2016-03-30T13:54:54-05:00 2015-12-31 410746749 CLIFTONLARSONALLEN LLP 227 WEST TRADE STREET SUITE 800 CHARLOTTE NC 28202 990 2015-01-01 237271041 THE CHAPEL HILL RESIDENTIAL RETIREMENT CENTER INC CHAP 9199684511 750 WEAVER DAIRY ROAD CHAPEL HILL NC 27514 PATRICIA E SPRIGG PRESIDENT/CEO 9199684511 2016-03-23 1 JOHN NORMAN P01506766 7049985200 2016-03-23 2015 2016-09-27 15:27:22Z CAROL WOODS RETIREMENT COMMUNITY PATRICIA E SPRIGG 750 WEAVER DAIRY ROAD CHAPEL HILL NC 27514 50357881 0 X WWW.CAROLWOODS.ORG X 1972 NC OPERATION OF A CCRC PROVIDING HOUSING, HEALTHCARE, AND OTHER SERVICES TO SENIORS. 19 16 431 50 0 0 489367 152835 23321596 25097344 4830888 5122227 451068 78644 29092919 30451050 684623 761711 0 0 12691501 13473093 0 0 0 11895688 13306197 25271812 27541001 3821107 2910049 115849324 113875968 97659859 97803620 18189465 16072348 X CAROL WOODS SHALL BE A CHARITABLE, NOT-FOR-PROFIT CORPORATION MEETING THE NEEDS OF OLDER ADULTS FOR HOUSING, HEALTH, WELL-BEING, AND PROTECTION OF FINANCIAL SECURITY. THE MISSION OF CAROL WOODS SHALL BE TO PROVIDE A SAFE, HEALTHFUL, AND SECURE ENVIRONMENT FOR PERSONS THROUGHOUT THEIR LATER YEARS, AS WELL AS ENGAGE IN COOPERATIVE RESEARCH, DEVELOPMENT AND EDUCATION IN AREAS ENCOMPASSED BY THE MISSION. HIGH QUALITY RESIDENTIAL LIVING AND HEALTH SERVICES SHALL BE PROVIDED ACCORDING TO INDIVDUAL NEEDS. RESIDENTS' ON-GOING NEEDS TO MAINTAIN AND PROMOTE HEALTH AND WELL-BEING SHALL BE SUPPORTED THROUGH THE PROVISION OF APPROPRIATE RESOURCES. CAROL WOODS SHALL ENCOURAGE DIVERSITY, RESIDENTS' LEADERSHIP, PARTICIPATION IN AND SERVICE TO CAROL WOODS AND THE LARGER COMMUNITY. CAROL WOODS SHALL ALSO FOSTER A HIGH QUALITY WORK EXPERIENCE FOR STAFF AND FACILITATE STAFF DEVELOPMENT THAT EMBODIES THE VALUES OF THE ORGANIZATION. 0 0 22884884 761711 25097344 PROVIDED HOUSING, HEALTHCARE AND OTHER RELATED SERVICES TO SENIOR RESIDENTS THROUGH OPERATION OF A CONTINUING CARE RETIREMENT COMMUNITY (CCRC) CONTAINING 312 INDEPENDENT LIVING APARTMENTS / COTTAGES, 59 ASSISTED LIVING ACCOMMODATIONS, AND A 60-BED HEALTH CENTER. SERVED AN AVERAGE OF 487 SENIORS UNDER LIFE CARE ARRANGEMENTS, INCLUDING AN AVERAGE OF 84 LIVING PERMANENTLY IN ASSISTED LIVING AND THE HEALTH CENTER. OFFER A CCRC WITHOUT LODGING PROGRAM APPROVED BY THE NC DEPARTMENT OF INSURANCE. SERVED AN AVERAGE OF 81 IN THE PROGRAM OVER THE COURSE OF THE YEAR. CONTINUED PROACTIVE AND INTENTIONAL CHARITABLE CARE AND COMMUNITY BENEFIT PROGRAM, INCLUDING: 1) PROVIDED $306,850 IN FINANCIAL ASSISTANCE TO RESIDENTS IN NEED; 2) MADE CHARITABLE GIFTS TO ORANGE COUNTY ($200,000), TOWN OF CHAPEL HILL ($75,000), AND THE LOCAL PUBLIC SCHOOLS ($30,000) TO SUPPORT VITAL SERVICES TO SENIORS IN THE COMMUNITY; AND 3) MADE $168,780 IN CHARITABLE GIFTS TO OTHER LOCAL NON-PROFIT ORGANIZATIONS PURSUING MISSIONS SIMILAR TO CAROL WOODS. CONTINUED TO PROVIDE IN-KIND BENEFITS TO THE OUTSIDE COMMUNITY, INCLUDING: 1) MAKING AVAILABLE CAROL WOODS' CAMPUS AND STAFF FOR A VARIETY OF EDUCATIONAL AND COMMUNITY SUPPORT PURPOSES -- PROVIDING INTERNSHIPS AND OTHER OPPORTUNITIES FOR STUDENTS TO LEARN OF AGING SERVICES OPPORTUNITIES IN DISCIPLINES RANGING FROM MEDICAL AND NURSE PRACTITIONER, TO NURSING, SOCIAL WORK AND CERTIFIED NURSING ASSISTANTS; 2) DONATED FOOD TO THE LOCAL HOMELESS SHELTER AND TO AN AIDS HOUSE, AND BUILDING MATERIALS TO THE HABITAT RESTORE. 22884884 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 28 0 1 431 1 0 0 0 0 0 0 0 0 0 0 X 19 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X KENNETH REEB CFO 9199684511 750 WEAVER DAIRY ROAD CHAPEL HILL NC 27514 CHRIS BARNES TREASURER 1.00 X 0 0 0 MARY BECK FORMER BOARD MEMBER 1.00 X 0 0 0 ROB BRUCE BOARD MEMBER 1.00 X 0 0 0 EVA CLONTZ RESIDENT, EX OFFICIO BOARD MEMBER 1.00 X 0 0 0 ROBERT DUNHAM BOARD MEMBER 1.00 X 0 0 0 STEPHEN ELKINS-WILLIAMS CHAIR 1.00 X 0 0 0 JACK EVANS BOARD MEMBER 1.00 X 0 0 0 TOM HABER BOARD MEMBER 1.00 X 0 0 0 BRENDA JAMERSON BOARD MEMBER 1.00 X 0 0 0 BARBARA JESSIE-BLACK VICE CHAIR 1.00 X 0 0 0 STEVE LACKEY SECRETARY 1.00 X 0 0 0 LARRY MCMANUS BOARD MEMBER 1.00 X 0 0 0 DINA MILLS BOARD MEMBER 1.00 X 0 0 0 PATTIE MOORE-BOYETTE BOARD MEMBER 1.00 X 0 0 0 MARLENE RIFKIN BOARD MEMBER 1.00 X 0 0 0 KELLY ROSS BOARD MEMBER 1.00 X 0 0 0 SANDRA VENEGONI RESIDENT, VOTING BOARD MEMBER 1.00 X 0 0 0 GORDON WHITAKER RESIDENT, EX OFFICIO BOARD MEMBER 1.00 X 0 0 0 HENRY WOODWARD RESIDENT, VOTING BOARD MEMBER 1.00 X 0 0 0 PATRICIA E SPRIGG PRESIDENT & CEO 40.00 X 790021 0 21448 KENNETH G REEB JR VP OF FINANCE / CFO 40.00 X 161804 0 33694 DAVID L WILKERSON VP OF OPERATIONS 40.00 X 168809 0 15589 AMY ALEXANDER DIRECTOR OF NURSING 40.00 X 101653 0 11522 1222287 0 82253 4 0 1 0 ROSCO'S REMODELING 3301 CLANDON PARK DRIVE RALEIGH NC 27613 CARPENTRY, GENERAL BUILDING REPAIRS 547440 KOESTER BUILDERS 7314 RAMBLEWOOD DR HILLSBOROUGH NC 27278 CARPENTRY, GENERAL BUILDING REPAIRS 499584 TRIANGLE ELECTRICAL SVCS 12085 US HWY 15-501 N CHAPEL HILL NC 27517 LICENSED ELECTRICAL WORK 321061 WELLSMONT LANDSCAPING 1005 DIMMOCKS MILL RD HILLSBOROUGH NC 27278 LANDSCAPING, DRAINAGE / IRRIGATION 244294 JD PLUMBING 4416 BENNETT MEMORIAL ROAD DURHAM NC 27705 LICENSED PLUMBING 237221 13 120901 31934 152835 RESIDENT CHARGES 623000 21105471 21105471 HEALTH CENTER 623000 3476479 3476479 MISC REVENUE 900099 297073 297073 GUEST MEALS AND LODGING 900099 153721 153721 APT OPTIONS 900099 34000 34000 30600 30600 25097344 1761042 1761042 78644 0 78644 78644 78644 23268016 19630433 276398 3637583 -276398 3361185 3361185 30451050 25097344 0 5200871 442500 442500 319211 319211 1120634 1120634 9753719 8450474 1303245 360046 277235 82811 1477072 1137345 339727 761622 586449 175173 14229 14229 95164 95164 441684 441684 857789 850906 6883 135213 135213 1961533 1543266 418267 35674 35674 2235098 2091100 143998 69628 41110 28518 318 318 1995540 1995540 3130517 3130517 189262 189262 MISC EXPENSES 2019231 2019231 BAD DEBT EXPENSE 90000 90000 RECRUITMENT 17759 17759 BOND ADMIN FEE 17558 17558 27541001 22884884 4656117 0 271467 176186 3616484 2833299 1577832 1752706 201253 212004 115765 166886 90524979 36715865 54428616 53809114 54964845 54292202 673062 633571 115849324 113875968 2708418 2526789 39893358 41389814 47487670 45850000 779363 7570413 7257654 97659859 97803620 X 17383840 15848542 805625 223806 18189465 16072348 115849324 113875968 X 2910049 -4156273 -25000 -845893 X 0 1 X 1 0 X 360235 627953 433400 318650 232835 1973073 20029361 20575694 21077150 25415595 25097344 112195144 20389596 21203647 21510550 25734245 25330179 114168217 505956 533448 483759 604153 697112 2824428 0 505956 533448 483759 604153 697112 2824428 111343789 1207705 1455508 1574423 1954015 1761042 7952693 1207705 1455508 1574423 1954015 1761042 7952693 365670 368883 351690 416824 1503067 21962971 23028038 23436663 28105084 27091221 123623977 0.90070 0.89780 0.06430 0.06510 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 833077 833077 77629073 32206562 45422511 6617267 2629772 3987495 5445562 1879531 3566031 53809114 LT DEBT INTEREST SWAP 7257654 7257654 X PART X, LINE 2: THE FOLLOWING IS THE FOOTNOTE FROM THE CONSOLIDATED FINANCIAL STATEMENTS FOR CAROL WOODS AND THE CHARITABLE FUND: CAROL WOODS AND THE CHARITABLE FUND ARE NOT-FOR-PROFIT ORGANIZATIONS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). CAROL WOODS AND THE CHARITABLE FUND FILE AS TAX-EXEMPT ORGANIZATIONS. MANAGEMENT IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE THE TAX-EXEMPT STATUS OF CAROL WOODS OR THE CHARITABLE FUND. MANAGEMENT IS NOT AWARE OF ANY SIGNIFICANT ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES FOR CAROL WOODS OR THE CHARITABLE FUND. 1 ORANGE COUNTY 200 SOUTH CAMERON STREET HILLSBOROUGH NC 27278 566000327 GOV'T 200000 GENERAL SUPPORT, SENIOR SERVICES TOWN OF CHAPEL HILL 405 MARTIN LUTHER KING BLVD CHAPEL HILL NC 27514 566001199 GOV'T 75000 GENERAL SUPPORT, SENIOR SERVICES CHAPEL HILL CARRBORO SCHOOLS 750 S MERRITT MILL ROAD CHAPEL HILL NC 27516 566001004 501(C)(3) 30000 PROMOTE CAREERS IN AGING SERVICES PIEDMONT HEALTH SERVICES 299 LLOYD STREET CARRBORO NC 27510 560952737 501(C)(3) 50000 VEHICLE TO TRANSPORT PARTICIPANTS OF PACE (PROGRAM FOR ALL INCLUSIVE CARE FOR THE ELDERLY). MEDICAL FOUNDATION OF NC 880 MARTIN LUTHER KING BLVD CHAPEL HILL NC 27514 566057494 501(C)(3) 20000 SUPPORT FOR NEW HOSPICE FACILITY CAROLINA VILLAGES PO BOX 878 CHAPEL HILL NC 27514 611618436 501(C)(3) 15000 SUPPORT START UP OF NEW COMMUNITY SERVICE GUIDING LIGHTS 3724 NATIONAL DRIVE SUITE 130 RALEIGH NC 27612 800555761 501(C)(3) 15000 SUPPORT TRAINING OF CNA'S & CAREGIVERS TRIANGLE J COUNCIL OF GOVERNMENTS AREA AGENCY ON AGING 4307 EMPEROR BLVD SUITE 110 DURHAM NC 27703 561017435 GOV'T 7500 COMMUNITY LIVABILITY ASSESSMENT PROJECT & COMMUNITY RESOURCE CENTER GLOBAL AGING GENERAL FUND UNC CHAPEL HILL PUBLIC HEALTH FOUNDATION INC PO BOX 899 CHAPEL HILL NC 275140899 561717285 501(C)(3) 5000 SUPPORT FOR TECHNOLOGY FOR AGING PROGRAM CHARLES HOUSE 7511 SUNRISE ROAD CHAPEL HILL NC 27514 581582881 501(C)(3) 25000 LEASE FOR ADULT DAY PROGRAM SET BELOW MARKET TO KEEP COSTS LOWER FOR SENIOR PARTICIPANTS 10 0 ASSISTANCE TO RESIDENTS WHOSE ASSETS HAVE BEEN DEPLETED 9 306850 TUITION ASSISTANCE FOR ELIGIBLE FT EMPLOYEES 13 12361 PART I, LINE 2: FOR ENTITIES WITHIN THE US, EACH GRANT RECIPIENT IS ASKED TO PROVIDE AN ANNUAL REPORT ON THE USE OF THE FUNDS THAT HAD BEEN DONATED BY CAROL WOODS. EACH YEAR GRANT RECIPIENTS ARE INVITED TO A MEETING OF THE CAROL WOODS RESIDENT ASSOCIATION WHERE THEY ARE ASKED TO REPORT BRIEFLY ON THE OUTCOMES FROM THE FUNDS THAT WERE GRANTED. TWO GROUPS OF INDIVIDUALS MAY RECEIVE FINANCIAL SUPPORT FROM CAROL WOODS. FIRST, CAROL WOODS PROVIDES FINANCIAL ASSISTANCE TO RESIDENTS WHO ARE UNDER CONTRACT SHOULD THEY OUTLIVE THEIR ASSETS. IF ASSETS ARE DEPLETED TO A DEFINED LEVEL, CAROL WOODS WILL PROVIDE A MONTHLY CREDIT TO THEIR STATEMENT IN AN AMOUNT INTENDED TO STOP FURTHER DETERIORATION OF ASSETS. SECOND, CAROL WOODS OFFERS A TUITION ASSISTANCE PROGRAM THROUGH IS HUMAN RESOURCES DEPARTMENT FOR FULL TIME EMPLOYEES WHO ARE TAKING COURSES IN AN ACCREDITED SCHOOL TOWARD A DEGREE OR CERTIFICATE RELATED TO CAROL WOODS' MISSION. X X X X X 0 1 0 0 0 0 0 0 0 PATRICIA E SPRIGG PRESIDENT & CEO 293695 0 59243 0 437083 0 10800 0 10648 0 811469 0 437083 0 KENNETH G REEB JR VP OF FINANCE / CFO 161804 0 0 0 0 0 26112 0 7582 0 195498 0 0 0 DAVID L WILKERSON VP OF OPERATIONS 168809 0 0 0 0 0 6834 0 8755 0 184398 0 0 0 PART I, LINE 4B PATRICIA E. SPRIGG - PAYMENT OF DEFERRED COMP UPON ATTAINING AGE 62. CURRENT AMOUNT IS $437,083. DEFERRED COMP PLAN SET UP BY THE BOARD IN 2003 TO RETAIN CEO UNTIL AT LEAST THE AGE OF 62. KENNETH G. REEB, JR. - ORGANIZATION ACCRUED ADDITIONAL DEFERRED COMP AND INTEREST. CURRENT AMOUNT IS $19,119. EMPLOYEE HAS NOT YET ATTAINED THE AGE OF 62, AT WHICH TIME THE DEFERRED COMPENSATION WILL BE PAID. A NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 2010-10-22 30000000 REFINANCING, ADDITIONAL CONSTRUCTION 0 0 0 B NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 2012-07-18 22000000 CAPITAL ACQUISITION, CONSTRUCTION 0 0 0 A 4390000 30000882 266032 4717553 25017297 2012 1 0 1 1 B 1760000 22000000 315478 21684522 2015 0 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 0 0 1 1 1 DEUTSCHE BANK 20.583333300000 0 0 0 0 1 B 0 1 0 0 1 1 1271 COUNTERPARTY LLC 20.583333300000 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: 01/22/2015 FORM 990, PART VI, SECTION A, LINE 1 TWO RESIDENTS SERVE AS EX OFFICIO WITHOUT VOTING RIGHTS. TWO OTHER RESIDENTS SERVE AS VOTINIG MEMBERS. PRESIDENT & CEO SERVES AS EX OFFICIO WITH NO VOTING RIGHTS. THE CORPORATION HAS AN EXECUTIVE COMMITTEE OF THE BOARD COMPRISED ENTIRELY OF MEMBERS OF THE GOVERNING BOARD. IN THE MONTHS THAT THE FULL BOARD DOES NOT MEET, THE EXECUTIVE COMMITTEE OF THE BOARD MEETS. THE SCOPE OF THE EXECUTIVE COMMITTEE IS ALMOST AS BROAD AS THE FULL BOARD, BUT FOR MOST SIGNFICANT ACTIONS, SUCH AS RESOLUTIONS TO INCUR ADDITIONAL DEBT, ADOPTION OF THE ANNUAL BUDGET, ETC. THESE ACTIONS ARE GENERALLY DONE WITH THE FULL BOARD. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION HAS A POLICY THAT STATES THAT PAPER AND/OR ELECTRONIC COPIES OF FORM 990 WILL BE PROVIDED TO EACH MEMBER OF THE BOARD OF DIRECTORS PRIOR TO ITS FILING WITH THE IRS. THE FORM 990 WAS PROVIDED TO BOARD MEMBERS FOR THEIR PERSONAL REVIEW. THE FORM 990 WAS FORMALLY ACCEPTED BY THE BOARD OF DIRECTORS AT A SUBSEQUENT BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY 1)DISCUSSING THE POLICY INITIALLY WITH BOARD OF DIRECTORS CANDIDATES PRIOR TO BEING NOMINATED TO THE BOARD, 2)REVIEWING THE POLICY ANNUALLY WITH EACH BOARD MEMBER, 3)ASKING EACH BOARD MEMBER TO ANNUALLY SIGN A STATEMENT INDICATING THAT HE OR SHE HAS READ AND UNDERSTANDS THE POLICY, AND 4)ASKING EACH BOARD MEMBER TO ALSO DISCLOSE IN WRITING ANY ORGANIZATIONAL RELATIONSHIP OR OTHER ACTIVITY OR INTEREST THAT MIGHT POSSIBLY CONSTITUTE A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 ANNUALLY, THE EXECUTIVE COMMITIEE OF THE ORGANIZATION WILL REVIEW THE OFFICERS (PRESIDENT/CEO, VP OF FINANCE/CFO, AND VP OF OPERATIONS) AS WELL AS KEY DEPARTMENT DIRECTOR POSITIONS. THIS IS DOCUMENTED IN THE ORGANIZATION'S MINUTES EVERY THREE TO FOUR YEARS. THE EXECUTIVE COMMITTEE OF THE ORGANIZATION'S BOARD RETAINS AN OUTSIDE CONSULTING FIRM TO ASSESS THE SALARIES OF ITS CORPORATE OFFICERS AS WELL AS KEY DEPARTMENT DIRECTOR POSITIONS. A REPORT IS PREPARED AND PRESENTED TO THE EXECUTIVE COMMITTEE FOR REVIEW. THIS INDEPENDENT, EXTERNAL PROCESS WAS LAST COMPLETED IN 2013. FORM 990, PART VI, SECTION C, LINE 19 1)ARTICLES OF INCORPORATION ARE AVAILABLE ON THE WEBSITE OF THE NC SECRETARY OF STATE, 2)BYLAWS ARE AVAILABLE FOR INSPECTION UPON REQUEST, 3)ANNUAL DISCLOSURE STATEMENT IS AVAILABLE ONLINE THROUGH THE NC DEPT OF INSURANCE AND INCLUDES, IN APPENDICES, COPIES OF THE DOI CCRC LICENSE, DHSR NURSING FACILITY LICENSE, ANNUAL AUDITED FINANCIAL STATEMENTS, 5-YEAR FINANCIAL PROJECTIONS, CONFLICT OF INTEREST POLICY, CCRC CONTRACT, AND OTHER CORPORATE INFORMATION, 4)CORPORATE CODE OF CONDUCT AND PRIVACY POLICY ARE AVAILABLE VIA CAROL WOODS' WEBSITE. WEBSITE AND DISCLOSURE STATEMENTS ALSO PROVIDE CURRENT LISTING OF BOARD OF DIRECTORS. FORM 990, PART XI, LINE 9: OTTI LOSS -925,866. OTHER -27. NET ASSETS RELEASED FROM RESTRICTIONS 80,000. THE CAROL WOODS CHARITABLE FUND INC 750 WEAVER DAIRY ROAD CHAPEL HILL NC 27514 204262143 SUPPORTING ORGANIZATION NC 501(C)(3) LINE 11A, I THE CHAPEL HILL RESIDENTIAL RETIREMENT CENTER INC 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 THE CAROL WOODS CHARITABLE FUND INC C 120182