2018-07-10T13:58:30-05:00 2017-09-30 410746749 CLIFTONLARSONALLEN LLP 227 WEST TRADE STREET SUITE 800 CHARLOTTE NC 28202 990 2016-10-01 560562308 BAPTIST RETIREMENT HOMES OF NORTH CAROLINA INCORPORATED BAPT 3367250202 PO BOX 11024 WINSTON SALEM NC 27116 WILLIAM B STILLERMAN PRESIDENT 3367250202 2018-07-10 1 JOHN NORMAN P01506766 7049985200 2018-07-10 2016 2022-09-23 18:48:47Z WILLIAM B STILLERMAN PO BOX 11024 WINSTON SALEM NC 27116 43660719 0 X WWW.BRH.ORG X 1952 NC TO PROVIDE QUALITY LIVING OPTIONS AND SERVICES TO NORTH CAROLINA'S OLDER ADULT POPULATION. 17 17 668 150 0 0 1320974 2321106 23315032 24528095 1050854 977556 548919 538833 26235779 28365590 524442 522342 0 0 13472303 13947955 0 0 173453 11795520 12291706 25792265 26762003 443514 1603587 87351002 87226278 57007763 54097669 30343239 33128609 X BAPTIST RETIREMENT HOMES OF NORTH CAROLINA, INCORPORATED IS A CHURCH RELATED NOT-FOR-PROFIT ORGANIZATION COMMITTED TO PROVIDING QUALITY CARE AND A MEANINGFUL WAY OF LIFE FOR RESIDENTS AND STAFF. A PLACE WHERE RESIDENTS AND STAFF BECOME AN EXTENSION OF FAMILY THAT RECOGNIZES THE DIGNITY AND WORTH OF EACH INDIVIDUAL. 0 0 22323353 522342 24528905 BAPTIST RETIREMENT HOMES OF NORTH CAROLINA, INCORPORATED ("HOMES) IS A NOT-FOR-PROFIT CORPORATION ORGANIZED UNDER THE LAWS OF THE STATE OF NORTH CAROLINA. IT IS EXEMPT FROM INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501[C][3] AND A PUBLIC CHARITY UNDER SECTION 509[A][2]. THE BOARD OF TRUSTEES OF HOMES HAS FIDUCIARY RESPONSIBILITY FOR THE OPERATION OF HOMES ORGANIZATION. THE MISSION OF THE HOMES IS TO PROVIDE QUALITY RESIDENTIAL AND HEALTH CARE LIVING OPTIONS AND SERVICES TO NORTH CAROLINA'S OLDER ADULT POPULATION. THE PROVISION OF THOSE SERVICES ARE BEING OFFERED TO THE POOR ELDERLY OF THE STATE AS WELL. IN ADDITION TO ITS PROGRAM OF BENEVOLENT FUNDING TO THE POOR ELDERLY OF THE STATE, HOMES ALSO PROVIDES A SPECIAL PROGRAM DESIGNED TO ENHANCE THE LIFESTYLE OF OLDER ADULTS WITH DEMENTIA RELATED DISORDERS LIKE ALZHEMER'S DISEASE. THREE SUCH PROGRAMS ARE OPERATED BY BAPTIST RETIREMENT HOMES. HOMES OWNS, MAINTAINS, AND OPERATES COMMUNITIES THROUGHOUT NORTH CAROLINA. ITS CURRENT COMMUNITIES INCLUDE 264 INDEPENDENT LIVING HOMES AND APARTMENTS, 140 ASSISTED LIVING RESIDENCES, AND 201 SKILLED NURSING CARE ROOMS. HOMES RECEIVES SUPPORT FROM INDIVIDUALS, BUSINESS, FOUNDATIONS, CHURCHES, SPECIAL OFFERING, AND BEQUESTS FROM OTHERS TO ASSIST IN THE OPERATION AND ADMINISTRATION OF ITS COMMUNITIES. 22323353 1 1 0 1 0 0 0 0 0 0 1 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 28 0 1 668 1 0 0 0 0 0 0 0 0 0 0 X 17 17 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X WILLIAM B STILLERMAN PRESIDENT 3367250202 1912 BETHABARA ROAD WINSTON SALEM NC 27106 MR SAMUEL R MOORE CHAIR (FORMER) 1.00 X X 0 0 0 MR CHARLES D MAST CORPORATE SECRETARY (FORMER) 1.00 X X 0 0 0 MR LEE M KIRBY JR FINANCE CHAIR 1.00 X 0 0 0 MR KENNETH W AMBURN TRUSTEE 1.00 X 0 0 0 MR A EDWARD BEDDINGFIELD JR CORPORATE SECRETARY 1.00 X 0 0 0 MR JEFFREY L COBB TRUSTEE 1.00 X 0 0 0 MR PHILLIP R FEAGAN CHAIR (FORMER) 1.00 X X 0 0 0 MRS BETH TYNER JONES CHAIR 1.00 X 0 0 0 MR CLARENCE R LAMBE JR TRUSTEE 1.00 X 0 0 0 MRS ANITA JOHNSON TRUSTEE 1.00 X 0 0 0 MRS MARY MORGAN TRUSTEE 1.00 X 0 0 0 MR RALPH S MORGAN VICE CHAIR 1.00 X 0 0 0 MR JOHN S POND JR TRUSTEE 1.00 X 0 0 0 MRS WENDY B ROBERSON TRUSTEE 1.00 X 0 0 0 MR SCOTT B ROGERS TRUSTEE 1.00 X 0 0 0 MRS TANA H HARTSELL TRUSTEE 1.00 X 0 0 0 MR BOBBY WATSON TRUSTEE 1.00 X 0 0 0 MR MICHAEL R TAYLOR VICE CHAIR (FORMER) 1.00 X X 0 0 0 MR JEFFREY K HOBART TRUSTEE 1.00 X 0 0 0 MRS NANCY FISH TRUSTEE 1.00 X 0 0 0 MR WILLIAM B STILLERMAN PRESIDENT 36.00 4.00 X 293482 0 59591 MR CHARLES R GASKINS CFO 36.00 4.00 X 137235 0 28760 MRS DEBRA H MEGINNIS EXECUTIVE VP AND COO 36.00 4.00 X 198917 0 62056 629634 0 150407 3 0 1 0 LEGACY HEALTHCARE SERVICES 3001 SPRING FOREST ROAD RALEIGH NC 27616 THERAPY SERVICE 1049814 HICKORY CONSTRUCTION COMPANY P O BOX 1769 HICKORY NC 28603 CONSTRUCTION PROJECT 572049 HAMLIN ROOFING COMPANY 1411 W GARNER ROAD GARNER NC 27529 ROOFING 144959 SIMPLEX GRINNELL 4189 EAGLE HILL DRIVE 120 HIGH POINT NC 27265 FIRE ALARM MONITORING 117509 FAULKNER FLOORING 3865 REYNOLDA ROAD 201 WINSTON SALEM NC 27106 FLOORING 103329 5 1399194 921912 2321106 RESIDENT SERVICES 623000 24528095 24528095 24528095 412543 412543 23970 0 23970 23970 23970 15860142 15268924 26205 591218 -26205 565013 565013 514863 514863 514863 28365590 25042958 0 1001526 5000 5000 517342 517342 773633 773633 10476731 9244498 1232233 1877327 1491904 385423 820264 698805 121459 33163 33163 66648 66648 1304506 1265357 39149 193085 12606 73823 106656 407457 228631 178826 197941 197941 1528652 1098346 430306 7110 4480 2630 7481 3217 4264 1731580 1731580 3358440 3358440 365106 365106 REPAIRS AND MAINTENANCE 1132686 978914 153772 FOOD 969211 928521 40690 MEDICAL SUPPLIES 466912 457323 9589 MEDICAL SERVICES 220242 220242 301486 78147 156542 66797 26762003 22323353 4265197 173453 6667728 7563578 138438 138079 802637 918868 77636 88624 485978 454343 100956365 50798984 52053156 50157381 19296015 19876376 5614333 5915799 2215081 2113230 87351002 87226278 1807124 2140884 13623700 13406987 83062 46141 41493877 38503657 57007763 54097669 X 21591491 24067970 1659405 1666563 7092343 7394076 30343239 33128609 87351002 87226278 X 1603587 880316 301467 X X 0 1 X 1 0 X 869652 1919026 1614404 1320974 2321106 8045162 24184484 23713424 25464687 23840805 24528095 121731495 25054136 25632450 27079091 25161779 26849201 129776657 36788 285341 27158 37875 8527 395689 0 36788 285341 27158 37875 8527 395689 129380968 399363 851875 1162750 545353 436513 3395854 399363 851875 1162750 545353 436513 3395854 215400 230574 525773 514863 1486610 25668899 26714899 28241841 26232905 27800577 134659121 0.96080 0.96240 0.02520 0.02500 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1080 1080 0 PART II-B, LINE 1: THE AMOUNT LISTED ABOVE CONSISTS OF MEMBERSHIP DUES PAID TO TRADE ORGANIZATIONS. 0 1 X 6045491 6045491 54604060 34275901 20328159 5830860 4970465 860395 34475954 11552618 22923336 50157381 CHARITABLE REMAINDER TRUSTS 1057725 C BENEFICIAL INTEREST IN PERPETUAL TRUST 4858074 C 5915799 X PART IV, LINE 2B: RESIDENT FUNDS HELD IN TRUST. PART X, LINE 2: THE HOMES AND THE FOUNDATION ARE NOT-FOR-PROFIT ORGANIZATIONS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THE HOMES AND THE FOUNDATION FILE AS TAX-EXEMPT ORGANIZATIONS. MANAGEMENT IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE THE TAX-EXEMPT STATUS OF THE HOMES OR THE FOUNDATION. MANAGEMENT IS NOT AWARE OF ANY SIGNIFICANT ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR ANY OTHER TAXES FOR HOMES OR THE FOUNDATION. 1 FIRST BAPTIST CHURCH CLEVELAND COUNTY 120 N LAFAYETTE STREET SHELBY NC 28150 501(C)3 5000 CLEVELAND COUNTY POTATO PROJECT BRH RESIDENTS - BENEVOLENCE 85 517342 PART I, LINE 2: BENEVOLENCE IS BASED ON PAYOR (MEDICARE, MEDICAID, ETC.) AND ABILITY TO PAY. REQUESTS FOR BENEVOLENT ASSISTANCE ARE REVIEWED AND APPROVED BY THE PRESIDENT. BENEVOLENCE IS RECORDED AS A CONTRA-REVENUE ON A MONTHLY BASIS. THE TRUSTEES APPROVE PROJECTS AND GIVE GENERAL GUIDANCE ON BENEVOLENCE. THE BAPTIST RETIREMENT HOMES FOUNDATION AGREED TO REIMBURSE HOMES FOR THOSE PROJECTS THAT BENEFIT POOR SENIOR ADULTS IN NORTH CAROLINA. THE ORGANIZATION REQUESTS SUPPORT THROUGH A LETTER TO BAPTIST RETIREMENT HOMES. SCHEDULE I, PART III, COLUMN B THE ORGANIZATION ESTIMATED THAT 40% OF THE TOTAL RESIDENT POPULATION SERVED UTILIZES SOME TYPE OF ASSISTANCE. 1 X X X X X 0 1 0 0 0 0 0 0 0 MR WILLIAM B STILLERMAN PRESIDENT 280482 0 13000 0 0 0 51209 0 8382 0 353073 0 0 0 MR CHARLES R GASKINS CFO 137235 0 0 0 0 0 13269 0 15491 0 165995 0 0 0 MRS DEBRA H MEGINNIS EXECUTIVE VP AND COO 161917 0 37000 0 0 0 51637 0 10419 0 260973 0 0 0 PART I, LINE 4B DEBRA MEGINNIS AND WILLIAM STILLERMAN BOTH PARTICIPATED IN A 457 BENEFIT PLAN AND CONTRIBUTED $18,000 AND $17,089, RESPECTIVELY, DURING THE YEAR. FORM 990, PART VI, SECTION B, LINE 11B ALL MEMBERS WILL BE PROVIDED A COPY OF FORM 990 TO REVIEW PRIOR TO IT BEING FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR, TRUSTEES MUST COMPLETE A "NON-CONFLICT OF INTEREST" QUESTIONNAIRE. ADDITIONALLY, EMPLOYEES MUST DISCLOSE ALL PERTINENT FACTS SURROUNDING A POTENTIAL CONFLICT OF INTEREST TO HIS OR HER IMMEDIATE SUPERIOR. FORM 990, PART VI, SECTION B, LINE 15 IN COOPERATION WITH THE PERSONNEL COMMITTEE, THE FINANCE COMMITTEE RECOMMENDS THE SALARY OF THE PRESIDENT,COO, AND CFO EVERY YEAR. THE PROCESS INCLUDES A REVIEW AND APPROVAL BY INDEPENDENT PERSONS EVERY TWO YEARS. THE MOST RECENT YEAR IN WHICH THE PROCESS WAS REVIEWED AND APPROVED BY INDEPENDENT PERSONS WAS 2016. GENERALLY, INCREASES TO EXECUTIVES ARE AT THE SAME PERCENTAGE AS GRANTED TO ALL EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST AND IN ACCORDANCE WITH REGULATORY REQUIREMENTS. THE ORGANIZATION'S CONFLICT OF INTEREST STATEMENT OUTLINES THE ACTIVITIES EMPLOYEES SHOULD AVOID WITHOUT PRIOR APPROVAL OF THE BOARD OF TRUSTEES, AND PROVIDES STEPS TO BE TAKEN IF A POSSIBLE CONFLICT OF INTEREST EXISTS. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF TRUSTS 301,467. FORM 990, PART XII, LINE 2C: THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. BAPTIST RETIREMENT HOMES FOUNDATION 1912 BETHABARA ROAD WINSTON SALEM NC 27106 562205837 SUPPORT BRH NC 501(C)(3) LINE 12A, I BRHNC INC 1 0 0 1 1 0 0 0 0 1 0 0 0 0 1 1 0 0 1 0 BAPTIST RETIREMENT HOMES OF NORTH CAROLINA INCORPORATED D 1997992 INTERCOMPANY BAPTIST RETIREMENT HOMES OF NORTH CAROLINA INCORPORATED C 1399194 INCOME DISTRIBUTION