2013-09-03T08:03:32-05:00 2012-12-31 131517563 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2012-01-01 113535388 LREFUAH MEDICAL AND REHABILITATION CENTER INC LREF 7186863786 1312 38TH STREET BROOKLYN NY 11218 YISHAI HECHT 7186863786 2013-08-14 1 FREDERICK H ROTHMAN P01275277 2128674000 2012 2016-02-24 21:20:13Z EZRA MEDICAL CENTER YISHAI HECHT 1312 38TH STREET BROOKLYN NY 11218 12777148 0 X WWW.EZRAMEDICAL.ORG X 2000 NY PATIENT CARE SERVICES 11 11 125 11 0 0 150731 893579 4506572 11874726 0 0 3692 8843 4660995 12777148 18000 32500 0 0 2790760 6926766 0 0 0 1665989 4235409 4474749 11194675 186246 1582473 4948225 6354704 1161029 1039755 3787196 5314949 THE PROVISION OF PATIENT CARE SERVICES OF THE HIGHEST QUALITY, THE CONTINUING ADVANCMENT OF TOTAL FAMILY WELLNESS, AND THE ONGOING EDUCATION OF OUR PATIENTS AND OUR COMMUNITY. 0 0 8408957 32500 11874726 IN FULFILLMENT OF OUR MISSION TO PROVIDE PATIENT CARE SERVICES OF THE HIGHEST QUALITY, THE CONTINUING ADVANCEMENT OF TOTAL FAMILY WELLNESS, AND THE ONGOING EDUCATION OF OUR PATIENTS AND OUR COMMUNITY, 57,670 VISITS WERE PROVIDED IN 2012. 8408957 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 32 0 125 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X BASYA UNGAR 7186862011 1312 38TH STREET BROOKLYN NY 11218 HERMAN SILBERSTEIN 1.00 X X 0 0 0 NACHUM SANDERS 1.00 X X 0 0 0 BEREL GRAUSZ 1.00 X X 0 0 0 JOSHUA SILBERBERG 1.00 X X 0 0 0 YITTY GRUNWALD 1.00 X 0 0 0 DAVID CHIMMEL 1.00 X 0 0 0 AVRAM PORGESZ 1.00 X 0 0 0 GITTEL KLEIN 1.00 X 0 0 0 SARA SPIRA 1.00 X 0 0 0 FAIGY ENGLANDER 1.00 X 0 0 0 BAILA GROSSMAN 1.00 X 0 0 0 YISHAI HECHT 37.00 X 165855 0 17194 BASYA UNGAR 37.00 X 102959 0 19407 AVROHOM LICHTENSTEIN 37.00 X 129480 0 10228 JEFFREY TEITELBAUM 37.00 X 289752 0 16499 DR KADAR 37.00 X 175600 0 15829 MERAV KROLL 37.00 X 283393 0 5977 DR ABITBOL 37.00 X 194580 0 793 SANDRA PETTY 37.00 X 149076 0 8112 1490695 0 94039 17 0 1 0 GO ADVERTISE 1205 43RD STREET BROOKLYN NY 11219 PUBLIC INFORMATION DISSEMINATION 139017 QSI PO BOX 809390 CHICAGO IL 60680 IT SUPPORT AND LISCENSING 134485 FILE SCAN SOLUTIONS 1425 37TH STREET SUITE 608 BROOKLYN NY 11218 SCANNING 123321 STATE COLLEGE OF OPTOMETRY PO BOX 5129 NEW YORK NY 10087 OPTOMETRY SERVICES 118883 MEDICAL DOCTOR ASSOCIATES PO BOX 277185 ATLANTA GA 30384 MEDICAL DOCTOR 110550 5 893579 175331 893579 PATIENT SERVICES 621110 11420165 11420165 INDIGNET CARE POOL DISTRIBUTION 621110 254482 254482 MEANINGFUL USE INCENTIVE 621110 200079 200079 11874726 OTHER 900099 8843 8843 8843 12777148 11874726 0 8843 32500 32500 447375 98276 349099 5590688 4922563 668125 34510 33288 1222 390142 355596 34546 464051 389803 74248 238959 238959 29654 29654 42811 42811 286878 286462 416 235016 7019 227997 540834 189020 351814 145840 145840 576093 445901 130192 24675 24675 29843 23253 6590 555079 424726 130353 374873 366910 7963 MEDICAL SUPPLIES 833640 833640 BAD DEBTS 321214 321214 11194675 8408957 2785718 0 385168 595132 119552 128089 1419933 2032327 131816 100591 5141059 1642494 2891756 3498565 4948225 6354704 561029 669755 600000 370000 1161029 1039755 X 3787196 5314949 3787196 5314949 4948225 6354704 X 1582473 -54720 X X 0 1 X 1 1 1 X 220242 124152 228195 150731 893579 1616899 5106180 7470406 9287092 4506572 11874726 38244976 5326422 7594558 9515287 4657303 12768305 39861875 0 0 0 39861875 4432 15837 10798 3692 8843 43602 5330854 7610395 9526085 4660995 12777148 39905477 0.99890 0.99880 0.00000 X SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: PART III, SECTION A: THE AMOUNTS FOR 2011 REFLECT A SIX MONTH YEAR END PERIOD RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1971575 429730 1541845 1550871 712319 838552 1618613 500445 1118168 3498565 X 12401214 -54720 -54720 12455934 321214 321214 12777148 10873461 0 10873461 321214 321214 11194675 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE CENTER HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PERIODS ENDING JUNE 30, 2010 AND SUBSEQUENT REMAIN SUBJECT TO EXAMINATION BY APPLICABLE TAXING AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF ASSETS -54,720. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 321,214. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 321,214. 1 LADIES BIKUR CHOLIM D'SATMAR 545 BEDFORD AVENUE BROOKLYN NY 11211 116081323 501(C)(3) 10000 FINANCIAL ASSISTANCE TO FURTHER THE MISSION OF PROVIDING VITAL SERVICES TO NEEDY HOSPITAL PATIENTS. 1 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: IN ORDER TO SHOW THAT THE FUNDS WERE EXPENDED FOR THE PURPOSES WHICH WERE APPROVED BY THE BOARD OF DIRECTORS, THE GRANTEE ORGANIZATION SHALL BE OBLIGATED TO FURNISH EZRA MEDICAL CENTER WITH ITS BOOKS AND RECORDS, FOR REVIEW AND INSPECTION BY A REPRESENTATIVE(S) OF EZRA MEDICAL CENTER, AT ANYTIME AND FROM TIME TO TIME, UPON REASONABLE NOTICE TO THE GRANTEE ORGANIZATION. X X X X 0 0 0 0 0 0 0 1 0 YISHAI HECHT 154363 0 2500 0 8992 0 10605 0 6589 0 183049 0 0 0 JEFFREY TEITELBAUM 286752 0 3000 0 0 0 0 0 16499 0 306251 0 0 0 DR KADAR 175600 0 0 0 0 0 1850 0 13979 0 191429 0 0 0 MERAV KROLL 283393 0 0 0 0 0 0 0 5977 0 289370 0 0 0 DR ABITBOL 194580 0 0 0 0 0 0 0 793 0 195373 0 0 0 SANDRA PETTY 149076 0 0 0 0 0 1494 0 6618 0 157188 0 0 0 PART I, LINE 7 THE BOARD OF DIRECTORS AWARDS AN ANNUAL HOLIDAY BONUS TO EMPLOYEES BASED ON SERVICE THROUGHOUT THE YEAR. X 1 175331 LETTER FROM VFC PROGRAM 0 1 0 METHOD FOR DETERMINING NUMBER OF CONTRIBUTORS: PART I, COLUMN (B): THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTORS. FORM 990, PART VI, SECTION B, LINE 11 THE EXECUTIVE DIRECTOR AND CONTROLLER REVIEW THE 990 AND THEN THEY FORWARD IT TO THE BOARD OF DIRECTORS AT THE NEXT BOARD MEETING FOR THEIR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C AS PER OUR CONFLICT OF INTEREST POLICY, WE HAVE OUR DIRECTORS AND OFFICERS COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT ON AN ANNUAL BASIS WHICH DISCLOSES ANY INTERESTS THAT COULD GIVE RISE TO CONFLICTS AND AFFIRMS THAT THEY HAVE READ, UNDERSTAND, AND AGREE TO COMPLY WITH THE POLICY. ALL POSSIBLE CONFLICTS OF INTEREST ARE REPORTED TO THE BOARD OR THE FINANCE AND AUDIT COMMITTEE. THE INTERESTED PERSON IS EXCLUDED FROM ANY MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION RESULTING IN THE CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 IN 2011, THE BOARD HIRED AN INDEPENDENT CONSULTING COMPANY TO REVIEW THE SALARIES OF TOP OFFICIALS FOR APPROPRIATENESS. IN 2011, THE COMPENSATION COMMITTEE REVIEWED THE SALARIES OF OFFICERS. THE NEXT INDEPENDENT STUDY WILL BE CONDUCTED IN 2013. FORM 990, PART VI, SECTION C, LINE 19 THE 990'S ARE AVAILABLE FOR PUBLIC INSPECTION. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: LOSS ON DISPOSAL OF ASSETS -54,720. PROCESS IS THE SAME AS PRIOR YEAR.