STRATEGY STUDIO / PUBLIC DATA EXPLORER

VALDESE NURSING HOME INC COLLEGE PINES NURSING CENTER: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
VALDESE NURSING HOME INC COLLEGE PINES NURSING CENTER (EIN 58-1978560)
Tax period
2019-01-01 to 2019-12-31
Filed
2020-11-03
IRS object ID
202003089349302090
Schema version
2019v5.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2020-11-03T14:48:06-06:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1227 WEST TRADE STREET SUITE 800AddressLine1Txt
CityCHARLOTTECityNm
State AbbreviationNCStateAbbreviationCd
ZIP28202ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN581978560EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1VALDESE NURSING HOME INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlVALDBusinessNameControlTxt
Phone8285805000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line195 LOCUSTAddressLine1Txt
CityCONNELLY SPRINGSCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28612ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonPATRICIA A MOLLPersonNm
Person TitleINTERIM CFOPersonTitleTxt
Phone8285805000PhoneNum
Signature2020-11-02SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJOHN NORMANPreparerPersonNm
PTINP01506766PTIN
Phone7049985200PhoneNum
Preparation2020-11-02PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address67.137.57.251IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-11-02IPDt
IP Tm15:38:54IPTm
IP TimezoneESIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdFDDE6E59ECAC1E5ABC0702B1D23036C1C3115FC1AtSubmissionCreationDeviceId
At Submission Filing Device IdA100E78DBE5AA521EFB92404D689E79D4538B985AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKATHY BAILEYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line195 LOCUSTAddressLine1Txt
CityCONNELLY SPRINGSCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28612ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$4,587,210GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.BLUERIDGEHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1993FormationYr
Legal Domicile StateNCLegalDomicileStateCd
Activity Or MissionTO PROVIDE HEALTHCARE TO THE ELDERLY AND AGING.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee141TotalEmployeeCnt
Total Volunteers14TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$8,576,694PYProgramServiceRevenueAmt
CY Program Service Revenue$4,587,210CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$8,576,694PYTotalRevenueAmt
CY Total Revenue$4,587,210CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$5,884,654PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$3,059,909CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,245,860PYOtherExpensesAmt
CY Other Expenses$1,361,659CYOtherExpensesAmt
PY Total Expenses$8,130,514PYTotalExpensesAmt
CY Total Expenses$4,421,568CYTotalExpensesAmt
PY Revenues Less Expenses$446,180PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$165,642CYRevenuesLessExpensesAmt
Total Assets BOY$2,576,231TotalAssetsBOYAmt
Total Assets EOY$1,264,875TotalAssetsEOYAmt
Total Liabilities BOY$5,729,504TotalLiabilitiesBOYAmt
Total Liabilities EOY$4,259,734TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$3,153,273NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$2,994,859NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionVALDESE NURSING HOME, INC. IS DEDICATED TO PROVIDING EXCELLENT CARE AND HELPING EACH RESIDENT ACHIEVE AN OPTIMAL QUALITY OF LIFE.MissionDesc
Significant New Program SrvcYes (1)SignificantNewProgramSrvcInd
Significant ChangeYes (1)SignificantChangeInd
Expense$3,606,744ExpenseAmt
Revenue$4,587,210RevenueAmt
DescVALDESE NURSING HOME, INC. PROVIDES INTERMEDIATE AND ASSISTED LIVING, AND PROVIDES COMPLETE REHABILITATION SERVICES WITH A FOCUS ON FOSTERING INDEPENDENCE WITHIN THE FACILITY. VALDESE NURSING HOME PROVIDES A COMPLETE RANGE OF THERAPY SERVICES UTILIZING BOTH CONTRACTED AND LICENSED THERAPISTS; THESE SERVICES INCLUDE: OCCUPATIONAL, PHYSICAL, RESPIRATORY AND SPEECH THERAPY. VALDESE NURSING HOME PROVIDED 33,956 DAYS OF CARE TO AN AVERAGE OF 93 RESIDENTS. VALDESE NURSING HOME OPERATES A 104 BED FACILITY TO MEET THE LONG-TERM AND SHORT-TERM CARE NEEDS OF ITS RESIDENTS.Desc
Total Program Service Expenses$3,606,744TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document1IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee141EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PATRICIA MOLLBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8285805545PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12201 S STERLING STAddressLine1Txt
CityMORGANTONCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28655ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeInd
CLAY RICHARDSON MD
MEMBER AT LARGE1.0050.00Yes (X)Yes (X)$0$235,531$49,802
J MICHAEL BRIDGES
CHAIRMAN1.00Yes (X)Yes (X)$0$0$0
M H MCCRARY
VICE-CHAIRMAN1.00Yes (X)Yes (X)$0$0$0
SHERROD SALSBURY
SECRETARY1.00Yes (X)Yes (X)$0$0$0
JEFF CARSWELL
TREASURER1.00Yes (X)Yes (X)$0$0$0
JOHN BRANSTROM
BOARD MEMBER1.00Yes (X)$0$0$0
LISA BUFF
BOARD MEMBER1.00Yes (X)$0$0$0
ALAN GRIFFIN
BOARD MEMBER1.00Yes (X)$0$0$0
ALLEN VANNOPPEN
BOARD MEMBER1.00Yes (X)$0$0$0
BRIAN GWYN
BOARD MEMBER1.00Yes (X)$0$0$0
FRIEDA LOWDER
BOARD MEMBER1.00Yes (X)$0$0$0
SUSAN HAIRE
BOARD MEMBER1.00Yes (X)$0$0$0
FELICIA SIMMONS
BOARD MEMBER1.00Yes (X)$0$0$0
KATHY BAILEY
PRESIDENT & CEO1.0050.00Yes (X)$0$0$0
ROBERT G FRITTS
SENIOR VP OF FINANCE/CFO1.0050.00Yes (X)$0$0$0
EDWARD PLYLER
CONTINUING CARE SERV.1.0050.00$0$204,815$41,788Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$440,346TotReportableCompRltdOrgAmt
Total Other Compensation$91,590TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
RESIDENT REVENUE623000$4,241,459$4,241,459
OTHER900099$345,751$345,751
FieldValueIRS element (for citing)
Total Program Service Revenue$4,587,210TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,587,210TotalRevenueColumnAmt
Related Or Exempt Func Income$4,587,210RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$2,538,461TotalAmt
Program Services$1,903,846ProgramServicesAmt
Management And General$634,615ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$39,949TotalAmt
Program Services$39,949ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$329,967TotalAmt
Program Services$329,967ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$151,532TotalAmt
Program Services$151,532ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$15,354TotalAmt
Management And General$15,354ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$148,291TotalAmt
Program Services$136,428ProgramServicesAmt
Management And General$11,863ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$8,137TotalAmt
Management And General$8,137ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$56,777TotalAmt
Management And General$56,777ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$100,795TotalAmt
Program Services$100,795ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$9,878TotalAmt
Program Services$9,878ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$146,577TotalAmt
Program Services$146,577ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$32,898TotalAmt
Management And General$32,898ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
SUPPLIES$360,035$360,035
INTERCOMPANY EXPENSE$267,935$267,935
ASSESSMENT$146,007$146,007

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$68,975TotalAmt
Program Services$13,795ProgramServicesAmt
Management And General$55,180ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$4,421,568TotalAmt
Program Services$3,606,744ProgramServicesAmt
Management And General$814,824ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$356,969BOYAmt
EOY$5,179EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$765,188BOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$20,331BOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$28,763BOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$4,004,965LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,745,271LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,394,165BOYAmt
EOY$1,259,694EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$10,815BOYAmt
EOY$2EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,576,231BOYAmt
EOY$1,264,875EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$441,322BOYAmt
EOY$1,187EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,288,182BOYAmt
EOY$4,258,547EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,729,504BOYAmt
EOY$4,259,734EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$3,153,273BOYAmt
EOY-$2,994,859EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$3,153,273BOYAmt
EOY-$2,994,859EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,576,231BOYAmt
EOY$1,264,875EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$165,642ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$7,228OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$4,258CurrentTaxYearMinus2YearsAmt
Total$4,258TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$7,672,613CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$8,542,624CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,363,902CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,576,888CurrentTaxYearMinus1YearAmt
Current Tax Year$4,587,210CurrentTaxYearAmt
Total$37,743,237TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$7,672,613CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$8,542,624CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,368,160CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,576,888CurrentTaxYearMinus1YearAmt
Current Tax Year$4,587,210CurrentTaxYearAmt
Total$37,747,495TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$37,747,495PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$30CurrentTaxYearMinus3YearsAmt
Total$30TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$30CurrentTaxYearMinus3YearsAmt
Total$30TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$7,672,613CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$8,542,654CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,368,160CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,576,888CurrentTaxYearMinus1YearAmt
Current Tax Year$4,587,210CurrentTaxYearAmt
Total$37,747,525TotalAmt
FieldValueIRS element (for citing)
Public Support CY5091.00000PublicSupportCY509Pct
Public Support PY5091.00000PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$928OtherActivitiesAmt
Total Lobbying Expenditures$928TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationA PORTION OF DUES PAID THE NCHFCA ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,347OtherCostOrOtherBasisAmt
Book Value$6,347BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,893,918OtherCostOrOtherBasisAmt
Depreciation$1,582,479DepreciationAmt
Book Value$1,311,439BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$988,600OtherCostOrOtherBasisAmt
Depreciation$1,065,497DepreciationAmt
Book Value-$76,897BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$116,100OtherCostOrOtherBasisAmt
Depreciation$97,295DepreciationAmt
Book Value$18,805BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,259,694TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescINTERCOMPANY LIABILITIESDesc
Amt$4,258,547Amt
FieldValueIRS element (for citing)
Total Liability$4,258,547TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE FILING ORGANIZATION IS A TAX-EXEMPT ORGANIZATION AS DEFINED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE FILING ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL AND STATE AUTHORITIES. THE FILING ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE FILING ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. THE FILING ORGANIZATION ADOPTED THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS IN ACCORDANCE WITH THE INCOME TAX STANDARD. THIS STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THIS STANDARD HAD NO IMPACT ON THE FILING ORGANIZATION'S FINANCIAL STATEMENTS FOR THE YEARS ENDED DECEMBER 31, 2019 OR DECEMBER 31, 2018.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (1)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsYes (1)CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
CLAY RICHARDSON MD
MEMBER AT LARGE$0$216,349$0$19,182$0$0$0$8,852$0$40,950$0$285,333$0$0
EDWARD PLYLER
CONTINUING CARE SERV.$0$182,471$0$6,000$0$16,344$0$6,893$0$34,895$0$246,603$0$16,344

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1AALL BENEFITS PROVIDED TO OFFICERS FACILITATE BUSINESS RELATIONSHIPS. DURING THE YEAR, A RELATED ORGANIZATION PAID FOR THE CLUB DUES FOR KATHY BAILEY AND INCLUDED THE AMOUNT OF DUES PAID IN HER TAXABLE INCOME.
PART I, LINE 3UNCHECKED ITEMS ARE CONDUCTED BY ATRIUM HEALTH (FORMERLY CAROLINAS HEALTHCARE SYSTEM) AS PART OF THE MANAGEMENT AGREEMENT. THE ORGANIZATION COMPENSATION COMMITTEE REVIEWS AND APPROVES.
PART I, LINE 4BDURING THE YEAR, THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SECTION 457(F) PLAN: EDWARD PLYLER $16,344
PART I, LINE 6BONUSES ARE PAID IF THE ORGANIZATION'S RESULTS MET CERTAIN PERFORMANCE INDICATORS.
PART IICOMPENSATION FOR KATHY BAILEY AND ROBERT FRITTS IS PAID BY ATRIUM HEALTH THROUGH A MANAGEMENT SERVICE CONTRACT.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 2ON 7/1/19 SANSTONE HEALTH & REHABILITATION TOOK OVER OPERATIONS OF THE FACILITY. GRACE NURSING CENTER LEASES THE BUILDING AND EQUIPMENT TO SANSTONE.
FORM 990, PART III, LINE 3SEE LINE 2
FORM 990, PART VI, SECTION A, LINE 3IN 1999, THE ORGANIZATION ENTERED INTO A MANAGEMENT SERVICES CONTRACT WITH ATRIUM HEALTH. THE TERMS OF THE CONTRACT CALL FOR THE ORGANIZATION TO PAY ATRIUM HEALTH AN ANNUAL MANAGEMENT FEE BASED UPON THE ORGANIZATION'S NET OPERATING REVENUES. IN ADDITION, ATRIUM HEALTH IS REQUIRED TO FURNISH THE ORGANIZATION WITH A CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER. THE ORGANIZATION REIMBURSES ATRIUM HEALTH FOR THE SALARY AND BENEFITS' COST OF THESE INDIVIDUALS.
FORM 990, PART VI, SECTION B, LINE 11BTHE CHIEF FINANCIAL OFFICER, THE BOARD AND THE EXECUTIVE COMMITTEE WILL REVIEW THE PREPARED FORM 990 BEFORE IT IS FILED WITH THE IRS. A DRAFT OF FORM 990 WAS POSTED FOR ACCESS BY THE GOVERNING BODY BEFORE IT WAS FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CCORPORATE COUNSEL, WHO REVIEWS ALL ANNUAL CONFLICT OF INTEREST DISCLOSURES, IS PRESENT AT EVERY BOARD MEETING TO ENSURE THAT ANY POTENTIAL CONFLICTS ARE APPROPRIATELY HANDLED BY MEMBERS ABSTAINING FROM VOTES AS APPROPRIATE.
FORM 990, PART VI, SECTION B, LINE 15SUCH A PROCESS WAS PERFORMED FOR DETERMINING THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT/CEO, CFO AND EXECUTIVE DIRECTOR DURING 2019.
FORM 990, PART VI, SECTION C, LINE 19BY-LAWS ARE AVAILABLE UPON REQUEST THROUGH CORPORATE COUNSEL. ARTICLES OF INCORPORATION ARE FILED WITH THE NORTH CAROLINA SECRETARY OF STATE AND ARE AVAILABLE ON THEIR WEBSITE. FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.
PART VIIDESCRIPTION OF HOURS -- FOR RELATED ORGANIZATIONS, OFFICERS AND KEY EMPLOYEES LISTED ON PART VII WORK AN AVERAGE OF 40 TO 50 HOURS PER WEEK. THEIR TIME IS SHARED BETWEEN THE FILING ORGANIZATION AND OTHER RELATED ENTITIES LISTED ON SCHEDULE R.
FORM 990, PART XI, LINE 9:LOSS ON ASSET DISPOSAL -7,228.
FORM 990, PART XII, LINE 2CNO CHANGES FOR APPROVING AUDITED FINANCIAL STATEMENTS OR SELECTION OF INDEPENDENT ACCOUNTANTS HAVE OCCURRED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
BLUE RIDGE HEALTHCARE HOSPITALS INC
2201 SOUTH STERLING STREETMORGANTONNC28655560529976HEALTHCARENC501(C)(3)LINE 3N/A0
GRACE LIFECARE INC
500 LENOIR ROADMORGANTONNC28655561722754HEALTHCARENC501(C)(3)LINE 10N/A0
GRACE PROPERTIES INC
500 LENOIR ROADMORGANTONNC28655561727514HEALTHCARENC501(C)(3)LINE 12A, IN/A0
BLUE RIDGE FOUNDATION INC
2201 SOUTH STERLING STREETMORGANTONNC28655582063920HEALTHCARENC501(C)(3)LINE 7N/A0
BLUE RIDGE HEALTHCARE MEDICAL GROUP INC
2201 SOUTH STERLING STREETMORGANTONNC28655020777195HEALTHCARENC501(C)(3)LINE 10N/A0
BLUE RIDGE HEALTHCARE SYSTEM INC
2201 SOUTH STERLING STREETMORGANTONNC28655562150313HEALTHCARENC501(C)(3)LINE 12B, IIN/A0
GRACE NURSING CENTER INC
109 FOOTHILLS DRIVEMORGANTONNC28655561838369HEALTHCARENC501(C)(3)LINE 10N/A0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1GRACE HEALTH VENTURES INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12201 SOUTH STERLING STREETAddressLine1Txt
CityMORGANTONCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28655ZIPCd
FieldValueIRS element (for citing)
EIN561581317EIN
Primary ActivitiesRELATEDPrimaryActivitiesTxt
Legal Domicile StateNCLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1BLUE RIDGE HEALTHCARE SYSTEMBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeCEntityTypeTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd