2024-02-06T09:53:13-06:00 2023-03-31 440160260 FORVIS LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2022-04-01 237179679 CAROLINA VILLAGE INC CARO 8286926275 600 CAROLINA VILLAGE ROAD HENDERSONVILLE NC 28792 AMBER ANDERSON CFO 8286926275 2024-02-06 1 AMBER ANDERSON 999009999 1 AMY BIBBY P00445891 8282542254 2024-02-06 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z KEVIN PARRIES 600 CAROLINA VILLAGE ROAD HENDERSONVILLE NC 28792 33459516 0 X WWW.CAROLINAVILLAGE.COM X 1972 NC TO MAINTAIN AND OPERATE A RETIREMENT HOME, MEDICAL CENTER, AND ASSISTED LIVING CENTER. 18 18 449 18 0 0 3498317 1835562 29818640 31315872 664858 83713 203927 224369 34185742 33459516 0 0 0 0 15413659 17207118 0 0 213543 13997136 14155611 29410795 31362729 4774947 2096787 124169436 129083654 121031333 124409154 3138103 4674500 X SEE SCHEDULE O:CAROLINA VILLAGE IS A NOT FOR-PROFIT FULL-SERVICE RETIREMENT FACILITY FOR SENIOR CITIZENS WITH A MISSION TO PROVIDE HOUSING, CONTINUING LIFE CARE, UP-TO-DATE SERVICE, AND A PLEASANT, CONGENIAL SOCIAL ENVIRONMENT TO ENCOURAGE PERSONAL GROWTH AND COMMUNITY PARTICIPATION WITHOUT REGARD TO RACE OR RELIGIOUS PERSUASION. 0 0 25332767 31315872 SEE SCHEDULE O FOR STATEMENT OF ACCOMPLISHMENTS:CAROLINA VILLAGE SERVES 530 RESIDENTS IN DIRECT HEALTH CARE NEEDS, MEALS, HOUSING, AND TRANSPORTATION. IN THE PAST YEAR WE HAVE SERVED 34,883 DAYS OF DIRECT PATIENT CARE IN OUR ASSISTED LIVING AND SKILLED NURSING CARE FACILITIES. ON OUR CAMPUS WE PROVIDE MEDICARE SERVICES INCLUDING BUT NOT LIMITED TO PHYSICAL THERAPY, OCCUPATIONAL THERAPY, AND SPEECH THERAPY. OUR RESIDENTS RECEIVE BENEFITS FROM OUR COMPREHENSIVE WELLNESS PROGRAM ORGANIZED AND COORDINATED BY A FACILITY STAFF MEMBER. THE WELLNESS PROGRAM INCLUDES EIGHT FACETS OF WELLNESS-PHYSICAL, SPIRITUAL, ENVIRONMENTAL, SOCIAL, VOCATIONAL, INTELLECTUAL, EMOTIONAL, AND NUTRITIONAL. WE MAINTAIN THE CAROLINA VILLAGE HUB WHICH IS A REAL TIME INFORMATION PORTAL FOR RESIDENTS AND EMPLOYEES TO RECEIVE UP TO THE MINUTE INFORMATION ABOUT CAROLINA VILLAGE. THE CV HUB IS EASILY ACCESSIBLE FROM ANY COMPUTER OR MOBILE DEVICE. THROUGH OUR QUALITY FIRST PROGRAM WE HAVE GIVEN BACK TO THE COMMUNITY THROUGH FOOD DRIVES, SCHOOL SUPPLY DRIVES, BENEFIT DINNERS, AND OTHER MONETARY GIFTS. WE HAVE PARTNERED WITH THE HENDERSON COUNTY COUNCIL ON AGING, SPECIAL OLYMPICS, MANNA FOOD BANK, UNITED WAY, AND OTHER LOCAL NON-PROFIT ORGANIZATIONS. CAROLINA VILLAGE PROVIDES 40 MEALS PER DAY, 5 DAYS A WEEK TO THE LOCAL CONGREGATE MEAL SITE IN ASSOCIATION WITH THE HENDERSON COUNTY MEALS-ON-WHEELS PROGRAM. 25332767 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 29 0 1 449 1 0 0 0 0 0 0 0 0 0 1 0 0 0 X 18 18 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X AMBER ANDERSON 8282330603 600 CAROLINA VILLAGE ROAD SUITE Z HENDERSONVILLE NC 28792 TRINA STROKES PRESIDENT 3.00 X X 0 0 0 MARK MORSE VICE-PRESIDENT 1.50 X X 0 0 0 TERRY ANDERSEN TREASURER 1.50 X X 0 0 0 ADAM SHEALY SECRETARY 1.50 X X 0 0 0 JUSTIN WARD ASSISTANT SECRETARY 1.50 X X 0 0 0 KENNETH YOUNGBLOOD BOARD MEMBER 1.50 X 0 0 0 RUTH BIRGE BOARD MEMBER 1.50 X 0 0 0 LYNN KILLIAN BOARD MEMBER 1.50 X 0 0 0 KIMBELA MCMINN BOARD MEMBER 1.50 X 0 0 0 LEE MULLIGAN BOARD MEMBER 1.50 X 0 0 0 ROBBIE CHENAULT BOARD MEMBER 1.50 X 0 0 0 STEVEN YOUNG BOARD MEMBER 1.50 X 0 0 0 RICK WOOD BOARD MEMBER 1.50 X 0 0 0 RICHARD BOBB RESIDENT - BOARD MEMBER 1.50 X 0 0 0 SHERRI METZGER RESIDENT - BOARD MEMBER 1.50 X 0 0 0 W GLOVER LITTLE BOARD MEMBER 1.50 X 0 0 0 RENEE KUMOR BOARD MEMBER 1.50 X 0 0 0 BILL GOLD BOARD MEMBER 1.50 X 0 0 0 KEVIN PARRIES CEO 40.00 X 451384 0 63579 AMBER ANDERSON CFO 40.00 X 174370 0 38608 JON RENEGAR DIRECTOR OF OPERATIONS 40.00 X 249656 0 63769 ALEX TUCKER HEALTH CARE ADMINISTRATOR 40.00 X 149524 0 50918 CHERYL JUSTUS DIRECTOR OF MARKETING 40.00 X 127957 0 36550 KRISTEL BANE BUSINESS OFFICE MANAGER 40.00 X 113621 0 35992 MARIA RICH DIRECTOR OF DINING 40.00 X 113399 0 36169 1379911 0 325585 11 0 1 0 FRANK BLUM CONSTRUCTION 70 CHARLOTTE ST SUITE 001 ASHEVILLE NC 28801 CONSTRUCTION/REMODELING 3605948 LYTLE CONSTRUCTION SERVICES 6 BRECKINRIDGE DR FAIRVIEW NC 28730 CONSTRUCTION/REMODELING 1836286 TP HOWARD 90 NUMBER NINE RD FAIRVIEW NC 28730 CONSTRUCTION/REMODELING/PLUMBING 483419 SELECT REHAB PO BOX 71985 CHICAGO IL 60694 REHABILITATION SERVICES 433001 NEW LIVING LANDSCAPE PO BOX 1251 FLAT ROCK NC 28731 LANDSCAPING 294233 19 1756165 79397 1835562 APARTMENT REVENUE 623000 22627687 22627687 MEDICAL CENTER 623000 3195004 3195004 DIETARY 623000 2071863 2071863 CARE CENTER 623000 1788376 1788376 DIETARY - MED CTR 623000 1632942 1632942 31315872 11879 11879 71834 0 71834 71834 71834 MISCELLANEOUS 900099 224369 224369 224369 33459516 31315872 0 308082 625754 625754 60914 60914 12436109 10592404 1843705 232855 189036 43819 2896984 2351826 545158 954502 774883 179619 12692 12692 126953 126953 355467 355467 213543 213543 1756319 1352041 404278 98183 98183 2517148 2515565 1583 108758 108758 2032858 2032858 4070362 4070362 FOOD 1481954 1481954 MEDICAL SUPPLY 675530 675530 THERAPY EXPENSE 408010 408010 MISCELLANEOUS 189236 189236 108598 108598 31362729 25332767 5816419 213543 6592668 2370170 4612219 6485998 173443 126688 225437 285625 163288995 61995351 95809512 101293644 16756157 18521529 124169436 129083654 3345257 3672355 64568645 63725793 53058414 49965221 59017 7045785 121031333 124409154 X 1312096 2969415 1826007 1705085 3138103 4674500 124169436 129083654 2096787 -560390 0 X X 0 1 X 1 0 X 189608 49962 3526190 3498317 1835562 9099639 24013009 26455366 29111688 29818640 31315872 140714575 24202617 26505328 32637878 33316957 33151434 149814214 105772 105772 0 105772 105772 149708442 16936 11950 10596 2824 11879 54185 16936 11950 10596 2824 11879 54185 226096 226460 267616 203927 224369 1148468 24445649 26743738 32916090 33523708 33387682 151016867 0.99130 0.99270 0.00040 0.00050 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 957607 51987 1557 76475 934676 924466 58256 366 25481 957607 642816 96255 806 -184589 924466 656916 37997 528 52625 642816 620145 37289 31482 32000 656916 0.38751 0.61249 0 0 1513495 1513495 152182546 58633518 93549028 8725594 3361833 5363761 867360 867360 101293644 X 32899126 -560390 -560390 33459516 0 33459516 31362729 0 31362729 0 31362729 PART V, LINE 4: THE CAROLINA VILLAGE ENDOWMENT FUND WAS ESTABLISHED TO RECEIVE GIFTS, DEVISES, BEQUESTS, AND OTHER CONVEYANCES AND TO USE THEM FOR PROPERTY MAINTENANCE OR IMPROVEMENT PROJECTS, OR TO PROVIDE ECONOMIC ASSISTANCE TO RESIDENTS OR TO PERSONS DESIRING TO BE RESIDENTS. THE ENDOWMENT FUNDS INCLUDE DONOR-RESTRICTED FUNDS CLASSIFIED AS PERMANENTLY RESTRICTED, AND THE EARNINGS, INCLUDING NET APPRECIATION, ON THESE FUNDS THAT ARE TO BE SPENT ON THOSE PURPOSES WHICH ARE CLASSIFIED AS TEMPORARILY RESTRICTED. AS REQUIRED BY GENERALLY ACCEPTED ACCOUNTING PRINCIPLES IN THE UNITED STATES OF AMERICA, NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS, INCLUDING FUNDS DESIGNATED BY THE BOARD OF DIRECTORS TO FUNCTION AS ENDOWMENTS, ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS. PART X, LINE 2: THE VILLAGE 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 VILLAGE HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF MARCH 31, 2023. X X X X 0 0 0 0 0 0 0 0 0 KEVIN PARRIES CEO 451384 0 0 0 0 0 50872 0 12707 0 514963 0 0 0 JON RENEGAR DIRECTOR OF OPERATIONS 249656 0 0 0 0 0 32144 0 31625 0 313425 0 0 0 AMBER ANDERSON CFO 174370 0 0 0 0 0 6983 0 31625 0 212978 0 0 0 ALEX TUCKER HEALTH CARE ADMINISTRATOR 149524 0 0 0 0 0 19355 0 31563 0 200442 0 0 0 CHERYL JUSTUS DIRECTOR OF MARKETING 127957 0 0 0 0 0 5118 0 31432 0 164507 0 0 0 A NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65820YPD2 2017-12-27 84363613 SERIES 2017 BONDS 0 0 0 A 33060000 84363613 1814396 1225735 62052617 19307136 2017 1 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 1 0 0 0 0 0 A 0 SCHEDULE K, PART II, LINE 3, TOTAL PROCEEDS: THE AMOUNT OF TOTAL PROCEEDS PRESENTED ON LINE 3 INCLUDES INVESTMENT EARNINGS FROM DATE OF ISSUE TO THE END OF THE PRESENT FISCAL YEAR AS FOLLOWS: SALE PROCEEDS: $ 84,363,613 INVESTMENT EARNINGS TO DATE: 0 TOTAL TO LINE 3: $ 84,363,613 SCHEDULE K, PART II, LINE 11, OTHER SPENT PROCEEDS: THE AMOUNT PRESENTED ON LINE 11 REPRESENTS PROCEEDS USED TO CURRENTLY REFUND PRIOR ISSUES SERIES 2008 AND SERIES 2013. TAMMY CAMBY SISTER OF CEO KEVIN PARRIES 60914 EMPLOYED BY ORGANIZATION AS ADMISSION COORDINATOR. REPORTS DIRECTLY TO THE HEALTHCARE ADMINISTRATOR. 0 FORM 990, PART VI, SECTION B, LINE 11B THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTANT WITH ASSISTANCE AND OVERSIGHT BY MANAGEMENT. UPON COMPLETION, THE RETURN WAS REVIEWED BY MANAGEMENT AND DISTRIBUTED TO THE MEMBERS OF THE BOARD OF DIRECTORS. THE FINANCE COMMITTEE FORMALLY REVIEWED THE RETURN, AND RECOMMENDED TO THE FULL BOARD THAT THE RETURN BE APPROVED BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C CAROLINA VILLAGE POLICY COMMITTEE REVIEWS THE POLICY ON AN ANNUAL BASIS AND MAKES ANY RECOMMENDATIONS TO THE BOARD OF DIRECTORS FOR ANY UPDATES AND CHANGES. THE EXECUTIVE DIRECTOR ENSURES EACH MEMBER OF THE BOARD RECEIVES REVIEWS AND SIGNS A COPY OF THE CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS. THE EXECUTIVE COMMITTEE AND EXECUTIVE DIRECTOR ARE RESPONSIBLE FOR ENFORCING THE POLICY WITH EACH MEMBER. IF A SITUATION ARISES IN WHICH CONFLICT OF INTEREST IS POSSIBLE THE BOARD MEMBER(S) INVOLVED WILL REMOVE THEMSELVES DURING ANY DISCUSSIONS AND ABSTAIN FROM ANY VOTING. THE MINUTES OF THE BOARD WILL REFLECT THE PROCESS AND ADDITIONAL INFORMATION. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION FOLLOWS THE PROCESS DESCRIBED IN TREASURY REGULATION 4958(C) FOR ESTABLISHING THE REBUTTABLE PRESUMPTION OF REASONABLENESS IN THE REVIEW, APPROVAL, AND DOCUMENTATION OF OFFICER AND KEY EMPLOYEE COMPENSATION. A COMMITTEE APPOINTED BY THE BOARD OF DIRECTORS EXAMINES DATA FROM THE FORMS 990 FROM VARIOUS SIMILARLY-SITUATED ORGANIZATIONS IN LIKE-SIZED COMMUNITIES AND ESTABLISHES COMPENSATION PACKAGES FOR THE CEO AND OTHER ORGANIZATION EXECUTIVES. FORM 990, PART VI, SECTION C, LINE 18 PHOTOCOPIES OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE OR THE CAROLINA VILLAGE LIBRARY. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, AND GOVERNING DOCUMENTS ARE AVAILABLE ON THE NORTH CAROLINA DEPARTMENT OF INSURANCE WEBSITE, AS WELL AS AVAILABLE FOR VIEWING AT THE CAROLINA VILLAGE LIBRARY. N/A THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.