2020-08-10T14:22:11-05:00 2019-09-30 560587953 GILLIAM BELL MOSER LLP PO BOX 621 BURLINGTON NC 272160621 990 2018-10-01 561077371 PRESBYTERIAN HOME OF HAWFIELDS INC PRES 3365784701 2502 SOUTH NC 119 MEBANE NC 27302 MR MAX KERNODLE ADMINISTRATOR 3365784701 2020-08-10 1 J BRADLEY MOSER P00024209 3362276283 2020-08-06 66.77.128.118 2020-08-10 10:44:18 ED P EBC73A9F2892323C6A8F037B68981624F544A8D5 5AB2C4CEE068951CF2CBFF7322D195CB2CCBE727 2018 2020-09-22 18:59:49Z MR MAX KERNODLE 2502 SOUTH NC 119 MEBANE NC 27302 5907732 0 X WWW.HAWFIELDS.ORG X 1973 NC PHH IS COMMITTED TO PROVIDING THE HIGHEST QUALITY OF LIFE FOR THE RESIDENT. THE HOME STRIVES TO CREATE A CARING LIVING ENVIRONMENT WITH EMPHASIS ON MAXIMIZING SELF-MOTIVATION, INDEPENDENCE, AND REHABILITATION. TO BETTER MEET THE NEEDS OF THE RESIDENTS, THE HOME IS DEDICATED TO SELECTING SUPERIOR RESOURCES AND IMPLEMENTING CONTINUOUS QUALITY MANAGEMENT STRATEGIES. 7 7 119 80 0 0 7278 4835 6129261 5871149 129 757 31484 30991 6168152 5907732 0 0 0 0 3257526 3056249 0 0 0 3376383 3563913 6633909 6620162 -465757 -712430 1586200 1570357 522685 1219272 1063515 351085 X PHH IS COMMITTED TO PROVIDING THE HIGHEST QUALITY OF LIFE FOR THE RESIDENTS. THE HOME STRIVES TO CREATE A CARING LIVING ENVIROMENT WITH EMPHASIS ON MAXIMIZING SELF-MOTIVATION, INDEPENDENCE, AND REHABILITATION. TO BETTER MEET THE NEEDS OF THE RESIDENTS, THE HOME IS DEDICATED TO SELECTING SUPERIOR RESOURCES AND IMPLEMENTING CONTINUOUS QUALITY MANAGEMENT STRATEGIES. 0 0 5884524 5900425 THE ORGANIZATION OPERATES A NURSING HOME FACILITY WITH 117 NURSING BEDS AND 37 INDEPENDENT LIVING BEDS IN MEBANE, NORTH CAROLINA. 5884524 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 8 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 0 NC X X MAX KERNODLE 3365784701 2502 SOUTH NC 119 MEBANE NC 27302 IRA TROLLINGER CHAIRMAN 1.00 X X 0 0 0 JIMMY EVANS VICE CHAIRMAN 1.00 X X 0 0 0 DANNY THOMPSON BOARD MEMBER 1.00 X 0 0 0 HENDERSON SCOTT BOARD MEMBER 1.00 X 0 0 0 BILL STOCKARD BOARD MEMBER 1.00 X 0 0 0 MARY ERWIN BOARD MEMBER 1.00 X 0 0 0 BILLY MEBANE BOARD MEMBER 1.00 X 0 0 0 MAX KERNODLE TREASURER/SECRETARY 70.00 X 110069 0 9815 110069 0 9815 1 0 0 0 NIGHTINGALE NURSING SERVICES PO BOX 1163 CARRBORO NC 27510 AGENCY NURSING 1402555 DHHS ACCOUNTS RECEIVEABLE 2022 MEDICAL SERVICE CENTER RALEIGH NC 27699 NURSING ASSESMENT FEE 432493 SYSCO FOOD SERVICES PO BOX 129 SELMA NC 27576 RAW FOODS/SUPPLEMENTS 346913 DIAMOND PAPER 802 MONUMENT ST DANVILLE VA 24541 PAPER PRODUCTS/HSKING SUPPLIES 204044 SENECA MEDICAL LLC PO BOX 531846 ATLANTA GA 30353 NURSING SUPPLIES 147824 5 4835 4835 SKILLED CARE RESIDENT 632000 5626770 5626770 INDEPENDENT LIVING REV 632000 265645 265645 SPECIAL SERVICES REVEN 632000 -21266 -21266 5871149 757 757 LATE PAYMENT INCOME 900009 10019 10019 DUKE POWER GENERATOR U 900009 9459 9459 MISCELLANEOUS INCOME 900009 8819 8819 2694 2694 30991 5907732 5871149 0 31748 X 121993 121993 2196942 2099488 97454 557273 519571 37702 180041 163307 16734 5212 5212 73216 73216 1755798 1701496 54302 6638 6638 52629 52629 245361 245361 4165 4041 124 20975 18296 2679 24059 24059 116067 116067 25434 25434 SUPPLIES 781725 781725 BAD DEBT EXPENSE 191569 191569 THERAPY 148435 148435 PHARMACY 74268 74268 38362 12469 25893 6620162 5884524 735638 0 59006 18597 100000 100000 765369 938151 155000 75000 37288 37288 41581 45520 5425346 5086228 407941 339118 20015 16683 1586200 1570357 502670 702539 500000 20015 16733 522685 1219272 X 963515 251085 100000 100000 1063515 351085 1586200 1570357 -712430 0 X 0 0 0 X 1966 3465 1760 7278 4835 19304 5804598 6098953 5788746 6129261 5871149 29692707 5806564 6102418 5790506 6136539 5875984 29712011 65 130 250 445 0 65 130 250 445 29711566 21799 18482 9468 17681 757 68187 21799 18482 9468 17681 757 68187 13080 28520 20174 13932 30991 106697 5841443 6149420 5820148 6168152 5907732 29886895 0.99410 0.99450 0.00230 0.00260 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: EMPLOYEE/GUESTS MEALS - 2014 AMOUNT: $ 3,767. 2015 AMOUNT: $ 10,386. 2016 AMOUNT: $ 6,443. 2017 AMOUNT: $ 2,045. 2018 AMOUNT: $ 2,694. DUKE POWER GENERATOR - 2014 AMOUNT: $ 9,920. 2015 AMOUNT: $ 9,987. 2016 AMOUNT: $ 8,672. 2017 AMOUNT: $ 9,618. 2018 AMOUNT: $ 9,459. OTHER REVENUE - 2014 AMOUNT: $ -607. 2015 AMOUNT: $ 8,147. 2016 AMOUNT: $ 5,059. 2017 AMOUNT: $ 2,269. 2018 AMOUNT: $ 18,838. 66878 66878 4073818 3867255 206563 940819 878196 62623 343831 340777 3054 339118 RESIDENT TRUST FUNDS 16733 16733 FORM 990, PART VI, SECTION A, LINE 8B THERE ARE SEVERAL COMMITTEES IN PLACE THAT REPORT TO THE GOVERNING BOARD AND MINUTES ARE RECORDED FOR THEIR PARTICULAR MEETINGS. THESE COMMITTEES DO NOT HAVE THE RIGHTS TO ACT ON BEHALF OF THE GOVERNING BOARD. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF FORM 990 WILL BE DISTRIBUTED AND REVIEWED AT THE MAY BOARD MEETING. ANY CHANGES WILL BE MADE PRIOR TO FILING THE FORM 990 WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD REVIEWS ANNUALLY AND SIGNS-OFF ON DOCUMENTS WHICH ARE RECORDED IN THE MEETING MINUTES. FORM 990, PART VI, SECTION B, LINE 15 RECOMMENDATIONS ARE MADE AND DISCUSSED THROUGH THE FINANCE COMMITTEE. THE BOARD OF DIRECTORS THEN APPROVE ANY RECOMMENDATIONS. FORM 990, PART VI, SECTION C, LINE 19 ALL OTHER APPLICABLE DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACTED OUT SERVICES: PROGRAM SERVICE EXPENSES 1,701,496. MANAGEMENT AND GENERAL EXPENSES 54,302. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,755,798.