2014-05-13T14:06:23-05:00 2013-09-30 560747981 DIXON HUGHES GOODMAN LLP 130 TURNBERRY WAY PINEHURST NC 28374 990 2012-10-01 560729010 THE EPISCOPAL HOME FOR THE AGEING IN THE DIOCESE OF NORTH CAROLINA INC EPIS 9106920300 500 EAST RHODE ISLAND AVENUE SOUTHERN PINES NC 28387 JEFFREY I HUTCHINS 9106920300 2014-05-08 1 SCOTT BREWER P00004789 9106928555 2012 2015-11-30 17:44:51Z PENICK VILLAGE JEFFREY I HUTCHINS 500 EAST RHODE ISLAND AVENUE SOUTHERN PINES NC 28387 15211726 0 X WWW.PENICKVILLAGE.ORG X 1957 NC OPERATES A CONTINUING CARE RETIREMENT COMMUNITY, SEE ALSO PT III, LN 1. 23 23 283 80 0 0 204983 245190 12009223 12767023 116892 128806 130456 202228 12461554 13343247 0 0 0 0 6995169 7140302 0 0 0 7068188 7074244 14063357 14214546 -1601803 -871299 50957465 45354929 47371296 42835254 3586169 2519675 X PENICK VILLAGE'S MISSION IS TO BE A FAMILY THAT CREATES A LOVING COMMUNITY BY MAKING EVERY DAY GREAT FOR ONE ANOTHER. THE MISSION INCLUDES PROVIDING HOUSING, SERVICES, AND LONG-TERM CARE TO OVER 200 RESIDENTS DURING FISCAL YEAR 2012. THE SERVICES AND CARE ARE PROVIDED IN INDEPENDENT LIVING, ASSISTED LIVING, AND SKILLED NURSING AREAS. PENICK VILLAGE ALSO CONTRIBUTES TO THE GREATER SOUTHERN PINES COMMUNITY IN WHICH IT IS LOCATED BY DONATING TIME AND RESOURCES TO THE MOORE COUNTY CHAMBER OF COMMERCE, FIRSTHEALTH HOSPITAL, LEADINGAGE NC, EPISCOPAL DAY SCHOOL, RED CROSS, MEALS ON WHEELS OF THE SANDHILLS, STOP HUNGER NOW, AND THE SOUTHERN PINES FIRE AND POLICE DEPARTMENTS. THE PENICK VILLAGE COMMUNITY ALSO PROVIDES FINANCIAL ASSISTANCE TO THOSE RESIDENTS IN NEED. 0 0 2485871 DINING SERVICES IS ONE OF PENICK VILLAGE'S ESSENTIAL SERVICES. DINING SERVICES STRIVES TO PROVIDE A WONDERFUL DINING EXPERIENCE IN ALL LEVELS OF CARE FOR THE RESIDENTS AND THEIR FAMILY AND FRIENDS. THERE ARE SEVERAL DINING OPPORTUNITIES ON THE CAMPUS, INCLUDING THE CAFE EXPERIENCE, A PRIVATE DINING ROOM, CATERING IN ONE'S APARTMENT OR COTTAGE, INDIVIDUALIZED MENUS, AND MORE. DINING SERVICES ALSO PREPARES THE MEALS FOR MEALS ON WHEELS OF THE SANDHILLS ALONG WITH HOSTING EVENTS FOR OTHER SPECIAL COMMUNITY GROUPS SUCH AS KIWANIS. AS AN EMPLOYEE BENEFIT, THE STAFF ALSO ENJOYS WONDERFUL MEALS AT A GENEROUS DISCOUNT. 590887 HOUSEKEEPING IS ANOTHER ONE OF PENICK VILLAGE'S ESSENTIAL SERVICES. HOUSEKEEPING PROVIDES GENERAL CLEANING SERVICES ALONG WITH LINEN SERVICES AS REQUESTED. THE HOUSEKEEPING PERSONNEL ALSO BUILD GREAT RELATIONSHIPS WITH THE RESIDENTS THEY ARE SERVING AND HAVE HELPED SIGNIFICANTLY IN TIMES OF NEED. 2691170 NURSING IS KEY TO THE CONTINUUM OF CARE FOR THE RESIDENTS AT PENICK VILLAGE. SKILLED NURSING SERVICES ARE PROVIDED PER PHYSICIAN ORDERS THAT MAY INCLUDE BUT AREN'T LIMITED TO ASSISTANCE WITH ACTIVITIES OF DAILY LIVING, MEDICATION ADMINISTRATION, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, SPECIALIZED DIETS, AND OTHER NEEDS PER ORDERS. THE VISION OF PENICK VILLAGE IS TO DEINSTITUTIONALIZE THE AGEING EXPERIENCE. QUALITY NURSING IS KEY TO ACHIEVING THIS AND IN MAXIMIZING THE QUALITY OF LIFE FOR EACH OF THE RESIDENTS. THE CARE IS PERSONALIZED, AND A STRONG PARTNERSHIP IS DEVELOPED AMONG THE RESIDENT, HIS OR HER FAMILY, AND THE STAFF AT PENICK VILLAGE IN ORDER TO HAVE THE RESIDENT'S NEEDS DRIVE HIS OR HER PLAN OF CARE. 5255256 PERSONAL CARE, PERSONAL SERVICES, FACILITY SERVICES, ACTIVITIES, AND HOME CARE. 5255256 11023184 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 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 1 0 0 0 1 37 0 1 283 1 0 0 0 0 0 0 0 0 0 0 X 23 23 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NC X JEFFREY I HUTCHINS 9106920300 500 EAST RHODE ISLAND AVENUE SOUTHERN PINES NC 28387 JUDITH LEGGETT 1.00 X X 0 0 0 KEITH JUNK 1.00 X X 0 0 0 JOHN GREER 1.00 X 0 0 0 BETTY ATWELL 1.00 X 0 0 0 ROOT EDMONSON 1.00 X 0 0 0 ALICE FREEMAN 1.00 X 0 0 0 JOHN FRIZZELL III 1.00 X 0 0 0 LOUIS GENTRY 1.00 X 0 0 0 REV HOLLY GLOFF 1.00 X 0 0 0 JANE MASK 1.00 X 0 0 0 MAY SHERROD 1.00 X 0 0 0 EUGENIA SIMONS 1.00 X 0 0 0 HARRIET WHITLEY 1.00 X 0 0 0 DARLENE G VAUGHN 1.00 X 0 0 0 ROBERT STEMLER 1.00 X 0 0 0 DOUGLAS GILL 1.00 X X 0 0 0 RT REV MICHAEL B CURRY 1.00 X X 0 0 0 RICHARD HIGGINBOTHAM 1.00 X 0 0 0 PATRICIA SWINDELL 1.00 X 0 0 0 THOMAS GOODRUM 1.00 X 0 0 0 REV FRED L THOMPSON 1.00 X 0 0 0 DAVID BYRD GWINN 1.00 X 0 0 0 CAROLYN BERANEK 1.00 X 0 0 0 ANNIE HAGER-BLUNK 1.00 X 0 0 0 C MARCUS HARRIS 1.00 X 0 0 0 LYNNE HEALY 1.00 X 0 0 0 JUDIE HENRY 1.00 X 0 0 0 KATHRYN CARTER JACOBS 1.00 X 0 0 0 MARION ROSE 1.00 X 0 0 0 REV NICHOLSON B WHITE 1.00 X 0 0 0 REV PAUL S WINTON 1.00 X 0 0 0 JEFFREY HUTCHINS 40.00 X 161830 0 0 CHERYL FUTRELL 40.00 X 113848 0 0 ROGER CIOKAN FORMER CFO 40.00 X 108518 0 0 384196 0 0 3 0 1 0 BREWER'S PAINTING 1129 MCNEIL ST CARTHAGE NC 28327 PAINTING 199950 DIXON HUGHES GOODMAN LLP PO BOX 602828 CHARLOTTE NC 28260 PROF SERVICES 109381 2 245190 245190 RESIDENT CARE 623000 4745903 4745903 NURSING 623000 2762478 2762478 ADMISSION DONATION 623000 2031930 2031930 PERSONAL CARE 623000 660203 660203 2566509 2566509 12767023 150766 150766 1846519 1851896 16583 -5377 -16583 -21960 -21960 R & R INCOME 900099 83757 83757 GUEST FEES & MEALS 900099 60177 60177 MEALS ON WHEELS 900099 58294 58294 202228 13343247 13098057 0 0 384196 384196 5254953 4789055 465898 1080880 943352 137528 420273 362008 58265 28991 28991 804642 226587 578055 166909 166909 1448503 1369892 78611 746949 679372 67577 583017 583017 1982145 1982145 493158 493158 REPAIRS & MAINTENANCE 527331 460615 66716 MISCELLANEOUS 268060 210158 57902 BAD DEBTS 24539 24539 14214546 11023184 3191362 0 1250 1250 6065522 1542036 2083792 832069 1151 1151 46386 177445 60511325 23405002 37532804 37106323 4580117 5180820 646443 513835 50957465 45354929 662438 360168 26566144 19394288 20142714 23080798 47371296 42835254 X 3107714 2070149 149048 120119 329407 329407 3586169 2519675 50957465 45354929 X -871299 -9043 -188386 2234 X 0 1 X 0 0 X 648246 782460 464545 204983 245190 2345424 10342593 10095372 11383229 12009223 12767023 56597440 10990839 10877832 11847774 12214206 13012213 58942864 170000 177500 185000 195000 207500 935000 0 170000 177500 185000 195000 207500 935000 58007864 159156 143031 130478 116892 128806 678363 159156 143031 130478 116892 128806 678363 311416 108609 120781 130456 202228 873490 11461411 11129472 12099033 12461554 13343247 60494717 0.95890 0.95960 0.01120 0.01400 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 796174 796174 54660279 19458057 35202222 5052596 3765744 1286852 2276 181201 -178925 37106323 DEFERRED ENTRANCE FEES 14380028 ACCRUED LIABILITIES 615768 REFUND LIABILITY 8085002 23080798 0 0 0 0 0 0 0 0 0 JEFFREY HUTCHINS 161830 0 0 0 0 0 0 0 0 0 161830 0 0 0 A NC MEDICAL CARE COMMISSION 521309402 NONEAVAIL 2004-01-22 5655000 CUR. REFUND/CONSTRUCTION 0 0 0 B NC MEDICAL CARE COMMISSION 521309402 NONEAVAIL 2010-01-20 30000000 NEW CONSTRUCTION 0 0 0 A 5655000 5839499 112959 4967866 1993 1 0 1 1 B 10020690 28031368 428691 550000 27052677 2011 0 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 1 0 0 0 1 B 0 0 1 0 1 1 BB&T 15.000000000000 0 0 0 0 1 A 1 B 1 PART I, COLUMN F DESCRIPTION OF PURPOSE - BOND A THE PROCEEDS OF THE SERIES 2004 ISSUE WERE USED TO PROVIDE FUNDS FOR (I) CURRENT REFUNDING OF TWO PRIOR ISSUES, (II) FUND A DEBT SERVICE FUND, (III) PAY A PORTION OF ISSUANCE COSTS, AND (IV) PAY ACCRUED INTEREST ON THE BONDS. PART I, COLUMN F DESCRIPTION OF PURPOSE - BOND B THE PROCEEDS OF THE SERIES 2010 ISSUE WERE USED TO PROVIDE FUNDS FOR (I) PAY A PORTION OF THE ISSUANCE COSTS AND (II) THE PROJECT, A NEW 69-UNIT APARTMENT BUILDING AND A NEW APPROXIMATELY 39,000 SQUARE FOOT COMMUNITY CENTER ON EXISTING CAMPUS. PART II, LINE 3 TOTAL PROCEEDS OF ISSUE - BOND A TOTAL PROCEEDS ON LINE 3 FOR BOND (A) INCLUDES CUMULATIVE INVESTMENT EARNINGS OF $185,655. PART II, LINE 10 CAPITAL EXPEDITURES FOR PROCEEDS - BOND B BOND (B) WAS ESTABLISHED AS A DRAW-DOWN AGREEMENT TO REIMBURSE THE ORGANIZATION FOR CAPITAL ACQUISITION AND CONSTRUCTION PERIODICALLY. BOND PROCEEDS WERE NOT INVESTED BY THE ORGANIZATION DURING CONSTRUCTION, AND THERE ARE NO INVESTMENT EARNINGS TO REPORT. PART II, LINE 11 OTHER SPENT PROCEEDS - BOND A OTHER SPENT PROCEEDS ON LINE 11 FOR BOND (A) INCLUDES AMOUNTS USED TO CURRENTLY REFUND PRIOR ISSUES FROM 1985 AND 1993. FORM 990, PART VI, SECTION B, LINE 11 PRIOR TO THE FILING OF THE FORM 990, THE ORGANIZATION PROVIDED A COPY OF FORM 990 TO ALL VOTING MEMBERS OF THE BOARD AND ASKED FOR QUESTIONS. FORM 990 IS REVIEWED IN DEPTH BY THE FINANCE COMMITTEE WHICH HAS BEEN APPOINTED BY THE BOARD OF DIRECTORS FOR THIS OVERSIGHT. THE BOARD OF DIRECTORS VOTED TO APPROVE AND ACCEPT THE FORM 990 AS PRESENTED. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES THE BOARD TO ANNUALLY COMPLETE DISCLOSURE FORMS CONCERNING POSSIBLE CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS APPOINTED A COMPENSATION REVIEW COMMITTEE TO DETERMINE COMPENSATION FOR THE CEO, CFO AND COO OF THE ORGANIZATION. THIS REVIEW IS CONDUCTED ON AN ANNUAL BASIS IN ACCORDANCE WITH THE REBUTTABLE PRESUMPTION OF REASONABLENESS GUIDELINES AND MUST BE REVIEWED AND APPROVED BY THE ENTIRE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT THE ADMINISTRATION OFFICES. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: DECREASE IN FAIR VALUE OF SPLIT-INTEREST AGREEMENT -256. UNREALIZED LOSS ON FAIR VALUE OF INTEREST RATE CAP AGREEMENT 2,490. PENICK VILLAGE FOUNDATION 500 EAST RHODE ISLAND AVENUE SOUTHERN PINES NC 28387 201055492 TO RAISE AND HOLD FUNDS FOR CHARITABLE PURPOSES NC 501(C)(3) LINE 9 THE EPISCOPAL HOME FOR THE AGEING IN THE DIOCESE OF NORTH CAROLINA INC 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 PENICK VILLAGE FOUNDATION C 324441 CASH