2013-05-15T11:19:07-05:00 2012-09-30 061533253 SASLOW LUFKIN & BUGGY LLP TEN TOWER LANE AVON CT 06001 990 2011-10-01 061432065 GAYLORD FARM REHABILITATION CENTER INC GAYF 2032842800 PO BOX 400 GAYLORD FARM ROAD WALLINGFORD CT 06492 JANINE L EPRIGHT 2032842800 2013-05-14 1 RICHARD BUGGY P00512316 8606789200 2011 2016-02-24 21:20:13Z JANINE L EPRIGHT PO BOX 400 GAYLORD FARM ROAD WALLINGFORD CT 06492 368943 0 X WWW.GAYLORD.ORG X 1999 CT REHABILITATION CARE HOME 4 2 0 0 0 0 130599 125084 288308 243859 0 0 0 0 418907 368943 0 0 0 0 597339 647207 0 0 0 132360 96901 729699 744108 -310792 -375165 0 0 1870037 2245202 -1870037 -2245202 X TO PROVIDE THE NECESSARY TRANSITION FOR PATIENTS WITH ACQUIRED BRAIN INJURY, IN ORDER TO EASE THE PATIENT FROM HOSPITAL TO HOME. 0 0 596740 243859 GAYLORD FARMS REHABILITATION CENTER, INC., DOING BUSINESS AS THE TRAURIG HOUSE, RECEIVED LICENSURE TO OPERATE AS A RESIDENTIAL CARE HOME ON MAY 5, 1999. THE LOUIS D. TRAURIG TRANSITIONAL LIVING CENTER (TRAURIG HOUSE) IS A FREE STANDING FOUR BEDROOM HOME ON THE WALLINGFORD CAMPUS OF GAYLORD HOSPITAL. OPEN SINCE 1999, IT OFFERS A TRANSITIONAL LIVING PROGRAM FOR 8 ADULTS. THE GOALS OF THE REINTEGRATION PROCESS FOR ADULTS WITH BRAIN INJURY ARE TO ACQUIRE THE BASIC SKILLS OF INDEPENDENT LIVING, TO REGAIN THE NECESSARY SKILLS FOR REENTERING THE COMMUNITY AND TO DEVELOP A WIDER RANGE OF VOCATIONAL OPTIONS. TO BE CONSIDERED FOR ADMISSION, A PERSON SHOULD HAVE A HISTORY OF ACQUIRED BRAIN INJURY (INCLUDING STROKE AND OTHER NEUROLOGICAL DIAGNOSES), BE MEDICALLY STABLE AND BE ABLE TO BENEFIT FROM REHABILITATION. PROGRAM ELEMENTS INCLUDE COGNITIVE RETRAINING, FUNCTIONAL ACADEMICS, PSYCHOTHERAPY, COMMUNITY ACTIVITES, COMMUNICATION SKILLS, INDEPENDENT LIVING SKILLS, SOCIAL WORK AND CASE MANAGEMENT, AND A FULL RANGE OF OTHER THERAPIES (INCLUDING PSHYCHOLOGY, OCCUPATIONAL AND PHYSICAL THERAPY, SPEECH AND LANGUAGE THERAPY, AND RECREATIONAL THERAPY). 596740 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 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 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 4 2 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X JANINE EPRIGHT 2032842800 GAYLORD FARM ROAD WALLINGFORD CT 06492 JAMES J CULLEN 1.00 X X 0 460511 26830 EDWARD H CANTOR ESQ 1.00 X X 0 0 0 WILLIAM SIMIONE JR 1.00 X X 0 0 0 JANINE L EPRIGHT 1.00 X X 0 279486 21564 GEORGE KYRIACOU 1.00 X X 0 43270 0 F PERRY WILSON 1.00 X X 0 0 0 0 783267 48394 0 0 1 0 0 125084 125084 PATIENT SERVICE REVENU 624310 243859 243859 243859 368943 243859 0 0 514881 444856 70025 9027 7799 1228 83910 72498 11412 39389 34032 5357 1453 1453 30695 30695 1319 1319 259 259 5145 5145 42636 42636 11565 11565 PATIENT SERVICES 3696 3696 MISCELLANEOUS 133 133 744108 596740 147368 0 0 0 1870037 2245202 1870037 2245202 X -1870037 -2245202 -1870037 -2245202 0 0 -375165 0 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 DUE TO AFFILIATE 2245202 2245202 368943 744108 -375165 -375165 368943 0 368943 0 368943 744108 0 744108 0 744108 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ASSOCIATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS WITH PROVISIONS OF FASB ASC 740, "INCOME TAXES" WHICH PROVIDE A FRAMEWORK FOR HOW COMPANIES SHOULD RECOGNIZE, MEASURE, PRESENT AND DISCLOSE UNCERTAIN TAX POSITIONS IN THEIR CONSOLIDATED FINANCIAL STATEMENTS. THE ASSOCIATION MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE ASSOCIATION DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2012 AND 2011. AS OF SEPTEMBER 30, 2012 AND 2011, THE ASSOCIATION DID NOT RECORD ANY PENALTIES OR INTEREST ASSOCIATED WITH UNCERTAIN TAX POSITIONS. THE ASSOCIATION'S PRIOR THREE TAX YEARS ARE OPEN AND SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. X 0 1 0 0 0 0 0 0 0 JAMES J CULLEN 0 429258 0 31253 0 0 0 2164 0 24666 0 487341 0 0 JANINE L EPRIGHT 0 279486 0 0 0 0 0 2359 0 19205 0 301050 0 0 SUPPLEMENTAL INFORMATION PART III PART 1 - LINE 4B (FROM ALL RELATED ORGANIZATIONS): JAMES J. CULLEN - SERP CONTRIBUTION - $208,661 GEORGE KYRIACOU - SERP CONTRIBUTION - $ 9,047 FORM 990, PART VI, SECTION A, LINE 6 THE HOSPITAL HAS ONE CLASS OF MEMBERS. THERE IS ONE SOLE MEMBER OF THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A THERE IS ONE SOLE MEMBER OF THE HOSPITAL. THE MEMBER HAS THE POWER TO ELECT THE BOARD OF DIRECTORS OF THE HOSPITAL. THE MEMBER HAS OTHER RIGHTS, POWERS AND PRIVILEGES USUALLY OR BY LAW ACCORDED TO THE MEMBERS OF A NONSTOCK NON-PROFIT CORPORATION. FORM 990, PART VI, SECTION B, LINE 11 A MEETING IS HELD PRIOR TO FILING, WITH THE AUDIT COMMITTEE OF THE BOARD AND SENIOR MANAGEMENT IN ORDER TO REVIEW THE 990 RETURNS. AFTER REVIEW, THE COMMITTEE REPORTS BACK TO THE FULL BOARD AND REVIEWS THE 990 WITH THEM. FORM 990, PART VI, SECTION B, LINE 12C ANY CONFLICT OF INTEREST SITUATION MUST BE DISCLOSED TO THE BOARD OF DIRECTORS OF THE ASSOCIATION OR THE COMPLIANCE OFFICER IMMEDIATEDLY AND SUCH DIRECTOR, OFFICER OR EMPLOYEE WITH A CONFLICT OF INTEREST WILL BE REQUIRED TO REFRAIN FROM PARTICIPATING IN ANY DISCUSSION OR ACTION CONCERNING SUCH CONFLICTED SITUATION. FORM 990, PART VI, SECTION B, LINE 15 GAYLORD HAS CONTRACTED WITH TOWERS WATSON TO PERFORM A TOTAL COMPENSATION REVIEW OF TWO KEY POSITIONS IN SENIOR MANAGEMENT: THE CEO AND THE TREASURER. A REPORT WILL BE MADE BY THE VICE PRESIDENT OF HUMAN RESOURCES TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS ANNUALLY FOR THEIR ENDORSEMENT. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 2C THE AUDIT COMMITTEE IS RESPONSIBLE FOR REVIEWING WITH THE INDEPENDENT AUDITORS THE SCOPE OF THEIR EXAMINATION WITH PARTICULAR EMPHASIS ON THE AREAS TO WHICH THE COMMITTEE BELIEVES SPECIAL ATTENTION SHOULD BE DIRECTED; AND SHALL REVIEW, AND IMPLEMENT AS REQUIRED, THE ANNUAL FINANCIAL AUDIT AND MANAGEMENT RECOMMENDATIONS OF THE INDEPENDENT AUDITORS. THE COMMITTEE SHALL ACQUAINT ITSELF WITH THE QUALITY AND DEPTH OF STAFFING OF THE CORPORATION'S ACCOUNTING AND FINANCIAL FUNCTIONS AND OF THE INTERNAL CONTROL SYSTEMS. THE COMMITTEE SHALL EVALUATE THE PERFORMANCE OF THE INDEPENDENT AUDITORS AND SHALL MAKE RECOMMENDATIONS, ANNUALLY OR WITH GREATER FREQUENCY AS NECESSARY, TO THE BOARD OF DIRECTORS ON THE ANNUAL SELECTION OF THE INDEPENDENT AUDITING FIRM OR ON ANY OTHER AUDIT MATTERS. THE PROCESS FOR SELECTION OF AN INDEPENDENT ACCOUNTANT AND AUDIT OVERSIGHT HAS NOT CHANGED SINCE THE PRIOR YEAR. GAYLORD HOSPITAL INC PO BOX 400 GAYLORD FARM ROAD WALLINGFORD CT 06492 060646649 HOSPITAL CT 501(C)(3) 3 GAYLORD FARM ASSOCIATION INC 0 GAYLORD RESEARCH INSTITUTE INC PO BOX 400 GAYLORD FARM ROAD WALLINGFORD CT 06492 061460112 RESEARCH ORGANIZATION CT 501(C)(3) 4 GAYLORD FARM ASSOCIATION INC 0 THE GAYLORD FOUNDATION INC PO BOX 400 GAYLORD FARM ROAD WALLINGFORD CT 06492 061521864 SUPPORTING CORPORATION CT 501(C)(3) 11 GAYLORD FARM ASSOCIATION INC 0 GAYLORD FARM ASSOCIATION INC PO BOX 400 GAYLORD FARM ROAD WALLINGFORD CT 06492 061302029 SUPPORTING CORPORATION CT 501(C)(3) 11 N/A 0 FARM PROPERTIES PO BOX 400 GAYLORD FARM ROAD WALLINGFORD CT 06492 061301584 PROPERTY DEVELOPMENT CT GAYLORD FARM ASSOCIATION INC C GAYLORD RISK SOLUTIONS LTD PO BOX 400 GAYLORD FARM ROAD WALLINGFORD CT 06492 980561423 INSURANCE PROVIDER CJ GAYLORD FARM ASSOCIATION INC C 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 GAYLORD HOSPITAL INC Q 368943 ACTUAL AMOUNT GAYLORD HOSPITAL INC M 96902 ACTUAL AMOUNT GAYLORD HOSPITAL INC N 647206 ACTUAL AMOUNT