2011-11-23T14:24:48-06:00 2011-09-30 GILLIAM COBLE & MOSER LLP PO BOX 621 BURLINGTON NC 272160621 990 2010-10-01 561077371 PRESBYTERIAN HOME OF HAWFIELDS INC PRES 3365784701 2502 SOUTH NC 119 MEBANE NC 27302 MR MAX KERNODLE 3365784701 2011-11-22 1 SCOTT WILLIAMS 3362276283 2010 2016-02-24 21:20:13Z MR MAX KERNODLE 2502 SOUTH NC 119 MEBANE NC 27302 6703316 0 X WWW.HAWFIELDS.ORG X 1973 NC TO PROVIDE HOUSING & RELATED FACILITIES & SERVICE FOR THE ELDERLY AND NEEDY. 10 10 180 90 0 0 4182 11201 7027639 6660229 8184 -1281 33104 29883 7073109 6700032 0 0 0 0 4450439 4306693 0 0 0 2785480 2581813 7235919 6888506 -162810 -188474 3564526 3343159 540796 507903 3023730 2835256 TO PROVIDE HOUSING & RELATED FACILITIES & SERVICE FOR THE ELDERLY AND NEEDY IN A HEALTH CARE SETTING. 0 0 6386315 6355753 THE ORGANIZATION PROVIDES HOUSING & SERVICES IN A 117 NURSING HOME BED AND 37 IL BED FOR THE ELDERLY & NEEDY. 6386315 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 7 0 180 0 0 0 0 0 0 0 0 0 0 0 X 10 10 1 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 0 X X MAX KERNODLE 3365784701 2502 SOUTH NC 119 MEBANE NC 27302 TOM GAMBLE 1.00 X 0 0 0 BILL STOCKARD 1.00 X 0 0 0 MARY SCOTT 1.00 X 0 0 0 JIMMY EVANS 1.00 X 0 0 0 HENDERSON SCOTT 1.00 X 0 0 0 MARSHALL TAYLOR 1.00 X 0 0 0 BILL MEBANE 1.00 X 0 0 0 MAX KERNODLE 40.00 X X 119123 0 15932 REV A B PLEXICO 1.00 X 0 0 0 GEORGE BASON 1.00 X 0 0 0 FENTON COVINGTON 1.00 X 0 0 0 119123 0 15932 1 0 0 0 SUNDANCE REHABILITATION 6459 PAYSPHERE CIRCLE CHICAGO IL 60674 THERAPY SERVICE 513877 DIVISION OF MEDICAL ASSISTANCE 2011 MAIL SERVICE CENTER RALEIGH NC 27699 NURSING ASSESSMENT FEES 384221 SYSCO FOOD SERVICES PO BOX 129 SELMA NC 27576 RAW FOODS/SUPPLEMENTS 345131 MMS PO BOX 955588 ST LOUIS MO 63195 MEDICAL SUPPLIES 184095 DIAMOND PAPER COMPANY PO BOX 1655 DANVILLE VA 24541 SUPPLIES 167045 10 11201 11201 INTER & SKILLED CARE 623000 6004799 6004799 INDEPENDENT LIVING 623000 350954 350954 SPECIAL SERVICES 900099 304476 304476 6660229 2003 2003 2765 2765 2765 2765 3284 -3284 -3284 -3284 LATE PAYMENT INCOME 900099 13302 13302 DUKE POWER GENERATOR U 900099 7770 7770 EMPLOYEE/GUEST MEALS 900099 3691 3691 2355 2355 27118 6700032 6355753 0 333078 144169 144169 2918506 2838574 79932 976081 878426 97655 267937 248512 19425 1598 1598 37591 37591 514931 500852 14079 8339 8339 43088 510 42578 344903 315924 28979 6265 5760 505 7120 7030 90 150189 150189 SUPPLIES 840101 840101 THERAPY 497802 497802 PHARMACY 87410 87410 BAD DEBT EXPENSE 27252 27252 PHYSICIAN SERVICE 10954 10954 4270 4270 6888506 6386315 502192 0 378702 476808 100000 100000 884693 710130 45424 51702 63216 56608 6280678 4338622 2086089 1942056 6402 5855 3564526 3343159 534394 502048 6402 5855 540796 507903 X 2923730 2735256 100000 100000 3023730 2835256 3564526 3343159 -188474 0 X 0 1 1 X 0 X 2827 8796 3257 4182 11201 30263 6489463 6988046 6945172 7027639 6660229 34110549 6492290 6996842 6948429 7031821 6671430 34140812 255 413 685 482 80 1915 0 255 413 685 482 80 1915 34138897 8313 7694 34990 24791 18070 93858 8313 7694 34990 24791 18070 93858 33702 38677 12239 13997 13816 112431 6534305 7043213 6995658 7070609 6703316 34347101 0.99390 0.99370 0.00270 0.00240 X 1028277 1028277 3923922 3160952 762969 928106 805249 122858 400373 372421 27952 1942056 RESIDENT TRUST FUNDS 5855 5855 6700032 6888506 -188474 0 -188474 6700032 0 6700032 0 6700032 6888506 0 6888506 0 6888506 FORM 990, PART VI, SECTION A, LINE 2 FENTON COVINGTON (TREASURER) IS MAX KERNODLE'S (SECRETARY/ADMINISTRATOR) BROTHER-IN-LAW. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE SEVERAL COMMITTEES IN PLACE THAT REPORT TO THE GOVERNING BOARD AND MINUTES ARE RECORDED FOR THEIR PARTICULAR MEETINGS. THESE COMMITTEES DO NOT HAVE THE RIGHTS TO ACT ON BEHALF OF THE GOVERNING BOARD. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF FORM 990 WILL BE DISTRIBUTED AND REVIEWED AT THE NOVEMBER BOARD MEETING. ANY CHANGES WILL BE MADE PRIOR TO FILING THE FORM 990 WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD REVIEWS ANNUALLY AND SIGNS-OFF ON DOCUMENTS WHICH ARE RECORDED IN THE MEETING MINUTES. FORM 990, PART VI, SECTION B, LINE 15 RECOMMENDATIONS ARE MADE AND DISCUSSED THROUGH THE FINANCE COMMITTEE. THE BOARD OF DIRECTORS THEN APPROVE ANY RECOMMENDATIONS. FORM 990, PART VI, SECTION C, LINE 19 ALL OTHER APPLICABLE DOCUMENTS ARE MADE AVAILABLE UPON REQUEST.