2012-11-15T08:22:31-06:00 2012-06-30 580692043 Mauldin & Jenkins LLC P O Box 1877 Macon GA 312021877 990 2011-07-01 581945826 AG RHODES HEALTH & REHAB COBB AGRH 7704278727 900 WYLIE ROAD MARIETTA GA 30067 ALBERT K BLACKWELDER 4046363512 2012-11-14 1 Rick Alibozek P00108158 4784648000 2012-11-14 X 2011 2016-02-24 21:20:13Z DAVID PERDUE 9161 LIBERTY MILLS ROAD SOMERSET VA 22972 11207691 0 X WWW.AGRHODES.ORG X 1992 GA THE MISSION OF A.G. RHODES HEALTH & REHAB - COBB IS TO PROVIDE THE HIGHEST POSSIBLE STANDARD OF QUALITY CARE TO OUR ELDERLY RESIDENTS WHILE PRESERVING THEIR DIGNITY, INDEPENDENCE, AND QUALITY OF LIFE. WE COMMIT OURSELVES TO CARE FOR ALL WHO NEED OUR SERVICES, REGARDLESS OF THEIR ECONOMIC STATUS. WE BELIEVE THE PRIMARY PURPOSE OF OUR WORK IS TO SERVE OUR RESIDENTS, WHILE STRIVING TO MAINTAIN OPEN LINES OF COMMUNICATION WITH THEIR FAMILIES. WE ARE PROUD TO BE CARING PEOPLE CARING FOR PEOPLE. 10 10 228 240 0 0 286266 395404 11084243 10793557 -1030 -22379 17325 17525 11386804 11184107 0 350 0 0 7079922 6935078 0 0 0 4061783 4514736 11141705 11450164 245099 -266057 6182913 6196816 1947601 2230767 4235312 3966049 X THE MISSION OF A.G. RHODES HEALTH & REHAB - COBB IS TO PROVIDE THE HIGHEST POSSIBLE STANDARD OF QUALITY CARE TO OUR ELDERLY RESIDENTS WHILE PRESERVING THEIR DIGNITY, INDEPENDENCE, AND QUALITY OF LIFE. WE COMMIT OURSELVES TO CARE FOR ALL WHO NEED OUR SERVICES, REGARDLESS OF THEIR ECONOMIC STATUS. WE BELIEVE THE PRIMARY PURPOSE OF OUR WORK IS TO SERVE OUR RESIDENTS, WHILE STRIVING TO MAINTAIN OPEN LINES OF COMMUNICATION WITH THEIR FAMILIES. WE ARE PROUD TO BE CARING PEOPLE CARING FOR PEOPLE. 0 0 9285033 10788703 THE ORGANIZATION OWNS AND OPERATES A 130-BED SKILLED NURSING FACILITY IN ATLANTA, GEORGIA AND PROVIDES SKILLED AND INTERMEDIATE NURSING HOME SERVICES TOTALING 45,950 CERTIFIED BED DAYS. 9285033 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 7 0 228 1 0 0 0 0 0 0 0 0 0 0 X 10 10 0 1 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 GA X The Organization 7704278727 900 WYLIE ROAD MARIETTA GA 30067 DAVID L PERDUE 5.00 X X 0 0 0 ANN BARRETT 5.00 X X 0 0 0 JOHN W WILCOX III 5.00 X X 0 0 0 GEORGE CHASE JR 2.00 X 0 0 0 SAM B HOLLIS 2.00 X 0 0 0 WILLIAIM E HUGER III 2.00 X 0 0 0 HERNDON MURRAY 2.00 X 0 0 0 JANE SCHWEERS 2.00 X 0 0 0 JACK SIBLEY 2.00 X 0 0 0 MARGARET STICKNEY 2.00 X 0 0 0 ALBERT K BLACKWELDER 40.00 X 0 142500 0 ANGELA DAUGHERTY 40.00 X 142809 0 6363 JENNIFER GILBRETH 40.00 X 101298 0 5457 244107 142500 11820 2 0 0 0 MORRISON MANAGEMENT SPECIALISTS 4721 MORRISON DR MOBILE AL 36609 DIETARY CONTRACT SERVICES 1188419 COVENTRY HEALTH CARE OF GA INC PO BOX 6502 CAROL STREAM IL 60197 HEALTH INSURANCE 609276 BAUGUESS MANAGEMENT COMPANY 1708 PEACHTREE ST SUITE 201 ATLANTA GA 30309 CONTRACT MANAGEMENT SERVICES 351835 LUSK & COMPANY INC 2350 JUSTIN TRAIL ALPHARETTA GA 30004 CONSTRUCTION SERVICES 312997 UNITED PHARMACY SERVICES PO BOX 1627 TOCCOA GA 30577 PHARMACY SUPPLIES 273003 6 258011 137393 395404 Medicare and Medicaid 623000 7668252 7668252 Private revenue 623000 3125305 3125305 10793557 1205 1205 23584 -23584 -23584 -23584 Cable TV charges 623000 17225 17225 Meal revenue 623000 178 178 Miscellaneous income 623000 122 122 17525 11184107 10788703 0 0 350 350 5789406 5209612 579794 112800 100312 12488 590632 519847 70785 442240 399915 42325 513547 513547 2331 2331 27233 27233 17411 17411 68263 68263 244419 244419 11230 11230 8114 8114 42965 41534 1431 302087 302087 110238 110238 Contracted services 1400897 1400897 Program supplies 785982 785982 Georgia Provider fee 553104 553104 Bad debt expense 126024 126024 300891 154054 146837 11450164 9285033 2165131 0 875526 489559 864965 895519 19085 16512 8475031 3702544 4396175 4772487 27162 22739 6182913 6196816 678533 722870 1282861 1510000 -13793 -2103 1947601 2230767 X 4235312 3966049 4235312 3966049 6182913 6196816 X -266057 -3206 X X 0 1 1 X 0 X 320776 256745 172238 286266 395404 1431429 10211826 10881147 11029469 11084243 10793557 54000242 10532602 11137892 11201707 11370509 11188961 55431671 304930 246453 161800 265034 384011 1362228 0 304930 246453 161800 265034 384011 1362228 54069443 26512 8773 3301 2780 1205 42571 26512 8773 3301 2780 1205 42571 17325 17525 34850 10559114 11146665 11205008 11390614 11207691 55509092 0.97410 0.97310 0.00080 0.00150 X Schedule A, Part II, Line 12, Explanation of Other Income: MEAL REVENUE CABLE TV REVENUE MISCELLANEOUS INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 915189 915189 5192305 2010421 3181884 1963304 1389690 573614 404233 302433 101800 4772487 Related Party Balances -20471 Interest rate swap liability 18368 -2103 Description of Uncertain Tax Positions Under FIN 48: Part X: It is the Organization's policy to account for any uncertainties in income tax law in accordance with FASB ASC 740-10 "Accounting for Uncertainty in Income Taxes". ASC 740-10 clarifies the accounting for uncertain tax positions and requires that the Organization recognize the impact of such a tax position in their financial statements if, upon ultimate settlement, that position is more likely than not to be sustained. Management has evaluated the Organization's tax positions and concluded that the Organization had maintained its tax-exempt status and had taken no uncertain tax positions that require adjustment to the financial statements. Form 990, Part VI, Section A, line 3 THROUGH FEBRUARY 2012, THE ORGANIZATION CONTRACTED WITH AN UNRELATED MANAGEMENT COMPANY TO OVERSEE OPERATIONAL DETAILS, IN CONJUNCTION WITH THE BOARD OF MANAGERS, THE BOARD OF TRUSTEES, AND THE STAFF OF A.G. RHODES HEALTH & REHAB COBB. EFFECTIVE IN FEBRUARY 2012, THE ORGANIZATION CONTRACTED WITH A.G. RHODES HEALTH & REHAB MANAGEMENT, INC., A RELATED TAX-EXEMPT ORGANIZATION, TO PERFORM THE SAME DUTIES. Form 990, Part VI, Section A, line 4 THE ORGANIZATION REVISED ITS BYLAWS DURING THE YEAR. Form 990, Part VI, Section B, line 11 A DRAFT OF THE FORM 990 FOR THE CURRENT YEAR IS PROVIDED TO MANAGEMENT, WHO FORWARDS TO JOINT COMMITTEE OF THE BOARD OF MANAGERS AND THE BOARD OF TRUSTEES FOR THEIR REVIEW. THE JOINT COMMITTEE REVIEWS THE DRAFT OF THE FORM 990 AND DISCUSSES ANY QUESTIONS WITH THE MANAGEMENT TEAM AND THE FIRM PREPARING THE FORM 990. ANY BOARD MEMBER OR MANAGEMENT QUESTIONS ARE ADDRESSED AND ANY PROPOSED CHANGES MADE BEFORE THE FORM 990 IS FILED ELECTRONICALLY WITH THE INTERNAL REVENUE SERVICES UPON AUTHORIZATION BY THE PRESIDENT OF THE BOARD OF TRUSTEES AND/OR THE CEO. Form 990, Part VI, Section B, line 12c ALL OF THE ORGANIZATION'S GOVERNING BOARD AND MANAGEMENT ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST POLICY STATEMENT ANNUALLY, WHICH ARE THEN REVIEWED FOR POSSIBLE CONFLICTS. ANY CONFLICTS OF INTEREST MUST BE RESOLVED THROUGH CHANGES IN RELATIONSHIPS AND/OR OTHER COMPENSATING CONTROLS. Form 990, Part VI, Section B, line 15 THE ORGANIZATION USES A COMPARISON OF MEDICAID COST REPORT DATA TO ESTABLISH SALARIES. AN INDEPENDENT COMMITTEE OF THE BOARD SETS MANAGEMENT SALARIES. THROUGH FEBRUARY 2012, THE ADMINISTRATOR SERVED AS THE TOP MANAGEMENT POSITION AT THE ORGANIZATION. THE CEO OF A.G. RHODES HEALTH & REHAB MANAGEMENT, INC. BECAME THE DE FACTO CEO OF THE ORGANIZATION STARTING IN FEBRUARY 2012. Form 990, Part VI, Section C, line 18 THE ORGANIZATION MAKES ITS FORM 1023 AND FORM 990 AVAILABLE TO THE PUBLIC UPON REQUEST. 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. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized losses on investments: -3,206. FORM 990, PART XII, LINE 2C THE AUDIT COMMITTEE AND SELECTED MEMBERS OF THE BOARD OF MANAGERS MEET WITH THE INDEPENDENT AUDITOR TO REVIEW AND DISCUSS AUDIT RESULTS. AG RHODES HEALTH & REHAB ATLANTA 350 BOULEVARD SE ATLANTA GA 30312 580586001 138 BED NURSING HOME-SEPARATE CORPORATION-COMMON BOARDS GA 501(c)(3) Line 9 NONE 0 AG RHODES HEALTH & REHAB WESLEY WOODS 1819 CLIFTON ROAD ATLANTA GA 30329 582189638 150 BED NURSING HOME-SEPARATE CORPORATION-COMMON BOARDS GA 501(c)(3) Line 9 NONE 0 THE FOUNDATION FOR RHODES HOMES INC 2801 BUFORD HIGHWAY SUITE 500 ATLANTA GA 30329 421596185 SUPPORTING ORGANIZATION GA 501(c)(3) Line 11a, I AG RHODES HEALTH & REHAB COBB WESLEY WOODS AND ATLANTA 1 AG RHODES EXTENDACARE INC 2801 BUFORD HIGHWAY SUITE 500 ATLANTA GA 30329 203021911 ADDITIONAL SUPPORT SERVICES FOR THE DISABLED, THE ELDERLY AND THE INDIGENT GA 501(c)(3) Line 9 NONE 0 AG RHODES HEALTH & REHAB MANAGEMENT INC 2801 BUFORD HIGHWAY SUITE 500 ATLANTA GA 30329 453723342 MANAGEMENT FOR NOT-FOR-PROFIT NURSING FACILITIES GA 501(c)(3) APPLICATION PENDING NONE 0 0 0 1 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 FOUNDATION FOR RHODES HOMES INC C 258011 FAIR VALUE