2016-06-14T13:10:55-05:00 2015-12-31 560571159 BERNARD ROBINSON & COMPANY LLP PO BOX 19608 GREENSBORO NC 274199608 990 2015-01-01 560529956 MASONIC AND EASTERN STAR HOME OF NORTH CAROLINA INC MASO 3362990031 700 S HOLDEN ROAD GREENSBORO NC 27407 MARK KOLADA EXECUTIVE DIRECTOR 3362990031 2016-06-06 1 OLGA OGANESOV P01279668 3362944494 2016-06-06 2015 2016-09-27 15:27:22Z WHITESTONE MARK KOLADA 700 S HOLDEN ROAD GREENSBORO NC 27407 20675963 0 X WWW.MESHHOME.ORG X 1912 NC AS A RETIREMENT COMMUNITY LEADER SINCE 1912, MASONIC AND EASTERN STAR HOME OF NC IS DEVOTED TO EXCELLENCE IN HOSPITALITY WITH TRADITIONAL VALUES PROMOTING FRATERNAL SERVICE, DIGNITY, DEPENDABILITY, AND CHOICE. 20 20 328 100 0 0 1165145 1852247 15651083 16674980 136297 674525 23631 6929 16976156 19208681 1115000 993280 0 0 7491872 7750717 0 0 0 9248449 9317046 17855321 18061043 -879165 1147638 56284652 56449141 40023112 40251978 16261540 16197163 AS A RETIREMENT COMMUNITY LEADER SINCE 1912, MASONIC AND EASTERN STAR HOME OF NC IS DEVOTED TO EXCELLENCE IN HOSPITALITY WITH TRADITIONAL VALUES PROMOTING FRATERNAL SERVICE, DIGNITY, DEPENDABILITY, AND CHOICE. 0 0 15907617 993280 16681909 MASONIC AND EASTERN STAR HOME OF NC PROVIDES RESIDENTIAL, HEALTH CARE, AND OTHER RELATED SERVICES TO ELDERLY RESIDENTS. THE HOME OFFERS INDEPENDENT LIVNG, ASSISTED LIVING, AND SKILLED NURSING SERVICES. 15907617 1 1 0 0 0 0 0 0 0 1 1 1 0 0 1 1 1 0 0 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 0 0 1 0 0 0 1 58 0 1 328 1 0 0 0 0 0 0 0 0 0 0 X 20 20 0 1 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X PHIL HUGHES 3362990031 700 S HOLDEN ROAD GREENSBORO NC 27407 X GENE JERNIGAN CHAIRMAN 1.00 X X 0 0 0 FRAN SOUTHERN VICE CHAIR & TREASURER 1.00 X X 0 0 0 JAMES H WOOLARD SECRETARY 1.00 X X 0 0 0 LINDA BONNER DIRECTOR 1.00 X 0 0 0 MIKE CASHION DIRECTOR 1.00 X 0 0 0 DOUGLAS CAUDLE DIRECTOR 1.00 X 0 0 0 REX EVANS DIRECTOR 1.00 X 0 0 0 BETTY HARRIS DIRECTOR 1.00 X 0 0 0 LINDA HYATT DIRECTOR 1.00 X 0 0 0 SHERRIL NORMAN DIRECTOR 1.00 X 0 0 0 WAYNE SOUTHERN DIRECTOR 1.00 X 0 0 0 JAMES SYKES DIRECTOR 1.00 X 0 0 0 DAVID WICKER JR DIRECTOR 1.00 X 0 0 0 ARNOLD GENE COBB DIRECTOR 1.00 X 0 0 0 ROSS GELLER DIRECTOR 1.00 X 0 0 0 JOEY TRANSOU DIRECTOR 1.00 X 0 0 0 BRYANT WEBSTER DIRECTOR 1.00 X 0 0 0 KEVIN COMBS DIRECTOR 1.00 X 0 0 0 GILBERT BAILEY DIRECTOR 1.00 X 0 0 0 DON ALDERMAN DIRECTOR 1.00 X 0 0 0 MARK KOLADA EXECUTIVE DIRECTOR 40.00 X 0 0 0 DIANNE ARMSTRONG HEALTH CENTER ADMINISTRATO 40.00 X 107432 0 17672 LORI YASKEWICZ MARKETING DIRECTOR 40.00 X 107364 0 5412 214796 0 23084 2 0 0 1 HERITAGE HEALTHCARE 536 OLD HOWELL ROAD GREENVILLE SC 29615 THERAPY SERVICES 1057785 LIFE CARE SERVICES LLC 400 LOCUST STREET SUITE 820 DES MOINES IA 50309 MANAGEMENT SERVICES 870532 CHEEK CONSTRUCTION 7020 PAWNEE ROAD GREENSBORO NC 27410 CONSTRUCTION AND REMODELING 235089 BRICKMAN GROUP 3630 SOLUTIONS CENTER CHICAGO IL 60677 LANDSCAPE MAINTENANCE 130303 4 717590 1134657 1852247 RESIDENT SERVICES 623000 16674980 16674980 16674980 174266 174266 1967541 1467282 500259 500259 500259 OTHER INCOME 623000 6929 6929 6929 19208681 16681909 0 674525 993280 993280 6380378 5605737 774641 62496 53000 9496 623938 566872 57066 683905 644969 38936 630513 117275 513238 52813 4435 48378 44929 44929 159944 140074 19870 1491908 1491908 60164 16427 43737 1835490 1835490 1697649 1697649 181099 112 180987 MEDICAL SERVICES 1571885 1571885 VARIOUS SUPPLIES 492276 476227 16049 REPAIRS AND MAINTENANCE 395933 333023 62910 ADMINISTRATIVE EXPENSES 342556 103449 239107 359887 255805 104082 18061043 15907617 2153426 0 4309191 4865288 26778 44685 1421570 1656523 62880 83126 233192 245162 48813577 16051371 33707385 32762206 7270484 8593890 5437264 4913246 1986674 1982553 1829234 1302462 56284652 56449141 1714378 1813753 12255021 12818119 22059157 21475695 3994556 4144411 40023112 40251978 X 7656608 7617187 1733828 2175416 6871104 6404560 16261540 16197163 56284652 56449141 1147638 -1212015 0 X 0 1 X 1 0 X 1697836 966338 914810 1165145 1852247 6596376 1697836 966338 914810 1165145 1852247 6596376 1151190 5445186 321294 299778 119903 139750 174266 1054991 2176 35814 47631 23631 6929 116181 7767548 71950507 0.70100 0.64150 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6871104 -466544 6404560 6958944 -87840 6871104 6624695 334249 6958944 6347632 277063 6624695 6556430 -208798 6347632 1.00000 0 0 55677 55677 45820649 14364520 31456129 2166479 1174636 991843 770772 512215 258557 32762206 ASSETS IN SPLIT INTEREST AGREEMENTS 4913246 F 4913246 REFUNDABLE ADVANCE FEES 3625482 DEPOSITS ON UNOCCUPIED UNITS 88185 RESIDENT TRUST FUNDS 430744 4144411 X 17003386 -1212015 -1212015 18215401 993280 993280 19208681 17067763 0 17067763 993280 993280 18061043 PART X, LINE 2: IT IS THE HOME'S POLICY TO EVALUATE ALL TAX POSITIONS TO IDENTIFY ANY THAT MAY BE CONSIDERED UNCERTAIN. ALL IDENTIFIED MATERIAL TAX POSITIONS ARE ASSESSED AND MEASURED BY A "MORE-LIKELY-THAN-NOT" THRESHOLD TO DETERMINE IF THE TAX POSITION IS UNCERTAIN AND WHAT, IF ANY, THE EFFECT OF THE UNCERTAIN TAX POSITION MAY HAVE ON THE FINANCIAL STATEMENTS. NO MATERIAL UNCERTAIN TAX POSITIONS WERE IDENTIFIED DURING 2015. PART XI, LINE 4B - OTHER ADJUSTMENTS: GRANTS MADE TO RESIDENTS 993,280. PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANTS MADE TO RESIDENTS 993,280. 1 WAIVER OF FEES FOR INDIVIDUALS DUE TO HARDSHIPS. 35 993280 FMV RESIDENTIAL AND HEALTH SERVICES. PART I, LINE 2: THE ORGANIZATION PROVIDES GRANTS FOR RESIDENTS UNABLE TO AFFORD TO PAY FOR THEIR CARE. THE MAJORITY OF THE GRANT RECIPIENTS ALSO RECEIVE MEDICAID BENEFITS. EACH RESIDENT IS REQUIRED TO CONTRIBUTE AS MUCH AS THEY CAN AFFORD TOWARDS THE COST OF THEIR CARE. THE GRANTS ARE PAID DIRECTLY TO THE VENDORS PROVIDING THE CARE, TO ENSURE THE FUNDS ARE USED APPROPRIATELY. X 0 0 0 0 0 0 0 0 0 FORM 990, SCHEDULE J, PART I, LINE 3 MARK KOLADA IS THE EXECUTIVE DIRECTOR OF MASONIC AND EASTERN STAR HOME OF NORTH CAROLINA. HOWEVER, MARK KOLADA IS EMPLOYED BY LIFE CARE SERVICES, LLC. (AN UNRELATED ORGANIZATION). MASONIC AND EASTERN STAR HOME OF NC PAYS LIFE CARE SERVICES, LLC. TO MANAGE OPERATIONS OF THE HOME. MARK KOLADA'S SALARY AND BENEFITS ARE PAID BY LIFE CARE SERVICES, LLC. FOR THE 2015 TAX YEAR, LIFE CARE SERVICES, LLC PAID MARK KOLADA MEDICARE WAGES IN THE AMOUNT OF $155,766. A NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65820YJN7 2011-04-28 26642514 SEE PART VI 0 0 0 A 285000 26642514 1971475 2234840 3874001 532850 12196700 5832648 2012 1 0 0 1 A 0 0 0 0 0 0 0 A 0 0 0 0 1 0 0 0 0 A 0 FORM 990, SCHEDULE K, PART I, COLUMN F THE BONDS WERE ISSUED TO PAY FOR CONSTRUCTION OF AN EXPANSION TO THE HOMES' EXISTING FACILITY, REFUNDING CERTAIN INDEBTEDNESS INCURRED TO FINANCE A PORTION OF THE EXPANSION, FUNDING A DEBT SERVICE RESERVE FUND AND PAYING CERTAIN EXPENSES INCURRED IN CONNECTION WITH THE ISSUANCE OF THE BONDS. FORM 990, PART VI, SECTION A, LINE 3 THE BOARD OF DIRECTORS HAS CONTRACTED WITH LIFE CARE SERVICES, LLC. TO MANAGE, OPERATE AND MAINTAIN THE RETIREMENT COMMUNITY. THE EXECUTIVE DIRECTOR, MARK KOLADA, IS AN EMPLOYEE OF LIFE CARE SERVICES, LLC. FORM 990, PART VI, SECTION A, LINE 7A THE GRAND MASTER APPOINTS THREE BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 11 THE BOARD OF DIRECTORS WILL REVIEW THE FORM 990 AS IT IS PRESENTED BY LIFE CARE SERVICES, LLC. THE BOARD OF DIRECTORS WILL ASK ANY PERTINENT QUESTIONS AT THAT TIME. FORM 990, PART VI, SECTION B, LINE 12C ANNUAL MONITORING OF CONFLICT OF INTEREST IS PART OF THE DUTIES OF THE CORPORATE COMPLIANCE COMMITTEE. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR CEO, CURRENT OFFICERS, ETC. IS REVIEWED AS A PART OF ANNUAL BUDGET BY THE BOARD OF DIRECTORS, FINANCE COMMITTEE AND PERSONNEL COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND POLICIES ARE AVAILABLE UPON REQUEST. THE AUDITED FINANCIALS ARE INCLUDED IN ANNUAL DISCLOSURE AS REQUIRED BY DEPARTMENT OF INSURANCE. GRAND LODGE OF THE AF AND AM OF NC PO BOX 6506 RALEIGH NC 27628 560228750 PROVIDE SUPPORT FOR NC MASONS NC 501(C)(10) 0 GRAND CHAPTER OF THE ORDER OF THE EASTERN STAR OF NC PO BOX 4730 WILMINGTON NC 28406 560239941 CHARITABLE, EDUCATIONAL AND FRATERNAL NC 501(C)(8) 0 NC MASONIC FOUNDATION INC PO BOX 6506 RALEIGH NC 27628 566049500 RECEIVE DONATIONS AND DISTRIBUTE ALL INCOME TO CHARITABLE ORGANIZATIONS NC 501(C)(3) LINE 11B, II 0 NC EASTERN STAR FOUNDATION INC PO BOX 2296 GARNER NC 27529 561974972 INVEST FUNDS RAISED TO PROVIDE PERPETUAL FUND TO EASTERN STAR HOME NC 501(C)(3) PF 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 GRAND CHAPTER OF ORDER OF THE EASTERN STAR OF NORTH CAROLINA C 263450 NORTH CAROLINA MASONIC AND EASTERN STAR HOME FOUNDATION LLC C 339770