CAROLINA ADVENTIST RETIREMENT SYSTEMS INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- CAROLINA ADVENTIST RETIREMENT SYSTEMS INC (EIN 56-1089384)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-08-13
- IRS object ID
- 201332259349300548
- Schema version
- 2011v1.5
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-08-13T09:09:16-05:00 | Timestamp |
| Tax Period End Date | 2012-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560747981 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIXON HUGHES PLLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 RIDGEFIELD COURT | AddressLine1 |
| City | ASHEVILLE | City |
| State | NC | State |
| ZIP Code | 28806 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 561089384 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CAROLINA ADVENTIST RETIREMENT SYSTEMS INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CARO | NameControl |
| Phone | 7046679851 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 95 HOLCOMBE COVE RD | AddressLine1 |
| City | CANDLER | City |
| State | NC | State |
| ZIP Code | 287159450 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DEBORAH HAWKINS | Name |
| Title | TREASURER / CFO | Title |
| Phone | 7046679851 | Phone |
| Date Signed | 2013-08-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | AMY BIBBY | Name |
| PTIN | P00445891 | PTIN |
| Phone | 8282542254 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DAVID KIDDER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 95 HOLCOMBE COVE RD | AddressLine1 |
| City | CANDLER | City |
| State | NC | State |
| ZIP Code | 287159450 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 22664373 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.PISGAHVALLEY.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1975 | YearFormation |
| State Legal Domicile | NC | StateLegalDomicile |
| Activity Or Mission Description | SERVING HEALTHCARE AND RESIDENTIAL NEEDS WHILE UPHOLDING CHRISTIAN PRINCIPLES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 25 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 642 | TotalNbrEmployees |
| Total Nbr Volunteers | 13 | TotalNbrVolunteers |
| Total Gross UBI | 82882 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -39543 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 136638 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1221934 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 22585889 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 21085506 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 39881 | InvestmentIncomePriorYear |
| Investment Income Current Year | 27838 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 392247 | OtherRevenuePriorYear |
| Other Revenue Current Year | 324440 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 23154655 | TotalRevenuePriorYear |
| Total Revenue Current Year | 22659718 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 90467 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 429735 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 12274838 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 11873674 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 9053558 | OtherExpensePriorYear |
| Other Expenses Current Year | 9077441 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 21418863 | TotalExpensesPriorYear |
| Total Expenses Current Year | 21380850 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1735792 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1278868 | RevenuesLessExpensesCY |
| Total Assets BOY | 25165506 | TotalAssetsBOY |
| Total Assets EOY | 36800001 | TotalAssetsEOY |
| Total Liabilities BOY | 10721808 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 22511675 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 14443698 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 14288326 | NetAssetsOrFundBalancesEOY |
| Mission Description | AS A FAITH-BASED SEVENTH-DAY ADVENTIST ORGANIZATION, WE ARE DEDICATED TO SERVING THE HEALTHCARE AND RESIDENTIAL NEEDS OF OUR COMMUNITY WHILE UPHOLDING CHRISTIAN PRINCIPLES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 8971058 | Expense |
| Grants | 200090 | Grants |
| Revenue | 10550571 | Revenue |
| Description | PISGAH VALLEY RETIREMENT COMMUNITY OWNS AND OPERATES A LICENSED CONTINUING CARE RETIREMENT COMMUNITY WITH 21 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). | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 9200967 | Expense |
| Grants | 229645 | Grants |
| Revenue | 10624093 | Revenue |
| Description | WINSLOW OPERATES A RETIREMENT COMMUNITY WITH 24 INDEPENDENT LIVING STUDIO APARTMENT UNITS AND 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). | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 18172025 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 1 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 40 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 642 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 25 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DEBORAH HAWKINS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8284182334 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 95 HOLCOMBE COVE ROAD | AddressLine1 |
| City | CANDLER | City |
| State | NC | State |
| ZIP Code | 28715 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (28 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer |
|---|---|---|---|---|---|---|
| RICHARD ANDERSON | ||||||
| DIRECTOR | 1.00 | X | 0 | 50460 | 9954 | |
| SAMUEL BONHAM | ||||||
| DIRECTOR | 1.00 | X | 0 | 75 | 0 | |
| ERNEST BOUGHMAN JR | ||||||
| DIRECTOR | 1.00 | X | 0 | 300 | 0 | |
| JIMM BUNCH | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| DEWAYNE BUTCHER MD | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| BRENNA BOULANGER | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| JOHN COELHO | ||||||
| DIRECTOR | 1.00 | X | 0 | 62655 | 30014 | |
| NOEMI CRUZ | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| JIM DAVIDSON | ||||||
| CHAIRMAN THROUGH OCTOBER 2011 | 1.00 | X | 0 | 64810 | 41113 | |
| LESLIE LOUIS | ||||||
| CHAIRMAN AS OF JANUARY 2012 | 1.00 | X | 0 | 0 | 0 | |
| DONOVAN DAVIS | ||||||
| DIRECTOR | 1.00 | X | 0 | 65347 | 40461 | |
| JOHN EARNHARDT | ||||||
| DIRECTOR | 1.00 | X | 0 | 65179 | 49512 | |
| CHARLES FERGUSON | ||||||
| DIRECTOR | 1.00 | X | 0 | 67114 | 31477 | |
| SAMUEL GARCIA | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| MAURY GILMORE | ||||||
| DIRECTOR | 1.00 | X | 0 | 150 | 0 | |
| CHAD GRUNDY | ||||||
| DIRECTOR | 1.00 | X | 0 | 65002 | 14690 | |
| ROBERT CUNDIFF | ||||||
| DIRECTOR | 1.00 | X | 0 | 71518 | 46022 | |
| LARRY KROLL MD | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| MINERVINO LABRADOR JR | ||||||
| DIRECTOR | 1.00 | X | 0 | 81268 | 49773 | |
| JEFFREY DONALDSON | ||||||
| DIRECTOR | 1.00 | X | 0 | 58879 | 31537 | |
| GARY MOYER | ||||||
| DIRECTOR/SECRETARY | 1.00 | X | 0 | 77452 | 31958 | X |
| RICHARD RUSSELL | ||||||
| DIRECTOR | 1.00 | X | 0 | 71193 | 14774 | |
| WON LEE | ||||||
| DIRECTOR | 1.00 | X | 0 | 75 | 0 | |
| ARLEEN STUBBS | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| ANDREW WILLIAMS | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| KEVIN WORTH | ||||||
| DIRECTOR | 1.00 | X | 0 | 49975 | 9954 | |
| DEBORAH HAWKINS | ||||||
| TREASURER/CFO | 40.00 | 129792 | 0 | 22898 | X | |
| DAVID KIDDER | ||||||
| PRESIDENT/CEO | 40.00 | 142121 | 0 | 28684 | X | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 271913 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 851452 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 452821 | TotalOtherCompensation |
| Number Individuals GT100 K | 2 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (3 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| SYNERTX | |||||
| 7540 NORTH 19TH AVENUE | PHOENIX | AZ | 85021 | PHYSICAL, SPEECH AND OCCUPATIONAL THERAP | 1030548 |
| KINDRED REHAB SERVICES INC (DBA PEOPLEF | |||||
| PO BOX 277365 | ALTANTA | GA | 30384 | PHYSICAL, SPEECH AND OCCUPATIONAL THERAP | 854209 |
| DIXON HUGHES GOODMAN LLP | |||||
| 500 RIDGEFIELD COURT | ASHEVILLE | NC | 28806 | AUDIT, TAX, DATA PROCESSING, CONSULTING | 217431 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| Related Organizations | 1093000 | RelatedOrganizations |
| All Other Contributions | 128934 | AllOtherContributions |
| Noncash Contributions | 1075000 | NoncashContributions |
| Total Contributions | 1221934 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| MEDICARE/MEDICAID PAYM | 623000 | 15939790 | 15939790 |
| SKILLED NURSING, ASSIS | 623000 | 5095611 | 5095611 |
| AMORTIZATION OF ENTRAN | 623000 | 50105 | 50105 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 21085506 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 32493 | TotalRevenueColumn |
| Exclusion | $32,493 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 5400 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 5400 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5400 | TotalRevenueColumn |
| Exclusion | $5,400 | ExclusionAmount |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 4655 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -4655 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -4655 | TotalRevenueColumn |
| Exclusion | -$4,655 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|---|
| MANAGEMENT FEES FROM H | 531390 | 147000 | $147,000 | ||
| WELLNESS CENTER REVENU | 713940 | 125664 | 42782 | 82882 | |
| MISCELLANEOUS INCOME | 623000 | 46376 | 46376 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 319040 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 22659718 | TotalRevenueColumn |
| Related Or Exempt Function Income | 21174664 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 82882 | UnrelatedBusinessRevenue |
| Exclusion | $180,238 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 429735 | Total |
| Program Services | 429735 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 368080 | Total |
| Management And General | 368080 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 62266 | Total |
| Management And General | 62266 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9302880 | Total |
| Program Services | 8451772 | ProgramServices |
| Management And General | 851108 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 53364 | Total |
| Program Services | 45800 | ProgramServices |
| Management And General | 7564 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1381211 | Total |
| Program Services | 1260019 | ProgramServices |
| Management And General | 121192 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 705873 | Total |
| Program Services | 614230 | ProgramServices |
| Management And General | 91643 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23509 | Total |
| Management And General | 23509 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 96574 | Total |
| Management And General | 96574 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3018300 | Total |
| Program Services | 3003697 | ProgramServices |
| Management And General | 14603 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 59246 | Total |
| Management And General | 59246 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1031160 | Total |
| Program Services | 743677 | ProgramServices |
| Management And General | 287483 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 148232 | Total |
| Management And General | 148232 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1094587 | Total |
| Program Services | 889714 | ProgramServices |
| Management And General | 204873 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 107894 | Total |
| Program Services | 74845 | ProgramServices |
| Management And General | 33049 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 29571 | Total |
| Program Services | 15270 | ProgramServices |
| Management And General | 14301 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5086 | Total |
| Program Services | 5086 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1046168 | Total |
| Program Services | 1031344 | ProgramServices |
| Management And General | 14824 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 109676 | Total |
| Program Services | 8371 | ProgramServices |
| Management And General | 101305 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MED. RELATED SUPPLIES | 1598465 | 1598465 | |
| BAD DEBT | 398604 | 398604 | |
| PROVIDER TAX | 265040 | 265040 | |
| WRITE OFF OF FINANCING | 39517 | 39517 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5812 | Total |
| Management And General | 5812 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21380850 | Total |
| Program Services | 18172025 | ProgramServices |
| Management And General | 3208825 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 900 | BOY |
| EOY | 900 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7277195 | BOY |
| EOY | 13584622 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 73668 | BOY |
| EOY | 75753 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1722580 | BOY |
| EOY | 2198198 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 98300 | BOY |
| EOY | 101300 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 200252 | BOY |
| EOY | 442980 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 30157545 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 9953741 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15631927 | BOY |
| EOY | 20203804 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 160684 | BOY |
| EOY | 192444 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25165506 | BOY |
| EOY | 36800001 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1938060 | BOY |
| EOY | 2445966 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2847997 | BOY |
| EOY | 349169 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 13045000 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5734528 | BOY |
| EOY | 1702483 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 201223 | BOY |
| EOY | 4969057 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10721808 | BOY |
| EOY | 22511675 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14443698 | BOY |
| EOY | 14288326 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14443698 | BOY |
| EOY | 14288326 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25165506 | BOY |
| EOY | 36800001 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 1278868 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -1434240 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1638448 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 275538 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 619724 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 24378 | CurrentTaxYearMinus1Year |
| Current Tax Year | 146934 | CurrentTaxYear |
| Total | 2705022 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 18804594 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 21068695 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 21709744 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 22585889 | CurrentTaxYearMinus1Year |
| Current Tax Year | 21085506 | CurrentTaxYear |
| Total | 105254428 | Total |
Gross Receipts From Non UBI GrossReceiptsFromNonUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 270525 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 253795 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 236752 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 288899 | CurrentTaxYearMinus1Year |
| Current Tax Year | 220605 | CurrentTaxYear |
| Total | 1270576 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 20713567 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 21598028 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 22566220 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 22899166 | CurrentTaxYearMinus1Year |
| Current Tax Year | 21453045 | CurrentTaxYear |
| Total | 109230026 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 109230026 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 80286 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 59082 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 74806 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 63194 | CurrentTaxYearMinus1Year |
| Current Tax Year | 33238 | CurrentTaxYear |
| Total | 310606 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 80286 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 59082 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 74806 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 63194 | CurrentTaxYearMinus1Year |
| Current Tax Year | 33238 | CurrentTaxYear |
| Total | 310606 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 20793853 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 21657110 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 22641026 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 22962360 | CurrentTaxYearMinus1Year |
| Current Tax Year | 21486283 | CurrentTaxYear |
| Total | 109540632 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99720 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.99670 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00280 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00330 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $2,616 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 2616 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | THE 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 2012, AMOUNTS OF MEMBERSHIP DUES ALLOCATED TO THESE EXPENDITURES WERE $1,765 FOR HFA AND $ 851 FOR LAA. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1720000 | OtherCostOrOtherBasis |
| Book Value | 1720000 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 19429377 | OtherCostOrOtherBasis |
| Depreciation | 7019241 | Depreciation |
| Book Value | 12410136 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 197580 | OtherCostOrOtherBasis |
| Depreciation | 77542 | Depreciation |
| Book Value | 120038 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4004927 | OtherCostOrOtherBasis |
| Depreciation | 2367776 | Depreciation |
| Book Value | 1637151 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4805661 | OtherCostOrOtherBasis |
| Depreciation | 489182 | Depreciation |
| Book Value | 4316479 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 20203804 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO RELATED PARTIES | $147,000 |
| INTEREST RATE SWAP LIABILITY | $923,595 |
| PATIENT TRUST FUND LIABILITY | $40,789 |
| RESIDENT REFUNDS PAYABLE | $3,857,673 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 4969057 | TotalOfAmounts |
| Total Revenue | 22659718 | TotalRevenue |
| Total Expenses | 21380850 | TotalExpenses |
| Excess Or Deficit For Year | 1278868 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -730119 | NetUnrealizedGLOnInvestments |
| Other | -$704,121 | OtherAmount |
| Total Adjustments | -1434240 | TotalAdjustments |
| Excess Or Deficit Per FS | -155372 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 22659718 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 22659718 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 22659718 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 22535311 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 1154461 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 1154461 | ExpensesNotRptdF990 |
| Expenses Subtotal | 21380850 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 21380850 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | 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, 2011 AND 2012 AND, ACCORDINGLY, NO LIABILITY WAS ACCRUED. FISCAL YEARS ENDING ON OR AFTER SEPTEMBER 30, 2009 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | LOSS ON ABANDON PROJECT -424,342. RESTATEMENT DUE TO CHANGE IN ACCOUNTING METHOD OF ENTRANCE FEES -279,779. TOTAL TO SCHEDULE D, PART XI, LINE 8: -704,121. | |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | LOSS ON ABANDONED PROJECT 424,342. UNREALIZED LOSS ON SWAPS 730,119. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Method Of ValuationMethodOfValuation | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|---|
| CAROLINA CONFERENCE OF SEVENTH-DAY ADVENTISTS | ||||||||
| 2701 WT HARRIS BLVD | CHARLOTTE | NC | 28256 | 454284485 | 501(C)(3) | 35611 | FMV | TO ASSIST WITH LOCAL PASTOR SALARY |
| MOUNT PISGAH ACADEMY | ||||||||
| 75 ACADEMY DRIVE | CANDLER | NC | 28715 | 560713794 | 501(C)(3) | 390150 | FMV | STUDENT SCHOLARSHIPS AND GENERAL OPERATIONS |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 2 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: THE 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. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 0 | SubstantiationRequired |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DEBORAH HAWKINS | |||||||||||||
| 127034 | 0 | 1918 | 0 | 840 | 0 | 3207 | 0 | 19691 | 0 | 152690 | 0 | 0 | 0 |
| DAVID KIDDER | |||||||||||||
| 123241 | 0 | 2074 | 0 | 16806 | 0 | 3996 | 0 | 24688 | 0 | 170805 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINE 1A | ReturnReference |
| Explanation | CARS WAIVES 100% AND 50% OF THE STANDARD MEMBERSHIP FEE FOR THE CEO AND CFO, RESPECTIVELY, FOR 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. | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH CAROLINA MEDICAL CARE COMMISSION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 521309402 | IssuerEIN |
| Date Issued | 2012-03-27 | DateIssued |
| Issue Price | 13045000 | IssuePrice |
| Description Of Purpose | REFUNDING, NEW CONSTRUCTION | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Proceeds | 13051939 | TotalProceeds |
| Capitalized Interest | 145816 | CapitalizedInterest |
| Issuance Costs From Proceeds | 225591 | IssuanceCostsFromProceeds |
| Capital Expenditures | 3109235 | CapitalExpenditures |
| Other Spent Proceeds | 3611204 | OtherSpentProceeds |
| Amount Unspent | 5960092 | AmountUnspent |
| Year Of Subst Completion | 2013 | YearOfSubstCompletion |
| Current Refunding | 1 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 0 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Prcntge Prvt Business Use By Others | 0.00000 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0.00000 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUse |
| Post Issuance Compliance Procdrs | 1 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 0 | Form8038TFiled |
| Variable Rate Issue | 1 | VariableRateIssue |
| Hedge Identified In Books And Recds | 1 | HedgeIdentifiedInBooksAndRecds |
Name Of Hedge Provider NameOfHedgeProvider
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BB&T | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 10.000000000000 | TermOfHedge |
| Superintegrated Hedge | 0 | SuperintegratedHedge |
| Hedge Terminated | 0 | HedgeTerminated |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 0 | ExceptionToRebate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fed Tax Requirements Compliance | X | FedTaxRequirementsCompliance |
Form990 Schedule K Part VI Form990ScheduleKPartVI (3 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| 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: 6,939 TOTAL TO LINE 3: 13,051,939 |
| 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
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | ELLA KIDDER | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | FAMILY RELATIONSHIP WITH DAVID KIDDER, CEO | Relationship |
| Amount Of Transaction | 62266 | AmountOfTransaction |
| Description Of Transaction | ELLA KIDDER IS AN EMPLOYEE OF THE ORGANIZATION | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule M IRS990ScheduleM
Other Non Cash Contributions Table OtherNonCashContributionsTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Description | 23 ACRES OF LAND | Description |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 1075000 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | AS 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 7A | AS 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 7B | AS 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 11 | THE 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. | |
| FORM 990, PART VI, SECTION B, LINE 12C | AT 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 15 | ANNUALLY MANAGEMENT PREPARES A SCHEDULE SHOWING THE PRIOR YEAR SALARIES PAID AND THE CURRENT YEAR BUDGETED SALARIES FOR THE CEO AND CFO. THE SCHEDULE COMPARES THE BUDGETED SALARY TO THE MOST CURRENT NORTH CAROLINA ASSOCIATION OF NOT-FOR-PROFIT HOMES FOR THE AGED WAGE & BENEFIT SURVEY AND SALARIES OF FOUR NORTH CAROLINA NOT-FOR-PROFIT CCRC'S AS OBTAINED FROM THEIR ORGANIZATION'S FORM 990 AS AVAILABLE ON GUIDESTAR. THIS SCHEDULE IS REVIEWED AND APPROVED BY THE EXECUTIVE BOARD OF THE BOARD OF DIRECTORS. THE EXECUTIVE BOARD THEN PRESENTS THIS INFORMATION AS PART OF THE BUDGET TO THE FULL BOARD OF DIRECTORS AT THEIR ANNUAL MEETING. | |
| FORM 990, PART VI, SECTION C, LINE 18 | THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE TO THE PUBLIC UPON REQUEST. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE UPON REQUEST AND ON WWW.GUIDESTAR.ORG | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -730,119. LOSS ON ABANDON PROJECT -424,342. RESTATEMENT DUE TO CHANGE IN ACCOUNTING METHOD OF ENTRANCE FEES -279,779. TOTAL TO FORM 990, PART XI, LINE 5: -1,434,240. | CHANGES IN NET ASSETS OR FUND BALANCES: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CAROLINA CONFERENCE OF SEVENTH-DAY ADVENTISTS INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 44270 | AddressLine1 |
| City | CHARLOTTE | City |
| State | NC | State |
| ZIP Code | 28215 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 454284485 | EIN |
| Primary Activities | SPIRITUAL DEVELOPMENT | PrimaryActivities |
| Legal Domicile State | NC | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | 1 | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Controlled Org | 0 | ControlledOrg |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PISGAH ESTATES UNIT OWNERS ASSOCIATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 95 HOLCOMBE COVE ROAD | AddressLine1 |
| City | CANDLER | City |
| State | NC | State |
| ZIP Code | 28715 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 561769989 | EIN |
| Primary Activity | HOME OWNERS ASSOCIATION | PrimaryActivity |
| Legal Domicile State | NC | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| PISGAH ESTATES UNIT OWNERS ASSOCIATION | ||
| K | 147000 | CASH |
| PISGAH ESTATES UNIT OWNERS ASSOCIATION | ||
| L | 63527 | CASH |
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