2012-11-15T16:25:37-06:00 2012-03-31 721396621 CARR RIGGS & INGRAMLLC 4360 CHAMBLEE DUNWOODY RD SUITE 420 ATLANTA GA 30341 990 2011-04-01 510141601 SHEPHERD CENTER INC SHEP 4043507310 2020 PEACHTREE ROAD NW ATLANTA GA 30309 STEPHEN B HOLLEMAN 4043507310 2012-11-16 1 WILLA P BROWNLEE P00746452 7704576606 2011 2016-02-24 21:20:13Z GARY R ULICNY 2020 PEACHTREE ROAD NW ATLANTA GA 30309 158914972 0 X WWW.SHEPHERD.ORG X 1975 GA SEE SCHEDULE O FOR A COMPLETE DESCRIPTION OF SHEPHERD CENTER'S MISSION STATEMENT.SHEPHERD CENTER'S MISSION IS TO HELP PEOPLE WITH A TEMPORARY OR PERMANENT DISABILITY CAUSED BY INJURY OR DISEASE REBUILD THEIR LIVES WITH HOPE, INDEPENDENCE, AND DIGNITY, ADVOCATING FOR THEIR FULL INCLUSION IN ALL ASPECTS OF COMMUNITY LIFE WHILE PROMOTING SAFETY AND INJURY PREVENTION. 24 20 1530 800 122440 -123539 15992840 11570889 116725223 142403110 364820 1453926 3294250 3458379 136377133 158886304 0 0 0 0 80109869 88141524 0 0 0 45111393 50971124 125221262 139112648 11155871 19773656 299977627 323341883 86963088 88522197 213014539 234819686 X SHEPHERD CENTER'S PRIMARY PURPOSE IS TO PROVIDE ACUTE AND REHABILITATIVE HOSPITAL CARE TO PATIENTS WITH SPINAL CORD INJURIES, ACQUIRED BRAIN INJURIES, MULTIPLE SCLEROSIS, AND OTHER NEUROMUSCULAR AND UROLOGICAL DISEASES. CONTINUED ON SCHEDULE O.WE STRIVE TO BE THE MOST COMPREHENSIVE CATASTROPHIC CARE SPECIALTY HOSPITAL IN THE WORLD COMMITTED TO IMPROVING OUR PATIENTS' LIVES. 1 0 88214256 142403110 IN REFERENCE TO THE PROVISION OF PATIENT CARE SERVICES, SHEPHERD CENTER IS DEDICATED TO HELPING PEOPLE WHO HAVE EXPERIENCED CATASTROPHIC INJURY OR DISEASE REBUILD THEIR LIVES WITH HOPE, DIGNITY, AND INDEPENDENCE, ADVOCATING FOR THEIR FULL INCLUSION IN ALL ASPECTS OF COMMUNITY LIFE. IN THE LAST FISCAL YEAR, SHEPHERD CENTER INCURRED EXPENSES TO PROVIDE SERVICES FOR 968 INPATIENT ADMISSIONS, 41,236 INPATIENT DAYS, 47,997 OUTPATIENT VISITS, AND 14,357 DAY PATIENT DAYS. 11117213 9090901 BECAUSE OF THE GENEROUS FINANCIAL SUPPORT OF THE COMMUNITY, SHEPHERD CENTER IS ABLE TO PROVIDE MANY COMMUNITY FUNDED SERVICES THAT ARE NOT AVAILABLE IN OTHER HOSPITALS. SHEPHERD CENTER OFFERS SERVICES SUCH AS FAMILY HOUSING AND TRAINING, EXPANDED THERAPEUTIC RECREATION SERVICES, ASSISTIVE TECHNOLOGY AND ADAPTIVE EQUIPMENT, AND VOCATIONAL TRAINING, AS WELL AS MEDICAL CARE FOR PATIENTS WITHOUT THE ABILITY TO PAY FOR THESE SERVICES. 4415153 3344264 WITH REGARD TO RESEARCH ACTIVITY, SHEPHERD CENTER IS A SITE FOR LEADING-EDGE RESEARCH AND PROVIDES IMPORTANT OUTCOMES TRACKING THAT HELP SHAPE THE FACE OF REHABILITATION IN THE UNITED STATES. OUR VISION IS TO BE A CENTER OF EXCELLENCE IN PATIENT CARE, PARTICIPATING IN RESEARCH THAT WILL ACHIEVE THE HIGHEST OUTCOMES AND IMPROVE THE LIVES OF OUR PATIENTS AND FAMILIES. 103746622 1 0 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 1 1 1 0 0 1 436 0 1 1530 1 1 1 0 0 0 0 0 0 0 0 0 X 24 20 1 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 GA SC FL TN AL NC X NORA MANGRUM 4043507320 2020 PEACHTREE RD NW ATLANTA GA 303091402 FRED V ALIAS 1.00 X 0 0 0 GREGORY ANDERSON 1.00 X 0 0 0 DAVID F APPLE JR MD 24.00 X X 168406 0 17724 JAMES M CASWELL JR 1.00 X 0 0 0 SARA S CHAPMAN 1.00 X 0 0 0 CLARK H DEAN 1.00 X 0 0 0 JOHN S DRYMAN 1.00 X 0 0 0 DAVID H FLINT 1.00 X 0 0 0 DONALD P LESLIE MD 40.00 X X 629659 0 16375 DOUGLAS LINDAUER 1.00 X 0 0 0 BERNARD MARCUS 1.00 X 0 0 0 JULIAN B MOHR 1.00 X 0 0 0 C TALBOT NUNNALLY III 1.00 X 0 0 0 SALLY D NUNNALLY 1.00 X 0 0 0 J HAROLD SHEPHERD 1.00 X 0 0 0 W CLYDE SHEPHERD III 1.00 X 0 0 0 JAMES E STEPHENSON 1.00 X 0 0 0 JAMES D THOMPSON 1.00 X 0 0 0 JAMES H SHEPHERD JR 40.00 X X 259323 0 19666 GARY ULICNY PHD 40.00 X X 582719 0 20720 EMORY A SCHWALL 4.00 X X 0 0 0 WILLIAM C FOWLER 2.00 X X 0 0 0 STEPHEN B GOOT 2.00 X X 0 0 0 ALANA SHEPHERD 20.00 X X 0 0 0 STEPHEN B HOLLEMAN 40.00 X X 336209 0 24144 WILMA BUNCH 40.00 X X 187359 0 18663 MITCHELL J FILLHABER 40.00 X X 301044 0 12970 BROCK BOWMAN MD 40.00 X X 443712 0 20656 TAMARA KING 40.00 X X 198151 0 20416 MICHAEL JONES 40.00 X X 298921 0 21984 SCOTT H SIKES 40.00 X X 242590 0 13844 GERALD BILSKY MD 40.00 X 470524 0 11734 ANNA ELMERS MD 40.00 X 524595 0 8611 JOHN MUSSER MD 40.00 X 470963 0 0 ERIK SHAW MD 40.00 X 562624 0 9719 BEN THROWER MD 40.00 X 609114 0 460 6285913 0 237686 88 0 1 0 PIEDMONT HOSPITAL PO BOX 725507 ATLANTA GA 31139 MEDICAL SERVICES 5102417 HIMFORMATICS 1735 BUFORD HWY STE 215-311 CUMMING GA 30041 COMPUTER CONSULTING SERVICES 968854 CAREFUSION SOLUTIONS LLC 25082 NETWORK PLACE CHICAGO IL 60673 RENTAL SERVICES OF PXYIS MACHINES 590410 ANGELICA TEXTILE SERVICES PO BOX 535122 ATLANTA GA 30353 LINEN & LAUNDRY CLEANING SERVICES 512524 SUCCESS ADVERTISING INC 26 EASTMANS ROAD PARSIPPANY NJ 07054 ADVERTISING SERVICES 476942 25 2407724 9163165 396377 11570889 NET INPATIENT SERVICE 900099 111231365 111231365 NET OUTPATIENT SERVICE 900099 23509520 23509520 NET DAYPATIENT SERVICE 900099 7662225 7662225 142403110 1451311 1451311 631620 27783 603837 603837 603837 3500 885 2615 2615 2615 CAFETERIA REVENUE 900099 1111314 1111314 ADMINISTRATIVE FEES 532000 61407 61407 RENTAL INCOME 532000 61033 61033 1620788 1620788 2854542 158886304 144627735 122440 2565240 X 3855255 1836004 2019251 68763193 55309444 13453749 1705726 1705726 3037577 2443265 594312 10779773 4371365 6408408 822075 129288 692787 215638 2623 213015 113107 113107 9697271 7779936 1917335 461660 461660 2679244 1528366 1150878 1472735 1472735 2572245 501622 2070623 948285 574505 373780 485462 205858 279604 939185 939185 8713818 1871410 6842408 806392 104047 702345 MEDICAL SUPPLIES 14679860 13680788 999072 BAD DEBT EXPENSE 2519205 2519205 EQUIPMENT RENTAL & MAIN 1982440 1515477 466963 ALLOCATION OF INDIRECT 0 11484248 -11484248 1862502 408376 1454126 139112648 103746622 35366026 0 9178530 10174786 10365880 24238510 1048070 673367 23905381 29461673 918291 1212204 1742925 2122505 220205447 93679161 127600339 126526286 122715800 126315056 2502411 2617496 299977627 323341883 10872841 13902749 629707 918230 68900000 67200000 6560540 6501218 86963088 88522197 X 157212964 176379764 14368852 16119646 41432723 42320276 213014539 234819686 299977627 323341883 X 19773656 2031491 X X 0 1 1 X 1 1 X 44752 11776 56528 103690094 103746622 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 9789 37087 49024 56528 152428 250000 250000 250000 250000 1000000 1500000 9544 31048 42730 44752 128074 PART IV, SUPPLEMENTAL INFORMATION: SHEPHERD CENTER, INC. EMPLOYS MARK JOHNSON AS DIRECTOR OF ADVOCACY. DURING THE YEAR, HE AND ADVOCACY SPECIALIST CAROL JONES WERE INVOLVED IN THE FOLLOWING ACTIVITIES: 1. MAINTAINED ADVOCACY BULLETIN BOARD, A LISTING OF ADVOCACY OPPORTUNITIES FOR STAFF (GRASSROOTS - LINE 1A). 2. SUPPORTED EFFORTS TO INCREASE AND IMPROVE HOME AND COMMUNITY BASED SERVICES AS WELL AS TRANSPORTATION (GRASSROOTS - LINE 1A). 3. PARTICIPATED IN PROMOTING THE NATIONAL DISABILITY ALLIANCES PUBLIC POLICY AGENDA (NDLA,HTTP://WWW.DISABILITYLEADERSHIP.NET)(DIRECT LOBBYING - LINE 1B). 4. PARTICIPATED IN GEORGIA'S ANNUAL DISABILITY DAY AT THE CAPITOL, FEBRUARY 16, 2011 (DIRECT LOBBYING - LINE 1B). 5. HOSTED MEETINGS WITH THE US ACCESS BOARD AND FEMA DEPUTY ADMINISTRATOR (DIRECT LOBBYING - LINE 1B). 6. PROMOTED FAIR HOUSING MONTH IN APRIL 2011 AND NATIONAL DISABILITY EMPLOYMENT AWARENESS MONTH AND RELATED EFFORTS IN OCTOBER, 2011. 41432723 887553 42320276 43555890 -2123167 41432723 43196059 359831 43555890 41657033 1539026 43196059 1.00000 0 0 16628506 16628506 99832674 29918785 69913889 96762785 63061806 33700979 6981482 698570 6282912 126526286 ANNUITIES PAYABLE 6501218 6501218 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE CENTER APPLIES THE FASB ASC PROVISIONS FOR INCOME TAXES. THESE PROVISIONS REQUIRE THAT A TAX POSITION BE RECOGNIZED OR DERECOGNIZED BASED ON A "MORE-LIKELY-THAN-NOT" THRESHOLD. THIS APPLIES TO POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE CENTER DOES NOT BELIEVE ITS CONSOLIDATED FINANCIAL STATEMENTS INCLUDE ANY MATERIAL UNCERTAIN TAX POSITIONS. 1 1 0 1 X 1 1 1 0 1 1 1 2127 3554883 0 3554883 0.02600 1 1722 2187964 0 2187964 0.01600 2 3849 5742847 5742847 0.04200 72 18880 5859897 44846 5815051 0.04260 2 12 219303 0 219303 0.00160 8 7132 463126 2000 461126 0.00340 37 300 3674540 73554 3600986 0.02640 4 71 62876 0 62876 0.00050 123 26395 10279742 120400 10159342 0.07450 125 30244 16022589 120400 15902189 0.11650 1 2199 571935 6815 565120 0.00410 1 1500 129528 0 129528 0.00090 3 2182 34945 0 34945 0.00030 5 5881 736408 6815 729593 0.00530 0 1123069 0 12388310 17669971 -5281661 X 1 1 1 1 SHEPHERD CENTER INC

2020 PEACHTREE ROAD NW ATLANTA GA 30309

X X SHEPHERD CENTER INC 1 1 0 1 250.000000000000 1 X X X X X X X 1 1 X 0 0 0 0 0 2 SHEPHERD PATHWAYS

1942 CLAIRMONT ROAD DECATUR GA 30033

OUTPATIENT CENTER SERVING BRAIN INJURY PATIENTS BEYOND THERAPY TENNESSEE

277 MALLORY STATION FRANKLIN TN 37067

OUTPATIENT CENTER PROVIDING INTENSIVE REHABILITATION SERVICES PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 2519205. PART II: SHEPHERD CENTER'S COMMUNITY BUILDING ACTIVITIES ARE CONCENTRATED IN THE FOLLOWING AREAS:ADVOCACYSHEPHERD CENTER'S ADVOCACY PROGRAM IS RESPONSIBLE FOR THE FOLLOWING:1.SERVE AS A PRIMARY LIAISON BETWEEN SHEPHERD CENTER AND THE DISABILITY COMMUNITY.2.PROVIDE DAY-TO-DAY EXPERTISE ON DISABILITY RIGHTS ISSUES.3.PROMOTE DISABILITY RIGHTS.4.SUPPORT THE DEVELOPMENT OF LOCAL AND NATIONAL CAMPAIGNS RELATED TO HOME AND COMMUNITY BASED SERVICES (HCBS), ACCESSIBLE, AFFORDABLE, INTEGRATED HOUSING, AFFORDABLE, INTEGRATED HOUSING, REUSE EFFORTS AND INCLUSIVE EMERGENCY MANAGEMENT.5.SERVE ON AMERIGROUP'S AGING AND DISABILITY ADVISORY BOARDONE OF THE HIGHLIGHTS IN FYE 2011 WAS DISABILITY DAY AT THE GEORGIA STATE CAPITAL WHERE MARK JOHNSON, DIRECTOR OF ADVOCACY AT THE SHEPHERD CENTER HOSTED A RALLY TO RAISE AWARENESS IN REGARD TO CURRENT BILLS UNDER REVIEW BY THE STATE LEGISLATURE PERTAINING TO DISABILITY RIGHTS. HOUSINGHAVING THE FAMILIES AND LOVED ONES INVOLVED IN REHABILITATION AFTER A CATASTROPHIC INJURY IS IMPERATIVE TO THE SUCCESSFUL TRANSITION TO COMMUNITY, HOME, WORK AND/OR SCHOOL. SHEPHERD CENTER OFFERS COMPLIMENTARY HOUSING FOR 30 DAYS FOR FAMILIES WHO TRAVEL MORE THAN 60 MILES FROM ATLANTA TO GET TO SHEPHERD CENTER. THIS SUPPORT IS CRUCIAL AND APPRECIATED BY FAMILIES AS IT ENABLES THEM TO FOCUS ON THEIR LOVED ONE GETTING BETTER AND NOT THE FINANCIAL BURDENS AND STRESS THAT COMES WITH MOVING FROM HOME FOR CARE. COMPLIMENTARY HOUSING IS ALSO OFFERED FOR DAY PROGRAM PATIENTS AS A WAY TO EXPERIENCE WHAT THEY HAVE LEARNED IN THE INPATIENT SETTING AND PUT IT TO WORK IN A SAFE ENVIRONMENT. THE HOUSING PROGRAM HELPS ALLEVIATE STRESS AND UNCERTAINTY AS PATIENTS TRANSITION BACK TO THEIR HOME AND COMMUNITY. IN ORDER TO PROVIDE A PEER SUPPORT COMMUNITY FOR MILITARY PATIENTS, HOUSING IS PROVIDED AT BISCAYNE PLACE, AN APARTMENT COMPLEX WITH WITHIN TWO MILES OF SHEPHERD CENTER. MOST EVERY FAMILY MEMBER THAT STAYS IN THE WOODRUFF FAMILY RESIDENCE CENTER HAS SHARED THAT, BY HAVING HOUSING AVAILABLE TO THEM, SHEPHERD CENTER HAS ALLEVIATED THE STRESS AND WORRY OF TRYING TO FIND AND PAY FOR A PLACE TO STAY. PLUS, THEY ARE SO CLOSE TO THEIR LOVED ONES AT THE HOSPITAL, IT GIVES THEM A SENSE OF SECURITY AND CONVENIENCE THEY WOULDN'T HAVE HAD OTHERWISE. INJURY PREVENTIONINJURY PREVENTION AT SHEPHERD CENTER IS A SERIOUS EFFORT TO PREVENT BRAIN, SPINAL CORD AND OTHER TRAUMATIC INJURIES THROUGH THE EDUCATION OF INDIVIDUALS (PRE-K THROUGH COLLEGE STUDENTS), COMMUNITY LEADERS AND CIVIC ORGANIZATIONS. THE GOAL OF THE PROGRAM IS TO MAKE YOUNG PEOPLE UNDERSTAND THE DANGERS OF DIVING HEAD FIRST INTO SHALLOW WATERS, RIDING WITHOUT A HELMET AND DRIVING WITHOUT SEATBELTS. LAST YEAR, NEW SOCIAL MEDIA CONTENT AND OUTREACH EDUCATION WAS DEVELOPED THROUGH THE CREATION OF THE YIPES!! PROGRAM. YIPES!! STANDS FOR YOUTH AND INJURY PREVENTION EDUCATION AT SHEPHERD. THROUGH YIPES!! VIDEO PSAS HAVE BEEN ABLE TO REACH AND EDUCATE MORE YOUNG DRIVERS IN THE ATLANTA AREA. SHEPHERD CENTER'S THINK FIRST CHAPTER HAS ASSISTED IN TRAINING TWO NEW THINK FIRST CHAPTERS IN GEORGIA (DALTON AND ATLANTA), AS WELL AS TRAINING FIVE NEW CHAPTERS IN SOUTH CAROLINA (AIKEN, FLORENCE, GREENVILLE, COLUMBIA, AND HORRY COUNTY). PART III, LINE 4: AS STATED IN THE FOOTNOTES OF SHEPHERD CENTER'S FINANCIAL STATEMENTS, THE CENTER PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE THE CENTER DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS NET REVENUE OR ACCOUNTS RECEIVABLE.THE CENTER MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FOREGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY AND THE ESTIMATED COSTS OF THOSE SERVICES AND SUPPLIES. THE AMOUNTS OF CHARGES FOREGONE, BASED ON ESTABLISHED RATES, AND ESTIMATED COSTS AND EXPENSES INCURRED TO PROVIDE CHARITY CARE IN FY 2012 WERE $ $8,108,424 AND $ $3,554,883, RESPECTIVELY, RESULTING IN A 43.84% COST FACTOR. THIS COST FACTOR WAS APPLIED TO GROSS BAD DEBT EXPENSE OF $ $2,561,636 TO GET THE AMOUNT ON PART III, LINE TWO. PART III, LINE 9B: ACCORDING TO SHEPHERD CENTER'S DEBT COLLECTION POLICY, ALL PATIENTS ARE ASKED TO COMPLETE A FINANCIAL SCREENING AT THE TIME OF REGISTRATION. IF A PATIENT IS APPROVED FOR ASSISTANCE BASED ON THE FINANCIAL DATA SUPPLIED, ANY PATIENT BALANCES WILL BE APPLIED TO A CHARITY ALLOWANCE BASED ON THE HOSPITAL'S FINANCIAL ASSISTANCE TO PATIENTS POLICY. SHEPHERD CENTER, INC. PART V, SECTION B, LINE 10: IT IS SHEPHERD CENTER'S POLICY TO EXTEND ITS SERVICES TO AS MANY PATIENTS AS IT CAN WITHIN THE FINANCIAL RESOURCES THAT ARE AVAILABLE. THOSE WHO DO NOT HAVE FINANCIAL RESOURCES TO PAY FOR THEIR CARE WILL BE CONSIDERED FOR FINANCIAL ASSISTANCE. IT IS CRITICAL TO SAFEGUARD FUNDS AVAILABLE FOR THIS PURPOSE BY ASSURING THAT THIS ASSISTANCE PROGRAM IS THE "PAYER OF LAST RESORT" AND IS ONLY PROVIDED TO THOSE WHO HAVE PROVEN AN INABILITY TO PAY.WHEN PATIENTS ARE SCHEDULED OR AN ADMISSION REFERRAL IS MADE, APPROPRIATE FINANCIAL SCREENING IS PROVIDED. THE FIRST STEP OF THIS SCREENING WILL INCLUDE DETERMINING WHETHER THIRD PARTY PAYER RESOURCES ARE AVAILABLE TO COVER THE COST OF CARE FOR THE INPATIENT OR DAY PATIENT CHARGES IN FULL. IF THERE ARE NO THIRD PARTY PAYER RESOURCES AVAILABLE, OR THERE IS EXPECTED TO BE PATIENT LIABILITY BALANCES DUE AFTER INSURANCE, THE FINANCIAL COUNSELOR WILL COMPLETE A "PRE-SCREENING" USING THE FINANCIAL ASSISTANCE SCREENING FORM. IF FINANCIAL RESOURCES DO NOT APPEAR TO BE AVAILABLE AND THE PATIENT LIABILITY IS EXPECTED TO EXCEED $5,000, THE PATIENT OR GUARANTOR WILL BE ASKED TO COMPLETE A "PATIENT FINANCIAL EVALUATION" FORM TO OBTAIN ADDITIONAL INFORMATION THAT WILL FURTHER ASSIST IN THE ASSESSMENT OF THEIR ELIGIBILITY FOR CHARITY ASSISTANCE. THE PATIENT OR GUARANTOR WILL BE REQUIRED TO COMPLETE THE APPLICATION IN FULL AND PROVIDE SUPPORTING EVIDENCE TO SUBSTANTIATE INCOME. MINIMUM SUPPORTING EVIDENCE FOR INCOME INCLUDES: PAY STUBS REPRESENTING CURRENT INCOME OF HOUSEHOLD. ANYTHING THAT PROVIDES PROOF OF INCOME, I.E., W2S, PRIOR YEAR INCOME TAX FORMS, LETTERS FROM EMPLOYERS ETC. IF NO INCOME, LETTER FROM PERSON PROVIDING ROOM & BOARD TO PATIENT IS REQUIRED.ONCE THE FINANCIAL ASSISTANCE FORM IS COMPLETE THE FINANCIAL COUNSELOR WILL REVIEW TO ASSURE THAT SUPPORTING DOCUMENTATION IS ATTACHED, PROVIDE ALL THE CALCULATIONS REQUIRED, AND PROVIDE A PRELIMINARY ASSESSMENT OF ELIGIBILITY. ELIGIBILITY WILL BE BASED ON THE CRITERIA ESTABLISHED BY SHEPHERD CENTER AS FOLLOWS:A. CURRENT INCOME MUST NOT EXCEED 250% OF THE FEDERAL POVERTY GUIDELINES FOR THE CURRENT YEAR. B. IF INCOME EXCEEDS 250% OF THE FEDERAL POVERTY GUIDELINES, ADDITIONAL INFORMATION MAY BE REQUIRED FROM THE PATIENT OR GUARANTOR TO DETERMINE IF ASSISTANCE CAN BE GRANTED BASED ON A "MEDICALLY NEEDY" SITUATION RESULTING FROM THE CATASTROPHIC EVENT NECESSITATING ADMISSION TO SHEPHERD CENTER.IF THE PATIENT STILL DOES NOT MEET CRITERIA, THE FINANCIAL COUNSELOR WILL ESTABLISH DEPOSIT REQUIREMENTS BASED ON THE EXPECTED LENGTH OF STAY AND WILL OFFER THE PATIENT PAYMENT OPTIONS INCLUDING, BUT NOT LIMITED TO: (SEE ALSO FINANCIAL ARRANGEMENTS POLICY FOR SELF PAY PATIENTS) BANK LOAN VISA/MASTERCARD/DISCOVER/AMERICAN EXPRESS NINETY-(90) DAY PAYMENT PLAN, AS DETAILED IN THE CREDIT & COLLECTIONS POLICY IF THE PRELIMINARY ASSESSMENT APPROVES THE PATIENT FOR FINANCIAL ASSISTANCE, THE FINANCIAL COUNSELOR WILL PRESENT THE PACKET TO THE MANAGER OF PATIENT FINANCIAL SERVICES FOR REVIEW AND QUALIFICATION APPROVAL. IN ADDITION, THE PROGRAM DIRECTOR WILL SIGN TO APPROVE THAT THE USE OF FUNDS MEETS CLINICAL APPROPRIATENESS FOR THEIR AREA. FOR INPATIENTS AND DAY PATIENTS, THE PATIENT WILL NEED TO MEET ASSET REQUIREMENTS. EXPECTATION WOULD BE THAT ASSETS OTHER THAN THOSE LISTED BELOW AND DISPOSABLE INCOME AFTER REASONABLE LIVING EXPENSES WOULD BE USED TO SATISFY A PORTION OR ALL OF THE FINANCIAL REQUIREMENTS OF THE PATIENT'S CARE. ASSETS THAT MAY BE EXCLUDED FROM CONSIDERATION ARE: PATIENT'S HOME WITH NO MORE THAN 25% OR $25,000 EQUITY, WHICHEVER IS LESS. THE REQUIREMENTS TO USE HOME EQUITY CAN BE WAIVED IF THE PATIENT IS UNABLE TO MAKE PAYMENTS ON ADDITIONAL DEBT. IF THE PATIENT HAS APPLIED FOR GEORGIA MEDICAID, THE FINANCIAL ASSISTANCE PROGRAM FORM SHOULD BE COMPLETED AND IF SUCH CHARGES ARE ULTIMATELY NOT COVERED OR UNCOLLECTIBLE THE PATIENT IS DEEMED ELIGIBLE FOR FINANCIAL ASSISTANCE. ALL FINANCIAL AND OTHER MITIGATING CIRCUMSTANCES ARE REVIEWED BY THE MANAGER OF PATIENT FINANCIAL SERVICES WHO THEN MAKES THE FINAL DECISION REGARDING ELIGIBILITY. IF ASSISTANCE IS NOT APPROVED THE FINANCIAL COUNSELOR WILL COORDINATE THE NOTIFICATION TO THE PATIENT. PAYMENT ARRANGEMENTS WILL BE COMPLETED AS LISTED ABOVE AND BASED ON THE FINANCIAL ARRANGEMENTS POLICY. IF APPROVED FOR FULL ASSISTANCE OR ASSISTANCE FOR PATIENT LIABILITY OVER INSURANCE AMOUNTS, THE FINANCIAL COUNSELOR WILL NOTIFY THE PATIENT. THE COVERED AMOUNT WILL BE WRITTEN-OFF PURSUANT TO ESTABLISHED POLICY AFTER DISCHARGE OR INSURANCE IS FINALIZED. SHEPHERD CENTER, INC. PART V, SECTION B, LINE 13G: WHEN PATIENTS ARE SCHEDULED OR AN ADMISSION REFERRAL IS MADE, APPROPRIATE FINANCIAL SCREENING IS PROVIDED. PART VI, LINE 2: SHEPHERD CENTER'S MISSION IS TO HELP PEOPLE WITH A TEMPORARY OR PERMANENT DISABILITY CAUSED BY INJURY OR DISEASE REBUILD THEIR LIVES WITH HOPE, INDEPENDENCE AND DIGNITY, ADVOCATING FOR THEIR FULL INCLUSION IN ALL ASPECTS OF COMMUNITY LIFE WHILE PROMOTING SAFETY AND INJURY PREVENTION. SHEPHERD CENTER IS COMMITTED TO PROVIDING THE RESOURCES AND TOOLS OUR PATIENTS NEED TO FACILITATE THE SUCCESSFUL TRANSITION BACK TO LIFE AND COMMUNITY AFTER A CATASTROPHIC INJURY.FROM DAY ONE, SHEPHERD CENTER HAS FOCUSED ON PATIENT-CENTERED CARE AND HAS DEVELOPED A CONTINUUM THAT IS UNIQUE IN THE SETTING OF AN ACUTE CARE, REHABILITATION HOSPITAL. BECAUSE OF THE VALUE-ADDED PROGRAMS OFFERED AT SHEPHERD CENTER, OUR PATIENTS HAVE THE RESOURCES TO RE-LEARN ACTIVITIES OF DAILY LIVING AND ACHIEVE THE GOALS THEY SET FOR THEMSELVES POST-INJURY. THOSE GOALS INCLUDE RETURNING TO HOME, SCHOOL AND/OR WORK. THEY ALSO INCLUDE "GETTING THEIR LIFE BACK" IN REGARD TO REGAINING THE ABILITY TO ENJOY LIFE THROUGH SOCIAL EVENTS, HOBBIES, AND LEISURE ACTIVITIES, AS WELL AS PROVIDING FOR THEMSELVES AND THEIR FAMILY. THE VALUE-ADDED PROGRAMS AID IN REGAINING ONE'S LIFE AND REBUILDING THEIR HOPE, BUT ARE OFTEN NOT REIMBURSED BY INSURANCE OR MEDICARE/MEDICAID. THEY ARE ESSENTIAL IN A PATIENT'S SUCCESSFUL RECOVERY. SHEPHERD CENTER BELIEVES THESE PROGRAMS DIRECTLY CONTRIBUTE TO THE MUCH GREATER THAN AVERAGE CLINICAL OUTCOMES ACHIEVED BY OUR PATIENTS. SHEPHERD CENTER'S RETURN TO HOME AND COMMUNITY RATES FOR SPINAL CORD INJURY PATIENT ARE 87 PERCENT AS COMPARED TO THE NATIONAL AVERAGE OF 73 PERCENT AND FOR BRAIN INJURY PATIENTS 93 PERCENT AS COMPARED TO THE NATIONAL AVERAGE OF 65 PERCENT. SHEPHERD CENTER'S CLINICAL OUTCOMES HAVE BEEN RECOGNIZED THREE STRAIGHT YEARS AS A TOP 10 REHABILITATION HOSPITAL BY U.S. WORLD & NEWS REPORT. PART VI, LINE 3: IT IS SHEPHERD CENTER'S (SC) POLICY TO EXTEND ITS SERVICES TO AS MANY PATIENTS AS IT CAN WITHIN THE FINANCIAL RESOURCES THAT ARE AVAILABLE. THOSE WHO DO NOT HAVE FINANCIAL RESOURCES TO PAY FOR THEIR CARE AT SC WILL BE CONSIDERED FOR FINANCIAL ASSISTANCE.WHEN PATIENTS ARE SCHEDULED OR AN ADMISSION REFERRAL IS MADE, APPROPRIATE FINANCIAL SCREENING IS PROVIDED. THE FIRST STEP OF THIS SCREENING WILL INCLUDE WHETHER THIRD PARTY PAYER RESOURCES ARE AVAILABLE TO COVER THE COST OF CARE FOR THE INPATIENT OR DAY PATIENT CHARGES IN FULL. IF THERE ARE NO THIRD PARTY PAYER RESOURCES AVAILABLE, OR THERE IS EXPECTED TO BE PATIENT LIABILITY BALANCES DUE OVER INSURANCE, THE FINANCIAL COUNSELOR WILL COMPLETE A 'PRE-SCREENING' USING THE FINANCIAL ASSISTANCE SCREENING FORM. IF FINANCIAL RESOURCES DO NOT APPEAR TO BE AVAILABLE AND THE PATIENT LIABILITY IS EXPECTED TO EXCEED $5,000, THE PATIENT OR GUARANTOR WILL BE ASKED TO COMPLETE A 'PATIENT FINANCIAL EVALUATION' FORM TO OBTAIN ADDITIONAL INFORMATION THAT WILL FURTHER ASSIST IN THE ASSESSMENT OF THEIR ELIGIBILITY FOR CHARITY ASSISTANCE. THE PATIENT OR GUARANTOR WILL BE REQUIRED TO COMPLETE THE APPLICATION IN FULL AND PROVIDE SUPPORTING EVIDENCE TO SUBSTANTIATE INCOME. MINIMUM SUPPORTING EVIDENCE FOR INCOME WOULD INCLUDE:-PAY STUBS REPRESENTING CURRENT INCOME OF HOUSEHOLD.-ANYTHING THAT PROVIDES PROOF OF INCOME, I.E., W2S, PRIOR YEAR INCOME TAX FORMS, LETTERS FROM EMPLOYERS ETC. -IF NO INCOME, LETTER FROM PERSON PROVIDING ROOM & BOARD TO PATIENT IS REQUIRED.ONCE THE FINANCIAL ASSISTANCE FORM IS COMPLETE THE FINANCIAL COUNSELOR WILL REVIEW TO ASSURE THAT SUPPORTING DOCUMENTATION IS ATTACHED, PROVIDE ALL THE CALCULATIONS REQUIRED, AND PROVIDE A PRELIMINARY ASSESSMENT OF ELIGIBILITY. ELIGIBILITY WILL BE BASED ON THE CRITERIA ESTABLISHED BY SHEPHERD CENTER AS FOLLOWS:A.CURRENT INCOME MUST NOT EXCEED 250% OF THE FEDERAL POVERTY GUIDELINES FOR THE CURRENT YEAR. B.IF INCOME EXCEEDS 250% OF THE FEDERAL POVERTY GUIDELINES, ADDITIONAL INFORMATION MAY BE REQUIRED FROM THE PATIENT OR GUARANTOR TO DETERMINE IF ASSISTANCE CAN BE GRANTED BASED ON A 'MEDICALLY NEEDY' SITUATION RESULTING FROM THE CATASTROPHIC EVENT NECESSITATING ADMISSION TO SHEPHERD CENTER.IF THE PATIENT STILL DOES NOT MEET CRITERIA, THE FINANCIAL COUNSELOR WILL ESTABLISH DEPOSIT REQUIREMENTS BASED ON THE EXPECTED LENGTH OF STAY AND WILL OFFER THE PATIENT PAYMENT OPTIONS INCLUDING, BUT NOT LIMITED TO: (SEE ALSO FINANCIAL ARRANGEMENTS POLICY FOR SELF PAY PATIENTS)-BANK LOAN-VISA/MASTERCARD/DISCOVER/AMERICAN EXPRESS-NINETY-(90) DAY PAYMENT PLAN, AS DETAILED IN THE CREDIT & COLLECTIONS POLICY IF THE PRELIMINARY ASSESSMENT IS TO APPROVE THE PATIENT FOR FINANCIAL ASSISTANCE, THE FINANCIAL COUNSELOR WILL PRESENT THE PACKET TO THE MANAGER OF PATIENT FINANCIAL SERVICES FOR REVIEW AND QUALIFICATION APPROVAL. IN ADDITION, THE PROGRAM DIRECTOR WILL SIGN TO APPROVE THAT USE OF FUNDS MEET CLINICAL APPROPRIATENESS FOR THEIR AREA. FOR INPATIENTS AND DAY PATIENTS, THE PATIENT WILL NEED TO MEET ASSET REQUIREMENTS. EXPECTATION WOULD BE THAT ASSETS OTHER THAN THOSE LISTED BELOW AND DISPOSABLE INCOME AFTER REASONABLE LIVING EXPENSES WOULD BE USED TO SATISFY A PORTION OR ALL OF THE FINANCIAL REQUIREMENTS OF THE PATIENT'S CARE. ASSETS THAT MAY BE EXCLUDED FROM CONSIDERATION ARE:-PATIENT'S HOME WITH NO MORE THAN 25% OR $25,000 EQUITY, WHICHEVER IS LESS. THE REQUIREMENTS TO USE HOME EQUITY CAN BE WAIVED IF THE PATIENT IS UNABLE TO MAKE PAYMENTS ON ADDITIONAL DEBT.-IF THE PATIENT HAS APPLIED FOR GEORGIA MEDICAID, THE FAP FORM SHOULD BE COMPLETED AND IF SUCH CHARGES ARE ULTIMATELY NOT COVERED OR UNCOLLECTIBLE THE PATIENT IS DEEMED ELIGIBLE FOR FINANCIAL ASSISTANCE. ALL FINANCIAL AND OTHER MITIGATING CIRCUMSTANCES ARE REVIEWED BY THE MANAGER OF PATIENT FINANCIAL SERVICES WHO THEN MAKES THE FINAL DECISION REGARDING ELIGIBILITY. IF ASSISTANCE IS NOT APPROVED THE FINANCIAL COUNSELOR WILL COORDINATE THE NOTIFICATION TO THE PATIENT. PAYMENT ARRANGEMENTS WILL BE COMPLETED AS LISTED ABOVE AND BASED ON THE FINANCIAL ARRANGEMENTS POLICY. IF APPROVED FOR FULL ASSISTANCE OR ASSISTANCE FOR PATIENT LIABILITY OVER INSURANCE AMOUNTS, THE FINANCIAL COUNSELOR WILL NOTIFY THE PATIENT. THE COVERED AMOUNT WILL BE WRITTEN OFF PURSUANT TO ESTABLISHED POLICY AFTER DISCHARGE OR INSURANCE IS FINALIZED. PART VI, LINE 4: SHEPHERD CENTER DEFINES COMMUNITY BENEFIT AS SERVICES AND ACTIVITIES THAT SPECIFICALLY ADDRESS THE HEALTH NEEDS OF PATIENTS WITH SPINAL CORD AND BRAIN INJURY, MULTIPLE SCLEROSIS, CHRONIC PAIN, OTHER NEUROMUSCULAR DISEASES, AS WELL AS THE FAMILY OR LOVED ONES OF THOSE PATIENTS. THESE SERVICES INCLUDE THE FULL CONTINUUM OF CARE AS A PATIENT AND EXTEND BACK TO THE PATIENT'S COMMUNITY. BECAUSE OF THE UNDERSERVED NATURE OF THIS PATIENT POPULATION, SHEPHERD CENTER CONTINUES TO BE A RESOURCE FOR OUR PATIENTS THROUGHOUT THEIR LIFE. SHEPHERD CENTER'S COMMUNITY INCLUDES CURRENT PATIENTS AND THEIR FAMILY, AS WELL AS FORMER PATIENTS AND THEIR FAMILY. SHEPHERD CENTER ALSO TAKES A LEADERSHIP ROLE IN EDUCATING HEALTH-CARE PROFESSIONALS (PHYSICIANS, NURSES AND THERAPISTS) WHO ARE FOCUSED ON SPECIALTIES IN SPINAL CORD AND BRAIN INJURY REHABILITATION. SHEPHERD CENTER HAS ALWAYS SERVED AS A STRONG ADVOCATE IN THE COMMUNITY FOR ANYONE LIVING WITH A PHYSICAL DISABILITY. SHEPHERD CENTER'S COMMUNITY EXTENDS BEYOND OUR CURRENT PATIENT POPULATION TO ATLANTA, THE STATE OF GEORGIA, THE NATION AND THE WORLD AS THE LEADING AND SPECIALTY HOSPITAL FOR THIS PATIENT POPULATION. AS A RECOGNIZED ADVOCATE FOR PEOPLE LIVING WITH DISABILITIES, SHEPHERD CENTER HAS CHANGED THE LANDSCAPE IN ATLANTA AND BEYOND TO BE MORE RECEPTIVE OF PEOPLE WITH DISABILITIES LIVING IN OUR COMMUNITY. SHEPHERD CENTER HAS TREATED PATIENTS FROM ALL 50 STATES AND MORE THAN 22 FOREIGN COUNTRIES. REPORTS FILED WITH STATES PART VI, LINE 7 GA X X X X X 0 0 0 0 0 1 0 0 0 DAVID F APPLE JR MD 127719 0 29512 0 11175 0 10250 0 7474 0 186130 0 0 0 DONALD P LESLIE MD 529759 0 24600 0 75300 0 11000 0 5375 0 646034 0 0 0 JAMES H SHEPHERD JR 218804 0 10130 0 30389 0 10250 0 9416 0 278989 0 0 0 GARY ULICNY PHD 487459 0 23815 0 71445 0 11000 0 9720 0 603439 0 0 0 STEPHEN B HOLLEMAN 280420 0 13947 0 41842 0 11000 0 13144 0 360353 0 0 0 WILMA BUNCH 181859 0 5500 0 0 0 11000 0 7663 0 206022 0 0 0 MITCHELL J FILLHABER 266044 0 35000 0 0 0 3250 0 9720 0 314014 0 0 0 BROCK BOWMAN MD 439712 0 4000 0 0 0 8250 0 12406 0 464368 0 0 0 TAMARA KING 191151 0 5500 0 1500 0 11000 0 9416 0 218567 0 0 0 MICHAEL JONES 247943 0 49478 0 1500 0 10250 0 11734 0 320905 0 0 0 SCOTT H SIKES 240590 0 2000 0 0 0 4125 0 9719 0 256434 0 0 0 GERALD BILSKY MD 466224 0 4300 0 0 0 11274 0 460 0 482258 0 0 0 ANNA ELMERS MD 518879 0 5716 0 0 0 8308 0 303 0 533206 0 0 0 JOHN MUSSER MD 463772 0 7191 0 0 0 0 0 0 0 470963 0 0 0 ERIK SHAW MD 558724 0 3650 0 250 0 9416 0 303 0 572343 0 0 0 BEN THROWER MD 501734 0 106630 0 750 0 0 0 460 0 609574 0 0 0 PART I, LINE 6 SHEPHERD CENTER'S BOARD OF DIRECTORS APPROVED A "SHEPHERD SHARE" IN FY 2012 FOR ALL ELIGIBLE EMPLOYEES BECAUSE THE CENTER SUCCESSFULLY MET TARGETED GOALS. THE BOARD RESERVES THE RIGHT TO DECLINE TO PAY EVEN IF THE CENTER MEETS TARGETED FINANCIAL GOALS IF WE DO NOT MEET OTHER GOALS SUCH AS QUALITY AND CUSTOMER SERVICE GOALS. DEVELOPMENT AUTHORITY OF FULTON COUNTY 581506878 359900ZT7 2009-11-04 56000000 PROVIDE FUNDS TO REFUND 4/20/05 ISSUE FOR HOSPITAL EXPANSION 0 0 0 DEVELOPMENT AUTHORITY OF FULTON COUNTY 581506878 359597EB3 2010-12-02 13900000 PROVIDE FUNDS TO REFUND 9/29/97 ISSUE FOR HOSPITAL RENOVATIONS 0 0 0 1000000 56000000 56000000 2007 1 0 1 1 1700000 13900000 13900000 1998 1 0 1 1 0 1 1 0 0 0.00000 0.01400 0.01400 1 0 0 0 0 0 0 0 0 0 0 0 0 LINDA SHEPHERD FAMILY MEMBER 35686 EMPLOYEE 0 SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (A) NAME OF PERSON: LINDA SHEPHERD (D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION X 45 346369 MARKET VALUE X LIGHTING 1 50008 FAIR MARKET VALUE 0 1 0 NEW PROGRAM SERVICES FORM 990, PART III, LINE 2 SHEPHERD CENTER LAUNCHED RESCUE, A COMMUNITY SERVICE PROGRAM PROVIDING HOME ALERT LABELS AND EDUCATION FOR PEOPLE WITH PHYSICAL AND OR COGNITIVE LIMITATIONS WHO FIND THEMSELVES IN EMERGENCY SITUATIONS. THE MISSION IS TO AID IN QUICKER RESPONSE TIMES AND CREATION OF BETTER EMERGENCY PLANS. FORM 990, PART VI, SECTION A, LINE 2 FAMILY RELATIONSHIP: JAMES SHEPHERD (CHAIRMAN OF THE BOARD), ALANA SHEPHERD (RECORDING SECRETARY), J. HAROLD SHEPHERD (BOARD MEMBER), AND W. CLYDE SHEPHERD, III (BOARD MEMBER). FAMILY & BUSINESS RELATIONSHIP: LINDA SHEPHERD (EMPLOYEE) AND JULIE SHEPHERD (EMPLOYEE). BUSINESS RELATIONSHIP: JAMES E. STEPHENSON BUSINESS RELATIONSHIP: DAVID F. APPLE, M.D. FORM 990, PART VI, SECTION B, LINE 11 THE FORM IS PREPARED BY CARR, RIGGS & INGRAM, LLC WITH THE ASSISTANCE OF THE ACCOUNTING STAFF AT SHEPHERD CENTER. THE RETURN IS THEN REVIEWED BY THE CHIEF FINANCIAL OFFICER WITH FURTHER CONSULTATION WITH CRI FOR ALL QUESTIONS THAT ARE UNCLEAR AS TO MEANING AND INTENT. THE CHIEF FINANCIAL OFFICER THEN REVIEWS THE FORM 990 WITH THE CHAIRMAN OF THE BOARD, THE CHIEF EXECUTIVE OFFICER, AND THE EXECUTIVE DIRECTOR OF SHEPHERD CENTER FOUNDATION FOR THEIR INPUT AND APPROVAL. SHEPHERD CENTER PROVIDES EACH MEMBER OF THE BOARD WITH A FINAL COPY OF THE FILED 990 UPON COMPLETION OF THE PROCESS. FORM 990, PART VI, SECTION B, LINE 12C SHEPHERD CENTER BOARD OF DIRECTORS ARE PRESENTED WITH A CONFLICT OF INTEREST QUESTIONNAIRE ON AN ANNUAL BASIS AND THEY INDICATE THEIR COMPLIANCE BY SIGNING THE DOCUMENT, WHICH IS KEPT ON FILE IN ADMINISTRATION. IN ADDITION, ON AN ANNUAL BASIS SHEPHERD CENTER ACCOUNTING STAFF AS WELL AS THE CHIEF FINANCIAL OFFICER REVIEWS ALL 1099'S BEFORE DISTRIBUTION FOR ANY BOARD MEMBER NAMES/COMPANIES. THE STAFF ALSO CHECKS WITH THE DEVELOPMENT OFFICE FOR ANY ADDITIONAL INFORMATION REGARDING BOARD MEMBER AFFILIATIONS WITH OTHER ENTITIES WITH WHICH SHEPHERD CENTER DOES BUSINESS. FORM 990, PART VI, SECTION B, LINE 15 SHEPHERD CENTER UTILIZES A BOARD COMPENSATION COMMITTEE TO DETERMINE COMPENSATION FOR THE CEO AND OTHER EXECUTIVE MANAGEMENT. THIS COMMITTEE UTILIZES OUTSIDE CONSULTANTS (FOR EXAMPLE, SULLIVAN COTTER), INDUSTRY COMPENSATION SURVEYS, AND REVIEWS OF SIMILAR ORGANIZATIONS' FORMS 990 TO DETERMINE APPROPRIATENESS OF COMPENSATION. SHEPHERD CENTER UTILIZES WATSON WYATT DATA SERVICES COMPENSATION SURVEYS TO DETERMINE WHETHER OR NOT A COMPENSATION PACKAGE IS IN LINE WITH OUR REGION AND RELATIVE BED SIZE. THE HUMAN RESOURCES DIRECTOR ANALYZES THE DATA AND GETS APPROVAL FROM THE CEO. FORM 990, PART VI, SECTION C, LINE 18 AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE UPON REQUEST. FORM 990, PART IX: SHEPHERD CENTER HAS ALLOCATED A PORTION OF THE EXPENSES OF THESE INDIRECT COST CENTERS TO PROGRAM SERVICE EXPENSE: DEPRECIATION, ENGINEERING, INFORMATION SYSTEMS, COMMUNICATIONS, QUALITY AND OUTCOMES MANAGEMENT, SECURITY, SEATING CLINIC, TRANSPORATION, COMPLIANCE AND AUDIT, RISK MANAGEMENT, CODING AUDIT, AND RENOVATIONS. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 998,397. CHANGES IN TEMPORARILY RESTRICTED NET ASSETS 1,750,793. CHANGE IN INTERCOMPANY ACCOUNTS -1,605,240. CHANGES IN PERMANENTLY RESTRICTED NET ASSETS 887,553. ROUNDING -12. TOTAL TO FORM 990, PART XI, LINE 5: 2,031,491. FORM 990, PART XI, LINE 2C NO CHANGE HAS OCCURRED FROM PRIOR YEAR. 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