2022-08-29T07:32:01-05:00 2021-12-31 440160260 FORVIS LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2021-01-01 561152263 ARBOR ACRES UNITED METHODIST RETIREMENT COMMUNITY INC ARBO 3367247921 1240 ARBOR ROAD WINSTONSALEM NC 271041197 DAVID W MATTHEWS VICE PRESIDENT/CFO 3367247921 2022-08-26 1 DAVID MATTHEWS 999009999 AMY BIBBY P00445891 8282542254 2022-08-26 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z ANDREW APPLEGATE 1240 ARBOR ROAD WINSTONSALEM NC 271041197 41001828 0 X WWW.ARBORACRES.ORG X 1975 NC TO SERVE SENIOR ADULTS WHILE PROVIDING SECURITY, CONTENTMENT, AND LIFE WITH MEANING & PURPOSE. 22 22 607 35 0 0 3468407 2021914 35448155 35244106 848697 3064084 83514 64609 39848773 40394713 1558579 1385013 0 0 18187729 18578826 0 0 281693 18069592 18938685 37815900 38902524 2032873 1492189 141135946 155220604 83702447 92850912 57433499 62369692 X ARBOR ACRES, AN AFFILIATE MINISTRY OF THE UNITED METHODIST CHURCH, SERVES SENIOR ADULTS THROUGH FACILITIES AND PROGRAMS THAT ENHANCE OPPORTUNITY FOR SECURITY, CONTENTMENT AND LIFE WITH MEANING AND PURPOSE. 0 0 25630928 1385013 34178093 ARBOR ACRES, A CONTINUING CARE RETIREMENT COMMUNITY (CCRC), PROVIDING A RESIDENTIAL WINGS CONTAINING 120 UNITS (STUDIO, EFFICIENCY AND CONNECTING ROOM SUITES); 2 TWO-BEDROOM COURTYARD APARTMENTS; 6 ONE-BEDROOM AND 6 TWO-BEDROOM CLUSTER HOMES AND 119 HOUSES. IN ADDITION TO THE INDEPENDENT LIVING FACILITIES, ARBOR ACRES ALSO HAS 95 ADULT CARE HOME BEDS AND 83 NURSING CARE BEDS (LOCATED IN THE FITZGERALD HEALTH CENTER). AS OF DECEMBER 31, 2021, ARBOR ACRES SERVED 466 RESIDENTS IN THE ABOVE UNITS.ARBOR ACRES HOLDS MEMBERSHIPS WITH LEADING AGE (FORMERLY THE AMERICAN ASSOCIATION OF HOMES AND SERVICES FOR THE AGING) AND LEADING AGE NC (FORMERLY THE NORTH CAROLINA ASSOCIATION OF NON-PROFIT HOMES FOR THE AGING). THE FACILITY IS ACCREDITED THROUGH THE CONTINUING CARE ACCREDITATION COMMISSION.AN IMPORTANT COMPONENT OF FULFILLING ARBOR ACRES' MISSION IS THE PROVISION OF FINANCIAL ASSISTANCE SUPPORT TO ENABLE RESIDENTS TO RESIDE AT ARBOR ACRES WHO WOULD OTHERWISE BE UNABLE TO AFFORD TO DO SO. FOR THE YEAR ENDING DECEMBER 31, 2021, $1,066,013 OF FINANCIAL ASSISTANCE WAS PROVIDED TO RESIDENTS TO HELP THEM MAINTAIN RESIDENCY AT THE FACILITY.DURING 2021 THE FOLLOWING SPECIFIC ACCOMPLISHMENTS ENHANCED THE ABILITY TO SERVE RESIDENTS:1. MAINTAINED NEAR FULL OCCUPANCY OF ASSISTED LIVING, MEMORY CARE AND SKILLED NURSING LEVELS OF LICENSED CARE AND EXCEEDED 90% OCCUPANCY OF INDEPENDENT LIVING UNITS.2. SPONSORED AND FACILITATED PARTICIPATION OF RESIDENT EFFORTS IN COMMUNITY SERVICE PROJECTS INCLUDE THE SALVATION ARMY. 25630928 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 1 72 0 1 607 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 22 22 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X DAVID W MATTHEWS VICE PRESIDENTCFO 3367247921 1240 ARBOR ROAD WINSTONSALEM NC 27104 TANYA AFOLAYAN BOARD MEMBER 1.00 X 0 0 0 PAMELA BALL CHAIR 1.00 X X 0 0 0 SAMUEL BLACK BOARD MEMBER 1.00 X 0 0 0 ART BLOOM BOARD MEMBER 1.00 X 0 0 0 DUDLEY CHANDLER BOARD MEMBER 1.00 X 0 0 0 FLORENCE CORPENING SECRETARY 1.00 X X 0 0 0 COURTNEY DOUGLAS BOARD MEMBER 1.00 X 0 0 0 CHRISTINE DUNN BOARD MEMBER 1.00 X 0 0 0 JOHN EARLE BOARD MEMBER 1.00 X 0 0 0 SUSAN ELSTER BOARD MEMBER 1.00 X 0 0 0 DONALD EPPERT BOARD MEMBER 1.00 X 0 0 0 CINNY S GRAHAM SECRETARY 1.00 X X 0 0 0 DAVID HINTON BOARD MEMBER 1.00 X 0 0 0 VINCENT HOWELL BOARD MEMBER 1.00 X 0 0 0 VICTORIA HUNT VICE CHAIR 1.00 X X 0 0 0 KAYE LAMBERT BOARD MEMBER 1.00 X 0 0 0 JOHN E LAUER TREASURER 1.00 X X 0 0 0 BISHOP PAUL LEELAND EX-OFFICIO 1.00 X 0 0 0 CARROLL MCCULLOUGH BOARD MEMBER 1.00 X 0 0 0 J WILLIAM MCGUINN JR BOARD MEMBER 1.00 X 0 0 0 SAM MOORE EX-OFFICIO 1.00 X 0 0 0 DREWRY NOSTITZ BOARD MEMBER 1.00 X 0 0 0 CHRISTOPHER PEARCE BOARD MEMBER 1.00 X 0 0 0 FRANK RAYBURN EX-OFFICIO 1.00 X 0 0 0 JUDY REEDER EX-OFFICIO 1.00 X 0 0 0 SUSAN SCHWARTZ BOARD MEMBER 1.00 X 0 0 0 J HILL STOCKTON BOARD MEMBER 1.00 X 0 0 0 WENDY WALKER-FOX BOARD MEMBER 1.00 X 0 0 0 JOHN WILLINGHAM CHAIR ELECT 1.00 X 0 0 0 ANDREW APPLEGATE CEO 40.00 X 299952 0 42545 KENNETH BOYLES COO 40.00 X 161405 0 19069 KATHY GWYN VP HEALTH SERVICES 40.00 X 180614 0 29478 DAVID MATTHEWS CFO 40.00 X 183470 0 23904 JULIE TAMPA SECRETARY 40.00 X 70789 0 12235 LYNN ROSS DIRECTOR OF MARKETING 40.00 X 130367 0 15480 AMANDA CLEARY NURSE MANAGER 40.00 X 128497 0 15289 LES CRANFILL DIRECTOR OF BUILDINGS AND 40.00 X 122322 0 15282 HANNAH YOON HEALTHCARE ADMINISTRATOR 40.00 X 122092 0 17415 KEVIN CLINKENBEARD DIRECTOR OF FACILITIES 40.00 X 140762 0 24302 1540270 0 214999 11 0 1 0 FRANK L BLUM CONSTRUCTION COMPANY 830 NE 25TH ST WINSTON SALEM NC 27105 CONSTRUCTION 5008216 US FOOD SERVICE 125 FORT MILL PKWY FORT MILL SC 29715 FOOD SERVICE 1136628 SOLID FOUNDATION CONSTRUCTION INC 1240 YORKSHIRE RD WINSTON SALEM NC 27106 CONSTRUCTION 1012197 SFCS INC 305 SOUTH JEFFERSON ST ROANOKE VA 24011 ARCHITECTS 756886 CHENEY BROTHERS 195 BUSINESS PARK STATESVILLE NC 28677 FOOD SERVICE 686687 23 371340 1650574 2021914 RESIDENT FEES 623000 28232919 28232919 DEFERRED ENTRANCE FEES 623000 5372903 5372903 HOME CARE FEES 623000 1537329 1537329 MODIFICATION FEES EARNED 623000 85955 85955 APPLICATION FEES 623000 15000 15000 35244106 1147533 1147533 2501139 0 584588 2501139 -584588 1916551 1916551 22640 22527 113 113 FOOD SERVICE REVENUE 900099 58136 58136 GUEST ROOM RENTAL 900099 6360 6360 64496 40394713 35244106 0 3128693 319000 319000 1066013 1066013 896231 187642 708589 104228 104228 13786146 12258745 1343288 184113 3792221 3137238 606570 48413 154375 154375 216354 216354 1836521 1700393 136128 244033 244033 2671480 2331869 290538 49073 107008 107008 1628958 1464503 164455 17218 13559 3659 458 458 1307557 1307557 7661283 7661283 393147 393147 FOOD COST 1665589 1665589 COVID EXPENSES 707321 707321 MEDICAL SUPPLIES 295030 295030 MISCELLANEOUS 32351 28297 3960 94 2 2 38902524 25630928 12989903 281693 2984475 7121721 592104 592736 798196 635398 360402 370639 173025614 81839029 86632859 91186585 47543563 52459061 1449495 1536729 655789 1198672 119063 119063 141135946 155220604 2805455 5935497 33535569 33969622 34025000 47194228 7876184 490000 5460239 5261565 83702447 92850912 X 43909871 47362360 13523628 15007332 57433499 62369692 141135946 155220604 X 1492189 1192206 2251798 X X 0 1 X 1 0 X 1561245 4116152 2586876 3468407 2021914 13754594 30364789 31981468 32760642 35448155 34178093 164733147 164890 134070 176179 108967 87136 671242 32090924 36231690 35523697 39025529 36287143 179158983 525323 558777 688710 568943 681634 3023387 0 525323 558777 688710 568943 681634 3023387 176135596 752995 890455 879976 847915 1147533 4518874 752995 890455 879976 847915 1147533 4518874 32843919 37122145 36403673 39873444 37434676 183677857 0.95890 0.96070 0.02460 0.02320 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 542 542 0 PART II-B, LINE 1: THE ORGANIZATION ENGAGED IN VARIOUS LOBBYING ACTIVITES WITH LEADING AGE NORTH CAROLINA IN THE AMOUNT OF $270 AND LEADING AGE (NATIONAL) IN THE AMOUNT OF $272. 18288955 382761 1720288 711702 19680302 16210205 1088308 1664828 674386 18288955 14410233 129350 2275202 604580 16210205 15367393 299878 -612038 645000 14410233 14074117 102479 1790797 600000 15367393 0.36110 0.63890 0 0 2166825 2166825 137100020 67371540 69728480 10982121 7832286 3149835 22776648 6635203 16141445 91186585 REFUNDABLE DEPOSITS 2076530 INTEREST RATE SWAP LIABILITY 3185035 5261565 X 42764048 1192206 78578 1270784 41493264 -1098551 -1098551 40394713 37827855 22527 22527 37805328 1097196 1097196 38902524 PART V, LINE 4: ARBOR ACRES CURRENTLY MAINTAINS A FINANCIAL ASSISTANCE PROGRAM AND POLICY FOR RESIDENTS HOLDING CONTINUING CARE RESIDENCY AGREEMENTS IN THE EVENT THE RESIDENT(S) SHOULD BECOME UNABLE TO PAY FOR SERVICES. THERE IS A DESIGNATED ASSISTANCE ENDOWMENT OF $7,107,194 WITHOUT DONOR RESTRICTIONS AND A ASSISTANCE ENDOWMENT OF $12,573,109 WITH DONOR RESTRICTIONS. PART X, LINE 2: ARBOR ACRES IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. HOME CARE IS A LIMITED LIABILITY COMPANY THAT HAS NOT ELECTED TO BE TAXED AS A CORPORATION UNDER CURRENT INTERNAL REVENUE CODE (IRC) REGULATIONS. HOME CARE IS WHOLLY OWNED BY ARBOR ACRES. AS SUCH, HOME CARE IS CONSIDERED A DISREGARDED ENTITY UNDER CURRENT IRC REGULATIONS. BASED ON THE INFORMATION ABOVE, THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION OR LIABILITY FOR FEDERAL AND STATE INCOME TAXES. THE COMPANY HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF DECEMBER 31, 2021. PART XI, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD 22,527. CHANGE IN VALUE OF PERPETUAL TRUST 87,234. REVENUES IN EXPENSES -31,183. PART XI, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN INTEREST RATE SWAP -2,164,564. GRANTS TO INDIVIDUALS 1,066,013. PART XII, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD 22,527. PART XII, LINE 4B - OTHER ADJUSTMENTS: REVENUES IN EXPENSES 31,183. GRANTS TO INDIVIDUALS 1,066,013. 1 HABITAT FOR HUMANITY 608 COLISEUM DR NW WINSTONSALEM NC 27106 561448955 501(C)(3) 30000 0 OPERATIONAL SUPPORT THE SHEPHERD'S CENTER 1700 EBERT ST WINSTONSALEM NC 27103 561646960 501(C)(3) 30000 0 OPERATIONAL SUPPORT YWCA 1300 S MAIN ST WINSTONSALEM NC 27127 560564345 501(C)(3) 30000 0 OPERATIONAL SUPPORT THE WINSTON-SALEM FOUNDATION 751 W 4TH ST 200 WINSTONSALEM NC 27101 566037615 501(C)(3) 200000 0 OPERATIONAL SUPPORT SENIOR SERVICES 2895 SHOREFAIR DRIVE WINSTONSALEM NC 27105 561085968 501(C)(3) 25000 0 OPERATIONAL SUPPORT 5 FINANCIAL ASSISTANCE PROVIDED TO RESIDENTS 15 0 1066013 FMV FINANCIAL ASSISTANCE TO RESIDENTS PART I, LINE 2: THE ORGANIZATION PROVIDES FINANCIAL ASSISTANCE TO RESIDENTS UNABLE TO PAY FOR SERVICES. THE ORGANIZATION KEEPS A RECORD OF HOW IT DETERMINES A RESIDENTS FINANCIAL NEED AND THE AMOUNT OF ASSISTANCE PROVIDED. X X X X 0 0 0 0 0 0 0 0 0 ANDREW APPLEGATE CEO 262464 0 14687 0 22801 0 17599 0 24946 0 342497 0 0 0 KATHY GWYN VP HEALTH SERVICES 156987 0 16808 0 6819 0 10733 0 18745 0 210092 0 0 0 DAVID MATTHEWS CFO 171220 0 12000 0 250 0 9859 0 14045 0 207374 0 0 0 KENNETH BOYLES COO 148592 0 12000 0 813 0 9696 0 9373 0 180474 0 0 0 KEVIN CLINKENBEARD DIRECTOR OF FACILITIES 138008 0 2754 0 0 0 8889 0 15413 0 165064 0 0 0 A NORTH CAROLINA MEDICAL CARE COMMISSION 531309402 2016-12-15 13159000 REFUND SERIES 2007 ISSUE 0 0 0 B NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 2019-08-01 24900000 REFUND SERIES 2010 ISSUE 0 0 0 C NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 2021-07-27 62640000 RETIREMENT FACILITIES FIRST MORTGAGE REVENUE BONDS 0 0 0 A 4793000 13159000 13159000 2016 0 0 1 1 B 1460000 24900000 24900000 2019 0 0 1 1 C 62640000 629909 900000 52024525 9085566 2023 0 1 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 1 1 BB&T 16.000000000000 0 0 0 0 1 B 0 1 0 0 1 1 BB&T 19.000000000000 0 0 0 0 1 C 0 1 0 0 1 1 TRUIST BANK 10.000000000000 0 0 0 0 1 A 1 B 1 C 1 KIMBERLY SNOW FAMILY RELATIONSHIP WITH AN OFFICER 104228 COMPENSATION 0 FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION PROVIDES A COMPLETE COPY OF THE 990 TO THE BOARD OF DIRECTORS' FINANCE COMMITTEE, PRIOR TO FILING. AFTER REVIEW AND APPROVAL BY THE FINANCE COMMITTEE THE 990 IS MADE AVAILABLE TO ALL BOARD MEMBERS PRIOR TO FILING. ONCE ACCEPTED BY THE BOARD OF DIRECTORS THE 990 IS FILED BY MANAGEMENT. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR, ALL BOARD MEMBERS ARE REQUIRED TO SIGN A CERTIFICATION THAT THEY HAVE READ AND UNDERSTAND OUR POLICY. THEY ARE ALSO REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICTS OR RELATIONSHIPS. THESE CERTIFICATIONS ARE KEPT ON FILE AND ARE REVIEWED ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 THE CEO'S COMPENSATION IS REVIEWED BY THE BOARD OF DIRECTORS' COMPENSATION COMMITTEE ANNUALLY. SPECIFIC SALARY INFORMATION AVAILABLE FOR COMPARABLE FACILITIES WILL BE UTILIZED IN EVALUATING THE CEO'S COMPENSATION. WHEN EVALUATING SURVEY AND LOCAL COMMUNITY'S DATA, SIZE OF COMMUNITY AND ANNUAL REVENUES WILL BE UTILIZED AS THE PRIMARY BENCHMARKS. THE CEO, WORKING WITH THE DIRECTOR OF TALENT ARTS, WILL RECOMMEND COMPENSATION FOR OTHER OFFICERS AND KEY EMPLOYEES TO THE COMPENSATION COMMITTEE, SEEKING THEIR APPROVAL BEFORE IMPLEMENTING ANY CHANGES. THE SAME SOURCES OF DATA USED TO EVALUATE THE CEO'S COMPENSATION IS USED FOR OTHER OFFICERS AND KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION'S FORM 990 IS MADE AVAILABLE TO THE PUBLIC UPON REQUEST. ADDITIONALLY, RECENT FILINGS OF THE FORM CAN BE FOUND ON WWW.GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE UPON REQUEST. ANNUAL FINANCIAL STATEMENTS ARE PART OF THE ANNUAL DISCLOSURE STATEMENT MADE AVAILABLE THROUGH THE NC DEPARTMENT OF INSURANCE WEBSITE. THE ANNUAL AUDIT IS DISTRIBUTED TO RESIDENT COUNCIL AND MADE AVAILABLE TO ANY RESIDENT UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST RATE SWAP 2,164,564. CHANGE IN VALUE OF PERPETUAL TRUST 87,234. PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. ARBOR ACRES HOME CARE LLC 1240 ARBOR ROAD WINSTONSALEM NC 27104 832830530 IN HOME CARE SERVICES NC 1537329 1686256 ARBOR ACRES UNITED METHODIST RETIREMENT COMMUNITY INC