2017-02-13T14:46:44-06:00 2016-09-30 560571159 BERNARD ROBINSON & COMPANY LLP PO BOX 19608 GREENSBORO NC 274199608 990 2015-10-01 566056582 UNITED CHURCH HOMES AND SERVICES UNIT 8284658006 100 LEONARD AVENUE NEWTON NC 28658 LEE SYRIA PRESIDENT/CEO 8284658006 2017-02-13 1 OLGA OGANESOV P01279668 3362944494 2017-02-10 2015 2021-01-29 14:40:06Z LEE SYRIA 100 LEONARD AVENUE NEWTON NC 28658 39454024 0 X WWW.UCHAS.ORG X 1961 NC A CHRISTIAN MINISTRY COMMITTED TO PROVIDING VIBRANT SENIOR LIVING OPPORTUNITIES, DIVERSE PROGRAMS OF OUTREACH, AND COMPASSIONATE HEALTHCARE SERVICES. 19 19 881 217 23677 -65866 138504 63293 33626892 34716558 2728525 1278820 2444374 2673257 38938295 38731928 250622 136974 0 0 20970293 21942487 0 0 0 17409389 17856912 38630304 39936373 307991 -1204445 93210831 99822801 69933395 74354699 23277436 25468102 A CHRISTIAN MINISTRY COMMITTED TO PROVIDING VIBRANT SENIOR LIVING OPPORTUNITIES, DIVERSE PROGRAMS OF OUTREACH, AND COMPASSIONATE HEALTHCARE SERVICES. 0 0 33918640 136974 36899648 UNITED CHURCH HOMES AND SERVICES OWNS AND OPERATES CONTINUING CARE RETIREMENT COMMUNITIES IN NEWTON ("ABERNETHY LAURELS") AND THOMASVILLE ("PIEDMONT CROSSING"), NORTH CAROLINA, CONSISTING OF RESIDENTIAL LIVING UNITS, ASSISTED LIVING UNITS AND NURSING FACILITIES PROVIDING ADULT CARE AND INTERMEDIATE AND SKILLED NURSING CARE. 33918640 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 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 0 0 1 1 0 0 0 1 70 0 1 881 1 1 1 0 0 0 0 0 0 0 0 0 X 19 19 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X GARY SHULL 8284658006 100 LEONARD AVENUE NEWTON NC 28658 J RAY DEAL CHAIR 1.00 X X 0 0 0 LINDA J MORRIS VICE CHAIR 1.00 X X 0 0 0 MARK L BURNS SECRETARY 1.00 X X 0 0 0 ANTHONY J BRANCH TREASURER 1.00 X X 0 0 0 MARK W SIGMON MEMBER-AT-LARGE 1.00 X X 0 0 0 JEFFREY S GILLIAM PAST BOARD CHAIR 1.00 X X 0 0 0 GREGORY M ALCORN BOARD MEMBER 1.00 X 0 0 0 JAMES W BUCHANAN SR BOARD MEMBER 1.00 X 0 0 0 NAOMI Y EAST BOARD MEMBER 1.00 X 0 0 0 BRENDA C ECKARD BOARD MEMBER 1.00 X 0 0 0 PARKER D HOWELL III BOARD MEMBER 1.00 X 0 0 0 JOAN K MARSH BOARD MEMBER 1.00 X 0 0 0 KELSEY MCCLEAVE BOARD MEMBER 1.00 X 0 0 0 RANDALL L ORWIG BOARD MEMBER 1.00 X 0 0 0 BRAD THIE BOARD MEMBER 1.00 X 0 0 0 RAY H WALKER BOARD MEMBER 1.00 X 0 0 0 HEATHER PAUL ADVISORY COUNCIL 1.00 X 0 0 0 RALPH L HOWELL JR ADVISORY COUNCIL 1.00 X 0 0 0 A DARRELL SLUDER JR ADVISORY COUNCIL 1.00 X 0 0 0 LEE B SYRIA PRESIDENT/CEO 40.00 X 232603 0 33212 GARY W SHULL VP - FINANCE 40.00 X 197598 0 31137 AIMEE N REIMANN PACE/VP OF OPERATIONS 40.00 X 170291 0 24894 STEPHEN T PATERSON VP OF COMPLIANCE & EDUCATION 40.00 X 156651 0 25422 JOYCE B CLINE DIRECTOR OF DEVELOPMENT & PR 40.00 X 156416 0 18783 AMBER T MCINTOSH EXECUTIVE DIRECTOR 40.00 X 143410 0 19239 ELIZABETH B WHITE MARKETING 40.00 X 135126 0 7074 1192095 0 159761 10 0 1 0 SELECT REHABILITATION INC 550 FRONTAGE ROAD SUITE 2415 NORTHFIELD IL 60093 THERAPIES 2053609 DIVERSIFIED INVESTMENT ADVISORS PO BOX 13029 NEWARK NJ 07188 RETIREMENT SERVICES 1224938 ACS BENEFIT SERVICES INC PO BOX 2000 WINSTONSALEM NC 27102 HEALTH CARE ADMINISTRATOR 873360 OMNICARE PHARMACY PO BOX 78000 DETROIT MI 48278 PHARMACEUTICALS 730312 NWN CORPORATION PO BOX 535596 ATLANTA GA 30353 COMPUTER EQUIPMENT/MAINTENANCE AGREEMENT 272620 10 52973 10320 63293 RESIDENT REVENUE 623000 32723276 32723276 HOME CARE 621610 1993282 1993282 34716558 1993707 1993707 40668 0 40668 40668 40668 710550 4337 -710550 -4337 -714887 -714887 6147 7209 -1062 -1062 MANAGEMENT FEE INCOME 541200 1662308 1662308 CHILD DAY CARE 624410 309900 309900 BUILDING LEASE REVENUE 623000 283250 283250 378193 196864 23677 157652 2633651 38731928 36858980 23677 1785978 136974 136974 432736 432736 17386314 14917606 2468708 509450 279538 229912 2289135 2075595 213540 1324852 1165898 158954 87602 87602 75675 75675 173560 173560 2413780 1749461 664319 118674 90864 27810 517874 310867 207007 2560485 2560485 97809 23308 74501 1521795 1521795 3522464 3522464 430632 430632 SUPPLIES 3315548 3301706 13842 FOOD 1352849 1352849 WORKMENS COMPENSATION 544412 544412 BAD DEBT EXPENSE 347500 347500 776253 561730 214523 39936373 33918640 6017733 0 480520 534515 3536443 3692483 52006 53367 369873 355067 96247378 53483674 38327705 42763704 46423624 49106882 4020660 3316783 93210831 99822801 3974091 3802268 17169241 18987334 33766599 40983739 4661430 0 10362034 10581358 69933395 74354699 X 23277436 25468102 23277436 25468102 93210831 99822801 -1204445 3395102 9 0 X 0 1 X 1 0 X 89150 79138 828595 138504 63293 1198680 31907034 31086773 31909868 33632309 34722705 163258689 31996184 31165911 32738463 33770813 34785998 164457369 0 0 0 164457369 1461322 1581944 1507333 2034695 2034375 8619669 1461322 1581944 1507333 2034695 2034375 8619669 1230781 1311078 2027081 2422732 2609974 9601646 34688287 34058933 36272877 38228240 39430347 182678684 0.90030 0.90810 0.04720 0.04500 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 0 1 0 0 0 0 PART II-B, LINE 1: UNITED CHURCH HOMES AND SERVICES JOINED TOGETHER WITH NORTH CAROLINA HEALTH CARE FACILITIES ASSOCIATION, LEADING AGE NATIONAL, AND LEADING AGE NORTH CAROLINA, TO PERSUADE THE GENERAL PUBLIC TO VOTE FOR ISSUES AFFECTING UCHS AND OUR INDUSTRY. 1385787 1385787 75655452 45337192 30318260 6707039 5006721 1700318 12499100 3139761 9359339 42763704 LONG-TERM REFUNDS PAYABLE 9173711 RESIDENT PERSONAL FUNDS LIABILITY 30285 REFUNDS PAYABLE 384252 ADVANCE DEPOSITS 402440 RESIDENT ESCROWS 326376 OTHER PAYABLES 264294 10581358 X PART X, LINE 2: IT IS THE ORGANIZATION'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 FOR 2016 AND 2015. 1 BENEVOLENT ASSISTANCE FOR RESIDENTS WHO ARE UNABLE TO PAY FOR CONTINUING CARE AT THE RESIDENTIAL FACILITIES OPERATED BY UNITED CHURCH HOMES AND SERVICES. FIVE PRIMARY RESIDENTS RECEIVED BENEVOLENT FUNDS, AND MANY RESIDENTS RECEIVED BLOCK GRANTS. BLOCK GRANTS ARE ASSISTANCE PROVIDED TO MULTIPLE RESIDENTS IN NEED. 5 136974 PART I, LINE 2: THE BENEVOLENT ASSISTANCE FUNDS ARE MANAGED BY THE ORGANIZATION'S FINANCE PERSONNEL TO COVER THE EXPENSES OF INDIGENT RESIDENTS. THE ASSISTANCE IS DISBURSED ON AN AS NEEDED CASE BY CASE BASIS. X X X X X 0 0 0 0 0 0 0 0 0 LEE B SYRIA PRESIDENT/CEO 232603 0 0 0 0 0 31852 0 1360 0 265815 0 0 0 GARY W SHULL VP - FINANCE 197598 0 0 0 0 0 29932 0 1205 0 228735 0 0 0 AIMEE N REIMANN PACE/VP OF OPERATIONS 170291 0 0 0 0 0 23848 0 1046 0 195185 0 0 0 STEPHEN T PATERSON VP OF COMPLIANCE & EDUCATION 156651 0 0 0 0 0 24460 0 962 0 182073 0 0 0 JOYCE B CLINE DIRECTOR OF DEVELOPMENT & PR 156416 0 0 0 0 0 18085 0 698 0 175199 0 0 0 AMBER T MCINTOSH EXECUTIVE DIRECTOR 143410 0 0 0 0 0 18350 0 889 0 162649 0 0 0 A NC MEDICAL CARE COMMISSION 521309402 65820YEH5 2005-04-21 18723911 TO REFUND PRIOR ISSUE OF BONDS AND TO FINANCE EXPANSION PROJECTS. 0 0 0 B NC MEDICAL CARE COMMISSION 521309402 65820YLD6 2015-04-08 23293353 TO REFUND THE 2010 BOND ISSUE. 0 0 0 C NC MEDICAL CARE COMMISSION 521309402 2015-12-10 31570000 TO REFUND PRIOR ISSUE OF BONDS AND TO FINANCE EXPANSION PROJECTS. 0 0 0 A 13755000 18723911 16841213 374478 1503242 4978 2007 1 0 1 1 B 450000 23293353 1261826 21565660 465867 2012 1 0 1 1 C 565000 31570000 5124198 460438 25985364 1 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 A 0 0 0 0 1 0 0 0 0 B 0 0 0 0 0 0 0 0 1 C 0 0 0 0 1 0 0 0 1 A 0 B 0 FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS REVIEWED BY THE BOARD'S FINANCE COMMITTEE BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS, DIRECTORS AND EMPLOYEES OF THE ORGANIZATION HAVE AN OBLIGATION TO CONDUCT BUSINESS WITHIN GUIDELINES THAT PROHIBIT ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. ALL EMPLOYEES AND BOARD MEMBERS ARE REQUIRED TO EVALUATE COMPLIANCE WITH CONFLICT OF INTEREST POLICY ANNUALLY AND DISCLOSE ANY POTENTIAL CONFLICTS. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT IS DETERMINED BY THE BOARD'S EXECUTIVE COMMITTEE. THE PROCESS FOR DETERMINING COMPENSATION INCLUDES THE USE OF AN INDEPENDENT CONSULTANT, SALARY SURVEYS OF SIMILAR ORGANIZATIONS ACROSS THE COUNTRY AS WELL AS THE USE OF COMPARABILITY DATA. COMPENSATION OF OFFICERS AND KEY EMPLOYEES IS SUGGESTED BY THE CEO AND APPROVED BY THE EXECUTIVE COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE KEPT ON FILE AT THE ADMINISTRATION OFFICE AND ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. ALBEMARLE OLDER ADULT HOUSING INC 411 SOUTH FOURTH STREET ALBEMARLE NC 28001 800030872 PROVIDING AFFORDABLE HOUSING TO SENIOR CITIZENS NC 501(C)(3) LINE 9 N/A 0 CAROLINA SENIOR LIVING 100 LEONARD AVENUE NEWTON NC 28658 454956541 PROVIDING AFFORDABLE HOUSING TO SENIOR CITIZENS NC 501(C)(3) LINE 9 N/A 0 CAROLINA SENIORCARE 100 LEONARD AVENUE NEWTON NC 28658 274450562 PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY NC 501(C)(3) LINE 3 N/A 0 LAKE PRINCE CENTER 100 LEONARD AVENUE NEWTON NC 28658 562151716 CONTINUING CARE RETIREMENT COMMUNITY NC 501(C)(3) LINE 9 N/A 0 NEW BERN OLDER ADULT HOUSING INCORPORATE 3800 LOFLAND WAY NEW BERN NC 28562 562133316 PROVIDING AFFORDABLE HOUSING TO SENIOR CITIZENS NC 501(C)(3) LINE 9 N/A 0 STATESVILLE ELDERLY HOUSING INC 700 WILS WAY STATESVILLE NC 28677 562192096 PROVIDING AFFORDABLE HOUSING TO SENIOR CITIZENS NC 501(C)(3) LINE 9 N/A 0 UCC LIVING CENTERS INCORPORATED 103 CULBREATH ROAD CHAPEL HILL NC 27516 561964906 PROVIDING AFFORDABLE HOUSING TO SENIOR CITIZENS NC 501(C)(3) LINE 9 N/A 0 UNITED CHURCH HOMES AND SERVICES FOUNDATION 100 LEONARD AVENUE NEWTON NC 28658 562243082 FUND AND SUPPORT THE OPERATIONS & PROGRAMS OF UCHS NC 501(C)(3) LINE 11A, I UNITED CHURCH HOMES AND SERVICES 1 0 0 1 1 1 0 0 0 0 0 0 1 0 0 1 0 0 0 0 ALBEMARLE OLDER ADULT HOUSING INC O 74649 CAROLINA SENIORCARE D 94423 CAROLINA SENIORCARE O 3442611 LAKE PRINCE CENTER E 2174913 LAKE PRINCE CENTER L 725638 LAKE PRINCE CENTER O 3337351 NEW BERN OLDER ADULT HOUSING INCORPORATED D 116100 NEW BERN OLDER ADULT HOUSING INCORPORATED O 179453 STATESVILLE ELDERLY HOUSING INC O 74798 UCC LIVING CENTERS INCORPORATED O 75914 UNITED CHURCH HOMES AND SERVICES FOUNDATION C 52973 UNITED CHURCH HOMES AND SERVICES FOUNDATION D 2748255 UNITED CHURCH HOMES AND SERVICES FOUNDATION O 246047 CAROLINA SENIOR LIVING O 62109