2013-01-30T11:03:26-06:00 2012-03-31 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2011-04-01 560963926 MORAVIAN HOME INCORPORATED MORA 3367678130 1000 SALEMTOWNE DRIVE WINSTONSALEM NC 27106 CAROLYN J TWISDALE 3367678130 2013-01-30 1 AMY BIBBY P00445891 8282542254 2011 2016-02-25 16:41:14Z SALEMTOWNE CAROLYN J TWISDALE 1000 SALEMTOWNE DRIVE WINSTONSALEM NC 27106 19144976 0 X WWW.SALEMTOWNE.ORG X 1971 NC LONG TERM CARE FOR THE ELDERLY 18 18 362 212 0 0 1232642 1098735 16569423 17038657 840510 650666 307160 264301 18949735 19052359 665596 679265 0 0 9091642 9420777 0 0 125899 7947745 8149749 17704983 18249791 1244752 802568 68474344 68540459 44622070 43510691 23852274 25029768 X SALEMTOWNE IS A NON-PROFIT CONTINUING CARE RETIREMENT COMMUNITY THAT PROMOTES THE WELL-BEING OF ITS RESIDENTS BY PROVIDING A CARING ENVIRONMENT. SALEMTOWNE IS AN ECUMENICAL COMMUNITY THAT REFLECTS THE MORAVIAN VALUES OF INDIVIDUAL RESPECT, HOSPITALITY, LIFE-LONG LEARNING, AND LOVE OF THE ARTS. 0 0 15782786 177732 17038657 SALEMTOWNE PROVIDED SERVICES THROUGH LONG-TERM CARE FOR ELDERLY IN THE WINSTON-SALEM COMMUNITY AND SURROUNDING AREAS. IT IS THE MISSION OF THE SALEMTOWNE COMMUNITY OUTREACH PROGRAM TO PROVIDE RESOURCES FOR SERVICES, PROGRAMS AND EDUCATION THAT ENHANCE THE QUALITY OF LIVING AND CARE FOR SENIOR ADULTS OF PIEDMONT NORTH CAROLINA. SALEMTOWNE STRIVES TO SHARE ITS EXPERTISE IN THE AREA OF AGING BY OFFERING EDUCATION AND TRAINING TO SENIOR ADULTS, FAMILIES AND CAREGIVERS; BY UTILIZING ITS TIME, TALENTS, AND FACILITIES FOR PROGRAMS AND EDUCATION; AND BY SPONSORING AND/OR SUPPORTING PROGRAMS OF ORGANIZATIONS AND ASSOCIATIONS DEDICATED TO SENIOR ADVOCACY. SALEMTOWNE PROVIDED CONTRIBUTIONS AND SERVICES TO ORGANIZATIONS SUCH AS: - ALZHEIMER'S ASSOCIATION OF FORSYTH COUNTY- AMERICAN HEART ASSOCIATION- ARDMORE MORAVIAN CHURCH- AUGSBURG LUTHERAN CHURCH- BOOKMARKS BOOK FESTIVAL - CALVARY MORAVIAN CHURCH - CARENET COUNSELING, INC.- COALITION OF MINISTRIES FOR OLDER ADULTS- COMMUNITY PARTNERSHIP FOR END OF LIFE (HOSPICE)- CONGREGATIONAL NURSE AND HEALTH MINISTRIES OF FORSYTH COUNTY- DIXIE CLASSIC FAIR- ECHO COUNCIL- EMMA BAHNSON SERVICE LEAGUE- N.C. CHAPLAINS' ASSOCIATION- FAMILY SERVICES- FORSYTH COUNTY AGING SERVICES- FORSYTH COUNTY SENIOR SERVICES- FORSYTH TECHNICAL COMMUNITY COLLEGE- HABITAT FOR HUMANITY- HANDS ON NWNC- HOSPICE & PALLIATIVE CARE CENTER- HOSPICE HOPE RUN/WALK- IWO JIMA SURVIVORS - JEFFERSON ELEMENTARY SCHOOL- KNOLLWOOD BAPTIST CHURCH - LEADERSHIP WINSTON SALEM- LIFE MINISTRIES- MARY ANN FOGLE SERVICE LEAGUE- MORAVIAN CHURCH SOUTHERN PROVINCE- MORAVIAN MUSIC FOUNDATION- N.C. NURSING HOME ADMINISTRATORS BOARD- N.C. DIRECTORS OF NURSING ADMINISTRATION - LONG TERM CARE- NATIONAL ASSOCIATION OF DIRECTORS OF NURSING - LONG TERM CARE- NORTHWEST AHEC- OLIVET MORAVIAN CHURCH- ROTARY CLUB OF FORSYTH COUNTY- SAMARITAN MINISTRIES- SHEPHERD'S CENTER- SPEAS SCHOOL/WINGS PROGRAM- SPECIAL NEEDS DANCE FOR ADULT HANDICAP - NO LIMITS 11- ST. PAUL'S EPISCOPAL CHURCH- STORYLINE- SUNNYSIDE MINISTRIES OF THE MORAVIAN CHURCH- UNITED WAY OF FORSYTH COUNTY- WAKE FOREST BAPTIST HEALTH- WAKE FOREST BAPTIST HEALTH STITCH CENTER FOR AGING - WAKE FOREST UNIVERSITY - INSTITUTIONAL REVIEW BOARD- WAKE FOREST UNIVERSITY (VARIOUS STUDENT GROUPS/CLASSES)- WINSTON SALEM FOUNDATION - WINSTON SALEM MAYOR'S PHYSICAL FITNESS DAYSALEMTOWNE'S CURRENT COMMUNITY BENEFIT PROGRAMS INCLUDE FINANCIAL ASSISTANCE FOR RESIDENTS MOVING THROUGH THE CONTINUUM OF CARE AT SALEMTOWNE, FINANCIAL ASSISTANCE FOR DIRECT ADMISSIONS TO THE ASSISTED LIVING CENTER & HEALTH CARE CENTER AT SALEMTOWNE, AND PARTICIPATION IN AND SUPPORT OF VARIOUS AGENCIES/ORGANIZATIONS LISTED ABOVE THROUGH DONATIONS OF CASH, TIME, PROPERTY AND MATERIALS. 501533 501533 PROVIDED FINANCIAL ASSISTANCE FOR RESIDENTS MOVING THROUGH THE CONTINUUM OF CARE AT SALEMTOWNE. PROVIDED FINANCIAL ASSISTANCE FOR DIRECT ADMISSIONS TO THE ASSISTED LIVING CENTER & HEALTH CARE CENTER AT SALEMTOWNE. 16284319 1 1 0 0 0 0 1 0 0 1 1 0 0 0 1 1 1 0 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 1 44 0 1 362 1 0 0 0 0 0 0 0 0 0 0 X 18 18 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 ME AK AZ OR NM MN MS GA ND CO FL KY OH NH SC UT WA WI X X CAROLYN J TWISDALE CFO 3367678130 1000 SALEMTOWNE DRIVE WINSTONSALEM NC 27106 DR VARDAMAN M BUCKALEW 1.00 X X 0 0 0 DAVID COTTERILL 1.00 X X 0 0 0 REGINALD F COMBS 1.00 X X 0 0 0 DOUGLAS S BEETS 1.00 X X 0 0 0 MARTY EDWARDS 1.00 X 0 0 0 JOHN FERGUSON 1.00 X 0 0 0 ANNE GEIS 1.00 X 0 0 0 JEAN S GREENE 1.00 X 0 0 0 DR FRANCIS JAMES III 1.00 X 0 0 0 ANN LONG 1.00 X 0 0 0 RICHARD MARVIN 1.00 X 0 0 0 REV BILL MCELVEEN 1.00 X 0 0 0 ALAN MOORE 1.00 X 0 0 0 DR TIMOTHY PENNELL 1.00 X 0 0 0 DR J HOWELL SMITH 1.00 X 0 0 0 CHARLOTTE ZAMJAHN 1.00 X 0 0 0 BETSY ANNESE 1.00 X 0 0 0 PEGGY CARTER 1.00 X 0 0 0 JOSEPH LYDON 40.00 X 183429 0 13675 CAROLYN TWISDALE 40.00 X 129162 0 12183 312591 0 25858 2 0 1 0 LEGACY HEALTHCARE SERVICES PO BOX 951003 CLEVELAND OH 44193 THERAPY 502631 WOOD HOME IMPROVEMENT INC 480 DULIN ROAD MOCKSVILLE NC 27028 CONSTRUCTION 341057 DIXON HUGHES GOODMAN LLP PO BOX 3049 ASHEVILLE NC 28802 CONTRACT PROFESSIONAL SERVICE 148515 HUGH G STRICKLAND INC PO BOX 4162 WINSTONSALEM NC 271154162 CONSTRUCTION 117830 S&L PAINTING 1011 W NORTHWEST BLVD WINSTONSALEM NC 27101 PAINTING/LABOR 115357 5 185932 912803 1098735 RESIDENT SERVICES 623000 14931336 14931336 AMORT. OF ADVANCE FEES 623000 2107321 2107321 17038657 222528 222528 439349 0 11211 439349 -11211 428138 428138 0 185932 81406 -81406 -81406 BEAUTY SHOP 812900 124168 124168 FOOD SERVICE 722210 85630 85630 GIFT SHOP INCOME 453220 31517 31517 104392 104392 345707 19052359 17038657 0 914967 177732 177732 501533 501533 328238 326280 1958 7150093 6265424 811844 72825 123300 123300 1216335 1203793 379 12163 602811 505041 91742 6028 36699 36699 38900 38900 97791 97791 421211 324395 89787 7029 111538 102294 8170 1074 2492747 2390503 77422 24822 140952 140917 35 766051 766051 42933 41733 1200 1583951 1583951 2130320 2130320 227080 365 226715 FOOD 42373 16596 25777 TRAINING 7368 5063 2305 MISCELLANEOUS 5308 5308 BAD DEBT 4527 4527 18249791 16284319 1839573 125899 3500 3500 5766180 11453129 503207 402848 24086 48299 130775 187888 66442802 25905209 41451820 40537593 18758431 13913146 1129780 1129780 706565 864276 68474344 68540459 1180624 1433374 9917089 9642241 32144456 31173462 1379901 1261614 44622070 43510691 X 13534546 14559647 773604 873006 9544124 9597115 23852274 25029768 68474344 68540459 X 802568 374926 X X 0 1 1 X 0 X 656116 1101798 1402710 1232642 1098735 5492001 14664516 15385702 16429483 16569423 17038657 80087781 220431 318047 259342 307159 345794 1450773 15541063 16805547 18091535 18109224 18483186 87030555 71881 23471 23577 28749 42185 189863 0 71881 23471 23577 28749 42185 189863 86840692 911507 861103 688036 350865 222441 3033952 911507 861103 688036 350865 222441 3033952 16452570 17666650 18779571 18460089 18705627 90064507 0.96420 0.93500 0.03370 0.06250 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 1 25.00 1 1 1 0.00 0 0 10317728 316026 218896 382529 10470121 10255464 241253 306422 485411 10317728 9644545 616173 494329 499583 10255464 9682590 268510 199864 9644545 0.91670 0.08330 0 0 3054250 3054250 58356620 23848793 34507827 4266510 1743608 2522902 765422 312808 452614 40537593 DEPOSITS 23100 REFUNDABLE ADVANCE FEES 456954 BOND INTEREST PAYABLE 781560 1261614 19052359 18249791 802568 398166 -23240 374926 1177494 19007158 398166 -443367 -45201 19052359 0 19052359 17829664 81406 81406 17748258 501533 501533 18249791 DESCRIPTION OF HOW ORGANIZATION REPORTS CONSERVATION EASEMENTS: PART II, LINE 9: THE CONSERVATION EASEMENT IS REPORTED IN THE ORGANIZATION'S FINANCIAL STATEMENTS AS PART OF PERMANENTLY RESTRICTED NET ASSETS. DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: SUPPORT FOR RESIDENTS IN FINANCIAL NEED, PERSONNEL RECRUITING AND OTHER GENERAL OBLIGATIONS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE COMMUNITY IS A TAX EXEMPT ORGANIZATION AS DESCRIBED IN 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 COMMUNITY HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENFITS OR OBLIGATIONS AS OF MARCH 31, 2012. IN ADDITION, THE COMMUNITY QUALIFIED FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A) AND IS CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION UNDER SECTION 509(A)(2). THE COMMUNITY BELIEVES THEY ARE NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO MARCH 31, 2009. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENTS -23,240. PART XII, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENTS -23,240. FUNDRAISING EXPENSES 81,406. INDIVIDUAL ASSISTANCE INCLUDED IN INCOME -501,533. PART XIII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 81,406. PART XIII, LINE 4B - OTHER ADJUSTMENTS: INDIVIDUAL ASSISTANCE INCLUDED IN INCOME 501,533. ASSOCIATE APPRECIATION 73301 73301 71974 BABCOCK RENOVATIONS 50050 50050 887 2 62581 62581 8545 185932 185932 81406 81406 -81406 1 SAMARITAN MINISTRIES 1243 PATTERSON AVE WINSTONSALEM NC 27103 561490019 501(C)(3) 44410 FMV FOOD PROVIDED MEALS TO ORGANIZATIONS SUPPORTING ELDERLY POPULATION SENIOR SERVICES INC 2895 SHOREFAIR DRIVE WINSTONSALEM NC 27105 561085968 501(C)(3) 78412 FMV FOOD PROVIDED MEALS TO ORGANIZATIONS SUPPORTING ELDERLY POPULATION BOOKMARKS PO BOX 11867 WINSTONSALEM NC 27116 542152610 501(C)(3) 7500 FMV PROVIDED DONATION TO ORGANIZATION WAKE FOREST UNIVERSITY HEALTH SCIENCES MEDICAL CENTER BLVD WINSTONSALEM NC 27157 900222618 501(C)(3) 22151 FMV PROVIDED DONATION OF USE OF 5080 WACH. VILLAGE COTTAGE 4 0 BENEVOLENT ASSISTANCE 17 501533 FMV PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: RESIDENTS - RESIDENTS MUST APPLY FOR FINANCIAL ASSISTANCE AND PROVIDE VERIFICATION OF ASSETS AND INCOME. APPLICANTS APPROVED FOR FINANCIAL ASSISTANCE MUST SIGN A FINANCIAL ASSISTANCE AGREEMENT OUTLINING THE TERMS AND CONDITIONS OF THE PROGRAM. THE MANAGER OF BILLING PREPARES A MONTHLY FINANCIAL ASSISTANCE REPORT LISTING USAGE OF FUNDS WHICH IS APPROVED BY THE DIRECTOR OF ACCOUNTING. FINANCIAL ASSISTANCE TOTALS ARE LISTED AS PART OF THE FINANCIAL STATEMENT PACKAGE FOR THE BOARD OF TRUSTEES AND OFFICERS OF THE ORGANIZATION. OUTSIDE ORGANIZATIONS - SALEMTOWNE CHOOSES TO GIVE TO WELL ESTABLISHED NON-PROFIT ORGANIZATIONS IN GOOD STANDING WITH THE IRS WHO SUPPORT AND/OR ENHANCE OUR MISSION AND VALUES. IT IS THE MISSION OF SALEMTOWNE AND ITS OUTREACH PROGRAM TO PROVIDE HOUSING AND SERVICES FOR RESIDENTS WHO HAVE OUTLIVED THEIR RESOURCES, RESOURCES FOR SERVICES, PROGRAMS AND EDUCATION THAT ENHANCE THE QUALITY OF LIVING AND CARE FOR THE SENIOR CITIZENS OF PIEDMONT NORTH CAROLINA. SALEMTOWNE STRIVES TO SHARE ITS EXPERTISE IN THE AREA OF AGING BY OFFERING EDUCATION AND TRAINING TO SENIORS, FAMILIES AND CARE GIVERS; BY UTILIZING ITS TIME, TALENTS, AND FACILITIES FOR PROGRAMS AND EDUCATION; AND BY SPONSORING PROGRAMS OF ORGANIZATIONS AND ASSOCIATIONS DEDICATED TO SENIOR ADVOCACY. X X X X 0 0 0 0 0 0 0 0 0 JOSEPH LYDON 164229 0 6004 0 13196 0 6747 0 6928 0 197104 0 0 0 NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 6579025M0 2006-11-14 35248843 REFUND 1999 & 2001 BONDS 0 0 0 4070000 35248843 2554943 666958 2003 0 1 1 1 0 0 0 1 BANK OF AMERICA NA 23.000000000000 1 0 0 FORM 990, PART VI, SECTION A, LINE 1 THE CHAIR OF THE BOARD, ALONG WITH THE CHAIRS OF EACH OF THE BOARD'S STANDING COMMITTEES AND, IN AN EX-OFFICIO CAPACITY, THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION SHALL CONSTITUTE THE GOVERNANCE COMMITTEE OF THE GOVERNING BOARD. THE GOVERNANCE COMMITTEE SHALL, DURING INTERVALS BETWEEN MEETINGS OF THE BOARD, EXERCISE ALL THE POWERS OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 7A THE QUADRENNIEL MEETING OF THE MORAVIAN CHURCH IN AMERICA, SOUTHERN PROVINCE (KNOWN AS SYNOD) ELECTS FOUR MEMBERS TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE 990 WAS PROVIDED TO EACH BOARD MEMBER BEFORE THE RETURN WAS FILED. PRIOR TO FILING, THE BOARD REVIEWED AND APPROVED THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C EACH BOARD MEMBER IS REQUIRED TO SIGN A CONFLICT OF INTEREST POLICY UPON INITIALLY JOINING THE BOARD. BEFORE EACH BOARD MEETING, THE MEMBERS ARE ASKED TO DISCLOSE ANY POTENTIAL CONFLICTS. CHANGES IN CONFLICTS OF INTEREST ARE MAINTAINED BY THE CFO. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS PULLED FROM GUIDESTAR FOR CCRCS IN NORTH CAROLINA OF COMPARABLE SIZE AND FROM THE LEADING AGE SALARY SURVEY. THIS INFORMATION IS PROVIDED TO THE BOARD ALONG WITH HISTORY OF COMPENSATION FOR THE CEO AND CFO. THE BOARD THEN REVIEWS AND APPROVES THE COMPENSATION FOR BOTH OFFICERS. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION'S FORM 1023, 990, AND 990-T ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE ALSO MADE AVAILABLE ON THE NC DEPARTMENT OF INSURANCE WEBSITE. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 398,166. CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENTS -23,240. TOTAL TO FORM 990, PART XI, LINE 5: 374,926. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.