2020-09-11T15:14:21-05:00 2019-12-31 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2019-01-01 561152263 ARBOR ACRES UNITED METHODIST RETIREMENT COMMUNITY INC ARBO 3367247921 1240 ARBOR ROAD WINSTONSALEM NC 271041197 DAVID W MATTHEWS VICE PRESIDENT/CFO 3367247921 2020-09-11 1 AMY BIBBY P00445891 8282542254 2020-09-11 99.47.28.203 2020-09-11 10:30:13 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 48FB394F9AA065459641371F168D9F2AFFFBB473 2019 2021-01-29 14:40:06Z ANDREW APPLEGATE 1240 ARBOR ROAD WINSTONSALEM NC 271041197 40755194 0 X WWW.ARBORACRES.ORG X 1975 NC TO SERVE SENIOR ADULTS WHILE PROVIDING SECURITY, CONTENTMENT, AND LIFE WITH MEANING & PURPOSE. 28 28 544 75 0 0 2599702 2586822 33497918 34486391 55996 2774314 90133 134748 36243749 39982275 1516450 1761749 0 0 16214669 17279903 0 0 298507 16776844 17360775 34507963 36402427 1735786 3579848 129937686 136351629 79185603 81676920 50752083 54674709 X ARBOR ACRES, AN AFFILIATE MINISTRY OF THE UNITED METHODIST CHURCH, SERVES SENIOR ADULTS THROUGH FACILITIES AND PROGRAMS THAT ENHANCE OPPORTUNITY FOR SECURITY, CONTENTMENT AND LIFE WITH MEANING AND PURPOSE. 0 0 23961685 1761749 34522391 ARBOR ACRES, A CONTINUING CARE RETIREMENT COMMUNITY (CCRC), PROVIDING A CONTINUUM OF INDEPENDENT LIVING FACILITIES WHICH INCLUDE FOUR MID-RISE RESIDENTIAL WINGS CONTAINING 124 UNITS (STUDIO, EFFICIENCY AND CONNECTING ROOM SUITES); 2 TWO-BEDROOM COURTYARD APARTMENTS; 6 ONE-BEDROOM AND 6 TWO-BEDROOM CLUSTER HOMES AND 128 HOUSES. IN ADDITION TO THE INDEPENDENT LIVING FACILITIES, ARBOR ACRES ALSO HAS 102 ADULT CARE HOME BEDS AND 83 NURSING CARE BEDS (LOCATED IN THE FITZGERALD HEALTH CENTER). AS OF DECEMBER 31, 2019, ARBOR ACRES SERVED 508 RESIDENTS IN THE ABOVE UNITS.ARBOR ACRES HOLDS MEMBERSHIPS WITH LEADING AGE (FORMERLY THE AMERICAN ASSOCIATION OF HOMES AND SERVICES FOR THE AGING) AND LEADING AGE NC (FORMERLY THE NORTH CAROLINA ASSOCIATION OF NON-PROFIT HOMES FOR THE AGING). THE FACILITY IS ACCREDITED THROUGH THE CONTINUING CARE ACCREDITATION COMMISSION.AN IMPORTANT COMPONENT OF FULFILLING ARBOR ACRES' MISSION IS THE PROVISION OF FINANCIAL ASSISTANCE SUPPORT TO ENABLE RESIDENTS TO RESIDE AT ARBOR ACRES WHO WOULD OTHERWISE BE UNABLE TO AFFORD TO DO SO. FOR THE YEAR ENDING DECEMBER 31, 2019, $1,761,749 OF FINANCIAL ASSISTANCE WAS PROVIDED TO RESIDENTS TO HELP THEM MAINTAIN RESIDENCY AT THE FACILITY.DURING 2019 THE FOLLOWING SPECIFIC ACCOMPLISHMENTS ENHANCED THE ABILITY TO SERVE RESIDENTS:1. MAINTAINED NEAR FULL OCCUPANCY OF ASSISTED LIVING, MEMORY CARE AND SKILLED NURSING LEVELS OF LICENSED CARE AND EXCEEDED 90% OCCUPANCY OF INDEPENDENT LIVING UNITS.2. SPONSORED AND FACILITATED PARTICIPATION OF RESIDENT EFFORTS IN COMMUNITY SERVICE PROJECTS TO INCLUDE CROSSNORE SCHOOL & CHILDREN'S HOME, SENIOR SERVICES PROGRAMS, RONALD MCDONALD HOUSE LUMINARIES, TUTORING STUDENTS AT COOK ELEMENTARY SCHOOL, BACK TO SCHOOL SUPPLIES PROGRAM FOR COOK ELEMENTARY SCHOOL, ALZHEIMER ASSOCIATION-WESTERN CAROLINA CHAPTER, AND SOLES FOR SOULS SHOE DRIVE, ETC. 23961685 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 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 1 92 0 1 544 1 0 0 0 0 0 0 0 0 0 0 0 0 X 28 28 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X DAVID W MATTHEWS VICE PRESIDENTCFO 3367247921 1240 ARBOR ROAD WINSTONSALEM NC 27104 SUSAN A SCHWARTZ BOARD CHAIR 1.00 X X 0 0 0 PAMELA BALL CHAIR ELECT 1.00 X X 0 0 0 VICTORIA HUNT VICE CHAIR 1.00 X X 0 0 0 KATHY NELSON VICE CHAIR 1.00 X X 0 0 0 PAUL WILES TREASURER 1.00 X X 0 0 0 DANNY NEWCOMB TREASURER 1.00 X X 0 0 0 FLORENCE CORPENING SECRETARY 1.00 X X 0 0 0 WELBORN ALEXANDER BOARD MEMBER 1.00 X 0 0 0 MARSHA BLEDSOE BOARD MEMBER 1.00 X 0 0 0 ART BLOOM BOARD MEMBER 1.00 X 0 0 0 DR DUDLEY CHANDLER BOARD MEMBER 1.00 X 0 0 0 COURTNEY DOUGLAS BOARD MEMBER 1.00 X 0 0 0 MARIAN DOUGLAS BOARD MEMBER 1.00 X 0 0 0 MARK DUNNAGAN BOARD MEMBER 1.00 X 0 0 0 SUSAN ELSTER BOARD MEMBER 1.00 X 0 0 0 SCOTT GERDING BOARD MEMBER 1.00 X 0 0 0 CINDY S GRAHAM BOARD MEMBER 1.00 X 0 0 0 DAVID HINTON BOARD MEMBER 1.00 X 0 0 0 KAY JOHNSON BOARD MEMBER 1.00 X 0 0 0 KAYE LAMBERT BOARD MEMBER 1.00 X 0 0 0 J WILLIAM MCGUINN JR BOARD MEMBER 1.00 X 0 0 0 DREWERY NOSTITZ BOARD MEMBER 1.00 X 0 0 0 STEVEN REEDER BOARD MEMBER 1.00 X 0 0 0 JAMES RUFFIN BOARD MEMBER 1.00 X 0 0 0 WILLIAM SAYERS BOARD MEMBER 1.00 X 0 0 0 RICHARD SPANGLER BOARD MEMBER 1.00 X 0 0 0 J HILL STOCKTON BOARD MEMBER 1.00 X 0 0 0 WENDY WALKER-FOX BOARD MEMBER 1.00 X 0 0 0 JOHN WILLINGHAM BOARD MEMBER 1.00 X 0 0 0 MIKE BAILEY BOARD MEMBER-EX OFFICIO 1.00 X 0 0 0 DALE DEK DRISCOLL BOARD MEMBER-EX OFFICIO 1.00 X 0 0 0 MARGARET HAYDEN BOARD MEMBER-EX OFFICIO 2.00 X 0 0 0 HAMPTON LEFLER BOARD MEMBER-EX OFFICIO 1.00 X 0 0 0 BISHOP PAUL LELAND BOARD MEMBER-EX OFFICIO 1.00 X 0 0 0 ANDREW APPLEGATE CEO 40.00 X 288668 0 39765 DAVID MATTHEWS CFO 40.00 X 154690 0 22037 KENNETH BOYLES COO 40.00 X 201982 0 29099 KATHY GWYN VP HEALTH SERVICES 40.00 X 168246 0 27040 JULIE SENNEMA SECRETARY 40.00 X 49197 0 4169 LYNN A ROSS DIRECTOR OF MARKETING 40.00 X 113386 0 17970 AMANDA CLEARY NURSE MANAGER 40.00 X 110033 0 6493 LES CRANFILL DIRECTOR OF BUILDINGS AND 40.00 X 118947 0 13872 NANCY PEEBLES DEVELOPMENT DIRECTOR 40.00 X 111481 0 13830 KEVIN CLINKENBEARD DIRECTOR OF FACILITIES 40.00 X 117631 0 10234 1434261 0 184509 9 0 1 0 US FOOD SERVICE 125 FORT MILL PKWY FORT MILL SC 29715 FOOD SERVICES 1356585 BWHAWKINS BUILDERS 3614 N LAKESHORE DRIVE CLEMMONS NC 27012 CONSTRUCTION 967992 MILLER BUILDING & REMODELING LLC 550 BEAUCHAMP RD ADVANCE NC 27006 CONSTRUCTION 929724 ICON BUILDERS LLC 2655 FOREST DR WINSTONSALEM NC 27104 CONSTRUCTION 881143 LANDMARK BUILDERS OF THE TRIAD 3250 TRIAD CT WINSTONSALEM NC 27107 CONSTRUCTION 751535 24 2586822 2586822 RESIDENT FEES 623000 28545484 28545484 DEFERRED ENTRANCE FEES 623000 5499126 5499126 HOME CARE FEES 623000 366428 366428 MODIFICATION FEES EARNED 623000 49153 49153 APPLICATION FEES 623000 26200 26200 34486391 879976 879976 2625826 0 731488 2625826 -731488 1894338 1894338 41944 41431 513 513 FOOD SERVICE REVENUE 900099 99111 99111 GUEST ROOM RENTAL 900099 35124 35124 134235 39982275 34486391 0 2909062 1761749 1761749 984893 213771 771122 93484 93484 12423333 11254293 991627 177413 3778193 3227962 501570 48661 172670 172670 108744 108744 1590112 1559536 30576 180265 180265 2690307 2244229 375306 70772 87557 87557 1799780 1603245 196535 16203 13404 2636 163 1712 1712 1456872 1456872 7240308 7240308 284974 284974 FOOD COST 1392272 1392272 MEDICAL SUPPLIES 268449 268449 LOSS ON DEBT 42191 42191 MISCELLANEOUS 21556 17565 2493 1498 6803 1 6802 36402427 23961685 12142235 298507 3018911 2686310 578437 590090 267642 30905 340821 638525 317333 376378 158638430 69363098 90954414 89275332 33656828 40586627 1344661 684237 703738 119063 119063 129937686 136351629 2032131 2311706 31969529 33006098 44567000 35487000 8335907 616943 2536209 79185603 81676920 X 41284674 43123840 9467409 11550869 50752083 54674709 129937686 136351629 X 3579848 2112076 -1769298 X X 0 1 X 1 0 X 2524789 2057346 1561245 4116152 2586876 12846408 26761749 28914297 30364789 31981468 32760642 150782945 154839 153946 164890 134070 176179 783924 29441377 31125589 32090924 36231690 35523697 164413277 625373 536466 525323 558777 688710 2934649 0 625373 536466 525323 558777 688710 2934649 161478628 689978 755458 752995 890455 879976 3968862 689978 755458 752995 890455 879976 3968862 30131355 31881047 32843919 37122145 36403673 168382139 0.95900 0.95710 0.02360 0.02310 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 14410233 129350 2275202 604580 16210205 15367393 299878 -612038 645000 14410233 14074117 102479 1790797 600000 15367393 13719172 149629 797317 592001 14074117 13889622 455424 -59169 566705 13719172 0.39160 0.60840 0 0 2166825 2166825 132808489 56794772 76013717 10090000 6749144 3340856 13573116 5819182 7753934 89275332 REFUNDABLE DEPOSITS 54360 INTEREST RATE SWAP LIABILITY 2481849 2536209 X 38500821 2112076 80588 2192664 36308157 3674118 3674118 39982275 34578195 41431 41431 34536764 1865663 1865663 36402427 PART V, LINE 4: ARBOR ACRES CURRENTLY MAINTAINS A FINANCIAL ASSISTANCE PROGRAM AND POLICY FOR RESIDENTS HOLDING CONTINUING CARE RESIDENCY AGREEMENTS IN THE EVENT THE RESIDENT(S) SHOULD BECOME UNABLE TO PAY FOR SERVICES. THERE IS A DESIGNATED ASSISTANCE ENDOWMENT OF $6,348,200 WITHOUT DONOR RESTRICTIONS AND A ASSISTANCE ENDOWMENT OF $9,862,006 WITH DONOR RESTRICTIONS. PART X, LINE 2: ARBOR ACRES IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. HOME CARE IS A LIMITED LIABILITY COMPANY THAT HAS NOT ELECTED TO BE TAXED AS A CORPORATION UNDER CURRENT INTERNAL REVENUE CODE (IRC) REGULATIONS. HOME CARE IS WHOLLY OWNED BY ARBOR ACRES. AS SUCH, HOME CARE IS CONSIDERED A DISREGARDED ENTITY UNDER CURRENT IRC REGULATIONS. BASED ON THE INFORMATION ABOVE, THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION OR LIABILITY FOR FEDERAL AND STATE INCOME TAXES. THE COMPANY HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF DECEMBER 31, 2019. PART XI, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD 41,431. CHANGE IN VALUE OF PERPETUAL TRUST 143,071. REVENUES IN EXPENSES -103,914. PART XI, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN INTEREST RATE SWAP 1,912,369. GRANTS TO INDIVIDUALS 1,761,749. PART XII, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD 41,431. PART XII, LINE 4B - OTHER ADJUSTMENTS: REVENUES IN EXPENSES 103,914. GRANTS TO INDIVIDUALS 1,761,749. 1 FINANCIAL ASSISTANCE PROVIDED TO RESIDENTS 26 1761749 FMV FINANCIAL ASSISTANCE TO RESIDENTS PART I, LINE 2: THE ORGANIZATION PROVIDES FINANCIAL ASSISTANCE TO RESIDENTS UNABLE TO PAY FOR SERVICES. THE ORGANIZATION KEEPS A RECORD OF HOW IT DETERMINES A RESIDENTS FINANCIAL NEED AND THE AMOUNT OF ASSISTANCE PROVIDED. X X X X X 0 0 0 0 0 0 0 0 0 ANDREW APPLEGATE CEO 254278 0 22733 0 11657 0 17483 0 22282 0 328433 0 0 0 DAVID MATTHEWS CFO 146815 0 7875 0 0 0 9483 0 12554 0 176727 0 0 0 KENNETH BOYLES COO 188338 0 10557 0 3087 0 12373 0 16726 0 231081 0 0 0 KATHY GWYN VP HEALTH SERVICES 147981 0 13441 0 6824 0 10314 0 16726 0 195286 0 0 0 PART I, LINE 3 IN 2019, THE ORGANIZATION ENGAGED A COMPENSATION CONSULTANT. THE RESULTS OF SUCH WERE NOT REFLECTED IN THE 2019 COMPENSATION, BUT WILL AFFECT THE 2020 COMPENSATION. A NORTH CAROLINA MEDICAL CARE COMMISSION 531309402 2016-12-15 13159000 REFUND SERIES 2007 ISSUE 0 0 0 B NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 2019-08-01 24900000 REFUND SERIES 2010 ISSUE 0 0 0 A 3056000 13159000 13159000 2016 0 0 1 1 B 24900000 24900000 2019 0 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 1 0 0 1 1 BB&T 16.000000000000 0 0 0 0 1 B 0 1 0 0 1 1 BB&T 19.000000000000 0 0 0 0 1 A 0 KIMBERLY SNOW FAMILY RELATIONSHIP WITH AN OFFICER 93484 COMPENSATION 0 FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION PROVIDES A COMPLETE COPY OF THE 990 TO THE BOARD OF DIRECTORS' FINANCE COMMITTEE, PRIOR TO FILING. AFTER REVIEW AND APPROVAL BY THE FINANCE COMMITTEE THE 990 IS MADE AVAILABLE TO ALL BOARD MEMBERS PRIOR TO FILING. ONCE ACCEPTED BY THE BOARD OF DIRECTORS THE 990 IS FILED BY MANAGEMENT. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR, ALL BOARD MEMBERS ARE REQUIRED TO SIGN A CERTIFICATION THAT THEY HAVE READ AND UNDERSTAND OUR POLICY. THEY ARE ALSO REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICTS OR RELATIONSHIPS. THESE CERTIFICATIONS ARE KEPT ON FILE AND ARE REVIEWED ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 THE CEO'S COMPENSATION IS REVIEWED BY THE BOARD OF DIRECTORS' COMPENSATION COMMITTEE ANNUALLY. SPECIFIC SALARY INFORMATION AVAILABLE FOR COMPARABLE FACILTIES WILL BE UTILIZED IN EVALUATING THE CEO'S COMPENSATION. WHEN EVALUATING SURVEY AND LOCAL COMMUNITY'S DATA, SIZE OF COMMUNITY AND ANNUAL REVENUES WILL BE UTLIZED AS THE PRIMARY BENCHMARKS. DURING 2019 THE ORGANIZATION ENGAGED A COMPENSATION CONSULTANT TO ASSIST IN EVALUATING COMPENSATION. THE CEO, WORKING WITH THE DIRECTOR OF TALENT ARTS, WILL RECOMMEND COMPENSATION FOR OTHER OFFICERS AND KEY EMPLOYEES TO THE COMPENSATION COMMITTEE, SEEKING THEIR APPROVAL BEFORE IMPLEMENTING ANY CHANGES. THE SAME SOURCES OF DATA USED TO EVALUATE THE CEO'S COMPENSATION IS USED FOR OTHER OFFICERS AND KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION'S FORM 990 IS MADE AVAILABLE TO THE PUBLIC UPON REQUEST. ADDITIONALLY, RECENT FILINGS OF THE FORM CAN BE FOUND ON WWW.GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE UPON REQUEST. ANNUAL FINANCIAL STATEMENTS ARE PART OF THE ANNUAL DISCLOSURE STATEMENT MADE AVAILABLE THROUGH THE NC DEPARTMENT OF INSURANCE WEBSITE. THE ANNUAL AUDIT IS DISTRIBUTED TO RESIDENT COUNCIL AND MADE AVAILABLE TO ANY RESIDENT UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST RATE SWAP -1,912,369. CHANGE IN VALUE OF PERPETUAL TRUST 143,071. PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. ARBOR ACRES HOME CARE LLC 1240 ARBOR ROAD WINSTONSALEM NC 27104 832830530 IN HOME CARE SERVICES NC 366428 336157 ARBOR ACRES UNITED METHODIST RETIREMENT COMMUNITY INC