CAROLINA ADVENTIST RETIREMENT SYSTEMS INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
CAROLINA ADVENTIST RETIREMENT SYSTEMS INC (EIN 56-1089384)
Tax period
2014-10-01 to 2015-09-30
Filed
2016-07-29
IRS object ID
201602119349300040
Schema version
2014v6.0
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)
Return2016-07-29T13:14:43-05:00ReturnTs
Tax Period End2015-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN560747981PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1DIXON HUGHES GOODMAN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1500 RIDGEFIELD COURTAddressLine1Txt
CityASHEVILLECityNm
State AbbreviationNCStateAbbreviationCd
ZIP28806ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN561089384EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CAROLINA ADVENTIST RETIREMENT SYSTEMS INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCAROBusinessNameControlTxt
Phone7046679851PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line195 HOLCOMBE COVE RDAddressLine1Txt
CityCANDLERCityNm
State AbbreviationNCStateAbbreviationCd
ZIP287159450ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDEBORAH HAWKINSPersonNm
Person TitleTREASURER / CFOPersonTitleTxt
Phone7046679851PhoneNum
Signature2016-07-29SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAMY BIBBYPreparerPersonNm
PTINP00445891PTIN
Phone8282542254PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-12-15 16:53:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDAVID KIDDERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line195 HOLCOMBE COVE RDAddressLine1Txt
CityCANDLERCityNm
State AbbreviationNCStateAbbreviationCd
ZIP287159450ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$24,017,481GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PISGAHVALLEY.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1975FormationYr
Legal Domicile StateNCLegalDomicileStateCd
Activity Or MissionSERVING HEALTHCARE AND RESIDENTIAL NEEDS WHILE UPHOLDING CHRISTIAN PRINCIPLES.ActivityOrMissionDesc
Voting Members Governing Body25VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee673TotalEmployeeCnt
Total Volunteers16TotalVolunteersCnt
Total Gross UBI$84,689TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$33,814NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$175,785PYContributionsGrantsAmt
CY Contributions Grants$138,175CYContributionsGrantsAmt
PY Program Service Revenue$23,788,657PYProgramServiceRevenueAmt
CY Program Service Revenue$23,372,147CYProgramServiceRevenueAmt
PY Investment Income-$218,481PYInvestmentIncomeAmt
CY Investment Income-$105,106CYInvestmentIncomeAmt
PY Other Revenue$346,020PYOtherRevenueAmt
CY Other Revenue$346,545CYOtherRevenueAmt
PY Total Revenue$24,091,981PYTotalRevenueAmt
CY Total Revenue$23,751,761CYTotalRevenueAmt
PY Grants And Similar Paid$246,500PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$195,003CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$12,733,118PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$13,090,170CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$11,168,282PYOtherExpensesAmt
CY Other Expenses$11,245,984CYOtherExpensesAmt
PY Total Expenses$24,147,900PYTotalExpensesAmt
CY Total Expenses$24,531,157CYTotalExpensesAmt
PY Revenues Less Expenses-$55,919PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$779,396CYRevenuesLessExpensesAmt
Total Assets BOY$37,266,484TotalAssetsBOYAmt
Total Assets EOY$37,542,097TotalAssetsEOYAmt
Total Liabilities BOY$22,385,656TotalLiabilitiesBOYAmt
Total Liabilities EOY$23,838,147TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$14,880,828NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$13,703,950NetAssetsOrFundBalancesEOYAmt
MissionAS A FAITH-BASED SEVENTH-DAY ADVENTIST ORGANIZATION, WE ARE DEDICATED TO SERVING THE HEALTHCARE AND RESIDENTIAL NEEDS OF OUR COMMUNITY WHILE UPHOLDING CHRISTIAN PRINCIPLES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$10,391,617ExpenseAmt
Grant$195,003GrantAmt
Revenue$11,785,527RevenueAmt
DescPISGAH VALLEY RETIREMENT COMMUNITY OWNS AND OPERATES A LICENSED CONTINUING CARE RETIREMENT COMMUNITY WITH 43 INDEPENDENT LIVING DUPLEX CONDOMINIUM UNITS, A 24-UNIT MULTI-UNIT ASSISTED HOUSING WITH SERVICES FACILITY, AND A 118-BED SKILLED NURSING FACILITY IN CANDLER, NORTH CAROLINA. PROGRAM SERVICE ACCOMPLISHMENTS INCLUDE THE PROVIDING OF ROOM AND BOARD (SHELTER, UTILITIES, MEALS, HOUSEKEEPING, LAUNDRY, AND MAINTENANCE), TRANSPORTATION, WELLNESS CENTER/ACTIVITIES, ASSISTANCE WITH ACTIVITIES OF DAILY LIVING, AND MEDICAL SERVICES TO OUR COMMUNITY (PRIMARILY AGE 55 AND OLDER).Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$9,941,987ExpenseAmt
Revenue$11,682,276RevenueAmt
DescWINSLOW OPERATES A RETIREMENT COMMUNITY WITH A 146-BED SKILLED NURSING FACILITY IN ELIZABETH CITY, NORTH CAROLINA. PROGRAM SERVICE ACCOMPLISHMENTS INCLUDE THE PROVIDING OF ROOM AND BOARD (SHELTER, UTILITIES, MEALS, HOUSEKEEPING, LAUNDRY, AND MAINTENANCE), TRANSPORTATION, ACTIVITIES, ASSISTANCE WITH ACTIVITIES OF DAILY LIVING, AND MEDICAL SERVICES TO OUR COMMUNITY (PRIMARILY AGE 55 AND OLDER).Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$20,333,604TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
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 FootnoteYes (1)IncludeFIN48FootnoteInd
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 OrganizationsYes (1)GrantsToOrganizationsInd
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 MemYes (1)BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document70IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee673EmployeeCnt
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 Members25GoverningBodyVotingMembersCnt
Independent Voting Member13IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
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
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DEBORAH HAWKINSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8284182334PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line195 HOLCOMBE COVE ROADAddressLine1Txt
CityCANDLERCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28715ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
ERNEST BOUGHMAN SR
DIRECTOR1.00Yes (X)$0$375$0
BRENNA BOULANGER
DIRECTOR1.00Yes (X)$0$300$0
JIMM BUNCH
DIRECTOR1.00Yes (X)$0$0$0
DEWAYNE BUTCHER MD
DIRECTOR1.00Yes (X)$0$150$0
JOHN COEHLO
DIRECTOR1.00Yes (X)$0$65,840$26,52940.00
BRAD CAULEY
DIRECTOR1.00Yes (X)$0$68,248$35,26440.00
DONOVAN DAVIS
DIRECTOR1.00Yes (X)$0$69,346$37,76640.00
JEFF DONALDSON
DIRECTOR1.00Yes (X)$0$65,658$35,03840.00
JOHN EARNHARDT
DIRECTOR1.00Yes (X)$0$67,876$35,15140.00
SAMUEL GARCIA
DIRECTOR1.00Yes (X)$0$75$0
MAURY GILMORE
DIRECTOR1.00Yes (X)$0$75$0
CHAD GRUNDY
DIRECTOR1.00Yes (X)$0$70,627$21,00740.00
JERRY LAFAVE
DIRECTOR1.00Yes (X)$0$64,432$60,03240.00
WON LEE
DIRECTOR/CHAIRMAN1.00Yes (X)$0$375$0
LESLIE LOUIS
DIRECTOR1.00Yes (X)$0$76,725$14,26640.00
GARY MOYER
DIRECTOR1.00Yes (X)$0$78,000$36,21940.00Yes (X)
DEXTER RICHARDSON
DIRECTOR1.00Yes (X)$0$66,068$50,40640.00
LESTER RILEA
DIRECTOR1.00Yes (X)$0$300$0
RIVERA JOSE
DIRECTOR1.00Yes (X)$0$65,503$41,87540.00
RICHARD RUSSELL
DIRECTOR1.00Yes (X)$0$76,706$28,06140.00
STAN SHIREMAN
DIRECTOR1.00Yes (X)$0$57,786$14,32740.00
LINDA STAMP
DIRECTOR1.00Yes (X)$0$225$0
DON WETMORE
DIRECTOR1.00Yes (X)$0$150$0
ANDREW WILLIAMS
DIRECTOR1.00Yes (X)$0$375$0
CHARLES WILLIAMS
DIRECTOR1.00Yes (X)$0$225$0
KEVIN WORTH
DIRECTOR1.00Yes (X)$0$51,790$14,39140.00
CHRISTIAN YASTE
DIRECTOR1.00Yes (X)$0$0$0
DEBORAH HAWKINS
TREASURER/CFO40.00$163,024$0$14,2511.00Yes (X)
DAVID KIDDER
PRESIDENT/CEO40.00$232,875$0$33,9091.00Yes (X)
MICHELLE GRANDY
ADMINISTRATOR40.00$108,759$0$11,872Yes (X)
HARDY VICKIE
DIRECTOR OF NURSING40.00$102,070$0$25,194Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$606,728TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$947,230TotReportableCompRltdOrgAmt
Total Other Compensation$535,558TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K4IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
REHABCARE GROUP EAST INC (DBA REHABCARE
PO BOX 503534ST LOUISMO63150PHYSICAL, SPEECH AND OCCUPATIONAL THERAP$1,322,859
KINDRED REHAB SERVICES INC (DBA PEOPLEF
PO BOX 277365ALTANTAGA30384PHYSICAL, SPEECH AND OCCUPATIONAL THERAP$1,289,779
DIXON HUGHES GOODMAN LLP
PO BOX 3049ASHEVILLENC28802AUDITING, ACCOUNTING, TAX, AND CONSULTIN$238,915
INDOFF INCORPORATED
PO BOX 842808KANSAS CITYMO64184INTERIOR DESIGN$145,444
CASE CONSTRUCTION
PO BOX 1780CANDLERNC28715BUILDING DEMOLITION$125,719
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K6CntrctRcvdGreaterThan100KCnt
Related Organizations$12,000RelatedOrganizationsAmt
All Other Contributions$126,175AllOtherContributionsAmt
Total Contributions$138,175TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MEDICARE/MEDICAID PAYMENTS623000$18,384,342$18,384,342
SKILLED NURSING, ASSISTED LIVING,623000$4,883,079$4,883,079
AMORTIZATION OF ENTRANCE FEE623000$104,726$104,726
FieldValueIRS element (for citing)
Total Program Service Revenue$23,372,147TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$160,614TotalRevenueColumnAmt
Exclusion$160,614ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$260,465SecuritiesAmt
Other$5,255OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$260,465SecuritiesAmt
Other-$5,255OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$265,720TotalRevenueColumnAmt
Exclusion-$265,720ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
MANAGEMENT FEES FROM HOA531390$166,200$166,200
WELLNESS CENTER REVENUE713940$122,367$37,678$84,689
MISCELLANEOUS INCOME623000$57,978$57,978
FieldValueIRS element (for citing)
Other Revenue Total$346,545OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$23,751,761TotalRevenueColumnAmt
Related Or Exempt Func Income$23,467,803RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$84,689UnrelatedBusinessRevenueAmt
Exclusion$61,094ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$195,003TotalAmt
Program Services$195,003ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$426,259TotalAmt
Management And General$426,259ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$99,843TotalAmt
Management And General$99,843ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$10,090,170TotalAmt
Program Services$9,071,360ProgramServicesAmt
Management And General$1,018,810ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$125,977TotalAmt
Program Services$116,366ProgramServicesAmt
Management And General$9,611ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,577,685TotalAmt
Program Services$1,424,635ProgramServicesAmt
Management And General$153,050ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$770,236TotalAmt
Program Services$662,219ProgramServicesAmt
Management And General$108,017ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$18,599TotalAmt
Management And General$18,599ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$96,107TotalAmt
Management And General$96,107ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,673,635TotalAmt
Program Services$2,667,093ProgramServicesAmt
Management And General$6,542ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$275,749TotalAmt
Management And General$275,749ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,584,925TotalAmt
Program Services$1,191,750ProgramServicesAmt
Management And General$393,175ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$157,159TotalAmt
Management And General$157,159ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,604,495TotalAmt
Program Services$1,116,398ProgramServicesAmt
Management And General$488,097ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$98,532TotalAmt
Program Services$67,205ProgramServicesAmt
Management And General$31,327ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$55,490TotalAmt
Program Services$34,442ProgramServicesAmt
Management And General$21,048ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$6,970TotalAmt
Program Services$6,970ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,751,150TotalAmt
Program Services$1,707,008ProgramServicesAmt
Management And General$44,142ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$135,209TotalAmt
Program Services$15,904ProgramServicesAmt
Management And General$119,305ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MED. RELATED SUPPLIES$1,804,931$1,804,931
BAD DEBT$723,919$723,919
PROVIDER TAX$252,320$252,320
MISCELLANEOUS$6,794$6,794

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$24,531,157TotalAmt
Program Services$20,333,604ProgramServicesAmt
Management And General$4,197,553ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$900BOYAmt
EOY$900EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$8,833,204BOYAmt
EOY$9,049,090EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$94,500BOYAmt
EOY$94,500EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,079,566BOYAmt
EOY$1,625,999EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$134,500BOYAmt
EOY$121,900EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$359,806BOYAmt
EOY$440,427EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$35,921,652LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$9,800,592LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$25,577,269BOYAmt
EOY$26,121,060EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$186,739BOYAmt
EOY$88,221EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$37,266,484BOYAmt
EOY$37,542,097EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,834,195BOYAmt
EOY$1,803,271EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$587,220BOYAmt
EOY$659,417EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$12,905,584BOYAmt
EOY$12,797,527EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$617,957BOYAmt
EOY$388,926EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,440,700BOYAmt
EOY$8,189,006EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$22,385,656BOYAmt
EOY$23,838,147EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$14,880,828BOYAmt
EOY$13,703,950EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$14,880,828BOYAmt
EOY$13,703,950EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$37,266,484BOYAmt
EOY$37,542,097EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$779,396ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$397,482NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
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$24,378CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$146,934CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$185,451CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$175,785CurrentTaxYearMinus1YearAmt
Current Tax Year$138,175CurrentTaxYearAmt
Total$670,723TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$22,585,889CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$21,085,506CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$22,355,989CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$23,788,657CurrentTaxYearMinus1YearAmt
Current Tax Year$23,372,147CurrentTaxYearAmt
Total$113,188,188TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$288,899CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$220,605CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$259,285CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$265,383CurrentTaxYearMinus1YearAmt
Current Tax Year$261,856CurrentTaxYearAmt
Total$1,296,028TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$22,899,166CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$21,453,045CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$22,800,725CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$24,229,825CurrentTaxYearMinus1YearAmt
Current Tax Year$23,772,178CurrentTaxYearAmt
Total$115,154,939TotalAmt

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$115,154,939PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$63,194CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$33,238CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$22,302CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$19,959CurrentTaxYearMinus1YearAmt
Current Tax Year$160,614CurrentTaxYearAmt
Total$299,307TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$63,194CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$33,238CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$22,302CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$19,959CurrentTaxYearMinus1YearAmt
Current Tax Year$160,614CurrentTaxYearAmt
Total$299,307TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$22,962,360CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$21,486,283CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$22,823,027CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$24,249,784CurrentTaxYearMinus1YearAmt
Current Tax Year$23,932,792CurrentTaxYearAmt
Total$115,454,246TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99740PublicSupportCY509Pct
Public Support PY5090.99810PublicSupportPY509Pct
Investment Income CY0.00260InvestmentIncomeCYPct
Investment Income PY0.00190InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$2,644OtherActivitiesAmt
Total Lobbying Expenditures$2,644TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION IS A MEMBER OF THE HEALTHCARE FACILITIES ASSOCIATION (HFA) AND THE LEADING AGE ASSOCIATION (LAA). EACH YEAR, A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS IS ALLOCATED TOWARDS LOBBYING EFFORTS ON BEHALF OF THEIR MEMBERSHIP BODIES. FOR FY 2015, AMOUNTS OF MEMBERSHIP DUES ALLOCATED TO THESE EXPENDITURES WERE $1,831 FOR HFA AND $813 FOR LAA.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,720,000OtherCostOrOtherBasisAmt
Book Value$1,720,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$27,457,245OtherCostOrOtherBasisAmt
Depreciation$6,566,703DepreciationAmt
Book Value$20,890,542BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$236,692OtherCostOrOtherBasisAmt
Depreciation$132,989DepreciationAmt
Book Value$103,703BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,111,173OtherCostOrOtherBasisAmt
Depreciation$2,510,514DepreciationAmt
Book Value$1,600,659BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,396,542OtherCostOrOtherBasisAmt
Depreciation$590,386DepreciationAmt
Book Value$1,806,156BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$26,121,060TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
INTEREST RATE SWAP LIABILITY$649,649
PATIENT TRUST FUND LIABILITY$41,034
RESIDENT REFUNDS PAYABLE$7,355,359
ESTIMATED 3RD PARTY SETTLEMENTS$142,964
FieldValueIRS element (for citing)
Total Liability$8,189,006TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$23,984,181TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$23,984,181RevenueSubtotalAmt
Other Revenues Not Included-$232,420OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt-$232,420RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$23,751,761TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$25,161,059TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$629,902OtherExpensesIncludedAmt
Expenses Not Reported$629,902ExpensesNotReportedAmt
Expenses Subtotal$24,531,157ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$24,531,157TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:INCOME TAXES - CARS IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC), AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE IRC. THE ORGANIZATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS BY RECORDING A LIABILITY FOR ANY TAX POSITION TAKEN THAT IS BENEFICIAL TO THE ORGANIZATION, INCLUDING ANY RELATED INTEREST AND PENALTIES, WHEN IT IS MORE LIKELY THAN NOT THE POSITION TAKEN BY MANAGEMENT WITH RESPECT TO A TRANSACTION OR CLASS OF TRANSACTIONS WILL BE OVERTURNED BY A TAXING AUTHORITY UPON EXAMINATION. MANAGEMENT BELIEVES THERE WERE NO SUCH POSITIONS AS OF SEPTEMBER 30, 2014 AND 2015 AND, ACCORDINGLY, NO LIABILITY WAS ACCRUED. FISCAL YEARS ENDING ON OR AFTER SEPTEMBER 30, 2012 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES.
PART XI, LINE 4B - OTHER ADJUSTMENTS:LOSS ON DISPOSAL OF ASSETS -5,255. MANAGEMENT FEES REVENUE NET WITH EXPENSES 33,300. LOSS ON DISPOSAL OF INVESTMENTS -260,465.
PART XII, LINE 2D - OTHER ADJUSTMENTS:LOSS ON DISPOSAL OF ASSETS 5,255. UNREALIZED LOSS ON SWAPS 397,482. MANAGEMENT FEES REVENUE NET WITH EXPENSES -33,300. LOSS ON DISPOSAL OF INVESTMENTS 260,465.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtValuation Method UsedValuationMethodUsedDescPurpose Of GrantPurposeOfGrantTxt
CAROLINA CONFERENCE OF SEVENTH-DAY ADVENTISTS
2701 WT HARRIS BLVDCHARLOTTENC28256454284485501(C)(3)$42,000FMVTO ASSIST WITH LOCAL PASTOR SALARY
MOUNT PISGAH ACADEMY
75 ACADEMY DRIVECANDLERNC28715560713794501(C)(3)$148,680FMVSTUDENT SCHOLARSHIPS AND GENERAL OPERATIONS
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION PROVIDES ASSISTANCE TO OTHER SEVENTH-DAY ADVENTIST NOT-FOR-PROFIT ORGANIZATIONS FOR SPECIFIC PURPOSES RELATED TO ONE-TIME TRANSACTIONS (STUDENT SCHOLARSHIPS AND PASTOR SALARIES); THEREFORE, MONITORING OF THE EXPENDITURES IS ACCOMPLISHED THROUGH OBSERVATIONS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation Required0SubstantiationRequiredInd
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
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
DEBORAH HAWKINS
TREASURER/CFO$127,501$0$1,085$0$34,438$0$4,195$0$10,056$0$177,275$0$0$0
DAVID KIDDER
PRESIDENT/CEO$194,364$0$1,564$0$36,947$0$6,234$0$27,675$0$266,784$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 1AFormAndLineReferenceDesc
ExplanationCARS WAIVES 100% OF THE STANDARD MEMBERSHIP FEE FOR THE CEO AND ADMINISTRATOR AND 50% FOR THE CFO RELATED TO MEMBERSHIP AT CARS' PISGAH VALLEY WELLNESS CENTER. ANY REMAINING PORTION OF THE MEMBERSHIP FEE DUE IS PAID BY THE EMPLOYEE THROUGH PAYROLL DEDUCTIONS. ALL EMPLOYEES AT CARS' PISGAH VALLEY RETIREMENT COMMUNITY CAMPUS ARE ELIGIBLE FOR WAIVER OF SOME PORTION OF PISGAH VALLEY WELLNESS CENTER MEMBERSHIP FEES.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1NORTH CAROLINA MEDICAL CARE COMMISSIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN521309402BondIssuerEIN
Bond Issued2012-03-27BondIssuedDt
Issue Price$13,045,000IssuePriceAmt
PurposeREFUNDING, NEW CONSTRUCTIONPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$55,000RetiredAmt
Total Proceeds$13,054,913TotalProceedsAmt
Capitalized Interest$304,559CapitalizedInterestAmt
Issuance Costs From Proceeds$225,591IssuanceCostsFromProceedsAmt
Capital Expenditures$8,913,558CapitalExpendituresAmt
Other Spent Proceeds$3,611,204OtherSpentProceedsAmt
Substantial Completion2013SubstantialCompletionYr
Current RefundingYes (1)CurrentRefundingInd
Advance Refunding0AdvanceRefundingInd
Final Allocation Made0FinalAllocationMadeInd
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
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd0ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due YetYes (1)RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate IssueYes (1)VariableRateIssueInd
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 Hedge10.000000000000TermOfHedgePct
Superintegrated Hedge0SuperintegratedHedgeInd
Hedge Terminated0HedgeTerminatedInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor Reqs0WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

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

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE K, PART I, DESCRIPTION OF PURPOSE:THE PURPOSE OF THE ISSUE IS TO PROVIDE FUNDS TO (1) REFUND A PORTION OF THE 2008 BANK LOAN ALLOCABLE TO THE PRIOR PROJECT, (2) PAY OR REIMBURSE THE ORGANIZATION FOR PAYING A PORTION OF THE COST OF ACQUIRING, CONSTRUCTING AND EQUIPPING A NEW APPROXIMATELY 66,000 SQUARE-FOOT, 118-BED SKILLED NURSING FACILITY TO REPLACE THE PISGAH VALLEY RETIREMENT MANOR, (3) PAY INTEREST ON THE NEW MONEY PORTION OF THE BONDS FOR APPROXIMATELY 13 MONTHS, AND (4) PAY CERTAIN COSTS INCURRED IN CONNECTION WITH THE ISSUANCE OF THE BONDS.
SCHEDULE K, PART II, LINE 3, TOTAL PROCEEDS:TOTAL PROCEEDS PRESENTED ON LINE 3 INCLUDE INVESTMENT EARNINGS TO DATE, CALCULATED AS SHOWN: BOND (A) - SALE PROCEEDS: $ 13,045,000 INVESTMENT EARNINGS: 9,913 TOTAL TO LINE 3: 13,054,913
SCHEDULE K, PART II, LINE 11, OTHER SPENT PROCEEDS:THE AMOUNT PRESENTED ON LINE 11 REPRESENTS AMOUNTS USED TO CURRENTLY REFUND A PORTION OF A PRIOR BANK LOAN ISSUED IN 2008.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
ELLA KIDDER
FAMILY RELATIONSHIP WITH DAVID KIDDER, CEO$67,322ELLA KIDDER IS AN EMPLOYEE OF THE ORGANIZATION0
KELLY KIMBLEY
FAMILY RELATIONSHIP WITH DAVID KIDDER, CEO$32,521KELLY KIMBLEY IS AN EMPLOYEE OF THE ORGANIZATION0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6AS STATED IN CARS' BYLAWS SECTION 3.1 "THE MEMBERS OF THE CORPORATION SHALL BE THE MEMBERS OF THE EXECUTIVE COMMITTEE OF THE CAROLINA CONFERENCE."
FORM 990, PART VI, SECTION A, LINE 7AAS STATED IN CARS' BYLAWS SECTION 4.3 "EACH VOTING MEMBER OF THE EXECUTIVE COMMITTEE OF THE CAROLINA CONFERENCE SHALL SERVE EX OFFICIO AS A VOTING MEMBER OF THE CARS BOARD OF DIRECTORS (I.E., CONSTITUENT BOARD)."
FORM 990, PART VI, SECTION A, LINE 7BAS STATED IN CARS' BYLAWS SECTION 4.1 "THE BUSINESS AND AFFAIRS OF THE CORPORATION SHALL BE MANAGED BY A BOARD OF DIRECTORS, REFERRED TO HEREIN AS THE "CONSTITUENT BOARD AND SECTION 4.13 "EXCEPT AS OTHERWISE PROVIDED IN THESE BYLAWS, THE ACT OF THE MAJORITY OF THE DIRECTORS PRESENT AT A MEETING AT WHICH A QUORUM IS PRESENT SHALL BE THE ACT OF THE CONSTITUENT BOARD."
FORM 990, PART VI, SECTION B, LINE 11THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM WITH ASSISTANCE AND OVERSIGHT BY MANAGEMENT. A COPY OF THE RETURN WAS PROVIDED TO EACH BOARD OF DIRECTORS MEMBER PRIOR TO ITS FILING. THE RETURN WAS REVIEWED AND DISCUSSED BY THE BOARD OF DIRECTORS AT THEIR REGULARY SCHEDULED MEETING.
FORM 990, PART VI, SECTION B, LINE 12CAT THE BOARD OF DIRECTORS ANNUAL MEETING, THE PRESIDENT AND CEO OF CAROLINA ADVENTIST RETIREMENT SYSTEMS, INC. PRESENTS A "STATEMENT OF ACCEPTANCE" OF THE POLICY ON CONFLICT OF INTEREST TO EACH OFFICER, DIRECTOR (I.E., BOARD MEMBER), AND KEY EMPLOYEE (I.E., ADMINISTRATORS). EACH OF THESE INDIVIDUALS ARE ASKED TO REVIEW AND SIGN THE STATEMENT WHICH INCLUDES A REPRESENTATION THAT THEY DO NOT HAVE A CONFLICT OF INTEREST. ADDITIONALLY, EACH OFFICER, DIRECTOR, AND KEY EMPLOYEE RECEIVE AN ORIENTATION AND ANNUAL TRAINING RELATED TO THE ORGANIZATION'S CORPORATE COMPLIANCE POLICY, INCLUDING ITS CORE VALUE OF CARING, DEDICATION, INTEGRITY, PROFESSIONALISM, QUALITY, RESPECT, AND SAFETY.
FORM 990, PART VI, SECTION B, LINE 15ANNUALLY MANAGEMENT OBTAINS A LETTER PREPARED BY A 3RD PARTY CONSULTANT COMPARING A RANGE OF CEO AND CFO SALARIES BASED ON HISTORICAL SALARIES OF COMPARABLE ORGANIZATIONS TO THE ORGANIZATION'S CEO AND CFO CURRENT SALARIES. IN THIS LETTER THE CONSULTANT PROVIDES COMMENTS AS TO THE REASONABLENESS OF THE ORGANIZATION'S CEO AND CFO'S SALARIES, WHICH IS REVIEWED BY THE ORGANIZATION'S EXECUTIVE BOARD. THE EXECUTIVE BOARD MAKES RECOMMENDATIONS FOR CEO AND CFO ANNUAL SALARY ADJUSTMENTS, WHICH MANAGEMENT INCORPORATES INTO THE ORGANIZATION'S ANNUAL BUDGET. THE EXECUTIVE BOARD THEN PRESENTS THIS INFORMATION AS PART OF THE BUDGET TO THE FULL BOARD OF DIRECTORS FOR APPROVAL AT THEIR ANNUAL MEETING.
FORM 990, PART VI, SECTION C, LINE 18THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. AUDITED FINANCIAL STATEMENTS ARE ALSO AVAILABLE TO THE PUBLIC ON THE NORTH CAROLINA DEPARTMENT OF INSURANCE'S WEBSITE. THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE UPON REQUEST.
FORM 990, PART IX, LINE 11GCONTRACT SERVICES: PROGRAM SERVICE EXPENSES 2,667,093. MANAGEMENT AND GENERAL EXPENSES 6,542. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,673,635.
FORM 990, PART XII, LINE 2C:THE PROCESS FOR THIS HAS NOT CHANGED SINCE THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1CAROLINA CONFERENCE OF SEVENTH-DAY ADVENTISTS INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 44270AddressLine1Txt
CityCHARLOTTECityNm
State AbbreviationNCStateAbbreviationCd
ZIP28215ZIPCd
FieldValueIRS element (for citing)
EIN454284485EIN
Primary ActivitiesSPIRITUAL DEVELOPMENTPrimaryActivitiesTxt
Legal Domicile StateNCLegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity Status1PublicCharityStatusTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled Organization0ControlledOrganizationInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1PISGAH ESTATES UNIT OWNERS ASSOCIATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line195 HOLCOMBE COVE ROADAddressLine1Txt
CityCANDLERCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28715ZIPCd
FieldValueIRS element (for citing)
EIN561769989EIN
Primary ActivitiesHOME OWNERS ASSOCIATIONPrimaryActivitiesTxt
Legal Domicile StateNCLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeCEntityTypeTxt
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
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 OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
PISGAH ESTATES UNIT OWNERS ASSOCIATION
L$166,200CASH
PISGAH ESTATES UNIT OWNERS ASSOCIATION
M$129,913CASH

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