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      <Desc>The Forest at Duke welcomed its first residents in 1992 with a mission to provide a caring, responsible community that fosters the independence of residents of retirement age by enhancing their ability to lead purposeful, active, healthy and secure lives. The 47-acre campus is home to approximately 400 residents and includes 235 independent living residences, 32 assisted living suites and 58 skilled nursing residences. In 2007, The Forest was awarded a BBB+ credit rating by Fitch Ratings, achieved national Commission on Accreditation of Rehabilitation Facilities/Continuing Care Accreditation Commission (CARF-CCAC) accreditation, and received another health center deficiency free survey from the NC Department of Health Regulators. In 2007, The Forest also chose to participate in the Medicare Part A program and gained certification under Medicare. In December 2022, The Forest at Duke was reviewed by CARF-CCAC and earned another five-year term as an accredited continuing retirement community. The Forest has completed the construction of 15 cottage homes and all were occupied by the end of fiscal year 2015. The renovation to the Community Center, including enlarging the Fitness Center, enhancing dining and other interior program modifications, was completed by the end of fiscal year 2016. In June 2021, The Forest completed the financing to build a new health center on its current campus. The facility will have 90 new units in the "small house" format in a five-story, approximately 110,000 square foot building. The small house model of care is designed around houses (or groups of rooms) in which each house has 10 private rooms each with a bathroom and all common spaces and support areas located within the house. The small house model will provide the same scope of services, each neighborhood will have a team that provides the care, residents will have short walking distances to increase level of independence, resident privacy, additional dining and fitness venues. The project is complete and the residents moved into the new health center in February 2023. In November 2022, The Forest completed the financing for Phase Two of the project. The project includes the addition of seventy-one (71) new independent living apartments and an expanded community center which connects the existing community center to the health center. The expanded community center also includes service and amenity spaces such as additional dining, fitness area, classroom, multipurpose rooms, a clinic and office spaces. The new apartments have an average of 1,450 square feet with spacious open-living design floorplans, ten foot ceilings, and finishes commensurate with high-end real estate in the market area. Other features include gourmet kitchens with stainless steel appliances, large covered balconies or ground level patios for outdoor living in each apartment home. Each apartment home is expected to include assigned underground parking. Site work began in May 2023 and is anticipated to be completed by summer 2025. The Forest at Duke takes seriously its commitment to social responsibility and leadership. Outreach includes major annual corporate financial assistance to the Durham Council for Senior Citizens, the Durham Center for Senior Life, the Senior PHARMAssist Program, and Rogers-Herr Middle School. Throughout the year, other local non-profits are helped with cash, in-kind and volunteer donations as well. More than 75,000 resident volunteer hours per year benefit local schools, churches, Duke Hospitals and other area service organizations. The Forest Employee Educational Assistance Fund continues to award monies to over 20 Forest staff each year to further their education. The Forest continues to have strong associations with educational and licensing institutions. The community serves as a training site for: * Geriatric Fellows - Duke University Medical Center * Internal Medicine Residents - Duke University Medical Center * Nursing students - Watts School of Nursing * Interns in the Leadership in Aging Program - Duke University * Therapeutic recreation interns from surrounding universities * Nursing Home Administrators - The North Carolina Board of Licensing of Nursing Home Administrators The Forest actively participates with its peers in the industry through Association involvement. Forest employees often serve in leadership and as presenters at state and national educational sessions. The Forest maintains memberships in the following professional associations: * LeadingAge * Leading Age North Carolina * North Carolina Health Care Association * American Health Care Association * Durham Chamber of Commerce * North Carolina Coalition for Long Term Care Enhancement * Society for the Advancement of Gerontological Environments</Desc>
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        <PurposeOfGrantTxt>Operating Support</PurposeOfGrantTxt>
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      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>UNC - WUNC Public Radio</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <RecipientEIN>566001393</RecipientEIN>
        <IRCSectionDesc>501 c(3)</IRCSectionDesc>
        <CashGrantAmt>10000</CashGrantAmt>
        <PurposeOfGrantTxt>Operating Support</PurposeOfGrantTxt>
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      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Urban Ministries of Durham</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <RecipientEIN>581505891</RecipientEIN>
        <IRCSectionDesc>501 c(3)</IRCSectionDesc>
        <CashGrantAmt>50000</CashGrantAmt>
        <PurposeOfGrantTxt>Operating Support</PurposeOfGrantTxt>
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      <Total501c3OrgCnt>42</Total501c3OrgCnt>
      <TotalOtherOrgCnt>1</TotalOtherOrgCnt>
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        <FormAndLineReferenceDesc>Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION HAS A COMMUNITY RELATIONS COMMITTEE CONSISTING OF BOARD MEMBERS, STAFF AND RESIDENTS THAT OVERSEES THE CONTRIBUTIONS MADE TO THE COMMUNITY.</ExplanationTxt>
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      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>NORTH CAROLINA MEDICAL CARE COMMISSION</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>521309402</BondIssuerEIN>
        <BondIssuedDt>2017-08-24</BondIssuedDt>
        <IssuePriceAmt>20210000</IssuePriceAmt>
        <PurposeDesc>refinance series 2007</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>NORTH CAROLINA MEDICAL CARE COMMISSION</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>521309402</BondIssuerEIN>
        <CUSIPNum>65820YSM9</CUSIPNum>
        <BondIssuedDt>2021-06-03</BondIssuedDt>
        <IssuePriceAmt>50818934</IssuePriceAmt>
        <PurposeDesc>Column B: To construct and equip replacement health care center</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
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      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>North CAROLINA MEDICAL CARE COMMISSION</BusinessNameLine1Txt>
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        <BondIssuerEIN>521309402</BondIssuerEIN>
        <BondIssuedDt>2022-11-16</BondIssuedDt>
        <IssuePriceAmt>95570000</IssuePriceAmt>
        <PurposeDesc>Column C: To construct and equip expansion</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
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        <BondReferenceCd>A</BondReferenceCd>
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        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
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      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <RetiredAmt>0</RetiredAmt>
        <TotalProceedsAmt>50818934</TotalProceedsAmt>
        <CapitalizedInterestAmt>2423582</CapitalizedInterestAmt>
        <IssuanceCostsFromProceedsAmt>890237</IssuanceCostsFromProceedsAmt>
        <CapitalExpendituresAmt>46201151</CapitalExpendituresAmt>
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        <SubstantialCompletionYr>2023</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>false</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
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        <TotalProceedsAmt>95570000</TotalProceedsAmt>
        <CapitalizedInterestAmt>5413383</CapitalizedInterestAmt>
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        <WorkingCapitalExpendituresAmt>1012000</WorkingCapitalExpendituresAmt>
        <CapitalExpendituresAmt>44979293</CapitalExpendituresAmt>
        <UnspentAmt>50590707</UnspentAmt>
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        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>false</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>true</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>true</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>true</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.0</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.0</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.0</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>true</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>true</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.0</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.0</PrivateBusConcerningUBIPct>
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        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>true</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>true</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
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      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>false</RebateNotDueYetInd>
        <ExceptionToRebateInd>true</ExceptionToRebateInd>
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        <VariableRateIssueInd>true</VariableRateIssueInd>
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        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
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        <NoRebateDueInd>false</NoRebateDueInd>
        <VariableRateIssueInd>false</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
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      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>true</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>false</NoRebateDueInd>
        <VariableRateIssueInd>true</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>true</HedgeIdentifiedInBksAndRecInd>
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        <SuperintegratedHedgeInd>false</SuperintegratedHedgeInd>
        <HedgeTerminatedInd>false</HedgeTerminatedInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
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      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
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      <ProceduresCorrectiveActionGrp>
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        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
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      <ProceduresCorrectiveActionGrp>
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        <FormAndLineReferenceDesc>Schedule K, Part I</FormAndLineReferenceDesc>
        <ExplanationTxt>PURPOSE OF SERIES 2017 ISSUE (Column A): THE PROCEEDS OF THIS ISSUE WERE USED TO REFINANCE THE SERIES 2007 BONDS ISSUED JULY 12, 2007. PURPOSE OF SERIES 2007 ISSUE: A PORTION OF THE RECEIPTS DERIVED FROM THE SALE OF THE SERIES 2007 BONDS WAS USED TO REFUND THE ISSUER'S SERIES 2002 BONDS, WHICH WERE ISSUED UNDER A TRUST AGREEMENT DATED MARCH 15, 2002 AND THE SERIES 2003B BONDS, WHICH WERE ISSUED UNDER A TRUST AGREEMENT DATED NOVEMBER 1, 2003. PROCEEDS OF THE SERIES 2003B BONDS WERE USED TO REFUND BONDS PREVIOUSLY ISSUED BY THE ISSUER IN 1994, WHICH WERE ISSUED TO FINANCE THE COST OF ACQUIRING, CONSTRUCTING, AND EQUIPPING A CONTINUING CARE RETIREMENT FACILITY IN DURHAM, NC KNOWN AS THE FOREST AT DUKE. PROCEEDS OF THE SERIES 2002 BONDS WERE ISSUED TO FINANCE THE COSTS OF AN EXPANSION AND RENOVATION OF THE FACILITY. Proceeds of the series 2021 bonds (Column B) were issued to construct and equip the replacement health center. Purpose of series 2022 issue (Column C): To construct and equip an expansion of and renovation to the facility, including 71 new independent living units and related improvements.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part II, Line 11 Schedule K, Part II, Line 11, Column A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE AMOUNTS PRESENTED ON LINE 11 for Column A AS OTHER SPENT PROCEEDS REPRESENT AMOUNTS USED TO REFUND PRIOR ISSUES. SEE THE EXPLANATION OF EACH BOND'S USE ABOVE.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part II, Line 11</FormAndLineReferenceDesc>
        <ExplanationTxt>The amounts presented on Line 11 for Column B as other spent proceeds represent unexpected surplus proceeds after completion of construction that were then used to pay interest on the 2021 Bonds.</ExplanationTxt>
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        <ExplanationTxt>THE ORGANIZATION'S FORM 990 IS AVAILABLE UPON REQUEST. ADDITIONALLY, RECENT FILINGS OF THE FORM ARE AVAILABLE ON WWW.GUIDESTAR.ORG.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11b Review of form 990 by governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>THE SUBCOMMITTEE OF THE BOARD REVIEWED THE FORM 990 BEFORE IT WAS SUBMITTED TO THE IRS. THE SUBCOMMITTEE REPORTED TO THE BOARD ON THE REVIEW OF THE FORM 990. EACH BOARD MEMBER RECEIVED AN ELECTRONIC VERSION OF THE RETURN FOR PERSONAL REVIEW WITH ANY QUESTIONS DIRECTED TO THE CFO. AFTER THE BOARD'S PERSONAL REVIEW, THE RETURN WAS APPROVED TO BE SUBMITTED TO THE IRS AS PRESENTED.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 12c Conflict of interest policy</FormAndLineReferenceDesc>
        <ExplanationTxt>BEFORE EACH BOARD MEETING, THE AGENDA IS PRESENTED TO THE BOARD. EACH BOARD MEMBER IS REQUIRED TO REVIEW THE MEETING AGENDA AND INDICATE IF THERE IS A POTENTIAL CONFLICT BY COMPLETING A CONFLICT OF INTEREST FORM AND HANDING IT IN PRIOR TO THE MEETING. IT IS REVIEWED AT THE TIME BY THE CEO AND ANY RELEVANT OR POTENTIAL CONFLICT, AS IT RELATES TO A SPECIFIC AGENDA ITEM, IS BROUGHT TO THE BOARD'S ATTENTION.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15a Process to establish compensation of top management official</FormAndLineReferenceDesc>
        <ExplanationTxt>EACH YEAR, THE CEO AND CFO'S COMPENSATION ARE REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS AT THEIR OCTOBER MEETING. COMPARABLE SALARY DATA FROM SURVEYS, OTHER 990S, AND PERFORMANCE EVALUATIONS ARE UTILIZED AS PART OF THE PROCESS.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15b Process to establish compensation of other employees</FormAndLineReferenceDesc>
        <ExplanationTxt>EACH YEAR, THE CEO AND CFO'S COMPENSATION ARE REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS AT THEIR OCTOBER MEETING. COMPARABLE SALARY DATA FROM SURVEYS, OTHER 990S, AND PERFORMANCE EVALUATIONS ARE UTILIZED AS PART OF THE PROCESS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 19 Required documents available to the public</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC ON SITE. THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC ON SITE, ON THE EMMA WEBSITE FOR MUNICIPAL SECURITIES, AND IN THE DISCLOSURE STATEMENT WITH THE DEPARTMENT OF INSURANCE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9 Other changes in net assets or fund balances</FormAndLineReferenceDesc>
        <ExplanationTxt>change in FMV of Interest Rate - -3901076;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XII, Line 2c</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.</ExplanationTxt>
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