2016-12-15T00:00:00-06:00 2016-09-30 560587953 GILLIAM COBLE & MOSER LLP PO BOX 621 BURLINGTON NC 272160621 990 2015-10-01 561077371 PRESBYTERIAN HOME OF HAWFIELDS INC PRES 3365784701 2502 SOUTH NC 119 MEBANE NC 27302 MR MAX KERNODLE ADMINISTRATOR 3365784701 2016-12-14 1 J BRADLEY MOSER P00024209 3362276283 2015 2017-02-10 21:41:12Z MR MAX KERNODLE 2502 SOUTH NC 119 MEBANE NC 27302 6149420 0 X WWW.HAWFIELDS.ORG X 1973 NC TO PROVIDE HOUSING & RELATED FACILITIES & SERVICE FOR THE ELDERLY AND NEEDY. 7 7 160 80 0 0 1966 3465 5804598 6098953 2132 401 32747 46601 5841443 6149420 0 0 0 0 3915392 3206279 0 0 0 2798280 3037737 6713672 6244016 -872229 -94596 3174571 2964187 1912424 1796636 1262147 1167551 TO PROVIDE HOUSING & RELATED FACILITIES & SERVICE FOR THE ELDERLY AND NEEDY IN A HEALTH CARE SETTING. 0 0 5405061 6098953 THE ORGANIZATION OPERATES A NURSING HOME FACILITY WITH 117 NURSING BEDS AND 19 INDEPENDENT LIVING BEDS IN MEBANE, NORTH CAROLINA. 5405061 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 10 0 160 1 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 JIMMY EVANS CHAIRMAN 1.00 X X 0 0 0 GEORGE BASON VICE CHAIRMAN 1.00 X X 0 0 0 REV AB PLEXICO BOARD MEMBER 1.00 X 0 0 0 HENDERSON SCOTT BOARD MEMBER 1.00 X 0 0 0 BILL MEBANE BOARD MEMBER 1.00 X 0 0 0 TOM GAMBLE BOARD MEMBER 1.00 X 0 0 0 BILL STOCKARD BOARD MEMBER 1.00 X 0 0 0 MAX KERNODLE TREASURER/SECRETARY 70.00 X 149325 0 16718 WILLIAM C OSMAN RN, DIRECTOR OF NURSING 45.00 X 102012 0 10094 251337 0 26812 2 0 1 0 NIGHTINGALE NURSING SERVICES PO BOX 1163 CARRBORO NC 27510 AGENCY NURSING 886381 SYSCO FOOD SERVICES PO BOX 129 SELMA NC 27576 RAW FOODS/SUPPLEMENTS 325420 CONCORDANCE HEALTHCARE SOLUTIONS 2675 SOLUTION CENTER CHICAGO IL 606772006 NURSING SUPPLIES 209816 DIAMOND PAPER CO INC 802 MONUMENT ST DANVILLE VA 24541 PAPER PRODUCTS/HSKING/SUPPLIES/LAUNDRY 190352 4 3465 3465 SKILLED CARE RESIDENT 632000 5669134 5669134 INDEPENDENT LIVING REV 632000 246098 246098 SPECIAL SERVICES REVEN 623000 183721 183721 6098953 401 401 2500 0 2500 2500 2500 LATE PAYMENT INCOME 900009 15581 15581 EMPLOYEE/GUEST MEALS 900009 10386 10386 DUKE POWER GENERATOR U 900009 9987 9987 8147 8147 44101 6149420 6098953 0 47002 X 119436 119436 2346790 2253699 93091 535080 501732 33348 204973 190022 14951 10779 10779 69399 69399 1052608 1014273 38335 7363 7363 60559 60559 227819 227819 2859 2544 315 5774 1948 3826 153624 153624 139899 129551 10348 22707 22707 SUPPLIES 785121 785121 THERAPY 214812 214812 BAD DEBT EXPENSE 193134 193134 PHARMACY 71688 71688 19592 11852 7740 6244016 5405061 838955 0 782011 352738 100000 100000 611630 849398 52885 50705 53550 49488 6272418 4726111 1554643 1546307 19852 15551 3174571 2964187 457021 446943 1400000 1314900 35551 20104 19852 14689 1912424 1796636 X 1162147 1067551 100000 100000 1262147 1167551 3174571 2964187 -94596 0 X X 0 1 X 1 0 X 1570 9033 9264 1966 3465 25298 6700276 6148298 6320341 5804598 6098953 31072466 6701846 6157331 6329605 5806564 6102418 31097764 140 210 90 65 130 635 0 140 210 90 65 130 635 31097129 7052 10021 12023 21799 18482 69377 7052 10021 12023 21799 18482 69377 58809 16139 11991 13080 28520 128539 6767707 6183491 6353619 5841443 6149420 31295680 0.99370 0.99420 0.00220 0.00220 X 1028277 1028277 3987055 3596992 390063 913255 790675 122580 343831 338444 5387 1546307 RESIDENT TRUST FUNDS 14689 14689 6149420 0 6149420 0 6149420 6244016 0 6244016 0 6244016 X 0 0 0 0 0 0 0 0 0 MAX KERNODLE TREASURER/SECRETARY 149325 0 0 0 0 0 11125 0 5593 0 166043 0 0 0 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 11 A COPY OF FORM 990 WILL BE DISTRIBUTED AND REVIEWED AT THE DECEMBER 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 SK - CONTRACT OUT SERV : PROGRAM SERVICE EXPENSES 40,119. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 40,119. SK - CONTRACT OUT-MED DIR : PROGRAM SERVICE EXPENSES 5,100. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,100. SK - CONTRACT OUT-RN : PROGRAM SERVICE EXPENSES 169,929. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 169,929. SK - CONTRACT OUT-LPN : PROGRAM SERVICE EXPENSES 191,457. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 191,457. SK - CONTRACT OUT-CNA : PROGRAM SERVICE EXPENSES 506,088. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 506,088. PHARMACY - CONTRACT OUT SERV : PROGRAM SERVICE EXPENSES 2,808. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,808. TRANSP - CONTRACT OUT SERV : PROGRAM SERVICE EXPENSES 1,302. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,302. B & B - CONTRACT OUT SERV : PROGRAM SERVICE EXPENSES 17,688. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,688. DIET - CONTRACT OUT SERV : PROGRAM SERVICE EXPENSES 39,649. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 39,649. LAUND - CONTRACT OUT SERV : PROGRAM SERVICE EXPENSES 1,294. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,294. HK - CONTRACT OUT SERV : PROGRAM SERVICE EXPENSES 839. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 839. MAINT - CONTRACT OUT SERV : PROGRAM SERVICE EXPENSES 15,606. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,606. IL - CONTRACT OUT SERV : PROGRAM SERVICE EXPENSES 19,730. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,730. CONTRACT OUT SERV : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 33,835. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 33,835. DATA PROCESSING - CONTRACT OUT SERV : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 4,500. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,500. ACTIVITY - CONTRACT OUT SERV: PROGRAM SERVICE EXPENSES 2,664. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,664. FORM 990. PART XII, LINE 2C THERE ARE NO CHANGES FROM PRIOR YEAR.