2021-08-10T15:15:28-05:00 2020-09-30 410746749 CLIFTONLARSONALLEN LLP 227 WEST TRADE STREET SUITE 800 CHARLOTTE NC 28202 990 2019-10-01 560729010 PENICK VILLAGE INC PENI 9106920300 500 EAST RHODE ISLAND AVENUE SOUTHERN PINES NC 28387 TERRY R KEES CHIEF FINANCIAL OFFICER 9106920300 2021-08-10 1 JOHN NORMAN P01506766 7049985200 2021-08-10 2019 2022-09-23 18:48:47Z TERRY R KEES 500 EAST RHODE ISLAND AVENUE SOUTHERN PINES NC 28387 18076323 0 X WWW.PENICKVILLAGE.ORG X 1957 NC OPERATES A LIFE PLANNING COMMUNITY, SEE ALSO PART III, LINE 1. 16 16 367 340 385785 -109981 874819 631753 17367697 17202057 245089 242513 0 0 18487605 18076323 0 0 0 0 9153123 9234108 0 0 11872 8851061 9254628 18004184 18488736 483421 -412413 58057431 72601027 49725226 64175273 8332205 8425754 X PENICK VILLAGE'S MISSION IS TO BE A FAMILY THAT CREATES A LOVING COMMUNITY BY MAKING EVERY DAY GREAT FOR ONE ANOTHER THROUGH ITS UNCOMPROMISING COMMITMENT TO DEINSTITUTIONALIZING THE AGING EXPERIENCE. 0 0 14383002 16816272 PENICK VILLAGE PROVIDES HOUSING, SERVICES, AND LONG-TERM CARE TO OVER 230 RESIDENTS. THE SERVICES AND CARE ARE PROVIDED IN INDEPENDENT LIVING, ASSISTED LIVING, AND SKILLED NURSING AREAS. PENICK VILLAGE ALSO CONTRIBUTES TO THE GREATER SOUTHERN PINES COMMUNITY AND MOORE COUNTY IN WHICH IT IS LOCATED BY DONATING TIME AND RESOURCES TO, AMONG OTHERS, THE MOORE COUNTY CHAMBER OF COMMERCE, FIRSTHEALTH HOSPITAL, LEADINGAGE NC, EPISCOPAL DAY SCHOOL, RED CROSS, HABITAT FOR HUMANITY, FRIEND TO FRIEND, AND THE SOUTHERN PINES FIRE AND POLICE DEPARTMENTS. THE PENICK VILLAGE COMMUNITY ALSO PROVIDES FINANCIAL ASSISTANCE TO THOSE RESIDENTS IN NEED.NURSING IS KEY TO THE CONTINUUM OF CARE FOR THE RESIDENTS AT PENICK VILLAGE. SKILLED NURSING SERVICES ARE PROVIDED PER PHYSICIAN ORDERS THAT MAY INCLUDE BUT ARE NOT LIMITED TO ASSISTANCE WITH ACTIVITIES OF DAILY LIVING, MEDICATION ADMINISTRATION, PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY, SPECIALIZED DIETS AND OTHER NEEDS PER ORDERS. THE QUALITY NURSING IS KEY TO ACHIEVING THIS AND IN MAXIMIZING THE QUALITY OF LIFE FOR EACH OF THE RESIDENTS. THE CARE IS PERSONALIZED, AND A STRONG PARTNERSHIP IS DEVELOPED AMONG THE RESIDENT, HIS OR HER FAMILY, AND THE STAFF AT PENICK VILLAGE IN ORDER TO HAVE THE RESIDENT'S NEEDS DRIVE HIS OR HER PLAN OF CARE. PENICK VILLAGE ALSO OFFERS A BROAD RANGE OF IN-HOME SERVICES TO THOSE SENIORS THAT PREFER TO AGE IN HOME. PENICK TAILORS CARE PLANS INDIVIDUALLY, FOLLOWING A FREE IN-HOME CONSULTATION AND ASSESSMENT. POTENTIAL HOME CARE SERVICES INCLUDE COMPANION/SITTER/RESPITE CARE (INCLUDING TRANSPORTATION, LIGHT HOUSEKEEPING, ERRANDS, PET CARE, DAILY CHECK-INS, AND MEDICATION REMINDERS), CARE MANAGEMENT TO ENSURE PROPER TREATMENT, AND POST HOSPITAL DISCHARGE FOLLOW UPS (INCLUDING MEDICARE/LONG-TERM CARE INSURANCE REVIEWS, HOME ORGANIZING/DOWNSIZING, SUPPORT THROUGH DIFFERENT LEVELS OF CARE, HOME SAFETY ASSESSMENTS/MODIFICATIONS, AND REFERRALS TO COMMUMINITY PARTNERS).INDIVIDUALS WHO MOVE INTO PENICK FOR ASSISTED LIVING ARE PROVIDED A UNIQUE SERVICE THAT HAS BEEN PURPOSEFULLY PLANNED TO FILL THEIR INDIVIDUAL NEEDS AND PREFERENCES AND DESIGNED TO SERVE THEM TO THE BEST OF OUR ABILITY. OUR NURSING STAFF MEETS WITH THE NEW RESIDENT AND FAMILY PRIOR TO MOVE IN TO FULLY UNDERSTAND EACH SITUATION AND DESIGN A PERSONALIZED PLAN. ASSISTED LIVING RESIDENTS ENJOY: - A SPACIOUS, PRIVATE APARTMENT- LICENSED CARE SEVEN DAYS A WEEK- DELICIOUS, NUTRITIOUS MEALS- A SAFE SETTING THAT PROMOTES INDEPENDENCE- MEDICATION ASSISTANCE AND/OR ADMINISTRATION AVAILABLE- CARING AND DEDICATED HEALTHCARE PROFESSIONALS- 24-HOUR EMERGENCY CALL SYSTEMS- A VIBRANT SOCIAL ATMOSPHERE- ACCESS TO ALL COMMUNITY AMENITIESDINING SERVICES IS ONE OF PENICK VILLAGE'S ESSENTIAL SERVICES. DINING SERVICES STRIVES TO PRIVIDE A WONDERFUL DINING EXPERIENCE IN ALL LEVELS OF CARE FOR THE RESIDENTS AND THEIR FAMILY AND FRIENDS. THERE ARE SEVERAL DINING OPPORTUNITIES ON THE CAMPUS, INCLUDING THE CAFE EXPERIENCE, A PRIVATE DINING ROOM, CATERING IN ONE'S APARTMENT OR COTTAGE, INDIVIDUALIZED MENUS AND MORE. DINING SERVICES IS COMMITTED TO PREPARING THE SAME QUALITY AND CHOICES OF FOOD ITEMS IN THE HEALTHCARE AREAS THAT ARE AVAILABLE TO INDEPENDENT RESIDENTS. DINING SERVICES ALSO HOSTS EVENTS FOR OTHER SPECIAL COMMUNITY GROUPS SUCH AS THE KIWANIS. AS AN EMPLOYEE BENEFIT, THE STAFF ALSO ENJOYS WONDERFUL MEALS AT A GENEROUS DISCOUNT.PENICK VILLAGE IS ALSO VERY PROUD OF ITS HOUSEKEEPING SERVICES. HOUSEKEEPING PROVIDES GENERAL CLEANING SERVICES ALONG WITH LINEN SERVICES AS REQUESTED. THE HOUSEKEEPING TEAM BUILDS GREAT RELATIONSHIPS WITH THE RESIDENTS THEY ARE SERVING AND HAVE HELPED SIGNIFICANTLY IN TIMES OF NEED. 14383002 1 1 0 0 0 0 0 0 1 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 63 0 367 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 16 16 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NC X TERRY R KEES CFO 9106920300 500 EAST RHODE ISLAND AVENUE SOUTHERN PINES NC 28387 THE RT REV SAMUEL RODMAN BOARD MEMBER 1.00 X 0 0 0 THE RT REV ANNE HODGES-COPPLE BOARD MEMBER 1.00 X 0 0 0 STEVE LEGGETT SECRETARY 1.00 X X 0 0 0 BYRD GWINN BOARD MEMBER 1.00 X 0 0 0 GARY HILDEBRAND BOARD MEMBER 1.00 X 0 0 0 KAY RHOADES BOARD MEMBER 1.00 X 0 0 0 DOUG GILL BOARD MEMBER 1.00 X 0 0 0 GARY KRASICKY PRESIDENT 1.00 X X 0 0 0 MIKE PENICK BOARD MEMBER 1.00 X 0 0 0 RICK SMITH BOARD MEMBER 1.00 X 0 0 0 DARLENE VAUGHN BOARD MEMBER 1.00 X 0 0 0 JOHN FRIZZELL III TREASURER 1.00 X X 0 0 0 MARSHA COLES BOARD MEMBER 1.00 X 0 0 0 LYNNE HEALY BOARD MEMBER 1.00 X 0 0 0 SHERRY PRICE BOARD MEMBER 1.00 X 0 0 0 MICAH NIEBAUER BOARD MEMBER 1.00 X 0 0 0 W LANCE CRAIG BOARD MEMBER 1.00 X 0 0 0 MARY RECA TODD BOARD MEMBER 1.00 X 0 0 0 JEFFREY I HUTCHINS CEO 39.00 1.00 X 221204 0 42766 CAROLINE HENDRICKS COO 40.00 X 161408 0 22071 TERRY KEES CFO 39.00 1.00 X 181480 0 0 564092 0 64837 3 0 1 0 PINNACLE RESOLUTE CONSTRUCTION 211 CLOISTER CT CHAPEL HILL NC 27514 BUILDER 4269328 PINNACLE DEVELOPMENT DESIGN PO BOX 55 SOUTHERN PINES NC 28387 BUILDER 192350 ALLIED UNIVERSAL PO BOX 828854 PHILADELPHA PA 19104 SECURITY 163402 3 337632 294121 631753 HEALTHCARE 623000 6758408 6758408 INDEPENDENT LIVING 623000 6627329 6627329 EARNED ENTRANCE FEES 623000 2585826 2585826 1230494 844709 385785 17202057 242513 242513 18076323 16816272 385785 242513 7485536 6434456 1051080 1099738 720412 379326 648834 538370 110464 6000 6000 126029 126029 64910 64910 606771 197530 409241 120617 120617 476119 86722 377525 11872 1200638 806270 394368 25938 6952 18986 5921 5921 1351167 1351167 2176137 2176137 161661 13615 148046 OTHER PATIENT SERVICES 1519378 1505103 14275 MISCELLANEOUS 963628 183399 780229 EMPLOYEE RECRUITMENT AN 214858 128013 86845 MEDICAL SUPPLIES 125982 125982 108874 108874 18488736 14383002 4093862 11872 1402 1200 3352491 5150830 1180626 2166052 128580 252750 66489227 17261137 43461913 49228090 9557319 10595397 375100 5206708 58057431 72601027 2064813 1476040 15525910 17198503 14383691 33678943 21221 9206096 2949850 8523495 8871937 49725226 64175273 X 7445796 7477548 886409 948206 8332205 8425754 58057431 72601027 X -412413 657179 -151217 X 0 1 X 1 0 X 240170 304186 871432 874819 294121 2584728 15050652 16197265 16982904 16999442 16816272 82046535 15290822 16501451 17854336 17874261 17110393 84631263 0 0 0 84631263 192312 279545 265962 295686 268254 1301759 192312 279545 265962 295686 268254 1301759 385785 385785 138927 135718 274645 15622061 16916714 18120298 18169947 17764432 86593452 0.97730 0.98100 0.01500 0.01370 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X ANNUAL ART SHOW 1 0 1 X 329407 329407 329407 329407 329407 329407 329407 329407 329407 329407 1.00000 0 0 678542 678542 64140006 16487022 47652984 185771 108210 77561 855367 479254 376113 629541 186651 442890 49228090 DEPOSITS 28970 INTEREST RATE CAP AGREEMENT 653 BENEFICIAL INTEREST IN ANNUITIES 189810 INTANGIBLE ASSET 79662 INVESTMENT IN AFFILIATE 1000 HELD BY TRUSTEE UNDER BOND AGREEMENTS 4906613 5206708 REFUND LIABILITY 5311574 APPLICATION AND PREPAID ADMISSION DEPOSITS 546860 DUE TO AFFILIATE 1264363 LEASE LIABILITY 29040 REFUNDABLE ADVANCE 1720100 8871937 X PART III, LINE 4: FOR THE PAST 14 YEARS, PENICK VILLAGE HAS BROUGHT TOGETHER THE LOCAL COMMUNITY -- RESIDENTS, NEIGHBORS AND RENOWNED LOCAL ARTISTS -- FOR AN ART SHOW AND AUCTION. ONE HUNDRED PERCENT OF THE PROCEEDS RAISED DURING THE ANNUAL ART SHOW AND AUCTION GOES DIRECTLY TO THE PENICK VILLAGE BENEVOLENT ASSISTANCE PROGRAM, WHICH SUPPORTS RESIDENTS WHEN THEY OUTLIVE THEIR FINANCIAL RESOURCES THROUGH NO FAULT OF THEIR OWN. FOR THIS REASON, PENICK VILLAGE HAS NEVER ASKED A RESIDENT TO LEAVE IN OUR 56-YEAR HISTORY! PART IV, LINE 2B: PENICK VILLAGE MAINTAINS CUSTODY OVER A RESIDENT TRUST CASH ACCOUNT WHEREIN VARIOUS RESIDENTS' MONIES ARE REGULARLY DEPOSITED. OUT OF THIS ACCOUNT, PENICK VILLAGE ASSISTS THOSE RESIDENTS IN PAYING THEIR BILLS AND/OR MONTHLY SERVICE CHARGES THROUGH AN AUTOMATIC WITHDRAWAL FROM THEIR FUNDS. PART X, LINE 2: THE VILLAGE IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE IRC; ACCORDINGLY, THE CONSOLIDATED FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION OR LIABILITY FOR FEDERAL AND STATE INCOME TAXES. AS A LIMITED LIABILITY COMPANY, GREER'S TAXABLE INCOME OR LOSS IS ALLOCATED TO ITS MEMBERS IN ACCORDANCE WITH THE OPERATING AGREEMENT AND IS INCLUDED IN THEIR INDIVIDUAL INCOME TAX RETURNS; ACCORDINGLY, THE ACCOMPANYING FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION OR LIABILITY FOR FEDERAL AND STATE INCOME TAXES. THE ORGANIZATION HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2019 AND 2018. X X X 0 0 0 0 0 0 0 0 0 JEFFREY I HUTCHINS CEO 221204 0 0 0 0 0 19000 0 23766 0 263970 0 0 0 CAROLINE HENDRICKS COO 161408 0 0 0 0 0 8468 0 13603 0 183479 0 0 0 TERRY KEES CFO 180000 0 0 0 1480 0 0 0 0 0 181480 0 0 0 A PUBLIC FINANCE AUTHORITY 521309402 74444VAS9 2019-11-06 32440000 FINANCE PROJECT COSTS AND REFUND TAXABLE AND TAX-EXEMPT DEBT 0 0 0 A 150000 34864620 2007000 900824 697293 10484246 20775257 2020 1 0 1 1 A 0 0 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 FORM 990, PART VI, SECTION A, LINE 4 THE ORGANIZATION AMENDED ITS CORPORATE BYLAWS DURING THE YEAR. THE SIGNIFICANT CHANGES ARE SUMMARIZED BELOW: 1. AMENDED ARTICLE 6.1 TO SPECIFY THAT A QUORUM FOR THE EXECUTIVE COMMITTEE SHALL BE 5 COMMITTEE MEMBERS. 2. AMENDED ARTICLE 6.5 TO ADD A PROVISION THAT PREVENTS COMMITTEES FROM ENTERING INTO AN AGREEMENT FOR A LOAN, BOND, NOTE OR ANY OTHER WRITTEN PROMISE TO PAY A DEBT ON BEHALF OF THE CORPORATION. 3. AMENDED ARTICLE 7.1 TO PROVIDE FOR QUARTERLY BOARD MEETINGS, AS WELL AS TO SPECIFICY THAT THE ANNUAL MEETING SHALL BE THE FOURTH QUARTERLY MEETING OF THE FISCAL YEAR. 4. AMENDED ARTICLE 9.2 TO REMOVE THE PROVISION THAT PREVIOUSLY ALLOWED THE EXECUTIVE COMMITTEE TO CONTRACT ON BEHALF OF THE ORGANIZATION OR INCUR DEBT. 5. AMENDED ARTICLE 10.5 TO REQUIRE A TWO-THIRDS (2/3) MAJORITY OF DIRECTORS TO AMEND CORPORATE ARTICLES OR BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS REVIEWED BY THE ORGANIZATION'S OFFICERS, THEN SENT TO THE FINANCE COMMITTEE FOR REVIEW AND COMMENTS AND THEN PRESENTED TO THE FULL BOARD OF DIRECTORS. IT WILL BE REVIEWED BY THE OFFICERS AND FINANCE COMMITTEE MEMBERS BEFORE FILING WITH THE IRS AND WITH THE FULL BOARD IF THEY ARE SCHEDULED TO MEET BEFORE THE FILING DEADLINE. IF NOT IT WILL BE SENT TO THEM BEFORE THE FILING DEADLINE AND REVIEWED AT THE NEXT SCHEDULED MEETING. FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS AND BOARD MEMBERS ARE REQUIRED TO RECEIVE, REVIEW AND SIGN A COPY OF THE CONFLICT OF INTEREST POLICY ANNUALLY AND DISCLOSE IF ANY CONFLICTS MIGHT ARISE IN THE COURSE OF CONDUCTING PENICK VILLAGE BUSINESS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS APPOINTED AN AD-HOC COMPENSATION REVIEW COMMITTEE TO DETERINE THE COMPENSATION FOR THE CEO OF THE ORGANIZATION. THIS REVIEW IS CONDUCTED ON AN ANNUAL BASIS AND USES DATA FROM OTHER ORGANIZATIONS AS WELL AS WAGE SURVEYS TO DETERMINE THE COMPENSATION. THE RESULTS ARE DOCUMENTED IN THE CEO'S PERSONNEL FILE IN HR. THE CEO CONDUCTS ANNUAL REVIEWS FOR THE CFO AND COO OF THE ORGANIZATION. BASED ON THOSE REVIEWS AND WAGE SURVEYS, THE CEO DETERMINES THE UPCOMING YEAR COMPENSATION FOR THESE KEY EMPLOYEES. THE EVALUATION AND ADVICE OF PAYROLL ARE DOCUMENTED IN THE PERSONNEL FILES IN HR FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT THE ADMINISTRATION OFFICES. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF SPLIT-INTEREST AGREEMENT 10,221. LOSS ON REFUNDING OF DEBT -161,438. JA GREER GROUP LLC 500 EAST RHODE ISLAND AVENUE SOUTHERN PINES NC 28387 814456670 RENTAL NC 385785 3874549 PENICK VILLAGE PENICK VILLAGE FOUNDATION INC 500 EAST RHODE ISLAND AVENUE SOUTHERN PINES NC 28237 201055492 CHARITABLE FUNDRAISING NC 501(C)(3) LINE 10 PENICK VILLAGE 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 PENICK VILLAGE FOUNDATION C 337632 CASH