2022-12-09T15:30:17-06:00 2021-12-31 410746749 CLIFTONLARSONALLEN LLP 227 WEST TRADE STREET SUITE 800 CHARLOTTE NC 28202 990 2021-01-01 560529956 MASONIC AND EASTERN STAR HOME OF NORTH CAROLINA INC MASO 3362990031 700 S HOLDEN ROAD GREENSBORO NC 27407 NIKKI STAFFORD DIRECTOR OF FINANCIAL SERVICES 3362990031 2022-12-06 1 NIKKI STAFFORD 999009999 JOHN NORMAN P01506766 7049985200 2022-12-06 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z WHITESTONE NIKKI STAFFORD 700 S HOLDEN ROAD GREENSBORO NC 27407 15654772 0 X WWW.LIVEATWHITESTONE.ORG X 1912 NC AS A RETIREMENT COMMUNITY LEADER SINCE 1912, MASONIC AND EASTERN STARHOME OF NC IS DEVOTED TO EXCELLENCE IN HOSPITALITY WITH TRADITIONALVALUES PROMOTING FRATERNAL SERVICE, DIGNITY, DEPENDABILITY, ANDCHOICE. 20 20 326 30 0 0 3629654 3562571 15732194 11824370 234639 240595 2792 27236 19599279 15654772 0 0 0 0 9020350 7779124 0 0 37165 8932324 8753675 17952674 16532799 1646605 -878027 136954901 138321577 120875314 121081639 16079587 17239938 AS A RETIREMENT COMMUNITY LEADER SINCE 1912, MASONIC AND EASTERN STARHOME OF NC IS DEVOTED TO EXCELLENCE IN HOSPITALITY WITH TRADITIONALVALUES PROMOTING FRATERNAL SERVICE, DIGNITY, DEPENDABILITY, ANDCHOICE. 0 0 9677581 11824370 MASONIC AND EASTERN STAR HOME OF NC PROVIDES RESIDENTIAL, HEALTH CARE, AND OTHER RELATED SERVICES TO ELDERLY RESIDENTS. THE HOME OFFERS INDEPENDENT LIVNG, ASSISTED LIVING, AND SKILLED NURSING SERVICES. 9677581 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 45 0 326 1 0 0 0 0 0 0 0 0 0 0 0 0 X 20 20 0 1 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X NIKKI STAFFORD 3365104809 700 S HOLDEN ROAD GREENSBORO NC 27407 GENE JERNIGAN CHAIRMAN 1.00 X X 0 0 0 KAVAN FRAZIER DIRECTOR 1.00 X 0 0 0 WAYNE SOUTHERN TREASURER 1.00 X X 0 0 0 MIKE UNDERWOOD SECRETARY 1.00 X X 0 0 0 RONALD HENSLEY DIRECTOR 1.00 X 0 0 0 MICHAEL FISCHER DIRECTOR 1.00 X 0 0 0 JON CANUPP DIRECTOR 1.00 X 0 0 0 JOEY TRANSOU DIRECTOR 1.00 X 0 0 0 TOMMY MILLS JR DIRECTOR 1.00 X 0 0 0 ELLEN BROOKS DIRECTOR 1.00 X 0 0 0 LINDA BURRIS DIRECTOR 1.00 X 0 0 0 BRYANT WEBSTER DIRECTOR 1.00 X 0 0 0 DAVID WICKER JR DIRECTOR 1.00 X 0 0 0 LINDA HYATT DIRECTOR 1.00 X 0 0 0 ALLEN HUGHES DIRECTOR 1.00 X 0 0 0 DAVID GRIFFITH DIRECTOR 1.00 X 0 0 0 LOUISE TAYLOR DIRECTOR 1.00 X 0 0 0 JAMES WOOLARD DIRECTOR 1.00 X 0 0 0 LARRY THOMPSON JR DIRECTOR 1.00 X 0 0 0 JERRY RANDY BROWNING III DIRECTOR 1.00 X 0 0 0 MARK LEWIS EXECUTIVE DIRECTOR 40.00 X 0 0 0 PIERCE CAREY HEALTH CENTER ADMINISTRATO 40.00 X 0 0 0 PAMELA NIKKI STAFFORD DIRECTOR OF FINANCIAL SERV 40.00 X 112463 0 0 RUZICA CVIJANOVIC NURSE 40.00 X 114190 0 0 MARIE DUNN DIRECTOR OF MARKETING 40.00 X 108375 0 0 335028 0 0 3 0 0 0 LIFE CARE COMPANIES LLC 400 LOCUST STREET SUITE 820 DES MOINES IA 50309 MANAGEMENT SERVICES 1313238 MAKO MEDICAL LABORATORIES 8461 GARVEY DRIVE RALEIGH NC 27616 COVID TESTING 422625 HEALTHPRO HERITAGE PO BOX 69268 BALTIMORE MD 21264 THERAPY 373105 ECS CAROLINA'S LLP 14026 THUNDERBOLT PLACE SUITE 500 CHANTILLY VA 20151 ENGINEERING 143173 4 1688329 1853592 20650 3562571 RESIDENT SERVICES AND HEALTH CARE 623000 11824370 11824370 11824370 240595 240595 OTHER INCOME 623000 27236 27236 27236 15654772 11824370 0 267831 6597519 4899809 1676279 21431 81098 60230 20605 263 441551 327929 112188 1434 658956 489390 167426 2140 514753 514753 35908 7159 28465 284 40725 8119 32284 322 471501 94000 373772 3729 629741 629741 27345 5452 21677 216 1033262 619957 413305 1725061 1035037 690024 241901 241901 VARIOUS SUPPLIES & ACTI 972716 437722 534994 OTHER ADMINISTRATIVE EX 844461 100790 736325 7346 FOOD SUPPLIES & SERVICE 745705 559279 186426 MEDICAL SUPPLIES & SERV 740783 740783 729813 291925 437888 16532799 9677581 6818053 37165 3908034 2985338 76851496 54550612 1009959 866083 69567 60238 237890 264818 83682861 26144589 37527239 57538272 15924919 17969973 4097253 4368958 -2745168 -398932 73712 116217 136954901 138321577 3802598 5664234 12116837 12159909 97657457 97372398 7298422 5885098 120875314 121081639 X 10768753 11483414 5310834 5756524 16079587 17239938 136954901 138321577 X -878027 1766673 271705 X 0 1 X 1 0 X 2250218 1489837 1555079 3629654 3562571 12487359 2250218 1489837 1555079 3629654 3562571 12487359 12487359 234794 245919 250758 234639 240595 1206705 8309 14939 22434 2792 27236 75710 13769774 78298320 0.90690 0.89070 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4551728 380740 73173 4859295 3316368 862918 372442 4551728 3316368 3316368 3316368 3316368 3316368 3316368 0.77880 0.22120 0 0 1045442 1045442 49866356 22960030 26906326 469580 -469580 3346366 2576299 770067 29424697 138680 29286017 57538272 REFUNDABLE ADVANCE FEES 4316517 DEPOSITS ON UNOCCUPIED UNITS 1208230 RESIDENT TRUST FUNDS 320351 LONG TERM ACCOUNTS PAYABLE 40000 5885098 X 15480787 84390 84390 15396397 258375 258375 15654772 16532799 0 16532799 0 16532799 PART V, LINE 4: THE HOME'S ENDOWMENTS CONSIST OF A BOARD DESIGNATED OPERATING RESERVE FUND AND DONOR-RESTRICTED ENDOWMENT FUNDS TO PROVIDE BENEVOLENT CARE TO RESIDENTS IN NEED. PART X, LINE 2: IT IS THE HOME'S POLICY TO EVALUATE ALL TAX POSITIONS TO IDENTIFY ANY THAT MAY BE CONSIDERED UNCERTAIN. ALL IDENTIFIED MATERIAL TAX POSITIONS ARE ASSESSED AND MEASURED BY A "MORE-LIKELY-THAN-NOT" THRESHOLD TO DETERMINE IF THE TAX POSITION IS UNCERTAIN AND WHAT, IF ANY, THE EFFECT OF THE UNCERTAIN TAX POSITION MAY HAVE ON THE FINANCIAL STATEMENTS. NO MATERIAL UNCERTAIN TAX POSITIONS WERE IDENTIFIED DURING 2020. PART XI, LINE 2D - OTHER ADJUSTMENTS: RELEASE FROM RESTRICTION 84,390. PART XI, LINE 4B - OTHER ADJUSTMENTS: RESTRICTED CONTRIBUTIONS 20,650. RESTRICTED INVESTMENT INCOME 237,725. X 0 0 0 0 0 0 0 0 0 A PUBLIC FINANCE AUTHORITY 273866124 74444VAD2 2017-11-28 25023276 REFUND 2011A BONDS 0 0 0 B PUBLIC FINANCE AUTHORITY 273866124 74444VAW0 2020-09-10 76438581 EXPANSION OF FACILITIES, DEBT SERVICE, PAY INTEREST AND ISSUANCE COSTS 0 0 0 A 2623276 25023276 24520225 500465 2586 2012 1 0 0 1 B 76438581 5432436 1528767 69477378 1502538 1 0 0 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 1 A 0 0 0 0 1 0 0 0 0 B 0 1 0 0 0 0 0 0 1 A 0 B 1 FORM 990, PART VI, SECTION A, LINE 3 THE BOARD OF DIRECTORS HAS CONTRACTED WITH LIFE CARE SERVICES, LLC. TO MANAGE, OPERATE AND MAINTAIN THE RETIREMENT COMMUNITY. THE EXECUTIVE DIRECTOR, MARK LEWIS, IS AN EMPLOYEE OF LIFE CARE SERVICES, LLC. FORM 990, PART VI, SECTION A, LINE 7A THE GRAND MASTER APPOINTS THREE BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B THE EXECUTIVE DIRECTOR AND DIRECTOR OF FINANCIAL SERVICES REVIEW THE FORM 990 WITH THE TAX PREPARER AND PROVIDE A COPY TO THE BOARD PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ANNUAL MONITORING OF CONFLICT OF INTEREST IS PART OF THE DUTIES OF THE CORPORATE COMPLIANCE COMMITTEE. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR CEO, CURRENT OFFICERS, ETC. IS REVIEWED AS A PART OF ANNUAL BUDGET BY THE BOARD OF DIRECTORS, FINANCE COMMITTEE AND PERSONNEL COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND POLICIES ARE AVAILABLE UPON REQUEST. THE AUDITED FINANCIALS ARE INCLUDED IN ANNUAL DISCLOSURE AS REQUIRED BY DEPARTMENT OF INSURANCE. FORM 990, PART XI, LINE 9: CHANGE IN THE VALUE OF SPLIT-INTEREST AGREEMENTS 271,705. GRAND LODGE OF THE AF AND AM OF NC PO BOX 6506 RALEIGH NC 27628 560228750 PROVIDE SUPPORT FOR NC MASONS NC 501(C)(8) & (C)(10) 0 GRAND CHAPTER OF THE ORDER OF THE EASTERN STAR OF NC PO BOX 4730 WILMINGTON NC 28406 560239941 CHARITABLE, EDUCATIONAL AND FRATERNAL NC 501(C)(8) & (C)(10) 0 NC MASONIC FOUNDATION INC PO BOX 6506 RALEIGH NC 27628 566049500 RECEIVE DONATIONS AND NC 501(C)(3) LINE 12B, II 0 NC EASTERN STAR FOUNDATION INC PO BOX 2296 GARNER NC 27529 561974972 INVEST FUNDS RAISED TO NC 501(C)(3) PF 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 GRAND CHAPTER OF THE EASTERN STAR OF NORTH CAROLINA C 376546 NORTH CAROLINA MASONIC FOUNDATION C 295024 MESH FOUNDATION LLC C 804099 OTHER MASONIC BODIES C 113055