2014-08-13T13:10:27-05:00 2013-09-30 420714325 MCGLADREY LLP 230 N ELM ST STE 1100 GREENSBORO NC 27401 990 2012-10-01 560634527 THE UNITED METHODIST RETIREMENT HOMES INC UNIT 9193843000 2600 CROASDAILE FARM PKWY NO A-500 DURHAM NC 277053153 JONATHAN ERICKSON 9193843000 2014-08-13 TAMELA L GAINEY P00437957 3362724551 2012 2015-11-30 17:44:51Z JONATHAN ERICKSON 2600 CROASDAILE FARM PKWY NO A-500 DURHAM NC 277053153 51290341 0 X WWW.UMRH.ORG X 1946 NC OWN, OPERATE, AND MANAGE CONTINUING CARE RETIREMENT COMMUNITIES 27 27 640 478 0 0 922478 475239 41872553 43093483 437967 1150655 304655 179395 43537653 44898772 441292 497279 0 0 15758802 16059938 0 0 0 24008176 25249523 40208270 41806740 3329383 3092032 159412632 161342715 133918652 131687168 25493980 29655547 TO PROVIDE QUALITY CARE AND SERVICES FOR AN INCLUSIVE AND DIVERSE POPULATION OF SENIOR ADULTS. 0 0 32478729 497279 43093483 OPERATE CONTINUING CARE RETIREMENT COMMUNITIES INCLUDING SKILLED NURSING FACILITIES. 32478729 1 1 0 0 0 0 0 0 0 1 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 1 0 0 0 1 1 1 0 0 0 1 74 0 640 1 0 0 0 0 0 0 0 0 0 0 X 27 27 1 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X STACY DOBSON 9193843002 2600 CROASDAILE FARM PKWY STE A-500 DURHAM NC 27705 JONATHAN ERICKSON 40.00 X X 166133 0 33901 DONALD METZGER 1.00 X X 0 0 0 GARY WHALEY 1.00 X X 0 0 0 JULIUS ADAMS 1.00 X X 0 0 0 NANCY MARKS 1.00 X X 0 0 0 LEE HARRISS 1.00 X X 0 0 0 JERRY GAMBILL 1.00 X 0 0 0 BRUCE JOBE 1.00 X 0 0 0 CARL HAMILL 1.00 X 0 0 0 JOHN GRISSOM 1.00 X 0 0 0 ROBBY LOWRY 1.00 X 0 0 0 CONNIE MOSELEY 1.00 X 0 0 0 WALTER PORIES 1.00 X 0 0 0 DEBBY MEYER 1.00 X 0 0 0 JERRY WOODARD 1.00 X 0 0 0 GREG WALLACE 1.00 X 0 0 0 PAUL CUNNINGHAM 1.00 X 0 0 0 HOPE WARD 1.00 X 0 0 0 CAROL GOEHRING 1.00 X 0 0 0 DONNA BANKS 1.00 X 0 0 0 ARTIE ROGERS 1.00 X 0 0 0 JERRY HOPFENGARDNER 1.00 X 0 0 0 LINDA TAYLOR 1.00 X 0 0 0 JACK CARROLL 1.00 X 0 0 0 SAM WYNN 1.00 X 0 0 0 JAYNE HUGGINS 1.00 X 0 0 0 DORIS REED 1.00 X 0 0 0 JAMES EBERT 1.00 X 0 0 0 STACY DOBSON 40.00 X 143063 0 22270 HOWARD DEWITT 40.00 X 137496 0 6040 WADE ROZIER 40.00 X 133367 0 34187 HEATHER MARCH 40.00 X 120128 0 13365 CAROL ROYCROFT 40.00 X 101319 0 19458 801506 0 129221 6 0 1 0 MORRISON MANAGEMENT SPECIALISTS 4721 MORRISON DRIVE STE 300 MOBILE AL 36625 DIETARY MANAGEMENT 2338729 LIFE CARE SERVICES LLC 400 LOCUST STREET SUITE 820 DES MOINES IA 50309 MANAGEMENT COMPANY 1540562 HERITAGE HEALTHCARE INC 536 OLD HOWELL ROAD GREENVILLE SC 29615 THERAPY PROVIDER 1148665 TRI-WAVE CARPETS 3222 GUESS ROAD DURHAM NC 27705 FLOORING CONTRACTOR 493616 THE BRICKMAN GROUP LTD 3630 SOLUTIONS CENTER CHICAGO IL 60677 LANDSCAPE MANAGEMENT 487735 13 475239 34812 475239 PATIENT SERVICES 623000 29737415 29737415 MEDICARE/MEDICAID PAYMENTS 623000 7293950 7293950 AMORT. OF ADVANCE FEES 623000 5153524 5153524 MANAGEMENT FEE 623000 908594 908594 43093483 1250774 1250774 12995 0 12995 12995 12995 6267432 24018 6061019 330550 206413 -306532 -100119 -100119 MISC OPERATING REVENUE 623000 162836 162836 3564 3564 166400 44898772 43093483 0 1330050 497279 497279 676458 676458 12918051 11657294 1260757 158166 114475 43691 995802 846972 148830 1311461 1152040 159421 2302469 287519 2014950 154849 154849 75804 75804 194773 194773 417887 301044 116843 189170 1687 187483 2867408 2744115 123293 1274342 837625 436717 36823 16700 20123 77911 37580 40331 4031824 3927803 104021 5581946 3669013 1912933 527209 527209 CONTRACTED LABOR 3596034 3170569 425465 ANCILLARY EXPENSES 1921885 1921885 EQUIPMENT RENTAL AND MA 611988 527108 84880 PATIENT DISCOUNTS 387524 387524 999677 380497 619180 41806740 32478729 9328011 0 800 1400 19046643 16150062 1782444 1897697 2317874 2624255 103092 103736 648823 536460 145228835 45155750 101471346 100073085 28651474 36236963 30937 31129 5359199 3687928 159412632 161342715 4202381 3928442 41966725 42212522 86456851 84325773 1292695 1220431 133918652 131687168 X 23034543 27081233 542102 549306 1917335 2025008 25493980 29655547 159412632 161342715 X 3092032 747854 321681 X X 0 1 X 1 0 X 679526 720870 600887 922478 475239 3399000 32682793 33410086 34773766 41872553 43093483 185832681 33362319 34130956 35374653 42795031 43568722 189231681 0 0 0 189231681 1104942 1057816 1165812 1506339 1263769 6098678 1104942 1057816 1165812 1506339 1263769 6098678 5509384 5816315 5801463 291865 166400 17585427 39976645 41005087 42341928 44593235 44998891 212915786 0.88880 0.85730 0.02860 0.03050 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2144657 332312 130216 16000 541314 4841 2045030 2055865 577293 251659 26425 713465 270 2144657 2291134 429226 -4112 23200 636898 285 2055865 1893373 510626 251738 19400 345203 2291134 1823773 261816 43683 235899 1893373 0.00000 0.72110 0.27890 0 1 1 6060019 6060019 119019906 34259463 84760443 8355383 5371213 2984170 11793527 5525074 6268453 100073085 FUNDS HELD FOR OTHERS 860457 DUE TO RELATED PARTY 48975 INTEREST RATE SWAP AGREEMENT 310999 1220431 X 44969966 747854 -676660 71194 44898772 0 44898772 40808399 0 40808399 998341 998341 41806740 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: AS DICTATED BY THE DONOR, EARNINGS ON THE ENDOWMENT FUNDS WILL SUPPORT BENEVOLENT NEEDS AT THE COMMUNITY AND EMPLOYEE SCHOLARSHIPS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE COMPANY IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE; ACCORDINGLY, THE ACCOMPANYING FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION OR LIABILITY FOR FEDERAL AND STATE INCOME TAXES. THE COMPANY HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2013. THE COMPANY BELIEVES THAT THEY ARE NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO SEPTEMBER 30, 2010. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN SPLIT INTEREST AGREEMENT 96,148. CHANGE IN VALUE OF PLEDGES 5,603. SPECIFIC INDIVIDUAL ASSISTANCE -481,279. BEAUTY AND BARBER EXPENSE -96,988. PATIENT SERVICE REVENUE DISCOUNTS -387,524. CHANGE IN VALUE OF INTEREST RATE SWAP AGREEMENT 219,930. BAD DEBT EXPENSE -32,550. PART XII, LINE 4B - OTHER ADJUSTMENTS: SPECIFIC INDIVIDUAL ASSISTANCE 481,279. BEAUTY & BARBER EXPENSE 96,988. PATIENT SERVICE REVENUE DISCOUNTS 387,524. BAD DEBT EXPENSE RECLASS 32,550. PART XII, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN SPLIT INTEREST AGREEMENTS - 96,148 CHANGE IN VALUE OF PLEDGES - 5,603 SPECIFIC INDIVIDUAL ASSISTANCE - (481,279) BEAUTY & BARBER EXPENSE - (96,988) PATIENT SERVICE REVENUE DISCOUNTS - (387,524) CHANGE IN VALUE OF INTEREST RATE SWAP AGREEMENT - 96,148 PART XIII, LINE 4B - OTHER ADJUSTMENTS: SPECIFIC INDIVIDUAL ASSISTANCE - 481,279 PATIENT SERVICE REVENUE DISCOUNTS - 387,524 BEAUTY & BARBER EXPENSE - 96,988 1 BENEVOLENT ASSISTANCE FOR RESIDENTS 35 481279 NURSING SCHOLARSHIPS 5 3000 STUDENT SCHOLARSHIPS 13 13000 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: UPON REVIEW OF EACH RESIDENT'S INDIVIDUAL FINANCIAL SITUATION, THE COMPANY MAY PERMIT THE RESIDENT TO REMAIN AT THE FACILITY FOR A LESSER FEE BASED ON THE RESIDENT'S ABILITY TO PAY BUT ONLY AFTER MEETING ALL OF THE SPEND-DOWN PROVISIONS OF ELIGIBILITY FOR THE MEDICAID PROGRAM AND ANY PUBLIC ASSISTANCE FUNDS. THE UNITED METHODIST RETIREMENT HOMES HAS FOUR POST-SECONDARY EDUCATION SCHOLARSHIP PROGRAMS FOR EMPLOYEES OF UNITED METHODIST RETIREMENT HOMES AND ITS CONTRACTORS. THE SCHOLARSHIPS ARE FUNDED BY DONORS AND ARE AWARDED ANNUALLY. SCHOLARSHIP RECIPIENTS ARE NOMINATED BY THEIR MANAGEMENT AND ARE SELECTED BY A THREE-MEMBER COMMITTEE COMPRISING THE MANAGER OF THE SCHOLARSHIP APPLICANTS, THE UNITED METHODIST RETIREMENT HOMES DIRECTOR OF HUMAN RESOURCES, AND THE VICE PRESIDENT OF THE UNITED METHODIST RETIREMENT HOMES FOUNDATION. THE COMMITTEE MAKES SELECTIONS OF SCHOLARSHIP RECIPIENTS BASED ON THE POLICY FOR DONOR-DIRECTED SCHOLARSHIP FUNDS, AND ON THE DONOR'S CRITERIA FOR AWARDING THE SCHOLARSHIP. 1 X X X X 0 0 0 0 0 0 0 0 0 JONATHAN ERICKSON 134132 0 31449 0 552 0 7535 0 26366 0 200034 0 0 0 STACY DOBSON 129943 0 13000 0 120 0 1007 0 21263 0 165333 0 0 0 WADE ROZIER 101367 0 31449 0 551 0 5687 0 28500 0 167554 0 0 0 A NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65820YDR4 2005-02-01 20790000 BUILD 59 NEW APARTMENTS 0 0 0 B NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65820YEW2 2005-09-01 47835000 REFUND SERIES 2000 BOND BALANCES 0 0 0 C NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 NONEAVAIL 2010-02-04 14300000 REPLACEMENT HEALTHCARE CENTER 0 0 0 D NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 NONEAVAIL 2010-02-18 12880000 CONVERT 2005B BONDS TO BQ STATUS 0 0 0 A 20790000 2036537 415800 18337663 2005 0 0 1 1 B 47835000 3011368 956700 43866932 2005 0 1 1 1 C 14300000 10401084 2010 0 0 1 1 D 12880000 12880000 2010 1 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 C 0 0 0 0 0 0 0 D 0 0 0 0 0 0 0 A 1 0 0 0 0 0 B 1 0 0 0 0 0 C 1 1 0 0 0 0 D 1 1 1 BB&T 5.000000000000 0 0 0 0 0 A 0 B 0 C 0 D 0 X 1 34812 FAIR MARKET VALUE 0 1 0 METHOD FOR DETERMINING NUMBER OF CONTRIBUTIONS: PART I, COLUMN (B): THE NUMBER OF CONTRIBUTORS REFERENCED IN PART I, COLUMN B IS REPRESENTATIVE OF THE NUMBER OF CONTRIBUTIONS. FORM 990, PART VI, SECTION A, LINE 2 JONATHAN ERICKSON (CORPORATE EXECUTIVE DIRECTOR) AND STACY DOBSON (CHIEF FINANCIAL OFFICER) SERVE AS OFFICERS OF UNITED METHODIST RETIREMENT HOMES AFFORDABLE HOUSING, INC. JONATHAN ERICKSON IS THE PRESIDENT OF UMRH AFFORDABLE HOUSING, INC. THE FOLLOWING MEMBERS OF THE BOARD OF TRUSTEES ARE ALSO MEMBERS OF THE BOARD OF TRUSTEES FOR CYPRESS GLEN RETIREMENT COMMUNITY, A RELATED ENTITY DISCLOSED ON SCHEDULE R: JONATHAN ERICKSON, NANCY MARKS, JULIUS ADAMS, JAYNE HUGGINS, ROBBY LOWRY, DONALD E. METZGER, WALTER PORIES, GREG WALLACE, CAROL GOEHRING, GARY WHALEY, CONNIE MOSELEY, CARL HAMILL, LEE HARRISS, DONNA BANKS, JERRY HOPFENGARDNER, JOHN GRISSOM, PAUL CUNNINGHAM, LINDA TAYLOR, HOPE WARD, JERRY WOODARD, AND SAM WYNN. THE FOLLOWING MEMBERS OF THE BOARD OF TRUSTEES ARE ALSO MEMBERS OF THE BOARD OF TRUSTEES FOR UNITED METHODIST RETIREMENT HOMES FOUNDATION, INC., A RELATED ENTITY DISCLOSED ON SCHEDULE R: JONATHAN ERICKSON, STACY DOBSON, JULIUS ADAMS, JOHN GRISSOM, CARL HAMILL, LEE HARRISS, DON METZGER, AND NANCY MARKS. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION'S CHIEF FINANCIAL OFFICER REVIEWS THE 990. FORM 990, PART VI, SECTION B, LINE 12C THE UMRH, INC. BOARD FILLS OUT THE CONFLICT OF INTEREST POLICY FORM EACH SEPTEMBER NOTING ANY CONTINUED CONFLICTS OF INTEREST. NEW BOARD MEMBERS ARE ORIENTED TO THE POLICY AND SIGN THE FORM UPON BECOMING MEMBERS. EACH BOARD MEMBER IS REQUIRED TO DISCLOSE ANY CONFLICTS TO THE CHAIRMAN PRIOR TO A VOTE BEING TAKEN. THE MEMBER MUST ABSTAIN FROM VOTING. THE CONFLICT OF INTEREST POLICY IS ALSO REVIEWED FOR THE EMPLOYEES AT ORIENTATION AND AT ANNUAL REVIEW. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION ROUTINELY CONSULTS THE SERVICES OF AN OUTSIDE AGENCY TO EVALUATE THE ORGANIZATION'S WAGE SCALES AND PAY GRADES. THE RESULTING WAGE SCALE AND THE EMPLOYEE'S PERFORMANCE AND ACCOMPLISHMENTS ARE CONSIDERED IN THE ANNUAL REVIEW PROCESS. IN SOME INSTANCES, A SOFTWARE PROGRAM CALLED "PERFORMANCE NOW" IS USED TO SIMPLIFY THE COMMUNICATION OF THE REVIEW AND ITS RESULTS. 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. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN SPLIT INTEREST AGREEMENT 96,148. CHANGE IN VALUE OF PLEDGES 5,603. CHANGE IN VALUE OF INTEREST RATE SWAP AGREEMENT 219,930. FORM 990, PART XII, LINE 2C THE ORGANIZATION'S OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED SINCE THE PRIOR YEAR. FORM 990, PART VII, SECTION A HOURS TO RELATED ORGANIZATION: JONATHAN ERICKSON - 1 HOUR PER WEEK TO CYPRESS GLEN RETIREMENT COMMUNITY AS A MEMBER OF THE BOARD OF TRUSTEES AND 1 HOUR PER WEEK TO UNITED METHODIST HOMES FOUNDATION, INC. AS A MEMBER OF THE BOARD OF TRUSTEES. THE FOLLOWING MEMBERS OF THE BOARD OF TRUSTEES ARE ALSO MEMBERS OF THE BOARD OF TRUSTEES FOR CYPRESS GLEN RETIREMENT COMMUNITY AND PROVIDE 1 HOUR OF SERVICE PER WEEK: NANCY MARKS, JULIUS ADAMS, JAYNE HUGGINS,JERRY GAMBILL, BRUCE JOBE, DEBBY MEYER,ARTIE ROGERS,JACK CARROLL, DORIS REED, JAMES EBERT, ROBBY LOWRY, DONALD E. METZGER, WALTER PORIES, GREG WALLACE, CAROL GOEHRING, GARY WHALEY, CONNIE MOSELEY, CARL HAMILL, LEE HARRISS, DONNA BANKS, JERRY HOPFENGARDNER, JOHN GRISSOM, PAUL CUNNINGHAM, LINDA TAYLOR, HOPE WARD, JERRY WOODARD, AND SAM WYNN. THE FOLLOWING MEMBERS OF THE BOARD OF TRUSTEES ARE ALSO MEMBERS OF THE BOARD OF TRUSTEES FOR UNITED METHODIST RETIREMENT HOMES FOUNDATION, INC. AND PROVIDE 1 HOUR OF SERVICE PER WEEK: STACY DOBSON, JULIUS ADAMS, JOHN GRISSOM, CARL HAMILL, LEE HARRISS, DON METZGER, AND NANCY MARKS. FORM 990, SCHEDULE R, PART V, LINE 2 TRANSACTIONS WITH RELATED ORGANIZATIONS: THE FILING ORGANIZATION AND UMRH AFFORDABLE HOUSING, INC. SHARE A FACILITY THAT HAS A NET BOOK BASIS OF $84,760,443 (COST = $119,019,906 AND ACCUMULATED DEPRECIATION = $34,259,463). THE FILING ORGANIZATION AND UMRH AFFORDABLE HOUSING, INC. SHARE TWO EMPLOYESS, JONATHAN ERICKSON ($166,133 REPORTABLE COMPENSATION AND $26,366 OTHER COMPENSATION BOTH PAID BY THE FILING ORGANIZATION) AND STACY DOBSON ($143,063 REPORTABLE COMPENSATION AND $21,263 OTHER COMPENSATION BOTH PAID BY THE FILING ORGANIZATION). FORM 990, PART VII, SECTION A, COLUMN F THE ORGANIZATION, IN A FULL TRANSPARENCY POSTURE TO REPORTING, IS REPORTING ALL BENEFITS IN FULL IN COLUMN F, PART VII AND NOT APPLYING THE $10,000 PER ITEM EXCEPTION FOR CERTAIN BENEFITS. UMRH AFFORDABLE HOUSING DEVELOPMENT LLC 2600 CROASDAILE FARM PKWY STE A-500 DURHAM NC 277053153 043701058 DEVELOP AFFORDABLE HOUSING NC 63 87572 N/A CYPRESS GLEN RETIREMENT COMMUNITY 2600 CROASDAILE FARM PARKWAY SUITE DURHAM NC 27705 561961935 CONTINUING CARE RETIREMENT COMMUNITY NC 501(C)(3) LINE 9 N/A 0 UNITED METHODIST RETIREMENT HOMES FOUNDATION INC 2600 CROASDAILE FARM PARKWAY SUITE DURHAM NC 27705 561870172 CONTRIBUTE FUNDS TO UMRH, INC. AND CYPRESS GLEN RETIREMENT COMMUNITY NC 501(C)(3) LINE 11A N/A 0 UMRH AFFORDABLE HOUSING INC 2600 CROASDAILE FARM PARKWAY SUITE DURHAM NC 27705 010724816 OPERATE AFFORDABLE HOUSING NC N/A C 4495 34980 1.00000 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 UMRH AFFORDABLE HOUSING INC N 84760443 UMRH AFFORDABLE HOUSING INC O 365368