Form990
Click to see list of attachments
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2012
Open to Public Inspection
A For the 2012 calendar year, or tax year beginning 07-01-2012 , 2012, and ending 06-30-2013
BCheck if applicable:
CName of organization
Schwab Rehabilitation Hospital and Care
Network
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
1401 S California Avenue
 
Room/suite
City or town, state or country, and ZIP + 4
Chicago, IL60608
D Employer identification number

36-2179802
E Telephone number

G Gross receipts $ 41,927,011
F Name and address of principal officer:
 
 
 
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.SINAI.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1922
M State of legal domicile: IL
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: As a member organization of Sinai Health System, Schwab Rehabilitation Hospital has a mission of improving the health of the individuals and communities it serves by providing comprehensive inpatient, short term subacute and outpatient physical rehabilitation services. Schwab performs these services in the areas of stroke, traumatic brain injury, spinal cord injury, amputation, and general rehabilitation for adult and pediatric patients. Schwab Extended Services departments assist patients in rejoining their communities guiding them in accessing public transportation, accessible housing, education and recreation. The peer mentoring programs pairs individuals with previously acquired disabilities with patients for whom living with disabilities is new.Schwab is a teaching hospital hosting residents and other health professionals. Schwab Rehabilitation Hospital supports its patient diversity with medical interpreters and capacity for interpretation in over 150 languages including American
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 48
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 45
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...... 5 500
6 Total number of volunteers (estimate if necessary) ............. 6 9
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  
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 279,759 168,266
9 Program service revenue (Part VIII, line 2g) ......... 40,386,143 40,473,883
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 989,420 1,103,287
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 95,343 181,575
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 41,750,665 41,927,011
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...   0
14 Benefits paid to or for members (Part IX, column (A), line 4).....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 25,126,246 24,429,719
16a Professional fundraising fees (Part IX, column (A), line 11e).....   0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 16,505,075 17,596,145
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 41,631,321 42,025,864
19 Revenue less expenses. Subtract line 18 from line 12....... 119,344 -98,853
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 85,011,431 80,957,377
21 Total liabilities (Part X, line 26)............. 31,272,198 27,160,746
22 Net assets or fund balances. Subtract line 21 from line 20..... 53,739,233 53,796,631
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2012)
Form 990 (2012)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III ...............
1
Briefly describe the organization’s mission: As a member organization of Sinai Health System, Schwab Rehabilitation Hospital has a mission of improving the health of the individuals and communities it serves by providing comprehensive inpatient, short term subacute and outpatient physical rehabilitation services. Schwab performs these services in the areas of stroke, traumatic brain injury, spinal cord injury, amputation, and general rehabilitation for adult and pediatric patients. Schwab Extended Services departments assist patients in rejoining their communities guiding them in accessing public transportation, accessible housing, education and recreation. The peer mentoring programs pairs individuals with previously acquired disabilities with patients for whom living with disabilities is new.Schwab is a teaching hospital hosting residents and other health professionals. Schwab Rehabilitation Hospital supports its patient diversity with medical interpreters and capacity for interpretation in over 150 languages including American
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If “Yes,” describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 11,105,355 including grants of $   ) (Revenue $ 15,229,382 )
Patient CareAccreditations include hospital accreditation by The Joint Commission, Disease Specific Certification for Stroke Rehabilitation by The Joint Commission, Comprehensive Integrated Inpatient Rehabilitation accreditation from CARF International, and specialty Stroke Rehabilitation accreditation from CARF International. The Schwab Attending Physicians are all Board Certified Physiatrists. In addition to general rehabilitative medicine for inpatients and outpatients, the physicians provide specialty care to the persons served. Schwab also has Physiatrists with specialty Board Certifications in Spinal Cord Injury, Brain Injury, Pediatric Rehabilitation, EMG and Pain. Nursing care is provided 24/7 which includes RNs, LPNs, CNAs, and Nurse Managers/Supervisors. 44% of eligible RN staff is certified in Rehabilitation Nursing. Nursing completes comprehensive assessments upon admission and follow-up assessments on every shift. Basic care includes medical administration, wound care, bladder and bowel management and patient education. Complicated care may include respiratory care, trachestomy care, suctioning, tube feedings and IV therapy. The Schwab Physical Medicine and Rehabilitation residency program is an ACGME accredited post graduate training program for specialization in Physical Medicine and Rehabilitation. 5 residents per year are admitted to the program for 3 years of training (total of 15 residents each year). Schwab residents are recognized as graduating with the ability to care for persons with a wide range of disabling conditions, including competence in stroke, spinal cord injury, traumatic brain injury, complex medical conditions, and a wide range of patients including geriatric and pediatric patients with disabilities. Many of the residents are accepted for subspecialty fellowships to further hone their skills in management of specialty rehabilitation conditions. Schwab Residents are also involved in administrative rotations, and quality and patient safety focused process improvement projects.Rehabilitation Services staff members participate in Research projects, Team conferences, Interdisciplinary Hospital Committees, and attend meetings of various professional organizations. Several Physiatrists and hospital leaders serve on Board of local, state and national organizations. Therapist keep current with best practices by attending professional continuing education courses and by sharing knowledge via inservices to the department as well as to other disciplines.Staff Nurse Engagement:Staff Nurses are engaged with nursing leadership through the Professional Practice Council to continually improve the patient care that is provided. Hourly rounding is conducted on every patient to assure that needs are being met, especially in areas such as pain control and toileting. These efforts have helped us sustain below average fall rates across all of the nursing units. Change of shift report is done at the bedside, in collaboration with the patient/family to promote safety, team work and collaborative goals setting. The Bedside Medication Verification (BMV) - bar code scanning on medication and patient wrist bands - continues to be used to assure that the right medication is administered to the right patient. This process has proven to substantially reduce common errors in medication administration and has been used at Schwab for over 3 years,. Nurses are encouraged to continue their education and attain specialty certification. 44% of our eligible RNs have achieved rehabilitation nursing certification indicating advanced preparation and knowledge in the field. Additionally, our nurses participate in a shared decision-making council and a clinical ladder program which encourages projects to impact patient outcomes on their units. Several of our nurses are also recipients of the DAISY Award, a national program recognizing the compassionate care provided to patients.
4b (Code:   ) (Expenses $ 9,106,461 including grants of $   ) (Revenue $ 17,594,238 )
TherapySchwab Rehabilitation Hospital provides an extensive array of Rehabilitation Services, including Physical Therapy, Occupational Therapy, Speech-Language Pathology, and Psychology services. All service lines work together with the medical, nursing, and case management teams to establish a plan of care for each patient that focuses on maximizing independence. This is done utilizing evidence-based interventions and best practices as established by research and by each professional organization.Physical Therapy focuses on gross motor movements: balance, coordination, strengthening, general mobility, pain and gait dysfunction. Physical Therapists utilize interventions such as therapeutic exercise, neuromuscular re-education, gait training, manual therapy techniques, therapeutic modalities (various forms of heat, cold, hydrotherapy, electrical stimulation, traction). Therapists also perform wheelchair management, including customized seating, fitting, and positioning, and wheelchair propulsion and mobility training.Occupational Therapy focuses on activities of daily living; such as dressing, bathing, grooming, cooking, cleaning, money management, as well as working on fine motor coordination, visual-spatial deficits and sensory integration deficits. Occupational therapists utilize interventions such as therapeutic exercise, neuromuscular re-education, energy conservation techniques, vision rehab, retraining in home management, activities of daily living skills, and cognitive skill development.Speech-Language Pathology focuses on evaluation and treatment of swallow function, speech and language deficits, including written and verbal communication, memory, problem solving, and social interaction. Speech-Language Pathologists use a variety of diagnostic techniques, including Video Fluoroscopic Swallow Studies to evaluate dysphagia (swallow disorders), and a number of test batteries to evaluate language, cognition, and memory. These therapists then utilize techniques such as oral-facial-laryngeal muscular re-education, compensatory techniques with modified diet consistencies, communication strategies, cognitive retraining, and memory techniques.Audiology services are provided mainly on an Outpatient basis. Schwab has one of the only wheelchair accessible Audiology booths in all of Chicagoland. Schwab Audiologist are fluent in both ASL and Spanish, and serve all age ranges from infant to geriatric adults. Audiology is available to our inpatients, should a sudden hearing loss occur related to a new medical condition; otherwise patients are scheduled for visits following discharge from the hospital.Psychology Services focus on patients adjusting to the "new normal" of living with a disability; concentrating on loss, anxiety, depression, role definition, and patient and family coping. In addition, they assist patients with encouragement to participate in their overall plan of care.All therapies perform patient and family education and make recommendations regarding discharge disposition, assistance required at home, and recommendations for next level of services required. Additional multi-disciplinary interventions include Group Therapy, Individualized Home Visits, and Community Reintegration Outings.Therapy Services has a robust and well-respected Clinical Education program having affiliations with Physical Therapy, Occupational Therapy, and Communications Disorders programs across all of Chicagoland along with numerous out-of-state programs as well. Dozens of students come to Schwab each year to complete the final stages of their graduate level clinical internship, supported by Clinical Instructors among Schwab staff therapists, and prepare for employment as entry-level clinicians.Therapists hold a variety of specialty skills and certifications. Specializations held among our staff includes: APTA Neurological,Pediatric, and Orthopedic Clinical Specialists, RESNA-certified clinicians, LANA-certified, and NDT-trained therapists, Vital Stim certifications, Lee Silverman Voice, and many other specialties.
4c (Code:   ) (Expenses $ 1,652,214 including grants of $   ) (Revenue $ 3,401,718 )
Support ServicesOther Program Service Accomplishments in Education, Lab, Patient Related Services, Psychology, Radiology, Rehabilitation, Communication, and Other. Materials Management works with Nursing and Therapies to review new, high quality, and cost effective products in a continuous manner to support the use of cost-effective supplies, services, and equipment in the provision of rehabilitation services. This collaboration is facilitated through the system's value analysis committee, comprised of clinical representatives across the system. The committee has reviewed items such as sequential pressure devices, casting and padding, elastic wraps/bandages, assistive equipment and catheters- to ensure our supplies support a high level of quality for our patients at Schwab Rehabilitation Hospital.
4d Other program services (Describe in Schedule O.)
(Expenses $ 1,085,872 including grants of $   ) (Revenue $ 4,248,546 )
4e Total program service expensesMediumBullet22,949,902
Form 990 (2012)
Form 990 (2012)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If “Yes,” complete Schedule C, Part II........
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C,
Part III............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,” complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If “Yes,” complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part XClick to see attachment.........................
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the United States? If “Yes,” complete Schedule F, Parts II and IV
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the United States? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I (see instructions)....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If “Yes,” complete Schedule H.... Click to see attachment
20a
Yes
 
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
Form 990 (2012)
Form 990 (2012)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II...
21
 
No
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I........
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I...................
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highest compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II..........................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ..........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV.....................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If “Yes,” complete Schedule L, Part IV...
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
35b
 
No
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2012)
Form 990 (2012)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V ...............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
5
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
500
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
No
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes,” to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
0
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
No
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
No
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?............
8
 
No
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?..........
9a
 
No
b
Did the organization make a distribution to a donor, donor advisor, or related person?.......
9b
 
No
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
No
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
No
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
No
Form 990 (2012)
Form 990 (2012)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI ...............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
48
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
45
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
IL
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletSchwab Rehabilitation Hospital1401 S California AveChicagoIL60608 (773) 257-5124
Form 990 (2012)
Form 990 (2012)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII ...............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(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
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) Klaus Wisiol........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(2) Bruce K Stickler........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(3) Terry Wheat........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(4) Lawrence Sherman........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(5) AR Umans........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(6) Michael Mitchel........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(7) Susan Manilow........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(8) Ernest Karmin........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(9) Bernard Kalish........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(10) Steve Topel........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(11) Ben Soldinger........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(12) Alan Inbinder........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(13) Richard Hoffman........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(14) Howard Gilbert........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(15) Paul Francis........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(16) Robert Shakno........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(17) Bettylu Saltzman........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
Form 990 (2012)
Form 990 (2012)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(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
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) Paul Cherner........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(19) Abraham Morgan........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(20) Robert Steele........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(21) Mark J Frish........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(22) Sharon Rossmark........................................................................
Vice Chair
 1.00
.......................0.00 		X           0 0 0
(23) Bret Maxwell........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(24) Gary Keller........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(25) William Singer........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(26) Jonathon Jonas........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(27) Henri Havdala MD........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(28) Ruth Rothstein........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(29) Richard Gilford........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(30) Neal Goldstein........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(31) Albert Grace........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(32) Aida Giachello........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(33) Lenard Baritz........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(34) Harold Sherman........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(35) Daniel Cantrell........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(36) Charles Brown........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(37) Alan Solow........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(38) Maurice Schwartz MD........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(39) Sr Immacula Wendt........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(40) Wayne Pierce........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(41) Robert Markin........................................................................
Secretary
 1.00
.......................0.00 		X           0 0 0
(42) Gloria Materre........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(43) Leslie Davis........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(44) Yogi Ahluwalia MD........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(45) John Danaher MD........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(46) Alan Channing........................................................................
President & CEO
 0.00
.......................40.00 		X   X       0 0 0
(47) Gary Niederpruem........................................................................
Chairman
 1.00
.......................0.00 		X           0 0 0
(48) Kenneth Luccioni........................................................................
Treasurer
 1.00
.......................0.00 		X           0 0 0
(49) Anita Halvorsen........................................................................
Vice President
 40.00
.......................0.00 		    X       181,761 0 16,044
(50) Charles Weis........................................................................
EVP and CFO
 8.00
.......................32.00 		    X       86,505 346,024 71,404
(51) Suzan Rayner MD........................................................................
Executive V.P.
 40.00
.......................0.00 		    X       114,125 0 8,124
(52) Lori Jean Pacura........................................................................
COO
 12.00
.......................28.00 		    X       58,526 136,559 21,100
(53) Karen Teitelbaum........................................................................
Chief Operating
 16.00
.......................24.00 		    X       166,706 250,060 58,981
(54) Lisa Thornton........................................................................
Physician
 40.00
.......................0.00 		        X   237,185 0 20,810
(55) Patricia Hantsch........................................................................
Physician
 40.00
.......................0.00 		        X   219,718 0 18,586
(56) Michelle Gittler........................................................................
Physician
 40.00
.......................0.00 		        X   220,891 0 31,226
(57) Edward Park........................................................................
Physician
 40.00
.......................0.00 		        X   194,476 0 21,900
(58) Robert Lee........................................................................
Physician
 40.00
.......................0.00 		        X   215,358 0 4,705
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 1,695,251 732,643 272,880
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet26
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
SODEXO INC & AFFILIATESPO BOX 70060CHICAGOIL606730060 ENVIRONMENTAL SERVIC 124,474
PRIME HEALTHCARE STAFFING27240 HAGGERTY ROAD SUITE E-15FARMINGTON HILLSMI48331 THERAPY LABOR 141,108
ANGELICA CORPORATION920 SOUTH CAMPBELL AVENUECHICAGOIL60612 LAUNDRY SERVICES 225,661
AMERICAN HERITAGE PROTECTIVE5100 W 127TH STALSIPIL60803 SECURITY/TRANSPORT 280,291
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet4
Form 990 (2012)
Form 990 (2012)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response to any question in this Part VIII ..............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e 92,698
f All other contributions, gifts, grants, and
similar amounts not included above1f 		75,568
g Noncash contributions included in lines
1a-1f:$ 		 
h Total. Add lines 1a-1f.......MediumBullet 168,266
Program Service Revenue Business Code
2a PATIENT SERVICES 900099 39,788,566 39,788,566    
b PARKING 812930 38,248 38,248    
c MEDICAL DIRECTOR 541900 558,398 558,398    
d CAFETERIA 722210 83,346 83,346    
e ALL OTHER PROGRAM SERVICE   5,325 5,325    
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 40,473,883
Other Revenue 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 1,103,287 1,103,287    
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties...........MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet 0      
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory    
b Less: cost or other basis and sales expenses    
c Gain or (loss)    
d Net gain or (loss)..........MediumBullet 0      
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..MediumBullet 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...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a Other Revenue 900099 181,575     181,575
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 181,575
12 Total revenue. See Instructions......MediumBullet 41,927,011 41,577,170   181,575
Form 990 (2012)
Form 990 (2012)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response to any question in this Part IX ...............
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 0  
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 .... 675,994   675,994  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 20,555,718 16,956,595 3,599,123  
7 Other salaries and wages 0      
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 275,511 220,035 55,476  
9 Other employee benefits ....... 1,498,064 1,196,421 301,643  
10 Payroll taxes ........... 1,424,432 1,137,616 286,816  
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 30,000   30,000  
c Accounting ........... 24,931   24,931  
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) ........ 0      
12 Advertising and promotion .... 0      
13 Office expenses ....... 33,822 27,293 6,529  
14 Information technology ...... 508,712 381,992 126,720  
15 Royalties .. 0      
16 Occupancy ........... 372,231 5,576 366,655  
17 Travel ............ 14,412 6,762 7,650  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 53,310 47,994 5,316  
20 Interest ........... 935,523   935,523  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 2,480,632   2,480,632  
23 Insurance .............. 568,130 202,193 365,937  
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 SUPPLIES 2,015,102 1,916,390 98,712  
b CONTRACT/PROFESSIONAL 2,677,031 523,021 2,154,010  
c ICT PROF SERVICES 2,966,555 59,000 2,907,555  
d TAX ASSESSMENT 3,215,364   3,215,364  
e All other expenses 1,700,390 269,014 1,431,376  
25 Total functional expenses. Add lines 1 through 24e 42,025,864 22,949,902 19,075,962 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 MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2012)
Form 990 (2012)
Page 11
Part X Balance Sheet Check if Schedule O contains a response to any question in this Part X ...............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing ............. 623,487 1 423,646
2 Savings and temporary cash investments ......... 611,275 2 610,400
3 Pledges and grants receivable, net ...........   3 0
4 Accounts receivable, net ............. 5,985,495 4 5,959,338
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 0
8 Inventories for sale or use .............. 72,932 8 58,435
9 Prepaid expenses and deferred charges .......... 242,341 9 1,224,997
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 36,414,460
b Less: accumulated depreciation ..... 10b 19,137,693 18,190,097 10c 17,276,767
11 Investments—publicly traded securities .......... 3,655,361 11 2,391,220
12 Investments—other securities. See Part IV, line 11 ..... 2,261,924 12 2,478,825
13 Investments—program-related. See Part IV, line 11 .....   13 0
14 Intangible assets ...............   14 0
15 Other assets. See Part IV, line 11 ........... 53,368,519 15 50,533,749
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 85,011,431 16 80,957,377
Liabilities 17 Accounts payable and accrued expenses ......... 2,800,463 17 2,664,538
18 Grants payable .................   18  
19 Deferred revenue ................   19  
20 Tax-exempt bond liabilities ............. 20,568,616 20 19,026,000
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  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
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.................... 7,903,119 25 5,470,208
26 Total liabilities. Add lines 17 through 25......... 31,272,198 26 27,160,746
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 53,377,408 27 53,278,555
28 Temporarily restricted net assets ........... 361,825 28 518,076
29 Permanently restricted net assets ...........   29  
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet 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 ........... 53,739,233 33 53,796,631
34 Total liabilities and net assets/fund balances ........ 85,011,431 34 80,957,377
Form 990 (2012)
Form 990 (2012)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI ...............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
41,927,011
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
42,025,864
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-98,853
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
53,739,233
5
Net unrealized gains (losses) on investments ...............
5
 
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
156,251
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
53,796,631
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII ..............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If “Yes,” to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits
3b
Yes
 
Form 990 (2012)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID: 12000229
Software Version: 2012v2.0
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.
right arrow 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
Schwab Rehabilitation Hospital and Care
Network
Employer identification number

36-2179802
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.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
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.)
10
11
e
f
g
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
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)
 
 
h
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (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
Yes No Yes No Yes No
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
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) right arrow (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) right arrow (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).            
12
12
 
13
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
14
14
 
15
15
 
16a
b
17a
b
18
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
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) right arrow (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) right arrow (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.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2012
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: 12000229
Software Version: 2012v2.0
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2012
Name of the organization
Schwab Rehabilitation Hospital and Care
Network
Employer identification number

36-2179802
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




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
Special Rules
......................... 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
Schwab Rehabilitation Hospital and Care
Network 		Employer identification number

36-2179802
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


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(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
Schwab Rehabilitation Hospital and Care
Network 		Employer identification number

36-2179802
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
Schwab Rehabilitation Hospital and Care
Network 		Employer identification number

36-2179802
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 (c) Use 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 (c) Use 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 (c) Use 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 (c) Use 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: 12000229
Software Version: 2012v2.0
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet 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
Schwab Rehabilitation Hospital and Care
Network
Employer identification number

36-2179802
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 ........    
5
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? ............
6
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? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
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.
Held at the End of the 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  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
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)? .......................................
9
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.
1a
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.
b
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 $  
2
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:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
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

Schedule D (Form 990) 2012
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
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?........
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.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
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 ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
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 .................   495,490 495,490
b Buildings ................   28,390,557 12,959,805 15,430,752
c Leasehold improvements ............   95,260 93,918 1,342
d Equipment ................   7,401,168 6,009,823 1,391,345
e Other .................   31,985 74,147 -42,162
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 17,276,767
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 3
Part VII
Investments—Other 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.)Small Bullet  
Part VIII
Investments—Program 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.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) OTHER RECEIVABLES 110,486
(2) OTHER ASSETS 18,600
(3) DUE FROM UNRESTRICTED FUNDS 68,079
(4) DUE FROM THE AFFILIATES 49,980,984
(5) DEFERRED BOND 355,600




Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 50,533,749
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes  
THIRD PARTY RESERVE 440,325
SELF INSURANCE LIABILITY 2,770,145
PPO LIABILITY 375,543
OTHER CURRENT LIABILITY 634,288
MCD-TAP 299
MCD DISPROPORTIONATE/HMO 68,959
HAP LIABILITY 483,115
DUE TO/FROM MEDICARE&MEDICAID -919,053
DUE FROM UNRESTRICTED 68,079
DEFERRED LIABILITIES 287,074
CURRENT PORTION SELF INS 432,487
CURRENT PORTION CAPITAL LEASE 53,460
CAPITAL LEASE LESS CURR PORTION 32,759
BLUE CROSS LIABILITY 92,706
ASSET RETIREMENT OBLIGATION 650,022
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 5,470,208
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

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  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
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  
c Add lines 4a and 4b....................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ........... 1  
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  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
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  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
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
Part X Part X : FIN48 Footnote INCOME TAXES: THE CORPORATION, MOUNT SINAI, SCHWAB, HOLY CROSS, SMG, AND SCI ARE TAX-EXEMPT ORGANIZATIONS UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND EACH AS REQUIRED FILES A FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX) ANNUALLY. HCHP FILES FEDERAL AND ILLINOIS FORMS 1120 (U.S. CORPORATION INCOME TAX RETURN) ANNUALLY.THE CORPORATION ADOPTED FASB ISSUED GUIDANCE FOR UNCERTAINTY IN INCOME TAXES. THE GUIDANCE PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE CONSOLIDATED FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAXEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. EXAMPLES OF TAX POSITIONS COMMON TO HEALTH SYSTEMS INCLUDE SUCH MATTERS AS THE FOLLOWING: THE TAX-EXEMPT STATUS OF EACH ENTITY, THE NATURE, CHARACTERIZATION AND TAXABILITY OF JOINT VENTURE INCOME AND VARIOS POSITIONS RELATIVE TO POTENTIAL SOURCES OF UNRELATED BUSINESS TAXABLE INCOME (UBIT). UBIT IS REPORTED ON FORM 990T, AS APPROPRIATE. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES THAT IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY.TAX POSITIONS ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE "MORE LIKELY THAN NOT" RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50 PERCENT LIKELY TO BE REALIZED ON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE IS REFLECTED AS A LIABILITY FOR UNRECOGNIZED TAX BENEFITS IN THE CONSOLIDATED BALANCE SHEETS ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. AS OF JUNE 30, 2013 AND 2012, THERE WERE NOT UNRECOGNIZED TAX BENEFITS IDENTIFIED AND RECORDED.FORMS 990 AND 1120 FILED BY THE CORPORATION, MOUNT SINAI, SCHWAB, HCH, SMG, AND SCI ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS) FOR UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN. FORMS 990 AND 1120 FILED BY THE CORPORATION, MOUNT SINAI, SCHWAB, HCH, SMG, AND SCI ARE NO LONGER SUBJECT TO EXAMINATION OF THE YEARS ENDED JUNE 30, 2009 AND PRIOR SINCE.
Schedule D (Form 990) 2012

Additional Data


Software ID: 12000229
Software Version: 2012v2.0




SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet 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
Schwab Rehabilitation Hospital and Care
Network
Employer identification number

36-2179802
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
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.
3
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.
a
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:
3a
Yes
 
%
b
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: .........
3b
Yes
 
c
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.
4
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"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
Yes
 
c
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? ..............
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
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) .. 		    1,276,172   1,276,172 3.040 %
b Medicaid (from Worksheet 3,
column a) .... 		    19,827,852 19,106,030 721,822 1.720 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		           
d Total Financial Assistance
and Means-Tested
Government Programs . 		    21,104,024 19,106,030 1,997,994 4.760 %
Other Benefits
     289,809   289,809 0.690 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		    1,776,159 1,261,399 514,760 1.220 %
g Subsidized health services
(from Worksheet 6) .. 		    551,748   551,748 1.310 %
h Research (from Worksheet 7)            
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		           
j Total. Other Benefits ..     2,617,716 1,261,399 1,356,317 3.220 %
k Total. Add lines 7d and 7j .     23,721,740 20,367,429 3,354,311 7.980 %
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 		(e) Net community building expense (f) Percent of total expense
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            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
1,027,494
3
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. ......
3
256,874
4
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
5
Enter total revenue received from Medicare (including DSH and IME).....
5
11,497,593
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
9,959,065
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
1,538,528
8
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:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
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.......................

9b

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
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 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 Schwab Rehabilitation Hospital
1401 S California Ave
Chicago,IL60608 		X                  
Schedule H (Form 990) 2012
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)
 
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 No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 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.................... 1 Yes  
If “Yes,” indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
3 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 .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................ 4   No
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If “Yes,” indicate how the CHNA report was made widely available (check all that apply):
a
b
c
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):
a
b
c
d
e
f
g
h
i
7 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 ........ 7 Yes  
8a 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)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b   No
c 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
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: 200.0000%
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: 600.0000%
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
b
c
d
e
f
g
h
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
b
c
d
e
f
g
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
b
c
d
e
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 Yes  
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 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?.......... 19 Yes  
If “No,” indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 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.
a
b
c
d
21 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? ............................ 21   No
If “Yes,” explain in Part VI.
22 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? ......................... 22   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2012
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?  
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2012
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
  Part V - Explanation of Number of Facility Type There are no healthcare facility, other than those required to be licensed, registered, or similarly recognized as a health care facility under state law.
  Part VI - States Where Community Benefit Report Filed IL
  Part VI - Affilated Health Care System Roles and Promotion Schwab is part of Sinai Health System. Sinai Health System has organizations such as Sinai Community Institute, Mount Sinai Community Foundation and Sinai Urban Health Institute who partner with neighborhood groups and the community overall to understand health and well-being needs. Sinai Community Institute mostly concentrates on serving women, infants and children; families; and building individual potential. Sinai Community Institute and Sinai Urban Health Institute have created "How Healthy is Your Zip Code" which brings together providers, residents and health educators. Additional details of each entity and services are provided in Supplemental Information Line 2.
  Part VI - Explanation Of How Organization Furthers Its Exempt Purpose Schwab, as a part of Sinai Health System, has a board comprised of respected leaders in banking, finance, manufacturing, legal, health care and other industries. Schwab extends medical staff privileges to all qualified physicians for all departments. Schwab invests any surplus funds into improving patient care.
  Part VI - Community Building Activities No community building activities (as reported in Part II) are reported. Schwab reports all community related activities as part of Part I - Charity Care and Certain Other Community Benefits.
  Part VI - Community Information Schwab, as a part of Sinai Health System, serves a population base of over 750,000 people located on the west side of Chicago. One outlying facility, Sinai's Touhy Clinic on the north side of Chicago, sees refugees from many nations (for example Sudan, Iraq and Burma) as well as resident Orthodox Jewish and Russian populations. Otherwise, Sinai Health System serves primarily African-American and Latino patients. Over 60% of Sinai's patients are Medicaid recipients and 15% are uninsured. Sinai's interpreter services support 150 different languages, including American Sign Language, making Sinai one of the strongest medical programs in the nation for Deaf and Hard of Hearing patients. Sinai is one of the largest Medicaid providors in Illinois. Ninety-three percent of Sinai's patients are individuals classified in minority race categories.
  Part VI - Patient Education of Eligibility for Assistance Schwab informs patients of the charity care policy through signage in the hospital, written communication, statements and related corporation Sinai Health System website. Each hospital bill, invoice, or other summary of charges to an uninsured patient shall include with it, or on it, a prominent statement that an uninsured patient who meets certain income requirements may qualify for an uninsured patient discount along with information regarding how the patient may apply for financial assistance.
  Part VI - Needs Assessment Schwab begins outreach and assessment of community health by first evaluating which health conditions and diseases are prevalent among its inpatients and outpatients. Determination of prevalence then guides the design of community services and also assures there is no bias based on race, gender, or patients' ability to pay. Schwab is related to organizations such as Sinai Community Institute, Mount Sinai Community Foundation and Sinai Urban Health Institute(SUHI) who partner with neighborhood groups and the community overall to understand health and well-being needs. SUHI, in particular, conducts comprehensive door-to-door health needs assessments. Sinai shared the health assessment findings with local residents and community groups, forging interventional partnerships. Together they confirmed the need for education and other interventions for asthma, obesity, diabetes and breast cancer. Schwab also supports Sinai Community Institute and Sinai Urban Health Institute by providing clinicians and health educators to community education series "How Healthy is Your Zip Code". These forums arm participants with knowledge about the chronic diseases that can affect them and action plans for avoiding or managing those diseases. Through its community-based asthma education interventions, Sinai demonstrated that for every $1 invested in the community health educators, up to $14 in acute care services can be avoided. Schwab also specifically builds healthier communities through the In My Shoes Violence Prevention program. In My Shoes educators, all former gang members and people with disabilities, most using wheel chairs, visit schools and community groups, explaining what gang membership is really like. The educator's language is plain, direct and non-judgmental but it addresses what youthful audience members have never thought about: the possibility of living with a disability.
Number of Hospital Faciltiy - 1 Part V, Line 11 - Criteria Used For Discounted Care If Not FPG None Uninsured
Number of Hospital Faciltiy - 1 Part V, Line 3 - Account Input from Person Who Represent the Community Many people have helped write this report. Among these have been the staff and leadership of Schwab and SUHI, incorporating expertise from both rehabilitation professionals and epidemiologists. Most notably, the contributions of the Schwab medical staff are valued due to the personal nature of the model of care delivered each day, to each patient. We thus believe that the public health credentials of the authors of this report are substantial and notable.In this section we share data collected in three different ways: in person surveys of Schwab patients and families, online surveys of Schwab staff, and Town Hall forums. Both the in-person and online surveys were collected as this CHNA was being constructed, in order to gain a better understanding of the health needs of the community we serve. The Town Hall forums were held after we had collected data for this CHNA. At each of the 3 forums, we shared the data with the community members and gathered feedback to see how the data resonated with their daily experiences as well as what suggestions they had for using this data to best meet the health needs of the community.
Number of Hospital Faciltiy - 1 Part V, Line 1j - Description of Other Needs Assessment The focal points of Schwab's CHIP are, or course, not the only health concerns of the community. Survey participants mentioned mental health and parenting skills as key issues affecting health. (See Section 7). Research participants discussed the lack of accessible housing and transportation that prevented them from acessing healthcare and from enjoying a higher quality of life. These issues are outside the scope of a hospital and thus are not included in our action plan; we can have a greater impact by concentrating on the focal issues described above. Beyond these issues, people with and without disabilities within Schwab's PSA have many other health concerns; we hope you will also read the CHNA reports for Mount Sinai Hospital and Holy Cross Hospital to gain a better understanding of some of these issues, and how other hospitals within Sinai Health System are developing their own action plans to improve the health of their communities (which, of course, overlap with Schwab's PSA).
  Part III, Line 9b - Provisions On Collection Practices For Qualified Patients "Staff will apply the same collection standards to all patients who receive services. Staff will comply with Fair Debt Collection Practices and The Fair Patient Billing Act when interacting with the patient or guarantor. Collection practices will follow the mission and values of the Hospital and all staff will treat our patients and guarantors with consideration and in a professional manner."Identify Self-pay and Uninsured Balances. Uninsured residents of Illinois are eligible for a discount of 70% of total charges and may be eligible for additional assistance following the full Financial Assistance Policy."The hospital will, through the billing system, submit monthly statements to patients or guarantors indicating the patient balance due."During this time, the billing system will reflect a minimum of three collection attempts. Staff will also provide communication concering Sinai Health System's financial assistance policy and program."At the conclusion of this period, if internal collection efforts have not secured qualifying payment, agreeable payment arrangements, automated notification of charity qualification, or application for financial assistance, the account may be placed to external collections."On occasion the Patient Accounts department may modify the standard collection process based on specific circumstances; for example, to accelerate the cycle of the internal collection process where patient or guarantors are uncooperative or mail cannot be delivered. Conversely, the department may elect to extend internal collections if the debtor has provided good faith effort to pay the account or apply for coverage or assistance."On occasion, balances may be waived based on specific circumstances involving the account for the patient i.e. timely filing or payment from insurance. At no time will waivers of patient out of pocket balances be standard practice. Any waivers must be approved by administration or the Director of Patient Accounts. Accounts may be requested to be returned from an external collection agency with a satisfying qualifying event."Once an account is transferred to a collection agency to pursue collection activity within the guidelines of this policy and all state and federal regulations, the collection agency will proceed with reasonable collection action. No legal action shall be brought against a patient for nonpayment of an account, without the written approval of the Director of Patient Accounts. If all reasonable collection actions have been taken by the collection agency to collect a debt and the collection agency determines that the account is uncollectable, the account shall be closed and returned to Sinai Health System
  Part I, Line 7g - Costs Associated With Physicans Clinics No subsidized health services were reported
  Part I, Line 7, Column F - Explanation of Bad Debt Expense The bad debt expense is $1,027,494
  Part I, Line 7 - Explanation of Costing Methodology Total cost per the Medicare Cost Report worksheet B,PT1 column 26 divided by total inpatient and outpatient gross revenue.
  Part I, Line 6a - Related Organization Community Benefit Report The community benefit report is prepared by related corporation Sinai Health System. Sinai Health System in total contributed $134,064,369 to charity care and community benefits of which $46,742,376 is charity care and $87,321,993 is other community benefits. Of these amounts Schwab Rehabilitation Hospital contributed $3,660,378 to charity and other community benefits of which $1,276,172 is charity care and $2,383,800 is other community benefits.
Schedule H (Form 990) 2012
Additional Data


Software ID: 12000229
Software Version: 2012v2.0
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
Schwab Rehabilitation Hospital and Care
Network
Employer identification number

36-2179802
Part I
Questions Regarding Compensation
Yes
No
1a
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.
b
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....
1b
 
 
2
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? .......
2
 
 
3
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.
4
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:
a
Receive a severance payment or change-of-control payment? ................
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
 
No
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
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.
5
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:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
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:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
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 ............
7
Yes
 
8
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 .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2012

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
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1)Robert LeePhysician (i)
(ii)		 178,143
  		10,306
  		26,909
  		4,037
  		668
  		220,063
  		 
 
(2)Patricia HantschPhysician (i)
(ii)		 161,176
  		41,960
  		16,582
  		11,088
  		7,498
  		238,304
  		 
 
(3)Michelle GittlerPhysician (i)
(ii)		 192,946
  		12,320
  		15,625
  		12,730
  		18,496
  		252,117
  		 
 
(4)Lori Jean PacuraCOO (i)
(ii)		 53,014
123,699 		 
  		5,512
12,860 		2,020
4,714 		4,310
10,056 		64,856
151,329 		 
 
(5)Lisa ThorntonPhysician (i)
(ii)		 209,059
  		12,000
  		16,126
  		13,872
  		6,938
  		257,995
  		 
 
(6)Karen TeitelbaumChief Operating (i)
(ii)		 138,719
208,079 		10,583
15,875 		17,404
26,106 		20,524
30,786 		3,068
4,603 		190,298
285,449 		 
 
(7)Edward ParkPhysician (i)
(ii)		 137,894
  		39,700
  		16,882
  		3,250
  		18,650
  		216,376
  		 
 
(8)Charles WeisEVP and CFO (i)
(ii)		 72,224
288,898 		5,599
22,398 		8,682
34,728 		10,488
41,950 		3,793
15,173 		100,786
403,147 		 
 
(9)Anita HalvorsenVice President (i)
(ii)		 164,167
  		 
  		17,594
  		8,512
  		7,532
  		197,805
  		 
 
Schedule J (Form 990) 2012

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
Sch J, Part I, Line 7 Part I, Line 7: Non-Fixed payments not listed above Schwab Rehabilitation Hospital pays out bonuses based on the procedures below.Sinai Health System has an Executive Compensation Committee to support the organizational performance of Sinai Health System and its related entities through the alignment of executive compensation with system strategies and programs and ensure compliance with applicable law. The voting members of the Committee are independent members of the Board of Directors. The Committee meets twice annually or more frequently as circumstances require. The Committee establishes detailed goals annually for the President and CEO and other executives, and reviews performance against these goals on an annual basis. The Committee annually engages an outside, independent compensation consultant to benchmark the salaries and benefits of the organization's Assistant Vice Presidents and above, as well as a few directors. Compensation is based on detailed written performance appraisals and external market data. In executive session, the Committee reviews the performance of the President and CEOs of comparable organizations, and conducts an annual review of CEO performance against established goals. The committee maintains written minutes which are maintained in Executive Administration.
Schedule J (Form 990) 2012

Additional Data


Software ID: 12000229
Software Version: 2012v2.0
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
Schwab Rehabilitation Hospital and Care
Network
Employer identification number

36-2179802
Identifier Return Reference Explanation
Form 990, Part XI, Line 9 Other Changes In Net Assets Or Fund Balances - Other Increases Other Restricted Changes = $156251
Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available Governing documents, conflict of interest and financial statements are made available upon request and after review by management.
Form 990, Part VI, Line 15b Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees Sinai Health System has an Executive Compensation Committee to support the organizational performance of Sinai Health System and its related entities through the alignment of executive compensation with system strategies and programs and ensure compliance with applicable law. The voting members of the Committee are independent members of the Board of Directors. The Committee meets twice annually, or more frequently, as circumstances require. The Committee establishes detailed goals annually for the President and CEO and other executives, and reviews performance against these goals on an annual basis. The Committee annually engages an outside, independent compensation consultant to benchmark the salaries and benefits of the organization's Assistant Vice Presidents and above, as well as a few directors. Compensation is based on detailed written performance appraisals and external market data. In executive session, the Committee reviews the performance of the President and CEO, each element of compensation, data of compensation programs in effect for CEOs of comparable organizations, and conducts an annual review of CEO performance against established goals. The Committee maintains written minutes which are maintained in Executive Administration.
Form 990, Part VI, Line 12c Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts The Conflict of Interest Disclosure Form is completed and signed annually by all board members, employed physicians, management personnel as well as other employees who are in a position to influence purchasing decisions. In addition to the annual filing of the form, an update is required to be filed any time there has been a change. Based on the information disclosed, the Chief Integrity Officer, along with other members of management and counsel as needed, implements an appropriate conflict management plan, which may include requiring the interested party to abstain from participation in certain decisions. The information disclosed also is taken into consideration in making Board and Board Committee assignments. Further, board members are required to disclose potential conflicts relating to Board and Committee proceedings to the appropriate Board or Committee Chair for appropriate conflict management procedures, including abstention from participation in certain decisions.
Form 990, Part VI, Line 11b Form 990, Part VI, Line 11b: Form 990 Review Process The 990 was initially prepared by the Finance Staff with multi disciplinary inputfrom Public Affairs, Corporate Integrity and other appropriate staff of theorganization. The 990 was then reviewed by senior finance staff and other members ofSenior Leadership. Prior to the filing, the 990 was made available via email to Finance Board Committee . The 990 form was presented as a discussion item for the Finance Board Committee where members had an opportunity for questions and comments. The 990 was also made available via email to the full Board of Directors.
Form 990, Part VI, Line 7b Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders The sole corporate member has certain reserved powers over significant corporate actions, including matters such as appointment of corporate officers, amendment of governing documents, approval of a merger, consolidation or dissolution, approval of budgets and strategic plans, approval of independent certified public accountants for the organization, and approval of non-budgeted long-term debt.
Form 990, Part VI, Line 7a Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body Board members are nominated by the Board Recruitment, Education and Nominating Committee of the sole corporate member, Sinai Health System, and elected by the sole corporate member.
Form 990, Part VI, Line 6 Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder SINAI HEALTH SYSTEM, EIN 36-3166895, is sole member.
Form 990, Part VI, Line 1a Form 990, Part VI, Line 1a: Explanation of Delegated Broad Authority to Committee The Executive Committee of Schwab Rehabilitation Hospital consists of the Board Chairman, and at least 15 but no more than 17, members of the Board of Directors. The Board Chairman appoints the members of the Executive Committee. The Executive Committee has the power to transact regular business of the corporation during the period between meetings of the Board, subject to limitations imposed by the Board or law. when action is taken by the Executive Committee, it is reported to the Board.
Form 990, Part III, Line 4d Form 990, Part III, Line 4d: Other Program Services Description OTHER PROGRAM SERVICES 4: Pharmacy:Schwab Anticoagulation Program: Adverse Drug Event PreventionThe Medication Use Safety Improvement Committee addresses anticoagulation therapy at Mount Sinai and Schwab Rehabilitation Hospital. Anticoagulation medications are considered high risk in that they require close monitoring for continued dose adjustments to maintain therapeutically effective dose levels, while having a high potential for adverse patient events. Addressing regulatory standards and best practices for overall Venous Thrombo-Embolism prevention, anticoagulation treatment protocols were reviewed, updated and approved. The Medication Use Safety Improvement Committee also reviewed data from the Institute for Healthcare Improvement (IHI) anticoagulation trigger tool document, which provides screening criteria for adverse drug events. This data assisted the committee in determining which interventions need to be made at the respective hospital and the type of intervention: education, protocol changes, formulary changes and management of the medication. The Pharmacy department worked closely with Schwab Rehabilitation Hospital in recommending anticoagulation education to nurses, Residents and attending Physicians. This education focused on prescribing, dose adjustment, administration and monitoring of anticoagulants and helped decrease the number of adverse drug events. Education was provided several times and will continue to be provided to promote a culture of medication safety. OTHER PROGRAM SERVICES 5: Other Program Service Accomplishments in Education, Lab, Patient Related Services, Psychology, Radiology, Rehabilitation, Communication, and Other.(Replace) Materials Management works with Nursing and Therapy Services to review new, high quality, and cost effective products in a continuous manner to support the use of cost-effective supplies, services, and equipment in the provision of rehabilitation services. This collaboration is facilitated through the health system's Value Analysis Committee, comprised of clinical representatives across the system including the acute and rehabilitation/sub-acute settings. The committee has reviewed items such as specialty and enclosure beds, casting and padding, wound care, skin care, assistive equipment, - to name a few - to ensure our supplies and services support a high level of quality for our patients at Schwab Rehabilitation Hospital.Some points of interest and highlights:This includes 6 interventions/programs that help to fill the gaps between what participants need and what is available to them in the community: Accessibility: recommendations for Sinai Health System to increase accessibility for all patients. Community Technology Center: accessible computer lab, education. Disability Resource Center: support, referrals, information, and advocacy. Domestic Violence: support, referrals, information, and advocacy. In My Shoes: violence prevention for youth. Peer Mentoring: positive role modeling and support by and for people with disabilities.
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: 12000229
Software Version: 2012v2.0
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
Schwab Rehabilitation Hospital and Care
Network
Employer identification number

36-2179802
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?
Yes No
(1) HOLY CROSS HOSPITAL

2701 WEST 68TH STREET

CHICAGO,IL60629
36-2170133 		CATHOLIC HEALTHCARE ORGANIZATION IL 501(c)(3) 170(b)(1) A SINAI HEALTH SYSTEM
 
 
No
(2) SINAI COMMUNITY INSTITUTE

2653 WEST OGDEN AVE

CHICAGO,IL60680
36-3933824 		SUPPORTING ORGANIZATION IL 501(c)(3) 7 SINAI HEALTH SYSTEM
 
 
No
(3) SINAI HEALTH SYSTEM

CALIFORNIA AVE AT 15th ST

CHICAGO,IL60608
36-3166895 		SUPPORTING ORGANIZATION IL 501(c)(3) 11a SINAI HEALTH SYSTEM
 
 
No
(4) MOUNT SINAI COMMUNITY FOUNDATION

CALIFORNIA AVE AT 15TH ST

CHICAGO,IL60608
36-3305449 		HEALTHCARE IL 501(c)(3) 11a SINAI HEALTH SYSTEM
 
 
No
(5) MOUNT SINAI HOSPITAL MEDICAL CENTER

CALFORNIA AVE AT 15TH ST

CHICAGO,IL60608
36-1509000 		HEALTHCARE IL 501(c)(3) 3 SINAI HEALTH SYSTEM
 
 
No




For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2012
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



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No 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
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No












Schedule R (Form 990) 2012
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
No
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 . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
No
2
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) SINAI COMMUNITY INSTITUTE

 k 27,840 Cost
(2) MOUNT SINAI COMMUNITY FOUNDATION

 m 143,422 Cost
(3) MOUNT SINAI COMMUNITY FOUNDATION

 k 21,802 Cost
(4) MOUNT SINAI HOSPITAL MEDICAL CENTER

 q 85,500 Cost
(5) MOUNT SINAI HOSPITAL MEDICAL CENTER

 m 1,488,375 Cost
(6) MOUNT SINAI HOSPITAL MEDICAL CENTER

 k 20,528 Cost
Schedule R (Form 990) 2012
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) 		(d)
Predominant income (related, unrelated, excluded from tax under section 512-514)

(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 V—UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2012
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: 12000229
Software Version: 2012v2.0