2017-02-15T14:06:13-06:00 2016-09-30 561706742 DAVIDSON HOLLAND WHITESELL & CO PLLC 209 13TH AVE PLACE NW SUITE 200 HICKORY NC 28601 990 2015-10-01 561255030 MOUNTAIN VISTA HEALTH PARK INC MOUN 3368592181 POST OFFICE BOX 1547 DENTON NC 27239 AVA BADGETT TREASURER 3368592181 2017-02-14 1 VIRGINIA LOWDER P01609579 8283222070 2015 2021-01-29 14:40:06Z AVA BADGETT POST OFFICE BOX 1547 DENTON NC 27239 6082997 0 X N/A X 1971 NC PROVIDE QUALITY LONG-TERM NURSING CARE FOR RESIDENTS. 9 9 166 25 0 0 0 0 6141590 5969628 -28056 58835 4765 2200 6118299 6030663 0 0 0 0 3423978 3420387 0 0 0 2612911 2630453 6036889 6050840 81410 -20177 5717775 5708318 574893 497793 5142882 5210525 TO PROVIDE QUALITY LONG-TERM SKILLED NURSING CARE AND ASSISTED LIVING SERVICES TO THE SOUTH DAVIDSON COUNTY COMMUNITY. 0 0 5073753 5969628 MOUNTAIN VISTA HEALTH PARK, INC. IS A CORPORATION WHICH PROVIDES LONG-TERM NURSING CARE AND ADULT CARE HOME SERVICES. THE FACILITY HAS 60 NURSING AND 60 ADULT-CARE BEDS. WE OFFER SERVICES TO THE PUBLIC WITHOUT REGARD TO RELIGION OR ETHNICITY. 5073753 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 7 0 1 166 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 NC X TULLOCK MANAGEMENT COMPANY 3369985001 5190 US HWY 158 ADVANCE NC 27006 MAL MARTIN PRESIDENT 0.25 X X 0 0 0 SCOTT MORRIS VICE PRESIDENT 0.25 X X 0 0 0 AVA BADGETT TREASURER 0.25 X X 0 0 0 ADALYN NOPANEN SECRETARY 0.25 X X 0 0 0 DEL CRANFORD DIRECTOR 0.25 X X 0 0 0 KURT BEYELER DIRECTOR 0.25 X 0 0 0 RANDY HARDISTER DIRECTOR 0.25 X 0 0 0 JEANETTE POTTS DIRECTOR 0.25 X 0 0 0 DALE FUTRELL ASST TREASURER 0.25 X 0 0 0 PRISCILLA VINT ADMINISTRATOR 40.00 X 77267 0 0 77267 0 0 0 0 0 0 LEGACY HEALTHCARE SERVICES INC PO BOX 951003 CLEVELAND OH 44193 PHYSICAL, SPEECH & OCC THERAPY 797915 BLUE CROSS BLUE SHIELD PO BOX 580017 CHARLOTTE NC 28258 GROUP MEDICAL INSURANCE 499059 TULLOCK MANAGEMENT COMPANY 5190 US-158 ADVANCE NC 27006 MANAGEMENT 314443 US FOOD SERVICE 125 FORT MILL PARKWAY FORT MILL SC 29715 FOOD SERVICE/SUPPLY 261021 YADKIN VALLEY HEALTHCARE 213 WINSTON RD JONESVILLE NC 28642 NURSING/MEDICAL SUPPLIES 135610 5 ROUTINE NURSING CARE 623000 5957874 5957874 ANCILLARIES 623000 11754 11754 5969628 111169 111169 2200 0 2200 2200 2200 52334 -52334 -52334 -52334 6030663 5969628 0 61035 X 77267 77267 3007710 2865460 142250 92851 87632 5219 242559 218666 23893 299142 299142 2438 2438 18000 18000 22826 22826 263870 263870 2493 2493 9275 5342 3933 38 38 135430 135430 370005 329297 40708 CONTRACT SERVICES 633487 633487 SUPPLIES 548347 548347 UTILITIES 168826 168826 EQUIPMENT RENTAL AND MA 68606 68606 87670 12660 75010 6050840 5073753 977087 0 1104374 2525941 276112 510395 438818 16344 14556 78038 72675 4013099 3125555 809340 887544 1777717 2914239 5717775 5708318 542575 461044 32318 36749 574893 497793 X 5142882 5210525 5142882 5210525 5717775 5708318 -20177 87820 0 X X 0 1 X 1 0 X 6131780 6273271 5935889 5141590 5969628 29452158 2400 2400 1200 4765 0 10765 6134180 6275671 5937089 5146355 5969628 29462923 0 0 0 29462923 25540 30703 66372 -20432 113369 215552 25540 30703 66372 -20432 113369 215552 6159720 6306374 6003461 5125923 6082997 29678475 0.99270 0.99510 0.00730 0.00490 X 677 0 0 0 0 0 0 0 0 1 677 677 0 PART I-A, LINE 1: A PORTION OF THE DUES PAID TO THE NORTH CAROLINA HEALTH CARE FACILITIES ASSOCIATION BY THE ENTITY WERE ATTRIBUTABLE TO LOBBYING ACTIVITIES. PART II-B, LINE 1: A PORTION OF THE DUES PAID TO THE NORTH CAROLINA HEALTH CARE FACILITIES ASSOCIATION BY THE ENTITY WERE ATTRIBUTABLE TO LOBBYING ACTIVITIES. 19358 19358 1382938 1319902 63036 1739854 1229891 509963 817546 575762 241784 53403 53403 887544 PATIENT FUNDS 36749 CASH VALUE OF LIFE INSURANCE 331519 INVESTMENTS 2545971 2914239 PATIENTS LIABILITY 36749 36749 X 6095619 87820 87820 6007799 22826 38 22864 6030663 6027976 0 6027976 22826 38 22864 6050840 PART X, LINE 2: THE COMPANY HAS IMPLEMENTED THE NEW ACCOUNTING REQUIREMENTS ASSOCIATED WITH UNCERTAINTY IN INCOME TAXES USING THE PROVISIONS OF FINANCIAL ACCOUNTING STANDARDS BOARD ("FASB") ASC 740, INCOME TAXES. USING THAT GUIDANCE, TAX POSITIONS INITIALLY NEED TO BE RECOGNIZED IN THE FINANCIAL STATEMENTS WHEN IT IS MORE-LIKELY-THAN-NOT THE POSITIONS WILL BE SUSTAINED UPON EXAMINATION BY THE TAX AUTHORITIES. IT ALSO PROVIDES GUIDANCE FOR DE-RECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, DISCLOUSURE AND TRANSITION. AS OF THE CURRENT YEAR, THE COMPANY HAS NO UNCERTAIN TAX POSITIONS THAT QUALIFY FOR EITHER RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS AND RECOGNIZED NO SUCH INTEREST OR PENALTIES. PART XI, LINE 4B - OTHER ADJUSTMENTS: INTEREST EXPENSE NETTED AGAINST INCOME ON FINANCIAL STATEMENTS 38. PART XII, LINE 4B - OTHER ADJUSTMENTS: INTEREST EXPENSES NETTED AGAINST INCOME ON FINANCIAL STATEMENTS 38. FORM 990, PART VI, SECTION A, LINE 3 MOUNTAIN VISTA HEALTH PARK CONTRACTS TULLOCK MANAGEMENT COMPANY TO PERFORM VARIOUS OPERATIONAL MANAGEMENT DUTIES FORM 990, PART VI, SECTION B, LINE 11 A DRAFT COPY OF FORM 990 IS GIVEN TO THE TREASURER TO REVIEW BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY FORM 990, PART VI, SECTION B, LINE 15 DIRECTORS RECEIVE NO COMPENSATION. KEY EMPLOYEE COMPENSATION IS REVIEWED BY THE MANAGEMENT COMPANY AND THE ADMINISTRATOR ANNUALLY. COMPENSATION RATES FOR KEY EMPLOYEES ARE COMMENSURATE WITH SIMILAR POSITIONS AS COMPARED WITH INDUSTRY DATA. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE UPON REQUEST TO THE MANAGEMENT COMPANY DURING NORMAL BUSINESS HOURS. FORM 990, PART IX, LINE 24E MISCELLANEOUS : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 26,978. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 26,978. SUPPLIES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 15,215. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,215. UTILITIES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 13,165. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,165. TAXES AND LICENSE : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 12,384. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,384. MISCELLANEOUS : PROGRAM SERVICE EXPENSES 10,499. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,499. DUES AND SUBSCRIPTIONS : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 4,165. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,165. BANK FEES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 2,359. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,359. TRANSPORTATION : PROGRAM SERVICE EXPENSES 2,161. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,161. CONTRACT SERVICES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 684. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 684. EQUIPMENT RENTAL AND MAINTENANCE : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 60. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 60. FORM 990, PART XII, LINE 2C AUDIT OVERSIGHT/SELECTION-INDEPENDENT ACCT THE ORGANIZATION DID NOT CHANGE EITHER ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX YEAR; HOWEVER, THIS QUESTION HAD PREVIOUSLY BEEN ANSWERED NO BECAUSE THERE IS NOT A SEPARATE COMMITTEE THAT OVERSEES THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTS AN INDEPENDENT ACCOUNTANT. THE MEMBERS OF THE BOARD HAVE ALWAYS BEEN RESPONSIBLE FOR THESE ACTIONS AS OUTLINED IN THE ORGANIZATION'S GOVERNING DOCUMENTS. FOR THIS REASON, THE RESPONSE HAS BEEN CHANGED TO "YES" TO MORE ACCURATELY REFLECT THE BOARD'S RESPONSIBILITY REGARDING THESE FUNCTIONS.