Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Pt VI, Line 6 | MEDISYS HEALTH NETWORK WAS THE SOLE MEMBER UNTIL SEPTEMBER 27, 2012 | |
| WHEN BROOKDALE HEALTH SYSTEM INC., A NEW YORK NOT FOR PROFIT, | ||
| BECAME THE SOLE MEMBER. | ||
| Pt VI, Line 7a | IN MARCH 2012, GRANT THORNTON WAS ENGAGED BY THE ORGANIZATION | |
| TO PROVIDE MANAGEMENT SERVICES. COMMENCING APRIL 26, 2012 | ||
| GRANT THORNTON'S MANAGEMENT SERVICES INCLUDED THE CHIEF | ||
| EXECUTIVE AND RESTRUCTURING OFFICER, CHIEF OPERATING OFFICE AND CHIEF FINANCIAL | ||
| OFFICER POSITIONS WHICH WERE PROVIDED RESPECTIVLEY BY GRANT | ||
| THORNTON EMPLOYEES MARK TONEY, STEVEN KORF, AND JAMES PORTER | ||
| AS INDICATED IN PART VII SECTION A OFFICERS, DIRECTORS, TRUSTEES, | ||
| KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES. ANY AMOUNTS | ||
| PAID IN CONNECTION WITH THESE SERVICES ARE PAID DIRECTLY | ||
| TO GRANT THORNTON. | ||
| Pt VI, Line 7b | BROOKDALE HEALTH SYSTEM, INC., AS SOLE MEMBER OF THE ORGANIZATION, | |
| HAS THE AUTHORITY TO APPOINT AND REMOVE THE TRUSTEES OF THE ORGANIZATION, | ||
| AND OTHER AUTHORITIES AS DELINEATED IN THE BYLAWS OF THE ORGANIZATION. | ||
| Pt VI, Line 11b | THE FORM 990 AND APPROPRIATE SCHEDULES, AS REQUIRED, | |
| IS PREPARED BY OUTSIDE ACCOUNTANTS AND REVIEWED | ||
| INTERNALLY BY MANAGEMENT AND COUNSEL, AT WHICH TIME IT IS CONSIDERED | ||
| THE FINAL DRAFT. THE FINAL DRAFT OF THE FORM IS THEN FILED WITH THE IRS. | ||
| Pt XII, Line 2c | THE OVERSIGHT AND SELECTION PROCESSES DID NOT CHANGE FROM THE PRIOR YEAR. | |
| Pt VI, Line 12c | DISCLOSURE IN ACCORDANCE WITH THE CONFLICT OF INTEREST | |
| POLICY BY EMPLOYEES THAT SATISFY THE CRITERIA TO BE CONSIDERED | ||
| "INTERESTED PERSONS" IS SUBMITTED UPON HIRING AND ANNUALLY THEREAFTER. | ||
| THE AUDIT AND COMPLIANCE COMMITTEE REVIEWS THE SUBMISSIONS | ||
| FOR CONFLICTS AND THE DEPARTMENT OF INTERNAL AUDIT MANAGES COMPLIANCE. | ||
| Form 990, Part IX, Line 24f | OFFICE 56. 0. 56. 0. PROFESSIONAL SERVICES 27422. 0. 27422. 0. LICENSES & PERMITS 18531. 0. 18531. 0. REAL ESTATE TAXES 9459. 0. 9459. 0. | |
| Pt VI, Line 2 | ALEX ROVT, CHAIRMAN AND TRUSTEE, IRINA BENFIELD, TRUSTEE, | |
| AND STEVEN PLOTNICK, TRUSTEE, ALL HAVE A BUSINESS RELATIONSHIP | ||
| WITH EACH OTHER. ALVIN KAHN MD, FORMER TRUSTEE AND CHAIRMAN, | ||
| HAS A FAMILY RELATIONSHIP WITH DIANE SIMON, A FORMER TRUSTEE. | ||
| Pt VII, Col (E) | MEDISYS HEALTH NETWORK WAS THE SOLE MEMBER UNTIL SEPTEMBER 27, 2012 | |
| WHEN BROOKDALE HEALTH SYSTEM,INC., A NEW YORK NOT FOR PROFIT | ||
| BECAME THE SOLE MEMBER. ACCORDINGLY, MEDISYS HEALTH NETWORK | ||
| WAS NOT A RELATED PARTY AT DECEMBER 31, 2012. | ||
| HOWEVER FOR THE PERIOD FROM JANUARY 1, 2012 TO SEPTEMBER 27, 2012 | ||
| MEDISYS HEALTH NETWORK INCURRED THE FOLLOWING COMPENSATION | ||
| ON BEHALF OF THE ORGANIZATION: | ||
| MOUNIR F. DOSS $1,198679 | ||
| BRUCE F. FLANZ $1,407,376 | ||
| Pt VI, Line 15a | FORM 990, PART VI, SECTION B, LINE 15: EXECUTIVE COMPENSATION POLICY - | |
| THE HOSPTIAL'S BYLAWS PROHIBIT TRUSTEES FROM RECEIVING ANY | ||
| COMPENSATION FOR SERVICES PERFORMED IN THEIR CAPACITY AS A | ||
| TRUSTEE. ALSO PURSUANT TO THE HOSPITAL'S BYLAWS A TRUSTEE | ||
| SERVING IN ANOTHER CAPACITY MAY RECEIVE REASONABLE COMPENSATION | ||
| THEREFORE AS AUTHORIZED BY THE BOARD OF TRUSTEES. IT IS THE | ||
| HOSPITAL'S PRACTICE TO TARGET TOTAL EXECUTIVE COMPENSATION | ||
| (BASE SALARY, INCENTIVE COMPENSATION AND BENEFITS) AS THE | ||
| MEDIAN OF THE RELEVANT MARKETPLACE FOR SIMILARLY SITUATED | ||
| EXECUTIVES, WITH APPROPRIATE ADJUSTMENTS FOR SPECIAL SKILL, | ||
| EXPERIENCE, COMPETENCE, AND PERFORMANCE. |
| Software ID: | 12000225 |
| Software Version: |