2023-01-30T11:36:45-06:00 2022-09-30 560587953 GILLIAM BELL MOSER LLP PO BOX 621 BURLINGTON NC 272160621 990 2021-10-01 561270984 LUTHERAN RETIREMENT MINISTRIES OF ALAMANCE COUNTY NORTH CAROLINA LUTH 3365381500 3701 WADE COBLE DRIVE BURLINGTON NC 27215 BRENT CONKLIN CFO 3365381515 2023-01-27 1 BRENT CONKLIN 999009999 JEREMY C HARTLE P00643154 3362276283 2023-01-26 3 AAL1 IAL1 2021 2023-03-07 01:45:13Z TWIN LAKES COMMUNITY PAMELA S FOX 3701 WADE COBLE DRIVE BURLINGTON NC 27215 48174925 0 X WWW.TWINLAKESCOMM.ORG X 1980 NC TO PROVIDE COMPREHENSIVE RESIDENTIAL, SOCIAL, AND HEALTH RELATED SERVICES TO THE ELDERLY. 19 19 594 109 0 0 3374534 254776 35859005 38673832 984696 1273540 90 17639 40218325 40219787 1976963 2630328 0 0 15749610 19056778 0 0 84637 15555084 19259700 33281657 40946806 6936668 -727019 193099314 194352583 133036784 134913678 60062530 59438905 AS A NON-PROFIT BUILT ON CHRISTIAN VALUES, WE CELEBRATE THE PROGRESSION OF LIFE AND DIGNITY OF THE INDIVIDUAL BY EMPOWERING ALL MEMBERS OF OUR COMMUNITY TO LIVE, WORK AND SERVE TO THEIR FULLEST POTENTIAL. 0 0 37540048 2630328 38691471 OPERATION OF CONTINUING CARE RETIREMENT COMMUNITY CONSISTING OF 104 NURSING CARE BEDS, 36 ASSISTED LIVING UNITS, 434 APARTMENTS, VILLAS AND GARDEN HOMES, AND 32 MEMORY CARE ASSISTED LIVING BEDS. THE NURSING FACILITY AND THE MEMORY CARE FACILITY PROVIDE SERVICES TO RESIDENTS THROUGH BOTH MEDICARE AND MEDICAID. THESE FACILITIES ALSO PROVIDE REHABILITATIVE SERVICES INCLUDING PHYSICAL THERAPY, SPEECH THERAPY AND OCCUPATIONAL THERAPY. THIS CONTINUING CARE RETIREMENT COMMUNITY ALSO PROVIDES ADULT DAY CARE AND HOME CARE SERVICES. PARKINSON'S SUPPORT AND CAREGIVER'S SUPPORT IS AVAILABLE ALONG WITH SERVICES FOR OLDER ADULTS WITH DEVELOPMENTALLY DISABLED ADULT CHILDREN. 37540048 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 49 0 594 1 0 0 0 0 0 0 0 0 0 0 X 19 19 0 0 0 0 0 0 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X X BRENT CONKLIN 3365381502 3701 WADE COBLE DRIVE BURLINGTON NC 27215 JACKIE S COLE BOARD CHAIR 2.00 X X 0 0 0 K DALE GREESON VICE CHAIR THRU 08.22 2.00 X X 0 0 0 JOY F ISLEY TREASURER 2.00 X X 0 0 0 JAMES K ROBERSON SECRETARY 2.00 X X 0 0 0 DAVID KOESTER BOARD MEMBER 1.00 X 0 0 0 JANET J LAHAYNE BOARD MEMBER 1.00 X 0 0 0 DAVID COOPER BOARD MEMBER 1.00 X 0 0 0 T BRUCE MOORE BOARD MEMBER 1.00 X 0 0 0 CONNIE POOVEY BOARD MEMBER 1.00 X 0 0 0 MELANIE THOMAS BOARD MEMBER 1.00 X 0 0 0 JERRY R TOLLEY JR BOARD MEMBER 1.00 X 0 0 0 KYLE CORUM BOARD MEMBER 1.00 X 0 0 0 SHERRY S HUNT BOARD MEMBER 1.00 X 0 0 0 FRANKLIN RHUE BOARD MEMBER 1.00 X 0 0 0 K ALEXIS MOORE BOARD MEMBER 1.00 X 0 0 0 MICHAEL MENZ BOARD MEMBER 1.00 X 0 0 0 DAVID MASSEY BOARD MEMBER 1.00 X 0 0 0 JULIA SHUMATE EWING BOARD MEMBER 1.00 X 0 0 0 ANTHONY FORIEST BOARD MEMBER 1.00 X 0 0 0 JILL GERRINGER BOARD MEMBER 1.00 X 0 0 0 PAMELA S FOX PRESIDENT/CEO 40.00 X 238718 0 27715 BRENT CONKLIN CFO 40.00 X 163215 0 22400 KIMBERLY THOMAS HRO 40.00 X 99042 0 13331 LAUREN COOK HC ADMINISTRATOR 40.00 X 106306 0 32738 ANTHONY ELLIS FOOD SERVICES DIRECTOR 40.00 X 108042 0 22408 JESSY TANGHAM HC RN 40.00 X 106191 0 13137 821514 0 131729 5 0 1 0 RAY A WHITESELL CONTRACTING LLC 1662 ST MARKS CHURCH ROAD BURLINGTON NC 27215 BUILDING RENOVATIONS 2213966 WEAVER COOKE CONSTRUCTION 8401 KEY BLVD GREENSBORO NC 27409 NEW CONSTRUCTION 508132 TEAGUE FREYALDENHOVEN FREYALDENHOVEN 300 NORTH GREENE STREET SUITE 285 GREENSBORO NC 27401 ARCHITECT SERVICES 228208 NEW ATLANTIC CONTRACTING INC 2635 REYNOLDA ROAD WINSTONSALEM NC 27106 BUILDING RENOVATIONS 202312 LOVE & COMPANY INC 7490 NEW TECHNOLOGY WAY FREDERICK MD 21703 MARKETING SERVICES 161423 5 254776 254776 INDEPENDENT LIVING FACILITIES 623000 13871740 13871740 NURSING CARE 623000 11784366 11784366 ADMISSION FEES EARNED 623000 5100082 5100082 MEMORY CARE 623000 3107658 3107658 ASSISTED LIVING 623000 1836933 1836933 2973053 2973053 38673832 368044 368044 17639 0 17639 17639 17639 8242564 618070 7608768 346370 633796 271700 905496 905496 40219787 38691471 0 1273540 150003 150003 2480325 2480325 695455 695455 14875593 13894170 931772 49651 348492 340178 2719 5595 2014274 1901365 112909 1122964 1013575 104164 5225 8498 8498 128411 128411 118320 118320 981388 954615 26773 104865 104865 2658222 2147520 488020 22682 369838 64126 305712 1543401 1512533 30868 26023 18533 6006 1484 2197223 2153279 43944 8119901 7957503 162398 922704 904250 18454 PATIENT DRUGS AND FOOD 1132470 1132470 REPAIRS AND MAINTENANCE 874751 874751 EDUCATION 43647 40852 2795 BAD DEBTS 30038 30038 40946806 37540048 3322121 84637 19066599 20093321 1004908 1321621 372561 421049 35746 94021 229721253 77228343 152605680 152492910 20013820 18500751 0 1428910 193099314 194352583 4668524 5098438 62099963 62847757 65454056 66967483 814241 0 133036784 134913678 X 55241781 55077957 4820749 4360948 60062530 59438905 193099314 194352583 X -727019 -2139757 2243151 X X 0 1 X 1 1 1 X 145980 212524 239897 3374534 254776 4227711 29866945 33200212 33790720 35859005 38673832 171390714 30012925 33412736 34030617 39233539 38928608 175618425 46023 37482 22018 221718 37130 364371 0 46023 37482 22018 221718 37130 364371 175254054 366124 584339 645699 315467 385683 2297312 366124 584339 645699 315467 385683 2297312 30379049 33997075 34676316 39549006 39314291 177915737 0.98500 0.98410 0.01290 0.01320 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3690867 27051 -593141 41315 31122 3052340 3098737 17177 653875 49405 29517 3690867 2971938 3393 187723 38474 25843 3098737 2878960 52331 107746 42210 24889 2971938 2691092 2016 247182 36032 25298 2878960 0.07610 0.92390 0.00000 0 0 8661846 8661846 173858013 56244087 117613926 17730921 8245440 9485481 29470473 12738816 16731657 152492910 37694498 -2139757 2243151 103394 37591104 118320 2510363 2628683 40219787 38318123 0 38318123 118320 2510363 2628683 40946806 PART V, LINE 4: THE INCOME OF THE ENDOWMENT FUNDS IS USED TO SUPPORT THE OPERATIONS OF LUTHERAN RETIREMENT MINISTRIES OF ALAMANCE COUNTY, NORTH CAROLINA. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN MARKET VALUE OF RATE SWAP AGREEMENT RELATED TO TAX-EXEMPT BONDS 2,243,151. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE NETTED WITH REVENUE ON FINANCIALS 30,038. UNREIMBURSED COSTS UNDER MEDICAID 1,971,597. FORGIVEN MONTHLY AND DAILY FEES 508,728. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE NETTED WITH REVENUE ON FINANCIALS 30,038. UNREIMBURSED COSTS UNDER MEDICAID 1,971,597. FORGIVEN MONTHLY AND DAILY FEES 508,728. 1 LUTHERAN SERVICES IN AMERICA 100 MARYLAND AVE NE WASHINGTON DC 20002 363304707 501(C)(3) 10000 0 CONTRIBUTION FOR CEO AND LEADERSHIP ACADEMIES TOWN OF ELON PO BOX 595 ELON NC 27244 561174600 501(C)(3) 56000 0 CONTRIBUTION TO COST OF PROVIDING FIRE AND EMERGENCY RESPONSE. ALAMANCE COMMUNITY COLLEGE FOUNDATION 1247 JIMMIE KERR RD GRAHAM NC 27253 581511004 501(C)(3) 12500 0 SCHOLARSHIPS AND DISTRESS FUND MEALS ON WHEELS OF ALAMANCE COUNTY 508 W DAVIS STREET BURLINGTON NC 27215 561061980 501(C)(3) 43016 0 LANES OF LIGHT PROCEEDS/CAMPAIGN GIFT SALVATION ARMY 812 ANTHONY STREET BURLINGTON NC 27217 501(C)(3) 8016 0 LANES OF LIGHT PROCEEDS 5 FINANCIAL AID 30 1971597 FMV UNREIMBURSED COSTS UNDER MEDICAID FINANCIAL AID 12 508728 FMV FORGIVEN MONTHLY AND DAILY FEES PART I, LINE 2: THE BOARD RECOGNIZES LRM/TLC'S RESPONSIBILITY TO COMMUNITY OUTREACH AND SUPPORT AND AGREES WITH THE FOLLOWING STATEMENTS. I. FINANCIAL CONTRIBUTIONS ARE SUBJECT TO THE REQUIREMENTS IN THE CHARITABLE CARE AND COMMUNITY BENEFIT POLICY. II. CHARITABLE GIFTS WILL BE GRANTED TO QUALIFYING TAX-EXEMPT ORGANIZATIONS THAT COMPLEMENT OR ADVANCE OUR MISSION OR AT THE DISCRETION OF PRESIDENT/CEO, OUTREACH COMMITTEE OR THE BOARD. ORGANIZATIONS MEETING THE OBJECTIVES OF OUR PRIMARY MISSION WILL BE GIVEN PRIORITY. HOWEVER, ALL GIVING OPPORTUNITIES WILL BE CONSIDERED CAREFULLY AND MAY BE APPROVED FOR ORGANIZATIONS FALLING OUTSIDE OF OUR ESTABLISHED FOCUS AREA. III. OUTREACH COMMITTEE WILL RECOMMEND A GIFT AND SPONSORSHIP EXPENDITURE ANNUALLY TO BE APPROVED BY THE BOARD OF DIRECTORS. THIS TOTAL, THAT WILL INCLUDE ANTICIPATED PLEDGE PAYMENTS, WILL BE DETERMINED BASED ON PRIOR YEAR'S GIVING, CURRENT FINANCIAL STATUS OF TWIN LAKES AND AGREED OBJECTIVES OF THE COMMITTEE. CHARITABLE GIFTS AND GRANTS WILL BE DISBURSED FROM THE ANNUAL OPERATING BUDGET AND FROM SPECIAL RESERVE ACCOUNTS DESIGNATED FOR THIS PURPOSE. THE APPROVED GIFT AMOUNT CAN BE CHANGED AT ANY TIME WITH COMMITTEE AND BOARD APPROVAL. X X X X 0 1 0 0 0 0 0 0 0 PAMELA S FOX PRESIDENT/CEO 238718 0 0 0 0 0 11735 0 15980 0 266433 0 0 0 BRENT CONKLIN CFO 163215 0 0 0 0 0 7999 0 14401 0 185615 0 0 0 PART I, LINE 4B PAMELA S. FOX, PRESIDENT/CEO - 457(B) DEFERRED COMPENSATION PLAN CONTRIBUTION FOR THE YEAR WAS $20,500. THIS CONTRIBUTION IS ACCRUED BY THE ORGANIZATION AND IS NOT INCLUDED IN TAXABLE COMPENSATION UNTIL RECEIVED. A NC MEDICAL CARE COMMISSION 521309402 2019-10-01 42860000 SEE DESCRIPTION ON SCHEDULE O 0 0 0 B NC MEDICAL CARE COMMISSION 521309402 2019-10-01 23025000 SEE DESCRIPTION ON SCHEDULE O 0 0 0 A 49221157 3702624 1088599 44429934 2021 0 0 1 1 B 3065000 23025000 92100 5768968 16700000 463932 1 0 1 1 A 0 0 0 1 0 0 0 1 0 B 0 0 0 1 1 0 0 1 0 A 0 B 0 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: NC MEDICAL CARE COMMISSION DATE THE REBATE COMPUTATION WAS PERFORMED: 12/31/2021 ISSUER NAME: NC MEDICAL CARE COMMISSION DATE THE REBATE COMPUTATION WAS PERFORMED: 12/31/2021 FORM 990, PART VI, SECTION A, LINE 7B ANY AMENDMENT TO THE BYLAWS MUST BE APPROVED BY THE MACEDONIA LUTHERAN CHURCH GOVERNING COUNCIL. THE MACEDONIA LUTHERAN CHURCH GOVERNING COUNCIL MUST ALSO APPROVE THE SLATE OF NEW MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 WAS REVIEWED IN DETAIL WITH THE AUDIT COMMITTEE OF OUR BOARD OF DIRECTORS PRIOR TO FILING. AFTER A DISCUSSION PERIOD AND A QUESTION AND ANSWER PERIOD, THE AUDIT COMMITTEE VOTED TO RECOMMEND TO THE FULL BOARD OF DIRECTORS THAT THE FORM 990 BE ACCEPTED AND FILED. A COPY OF THE ENTIRE FORM 990 WAS PROVIDED TO EACH MEMBER OF THE ENTIRE BOARD OF DIRECTORS WHO THEN VOTED TO ACCEPT THE RECOMMENDATION OF THE AUDIT COMMITTEE. FORM 990 WAS FILED AFTER A COPY WAS PROVIDED TO EACH BOARD MEMBER AND THE BOARD HAD APPROVED THE RECOMMENDATION OF THE AUDIT COMMITTEE. FORM 990, PART VI, SECTION B, LINE 12C LUTHERAN RETIREMENT MINISTRIES OF ALAMANCE COUNTY, NORTH CAROLINA HAS A CONFLICT OF INTEREST POLICY WHICH IS REVIEWED, ACCEPTED AND SIGNED BY EACH OFFICER AND VOTING BOARD MEMBER ON AN ANNUAL BASIS. PURSUANT TO THIS POLICY, EACH OFFICER AND BOARD MEMBER WILL DISCLOSE AND THEN EXCUSE THEMSELVES FROM ANY DISCUSSION AND VOTE FOR ANY MATTER FOR WHICH A CONFLICT EXISTS FOR THEMSELVES OR ANY FAMILY MEMBER. ACTUAL CONFLICTS ARE REVIEWED BY THE BOARD WITHOUT THE PRESENCE OF THE INTERESTED PARTY. FORM 990, PART VI, SECTION B, LINE 15 LUTHERAN RETIREMENT MINISTRIES OF ALAMANCE COUNTY, NORTH CAROLINA FOLLOWS THE PROCESS DESCRIBED IN TREASURY REGULATION 4958(6)(C) FOR ESTABLISHING THE REBUTTABLE PRESUMPTION OF REASONABLENESS IN THE REVIEW, APPROVAL, AND DOCUMENTATION OF OFFICER, KEY MANAGEMENT, AND DIRECTOR COMPENSATION. ON AN ANNUAL BASIS THE ENTIRE GOVERNING BOARD REVIEWS AND APPROVES THE ENTIRE COMPENSATION PACKAGE OF THE PRESIDENT/CHIEF EXECUTIVE OFFICER BASED ON COMPARABILITY FACTORS INCLUDING BUT NOT LIMITED TO THE SIZE OF THE ORGANIZATION, THE GEOGRAPHIC LOCATION OF THE ORGANIZATION, AND THE EMPLOYEE'S LENGTH OF SERVICE. THE EXECUTIVE COMMITTEE OF THE BOARD CONDUCTS AN ANNUAL PERFORMANCE REVIEW OF THE PRESIDENT/CHIEF EXECUTIVE OFFICER, REVIEWS THE COMPARABILITY DATA, AND MAKES A RECOMMENDATION TO THE FULL BOARD OF DIRECTORS WHO THEN APPROVE THE ENTIRE COMPENSATION PACKAGE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICES. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE ALSO AVAILABLE AT THE NC DEPARTMENT OF INSURANCE WEBSITE AND THE ORGANIZATION'S FORM 990 IS AVAILABLE ON THE GUIDESTAR WEBSITE. FORM 990, PART XI, LINE 9: CHANGE IN MARKET VALUE OF RATE SWAP AGREEMENT RELATED TO TAX-EXEMPT BONDS 2,243,151. PART XII, LINE 3A DURING FYE 9.30.21, LUTHERAN RETIREMENT MINISTRIES OF ALAMANCE COUNTY, NORTH CAROLINA RECEIVED AND EXPENSED FUNDS IN CONNECTION WITH THE COVID-19 PROVIDER RELIEF FUND AND AMERICAN RESCUE PLAN RURAL DISTRIBUTION FROM U.S. DEPARTMENT OF HEALTH AND HUMAN RESOURCES IN EXCESS OF THE DOLLAR THRESHOLD WHICH WOULD REQUIRE A SINGLE AUDIT. A SINGLE AUDIT WAS PERFORMED DURING FYE 9.30.22. THE AUDITOR'S REPORT, DATED NOVEMBER 22, 2022, EXPRESSED AN UNQUALIFIED OPINION ON THE EXPENDITURES OF FUNDS RECEIVED. FORM 990, PART 1, LINE 1 LUTHERAN RETIREMENT MINISTRIES OF ALAMANCE COUNTY THROUGH ITS CONTINUING CARE RETIREMENT COMMUNITY, TWIN LAKES COMMUNITY (LRM/TLC) PROVIDES COMPREHENSIVE SERVICES TO THE ELDERLY. PROGRAMS AND SERVICES PROVIDED INCLUDE (1) A SKILLED NURSING FACILITY; (2) A RESIDENTIAL MODEL ASSISTED LIVING FACILITY; (3) A MEMORY CARE FACILITY; (4) INDEPENDENT LIVING UNITS; (5) HOME CARE AGENCY; (6) REHABILITATIVE/THERAPY SERVICES; (7) AN ADULT DAY CARE CENTER; (8) A PARKINSON'S SUPPORT GROUP; (9) CARE GIVER SUPPORT AND EDUCATION CLASSES; (10) PROGRAMS/ACTIVITIES WITHIN THE SPECTRUM OF WELLNESS AND HEALTHY AGING; (11) COMMUNITY OUTREACH PROGRAMS; (12) STUDENT INTERNSHIPS AND EDUCATIONAL PRACTICUMS; (13) GRIEF SUPPORT SERVICES; AND (14) RELIGIOUS/SPIRITUAL SERVICES. LRM/TLC SERVES A DIVERSE POPULATION OF APPROXIMATELY 1,000 INDIVIDUALS A YEAR. LRM/TLC IS AN ACCREDITED FACILITY THROUGH THE COMMISSION FOR ACCREDITATION OF REHABILITATIVE FACILITIES (CARF-CCRC). DURING THE YEAR, ITS SKILLED NURSING FACILITY OBTAINED A "4 STAR" RATING THROUGH THE CMS SURVEY SYSTEM. LRM/TLC ACCEPTS MEDICAID PATIENTS AND PROVIDES FINANCIAL ASSISTANCE FOR PERSONS WHO WOULD NOT OTHERWISE QUALIFY FOR GOVERNMENTAL ASSISTANCE PROGRAMS. ITS COMMUNITY OUTREACH PROGRAMS SUPPORTED OVER 50 GOVERNMENTAL, EDUCATIONAL, RELIGIOUS, AND NON-PROFIT CHARITABLE ORGANIZATIONS DURING THE YEAR. LRM/TLC PROVIDES WITHOUT CHARGE THE ONLY PARKINSON'S SUPPORT GROUP IN ALAMANCE COUNTY AND CONSISTENTLY SERVES 60 INDIVIDUALS AND FAMILIES. SCHEDULE K, PART I, ROW A, COLUMN (F) TO PAY OR REIMBURSE THE CORPORATION FOR PAYING A PORTION OF THE COSTS OF THE PROJECT AND PAY CERTAIN EXPENSES INCURRED IN CONNECTION WITH THE ISSUANCE OF THE 2019A BONDS. SCHEDULE K, PART I, ROW A, COLUMN (F) TO REFUND A PORTION OF THE COMMISSION'S OUTSTANDING HEALTH CARE FACILITIES REVENUE AND REVENUE REFUNDING BONDS SERIES 2009 AND PAYING A PORTION OF THE COSTS OF THE PROJECT. MACEDONIA EVANGELICAL LUTHERAN CHURCH 421 WEST FRONT STREET BURLINGTON NC 27215 560594586 CHURCH NC 501(C)(3) 1 N/A 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0