2012-04-04T18:39:19-05:00 2011-09-30 MCGLADREY & PULLEN LLP 230 N ELM ST STE 1100 GREENSBORO NC 27401 990 2010-10-01 560562308 BAPTIST RETIREMENT HOMES OF NORTH CAROLINA INCORPORATED BAPT 3367250202 PO BOX 11024 WINSTONSALEM NC 27116 WILLIAM B STILLERMAN 3367250202 2012-04-04 ADRIENNE MCKINNEY 3362724551 2010 2016-02-24 21:20:13Z WILLIAM B STILLERMAN PO BOX 11024 WINSTONSALEM NC 27116 38277303 0 X WWW.BRH.ORG X 1952 NC TO PROVIDE QUALITY LIVING OPTIONS AND SERVICES TO NORTH CAROLINA'S OLDER ADULT POPULATION. 20 20 608 0 0 0 866633 3994195 23730348 25106860 599024 1157384 442350 435673 25638355 30694112 604791 660648 0 0 12473442 12155537 0 0 242591 11244316 11463688 24322549 24279873 1315806 6414239 76815663 77817726 60788513 56968936 16027150 20848790 X TO PROVIDE QUALITY LIVING OPTIONS AND SERVICES TO NORTH CAROLINA'S OLDER ADULT POPULATION. 0 0 20049453 660648 25261852 BAPTIST RETIREMENT HOMES OF NORTH CAROLINA, INCORPORATED ("HOMES") IS A NOT-FOR-PROFIT CORPORATION ORGANIZED UNDER THE LAWS OF THE STATE OF NORTH CAROLINA. IT IS EXEMPT FROM INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND A PUBLIC CHARITY UNDER SECTION 509(A)(2). THE BOARD OF TRUSTEES OF THE HOMES HAS FIDUCIARY RESPONSIBILITY AND AUTHORITY TO OPERATE AND MAKE MANAGEMENT DECISIONS FOR HOMES.THE MISSION OF HOMES IS TO PROVIDE QUALITY RESIDENTIAL AND HEALTH CARE LIVING OPTIONS AND SERVICES TO NORTH CAROLINA'S OLDER ADULT POPULATION. THE PROVISION OF THOSE SERVICES BEING DIRECTED TO THE "POOR ELDERLY" AS WELL AS THOSE OLDER PERSONS WHO DO HAVE THE FINANCIAL RESOURCES NECESSARY TO PAY FOR THE INSTITUTIONAL SERVICES THEY RECEIVE.IN ADDITION TO ITS PROGRAM OF BENEVOLENT FUNDING TO THE "POOR ELDERLY" OF THE STATE, HOMES ALSO PROVIDES AT NO COST TO ITS INDIGENT POPULATION, A SPECIAL PROGRAM DESIGNED TO ENHANCE THE LIFESTYLE OF OLDER ADULTS WITH DEMENTIA RELATED DISORDERS LIKE ALZHEIMER'S DISEASE. TWO SUCH PROGRAMS ARE OPERATED BY BAPTIST RETIREMENT HOMES: ONE AT BROOKRIDGE AND ONE AT ITS WESTERN NORTH CAROLINA BAPTIST HOME.HOMES OWNS, MAINTAINS, AND OPERATES FACILITIES THROUGHOUT NORTH CAROLINA. THE CURRENT FACILITIES CONSIST OF 270 INDEPENDENT LIVING HOMES AND APARTMENTS, 170 ASSISTED LIVING UNITS, AND 209 SKILLED CARE ROOMS. HOMES RECEIVES SUPPORT FROM INDIVUDUALS, BUSINESSES, FOUNDATION, CHURCHES, SPECIAL OFFERINGS, AND BEQUESTS FROM OTHERS TO ASSIST IN THE OPERATION AND ADMINISTRATION OF THESE FACILITIES. 20049453 1 1 0 0 0 0 0 1 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 24 0 1 608 1 0 0 0 0 0 0 0 0 0 0 X 20 20 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X CHARLES R GASKINS CFO 3367250202 1912 BETHABARA ROAD WINSTONSALEM NC 27106 WILLIAM B STILLERMAN 36.00 X 300493 0 22923 DEBRA A MEGINNIS 36.00 X 178062 0 12928 CHARLES R GASKINS 36.00 X 120706 0 19636 KENNETH W MASSEY 1.00 X 0 0 0 CHARLES D MAST 1.00 X 0 0 0 MARY ANN DAVIS 1.00 X 0 0 0 KENNTH W AMBURN 1.00 X 0 0 0 EDWARD A BEDDINGFIELD JR 1.00 X 0 0 0 MELBA M BRIDGES 1.00 X 0 0 0 JEFFREY L COBB 1.00 X 0 0 0 JENNIE B COUNTS 1.00 X 0 0 0 BRADY W DICKSON 1.00 X 0 0 0 PHILLIP R FEAGAN 1.00 X 0 0 0 CAROLYN D HELMS 1.00 X 0 0 0 BETH T JONES 1.00 X 0 0 0 MICHAEL L JOYCE 1.00 X 0 0 0 CLARENCE R LAMBE JR 1.00 X 0 0 0 AL L LYERLY 1.00 X 0 0 0 MARY ALICE MARSHBANKS 1.00 X 0 0 0 SAMUEL R MOORE 1.00 X 0 0 0 RALPH S MORGAN 1.00 X 0 0 0 HENRY M SKINNER JR 1.00 X 0 0 0 GLUTHER STARKS 1.00 X 0 0 0 599261 0 55487 3 0 1 0 HERITAGE HEALTHCARE INC 536 OLD HOWELL ROAD GREENVILLE SC 29615 NURSING 543216 LARRY MCDANIEL BUILDERS INC PO BOX 577 MOCKSVILLE NC 27028 CONSTRUCTION 480167 BAY VIEW FUNDING PO BOX 881774 SAN FRANCISCO CA 941881774 NURSING 163804 DANSEL CONSTRUCTION INC 7201 VANCE ROAD KERNERSVILLE NC 27284 CONSTRUCTION 149100 LARSON ALLEN LLP PO BOX 643661 CINCINNATI OH 452643661 ACCOUNTING 107385 6 238075 3756120 2259736 3994195 RESIDENT REVENUE 623000 25106860 25106860 25106860 766011 766011 22108 22108 22108 22108 7954347 20217 7566842 16349 387505 3868 391373 391373 413565 154992 258573 413565 30694112 25261852 0 1438065 660648 660648 673428 673428 10158760 8722498 1402262 34000 560240 398749 154691 6800 763109 639793 123316 166127 166127 74760 74760 928667 872645 56022 303786 19516 82479 201791 71876 32881 38995 137752 137752 6258 3773 2485 7794 1679 6115 2290385 2290385 2508879 2508879 367788 367788 UTILITIES 1212701 1057226 155475 FOOD 845692 814477 31215 REPAIRS 696112 610491 85621 MISCELLANEOUS 571358 208878 362480 MEDICAL SUPPLIES 471782 471782 801971 735153 66818 24279873 20049453 3987829 242591 3633946 2793645 7269709 9060599 103584 105993 711410 781732 97295 77618 63401 64492 317993 285576 77898820 32454944 46063716 45443876 10353080 11274843 7238711 7042007 17200 17200 870763 791998 74855 78147 76815663 77817726 3070963 2861239 18636423 17930420 36540177 35725168 31653 2540950 420456 60788513 56968936 X 6663231 11803244 3417646 3505403 5946273 5540143 16027150 20848790 76815663 77817726 X 6414239 -1592599 X 0 1 1 X 0 X 1762299 1099869 1050969 866633 3756120 8535890 20604275 22434005 22479867 23858631 25261852 114638630 22366574 23533874 23530836 24725264 29017972 123174520 46169 12837 6904 24028 19378 109316 486532 135000 2484409 3105941 532701 147837 6904 24028 2503787 3215257 119959263 1123578 492573 172092 620714 788119 3197076 1123578 492573 172092 620714 788119 3197076 285285 447172 407666 423202 258573 1821898 23775437 24473619 24110594 25769180 30064664 128193494 0.93580 0.92940 0.02490 0.02810 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 9737705 305051 -909777 9132979 7541920 481433 1714352 9737705 7932069 169197 -559346 7541920 0.00000 0.61060 0.38940 0 0 6090491 6090491 54104349 25281096 28823253 11962334 3306780 8655554 4554152 3832422 721730 1187494 34646 1152848 45443876 CHARITABLE REMAINDER TRUST 3380059 F BENEFICIAL INTEREST IN PERPETUAL TRUSTS 3661948 F 7042007 DUE TO RELATED ORGANIZATION 420456 420456 30694112 24279873 6414239 -774276 -818323 -1592599 4821640 28440865 -774276 -1240896 -2015172 30456037 238075 238075 30694112 23619225 0 23619225 660648 660648 24279873 PART IV, LINE 2B: RESIDENT TRUST FUNDS DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: RESTRICTED FUNDS ARE INTENDED FOR RESIDENT ASSISTANCE AND OTHER RESTRICTED PURPOSES. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: BAPTIST RETIREMENT HOMES OF NORTH CAROLINA, INC. (HOMES) IS A NOT-FOR-PROFIT ORGANIZATION EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). HOMES FILES AS A TAX-EXEMPT ORGANIZATION. BECAUSE MANAGEMENT HAS NOT IDENTIFIED UNRELATED BUSINESS INCOME IN PAST YEARS, HOMES HAS NOT FILED FORM 990-T, EXEMPT ORGANIZATION BUSINES INCOME TAX RETURN. AS A RESULT, ALL YEARS ARE POTENTIALLY OPEN TO REVIEW BY TAXING AUTHORITIES. MANAGEMENT IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE THE TAX-EXEMPT STATUS OF HOMES. MANAGEMENT IS NOT AWARE OF ANY SIGNIFICANT ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES FOR HOMES. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN VALUE OF CHARITABLE REMAINDER TRUSTS -148,788. CHANGE IN VALUE OF BENEFICIAL INTEREST IN PERPETUAL TRUSTS -431,460. GRANT ASSISTANCE FROM BAPTIST RETIREMENT HOMES FOUNDATION -238,075. PART XII, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF CHARITABLE REMAINDER TRUSTS -148,788. CHANGE IN VALUE OF BENEFICIAL INTEREST IN PERPETUAL TRUSTS -431,460. BENEVOLENT ASSISTANCE -660,648. PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANT ASSISTANCE FROM BAPTIST RETIREMENT HOMES FOUNDATION 238,075. PART XIII, LINE 4B - OTHER ADJUSTMENTS: BENEVOLENT ASSISTANCE 660,648. 1 BENEVOLENT ASSISTANCE FOR RESIDENTS 270 660588 BENEVOLENT ASSISTANCE FOR EMPLOYEES 1 60 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: BENEVOLENCE IS BASED ON PAYOR (MEDICARE, MEDICAID, ETC.) AND ABILITY TO PAY. REQUESTS FOR BENEVOLENT ASSISTANCE ARE REVIEWED AND APPROVED BY THE PRESIDENT. BENEVOLENCE IS RECORDED AS A CONTRA-REVENUE ON A MONTHLY BASIS. 1 X X X X 0 0 0 0 0 0 0 1 0 WILLIAM B STILLERMAN 252679 0 47358 0 456 0 9892 0 13031 0 323416 0 0 0 DEBRA A MEGINNIS 176236 0 1629 0 197 0 7121 0 5807 0 190990 0 0 0 PART I, LINE 7 MR. STILLERMAN PAYS DOWN LOAN BALANCE. THIS SHOWS UP AS ADDITIONAL COMPENSATION. DISCRETIONARY BONUSES PAID TO WILLIAM STILLERMAN, DEBI MEGINNIS, AND CHARLES GASKINS. WILLIAM B STILLERMAN X 252874 77618 0 1 1 77618 SCHEDULE L, PART II, LOANS TO AND FROM INTERESTED PERSONS: (A) PURPOSE OF LOANBAPTIST RETIREMENT HOMES AND MR. STILLERMAN HAD A SPLIT INTEREST LIFE INSURANCE POLICY IN THE PAST. WHILE THAT POLICY WAS IN EFFECT, MR. STILLERMAN TOOK OUT A LOAN AGAINST THE CASH SURRENDER VALUE. WHEN THE SPLIT INTEREST ARRANGEMENT WAS TERMINATED DUE TO A CHANGE IN TAX LAWS, A NEW LIFE INSURANCE POLICY WAS PURCHASED AND THE ORGANIZATION PAID OFF THE LOAN. MR. STILLERMAN HAS BEEN REPAYING THE ORGANIZATION WITH INTEREST. BAPTIST RETIREMENT HOMES IS THE OWNER AND BENEFICIARY OF THE NEW LIFE INSURANCE POLICY. X 1 2259736 FAIR MARKET VALUE 0 0 1 THIRD PARTY USE: PART I, LINE 32B: THE ORGANIZATION USES A BROKER OR BANK TO SELL STOCK CONTRIBUTIONS. THE ORGANIZATION USES A REALTOR TO SELL REAL ESTATE CONTRIBUTIONS. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990, EXCEPT FOR THE DETAILS OF THE DONORS ON SCHEDULE B, IS PRESENTED FOR REVIEW AT THE FEBRUARY TRUSTEE MEETING. IF NOT AVAILABLE IN TIME FOR THE MEETING, IT IS MAILED TO THE TRUSTEES FOR REVIEW PRIOR TO SUBMITTING THE 990 TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR, TRUSTEES MUST COMPLETE A "NON-CONFLICT OF INTEREST" QUESTIONNAIRE. FORM 990, PART VI, SECTION B, LINE 15 IN COOPERATION WITH THE PERSONNEL COMMITTEE, THE FINANCE COMMITTEE RECOMMENDS THE SALARY OF THE PRESIDENT, COO, AND CFO. EVERY TWO YEARS, THE PROCESS INCLUDES A REVIEW AND APPROVAL BY INDEPENDENT PERSONS. THE MOST RECENT YEAR IN WHICH THE PROCESS WAS REVIEWED AND APPROVED BY INDEPENDENT PERSONS WAS 2011. GENERALLY, INCREASES TO EXECUTIVES ARE AT THE SAME PERCENTAGE AS GRANTED TO ALL EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST AND IN ACCORDANCE WITH BOND COVENANTS AND REGULATORY REQUIREMENTS. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -774,276. CHANGE IN VALUE OF CHARITABLE REMAINDER TRUSTS -148,788. CHANGE IN VALUE OF BENEFICIAL INTEREST IN PERPETUAL TRUSTS -431,460. GRANT ASSISTANCE FROM BAPTIST RETIREMENT HOMES FOUNDATION -238,075. TOTAL TO FORM 990, PART XI, LINE 5: -1,592,599. FORM 990, PART VII, SECTION A, LINE 1A, COLUMN B: HOURS PROVIDED TO RELATED ORGANIZATION, BAPTIST RETIREMENT HOMES FOUNDATION: WILLIAM B. STILLERMAN - 4 HRS PER WEEK DEBRA A. MEGINNIS - 4 HRS PER WEEK CHARLES R. GASKINS - 4 HRS PER WEEK BETH T. JONES - 1 HR PER WEEK BRADY DICKSON - 1 HR PER WEEK W. LINVILLE ROACH - 1 HR PER WEEK SCHEDULE M, PART I, LINE 31 ALTHOUGH THE ORGANIZATION DOES NOT HAVE A WRITTEN GIFT ACCEPTANCE POLICY THAT REQUIRES THE REVIEW OF ANY NON-STANDARD CONTRIBUTIONS, ALL NON-STANDARD CONTRIBUTIONS ARE REVIEWED BY THE PRESIDENT OF THE ORGANIZATION BEFORE THEY ARE ACCEPTED. BAPTIST RETIREMENT HOMES FOUNDATION 1912 BETHABARA ROAD WINSTONSALEM NC 27106 562205837 SUPPORT BAPTIST RETIREMENT HOMES OF NORTH CAROLINA, INCORPORATED (BRH, INC.) NC 501(C)(3) 11-TYPE 1 BRH INC 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 BAPTIST RETIREMENT HOMES FOUNDATION E 420456 BAPTIST RETIREMENT HOMES FOUNDATION C 238075 BAPTIST RETIREMENT HOMES FOUNDATION Q 2422505