2024-08-15T11:37:13-05:00 2023-09-30 560571159 BERNARD ROBINSON & COMPANY LLP PO BOX 19608 GREENSBORO NC 274199608 990 2022-10-01 273481562 PROVIDENCE PLACE ASSISTED LIVING INC PROV 3368884561 1701 WESTCHESTER DRIVE SUITE 400 HIGH POINT NC 27262 KIM S HOPPE PRESIDENT/CEO 3368884561 2024-08-15 1 0 JOHN M ROBINSON P01281319 3362944494 2024-08-15 2022 2024-08-08 14:25:15Z KIM S HOPPE 1701 WESTCHESTER DRIVE SUITE 400 HIGH POINT NC 27262 4573903 0 X WWW.PROVIDENCEPLACENC.COM X 2010 NC TO PASSIONATELY SERVE THE HOUSING AND CARE NEEDS OF SENIOR ADULTS WITH INNOVATIVE PROGRAMS AND SERVICES DELIVERED AT AN EXCEPTIONAL VALUE WHILE ENCOURAGING PERSONAL AND SPIRTUAL GROWTH AND DEVELOPMENT. 3 3 92 7 0 0 0 0 4288610 4285310 -54494 31753 212563 244289 4446679 4561352 0 0 0 0 2209339 2197820 0 0 0 2595284 3026943 4804623 5224763 -357944 -663411 6571220 5539930 6350227 5982348 220993 -442418 TO PASSIONATELY SERVE THE HOUSING AND CARE NEEDS OF SENIOR ADULTS WITH INNOVATIVE PROGRAMS AND SERVICES DELIVERED AT AN EXCEPTIONAL VALUE WHILE ENCOURAGING PERSONAL AND SPIRTUAL GROWTH AND DEVELOPMENT. 0 0 4042596 4529599 PROVIDING HOUSING AND SENIOR SERVICES THROUGH INNOVATIVE MODELS AND STATE OF THE ART CARE SYSTEMS THAT MAXIMIZE FUNCTIONAL ABILITIES AND SPIRITUAL DEVELOPMENT OF THE RESIDENTS AND PROGRAM PARTICIPANTS IN A CHRISTIAN ENVIRONMENT. THE PRIMARY SERVICES PROVIDED ARE ASSISTED LIVING SERVICES AND MEMORY CARE. 55,170 SQ. FT. OF LIVING SPACE, MEMORY CARE CENTER PROVIDING THERAPEUTIC CARE FOR ALZHEIMER'S/DEMENTIA RESIDENTS, PRIVATE AND SEMI-PRIVATE ROOMS AND ON SITE PHYSICAL THERAPY. 4042596 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 22 0 1 92 1 0 0 0 0 0 0 0 0 0 0 0 0 X 3 3 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X KIM S HOPPE 3368884560 1701 WESTCHESTER DRIVE SUITE 400 HIGH POINT NC 27262 TERRY MILLER PRESIDENT/CEO 4.00 12.00 X X 0 312351 1418 PENNY CATES CHAIRMAN 3.14 X X 0 0 0 ED WINSLOW SECRETARY 3.14 X X 0 0 0 CRAIG DUNN DIRECTOR 3.14 X 0 0 0 THOMAS NEILL DIRECTOR 3.14 X 0 0 0 C NORWOOD DAVIS DIRECTOR 3.14 X 0 0 0 REGINA SHARROW DIRECTOR 3.14 X 0 0 0 BARRY YATES CFO 5.00 20.00 X 0 351031 44954 0 663382 46372 0 0 1 0 CULINARY SERVICES GROUP LLC 1135 BUSINESS PARKWAY S 10 WESTMINSTER MD 21157 FOOD SERVICE 604672 INTELYCARE INC PO BOX 200413 PITTSBURG PA 15251 HEALTHCARE STAFFING 101221 2 ROOM AND BOARD 623000 4285310 4285310 4285310 44304 44304 12551 -12551 -12551 -12551 MISCELLANEOUS 623000 244289 244289 244289 4561352 4529599 0 31753 77486 77486 1873513 1143634 729879 99562 69693 29869 147259 103081 44178 257119 257119 7161 7161 45137 22237 22900 40062 40062 16540 16540 64722 64722 153372 153372 404405 404405 261326 261326 122410 122410 ANCILLARY EXPENSES 885169 885169 CONTRACT SERVICES 576840 576840 REPAIRS AND MAINTENANCE 158559 158559 ADMINISTRATIVE EXPENSES 13575 13575 20546 20546 5224763 4042596 1182167 0 564055 218743 1000 1000 567161 88753 26355 34205 8618171 3745682 5060017 4872489 54569 47818 298063 276922 6571220 5539930 217951 240388 244958 5623 5872851 5712027 14467 24310 6350227 5982348 X 220993 -442418 220993 -442418 6571220 5539930 -663411 0 X 0 1 X 1 0 X 282757 282757 4664878 4529354 4769139 4501173 4529599 22994143 4664878 4529354 5051896 4501173 4529599 23276900 0 0 0 23276900 2648 5223 1485 9701 44304 63361 2648 5223 1485 9701 44304 63361 4667526 4534577 5053381 4510874 4573903 23340261 0.99730 0.99910 0.00270 0.00090 X 1218000 1218000 6397649 2813843 3583806 985674 931839 53835 16848 16848 4872489 DUE TO RELATED ORGANIZATIONS 24310 24310 X 4573903 0 4573903 -12551 -12551 4561352 5237314 12551 12551 5224763 0 5224763 PART X, LINE 2: THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION IS NOT CLASSIFIED AS A PRIVATE FOUNDATION. IT IS THE ORGANIZATION'S POLICY TO EVALUATE ALL TAX POSITIONS TO IDENTIFY ANY THAT MAY BE CONSIDERED UNCERTAIN. ALL IDENTIFIED MATERIAL TAX POSITIONS ARE ASSESSED AND MEASURED BY A "MORE-LIKELY-THAN-NOT" THRESHOLD TO DETERMINE IF THE TAX POSITION IS UNCERTAIN AND WHAT, IF ANY, THE EFFECT OF THE UNCERTAIN TAX POSITION MAY HAVE ON THE FINANCIAL STATEMENTS. NO MATERIAL UNCERTAIN TAX POSITIONS WERE IDENTIFIED FOR 2023 AND 2022. PART XI, LINE 4B - OTHER ADJUSTMENTS: LOSS ON FIXED ASSET DISPOSAL -12,551. PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON FIXED ASSET DISPOSAL 12,551. 0 0 0 0 0 0 0 0 0 BARRY YATES CFO 0 351031 0 0 0 0 0 0 0 44954 0 395985 0 0 TERRY MILLER PRESIDENT/CEO 0 312351 0 0 0 0 0 0 0 1418 0 313769 0 0 FORM 990, PART VI, SECTION A, LINE 3 CERTAIN MANAGEMENT DUTIES WERE DELEGATED TO A RELATED 501(C)(3) ORGANIZATION: WESLEYAN ARMS, INC. (56-1012908). FORM 990, PART VI, SECTION B, LINE 11B PROVIDENCE PLACE ASSISTED LIVING, INC. DOES NOT PROVIDE ITS FORM 990 TO THE BOARD FOR REVIEW PRIOR TO FILING THE 990 RETURN. THE FINANCIAL STATEMENTS ARE REVIEWED ON A MONTHLY BASIS BY THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS ARE ASKED TO DISCLOSE ALL POTENTIAL CONFLICTS OF INTEREST AND IN THE EVENT OF A CONFLICT OF INTEREST THAT MEMBER IS ASKED TO ABSTAIN FROM VOTING. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING COMPENSATION FOR THE CEO AND CERTAIN TOP EMPLOYEES IS DETERMINED BY AN INDEPENDENT BOARD OF DIRECTORS. THE DIRECTORS ARE ALL LOCAL BUSINESS EXECUTIVES AND PROFESSIONALS. THE REVIEW AND ANALYSIS IS CONDUCTED IN A CLOSED SESSION WHERE THE INDIVIDUAL WHO IS THE SUBJECT OF THE REVIEW IS EXCLUDED FROM THE DISCUSSIONS SO AS TO ENCOURAGE FRANK AND FORTHRIGHT DEBATE. DURING THE DISCUSSIONS, COMPARABILITY DATA IS OFTEN IDENTIFIED. FOR EXAMPLE, ONE OF THE DIRECTORS IS A HEALTHCARE ATTORNEY AND IS AWARE OF EXECUTIVE SALARIES AT A NUMBER OF SIMILAR LONG TERM CARE ORGANIZATIONS THROUGHOUT THE STATE. NOTES AND MINUTES ARE TAKEN OF THE DISCUSSION AND THE DECISION AND THEN THE CONCLUSIONS OF THE BOARD ARE THEN PUT INTO PLACE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST BY ANY INTERESTED PARTY. WESLEYAN ARMS INC 1701 WESTCHESTER DRIVE HIGH POINT NC 27262 561012908 ASSISTED LIVING NC 501(C)(3) LINE 10 N/A 0 PPRC NURSING HOME INC 1795 WESTCHESTER DRIVE HIGH POINT NC 27262 311733046 NURSING HOME NC 501(C)(3) LINE 10 N/A 0 PPRC SENIOR LIVING I INC 1795 WESTCHESTER DRIVE HIGH POINT NC 27262 311733044 INDEPENDENT LIVING NC 501(C)(3) LINE 10 N/A 0 PPRC SENIOR LIVING II INC 1727 WESTCHESTER DRIVE HIGH POINT NC 27262 300113709 INDEPENDENT LIVING NC 501(C)(3) LINE 10 N/A 0 WESTCHESTER CHRISTIAN CENTER INC 1701 WESTCHESTER DRIVE HIGH POINT NC 27262 561963673 ACQUISITION, IMPROVEMENT, MAINTENANCE, LEASING OF PROPERTY NC N/A C 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 1 0 0 0 WESTCHESTER CHRISTIAN CENTER INC D 275000 CASH PAID WESLEYAN ARMS INC M 257119 CASH PAID