2017-01-16T00:00:00-06:00 2016-03-31 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2015-04-01 560963926 MORAVIAN HOME INCORPORATED DBA SALEMTOWNE MORA 3367678130 1000 SALEMTOWNE DRIVE WINSTONSALEM NC 27106 MARK STEELE CEO 3367678130 2017-01-18 1 AMY BIBBY P00445891 8282542254 2015 2021-01-29 14:40:06Z SALEMTOWNE MARK STEELE 1000 SALEMTOWNE DRIVE WINSTONSALEM NC 27106 20656119 0 X WWW.SALEMTOWNE.ORG X 1971 NC LONG TERM CARE FOR THE ELDERLY 16 16 257 296 0 0 1291873 608667 18928825 18779046 1888272 840861 267355 331447 22376325 20560021 1610858 1248119 0 0 10718396 10981425 0 0 286149 9301714 10353202 21630968 22582746 745357 -2022725 74622052 115180258 44636040 87493790 29986012 27686468 X SALEMTOWNE IS A NON-PROFIT CONTINUING CARE RETIREMENT COMMUNITY THAT PROMOTES THE WELL-BEING OF ITS RESIDENTS BY PROVIDING A CARING ENVIRONMENT. SALEMTOWNE IS AN ECUMENICAL COMMUNITY THAT REFLECTS THE MORAVIAN VALUES OF INDIVIDUAL RESPECT, HOSPITALITY, LIFE-LONG LEARNING, AND LOVE OF THE ARTS. 0 0 18532252 107031 18779046 SALEMTOWNE PROVIDED SERVICES THROUGH LONG-TERM CARE FOR ELDERLY IN THE WINSTON-SALEM COMMUNITY AND SURROUNDING AREAS. IT IS THE MISSION OF THE SALEMTOWNE COMMUNITY OUTREACH PROGRAM TO PROVIDE RESOURCES FOR SERVICES, PROGRAMS AND EDUCATION THAT ENHANCE THE QUALITY OF LIVING AND CARE FOR SENIOR ADULTS OF PIEDMONT NORTH CAROLINA. SALEMTOWNE STRIVES TO SHARE ITS EXPERTISE IN THE AREA OF AGING BY OFFERING EDUCATION AND TRAINING TO SENIOR ADULTS, FAMILIES AND CAREGIVERS; BY UTILIZING ITS TIME, TALENTS, AND FACILITIES FOR PROGRAMS AND EDUCATION; AND BY SPONSORING AND/OR SUPPORTING PROGRAMS OF ORGANIZATIONS AND ASSOCIATIONS DEDICATED TO SENIOR ADVOCACY. SALEMTOWNE PROVIDED CONTRIBUTIONS AND SERVICES TO ORGANIZATIONS SUCH AS: - ALZHEIMER'S ASSOCIATION OF FORSYTH COUNTY- AMERICAN HEART ASSOCIATION- APPALACHIAN STATE UNIVERSITY FOUNDATION- ARDMORE MORAVIAN CHURCH- BOOKMARKS BOOK FESTIVAL- CARENET COUNSELING, INC- COALITION OF MINISTRIES FOR OLDER ADULTS- COMMUNITY PARTNERSHIP FOR END OF LIFE (HOSPICE)- CONGREGATIONAL NURSE AND HEALTH MINISTRIES OF FORSYTH COUNTY- ECHO COUNCIL- N.C. CHAPLAINS' ASSOCIATION- FAMILY SERVICES- FORSYTH COUNTY AGING SERVICES- FORSYTH COUNTY SENIOR SERVICES - FORSYTH TECHNICAL COMMUNITY COLLEGE- HANDS ON NWNC- HOSPICE & PALLIATIVE CARE CENTER- IWO JIMA SURVIVORS- KING MORAVIAN CHURCH- KNOLLWOOD BAPTIST CHURCH- LEADERSHIP WINSTON SALEM- LIFE MINISTRIES- MARY ANN FOGLE SERVICE LEAGUE- MORAVIAN CHURCH SOUTHERN PROVINCE- MORAVIAN MUSIC FOUNDATION- N. C. NURSING HOME ADMINISTRATORS BOARD- N.C. DIRECTORS OF NURSING ADMINISTRATION LONG TERM CARE- NATIONAL ASSOCIATION OF DIRECTORS OF NURSING LONG TERM CARE- NORTHWEST AHEC- ROTARY CLUB OF FORSYTH COUNTY- SAMARITAN MINISTRIES- SHEPHERD'S CENTER- SPECIAL NEEDS DANCE FOR ADULT HANDICAP NO LIMITS 11- ST. PAUL'S EPISCOPAL CHURCH- SUNNYSIDE MINISTRIES OF THE MORAVIAN CHURCH- UNITED WAY OF FORSYTH COUNTY- WAKE FOREST BAPTIST HEALTH- WAKE FOREST BAPTIST HEALTH STICHT CENTER FOR AGING- WAKE FOREST UNIVERSITY DIVINITY SCHOOL- WAKE FOREST UNIVERSITY INSTITUTIONAL REVIEW BOARD- WAKE FOREST UNIVERSITY (VARIOUS STUDENT GROUPS/CLASSES)- WINSTON SALEM FOUNDATIONSALEMTOWNE'S CURRENT COMMUNITY BENEFIT PROGRAMS INCLUDE FINANCIAL ASSISTANCE FOR RESIDENTS MOVING THROUGH THE CONTINUUM OF CARE AT SALEMTOWNE, FINANCIAL ASSISTANCE FOR DIRECT ADMISSIONS TO THE ASSISTED LIVING CENTER & HEALTH CARE CENTER AT SALEMTOWNE, AND PARTICIPATION IN AND SUPPORT OF VARIOUS AGENCIES/ORGANIZATIONS LISTED ABOVE THROUGH DONATIONS OF CASH, TIME, PROPERTY AND MATERIALS. 1141088 1141088 PROVIDED FINANCIAL ASSISTANCE FOR RESIDENTS MOVING THROUGH THE CONTINUUM OF CARE AT SALEMTOWNE. PROVIDED FINANCIAL ASSISTANCE FOR DIRECT ADMISSIONS TO INDEPENDENT LIVING, THE ASSISTED LIVING CENTER & THE HEALTH CARE CENTER AT SALEMTOWNE. 19673340 1 1 0 0 0 0 1 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 97 0 1 257 1 0 0 0 0 0 0 0 0 0 0 X 16 16 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 ME AK AZ OR NM MN MS GA ND CO FL KY OH NH SC UT WA WI X X JAMES KONISZEWSKI 3367142141 1000 SALEMTOWNE DRIVE WINSTONSALEM NC 27106 FRANCIS JAMES III CHAIRMAN 1.00 X X 0 0 0 PEGGY CARTER VICE CHAIR 1.00 X X 0 0 0 KIMBERLY STOGNER SECRETARY 1.00 X X 0 0 0 DAVID SHAFFNER TREASURER 1.00 X X 0 0 0 MARTY EDWARDS BOARD MEMBER 1.00 X 0 0 0 CAROLANN ADCOCK BOARD MEMBER 1.00 X 0 0 0 REBECCA COOK BOARD MEMBER 1.00 X 0 0 0 DONALD FREY BOARD MEMBER 1.00 X 0 0 0 DERON MABE BOARD MEMBER 1.00 X 0 0 0 EVELYN ACREE BOARD MEMBER 1.00 X 0 0 0 JOHN FERGUSON BOARD MEMBER 1.00 X 0 0 0 VALENE FRANCO BOARD MEMBER 1.00 X 0 0 0 CHRIS PERRY BOARD MEMBER 1.00 X 0 0 0 GRAHAM RIGHTS BOARD MEMBER 1.00 X 0 0 0 BILL MCELVEEN BOARD MEMBER 1.00 X 0 0 0 BETSY ANNESE BOARD MEMBER 1.00 X 0 0 0 CHARLOTTE ZAMJAHN BOARD MEMBER (THROUGH JULY 15) 1.00 X 0 0 0 JOSEPH LYDON CEO (THROUGH JAN. 16) 40.00 X 183210 0 13668 MARK STEELE CEO (BEGAN AUG. 15) 40.00 X 94647 0 734 CAROLYN TWISDALE CFO 40.00 X 153319 0 12250 KATHY WILSON COMPLIANCE OFFICER & ASSISTANT SECRETARY 40.00 X 115839 0 3697 JAMES MATTHEWS ADMIN. OF HEALTH CARE 40.00 X 126430 0 11123 ELWIN MELTON DIRECTOR OF DEVELOPMENT 40.00 X 109589 0 6882 ANN BURRIS DIRECTOR OF ADMISSIONS 40.00 X 102476 0 432 885510 0 48786 6 0 1 0 HUGH G STRICKLAND INC 4072 BENTON CREEK DR WINSTONSALEM NC 271154162 GENERAL CONTRACTOR 1333810 CJMW ARCHITECTURE PA 119 BROOKSTOWN AVE STE 100 WINSTONSALEM NC 27101 CONSULTANT 672424 THERAPY PARTNERS LLC 1032 TRADERS TRAIL WAKE FOREST NC 27587 THERAPY 654045 WOOD HOME IMPROVEMENT INC 480 DULIN ROAD MOCKSVILLE NC 27028 CONSTRUCTION 465303 BETA BUILDERS LLC 256 CARTER CIRCLE WINSTONSALEM NC 27106 GENERAL CONTRACTOR 314476 15 144488 464179 608667 RESIDENT SERVICES 623000 16810382 16810382 AMORT. OF ADVANCE FEES 623000 1887583 1887583 NAVIGATION REVENUE 623000 81081 81081 18779046 290707 290707 553876 0 3722 553876 -3722 550154 550154 0 144488 92376 -92376 -92376 MISCELLANEOUS INCOME 900099 208113 208113 BEAUTY SHOP 812900 133074 133074 FOOD SERVICE 722210 63717 63717 18919 18919 423823 20560021 18779046 0 1172308 107031 107031 1141088 1141088 546201 543590 2611 8330655 7410538 833959 86158 155568 129871 24142 1555 1258387 1050521 195282 12584 690614 576535 107173 6906 61689 61689 43668 43668 123033 123033 1893416 1675458 215179 2779 233023 202117 25425 5481 1006472 786542 93495 126435 257673 247828 9845 734769 734769 60002 46192 13810 1366370 1366370 2850361 2850361 233417 245 233172 FOOD 858169 770273 87797 99 HEALTHCARE SUPPLIES & S 519049 519049 MISC 40561 14067 7084 19410 TRAINING 37411 10366 14759 12286 34119 34119 22582746 19673340 2623257 286149 1644638 291894 5251416 2198500 942127 1202086 26902 26062 153809 170689 87163308 35040515 43153701 52122793 22451108 57729240 998351 1438994 74622052 115180258 2743870 1877355 12175559 12698185 27985483 69002926 1731128 3915324 44636040 87493790 X 18205568 15693516 890018 932038 10890426 11060914 29986012 27686468 74622052 115180258 X -2022725 -264490 -12329 X X 0 1 X 1 0 X 1098735 1472127 518858 1291873 608667 4990260 17038657 16976312 18096731 18928825 18779046 89819571 345794 327300 484477 348152 423823 1929546 18483186 18775739 19100066 20568850 19811536 96739377 42185 32468 58484 30178 115409 278724 0 42185 32468 58484 30178 115409 278724 96460653 222441 308704 398839 327464 290707 1548155 222441 308704 398839 327464 290707 1548155 18705627 19084443 19498905 20896314 20102243 98287532 0.98140 0.98140 0.01580 0.01660 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 1 25.00 1 1 1 0.00 0 0 11865131 383504 92140 347823 11992952 11740234 235920 152156 263179 11865131 11624873 308351 237824 430814 11740234 10470121 1237693 165401 248342 11624873 10317728 316026 218896 382529 10470121 0.92230 0.07770 0 0 3506430 3506430 66210950 31754621 34456329 903446 433291 470155 5522722 2648685 2874037 11019760 203918 10815842 52122793 DEPOSITS 98100 REFUNDABLE ADVANCE FEES 2005134 BOND INTEREST PAYABLE 1812090 3915324 X 19238212 -264490 96098 -168392 19406604 1153417 1153417 20560021 21537756 96098 96098 21441658 1141088 1141088 22582746 PART II, LINE 9: THE CONSERVATION EASEMENT IS REPORTED IN THE ORGANIZATION'S FINANCIAL STATEMENTS AS PART OF PERMANENTLY RESTRICTED NET ASSETS. PART V, LINE 4: SUPPORT FOR RESIDENTS IN FINANCIAL NEED, PERSONNEL RECRUITING AND OTHER GENERAL OBLIGATIONS. PART X, LINE 2: THE COMMUNITY IS A TAX EXEMPT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE; ACCORDINGLY, THE ACCOMPANYING FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION OR LIABILITY FOR FEDERAL AND STATE INCOME TAXES. THE COMMUNITY HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENFITS OR OBLIGATIONS AS OF MARCH 31, 2016. IN ADDITION, THE COMMUNITY QUALIFIED FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A) AND IS CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION UNDER SECTION 509(A)(2). PART XI, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 92,376. GAIN/LOSS ON FIXED ASSETS 3,722. PART XI, LINE 4B - OTHER ADJUSTMENTS: INDIVIDUAL ASSISTANCE INCLUDED IN INCOME 1,141,088. CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENTS 12,329. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 92,376. GAIN/LOSS ON FIXED ASSETS 3,722. PART XII, LINE 4B - OTHER ADJUSTMENTS: INDIVIDUAL ASSISTANCE INCLUDED IN INCOME 1,141,088. ASSOCIATE APPRECIATION 95588 95588 92376 GIVING TREE 29090 29090 1 19810 19810 144488 144488 92376 92376 -92376 1 SHEPERD'S CENTER OF WINSTON SALEM 1700 EBERT ST WINSTONSALEM NC 27103 561646960 501(C)(3) 7750 FMV PROVIDED DONATION TO ORGANIZATION SENIOR SERVICES INC 2895 SHOREFAIR DRIVE WINSTONSALEM NC 27105 561085968 501(C)(3) 1500 69592 FMV FOOD PROVIDED MEALS TO ORGANIZATIONS SUPPORTING ELDERLY POPULATION BOOKMARKS PO BOX 11867 WINSTONSALEM NC 27116 542152610 501(C)(3) 7500 FMV PROVIDED DONATION TO ORGANIZATION WINSTON SALEM SYMPHONY 201 N BROAD ST STE 200 WINSTONSALEM NC 27101 560692826 501(C)(3) 5000 FMV PROVIDED DONATION TO ORGANIZATION 4 BENEVOLENT ASSISTANCE 21 1141088 FMV SCHEDULE I, PART I, LINE 2: RESIDENTS - RESIDENTS MUST APPLY FOR FINANCIAL ASSISTANCE AND PROVIDE VERIFICATION OF ASSETS AND INCOME. APPLICANTS APPROVED FOR FINANCIAL ASSISTANCE MUST SIGN A FINANCIAL ASSISTANCE AGREEMENT OUTLINING THE TERMS AND CONDITIONS OF THE PROGRAM. FINANCIAL ASSISTANCE TOTALS ARE LISTED AS PART OF THE FINANCIAL STATEMENT PACKAGE FOR THE BOARD OF TRUSTEES AND OFFICERS OF THE ORGANIZATION. OUTSIDE ORGANIZATIONS - SALEMTOWNE CHOOSES TO GIVE TO WELL ESTABLISHED NON-PROFIT ORGANIZATIONS IN GOOD STANDING WITH THE IRS WHO SUPPORT AND/OR ENHANCE OUR MISSION AND VALUES. IT IS THE MISSION OF SALEMTOWNE AND ITS OUTREACH PROGRAM TO PROVIDE HOUSING AND SERVICES FOR RESIDENTS WHO HAVE OUTLIVED THEIR RESOURCES, RESOURCES FOR SERVICES, PROGRAMS AND EDUCATION THAT ENHANCE THE QUALITY OF LIVING AND CARE FOR THE SENIOR CITIZENS OF PIEDMONT NORTH CAROLINA. SALEMTOWNE STRIVES TO SHARE ITS EXPERTISE IN THE AREA OF AGING BY OFFERING EDUCATION AND TRAINING TO SENIORS, FAMILIES AND CARE GIVERS; BY UTILIZING ITS TIME, TALENTS, AND FACILITIES FOR PROGRAMS AND EDUCATION; AND BY SPONSORING PROGRAMS OF ORGANIZATIONS AND ASSOCIATIONS DEDICATED TO SENIOR ADVOCACY. X 0 0 X X X X 0 0 0 0 0 0 0 0 0 JOSEPH LYDON CEO (THROUGH JAN. 16) 152145 0 17565 0 13500 0 7196 0 6472 0 196878 0 0 0 CAROLYN TWISDALE CFO 137744 0 0 0 15575 0 5720 0 6530 0 165569 0 0 0 PART I, LINE 1A THE FOLLOWING INDIVIDUAL'S RECEIVED A HOUSING ALLOWANCE DURING THE YEAR: MARK STEELE - $28,394 LINDA BROWNE - 25,480 THE HOUSING ALLOWANCE WAS INCLUDED IN THEIR TAXABLE WAGES. A NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 6579025M0 2006-11-14 35248843 REFUND 1999 & 2001 BONDS 0 0 0 B NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65820YLG9 2015-08-18 42180601 CONSTRUCT NEW NURSING FACILITY 0 0 0 A 8425000 41898215 2555161 666958 41230661 2003 0 1 1 1 B 42182954 2331191 1406821 843600 5501891 33503319 0 0 0 0 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 1 BANK OF AMERICA NA 23.000000000000 1 0 1 B 0 1 0 1 0 0 0 0 1 A 1 B 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: NORTH CAROLINA MEDICAL CARE COMMISSION DATE THE REBATE COMPUTATION WAS PERFORMED: 12/09/2011 ISSUER NAME: NORTH CAROLINA MEDICAL CARE COMMISSION DATE THE REBATE COMPUTATION WAS PERFORMED: 05/08/2015 SCHEDULE K, PART I, DESCRIPTION OF PURPOSE: THE BONDS WERE ISSUED FOR THE PURPOSE OF (1) REFUNDING PRIOR ISSUES DATED OCTOBER 20, 1999 AND APRIL 26, 2001; (2) PAYING THE COSTS OF ISSUING THE SERIES 2006 BONDS; AND (3) FUNDING A DEBT SERVICE RESERVE FUND. SCHEDULE K, PART II, LINE 3, BOND A, TOTAL PROCEEDS: THE AMOUNT OF TOTAL PROCEEDS ON PART II, LINE 3 INCLUDES $6,649,372 INVESTMENT EARNINGS OF BOND PROCEEDS. SCHEDULE K, PART II, LINE 3, BOND B, TOTAL PROCEEDS: THE AMOUNT OF TOTAL PROCEEDS ON PART II, LINE 3 INCLUDES $2,353 INVESTMENT EARNINGS OF BOND PROCEEDS. SCHEDULE K, PART II, LINE 11, OTHER SPENT PROCEEDS: THE AMOUNT PRESENTED ON PART II, LINE 11 REPRESENTS AMOUNTS USED TO PAY AT MATURITY OR REDEEM THE REFUNDED PRIOR ISSUES DATED OCTOBER 20, 1999 AND APRIL 26, 2001. SCHEDULE K, PART III (BOND A): BECAUSE THE ISSUE IS AN ADVANCE REFUNDING FOR PRIOR BONDS ISSUED BEFORE JANUARY 1, 2003, AND CONTAINED NO NEW CAPITAL PROJECT BORROWINGS, PART III IS NOT REQUIRED. FORM 990, PART VI, SECTION A, LINE 7A THE QUADRENNIEL MEETING OF THE MORAVIAN CHURCH IN AMERICA, SOUTHERN PROVINCE (KNOWN AS SYNOD) ELECTS FOUR MEMBERS TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE 990 WAS PROVIDED TO EACH BOARD MEMBER BEFORE THE RETURN WAS FILED. PRIOR TO FILING, THE BOARD REVIEWED AND APPROVED THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C EACH BOARD MEMBER IS REQUIRED TO SIGN A CONFLICT OF INTEREST POLICY UPON INITIALLY JOINING THE BOARD. BEFORE EACH BOARD MEETING, THE MEMBERS ARE ASKED TO DISCLOSE ANY POTENTIAL CONFLICTS. CHANGES IN CONFLICTS OF INTEREST ARE MAINTAINED BY THE CFO. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS PULLED FROM GUIDESTAR FOR CCRCS IN NORTH CAROLINA OF COMPARABLE SIZE AND FROM THE LEADING AGE SALARY SURVEY. THIS INFORMATION IS PROVIDED TO THE BOARD ALONG WITH HISTORY OF COMPENSATION FOR THE CEO AND CFO. THE BOARD THEN REVIEWS AND APPROVES THE COMPENSATION FOR ALL OFFICERS. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION'S FORM 1023, 990, AND 990-T ARE AVAILABLE TO THE PUBLIC UPON REQUEST. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE MADE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE ALSO MADE AVAILABLE ON THE NC DEPARTMENT OF INSURANCE WEBSITE. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENTS -12,329. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.