TY 2012 Form 990

(A) Name and business address	(B) Description of services	(C) Compensation
TREAT AMERICA FOOD SERVICES8500 SHAWNEE MISSION PARKWAYMERRIAMKS66202	DIETARY SERVICES	1,156,390
IU HEALTHCLARIAN HEALTHPO BOX 66835INDIANAPOLISIN462776835	LAB & BILLING SERVICES	708,530
UNIVERSITY OF PHYSIATRIC ASSOCIATES541 N CLINICAL DRIVE CL 626INDIANAPOLISIN462025111	PHYSICIAN SERVICES	608,028
MEDISERVE INFORMATION SYSTEMS INC585 N JUNIPER DRIVE SUITE 100CHANDLERAZ85226	SOFTWARE MAINTENANCE FEES	444,014
ADVANCE MICROELECTORNICS INC6001 EAST OLD HWY 50VINCENNESIN47591	INFORMATION TECHNOLOGY SERVICES	378,104
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 10

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.	(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the United States. See Part IV, line 21	5,200	5,200
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	569,653		569,653
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	17,248,118	12,764,704	4,483,414
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	462,219	332,798	129,421
9	Other employee benefits .......	4,546,559	3,273,522	1,273,037
10	Payroll taxes ...........	1,363,060	976,500	386,560
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	27,291	19,552	7,739
c	Accounting ...........	425,191	304,608	120,583
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	4,845,837	3,812,798	1,033,039	0
12	Advertising and promotion ....	175,296		175,296
13	Office expenses .......	1,875,211	1,519,210	356,001
14	Information technology ......	552,958	396,141	156,817
15	Royalties ..	0
16	Occupancy ...........	925,631	733,788	191,843
17	Travel ............	223,907	135,603	88,304
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	253,134	13,692	239,442
20	Interest ...........	486,766	438,089	48,677
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	945,528	850,975	94,553
23	Insurance ..............	428,424	386,171	42,253
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES/DIRECT CARE	1,161,782	1,161,782
b	BAD DEBT RECOVERIES	-27,009	-27,009
c	MEMBERSHIPS	569		569
d
e	All other expenses	0	0	0	0
25	Total functional expenses. Add lines 1 through 24e	36,495,325	27,098,124	9,397,201	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).	0

Part X Balance Sheet Check if Schedule O contains a response to any question in this Part X ...............
	1	Cashnon-interest-bearing .............	2,614	1	2,714
2	Savings and temporary cash investments .........	7,635,393	2	7,734,801
3	Pledges and grants receivable, net ...........		3
4	Accounts receivable, net .............	6,791,709	4	4,824,458
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
			5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
			6	0
7	Notes and loans receivable, net .............		7
8	Inventories for sale or use ..............	234,388	8	247,388
9	Prepaid expenses and deferred charges ..........	284,941	9	1,894,782
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	27,804,195
b	Less: accumulated depreciation .....	10b	17,404,301	9,289,466	10c	10,399,894
11	Investments—publicly traded securities ..........	2,857,284	11	2,873,812
12	Investments—other securities. See Part IV, line 11 .....	0	12	0
13	Investments—program-related. See Part IV, line 11 .....	0	13	0
14	Intangible assets ...............		14
15	Other assets. See Part IV, line 11 ...........	628,254	15	662,058
16	Total assets. Add lines 1 through 15 (must equal line 34)......	27,724,049	16	28,639,907
	17	Accounts payable and accrued expenses .........	3,431,531	17	3,373,143
18	Grants payable .................		18
19	Deferred revenue ................		19
20	Tax-exempt bond liabilities .............	16,420,000	20	16,070,000
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		22	0
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ....	3,000,000	24	3,000,000
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................	2,107,460	25	1,767,324
26	Total liabilities. Add lines 17 through 25.........	24,958,991	26	24,210,467
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	2,765,058	27	4,429,440
28	Temporarily restricted net assets ...........		28
29	Permanently restricted net assets ...........		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	2,765,058	33	4,429,440
34	Total liabilities and net assets/fund balances ........	27,724,049	34	28,639,907

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SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization

REHABILITATION HOSPITAL OF INDIANA INC

Employer identification number

35-1786005

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Non-functionally integrated

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

and (iii) below, the governing body of the supported organization? ................

11g(i)

(ii) A family member of a person described in (i) above? ......................

11g(ii)

(iii) A 35% controlled entity of a person described in (i) or (ii) above? ................

11g(iii)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization in col. (i) listed in your governing document?		(v) Did you notify the organization in col. (i) of your support?		(vi) Is the organization in col. (i) organized in the U.S.?		(vii) Amount of monetary support
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of monetary support


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2012

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
11	Total support (Add lines 7 through 10).

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2012 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2011 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2012. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2011. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2012. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2011. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2012

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2012 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2011 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2011 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2012. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ........ right arrow

33 1/3% support tests—2011. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2012

Page 4

Part IV

Supplemental Information. Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

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Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

OMB No. 1545-0047

2012

Name of the organization

REHABILITATION HOSPITAL OF INDIANA INC

Employer identification number

35-1786005

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi) and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not total to more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year ......................... Arrow Bullet

Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990; or check the box on line H of its
Form 990-EZ or on Part I, line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 2

Name of organization REHABILITATION HOSPITAL OF INDIANA INC

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 3

Name of organization REHABILITATION HOSPITAL OF INDIANA INC

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 4

Name of organization
REHABILITATION HOSPITAL OF INDIANA INC

Employer identification number

35-1786005

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

$
Use duplicate copies of Part III if additional space is needed.

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

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SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public
Inspection

If the organization answered “Yes” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35c (Proxy Tax), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

REHABILITATION HOSPITAL OF INDIANA INC

Employer identification number

35-1786005

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ................................... SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b.. SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2012

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......
b	Total lobbying expenditures to influence a legislative body (direct lobbying) .......
c	Total lobbying expenditures (add lines 1a and 1b) ...................
d	Other exempt purpose expenditures ........................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ......................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2012

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? ..........................

Yes

345

Total. Add lines 1c through 1i ...............................

345

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered “No” OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members .....................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ............................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

Part IV

Supplemental Information

Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.

Identifier	Return Reference	Explanation
Description of the activities reported on Lines 1a through 1i	Schedule C, Part II-B, Line 1	THE ORGANIZATION PAID DUES TO INDIANA HOSPITAL ASSOCIATION IN THE AMOUNT OF $6,349. OF THIS AMOUNT, $345 WAS ATTRIBUTABLE TO LOBBYING ACTIVITIES.

Schedule C (Form 990 or 990EZ) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

REHABILITATION HOSPITAL OF INDIANA INC

Employer identification number

35-1786005

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) .....
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ....................	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenues included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2012

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIII and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

If “Yes,” explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....
b	Contributions ........
c	Net investment earnings, gains, and losses
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	602,474	1,904,164		2,506,638
b	Buildings ................		14,667,752	10,117,821	4,549,931
c	Leasehold improvements ............		95,016	68,959	26,057
d	Equipment ................		9,529,947	7,217,521	2,312,426
e	Other .................		1,004,842		1,004,842
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......					10,399,894

Schedule D (Form 990) 2012

Page 3

Part VII

InvestmentsOther Securities. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)		(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. See Form 990, Part X, line 13.

(a) Description of investment type		(b) Book value	(c) Method of valuation: Cost or end-of-year market value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. See Form 990, Part X, line 15.

(a) Description				(b) Book value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. See Form 990, Part X, line 25.

1.(a) Description of liability		(b) Book value
Federal income taxes		0
INTEREST RATE SWAP LIABILITY		1,602,628
CAPITAL LEASE OBLIGATION		115,050
ESTIMATED THIRD-PARTY SETTLEMENTS		49,646






Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		1,767,324
2. Fin 48 (ASC 740) Footnote. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII .....................................................

Schedule D (Form 990) 2012

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1	Total revenue, gains, and other support per audited financial statements .......			1	38,230,244
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a	39,926
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	70,537
e	Add lines 2a through 2d .....................			2e	110,463
3	Subtract line 2e from line 1.....................			3	38,119,781
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b	0
c	Add lines 4a and 4b.......................			4c	0
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	38,119,781

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements ...........			1	36,565,862
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d	70,537
e	Add lines 2a through 2d......................			2e	70,537
3	Subtract line 2e from line 1.....................			3	36,495,325
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b	0
c	Add lines 4a and 4b.......................			4c	0
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	36,495,325

Part XIII

Supplemental Information

Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Identifier	Return Reference	Explanation
FIN 48 (ASC 740) footnote	Schedule D, Part X, Line 2	THE HOSPITAL ADOPTED GUIDANCE ISSUED BY THE FASB WITH RESPECT TO ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. A TAX POSITION IS RECOGNIZED AS A BENEFIT ONLY IF IT IS "MORE LIKELY THAN NOT" THAT THE TAX POSITION WOULD BE SUSTAINED IN A TAX EXAMINATION, WITH A TAX EXAMINATION BEING PRESUMED TO OCCUR. THE AMOUNT RECOGNIZED IS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED ON EXAMINATION. FOR TAX POSITIONS NOT MEETING THE "MORE LIKELY THAN NOT" TEST, NO TAX BENEFIT IS RECORDED. THE HOSPITAL IS NO LONGER SUBJECT TO EXAMINATION BY U.S. FEDERAL TAXING AUTHORITIES FOR YEARS BEFORE 2007. THE HOSPITAL DOES NOT EXPECT THE TOTAL AMOUNT OF UNRECOGNIZED TAX POSITIONS TO SIGNIFICANTLY CHANGE IN THE NEXT 12 MONTHS. THE HOSPITAL WOULD RECOGNIZE INTEREST AND/OR PENALTIES RELATED TO INCOME TAX MATTERS IN INCOME TAX EXPENSE. THE HOSPITAL HAS NO AMOUNTS ACCRUED FOR INTEREST OR PENALTIES AS OF DECEMBER 31, 2012 AND 2011.
Other revenues in audited financial statements not in form 990	Schedule D, Part XI, Line 2d	COST OF GOODS SOLD - 4250; RENTAL EXPENSE - 66287;
Other expenses in audited financial statements not in form 990	Schedule D, Part XII, Line 2d	COST OF GOODS SOLD - 4250; RENTAL EXPENSE - 66287;

Schedule D (Form 990) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

- TIN:

SCHEDULE H (Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

REHABILITATION HOSPITAL OF INDIANA INC

Employer identification number

35-1786005

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...

Yes

If "Yes," was it a written policy? .......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: .........

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............

Did the organization prepare a community benefit report during the tax year? ..........

Yes

If "Yes," did the organization make it available to the public? ..............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) ..			702,982	0	702,982	1.930 %
b	Medicaid (from Worksheet 3, column a) ....			3,639,366	1,800,897	1,838,469	5.040 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .			0	0	0	0 %
d	Total Financial Assistance and Means-Tested Government Programs .	0	0	4,342,348	1,800,897	2,541,451	6.970 %
Other Benefits				33,996	9,305	24,691	0.070 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..			33,996	9,305	24,691	0.070 %
f	Health professions education (from Worksheet 5) ..			221,246	107,605	113,641	0.310 %
g	Subsidized health services (from Worksheet 6) ..			0	0	0	0 %
h	Research (from Worksheet 7)			93,524	0	93,524	0.260 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8)			5,700	0	5,700	0.020 %
j	Total. Other Benefits ..	0	0	354,466	116,910	237,556	0.660 %
k	Total. Add lines 7d and 7j .	0	0	4,696,814	1,917,807	2,779,007	7.630 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2012

Schedule H (Form 990) 2012

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	0	0	0	0

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

14,924,991

Enter Medicare allowable costs of care relating to payments on line 5.....

15,360,169

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-435,178

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2012

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?1 Name, address, and primary website address				Other (Describe)
1	REHABILITATION HOSPITAL OF INDIANA 4141 SHORE DRIVE INDIANAPOLIS,IN46254 WWW.RHIN.COM	X	X	ACUTE REHABILIATION

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	REHABILITATION HOSPITAL OF INDIANA
Name of hospital facility or facility reporting group

For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9....................

If “Yes,” indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20

In conducting its most recent CHNA, did the hospital facility take into account input from representatives of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ....................

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................

Did the hospital facility make its CHNA report widely available to the public? .............

If “Yes,” indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Financial Assistance Policy			Yes	No
9	Did the hospital facility have in place during the tax year a written financial assistance policy that:
	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?	9	Yes
10	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........	10	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 200% If "No," explain in Part VI the criteria the hospital facility used.
11	Used FPG to determine eligibility for providing discounted care?.................	11	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 400% If "No," explain in Part VI the criteria the hospital facility used.
12	Explained the basis for calculating amounts charged to patients?.................	12	Yes
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Other (describe in Part VI)
13	Explained the method for applying for financial assistance?...................	13	Yes
14	Included measures to publicize the policy within the community served by the hospital facility?.......	14	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
Billing and Collections
15	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?.......	15	Yes
16	Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)
17	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?..........	17		No
	If “Yes,” check all actions in which the hospital facility or a third party engaged:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the patients regarding the patients’ bills

Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Part VI)

Policy Relating to Emergency Medical Care

Yes

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........

If “No,” indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

During the tax year, did the hospital facility charge any FAP-eligible individuals to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care? ............................

If “Yes,” explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? .........................

If “Yes,” explain in Part VI.

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?2
Name and address		Type of Facility (describe)
1	NEURO REHAB CENTER 9531 VALPARAISO COURT INDIANAPOLIS,IN46268	OUTPATIENT NEURO REHAB THERAPY
2	REHABILITATION HOSPITAL OF INDIANA - CARMEL 12425 OLD MERIDIAN STREET SUITE B2 CARMEL,IN46032	OUTPATIENT REHABILITATION THERAPY
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2012

Page

Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; Part V, Section A; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any needs assessments reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
8	Facility reporting group(s). If applicable, for each hospital facility in a facility reporting group provide the descriptions required for Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.

Identifier	ReturnReference	Explanation
Costing Methodology used to calculate financial assistance	Schedule H, Part I, Line 7	THE COST TO CHARGE RATIO BASED ON WORKSHEET 2 WAS USED TO CALCULATE THE AMOUNTS REPORTED ON LINES A-D. LINES E-J ARE REPORTED BASED ON ACTUAL COSTS INCURRED.
Bad Debt Expense excluded from financial assistance calculation	Schedule H, Part I, Line 7, column(f)	0
Bad debt expense - methodology used to estimate amount	Schedule H, Part III, Line 2	ALLOWANCES FOR DOUBTFUL ACCOUNTS: THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED COLLECTIONS OF ACCOUNTS RECEIVABLE CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AND CHARGED TO THE PROVISION FOR BAD DEBTS AFTER COLLECTION EFFORTS HAVE BEEN MADE IN ACCORDANCE WITH THE HOSPITAL'S POLICIES. RECOVERIES ARE TREATED AS A REDUCTION TO THE PROVISION FOR BAD DEBTS. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY MAJOR PAYER CATEGORY. DATA ABOUT THE MAJOR PAYER SOURCES OF REVENUE IS ANALYZED TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES AND PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, CONTRACTUALLY DUE AMOUNTS ARE ANALYZED AND COMPARED TO ACTUAL CASH COLLECTED OVER TIME TO ENHANCE THE QUALITY OF THE ESTIMATE OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), A SIGNIFICANT ALLOWANCE FOR DOUBTFUL ACCOUNTS IS RECORDED ON THE BASIS OF HISTORICAL EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. AN ESTIMATE OF THE DIFFERENCE BETWEEN CONTRACTED RATES AND AMOUNTS ACTUALLY COLLECTED, AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED, IS CHARGED TO THE PROVISION FOR BAD DEBTS AND CREDITED TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.
Bad debt expense - methodology used to estimate amount as community benefit	Schedule H, Part III, Line 3	N/A
Bad debt expense - financial statement footnote	Schedule H, Part III, Line 4	FOOTNOTE TO THE AUDITED FINANCIAL STATEMENT. ALLOWANCES FOR DOUBTFUL ACCOUNTS: THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED COLLECTIONS OF ACCOUNTS RECEIVABLE CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AND CHARGED TO THE PROVISION FOR BAD DEBTS AFTER COLLECTION EFFORTS HAVE BEEN MADE IN ACCORDANCE WITH THE HOSPITAL'S POLICIES. RECOVERIES ARE TREATED AS A REDUCTION TO THE PROVISION FOR BAD DEBTS. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY MAJOR PAYER CATEGORY. DATA ABOUT THE MAJOR PAYER SOURCES OF REVENUE IS ANALYZED TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES AND PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, CONTRACTUALLY DUE AMOUNTS ARE ANALYZED AND COMPARED TO ACTUAL CASH COLLECTED OVER TIME TO ENHANCE THE QUALITY OF THE ESTIMATE OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), A SIGNIFICANT ALLOWANCE FOR DOUBTFUL ACCOUNTS IS RECORDED ON THE BASIS OF HISTORICAL EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. AN ESTIMATE OF THE DIFFERENCE BETWEEN CONTRACTED RATES AND AMOUNTS ACTUALLY COLLECTED, AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED, IS CHARGED TO THE PROVISION FOR BAD DEBTS AND CREDITED TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.
Community benefit & methodology for determining medicare costs	Schedule H, Part III, Line 8	ANY COST INCURRED FOR TREATMENT OF A PATIENT IN WHICH THE TOTAL AMOUNT OF REVENUE WAS NOT COLLECTED, IS REPORTED AS A SHORTFALL. THE SHORTFALL IS DUE TO CONTINUED CUTS IN MEDICARE REIMBURSEMENT WHILE RHI CONTINUES TO INVEST IN STATE-OFTHE-ART EQUIPMENT AND FACILITIES TO MEET THE CHALLENGING HEALTHCARE NEEDS OF THE COMMUNITY. MEDICARE ALLOWABLE COSTS WERE DETERMINED BASED ON THE COST TO CHARGE RATIO FROM THE FY 2012 MEDICARE COST REPORT.
Collection practices for patients eligible for financial assistance	Schedule H, Part III, Line 9b	THE HOSPITAL'S COLLECTION POLICY CONTAINS PROVISIONS ON PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. THE COLLECTION POLICY STATES THAT RHI WILL NOT ENGAGE IN EXTRAORDINARY COLLECTION ACTIONS BEFORE MAKING REASONABLE EFFORTS TO DETERMINE WHETHER A PATIENT IS ELIGIBLE FOR ASSISTANCE UNDER RHI'S FINANCIAL ASSISTANCE POLICY.
Other ways hospital publicized Financial Assistance Policy	Schedule H, Part V Section B, Line 14g	(1) REHABILITATION HOSPITAL OF INDIANA - INSTEAD OF THE DETAILED POLICY, THE HOSPITAL FACILITY PROVIDED A SUMMARY OF THE POLICY WITH EACH PATIENT'S STATEMENT IN A MANNER LISTED IN LINES 14 A-F.;
Nondiscriminatory Policy	Schedule H, Part V Section B, Line 19d	(1) REHABILITATION HOSPITAL OF INDIANA - RHI IS NOT A GENERAL ACUTE CARE HOSPITAL/FACILITY NOR IS RHI EQUIPPED TO PROVIDE CARE TO PATIENTS WITH URGENT CARE NEEDS. RHI IS A SPECIALTY PROVIDER OF REHABILITATION SERVICES SUCH AS PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY.;
Means used to determine amounts billed	Schedule H, Part V Section B, Line 20d	(1) REHABILITATION HOSPITAL OF INDIANA - THE HOSPITAL LIMITS THE AMOUNT CHARGED TO FAP ELIGIBLE INDIVIDUALS. FAP ELIGIBLE INDIVIDUALS WILL NOT BE CHARGED MORE THAN THE AMOUNTS GENERALLY BILLED (AGB) TO THOSE INDIVIDUALS WHO DO HAVE INSURANCE. THE AGB IS CALCULATED BASED ON THE LOOK-BACK METHOD FOR PAYERS INCLUDING MEDICARE FEE FOR SERVICES ALONG WITH ALL PRIVATE HEALTH INSURERS. ;
Needs assessment.	Schedule H, Part VI, Line 2	RHI COMPLETED THE COMMUNITY HEALTH NEEDS ASSESSMENT IN CONJUNCTION WITH OUR MAJORITY OWNER/MEMBER HOSPITAL (INDIANA UNIVERSITY HEALTH). RHI'S PRIMARY SERVICE AREA (PSA) IS MARION COUNTY. THE AREAS OF NEED THAT WERE IDENTIFIED FROM THIS PSA BY THE NEEDS ASSESSMENT WERE : OBESITY, ACCESS TO CARE, MENTAL HEALTH, PRENATAL CARE AND TOBACCO USE. RHI DETERMINED THAT WE COULD IMPACT 3 OF THESE AREAS OF NEED. THE THREE AREAS CHOSEN BY RHI WERE: OBESITY, ACCESS TO CARE AND MENTAL HEALTH NEEDS. AN IMPLEMENTATION STRATEGY IS BEING DEVELOPED WHICH ADDRESSES HOW RHI WILL CONTRIBUTE TO EACH OF THESE THREE COMMUNITY HEALTH NEEDS. RHI ALSO EVALUATES THE HOSPITAL'S ACCESSIBILITY ON AN ANNUAL BASIS VIA AN ANNUAL ACCESSIBILITY STUDY. THIS PLAN INCLUDES ACTIONS TO FURTHER THE INTENT OF CREATING ACCESSIBLE FACILITIES, PROGRAMS AND COMMUNITIES FOR PERSONS WITH DISABILITIES. IN ADDITION, RHI ATTEMPTS TO ADDRESS THE NEEDS OF PEOPLE WITH DISABILITIES THROUGH TREATMENT PROGRAMS AND SERVICES, COMMUNITY PROGRAMMING AND COMMUNITY AWARENESS. THE PLAN WAS DEVELOPED WITH INPUT FROM PERSONS SERVED, SUPPORT GROUP INPUT, CLINICAL OUTCOMES DATA, SATISFACTION SURVEYS, RHI PERSONNEL USING SUGGESTIONS AND INPUT FROM COMMUNITY INVOLVEMENT AND OTHER STAKEHOLDERS.
Patient education of eligibility for assistance.	Schedule H, Part VI, Line 3	PATIENTS ARE INFORMED ABOUT FINANCIAL ASSISTANCE BEFORE ADMISSIONS BY THE CLINICAL LIAISON. THIS OCCURS WITH THE PATIENT IS AT THE GENERAL ACUTE CARE HOSPITAL BEFORE TRANSFERRING TO RHI. PATIENTS ARE ALSO INFORMED OF FINANCIAL ASSISTANCE DURING REGISTRATION BY THE ADMISSIONS REPRESENTATIVE AND A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS INCLUDED IN EACH ADMISSION PACKET. DURING THE PATIENT'S STAY, THE DISCHARGE PLANNER WILL WORK WITH THE PATIENT IN COMPLETING THE FINANCIAL ASSISTANCE APPLICATION. PATIENTS ARE INFORMED AGAIN OF FINANCIAL ASSISTANCE DURING THE DISCHARGE PROCESS BY THE DISCHARGE PLANNERS. THE DISCHARGE PLANNERS WILL CONTINUE TO WORK WITH THE PATIENTS AFTER DISCHARGE, IF THE SITUATION REQUIRES. PATIENTS RECEIVE A SUMMARY OF THE FAP WITH ALL STATEMENTS. RHI WILL ALSO MAIL A SUMMARY OF THE POLICY ALONG WITH A FINANCIAL ASSISTANCE APPLICATION TO ANY UNINSURED PATIENT THAT HAS A BALANCE ON HIS/HER ACCOUNT. RHI ALSO PUBLICIZES ITS FAP ON THE HOSPITAL WEBSITE. RHI WILL PROVIDE REPRESENTATIVES TO ASSIST PATIENTS WITH THE FINANCIAL ASSISTANCE PROCESS MONDAY THROUGH FRIDAY FROM 8AM TO 5PM.
Community information.	Schedule H, Part VI, Line 4	RHI SERVES ADOLESCENTS THROUGH ADULTS WITH PHYSICAL AND COGNITIVE DISABILITIES PRIMARILY FROM 100-MILE RADIUS OF RHI BUT CATCHMENT AREA NORMALLY INCLUDES ALL 92 INDIANA COUNTIES AND SURROUNDING STATES. RHI OFFERS SERVICES FOR INPATIENT FOR 91 BEDS AND 3 OUTPATIENT LOCATIONS. ONE LOCATION IS LOCATED WITHIN THE HOSPITAL AND TWO OFFICES CONVENIENTLY LOCATED AT SEPARATE LOCATIONS. RHI'S CORE SERVICES ARE STRUCTURED THROUGH SPECIALIZED UNITS. BY DOING SO, A REHABILITATIVE ENVIRONMENT IS CREATED THAT FOSTERS PROGRESSIVE LEADERSHIP, INNOVATION AND QUALITY THAT WILL LEAD TO PREEMINENT PATIENT CARE AND OUTCOMES. RHI'S MAIN SERVICES INCLUDE BUT NOT LIMITED TO STROKE REHABILITATION, BRAIN AND SPINAL CORD INJURY, MULTIPLE TRAUMA REHABILITATION AND ORTHOPEDIC REHABILITATION. RHI IS THE LARGEST FREESTANDING ACUTE REHABILITATION HOSPITAL IN INDIANA COUPLED WITH BEING THE ONLY REHAB HOSPITAL WITH CARF CERTIFICATION IN SPINAL CORD INJURY, GENERAL COMPREHENSIVE REHAB, BRAIN INJURY AND STROKE REHABILITATION. FOR 2012, NINETY FIVE PERCENT OF PATIENTS TREATED WERE NATIVES OF INDIANA. SIXTY PERCENT OF THE PATIENTS WERE FROM MARION COUNTY (INDIANAPOLIS), WHEREAS TWENTY-FIVE PERCENT WERE RESIDENTS OF COUNTIES SURROUNDING MARION COUNTY. RHI'S PRIMARY SERVICE AREA (PSA) IS IDENTIFIED AS MARION COUNTY. BASED ON THE MOST RECENT CENSUS BUREAU STATISTICS (2010), MARION COUNTY HAS A POPULATION OF 903,393 PERSONS WITH APPROXIMATELY 52% BEING FEMALE AND 48% BEING MALE. THE COUNTY'S POPULATION ESTIMATES BY RACE ARE 59.6% WHITE, 27.0% BLACK, 9.6% HISPANIC OR LATINO, 2.1% ASIAN, 0.5% AMERICAN INDIAN OR ALASKA NATIVE, AND 2.5% PERSON REPORTING TWO OR MORE RACES. A POVERTY RATE OF 19.7% WAS REPORTED IN 2009 FOR MARION COUNTY, RISING FROM 16.5% IN 2008. BASED ON US CENSUS BUREAU DATA (2009), MARION COUNTY'S PER CAPITAL PERSONAL INCOME WAS ESTIMATED TO BE $36,409, WHICH IS ABOVE THE STATE'S AVERAGE OF $33,323; AND A MEDIAN HOUSEHOLD INCOME OF $41,201, WHICH IS BELOW THE STATE'S AVERAGE OF $45,427. BASED ON INPATIENT DISCHARGE DATA FROM INDIANA HOSPITAL ASSOCIATION (IHA), 31% OF MARION COUNTY RESIDENTS HAVE COMMERCIAL INSURANCE, 22% ARE INSURED THROUGH MEDICAID, 30% ARE INSURED THROUGH MEDICARE, 11% ARE UNINSURED AND 6% HAVE OTHER GOVERNMENT INSURANCE OR ARE UNKNOWN. AT RHI, IT IS ESTIMATED THAT 54% OF PATIENTS HAVE MEDICARE, 11% HAVE MEDICAID, 2% ARE UNINSURED, AND 33% HAVE COMMERCIAL OR UNKNOWN INSURANCE.
Promotion of community health	Schedule H, Part VI, Line 5	RHI CONTINUES TO FORGE POSITIVE RELATIONSHIPS WITH ALL REFERRAL SOURCES TO IDENTIFY ACCESS CHALLENGES AND IMPROVEMENT. THIS IS PRIMARILY FOCUSED ON PARENT HEALTH SYSTEMS, REFERRAL SOURCES AND DISCHARGE SOURCES. RHI ALSO PROVIDES SUPPORT GROUPS FOR PATIENTS AND FAMILIES INCLUDING: * STROKE SUPPORT GROUP - MONTHLY ON MAIN CAMPUS * BRAIN INJURY SUPPORT GROUP - MONTHLY ON MAIN CAMPUS AND AT NRC * STROKE CARE GIVERS SUPPORT GROUP - MONTHLY ON MAIN CAMPUS RHI PROVIDES THE SUPPORT GROUPS WITH A MEETING ROOM, ONE STAFF MEMBER'S TIME AND REFRESHMENTS AT NO COST TO THE PATIENTS AND FAMILIES ATTENDING. SUMMARY OF GROUPS AND THEIR PURPOSES: STROKE SUPPORT GROUP THERE ARE TWO STOKE SUPPORT GROUPS OFFERED AT RHI. ONE GROUP IS TO TEACH INDIVIDUALS RECOVERING FROM A STROKE COPING SKILLS. THE SECOND STROKE SUPPORT GROUP IS TO PROVIDE TRAINING TO FAMILIES AND LOVED ONES OF THE RECOVERING STROKE PATIENT. THE GROUPS MEET MONTHLY ON THE MAIN HOSPITAL CAMPUS. BRAIN INJURY SUPPORT GROUP THE BRAIN INJURY SUPPORT GROUP TEACHES SURVIVORS OF BRAIN INJURY AND THEIR FAMILY AND CAREGIVERS THROUGH PERTINENT SITUATIONS, GOAL SETTING AND PROVIDING INFORMATION ABOUT RETURN TO WORK. APART FROM THE MONTHLY MEETINGS, SOCIAL GATHERINGS MEET TO DECREASE SOCIAL LONELINESS AND INCREASE SUPPORT IN THE COMMUNITY. RHI BELIEVES SUPPORT GROUPS PROVIDE ITS ATTENDEES WITH COPING SKILLS WHILE PROMOTING THE HEALTH OF THE COMMUNITY IT SERVES. THE SUPPORT GROUPS ENCOURAGE THE COMMUNICATION AMONG VICTIMS AND/OR FAMILY MEMBERS WITH THOSE WHO HAVE SUSTAINED A SIMILAR INJURY AND HAVE RETURNED TO THE COMMUNITY. RHI ALSO PROVIDED AN AQUATICS WELLNESS PROGRAM FOR INDIVIDUALS WITHIN THE COMMUNITY. THIS PROGRAM BENEFITS MEMBERS OF THE COMMUNITY SUCH AS INDIVIDUALS WITH ARTHRITIS AND WOMEN DURING PREGNANCY. THE WATER ALLOWS THEM TO EXERCISE UNDER CONDITIONS THAT THEY NORMALLY WOULD NOT BE ABLE TO EXERCISE. THIS PROGRAM COLLECTS A SMALL FEE TO OFFSET A SMALL PORTION OF THE COST OF THE PROGRAM. EVERY TUESDAY AND THURSDAY EVENINGS, RHI OFFERS A COMMUNITY FITNESS PROGRAM BY MAKING THE THERAPY GYM AVAILABLE TO ALL MEMBERS OF THE COMMUNITY THAT HAVE A PHYSICAL DISABILITY. RHI RECOGNIZES THAT AN INDIVIDUAL WITH PHYSICAL DISABILITY NEEDS TO CONTINUE A HEALTHY LIFE STYLE BY EXERCISING WHICH MAY REQUIRE THE NEED OF SPECIALIZED EQUIPMENT. ONE OR TWO RHI VOLUNTEERS WHO ARE LICENSED THERAPISTS SUPERVISE THE COMMUNITY FITNESS PROGRAM. RHI STAFF VOLUNTEERS THEIR TIME TO PROVIDE SUPERVISION FOR THE PROGRAM, WHICH IS AT NO COST TO THE ATTENDEES. RHI RECOGNIZES THAT MEDICAL REHABILITATION IS A COMPLEX, INTERDISCIPLINARY SYSTEM OF INPATIENT AND OUTPATIENT THERAPIES THAT IS PART OF MORE COMPLEX SYSTEM THAT INCLUDES EMERGENT AND ACUTE CARE FOLLOWING CATASTROPHIC ILLNESS OR INJURY AS WELL AS NETWORKS THAT PROVIDE LONG-TERM SERVICES AND SUPPORT. THIS SYSTEM AND ITS COMPONENTS PROVIDE OPPORTUNITIES FOR A BROAD DIVERSITY OF APPLIED RESEARCH STUDIES. THE TARGETS OF CURRENT RESEARCH AT RHI RANGE FROM INTERVENTIONS TO REDUCE DISABILITY TO A WAY TO BETTER MEASURE REHABILITATION EFFECTIVENESS TO LEADING EDGE METHODS TO EVALUATE PATIENTS AND MAXIMIZE THEIR OUTCOMES. OVERVIEW OF THE RESEARCH RHI CONDUCTS: * IDENTIFYING MEDICATIONS THAT ENHANCE RECOVERY FOLLOWING BRAIN INJURY, * IDENTIFYING COMMONLY PRESCRIBED MEDICATIONS FOLLOWING BRAIN INJURY THAT MAY HAVE ADVERSE EFFECTS ON RECOVERY * EVALUATING THE EFFECTIVENESS OF GROUP THERAPY FOR PATIENTS AND FAMILIES TO IMPROVE COPING SKILLS * IMPROVE RETURN TO WORK RATES BY DEVELOPING NETWORKS OF COMMUNITY SERVICES * STUDYING OUTCOMES (COMMUNITY REINTEGRATION, WELL-BEING, AND LIFE SATISFACTION) AFTER BRAIN AND SPINAL INJURIES. * COLLABORATING WITH THE MAYO CLINIC TRAUMATIC BRAIN INJURY SYSTEM, INDIANA UNIVERSITY SCHOOL OF MEDICINE, INDIANA UNIVERSITY HEALTH, ST. VINCENT AND PURDUE UNIVERSITY. AS WE CONTINUE TO GROW AS A REHABILITATION HOSPITAL AND LEADER IN MEDICINE AND RESEARCH DEVELOPMENT, RHI INVITES PHYSICIANS TO CONTACT US ABOUT PATIENTS THAT COULD BE ELIGIBLE FOR REHABILITATION AND PARTICIPATION IN OUR STUDIES AND MEDICAL ADVANCEMENT. THE PARTNERSHIP BETWEEN RHI AND PHYSICIANS IS IMPORTANT IN THE CONTINUAL EFFORT TO SUPPORT AND PROVIDE THE BEST CARE FOR THE PATIENT.
Affiliated health care system	Schedule H, Part VI, Line 6	RHI IS OWNED BY TWO MAJOR HEALTH SYSTEMS, INDIANA UNIVERSITY HEALTH (IUH) AND ST. VINCENT HEALTH. IUH IS THE MAJORITY OWNER OF RHI. RHI WORKS PRIMARILY WITH THE IUH SYSTEM ON VARIOUS ACTIVITIES TO ADDRESS THE COMMUNITY NEEDS.
State filing of community benefit report	Schedule H, Part VI, Line 7	IN

Schedule H (Form 990) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization
REHABILITATION HOSPITAL OF INDIANA INC

Employer identification number
35-1786005

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC Code section if applicable	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of non-cash assistance	(h) Purpose of grant or assistance

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2012

Page 2

Part III

Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a)Type of grant or assistance	(b)Number of recipients	(c)Amount of cash grant	(d)Amount of non-cash assistance	(e)Method of valuation (book, FMV, appraisal, other)	(f)Description of non-cash assistance

Part IV

Supplemental Information.

Complete this part to provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Identifier	Return Reference	Explanation
Procedures for monitoring use of grant funds	Schedule I, Part I, Line 2	RHI CONTRIBUTES MONEY TO ORGANIZATIONS WITH RELATED INTERESTS. THE MONEY IS CONTRIBUTED TO THE PROGRAM OPERATING FUNDS OF THESE ORGANIZATIONS IN ORDER TO SUPPORT THEIR MISSIONS IN SERVING LIKE PATIENTS. THEREFORE, THE ORGANIZATION RELIES ON THE BOARD OF DIRECTORS OF THE RESPECTIVE DONEE ORGANIZATIONS TO DETERMINE THE USE OF THE FUNDS.

Schedule I (Form 990) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

REHABILITATION HOSPITAL OF INDIANA INC

Employer identification number

35-1786005

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all officers,
directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? .......

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ................

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2012

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(1)NEIL PATELPHARMACY MANAGER	(i) (ii)	131,424 0	0 0	3,120 0	5,835 0	20,231 0	160,610 0	0 0
(2)LANCE E TREXLERDIR OF NEUROREHAB PSYCHOLOGY	(i) (ii)	138,431 0	0 0	3,661 0	6,094 0	32,865 0	181,051 0	0 0
(3)MONTE M SPENCECOO	(i) (ii)	136,964 0	23,624 0	362 0	3,354 0	32,501 0	196,805 0	0 0
(4)DANIEL WOLOSZYNCEO	(i) (ii)	258,746 0	45,000 0	2,456 0	0 0	24,421 0	330,623 0	0 0

Schedule J (Form 990) 2012

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.

Identifier	Return Reference	Explanation

Schedule J (Form 990) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization
REHABILITATION HOSPITAL OF INDIANA INC

Employer identification number
35-1786005

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	INDIANA FINANCE AUTHORITY	35-1602316	45471AEQ1	11-10-2011	16,420,000	CONSTRUCTION, EQUPMENT PURCHASES, REFUNDING OF SERIES 1990 BONDS.		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	350,000
2 Amount of bonds legally defeased . . . . . . . . . . .	0
3 Total proceeds of issue . . . . . . . . . . . . . .	16,420,517
4 Gross proceeds in reserve funds . . . . . . . . . . . .	0
5 Capitalized interest from proceeds . . . . . . . . . . .	0
6 Proceeds in refunding escrows . . . . . . . . . . . .	3,497
7 Issuance costs from proceeds . . . . . . . . . . . .	316,503
8 Credit enhancement from proceeds . . . . . . . . . . .	0
9 Working capital expenditures from proceeds . . . . . . . . .	0
10 Capital expenditures from proceeds . . . . . . . . . . .	1,734,514
11 Other spent proceeds . . . . . . . . . . . . . .	11,900,000
12 Other unspent proceeds . . . . . . . . . . . . . .	2,466,003
13 Year of substantial completion . . . . . . . . . . . .
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .	X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X
16 Has the final allocation of proceeds been made? . . . . . . . .		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .	X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2012

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .	X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . . . . . . . . . . . . .	X
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	0%		%		%		%
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .	0.0000%		%		%		%
6 Total of lines 4 and 5 . . . . . . . . . . . . . . .	0%		%		%		%
7 Does the bond issue meet the private security or payment test? . . . . .	X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X
b If “Yes” to line 8a, enter the percentage of bond-financed property sold or disposed of.	0.000000%		%		%		%
c If “Yes” to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2?		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T? . . . . .		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .	X
b Exception to rebate? . . . . . . . .		X
c No rebate due? . . . . . . . . . .		X
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .	X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X
b Name of provider . . . . . . . . .
c Term of hedge . . . . . . . . . .	0
d Was the hedge superintegrated? . . . . . .		X
e Was a hedge terminated? . . . . . . .		X

Schedule K (Form 990) 2012

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .		X
b Name of provider . . . . . . . . .
c Term of GIC . . . . . . . . . .	0
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .		X
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?		X

Part VI

Supplemental Information. Complete this part to provide additional information for responses to questions on Schedule K (see instructions).

Identifier	Return Reference	Explanation
TOTAL PROCEEDS OF ISSUE	SCHEDULE K, PART II, LINE 3	ISSUE PRICE: $16,420,000 EARNINGS: $517 TOTAL PROCEEDS: $16,420,517
WRITTEN PROCEDURES	SCHEDULE K, PART III, LINE 9	THE ORGANIZATION IS IN THE PROCESS OF ADOPTING WRITTEN PROCEDURES TO ENSURE ALL NONQUALIFIED BONDS (IF ANY) OF THE ISSUE ARE REMEDIATED IN ACCORDANCE WITH THE ASSOCIATED REGULATIONS. THE ORGANIZATION STRIVES TO STAY ABREAST OF FEDERAL REGULATIONS AND CONSIDERS THE REPERCUSSIONS OF ALL SIGNIFICANT ACTIVITIES WHICH COULD FORESEEABLY HAVE AN IMPACT ON THE ORGANIZATION'S TAX EXEMPT BONDS AND THE ASSOCIATED FEDERAL TAX REGULATIONS.
WRITTEN PROCEDURES	SCHEDULE K, PART IV, LINE 7	THE ORGANIZATION IS IN THE PROCESS OF ADOPTING WRITTEN PROCEDURES TO MONITOR THE ORGANIZATION'S ABILITY TO REMAIN IN COMPLIANCE WITH THE ARBITRAGE REQUIREMENTS UNDER SECTION 148 OF THE INTERNAL REVENUE CODE. THE ORGANIZATION STRIVES TO STAY ABREAST OF FEDERAL REGULATIONS AND CONSIDERS THE REPERCUSSIONS OF ALL SIGNIFICANT ACTIVITIES WHICH COULD FORESEEABLY HAVE AN IMPACT ON THE ORGANIZATION'S TAX EXEMPT BONDS AND THE ASSOCIATED FEDERAL TAX REGULATIONS.
WRITTEN PROCEDURES	SCHEDULE K, PART V	THE ORGANIZATION IS IN THE PROCESS OF ADOPTING WRITTEN PROCEDURES WHICH DICTATE HOW MANAGEMENT TIMELY IDENTIFIES AND CORRECTS VIOLATIONS OF FEDERAL TAX REQUIREMENTS USING THE VOLUNTARY CLOSING AGREEMENT PROGRAM PROVIDED BY THE IRS WHEN SELF-REMEDIATION IS NOT AVAILABLE TO THE ORGANIZATION. THE ORGANIZATION STRIVES TO STAY ABREAST OF FEDERAL REGULATIONS AND CONSIDERS THE REPERCUSSIONS OF ALL SIGNIFICANT ACTIVITIES WHICH COULD FORESEEABLY HAVE AN IMPACT ON THE ORGANIZATION'S TAX EXEMPT BONDS AND THE ASSOCIATED FEDERAL TAX REGULATIONS. IN THE EVENT A VIOLATION IS IDENTIFIED THE ORGANIZATION'S POLICY IS TO CORRECT THE VIOLATION AS SOON AS POSSIBLE, WHILE WORKING WITH THE FEDERAL AUTHORITIES AS NECESSARY TO ENSURE THAT SUFFICIENT CONTROLS ARE PRESENT WHICH WILL GUARD AGAINST FUTURE VIOLATIONS.
PRIVATE BUSINESS USE	SCHEDULE K, PART III, LINE 2	RHI OWNS PHYSICIAN LEASING SPACE, WHICH DOES NOT VIOLATE THE SAFE HARBOR OF SECTION 9713.
PRIVATE BUSINESS USE	SCHEDULE K, PART III, LINE 3A	RHA HAS AGREEMENTS WITH PHYSICIANS WHICH DO NOT VIOLATE SAFE HARBOR OF SECTION 9713.

Schedule K (Form 990) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

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SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization

REHABILITATION HOSPITAL OF INDIANA INC

Employer identification number

35-1786005

Identifier	Return Reference	Explanation
ORGANIZATION'S MISSION (CONTINUED FROM PART III, LINE 1)	FORM 990, PART III, LINE 1	RHI WILL ACHIEVE THIS VISION THROUGH THE FOLLOWING: ACHIEVING IN SUPERIOR PATIENT OUTCOMES; EMBRACING INNOVATIVE TREATMENT METHODS; RECRUITING OUTSTANDING CLINICAL EXPERTISE; TRAINING THE NEXT GENERATION OF REHABILITATION PROFESSIONALS; SEEKING PARTNERSHIPS WITH OTHER COMMUNITY MEMBERS WHO SERVE OUR PATIENT POPULATION; AND PROVIDING A LIFETIME CONTINUUM OF SERVICES FOR OUR PATIENTS. RHI'S VALUES INCLUDE: INTEGRITY: TREATING EACH INDIVIDUAL WITH DIGNITY AND RESPECT; INNOVATION: PIONEERING IN RESEARCH LEADING TO BETTER OUTCOMES; COMPASSION: PROVIDING AN EMPATHETIC AND HEALING ENVIRONMENT; TEAMWORK: EMPOWERING EMPLOYEES; AND SERVICE: PROVIDING COMMUNITY OUTREACH AND ADVOCACY FOR INDIVIDUALS WITH DISABILITIES THROUGH OUR STAFF, PHYSICIANS, AND THE RHI FOUNDATION. RHI OPERATES A 91 BED, FREESTANDING SPECIALTY MEDICAL REHABILITATION HOSPITAL LOCATED IN INDIANAPOLIS, INDIANA. THE HOSPITAL PROVIDES SHORT-TERM, COMPREHENSIVE REHABILITATION SERVICES TO PATIENTS, AND ITS PROGRAMS ARE DESIGNED TO RESTORE PHYSICAL, COGNITIVE AND PSYCHOSOCIAL FUNCTIONS FOLLOWING AN INCIDENT OF ACUTE ILLNESS OR TRAUMA. INPATIENT AND OUTPATIENT THERAPY AND SUPPORT SERVICES PROVIDED BY RHI INCLUDE PHYSICAL AND OCCUPATIONAL THERAPY, SPEECH THERAPY, RECREATIONAL THERAPY, ACTIVITIES OF DAILY LIVING, REHABILITATION NURSING, PSYCHOLOGY, SOCIAL SERVICES AND COGNITIVE RETRAINING, AND SUB ACUTE SERVICES REGARDLESS OF AN INDIVIDUAL'S ABILITY TO PAY. THE HOSPITAL PROVIDES FREE AND/OR DISCOUNTED CARE TO THOSE WHO QUALIFY ACCORDING TO RHI'S POLICY. RHI VERIFIES AND COLLECTS FINANCIAL RESOURCE INFORMATION ON EACH PATIENT IN A MANNER THAT PROTECTS EACH PATIENT'S DIGNITY AND QUALITY OF LIFE. NO PATIENT'S ADMISSION IS DENIED DUE TO A PATIENT'S INABILITY TO SETTLE THEIR ACCOUNT. ANY PATIENT WHO WISHES TO BE CONSIDERED FOR CHARITY CARE FURNISHES THE HOSPITAL WITH THE REQUIRED FINANCIAL DOCUMENTATION WHICH THE HOSPITAL USES TO DETERMINE WHETHER HE/SHE QUALIFIED. PATIENTS WHO APPLY FOR AND ARE ELIGIBLE FOR CHARITY CARE GENERALLY ARE APPROVED DURING THE ADMISSION PROCESS, HOWEVER, A PATIENT CAN APPLY FOR CHARITY AT ANY TIME. MEDICAID ELIGIBILITY IS ALSO EVALUATED PRIOR TO THE ADMISSION PROCESS. IF A PATIENT APPEARS TO BE ELIGIBLE FOR ASSISTANCE UNDER A GOVERNMENTAL PROGRAM SUCH AS MEDICAID, RHI ASSISTS THE PATIENT WITH THIS PROCESS. THE HOSPITAL PROVIDES MANY SUPPORT GROUPS THAT BENEFIT AND PROMOTE THE HEALTH OF THE COMMUNITY IT SERVES. SOME OF THESE GROUPS INCLUDE THE STROKE SURVIVOR SUPPORT GROUP, THE STROKE CAREGIVER SUPPORT GROUP AND THE BRAIN INJURY SUPPORT GROUP, WHICH ALL ENCOURAGE COMMUNICATION BETWEEN PATIENTS AND/OR FAMILY MEMBERS WITH THOSE WHO HAVE SUSTAINED A SIMILAR INJURY AND HAVE RETURNED TO THE COMMUNITY. RHI ALSO OFFERS VOCATIONAL REHABILITATION SUPPORT WHICH PROVIDES SEVERAL SERVICES, AMONG THEM PRE-VOCATIONAL COUNSELING AND CONNECTIONS TO OTHER AGENCIES THAT PROVIDE ASSISTANCE IN RETURNING TO WORK OR SCHOOL. RHI PROVIDES TRANSPORTATION SERVICES TO THOSE RHI OUTPATIENTS THAT NEEDED ASSISTANCE IN GETTING TO AND FROM THEIR THERAPY APPOINTMENTS. RHI ALSO PROVIDES AN AQUATICS WELLNESS PROGRAM FOR INDIVIDUALS WITHIN THE COMMUNITY. RHI ENCOURAGES AND PROMOTES EDUCATION BY OFFERING INTERNS AND MEDICAL RESIDENTS THE OPPORTUNITY TO LEARN THEIR SPECIALIZED INTEREST OF STUDY. MEDICAL RESIDENTS ARE PLACED IN POSITIONS WHERE THEY CAN LEARN AND GROW AS THEY WORK TOWARD COMPLETING THEIR RESIDENCY PROGRAM.
Delegate broad authority to a committee	Form 990, Part VI, Section A, Line 1a	THE EXECUTIVE COMMITTEE, IF ANY, SHALL BE COMPRISED OF THE OFFICERS OF THE BOARD OF DIRECTORS, AND THE CHIEF EXECUTIVE OFFICER, EX-OFFICIO. THE CHAIRMAN OF THE EXECUTIVE COMMITTEE SHALL BE THE CHAIRMAN OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE, IF ANY, SHALL MEET AT THE TIMES AND PLACES AS SHALL BE DETERMINED BY THE CHAIRMAN. WHEN ACTION IS TAKEN BY THE EXECUTIVE COMMITTEE, THE ACTION WILL BE REPORTED TO THE BOARD OF DIRECTORS AT ITS NEXT MEETING. THE EXECUTIVE COMMITTEE, IF ANY, SHALL HAVE THE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION DURING THE PERIOD BETWEEN MEETINGS SO THE BOARD OF DIRECTORS, SUBJECT TO ANY PRIOR LIMITATION IMPOSED BY THE BOARD OF DIRECTORS, EXCEPT THAT, IN ACCORDANCE WITH INDIANA LAW, THE EXECUTIVE COMMITTEE, IF ANY, MAY NOT AUTHORIZE DISTRIBUTIONS OR FILL VACANCIES ON THE BOARD OF DIRECTORS OR ON ANY COMMITTEE OF THE BOARD OF DIRECTORS.
Significant changes to organizational documents	Form 990, Part VI, Section A, Line 4	THE ORGANIZATION AMENDED ITS BYLAWS TO INCORPORATE THE FOLLOWING CHANGES: ON MARCH 23, 2012 - DECREASED THE CLASS A MEMBER FROM 50 TO 49 VOTES. - INCREASED THE CLASS B MEMBER FROM 50 TO 51 VOTES. FOR THE FOLLOWING MATTERS: 1) APPROVE CAPITAL AND OPERATING BUDGETS OF RHI 2) APPROVE THE LONG-RANGE FINANCIAL AND STRATEGIC PLANS OF RHI 3) APPROVE ALL MANAGED CARE CONTRACTS OF RHI
Classes of members or stockholders	Form 990, Part VI, Section A, Line 6	THE NOT-FOR-PROFIT CORPORATIONS ST. VINCENT HEALTH, INC. AND MH HEALTHCARE ARE THE CORPORATE MEMBERS OF RHI. THERE ARE 2 CLASSES OF MEMBERSHIP: CLASS A AND CLASS B. THE CLASS A MEMBER IS ST. VINCENT HEALTH AND THE CLASS B MEMBER IS MH HEALTHCARE. IN MARCH 2012, THE CORPORATE MEMBERS AGREED TO CHANGE THE VOTING RIGHTS OF THE MEMBERSHIP.
Members or stockholders electing members of governing body	Form 990, Part VI, Section A, Line 7a	EACH OF THE CORPORATE MEMBERS HAS THE RIGHT TO APPOINT 50% OF THE MEMBERS OF THE RHI BOARD OF DIRECTORS. THE CLASS A MEMBER, ST. VINCENT HEALTH, HAS THE RIGHT TO APPOINT ALL CLASS A DIRECTORS; THE CLASS B MEMBER, MH HEALTHCARE, HAS THE RIGHT TO APPOINT ALL CLASS B DIRECTORS.
Decisions requiring approval by members or stockholders	Form 990, Part VI, Section A, Line 7b	THE FOLLOWING MATTERS REQUIRE THE JOINT APPROVAL OF THE TWO CORPORATE MEMBERS OF THE HOSPITAL: 1. APPROVE, INTERPRET AND CHANGE ANY STATEMENT OF MISSION, PHILOSOPHY, ROLE AND PURPOSE OF RHI. 2. APPROVE AND AMEND BYLAWS AND ARTICLES OF INCORPORATION. 3. FIX THE NUMBER OF DIRECTORS OF RHI. THE APPOINTMENT, ELECTION OR REMOVAL OF ANY CLASS A DIRECTOR SHALL REQUIRE THE APPROVAL OF THE CLASS A MEMBER AND THE APPOINTMENT, ELECTION OR REMOVAL OF ANY CLASS B DIRECTOR SHALL REQUIRE THE APPROVAL OF THE CLASS B MEMBER. 4. APPROVE THE MERGER, DISSOLUTION, CONSOLIDATION OR REORGANIZATION OF RHI. 5. APPROVE THE FORMATION OF OTHER ENTITIES BY RHI. 6. APPROVE THE ACQUISITION, SALE, LEASE, TRANSFER OR OTHER ALIENATION OF PROPERTY OF RHI, OTHER THAN IN THE USUAL AND REGULAR COURSE OF RHI'S BUSINESS, WHEN SUCH ACQUISITION, SALE, LEASE, TRANSFER OR OTHER ALIENATION MEETS SPECIFIED FINANCIAL LEVELS SET IN ACCORDANCE WITH POLICIES ESTABLISHED FROM TIME TO TIME BY THE CLASS A AND CLASS B MEMBERS. 7. APPROVE CAPITAL AND OPERATING BUDGETS OF RHI. 8. APPROVE DEBT INCURRED BY RHI WHICH IS IN EXCESS OF SUCH LIMITS AS ARE ESTABLISHED BY THE CLASS A AND CLASS B CORPORATE MEMBERS. 9. APPROVE THE DISPOSITION OF THE ASSETS OF RHI AT THE TIME OF ITS DISSOLUTION. 10. ESTABLISH (I) POLICY CONCERNING QUALITY OF CARE AND SERVICES OR (II) POLICY AND PROCEDURES CONCERNING FINANCE AND RESOURCES FOR RHI, WHICH ARE INCONSISTENT WITH POLICIES ESTABLISHED BY THE CLASS A AND CLASS B CORPORATE MEMBERS. 11. APPROVE THE LONG-RANGE FINANCIAL AND STRATEGIC PLANS FOR RHI. 12. APPROVE AN INTERNAL AUDITING PROGRAM FOR RHI, WHICH IS INCONSISTENT WITH THE INTERNAL AUDITING PROGRAM ESTABLISHED BY THE CLASS A AND CLASS B CORPORATE MEMBERS. 13. APPOINT OR REMOVE THE CHIEF EXECUTIVE OFFICER OF RHI PROVIDED, HOWEVER, THAT THE CLASS A AND CLASS B CORPORATE MEMBERS SHALL CONFER WITH THE BOARD OF DIRECTORS CONCERNING THE APPOINTMENT OR REMOVAL OF THE CHIEF EXECUTIVE OFFICER. 14. APPROVE THE POLICY PERTAINING TO THE EVALUATION OF THE CHIEF EXECUTIVE OFFICER OF RHI. 15. APPOINT OR REMOVE THE MEDICAL DIRECTOR. 16. TAKE ANY ACTION WHICH WOULD BE INCONSISTENT WITH THE GOVERNING DOCUMENTS OR POLICIES OF THE CLASS A OR CLASS B CORPORATE MEMBERS.
Review of form 990 by governing body	Form 990, Part VI, Section B, Line 11b	A DETAILED REVIEW IS PERFORMED BY MANAGEMENT AND BY MAJORITY OWNER MEMBER ORIGANIZATION PRIOR TO FILING THE RETURN WITH THE IRS.
Conflict of interest policy	Form 990, Part VI, Section B, Line 12c	ANNUALLY, ALL EMPLOYEES AND BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST FORM. THE CEO AND CHAIRMAN OF THE BOARD REVIEW THE CONFLICT OF INTEREST FORMS COMPLETED BY THE BOARD MEMBERS AND THE DIRECTOR OF HUMAN RESOURCES REVIEWS CONFLICT OF INTEREST FORMS COMPLETED BY EMPLOYEES. IF, DURING A BOARD MEETING, THERE IS AN ACTION ITEM THAT PRESENTS A FORMAL CONFLICT, THE INTERESTED PERSON WOULD BE ASKED TO RECUSE HIMSELF/HERSELF FROM THE VOTE. THIS RECUSAL WOULD BE DOCUMENTED IN THE MINUTES. IF A KEY EMPLOYEE DISCLOSES A POTENTIAL CONFLICT, THAT PERSON IS REMOVED FROM THE DECISION-MAKING PROCESS FOR TRANSACTIONS RELATED TO THAT CONFLICT.
Process used to establish compensation of top management official	Form 990, Part VI, Section B, Line 15a	THE SALARY FOR THE CEO IS DEFINED IN THE WRITTEN HIRING AGREEMENT WHICH IS APPROVED BY THE BOARD OF DIRECTORS. ANNUAL PERFORMANCE GOALS ARE DETERMINED AND SET BY THE CHAIR AND VICE CHAIR OF THE BOARD OF DIRECTORS. SALARY INCREASES AND PERFORMANCE BONUSES ARE DETERMINED BASED UPON PERFORMANCE AND THE ATTAINMENT OF THESE GOALS. THE TOOL USED TO EVALUATE THE CEO'S ANNUAL PERFORMANCE AND PAY IS BASED ON THE ACCOMPLISHMENT OF THESE APPROVED GOALS AND OBJECTIVES. THE EVALUATION OF PERFORMANCE AND GOALS IS COMPLETED BY THE CHAIR AND VICE CHAIR OF THE BOARD ANNUALLY AND IS PERFORMED IN THE EXECUTIVE SESSION OF THE ANNUAL BOARD MEETING. THE CHAIR AND VICE CHAIR REPRESENT BOTH OF THE MEMBER OWNERS OF RHI. THE EVALUATION IS DOCUMENTED BY THE CHAIRMAN OF THE BOARD. IN ADDITION, RHI HUMAN RESOURCES OBTAINS A COMPENSATION SURVEY/STUDY ANNUALLY WHICH IS USED TO EVALUATE THE COMPENSATION OF RHI STAFF INCLUDING THE CEO. THIS PROCESS WAS UNDERTAKEN IN 2012 WITH THE HIRING OF THE CEO WAS IN 2012.
Process used to establish compensation of other officers/key employees	Form 990, Part VI, Section B, Line 15b	THE ADMINISTRATIVE OFFICERS' COMPENSATION IS EVALUATED ANNUALLY BASED ON THE HOSPITAL'S STANDARD PERFORMANCE REVIEW SYSTEM AND BASED ON THE PERFORMANCE OF ANNUAL GOALS. ANNUAL GOALS FOR EACH OFFICER ARE RECOMMENDED BY THE CEO AND APPROVED BY THE BOARD OF DIRECTORS. SALARY INCREASES AND PERFORMANCE BONUSES ARE DETERMINED BASED UPON PERFORMANCE AND GOALS. THE CEO REVIEWS AND EVALUATES THE ANNUAL PERFORMANCE OF EACH ADMINISTRATIVE OFFICER AND RECOMMENDS A PERFORMANCE RATING BASED ON THE HOSPITAL'S STANDARD PERFORMANCE REVIEW SYSTEM. THIS IS DOCUMENTED IN THE HR/PERSONNEL FILES. THE CEO ALSO REVIEWS AND EVALUATES THE PERFORMANCE OF EACH OFFICER AS IT RELATES TO THE ASSIGNED ANNUAL GOALS. THE ANNUAL EVALUATION OF PERFORMANCE GOALS IS TAKEN TO THE CHAIR AND VICE CHAIR OF THE BOARD TO REVIEW AND APPROVE IN AN EXECUTIVE SESSION OF THE ANNUAL BOARD MEETING. THIS IS DOCUMENTED BY THE CHAIRMAN OF THE BOARD. IN ADDITION, RHI HUMAN RESOURCES OBTAINS A COMPENSATION SURVEY/STUDY ANNUALLY WHICH IS USED TO EVALUATE THE COMPENSATION OF RHI STAFF INCLUDING THE ADMINISTRATIVE OFFICERS. THIS PROCESS WAS UNDERTAKEN DURING 2012.
Governing documents, conflict of interest policy and financial statements available to the public	Form 990, Part VI, Section C, Line 19	FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICIES ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 6104; THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME.
Other Expenses	Form 990, Part IX, Line 11g	PURCHASED CONTRACTS - TOTAL EXPENSE: 3053797, PROGRAM SERVICE EXPENSE: 2198734, MANAGEMENT AND GENERAL EXPENSES: 855063, FUNDRAISING EXPENSES: ; PHYSICIANS - TOTAL EXPENSE: 883422, PROGRAM SERVICE EXPENSE: 883422, MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; OTHER GENERAL & ADMIN - TOTAL EXPENSE: 446257, PROGRAM SERVICE EXPENSE: 367175, MANAGEMENT AND GENERAL EXPENSES: 79082, FUNDRAISING EXPENSES: ; CONSULTING - TOTAL EXPENSE: 353194, PROGRAM SERVICE EXPENSE: 254300, MANAGEMENT AND GENERAL EXPENSES: 98894, FUNDRAISING EXPENSES: ; COLLECTION AGENCY - TOTAL EXPENSE: 109167, PROGRAM SERVICE EXPENSE: 109167, MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ;

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

REHABILITATION HOSPITAL OF INDIANA INC

Employer identification number

35-1786005

Part I

Identification of Disregarded Entities (Complete if the organization answered "Yes" to Form 990, Part IV, line 33.)

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) RHI FOUNDATION INC 4141 SHORE DRIVE INDIANAPOLIS,IN46254	TO SUPPORT REHABILITATION HOSPITAL OF INDIANA	IN	501(C)(3)	11 - Type I	REHABILITATION HOSPITAL OF INDIANA INC	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2012

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No

Schedule R (Form 990) 2012

Page 3

Part V

Transactions With Related Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34, 35b, or 36.)

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

Yes

o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of other organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) RHI FOUNDATION INC	O	279,287	ALLOCATION
(2) RHI FOUNDATION INC	N	311,287	ALLOCATION

Schedule R (Form 990) 2012

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to Form 990, Part IV, line 37.)

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2012

Page 5

Part VII

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule R (see instructions).

Identifier	Return Reference	Explanation

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

1	Briefly describe the organization’s mission or most significant activities: THE PRIMARY FOCUS OF THE REHABILITATION HOSPITAL OF INDIANA IS TO DELIVER ACUTE INPATIENT AND OUTPATIENT REHABILITATION SERVICES TO THE RESIDENTS OF CENTRAL INDIANA REGARDLESS OF THEIR ABILITY TO PAY. THE COST OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT PROVIDED IN 2012 = $2.78 MILLION.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	4
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	4
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ......	5	514
6	Total number of volunteers (estimate if necessary) .............	6	72
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	112,452	1,035,615
9	Program service revenue (Part VIII, line 2g) .........	37,886,890	36,932,758
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	6,679	18,668
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	158,557	132,740
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	38,164,578	38,119,781
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	6,775	5,200
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	23,754,772	24,189,609
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	13,034,091	12,300,516
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	36,795,638	36,495,325
19	Revenue less expenses. Subtract line 18 from line 12.......	1,368,940	1,624,456
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	27,724,049	28,639,907
21	Total liabilities (Part X, line 26).............	24,958,991	24,210,467
22	Net assets or fund balances. Subtract line 21 from line 20.....	2,765,058	4,429,440

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 11,564,086 including grants of $ ) (Revenue $ 14,170,732 )
	REHABILITATION NURSING: REHABILITATION NURSES WORK TO REINFORCE HEALING TECHNIQUES BY ENCOURAGING PATIENTS TO PRACTICE WHAT THEY LEARN IN THERAPY. THE NURSES AT REHABILITATION HOSPITAL, INC. HAVE A STRONG BACKGROUND IN MEDICAL-SURGICAL NURSING AND MANY HAVE HAD EXTENSIVE EXPERIENCE IN THE CRITICAL CARE AND ACUTE REHAB SETTING.

4b	(Code: ) (Expenses $ 8,736,861 including grants of $ ) (Revenue $ 14,019,819 )
	THERAPY SERVICES: THERAPY IS A KEY COMPONENT OF A PATIENT'S RECOVERY AND INCLUDES PHYSICAL, OCCUPATIONAL, SPEECH, AND RECREATIONAL THERAPY. THE THERAPY PROGRAM'S PURPOSE IS TO DEVELOP A COMPREHENSIVE PLAN TO HELP PATIENTS BECOME INDEPENDENTLY CAPABLE IN THEIR EVERYDAY LIVES. ADDITIONALLY, THE OVERALL GOAL IS TO HELP BUILD STRENGTH AND ENDURANCE BY USING VARIOUS TECHNIQUES AND SPECIALIZED EQUIPMENT.

4c	(Code: ) (Expenses $ 5,936,580 including grants of $ 5,200 ) (Revenue $ 8,393,292 )
	OTHER PROGRAMS INCLUDE:ANCILLARY SERVICES WHICH CONSISTS OF LAB, EKG, RADIOLOGY, PHARMACY, CENTRAL SUPPLIES, SLEEP, NUTRITION, RESPIRATORY THERAPY, MEDICAL SERVICES (CLINICS), AND DIETARY SERVICES. OUR INTERNS & MEDICAL RESIDENTS PROGRAM REPRESENTS AN EDUCATIONAL PROGRAM TO TRAIN MEDICAL RESIDENTS IN THE ACUTE REHAB SETTING.

	(Code: ) (Expenses $ 860,597 including grants of $ ) (Revenue $ 348,915 )
	NEUROPSYCHOLOGY: THE PSYCHOLOGICAL ASPECT OF A PATIENT'S REHABILITATION IS ALSO A VERY IMPORTANT PART OF A PATIENT'S RECOVERY. THE NEUROPSYCHOLOGIST WORKS IN COLLABORATION WITH THE REHABILITATION TEAM TO DESIGN THE APPROPRIATE PROGRAM FOR EACH INDIVIDUAL PATIENT. MOREOVER, THE REHABILITATION NEUROPSYCHOLOGIST HELPS THE PATIENT AND FAMILY COPE WITH THEIR ILLNESS AND DISABILITY THROUGH COUNSELING, THERAPY AND EDUCATION.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 860,597 including grants of $ ) (Revenue $ 348,915 )
4e	Total program service expenses27,098,124

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)			(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(1) IAN WORDEN........................................................................ CHAIRMAN OF THE BOARD	1.00 .......................	X	X		0	0	0
(2) JAMES TERWILLIGER........................................................................ VICE CHAIR/SECRETARY	1.00 .......................	X	X		0	0	0
(3) MARVIN WHITE........................................................................ TREASURER	1.00 .......................	X	X		0	0	0
(4) ISADORE IZZY RIVAS........................................................................ BOARD MEMBER (PARTIAL YEAR)	1.00 .......................	X			0	0	0
(5) RYAN KITCHELL........................................................................ BOARD MEMBER	1.00 .......................	X			0	0	0
(6) SAMUEL L ODLE........................................................................ BOARD MEMBER (PARTIAL YEAR)	1.00 .......................	X			0	0	0
(7) DANIEL WOLOSZYN........................................................................ CEO	40.00 .......................		X		306,202	0	24,421
(8) MARJORIE BASEY........................................................................ CFO	40.00 .......................		X		127,398	0	16,719
(9) SIDNEY NORTON........................................................................ INTERIM CEO (PARTIAL YEAR)	40.00 .......................		X		84,441	0	10,472
(10) JOAN M TAYLOR........................................................................ CNO	40.00 .......................			X	111,628	0	19,411
(11) LANCE E TREXLER........................................................................ DIR OF NEUROREHAB PSYCHOLOGY	40.00 .......................			X	142,092	0	38,959
(12) MARY C ESCALANTE........................................................................ PHARMACISTS	40.00 .......................			X	111,492	0	28,030
(13) MONTE M SPENCE........................................................................ COO	40.00 .......................			X	160,950	0	35,855
(14) NEIL PATEL........................................................................ PHARMACY MANAGER	40.00 .......................			X	134,544	0	26,066

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	1,178,747	0	199,933

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d		35,615
e	Government grants (contributions)1e

f	All other contributions, gifts, grants, and similar amounts not included above1f		1,000,000

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			1,035,615
			Business Code
2a	NET PATIENT SERVICE REVENUE		621300	36,382,620	36,382,620
b	MANAGEMENT FEE		621300	528,744	528,744
c	OTHER PATIENT REVENUE		621300	21,394	21,394
d				0
e				0
f	All other program service revenue .			0	0	0	0
g	Total. Add lines 2a–2f........			36,932,758
3	Investment income (including dividends, interest, and other similar amounts).......			11,429			11,429
4	Income from investment of tax-exempt bond proceeds..			24			24
5	Royalties...........			0
		(i) Real	(ii) Personal
6a	Gross rents	75,921
b	Less: rental expenses	66,287
c	Rental income or (loss)	9,634	0
d	Net rental income or (loss).......			9,634			9,634
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory		7,215
b	Less: cost or other basis and sales expenses
c	Gain or (loss)	0	7,215
d	Net gain or (loss)..........			7,215			7,215
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ..
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...			0
10a	Gross sales of inventory, less returns and allowances .
	a		4,542
b	Less: cost of goods sold ..b		4,250
c	Net income or (loss) from sales of inventory..			292			292
Miscellaneous Revenue			Business Code
11a	CAFETERIA & VENDING		722210	117,487			117,487
b	GIFT SHOP		453220	5,327			5,327
c				0
d	All other revenue ....			0	0	0	0
e	Total. Add lines 11a–11d ......			122,814
12	Total revenue. See Instructions......			38,119,781	36,932,758	0	151,408


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing .............			2,614	1	2,714
2	Savings and temporary cash investments .........			7,635,393	2	7,734,801
3	Pledges and grants receivable, net ...........				3
4	Accounts receivable, net .............			6,791,709	4	4,824,458
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
					5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6	0
7	Notes and loans receivable, net .............				7
8	Inventories for sale or use ..............			234,388	8	247,388
9	Prepaid expenses and deferred charges ..........			284,941	9	1,894,782
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	27,804,195
b	Less: accumulated depreciation .....	10b	17,404,301	9,289,466	10c	10,399,894
11	Investments—publicly traded securities ..........			2,857,284	11	2,873,812
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 .....			0	13	0
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			628,254	15	662,058
16	Total assets. Add lines 1 through 15 (must equal line 34)......			27,724,049	16	28,639,907
17	Accounts payable and accrued expenses .........			3,431,531	17	3,373,143
18	Grants payable .................				18
19	Deferred revenue ................				19
20	Tax-exempt bond liabilities .............			16,420,000	20	16,070,000
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........				22	0
23	Secured mortgages and notes payable to unrelated third parties ..				23
24	Unsecured notes and loans payable to unrelated third parties ....			3,000,000	24	3,000,000
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................			2,107,460	25	1,767,324
26	Total liabilities. Add lines 17 through 25.........			24,958,991	26	24,210,467
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			2,765,058	27	4,429,440
28	Temporarily restricted net assets ...........				28
29	Permanently restricted net assets ...........				29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances ...........			2,765,058	33	4,429,440
34	Total liabilities and net assets/fund balances ........			27,724,049	34	28,639,907