Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i)Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 99,020 | 308,093 | 188,654 | 181,409 | 280,370 | 1,057,546 |
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... | 14,557,616 | 16,878,537 | 15,867,677 | 16,416,247 | 17,538,871 | 81,258,948 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 6 | Total. Add lines 1 through 5. | 14,656,636 | 17,186,630 | 16,056,331 | 16,597,656 | 17,819,241 | 82,316,494 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 10,116 | 6,525 | 5,025 | 6,150 | 27,816 | |
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | 579,567 | 1,132,683 | 1,712,250 | |||
| c | Add lines 7a and 7b.. | 10,116 | 586,092 | 1,137,708 | 6,150 | 1,740,066 | |
| 8 | Public support (Subtract line 7c from line 6.) | 80,576,428 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 14,656,636 | 17,186,630 | 16,056,331 | 16,597,656 | 17,819,241 | 82,316,494 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 1,519,044 | 1,361,632 | 1,162,285 | 905,296 | 813,072 | 5,761,329 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 1,519,044 | 1,361,632 | 1,162,285 | 905,296 | 813,072 | 5,761,329 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 16,175,680 | 18,548,262 | 17,218,616 | 17,502,952 | 18,632,313 | 88,077,823 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e | Discount claimed for blockage or other factors (explain in detail in Part VI): | |||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| 7 | Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions) | |||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2014 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2014 |
(iii) Distributable Amount for 2014 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2014 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2014: | ||||
| a From 2009.......X | ||||
| b From 2010.......X | ||||
| c From 2011.......X | ||||
| d From 2012.......X | ||||
| e From 2013....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2014 distributable amount | ||||
|
i
Carryover from 2009 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2014 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2014 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a From 2010.......X | ||||
| b From 2011.......X | ||||
| c From 2012.......X | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | EX OFFICIO MEMBERS DO NOT HAVE VOTING RIGHTS |
| FORM 990, PART VI, SECTION B, LINE 11 | THE BOARD OF DIRECTORS OF THE PINES AT DAVIDSON MAINTAINS AN AUDIT COMMITTEE AS ONE OF ITS STANDING COMMITTEES. ALL MEMBERS OF THE AUDIT COMMITTEE ARE VOLUNTEER DIRECTORS WHO ARE INDEPENDENT OF MANAGEMENT. ALL MEMBERS OF THE AUDIT COMMITTEE ARE EXPERIENCED BUSINESS PEOPLE OR CPAS AND THE CHAIRPERSON IS A CPA. THE CHAIRPERSON ALSO SERVES AS A MEMBER OF THE EXECUTIVE COMMITTEE OF THE ORGANIZATION'S BOARD OF DIRECTORS AND REPORTS AS NEEDED DIRECTLY TO THE BOARD OF DIRECTORS. THE AUDIT COMMITTEE MEETS AT LEAST ANNUALLY IN EXECUTIVE SESSION WITH THE AUDITORS WITHOUT MANAGEMENT PRESENT. CLIFTON LARSON ALLEN AUDITS THE ORGANIZATION AND ALSO PREPARES ITS FORM 990 BASED ON INFORMATION PROVIDED BY THE PINES' MANAGEMENT. PRIOR TO FILING THE 990 TAX RETURN THE FORM 990 IS REVIEWED BY THE AUDIT COMMITTEE. A COPY OF THE FORM 990 IS ALSO PROVIDED TO ALL DIRECTORS PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION MONITORS THE CONFLICT OF INTEREST POLICY BY SENDING A QUESTIONNAIRE PREPARED BY THE ORGANIZATION'S ATTORNEY AT LEAST ANNUALLY TO ALL DIRECTORS. THE DIRECTORS RETURN THE SIGNED QUESTIONNAIRES. MANAGEMENT OF THE PINES WORKS CLOSELY WITH ITS LEGAL AND TAX ADVISORS IN THE EVENT ANY DIRECTORS INDICATE POTENTIAL CONFLICTS AND PROVIDE ASSISTANCE IN DETERMINING PROPER TREATMENT AND DISCLOSURE. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS AND/OR THE BOARD OF DIRECTORS IS ALSO APPRISED OF ANY POTENTIAL CONFLICTS OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE EXECUTIVE COMMITTEE OF THE PINES' BOARD OF DIRECTORS ("BOARD") SERVES AS THE COMPENSATION COMMITTEE THAT EVALUATES THE PERFORMANCE AND REVIEWS AND SETS COMPENSATION FOR THE PRESIDENT/EXECUTIVE DIRECTOR AND VICE PRESIDENT/CFO OF THE PINES. THE EXECUTIVE COMMITTEE IS COMPRISED OF DIRECTORS OF THE CORPORATION, CONSISTING OF THE CHAIRMAN, VICE CHAIRMAN, TREASURER, AND SECRETARY OF THE CORPORATION AND THE CHAIRPERSONS OF THE COMMITTEES OF THE BOARD OF DIRECTORS. THE COMPENSATION COMMITTEE MEETS AT LEAST ANNUALLY TO EVALUATE THE PRESIDENT AND VICE PRESIDENT. A NUMBER OF FACTORS ARE CONSIDERED AS PART OF THIS PROCESS, INCLUDING BUT NOT LIMITED TO, AN ASSESSMENT OF JOB PERFORMANCE AS MEASURED BY THE ATTAINMENT OF KEY FINANCIAL AND NON-FINANCIAL OBJECTIVES ESTABLISHED BY THE BOARD AS PART OF THE CORPORATION'S STRATEGIC PLAN. THE STRATEGIC PLAN ADOPTED BY THE BOARD AND IN EFFECT FOR THE 2014 TAX YEAR INCLUDES EIGHT KEY STRATEGIC GOALS: (1) EXCEPTIONAL FACILITIES, (2) HIGH QUALITY HEALTH CARE AND OTHER SERVICES, (3) CARING, TALENTED AND LOYAL TEAM, (4) DELIGHTED RESIDENTS, (5) STRONG COMMUNITY RELATIONS, (6) FINANCIAL STRENGTH, (7) INNOVATIVE CULTURE DRIVING HIGH OCCUPANCY, AND (8) EFFECTIVE BOARD GOVERNANCE. THE BOARD ALSO ADOPTED QUANTIFIABLE,MEASURABLE OBJECTIVES FOR EACH OF THESE EIGHT KEY GOALS AS A WAY OF MEASURING THE PERFORMANCE OF THE PINES' MANAGEMENT TEAM. EXAMPLES OF SUCH OBJECTIVES INCLUDE BUT ARE NOT LIMITED TO THE FOLLOWING (NUMBERS IN PARENTHESES REFER TO THE RELATED STRATEGIC GOAL): MAINTAINING A PASSING HEALTH DEPARTMENT RATING ON THE POOLS (1), ACHIEVING A COUNTY HEALTH DEPARTMENT RESTAURANT SANITATION SCORE OF 95 OR BETTER (2), HAVING NO INCIDENTS OF RESIDENT ABUSE OR NEGLECT (2), MEETING EMPLOYEE TURNOVER AND SATISFACTION OBJECTIVES (3), MEETING RESIDENT SATISFACTION OBJECTIVES (4), ANSWERING NURSING CALL BELLS WITHIN 3 MINUTES 95% OF THE TIME (4), STRIVING TO RESPOND TO ALL LIFE SAFETY RELATED AND HIGH PRIORITY WORK ORDERS IN A TIMELY MANNER (4), COMPLYING WITH NC GENERAL STATUTES PERTAINING TO THE LEVEL OF CHARITY CARE AND COMMUNITY BENEFIT PROVIDED BY RETIREMENT COMMUNITIES TO OBTAIN EXCLUSION FROM PROPERTY TAXATION (5), SCORING AT THE MEDIAN OR BETTER ON 17 KEY FINANCIAL RATIOS CALCULATED ANNUALLY ON 139 SINGLE SITE NONPROFIT ACCREDITED CONTINUING CARE RETIREMENT COMMUNITIES (6), STRIVING TO MAINTAIN AN 'A-' FITCH RATING OR BETTER (6), OPERATING THE FACILITY AT AN OPERATING MARGIN OF 3% TO 5% OR BETTER (6), MAINTAINING POSITIVE CASH FLOW EACH YEAR AS MEASURED BY CASH USED OR PROVIDED FROM OPERATIONS (6), AND MAINTAINING 95% OCCUPANCY OR BETTER IN INDEPENDENT LIVING (7). IN EVALUATING THE REASONABLENESS AND APPROPRIATENESS OF COMPENSATION FOR THE PRESIDENT AND VICE PRESIDENT, THE COMPENSATION COMMITTEE CONSIDERS COMPENSATION FOR SIMILAR POSITIONS AT OTHER NONPROFIT ORGANIZATIONS IN THE SAME INDUSTRY WITH COMPARABLE TOTAL REVENUES. SUCH INFORMATION ON APPROXIMATELY 50 OTHER NONPROFIT CONTINUING CARE RETIREMENT COMMUNITIES (MAINLY IN NC) IS GATHERED FROM FORM 990 TAX RETURNS BY AN INDEPENDENT COMPENSATION CONSULTANT WHO IS A CPA. THE INDEPENDENT COMPENSATION CONSULTANT PROVIDES HIS REPORT DIRECTLY TO THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE ALSO CONSIDERS A NATIONAL COMPENSATION SURVEY DONE FOR LEADING AGE (FORMERLY THE AMERICAN ASSOCIATION OF HOMES AND SERVICES FOR THE AGING) THAT PROVIDES REGIONAL AND NATIONAL COMPENSATION DATA FOR SIMILAR POSITIONS AT APPROXIMATELY 380 NONPROFIT CONTINUING CARE RETIREMENT COMMUNITIES. THE PRESIDENT AND VICE PRESIDENT RANK BELOW THE 75TH PERCENTILE WHEN THEIR COMPENSATION IS COMPARED TO THE COMPENSATION SURVEY INFORMATION REFERRED TO ABOVE. |
| FORM 990, PART VI, SECTION C, LINE 19 | FORM 990 AS WELL AS THE CONFLICT OF INTEREST POLICY AND THE CORPORATE BYLAWS ARE AVAILABLE ON REQUEST AT THE BUSINESS OFFICE OF THE PINES. THE AUDITED FINANCIAL STATEMENTS ARE ALSO AVAILABLE ON REQUEST AND A COPY IS KEPT IN THE LIBRARY OF THE PINES AT DAVIDSON. THE ORGANIZATION FILES A DISCLOSURE STATEMENT ANNUALLY WITH THE NORTH CAROLINA DEPARTMENT OF INSURANCE AND IS AVAILABLE ON THE NCDOI WEBSITE. SUCH DISCLOSURE STATEMENT CONTAINS SIGNIFICANT INFORMATION ABOUT THE STATUS AND OPERATIONS OF THE PINES. SUCH DISCLOSURE STATEMENT IS ALSO AVAILABLE IN THE LIBRARY OF THE PINES AND IS DISTRIBUTED TO ALL APPLICANTS FOR RESIDENCE. |
| FORM 990, PART XI, LINE 9: | CHANGE IN DISCOUNT -13,265. NET ASSET RELEASED FROM RESTRICTION FOR OPERATIONS -336,324. |
| FORM 990, PART XII, LINE 2C: | NO CHANGE IN METHOD SINCE THE PRIOR YEAR. |
| FORM 990, PART I, LINE 19 RECONCILIATION | THE REVENUE LESS EXPENSES FOR THE FISCAL YEAR 2014, AS REPORTED ON PART I, LINE 19 OF THE FORM 990, RECONCILES TO THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS IN THE FOLLOWING MANNER: TOTAL OPERATING REVENUE AND SUPPORT 18,083,389 TOTAL OPERATING EXPENSES 17,330,786 INCREASE IN UNRESTRICTED NET ASSETS 752,603 FORM 990, PART I, LINE 19 -- REVENUE LESS EXPENSES 1,320,963 RESTRICTED CONTRIBUTIONS (273,720) UNRESTRICTED CONTRIBUTIONS (6,650) RESTRICTED INTEREST INCOME (268,554) REALIZED GAIN FROM SALE OF INVESTMENTS (19,436) INCREASE IN UNRESTRICTED NET ASSETS PER AUDITED FINANCIAL STATEMENTS 752,603 THE INCREASE IN UNRESTRICTED NET ASSETS OF $752,603 FOR FISCAL YEAR 2014 REPRESENTS 4.2% OF TOTAL OPERATING REVENUE OF $18,083,389 FOR SUCH YEAR. THIS RATIO IS REFERRED TO AS THE OPERATING MARGIN RATIO. AN OPERATING RATIO OF 4.2% MEANS THAT $4.20 OUT OF EVERY $100 IN OPERATING REVENUES REMAINED AFTER ACCOUNTING FOR OPERATING EXPENSES. BY WAY OF COMPARISON, THE 75TH PERCENTILE OPERATING MARGIN RATIO FOR A GROUP OF APPROXIMATELY 138 SINGLE SITE ACCREDITED CONTINUING CARE RETIREMENT COMMUNITIES WAS 4.96% FOR 2014 (SOURCE: FINANCIAL RATIOS TREND ANALYSIS OF CARF-CCAC ACCREDITED ORGANIZATIONS). A POSITIVE OPERATING MARGIN OVER TIME IS AN INDICATION THAT THE PINES CAN PRUDENTLY MANAGE ITS COSTS AND EXPENSES FROM YEAR TO YEAR, AND THAT THE PINES IS FINANCIALLY STABLE ENOUGH TO SUPPORT ITS SERVICES. |
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