FURP.ORG / PUBLIC DATA EXPLORER

PENICK VILLAGE INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
PENICK VILLAGE INC (EIN 56-0729010)
Tax period
2017-10-01 to 2018-09-30
Filed
2019-08-14
IRS object ID
201902269349302215
Schema version
2017v2.3
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2019-08-14T15:21:52-05:00ReturnTs
Tax Period End2018-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1227 WEST TRADE STREET SUITE 800AddressLine1Txt
CityCHARLOTTECityNm
State AbbreviationNCStateAbbreviationCd
ZIP28202ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN560729010EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PENICK VILLAGE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPENIBusinessNameControlTxt
Phone9106920300PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1500 EAST RHODE ISLAND AVENUEAddressLine1Txt
CitySOUTHERN PINESCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28387ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJEFFREY I HUTCHINSPersonNm
Person TitleCEOPersonTitleTxt
Phone9106920300PhoneNum
Signature2019-08-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJOHN NORMANPreparerPersonNm
PTINP01506766PTIN
Phone7049985200PhoneNum
Preparation2019-08-12PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address67.137.57.251IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-08-12IPDt
IP Tm13:30:55IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdE6B36A5AA947C5ABCF14DB2FEAA03B911CABFB79AtSubmissionCreationDeviceId
At Submission Filing Device IdADD9B0FA008286EFA839A4825521FFB3520D5A5CAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJEFFREY I HUTCHINSPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1500 EAST RHODE ISLAND AVENUEAddressLine1Txt
CitySOUTHERN PINESCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28387ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$18,392,282GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PENICKVILLAGE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1957FormationYr
Legal Domicile StateNCLegalDomicileStateCd
Activity Or MissionWE ARE A FAMILY CREATING A LOVING COMMUNITY BY MAKING EACH DAY GREAT FOR ONE ANOTHER.ActivityOrMissionDesc
Voting Members Governing Body17VotingMembersGoverningBodyCnt
Voting Members Independent17VotingMembersIndependentCnt
Total Employee363TotalEmployeeCnt
Total Volunteers350TotalVolunteersCnt
Total Gross UBI$350,708TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$93,989NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$304,186PYContributionsGrantsAmt
CY Contributions Grants$871,432CYContributionsGrantsAmt
PY Program Service Revenue$16,197,265PYProgramServiceRevenueAmt
CY Program Service Revenue$16,982,904CYProgramServiceRevenueAmt
PY Investment Income$430,531PYInvestmentIncomeAmt
CY Investment Income$537,946CYInvestmentIncomeAmt
PY Other Revenue-$6,241PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$16,925,741PYTotalRevenueAmt
CY Total Revenue$18,392,282CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$8,325,105PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$8,850,531CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$7,958,253PYOtherExpensesAmt
CY Other Expenses$8,553,527CYOtherExpensesAmt
PY Total Expenses$16,283,358PYTotalExpensesAmt
CY Total Expenses$17,404,058CYTotalExpensesAmt
PY Revenues Less Expenses$642,383PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$988,224CYRevenuesLessExpensesAmt
Total Assets BOY$55,464,548TotalAssetsBOYAmt
Total Assets EOY$55,317,094TotalAssetsEOYAmt
Total Liabilities BOY$48,869,185TotalLiabilitiesBOYAmt
Total Liabilities EOY$47,544,742TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$6,595,363NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$7,772,352NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionPENICK VILLAGE'S MISSION IS TO BE A FAMILY THAT CREATES A LOVING COMMUNITY BY MAKING EVERY DAY GREAT FOR ONE ANOTHER THROUGH ITS UNCOMPROMISING COMMITMENT TO DEINSTITUTIONALIZING THE AGING EXPERIENCE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$10,693,169ExpenseAmt
Revenue$16,632,196RevenueAmt
DescPENICK VILLAGE PROVIDES HOUSING, SERVICES, AND LONG-TERM CARE TO OVER 200 RESIDENTS. THE SERVICES AND CARE ARE PROVIDED IN INDEPENDENT LIVING, ASSISTED LIVING, AND SKILLED NURSING AREAS. PENICK VILLAGE ALSO CONTRIBUTES TO THE GREATER SOUTHERN PINES COMMUNITY AND MOORE COUNTY IN WHICH IT IS LOCATED BY DONATING TIME AND RESOURCES TO, AMONG OTHERS, THE MOORE COUNTY CHAMBER OF COMMERCE, FIRSTHEALTH HOSPITAL, LEADINGAGE NC, EPISCOPAL DAY SCHOOL, RED CROSS, MEALS ON WHEELS OF THE SANDHILLS, FRIEND TO FRIEND, AND THE SOUTHERN PINES FIRE AND POLICE DEPARTMENTS. THE PENICK VILLAGE COMMUNITY ALSO PROVIDES FINANCIAL ASSISTANCE TO THOSE RESIDENTS IN NEED.NURSING IS KEY TO THE CONTINUUM OF CARE FOR THE RESIDENTS AT PENICK VILLAGE. SKILLED NURSING SERVICES ARE PROVIDED PER PHYSICIAN ORDERS THAT MAY INCLUDE BUT ARE NOT LIMITED TO ASSISTANCE WITH ACTIVITIES OF DAILY LIVING, MEDICATION ADMINISTRATION, PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY, SPECIALIZED DIETS AND OTHER NEEDS PER ORDERS. THE QUALITY NURSING IS KEY TO ACHIEVING THIS AND IN MAXIMIZING THE QUALITY OF LIFE FOR EACH OF THE RESIDENTS. THE CARE IS PERSONALIZED, AND A STRONG PARTNERSHIP IS DEVELOPED AMONG THE RESIDENT, HIS OR HER FAMILY, AND THE STAFF AT PENICK VILLAGE IN ORDER TO HAVE THE RESIDENT'S NEEDS DRIVE HIS OR HER PLAN OF CARE. PENICK VILLAGE ALSO OFFERS A BROAD RANGE OF IN-HOME SERVICES TO THOSE SENIORS THAT PREFER TO AGE IN HOME. PENICK TAILORS CARE PLANS INDIVIDUALLY, FOLOWING A FREE IN-HOME CONSULTATION AND ASSESSMENT. POTENTIAL HOME CARE SERVICES INCLUDE COMPANION/SITTER/RESPITE CARE (INCLUDING TRANSPORTATION, LIGHT HOUSEKEEPING, ERRANDS, PET CARE, DAILY CHECK-INS, AND MEDICATION REMINDERS), CARE MANAGEMENT TO ENSURE PROPER TREATMENT, AND POST HOSPITAL DISCHARGE FOLLOW UPS (INCLUDING MEDICARE/LONG-TERM CARE INSURANCE REVIEWS, HOME ORGANIZING/DOWNSIZING, SUPPORT THROUGH DIFFERENT LEVELS OF CARE, HOME SAFETY ASSESSMENTS/MODIFICATIONS, AND REFERRALS TO COMMUMINITY PARTNERS).INDIVIDUALS WHO MOVE INTO PENICK FOR ASSISTED LIVING ARE PROVIDED A UNIQUE SERVICE THAT HAS BEEN PURPOSEFULLY PLANNED TO FILL THEIR INDIVIDUAL NEEDS AND PREFERENCES AND DESIGNED TO SERVE THEM TO THE BEST OF OUR ABILITY. OUR NURSING STAFF MEETS WITH THE NEW RESIDENT AND FAMILY PRIOR TO MOVE IN TO FULLY UNDERSTAND EACH SITUATION AND DESIGN A PERSONALIZED PLAN. ASSISTED LIVING RESIDENTS ENJOY: - A SPACIOUS, PRIVATE APARTMENT- LICENSED CARE SEVEN DAYS A WEEK- DELICIOUS, NUTRITIOUS MEALS- A SAFE SETTING THAT PROMOTES INDEPENDENCE- MEDICATION ASSISTANCE AND/OR ADMINISTRATION AVAILABLE- CARING AND DEDICATED HEALTHCARE PROFESSIONALS- 24-HOUR EMERGENCY CALL SYSTEMS- A VIBRANT SOCIAL ATMOSPHERE- ACCESS TO ALL COMMUNITY AMENITIESDINING SERVICES IS ONE OF PENICK VILLAGE'S ESSENTIAL SERVICES. DINING SERVICES STRIVES TO PRIVIDE A WONDERFUL DINING EXPERIENCE IN ALL LEVELS OF CARE FOR THE RESIDENTS AND THEIR FAMILY AND FRIENDS. THERE ARE SEVERAL DINING OPPORTUNITIES ON THE CAMPUS, INCLUDING THE CAFE EXPERIENCE, A PRIVATE DINING ROOM, CATERING IN ONE'S APARTMENT OR COTTAGE, INDIVIDUALIZED MENUS AND MORE. DINING SERVICES IS COMMITTED TO PREPARING THE SAME QUALITY AND CHOICES OF FOOD ITEMS IN THE HEALTHCARE AREAS THAT ARE AVAILABLE TO INDEPENDENT RESIDENTS. DINING SERVICES ALSO PREPARES THE MEALS FOR MEALS ON WHEELS OF THE SANDHILLS ALONG WITH HOSTING EVENTS FOR OTHER SPECIAL COMMUNITY GROUPS SUCH AS THE KIWANIS. AS AN EMPLOYEE BENEFIT, THE STAFF ALSO ENJOYS WONDERFUL MEALS AT A GENEROUS DISCOUNT.PENICK VILLAGE IS ALSO VERY PROUD OF ITS HOUSEKEEPING SERVICES. HOUSEKEEPING PROVIDES GENERAL CLEANING SERVICES ALONG WITH LINEN SERVICES AS REQUESTED. THE HOUSEKEEPING TEAM BUILDS GREAT RELATIONSHIPS WITH THE RESIDENTS THEY ARE SERVING AND HAVE HELPED SIGNIFICANTLY IN TIMES OF NEED.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
DescHOME CARE: HOME CARE IS ANOTHER OF PENICK VILLAGE'S ESSENTIAL SERVICES. IT ALLOWS RESIDENTS TO AGE IN PLACE IN THEIR INDEPENDENT LIVING HOMES WHILE RECEIVING COMPANIONSHIP AND A PERSON TO HELP WITH DAILY ACTIVITIES SUCH AS PET WALKING, DRIVING TO DOCTOR APPOINTMENTS, SHOPPING AND ACCOMPANYING THEM TO MEALS WITHIN THE VILLAGE. THIS ALLOWS THE RESIDENT TO REMAIN AT HOME FOR A LONGER PERIOD OF TIME AND GIVES THEIR FAMILIES PEACE OF MIND WHEN THEY ARE NOT AVAILABLE TO PROVIDE THE SERVICES HOME CARE CAN PROVIDE FOR THE RESIDENT.LIFE ENRICHMENT: LIFE ENRICHMENT IS THE HUB FOR ACTIVIES FOR THE RESIDENTS OF ALL LEVELS OF CARE. THEY PROVIDE ACTIVIES FOR THE MIND, BODY AND SPIRIT OF THE RESIDENTS. SOME OF THE ACTIVITIES ARE CHAIR VOLLEYBALL, EXERCISE CLASSES, NUTRITIONAL CLASSES AND ONE ON ONE SESSIONS WITH THE REGISTERED DIETICIAN, CONCERTS, TRIPS TO PLAYS, NC SYMPHONY, MUSEUMS AND MUCH MORE. THEY PROVIDE SING-ALONGS, BINGO AND CRAFTS FOR THE SKILLED AND ASSISTED LIVING RESIDENTS AS WELL AS LOCAL OUTINGS. THEIR MISSION IS TO KEEP THE RESIDENTS ACTIVE, TO EXERCISE THEIR BODIES AND MINDS EQUALLY.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$10,693,169TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document99IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee363EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members17GoverningBodyVotingMembersCnt
Independent Voting Member17IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNCStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JEFFREY I HUTCHINSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9106920300PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1500 EAST RHODE ISLAND AVENUEAddressLine1Txt
CitySOUTHERN PINESCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28387ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
THE RT REV SAMUEL RODMAN
BOARD MEMBER1.00Yes (X)$0$0$0
THE RT REV ANNE HODGES-COPPLE
BOARD MEMBER1.00Yes (X)$0$0$0
THE RE DAVID BEAM
BOARD MEMBER1.00Yes (X)$0$0$0
BYRD GWINN
BOARD MEMBER1.00Yes (X)$0$0$0
RICHARD HIGGINBOTHAM
TREASURER1.00Yes (X)$0$0$0Yes (X)
RAY PARDUE
BOARD MEMBER1.00Yes (X)$0$0$0
KAY RHOADES
BOARD MEMBER1.00Yes (X)$0$0$0
DOUG GILL
BOARD MEMBER1.00Yes (X)$0$0$0
GARY KRASICKY
PRESIDENT1.00Yes (X)$0$0$0Yes (X)
MIKE PENICK
BOARD MEMBER1.00Yes (X)$0$0$0
RICK SMITH
BOARD MEMBER1.00Yes (X)$0$0$0
EDNA STEPHENS
BOARD MEMBER1.00Yes (X)$0$0$0
DARLENE VAUGHN
BOARD MEMBER1.00Yes (X)$0$0$0
JOHN FRIZZELL III
SECOND VICE PRESIDENT1.00Yes (X)$0$0$0Yes (X)
JIM GRAY
BOARD MEMBER1.00Yes (X)$0$0$0
LYNNE HEALY
FIRST VICE PRESIDENT1.00Yes (X)$0$0$0Yes (X)
STEVE LEGGETT
BOARD MEMBER1.00Yes (X)$0$0$0
JEFFREY I HUTCHINS
CHIEF EXECUTIVE OFFICER40.00$172,480$0$0Yes (X)
TERRY KEES
CHIEF FINANCIAL OFFICER40.00$212,332$0$0Yes (X)
CAROLINE HENDRICKS
CHIEF OPERATING OFFICER40.00$41,323$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$426,135TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
REHAB CARE
PO BOX 503534ST LOUISMO63150REHAB SERVICES$530,924
PINNACLE DEVELOPMENT DESIGN BUILD
PO BOX 55SOUTHERN PINESNC28388CONSTRUCTION CONTRACTOR$518,782
HOLLIDAY HEALTHCARE INC
2560 LANDMARK DRWINSTONSALEMNC27103PHARMACY AND MEDICAL SUPPLIES$121,575
BKD LLP
PO BOX 1190SPRINGFIELDMO658013RD PARTY MEDICARE BILLING$110,784
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K4CntrctRcvdGreaterThan100KCnt
All Other Contributions$871,432AllOtherContributionsAmt
Total Contributions$871,432TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
HEALTHCARE623000$7,389,339$7,389,339
INDEPENDENT LIVING623000$6,150,708$6,150,708
EARNED ENTRANCE FEES623000$2,626,775$2,626,775

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$816,082TotalRevenueColumnAmt
Related Or Exempt Func Income$465,374RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$350,708UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$16,982,904TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$265,962TotalRevenueColumnAmt
Exclusion$265,962ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$271,984SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$271,984SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$271,984TotalRevenueColumnAmt
Exclusion$271,984ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$18,392,282TotalRevenueColumnAmt
Related Or Exempt Func Income$16,632,196RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$350,708UnrelatedBusinessRevenueAmt
Exclusion$537,946ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$384,812TotalAmt
Management And General$384,812ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$6,548,567TotalAmt
Program Services$5,536,335ProgramServicesAmt
Management And General$1,012,232ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,411,455TotalAmt
Program Services$814,131ProgramServicesAmt
Management And General$597,324ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$505,697TotalAmt
Program Services$411,832ProgramServicesAmt
Management And General$93,865ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$97,764TotalAmt
Management And General$97,764ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,003,451TotalAmt
Program Services$524,213ProgramServicesAmt
Management And General$479,238ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$216,392TotalAmt
Program Services$3,216ProgramServicesAmt
Management And General$213,176ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$908,359TotalAmt
Program Services$606,827ProgramServicesAmt
Management And General$301,532ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$862,419TotalAmt
Program Services$793,400ProgramServicesAmt
Management And General$69,019ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$30,094TotalAmt
Program Services$10,525ProgramServicesAmt
Management And General$19,569ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$6,381TotalAmt
Management And General$6,381ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$983,775TotalAmt
Management And General$983,775ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,202,142TotalAmt
Management And General$2,202,142ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$24,155TotalAmt
Program Services$5,761ProgramServicesAmt
Management And General$18,394ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
OTHER PATIENT SERVICES$1,627,141$1,617,636$9,505
PHARMACEUTICALS$134,378$134,378
EMPLOYEE RECRUITMENT AN$116,071$44,033$72,038
MEDICAL SUPPLIES$107,761$107,761

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$233,244TotalAmt
Program Services$83,121ProgramServicesAmt
Management And General$150,123ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$17,404,058TotalAmt
Program Services$10,693,169ProgramServicesAmt
Management And General$6,710,889ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,200BOYAmt
EOY$1,200EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,485,337BOYAmt
EOY$2,193,937EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$921,049BOYAmt
EOY$1,196,963EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$600,441BOYAmt
EOY$148,201EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$58,272,372LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$16,578,504LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$42,144,667BOYAmt
EOY$41,693,868EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$8,943,760BOYAmt
EOY$9,720,509EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$368,094BOYAmt
EOY$362,416EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$55,464,548BOYAmt
EOY$55,317,094EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,238,890BOYAmt
EOY$1,255,987EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
EOY$15,136,594EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
EOY$14,983,691EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$23,929,157BOYAmt
EOY$7,882,873EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$23,701,138BOYAmt
EOY$8,285,597EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$48,869,185BOYAmt
EOY$47,544,742EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$5,735,274BOYAmt
EOY$6,891,270EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$530,682BOYAmt
EOY$551,675EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$329,407BOYAmt
EOY$329,407EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,595,363BOYAmt
EOY$7,772,352EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$55,464,548BOYAmt
EOY$55,317,094EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$988,224ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$112,822NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$75,943OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$234,500CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,060,236CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$240,170CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$304,186CurrentTaxYearMinus1YearAmt
Current Tax Year$871,432CurrentTaxYearAmt
Total$5,710,524TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,880,620CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$14,354,470CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$15,050,652CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$16,197,265CurrentTaxYearMinus1YearAmt
Current Tax Year$16,982,904CurrentTaxYearAmt
Total$76,465,911TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$14,115,120CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$18,414,706CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$15,290,822CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$16,501,451CurrentTaxYearMinus1YearAmt
Current Tax Year$17,854,336CurrentTaxYearAmt
Total$82,176,435TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$82,176,435PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$194,006CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$166,322CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$192,312CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$279,545CurrentTaxYearMinus1YearAmt
Current Tax Year$265,962CurrentTaxYearAmt
Total$1,098,147TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$194,006CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$166,322CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$192,312CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$279,545CurrentTaxYearMinus1YearAmt
Current Tax Year$265,962CurrentTaxYearAmt
Total$1,098,147TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$153,195CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$186,323CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$138,927CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$135,718CurrentTaxYearMinus1YearAmt
Total$614,163TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$14,462,321CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$18,767,351CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$15,622,061CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$16,916,714CurrentTaxYearMinus1YearAmt
Current Tax Year$18,120,298CurrentTaxYearAmt
Total$83,888,745TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.97960PublicSupportCY509Pct
Investment Income CY0.01310InvestmentIncomeCYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$678,542OtherCostOrOtherBasisAmt
Book Value$678,542BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$54,144,208OtherCostOrOtherBasisAmt
Depreciation$14,657,698DepreciationAmt
Book Value$39,486,510BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$188,362OtherCostOrOtherBasisAmt
Depreciation$83,393DepreciationAmt
Book Value$104,969BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,209,056OtherCostOrOtherBasisAmt
Depreciation$1,806,621DepreciationAmt
Book Value$402,435BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,052,204OtherCostOrOtherBasisAmt
Depreciation$30,792DepreciationAmt
Book Value$1,021,412BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$41,693,868TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
REFUND LIABILITY$7,157,111
APPLICATION AND PREPAID ADMISSION DEPOSITS$883,079
DUE TO AFFILIATE$245,407
FieldValueIRS element (for citing)
Total Liability$8,285,597TotalLiabilityAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JEFFREY I HUTCHINS
CHIEF EXECUTIVE OFFICER$172,480$0$0$0$0$0$0$0$0$0$172,480$0$0$0
TERRY KEES
CHIEF FINANCIAL OFFICER$212,332$0$0$0$0$0$0$0$0$0$212,332$0$0$0

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1NC MEDICAL CARE COMMISSIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN521309402BondIssuerEIN
Bond Issued2010-01-20BondIssuedDt
Issue Price$30,000,000IssuePriceAmt
PurposeNEW CONTRUCTIONPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$13,542,677RetiredAmt
Total Proceeds$28,031,368TotalProceedsAmt
Capitalized Interest$428,691CapitalizedInterestAmt
Issuance Costs From Proceeds$550,000IssuanceCostsFromProceedsAmt
Capital Expenditures$27,052,677CapitalExpendituresAmt
Substantial Completion2011SubstantialCompletionYr
Current Refunding0CurrentRefundingInd
Advance Refunding0AdvanceRefundingInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Private Bus Use By Others0.00000PrivateBusUseByOthersPct
Private Bus Concerning UBI0.00000PrivateBusConcerningUBIPct
Total Private Business Use0.00000TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate DueYes (1)NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And RecYes (1)HedgeIdentifiedInBksAndRecInd

Hedge Provider Name HedgeProviderName

FieldValueIRS element (for citing)
Business Name Line1BB&TBusinessNameLine1Txt
FieldValueIRS element (for citing)
Term Of Hedge6.750000000000TermOfHedgePct
Superintegrated Hedge0SuperintegratedHedgeInd
Hedge Terminated0HedgeTerminatedInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Written Proc To Monitor ReqsYes (1)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BFORM 990 IS REVIEWED BY THE ORGANIZATION'S OFFICERS, THEN SENT TO THE FINANCE COMMITTEE FOR REVIEW AND COMMENTS AND THEN PRESENTED TO THE FULL BOARD OF DIRECTORS. IT WILL BE REVIEWED BY THE OFFICERS AND FINANCE COMMITTEE MEMBERS BEFORE FILING WITH THE IRS AND WITH THE FULL BOARD IF THEY ARE SCHEDULED TO MEET BEFORE THE FILING DEADLINE. IF NOT IT WILL BE SENT TO THEM BEFORE THE FILING DEADLINE AND REVIEWED AT THE NEXT SCHEDULED MEETING.
FORM 990, PART VI, SECTION B, LINE 12CALL OFFICERS AND BOARD MEMBERS ARE REQUIRED TO RECEIVE, REVIEW AND SIGN A COPY OF THE CONFLICT OF INTEREST POLICY ANNUALLY AND DISCLOSE IF ANY CONFLICTS MIGHT ARISE IN THE COURSE OF CONDUCTING PENICK VILLAGE BUSINESS.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD OF DIRECTORS APPOINTED AN AD-HOC COMPENSATION REVIEW COMMITTEE TO DETERINE THE COMPENSATION FOR THE CEO OF THE ORGANIZATION. THIS REVIEW IS CONDUCTED ON AN ANNUAL BASIS AND USES DATA FROM OTHER ORGANIZATIONS AS WELL AS WAGE SURVEYS TO DETERMINE THE COMPENSATION. THE RESULTS ARE DOCUMENTED IN THE CEO'S PERSONNEL FILE IN HR. THE CEO CONDUCTS ANNUAL REVIEWS FOR THE CFO AND COO OF THE ORGANIZATION. BASED ON THOSE REVIEWS AND WAGE SURVEYS, THE CEO DETERMINES THE UPCOMING YEAR COMPENSATION FOR THESE KEY EMPLOYEES. THE EVALUATION AND ADVICE OF PAYROLL ARE DOCUMENTED IN THE PERSONNEL FILES IN HR
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT THE ADMINISTRATION OFFICES.
FORM 990, PART XI, LINE 9:CHANGE IN FAIR VALUE OF SPLIT-INTEREST AGREEMENT 75,948. ROUNDING ADJUSTMENT -5.
FORM 990, PART XII, LINE 2CNO CHANGE FROM PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1JA GREER GROUP LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1500 EAST RHODE ISLAND AVENUEAddressLine1Txt
CitySOUTHERN PINESCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28387ZIPCd
FieldValueIRS element (for citing)
EIN814456670EIN
Primary ActivitiesRENTALPrimaryActivitiesTxt
Legal Domicile StateNCLegalDomicileStateCd
Total Income$350,708TotalIncomeAmt
End Of Year Assets$3,810,467EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1PENICK VILLAGEBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1PENICK VILLAGE FOUNDATION INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1500 EAST RHODE ISLAND AVENUEAddressLine1Txt
CitySOUTHERN PINESCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28237ZIPCd
FieldValueIRS element (for citing)
EIN201055492EIN
Primary ActivitiesCHARITABLE FUNDRAISINGPrimaryActivitiesTxt
Legal Domicile StateNCLegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 10PublicCharityStatusTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1PENICK VILLAGE FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeATransactionTypeTxt
Involved$602,156InvolvedAmt
Method Of Amount DeterminationCASHMethodOfAmountDeterminationTxt