2022-08-15T13:28:56-05:00 2021-09-30 410746749 CLIFTONLARSONALLEN LLP 227 WEST TRADE STREET SUITE 800 CHARLOTTE NC 28202 990 2020-10-01 560562308 BAPTIST RETIREMENT HOMES OF NORTH CAROLINA INCORPORATED BAPT 3367250202 PO BOX 11024 WINSTON SALEM NC 27116 REED A VANDERSLIK PRESIDENT AND CEO 3367250202 2022-08-15 1 REED VANDERSLIK 999009999 JOHN NORMAN P01506766 7049985200 2022-08-15 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z REED A VANDERSLIK PO BOX 11024 WINSTON SALEM NC 27116 32374194 0 X WWW.BRH.ORG X 1952 NC TO PROVIDE QUALITY LIVING OPTIONS AND SERVICES TO NORTH CAROLINA'S OLDER ADULT POPULATION. 20 20 582 415 0 0 2838860 5316887 24795083 25235357 909014 1524049 695055 297901 29238012 32374194 715101 1152163 0 0 15048007 15214087 0 0 187942 13487850 14099280 29250958 30465530 -12946 1908664 86440616 88647390 50220307 48131880 36220309 40515510 X BAPTIST RETIREMENT HOMES OF NORTH CAROLINA, INC. IS A CHURCH RELATED NOT-FOR-PROFIT ORGANIZATION COMMITTED TO PROVIDING QUALITY CARE AND A MEANINGFUL WAY OF LIFE FOR RESIDENTS AND STAFF... A PLACE WHERE RESIDENTS AND STAFF BECOME AN EXTENSION OF FAMILY THAT RECOGNIZES THE DIGNITY AND WORTH OF EACH INDIVIDUAL. 0 0 24793468 1152163 25235357 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 HOMES HAS FIDUCIARY RESPONSIBILITY FOR THE OPERATION OF HOMES ORGANIZATION. THE MISSION OF THE 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 OFFERED TO THE POOR ELDERLY OF THE STATE AS WELL AS THOSE OLDER PERSONS WHO DO HAVE THE FINANCIAL RESOURCES AVAILABLE TO PAY FOR THE INSTITUTIONAL SERVICES THEY NEED. IN ADDITION TO ITS PROGRAM OF BENEVOLENT FUNDING TO THE POOR ELDERLY OF THE STATE, HOMES ALSO PROVIDES A SPECIAL PROGRAM DESIGNED TO ENHANCE THE LIFESTYLE OF OLDER ADULTS WITH DEMENTIA RELATED DISORDERS LIKE ALZHEMER'S DISEASE. THREE SUCH PROGRAMS ARE OPERATED BY BAPTIST RETIREMENT HOMES. HOMES OWNS, MAINTAINS, AND OPERATES COMMUNITIES THROUGHOUT NORTH CAROLINA. ITS CURRENT COMMUNITIES INCLUDE 262 INDEPENDENT LIVING HOMES AND APARTMENTS, 138 ASSISTED LIVING RESIDENCES, AND 201 SKILLED NURSING CARE ROOMS. HOMES RECEIVES SUPPORT FROM INDIVIDUALS, BUSINESSES, FOUNDATIONS, CHURCHES, SPECIAL OFFERINGS, AND BEQUESTS FROM OTHERS TO ASSIST IN THE OPERATION AND ADMINISTRATION OF ITS COMMUNITIES. 24793468 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 54 0 582 1 0 0 0 0 0 0 0 0 0 0 0 0 X 20 20 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X SCOTT FARKAS CPA CFO 3367250202 1912 BETHABARA ROAD WINSTON SALEM NC 27106 PERRY H BAILEY BOARD MEMBER 1.00 1.00 X 0 0 0 EDWARD BEDDINGFIELD JR CORPORATE SECRETARY 1.00 1.00 X X 0 0 0 JEFFREY L COBB CHAIR 1.00 1.00 X X 0 0 0 CAROLYN D HELMS BOARD MEMBER 1.00 1.00 X 0 0 0 DAVE HORNE BOARD MEMBER 1.00 1.00 X 0 0 0 BETTY LYNNE JOHNSON BOARD MEMBER 1.00 1.00 X 0 0 0 MARY BETH JOHNSTON BOARD MEMBER 1.00 1.00 X 0 0 0 CLARENCE R LAMBE JR VICE CHAIR 1.00 1.00 X X 0 0 0 NATHANIEL LEONARD BOARD MEMBER 1.00 1.00 X 0 0 0 RHONDA LOWE BOARD MEMBER 1.00 1.00 X 0 0 0 CHARLES D MAST BOARD MEMBER 1.00 1.00 X 0 0 0 JAMES L MCCOY III BOARD MEMBER 1.00 1.00 X 0 0 0 RICHARD P MURRAY BOARD MEMBER 1.00 1.00 X 0 0 0 JOHN POND BOARD MEMBER 1.00 1.00 X 0 0 0 DANIEL RICE BOARD MEMBER 1.00 1.00 X 0 0 0 WANDA J ROSE BOARD MEMBER 1.00 1.00 X 0 0 0 HENRY SKINNER BOARD MEMBER 1.00 1.00 X 0 0 0 MICHAEL R TAYLOR BOARD MEMBER 1.00 1.00 X 0 0 0 FRANKLIN S WATKINS BOARD MEMBER 1.00 1.00 X 0 0 0 BOBBY F WATSON BOARD MEMBER 1.00 1.00 X 0 0 0 REED A VANDERSLIK PRESIDENT OF AFFILIATE & A 36.00 4.00 X 340955 0 17484 DEBRA A MEGINNIS EVP/COO OF AFFILIATE AND A 36.00 4.00 X 387000 0 18572 SCOTT FARKAS CFO 36.00 4.00 X 0 0 0 JESSICA MCCOLLUM VP OF OPERATIONS 40.00 X 125324 0 2381 RICHARD SIMPSON VP OF CLINICAL SERVICES 40.00 X 101612 0 24857 WILLIAM MEGINNIS CONSTRUCTION SERVICES 40.00 X 156288 0 0 CHRISTOPHER ELMER ADMINISTRATOR 40.00 X 109014 0 18149 BETTY JACKSON ADMINISTRATOR 40.00 X 102252 0 4054 WILLIAM B STILLERMAN EMERITUS PRESIDENT OF AFFI 36.00 4.00 X 493500 0 2821 MS JEANNINE M RICHMAN CFO 36.00 4.00 X 119165 0 8742 1935110 0 97060 9 1 1 0 LEGACY HEALTHCARE SERVICES 110 HORIZON DR STE 310 RALEIGH NC 27615 THERAPY SERVICES 1462962 FRANK L BLUM CONSTRUCTION CO PO BOX 4153 WINSTONSALEM NC 27115 CONSTRUCTION SERVICES 1038098 MAKO MEDICAL LABORATORIES LLC 8461 GARVEY DR RALEIGH NC 27616 LAB PROVIDER 644215 MASTERCRAFT ROOFING GROUP 316 HODGIN ST HIGH POINT NC 27262 CONTRACTOR 481632 PIEDMONT TUB INC PO BOX 1467 KING NC 27021 BATHROOM CONTRACTOR 433120 40 1174399 3210570 931918 5316887 RESIDENT SERVICES 623000 25235357 25235357 25235357 426505 426505 42439 0 42439 42439 42439 1085044 12500 0 0 1085044 12500 1097544 1097544 MISCELLANEOUS 623000 255462 255462 255462 32374194 25235357 0 1821950 180000 180000 972163 972163 727955 727955 11494333 10013991 1391218 89124 2021336 1631169 372342 17825 970463 799723 170740 54039 54039 92795 92795 2705556 2557583 147973 541858 39869 480899 21090 359923 250616 109307 235575 235575 1617231 1121058 496173 23073 950 22123 24049 4146 19903 996928 996928 3546003 3546003 423827 423827 REPAIRS AND MAINTENANCE 1034233 933731 100502 MEDICAL SUPPLIES 1008397 424316 584081 FOOD 954709 930659 24050 MEDICAL SERVICES 244679 244679 236405 145884 30618 59903 30465530 24793468 5484120 187942 8574297 4596486 132500 132500 1688402 2231841 159566 158710 226097 189635 109718437 64633880 43315825 45084557 23042843 26265750 6593489 7365382 2707597 2622529 86440616 88647390 2473159 3224797 14419088 15492492 66689 84918 33261371 29329673 0 50220307 48131880 X 27272716 30169115 8947593 10346395 36220309 40515510 86440616 88647390 X 1908664 475214 1911323 X 0 1 X 1 1 1 X 2321106 2440115 2586791 2838860 5316887 15503759 24528095 25539721 25132698 24795083 25235537 125231134 26849201 27979836 27719489 27633943 30552424 140734893 8527 17175 25315 16780 10025 77822 0 8527 17175 25315 16780 10025 77822 140657071 436513 518565 633000 464430 468944 2521452 436513 518565 633000 464430 468944 2521452 514863 421973 431042 670184 255462 2293524 27800577 28920374 28783531 28768557 31276830 145549869 0.96640 0.96250 0.01730 0.01850 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 6839731 1139430 96771 7882390 6693357 243145 96771 6839731 6941175 -176669 71149 6693357 7186807 65253 151690 462575 6941175 6904976 56776 405961 180906 7186807 0.84900 0.15100 0 0 6051281 6051281 94030435 59181607 34848828 5491380 4065011 1426369 4145341 1387262 2758079 45084557 CHARITABLE REMAINDER TRUSTS 1673113 C BENEFICIAL INTEREST IN PERPETUAL TRUST 5692269 C 7365382 X PART IV, LINE 2B: RESIDENT FUNDS HELD IN TRUST. PART V, LINE 4: RESTRICTED FUNDS ARE INTENDED FOR RESIDENT ASSISTANCE AND OTHER RESTRICTED PROGRAMS. PART X, LINE 2: THE HOMES AND THE FOUNDATION ARE NOT-FOR-PROFIT ORGANIZATIONS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THE HOMES AND THE FOUNDATION FILE AS TAX-EXEMPT ORGANIZATIONS. MANAGEMENT IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE THE TAX-EXEMPT STATUS OF THE HOMES OR THE FOUNDATION. MANAGEMENT IS NOT AWARE OF ANY SIGNIFICANT ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR ANY OTHER TAXES FOR HOMES OR THE FOUNDATION. 1 BAPTIST RETIREMENT HOMES FOUNDATION 1912 BETHABARA ROAD WINSTON SALEM NC 27106 562205837 501(C)(3) 180000 COMMUNITY BENEFIT DONATION 1 BRH RESIDENTS - BENEVOLENCE 74 922841 SPECIAL ASSISTANCE AND BENEVOLENT CARE CARE CAFE 21 14322 ADULT DAY CARE BENEVOLENCE. PAID THROUGH AP MEDICINE FROM THE HEART (FIRST BAPTIST CHURCH OF SMITHFIELD) 24 21000 MEDICINE FROM THE HEART MEDICINE FROM THE HEART/FELLOWSHIP ASSISTANCE (FIRST BAPTIST CHURCH OF WILSON) 24 14000 MEDICINE FROM THE HEART AND FELLOWSHIP MEALS TO GO OUT OF AP 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. THE TRUSTEES APPROVE PROJECTS AND GIVE GENERAL GUIDANCE ON BENEVOLENCE. THE BAPTIST RETIREMENT HOMES FOUNDATION AGREED TO REIMBURSE HOMES FOR THESE PROJECTS THAT BENEFIT POOR SENIOR ADULTS IN NORTH CAROLINA. THE ORGANIZATION REQUESTS SUPPORT THROUGH A LETTER TO BAPTIST RETIREMENT HOMES. SCHEDULE I, PART III, COLUMN B THE ORGANIZATION ESTIMATED THAT 40% OF THE TOTAL RESIDENT POPULATION SERVED UTILIZES SOME TYPE OF FINANCIAL ASSISTANCE. X X 1 0 0 0 0 0 0 1 0 WILLIAM B STILLERMAN EMERITUS PRESIDENT OF AFFI 0 0 150000 0 343500 0 1999 0 822 0 496321 0 0 0 DEBRA A MEGINNIS EVP/COO OF AFFILIATE AND A 226559 0 0 0 160441 0 7552 0 11020 0 405572 0 0 0 REED A VANDERSLIK PRESIDENT OF AFFILIATE & A 340955 0 0 0 0 0 0 0 17484 0 358439 0 0 0 WILLIAM MEGINNIS CONSTRUCTION SERVICES 156288 0 0 0 0 0 0 0 0 0 156288 0 0 0 MS JEANNINE M RICHMAN CFO 119165 0 0 0 0 0 0 0 8742 0 127907 0 0 0 PART I, LINE 4A DURING THE 2020 CALENDAR YEAR, DEBRA MEGINNIS RECEIVED A CHANGE OF CONTROL PAYMENT TOTALING $37,759.84. PART I, LINE 7 DISCRETIONARY BONUSES WERE PAID TO WILLIAM STILLERMAN AND DEBRA MEGINNIS. SEE SCHEDULE O OF FORM 990 FOR MORE DETAIL ON HOW COMPENSATION FOR THE PRESIDENT, COO, AND CFO IS DETERMINED. FORM 990, PART VI, SECTION B, LINE 11B BOTH MANAGEMENT AND TRUSTEES REVIEW THE 990 BEFORE IT IS FILED. IF CHANGES ARE SUGGESTED DURING THE REVIEW, THEY ARE MADE PRIOR TO THE IRS FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR, TRUSTEES MUST COMPLETE A "NON-CONFLICT OF INTEREST" QUESTIONNAIRE. ADDITIONALLY, EMPLOYEES MUST DISCLOSE ALL PERTINENT FACTS SURROUNDING A POTENTIAL CONFLICT OF INTEREST TO HIS OR HER IMMEDIATE SUPERVISOR. THE ORGANIZATION'S CONFLICT OF INTEREST STATEMENT OUTLINES THE ACTIVITIES EMPLOYEES SHOULD AVOID WITHOUT PRIOR APPROVAL OF THE BOARD OF TRUSTEES, AND PROVIDES STEPS TO BE TAKEN IF A POSSIBLE CONFLICT OF INTEREST EXISTS. 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 YEAR. COMPENSATION IS BENCHMARKED TO COMPENSATION SURVEYS. 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 2021. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST AND IN ACCORDANCE WITH REGULATORY REQUIREMENTS. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF CHARITABLE REMAINDER TRUSTS -39,196. CHANGE IN UNREALIZED GAINS ON INVESTMENTS 1,139,430. CHANGE IN VALUE OF BENEFICIAL INTEREST IN PERPETUAL TRUSTS 811,089. BAPTIST RETIREMENT HOMES FOUNDATION 1912 BETHABARA ROAD WINSTON SALEM NC 27106 562205837 SUPPORT BRH NC 501(C)(3) LINE 12A, I BRHNC INC 1 0 0 1 0 0 0 0 0 1 0 0 1 0 1 1 0 0 0 1 BAPTIST RETIREMENT HOMES OF NORTH CAROLINA INCORPORATED C INTERCOMPANY TRANSFER