2019-02-13T12:37:55-06:00 2018-09-30 410746749 CLIFTONLARSONALLEN LLP 227 WEST TRADE STREET SUITE 800 CHARLOTTE NC 28202 990 2017-10-01 560562308 BAPTIST RETIREMENT HOMES OF NORTH CAROLINA INCORPORATED BAPT 3367250202 PO BOX 11024 WINSTON SALEM NC 27116 WILLIAM B STILLERMAN PRESIDENT 3367250202 2019-02-12 1 JOHN NORMAN P01506766 7049985200 2019-02-12 67.137.57.251 2019-02-12 11:17:27 ES P 967DCA4FABF3D6C7AE4D014617AEEE9CE601AE20 38F034F93386ECDDFAAD50F04D2486A1391B3254 2017 2019-02-21 02:37:17Z WILLIAM B STILLERMAN PO BOX 11024 WINSTON SALEM NC 27116 38490745 0 X WWW.BRH.ORG X 1952 NC TO PROVIDE QUALITY LIVING OPTIONS AND SERVICES TO NORTH CAROLINA'S OLDER ADULT POPULATION. 19 19 744 869 0 0 2321106 2440115 24528095 25539721 977556 1109529 538833 445964 28365590 29535329 527790 679337 0 0 13947955 14682411 0 0 188505 12286258 12461218 26762003 27822966 1603587 1712363 87226278 85847330 54097669 50996491 33128609 34850839 X THE ORGANIZATION IS A CHURCH RELATED NOT-FOR-PROFIT ORGANIZATION COMMITTED TO PROVIDING QUALITY CARE AND A MEANINGFUL WAY OF LIFE FOR RESIDENTS AND STAFF... A PLACE WHERE RESIDENTS AND STAFF BECOME AN EXTENSION OF FAMILY THAT RECOGNIZES THE DIGNITY AND WORTH OF EACH INDIVIDUAL. 0 0 23089300 679337 25961694 BAPTIST RETIREMENT HOMES OF NORTH CAROLINA, INCORPORATED ("HOMES) IS A NOT-FOR-PROFIT CORPORATION ORGANIZED UNDER THE LAWS OF THE STATE OF NORTH CAROLINA. IT IS EXEMPT FROM INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501[C][3] AND A PUBLIC CHARITY UNDER SECTION 509[A][2]. THE BOARD OF TRUSTEES OF HOMES HAS FIDUCIARY RESPONSIBILITY FOR THE OPERATION OF HOMES ORGANIZATION. THE MISSION OF THE HOMES IS TO PROVIDE QUALITY RESIDENTIAL AND HEALTH CARE LIVING OPTIONS AND SERVICES TO NORTH CAROLINA'S OLDER ADULT POPULATION. THE PROVISION OF THOSE SERVICES BEING OFFERED TO THE POOR ELDERLY OF THE STATE AS WELL AS THOSE OLDER PERSONS WHO DO HAVE THE FINANCIAL RESOURCES AVAILABLE TO PAY FOR THE INSTITUTIONAL SERVICES THEY NEED. IN ADDITION TO ITS PROGRAM OF BENEVOLENT FUNDING TO THE POOR ELDERLY OF THE STATE, HOMES ALSO PROVIDES A SPECIAL PROGRAM DESIGNED TO ENHANCE THE LIFESTYLE OF OLDER ADULTS WITH DEMENTIA RELATED DISORDERS LIKE ALZHEMER'S DISEASE. THREE SUCH PROGRAMS ARE OPERATED BY BAPTIST RETIREMENT HOMES. HOMES OWNS, MAINTAINS, AND OPERATES COMMUNITIES THROUGHOUT NORTH CAROLINA. ITS CURRENT COMMUNITIES INCLUDE 264 INDEPENDENT LIVING HOMES AND APARTMENTS, 140 ASSISTED LIVING RESIDENCES, AND 201 SKILLED NURSING CARE ROOMS. HOMES RECEIVES SUPPORT FROM INDIVIDUALS, BUSINESSES, FOUNDATIONS, CHURCHES, SPECIAL OFFERINGS, AND BEQUESTS FROM OTHERS TO ASSIST IN THE OPERATION AND ADMINISTRATION OF ITS COMMUNITIES. 23089300 1 1 0 1 0 0 0 0 0 1 1 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 25 0 1 744 1 0 0 0 0 0 0 0 0 0 0 X 19 19 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X WILLIAM STILLERMAN PRESIDENT 3367250202 1912 BETHABARA ROAD WINSTON SALEM NC 27106 MR LEE M KIRBY JR CHAIR 1.00 X X 0 0 0 MRS MARY E MORGAN VICE CHAIR 1.00 X X 0 0 0 MR JEFFREY K HOBART CORPORATE SECRETARY 1.00 X X 0 0 0 MR CHARLES D MAST TRUSTEE 1.00 X 0 0 0 MRS PERRY BAILEY TRUSTEE 1.00 X 0 0 0 MR A EDWARD BEDDINGFIELD JR CORPORATE SECRETARY (FORMER) 1.00 X 0 0 0 MR JEFFREY L COBB TRUSTEE 1.00 X 0 0 0 MR PHILLIP R FAEGAN TRUSTEE 1.00 X 0 0 0 MRS NANCY E FISH TRUSTEE 1.00 X 0 0 0 MRS ANITA H JOHNSON TRUSTEE 1.00 X 0 0 0 MS MARY BETH F JOHNSTON TRUSTEE 1.00 X 0 0 0 MRS BETH TYNER JONES CHAIR (FORMER) 1.00 X 0 0 0 MR CLARENCE R LAMBE JR FINANCE CHAIR 1.00 X 0 0 0 MR RALPH S MORGAN VICE CHAIR (FORMER) 1.00 X 0 0 0 MR RICHARD P MURRAY TRUSTEE 1.00 X 0 0 0 MR JOHN S POND JR TRUSTEE 1.00 X 0 0 0 MR HENRY M SKINNER JR TRUSTEE 1.00 X 0 0 0 MR BOBBY WATSON TRUSTEE 1.00 X 0 0 0 MR MICHAEL R TAYLOR TRUSTEE 1.00 X 0 0 0 MR WILLIAM B STILLERMAN PRESIDENT 36.00 4.00 X 293562 0 63474 MRS DEBRA H MEGINNIS EXECUTIVE VP AND COO 36.00 4.00 X 240474 0 63728 MR CHARLES R GASKINS CFO 36.00 4.00 X 236738 0 26318 770774 0 153520 3 0 1 0 LEGACY HEALTHCARE SERVICES PO BOX 743715 ATLANTA GA 303843715 THERAPY SERVICES 1093444 CYPRESS NETWORKS 4125-A WALKER AVENUE GREENSBORO NC 27407 COMPUTER MAINTENANCE AND SUPPORT 192031 CLIFTONLARSONALLEN LLP PO BOX 531878 ATLANTA GA 303531878 ACCOUNTING SERVICES 158155 F&L ELECTRICAL 3826 CLEMMONS ROAD CLEMMONS GA 27012 ELECTRICAL RENOV.AND LIGHTING 141575 ASSIST HEALTHCARE SERVICES INC PO BOX 2530 BLUE RIDGE GA 30513 CONTRACTED NURSE STAFFING 104253 5 1383271 1056844 2440115 RESIDENT SERVICES 623000 25539721 25539721 25539721 494574 494574 23991 0 23991 23991 23991 9570371 8952439 2977 617932 -2977 614955 614955 421973 421973 421973 29535329 25961694 0 1133520 5000 5000 674337 674337 978687 978687 11055654 9781958 1273696 1772995 1427651 345344 875075 742884 132191 45379 45379 55070 55070 1563077 1434833 128244 186787 15042 81569 90176 429482 250800 178682 227077 227077 1616132 1181736 434396 3005 551 2454 8931 3265 5666 1601190 1601190 3465984 3465984 363982 363982 REPAIRS AND MAINTENANCE 985737 874029 111708 FOOD 966443 930387 36056 MEDICAL SUPPLIES 432175 427455 4720 MEDICAL SERVICES 195637 195637 315130 76561 140240 98329 27822966 23089300 4545161 188505 7563578 6830997 138079 130422 918868 1214077 88624 115553 454343 216648 102108486 54162971 50157381 47945515 19876376 21167821 5915799 5972857 2113230 2253440 87226278 85847330 2140884 2089162 13406987 12998562 46141 37547 38503657 35871220 54097669 50996491 X 24067970 26051053 1666563 1326822 7394076 7472964 33128609 34850839 87226278 85847330 X 1712363 -47190 57057 X X 0 1 X 1 0 X 1919026 1614404 1320974 2321106 2440115 9615625 23713424 25464687 23840805 24528095 25539721 123086732 25632450 27079091 25161779 26849201 27979836 132702357 285341 27158 37875 8527 358901 0 285341 27158 37875 8527 358901 132343456 851875 1162750 545353 436513 518565 3515056 851875 1162750 545353 436513 518565 3515056 230574 525773 514863 421973 1693183 26714899 28241841 26232905 27800577 28920374 137910596 0.95960 0.95960 0.02550 0.02770 X 0 0 0 0 0 0 0 0 1 1104 1104 0 PART II-B, LINE 1: THE AMOUNT LISTED ABOVE CONSISTS OF A PORTION OF MEMBERSHIP DUES PAID TO TRADE ORGANIZATIONS THAT IS ATTRIBUTABLE TO LOBBYING ACTIVITIES. 0 1 X 378400 27838 4013 402225 337481 44467 3547 378400 316850 12918 10958 3245 337481 312750 6233 2133 316850 276492 39380 3122 312750 1.00000 0 0 6045497 6045497 54664965 36067971 18596994 6045006 5060840 984166 35353018 13034160 22318858 47945515 CHARITABLE REMAINDER TRUSTS 1035895 C BENEFICIAL INTEREST IN PERPETUAL TRUST 4936962 C 5972857 X PART IV, LINE 2B: RESIDENT FUNDS HELD IN TRUST. PART X, LINE 2: THE HOMES AND THE FOUNDATION ARE NOT-FOR-PROFIT ORGANIZATIONS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THE HOMES AND THE FOUNDATION FILE AS TAX-EXEMPT ORGANIZATIONS. MANAGEMENT IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE THE TAX-EXEMPT STATUS OF THE HOMES OR THE FOUNDATION. MANAGEMENT IS NOT AWARE OF ANY SIGNIFICANT ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR ANY OTHER TAXES FOR HOMES OR THE FOUNDATION.3 1 FIRST BAPTIST CHURCH CLEVELAND COUNTY 120 N LAFAYETTE STREET SHELBY NC 28150 501(C)3 5000 CLEVELAND COUNTY POTATO PROJECT 1 BRH RESIDENTS - BENEVOLENCE 84 652997 CARE CAFE 200 16140 EDENTON BAPTIST CHURCH 450 5200 PART I, LINE 2: BENEVOLENCE IS BASED ON PAYOR (MEDICARE, MEDICAID, ETC.) AND ABILITY TO PAY. REQUESTS FOR BENEVOLENT ASSISTANCE ARE REVIEWED AND APPROVED BY THE PRESIDENT. BENEVOLENCE IS RECORDED AS A CONTRA-REVENUE ON A MONTHLY BASIS. THE TRUSTEES APPROVE PROJECTS AND GIVE GENERAL GUIDANCE ON BENEVOLENCE. THE BAPTIST RETIREMENT HOMES FOUNDATION AGREED TO REIMBURSE HOMES FOR THESE PROJECTS THAT BENEFIT POOR SENIOR ADULTS IN NORTH CAROLINA. THE ORGANIZATION REQUESTS SUPPORT THROUGH A LETTER TO BAPTIST RETIREMENT HOMES. SCHEDULE I, PART III, COLUMN B THE ORGANIZATION ESTIMATED THAT 40% OF THE TOTAL RESIDENT POPULATION SERVED UTILIZES SOME TYPE OF ASSISTANCE. 1 X X X X X 0 1 0 0 0 0 0 1 0 MR WILLIAM B STILLERMAN PRESIDENT 276927 0 16635 0 0 0 52800 0 10674 0 357036 0 0 0 MRS DEBRA H MEGINNIS EXECUTIVE VP AND COO 202716 0 37758 0 0 0 50335 0 13393 0 304202 0 0 0 MR CHARLES R GASKINS CFO 236738 0 0 0 0 0 13465 0 12853 0 263056 0 0 0 PART I, LINE 4B WILLIAM B. STILLERMAN, DEBRA MEGINNIS, AND CHARLES GASKINS PARTICIPATED IN 457 AND 403B BENEFIT PLANS AND CONTRIBUTED $42,000, $42,000 AND $7,481, RESPECTIVELY, DURING THE YEAR. PART I, LINE 7 DISCRETIONARY BONUSES WERE PAID TO WILLIAM STILLERMAN AND DEBRA MEGINNIS. SEE SCHEDULE O OF FORM 990 FOR MORE DETAIL ON HOW COMPENSATION FOR THE PRESIDENT AND COO CFO IS DETERMINED. FORM 990, PART VI, SECTION B, LINE 11B ALL MEMBERS ARE PROVIDED A COPY OF FORM 990 TO REVIEW PRIOR TO IT BEING FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR, TRUSTEES MUST COMPLETE A "NON-CONFLICT OF INTEREST" QUESTIONNAIRE. ADDITIONALLY, EMPLOYEES MUST DISCLOSE ALL PERTINENT FACTS SURROUNDING A POTENTIAL CONFLICT OF INTEREST TO HIS OR HER IMMEDIATE SUPERVISOR. THE ORGANIZATION'S CONFLICT OF INTEREST STATEMENT OUTLINES THE ACTIVITIES EMPLOYEES SHOULD AVOID WITHOUT PRIOR APPROVAL OF THE BOARD OF TRUSTEES, AND PROVIDES STEPS TO BE TAKEN IF A POSSIBLE CONFLICT OF INTEREST EXISTS. FORM 990, PART VI, SECTION B, LINE 15 IN COOPERATION WITH THE PERSONNEL COMMITTEE, THE FINANCE COMMITTEE RECOMMENDS THE SALARY OF THE PRESIDENT,COO, AND CFO EVERY YEAR. THE PROCESS INCLUDES A REVIEW AND APPROVAL BY INDEPENDENT PERSONS. THE MOST RECENT YEAR IN WHICH THE PROCESS WAS REVIEWED AND APPROVED BY INDEPENDENT PERSONS WAS 2017. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST AND IN ACCORDANCE WITH REGULATORY REQUIREMENTS. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF TRUSTS 57,057. FORM 990, PART XII, LINE 2C: THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. BAPTIST RETIREMENT HOMES FOUNDATION 1912 BETHABARA ROAD WINSTON SALEM NC 27106 562205837 SUPPORT BRH NC 501(C)(3) LINE 12B, II BRHNC INC 1 0 0 1 0 0 0 0 0 1 0 0 1 0 1 1 0 0 0 1 BAPTIST RETIREMENT HOMES OF NORTH CAROLINA INCORPORATED A 1383271