2017-05-12T13:55:21-05:00 2016-09-30 420714325 RSM US LLP 230 N ELM ST STE 1100 GREENSBORO NC 27401 990 2015-10-01 560634527 THE UNITED METHODIST RETIREMENT HOMES INC UNIT 9193843010 2600 CROASDAILE FARM PKWY NO A-500 DURHAM NC 277053153 JONATHAN ERICKSON CORPORATE EXECUTIVE DIRECTOR 9193843010 2017-05-12 1 TAMELA L GAINEY P00437957 3362724551 2015 2021-01-29 14:40:06Z JONATHAN ERICKSON 2600 CROASDAILE FARM PKWY NO A-500 DURHAM NC 277053153 132594976 0 X WWW.UMRH.ORG X 1946 NC OWN, OPERATE, AND MANAGE CONTINUING CARE RETIREMENT COMMUNITIES 23 23 1039 1864 0 0 748540 1544052 60425501 61171464 1526009 4717210 71957 -117955 62772007 67314771 553021 537681 0 0 23200118 24132042 0 0 0 34191925 32957576 57945064 57627299 4826943 9687472 221258835 220775861 169227928 162386838 52030907 58389023 TO PROVIDE QUALITY CARE AND SERVICES FOR AN INCLUSIVE AND DIVERSE POPULATION OF SENIOR ADULTS. 0 0 44544628 537681 61171464 OPERATE CONTINUING CARE RETIREMENT COMMUNITIES INCLUDING SKILLED NURSING FACILITIES. 44544628 1 1 0 0 0 0 1 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 1 99 0 1 1039 1 0 0 0 0 0 0 0 0 0 0 X 23 23 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 NC X STACY DOBSON 9193843000 2600 CROASDAILE FARM PKWY STE A-500 DURHAM NC 27705 DON METZGER CHAIR 1.00 X X 0 0 0 GARY WHALEY 1ST VICE CHAIR 1.00 X X 0 0 0 JERRY GAMBILL SECRETARY 1.00 X X 0 0 0 LEE HARRISS TREASURER 1.00 X X 0 0 0 JOHN LINK TRUSTEE 1.00 X 0 0 0 BRUCE JOBE TRUSTEE 1.00 X 0 0 0 DEBORAH MONTAGUE TRUSTEE 1.00 X 0 0 0 JOHN GRISSOM TRUSTEE 1.00 X 0 0 0 ROBBY LOWRY TRUSTEE 1.00 X 0 0 0 DEBBY MEYER TRUSTEE 1.00 X 0 0 0 TOM STEELE TRUSTEE 1.00 X 0 0 0 GREG WALLACE TRUSTEE 1.00 X 0 0 0 KATHRYN BRADLEY TRUSTEE 1.00 X 0 0 0 ARTIE ROGERS TRUSTEE 1.00 X 0 0 0 HOPE WARD EX-OFFICIO TRUSTEE 1.00 X 0 0 0 CAROL GOEHRING EX-OFFICIO TRUSTEE 1.00 X 0 0 0 VERN VAN BRUGGEN EX-OFFICIO TRUSTEE 1.00 X 0 0 0 LINDA TAYLOR EX-OFFICIO TRUSTEE 1.00 X 0 0 0 KENNETH LOCKLEAR EX-OFFICIO TRUSTEE 1.00 X 0 0 0 STEVE TAYLOR EX-OFFICIO TRUSTEE 1.00 X 0 0 0 WILLIAM SHERMAN EX-OFFICIO TRUSTEE 1.00 X 0 0 0 JAMES EBERT EX-OFFICIO TRUSTEE 1.00 X 0 0 0 SANDY SCARLETT EX-OFFICIO TRUSTEE 1.00 X 0 0 0 JONATHAN ERICKSON CORPORATE EXECUTIVE DIRECTOR 40.00 X 179455 0 45208 STACY DOBSON CHIEF FINANCIAL OFFICER 40.00 X 172281 0 14558 HOWARD DEWITT EXECUTIVE DIRECTOR (CV) 40.00 X 152946 0 7067 WADE ROZIER EXECUTIVE DIRECTOR (WP) 40.00 X 143126 0 26908 LAURIE STALLINGS EXECUTIVE DIRECTOR (CG) 40.00 X 167755 0 26704 HEATHER MARCH CAMPUS ADMINISTRATOR 40.00 X 137791 0 16251 SARAH EVERETTE DIRECTOR OF NURSING 40.00 X 119084 0 8281 JAMES SAKELL DIRECTOR DINING & ENVIRONMENTAL SERVICES 40.00 X 105055 0 148226 LISA SEALY CORPORATE HR/PR MANAGER 40.00 X 117496 0 14036 CAROL ROYCROFT MARKETING DIRECTOR 40.00 X 114835 0 7692 1409824 0 314931 11 0 1 0 MORRISON MANAGEMENT SPECIALISTS 400 LOCUST STREET SUITE 820 MOBILE AL 36625 DIETARY MANAGEMENT 2522964 HERITAGE HEALTHCARE INC 536 OLD HOWELL ROAD GREENVILLE SC 29615 THERAPY PROVIDER 2022245 LIFE CARE SERVICES LLC 400 LOCUST STREET SUITE 820 DES MOINES IA 50309 MANAGEMENT COMPANY 1942635 CARRINGTON CONTRACTING INC PO BOX 71048 DURHAM NC 27722 GENERAL CONTRACTOR 912352 TRI-WAVE CARPETS 3222 GUESS ROAD DURHAM NC 27705 FLOORING CONTRACTOR 538298 30 64342 1479710 641674 1544052 PATIENT SERVICES 623000 45396526 45396526 MEDICARE/MEDICAID PAYMENTS 623000 8255022 8255022 AMORT. OF ADVANCE FEES 623000 7519916 7519916 61171464 1772098 1772098 13390 0 13390 13390 13390 68214319 10998 64850407 429798 3363912 -418800 2945112 2945112 VENDING 623000 2705 2705 MISC OPERATING REVENUE 623000 -134050 -134050 -131345 67314771 61171464 0 4599255 537681 537681 1724754 1724754 18198758 16588371 1610387 235143 188303 46840 2501732 2061340 440392 1471655 1283676 187979 2092187 284485 1807702 174996 174996 109772 109772 237546 237546 4168435 3725487 442948 297019 702 296317 142018 142018 1890329 1242513 647816 42176 14584 27592 98064 53954 44110 3216402 3133419 82983 8765004 5761237 3003767 726395 726395 SUPPLIES 4162665 4162665 ANCILLARY EXPENSES 2864441 2864441 EQUIPMENT RENTAL AND MA 1083696 997929 85767 BAD DEBT EXPENSE 9645 9645 2876786 1634196 1242590 57627299 44544628 13082671 0 3575 2825 15309415 14328114 3332480 4367782 3342800 2617815 142993 140498 859388 1037267 219297608 87202083 130665182 132095525 62827717 63463779 31512 50669 4743773 2671587 221258835 220775861 5484652 5377382 61617337 62434275 101186162 93546395 939777 1028786 169227928 162386838 X 47120667 52232359 2007516 2949939 2902724 3206725 52030907 58389023 221258835 220775861 X 9687472 -1448261 -1881095 X X 0 1 X 1 0 X 922478 475239 1533172 748540 1544052 5223481 41872553 43093483 58317877 60440461 61171464 264895838 42795031 43568722 59851049 61189001 62715516 270119319 0 0 0 270119319 1506339 1263769 1734543 2070386 1785488 8360525 1506339 1263769 1734543 2070386 1785488 8360525 291865 166400 -140990 43557 -131345 229487 44593235 44998891 61444602 63302944 64369659 278709331 0.96920 0.94580 0.03000 0.03020 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: VENDING CHARGES - 2011 AMOUNT: $ 3,391. 2012 AMOUNT: $ 3,564. 2013 AMOUNT: $ 3,158. 2014 AMOUNT: $ 2,712. 2015 AMOUNT: $ 2,705. BAD DEBT RECOVERY - 2011 AMOUNT: $ 17,238. MISCELLANEOUS - 2011 AMOUNT: $ 271,236. 2012 AMOUNT: $ 162,836. 2013 AMOUNT: $ -144,148. 2014 AMOUNT: $ 40,845. 2015 AMOUNT: $ -134,050. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 1 1.59 0 0 0 1 0 0.00 0 4214916 1333726 433794 170921 358273 23209 5430033 4329537 540955 -92926 14700 453162 94788 4214916 3760159 1424320 305800 19700 1031539 109503 4329537 2144657 332312 130216 16000 541314 4841 2045030 2055865 577293 251659 26425 713465 270 2144657 0.50570 0.49430 0 1 1 6528046 6528046 179775811 69888965 109886846 14168799 9777524 4391275 18824952 7535594 11289358 132095525 FUNDS HELD FOR OTHERS 63071 DUE TO RELATED PARTY 60232 INTEREST RATE SWAP AGREEMENT 905483 1028786 X 62718740 -1448261 -3147770 -4596031 67314771 0 67314771 56360624 0 56360624 1266675 1266675 57627299 PART II, LINE 3: IN THE 1990'S, CYPRESS GLEN RETIREMENT COMMUNITY GRANTED AN EASEMENT TO THE CITY OF GREENVILLE FOR THE SOUTH TAR RIVER GREENWAY PROJECT. THE PROJECT CROSSES THE CYPRESS GLEN PROPERTY NEAR THE TAR RIVER. IN 2009, THE CITY BEGAN WORK ON THE PORTION OF THE GREENWAY BEHIND CYPRESS GLEN. THE CITY OF GREENVILLE WAS REQUIRED BY THE NC DIVISION OF WATER QUALITY TO AVOID SOME ENVIRONMENTALLY PROTECTED AREAS NEAR THE TAR RIVER IN THE CONSTRUCTION OF THE GREENWAY PROJECT. TO ACCOMPLISH THE REQUIREMENT, THE CITY ASKED THAT CYPRESS GLEN INCREASE THE EASEMENT IN A SPECIFIC AREA THAT IS 40 FEET WIDE AND 365 FEET LONG. THE EASEMENT WAS GRANTED BY THE BOARD CHAIRMAN IN NOVEMBER OF 2010. PART II, LINE 9: THE ORGANIZATION DOES NOT REPORT CONSERVATION EASEMENTS IN ITS REVENUE AND EXPENSE STATEMENTS AND BALANCE SHEETS. PART V, LINE 4: AS DICTATED BY THE DONOR, EARNINGS ON THE ENDOWMENT FUNDS WILL SUPPORT BENEVOLENT NEEDS AT THE COMMUNITY AND EMPLOYEE SCHOLARSHIPS. PART X, LINE 2: THE COMPANY IS EXEMPT FROM FEDERAL INCOME TAXES UNDER 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 COMPANY HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2016. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN SPLIT INTEREST AGREEMENT 75,685. CHANGE IN VALUE OF PLEDGES 67,067. SPECIFIC INDIVIDUAL ASSISTANCE -517,181. BEAUTY AND BARBER EXPENSE -185,689. PATIENT SERVICE REVENUE DISCOUNTS -554,160. CHANGE IN VALUE OF INTEREST RATE SWAP AGREEMENT -98,584. LOSS ON EARLY EXTINGUISHMENT OF DEBT -1,925,263. BAD DEBT EXPENSE -9,645. PART XII, LINE 4B - OTHER ADJUSTMENTS: SPECIFIC INDIVIDUAL ASSISTANCE 517,181. BEAUTY & BARBER EXPENSE 185,689. PATIENT SERVICE REVENUE DISCOUNTS 554,160. BAD DEBT EXPENSE 9,645. 1 BENEVOLENT ASSISTANCE FOR RESIDENTS 53 517181 0 NURSING SCHOLARSHIPS 5 3000 0 STUDENT SCHOLARSHIPS 14 17500 0 PART I, LINE 2: UPON REVIEW OF EACH RESIDENT'S INDIVIDUAL FINANCIAL SITUATION, THE COMPANY MAY PERMIT THE RESIDENT TO REMAIN AT THE FACILITY FOR A LESSER FEE BASED ON THE RESIDENT'S ABILITY TO PAY BUT ONLY AFTER MEETING ALL OF THE SPEND-DOWN PROVISIONS OF ELIGIBILITY FOR THE MEDICAID PROGRAM AND ANY PUBLIC ASSISTANCE FUNDS. THE UNITED METHODIST RETIREMENT HOMES HAS FOUR POST-SECONDARY EDUCATION SCHOLARSHIP PROGRAMS FOR EMPLOYEES OF UNITED METHODIST RETIREMENT HOMES AND ITS CONTRACTORS. THE SCHOLARSHIPS ARE FUNDED BY DONORS AND ARE AWARDED ANNUALLY. SCHOLARSHIP RECIPIENTS ARE NOMINATED BY THEIR MANAGEMENT AND ARE SELECTED BY A THREE-MEMBER COMMITTEE COMPRISING THE MANAGER OF THE SCHOLARSHIP APPLICANTS, THE DIRECTORS OF HUMAN RESOURCES FOR CROASDAILE VILLAGE AND CYPRESS GLEN, AND THE VICE PRESIDENT OF THE UNITED METHODIST RETIREMENT HOMES FOUNDATION. THE COMMITTEE MAKES SELECTIONS OF SCHOLARSHIP RECIPIENTS BASED ON THE POLICY FOR DONOR-DIRECTED SCHOLARSHIP FUNDS, AND ON THE DONOR'S CRITERIA FOR AWARDING THE SCHOLARSHIP. X X X X 0 0 0 0 0 0 0 0 0 JONATHAN ERICKSON CORPORATE EXECUTIVE DIRECTOR 145007 0 30877 0 3571 0 17284 0 27924 0 224663 0 0 0 STACY DOBSON CHIEF FINANCIAL OFFICER 154839 0 17326 0 116 0 6703 0 7855 0 186839 0 0 0 HOWARD DEWITT EXECUTIVE DIRECTOR (CV) 146877 0 5396 0 673 0 6131 0 936 0 160013 0 0 0 WADE ROZIER EXECUTIVE DIRECTOR (WP) 123435 0 18375 0 1316 0 5962 0 20946 0 170034 0 0 0 LAURIE STALLINGS EXECUTIVE DIRECTOR (CG) 153159 0 14342 0 254 0 6791 0 19913 0 194459 0 0 0 HEATHER MARCH CAMPUS ADMINISTRATOR 128742 0 8963 0 86 0 5554 0 10697 0 154042 0 0 0 JAMES SAKELL DIRECTOR DINING & ENVIRONMENTAL SERV 100641 0 3667 0 747 0 4381 0 143845 0 253281 0 0 0 A NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65820YDR4 2005-02-01 20790000 BUILD 59 NEW APARTMENTS 0 0 0 B NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65820YEW2 2005-09-01 47835000 REFUND SERIES 2000 BOND BALANCES 0 0 0 C NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 NONEAVAIL 2010-02-04 14300000 REPLACEMENT HEALTHCARE CENTER 0 0 0 D NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 NONEAVAIL 2010-02-18 12880000 CONVERT 2005B BONDS TO BQ STATUS 0 0 0 A 20790000 20790000 2036537 415800 18337663 2005 0 0 1 1 B 47835000 47835000 3011368 956700 43866932 2005 0 1 1 1 C 14300000 10401084 2010 0 0 1 1 D 12880000 12880000 2010 1 0 1 1 A 0 0 1 1 0 0 0 1 B 0 0 1 1 0 0 0 1 C 0 0 1 1 0 0 0 1 D 0 0 1 1 0 0 0 1 A 1 0 0 0 0 1 B 1 0 0 0 0 1 C 1 1 0 0 0 1 D 1 1 0 0 0 1 A 1 B 1 C 1 D 1 A NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 NONEAVAIL 2014-09-01 12025000 REFUND SERIES 2005B, 2004A, AND 2005A BONDS 0 0 0 B NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 NONEAVAIL 2009-10-15 6585000 REFUND 2004B & 2004D SERIES BONDS 0 0 0 C NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65820YKB1 2013-04-11 8370000 REFUND SERIES 2004C BONDS 0 0 0 D NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 NONEAVAIL 2015-10-01 16630000 REFUNDING 2005 BONDS 0 0 0 A 12025000 1310000 2014 1 0 1 1 B 6585000 127489 6572252 2009 1 0 1 1 C 8370000 226863 7971578 171559 2013 0 1 1 1 D 16630000 200000 16430000 2015 1 0 1 1 A 0 0 1 1 0 0 0 1 B 0 0 1 1 0 0 0 1 C 0 0 1 1 0 0 0 1 D 0 0 1 1 0 0 0 1 A 1 1 1 BB&T 10.000000000000 0 0 0 0 1 B 1 1 0 0 0 1 C 1 0 0 0 0 1 D 1 0 1 BB&T 9.000000000000 0 0 0 0 1 A 1 B 1 C 1 D 1 A NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65820YLQ7 2016-05-11 638610558 REFUND 2005A AND 2005C SERIES BONDS 0 0 0 A 38610558 710224 37900333 2016 1 0 1 1 A 0 0 1 1 0 0 0 1 A 1 0 0 0 0 1 X 5 641674 HI-LO AVERAGE 0 1 0 PART I, COLUMN (B): THE NUMBER IN COLUMN B REFLECTS THE NUMBER OF CONTRIBUTORS. FORM 990, PART VI, SECTION A, LINE 3 THE COMPANY PAYS MANAGEMENT FEES TO LIFE CARE SERVICES LLC ("LCS") PURSUANT TO A CLIENT SERVICES AGREEMENT. UNDER THIS AGREEMENT, LCS IS TO: (I) PROVIDE A QUALIFIED CORPORATE EXECUTIVE DIRECTOR, WHO IS AN EMPLOYEE OF LCS; AND (II) PERFORM GENERAL, FINANCIAL, PERSONNEL, FACILITY AND OTHER MANAGEMENT SERVICES NECESSARY FOR OPERATION OF UMRH'S CORPORATE OFFICE AND THE OPERATION AND MARKETING OF THE COMMUNITIES. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION'S CHIEF FINANCIAL OFFICER REVIEWS THE 990. FORM 990, PART VI, SECTION B, LINE 12C THE UMRH, INC. BOARD FILLS OUT THE CONFLICT OF INTEREST POLICY FORM EACH SEPTEMBER NOTING ANY CONTINUED CONFLICTS OF INTEREST. NEW BOARD MEMBERS ARE ORIENTED TO THE POLICY AND SIGN THE FORM UPON BECOMING MEMBERS. EACH BOARD MEMBER IS REQUIRED TO DISCLOSE ANY CONFLICTS TO THE CHAIRMAN PRIOR TO A VOTE BEING TAKEN. THE MEMBER MUST ABSTAIN FROM VOTING. THE CONFLICT OF INTEREST POLICY IS ALSO REVIEWED FOR THE EMPLOYEES AT ORIENTATION AND AT ANNUAL REVIEW. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION ROUTINELY CONSULTS THE SERVICES OF AN OUTSIDE AGENCY TO EVALUATE THE ORGANIZATION'S WAGE SCALES AND PAY GRADES. THE RESULTING WAGE SCALE AND THE EMPLOYEE'S PERFORMANCE AND ACCOMPLISHMENTS ARE CONSIDERED IN THE ANNUAL REVIEW PROCESS. IN SOME INSTANCES, A SOFTWARE PROGRAM CALLED "PERFORMANCE NOW" IS USED TO SIMPLIFY THE COMMUNICATION OF THE REVIEW AND ITS RESULTS. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). FORM 990, PART XI, LINE 9: CHANGE IN SPLIT INTEREST AGREEMENT 75,685. CHANGE IN VALUE OF PLEDGES 67,067. CHANGE IN VALUE OF INTEREST RATE SWAP AGREEMENT -98,584. LOSS ON EARLY EXTINGUISHMENT OF DEBT -1,925,263. FORM 990, PART XII, LINE 2C THE ORGANIZATION'S OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED SINCE THE PRIOR YEAR. FORM 990, PART VII, SECTION A HOURS TO RELATED ORGANIZATION: JONATHAN ERICKSON - 1 HOUR PER WEEK TO UNITED METHODIST RETIREMENT HOMES FOUNDATION, INC. AS A MEMBER OF THE BOARD OF TRUSTEES. THE FOLLOWING MEMBERS OF THE BOARD OF TRUSTEES ARE ALSO MEMBERS OF THE BOARD OF TRUSTEES FOR UNITED METHODIST RETIREMENT HOMES FOUNDATION, INC. AND PROVIDE 1 HOUR OF SERVICE PER WEEK: STACY DOBSON, JOHN GRISSOM, TOM STEELE, LEE HARRISS, DON METZGER, ARTIE ROGERS, GARY WHALEY, JERRY GAMBILL, AND JOHN LINK. FORM 990, PART VII, SECTION A, COLUMN F THE ORGANIZATION, IN A FULL TRANSPARENCY POSTURE TO REPORTING, IS REPORTING ALL BENEFITS IN FULL IN COLUMN F, PART VII AND NOT APPLYING THE $10,000 PER ITEM EXCEPTION FOR CERTAIN BENEFITS. UMRH AFFORDABLE HOUSING DEVELOPMENT LLC 2600 CROASDAILE FARM PKWY STE A-500 DURHAM NC 277053153 043701058 DEVELOP AFFORDABLE HOUSING NC 42 87074 N/A UNITED METHODIST RETIREMENT HOMES FOUNDATION INC 2600 CROASDAILE FARM PARKWAY SUITE DURHAM NC 27705 561870172 CONTRIBUTE FUNDS TO UMRH, INC. NC 501(C)(3) LINE 11A UMRH INC 1 UMRH AFFORDABLE HOUSING INC 2600 CROASDAILE FARM PARKWAY SUITE DURHAM NC 27705 010724816 OPERATE AFFORDABLE HOUSING NC N/A C 5880 46173 1.00000 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 UNITED METHODIST RETIREMENT HOMES FOUNDATION INC C 64342 CASH