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FRIENDS HOMES INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
FRIENDS HOMES INC (EIN 56-0754599)
Tax period
2012-10-01 to 2013-09-30
Filed
2013-12-09
IRS object ID
201323439349300602
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-12-09T08:29:19-06:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN560817345EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Turlington and Company LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO Box 1697AddressLine1
CityLexingtonCity
StateNCState
ZIP Code272931697ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN560754599EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Friends Homes IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlFRIENameControl
Phone3362928187Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1925 New Garden RoadAddressLine1
CityGreensboroCity
StateNCState
ZIP Code27410ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameWilson SheldonName
TitleChief Executive OfficerTitle
Phone3362928187Phone
Date Signed2013-11-20DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameMarcia W HenriksenName
PTINP01259831PTIN
Phone3362496856Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonWilson SheldonNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1925 New Garden RoadAddressLine1
CityGreensboroCity
StateNCState
ZIP Code27410ZIPCode
FieldValueIRS element (for citing)
Gross Receipts31898092GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitefriendshomes.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1958YearFormation
State Legal DomicileNCStateLegalDomicile
Activity Or Mission DescriptionTo establish and operate continuing care retirement communities in accordance with the principles of the Religious Society of Friends. These principles require that our communities provide, at a reasonable cost, an environment which fosters independence and a sense of wholeness, health, and security so that each resident may realize his or her full potential. In doing so we facilitate the basic Quaker principle that "there is God in every person," meaning that everyone has worth and value. Through continuous improvement and expansion, the organization will provide affordable services to the aged and support to the community at large. We accept the responsibility to promote consistent quality care while providing a home for our residents.ActivityOrMissionDescription
Nbr Voting Members Governing Body26NbrVotingMembersGoverningBody
Nbr Independent Voting Members26NbrIndependentVotingMembers
Total Nbr Employees521TotalNbrEmployees
Total Nbr Volunteers75TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1332243ContributionsGrantsPriorYear
Contributions Grants Current Year960047ContributionsGrantsCurrentYear
Program Service Revenue Prior Year23664598ProgramServiceRevenuePriorYear
Program Service Revenue CY23510093ProgramServiceRevenueCY
Investment Income Prior Year-334761InvestmentIncomePriorYear
Investment Income Current Year21242InvestmentIncomeCurrentYear
Other Revenue Prior Year-32480OtherRevenuePriorYear
Other Revenue Current Year7OtherRevenueCurrentYear
Total Revenue Prior Year24629600TotalRevenuePriorYear
Total Revenue Current Year24491389TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year12202078SalariesEtcPriorYear
Salaries Etc Current Year12449470SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year13032628OtherExpensePriorYear
Other Expenses Current Year11900917OtherExpensesCurrentYear
Total Expenses Prior Year25234706TotalExpensesPriorYear
Total Expenses Current Year24350387TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-605106RevenuesLessExpensesPriorYear
Revenues Less Expenses CY141002RevenuesLessExpensesCY
Total Assets BOY78779581TotalAssetsBOY
Total Assets EOY81478749TotalAssetsEOY
Total Liabilities BOY51987346TotalLiabilitiesBOY
Total Liabilities EOY50727177TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY26792235NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY30751572NetAssetsOrFundBalancesEOY
Mission DescriptionTo provide nursing and residential care and other support services to the elderly.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense21838850Expense
Revenue23510100Revenue
DescriptionThere are 10 cottages, 358 apartments, 100 assisted care beds and 109 nursing beds.Description
Total Program Service Expense21838850TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096117NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees521NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members26NbrVotingGoverningBodyMembers
Number Independent Voting Members26NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Wilson SheldonBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3362928187TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1925 New Garden RoadAddressLine1
CityGreensboroCity
StateNCState
ZIP Code27410ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (27 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployee
Jack Kirk
Board Member0.00X000
Dick Coe
Secretary0.00X000X
Ed Harris
Board Member0.00X000
Mary Farlow
Board Member0.00X000
Dale Brent McKinney
Board Member0.00X000
Bill Davis
Board Member0.00X000
Beth Joyce
Board Member0.00X000
David Millikan
Board Member0.00X000
Janie Edgerton
Board Member0.00X000
Dossie Davis
Board Member0.00X000
Tony Lowe
Board Member0.00X000
Patrick Tillman
Board Member0.00X000
Scott Wagoner
Board Member0.00X000
Carl Semmler
Vice-chairman0.00X000X
Gwen Taylor
Board Member0.00X000
Mark Farlow
Board Member0.00X000
Deets McCullen
Board Member0.00X000
Patrick Miller
Board Member0.00X000
Janet Robbins
Board Member0.00X000
Dan Allen
Treasurer0.00X000X
Martha Mattocks
Board Member0.00X000
Jennifer Ross
Board Member0.00X000
Sara Beth Terrell
Board Member0.00X000
Jon Mitchell
Board Member0.00X000
Tom Wright
Chair0.00X000X
William Stevens Jr
Board Member0.00X000
Wilson Sheldon Jr
CEO40.0017595900X
FieldValueIRS element (for citing)
Total Reportable Comp From Org175959TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
All Other Contributions960047AllOtherContributions
Total Contributions960047TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionResident servicesDescription
Business Code623000BusinessCode
Total Revenue Column23510093TotalRevenueColumn
Related Or Exempt Function Income23510093RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue23510093TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column537298TotalRevenueColumn
Exclusion$537,298ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities6886630Securities
Other4017Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities7405596Securities
Other1107Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-518966Securities
Other2910Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-516056TotalRevenueColumn
Exclusion-$516,056ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionChange in value of split interestDescription
Business Code623000BusinessCode
Total Revenue Column7TotalRevenueColumn
Related Or Exempt Function Income7RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue7TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column24491389TotalRevenueColumn
Related Or Exempt Function Income23510100RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$21,242ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total11319735Total
Program Services9974844ProgramServices
Management And General1344891ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total284180Total
Program Services223728ProgramServices
Management And General60452ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total845555Total
Program Services749532ProgramServices
Management And General96023ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total6188Total
Management And General6188ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total68924Total
Management And General68924ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total97204Total
Program Services97204ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total61769Total
Program Services45597ProgramServices
Management And General16172ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total710747Total
Program Services625457ProgramServices
Management And General85290ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1998666Total
Program Services1898733ProgramServices
Management And General99933ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Insurance22380961883286354810
Dietary18866061886606
Utilities1087152104203345119
Repairs & maintenance1042878101776525113

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2702687Total
Program Services2394065ProgramServices
Management And General308622ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total24350387Total
Program Services21838850ProgramServices
Management And General2511537ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY8306022BOY
EOY5786765EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY171510EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1792179BOY
EOY1686351EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY200943BOY
EOY213015EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY284173BOY
EOY102024EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis79365695LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec31279078LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY49209741BOY
EOY48086617EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY18654453BOY
EOY24806612EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY332070BOY
EOY625855EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY78779581BOY
EOY81478749EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2111510BOY
EOY2098450EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY11264558BOY
EOY11379334EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY36665000BOY
EOY35525000EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1697000BOY
EOY1614500EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY249278BOY
EOY109893EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY51987346BOY
EOY50727177EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY26050135BOY
EOY29939929EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY677100BOY
EOY746643EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY65000BOY
EOY65000EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY26792235BOY
EOY30751572EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY78779581BOY
EOY81478749EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses141002ReconcilationRevenueExpenses
Reconciliation Unrealized Invest3248176ReconciliationUnrealizedInvest
Reconcilation Other Changes570159ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years196638CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years184218CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years426574CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1332243CurrentTaxYearMinus1Year
Current Tax Year960047CurrentTaxYear
Total3099720Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years22523520CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years22601926CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years23478229CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year23664598CurrentTaxYearMinus1Year
Current Tax Year23510093CurrentTaxYear
Total115778366Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years22720158CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years22786144CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years23904803CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year24996841CurrentTaxYearMinus1Year
Current Tax Year24470140CurrentTaxYear
Total118878086Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total509118878086PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years536830CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years386167CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years475544CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year472990CurrentTaxYearMinus1Year
Current Tax Year537298CurrentTaxYear
Total2408829Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years536830CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years386167CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years475544CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year472990CurrentTaxYearMinus1Year
Current Tax Year537298CurrentTaxYear
Total2408829Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years23256988CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years23172311CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years24380347CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year25469831CurrentTaxYearMinus1Year
Current Tax Year25007438CurrentTaxYear
Total121286915Total
FieldValueIRS element (for citing)
Public Support Percentage5090.98010PublicSupportPercentage509
Prior Year Support Percentage0.97550PriorYearSupportPercentage
Investment Income Percentage0.01990InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.02450PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis5179990OtherCostOrOtherBasis
Book Value5179990BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis62227655OtherCostOrOtherBasis
Depreciation25188706Depreciation
Book Value37038949BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis6754199OtherCostOrOtherBasis
Depreciation1967316Depreciation
Book Value4786883BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis5203851OtherCostOrOtherBasis
Depreciation4123056Depreciation
Book Value1080795BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings48086617TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Occupancy deposits$49,600
Prepaid rent$60,293
FieldValueIRS element (for citing)
Total Of Amounts109893TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt28309724TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments3248176NetUnrealizedGainsInvestments
Other Revenues570159OtherRevenues
Revenue Not Rptd F9903818335RevenueNotRptdF990
Revenue Subtotal24491389RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99024491389TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt24350387TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal24350387ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99024350387TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Description of Uncertain Tax Positions Under FIN 48:Part X, Line 2:The Organization has determined that it has no uncertain income tax positions as of September 30, 2013 and 2012. Also, the Organization does not anticipate any increase or decrease in unrecognized tax benefits during the next twelve months that would result in a material change in its financial position. The Organization's income tax returns for years ended after September 30, 2010 remain open for examination.
Part XI, Line 2d - Other Adjustments:Unrealized gain on interest rate swap 570,159.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Housing Allowance Or ResidenceXHousingAllowanceOrResidence
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonWilson Sheldon JrNamePerson
TitleCEOTitle
Base Compensation Filing Org175959BaseCompensationFilingOrg
Comp Based On Related Orgs0CompBasedOnRelatedOrgs
Bonus Filing Org0BonusFilingOrg
Bonus Related Orgs0BonusRelatedOrgs
Other Compensation Filing Org0OtherCompensationFilingOrg
Other Compensation Related Orgs0OtherCompensationRelatedOrgs
Deferred Comp Filing Org0DeferredCompFilingOrg
Deferred Comp Related Orgs0DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org0NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs0NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org175959TotalCompensationFilingOrg
Total Compensation Related Orgs0TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org0CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs0CompReportPrior990RelatedOrgs

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1North Carolina Medical Care CommissionBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN521309402IssuerEIN
CUSIP Number657902M41CUSIPNumber
Date Issued2011-11-01DateIssued
Issue Price37745000IssuePrice
Description Of PurposeRefunding prior bond issue dated 10/16/03DescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Amount Retired2220000AmountRetired
Total Proceeds37745000TotalProceeds
Current Refunding1CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Bond Iss Meet Prvt Security Pay Test0BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop0ChangeInUseBondFinancedProp
Non Qualified Bond Remed Procdrs0NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiled
Rebate Not Due Yet0RebateNotDueYet
Exception To Rebate0ExceptionToRebate
No Rebate Due0NoRebateDue
Variable Rate Issue1VariableRateIssue
Hedge Identified In Books And Recds1HedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

FieldValueIRS element (for citing)
Business Name Line1Branch Bank & TrustBusinessNameLine1
FieldValueIRS element (for citing)
Term Of Hedge7.000000000000TermOfHedge
Superintegrated Hedge0SuperintegratedHedge
Hedge Terminated0HedgeTerminated
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Written Proc To Monitor Reqs0WrittenProcToMonitorReqs

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
Identifier(3C) Term of HedgeIdentifier
ExplanationEntered into two (2) year forward swap on September 27, 2012 effective September 1, 2014, for a seven (7) year term, ending November 1, 2021.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section B, line 11The 990 is reviewed by the Chief Executive Officer, the Controller and Chairman of the board.
Form 990, Part VI, Section B, line 12cThe policy is signed each time a member joins the board. The organization relies on the integrity of the board members to monitor their independence.
Form 990, Part VI, Section B, line 15aThe CEO's compensation is set by the compensation committee of the board who are independent.
Form 990, Part VI, Section C, line 19The Organization is regulated by the Insurance Commission and the financial statements are part of the Disclosure required by them.
Form 990, Part IX, line 24eContract Medical Services: Program service expenses 698,298. Management and general expenses 0. Fundraising expenses 0. Total expenses 698,298. Prescription drugs, etc.: Program service expenses 454,914. Management and general expenses 0. Fundraising expenses 0. Total expenses 454,914. Supplies: Program service expenses 450,305. Management and general expenses 0. Fundraising expenses 0. Total expenses 450,305. Miscellaneous: Program service expenses 270,262. Management and general expenses 155,278. Fundraising expenses 0. Total expenses 425,540. Charitable care: Program service expenses 378,268. Management and general expenses 0. Fundraising expenses 0. Total expenses 378,268. Office expenses: Program service expenses 50,054. Management and general expenses 129,476. Fundraising expenses 0. Total expenses 179,530. Property Taxes: Program service expenses 38,013. Management and general expenses 0. Fundraising expenses 0. Total expenses 38,013. Telephone: Program service expenses 28,969. Management and general expenses 2,935. Fundraising expenses 0. Total expenses 31,904. Amortization of bond issue costs: Program service expenses 23,243. Management and general expenses 0. Fundraising expenses 0. Total expenses 23,243. Dues and Subscriptions: Program service expenses 1,739. Management and general expenses 20,933. Fundraising expenses 0. Total expenses 22,672.All Other Functional Expenses
Form 990, Part XI, line 9:Unrealized gain/loss on interest rate swap 570,159.Changes in Net Assets or Fund Balances: