
| BRUCE M BLAKE | |||||||
| TREASURER | 2.00 | X | X | 0 | 102760 | 16606 | |
| BRIAN FULLER | |||||||
| SECRETARY | 2.00 | X | X | 0 | 182300 | 14449 | |
| MICHAEL SPIGEL | |||||||
| PRESIDENT | 2.00 | X | X | 0 | 378273 | 72792 | |
| GARY W SNEED | |||||||
| BOARD MEMBER | 2.00 | X | 0 | 38567 | 0 | ||
| DOUGLAS A HERNANDEZ | |||||||
| FACILITY OPERATOR | 40.00 | 102193 | 0 | 16500 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 102193 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1195662 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 233730 | TotalOtherCompensation |
| Number Individuals GT100 K | 1 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (3 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| SENIOR CARE OF ST JOHNS | |||||
| 1240 MARBELA PLACE DR | TAMPA | FL | 33629 | MEDICAL SERVICES | 611401 |
| HEALTHCARE SERVICES GROUP INC | |||||
| 3220 TILMAN DR SUITE 300 | BENSALEM | PA | 19020 | MEDICAL SERVICES | 304713 |
| PHARMERICA | |||||
| PO BOX 741700 | ATLANTA | GA | 30374 | MEDICAL SUPPLIES | 214415 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 3 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PROGRAM SERVICE | Description |
| Business Code | 621400 | BusinessCode |
| Total Revenue Column | 5144521 | TotalRevenueColumn |
| Related Or Exempt Function Income | 5144521 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 5144521 | TotalProgramServiceRevenue |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER REVENUE | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 70550 | TotalRevenueColumn |
| Exclusion | $70,550 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 70550 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5215071 | TotalRevenueColumn |
| Related Or Exempt Function Income | 5144521 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $70,550 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2131721 | Total |
| Program Services | 1868296 | ProgramServices |
| Management And General | 263425 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27290 | Total |
| Program Services | 26157 | ProgramServices |
| Management And General | 1133 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 345738 | Total |
| Program Services | 316057 | ProgramServices |
| Management And General | 29681 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 171599 | Total |
| Program Services | 148661 | ProgramServices |
| Management And General | 22938 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 645670 | Total |
| Management And General | 645670 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 172237 | Total |
| Management And General | 172237 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15954 | Total |
| Management And General | 15954 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 459772 | Total |
| Program Services | 331704 | ProgramServices |
| Management And General | 128068 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 342 | Total |
| Management And General | 342 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 985299 | Total |
| Program Services | 468315 | ProgramServices |
| Management And General | 516984 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 95433 | Total |
| Program Services | 95433 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10743 | Total |
| Program Services | 8396 | ProgramServices |
| Management And General | 2347 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1577 | Total |
| Management And General | 1577 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 115343 | Total |
| Management And General | 115343 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 220187 | Total |
| Program Services | 5604 | ProgramServices |
| Management And General | 214583 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28670 | Total |
| Management And General | 28670 | ManagementAndGeneral |
Other Expenses OtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | BAD DEBT EXPENSE | Description |
| Total | 1836 | Total |
| Program Services | 1836 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5429411 | Total |
| Program Services | 3270459 | ProgramServices |
| Management And General | 2158952 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 353673 | BOY |
| EOY | 331587 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 861575 | BOY |
| EOY | 443182 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14565 | BOY |
| EOY | 3141 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 198970 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 67499 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 172638 | BOY |
| EOY | 131471 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 491750 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 20597 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3295837 | BOY |
| EOY | 6780877 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4698288 | BOY |
| EOY | 8202605 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 528127 | BOY |
| EOY | 583169 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 3270058 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3823383 | BOY |
| EOY | 4253708 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 572675 | BOY |
| EOY | 535907 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4924185 | BOY |
| EOY | 8642842 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -225897 | BOY |
| EOY | -440237 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -225897 | BOY |
| EOY | -440237 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4698288 | BOY |
| EOY | 8202605 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -214340 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 60603 | OtherCostOrOtherBasis |
| Depreciation | 39779 | Depreciation |
| Book Value | 20824 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2556 | OtherCostOrOtherBasis |
| Depreciation | 1661 | Depreciation |
| Book Value | 895 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 135811 | OtherCostOrOtherBasis |
| Depreciation | 26059 | Depreciation |
| Book Value | 109752 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 131471 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| OTHER ASSETS | 63900 |
| LICENSURES AND START-UP COSTS, NET | 6716977 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 6780877 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ESTIMATED THIRD-PARTY PAYABLES | $217,754 |
| DUE TO AFFILIATES | $318,153 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 535907 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X: | ReturnReference |
| Explanation | 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. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DOUGLAS M BAER | |||||||||||||
| 0 | 326994 | 0 | 113219 | 0 | 53549 | 0 | 106500 | 0 | 6883 | 0 | 607145 | 0 | 0 |
| BRIAN FULLER | |||||||||||||
| 0 | 126076 | 0 | 40142 | 0 | 16082 | 0 | 9697 | 0 | 4752 | 0 | 196749 | 0 | 0 |
| MICHAEL SPIGEL | |||||||||||||
| 0 | 256192 | 0 | 94693 | 0 | 27388 | 0 | 67100 | 0 | 5692 | 0 | 451065 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| 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 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 | SUPPLEMENTAL INFORMATION |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JACKSONVILLE ECONOMIC DEVELOPMENT COMMISSION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Date Issued | 2011-05-31 | DateIssued |
| Issue Price | 3300000 | IssuePrice |
| Description Of Purpose | CAPITAL IMPROVEMENTS, REFINANCING | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Proceeds | 3300000 | TotalProceeds |
| Issuance Costs From Proceeds | 21682 | IssuanceCostsFromProceeds |
| Other Spent Proceeds | 3018400 | OtherSpentProceeds |
| Amount Unspent | 259918 | AmountUnspent |
| Year Of Subst Completion | 2014 | YearOfSubstCompletion |
| Current Refunding | 1 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 0 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 1 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Prcntge Prvt Business Use By Others | 0.00000 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0.00000 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUse |
| Post Issuance Compliance Procdrs | 0 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 0 | Form8038TFiled |
| Variable Rate Issue | 1 | VariableRateIssue |
| Hedge Identified In Books And Recds | 1 | HedgeIdentifiedInBooksAndRecds |
Name Of Hedge Provider NameOfHedgeProvider
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BBVA COMPASS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 15.000000000000 | TermOfHedge |
| Superintegrated Hedge | 1 | SuperintegratedHedge |
| Hedge Terminated | 0 | HedgeTerminated |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 0 | ExceptionToRebate |
Form990 Schedule K Part VI Form990ScheduleKPartVI (2 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| SCHEDULE K, PART I, DESCRIPTION OF PURPOSE: | THE JACKSONVILLE ECONOMIC DEVELOPMENT COMMISSION HEALTH CARE REVENUE BONDS, SERIES 2010 WAS APPROVED AT $65,000,000 TO BE DISBURSED IN THREE SEPARATE ISSUES. THE FIRST FUNDING WAS FOR $34,100,000 ISSUED IN AUGUST 2010, AND WAS ALLOCATED TO A RELATED ORGANIZATION. THE PURPOSE OF THE ISSUE WAS TO: (I) FINANCE A PORTION OF THE COST OF CAPITAL IMPROVEMENTS, (II) REFINANCE CERTAIN INDEBTEDNESS OF THE COMPANY WHICH FINANCED THE ACQUISITION OF BROOKS HOME CARE ADVANTAGE, INC. AND (III) PAY THE COSTS ASSOCIATED WITH THE ISSUANCE OF THE DEBT. THE CAPITAL IMPROVEMENTS WILL CONSIST OF: (I) BUILDING THE INFRASTRUCTURE ON LAND HELD FOR INVESTMENT, (II) IMPROVEMENTS AT THE COMPANY'S EXISTING INPATIENT REHABILITATION HOSPITAL, (III) ROUTINE CAPITAL IMPROVEMENTS TO HEALTH CARE FACILITIES OF THE COMPANY. THE REMAINING FUNDS WERE ISSUED IN MAY 2011. THE FIRST DRAW OF $3,300,000 (REPORTED ON THIS SCHEDULE K) WAS ALLOCATED TO THE FILING ORGANIZATION. THE REMAINING $27,600,000 WAS ALLOCATED TO A RELATED ORGANIZATION. |
| SCHEDULE K, PART IV, LINE 6: | AT THE TIME OF FILING, NOT ENOUGH TIME HAD PASSED TO DETERMINE IF THE ISSUE QUALIFIED FOR AN EXCEPTION TO REBATE. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (13 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| PROGRAM SERVICE STATEMENT | FORM 990, PART III, LINE 4A | RESIDENTS AND THEIR FAMILIES WILL BE ASSURED THE VERY BEST IN QUALITY FROM A FACILITY THAT HAS ALSO RECENTLY RECEIVED THE BRONZE AWARD FOR COMMITMENT TO QUALITY FROM THE AMERICAN HEALTH CARE ASSOCIATION. AT SAN MARCO TERRACE, WE BELIEVE IN A HOLISTIC APPROACH TO HEALING, FOCUSING ON THE PHYSICAL, EMOTIONAL AND SPIRITUAL HEALTH OF OUR RESIDENTS. OUR CARING, COMPASSIONATE STAFF WORKS AROUND THE CLOCK TO ENSURE THAT OUR RESIDENTS' NEEDS ARE ALWAYS ATTENDED TO WITH PATIENCE AND UNDERSTANDING. REHABILITATION SAN MARCO TERRACE IS PROUD TO OFFER PHYSICAL, OCCUPATIONAL AND SPEECH THERAPIES TO OUR RESIDENTS WHO NEED THESE SERVICES. THERAPY TAKES PLACE IN A VARIETY OF SETTINGS THROUGHOUT OUR CAMPUS. IN ADDITION TO OUR THERAPY GYM, RESIDENTS MAY LEARN TECHNIQUES FOR NAVIGATING DIFFERENT SURFACES IN OUR OUTDOOR THERAPY COURTYARD, A THERAPIST MAY HAVE A RESIDENT PRACTICE WALKING DOWN A HALLWAY WHILE GREETING OTHER RESIDENTS. THERAPISTS ALSO RETRAIN RESIDENTS IN ACTIVITIES OF DAILY LIVING SUCH AS DRESSING AND BATHING. THERAPIES WOVEN THROUGHOUT THE DAY DURING A RESIDENT'S STAY WILL ENSURE CONTINUED SUCCESS AS THEY RETURN HOME OR TO ANOTHER LEVEL OF CARE. OUR THERAPISTS AND PROFESSIONAL STAFF ARE COMMITTED TO HELPING EACH CLIENT MAINTAIN QUALITY OF LIFE, INDEPENDENCE AND DIGNITY WHILE ACHIEVING THEIR HIGHEST LEVEL OF RECOVERY. WE REALIZE THAT EACH RESIDENT HAS UNIQUE NEEDS AND CHALLENGES. OUR STAFF WILL DEVELOP AN EQUALLY UNIQUE, COMPREHENSIVE REHABILITATION PROGRAM. SAN MARCO TERRACE IS LOCATED AT 189 SAN MARCO AVENUE, ST. AUGUSTINE, FL, 32084. |
| FORM 990, PART VI, SECTION A, LINE 3 | BEGINNING IN SEPTEMBER 2011, JOHN DRIGGERS, AN INDEPENDENT CONTRACTOR, BEGAN SERVING AS INTERIM ADMINISTRATOR OF THE BROOKS SAN MARCO TERRACE FACILITY. HIS DUTIES INCLUDE THE GENERAL SUPERVISION OF EMPLOYEES AND ADMINISTRATION OF THE FACILITY. BEGINNING IN OCTOBER 2011, LYNN PETERSON, CONTRACTED WITH THE ORGANIZATION THROUGH THE HEALTH DIMENSIONS GROUP, AN UNRELATED ORGANIZATION, SERVED AS THE INTERIM DIRECTOR OF NURSING FOR THE FACILITY. HER DUTIES INCLUDE DIRECTING AND LEADING THE FACILITY'S DELIVERY OF CARE. | |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE ORGANIZATION IS BROOKS SKILLED NURSING, INC. A FLORIDA NOT FOR PROFIT CORPORATION. BROOKS SKILLED NURSING, INC. IS A SUBSIDIARY OF GENESIS HEALTH, INC., A FLORIDA 501(C)(3) NOT FOR PROFIT CORPORATION. | |
| FORM 990, PART VI, SECTION A, LINE 7A | THE ORGANIZATION SHALL HAVE AT ALL TIMES AT LEAST THREE MEMBERS OF THE BOARD OF DIRECTORS. THE MEMBERS OF THE BOARD OF DIRECTORS ARE ELECTED BY THE SOLE MEMBER ORGANIZATION AS PROVIDED IN THE BYLAWS OF THE ORGANIZATION. SEE THE RESPONSE TO LINE 6 ABOVE. | |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING ACTIONS REQUIRE THE APPROVAL OF THE SOLE MEMBER: - A CHANGE IN THE PURPOSE OF THE ORGANIZATION - THE TERMINATION OF THE TAX-EXEMPT STATUS OF THE ORGANIZATION UNDER SECTION 501(C)(3) - THE SALE OR DISPOSITION OF SUBSTANTIALLY ALL OF THE ASSETS OF THE ORGANIZATION OR A SUBSIDIARY OF THE ORGANIZATION - THE DISSOLUTION OR LIQUIDATION OF THE ORGANIZATION OR A SUBSIDIARY OF THE ORGANIZATION - THE ADDITION OF A MEMBER OF THE ORGANIZATION - THE MERGER OR CONSOLIDATION OF THE ORGANIZATION OR A SUBSIDIARY OF THE ORGANIZATION OR THE ESTABLISHMENT OF A SUBSIDIARY OF THE ORGANIZATION - THE AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OR BYLAWS 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 ASSISTANCE 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. | |
| 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 50 HOURS PER WEEK FOR BROOKS HEALTH SYSTEM. |
| INDEPENDENCE OF GOVERNING BODY: | PART VII, LINE 1: | THE ORGANIZATION IS A SUBSIDIARY OF GENESIS HEALTH, INC., A 501(C)(3) ORGANIZATION. THE BOARD OF DIRECTORS OF THIS ORGANIZATION FAILS TO HAVE A MAJORITY OF INDEPENDENT BOARD MEMBERS PER THE DEFINITION PROVIDED BY THE IRS. PLEASE NOTE, HOWEVER, THAT THE PARENT ORGANIZATION HAS A MAJORITY INDEPENDENT BOARD OF DIRECTORS, AND THROUGH ITS MEMBERSHIP PROVIDES GOVERNANCE OVERSIGHT OVER THE FILING ORGANIZATION. PLEASE SEE THE RESPONSES TO FORM 990, PART VI, LINES 6 THROUGH 7B FOR DETAILS ON THE SOLE MEMBER, THE SOLE MEMBER'S CORPORATE PARENT, AND ITS AUTHORITY. |
| FORM 990, PART XII, LINE 2C: | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (11 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| GENESIS HEALTH INC | |||||||||||
| 3599 UNIVERSITY BLVD SOUTH | JACKSONVILLE | FL | 32216 | 592249370 | HEALTHCARE | FL | 501(C)(3) | LINE 11A, I | N/A | 0 | |
| GENESIS REHABILITATION HOSPITAL INC | |||||||||||
| 3599 UNIVERSITY BLVD SOUTH | JACKSONVILLE | FL | 32216 | 593284221 | HEALTHCARE / REHAB CARE | FL | 501(C)(3) | LINE 3 | 0 | GENESIS HEALTH INC | |
| PHYSICAL MEDICINE SPECIALISTS INC | |||||||||||
| 3599 UNIVERSITY BLVD SOUTH | JACKSONVILLE | FL | 32216 | 593530305 | HEALTHCARE / PHYSICIANS | FL | 501(C)(3) | LINE 11A, I | 0 | GENESIS REHABILITATION HOSPITAL INC | |
| BROOKS HOME CARE ADVANTAGE INC | |||||||||||
| 3599 UNIVERSITY BLVD SOUTH | JACKSONVILLE | FL | 32216 | 262216181 | HEALTHCARE / HOME THERAPY | FL | 501(C)(3) | LINE 9 | 0 | GENESIS HEALTH INC | |
| GENESIS HEALTH DEVELOPMENT INC | |||||||||||
| 3599 UNIVERSITY BLVD SOUTH | JACKSONVILLE | FL | 32216 | 592249372 | HEALTHCARE / REHAB THERAPY | FL | 501(C)(3) | LINE 9 | 0 | GENESIS HEALTH INC | |
| BROOKS SKILLED NURSING INC | |||||||||||
| 3599 UNIVERSITY BLVD SOUTH | JACKSONVILLE | FL | 32216 | 264561148 | HEALTHCARE / SKILLED NURSING | FL | 501(C)(3) | LINE 9 | 0 | GENESIS HEALTH INC | |
| BROOKS SKILLED NURSING FACILITY B INC | |||||||||||
| 3599 UNIVERSITY BLVD SOUTH | JACKSONVILLE | FL | 32216 | 452623130 | HEALTHCARE / SKILLED NURSING | FL | 501(C)(3) | PENDING | 0 | BROOKS SKILLED NURSING INC | |
| THE GENESIS HEALTH FOUNDATION INC | |||||||||||
| 3599 UNIVERSITY BLVD SOUTH | JACKSONVILLE | FL | 32216 | 592249340 | SUPPORT / FUNDRAISING | FL | 501(C)(3) | LINE 7 | 0 | GENESIS HEALTH INC | |
| 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 | 0 | BROOKS SKILLED NURSING INC | |
| BROOKS SKILLED NURSING FACILITY HOLDINGS B INC | |||||||||||
| 3599 UNIVERSITY BLVD SOUTH | JACKSONVILLE | FL | 32216 | 452623488 | REAL ESTATE HOLDING | FL | 501(C)(3) | PENDING | 0 | BROOKS SKILLED NURSING INC | |
| HB REHABILITATIVE SERVICES INC | |||||||||||
| 3599 UNIVERSITY BLVD SOUTH | JACKSONVILLE | FL | 32216 | 452622986 | HEALTHCARE | FL | 501(C)(3) | PENDING | 0 | GENESIS HEALTH INC | |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST AUGUSTINE MOB LTD | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3599 UNIVERSITY BLVD SOUTH | AddressLine1 |
| City | JACKSONVILLE | City |
| State | FL | State |
| ZIP Code | 32216 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 593397507 | EIN |
| Primary Activity | REAL ESTATE HOLDING | PrimaryActivity |
| Legal Domicile State | FL | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
Form990 Schedule R Part IV Form990ScheduleRPartIV (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity |
|---|---|---|---|---|---|---|---|---|
| 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |