STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

MASONIC AND EASTERN STAR HOME: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
MASONIC AND EASTERN STAR HOME (EIN 56-0529956)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-05-14
IRS object ID
201211359349301511
Schema version
2011v1.2
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)
Timestamp2012-05-14T09:43:02-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN560571159EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BERNARD ROBINSON & COMPANY LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 19608AddressLine1
CityGREENSBOROCity
StateNCState
ZIP Code274199608ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN560529956EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MASONIC AND EASTERN STAR HOMEBusinessNameLine1
Business Name Line2OF NORTH CAROLINA INCBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlMASONameControl
Phone3362990031Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1700 S HOLDEN ROADAddressLine1
CityGREENSBOROCity
StateNCState
ZIP Code27407ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARK KOLADAName
TitleEXECUTIVE DIRECTORTitle
Phone3362990031Phone
Date Signed2012-05-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameLORY H KELLEYName
PTINP00431638PTIN
Phone3362944494Phone
Date Prepared2012-05-02DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1WHITESTONEBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonMARK KOLADANameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1700 S HOLDEN ROADAddressLine1
CityGREENSBOROCity
StateNCState
ZIP Code27407ZIPCode
FieldValueIRS element (for citing)
Gross Receipts39838877GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.MESHHOME.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1912YearFormation
State Legal DomicileNCStateLegalDomicile
Activity Or Mission DescriptionAS 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.ActivityOrMissionDescription
Nbr Voting Members Governing Body20NbrVotingMembersGoverningBody
Nbr Independent Voting Members20NbrIndependentVotingMembers
Total Nbr Employees277TotalNbrEmployees
Total Nbr Volunteers100TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1930137ContributionsGrantsPriorYear
Contributions Grants Current Year1697836ContributionsGrantsCurrentYear
Program Service Revenue Prior Year10861519ProgramServiceRevenuePriorYear
Program Service Revenue CY12012809ProgramServiceRevenueCY
Investment Income Prior Year191422InvestmentIncomePriorYear
Investment Income Current Year-196722InvestmentIncomeCurrentYear
Other Revenue Prior Year24657OtherRevenuePriorYear
Other Revenue Current Year2176OtherRevenueCurrentYear
Total Revenue Prior Year13007735TotalRevenuePriorYear
Total Revenue Current Year13516099TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1187973GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1314415GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year5561008SalariesEtcPriorYear
Salaries Etc Current Year5898486SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year5544113OtherExpensePriorYear
Other Expenses Current Year4880782OtherExpensesCurrentYear
Total Expenses Prior Year12293094TotalExpensesPriorYear
Total Expenses Current Year12093683TotalExpensesCurrentYear
Revenues Less Expenses Prior Year714641RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1422416RevenuesLessExpensesCY
Total Assets BOY32028874TotalAssetsBOY
Total Assets EOY54497984TotalAssetsEOY
Total Liabilities BOY16218450TotalLiabilitiesBOY
Total Liabilities EOY37095401TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY15810424NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY17402583NetAssetsOrFundBalancesEOY
Mission DescriptionAS 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.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense10708356Expense
Grants1314415Grants
Revenue12012809Revenue
DescriptionMASONIC 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.Description
Total Program Service Expense10708356TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest1ReportProgRelInvest
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 Individuals1GrantsToIndividuals
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 Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109652NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees277NumberOfEmployees
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
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members20NbrVotingGoverningBodyMembers
Number Independent Voting Members20NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonPHIL HUGHESNamePerson
Telephone Number3362990031TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1700 S HOLDEN ROADAddressLine1
CityGREENSBOROCity
StateNCState
ZIP Code27407ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (21 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
DEWEY PRESLAR JR
DIRECTOR1.00X000
LEWIS LEDFORD
DIRECTOR1.00X000
ROBERT E GRESHAM JR
DIRECTOR1.00X000
DAVID CRISP
DIRECTOR1.00X000
DAVID WICKER JR
DIRECTOR1.00X000
JANET DORSETT
VICE CHAIR1.00X000X
JIM SHEARON
DIRECTOR1.00X000
GENE JERNIGAN
CHAIRMAN1.00X000X
DWIGHT CREWS
DIRECTOR1.00X000
ARCHIBALD JARRELL
DIRECTOR1.00X000
LINDA BONNER
DIRECTOR1.00X000
THOMAS JACKSON
DIRECTOR1.00X000
DONNA CHESSER
DIRECTOR1.00X000
FRAN SOUTHERN
TREASURER1.00X000X
DONNA YATES
SECRETARY1.00X000X
MELISSA HOGAN
DIRECTOR1.00X000
DICK SLOOP
DIRECTOR1.00X000
JACK WALTERS
DIRECTOR1.00X000
WAYNE LAMBERTSON SR
DIRECTOR1.00X000
FREDERICK HINES WHITTY
DIRECTOR1.00X000
MARK KOLADA
EXECUTIVE DIRECTOR40.00000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources1CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
LIFE CARE SERVICES
800 LOCUST STREETDES MOINESIA50309MANAGEMENT OF HOME636782
SYSCO FOOD SERVICES CHARLOTTE
4500 CORPORATE DR NWCONCORDNC28027FOOD SERVICES559349
HERITAGE HEALTHCARE
536 OLD HOWELL ROADGREENVILLESC29615OCCUP, PHYSICAL & SPEECH THERAPY528778
BLUE CROSS & BLUE SHIELD OF NC
3530 TORINGDON WAYCHARLOTTENC28277INSURANCE525822
ZILLNER MARKETING
8725 ROSEHILL ROAD SUITE 200LENEXAKS66215MARKETING SERVICES319552
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Related Organizations688485RelatedOrganizations
All Other Contributions1009351AllOtherContributions
Total Contributions1697836TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionRESIDENT SERVICESDescription
Business Code623000BusinessCode
Total Revenue Column12012809TotalRevenueColumn
Related Or Exempt Function Income12012809RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue12012809TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column321294TotalRevenueColumn
Exclusion$321,294ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities25804762Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities26262882Securities
Other59896Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-458120Securities
Other-59896Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-518016TotalRevenueColumn
Exclusion-$518,016ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionOTHER INCOMEDescription
Business Code623000BusinessCode
Total Revenue Column2176TotalRevenueColumn
Exclusion$2,176ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue2176TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column13516099TotalRevenueColumn
Related Or Exempt Function Income12012809RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion-$194,546ExclusionAmount

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total1314415Total
Program Services1314415ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total4913147Total
Program Services4421463ProgramServices
Management And General491684ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total34926Total
Program Services34926ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total476143Total
Program Services451064ProgramServices
Management And General25079ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total474270Total
Program Services443026ProgramServices
Management And General31244ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total446101Total
Program Services98103ProgramServices
Management And General347998ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total44527Total
Program Services9226ProgramServices
Management And General35301ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total45568Total
Management And General45568ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total20351Total
Program Services4209ProgramServices
Management And General16142ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1197844Total
Program Services1197844ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total23135Total
Program Services3969ProgramServices
Management And General19166ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total152388Total
Program Services152388ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1000570Total
Program Services1000570ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total148071Total
Program Services597ProgramServices
Management And General147474ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SERVICES793094793094
REPAIRS AND MAINTENANCE29629725202644271
VARIOUS SUPPLIES29517027364321527
MISCELLANEOUS1777999181285987

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total239867Total
Program Services165981ProgramServices
Management And General73886ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total12093683Total
Program Services10708356ProgramServices
Management And General1385327ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1386816BOY
EOY905439EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY536572BOY
EOY3665274EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY747544BOY
EOY933405EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY31758BOY
EOY34801EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY211934BOY
EOY326758EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis38060647LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec11419247LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY19842166BOY
EOY26641400EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY4180770BOY
EOY1762108EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY5091314BOY
EOY5067554EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY15161245EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY32028874BOY
EOY54497984EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2276025BOY
EOY1233651EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY8042572BOY
EOY7063839EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY5899853BOY
EOY28797911EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY16218450BOY
EOY37095401EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY8766531BOY
EOY9936678EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY487463BOY
EOY1118273EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY6556430BOY
EOY6347632EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY15810424BOY
EOY17402583EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY32028874BOY
EOY54497984EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses1422416ReconcilationRevenueExpenses
Reconcilation Other Changes169743ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1149837CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1475256CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1177302CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1930137CurrentTaxYearMinus1Year
Current Tax Year1697836CurrentTaxYear
Total7430368Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1149837CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1475256CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1177302CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1930137CurrentTaxYearMinus1Year
Current Tax Year1697836CurrentTaxYear
Total7430368Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total2356665AmountsSubstContributorsTotal
Public Support Total1705073703PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years547808CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years825510CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years616467CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year191422CurrentTaxYearMinus1Year
Current Tax Year321294CurrentTaxYear
Total2502501Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years25828CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years57208CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years36569CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year21091CurrentTaxYearMinus1Year
Total140696Total
FieldValueIRS element (for citing)
Total Support10073565TotalSupport
Gross Receipts From Admissions Etc51511706GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.50370PublicSupportPertcentage170
Public Support Pertcent Prior Year0.60510PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

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

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance6556430BeginningOfYearBalance
Investment Earnings Or Losses-208798InvestmentEarningsOrLosses
End Of Year Balance6347632EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance6213730BeginningOfYearBalance
Investment Earnings Or Losses342700InvestmentEarningsOrLosses
End Of Year Balance6556430EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance5538689BeginningOfYearBalance
Investment Earnings Or Losses675041InvestmentEarningsOrLosses
End Of Year Balance6213730EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance7277779BeginningOfYearBalance
Investment Earnings Or Losses-1739090InvestmentEarningsOrLosses
End Of Year Balance5538689EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis55677OtherCostOrOtherBasis
Book Value55677BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis35708440OtherCostOrOtherBasis
Depreciation9954798Depreciation
Book Value25753642BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2179952OtherCostOrOtherBasis
Depreciation1359364Depreciation
Book Value820588BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis116578OtherCostOrOtherBasis
Depreciation105085Depreciation
Book Value11493BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings26641400TotalOfBookValueLandBuildings

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionASSETS IN SPLIT INTEREST AGREEMENTSDescription
Book Value5067554BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities5067554TotalOfBookValueSecurities

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
DescriptionBOND INVESTMENTSDescription
Book Value15161245BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Program Related15161245TotalOfBookValueProgramRelated

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
REFUNDABLE ADVANCE FEES$1,431,211
DEPOSITS ON UNOCCUPIED UNITS$618,938
RESIDENT TRUST FUNDS$92,126
BONDS PAYABLE$26,655,636
FieldValueIRS element (for citing)
Total Of Amounts28797911TotalOfAmounts
Total Revenue13516099TotalRevenue
Total Expenses12093683TotalExpenses
Excess Or Deficit For Year1422416ExcessOrDeficitForYear
Net Unrealized GL On Investments398993NetUnrealizedGLOnInvestments
Other-$229,250OtherAmount
Total Adjustments169743TotalAdjustments
Excess Or Deficit Per FS1592159ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt12371427TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments398993NetUnrealizedGainsInvestments
Other Revenues-229250OtherRevenues
Revenue Not Rptd F990169743RevenueNotRptdF990
Revenue Subtotal12201684RevenueSubtotal
Other Revenues Not Included1314415OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt1314415RevenueNotRptdOnFinStmt
Total Revenue Per Form99013516099TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt10779268TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal10779268ExpensesSubtotal
Other Expenses Not Included1314415OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt1314415ExpensesNotRptdOnFinStmt
Total Expenses Per Form99012093683TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X: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 2011. CURRENTLY, THE STATUTE OF LIMITATIONS REMAINS OPEN SUBSEQUENT TO AND INCLUDING 2008; HOWEVER, NO EXAMINATIONS ARE IN PROGRESS OR ANTICIPATED.
PART XI, LINE 8 - OTHER ADJUSTMENTS:CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS -229,250.
PART XII, LINE 2D - OTHER ADJUSTMENTS:CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS -229,250.
PART XII, LINE 4B - OTHER ADJUSTMENTS:GRANTS MADE TO RESIDENTS 1,314,415.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:GRANTS MADE TO RESIDENTS 1,314,415.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantWAIVER OF FEES FOR INDIVIDUALS DUE TO HARDSHIPS.TypeOfGrant
Number Of Recipients62NumberOfRecipients
Amount Of Cash Grant1314415AmountOfCashGrant
Method Of ValuationFMVMethodOfValuation
Description Of Non Cash AssistanceRESIDENTIAL AND HEALTH SERVICES.DescriptionOfNonCashAssistance

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, 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.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
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 III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
Return ReferencePART IIIReturnReference
ExplanationMARK 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 2011 TAX YEAR, LIFE CARE SERVICES, LLC PAID MARK KOLADA MEDICARE WAGES IN THE AMOUNT OF $124,104.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1NORTH CAROLINA MEDICAL CARE COMMISSIONBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN521309402IssuerEIN
CUSIP Number65820YJN7CUSIPNumber
Date Issued2011-04-28DateIssued
Issue Price26642514IssuePrice
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds26642514TotalProceeds
Amount In Reserve Fund1971475AmountInReserveFund
Issuance Costs From Proceeds532850IssuanceCostsFromProceeds
Capital Expenditures20264188CapitalExpenditures
Other Spent Proceeds3874001OtherSpentProceeds
Current Refunding0CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Post Issuance Compliance Procdrs1PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T Filed0Form8038TFiled
Variable Rate Issue1VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Exception To Rebate0ExceptionToRebate
FieldValueIRS element (for citing)
Fed Tax Requirements ComplianceXFedTaxRequirementsCompliance

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
ExplanationTHE 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.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 3THE 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 7ATHE GRAND MASTER APPOINTS THREE BOARD MEMBERS.
FORM 990, PART VI, SECTION B, LINE 11THE 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 12CANNUAL MONITORING OF CONFLICT OF INTEREST IS PART OF THE DUTIES OF THE CORPORATE COMPLIANCE COMMITTEE, CHAIRED BY TRACY ARMWOOD.
FORM 990, PART VI, SECTION B, LINE 15COMPENSATION FOR CEO, CURRENT OFFICERS, ETC ARE REVIEWED AS A PART OF ANNUAL BUDGET BY THE BOARD OF DIRECTORS, FINANCE COMMITTEE AND PERSONNEL COMMITTEE.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS AND POLICIES ARE AVAILABLE UPON REQUEST. THE AUDITED FINANCIALS ARE INCLUDED IN ANNUAL DISCLOSURE AS REQUIRED BY DEPARTMENT OF INSURANCE.
FORM 990, PART XI, LINE 5:NET UNREALIZED GAINS ON INVESTMENTS: 398,993. CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS -229,250. TOTAL TO FORM 990, PART XI, LINE 5: 169,743.CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionControlled OrgControlledOrgPublic Charity StatusPublicCharityStatus
GRAND LODGE OF THE AF AND AM OF NC
PO BOX 6506RALEIGHNC27628560228750PROVIDE SUPPORT FOR NC MASONSNC501(C)(10)0
GRAND CHAPTER OF THE ORDER OF THE EASTERN STAR OF NC
PO BOX 5516KINSTONNC28503560239941CHARITABLE, EDUCATIONAL AND FRATERNALNC501(C)(8)0
NC MASONIC FOUNDATION INC
PO BOX 6506RALEIGHNC27628566049500RECEIVE DONATIONS AND DISTRIBUTE ALL INCOME TO CHARITABLE ORGANIZATIONSNC501(C)(3)0LINE 11B, II
NC EASTERN STAR FOUNDATION INC
PO BOX 5516KINSTONNC28503561974972INVEST FUNDS RAISED TO PROVIDE PERPETUAL FUND TO EASTERN STAR HOMENC501(C)(3)0PF
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
NORTH CAROLINA MASONIC FOUNDATION INC
E4010345
NORTH CAROLINA MASONIC FOUNDATION INC
C95271
NORTH CAROLINA EASTERN STAR FOUNDATION INC
C139694
NC MASONIC FOUNDATION (RUCK FUND)
C179658

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
Return ReferenceSCH R, PART V, QUESTION 2, LINE 1E:ReturnReference
ExplanationAMOUNT INVOLVED IS BEGINNING OF YEAR AMOUNT. AMOUNT WAS PAID OFF BY THE END OF THE YEAR.Explanation