2023-11-14T13:35:16-06:00 2022-12-31 440160260 FORVIS LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2022-01-01 272187557 BROOKS SKILLED NURSING FACILITY HOLDINGS A INC BROO 9043460663 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 J BRITTON TABOR CFO 9043460663 2023-11-14 1 J BRITTON TABOR 999009999 1 AMY BIBBY P00445891 8282542254 2023-11-07 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z J BRITTON TABOR 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 991106 0 X WWW.BROOKSREHAB.ORG X 2010 FL PROPERTY HOLDING FOR BARTRAM CROSSING, A SKILLED NURSING FACILITY 2 0 0 0 0 0 0 0 996063 991106 0 0 0 0 996063 991106 0 0 0 0 0 0 0 0 0 996223 981232 996223 981232 -160 9874 23389744 22420040 30327173 29347595 -6937429 -6927555 TO ADVANCE THE HEALTH AND WELL-BEING OF PERSONS REQUIRING REHABILITATION THROUGH SUPERIOR OUTCOMES, SERVICE, EDUCATION, AND RESEARCH 0 0 969704 991106 BROOKS SKILLED NURSING FACILITY HOLDINGS A, INC. ("HOLDINGS") WAS ESTABLISHED IN 2010 AS A SUPPORTING ORGANIZATION TO BROOKS SKILLED NURSING, INC. HOLDINGS ASSISTS ITS SUPPORTED ORGANIZATION BY HOLDING TITLE TO REAL AND PERSONAL PROPERTY USED BY THE SUPPORTED ORGANIZATION IN FULFILLING ITS EXEMPT PURPOSE OF OPERATING A SKILLED NURSING FACILITY. 969704 1 0 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 2 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X X J BRITTON TABOR 9043457600 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 X DOUGLAS M BAER CHAIRMAN/CEO 1.00 51.00 X X 0 2402243 64171 DANIEL R CURRAN CFO 1.00 49.00 X 0 438079 19155 0 2840322 83326 0 0 1 0 0 RENTAL INCOME 531120 991106 991106 991106 991106 991106 0 0 11528 11528 969704 969704 981232 969704 11528 0 32758706 10338666 23389744 22420040 23389744 22420040 30327173 29347595 30327173 29347595 X -6937429 -6927555 -6937429 -6927555 23389744 22420040 9874 0 X X 0 1 X 1 0 X X X 1 BROOKS SKILLED NURSING INC 264561148 10 1 0 969704 1 0 969704 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 3432372 3432372 26113325 7711008 18402317 3213009 2627658 585351 22420040 DUE TO AFFILIATES 29347595 29347595 X PART X, LINE 2: THE ORGANIZATION RECEIVES CONSOLIDATED FINANCIAL STATEMENTS INCLUDING CORPORATE PARENT AND SUBSIDIARIES. THE FOLLOWING DISCLOSURE APPLIES TO THE SYSTEM AS A WHOLE: BROOKS REHABILITATION HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE IRC. 0 0 0 0 0 0 0 0 0 DOUGLAS M BAER CHAIRMAN/CEO 0 2398382 0 0 0 3861 0 47500 0 16671 0 2466414 0 0 DANIEL R CURRAN CFO 0 436595 0 0 0 1484 0 13223 0 5932 0 457234 0 0 PART I, LINE 3: THE ORGANIZATION DOES NOT COMPENSATE ANY OFFICERS OR KEY EMPLOYEES DIRECTLY. CERTAIN BOARD MEMBERS AND MANAGEMENT OFFICIALS ARE COMPENSATED BY BROOKS HEALTH SYSTEM, A RELATED ORGANIZATION. THE BOARD OF BROOKS HEALTH SYSTEM USES THE FOLLOWING METHODS TO DETERMINE EXECUTIVE COMPENSATION: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION STUDY OR SURVEY - APPROVAL BY COMPENSATION COMMITTEE FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS BROOKS SKILLED NURSING, INC. A FLORIDA NOT FOR PROFIT CORPORATION. BROOKS SKILLED NURSING, INC. IS A SUBSIDIARY OF GENESIS HEALTH, INC., A FLORIDA 501(C)(3) NOT FOR PROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION SHALL HAVE AT ALL TIMES AT LEAST THREE MEMBERS OF THE BOARD OF DIRECTORS. THE MEMBERS OF THE BOARD OF DIRECTORS ARE ELECTED BY THE SOLE MEMBER ORGANIZATION AS PROVIDED IN THE BYLAWS OF THE ORGANIZATION. SEE THE RESPONSE TO LINE 6 ABOVE. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING ACTIONS REQUIRE THE APPROVAL OF THE SOLE MEMBER: - A CHANGE IN THE PURPOSE OF THE ORGANIZATION - THE TERMINATION OF THE TAX-EXEMPT STATUS OF THE ORGANIZATION UNDER SECTION 501(C)(3) - THE SALE OR DISPOSITION OF SUBSTANTIALLY ALL OF THE ASSETS OF THE ORGANIZATION OR A SUBSIDIARY OF THE ORGANIZATION - THE DISSOLUTION OR LIQUIDATION OF THE ORGANIZATION OR A SUBSIDIARY OF THE ORGANIZATION - THE ADDITION OF A MEMBER OF THE ORGANIZATION - THE MERGER OR CONSOLIDATION OF THE ORGANIZATION OR A SUBSIDIARY OF THE ORGANIZATION OR THE ESTABLISHMENT OF A SUBSIDIARY OF THE ORGANIZATION - THE AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OR BYLAWS OF THE ORGANIZATION FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM WITH THE GUIDANCE AND ASSISTANCE OF MANAGEMENT. THE FORM WAS REVIEWED INTERNALLY AND THEN PRESENTED TO THE AUDIT COMMITTEE FOR REVIEW. THE AUDIT COMMITTEE THEN PREPARED A SUMMARY THAT WAS PRESENTED TO THE BOARD OF DIRECTORS ALONG WITH THE FORM 990 PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR BOARD MEMBERS ARE REQUIRED TO COMPLETE A FORM THAT WILL DISCLOSE ANY RELATIONSHIPS THAT MAY CREATE A CONFLICT OF INTEREST. THE FORMS ARE REVIEWED BY MANAGEMENT AND ANY CONCERNS ARE REFERRED TO THE BOARD IF NECESSARY. FORM 990, PART VI, SECTION B, LINE 15 GENESIS HEALTH USES AN OUTSIDE CONSULTANT FOR ALL OFFICER, EXECUTIVE, AND TOP MANAGEMENT OFFICIAL COMPENSATION DECISIONS. THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS MUST APPROVE ANY AND ALL DECISIONS REGARDING EXECUTIVE PAY. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION'S FORM 990 IS AVAILABLE UPON REQUEST. ADDITIONALLY, RECENT FILINGS OF THE FORM ARE AVAILABLE ON GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, LINE 1: THE ORGANIZATION IS A SUBSIDIARY OF GENESIS HEALTH, INC., A 501(C)(3) ORGANIZATION. THE BOARD OF DIRECTORS OF THIS ORGANIZATION FAILS TO HAVE A MAJORITY OF INDEPENDENT BOARD MEMBERS PER THE DEFINITION PROVIDED BY THE IRS. PLEASE NOTE, HOWEVER, THAT THE PARENT ORGANIZATION HAS A MAJORITY INDEPENDENT BOARD OF DIRECTORS, AND THROUGH ITS MEMBERSHIP PROVIDES GOVERNANCE OVERSIGHT OVER THE FILING ORGANIZATION. PLEASE SEE THE RESPONSES TO FORM 990, PART VI, LINES 6 THROUGH 7B FOR DETAILS ON THE SOLE MEMBER, THE SOLE MEMBER'S CORPORATE PARENT, AND ITS AUTHORITY. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. GENESIS HEALTH INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 592249370 HEALTHCARE FL 501(C)(3) LINE 12C, III-FI N/A 0 GENESIS REHABILITATION HOSPITAL INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 593284221 HEALTHCARE / REHAB CARE FL 501(C)(3) LINE 3 GENESIS HEALTH INC 0 PHYSICAL MEDICINE SPECIALISTS INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 593530305 HEALTHCARE / PHYSICIANS FL 501(C)(3) LINE 12B, II GENESIS REHABILITATION HOSPITAL INC 0 BROOKS HOME CARE ADVANTAGE INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 262216181 HEALTHCARE / HOME THERAPY FL 501(C)(3) LINE 11 GENESIS HEALTH INC 0 GENESIS HEALTH DEVELOPMENT INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 592249372 HEALTHCARE / REHAB THERAPY FL 501(C)(3) LINE 11 GENESIS HEALTH INC 0 BROOKS SKILLED NURSING INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 264561148 HEALTHCARE / SKILLED NURSING FL 501(C)(3) LINE 11 GENESIS HEALTH INC 0 BROOKS SKILLED NURSING FACILITY A INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 272153586 HEALTHCARE / SKILLED NURSING FL 501(C)(3) LINE 3 BROOKS SKILLED NURSING INC 0 BROOKS SKILLED NURSING FACILITY B INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 452623130 HEALTHCARE / SKILLED NURSING FL 501(C)(3) LINE 3 BROOKS SKILLED NURSING INC 0 THE GENESIS HEALTH FOUNDATION INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 592249340 SUPPORT / FUNDRAISING FL 501(C)(3) LINE 7 GENESIS HEALTH INC 0 BROOKS SKILLED NURSING FACILITY HOLDINGS B INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 452623488 REAL ESTATE HOLDING FL 501(C)(3) LINE 12B, II BROOKS SKILLED NURSING INC 0 BROOKS REHABILITATION CLINICAL RESEARCH CENTER INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 452094888 RESEARCH FL 501(C)(3) LINE 4 GENESIS HEALTH INC 0 HB OUTPATIENT REHABILITATIVE SERVICES INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 813748483 HEALTHCARE / REHAB THERAPY FL 501(C)(3) LINE 12A, I GENESIS HEALTH DEVELOPMENT INC 0 ST AUGUSTINE MOB LTD 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 593397507 REAL ESTATE HOLDING FL N/A 0 0 HB DELTONA REHABILITATIVE SERVICES 303 N CLYDE MORRIS BLVD DAYTONA FL 32114 862309610 OUTPATIENT REHABILITATION FL N/A 0 0 GH HOLDINGS INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 593007328 HOLDING COMPANY FL N/A C 0 GH MANAGEMENT INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 592387438 HOLDING COMPANY FL N/A C 0 GENESIS MANAGEMENT SERVICES INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 592183211 MANAGEMENT SERVICES FL N/A C 0 GH MEDICAL SERVICES INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 592742895 MEDICAL SERVICES FL N/A C 0 GH PARTNERSHIP HOLDINGS PPA INC 3599 UNIVERSITY BLVD SOUTH JACKSONVILLE FL 32216 593075439 INVESTMENT HOLDINGS FL N/A C 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0