2017-11-09T10:08:55-06:00 2014-12-31 221478099 COHNREZNICK LLP 1301 AVENUE OF THE AMERICAS NEW YORK NY 10019 990 2014-01-01 237085986 SAMUEL SCHULMAN INSTITUTE FOR NURSING AND REHABILITATION SAMU 7182405200 101-01 AVENUE D BROOKLYN NY 11236 JAMES PORTER CHIEF FINANCIAL OFFICER 7182405200 2017-11-02 1 MAGDALENA M CZERNIAWSKI CPA P00535099 2122970400 2017-11-02 2014 2021-01-29 14:40:06Z X JAMES PORTER 101-01 AVENUE D BROOKLYN NY 11236 65462452 0 X WWW.BROOKDALEHOSPITAL.ORG X 1970 NY THE ORGANIZATION IS A VOLUNTARY, NON-PROFIT, RESIDENTIAL HEALTHCARE FACILITY DEDICATED TO PROVIDING THE HIGHEST QUALITY OF MEDICAL CARE IN HOMELIKE ENVIRONMENT 10 10 591 62 0 0 0 0 65101281 64909261 18864 84 3740139 553107 68860284 65462452 0 0 0 0 41946748 43416362 0 0 0 38010062 43477611 79956810 86893973 -11096526 -21431521 20462191 18827354 162668186 182769897 -142205995 -163942543 THE ORGANIZATION IS A VOLUNTARY, NON-PROFIT, RESIDENTIAL HEALTHCARE FACILITY DEDICATED TO PROVIDING THE HIGHEST QUALITY OF MEDICAL CARE IN HOMELIKE ENVIRONMENT 0 0 78095502 65078115 THE SCHULMAN AND SCHACHNE INSTITUTE FOR NURSING AND REHABILITATION IS A VOLUNTARY, NOT FOR PROFIT, RESIDENTIAL HEALTHCARE FACILITY CREATED TO PROVIDING PATIENT HEALTH CARE SERVICES INCLUDING MEDICAL, NURSING REHABILITATIVE, AND THERAPEUTIC SERVICES. 78095502 1 0 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 49 0 1 591 1 0 0 0 0 0 0 0 0 0 0 X 10 10 1 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 NY X JAMES PORTER CFO 7182405186 101-01 AVENUE D BROOKLYN NY 11236 ALEX ROVT TRUSTEE/CHAIRMAN 1.00 5.40 X X 0 0 0 ANTHONY CLEMENZA TRUSTEE 1.00 5.40 X 0 0 0 ASCHER MESTEL MD TRUSTEE 1.00 5.40 X 0 0 0 BISHOP HUGH NELSON TRUSTEE 1.00 5.40 X 0 0 0 IRINA BENFIELD TRUSTEE/SECRETARY 1.00 5.40 X X 0 0 0 ISSAC KREIZMAN MD TRUSTEE 1.00 5.40 X 0 0 0 LOWELL M RUBIN TRUSTEE/VICE CHAIRMAN 1.00 5.40 X X 0 0 0 MICHAEL SCAGNELLI TRUSTEE 1.00 5.40 X 0 0 0 MICHAEL SPIEGEL TRUSTEE 1.00 5.40 X 0 0 0 RICHARD RADUTZKY TRUSTEE/SECRETARY 1.00 44.40 X X 0 0 0 STEPHEN PLOTNICK TRUSTEE 1.00 5.40 X 0 0 0 ARTHUR J FRIED ASSISTANT SECRETARY 1.00 44.40 X 0 0 0 JAMES R PORTER CHIEF FINANCIAL OFFICER 1.00 44.40 X 0 0 0 MARK E TONEY PRESIDENT AND CHIEF EXECUTIVE OFFICER 1.00 44.40 X 0 0 0 REGINALD BULLOCK ASSISTANT SECRETARY 1.00 44.40 X 0 243910 29367 STEVEN R KORF CHIEF OPERATING OFFICER 1.00 44.40 X 0 0 0 GENEVIEVE SORENSON ADMINISTRATOR 40.00 X 315269 0 15534 LOUIS BELZIE PHYSICIAN 40.00 X 147734 0 29454 MOSTAQUE AHMED PHYSICIAN 40.00 X 152322 0 22144 MRIDULA SAXENA PHYSICIAN 40.00 X 218995 0 23236 VIMALSON MONICAM PHYSICIAN 40.00 X 137981 0 12534 972301 243910 132269 44 0 1 0 AFFINITY REHABILITION LLP 10600 YORK ROAD SUITE 105 COCKYESVILLE MD 21030 THERAPY STAFFING 262783 HEALTHPRO MANAGEMENT LLP 10600 YORK ROAD SUITE 105 COCKYESVILLE MD 21030 THERAPY MANAGEMENT 168000 2 NET PATIENT REVENUE AFTER BAD DEB 623000 64909261 64909261 64909261 84 84 384253 0 384253 384253 384253 VENDOR SETTLEMENT 900099 129011 129011 REBATES 900099 36452 36452 CHARGEBACKS 900099 3148 3148 243 243 168854 65462452 65078115 0 384337 31727808 27569825 4157983 9240456 8305102 935354 2448098 2203288 244810 159226 155903 3323 1587814 1379385 208429 313 282 31 160816 155774 5042 79892 71903 7989 546727 492054 54673 3105 3105 2363 2127 236 28759033 25883130 2875903 1055429 949886 105543 168231 151408 16823 CASH RECEIPTS ASSESMENT 6309229 6309229 0 MEDICAL AND PHARMACEUTI 2397413 2349985 47428 REPAIRS AND MAINTENANCE 814684 699897 114787 BAD DEBT 786305 786305 647031 626914 20117 86893973 78095502 8798471 0 593578 704630 359008 11206253 10522679 399963 3000 51711128 44696553 8108421 7014575 14998 176933 185507 20462191 18827354 4990231 4374501 192303 189241 181810 157303842 178206155 162668186 182769897 X -142205995 -163942543 -142205995 -163942543 20462191 18827354 -21431521 -305027 0 X X 0 1 X 1 0 X 0 1 X 623716 623716 34899823 30826560 4073263 6814906 5525854 1289052 9372683 8344139 1028544 7014575 DUE TO THIRD-PARTY PAYORS 52632432 DUE TO AFFILIATES 125573723 178206155 X 64676159 -786293 -786293 65462452 0 65462452 86107668 0 86107668 786305 786305 86893973 PART IV, LINE 2B: FUNDS HELD IN TRUST FOR RESIDENTS REPRESENT FUNDS HELD BY THE INSTITUTE ON BEHALF OF RESIDENTS. SUCH FUNDS INCLUDE LIVING ALLOWANCES RECEIVED BY RESIDENTS, AS WELL AS, OTHER RESIDENT FUNDS DEPOSITED WITH THE INSTITUTE FOR SAFEKEEPING. THESE FUNDS ARE DISBURSED BY THE INSTITUTE AT THE REQUEST, OR ON BEHALF, OF RESIDENTS FOR THEIR PERSONAL USE. PART X, LINE 2: THE INSTITUTE AND THE FUND QUALIFY AS TAX - EXEMPT, NON- PROFIT ORGANIZATIONS UNDER SECTION 501 (C) (3) OF THE INTERNAL REVENUE CODE AND THEIR INCOME IS GENERALLY NOT SUBJECT TO FEDERAL, STATE, OR LOCAL INCOME TAXES. PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT EXPENSE -786,305. RELATED PARTY REVENUE 12. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 786,305. 0 0 0 0 0 0 0 0 0 REGINALD BULLOCK ASSISTANT SECRETARY 0 243910 0 0 0 0 0 0 0 29367 0 273277 0 0 GENEVIEVE SORENSON ADMINISTRATOR 296646 0 0 0 18623 0 0 0 15534 0 330803 0 0 0 LOUIS BELZIE PHYSICIAN 147734 0 0 0 0 0 0 0 29454 0 177188 0 0 0 MOSTAQUE AHMED PHYSICIAN 152322 0 0 0 0 0 0 0 22144 0 174466 0 0 0 MRIDULA SAXENA PHYSICIAN 218995 0 0 0 0 0 0 0 23236 0 242231 0 0 0 VIMALSON MONICAM PHYSICIAN 137981 0 0 0 0 0 0 0 12534 0 150515 0 0 0 FORM 990, PART VI, SECTION A, LINE 2 ALEX ROVT, TRUSTEE AND CHAIRMAN, IRINA BENFIELD, TRUSTEE AND SECRETARY, AND STEPHEN PLOTNICK, TRUSTEE, ALL HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER. FORM 990, PART VI, SECTION A, LINE 3 IN MARCH 2012, GRANT THORNTON WAS ENGAGED BY THE ORGANIZATION TO PROVIDE TEMPORARY STAFFING SERVICES. COMMENCING APRIL 26, 2012 GRANT THORTON'S GRANT THORTON'S TEMPORARY STAFFING SERVICES INCLUDED PROVIDING THE CHIEF EXECUTIVE AND RESTRUCTUTING OFFICER, CHIEF OPERATING OFFICER, CHIEF FINANCIAL OFFICER, AND CHIEF INFORMATION OFFICER POSITIONS. AS WELL AS MULTIPLE OTHER ADMINISTRATIVE POSITIONS IN FINANCE, OPERATIONS, AND IT. DURING 2013, THE POSITION OF CHIEF FINANCIAL OFFICER WAS FULFILLED BY JAMES PORTER OF GRANT THORNTON. IN DECEMBER 2012, THE HOSPITAL RETAINED TONEYKORF PARTNERS, LLC. TO PROVIDE INDIVIDUALS TO TEMPORARLY FILL THE POSITIONS OF CHIEF EXECUTIVE OFFICER AND CHIEF OPERATING OFFICER, FULLFILLED BY MARK TONEY AND STEVEN KORF, RESPECTIVELY. THESE POSITIONS ARE ALL INDICATED IN PART VII SECTION A FOR OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES. ANY AMOUNTS PAID IN CONNECTION WITH THE ABOVE SERVICES ARE PAID DIRECTLY TO GRANT THORNTON OR TONEYKORF PARTNERS, LLC RESPECTIVELY. THE FOLLOWING WERE PAID BY THE RELATED ORGANIZATION FOR SERVICES RENDERED DURING THE YEAR: TONEYKORF PARTNERS, LLC $2,944,152 FORM 990, PART VI, SECTION A, LINE 6 BROOKDALE HEALTH SYSTEM, INC., A NEW YORK NOT-FOR-PROFIT ORGANIZATION, IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A BROOKDALE HEALTH SYSTEM, INC., AS SOLE MEMBER OF THE ORGANIZATION, HAS THE AUTHORITY TO APPOINT AND REMOVE THE TRUSTEES OF THE ORGANIZATION, AND OTHER AUTHORITIES AS DELINEATED IN THE BYLAWS OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 AND APPROPRIATE SCHEDULES, AS REQUIRED, IS PREPARED BY OUTSIDE ACCOUNTANTS AND REVIEWED INTERNALLY BY MANAGEMENT AND COUNSEL, AT WHICH TIME IT IS CONSIDERED THE FINAL DRAFT. THE FINAL DRAFT OF THE FORM 990 IS THEN FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C DISCLOSURE IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY BY EMPLOYEES THAT SATISIFY THE CRITERIA TO BE CONSIDERED "INTERESTED PERSONS" IS SUBMITTED UPON HIRING AND ANNUALLY THEREAFTER. THE AUDIT AND COMPLIANCE COMITTEE REVIEWS THE SUBMISSIONS FOR CONFLICTS AND THE DEPARTMENT OF INTERNAL AUDIT MANAGES COMPLIANCE. FORM 990, PART VI, SECTION C, LINE 19 THE DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. AMENDED RETURN: FORM 990 WAS AMENDED TO REFLECT CORRECTED FINANCIAL AND OTHER INFORMATION. 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