2014-02-15T12:52:24-06:00 2013-03-31 910189318 MOSS ADAMS LLP 101 SECOND STREET 9TH FLOOR SAN FRANCISCO CA 94105 990 2012-04-01 953655256 CASA COLINA INC CASA 9095967733 255 E BONITA AVE POMONA CA 917696001 FELICE L LOVERSO 9095967733 2014-02-17 1 RENIE BURBANK P00159653 4159561500 2012 2015-11-30 17:44:51Z FELICE L LOVERSO PHD 255 E BONITA AVE POMONA CA 917696001 41356709 0 X WWW.CASACOLINA.ORG X 1981 CA IT IS THE MISSION OF CASA COLINA, INC. AND ITS AFFILIATES TO PROVIDE INDIVIDUALS THE OPPORTUNITY TO MAXIMIZE THEIR REHABILITATION POTENTIAL EFFICIENTLY AND EFFECTIVELY IN AN ENVIRONMENT THAT RECOGNIZES THEIR UNIQUENESS, DIGNITY AND SELF ESTEEM. 22 20 860 175 0 0 0 819 5531449 5858834 2726 64 33524105 35496992 39058280 41356709 0 0 0 0 37387626 39466291 0 0 0 1670654 1890418 39058280 41356709 0 0 7595614 7097724 6743394 6245504 852220 852220 X IT IS THE MISSION OF CASA COLINA, INC. AND ITS AFFILIATES TO PROVIDE INDIVIDUALS THE OPPORTUNITY TO MAXIMIZE THEIR REHABILITATION POTENTIAL EFFICIENTLY AND EFFECTIVELY IN AN ENVIRONMENT THAT RECOGNIZES THEIR UNIQUENESS, DIGNITY AND SELF ESTEEM.TO ACHIEVE THESE OBJECTIVES CASA COLINA, INC. MANAGES ITS RESOURCES IN TERMS OF STAFF, SERVICES AND QUALITY CARE BOTH EFFECTIVELY AND EFFICIENTLY. IN ORDER TO MAINTAIN FINANCIAL STRENGTH CASA COLINA, INC. CONTINUES TO STRATEGICALLY REPOSITION ITSELF AT THE FOREFRONT OF THE POST ACUTE CONTINUUM BY BECOMING THE CENTER OF EXCELLENCE IN THE PROVISION OF SERVICES TO PERSONS WHO CAN BENEFIT FROM SUCH CARE. 0 0 37543405 41355826 SEE SCHEDULE O. 37543405 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 147 0 0 860 1 0 0 0 0 0 0 0 0 0 0 X 22 20 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 0 0 CA X FELICE L LOVERSO PHD 9095967733 255 E BONITA AVE POMONA CA 917671923 FELICE L LOVERSO PHD 9.00 41.00 X X 1200354 0 15749 ACQUANETTA WARREN 0.50 2.50 X 0 0 0 ROBERT BALZER 0.50 2.50 X 0 0 0 RANDY BLACKMAN 0.50 2.50 X X 0 0 0 STEVE NORIN 0.50 2.50 X X 0 0 0 STEPHEN W GRAEBER 0.50 2.50 X X 0 0 0 SAMUEL P CROWE ESQ 0.50 2.50 X 0 0 0 MARY LOU JENSEN 0.50 2.50 X X 0 0 0 GEORGE E LANGLEY 0.50 2.50 X 0 0 0 DONALD A DRIFTMIER CP 0.50 2.50 X 0 0 0 ROHINDER SANDHU MD 0.50 2.50 X 0 0 0 FRANK S ALVAREZ 0.50 2.50 X 0 0 0 WILLIAM P DWRYE 0.50 2.50 X 0 0 0 JOSEPH UNIS MD 0.50 2.50 X 0 0 0 GARY LASTINGER 0.50 2.50 X 0 0 0 APRIL M MORRIS 0.50 2.50 X 0 0 0 CAMERON SAYLOR 0.50 2.50 X 0 0 0 GENE TANZEY 0.50 2.50 X 0 0 0 MARK WARREN 0.50 2.50 X 0 0 0 ROLLYN M BUTLER 0.50 2.50 X 0 0 0 GARY CRIPE 0.50 2.50 X 0 0 0 JAMES HENWOOD 0.50 2.50 X 0 0 0 ROBB QUINCEY 0.50 2.50 X 0 0 0 THOMAS REH 0.50 2.50 X 0 0 0 JOHN CHERRY 9.00 41.00 X X 147143 0 0 DAVID MORONY 9.00 41.00 X 132246 0 2701 KAY BERGLUND 9.00 41.00 X 271532 0 6054 ROD PEEK 1.00 44.00 X 260330 0 8093 JENNYFER PODUSKA 1.00 44.00 X 303324 0 9082 ROSS LESINS 45.00 0.00 X 213308 0 17724 ROBERT BARNES 45.00 0.00 X 322640 0 27000 CHRISTOPHER CHALIAN MD 30.00 15.00 X 294717 0 4114 KATHRYN JOHNSON 1.00 44.00 X 192780 0 22001 3338374 0 112518 34 0 1 0 MORRISON MANAGEMENT SPECIALISTS PO BOX 102289 ATLANTA GA 30368 MANAGEMENT/CATERING 1468240 TELNET-RX INC 18340 YORBA LINDA BLVD 107 YORBA LINDA CA 92886 PHARMACY SERVICES 291950 MISSION LINEN SUPPLY INC 5400 ALTON STREET CHINO CA 91710 CLEANING SERVICES 281056 FUTURENET TECHNOLOGIES CORPORATION 1320 VALLEY VISTA DRIVE DIAMOND BAR CA 91765 DICTATION SERVICES 249847 FITTANTE & SON PO BOX 8447 ALTA LOMA CA 91701 GROUNDSKEEPING 209249 5 819 819 PROGRAM SERVICES 900099 5858834 5858834 5858834 64 64 INTERCOMPANY SERVICES 900099 35496992 35496992 35496992 41356709 41355826 0 64 1800307 213523 1586784 27787104 26647050 1140054 581764 528147 53617 6855896 6224870 631026 2441220 2216232 224988 49841 49841 99925 99925 22341 19478 2863 211010 211010 12528 10034 2494 3234 3234 10944 10944 82137 82137 170094 170094 OUTSIDE SERVICES 715820 711730 4090 PRINTING/PUBLICATIONS 15045 15045 TELEPHONE 13319 9077 4242 484180 470800 13380 41356709 37543405 3813304 0 2472886 2018341 15748 33281 257623 141516 1322478 1055675 344937 266803 4504420 4637783 7595614 7097724 6559338 5932237 184056 179393 0 133874 6743394 6245504 X 852220 852220 852220 852220 7595614 7097724 0 0 X X 0 1 X 1 0 X X X 0 0 0 CCHRM INC 951643989 3 1 1 1 3910670 CCCRF 953655255 7 1 1 1 689160 CCCORS 953266014 7 1 1 1 181515 PADUA VILLAGE INC 953713170 7 0 1 1 412903 CCCR INC 953392219 7 0 1 1 664586 5 5858834 X 13000 13000 89035284 89048284 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 14202 10371 14223 13000 51796 250000 250000 250000 250000 1000000 1500000 1322478 1055675 266803 266803 CA HEALTH FACILITIES FINANCING AUTHORITY REV BONDS, SERIES 2001 4003 RECEIVABLE DUE FROM RELATED AFFILIATES 4500000 OTHER ASSETS 133780 4637783 PAYABLE DUE TO RELATED AFFILIATE 94 OTHER LIABILITIES 133780 133874 X 883 0 883 41355826 41355826 41356709 883 0 883 41355826 41355826 41356709 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: IN ACCORDANCE WITH ACCOUNTING STANDARDS CODIFICATION (ASC) 740-10, INCOME TAXES, THE COMPANY RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. PART XI, LINE 4B - OTHER ADJUSTMENTS: INTERCOMPANY SUPPORT SERVICES 35,496,992. OPERATING TRANSFER RECLASSIFIED FROM EXPENSES 5,858,834. PART XII, LINE 4B - OTHER ADJUSTMENTS: INTERCOMPANY SUPPORT SERVICES 35,496,992. OPERATING TRANSFER RECLASSIFIED TO REVENUES 5,858,834. X X X X X 1 0 0 0 0 0 0 0 0 FELICE L LOVERSO PHD 510477 0 570000 0 119877 0 8093 0 7656 0 1216103 0 0 0 KAY BERGLUND 99221 0 0 0 172311 0 0 0 6054 0 277586 0 0 0 ROD PEEK 181157 0 55000 0 24173 0 8093 0 0 0 268423 0 0 0 JENNYFER PODUSKA 197099 0 69608 0 36617 0 8093 0 989 0 312406 0 0 0 ROSS LESINS 158309 0 25000 0 29999 0 9415 0 8309 0 231032 0 0 0 ROBERT BARNES 225862 0 25000 0 71778 0 11218 0 15782 0 349640 0 0 0 CHRISTOPHER CHALIAN MD 271390 0 0 0 23327 0 3125 0 989 0 298831 0 0 0 KATHRYN JOHNSON 179258 0 0 0 13522 0 6393 0 15608 0 214781 0 0 0 PART I, LINE 4A KAY BERGLUND - OTHER COMPENSATION INCLUDES SEVERANCE PAYMENT OF $164,997 MELISSA GRAN DAUGHTER OF D. DRIFTMIER, CPA, DIRECTOR-AT-LARGE 82026 COMPENSATION FOR EMPLOYMENT 0 PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A DURING THE FISCAL YEAR CASA COLINA, INC. PROVIDED SUPPORT SERVICES TO ALL OF ITS AFFILIATES. SAID SERVICES AND SUPPORT CONSISTED OF ACCOUNTING, PAYROLL, HUMAN RESOURCES, MANAGEMENT INFORMATION SYSTEMS, CONTRACTING, PUBLIC RELATIONS, AND BILLING AND COLLECTIONS SERVICES TO THESE SIX (6) AFFILIATES. IN SUPPORT TO THE AFFILIATES CASA COLINA, INC. INCURRED $5,858,834 IN EXPENSES. THE EXPENSES ARE CHARGED TO THE AFFILIATES BASED ON A FORMULA AND USAGE OF SERVICES. AS A RESULT OF THESE NECESSARY SUPPORT SERVICES THE AFFILIATES WERE ABLE TO PROVIDE MEDICAL, RESIDENTIAL AND THERAPEUTIC SERVICES TO THE PATIENTS SERVED. THE RESULTS WERE THE FOLLOWING: HOSPITAL ACUTE INPATIENTS = 27,714 INPATIENT DAYS HOSPITAL OUTPATIENT VISITS = 75,203 VISITS OUTPATIENT SERVICES TO CHILDREN WITH VARIOUS DIAGNOSIS = 11,222 VISITS RESIDENTIAL INPATIENT SERVICES TO SHORT TERM/LONG TERM CARE = 38,560 RESIDENTIAL SERVICES OTHER OUTPATIENT REHABILITATION SERVICES FOR BRAIN INJURED PATIENT SERVICES = 3,061 VISITS ADULT DAY HEALTH CARE PERSONS SERVED = 14,585 VISITS CASA COLINA, INC. AND ITS AFFILIATES HAD 186 BEDS DURING THE FISCAL YEAR CONSISTING OF: 68 HOSPITAL ACUTE REHABILITATION BEDS; 26 SHORT TERM RESIDENTIAL; 83 LONG TERM RESIDENTIAL AND 10 LONG TERM SEMI INDEPENDENT BEDS. THE SERVICES WHICH CASA COLINA, INC. SUPPORTED CONSISTED OF: ADULT DAY HEALTH CARE WHICH PROVIDES A MEDICALLY-DIRECTED PROGRAM FOR ADULTS WITH DISABILITY WHO CANNOT STAY AT HOME SAFELY ON THEIR OWN DURING THE DAY, WHILE FAMILY MEMBERS OR CAREGIVERS ARE NOT AVAILABLE. A FULL DAY PROGRAM OF PHYSICAL AND COGNITIVE ACTIVITIES IS PROVIDED WITH OPPORTUNITIES FOR SOCIALIZATION AND SELF EXPRESSION. BRAIN INJURY SERVICES PROVIDE A CONTINUUM OF CARE FOR INDIVIDUALS WITH BRAIN OR SEVERE HEAD INJURIES. THE CONTINUUM INCLUDES: (A) ACUTE REHABILITATION FOR INDIVIDUALS WHO RESPOND MORE CONSISTENTLY TO STIMULATION OR ENGAGE IN SOME FORM OF COMMUNICATION, (B) RESIDENTIAL OR DAY PROGRAM TRANSITIONAL LIVING FOR PATIENTS WHO HAVE FINISHED ACUTE THERAPY BUT STILL NEED ASSISTANCE IN LEARNING THE SKILLS NECESSARY TO RE-ENTER LIVING WITH FAMILY OR ANOTHER COMMUNITY SETTING OR RETURNING WORK, (C) OUTPATIENT THERAPY THAT FOCUSES ON RESTORING PHYSICAL, COMMUNICATIVE, PSYCHOSOCIAL OR NEUROPSYCHOLOGICAL SKILLS, AND (D) RESIDENTIAL PROGRAMS FOR THOSE WHO WILL CONTINUE TO NEED A SUPERVISED LIVING SITUATION. BURN OR WOUND CARE REHABILITATION SERVICES PROVIDES REHABILITATION FOR INDIVIDUALS WHO HAVE EXPERIENCED SEVERE BURNS. SERVICES VARY, AND MULTIDISCIPLINARY CLINICS AND SERVICES SUCH AS AMPUTEE, INTERNAL MEDICINE, FOOT AND GAIT, AND WOMEN'S HEALTH ARE COORDINATED. CHILDREN'S SERVICES PROVIDES OUTPATIENT REHABILITATION SERVICES FOR CHILDREN AGE THREE MONTHS TO 16 YEARS INCLUDING SPECIALIZED PROGRAMS FOR INFANT DEVELOPMENT, AUTISM AND PEDIATRIC ORTHOPEDICS AT THE CHILDREN'S SERVICES CENTER. THE AFTER SCHOOL ACTIVITIES PROGRAM (ASAP) PROVIDES SOCIALIZATION, ENRICHMENT AND OPPORTUNITIES FOR SUCCESS FOR CHILDREN WITH DISABILITIES ATTENDING REGULAR SCHOOLS. A HIGH DEGREE OF COOPERATION IS MAINTAINED WITH ALL LOCAL SCHOOL SYSTEMS. SPECIALIZED SERVICES ARE PROVIDED FOR SPECIFIC DIAGNOSES, SUCH AS BRAIN INJURY, OSTEOGENESIS IMPERFECTA, CEREBRAL PALSY, MUSCULAR DYSTROPHY, SPINA BIFIDA AND SPINAL CORD INJURY, AS WELL AS THERAPIES FOR GENERAL REHABILITATION. GENERAL REHABILITATION PROVIDES CARE AND THERAPEUTIC INTERVENTION TO PATIENTS WHO NEED TO STRENGTHEN THEIR ABILITIES TO PERFORM ROUTINE AND WORK FUNCTIONS. THERAPIES FOCUS ON IMPROVING ENDURANCE, WORK CAPACITY, MOBILITY AND BALANCE. INDIVIDUAL REHABILITATION PROGRAMS ALSO ASSIST PEOPLE WITH DISABILITIES RESULTING FROM MULTIPLE SCLEROSIS, POST POLIO SYNDROME, CANCER, AND CEREBRAL PALSY, ORTHOPEDIC AND NEUROLOGICAL DISORDERS. HAND THERAPY OFFERS THE SERVICES OF CERTIFIED HAND THERAPIST WITH HIGHLY SPECIALIZED EXPERTISE TO WORK WITH PATIENTS TO RESTORE HAND FUNCTION AND UTILITY. PAIN MANAGEMENT PROVIDES SERVICES FOR INDIVIDUALS WITH CHRONIC PAIN AND AN INTERVENTION PROGRAM FOR INDIVIDUALS WITH ACUTE PAIN. ONE OF THE FIRST MULTIDISCIPLINARY, COMPREHENSIVE PAIN MANAGEMENT PROGRAMS IN THE UNITED STATES, THE PROGRAM HAS DEVELOPED SEVERAL TRACKS THAT APPROACH PAIN MANAGEMENT DIFFERENTLY. FOR THOSE WITH ACUTE PAIN, THE PROGRAM INCLUDES STRESS AND PAIN MANAGEMENT TECHNIQUES, EDUCATION, MEDICATION REDUCTION, AND BIOFEEDBACK AS WELL AS PHYSICAL RESTORATION THROUGH AN EXERCISE PROGRAM. RESIDENTIAL SERVICES PROVIDES THREE SUPERVISED, LONG-TERM LIVING HOMES FOR ADULTS WITH DEVELOPMENTAL DISABILITIES IN CLAREMONT AND POMONA, CALIFORNIA. FOR ADULTS WITH BRAIN INJURY, THE OBLIGATED GROUP OFFERS LONG-TERM FACILITIES IN LUCERNE VALLEY, CALIFORNIA AND IN APPLE VALLEY, CALIFORNIA. IN ADDITION, THERE ARE SEMI-INDEPENDENT LIVING ACCOMMODATIONS AT LUCERNE VALLEY. SPINAL CORD INJURY SPECIALIZED INCLUDE INTENSIVE THERAPY, COMPREHENSIVE TREATMENT, 24 HOUR REHABILITATION NURSING AND PHYSICIAN SUPERVISION, AND A CONTINUUM OF INPATIENT AND OUTPATIENT TREATMENT DESIGNED TO MAXIMIZE PHYSICAL PROGRESS AND SAFETY. SPORT AND RECREATION SERVICES OFFERS PERSONS WITH DISABILITY IN THE COMMUNITY THE OPPORTUNITY FOR PARTICIPATION IN ADAPTIVE RECREATION AND SPORTS. THE OUTDOOR ADVENTURES PROGRAM OFFERS MORE THAN 50 DAYS A YEAR OF TRIPS AND PROVIDES SERVICES TO MORE THAN 750 PERSONS ANNUALLY. THE LAND MEETS SEA SPORTS CAMP IS HELD ANNUALLY PROVIDING A FIRST EXPOSURE TO SPORTS AND OUTDOOR RECREATION TO MORE THAN 60 PERSONS WITH DISABILITY, FROM AGE FOUR UP. THESE ACTIVITIES INTRODUCE YOUNGSTERS AND PERSONS WITH RECENT INJURIES TO WHEELCHAIR BASKETBALL, HOCKEY, TENNIS AND RUGBY, AS WELL AS PROVIDING SPONSORSHIP TO ACCOMPLISHED ATHLETES WITH DISABILITY. THESE TRIPS AND SPORTS ARE AN EXTENSION OF THE REHABILITATION THERAPY PROCESS AND PLAY AN ESSENTIAL ROLE AS PEOPLE REBUILD THEIR LIVES AFTER REHABILITATION. STROKE SERVICES SPECIALIZES IN CREATING COMPREHENSIVE, PERSONALIZED TREATMENT FOR PEOPLE WHO HAVE EXPERIENCED SEVERELY DISABLING STROKES. STROKES REPRESENTS THE LARGEST DIAGNOSTIC CATEGORY OF PATIENTS ADMITTED TO THE HOSPITAL'S FACILITY. VENTILATION WEANING AND RESPIRATORY REHABILITATION SERVICES PROVIDES A PARTICULAR FOCUS ON WEANING PATIENTS FROM MECHANICAL VENTILATION, WHICH IS A MAJOR IMPEDIMENT TO THE REST OF THE REHABILITATION PROCESS. SPECIALTY CLINICS PROVIDES SERVICES TO PATIENTS WITH: MOVEMENT DISORDERS, WOUND CARE; FOOT AND ANKLE; AUDIOLOGY; MULTIPLE SCLEROSIS; URINARY DYSFUNCTION; ARTHRITIS, PULMONARY; VESTIBULAR AND BALANCE DISORDERS; AND GERIATRIC (SENIOR) EVALUATIONS. ALL THESE SERVICES ARE PROVIDED TO UNSERVED INDIVIDUALS WITHIN THE GREATER COMMUNITY. CASA COLINA INC.'S COMMUNITY BENEFIT ANALYSIS CONSISTED OF BENEFITS PROVIDED TO PATIENTS/RESIDENTS/PERSONS FOR MEDICAL AND THERAPEUTIC SERVICES AND BENEFITS PROVIDED ON A BROADER BASIS TO THE COMMUNITY AT LARGE. CASA COLINA INC. AND ITS AFFILIATES PROVIDED THE FOLLOWING BENEFITS TO PATIENTS/RESIDENTS/PERSONS, SEVERAL RESULTING IN LOSSES: -MEDI-CAL PATIENTS -SERVICES TO UNSERVED AUTISTIC CHILDREN RESULTED IN LOSSES -CHARITY CARE AND UNCOMPENSATED CARE PROVIDED TO PERSONS REQUIRING ASSISTANCE AT NO CHARGE TO INDIVIDUALS -REGIONAL CENTER - UNDERFUNDING FOR RESIDENTIAL SERVICES -SPORTS/RECREATIONAL SERVICES -SERVICES TO PERSONS WITH DISABILITIES CASA COLINA INC. THROUGH ITS RELATED AFFILIATES PROVIDED CHARITY CARE AT COST OF $270,752 AND PROVIDED COMMUNITY BENEFITS AT COST OF $3,577,377. FORM 990, PART VI, SECTION B, LINE 11 THE 990 WAS REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM FOR ACCURACY AND COMPLETENESS. AFTER WHICH TIME, A PAPER COPY OF THE 990 IS MADE AVAILABLE FOR REVIEW BY THE BOARD OF DIRECTORS. EACH MEMBER OF THE BOARD OF DIRECTORS IS ENCOURAGED TO REVIEW THE 990. FORM 990, PART VI, SECTION B, LINE 12C GOVERNANCE COMMITTEE OF THE BOARD REVIEWS DISCLOSURE FORMS ON AN ANNUAL BASIS. IN ADDITION, THE RATIO OF INTERESTED AND DISINTERESTED DIRECTORS IS CLOSELY MONITORED. INTERESTED DIRECTORS ARE NOT ALLOWED TO HOLD OFFICE OR SERVE ON THE AUDIT COMMITTEE. FINALLY, A PROTOCOL HAS BEEN ESTABLISHED THAT PREVENTS THE CONVERSION OF A CURRENT DISINTERESTED DIRECTOR TO AN INTERESTED DIRECTOR. FORM 990, PART VI, SECTION B, LINE 15A ON A REGULAR BASIS, THE COMPENSATION OF THE CEO IS REVIEWED BY AN OUTSIDE INDEPENDENT FIRM. THE FIRM'S FINDINGS ARE PRESENTED TO THE COMPENSATION COMMITTEE INDICATING THE COMPENSATION REASONABLENESS. THE COMPENSATION COMMITTEE DETERMINES ANY COURSE OF ACTION NECESSARY AND PRESENTS ITS FINDINGS/RECOMMENDATIONS TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENT INFORMATION IS MADE AVAILABLE TO THE PUBLIC FOR INSPECTION VIA THE GUIDESTAR WEBSITE. IN ADDITION, AUDITED FINANCIAL INFORMATION IS PROVIDED TO THE PUBLIC FOR THE PURPOSE OF GRANT AWARDS UPON REQUEST AS NECESSARY. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. AUDIT COMMITTEE AND OVERSIGHT FORM 990, PART XII, LINE 2C THERE HAVE BEEN NO CHANGES TO THIS PROCESS FROM THE PRIOR YEAR. STATEMENT OF REVENUE FORM 990, PART VIII, LINE 11A CASA COLINA INC., IS THE PARENT COMPANY AND AS SUCH ALL PAYROLL IS PAID OUT OF THIS ENTITY. WHILE PAYROLL EXPENSES REMAIN WITHIN THE SUBSIDIARY ENTITY, ALL PAYMENTS PERTAINING TO THAT EXPENSE IS REFLECTED IN CASA COLINA INC.'S FORM 990 AS ALL RELATED PAYROLL TAX FILING INFORMATION IS FILED UNDER THE CASA COLINA INC'S TAX IDENTIFICATION NUMBER. AS A RESULT EACH ENTITY IS RESPONSIBLE FOR REIMBURSING CASA COLINA INC. FOR THEIR RELATED PAYROLL EXPENSES. THIS WAS REFLECTED ON FORM 990, PART VIII, LINE 11A AND IS LABELED AS INTERCOMPANY SERVICES IN THE AMOUNT OF $35,496,992. CASA COLINA HOSPITAL FOR REHABILITATIVE MEDICINE 255 E BONITA AVE POMONA CA 91767 951643989 REHABILITATION MEDICINE CA 501(C)(3) 3 CASA COLINA INC 1 CASA COLINA CENTERS FOR REHABILITATION FOUNDATION 255 E BONITA AVE POMONA CA 91767 953655255 FUNDRAISING CA 501(C)(3) 7 CASA COLINA INC 1 CASA COLINA COMPREHENSIVE OUTPATIENT REHABILITATION 255 E BONITA AVE POMONA CA 91767 953266014 OUTPATIENT REHABILITATION SERVICES CA 501(C)(3) 7 CASA COLINA INC 1 PADUA VILLAGE INC 255 E BONITA AVE POMONA CA 91767 953713170 LONG TERM CARE FOR TRAUMATICALLY BRAIN INJURED CA 501(C)(3) 7 CASA COLINA INC 1 CASA COLINA REHABILITATION INC 255 E BONITA AVE POMONA CA 91767 953392219 TRANSITIONAL LIVING CENTER FOR TRAUMATICALLY BRAIN INJURED CA 501(C)(3) 7 CASA COLINA INC 1 DIAGNOSTIC IMAGING CENTER 255 E BONITA AVE POMONA CA 91769 134286907 RADIOLOGY CA N/A 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 CASA COLINA HOSPITAL FOR REHABILITATIVE MEDICINE Q 3910670 ACTUAL/BOOK VALUE CASA COLINA CENTERS FOR REHABILITATION FOUNDATION K 211010 ACTUAL/BOOK VALUE CASA COLINA CENTERS FOR REHABILITATION FOUNDATION Q 689160 ACTUAL/BOOK VALUE PADUA VILLAGE INC Q 412903 ACTUAL/BOOK VALUE CASA COLINA CENTERS FOR REHABILITATION INC Q 664586 ACTUAL/BOOK VALUE CASA COLINA COMPREHENSIVE OUTPATIENT REHABILITATION Q 181515 ACTUAL/BOOK VALUE CASA COLINA HOSPITAL FOR REHABILITATIVE MEDICINE P 117851 ACTUAL/BOOK VALUE CASA COLINA HOSPITAL FOR REHABILITATIVE MEDICINE 255 E BONITA AVE POMONA CA 917696001 951643989 X 0 13000 13000 61676967 61689967 1000000 250000 0 0 0 PADUA VILLAGE INC 255 E BONITA AVE POMONA CA 917696001 953713170 0 0 0 4321119 4321119 366056 91514 0 0 0 CASA COLINA CENTER FOR REHABILITATION INC 255 E BONITA AVE POMONA CA 917696001 953392219 0 0 0 13559096 13559096 827955 206989 0 0 0 CASA COLINA COMPREHENSIVE OUTPATIENT REHABILITATION SERVICES INC 255 E BONITA AVE POMONA CA 917696001 953266014 0 0 0 2006897 2006897 250345 62586 0 0 0 CASA COLINA CENTERS FOR REHABILITATION FOUNDATION 255 E BONITA AVE POMONA CA 917696001 953655255 0 0 0 7471205 7471205 523560 130890 0 0 0