Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (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 |
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Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 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) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (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) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 473,718 | 833,229 | 438,125 | 69,270 | 250 | 1,814,592 |
| 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 | 37,837,600 | 40,559,275 | 39,769,538 | 44,096,679 | 47,125,775 | 209,388,867 |
| 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 | 38,311,318 | 41,392,504 | 40,207,663 | 44,165,949 | 47,126,025 | 211,203,459 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 0 | |||||
| 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. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support. (Subtract line 7c from line 6.) | 211,203,459 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 38,311,318 | 41,392,504 | 40,207,663 | 44,165,949 | 47,126,025 | 211,203,459 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 680,386 | 697,497 | 1,005,125 | 1,113,439 | 987,205 | 4,483,652 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 680,386 | 697,497 | 1,005,125 | 1,113,439 | 987,205 | 4,483,652 |
| 11 | Net income from unrelated business activities not included on 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.) .. | 10,200 | 23,402 | 13,908 | 17,031 | 118,166 | 182,707 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 39,001,904 | 42,113,403 | 41,226,696 | 45,296,419 | 48,231,396 | 215,869,818 |
| 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) |
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| 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): |
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| 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 0.015 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 0.035 | 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 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2023 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2023 |
(iii) Distributable Amount for 2023 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2023 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2023: | ||||
| a From 2018....... | ||||
| b From 2019....... | ||||
| c From 2020....... | ||||
| d From 2021....... | ||||
| e From 2022....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2023 distributable amount | ||||
|
i
Carryover from 2018 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2023 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2023 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2023, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2023. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2024. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2019..... | ||||
| b Excess from 2020..... | ||||
| c Excess from 2021..... | ||||
| d Excess from 2022..... | ||||
| e Excess from 2023..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | MISCELLANOUS - 2019 AMOUNT: $ 10,200. 2020 AMOUNT: $ 23,402. 2021 AMOUNT: $ 13,908. 2022 AMOUNT: $ 17,031. 2023 AMOUNT: $ 118,166. |
| Software ID: | |
| Software Version: |
| Return Reference | Explanation |
|---|---|
| FORM 990, PART III, LINE 4A | SKILLED NURSING PROVIDES TWO SEPARATE DAILY PROGRAMS CONSISTING OF APPROXIMATELY TEN TO FIFTEEN RESIDENTS WITH MODERATE TO SEVERE MEMORY IMPAIRMENT ARE SERVED DAILY WHILE FIVE TO TEN RESIDENTS WITH RELATIVELY INTACT COGNITION. THERE IS ALSO A MUSIC AND MEMORY PROGRAM UTILIZING INDIVIDUALIZED MUSIC TO SERVE BOTH SKILLED NURSING AND MEMORY CARE RESIDENTS. VOLUNTEERS SUPPLEMENT STAFF MEMBERS TO ENHANCE PROGRAMMING AND QUALITY OF LIFE. ENVIRONMENTAL SERVICES: IN ADDITION TO CLEANING ALL COMMON AREAS AND PROVIDING DAILY SERVICE TO ALL SKILLED NURSING AND ASSISTED LIVING RESIDENTS, ENVIRONMENTAL SERVICES ALSO PROVIDES SERVICE TO APPROXIMATELY 192 INDEPENDENT LIVING RESIDENTS PER MONTH. APPROXIMATELY 60 POUNDS OF LINEN ARE WASHED, DRIED AND IRONED DAILY FOR THE CLUB CENTER DINING ROOMS, IN ADDITION TO LINENS PROVIDED IN THE SKILLED NURSING AND ASSISTED LIVING FACILITIES. TRANSPORTATION: TRANSPORTATION IS PROVIDED TO RESIDENTS AS NEEDED WITH A VARIETY OF VEHICLES, INCLUDING HYBRID SUVS AND HANDICAPPED ASSISTED VANS. INFORMATION TECHNOLOGY: INFORMATION TECHNOLOGY SERVICES ARE PROVIDED TO ALL RESIDENTS UPON REQUEST FOR ISSUES INCLUDING INTERNET, COMPUTER, TECH DEVICES, CABLE TELEVISION, AND PHONE SERVICES. THERE IS ALSO HELP PROVIDED TO ALL NEW INCOMING RESIDENTS AT THE TIME THEY MOVE ONTO CAMPUS. THE DEDICATED RESIDENT SUPPORT SPECIALIST POSITION PROVIDES COMPLETION OF TWELVE TO FIFTEEN RESIDENT SERVICE WORK ORDER TICKETS DAILY. PROPERTY TAXES: FOR 2023, VOLUNTARY PROPERTY TAXES OF $1,229,425 WERE PAID TO SUPPORT NEEDED INFRASTRUCTURE TO BENEFIT CHATHAM COUNTY, NORTH CAROLINA WHERE CAROLINA MEADOWS IS LOCATED. |
| FORM 990, PART VI, SECTION A, LINE 6 | CAROLINA MEADOWS SENIOR COMMUNITIES & SERVICES, INC. IS THE SOLE MEMBER OF CAROLINA MEADOWS, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | AS THE SOLE MEMBER, CAROLINA MEADOWS SENIOR COMMUNITIES & SERVICES, INC. ELECTS THE GOVERNING BODY OF CAROLINA MEADOWS, INC. |
| FORM 990, PART VI, SECTION A, LINE 7B | AS SOLE MEMBER, CAROLINA MEADOWS SENIOR COMMUNITIES & SERVICES, INC. MUST APPROVE ALL SIGNIFICANT DECISIONS OF CAROLINA MEADOWS, INC. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE 990 IS REVIEWED BY MANAGEMENT, RECOMMENDED BY THE CAROLINA MEADOWS, INC. BOARD FINANCE COMMITTEE AND THEN APPROVED BY THE PARENT BOARD FOLLOWING PREPARATION BY THE CFO AND THE INDEPENDENT TAX ACCOUNTANT. THE REVIEW IS CONDUCTED PRIOR TO FILING WITH THE IRS AND INVOLVES A THOROUGH EXAMINATION OF THE INFORMATION USED AS A BASIS FOR PREPARATION OF THE 990 BY THE CFO AND INDEPENDENT TAX ACCOUNTANT, AS WELL AS EXAMINATION OF THE DRAFT OF THE 990. ANY CHANGES ARE RECOMMENDED TO, AND REVIEWED BY, THE INDEPENDENT TAX ACCOUNTANT. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY, ALL SIGNED COI POLICY AND ATTESTATION FORMS ARE PROVIDED TO ALL BOARD MEMBERS, INCLUDING EX-OFFICIO MEMBERS. THE SAME FORMS ARE PROVIDED TO ALL KEY STAFF EMPLOYEES. THE ATTESTATION FORMS ARE COLLECTED FROM THE BOARD AND KEY EMPLOYEES IN MAY OF EACH YEAR. THEY ARE THEN REVIEWED BY THE BOARD GOVERNANCE COMMITTEE AND CEO FOR ANY INDICATIONS OF ACTUAL OR PERCEIVED CONFLICT NOTED. IF NONE, THE ATTESTATION FORMS ARE ACCEPTED AND STORED. IF THERE WERE TO BE ANY INDICATIONS OF ACTUAL OR PERCEIVED CONFLICT NOTED, THE GOVERNANCE COMMITTEE WOULD ALERT THE BOARD CHAIR AND THE ACTUAL OR PERCEIVED CONFLICT WOULD BE DISCUSSED FURTHER WITH THE INDIVIDUAL INVOLVED TO DETERMINE IF AN ACTUAL CONFLICT EXISTED. IF IT IS BELIEVED AN ACTUAL CONFLICT EXISTS, THEN THE FULL BOARD WOULD REVIEW THE CONFLICT AND MAKE A DETERMINATION HOW BEST TO RESOLVE THE CONFLICT BY EITHER ACCEPTING THE CONFLICT OR REQUIRING THE MEMBER OR STAFF PERSON TO CEASE AND DESIST OR FACE REMOVAL FROM THE BOARD OR TERMINATION FROM EMPLOYMENT IF A KEY STAFF EMPLOYEE. IF A CONFLICT IS ACCEPTED BY THE BOARD, A PERSON INVOLVED IN MATTERS WHERE A CONFLICT EXISTS MUST RECUSE HIMSELF OR HERSELF FROM BOARD MEETING DISCUSSIONS AROUND THE CONFLICT OR BOARD ACTION TAKEN IN REGARD TO THE CONFLICT. IF A CONFLICT INVOLVES A STAFF PERSON, THE STAFF PERSON WOULD EITHER BE REASSIGNED OR TERMINATED, DEPENDING ON THE TYPE OF CONFLICT AND IMPACT TO THE ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 15 | IN DETERMINING THE CEO'S COMPENSATION, SALARY INFORMATION IS COMPILED BY THE EXECUTIVE COMMITTEE OF THE PARENT BOARD OF DIRECTORS WHICH SERVES AS THE EXECUTIVE COMPENSATION COMMITTEE. THE COMMITTEE USES A VARIETY OF COMPARABILITY AND SALARY SURVEY DATA FROM CATAPULT, INC., FORMERLY CAPITAL ASSOCIATED INDUSTRIES (CAI), INCLUDING THE NORTH CAROLINA ANNUAL WAGE AND SALARY SURVEY, THE NATIONAL EXECUTIVE COMPENSATION SURVEY, AND GUIDESTAR EXECUTIVE COMPENSATION DATA. ASSESSMENT FORMS RATING THE CEO'S PERFORMANCE ARE ALSO COMPLETED BY MEMBERS OF ALL AFFILIATE BOARDS. USING THE SURVEY DATA AS BENCHMARKS AND THE COMPILED ASSESSMENT DATA AS AN INDICATOR OF PERFORMANCE MEASUREMENT, THE EXECUTIVE COMMITTEE RECOMMENDS TO THE FULL PARENT BOARD FOR APPROVAL OF THE TOTAL CEO COMPENSATION WITHIN THE BOARD ESTABLISHED SALARY RANGE FOR THE CEO POSITION. BASED ON SALARY AND TOTAL COMPENSATION DATA FROM CATAPULT (FORMERLY CAPITAL ASSOCIATED INDUSTRIES), GUIDESTAR, THE NATIONAL EXECUTIVE COMPENSATION SURVEY, AND LEADINGAGE SURVEY DATA, THE CEO SETS AND APPROVES COMPENSATION FOR THE COO AND CFO POSITIONS WITHIN ESTABLISHED RANGES FOR THE ORGANIZATION BASED ON INPUT AND REVIEW FROM THE PARENT BOARD. THE SALARY AMOUNTS FOR THE CEO, COO, AND CFO ARE FURTHER REVIEWED BY THE FULL PARENT BOARD AS A MEASURE OF OVERSIGHT AND UNDERSTANDING OF TOTAL EXECUTIVE COMPENSATION FOR THE TOP EXECUTIVE POSITIONS. THE PROCESS DESCRIBED HERE WAS LAST COMPLETED IN 2023. |
| FORM 990, PART VI, SECTION C, LINE 19 | MINUTES OF QUARTERLY BOARD MEETINGS INCLUDING THE QUARTERLY FINANCIALS AND ANNUAL AUDITED FINANCIAL STATEMENTS ARE PLACED IN THE CAROLINA MEADOWS RESIDENT'S LIBRARY. ARTICLES OF INCORPORATION ARE AVAILABLE ON THE SECRETARY OF STATE'S WEBSITE AND, ALONG WITH THE BOARD BYLAWS, ARE AVAILABLE FOR REVIEW UPON REQUEST. AN ANNUAL DISCLOSURE STATEMENT IS AVAILABLE ON-LINE THROUGH THE NC DEPARTMENT OF INSURANCE (NCDOI.COM), AND INCLUDES IN APPENDICES COPIES OF THE DOI CCRC LICENSE, DHSR NURSING FACILITY LICENSE, ANNUAL AUDITED FINANCIAL STATEMENTS, FIVE-YEAR FINANCIAL PROJECTIONS, CCRC CONTRACT AND OTHER CORPORATE INFORMATION. CONFLICT OF INTEREST STATEMENTS ARE AVAILABLE FOR REVIEW UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | CHANGE IN FAIR VALUE INTEREST RATE SWAP -169,631. TRANSFER OF NET ASSETS |
| Software ID: | |
| Software Version: |