2012-07-03T12:30:01-05:00 2011-09-30 MCGLADREY LLP 230 N ELM ST STE 1100 GREENSBORO NC 27401 990 2010-10-01 560634527 THE UNITED METHODIST RETIREMENT HOMES INC UNIT 9193843000 2600 CROASDAILE FARM PKWY NO A-500 DURHAM NC 277053153 JONATHAN ERICKSON 9193843000 2012-06-25 TAMELA L GAINEY 3362724551 2010 2016-02-24 21:20:13Z JONATHAN ERICKSON 2600 CROASDAILE FARM PKWY NO A-500 DURHAM NC 277053153 46341320 0 X WWW.UMRH.ORG X 1946 NC OWN, OPERATE, AND MANAGE CONTINUING CARE RETIREMENT COMMUNITIES 27 27 600 366 0 0 720870 600887 33410086 34773766 1052002 934727 5828063 5814253 41011021 42123633 426879 471292 0 0 14989511 15437237 0 0 0 22706467 22875582 38122857 38784111 2888164 3339522 145749030 155019750 127153285 133803518 18595745 21216232 TO PROVIDE QUALITY CARE AND SERVICES FOR AN INCLUSIVE AND DIVERSE POPULATION OF SENIOR ADULTS. 0 0 30924204 471292 40636490 OPERATE CONTINUING CARE RETIREMENT COMMUNITIES INCLUDING SKILLED NURSING FACILITIES. 30924204 1 1 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 1 68 0 1 600 1 0 0 0 0 0 0 0 0 0 0 X 27 27 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X STACY DOBSON 9193843002 2600 CROASDAILE FARM PKWY STE A-500 DURHAM NC 27705 JONATHAN ERICKSON 40.00 X X 163359 0 21062 DONALD METZGER 1.00 X X 0 0 0 JOHN HEMINGWAY 1.00 X X 0 0 0 JULIUS ADAMS 1.00 X X 0 0 0 NELSON PRICE 1.00 X X 0 0 0 NANCY SMITH MARKS 1.00 X X 0 0 0 JONATHAN BIGGS 1.00 X 0 0 0 EDGAR DOUGLAS 1.00 X 0 0 0 RICHARD EVANS 1.00 X 0 0 0 RICHARD FURR 1.00 X 0 0 0 CARL HAMILL 1.00 X 0 0 0 LEE HARRISS 1.00 X 0 0 0 ROBBY LOWRY 1.00 X 0 0 0 CONNIE MOSELEY 1.00 X 0 0 0 WALTER PORIES 1.00 X 0 0 0 MARK STEPHENS 1.00 X 0 0 0 GAYLE VAN VELSOR 1.00 X 0 0 0 GREG WALLACE 1.00 X 0 0 0 GARY WHALEY 1.00 X 0 0 0 LEONARD FAIRLEY 1.00 X 0 0 0 CAROL GOEHRING 1.00 X 0 0 0 GRAY SOUTHERN 1.00 X 0 0 0 ELIZABETH HOOD 1.00 X 0 0 0 WILLIE JOHNSON 1.00 X 0 0 0 CLYDE MCKEE 1.00 X 0 0 0 BURTON KING 1.00 X 0 0 0 MARY LAMM 1.00 X 0 0 0 ARTHUR SPRAGUE 1.00 X 0 0 0 STACY DOBSON 40.00 X 130408 0 10275 HOWARD DEWITT 40.00 X 127720 0 5984 WADE ROZIER 40.00 X 120875 0 22894 542362 0 60215 4 0 1 0 THE WEITZ COMPANY LLC 5901 THORNTON AVENUE DES MOINES IA 50321 GENERAL CONTRACTOR 8948120 MORRISON MANAGEMENT SPECIALISTS 4721 MORRISON DRIVE STE 300 MOBILE AL 36625 DIETARY MANAGEMENT 2273399 LIFE CARE SERVICES LLC 400 LOCUST SQUARE SUITE 820 DES MOINES IA 50309 MANAGEMENT COMPANY 1344094 HERITAGE HEALTHCARE INC 536 OLD HOWELL ROAD GREENVILLE SC 29615 THERAPY PROVIDER 1198878 FREEDOM LANDSCAPE SERVICES INC 85 JARED DRIVE FUQUAY VARINA NC 27526 LANDSCAPE MANAGEMENT 321237 16 600887 600887 PATIENT SERVICES 623000 28820130 28820130 MEDICARE/MEDICAID PAYM 623000 5953636 5953636 34773766 1153022 1153022 12790 12790 12790 12790 3935743 63649 3922215 295472 13528 -231823 -218295 -218295 AMORT. OF ADVANCE FEES 623000 4976665 4976665 MANAGEMENT FEE 623000 875588 875588 MISC OPERATING REVENUE 623000 -64012 -64012 13222 10471 2751 5801463 42123633 40636490 0 886256 471292 471292 602578 602578 12116377 10961941 1154436 160006 135140 24866 1544001 1340282 203719 1014275 879429 134846 1566448 273547 1292901 75211 75211 73050 73050 155930 155930 182744 182744 2732585 2625385 107200 1269943 834734 435209 36394 15112 21282 73955 35154 38801 4102800 3996948 105852 4909558 3227052 1682506 494262 494262 CONTRACTED LABOR 3322139 2938443 383696 ANCILLARY EXPENSES 1848110 1848110 PATIENT DISCOUNTS 428860 428860 EQUIPMENT RENTAL 426401 328029 98372 1177192 584746 592446 38784111 30924204 7859907 0 800 800 13123284 11844218 1864590 1563846 1937464 2457408 102447 103591 627397 506453 142628840 38530426 98741448 104098414 25455951 29926850 30349 30745 3865300 4487425 145749030 155019750 6578809 4319938 38835730 39842305 80572923 88442929 1165823 1198346 127153285 133803518 X 15885559 18812019 945008 637428 1765178 1766785 18595745 21216232 145749030 155019750 X 3339522 -719035 X X 0 1 1 X 0 X 940038 585445 679526 720870 600887 3526766 27298984 30413105 32682793 33410086 34773766 158578734 28239022 30998550 33362319 34130956 35374653 162105500 0 0 0 162105500 1585506 1452481 1104942 1057816 1165812 6366557 1585506 1452481 1104942 1057816 1165812 6366557 4510479 5691143 5509384 5816315 5801463 27328784 34335007 38142174 39976645 41005087 42341928 195800841 0.82790 0.82880 0.03250 0.03280 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2291134 429226 -4112 23200 636898 285 2055865 1893373 510626 251738 19400 345203 2291134 1823773 261816 43683 235899 1893373 0.00000 0.75930 0.24070 0 1 1 6060019 6060019 118163826 29725505 88438321 7217366 4052937 3164429 11187629 4751984 6435645 104098414 FUNDS HELD FOR OTHERS 509735 DUE TO RELATED PARTY 41382 INTEREST RATE SWAP AGREEMENT 647229 1198346 42123633 38784111 3339522 -603306 -115729 -719035 2620487 40437930 -603306 -1082397 -1685703 42123633 0 42123633 37817443 0 37817443 966668 966668 38784111 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: AS DICTATED BY THE DONOR, EARNINGS ON THE ENDOWMENT FUNDS WILL SUPPORT BENEVOLENT NEEDS AT THE COMMUNITY AND EMPLOYEE SCHOLARSHIPS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE COMPANY IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE; ACCORDINGLY, THE ACCOMPANYING FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION OR LIABILITY FOR FEDERAL AND STATE INCOME TAXES. THE COMPANY HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2011. THE COMPANY BELIEVES THAT THEY ARE NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO SEPTEMBER 30, 2008. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN VALUE OF INTEREST RATE SWAP AGREEMENT - 35,632 CHANGE IN SPLIT INTEREST AGREEMENTS - (55,368) CHANGE IN VALUE OF PLEDGES - (95,996) PART XII, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN SPLIT INTEREST AGREEMENTS - (55,368) CHANGE IN VALUE OF PLEDGES - (95,996) SPECIFIC INDIVIDUAL ASSISTANCE - (448,092) BEAUTY & BARBER EXPENSE - (89,711) PATIENT SERVICE REVENUE DISCOUNTS - (428,860) CHANGE IN VALUE OF INTEREST RATE SWAP AGREEMENT - 35,632 PART XIII, LINE 4B - OTHER ADJUSTMENTS: SPECIFIC INDIVIDUAL ASSISTANCE - 448,092 BEAUTY & BARBER EXPENSE - 89,711 PATIENT SERVICE REVENUE DISCOUNTS - 35,632 1 BENEVOLENT ASSISTANCE FOR RESIDENTS 27 448092 0 NURSING SCHOLARSHIPS 4 1200 0 STUDENT SCHOLARSHIPS 17 22000 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: UPON REVIEW OF EACH RESIDENT'S INDIVIDUAL FINANCIAL SITUATION, THE COMPANY MAY PERMIT THE RESIDENT TO REMAIN AT THE FACILITY FOR A LESSER FEE BASED ON THE RESIDENT'S ABILITY TO PAY BUT ONLY AFTER MEETING ALL OF THE SPEND-DOWN PROVISIONS OF ELIGIBILITY FOR THE MEDICAID PROGRAM AND ANY PUBLIC ASSISTANCE FUNDS. THE UNITED METHODIST RETIREMENT HOMES HAS FOUR POST-SECONDARY EDUCATION SCHOLARSHIP PROGRAMS FOR EMPLOYEES OF UNITED METHODIST RETIREMENT HOMES AND ITS CONTRACTORS. THE SCHOLARSHIPS ARE FUNDED BY DONORS AND ARE AWARDED ANNUALLY. SCHOLARSHIP RECIPIENTS ARE NOMINATED BY THEIR MANAGEMENT AND ARE SELECTED BY A THREE-MEMBER COMMITTEE COMPRISING THE MANAGER OF THE SCHOLARSHIP APPLICANTS, THE UNITED METHODIST RETIREMENT HOMES DIRECTOR OF HUMAN RESOURCES, AND THE VICE PRESIDENT OF THE UNITED METHODIST RETIREMENT HOMES FOUNDATION. THE COMMITTEE MAKES SELECTIONS OF SCHOLARSHIP RECIPIENTS BASED ON THE POLICY FOR DONOR-DIRECTED SCHOLARSHIP FUNDS, AND ON THE DONOR'S CRITERIA FOR AWARDING THE SCHOLARSHIP. 1 X X X X 0 0 0 0 0 0 0 0 0 JONATHAN ERICKSON 125605 0 37238 0 516 0 10262 0 10800 0 184421 0 0 0 NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65820YDR4 2005-02-01 20790000 BUILD 59 NEW APARTMENTS 0 0 0 NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65820YEW2 2005-09-01 47835000 REFUND SERIES 2000 BOND BALANCES 0 0 0 NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 NONEAVAIL 2010-02-04 14300000 REPLACEMENT HEALTHCARE CENTER 0 0 0 NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 NONEAVAIL 2010-02-18 12880000 CONVERT 2005B BONDS TO BQ STATUS 0 0 0 20790000 2036537 415800 18337663 2005 0 0 1 1 47835000 3011368 956700 43866932 2005 0 1 1 1 14300000 10401084 2010 0 0 1 1 12880000 12880000 2010 1 0 1 1 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 0 1 1 1 BB&T 5.000000000000 0 0 0 0 0 X 4 138997 AVG HIGH/LOW PRICES 0 1 0 FORM 990, PART VI, SECTION A, LINE 2 JONATHAN ERICKSON (CORPORATE EXECUTIVE DIRECTOR) AND STACY DOBSON (CHIEF FINANCIAL OFFICER) SERVE AS OFFICERS OF UNITED METHODIST RETIREMENT HOMES AFFORDABLE HOUSING, INC. JONATHAN ERICKSON IS THE PRESIDENT OF UMRH AFFORDABLE HOUSING, INC. AND STACY DOBSON IS THE SECRETARY. THE FOLLOWING MEMBERS OF THE BOARD OF TRUSTEES ARE ALSO MEMBERS OF THE BOARD OF TRUSTEES FOR CYPRESS GLEN RETIREMENT COMMUNITY, A RELATED ENTITY DISCLOSED ON SCHEDULE R: JONATHAN ERICKSON, JOHN HEMINGWAY, NELSON PRICE, NANCY SMITH MARKS, JULIUS ADAMS, JONATHAN BIGGS, EDGAR DOUGLAS, RICHARD H. EVANS, RICHARD FURR, ROBBY LOWRY, DONALD E. METZGER, WALTER PORIES, GREG WALLACE, MARK STEPHENS, CAROL GOEHRING, LEONARD E. FAIRLEY, ELIZABETH HOOD, GRAY SOUTHERN, MARY LAMM, GARY WHALEY, GAYLE VAN VELSOR, CONNIE MOSELEY, CARL HAMILL, AND LEE HARRISS. THE FOLLOWING MEMBERS OF THE BOARD OF TRUSTEES ARE ALSO MEMBERS OF THE BOARD OF TRUSTEES FOR UNITED METHODIST RETIREMENT HOMES FOUNDATION, INC., A RELATED ENTITY DISCLOSED ON SCHEDULE R: JONATHAN ERICKSON, STACY DOBSON, JULIUS ADAMS, JOHN HEMINGWAY, JONATHAN BIGGS, CARL HAMILL, LEE HARRISS, AND RICHARD FURR. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION'S CHIEF FINANCIAL OFFICER REVIEWS THE 990 RETURN. FORM 990, PART VI, SECTION B, LINE 12C THE UMRH, INC. BOARD FILLS OUT THE CONFLICT OF INTEREST POLICY FORM EACH SEPTEMBER NOTING ANY CONTINUED CONFLICTS OF INTEREST. NEW BOARD MEMBERS ARE ORIENTED TO THE POLICY AND SIGN THE FORM UPON BECOMING MEMBERS. EACH BOARD MEMBER IS REQUIRED TO DISCLOSE ANY CONFLICTS TO THE CHAIRMAN PRIOR TO A VOTE BEING TAKEN. THE MEMBER MUST ABSTAIN FROM VOTING. THE CONFLICT OF INTEREST POLICY IS ALSO REVIEWED FOR THE EMPLOYEES AT ORIENTATION AND AT ANNUAL REVIEW. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION ROUTINELY CONSULTS THE SERVICES OF AN OUTSIDE AGENCY TO EVALUATE THE ORGANIZATION'S WAGE SCALES AND PAY GRADES. THE RESULTING WAGE SCALE AND THE EMPLOYEE'S PERFORMANCE AND ACCOMPLISHMENTS ARE CONSIDERED IN THE ANNUAL REVIEW PROCESS. IN SOME INSTANCES, A SOFTWARE PROGRAM CALLED "PERFORMANCE NOW" IS USED TO SIMPLIFY THE COMMUNICATION OF THE REVIEW AND ITS RESULTS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -603,306. CHANGE IN SPLIT INTEREST AGREEMENT -55,368. CHANGE IN VALUE OF PLEDGES -95,993. CHANGE IN VALUE OF INTEREST RATE SWAP AGREEMENT 35,632. TOTAL TO FORM 990, PART XI, LINE 5: -719,035. FORM 990, PART XII, LINE 2C THE ORGANIZATION'S OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED SINCE THE PRIOR YEAR. FORM 990, PART VII, SECTION A HOURS TO RELATED ORGANIZATION: JONATHAN ERICKSON - 1 HOUR PER WEEK TO CYPRESS GLEN RETIREMENT COMMUNITY AS A MEMBER OF THE BOARD OF TRUSTEES AND 1 HOUR PER WEEK TO UNITED METHODIST HOMES FOUNDATION, INC. AS A MEMBER OF THE BOARD OF TRUSTEES. THE FOLLOWING MEMBERS OF THE BOARD OF TRUSTEEES ARE ALSO MEMBERS OF THE BOARD OF TRUSTEES FOR CYPRESS GLEN RETIREMENT COMMUNITY AND PROVIDE 1 HOUR OF SERVICE PER WEEK: JOHN HEMINGWAY, NELSON PRICE, NANCY SMITH MARKS, JULIUS ADAMS, JONATHAN BIGSS, EDGAR DOUGLAS, RICHARD FURR,RICHARD H. EVANS, ROBBY LOWRY, DONALD E. METZGER, WALTER PORIES, GREG WALLACE, MARK STEPHENS, CAROL GOEHRING, LEONARD E. FAIRLEY, ELIZABETH HOOD, GRAY SOUTHERN, MARY LAMM, GARY WHALEY, GAYLE VAN VELSOR, CONNIE MOSELEY, CARL HAMILL, AND LEE HARRISS. THE FOLLOWING MEMBERS OF THE BOARD OF TRUSTEES ARE ALSO MEMBERS OF THE BOARD OF TRUSTEES FOR UNITED METHODIST RETIREMENT HOMES FOUNDATION, INC. AND PROVIDE 1 HOUR OF SERVICE PER WEEK: STACY DOBSON, JULIUS ADAMS, JOHN HEMINGWAY, JONATHAN BIGGS, CARL HAMILL, LEE HARRISS, AND RICHARD FURR. FORM 990, SCHEDULE R, PART V, LINE 2 TRANSACTIONS WITH RELATED ORGANIZATIONS: THE FILING ORGANIZATION AND UMRH AFFORDABLE HOUSING, INC. SHARE A FACILITY THAT HAS A NET BOOK BASIS OF $88,438,321 (COST = $118,163,826 AND ACCUMULATED DEPRECIATION = $29,725,505). THE FILING ORGANIZATION AND UMRH AFFORDABLE HOUSING, INC. SHARE TWO EMPLOYESS, JONATHAN ERICKSON ($163,359 REPORTABLE COMPENSATION AND $21,062 OTHER COMPENSATION BOTH PAID BY THE FILING ORGANIZATION) AND STACY DOBSON ($130,049 REPORTABLE COMPENSATION AND $10,275 OTHER COMPENSATION BOTH PAID BY THE FILING ORGANIZATION). FORM 990, PART VII, SECTION A, COLUMN F THE ORGANIZATION, IN A FULL TRANSPARENCY POSTURE TO REPORTING, IS REPORTING ALL BENEFITS IN FULL IN COLUMN F, PART VII AND NOT APPLYING THE $10,000 PER ITEM EXCEPTION FOR CERTAIN BENEFITS. UMRH AFFORDABLE HOUSING DEVELOPMENT LLC 2600 CROASDAILE FARM PKWY STE A-500 DURHAM NC 277053153 043701058 DEVELOP AFFORDABLE HOUSING NC 307 87783 N/A CYPRESS GLEN RETIREMENT COMMUNITY 2600 CROASDAILE FARM PARKWAY SUITE DURHAM NC 27705 561961935 CONTINUING CARE RETIREMENT COMMUNITY NC 501(C)(3) LINE 9 N/A 0 UNITED METHODIST RETIREMENT HOMES FOUNDATION INC 2600 CROASDAILE FARM PARKWAY SUITE DURHAM NC 27705 561870172 CONTRIBUTE FUNDS TO UMRH, INC. AND CYPRESS GLEN RETIREMENT COMMUNITY NC 501(C)(3) LINE 11A N/A 0 UMRH AFFORDABLE HOUSING INC 2600 CROASDAILE FARM PARKWAY SUITE DURHAM NC 27705 010724816 OPERATE AFFORDABLE HOUSING NC N/A C 4137 27387 1.00000 0 0 1 1 0 0 0 0 0 0 1 0 1 1 0 0 0 0 UMRH AFFORDABLE HOUSING INC M 88438321 UMRH AFFORDABLE HOUSING INC N 325104