2015-08-14T10:21:15-05:00 2014-09-30 410746749 CLIFTONLARSONALLEN LLP 227 WEST TRADE STREET SUITE 800 CHARLOTTE NC 28202 990 2013-10-01 566065223 CORNELIA NIXON DAVIS INC CORN 9106867195 1011 PORTERS NECK RD WILMINGTON NC 28405 CHARLES LONG CEO 9106867195 2015-08-13 1 JOHN NORMAN P01506766 7049985200 2013 2016-02-25 16:41:14Z DAVIS HEALTH CARE CENTER CHARLES LONG 1011 PORTERS NECK RD WILMINGTON NC 28405 25119671 0 X WWW.THEDAVISCOMMUNITY.ORG X 1966 NC TO PROVIDE QUALITY HEALTH, REHABILITATION, AND WELLNESS SERVICES TO AGING ADULTS. 12 12 613 65 0 0 1006861 847010 23512780 23843140 5466 21718 251566 300551 24776673 25012419 0 0 0 0 12816610 13062586 0 0 0 9555916 10049036 22372526 23111622 2404147 1900797 47078380 56256843 17409245 24709685 29669135 31547158 X OUR MISSION IS TO PROVIDE QUALITY HEALTH, REHABILITATION, AND WELLNESS SERVICES TO AGING ADULTS IN A LOVING CONTINUUM OF CARE ENVIRONMENT IN WHICH EACH RESIDENT LIVES AT AN OPTIMUM LEVEL OF FUNCTION AND DIGNITY. WE STRIVE TO BE THE PLACE WHERE AGING ADULTS CHOOSE TO LIVE AND EMPLOYEES DESIRE TO WORK. 0 0 14064536 16320714 NURSING HOMECORNELIA NIXON DAVIS OPERATED A NURSING HOME THAT SERVED 63,783. PATIENT DAYS THROUGHOUT THE YEAR ENDED SEPTEMBER 30, 2014. TOTAL OCCUPANCY WAS 88%. 4835500 6906109 ASSISTED LIVING FACILITYCORNELIA NIXON DAVIS OPERATED AN ASSISTED LIVING RESIDENCY THAT SERVED 46,374 PATIENT DAYS THROUGHOUT THE YEAR ENDED SEPTEMBER 30, 2014. TOTAL OCCUPANCY WAS 86%. 504224 616317 WELLNESS CENTERTHE WELLNESS CENTER OPENED IN OCTOBER OF 2010 AND PROVIDES A CONTINUUM OF CARE TO RESIDENTS THAT ARE DISCHARGED FROM INPATIENT REHABILITATION. THE WELLNESS CENTER IS OPEN TO SENIORS FROM WITHIN THE DAVIS COMMUNITY AND ALSO THE GENERAL PUBLIC. THE CENTER PROVIDES OUTPATIENT REHABILITATION SERVICES AS WELL AS A FULLY FUNCTIONAL FITNESS FACILITY. MEMBERSHIP TO THE FITNESS FACILITY INCLUDES ACCESS TO A HEATED SALTWATER POOL, WEIGHT AND CARDIO EXERCISE ROOMS, EXERCISE CLASSES, AND SEMINARS DESIGNED TO MEET THE HEALTH AND FITNESS NEEDS OF SENIORS. 99009 99009 19503269 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 53 0 1 613 1 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X VINCE MCKNIGHT 9106867195 1011 PORTERS NECK RD WILMINGTON NC 28405 W LEE WILLIAMS SECRETARY/TREASURER 1.00 X 0 0 0 ELIZABETH KING BOARD MEMBER 1.00 X 0 0 0 LT GEN JAMES M LEE BOARD MEMBER 1.00 X 0 0 0 WILLIAM N SMITH BOARD MEMBER 1.00 X 0 0 0 ELIZABETH WRIGHT BOARD MEMBER 1.00 X 0 0 0 CHERYLL SCHRAMM BOARD MEMBER 1.00 X 0 0 0 WALTER CRAVEN BOARD MEMBER 1.00 X 0 0 0 DR WILLIAM O MCMILLAN JR CHAIRMAN 1.00 X 0 0 0 DR JAMES GRAHAM BOARD MEMBER 1.00 X 0 0 0 REID MURCHISON BOARD MEMBER 1.00 X 0 0 0 BRUCE GIBSON BOARD MEMBER 1.00 X 0 0 0 CHARLES LONG CEO 40.00 X 177557 0 16565 ANGIE BARR NURSING HOME ADMINISTRATOR 40.00 X 114926 0 19364 292483 0 35929 3 0 1 0 MONTEITH CONSTRUCTION 223 N GRAHAM STREET STE 100 CHARLOTTE NC 28202 CONSTRUCTION 9028304 GENESIS ELDERCARE PO BOX 821322 PHILADELPHIA PA 19182 THERAPY SERVICES 2559763 RX SERVICE DBA OMNICARE PO BOX 715268 COLUMBUS OH 43271 PHARMACY 779486 US FOOD SERVICE PO BOX 602211 CHARLOTTE NC 28260 FOOD SERVICE 707751 MCKESSON PO BOX 630693 CINCINNATI OH 45274 NURSING 419232 16 847010 847010 RESIDENT SERVICE 623000 23843140 23843140 23843140 35637 35637 143676 93333 50343 50343 50343 13919 -13919 -13919 -13919 PERSONAL CARE 900099 102840 102840 EMPLOYEE MEALS 900099 51065 51065 96303 96303 250208 25012419 23843140 0 322269 310800 6216 304584 9259956 8364922 895034 3460334 2805140 655194 31496 31496 36943 36943 66965 66965 2805727 2693102 112625 123162 2740 120422 235636 1862 233774 115316 115316 805091 805091 26212 2536 23676 180221 180221 1655778 1632186 23592 402825 402825 PROGRAM SUPPLIES 1591772 1591772 DIETARY SUPPLIES 937717 937717 BED TAX ASSESSMENT 359883 359883 BAD DEBT EXPENSE 200004 200004 505784 428485 77299 23111622 19503269 3608353 0 2655919 6904777 5181510 5104254 2218452 1624082 141264 131747 286378 284093 61480566 20068476 35594433 41412090 1000424 795800 47078380 56256843 2496831 3186644 6224 3120 14754705 21368436 151485 151485 17409245 24709685 X 29288981 31258540 325154 233618 55000 55000 29669135 31547158 47078380 56256843 X 1900797 -22774 X X 0 1 X 1 0 X 349883 85568 798559 1006861 847010 3087881 21179018 24298488 23318055 23512780 23843140 116151481 21528901 24384056 24116614 24519641 24690150 119239362 50000 736950 786950 0 50000 736950 786950 118452412 123758 101597 221802 41658 178145 666960 123758 101597 221802 41658 178145 666960 378300 269609 216879 250371 1115159 22030959 24755262 24338416 24778178 25118666 121021481 0.97880 0.96290 0.00550 0.00620 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 62652 1168 63820 61536 1116 62652 61335 201 61536 61065 270 61335 55245 5309 511 61065 0.98620 0.01380 0 0 3068678 3068678 48521102 13369218 35151884 6847568 6699258 148310 3043218 3043218 41412090 ENVIRONMENTAL REMEDIATION LIABILITY 151485 151485 25082978 0 25082978 -70559 -70559 25012419 23204955 93333 93333 23111622 0 23111622 PART V, LINE 4: THE EARNINGS FROM THE CORPUS AMOUNT OF THE INVESTED ENDOWMENT FUNDS ARE INTENDED TO BE USED TOWARDS EMPLOYEE APPRECIATION. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSE -93,333. ASSETS RELEASED FROM RESTRICTION 22,774. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSE 93,333. PART XII, LINE 4B - OTHER ADJUSTMENTS: OTHER X X X X X 0 0 0 1 0 0 0 0 0 CHARLES LONG CEO 130554 0 47003 0 0 0 6214 0 10351 0 194122 0 0 0 PART I, LINE 5 THE EXECUTIVE DIRECTOR'S COMPENSATION INCLUDES A YEARLY BONUS TIED TO BOTH OPERATIONAL AND FINANCIAL OBJECTIVES. THE EXECUTIVE COMMITTEE OF THE BOARD EVALUATES EXECUTIVE DIRECTOR PERFORMANCE AND DETERMINES THE YEARLY BONUS ACHIEVEMENT PERCENTAGE. A NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 NONEAVAIL 2012-09-27 27665000 NEW AND RENOVATED CONSTRUCTION 0 0 0 A 27665000 265000 8878436 10270000 8516564 1 0 0 1 A 0 0 1 1 0 0 0 1 A 1 1 0 0 0 0 A 1 FORM 990, PART VI, SECTION B, LINE 11 THE EXECUTIVE DIRECTOR AND FINANCE ADMINISTRATOR REVIEW THE FORM 990 PRIOR TO ISSUANCE. FORM 990, PART VI, SECTION B, LINE 12C IN THE COURSE OF MEETINGS OR ACTIVITIES, EACH DIRECTOR WILL DISCLOSE ANY INTERESTS IN A TRANSACTION OR DECISION WHERE THE DIRECTOR (INCLUDING THE DIRECTOR'S BUSINESS OR OTHER NONPROFIT AFFILIATION), THE DIRECTOR'S FAMILY AND /OR SIGNIFICANT OTHER, EMPLOYER, OR CLOSE ASSOCIATES WILL RECEIVE A BENEFIT OR GAIN. AFTER DISCLOSURE THE DIRECTOR WILL BE ASKED TO LEAVE THE ROOM FOR THE DISCUSSION AND NOT BE PERMITTED TO VOTE ON THE QUESTION. FORM 990, PART VI, SECTION B, LINE 15 ANNUALLY, THE COMPENSATION COMMITTEE REVIEWS THE EXECUTIVE DIRECTOR'S PERFORMANCE AND COMPARES HIS COMPENSATION TO SIMILAR NON-PROFITS BY REVIEWING 990 FORMS. THE COMPENSATION COMMITTEE IS COMPRISED ENTIRELY OF BOARD MEMBERS. THE FINANCE COMMITTE REVIEWS THE PROPOSED SALARIES OF ALL ADMINISTRATORS DURING ANNUAL BUDGET APPROVAL. EACH YEAR, THE NEED FOR A WAGE COMPARABILITY STUDY IS EVALUATED AND A CONSULTANT IS HIRED AS NECESSARY. ADDITIONALLY, THE HR DIRECTOR USES A PRINTED PUBLICATION ABOUT CCRC COMPENSATION TO REVIEW INDIVIDUAL SALARIES FOR COMPARISON TO INDUSTRY AVERAGES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: RELEASE FROM RESTRICTION -22,774. FORM 990, PART XII, LINE 2C NO CHANGE FROM PRIOR YEAR.