Arbor res - Arbor Acres

DlSCLOSIRE STATEME'

TABtE OF CONTENTS 

PAGE NUMBER 

ORGANIZATION INTRODUCTION AND INFOR-;1ATION (Corporation) 3 

• Narrative Description of the Organization and Its Operation 

• Non-ProfitIFor Profit Status 

• Affiliation(s) 

• Accredita!ion(s) 

FACILITY INTRODUCTION AND INFORMATION (Facility) 3 

• Narrative Description of the Facility and [rs Operation 

• Non-ProfitfFor Profit Status 

• Affilialion(s) 

• Accreditation(s) 

• Legal Description 

• Identification and Bm:kground of Officers, Directors, Management Staff, 

Owners, Including Addresses and Professional Services 

• Criminal Violation Statement 

• Location and Description of Physical Property 

• Estimated Number ofResidents 

POLICIES 10 

Admission 

• Health Criteria 

• Financial and Insurance Criteria 

• Age Requirements 

• Changes of Condition afResident Prior to Occupancy 

• Refund(s} ApplicablelNot 

Applicable/Time Frame ofRclund(s) 

• CaJlceliationrrermination - Refund(s) Applicable/Not 

Applicable/Time Frame of Refund(s) 

• Moves 

• MarriageslNew Second Occupant 

Inability to Pay 

Smoking Pollcv 

SERVICES 14 

• Standard Services Available 

• Services Available at Extra Charge~ Identified 

• ELITE Care 

• Adult Care Home (Assisted Living) 

• Health Services Available 

• Personal Services Available

PAGE NUMBER 

FEES 19 

• Application/Registration Fee w RefundablelNoll*Refundable 

• Entrance Fee Monthly Fee - RefundablelNon-Refundable 

• Notification of Fee Increase (5) 

• Changes in Fees for the Previous Fi ve Years 

FI~ANCIAL INt'ORMAnON 25 

• Financial Overview Statement 

• Reserves, Escrow and Trusts 

• Facility Development/Expansion 

• Completion of Operating Reserve Reporting I:Onn 

OTHER MATERIAL INFORMA nON, AS APPLICABLE 27 

• Description of Any Past/Current Litigation, Banknlptcy Filings, 

Receivership, Liquidation, Impending Actions or 

Perils, Etc" or Any Other Yfaterial Informarion 

ATTACHMENT I 28 

• Current Certitied Financial Statements 

ATTACH:\1ENT2 28 

• Five Year Projection Statements 

ATTACHMENT 3 28 

• Resident's Agreement/Contract 

ATTACHMENT 4 28 

• Escrow Agreement 

ATTACH:\1ENT 5 28 

• Actuarial Report, Feasibility Study, :Nlarketing Study, Pre·Sales Reports, 

Occupancy Reports or Other ~aterials 

2

DISCLOSURE STATEMENT 

ARBOR ACRES Uiln:n METHOJ)lST RETIREMENT COMMUNITY, INC 

June20lQ 

ORGANIZATION INTRODUCTlOl'i AND INFORMATION (Corporation) 

Narrative Descrlgtion of the Organization and Its Operation 

The name of this organization is Arbor Acres United Methodist Retirement Community, Inc. 

(fonnerly known as The Triad United Methodist Home, Inc.; amended by the Board of Directors 

May 25. 2000). Its business address is 1240 Arbor Road, Winston-Salem, North Carolina 27104. 

Arbor Acres is a continuing care retirement community. 

~on-ProfitIFor Profit Status 

Arbor Acres is a North Carolina non~proflt corporation~ exempt from the paymentoffederal income 

tax under Section 501 (e)(3) ofthe Internal Revenue Code. 

Affiliation(s) 

Arbor Acres is organized under the sponsorship ofthe Western North CaroHna Annual Conference 

of The United Methodist Churob, The extent of the affiliation between Arbor Acres and the 

Conference is set out in a Statement ofRelationship, a copy ofwhich follows the narrative section of 

this Disclosure Statement (pages 29-32). The Conrerence is not responsible for the financial and 

contract obligations of Arbor Acres, Arbor Acres holds membership in the American Association of 

Homes and Services for the Aging and the "S"orth CaroHnaAssodation ofNon-Profit Homes for the 

Aging, 

Accreditation(s) 

Arbor Acres is accredited through the Commission on Accreditation of Rehabilitation Facilities and 

the Continuing Care Accreditation Commission ofthe American Assoclation ofHomes and Services 

for the Aging, 

FACILITY INTRODUCTION AND INFORMATION (Facility) 

Arbor Acres is a continuing care retirement community providing a continuum of residential 

accommodations, These include independent living facilities with 2 mid-rise residential wings 

containing 67 units (studiQ, efticiency and connecting room units); 6 courtyard apartments, 8 duster 

homes, 44 Stockton Building apartments, and 107 houses, The main building complex contains [he 

2 mjd~rise residential wings and also contains the following support facilities: Business ofilces, 

Fellowship Hall, chapel, computer roOll4 arts and crafts room, library ~ recreational areas, dining 

room, beauty shop. several parlors, kitchen, housekeeping, laundry, and maintenance service areas. 

3

In addition to its independent Hving units and support facilities mentioned above. Arbor Acres also 

has licensed beds in two areas of the campus, these being in the Fitzgerald Health Center (herein 

after referred to as the Health Center) and in the Corpening Building. Arbor Acres is licensed for 

J67 beds (65 skilled beds and 102 Adult Care Home beds). Support facilities in the Health Center 

include offices, family rooms, dining rooms, activity ure~ physical therapy room. special bathing 

unit (SPA), and beauty shop. 

Arbor Acres operates under the supervision of a Board of Directors that is responsib~e for the 

establishment of operational policy. Daily operation of Arbor Acres is supervised by a President 

and CEO/Administrator. Operation ofthe facility is the immediate responsibility of! J departments. 

Those departments are MarketiogIPubtic Relations, Human Resources, Finance, Development, 

Facility Services, Buildings and Grounds, Dining Services, Nursing, Chaplaincy, Recreation 

Services., and Resident Services. 

Non-ProfitiFor-Profit Status 

See the corresponding sccllon above. 

Affiliation(s) 

See the correspondjng section above. 

Accreditation(s) 

See the corresponding section above, 

Legal Description 

Arbor Acres is a corporation chartered by the State of North Carolina. 

Identifi~mlQn and Backgrou.nd ofJ)JIigers, Directors, Management Staff. Owners Including 

Addresses. and Professional Services 

The present Officers and Directors of Arbor Acres. together ",1Ih the principal business affiliation 

and address of each, are as follows; 

Board of Directors 

Mrs. Unda G, Davis 

Chair 

Mr, Richard V. Bennett 

Chair Elect 

Princip~JJ3usiness Affiliation. Address 

Retired Chief of Police 

City of Winston-Salem 

4537 Thacker Hill Road 

Winston-Salem, NC 27106 

Attorney. Bennett & Guthrie 

1560 Westbrook Plaza 


4

BQard of DirectoJ~ 

Mrs, Susan S. Schwartz 

Secretary 

Mr. Richard Fulp 

Treasurer 

Mr, David \\I. Bailey 

Mr. William L Ball, Ir, 

(ResidenO 

Dr. Edward S. Beason 

Mrs, Judy M. Briggs 

Mr. Robert S. Chiles, Sr. 

Mr. James H. Corrigan 

(Residentj 

Mr, Don Eppert 

Dr. James Ferree 

Mrs. Emma Graham 

(Re,~ident) 

Principal Business AfnH~tion. Ad9re_ss 

Executive Director 

The Cemala Foundation 

330 S. Greene Street, Suite 101 

Greensboro, NC 27401 

Retired, Franklin Street Partners (investment mgmt.) 

2325 Warwick Road 

Winston-Salem, MC 27104 

Attorney, Bailey & Thomas 

P, 0. Box 52 

Wjru.1on w Salem, NC 27103 

Retired, CFO, Rmldolph-Macon College 

1244 Arbor Road, Box 183 

Winston-Salem, KC 27104 

Retired Physician 

340 Hambrick Court 

Win,ton-Salem, NC 27104 

Retired Business Owner 

929 Goodwood Road 


Real Estate/Business Development 

Cbiles-Dunnings, Inc. 

1804 ChileS-Higgins Court 


Retired Executive 

R, J, Reynolds Tobacco Company 



Retired, Human Resources Executive 

520 Claridge Circle 


Retired) United Methodist Minister 

168 Brooks Landing Drive 

Winston~Saleill, NC 27106 

Retired, Graham & Boles Realty 

1244 Arbor Road, #504 

Winston-Salem, NC 271 04 

5

Board of Direc!ors 

Mr. Ralph Holthouser 

~s. Victoria HWlt 

Mr. Gregory B. Hunter 

Mrs. Dyeann Jordan 

Dr. Henry Miller 

Mrs. Lisa Purcell 

Mrs. Brenda Robertson 

Dr. Althea Taylor-Jones 

ML William Womble, Jr. 

Ex Officio 

Bishop Larry Goodpaster 

Principal Business Affiliation, Address 

Hospital Administrator 

4161 Sulgravc Court 


Retired Nurse 

915 Kenleigh Circle 


I" Vice President, Merrill Lynch 

150 S. Stratford Road, Suite 150 


Homemaker/Volunteer 

911 Partridge Lane 


Retired Physician 

920 Gondwood Road 


Vice President. The Winston-Salem Foundation 

425 N. Avalon Road 


Retired, Verizon 

278 Old Hollow Road 


Retired, Coordlrul!or of Gerontology Program 

WSSU, Dept of Social Sciences 

1469 Country Meadow Lane 

Kernersville, NC 27284 

Attorney, Womble Carlyle Sandridge & Rice 

2658 Club Park Road 


Residing Bishop 

Western KC Annual Conference 

The United Methodist Chun:h 

P. O. Box 18750 

Charlotte, Ne 28218 

6

The Rev. Frank H. Ison 

The Rev. N. Fred Jordan, Jr. 

The Rev. Dr. Wm. T. Medlin III 

The Rev. Dr. Samuel H. Moore, Jr. 

District Superintendent 

Greensboro District 

The United Methodist Church 

P. O. Box 4523 



North Wilkesboro District 


P. O. Bnx 367 

North Wilkesboro, NC 28659 


Winston-Salem District 


1031 Re)TIolda Road 



'Northeast District 


P. O. Box 678 

Madison, NC 27025 

Mr. Michael L. Robinson Attorney. Robinson & Lawing~ LLP 

(Immediate Past Chair) 101 N. Cherry Street, Suite 720 


Mr. Richard Stockton 

{ResidenO 

The Rev. Sylvia D. Wilhelm 

Dr. Carl M. Worthy, Jr. 

President, Resident Council 

Arbor Acres United Methodist Retirement CommuuitYl Inc. 




Lexington District 


P. O. Box 1825 

Lexington, NC 27293-1825 


High Point District 


p, O. Box 4158 

Archdale, NC 27263 

Directors who are experienced in the operation or management of similar facilities are as follows: 

Mrs. Susan S, Schwartz is the ExeclltIve Director ofThe Cemala Foundation in Greensboro, NC 

7

Arbor Acres is managed on a day-to~day basis by three licensed nursing home administrators. as 

follows: 

W. David Piner (License #534) - President and Chief Executive Officer 

W. David Piner served as Arbor Acres' Health Center Administrator from January 1985 to February 

1989; in 1989, he became Executive Director of Arbor Acres and in November 2003 was named 

President and Chief Executive Officer. Previously he served as Executive Director of Covenant 

Village, Gastonia, "Iorth Carolina (January 1983-December 1984), and as Assistant Administrator of 

the Moravian Horne, Inc., Winston-Salem, North Carolina (January 1977-1anuary 1983). Me Piner 

is a graduate of \Vashington and Lee University (SA. Sociology and Anthropology) and the 

University ofOlQrth Carolina at Chapel Hill (MA, Anthropology). 

Lurana Day (License #1586) - Vice President and Chief Operating Officer 

In April of2006, Lurana Day was named Vice President and Chief Operating Officer at Arbor 

Acres. Her educational backgroW1d includes a Diploma in Nursing (Wesley School of Nursing. 

Wichita, Kansas), a BSN (Ft Hayes State University, Hayes, Kansas) and an MSN (Wichita 

State University, Wichita. Kansas). She has held an active North Carolina Nursing Home 

Administrators License since 1996. Professional activities include active participation and 

service on committees for tong-term care organizations and a gubernatorial appointment to serve 

on the Board for Licensing for Nursing Home Administrators in North Carolina. Prior to joining 

Arbor Acres, :Vis. Day served as Director ofNursing (Good Samaritan Center, Maryfield. and 

Moses Cone Extended Care Center), Administrator (Moses Cone and SalemtowTle), Performance 

Coach (High Point Regional Health System) and Vice President and Chief Operating Officer 

(Salemtowne). 

Tonja K. Wimmer (License #120281) - Director ofNursing 

Tonja K. Wimmer served as Charge Nurse in Arbor Acres Health Center from July 1992 to June 

1995; since February 2002 she has been the Directt1r ofNursing, Previously she served as Nurse 

Supervisor of Arbor Acres from August 1998 to February 2002; Asststant Director ofNursing of 

Salemtowne, The Moravian Retirement Community (April 1997 to May 1998); Nursing Supervisor 

ofBuchanan General Hospital (August 1988 to May 1992); and Director ofNursing, Heritage Hall 

Nursing Center in Clintwood, Virginia (September I 991-May 1992). She is a graduate ofBluefield 

State College, Bluefield, West Virginia. 

Arbor Acres has no present intention ofpurchasing goods, lea.-;es Qr services ofan aggregate of$5oo 

or more within any year from any of tbe persons listed above, who have a ten percent or greater 

interest in any professional service. finn, association, trust, partnership or corporation which 

provides goods, leases or services to Arbor Acres; nor is it intended that any of said persons shaH 

provide goods, leases or serviees to residents of Arbor Acres. If any resident ofArbor Acres shaH 

obtaill any goods, leases or services from any of said persons, it will be because the resident 

voluntarily elects and chooses to do so, not because the doing of such business is intended by Arbor 

Acres or is expected of the resident. Arbor Acres does not know the monetary value of such 

business, if any, as may be transacted between individuals who happen to reside at the facility and 

firms or busincsses owne-d or partially owned by individuals who happen to serve as officers or 

directors ofthe facility, nor does Arbor Acres have any infonnation from which to make an estimate. 

8

Criminal ViQlation Statement 

To tl\e best ofthe facility's knowledge, based on information furnished to Arbor Acres by each ofthe 

persons listed ahove, none of the matters referred to in paragraph (3)c of G.S. Section 58-64-20 

(felony convictions or charges, certain injunctions. etc,) applied to any of said persons. 

Location and Descri12tim1 of Physicai Property 

r\Tbor Acres is located ou an approximately 82-acre site at 1240 Arbor Road in Winston-Salem~ 

North Carolina. On this propeny are the residential facUities described above in the Narrative 

Description of the Facility and Its Operation. 

Egimatc.d Number of Residents 

The present number of residents is 399. 

9

POLICIES 

Health Criteria: To be accepted as a resident, the applicant's health must be such that the 

applicant's care requirements are appropriate to, and can be met within the level ofcare to which the 

person is requesting admission. For example, a person applying for admission to independent living 

must be ambulatory, mentally alert, and able 10 meet his or her personal care needs without 

assistance or supervision. The agreement entered into between Arbor Acres and a resident states that 

at (he rime ofthe execution ofthe agreement, Arbor Acres has detennined that the resident qualified 

for residency at Arbor Acres both with respect to the resident's mental and physical condition and 

the resident's ability to take care ofanticipated fees and charges. The agreement also provides that it 

wiH be necessary for the resident IO meet the Arbor Acres health and financial qualifications for 

residency at the time he or she becomes a resident ofthe facility, subject to the understanding that if 

at that time the person is not mentally or physically qualified to occupy a residential unit of (he type 

contemplated unde-r the agreement, but is qualified to live in an Adult Care Home (Assisted Living) 

unit or in the Fitzgerald Health Center of Arbor Acres, he or she win be entitled to such 

accommodations at the facility as are appropriate to the person's situation and needs, and are then or 

later become available. Once admitted to Aroor Acres, ares:ident, from the standpoint ofheaJth. may 

continue to reside at Arbor Acres so long as the facilities and services available can, in the opinion of 

the facility's medical advisers. provide the level ofcare needed by the resident As a resident's needs 

for care increase. the resident may be required to move to a higher level ofcare provided by Arbor 

Acres in order to continue the right ofresidency at the facility, 

Financial and Insurance Criteria: To be accepted as a resident and in order for residency to 

continue. an applicant must agree to pay the entrance fee and monthly fees and charges associated 

with the living unit and level ofcare required by the applicant. Arbor Acres requires applicants to 

provide a financial statement. Applicants with inadequate financial resources to carry them through 

their projected tife expectancy are nevertheless considered for admission iffamily members provide 

guaranties of payment or ifthe applicant qualifies for financial assistance within the limit ofArbor 

Acres' ability to provide, Residents whose resources are depleted during residency may remain as 

residents under the following cJrcwnstances: If members of resident's family or other interested 

parties provide guaranties of payment acceptable to Aroor Acres; or if the Arbor Acres' financial 

assistance resources are such as to enable the facility to provide the amounts needed. Residents 

whose financial resources are diverted to other persons or causes, thereby creating a financial nee

occupancy. an applicant's financial condition changes affecting the applicant's ability to pay 

expenses associated with residency, the applicant is required to submit a new financial statement 

Improvement in the applicant's financial position may atter previous: commitments by Arbor Acres 

to provide financial assistance. A decline in the applicant's capacity to pay the previously agreed 

upon periodic fees and charges may require reassessment ofthe applicant's ability to reside at Arbor 

Acres and whether Arbor Acres is in a position to provide financial a...«sistance. If the applicant is 

unable to move into Arbor Acres for any reason, the applicant is entitled to an entrance fee refund to 

the extent ofand in accordance with the provisions of the agreement. 

CancelialioniTennination - Refund(s) Applicable/Not ApplicablelTime Frame oj Rejufld(,): A 

resident may tenninate residency upon thirty (30) days written notice, Immediate v.'ithdrawal by a 

resident is pennitted jf the resident is in the Health Center, Arhar Acres may terminate one's 

residency if: 

L Resident does not pay monthly fees and other charges on a timely basis; 

2. Resident's behavior (or that of residenfs family members, responsible parties, or 

others specified in the residency agreement) is detrimental to the spirit of Arbor 

Acres; or 

3. Resident requires treatment or care other than that which Arbor Acres is licensed 

or staffed to provide. 

Termination ofresidency by Arbor Acres occurs only '''as a last resort," v.rhen it becomes dear that 

tenrunation is necessary, and after the resident andior the resident's responsible party has an 

opportunity to be heard, On tenninahon ofresidency any monthly fees paid in advance are prorated 

and an appropriate refund is made thereof. if any, within sixty (60) days. Provisions relating to 

entf'drtce fee refunds upon termination ofresidency are set out in residency agreements. Subject to 

the statutory refund provisions which apply in the event ofrescission ofthe agreement within thirty 

(30) days or preclusion. by death, illness, injury, or incapacity, from occupying a unit under the 

terms ofthe agreement, Arbor Acres' standard agreement generally provides that $2.500 per person 

of the entrance fee is net refundable and that the remainder of the entrance fee is refundable on a 

declining basis of two percent (2%) per month for fifty (50) montilS, with no part ofthe entrance fee 

being refundable after a person bas resided at Arbor Acres for fifty (50) or more months, The 

agreements further provide that payment of the refund is to be made from the entrance fee received 

by Arbor Acres from the next occupant of the unit. The calculation and payment ofany refund to a 

person who has become a resident is made in the same manner whether termination of residency is 

voluntary, is at the request ofArbor Acres, or is occasioned by death. 

}doves: Provisions governing moves ben.veen levels of living are outlined in the residency 

agreement. Independent living residential units (such as studios, apartments, houses) may not be 

made available to a different or new resident except under the following circumstances: 

1" Ifthe resident terminates residency at Arbor Acres either voluntarily or at me request 

ofArbor Acres tor cause. 

II

2. Ifthe resident tenninates occupancy of the unit by moving to another unit at Arbor 

Acres either because of a desire on the part of the resident to move or because of 

health problems that necessitate a move to another type ofunit, such as a studio unit 

(if the resident resides in a house), Adult Care Home (Assisted Living) or the Health 

Center. 

3. If the iullowing situation prevails: In a limited number of cases Arbor Acres has 

contracted with a non-resident ofArbor Acres who has paid an entrance fee and been 

given the right to occupy a particular unit in the future, Any other resident of such 

unit resides in that unit under a special agreement (with a reduced non-refundable 

entrance fee which explains the situation and provides for the movement of that 

resident to another unit in the event the non~resident with whom Aroor Acres has the 

contract elects to occupy the unit). 

4. Changing market conditions (specifically, increasing requests for multiple room 

residency W1its and decreasing requests for studios) make it necessary from time to 

time for Arbor Acres to convert studios to connecting room suites in order to keep 

studios fully occupied. When this must be done, Arbor Acres occasionaUy finds that 

it can be accomplished only by having a resident move to another studio in order to 

'i'ree up" adjacent studios for conversion to a connecting room suite:. Should Arbor 

Acres find that it must have a resident make such a move, the matter is thoroughly 

discussed with the resident and the resident is shown the studio to which the resident 

is to move. Arbor Acres will make the studio to which the resident is to move ready 

for occllpant.-y. including any needed refurbishment, and wiU assist the resident with 

the move, all at the expense of the facility. 

5, Ifthe resident dies. 

In the case of a couple, the death or pennanent transfer of one spouse to a different unit does not 

affect the remaining spouse~s right to continue residency in the unit 

In Adult Care Home (Assisted Living) or in the Health Center, Arbor Acres reserves the right to 

change one's room from time to time as deemed by Arbor Acres to be necessary or appropriate, Any 

such changes are made with due regard to the wishes and best interest of the resident as well as 

Arbor Acres. 

AfarriageslNew Second Occupant: Ifa resident marries whiJe residing at Arbor Acre~ the spouse of 

the resident is expected to follow the facility's normal admission procedure. Among the basic 

factors for approval are: 

l. Spouse ofresident must be a lea~t 60 years of age (i.e., older spouse must be at least 

62; younger spouse must be at least 60); 

12

2, Physical condition must be appropriate to the level of care to which the person 

requests entry and the care required must be within levels of care Arbor Acres 

provides; 

3. Behavioral characteristics must be appropriate for group Jiving at tl\rbor Acres; 

4. There must be sufficient financial resources to enable- the couple to meet financial 

obligations, or their circumstances must be such as to qualify for financial assistance 

within Arbor Acres' policies and ability to provide, 

If the applying spouse is approved for residency at Arbor Acres and is to live in the same residential 

unit with the resident, the applicable second person entrance fee will be required. If the applying 

spouse is to live in a separate unit, an entrance fee is required. Regular monthly (daily in nursing 

care and assisted Ijving) fees and other charges would be in accordance with Arbor Acres' regular 

schedule for double occupancy, or individual occupancy, as appropriate. 

Ifthe applying spouse should not meet the requirements for residency, the applying spouse would 

not be able to reside at Arbor Acres. As of the date ofthis Disclosure Statement, no applying spouse 

has failed to meet the requirements. 

Other than in the case of a spouse" there are no other provisions currently in pJace to permit 

occupancy of a unit by a second occupant who was not party to the original residency agreement. 

Inability to Pay: If a resident sbould encounter finandal difficulty while residing at Arbor Acres, 

the resident may apply for financiaJ assistance, Arbor Acres has limited financial assistance 

resources for this purpose, Also, in a number ofcases there are guaranty agreements between Arbor 

Acres and members ofa resident's family which make possible the resident's continued residence at 

the facility. Arbor Acres is unable to guarantee initial or continuing allocations of financial 

assistance to a resident. As of the date of this Disclosure Statement, it has not been necessary for 

Arbor Acres to require tennination of residency tor financial reasons. 

Several years ago Arbor Acres initiated and has since worked to develop its Assistance Endo\h'lTIent 

Fund. the income of which is available to Arbor Acres for the assistance ofresidents who require 

financial assistance. As ofthis date the value ofthis Endo'lhnlent Fund is approximately $9,064,297; 

and the income from it constitutes one of the several sources of Arbor Acres' annual assistance 

funds which currently aggregate more than $1,000,000 a year. The other sources ofassisumce funds 

include an annual Mother's Day Offering, and grants from wills, trusts, foundati OIlS and the Western 

North Carolina Annual Conference of The United Methodist Church. 

Smoking Policy Arbor Acres respects ea{;h resident's right to freedom of choice regarding 

smoking, and at the same time strives to promote healtb and safety for all residents. employees, 

and properties, Consistent with these responsibilities, Arbor Acres, as of October 1,2007, will 

enforce the following restrictions on the use ofcigarettes and other burned tobacco products.

• Smoking is prohibited in all indoor enclosed facilities for dining, activity programming, 

and assembly, and all congregate independent Jiving residential facilities (McPherson, 

Womble, and Stockton Buildings), The only exceptions to this prohihition are those 

spe

personal telephone handset or telephone service 

3. Basic cable television (not television set) 

4. Emergency call system 

5. Recreational, educational, cultuml and spirituai life programs 

6. Transportation to routine non~emergency medical apPoIntments within Winston~ 

Salem (transportation by ambulance not included) 

7. Limited in~patienttemporarycare (see Services Available at Extra Charge, Identified: 

Temporary in-patient care) 

8. Routine nursing a

during any ninety (90) consecutive day period, These five (5) days can be restored only upon 

completion of ninety (90) consecutive days afterdischarge from temporary care withoutretumirtg to 

and occupying a temporary care bed, Meals are charged from the first day forthose residents not on 

the meal plan, 

4. Supplies (such as syringes, dressings, etc) utilized by the clinic nurse in providing the 

resident routine nursing services. 

Other services available at extra charge are: 

a. Guest meals: Residents who are not on the mea) plan, and residents desiring to have guests 

for meals may purchase meals at the established guest meal rate. 

b, GUest accommodations: Guest accommodations are available to residents on a first corne 

first serve basis for an additional daily fee. 

c. Personal Services: Individual personal services are available to residents at an additional 

hourly rate, 

For schedule ofcharges applicable at this time to services available at an extrd charge, see pages 20 

22, 

ELITE Care 

ELITE, Easy Living Including the Extras, is a level ofeare lhat is higher than fuil independent living, 

but below the Jevel of full Assisted Living. ELlTE residents may require and are eligible to receive a 

broad spectrum ofservices necessary to enable them to remain comfortable and safe in independent 

living longer than would be possible othel"\vise. ELITE residents have access to the following 

support services as needed: escort to meals and special events on an occasional basis. escort10 doctor 

appointments, daHy medication reminders, order ofmedication and setting up ofmedication boxes, 

monthly health evaluation by a nurse in a clInical setting. assistance entering and exiting the 

tub/monitoring while bathing, personal laundry including ironing when necessary, additional 

housekeeping, assistance with dressing, activity reminders, consultation about and assistance with 

managing incontinence, daily home visits by trained ELlTE staffmem"bers. See pages 20-22 for 

ELITE Care charges. 

AdlllJ Cllfe.Hol]l" (generally referred to as "Assisted Living") 

Adult Care Home (Assisted Living) agreements specifY the following services provided by Arbor 

Acres: 

1. Maintenance of buildings and grounds, including room occupied by resident 

2. Utilities: heat. air conditioning, electricity~ water and sewer; telephone jack included, 

but not personal telephone handset or telephone service 

3. Ba.

6. Transportation to routine non-emergency medical appointments within Winston 

Salem (transportation by ambulance not induded) 

7. Limited in~patient infirmary care 

8, Around-the-clock nursing superi,tision (in accordance with regulatory standards; does 

not include private duty or individual nurse for each resident). prescribed medication 

administration and limited assistance with activities: of daily living 

9, Daily housekeeping assistance 

10. Laundering of bed and bath linens furnished by Arbor Acres 

II. Laundering of personal clothing (washing, drying, folding, and ironing). Dry 

cleaning is sent out. 

12, Staffed entrance gate 

13. Food service (3 meals daily) 

Health Services Available 

--~. --_. 

Health Center agreements specifY the following services provided by Arbor Acres: 

I, Maintenance of buildings and grounds, including room occupied by resident 

2. Utilities: heat, air conditioning, electricity. water and sewer; teJephonejack included, 

but not personallelephone handset or telephone service 

3. BaSIC cable television (not television set) 

4. Nurse caB system 

5. Recreational. educational. cultural and spiritual lite programs 

6. Transportation to routine non~emergency medical appointments within Winston 

Salem (transportation by ambulance, not included) 

7. Around-the~clock nun::ing care (in accordance with regulatory standards: does not 

indude private duty or individual nurse for each resident) 

8. Daily housekeeping assistance 

9. Laundering ofbed and bath linens furnished by Arbor Acres 

10. Laundering of personal clothing (washing, drying and folding, not ironing or dry 

cleaning) 

II. Staffed entrance gate 

12. Food service (3 meals daily and routine between mea] nourishments). Note: 

Administration of physician-prescribed gastric tube feeding included; cost of 

prescribed food substitutes and supplements. not included. 

Arbor Acres furnishes each Health Center resident a document entitled "Fitzgerald Health Care 

Center Statement of Services and Related Charges," The statement currently reads as foHow'S: 

The Fitzgerald Health Center ofArbor Acres provides a full range ofnursing care and heruth 

supportive services for each resident. The Fitzgerald Health Center provides tor Assisted 

Living Level II and skilled nursing care, for which the facility is duly licensed by the State of 

Korth Carolina, The foHowing rates have been established for admission to and residency in 

the Fitzgerald Health Center. Persons admitted directly to the Fitzgerald Health Center 

17

without having previously resided at Arbor Acres must pay a $1,000 non~refundable entrance 

fee at the time ofadmission, Charges for the first month ofoccupancy will be due at the time 

ofadmission and will be prorated based on the number ofdays remaining in the first month 

of occupancy. Payments for subsequent months will be due in advance at the first of each 

month. Payments may be made between the first and ~he tenth of the month, 

Residents pay a daily charge tor services rendered by both licensed nurses and certified 

nursing assistant.'), This daily charge also includes meaJs and clinical dietetic services. 

personal laundry service. all utiHties (except telephone), housekeeping, maintenance. and 

access to Arbor Acres program activities and social services. Services rendered at Arbor 

Acres are not reimbursable under the ~1edicare and Medicaid programs of the federal 

government. The restriction on Medicaid participation was imposed by the State of:t-;orth 

Carolina as a condition for the construction and licensing of the Fitzgerald Health Center, 

The current room rates in the Fitzgerald Health Cemer are as follows: 

Skilled Nursing - $231.00 per day, MemoryCare (Dementia Unit) - $231.00 per day, and 

Assisted Liying Level II - S167.00 per day, Excluded from the daily room rate are charges 

for pharmacy services, personal medical supplies, personal care products. beauty/barber shop 

visits, physician services, dental services, podiatry services and services rendered by a 

licensed therapist as part ofan individualized program ofrehabilitation, Since Arbor Acres 

is not a certified Medicare facility, therapy services are not covered under Medicare Part A. 

Therapy services are provided under Medicare Part B benefits and there are some limitations. 

The therapy provider advises residents about the coverage under :Medicare and what must be 

private pay. 

Our staff physician schedules weekly appointments in the Fitzgerald Health Center and 

arranges for emergency physician services 24 hours a day. Residents may use the services of 

our staff physician or may select another personal physician who will come to Arbor Acres 

011 a monthly basis and perform the services required by state licensure. The resident will be 

fuHy responsible for all physician services charges which they may incur, inclurling the 

Medicare deductible and co-payment. 

Medical supplies, phannaceutical services and some personal care products are provided for 

all residents of the Fitzgerald Health Center. Enrollment in these programs will assw'e 

maximum efficiency and security in the administration of resident's medications, and 

availability of needed supplies on a continuous basis. A list ofcurrent charges is availahle 

upon request. AU medications, medical supplies.and personal care products will be billed 

monthly to each resident either by the facility or the provider of the service, 

18

'The maintenance fee (whether stated on a monthly or daiiy basis) is payable in advance each 

month~ a11 charges incurred during a month are bHled at the end ofthe month. All fees and 

charges are normally included in one monthly statement and are payable in full promptly 

upon receipt of statement. An itemized statement may include medical suppJies, oxygen, 

beauty/barber shop charges, personal care prooucts, guest meals, special activities and guest 

room or guest house charges. Pa}ment is requested within 10 days. A late payment charge 

of 1,5% per month. computed from tbe statement date, will be made on any amount not 

received within 30 days of the statement date. 

Residents are responsible for continuing payment ofthe daily rate during absences from the 

facility. This is necessary in order to assure the availability ofa bed upon rerurning. Fees for 

services during the last month ofoccupancy will be prorated and any remaining unused days 

ofcare will be refunded to the resident or to the resident's estate, 

Other services available for '\vhich there is no additional charge include dally contact with the front 

desk receptionist to increase resident's sense ofsecurityI check cashing services, package wrapping. 

storage area, access to washers/dryers, minor repairs to personal clothing and personal 

appliances, parking spaces, and access to complete kitchern and lounges. Services available through 

Arbor Acres may be added or deleted from time to time. Charges for services may be adjusted 

periodically as found necessary by Arbor Acres. Normally such adjustments are made as part of the 

facility's annual budget preparation process, 

FEES 

Arbor Acres' application ree is $100.00 ($200.00 for a couple); it is non-refundable. 

[Fee Schedule on Next Pagel 

19

Residence 1 ype 

SrCDIOS ;".'iD ONE·BEDRooM 

APARTMENTS 

Sludio 

One-bedroom Apartment 

On~·bcdroom Apartnlent with Khch;:netle 

One-bedroom Apartmem for Two Residents 

Financiallnform{/Iion 2010 

Independent Living 

Square Footage 

i 

I , 

, 

Entrance fee 

$27,000 

I J04 , 576.;;08 

$57,000 

576~S 

$68,0';0 

567.000-78,000 

Monrhly Single fee 

'"MumMy fee includes .Itrite ,1/l'o.{,5 (j ;f(j)' 

ami utilities 

$L%2 

$2.6\7 

$2,6! 7 

53,92;4 

*Dedming mea! aflowllfll..'

Finandililn/ormation 2010 

Assisted Living 

Residence Type Entrance Fee Darly Rate 

Assisted Living Level I $1.000 $137 pcrday 

Assisted Living Level 11 $1,000 $167 per day 

Assisted Living Level 11 

w McmoryCare $1,000 $231pcr day 

As:siMCd Living Level! lU.iCCflIfllI}(iutirms are studio iJ{wrtmefils withfilll hl1lh~ and (WI! toea/lid in liN: CvrpC'rJinK Building, 

Assiswd Living Len'J !1

Entrance Fees for residential units are refundable. less $2,500 ($5,000 iftwo persons enter under 

one residency agreement) and less 2% a month for the first 50 months ofresidency. Skilled Nursing 

and Assisted Living entrance fees are non~refundab)e except as specified in the residency agreement 

Monthly fees are non-refundable; however, because fees are paid in advance, fees will be prorated to 

the last day of occupancy and a refund ofthe balance paid to a resident in the event ofterminatlon of 

residency, 

For Temporary Care stays beyond the five (5) day period, the daily rate is $23 LOO. 

Home Care rates apply only to those residents living in independent Jiving who have the need for the 

specific service offered. 111rough utilization ofthose services. residents are able to continue living in 

an independent W1it rather than having to move to a higher level of care. Monthly rates are as 

1'ol1o\'I"s: 

Medication Control $110.00 

ELITE Care (package ofservices) $694.00 

Meal Rates for Guests and for residents not on the meal plan are a La carte with entrees beginning at 

$5.50 and side items at $1.00 each. The soup and salad bar is priced separately, Pricing infomlation 

is printed on daily menus. 

Guest House/Guest Room rates are: 

Guest Room (includes breakfast) 

1 Person $ 78.00 per night 

2 Pe-rsons S 84.00 por night 

Each Additional Person S 8.00 per night 

Guest House 

1 Person S 95.00 per night 

2 Persons $105.00 per night 

3 Persons $115.00 per night 

22

Additional Services 

Additional housekeeping services, such as 

cleaning attics and closets, polishing silver, 

cleaning carpets (other than annual cleaning, 

persnnallaundry) 

Assistance with bathing. personal hygiene, 

and other personal services 

Transportation to non-medical locations 

within Winston-Salem city limits, e.g. 

hairdresser, bank, attorney appointments, etc. 

This service is available during regular 

working hours only. (Transportation to 

medical appointments is included in month1y 

charge,) 

Private transportation to public and private 

events not included in Arbor Acres; activity 

program schedule 

Escort services for medical/dental 

appointments for residents other than those in 

licensed areas. 

Services outside those included in the monthly 

charge, such as hanging shelves, putting 

fumiture together, rearranging furniture, non 

level-of-care moves (i.e. house to Stockton), 

Charge 

$25,00 per person, per half hour 

$1250 tor first half hour; billed in IS-minute 

increments after the first half hour 

$15,00 for first half hour; billed in IS-minute 

increments after the first balf hour, and 

includes travel and return time to Aroor Acres 

for both drop off and pick up 

S 50 per minute for single passenger ($30,00 

per hr,); $ ,I 0 per minute tor each additional 

passenger ($6,00 per hour) 

$12.50 for first half hour; billed in 15-minute 

increments after the first half hour 

$25,00 per person, per half hour 

Arbor Acres may increase fees Qf may otherwise adjust periodic charges and fees as: detennined 

necessary by the Board ofDirectors in order to maintain the desired quality of service and to operate 

Arbor Acres on a fiscally sound, non·profit basis. Proposed adjustments in charges and fees are 

nonnally made if, and to the extent, found necessary in the course of preparing an annual budget: 

then. upon approval by the Board ofDirectors, are implemented at the beginning of the upcomlug 

fiscal year. 

Changi;.s in Fees for the:. Previ9us Five Years 

A five~year history ofadjustments 1n Arbor Acres' most common room fees is reflcrted below. 

23

0ctupa'lCY 

C'a$$r-""'Jel' 

i 20t8 

ChG: "'" C~O' CNG 

:;;01.1' f«'CM' Fi:\'CM 

RArE RATE ?PE'J Rfon, ,.€V "-ArE ?REV, RATE 

• ,7: iJ 1,_'4" 1 ~IS 74 

$ucb;3 "'e~wlaal') 1.170 1 g.;" lit 1,1162 

EIIi",,,'l:'y \~ meafll'day) 1,721 VS2 6Q i,as: 71 1,$21 74 U!66 19 UPS , 

" " 

C')MC~,,~g mem SI",a i1 m"a;!:IIdmy) 2,274 2,J54 6) 2448 U4G 98 2,597 51 ; 6,7 

o-~ 8~ C:>.Jctyard Ap: 

ResiI1!7N'I. ,""or to li " 

H% 1J29 

~.. Slid,"",,,, 1-'0""" 

R""'oe"i($ pryer :c 'liliJ 1 (no '1e'aI$) 1,254 1,4-43 t SOl 1 561 I S9~ 1524 

f\$$,deMl; hi l.'1.CJ 1654 , 7':3 1 to 219S 'l,i) 

,,. 

f'.~~' 3 '95 3435 3,504 

" 

". 

'" 

S:«:~"'." Apartmt!m.io -a:..t 1Ir"e baoeG "f'O*1 Me pefSM Q

FINANCIAL INFORMATION 

Financ~9:t Overyie_w StaJement 

Arbor Acres has relied upon gifts, pledges and bequests, and upon funds received from entrance fees 

to cover most of the cost of construction. equipment, land improvements. other extraordinary 

expenses, debt amortization and accumulation of reserve funds. Secondly, Arbor Acres generally 

relies upon periodic fees and charges from residents to support the cash requirements foroperalions. 

In 2002, Arbor Acres used proceeds from a $23,105,000 tax~exempt bond issue to finance major 

campus additions and renovations, Intermediate tenn bonds totaling $5,500,000 were recalled and 

paid offin April 2005 ratherthan waiting until their maturity date ofMarch 2007, Reserve funding 

has not been necessary to enable Arbor Acres to perform its entrance fee refund obligations for the 

reason that the Arbor Acres residency agreements have generally provided that any refund wou}d be 

payable out of the next occupant's entrance fee. 

On March 21. 2007, Arbor Acres used proceeds from a $17,765,000 tax-exempt bond issue to 

Advance Refund SI5,800,000 cftb. outstanding 2002 bonds leavingSI,805,OOO unrefunded, The 

purpose ofthc refunding was to take advantage ofa large decrease on the effective interest rates in 

the bond market Arbor Acres reduced the average coupon rate ofthe refunded bonds from 6.27% to 

4.49%, resulting in a net present value savings of $1.682,283 or 10.6 % on the refunded bonds. 

As required by G,S. 58-64-30, a comparison of Actual Results with Forecasted Projections as of 

December 31. 2009 follows the financia1 section of this Disclosure Statement. (page 92). 

&.seryes. Escrow and Trusts 

As of the end of 2009, Arbor Acres had unrestricted cash and investments of $7,499,009, 

investments funding operating reserves of $3,775,000, and restricted cash and investments for 

purposes other than financial assistance of $541.366, The $541,366 restricted inv-estment includes a 

$500,000 endo\\1Uent, the income from which helps support the operating expense of a s'Wimming 

pool and spendable restricted funds to support a number of smaller ongoing projects on campus. 

The facUity expects to have a reserve requirement of $3)665,000 based on the 2010 Forecast and 

expects to exceed this reserve requirement with reserve funding of$3,775,000 as of December 31, 

2010. The building of these reserves will continue in future years and will be accomplished 

primarily through the receipt of entrance fees, contributions, and bequests from \-vills and rrusts. 

These projections show the achievement of an increasing operating reserve fund (projected at 

$5,084,000 at December 31, 2014) which will enable Arbor Acres to maintain the reserve 

M 

requirements of (is, 58 64-33 during the period ofthis forecast. The achjevement ofthis reserve 

requirement is predi\!ated upon Arbor Acres being subject to the 25% reserve requirement based 

upon the facility's anticipated occupancy of units exceeding 90%. The facility's occupancy is 

projected to be approximately 95% during this five--year period. 

25

Arhor Acres is continuing to convert two single room WlitS (studio/efficiency units) into a single 

larger unit Over a period of time, the number of units wiH gradually decrease as this conversion 

continues in response to meeting the needs and demands of today's demographics. 

Within the facility's licensed areas, all semi~private skilled nursing beds have been converted to 

private skilled nursing beds. A renovation project was completed in the fall of2003, at which time 

our licensed bed count became 84 assisted living (50 in the Fitzgerald Health Center and 34 in the 

Corpening Building) and 53 skilled. 

In addition to the investments discussed above. Arbor Acres had $9,407,149 offinancial assistance 

funds in place at d,e end of2009. $8,724,309 ofthat amount constituted the Assistance Endowment 

Fund; the balance constituted funds available for assistance to residents. These are funds which are 

used to provide charitable assistance to residents who othernise would nor be able to aftord 

residency at Aroor Acres, 

Investments of funds are currently in an interest-bearing checking account; Money MarketaccOlmts; 

two different accounts ofmne no*load mutual funds, each with the Vanguard Group; two Real Estate 

Funds with UBS and two Absolute Return Funds Vltith Private Advisors, One ofthe accounts with 

Vanguard. one of the Real Estate Flmds and one ofthe Absolute Return Funds are specifically for 

Assistance Endowment resources. Future investment strategies will depend upon future investment 

opportunities and market conditions. One mutual fund account is currently the investment vehicle 

for the operating reserve fund. Investment strategies will be reviev."Cd continuously. and as the 

amount of money available lur long~tenn investment changes., the diversity ofinvesunent vehicles 

utilized by the facility is likely to change. 

Overall policies and decisions relative to the magnitude of reserve funds and the investment of 

reserve funds and financial assistance funds are under the direction ofthe Finance Committee ofthe 

Board of Directors. \Vithin the parameters ofthese policies, specific investment decisions may be 

authorized by any two ofthe persons holding the positions of Chair, Vice Chair, Treasurer, Chief 

Financial Officer (provided one ofthe two is Treasurer or Chief Financial Officer). An ofthe above 

positions are held by Board members with the exception ofthe Chief Financial Officer, Kenneth W, 

Boyles, Chief Financial Oftlcer, is the only individual in the direct employment ofArbor Acres who 

is included in this investment decision authorization. Mr. Boyles holds a Bachelor of Arts degree 

with a specialty in Economics from Wake Forest University (1972). Mr. Boyles also earned a 

concentration in Accounting from the Graduate Business School at the University ofNorth Carolina 

at Greensboro (1978). Mr. Boyles is a Certified Public Accountant licensed in North Carolina 

(19S0), His experience includes 6 years in the banking industry. 3 years in Public Accounting and 24 

years as Controller/CFO in the manufacturing industry, and 4 years as CFO In a Continuing Care 

Retirement Community. 

26

An Escrow Agreement has been established for administering entrance fee receipts to the extent and 

as required by applicable statutes. A copy ofthe Escrow Agreement follows the financial section of 

this Disclosure Statement (page 93). 

Currently Arbor Acres has under construction a 12 bed, 8)500 square feet addition to its existing 

MemmyCare facility, and a 72 bed, 117,000 square feet Assisted Living Building. These additions, 

along with another 12 skilled nursing beds allocated to Arbor Acres through the Certificate ofNeed 

process will increase Arbor Acres total licensed bed capacity from 137 to 167. Additionally, Arhor 

Acres expects to break ground in 2010 on a minimum of 24 new independent Hving houses, 

construction of which will be completed by year end 2011. Also, with construction of the new 

Assisted Living Building scheduled for compietion in December, 2011, Arbor Acres anticipates that 

vacated space in one of its existing buildings (currently used for licensed Assisted Living) wm 

convert to 11 moderately priced one~bedroom apartments for independent residents, Upon 

completion of all major new construction and the latter renovations. Arbor Acres projects its total 

resident population to increase from 400 residents currently to approximately 480 residents. 

In anticipation of this increase in the total residents served. Arbor Acres is developing plans to 

enlarge its existing dining facilities for independent living residents, and to expand the availability of 

convenient parking for the use of all residents. 

Cot11pletion ofAnnual Disclosure Statement Filing Supplement 

An Annual Djsc-losure Statement Filing Supplement was completed and included with Arbor Acres' 

2010 disclosure filing to the North Carolina Department of Insurance. 

OTHER MATERlAL INFORMATION, AS APPLICABLE 

Arbor Acres is not the subject ofany existing or threatened litigation, bankruptcy filing, reeeivership, 

liquidation or the like, The facility has historically been exempt from property taxes and remains 

exempt under current statute which bases the degree ofexemption upon the amount ofcharity care 

and community benefit provided by the facility. 

27

ATTACHMENT I 

$dll1ent C~rtified I:inancial Statements 

Arbor Acres operates on a fiscaJ year which coincides with the calendar year and the financial 

records of the facility have been audited annually through our 2003 fiscal year by Butler &. Burke, 

CPA, an independent auditor. Aroor Acres selectt!d Dixon Hughes, PLLC, as its independent auditor 

for fiscal year beghming January 1,2004 and anticipates continuing this relationship through at least 

2010. Audited figures for 2009 are induded in the financial section of this Disclosure Statement 

(pages 33.54). 

Interim financial statements dated March 31,2009, as required by V.S. 58·64-20(3)(10), follows the 

audit report (pages 55·57). 

ATTACH.'\IENT 2 

Five year Projet,:.tion Statements 

Five year projections are included in the financial section uftbe Disclosure Statement (pages 58-92). 

ATTACHME:'!T 3 

Residenes Agreement/(:ongact 

A copy of the standard resident agreement for the unit under consideration by the recipient of this 

Disdosure Statement is inserted in the back ofthe Disclosure Statement. Copies of standard resident 

agreements for each type of unit available in the taciHty are filed with the Disclosure Statement 

submitted annually to the Korth Carolina Department of Insurance. 

ATTACHMENT 4 

Escrow Agreement 

An Eserow Agreement has been established for administering entrance fee receipts to the extent and 

as required by applicable statutes. 

A copy of the Escro\.v Agreement follows the financial section ofthis Disclosure Statement (page 

93). 

ATTACHMENT 5 

~~ial Summary Repo~Feasibility Stq51y. Marketing Study,.J)re~Sgles..Reports, Occupancy 

Reports. or Other Material Infonnation 

None of the reports Hsted above are attached. 

28

§:IATEMENT OF RElATIONSEll;' 

TIITS STATFJ,ffiNT OF RELATIO:i'SHlP is made and entered icto as of the 

.'1E day of ~=e .~__~ 199.2.. by and between the WESTERN NORm C.AROLINA 

ANNlV\.L CONFERENCE OF THE UNTIED M1:l'HODlST CHURCrl (the "Co;lference··, 

and IRE TRl.A.D llNI1EDMETHODISTHOME, INc.. a nonprofit corporationo,ganized ""j 

e:risting under the laws of the State of NDrth CaI"f)Ea (the ".4ifiliated Orgrurization"). 

PR.ELJ::M:!NARY STA1F2~' 

The Conference is one of the annual conferences of The United Methodist 

Cnurch. The term ~e 'United Methodist Church" refers to the cr-...era.ll dennmination and 

connectionall""""....iation and iden:tity betWeen its Dl3TIY local churches.,. the various wnfereoces anc 

their respective wunciJs, hoards and agencies, a'ld other ehan:b units, wI:riclI ooU_ly 

constitute the religious system known as "United Methodism. Under the Constitution 2nd 

discipliuary proced= set forth in The Book ofIY.scip!in.e ofT"" United MethDdist CP.=J, (the 

"Discipline"), 'The Uili'.ed Methodist Orutcb' as a denomlnational wbole is ilot·an entity, nor 

does it possess legal capacities and aJ:trlb= It does not and cannot hold title to property, nar 

does it have any officer, agent, ""'l'!oyee, omce DC locaticm. Conf=_ coU!lCils, boards, 

age:lcies j 

iOC2l ci:rnrches and ot.1:ler urrits bearing the r.ar.:J.e "United M~thodist" a.--e,. for the most 

nan le£"3.l entitics cat:abk of snlrltl and beinG sued and D()SSesse:G of le~ ca""zui:ie!. 

~..,:o • ~ I:> " ::I> t' 

Tn':; ronn~Ct-:la1 str'!.lct'ure of the Chw-ch is maint~ned fut-ongh the coIlier::nc:::s. 

Each of the A!musl Conierences (of which the Con.fCJrence is roe) is composed of ac. equal 

!l'J:l'!l.be: of rnin.ister5 end Jay members elected by the local cha:ches.. In til...'"D,. there is one 

General Conference, composed of3.."1 equal nU11'.ber of mi.cistets and lay members elected by the 

A::mua! Con.£:erences., The Discipline is the bOOK Gf 13w of tOe Church. The v.scipliJte is the 

product Dr more than 200 r....ars of the General Code:ren~ of the denoo:narions which now 

form the O1xc:b.. &ch G-en~ Coclerence amen:::.s., per:e..,.""ts, ~l1... 

29

United M.etnodists-, the O)nference atlj t..l.;ae "\'!iI.iolTh iP..stitu:ior:.aJ zlli-isGi::s S?;:G.:e: 

a c;):r:.::::lDlJ in:~e:rt that heal.::h and welfare :ruh'listt1es beatiz:rg r.b~ name 1,Jr:i~ej M~t..~odi;;t s.ha:.J 

~e demons:r.i)ly ::::.9.-"ing, q:lB.ii':}' r;:rissio::lS of QU"istian service that operate Li a maLkleT W:::J.SLt:1: 

vYitb tb: Socia Principles and o;;ber pertinent provisions of the Discipline. 

The Affi.Jia:ed Organi.zation is one of the health and welfare ministries ofD:lliej 

Methodism within :be brr:L"ld.arie:s of 8..:.'1:d afBlisr.eC with the Conference. The _A f:mi:;:ed 

organization v.as orga::riz.ed 'with enCD·.J!'ag~ent and approval of the Couference bv 

individuals mt::;!,',l:!bers of rbe Clu:::ch 'Who w!.T'e coz:,,"j't"c.ed to w~e belief rhat the Afiilialei 

Organization vt'as needed to peITOi'!!:o the I:lbistry set forth in iu; chw..er (the "Ministry"), The 

Conference and ;;be Affllia red Organi.zatior. co::rtinue; In that beUeL 'I'i"'le 10iLJ.isLry is amon!:!: the 

O::rristia::l missions of Un.ited Methodis:n and or De O::mfer-vnce. ~ 

The purpose or t.l:.U.l; Stalem~ of Relaticms..:.up is to set lorJJ. an accurate 

;;tate;::ne::u of tl-..e relatiollSblp between the Conference and the 

_= 

Affij:Med Organization. 

NOW, THEREFORE, tile Confer=cc covenanl:s and with tile A£fi!i!lted 

O'ganization and IDe A£fi!i!lted Organization c(m:mmlS aad agr= with tile lli:ll=:nco fuat dill 

8t:atemem of Re:!arionship, mcludiJlg the foregoing Prelimin,ary Statemer:t, is a:l Ziccr.:rrate 

stat~cnent of the rciationship between the C,on.ference and the Affiiiated O~gal';z:atio:l. 

COV3NANTS 

1. Alilio:;.gt. tbe. Confe:e:lC':e 2.Jd r:hc~~ Org?D7::;:dun shcse:3 ;::0:-;""0;: 

interest in carrying o'il!. the C:ui.&tian r::rission or Urlli.e>:l Medlodism and in the purposes of the 

MiDis:t

OpPDrt:u.-"'li.--y for th::. fi....f:Biia:.ed Orga.1ization La repo;1 OD the Y.J.-,..,j;;n)' :0 each 

,egular sessioa of the Confer ence, 

c.. Tne •.o...fi:lliated OrgarrizatioD unde."1.akes: (0 to fi.:L.fi1J it.>: 

t:llSSlOD of Dtristian service b a rr.armer that is consistc:n.: with the Social 

Principles and other ~en: pro;.isioTI." of thelY.sc:i.piine, and acceptable to those 

'Wh:::n:n it wouid serye and to members of the Chcrch in the Conference; zt1d nn 

to :he e::uent it dee.ms appropriate., LC uw1tze se..'""?ices of the Conference and th~ 

Churcil available to the .A..fiillated Org"'-=ili:ation in perfurn:ring its MJ:r;,ktr)'. 

d, The Affiliated Organization, desiro'.lS of gaining marim:r:n 

benefit from .its affiliation with the C::>rrfaeoce and to satisfy the Co.:lference tl:.at 

It coutinues to operate in a manner worthy of a United Methodist mfnistry, will 

conti::lue to provide to the Cccl.erence such of the fonowing as may he req'Jested 

or desired by the Conference: CD in£oonation that !Jl3y !>, of in:erest to other 

similar ministries; (ii) copies of re.aular opaatiolllll and fi'l3!lcial re;>orts; and (ill) 

other bformatioD regarding pla~ 

Organization. 

services and niirUstties of the I>.1Ullated 

2. Tue Conference is not CC)ntra~y or legally co~e4 to provide azy 

pat-ticulEr level or amount ::Ji fblwcial S".rpport to Cle Affiliated 0:"gan;72tion. Any strppor: i±a! 

the Canfereuce does or Day provide:o the Afilillt;:.d O~..nizatior: is, and sna!1 be. volr.::n::?_'J, 

as; de~-m.bed, from time to time, soie:ly by the C'1ruereuce. Tl1~ Conierence b3.s DO auilionr-,; 

w req-se ilie AffiIiafed Organlzatio::':'J to ~.Iille any contractt.ta1. financial or :J6er obli;,;--a:l~: 

i1:lr may the Confe,e.t!ce accep: or ass'Cme ;my S',lcb obliga'io:1 i:n the name of the iL"ffiliatert 

Orgenizatic:;, Sir;ill2.1-Iy. me A..rr'J.ia!.ed Org.ani.z.:stion. has no RU::hOrity to accevt or assuoe- a::v 

s>xh ;)bligation in the D:l.'ffile of the Confere::!ce. Both a~ee::.tat !he Co~~re shall n....VC 1:0 

DbligatiD::!. or respolm'bility for or ~th respe.c:;: to any con:r'aC":.., o::;!!rmi~ent or fiehility of :::1.:: 

Affi}i2t~ Orgaciz.auon. 

3. C1:l!::rch~1+1de soli::itatiom (::hat i;:;, :>.olici::atiOIlS EH:ldressed to t.i)c ge::le:-ai 

rnembershi£l ot a bc::al church) 'Within or !l:u....Oi1igh local United 1-1etbod.ist c:rurches uf :he 

Cotie::-encc are nD~ to be oooe by the Affilia~ Organj 7Q tbn e:xcept as heretofo::-e or b.~:;3i".-e; 

::i.?p!'a.;::;d t-y tl::;e Conferen-;;e or the resi:ielli his-bop. Other SOticit3:.:10:ll, sncb ?..5 sOllci~ti:)IlS of 

h:dh-id:::.nls :::uc c:;}tities, whether wT not C1-I]7cJ. me!!l:'ers OT cbur-ch·related. 2:'e ~tters oo,;;,>e:e::J 

me Affilia:.ej Org-aniz:atiOiJ and the parties saild:ed 3.:JG do -:Jut reqcili-e 6e a?~'21 of ~h~ 

~ , 

I-OjJjC,Cilc.e.. 

i. Ii r:1::Ie affifi"'tion bec.:veen the Confer:-ncc 2nd 6e Afillia:e:d 0:"g:onj::scti0:J 

sDocid a: a::;y tin:;e e:.ero:::l~ :na;;x.ptal:>k to ::he:-:::1, or to Q::JC Jf:he;::n. :beyer either cftb~ Bay 

"'·:!'\fez r:...""'e "Fi'iFation bemeen ilier:. [,h'1d ~berC-fu":::r ope::-ate e;:~-ely fndey:::ndenriy of the other, 

:f :>."t-:.",... rr"1 """"'.t"'r t .. .., - ...:,,,,,.\F-.r;,i,'1"') i" f-~'-""_' h-... /..~'" ;'''=-:-;'; "",.,tv ~h"'t ~".tr7"" ~1,.,~1 ""O~_"-:Jt ~ __~-:C"".'"' 

-~ -",,~,,-, ._ .......... (.i.f_. '-'~_.""_ =t" 0;> \-C~•• -.~ ~"","" i;'~", .).-~, -'"".. ('''''-' --: "'- ~ ;-" -L • -" ~ • 

.. , 

31

5. b the event (>c ~ne diss:Jluuon of the ~A.i5liated Organ:.zatior", jt.> :azse-:s :::3)' 

be- conveyed tv the Conference or ~$ ot.'1er,",,1se provided in the ch?.r:er Df th: A;:ffiiated 

Or&~tiQr:. 

6. Tnis Statement 0: R:e;~ati:)r.shlp shall be subject :0 revJ:!W £Ina a::;:,e:lci.iJJe.."1t 

as S'.lcD ti:ne:s and b suc::t manne:- as :0::2)' be mu':UaIiy ag:-eeab}e ;;:Q th¢ Cor:ie:~1C:! Dd the 

~4..I"llli2!;ed Organi.,.~tior:.. 

This S~t:'A!le."1t ofRelatio;:u;mp sU?e;:seaes :...~e Stai:.ernen: J[Rclatiomhb )C';:v;.'ec;} 

the pardes 6at was executed by the Cocfere:1ce on the 16th daj' of Jc:..1;', 1987 a.~d by the 

.AiB.iatej Orgarizatior:. on the 24th day of iUlg'.lS!., 1987. 

fr~ ~TI1'J..bSS W.dE?..EO?. eacb CJf the par-...ies h::i":::to has C3USed t.1is S;Rt;Zlell: 

of Relatio~'jip to be f4X..CUted In it; Zl.aIDe On the date set o?postte its name :..etcr,.,'_ 

'WPS:lE&'l NORTII CAROllNA ANNUAL alNFERENCE 

OF THE UNITED MEI'HODJST CBIJRCH 

A.l'LESI: 

_ :\,..-.,-! 1· :: 

D}':_"_"q,, ~f.... 

I is i./~Y-f:.. 

~_i.:--..L'''' 

S3C:.-e+~~' 

., 

32

ARBOR ACRES UNITED METHODIST 

RETIREMENT COMMUNITY, INC. 

Fi:':ancia! S:aterr:ents 

Decenber 3~, 

2009 and 2QCB 

{ with incepef'iden! Aud'tors' Re:.::trt thereon} 

33

ARBOR ACRES UNITED METHODIST 

RETIRElIIEl\T COM.~UNITY, INC. 

T able of COJ.:tents 

Deoember 31, 2009 and 2008 

Lrldependent Auditors' Repon" ...... "" ... "...... 

Pagers) 

, 

.-.-..._..•.•.•. , ........ ""' •••. ,., . _.....• -" •........•q"....,"- 

Balance Sheets ,." ......... '.,,,, ........... ,, ... ___ ...................... ""...."" ...... '« .,._ •..•. _,""" .............. , .. " ..... 2-3 

Statements ofOperations and Changes in Net Assets 

''''''"'" "'",,,,.,,,"""""""""""""'"'' 4-5 

Statements of Cash F1C\vs .........",..... __ ,.,... " ..., .......... , .............. " ........... , . ., ...........", .... u" •••.••••• 6- 7 

Notes to Fina::JCial Statements.. 

'",,'''',,'''''''",""'"""'" ,.,,,,,,,,,,, ,,',"''''''''''"",',., """., " 8-19 

34

DIXON HUGHES",-'..\, 

- lnd~peDdent auditors' Report ~ 

Board ofDirectors 

Asbor Acres Cnited Methodist Reriremen: Com.-nuni:y', Inc" 

\Vinston-Salen:, ;-';ortb Carolina 

We have aud}ted the accompanying ,alance sheets of ..\roor Acres 1:nired Methodist 

Ret.remen: CommllIilty, L'1C, (".mor Acres") as ofDecernber 31, 2009 and 2008, l.L'1d the 

related statements of operatIons and changes ic net assets and cash flows for the years 

then ended. These Enancial S12.tements are the responsibility of At-bor Acres' 

mar;.age!!1e!1t Our :cesponsibillty is to express: an opinion on these financial state::ner:.ts 

based or: our auillts. 

We conducted our s.udits & accordance "'11.1) auciting standards generally accepted in the 

1:nited States of .AJnerica. Those standards require t3a! we plan and pe:tarm the amlit to 

ob:ain reasonable assurance about wiether the financial sta:"ements are fTee of material 

misstatement. An audit includes consideration of internal control over financial reporting 

as a basis for desigmng audit procedures that are appropriare in the circumstances, but llot 

for the purpose of expressing an opi.liot! on th~ effectiveness of Arbor Acres' internal 

cOlltrol over fulancial reportmg. Accon:i:iLgly, we express no such opi-rim:. A.n audit also 

includes examining, on a test basis, evjdence supporting the arn01mts ane disdoscres in 

the iinanclal state:nents and assessing the accounti::1g principles used and significant 

esr'..mates made by manageme:1t, as w::U as evaluatix:.g the overall financial staterncm 

presentation. We believe that our audits pwvide a reasonable basis for our opinion, 

In o:rr opimon, the iiuancial statements referred to above present fairly, in a:J material 

respects, the ftnancial position of A:-bor Acres as of December 31, 2009 a'1d 2008, and 

the resu!:s of its operatio':1S, changes in net assets and cash flows fo;' tile years then ended 

in confonnit:v Vlrith accounting principles generally accepted a t1::e United States of 

America.. 

As deSv"I1bed L'l ~ote 1 to ilie 5natLcial statements, Arbor Acres ariopted the provisions 0: 

the fa:r va.ue option for fillancia2 assets a.ld fillaficia: liabilities. As a result, u."1Ica.hzed 

gains on l:1Vcstrnents are :ncluced in excess of revent:.es over expenses effective for the 

yea: ended December 3l, 2009, 

February 11 ,2010 

hlJ R,dgeiie'o G:JJIl 

(1) "G Bex 3[;4E 

.i.shev'~,e NC 2S3C2 

)~, 82B2.3A 2234 Fy 323.25:3 2':r4 

35

ARBOR ACRES L""'ITED :I1ETHODIST 

RETIREMENT CO,\~f[JNITY, r

Liabilities and :"et Assets 

C;,ment liabilities: 

Acco·:.mts payable 

Accrued expenses 

Accruec 4'1terest paya::le 

CurrerI mat'mties o;~bonds payable 

Total current :iabilities 

Long-tern.:: liabilities: 

Refu:t!dable depOSlts 

Deferred revenue £rom er:.trance fees 

Bonds payable, less CLl."Te:r:t ID.fu"'.lnties 

Iotallor:.g-tern::;. 1iahilities 

Toul Eabiliries 

Net assets: 

l::nrest:'icted 

Temporarily restricted 

Permane::li1y restDcred 

Total net ass ets 

735,465 122,737 

546,288 894,:57 

416,741 425,491 

505,000 ~80,OCG 

2,203,494 2,022,385 

70,000 67,500 

18,569,044 ,7,476,406 

;8,313,616 18,821,025 

36,952,660 36,364,931 

39,156,154 38,387,316 

24,229,905 20,6 7 0,111 

1,638,245 803,416 

5,124 S18 4,307,134 

30,993,128 25,7&0,661 

Total Eabilities and net assets 

$ 70,149,282 $ 167m? 

(3) 

3i

~..~~--~- 

Revenue, gains. and o:...er support" 

CO::'!t:ibh-nam 

R::sioerH fees 

ELtra::Jce fees earned 

Ket realizi:d gain (Joss) on i!:VestmenE 

lnveS1;llent lnc::.>me 

Other 

Net aSsets rel!:ased from :esmc-'.JC\::ls 

TaU: revenue, gains, and 

other su;:rpo:r. 

Expenses: 

Medical a::lti persona :;lln 

Foodsm,ce 

.?acUity s=-ices 

Ut~1in::s 

Reside:m services 

(YO>" 

Adnilill.~:ration 

Hu::na:!1 resou:::-es 

Mllrke.+:ing and developmen~ 

Amor..zatior. 

:;)eprec:ia:JoIJ 

In:e::est 

Expense due to termination of;"ealtb 

insurance p:a.'1 

T:>laJ expe:}$E;; 

Ope:-ating income (loss) 

Non-operating ,!!'venue: 

~et unrealized gain on :nvestrne:r.ts 

(po~ atio?tion of f2.u value o?tion) 

Excess ofrevenues over (:.:nder) expenses 

Oilier cboges in ne. a'>sets: 

Net unreali.zeC. !OS;;e!; on inves::nents 

Curio! tC adoptOD of r.::.ir value upoon) 

~et assets :-eleased fro:c restricrions~-ca?l:hl 

ARBOR ACRES t'NITED M:.ETHODlST 

RETIREMEl'T COll'nmNITY, L~C. 

Statemects of Operations a:nd C1:anges };) Net Assets 

For the Years Ended Decenber 31, 2009 and 2008 

linrestricted 

$ 464,25 7 

;5,169.L68 

3.021,195 

5,855 

455,928 

193.C20 

936,05 7 

20.245,780 

3.9'71,262 

3,032,039 

3,611:45 

9;4,566 

955,28"9 

33.8':W 

1.691.96 

210,49: 

55?,.~52 

10,036 

2,631.793 

354,747 

1§,544,&:!S 

Temporarily 

Restricted 

$ 1~"62)i89 

208,097 

~936,O57~ 

834,829 

2009 

Permanently 

Restricted 

> 202,5:8 

(5:,613) 

144.9(\'5 

1.7.~.9'42 R34,829 244.965 

Total 

> 2..229.624 

15.169,468 

2,195 

(5:,758) 

664,025 

: 93.020 

. 2'~,~25,5-:~. __ 

3,9': 1 ,262 

;,032.039 

3,6lJ?45 

974566 

955,289 

.33,820 

1,691,596 

2lDA93 

55":,452 

20,0,6 

2,6::·1.793 

854,:4'7 

18,544 83?: 

),580,736 

1.858.,852 6'7"; ,_._ >:'7G 'J 

2;;;:1,73] 

3,559,794 &34,829 817,S44 5.212,467 

Cbange ill ne: L1>Se.-ts :.559,794 834.829 8]7.844 5212,467 

Set ass::z.~. begbnbg of ye.R,,- 20,670,1 J: S03,.a16 4,30'i,13t "}5,780,661 

"?-Jet assets. ",nd of year $ 2422;0:905 $ 1,638.245 S 5,124.978- $ 30,993,128 

The, accoII!?2l1yicg notes are an in:egraJ part of these financjal statements. 

(4) 

38

2008 

Temporarily Permanently 

Unrestricted Restricted Restricted 

:; 1..7.57,047 

'.4A76,78 7 

14,4:6,?a" 

~316.gf. 1,916,861 

:95.639 

221,003 

9.12,793 

144.092 144,09::: 

99g,C.6S 

S 89,04-:' s s 

19,958,583 

2,,38251 

3,::20,443 3,020,443 

:,;::9,252 3J392S2 

944_680 944,580 

885,59: &&5,59'2 

23,"'&3 

2:),'783 

'..,585A"'

ARBOR ACRES l:'lTED METHODIST 

RETIRE.'\1E~ COMMCNITY, Il'c. 

Statements of Cash Flows 

FDrm:: Years Ended December 31, 2009 and 2008 

Operating activities: 

Cilange in De: asse:s 

Ac\justmen:s to reconc~le change i:J. net assets to net cash 

:;;rcwided by operati:cg a.;uvl!ies; 

Depreciatlo::1 

Reilized and umeal:..zed losses (gai:::..s) or, iJ::vestmen:s 

Ent:ance fees and dC;)Qs:ts re=eJ',,"ed 

A.mortizatio::l ofentranL,e fees 

Amoni7..atio:o of on gina: issue discount 

iunortizarion ofdeferred cos!.s 

Perwa."1ently rest-i cted cont:ibu:ions 

Changes in operating a%ets and liabiht.es: 

Accounts receiva'J:e 

Lnconditional pro::xnse; to give 

Prepaid eX?enses 

A::CDunts payable 

Accrued Eahlilties 

:Sct 2ash prov"ided by O?-erating activities 

Investing activities: 

Acquisition ofproPer':)' and eqm:;:>men: 

Dec7Base (increase) in investments 

Decrease (increase) 11: assets lirn:ted as to use 

Fina.'1cing ref.mc 

Net cash used by i:n'esting activities 

$ 5,211,467 

2,631,793 

(2,4 79 ,9731 

3,686.227 

(3 ,02 1,I95) 

(2,4D9) 

20,036 

(202,578) 

(60,318) 

(242,959) 

130,863 

512,728 

(356,6~9) 

5,828,063 

(5,377,468) 

~,72J,046 

(2,000,187) 

$ (4,169,926) 

2,539,83 j 

5,&46,097 

4,076.530 

(2.916,&61) 

(2,410) 

20,037 

(396,O581 

28,,'84 

(86,L69) 

(8~ 4"'t.::.) 

, ~, i 

437,255 

5,292,536 

(5,848,628) 

( 14,0) "37'9' >,IS ! 

1,"40,377 

4,564 

(5,95/,476) 

(6) 

40 

(continued)

ARBOR ACRES L~lTED METHODIST 

RE'UREMENT CO:\

This Page Was Left Blank Intentionally 

42

ARBOR ACRES ID.ITED METHODIST 

RETIREME:ST CO!l

ARBOR ACRES t:~ITED MIITBODlST 

RETIREMEJ','T CO:~fMlil'U1!.~INC. ._.__..___.._~_..__..Not:s to FU:a.nciai ~eIDellts, Ctmtillutd 

InvestmeJj~ - lnvestmen:s ill eqt;.jty sec:;::itJes with readily deterr::rinabJe fair val';1es anc. all 

investments in deb! secur.::les are measured at fair value based on S'Joted llIarke~ p71ces in 

the balance sheet Investme:l! ~ real estate fcJ.ds is recorded a~ faJ: value as det~jed b:y 

an apprz:ser. \';~h::: is Ll1de;:;;:mdent :rom AIDe.; Acres a.."ld the ihnd manageL Invest:nent iT: 'the 

stahle va:'ue fund :5 rec:x"ded at net a5se: Yahe as determined by an appraise;:-. who :5 

mdepe!1dent from Arbor Acres and the fund oa:n.ager 

14.ssets: l.imited as to Use - ..o\ssets limited as to :lSe primarily include ass.ets de~ignated ·cy 

the Board of Dlrecto:-s, ove: wh:ch che Board of Directors reta'.ns CODtToi and may at 1:5 

discreti:m subsequently uJ;e fo:- other Pll?oses, or res':ricted by donors or trustee agreeoents 

for future capitallmproveroents, :resident assis::an::c. 3Z)d cobt service, 

~orJ: Caro!ina General Stat'Jte Chapter 58, ~~-tide 64, req;Jixs con:inuing care retireme:l1 

2Dmml:::ti:ies to maintair: an operating :eserve equal :0 a sta:utorily required p~centage of 

total fore:::asted oycratir.g costs (less certain expenses) for a spe.cific penod. At Decen'::ier 

31" 2009 ami 2008, the Board of Directors has committed $3,775,000 a.~d $3,725,000, 

respec::ivelyo ofits ge!1eral funds to satisfy this reqm.e::nent 

A

ARBOR ACRES lJ!'lTED METHODIST 

RE11REMENT COMM1-TNITY,c'''''·''C,-._____________."i\io:::t,-,f's~Xi:Ilancial..Statement£, ~/)nt:iljued 

Unc;:onditional Promises to Give - Unconditional pro:nises to give are ex?ccted ~o be 

collected w~ti:.in one year to five yea'rS and are reeoy-ded at :let rewabk value, discounted ~~ 

a rate of2% witi:t an al~owanGe :m do:.:btful acc::mnts of$13,748. 

PropertY and .Equipment. Property and eqcipmenr are stated at coSt less accum: ..Ilated 

depreciation. Do~a:ed property is re~ordec at its estimated fair value at the time of receipt. 

IntereSt on OotTowings used to finance the facility is capitalized durir:.g constrJction. 

Depreciation is computed using :he suaight-line method base:: or. the folk')\l,-"i:1g estimated 

IlsefuJ lives: 

Land i.rn:provements 

20 years 

Buildings 

20 - 40 yeL"S 

FlL..,nture aIld equipmer::t 3 ~ 20 years 

Deferred Fina~.cing Costs - Deferred financing CCSIS cor.sist ofbond issuazlce costs related 

to the Health Care Facilities First Mortgage Revenue Bonds issued in Ma""'th 2002 and 

200? These costs inclLrle :.mderwriler fees, feasJbiliry- studies and other professional fees. 

The costs are being amortized using the straight line :t:1cthod over the lives of the va..rious 

boods, wp.ich approxirr:.ate amortization ::;ornpt:ted using the effective interest metJ:od. 

Deferred fi!lax:.c~'1g costs net of accumulated amortization totaled $290,019 and $310,055 at 

December 3 J, 2009 and 2008, respectively. 

Refundable Deposits· Refundable deposits represent the portion ofthe pa:rme!1t of pzrking 

fees that will be refunded to be resident when parking is no longer required, 

Donor Restrictions * Gifts ofcash and othe:- assets are reponed as restricted support if they 

are received v,.~ch donor stipulations thai limit the usc of the donated assets. "Vhen a donor 

res:ticticD expires (that is, when a stipulated time restriction ends or a purpose restrictio:1 is 

accomplished), temporarily restricted net assets are rec1assi:5ed to '..ll1restricted net assets 

and repcrted in the statement of operations and cbanges in net assets as ::let assets relea.5fo'A 

from restrictions. 

Gifts of property a:Jd equipment (or othe;- long-lived assets) are reported as un.restricted 

s~ppon unless specific donor stipulations 'ipccifY how the donated assets must be used. 

Gifts of long-lived assets wit::t explicit restictiolls L'rtat specify how the assets are to be used 

and gIfts of casb or other asse!s :bat llus.: be '!.lsed to acq"Jire long-lived asse:s are reponed 

as :estricted support Abser.t explICit donor stipulations about ho\v long those assets must be 

maimai:3ed, expirations of donor restrictions are reponed when the donated or acquired 

long-lived assets are placed in senice. 

(10) 

45

Obligation to Fro\lglt Future Services ~ Arbor Acres annual;y ca1cliates the present vaJce 

ofthe net cost of future services and the use of facilities 10 be provided ~o CUITe:ll reslDents 

and compares :hat arno1--at v.ith the ba2ance 0: deferred entrance fees. If this c.alcula:ed 

vai:.le exceeds the deferred er.'TcIDce fees, a Hab1irty !s ::-ocorded, ""ito 8. coITe5?oncii.J:lg (',harge 

to mc(>oc. The obhgation is discrmLlec at 3% based 0:.1 management's estimate of oterest 

earnings. A: De:::erober 31, 2009 and 1008, the caiculatcc value Cid nN :::xceed the b21a:::lCE 

of deferred entrance fees; tberefore, :iJO liab:Jiry for be obilgation to provIde fLlture S~'1ces 

is reC''::red to be recorded. 

Income Taxes ~ "..;\:":)0, Acres is exempt from federal incone taxes under Section 501(,)(3) 

of the b:ttemal Reve:iue Code; acco::-dingly, the acco:npanying financial stater:::u:ms do not 

:-efiect a pn:rv:sbn 0;- liability for fede:al and st21e incof:le taxes. .trrbo-r Acres has 

detemuned that it does DOt have any mater:al u.''lrecogrr;zed tax bene.5ts or obligau::xr:s as of 

Dece:::IJber 31, 2009. 

Refundable ~ntrance Fees ~ Resident entrance tees are ;ec·orded as defewed revenue and 

amorized as described in Deferred Revem.le from Entrance Fees below, Subject to cenain 

exceptions, entrance f~s are ir:..;tially refundable, but become :;'lon-refundable at the rate of 

2~·c ?er month until becoming fuJJy DOD-refundab:e after 50 mon±s. At Decemb~ 31, 2009 

and 2008, entrance fees st!bject 10' contrac1J..!31 refund proVisions "totaled $5,990.975 and 

$5,753,.850, respectively. 

DE:feued Re"~,~ue from Entrance Fees - Fees paid by a resident upo::! enter1rkg into a 

COntra;;.: agree:neIn are recorded as deferred revenue md lk-nOrtlzeC into income USl."1g the 

stratghVine method over the esr:.rnated rer:r:lai:;::llng life expectancy of the reside:li." adjusted 

on an aDllual basl$, The !)oD~refundable portion of the ent"ance fee that is considered ~ 

application fee is recogrized as income when the resident moves in. 

Statement of Operations - The statements of operations includes excess of revenues over 

(un de:) expe:1ses, Changes ill net asse:s wh:ch are excluded fr')m excess of revenues over 

(ender) expenses, consiS!.cnt with industry practi~e, include tL'lfea1Jzed gains and losses on 

investn'lents other than trading securities and c()atrf~utio-:lS of long~lived assets (including 

assets acgllired usbg con::ributions which by donor restriction were to be used for the 

purposes of acquiring such ass~,s). }\.,~or A.ere;; considers excess of:;evenues over (under) 

expenses tc> be its penc>rmance indicator. 

Functional J;xpense Classification - All ex?enses 111 the accompanying statements of 

operation were incurred for or re1a:ed to L':!e provision of services by the retireme::rt cen:er. 

Resident Fees - Resident fees ::-epresen! the estIL.'1aIed nei realizable amounts from pajents, 

third-pa.."1:Y payoys, and o:hers for s:ervlces rendered, Resident fees are recorded as reve:1ue 

wher: ea:rr..ed.

ARBOR ACRES l~]TI:D )\.-lETBODL

The followbg table setS fOn.1 by level V.'1thi:i the:air value rJerarchy Arbor Acres' f.nancial 

assets and liabi:ities a:::c,ountoo for at fair "aloe or:. a recur.ir:g basis as of :;)ecembe: 3 J, 

20()9 and 20;)8, Assets and liabllities are classified in their entirety based ~r; the lowest level 

of inp:lt that IS s;ign~5cant to the fair value ::::Ieasureme:nL .4..nOT Ac:es' assessmen:: of the 

sigcificance of a partlcula.! inp41: tCl the fair val'Je measure..'7Ient requires jeldgme!11, and rr~ay 

affecT ;:be valt!at10:J of fair value assets 3.

ARBOR ACRES L'NITED METHODIST 

REl'J'.RLM:E1'\T COMMl::tr.1TY. L"iC, 

3. PropertY illld EquipII1ent 

!'Ilores tll 

--"- 

Financial Statements, C6utiuued 

.~.- •..--~... 

P::'opert:..; and equipment consists o.fthe follo\'.'U".g at December 3:. 2009 and 20eB: 

Land 3..'1d impr

ARBOR ACRES ID'JTED METHODIST 

RETlltEMENI COMM"lr.\~.!2:.' INC 

Tern bonds with principa: payrr.en:s due 

January 1, 2026 through 2Ci32, interesr rate 

~;f 4S:,(" payments of S990,OOO 'i-O 

$},290,000 $ 7,945,00(;· $ 7,945,000 

Series 2002 Health Care Facilities Fi::st 

:vlortgage Revenue Bonds payable, as foJows: 

Fixed rate serial hor.ds wi:h prinC1?al 

payme.'1ts begi:ming:n 2008 through 2012 

",,,::h inte:-cst rates of 5,15 % to 5.5C:;"n, 

March 1 due dates and annual pa:yr:t~'1ts 

rangrng from $325,000 to $400,000 1,,140,000 _~1,480,:JOO 

18,765,00(' 19,245,000 

Less: CIl."Tent mat'.lrities (505,000) (480,(>JO) 

Plus: Unamorned Origi11ru issue prer:liUffi 53,616 56,025 

$ 18,313,616 $ 13,821,025 

T,"Je Series 2002 :,onds bear L"1terest payable scrm.-am:ualJ:y on September 1 and March L 

T!Je Series 2007 b:Jnds bear intereT. payable semi··annually on January ~ and J:1ly L Tte 

bonds are secured t-y a }11edge of futu:e reveJ:'.ues and substantially all of the property and 

eq:;ipmem: of Arbor Acres, Tbe trJst indentures a:id loan agreeme:::rts Ul";derlymg the Series 

2002 and Series 2007 bonds c011~ain certarn covenants and restrictions, 

A.nr:jl.i. prinCIpal matu:£ties cfbonds payable are as follows: 

20'0 $ 505,000 

20ll 

53D.,OfJO 

2012 555,000 

2013 165,000 

2014 580,000 

Thereafter 16.430,000 

$ 18,765,000

ARBOR ACRES tJNITED METHODIST 

RE~;t'RFM:&""iT CO]'..t:!\1t~j\TI'Y, INC 

~ote5 t() !,:!»aDcial Statements, Continued 

.5" r nrestricted 1\"et Assets 

C:::rrestrlCled ner assets include t

A1UIDR A,CR£S ll\TIID ,":1£THODISr 

RETIREME!\"T COltIMV!'''IIT NC, 

Contrnueti 

'7 Endowment Funds/Permancntl", Restricted ,;"Ii!et Assets 

Arbor ACies' emlo\:\ment "was org-.:1IllZed to prcv:de fina.T1cial assistance to- the ::-eside!1ts of 

Arbor Acres in the event the resident(s) :,ecome :::table 10 pay for services. and ::0 be:p 

provide lllainte::la:t1ce to the S\h~g pooL /\:'bor Acre.s' endo~'men! funds: mclude d07l0r~ 

res:risted funds classified as pem:.anently restricted,. tL'1d board designated nods dassl.fied 

as UL'"estric~ed. As required by gene:ally accepted ac~ounting principJes LD the United States 

0: America. net asse!s associated 'With endowmect funds. indudi."'1g fund..:; desigBated by the 

Board of Directors to function as endo.vments, are classified and reported base-d on '±e 

existence or absence ofoonor-i:nposec. :-:::strict:ons. 

InterPretation o(Relevant Law· The Board of DL"Cctors of AIoor Acres. bas -interpreted 

the ~ortb Caroli:la Uniform P.uder.1 !>.1anagement of L"1St1t'..;.honal Funds Act (me Act) as 

reguinng :he presef\'arion of the fair yalue of L'1e original gift as of the gift c.ate of the 

6onofw resuic:ed endov."ment f:;!lds absenl ex?licit dO::lOr stipulations: to the c.ontrary. As a 

reslilt offr.cis L'1terpretatton, A.-bor Acres has classified 2.S pennanently restJict'oo net assets 

(a} 6e original val:Jc of gifts. donated to ilie permanent endowment. (b) the origina2 v-alue of 

subseq:lent gi,"'ts to t..'I:!:: permanent endoWI::le:n. and (c) acc'J1l'lulation£ TO the permanent 

endov,'me:lt made in accordance ~ith the direction of the applicabie dO::1o" gift D.sL"1Ullent at 

the time the accun:n::.latro is added to the fund, The re:naming portion ofth-e donor-restricted 

endo~ment fund that is not classified i"l. pennanently restricted net assets is classified as 

'ternporanly restri:::tcd net assets until those amoun:s are appropriated for expenditure by 

Arbor Acres iJ:: a ma.'rJJIer Cot:.Slstent wi:h the S"..anda..-c. of prudence pre;:;cribed by the Act. b. 

accordiL'1ce with !be Act, Arbo, Acres conslders the following factors in maki.:lg a 

determination to appropriaTe or accUI:"ialate donor-restricted endo,\vt:lent funds: 

(1) The duration and preservatior:. ofthe fund 

(2) The purposes ofthe organization and L'lJe donor·restricted endo\\,1lleIlt rJnd 

(3) Ge:1eral economic conditions 

(4) The posslble effect of b:rilatJon aad defla.tion 

(5) The expected total return from income and:he appreciatlOt: ofinve,s::mer:ts 

(6) The investment policies of me Arbor Ac.re~ 

Return Objectives and Risk Parameters - Arbor Acres has adopted investment and 

spending policies for end:::,vlIIJent assets that arB in:.ended to provjde an ongoing stream :Jf 

funding for ii:J.anciil assistance that is supported by the endov,'l!letlt Endo~1lle::l': assets 

:nclude as~ets of donor-r~str:k:~ed funds thai the organization must hold in perpetU1ty as well 

as boan:l-designate1 fUnds, Under this po:icy, as approved by the Board" the e,ndo'wwent 

assets are i12vested in a mfuJ1lCT that is intended to p:-oduce a high level of totaJ inves::rnem 

retJ1l'l consistent WIth a prudent level 0: portfoho risk. .A.:oor Acres expe;;u; its e:)doVlwent 

funds, over time, to provlac an average rate of TetJrn of approximate~y 4.5°/'(; perce!!: 

ammally, Actual rerums ir. any given year may vary £rOD this amount 

(]7) 

'52

ARBOR AC:R£S tlNITF.,D METHODIST 

RETIR£ME~T COMMlr.'IO'Y, INC. 

~otes ttl Financial SUtc:ments, Continued 

Strategies Employed for Achie"ing Objectives ~ To satisfy its loI3.g~tefD rate-of-ret'Jrn 

objectives, ...\..-bor Acres relies on a total rerum strategy 6 which ir.;vesm:er:r :-enlr.15 .re 

ac·bievec through ~")oth capital appreciation (realized and unrealized) and Cll..ient yield 

(i:lterest and diY-:de::J.ds). kbar Acres targets a diversified asset allocatior. t:J.2.t L"7ch.:.des fixed 

income lnStru...'LH?JJts and h'!I:enr assets held in perpe:uity or for a specified temJ as 

well as to pro...ide addltlonal real grov.'Lh tlrougb new gifts and investment ::-erum. 

Ch2l;ges LV). endowment net assets for the year ended Dccen:ber 31, 2009 is as fol.1ows: 

Permanently 

Unrestricted 

Restricted 

(Board TemporarilJ (Donor 

Desip!tedJ Restricted Restricted) Tt)uu 

Endowment r:et assets 

Decerr.be: 3 J, 20CB $ ;1,81553; $ $ 4,307,134 $ 8,122,655 

ContnDuttoll£ 202,578 202,578 

Invesmle:ot earobgs :06,774 2nS,09"" 314"87 1 

Net appreclanon 350,259 615,166 965,525 

Appropriation of 

endo......WCnt assets 

for ex;pendirure {2D&,(97) (381,,330) 

E~dov;ment net assets 

De

ARBOR ACRES L:\lITED METHODIST 

RETIREMENT COMML"'hlTY, NC 

N(rtf:!i w FimmciaJ Statements, Cominued 

8~ Emp)m."ee Benefits: 

:\.rbor Acres' err:p;oyees ffiay panicipate in me 0..unula:ive P-s:lSiOD a:ld Benefit Fund and 

the Tax-Deferred lillnttity Contrib

ARBOR ACRES UNlTE:D ME,HODIS; RE7'IREMENT COMMUNITY INC. 

BALANCE SnEET 

AS OF MARCH 3"1, 2010 

ASSETS 

C',.!:r;'1'l1 Assew 

Cast: llnc :::ash Eq.J,..slents 

!nvest:"':errts 

.L.c::o~nts Re:e!\labie 

Campaign ?ieC2:o ;:(e,;e'>'aDles-c;--:-ern port'Dr 

Pre;:4;H:'l Expe,se!> 

Teta' Curreni A,srets 

No,,"curre:rt asse:s: 

Asse:s hmr,:ej as t:;, usa:; 

Board desig.nated tDt 

Ope:atmg rese'V$ re::::Jlremenl 

AsslS~arCB end::>wm9:l1 

Capite; Projects 

Donor re>rt~::::ec for: 

Resioe:rt assista'lcs 

.!.,ssistarJce enooWf')en: 

Qt'ler 5;:;ecmc ;:mr;:wses 

Son:: :rustee 

Teta! as;;ets liMite: as tc lise 

D:>;-;a:ed ::'fooerty held for casale 

?roperty aM equ:omen:. net 

Deterred financmg :;:0$1$ net 

Tota! "on~current assets 

"'-OTALASSETS 

3-31-10 

543,299 

7,933,827 

2:31,48' 

740,134 

203,336 

9,652.,~1£ 

:t77S.000 

4,201.58l.l 

2.,520,013 

389,032 

4,789,499 

496,632: 

2,225,952 

18,397.9()B 

2,000 

42,909,394 

285,009 

61,594..310 

7124£,387 

UABJUTIES AND NET ASSETS 

:;Jl'TSnt liabiliUes: 

A:::c::>,./,ts Paya;ne 

A:x:ru..d Expenses 

ClJ:Te;-t MatJrifes of B::nj:; ?ayablB 

-:-otal cu,,~nt ilabiji{es 

59"Z,35;1 

859,46.5 

505,000 

1,951:i.S24 

LO:"fH:etTl liF.olJities: 

Refu"'dsble De;:;.osits 

Defa:red u:raroce Fees 

Bonos paya!Jie 

7ota: iong lerITI ii3~mtH?S 

10,000 

18,948,3$5 

17,80e,013 

36,826,39B 

T :>~al Liaoilities 

33,7B3.221 

Net Assets 

Lhrestricted 

Tam;»~arily ~estriCi?d 

Pe:man$:".t'y Rasticted 

TDtal Net Assets 

Tota! Liabilities and ~et Assets 

55 

25,276,385 

1,801,652 

5.$33,118 

32,463,1$15 

71,24-5.387 

\'~n2kD5\BuJjet" 3oan:fJi.ccD~.mting\SYM;=!LE\Bcmd Re;.x>rtmg\2J1C Mar 3 i ;;:na7Cial Repois

ARBOR: ACRES UNITED MEJrlODIST Rc.1!~EMENT CQMMUNfTY INC. 

STATEMENT OF O?ERATIONS 

AS OF MARCH 31 2010 

Revenue, Gains ant ot1er SUP?o;t 

C::)jItribwtiofm 

Financial Astiistail:::e 

Campaign 

Ocher' 

~otal C?nti~utJons 

:::;:esiiie;;: ;;:a.es 

~'1t";mce FeBS cameo 

invest-r:enl ,,.c;)r:ie 

Otnej Revent,;e 

Gain ·::m Dispose! Df Pr:'Jparry 

Total R:!'vQn'Je, Gains and other Support 

170.919 

72.7,404 

30,2DG 

3,808,043 

£44,3SC 

109,117 

28,417 

502 

5,51 a,{}28 

E.xp~nses 

Medical an::! Perso;;ai Gare 

F:ope Sa;y';;::e 

Fa::;l1iry Se'Vl:::es 

Uti:it:es 

Resident Services 

Adrnlni:;'ttation 

IJiaritetl;)g Ii Develt>::.rnent 

O:ne' 

Dep~ecja:ti;,n 

Amortizator. 

Inlerest Expense 

:-?SS 0"', DIsposal of Property 

'Total Ex;penSQs 

Operating Income (lOSS) 

1,020,542 

71'3,050 

931,110 

25B,345 

264,125 

473,2'17 

145,020 

9,191 

558,732 

5,010 

209,861 

4,708,333 

ft10,695 

Ke: '.;'.aliz;.;d gal:i ;,oss) or ir\>estmen~s 

Neo ~;;reil""1 In¥Bsimerm> 

659,349 

Change in Net Assets 

1,470,044 

56

ARBOR ACRES UNITED METHODIST RETIREMENT COMMJNITY INC. 

STATEMENT OF CASH FLOWS 

AS OF MARC'"I31. 2010 

Cash Flows from Dperatiflg Activmes 

C;ha;;ge m "

ARBOR ACRES UNiTED METHODIST 

RETIREMENT COMMUNITY, INC, 

::x Ea::;h:>i De =!Vi;; Y",ars Ending 

:)acanY-f 31 2«4 

(With inoepe:'lde;-: .Ac:::;oun':arrts" 

;:'ornpilab,r. ~ep:)rt thereOf.! 

5&

Ai'bur ACre! l"nited ~etnodist Retirement CommnD.i~', Inc- 

TABLE OF CO~"'TL"TS 

lnde?:.noen: A;:.:>:Juntant;;· Rep::!rt ""',.., ... ,' 

?r~le::ted F::nav:-1aJ S-;:a't-""l:JCD1S: 

P:-0ectecl Swemenn cf Operarioru. ... , ) 

Pro.ie;::te.5 Sta:,.emenTJ 0: Changes in :SCt ."'>Sse.ts ........... " .......... . 

?rojectee State:':le:)ts of Cas}; Flc-"'s",.,,,,,, 

P;"o)ecleC Balance Sheets ....., ... __ ..... . 

Basi.~ of rrese::l"catlo!!. ............... 

Ba.ckground O~--:be Co::-;x>ration _. 

Background o[""0,e Corm::llO..t~-_. 

Jescrip!i::m of me ProJect.. .. 

S::m.::na.,,) o:'Tinan;:-bg ..... 

Descokpoon o:tbc Re~jdence Agreemerr: 

ASSUIiJC..;;su:ne:: .A_ssiSted :.jYIDg :J:ilizatio:: . ,................,,- ."..... , ... " -" 

/ ...ss·..:uned Memo)) Care Ui,lization .... , 

........." ................,.' ................ ".,... ,,",-' 

Su:nmE.:t') of Signifi;:;aa: Accolmti"lg Policje,_ .. 

Reve!l'Ue , .... , ......... '" ,,,. _... H 

"." "." .... " ...... , ••• 

Operating Expemes .".. ",.. 29 

It,SSe'ts Lim:te:: as to 1j"e ... .]9 

PropC:1)- and E.q-.ripmenl and Dep:-edatior:. Expense .. . 

..... 3D 

:""ong-Ter:n Debt an::llmerest Expense... ,.,..........,,"'"",.......,....,...........".."... .. 

O.UT;Wl :\5.S~~ and CUITem Lia"ilitie:S... .. .....".......... ___ 32 

59

• "" 

.. 

,1l' 

..iI 

DIXON HUGHES""", 

tldi:II:!,...~~ 

]).l)£PE!'iDE"T ACCOUNTA.''TS' REPORT 

Boan:: cfDirecl.Ors 

.vbo::- A;:; a :2 ua'1 assisted ]jyin,& nernOl'Y c:.s.re expar.&i01l. ::':C 11:::V, 

i:J::ie;;enCeJ1t 'hing !1vme$., and 1be co::verS10t of vacate:: spau. in:o a 11 ::'ec skillee DUTSL'1£ expaLs:;:;);::: 

and J ~ af'fonhbit independen,- :iAng apa"tl'ncut>: (C{',nective~:, the ''P:ujecr-). 

A coID?iJarior is hmJteci CC p!"!!senting. it, t.~e ior::r: of a ?,ojec:io!'L, :morroauon :!;a; I:: !be 

rt?Ti."se:rnatio:: ct Managemeu'. We a:"t 001 ~gaged to. and did :;)01 p-e:rf~ ar.: examir:.a::ioL the 

objee--:lve of wrue!:! would be the exv-,"ssiOE of at: :.pimo:c on the a::cornpa:cy:ng pro,:ecwd financi& 

S"'~en:s, Acc-o:"::ngl), we do nOi express an OpirjOL on wbether the p:"ojecc 5.r..anciaJ stateme:::rt:; 

a:e pres:.mted in c:mf;)~iY ",ib A1C?A -pre>entat:;);::: gujdelines 0:- whethe: ;be :mde:-lyi::lg 

asst:m:p::ions p-:-c..,ide tJ reas:!l,a::'~e basiE fOe the presectati:m_ Raj v.'e perfor.:n0d additio:li!! pro::ej-,: ..,·'er., 

n:b.er maners might have co:::ne to ;)'..U' an.errtio;::: that '>'>'0-";";6 ha:ye ::een repo:-:ed tc ;'OU, 

FLL---t:lmnor-e, :oven if:be 1:::;]]0"-tg "Hypo'±ieticaJ Ass'JIlXf'tl:ll:3" occu: ::i-:l!'ing fue projection perj~:i: 

• Cons:r

wc ha',~ ;:)0 ;,espo:::Yi~Hir: !o update till:; -epo:"', fa:- ev~rr~ a::.J Cu:;u:o:::L

..__._-_. 

Arbor Acres rUlted Methodist Retirement Communit:", Inc" 

Projected SmeIT!eontr 0,- Operations 

For -::ae Years Euiing Derernber ;,;. 

Tno'.lSan:I,'j 

--.-..- ...-.---- 

, , , 

':nd-jJ~ hvJQg ltiri..'"!1! 'ie!r i ,',lH ~.6:m K01! t -dS: &,t::~ 

Rt"v!OJrtle.s; 

, 

F.t:1l11hcive f"'~ iter L:t"! 8.:5:: 5.365 52~~ :.46: 

' J .., ,:"- ~ 

_~ 

.• :...c 

!\ieu i'rIC-~ ~Bt,=, 

-;.,;~" lrti:l:peod~ 1M!">" AD~ ; 73 7", :;~:; 

."'cv , ."-..s.m\eJ ~ 1...]= 795 45~.::: 4.~;'; 

>.;:;v. 6-~ 

"'= C= c- ;,0~C l.'lK' ; i:i 

r;;~" !~~Be6 .o.l-f . c'n LJ95 

~ Jbe., ell!'llUJ :"45:1 7.;;/'7 :!.Y7C ~,.~" 3.,45 

:mve!t.:w!:!l! m;;,..",= 43~ ., . 0St- • ::t3 

0_ 1?; 

,.. '"' _.n 303 376 3;10 

X:: as.e'.l-~ t[)W JeillTlCll;>l) &4g &67 6~7 ;:)5 ,,' 

Tom:~ g:av;, J1£ ~ s-~--: 19,) i£ 21 "::7:; : 55 :--'.065 ,::&.155 

--.---.---.---..~.-.. 

" 

~l:I$e~: 

"'" 

:V~ and ;J:rnm:aI 

.-.~ 4.255 4,46: ....>kO' ';.!& 

.Fe«! f!L"\= 3,(l4t, 3.?S! ,.,« 4,.23"9 4.5S: 

F~ ~~ 3,?i}O ),59C 3.9Cl 4.E' , ",;J 

._ .G"," 

''" 

,.. 

- ,~~ 

"' ' ~..- , 

'JIiic~, l/~'}: ~,;4(l ~,33f lASS 

~= 

~,:O" Ll:); L2:J8 :.256 J.3!9 

""""" 1, ;57 i.S4f L-?5;; :";;54 7 :,:;c 

."'~ 

~r.:s:lur= _.;c;, :;;;: 2< :SC 26{, 

;-'-':aii..~ arui ~v:;~ 570 ;9: 61 ~ "'( 6~S 

.~ 9 ." "' 3) n ~ 

::.~ ;',(,]J ::);"79 :;,4"'E :;;,~9: 3515 

~ g;l S06 1,gOt 

 

U~; Lt:.: 

-;(Yi'.aJ!:~ lS 

.-------..~--~.- , 

~59 1:;j;75 '::::,79(; =4.55:' ::59t· 

~lElW"!;(t 55~ 

, 

..~---.- 

1,39'7 \ L:;6~ 2.515 \ 2.5ti: 

.,,;;::: 1lSS~ r*~d ian:T!!SIfn..."'IDi: • 1.1::'& ':'6 

3:' 

, 

" " 

'~ilJ ~~dnmasserr 1,@5 \ :.43~ \ 1 ,"f,1 - 5

Arbor Acres Vnited Methodist Retirement Cfimmnnity, Inc. 

Pr0}eCleil $tatemerrts :;,fC.b.ang:e-s 1t: rve: Asserts 

F O~ IDe YGa:£ E:cldmg De~:;:,mber ;: 1, 

C1'": Tno~

Arbor Acres L"inited Methodist Renremeut Communit)·, lnc 

J>roje:;u:d Statem::n:;; of Cas]: Flow:; 

?ot The )' tan Endl:Jg Det',emb~ ? 1. 

tin Tnousand.;;) 

Usil. Jlt!ws, from ope~ aetn'rii~,: 

C~lQll::.an~ 

, " 

-"', , !5?h , .19~ 2649 , 

" 

Adjfsrm=,rtlt W reC!.)l:C\e thfl'n~ 1fJ::.t:::"~"1E 

u; ;;;:t: :;as.h pr:i\-1deC r>' ~a..~;: 

:9'e:::j8D::rn :::::.04 2,87: 7.4~S :,J9: ;.5:2 

7,16::: 3":;' II 

,. ,~, 

P~i:nd.: c:-~'! m \'; :'C', \ 1:'4 6.91t ~52:\' '1,06C; 

" 

" , 

695 

"'" 

 

~:u; ;;cl an( :;;m;h ~ 

Case n? casl:, e~ D~£PFlP!',--?f~1fl ..____.___"""____8~:' 

ClliIi un::.ciJ ::;;tIMl.kOt.ttS. t:::lI:! 0:';If:1r ~ 1,5T 5 

gp' ;,:::; 

See Summary of SigDifieatlt Projectioll Assumptions and .~c:countiug Policies 

64

Arbor Acres Lnited Metbodist Reti..·emeDt Community. Inc. 

t7C'.ICCfr.D Balance Sheets 

Endbg DeCemM.7 31. 

(ill T~o::S!mds} 

i:u:::r~ 2,~ll: 

, , ~~ 

cast ?,G;~ 

, , 

iIDt :=t ~ :.5::~ 2. $ :uw ~-,,- " 

l:rra; C. d::~ :Dr 

, , , 

~ ~e:r-.~ req=:Jell! :;;:::. I 4,50~ : 3(1 l 4,i$P 1 5,J~ 

,t,s~ !:'l. 

A,ss~:::rui:>w= 4.£"0 , 7)6 4_'04 ...81:'· 4~B~ 

Ofu:,:;~~ 5t:) 54: 54: 541 5"-: 

5:md tnllll.e:e .__._--. 2,,5\, 2,7"'S 2,"&5 :::i~ 2,'n:: 

' 

'-...~ ~ lIE ill usc l?,m 1¥_:l31 n,~' X ", 2().!{17 

Drn::\ItIL::J pmpe:rt)' hclC :br 1esilk 2 , 

:T{lP"Sl""!!DC ~ net 53.~ 6;_5~ 76.6C5 ~:,;'Jj 74, ~5: 

..,,,~ 

:>.:~t ~OOim.- ~ sn 862 S:;:: 8Dl 

,., 

, j:!SA , ]' --- :~ : 1l.54(J 

~.,.~ 

,", .. I I 

r &:.E;;; , O:~,6SS 

, 

A;;co-.lIl'tS ?8!'3tm $ "'58 , 7'" ! 83~ S ~9:: 

, 928 

A~ expe::l5~t ~g.; t4b 

Ac:;ned~ ." 4"'g 481 '''' ::~1 4" "" 

Curre:a: ~ OflloniW :::/!yllbJ: 470 48~; ".l.: 

'?Dta1 ~ h\:J..:lJIx$ '-:15J7 264'" ;:."'9: 

:,ollfpe:m iWliil:eE 

khltdabk dep:J= 7~ 70 70 7~ 7;: 

~, ~-< 

D~,.,j ~ fo:r e:lI:'aIlr,e -Cts J9.64£ ----"'--.. '. ::5,'22 2~A-w ::--4:': 

S= 2)(12 & ~ 2JG~ ~ ?ayablr:..K tlm:rr.~ 111,.;:1; 1";.":"'9 J - ~~~ 

' ; ',{;54 :t4':'1 

: O.25~ J{.?53 2g,4QS ""'D"" 

X

ARBOR ACRES 1:"!\TTED "ffTHODISTRF.:n:REME'" COMMl"lITY.l'\C 

Sll mmary of Significant Projection Assumpti were to occu:, '.±iere. will ust;al1) be 

diffi::enccs be:weem U:,,,, proJ~""::ion anc a,.-ma] rem:'l1, oeca',.lSe e~eDlS m'ld Ct;Cul11StanceS frequency do :lot 

Qoe-a: a;: expecte2~ and those di;'fere:Dces :na.y be 1:18Jeriai. \1an~emen1 has P~!!pareJ itt fino::ial p:o.;ec::i::m 

assur::ing -;:ha: :he follvw~g ::iYP8meuca.l AsSu.t::lpti)l1S: 

• Cons...... 'U.0t!;)L de\lc:opment. :r::mrkming and 0'l:hw related ::»m for the prur.:.-osed ?roje::! (be:-eL"'l?.it::: 

de£ined) would aJ'F8xi:::rae $29 ::ni1!ion; 

• The oon..;,"-;"CtiOD costs ZS~(.iCla:l!:d w;t!: the P::-cjec:- are Enanced at re:-rm a::lO :1lte~ -su:nihr tj these 

r!'fiect~ bJ 0: prD.lectbns. 

• ?'""ne Pro.iect"s :ndepenoem bing ur.iu re ~uc.{;ess:'::u'y :::na.-1;etes.; ane 

• Adeq:u!.te d..emaDd fa, se:r;')u:s exist TO SllppDC'. oe a5Smned ocCU?anc} of the Com:nun:1)· 

:):i5!'Cinafter de-fined) 

A c> ;:v)"tht':ci~ a'>';lL'7lp1iDll i~ ax: as~UlIlpti01l used in a f.:ll'IDG0.aJ p:,r:lezOo') to p:eseo: a co-n-d~o-:: or COll.'"'Se of 

ac.::ion lnax is nOT Leces~-il) e\,pecred to OC':::'U:. bu,; i.~ COl'.slsr--

"4~rt>ur At::-e! :: llired MerblJtUs: 

Summa!,)' "f Slgnl:l'blDl1'r"jectit'l! As>;umptioru 

}~etirt~nl C/:lQ,'jMnlliI~" l!:~___~_ ..______.._____.. _________--"a~.d Atto~n~ :ruhc~, C(lnti??oo 

Backgrounc of the- Communi!}' 

The c.or:::u:u'Unit:, is lDcatx on a;>;m::nirnately :5 a::::res In Wins·ton·Saje!:l:1, FO:;-S:,11 COlm,) , i'ortb Carolim. at 

::2.::.:' _A...~bo, :".wes Rnad and priJy)d~ a oonti.'1;':'urr: of :esiden:la2 ac::vmoo:iarions ;:ba: CtLwrc:JtJ) iPc~udt ;] ~ 

inde-p~:i!O'.(I: he; a))a."1lDeT..lU \. the -"ExiS!i:l.; lnde?iOnden·. :_5ing Ap3J1me:l!.f"1. 1 J':: tnde:;x:!:l::ienl b IDg 

bo::ne$ (-:be "£'xis.'ling lDciependcOl Liv::::g Hor::;es")_ 66 a';silsttc :;--,-mg Ull.~ (tin: "Exi;:;:ing AssineC ~:\'inf 

L'ni:{"J. ; b Zl.$s!sreil b'i::g memo:;: care uni:s (the "Existing Memo;-:- Cart: l::u:,"L and 5; skilJed ntJ:s1n(,: 

:'eds fIDe ":=.ust:1ng :-'::.::rsinf Bed;-i. 

T:J{: ?_>;i~ indepe::dcm L\ 1:12 ApaI':ments X"E ioc(:lte::i ill tv.':;. :nia-::-:se resid~IJ::;aJ ::'!LGdi::££ that ilio 

i::lc,]u::ie 'd:::ic fol!c-v.-:r.g su?pon fClc::i::;es: -cm"ines5 oB:::es. feJJowship hall. chapeL CDIT.l?:..r,z:: J:"OOI:.1, aT"'J' and 

;;rr..s r-oo:r:. li~, ,!:cna::io::Ial

Arlmr AertS VaiUcd Metboour: 

~~~eI!t COUJ-m~~::.ll:t" 

f ee.s:;1 

$1.962 

3.9"'5 

" ~!b 

$1.,%3 

A:.6F 

~,679 

• .,!::?5 

$2,-407 

$~"8i;4 

2.214 

2,4:;1J 

::,7&7 

3,1:0 

3289 

Bayberry HollH'$ 

13R- i Bath 

13R -? 3mb 

To,.l'''''''',''''' _ 

Apaf'tmeDU 

: BR-J Bach -- Type A 

1BR-:5 Ba::h B 

:- BR -:: 3a±- Type C~; 

2BR-:-3at::: Type C·: 

J BR - :: 3a

Al'iror Acre.; Uniteii M~t.iwdm 

~_~_C~lmll}\ It)!'", 

Summa..: OfSigniDc.aOf Prt)jetD61l A.s~wnptiou~ 

fWd Accounti.ng Polkies, Continued 

'?be foil6'91ing :able ml!Xl!?la.-'.z.e;S 7lte Type. DUl!lber, approximate sq"t.W"! fo(~-:::age, 

::lo::.tbJ) :J.a:.!:- ices ::lf12lt Eximllg He;aitDDm"e Units effective January L 2OJ:} 

e-n:rance fees" and the 

Table 2 

Existing HealtDcare Unit ConfignratiDlt 

Approrimah 

Square Frw-...age 

MmrthiyiDai!y 

Fees a, 

;4 .zgS .";t.167 

'0 0," 

,- :-) $5.080 

EDsting MrlDtlT) Care r'nJU 

Level m Memon CIi)'t; 1! 45D $'7 "'>{, 

,"-' 

SO :L'6 S5,:m 

-,- "". 

Existing Nursing Bt-.ds 

pm'at:; Room 53 :;j4 $::':;J 

T~_ 

U1 3Z1 

5o::rrr:e- Mar.ageoen: 

:') He C~ it ::mrtCL";. :.\~~ £4 lit=ee.~ Care ~ beds ill Cz;mm:unilY if J:=..~!:{: 0; mr::..£s f:r 1C: '\:.icl: 

Ca.~ Hom

A.mar Acres ~;niteil MetbOOiSt 

Summary t,f ilgu.ifkant Pr{>jectiot: A.lisumpuafl.. 

Retifl:lment Cmnm!l.~","."c'-_____________________"'='C'O""''''"."''n~~.~oiiciet, Con!inuet! 

Descriptiofl of the Project 

The Corpo:mior. ~5 plan:ling ar e);?:ausloo U'. tile C;;:m;:}unr.y an:;lcipated to include a 6(1 mli1 replacement 

!ee :"'iYIDg L~r::jtS'-I, i:. J:2 UJlJ1 n-pansioll of a!sisted bving memo:-)" 

;;;a;-e urjn (6e '':'''e\C\ Memof) Can' ~:nhs"'), 20 nev. :n.ctependent living bomes (the ·~e.. bdepender:..l L:ving 

nome::",. ;: CDI:!\'C::-SlO::: of \'B.C8100 space ill F:rtz.gerald IDle' a 12 bed skilled nUl'S""'g e..xp~on ::Je '-:-;e\' 

Nur.sing 3~'~J, an:! .: conversion of vacated space iIJ Corpe.ung to j"'} aff::lfdab:e :ncepe:n:le:1t ~:\'i;:,&" 

a?a~e;;:.t~ (t.;e "~e¥ LI::o.ependen1 Living Aparn:oent

Arpl>r 4.cre:!i 'C' nlteri Metiwdi£ 

Retiremept Cif~"~Uilit). ~"C'-~~_____~~~~ 

SuB'lllUlry &fSiglIifict.ttc Pl"(l)t:t:lil'll ASllUmptmn& 

aud AcroilntiU; rnDci~ Cnvuvooo 

-:-:::;e N-ew ,~;sted 2...i\·lng "!..J:cits at!: planned to IDclude six two-oedroo:n "!.I!:iT.S an:: a£;u::ne:o ~-e 2vai.labie 

ED: coe·be:i;;)Otn ·.mits b, d:)'.£~;e 0cc'.;rpa::tc:". for a total of 72 beds licensed as ,';duJ: Care Ho::c.t 'o

Aroor Ao-m; "\>nited MeUI9!llst 

Rt:tirerllelll CttromlUli'0'.lne. 

SIlNUlIIJ1' (If Significant T'rojecDI.a A&RlmptiDm 

aDd Accounting P(lliciCl>, C(lntinuell 

Table I) 

Assumed CommlUlit;' l:nn Configll1"ation 

l'uHs 

Leyel of Care EDsting Removed Commu 

bdepe:nceu.: 1.lving, Apa,rtmenxs 

J l' 

bde;x-ncem l.,hing HO!D~s ::0 

66 (66) 6( 60 

Memo;:' ere 1..:'"0.'15 )g 30 

;""',;.r$iI;g Beds 53 65 

Total 121 

5c',rQ>;., :~:;g~:o: 

'1! Tu 66 .EXb'"tL:lg .';..,;;:.,-wd :":vTI::.t; Units are: a::'>Ul::leC ,\(,,;:W rep:aced r: !l:¢ 61: Nev>' AssiS'teC i..rnng ':niCL y-:ne: b::;lwie b:'Wl) 

":,:dr:mr.: crL'Ts ane IBsm::l!O" tp mak:: w.'lill.abl: \U on::-bOOnmm unitt fu' dmibk rnxr.rpanc;' fffi' f. tota: Q;. -: 11cens~c .;6.l1: Care: 

~-lJID!' b* 

A XQ,dicg ;:c, Ma:1a.,,~ent sitewo;"j.; ;~Ja;ed :C tb~ Proje:.:.l began m Marcb ':;0 J0 T';:,e a:f:icipm!t: :lme:2le fur 

the ProjeC": :s shown be;.;: ...... : 

S'new~k xmunence, 

P=anem financing 

COIb-"truct-.oL COIillDeuceS 

Table't 

Developmeni' Timeline 

March20JD 

\le~ Memo;, Carec l:wr.s ;:vaiji:Jie for occupancy Febru.ary 2C J1 

),je'\o\" Lndep:.nde

",-roor AtJU. l.:

ArtJur Ac""I:S L'Cited MetbootSt 

Summary DfSi.r;nifidult Pr'bjectiOIl AJi5Umptim.lli 

RetiremeBt C~?,_~~m_""lD,,,,"~~~~~~~~~~~~ ~~~~~~~~~_...~d ACCOlIlIt:iJq: l'nhci= CODtinUeC 

.1', }u::c:ording to 'fue ·Jnder'\J.~·!teL the :-.;"""- .

;":1'KW Acres entw.: MM:btluim 

keti~: Cfm1mu:ui:t:, Inc. 

5uml(l.IL....' (If Sigllifleanl ProjectWn .-"I.ssumptillm. 

aod A~"Qnting P"licis. umtiu.ed 

Description ofi:be Residence ~.\.greemeut 

J.1!' ::':or,:m:"'atior: CJ..t1TI'Jl!h has a resldenot fl.!c'Te:e:ment (ID!', ·'Ag::eemen,'·'j fo? :::es)(ie.::;t!: seek:og 1e live 

:nd!?i!:ldexr:j~ IlJ '!:he urn::u::umi1) 

Unde~ :L: te;-:;:cs of the Agr~ent., iii prospective resldent must b:. at ~ea.~ 62 yers cj agr: aT the :i:ne 

resident: is !$~lished (spouse must be at leas1 60, iJ apphcabje:;' :';l"e! :.ea:tb que.li5catkc.s t:: live 

inde:;n!!)5enr:y at the CCltl1lllu:oHy. have ::t!HI)';tci&J llssel:$- lldequate :c, :?e) the E::tauce Ft"e, and .:n";!5'. have 

~ufficien; income te rtleer the antimpated Month:) Fee a::::lC 0iher persona: expenses no: pre-vldeo -:odes ::be 

Agree,t)en::. (!be "Resident'} Reside:m bas the folJo'\\'ing paymere opr:.m:s: (j, pay me bt"";mce Tee iL :'hl: 

upon eJ:ecuti:r::J of the Agreement or (i:) pay 15 perceIf. of the to-ta:. UltTa:l:;e Fee u;xxn e:)(w..n:km fte:::::pora..'·y U"J:rsing care a:t no addJtional charge ou..-';ng any ninety jay oonsecu'"i"'e d.ay perio:i These 

:5n car. be :-enoree upon cornpktioo of nine!)" co~,..uthe days aner discharge frum lempora;r: 

ca.~e wilbon: returning to and occupying a ternpo;:ary care bed. 

ELITE C::Ire 

Eas: Uvbg bcluiing the Extras ("ELITE-). is a le\'el or care ibm is hlg.her ilia:! ::"'~ inoepe::Joem b'ing, bu: 

be):;'w 1,'")0' jeveJ cf f;;ll assisted vviog :EL1IT rtcsio!m.ts me; :-equre a::Jd ere e;lig;~le t::J receh~ a b::,oad 

spcx.nn ;:,f ;;.enices necessar; to enable them tc remaic ::omfo;-

Arirur AC:-e!i l'nited M.ethtJdist 

R~em C(tmmUbJ!;C'"'",,",-~~~~~~~~ 

Summllr:' ofSilfllifit::ant l'roj~c1itm Assum~tioru: 

alll1 Ar:tounbng f't>liciet. CODtinUeC 

w(.x;:d '::,e ?Os:;:ble othe:'V.'l.$e. E:.JTE resident;; haye a;:c:':Ss to the :follm\,lng SUppoJi se;r-ncer as !le:eded: e!'cor: 

10 :::oeal~ a:lC :;pecia: eve:nu. or: at) occasional '.::asi>:.. es:::ort to doctor appoin:,"'Uents. 3.311;.' ID!Odk;uior: re::ricUen:. 

order of IDed)cati~lD ane setting up of meili;;at)oD 'PO).es. m:mwy health eva:!ua::io!J by a IlurSt '!D it clirucal 

s;cnr::g.. as.,Q£'A'1Ce enten::g ane eXiting the tutym:r:i:ltorin& while bathIng, persona:: iel1:Jdl:, iDd:.dins: unumg 

v.,±le:: ne::.essa."). a..i,.:n::ionaJ :t\o'.Gekeeping. a£siKtance v.rf'-2:: ,:':n~ss>!::g, actiyi't)· re::rinoers, ;;omaJtauon ibo~ c\DO 

asstnanc!: wiin :Cla.'"laging l!)c:mrinence and daily nome Y1STtS :';' tramed E~ITE stE...--"f;:neruPe:-s. 

The COQ,x"ztnor: offers c traditional i'loo:rc:n::g t!ltJalc{: Fee ?2.n. O! ' pe.:-cen1 p~ me>nth 

No :-ef~d :>:ne En':rn!lcl!" Fee v.-jJJ be p!ric t:: the Residen: a.fte:" SO !::)o::1th£ (·f :Jccupanc;. 

A Res:aem u:u:' terminate the Agr~en: for ax:, T!!.'!son,mOl' to occupancy b) gh'bg v,'1itte::: nODce tc' the 

COT?oration. In the ?vent t

Arhhr Acm ::;nitdl Metlwdi&: 

Reti1'l:metr; CtmUll'trn~.lnL:...........~__ _ 

Summllt:' tJ Sl.."1iifitiw: Pn,]ection ABsumptiom 

_ ____________................lU!d J\crol1JltiJlg l'olicie5. COlltinued 

A •.ssumed Independent Living 'Cnit Vtil.imtion 

The Existing Independent U\'Zlg -,:m:!; are asS'.:l:DeO to acm!"v!" and rna:rntain a 95.: per..eru occupanC)- If''\'e: 

ane remain (;lm~1.ant at thm le\)e; throu.g:bO:'1 ±Ie projecti::n:: perioe. Com;tru,,'tloo 0; the N e;>.' Independen: 

Lh'ing Homes is essumed to be stagge~d oye:r a:6 OO::lt: ~:7:::>d begin:ni:t:g i::::l February 20) L du...-IDg v.hicb 

,eside:nt! would OCCUP) each ~ev,· Imiependent l.Jviug Fiorne as :he) are c:>:np;ete,L The }\;ew lndependeI11 

LJving Homes are a$sumed to acmeve ano !':la.ur.ain 2. >;;5.0 pe,~c.e-::1 OC::':;HlXlcy feve: IT, 20B and remam 

X'n."'..Mt ai cbs.: je\'e! Througrloul the projectioD pe::iod- "J'":le }.

Aroor Acres Vniled MetbMIBt 

Rt:tir-ernent Com.rnlln\t:l". Int. 

Sw:nwary of Slpificanl ProjectlOl): !\5~wupnf'IIS 

lind Accounting PuliciES. ('-«DonnaN! 

Re~idcnts are asSUI'tlCC w begiL moving mt~"±Ie ~e\\ Independent Liymg Homes ~l1Jni:n& k JUDi:' ::OJ 1 and 

tbe :"lev, Independent Lh-mg ApIJ,,"'ttoerr-..; IT j::J~ 20::. The asrur::lCC morrrhl: move-in patten::3 5~ 

in -::he table bel('w 

F:s.;el 

YeatMonth 

Tabk ](1 

MOllthl~' M(JVe~iIJ Pattern for the ~~ Independe.nt Uving B&mes 

& ~e~' Independent Living Apartme:ots 

~et of Mo,'e-Ouu;) 

Mon1hiy Total 

~~-""='--"= ............. 

:-Jev. 

Ne.... Ho:ne~ 

lnc~pende.nt 

L~·,'in5 

A?ar:me;;,ts 

CUlnulal:iI'e 

Total 

Cur:nu~atlve 

Percentage 

hoe 

4.0 

4.0 

lCd?% 

10.8% 

Au~ 

4.0 

HLg,?·~ 

Sep:ern'::Jer 

6.(1 

J62'h 

O:;wbe: 

LO 

6.0 

c.0 

10.0 

162'h 

16_::'"'~ 

2(;1.2 

10.0 

.1anllaJ·Y 

I'chroaTY 

).f.a.cb 

::"0 

10.0 

; 0.0 

12.0 

l2.0 

J2.0 

kne 

Jill: 

2.(' 

4.0 

14.0 

J8.0 

Augns: 

4.D 

22.0 

September 

:.C .3.0 

27.0 

Octobc: 

3.0 

81.J~-r, 

., 

...:.v 

2 ] 5 

32.': 

34.2 

S6_9~'" 

.~an::.a.; 

?~bruar; 

Ma:ch 

1.0 

lotaJ 19.0 :6.: 5 

34.: 

See ACCOmpan)ing Acoountant's Compiiation Report 

78 

19

Arhflt Acre;; l>nned Metbt>dW. 

S\lI'll.iIDlD (jf SigniflC'lHlt Projectmll Anumpoow; 

Ren.."efIleut CrunJVruI~.lW- _____________~_ !':!!~ ACCtlll~ P{)bcie!.. COlltWUeC 

Assumed Jr.;;ieperdem L!nng lu-'7tOl'cr 

The aS~:J:)ed t'.I::;;n'eT for C::te LIJdepen~"!l: L:\'ing l;~u due 1:- 5eatll. wi:carav.'al or t:"al:S:~:- to assi"t~d ll":in§" 

r:;ternory CBI'I!, or Dl.L-Sing ac.;:;om:noda:ions, ane d::>'.lbJe :J0~Up3JJC:- cf me 1nd~?enden' l.Jying e:n.iu: has been 

based. in par'_ on historical :xpenence of the C:;;rporau0L.. 

Re'filllds d Emrance Fees are geD~~ Up:::>L te:-rt:illa:)oo of :,1:te resi:ien.:': ag;reeroe-::r:: (tbe -Re!l-ici~n;:: 

Ag::eemen:'·) fu'")::l with:i"!fv.'hI fr:Jm me t~unjt;. subje:., w toe re-ocrupan:y ;:.f!h~ vacated lndependect 

L:,-i:1g Cnit.S, Ent"a::,:::t' Fees :nay be generate:': from ::Udependem Living Units :-;.rrning 8yer wi"hou: :< 

corres~:mding. refund b-'-..cause '±e: ~eSldeD1 bas nO" wHbdra\\':3 from ';he Com::::mmr; •. :'n! has pe:]:1Mt',d: 

U"aus:'t:-:TCO to &$sistoo b':ing, rnetnor:' Caee.,;)7 lm:-;-:ng ac.c):n:;nXat:J:ls. The assumed numbe:- cfrefunds OIl 

me Independent Unng Unr.s is pr::'i:i~ by Y1a;n.g~~nt. 

T:J.e folJ;:r~'irl&" table ?Tesen'ts me p:rojectoo irjrial and ~'!::iOD E.n:ra:o:::e Fe-es teC'-e:yeQ ~=:be total E,cTanoe 

Foe refunds. 

Table 11 

Initial and ;\tt;jtiOl! Entra.Dce Fee Receipn and T oU.! Enrraoce Fe!' Refunds 

Independent Lhi.ng 'Cllits 

(ln Thousands) 

Fwc:aI Year Ending December 31, Uno Z{lJj "'12 2013 2014 

}.:C9.' ln6epenc.em Lrving Ho::ne> • lnlnaJ ;;; 

N!"w bde;x;ndent LiYlo! Apa"tmeutE ' It:fual 

:Existing lndep~nden! Lhin,g. 'jnm _ At:rm:m ;2-, 

, " ;:;.0 6.0 

"." 

:6.~ 

Z2.Q 2; ,0 1:,C 

:Seu' Inde;>4 S 5.]77 $ ::.:23 s 3,;61 

Source. Manag=er:t 

il \ bJ:JaJ entnma fee; wucid be Uled ill dire::-":; fund :be :uus::rucnoc ;}f (lac!;. ~e\.l'lndCJY.lUtL"'.tlt !J\m!!, Htll'Dt ar.c ) OC' pe:-n::lft of 

the}\;e-;;. 1ndepenrul:lI Llvlt:p tlOIDiS aJ"

.... I'TI(!! Att"!S rJ1~ MetiJwfu:: Summar:'< of Signifit::IIIDt Projecti(ll' Alsumpti!.la! 

Rc:nrnmero CbmlD~·.lDc 

.______________~•••~d";~::OUDtinl! Foh::ie:s., CI)DtuWe\l 

!'be average ern::an::e fee IS as-sU:I:)e;o ro i,,~ apprtnj::aate::-- $212,000 TO! the Urst-gene;atio::J :):~ residen::s of the 

).i?1). lndepender:t Lh'lng Homes and approximet,:.l; SS8,OCtO fur :be fin.-: ge:l~:wjtm reSloems of fue J';cw 

:'::::'depe::loe::: U'wg Apa"lIDer:rts. 

E!)tra::lc!: Fees :0; :;J!: Lxistillg bdep::ndem Ll\'tnf): L" tritr are assumed to increase 4.::1 per;Y:;:::t "'F.""'"' 

Jaln.m.",) 1. 20J: and annually tberede: 

See Accompall~log Accountant's Compilatioll Report

4.roor \e.~ Unlt.\ld MethodISt 

Retir.tiom 

kDd AcoouuTiug Pttlicitt. CoDtiDued 

The Co:tur:nXll.lt;. ;::·.:r;ently bas aZ:C0mmo.:iation..s, equipment, ;na,~ prog;-ams. s::J"vius,. and suy.::·Yisio~ 

necessary fo: the .4.3S4'1.eD LlYing t,'nm;, v.Tth tbese aUOffi.1Ttodanons ayaiJab1e to !"eSlOe;:r..s or: II priori;:, ba.':~s. 

Howe-\'eL the CO:j>Otatior. can::!01 g:.a-amee aZ:ceSf t:> thest'- .!L-eas. 

The '::O,?onl.tlon plans to replac,e we 66 ExiS'tiIig A3srsred Livbg U:lits- w:~" the 5(> :Se~ A$sisred l..-ivIDg 

L::U'S. -::lle ~e\\ Assls,ed Uvi.:J.g '.)r:it~ ::oclLlde ;;0. ""')c.-bedroom lJl:41:! a,le asSL::me to -::rta£.f' cYalla::ie six :me, 

jein)o:n unitS for d::nb;e O:;:;:;'-.1pl'illC)'. :tDCUpa::JC) of &8.8 pe:-cent. :'ev. }·..ss:sted LlvTI:g JEts UDOCC.UplOO after the transfer of reS;:le:;:s trOlL the 

ExiS'Zing Assisted L:ving Units a-e asS'.'.lmed to fin up 10 s:abiiizec oceupancy of95. G per.,ent_ 

The :S:ew Assisted Living UIll1:, are assurned to acbeve and ;uaintain !i 94_1 ?e".rc~t ooc,smm.N ijviLg :"::&05 meiutt Sf), twO'V:lW-OOW units an:: assum~ tf;. t::au.:e ay;lliabl~ ~iJ-; ffiJ"·:'"1:Or~om :x:ll!'i far 

:ioublc mIT ll$3l1!D:X; W -;:l:O 

available for lXCUpanC! ill Jlltluary 2012, 

{2; Upon availiIDL: OOCIlpiIDC, of me 1':

Arbor At:res l'·nited Metbodist 

Retirement CommUD~', hie:. 

Summary' of Signifit:B.nl Projectiou Assumptiou~ 

and A~counting Policies.. Continued 

Doubje occupancy ?ercentage~ ill the !'>Jew Assisted LiYing l'nits are assumed to be 2C! percen: of the 

o~cupied units in 2012 and throughout the projectior. period. 

Accordmg to Management, residents moying imo a n¥o-bedroom ~e'" ."'-ssisted Liying Lill', WOLlld agree 

to ei1her 1 ') continue to pa:- the Monthly Se~'ice Fee should the other resldent vacale me unit: or 2') mO'i'e 

to a studio or one-bedroom _!>,.,ssisted Vying lInit snowc the other resident vacate the unit . 

. fVlsumed Memor~' Care Utilization 

The Community clL-remly nas accommodations, equipment, staffing. programs, se:"yices. and supe:rTisio:c 

necessary for ::be Memor) Care 1.:nits. "'itb these accornmOo.atioTIS 3yalJabie to residents on a priori,y basis. 

However, the Co,?o;ation cannot guarantee access to wese areas. 

The Corpora-tio:c ?lans to expand the 18 Existing Memo:r"~' Care Units \"'im the addition of J:2 ~ew Memory 

Care Units. Tne '\it'" Memor)' Care l-niu are assumed to be a\'aiJable for occupancy in Februa.~' 2011 

Tne ~ew Memory Care Cnits are assumed to achieve and maintain a 95.0 percent occupanc:- ie\'e: ~eginning 

in 201: and remain constant a! that J,:vei througbout the projectioD period. Tbe folJowing tabje summanze, 

me projected utilizatiOIJ offrle Memory Care LJruts. 

Yean ended 

TabJe 13 

Utilization oftbe Existing Memory' Care Units and 

the Nel'I' Memory' Care Dnits 

December 31. El:isting Memory' Care (:nru :!'Iiew Memory Care (1nits Total 

Histo:i cal . 

Projected: 

Oc::upiecl Ayailable % Oc:mpbl Occunicc Availllhk %Occumed % OccllRied 

2007 J 8.0 18.0 100.0% 100.0% 

2008 ~ 7.9 18.0 99,4% 99,4% 

2009 iH 18.0 98.9% 98.9"/0 

2010 J7.0 18.0 94.5% 94.5% 

2~'11 ('1:: 17.0 18.0 94.5% 7.7 12.0 64.:'% 82.4% 

2012 j 7.0 18.0 94.5% 11.4 12.0 95.0% 947% 

2013 J7.0 18.0 94.5% 11.4 12.0 95.0% 94 7~,,, 

2014 ]7.0 18.0 94.5% J J 4 12.0 95.0% 947%, 

Source: Mana!!elm:n1 

(I) Tne f'ev, Memo!) Car~ ricin are assumed to be ayailable for occup8lJ~ lL ?ebru.r,l 2(1] J 

(2', The f'~" Memo!) Care Units are assumed 10:5l1 over a 6-monID period at an ave:-age of approxiIDa~;) 1.9 units per mootn. 

See Accompanying Accountant's Compiiation Report

Artwr Ac,t$ l'nited Met;bodim: s.IJIIJl...., ..f S)pliit:Mlt Projer:OOr .~-umptWnr 

R~~IIJ_~t CummWl~ , ~.::... 

and A.cc.. ulftint P(lBcie& ConDoueC 

The Conml1mTrY ;::mrentiy has accon:::modJ;.ti:m£. eq;:;i;n:ne!i'L s-r.a.ffi:!lg, pl'Ograms. serv)c:es. and supervislon 

necessary fm the Nursing Beds ...itt oese ac:om::Dodations availahle 1(1 residen", 9::: f% 

2Cf:i8 4£,8 53.0 92.0°;0 ~:::.~"-~ 

1:)::9 493 53,0 93.0% s: -,y;.~ 

Projecrcd: 

Source 

2010 -'-9_:: ,, " 

.~.\' ?2_:% 925% 

:::0n 

21J'- ,- I:,,) 

::C13 

2-C:~4 

\/ia:;ageroent 

49.0 

49.0 

4;;;.0 

49,0 

53 D 

5: 0 

5;:' 0 

:>;',,' - - 

92.5"!r 

::>'::.5'>;£ 

92.51>+ 

"7 ~o 

Oi_,/ it 

3 

, 

1: , 

JU 

:1.(: 

.,_.-.' 

") r 

)H; 

31 :~% 

92.:5~~ 

925% 

9~ ':;0' 

--~ 'P 

81.:'% 

92.5~/, 

92.5~-'; 

(J J 7h~ Cornnnmiry is lirw.

Arb< Ac:re!' Vnired Me1iIoois: 

Summ.ary ofSiguib ,\..!l"llmptim'l~ 

Retir~1 Commll.~~}.~.t.~~~ .._____ ~~~ ___......~~~ ..._____ ~~~ ___......~~~...._~ Aee(llluti:n$ ~.~~~~ ContinueC 

Summary' ofSignmcant Accounting Policies 

(al 3.a£~LOf AQ?0untL.."lg 

:De Co:po;::on1s ~::-::):-dinz it the ac~-JaJ -:.asi;; of 

ac:x>un::t:1g. 

Cash Wd Casb Egci,'al~t+ 

Cash and cast e~-.;jyaleDt~" e:>.cJubg those c;as:sw5ed a5- im-e31:ments and asse-::s whose use is li:!:::J.r..ec. 

includ::: cash it: bws. :::a;n ou hand and irr"e:;tm~u in rug);.:;- l'quic oem JJ:!S:;umeJ::U wi:1 ar: 

IIlZ'J:-:ty of :::'lree t)]oc:rttJI OJ jess wben pu:r:;ha!.·oo Tn: Co::poratJon ;naintaim its casb in bl'il:l..l.: ac::oun!.; 

WhlGL a! ±:Des., x;;a> e>::.:ee: federall: oept';itof) ins~oe (F:>:C) 1;"7'J1--'. Management be;:ieves the 

credil :is~: assoc:atej "'7th these deposits is n::J11in::aJ due 10 tbe strong credn :,ating 0: tbe ii:la:Jcial 

lIl~TlP.t:lOL 

:n"estr:Je!lts in eqwty se::uriti::s \'I':th readily deb:mmable fair val-::!$ and aiJ invc5:n::.enu. in jebt 

seeuri':]!!s a.~ ::::Jeasured at faIT yalue base-:: on ;;tIoed II1a:"ket prices itt the 'tlil2nce sheet. lrvCs:me!:-1 

moo::!!: (inc:ruiing rea:.:zed ga:ns aDd bsses 0:1 in,'estmen"..s. interest, anc dhideods) is Zlcluded ir: 

O?o:-atrng: income '.l!lies;, re-s:::::"ieted ;') donor Of l?w, L:rr'ealized gains :me losses M m\'e~e::ts. i::t.h~r 

~ :bose consld.ered tc be !lXl ~~~:m-tem?OTa.;, J~lwe, a:e excluded :ron opera:ti.:rJ.g :::tcomc ane are 

SbD-.v:J as other changes :n net assets ill ~e ,,'tatem~1 of ope:a:tions and changes in ne-: assets. smce the 

CO:-PO:-ariOD has no !L"estments cnnsid~d to be trading. sectL-1tie,;, Manage:arem ass:m;e5 no u:n-ealize::l 

and bs.;es in the pmjec:ion period. 

t,:-: Asset1J,l:llired as tot:s::: 

}l....sscts limhec a'; to ::;;0 pnmwh incla:ie asse"S designated by the Board, over whlcl::. dJe Board retai::.s 

c::m::rDl and may (1;: r-s discrdor. subSiX;lJent:~ use for :r:ber ?t:l?oses, or r.est:"1ctee by don:r; OJ trJstee 

agreemenu for future cayital improvements. O}X".ra:lng re3erYC!i, reside::r, assistru;lce, and deb": sen':=e 

1'"orll Carol:na Gene;a] SUi~ $ectio!; 58-6-i~33 ::-equ.L""es CCRe's t.c maintain an 0~clting reserve eq~ 

t:> 50 per~n~ orrow operating expe::1ses (adjusted for pon-cas;: terns) in c gh'e:;) year, Of 25 percent of 

;u::::b tota: operating eXp!:::lSes (adjus:ed for Don-cas:: :terns; if indepe:1dent living oc:.:upanC) ex~.eei.~ 90 

pen;otl~ 

Ass~smnce :mdowmen1 funds inclucie d;mor resi:ri:;ted ft:ndi. and amounts designated by the Soard.. The 

Corpor4TiOL! u.ses CC!1a:m board designa1bd ]'jet assets and the e8JnirJgs fr::n::: certain pe-rm:a::>e::t1y res:tricted 

:let asSC':5 for ass:stauce:c residen:s. 

Prope;r;.· and eqU!pme:nt are ~ed 3' COS1 less- accumulated :lepreciatio::t. Do-nateC l'r~;perty is reesi(rnal fees The costs a-e being amo:tized l:.sbg tt'le Strlrigln :iLe me:tbod OYer the 

jjves of the ya.-10m deb:. 

See AcCOmpanying Accountant's Compilation Rep()rt

~+rbO! AcrS rnlt:erl Methl>dis! 

RetiremelJt Comm"",,'=;hJ.~.I~'~L,-_____ 

Summar; of Sig:nl.ficall' P:'Djeetrtoa Assumptloru 

Ami Aeooullting r(Jlki~ Continued 

Ri:o-;"-.:.nciible depo;its represeni the ?():tio~ of the pa)'men, of parq f~ mal VlW ,.., :-e-:unaea ,0 ::he 

residen:t wnen parking is no longe: req:.lire;i 

-=:'be Corp?!"3ti::;:::; a.'IDuai.:y ca:cwate$ the- present valUt of the n~ cost :;::' f-... '"tUTe se:-nces and me usc of 

fa:ili::ics ID be pl"Oyjded to curr

Anwr AC1"C:S (iulUlid Me:t}w,tlist 

Rebremcnl ellUU'''.!."" ts.t. 

Swnmllry 6fS~m Pn.j«.tiOt A.S!'umptioRf. 

auri Aecm.!lIW1g. P(>hciCf.. C IIPlWllt;tl 

The prepara:r:io(] rof the )Jros~ecti v!' :5na:x.'1.a: s';a:t:;merrs in CO::Iorr::jty v.':hh ac;;.oun:mg principles generally 

:'pora:}(>t; cor:.io:n::J.S tc the requirements of Stalernent of Financial AC::%Iu;;:ung S:anda-js ;SF.!..S, 

:';c 1: ':'. Fi::.:mda) ST31~~ec;tr; of :S;81-fm-Pro:5:, Orga.niz.ations. SPAS 11 -: es,.'e:na: 

repo:'ling by not~fJ!-?~0fu mgan:zat:ClTIS .and requires these res(}urce~ be c;assi.5ri! fo~ w0UOtJ::.g 

anc repJ:1:i:lg p'.L"';lOSI!S i-:10 :i:L-ee [Ie: asset categories. In accordance with SFAS J 1"'. me COljX)rauoL 

dassi£ics il$ f.mds foc 3L:Co:mr.ng and Te?Dr::ing ::':..l.Tposef as unresuicted. rempo:rariJy re$rric~ec Dr 

permanen:ly :'!Str'icted: 

" Ltr'estriCt!:d ner asSet;; w resou-ce>: of th-e C:xP0::1l.1:oJ: :hat ere :::lot res7:ric~ed donors 0: grantors 

as to use tr' P'.J.1l'0>;e. These rtfu)u::::es mc:ude a:n::m:n:.; ge:1e:-ated fro:n operations. undesignatej 

ana the mvcs1IDen! ill ?Tope:"!) and :guirnen: 

" T:zn;xr.a..;Jy restricted ner assets - 'e50".liC¢S '±at car:; a donQT~i:n?o$~ :est;j;;:':i:>n :'1a1 'Penr.i:s thO' 

C:rporatioo tt.> use 0)" ex.pend me donated assets as specined an:: is sati:5ed by C:Jt passage O,":ime 

:)r ac:ions ::of :he CD:yOraUDll. 

• ?er::naneo:::y re'>tric:ed be': as>;et - resource; thar carr:-' a donor-imposed r'esu1C':i0t: tha-:- mp-J1a,cs 

mal doua:ed a!;set!; ::'e :c\aintai::led in perperuit;, hUl may pen:rut the C:VP07a!JCe derive:::fro:n the dona:OO assets. 

Re'l'enue 

Resident 5e"'\1CC )'¢ven:Lle for residents living in :he lndep~nde:r:r; Living ::nits is ":>23e:: UPOL the lC2 

L;ving ~~:u1tt to i:Je Memory Care C::rits are assomed to pay the then curre:n1 Mr:m:2.ly Fee. YlC:::::::H: Ca-e 

Man;}';)' Fees are aS5~ec !C incease 4.0 perreot Oeg'.nnmg: Jano.a:r; L::O:] and therea,'ter. 

See Ac:~mpall:ring AccOirntanCs CompilatJon Report

Arbur AcrtSlinned M~ttll'dwr 

Re1::trewtm Ct>mmun~', ~ 

s.ummary- Df Sl;gr.iiieaut ProjectIDll Assumpti{tn~ 

~~-,."n,d:,:~el!1)1Jnring Polkles, C(tBtlDu~d 

T!)e D~~' Fees: a:c generated fro::;n $erV1CeS provided:c- :residents transf=ing fr::nn ine bdependen: LiYlng 

'Uni'£, th~ P.sslSled Living 'L;ni!S, :he MernDJ) Care ::ruts. or as ;:fuec: a±:nissiom frtrro ne su,-rouneing. re;:. "':0 

the :\Q"'SllB Beds. ResIdents peTIDaDent!: 1:'alliferri.;.g fro:::;be lndep~dent LiYing 'Cnits, th-;, A.sslste:: ~h ing 

--CniE. 01 the Me:::nol) Care ('nits w::Juid }Xly the Then cu,-;-$nt daiJ: rate One-1:rodreCl per,;:ent of the ~ursb& 

Beds are il.Ssum~d 16 be utilized:o: privare pa~ residents. Nu."'Sing Be:1 daih feet; are iL~;:ume3:o mcreast: 4.0 

pe;-~'ent 

beg_::ming JtLl~ L 2(:)'_ ilL"1j a:mual,y "tbereci:er. 

ill ad:;Y:jOi'~ ~esi:ir:n: fees for ine lndepenaeul Ljving: U:rlK /\ssl$ted Uv:ng lJnn!.. f..'Je-LlO:: :'a:"e; L ur.s and 

~':.lrSi:ng Beds ruS{' inc;ude "evenues from ad:';::::O:::laJ rcsi:ienl z=)eais. ba:oo: and bea:J.':Y S~'J:;:-es, and gift sbop 

sale.;, whic:.n ar-~ 2ssmne:: :0 i!)creas: 3.0 percem :'eg:inning. Ja3ua.:' 1, 2:, ! an: annual)) !he;-ea.fie:. 

O:ber reyen'.le consiS":s 01- !'i'ye:rl.

Arnl)( Acres wnrted Methodist 

Retirement Com:nntlri~, lh~ 

Su:m_~ "fS~ni h#jeetID» "'-SStllnpDf)llS 

and Accpllnting P&ii6e$.. CobtlDued 

Operating Expenses 

Opera::ing expense~ a.r~ estima:te6 h; Mana.:-emen:: '::.as,ed ::m 1";3 exper:le:lC'J: ~1tb :be dcyclopmem anc 

opera:lon of w.l:ler similar ret:i.renJcm COl:::cn::-miti~_ SR+: saia-it:S wd oeue5+.s are ':::asec 00 preYlliling locaJ 

sa1ar:'- and wage rate, and are assumed to in~ease 4.0 ;:¢.-cent ann;;;al]y :lro;;gho:lt:he proj~--:)OL peri..">:i. Tne 

::;:.scs {)': Ct:lDJoyee f:ing: be:o~fjts are assume': to approximate 26 perce::l 0:' salaries and \>"ages 

Table 15 

Staffm; Le'i'els - F'Y 2014 

FuU~timt Equh'liIleJIt (FTE'&) 

Department Existing Proje

Arbor Acre> liniud Me!1MlI;/ 

Retirement ComwuaJtr.lnt:.~~~.~.______~ 

~UI!lln.~' ofSiguillc.aull'J"{)jecti(JD Assumpti(JlI~ 

uri Aeecouutin:. P{i!icie£, COlltill1led 

Proper!}" and Eqnipment and Depreciation Expense 

Const"-'~·U0IH'e:)[J.le.d 

:b;: tatJ~ ~Jow, 

COs:5 as well as row....ue. capital a6:dinans cur.ng tb:; p-:-c:ie;;:;:im; pe::ioc an surr:;mari.ze:C ic 

YeArs Eoding 

December 3:, 

Table 16 

Schedule of Property Abd Eqnipmell1 

(In Thousands) 

lOU} 2l!n lfn4 

?rope:r:y aoe eqhlpn:tent" ne'l 

beginnmg baJan~t 

$ 9C.?05 

~ew Assis:ei Livmg ~-'!Lits &: 

:s~ ?;1:m:::r:) Ca""t ''':xr;; 

:;';e-w IDdepePdem :L:Y1:1g 

tlomeb. xe'>" Nursing ]3ed5. 8: 

:\ew lnciepende:::: LJvrog 

;0.376 l.5.4S0 3-.8Ci9 

"-'.~?ar:m::nts 

Capr-..a!ized i:I~-:::Sl :3: 666 

?.,l9S :"-;;::;4 3.950 ~ l ~ 

Romme ;::apiUll a,.;djtioru 2/jC'" 2,.672 2,£.~0 2360 

Proper:} and equipment. grMs 

S 90.90;'\ s: 10938"; ! ~: 9,9"04 

S J25,G65 

A-::::urr:n.Jatx de:oreciatbr 

$ (;6.941) 

$ (3S.820j 

" 

$ ~A3,299; 

$ :.?2,"C': 

$, \46,"';('i 

); :.50"':'::;: 

Pro~

Arbll'~ ,~I;re> rlliteC Methodis: 

Refu"em_!ll! Cowmunr.;. _lDt:.-~~~_ 

Summary 11'1 Significwlt Proj:ctioc Alisurrrptll>k! 

ann Aeoounting;}':?~,~es, Co~!:,~~_ 

Long-Term Debt and lnrerest L:t:pense 

52n.SS ](if}2 };:mas and the Senes 21)0- Bonds 

In Marc"i. :00-. ~:5,8i):;,OOD o"! the >JOnL Carolina Medical Care ComJ:nissiou H~l C..a:e FacEmes ?z!;1 

Morr.gage- Revenue Bonds Series .2:10:: bonds (the -Sene): 200:: Bondr"') were aj':ance refllnli..-41 The 

Co:p~cm used s po:-tion of ::!=.e De~ PTOt.~ from me l'o:"th Ca.--olina Me±ical Care Cotnm:!ssion 

Re-i.~me:n, 5er:Je-r. ::007 ll,j,'ance Refund Bonds (the '·Smer. 2007 Bonds", to pur:::n;:s: ~~'.S G.:-vernmen: 

;-:x::.-i:Jes. 

rhe 2(;} (: Ban} Mar 

.\fanagemer:t ilSS:.n:::le5 fb.at !he Corporatioo 1$ ie, obtaJ..n me 20: D Bci L:)an to p) fY::be co:l5t!"'.lct!;):;) of rile 

?r:.)ect. T::Je :;C';C 3w LOa!: is 2.ssumec TO consist of $28,875,1)00 of II lang te:-c lea:: ~:be "Long :err::: 

Loan"":) >-"ntb an average inre:-:s1 rate of 3,8 pert:en"_ 11teresT e:l me LO!'.g Te:-m Loan is 

1::'.!;)D:l:Jy 

begim_ulg july 1, 20}(i. ?rincipal on ibe :"'o::g Te~ Lean IE:o"::x; pai:: monthly commenc~ng on Ja.rn..:ar; 1. 

2Q~.3 wi-.:b;'l [IDa] maUL"1TY OTI Januar::v 1, 203.8. 

The fO:::J~bg :o.b:e prese::1to- !be p:oject[';c annual deb1 service during the ;:r,ojectioIl pe;io=- and ::'::1e,elli:er 

Table 1" 

AJlbUaJ Debt Serdce 

lIn ThonS8Dtl-s} 

1· ear Ending. S~~es 2C~2-..£PO; Bond,; TO".a: 

j;?ecembeJ 31. Pfflx:i;,al lnte:est Im:erest Deb! S&fr);:::e") 

20JCi $505 $ 84: $ 98 $1.445 

20] : 5% 816 1.966 

20 I-=: 5:55 788 J,084 

2013 165 77'" 1.S! 6 

20}4 580 ?53 1.899 

Tberea:fEe'r':J £:6.-"30 $7.465 $27.925 $] 6.717 S6S.537 

Total S~ 8,765 $1 :,441 $28,875 $10.7f)9 $79"790 

SDlED:;' Mantl,,"'!'Wenl and the Und!:nl'lirer 

(J; 'be Maxiro\,l;ll; Annuai Deht Sen·jC¢: i. a$llUtUed to h~ apprti,,j:na:eJ) 5:-957,0;)0 

See Accompanying ACC(}Dnt3nt's CCUllpnat;ofl Report

ArOOt- >\ crt:S 'Clined M~isI 

RctiretneDr Communrr," In:. ________... 

Summar:" of Significallt ProjectioD Asswnptioru 

= :",(;(c.fUIDtmt l'olicle& Conti';l.~~ 

Operating experu.es txclude amD~za:tion. depreciatbr:., tither ::;or:-ca5h e).l1ensc.s and 1nteres1 n?en.~e_ 

~ating re\'(:~:I\.teS mclude sef"jce fees. 'VI"orking ma.p:tal corn.yone-:rs hzve beo:: es:r::nate'd based;:m ind~ 

S"'.a:xim-cis anc Managet::ltlllfs histor1caJ experienc:!' as foli(lw;;: 

TaMe 18 

Working Capital - Da~'s on Rant! 

ciay> operat:mg expense, 

day~ upera:tmg r~venues 

Prepaid ~peru"" 

Axoun:s payable 

ot'lC;; ~""1.l:;d liahilitie.'i 

£illy, ,~g expC!lSe!; 

d.ayo operazmg ex~es 

OperatiDg Reserve Requirement 

So:-fu Car:.lina GePeraI Statute § 58--64·33 requires- CCRC"" to:nainrnin a:J :)pe:atin£ reserve (tl!' "StaIU!ory 

Opera::.:.;g Res~\'e-; equal to 50 pe;:-ttnt of me tom] op~ c,osts i:1 a gJ"e:l year_ OJ 15 percen: ;:If sllch t01aJ 

opera:cin E costs :: OCCUPllJ)cy as of a C~ da.:e ex:;eed$ 90 percent of~ indejlende::t: Hvbg :.mi: capa;;iry. 

Thi

ARBOR ACRES UNITED METHOD!ST RE'fIREMENT HOME, INC, 

Comparisor; of Actual =nerts 0 (51,758) (51,758) 0.0% C 

Investment earni,1gs 634,50C 664,025 29,525 4.7% 

other Earnings 275,472 193;020 (82,452) -29.9% 

T otel Rellitnues, Gains 8, 

Other Support ~ 9 126,388 2~,225,574 2,093,186 11.0% 

Operating Expenses 

Medical 8. personal care 4,018,257 3,971,262 (46,995) -1.2% 

Food Service 3,048,013 3,032,039 (~5,974) -0,5(>/.., 

Facility Services 3.249,260 3.611,745 362,485 11.2% E 

Ut])ties 1,030,736 974,566 (56,172) -5.4% 0 

ReslI:ien; Services 1,034,420 955,289 (79,131) ~7,6% 

Other 36,264 33,820 (2,444) ~.7% 

Ad'l1;'lislra,ior 1,688,023 1,691,596 23,573 1.4% 

Human ResOurces 203,043 210,493 7,450 3.7% 

Development! Markeb"'g 540,041 557,452 17,411 32% 

Arno rtization 2:0,100 20,036 (64) -03% 

Deprecia.tior: 2.498,700 2,631,793 133,093 5.3% B 

Interest 857.114 854,747 (2,367) -0.3% 

Loss on disposal of property 0 0 D 0,0% 

Tata! Expenses 

Reve,"Jues ave, Expenses 

18,203,973 

922,415 

18,544,8.38 

2,680,736 

340,865 

, 752,3.21 

1.9% 

190.6% 

Ur.reaHzed Gain (LOSS) on investments 

Change i, Net Assets 

0 

922,415 

2,531,731 

5,212.467 

2,531,731 

4.290,052 

100.0% 

290.82% 

F 

NOTES: 

A Incluoed In Conlribut'ons for 2009 was a Capital Carnpalgn amount of $888,865. 

Approximately' $600,;)CO of I'i:"lnual contributions for Financial Assistance are fairly consistent and predictaole, 

B 

C 

Remaining contributions are always- a very unoredictable nU'T'ber. Proceeds from wills and bequests 

are the mcsi unpred.lctable cor,1ribution source. 

Relatively rugh !Mependent Llvmg tumovej throug'1ou: the year created strong entrance fee earned rever,ue 

and also r&muted in higher depreciailOfl on capitalozatio" of assets, 

Decline in return on mvestments oue to general decline and weakness in the investment marKet 

D. Lower expenses than anticipated Decrease.o utilities cost driven by installation of new more efficient gas boilers, 

E. $~54,OOO expense due a failed stormwater d~ajn system after a severe thundersrorrr. and the failure of 

a 3C year old I\.1cher drain system at a replacement cost of $126,COO. 

F. Rebound in s:ock markef from 2008 declines resulted i.'l sizeable ur'JreaLzed gans in investments, 

0; \A:::cour:.::.ing\SYMFI1.E\DISCLOSE\2Q09 Material Differences for 2010 Di,,::losure 

Statement 

92

) 

) ESCROW AGREE,,1ENT 

FO~I'TH COUNTY ) (rosa ;;,; ....:;:(: ;\f.e G.S, 

Sec-..:on 58-64-35) 

.A.rbor !i~cres U!1itcd MerllooL

NORTH CAROLINA ) 

) AGREEMENT 

FORSYTH COL"NTY ) 

MissioD Statement 

Arbor Acres, an qffiliate ministry ofthe United Methodist Church, serves senior 

adults through facilities and programs thot provide opportunity for security, 

contentment, and life with meaning andpurpose. 

On (date), as an expression of this mission, and in support of it, 

ARBOR ACRES UNITED METHODIST RETIREMENT COMMUl\lJTY (Arbor 

Acres), and 

(Resident) desire mutually to enter into THIS 

AGREEMENT; 

Resident has applied and been approved for residency at Arbor Acres 

in 

(the Accommodation), and has received a copy of Arbor 

Acres' Disclosure Statement dated June 1,20_: 

Resident and Arbor Acres agree to the following; 

1. Entrance Fee. 

Resident agrees to pay Arbor Acres an entrance fee of 

($ ) ("the "Entrance Fee"), of which 

=TW=O;-'TH=O:::CU;-:;S::;-AND~;;:-::F::::lVE:C=-;;CHUND=RED DOLLARS ($2,500.00) is nonrefundable 

(the "Nonrefundable Fee"). Resident has the following payment options: (i) pay 

the Entrance Fee in full upon execution of this agreement, or (ii) pay 25% of the 

total Entrance Fee ($ ) upon execution of this agreement, with the 

balance to be paid no later than five (5) days prior to the Residency Date (as 

defined in Section 2), Resident does not acquire any ownership interest in the 

Accommodation as a result ofpayment ofthe Entrance Fee. 

2. Initial Occupancy. 

Arbor Acres anticipates having the Accommodation ready for 

occupancy by 

Resident is not required to move into the 

Accommodation before it is ready for occupancy, or before the expiration of thirty 

(30) days from the date of this Agreement, whichever is later. Resident plans to 

move into the Accommodation on or before 

. Resident agrees to 

94

pay Arbor Acres' applicable fees and charges for use of the Accommodation from 

the earlier of (a) the date of actual occupancy (first night of residency or when 

personal property is moved into the Accommodation) or (b) 

(the 

"Residency Date"). Resident has selected all interior finishes (paint colors, 

carpeting and floor covering as may be necessary to prepare the Accommodation 

for Resident) and has advised Arbor Acres of those selections. 

3. Resident's Right to Rescind or Cancel Within the First Thirty 

(30) Days. 

(a) Resident may rescind this Agreement within thirty (30) days 

from the date of this Agreement by delivering to Arbor Acres a signed ",Titten 

notice ofrescission. IfResident dies within this thirty (30) dey period either before 

or after becoming a resident, or if, on account of illness, injury or incapacity 

Resident should be precluded from occupying the Accommodation, this 

Agreement shall be automatically canceled. 

(b) IfResident rescinds this Agreement or if this Agreement is 

automatically canceled as described above, Resident or Resident's legal 

representative will receive a refund of the Entrance Fee, less the Nonrefundable 

Fee, and less any residency fees charged for the time Resident shall have resided at 

Arbor Acres. All nonstandard costs specifically described in a signed addendum to 

thls Agreement are nonrefundable in the event ofrescission or cancellation 

4. Failure to Move to Arbor Acres. 

If this Agreement is neither rescinded nor canceled, and if Resident 

fails to move to Arbor Acres by the Residency Date, this Agreement may be 

terminated by Arbor Acres or Resident upon written notice to the other. Resident 

shall receive a refund of the Entrance Fee less the Nonrefundable Fee, and less the 

amount of the monthiy fee that would have been charged to Resident had Resident 

moved to Arbor Acres on the Residency Date. Afterward, neither Resident nor 

Arbor Acres shall have any obligation to the other under this Agreement. 

5. Refund Upon Termination ofResidencv After the First 30 Days 

and Withln 50 Months. 

If Resident, for any reason, vacates and perrnanenUy terminates 

residency at Arbor Acres after the first 30 days followiag execution of this 

agreement (during which the above provisions regarding rescission and 

cancellation will apply) and within the first 50 months following the Residency 

#231049lv4 

95

Date, Resident shall be entitled to a refund. This refund shall be detennined as 

follows: Upon receiving payment of an Entrance Fee from an acceptable substitute 

resident, Arbor Acres will refund to Resident, or to Resident's estate, the amount 

ofResident's Entrance Fee (i) less the Nonrefundable Fee; and (ii) less two percent 

(2%) ofthe remainder for each month from the month ofthe Residency Date to the 

Date of Termination of Occupancy (as defined in Section 6) up to the full 

refundable amount of Resident's Entrance Fee (for this purpose, one-half month 

shall be considered as a full month; one-half month or less shall be disregarded); 

and (iii) less any unpaid obligations of Resident to Arbor Acres. Resident shall 

receive no refund if Resident's fmal tennination of all rights of residency at Arbor 

Acres occurs after the fifty (50) month period referred to above. 

6. Notice of TerrnJnation of Occupancy. 

If after moving to Arbor Acres (and after the allowable 30 day period 

during which resident may rescind this Agreement), Resident should decide to 

terminate this Agreement and residency at Arbor Acres, Resident will give Arbor 

Acres a minimum of thirty (30) days advance written notice stating the date on 

which Resident plans to terminate residency. This Agreement, and Residllnt's 

obligation to pay Arbor Acres' fees and charges, shall continue in effect until 

Resident vacates the Accommodation and removes alJ personal property from the 

premises or until the end of the 30 day notice period, whichever is later (the "Date 

ofTennination ofOccupancy"). 

7. Transfer to a Higher Level of Care Within 6 Months. 

If within six (6) months after the Residency Date, Resident transfers 

to a licensed level of care (the assisted living facility or the skilled nursing facility), 

Resident will be entitled to a refund which will be calculated as set out in Section 5 

above. Resident shall not be required to pay any additional Entrance Fee on 

transferring to the assisted living facility or the skilled nursing facility. 

8. Terms..and Conditi()lls of Initial Residencv and Contioued 

Residency. 

Resident shall have the right to occupy the Accommodation and to 

reside at Arbor Acres subject to the provisions ofthis Agreement and subject to the 

following understandings, terms and conditions: 

#2310491'14 

96

(a) 

Health and Financial Qualification/or Residency 

At the time of the execution oflhis •.

agreement shall be an option exercised as necessary to assure the financial viability 

of Arbor Acres and ofits fmancial assistance program, 

(c) 

Rights and Obligations During Temporary Absence 

Temporary absence because of illness, trips or olberwise shall 

not affect Resident's right to retain the Accommodation as Resident's place of 

residency; however, Resident shall continue to be charged and to pay Arbor Acres' 

applicable fees and charges during such absence, 

(d) 

Requirement ofCompliance with Recommendations for 

Additional Services or Care 

If Resident shall incur a physical or mental illness or 

impairment so that Resident requires additional services or a higher level of care 

than is available at lbe Accommodation, Arbor Acres, through its nursing and 

Resident Services staffs, will make recommendations regarding appropriate 

additional service options and/or options for transfer to a bigher level of care. 

Resident agrees (i) that Arbor Acres is obligated to assure the care and safety of 

residents and, (ii) lbat Resident will comply wilb nursing and Resident Services 

recommendations regarding additional services or transfer to bigher levels of care, 

If such additional services or higher level of care can be provided in a different 

accommodation at Arbor Acres, Resident has a right to, and may be required to 

move to such aceommodation. Arbor Acres will recommend and require such a 

move or additional services only when, in lbe judgment of Arbor Acres, it is 

necessary in lbe best interest of Resident and, secondarily, of Arbor Acres' as a 

whole, Before any such move or additional services are required, Arbor Acres will 

discuss lbe matter with Resident andlor Resident's responsible party in an effort to 

secure Resident's understanding and cooperation with lbe required additional 

services or change of accommodation or level of care. Resident and/or Resident's 

responsible party shall have lbe right to appeal a decision to change Resident's 

accommodation andlor level of care in accordance with lbe provisions of (h) 

below. 

(e) 

Requirement of Compliance With Policies, Rules and 

Regulations 

In order to operate Arbor Acres in lbe best interest of the entire 

Arbor Acres community, Arbor Acres has established policies, rules and 

regulations relating to residency, which are subject to modification from time to 

time as deemed appropriate by Arbor Acres. Resident has received information as 

#2310491v4 

98

to current policies, rules and regulations in the Disclosure Statement and in other 

written information. Arbor Acres reserveS the right to make or change policies, 

rules, and regulations, and will use its best efforts to cmnmunicate through 

appropriate means to all residents the substance and content ofthese changes; also, 

copies of particular policies, rules and regulations relating to residency will be 

furnished to Resident on request Resident agrees to comply with Arbor Acres' 

policies, rules, and regulations applicable to Resident's residency in Arbor Acres. 

(f) 

Cooperation ofResponsible Parties and Other Associates 

Resident understands and agrees that in order for Arbor Acres 

to operate in the best interest of both Resident and the entire Arbor Acres 

community, Arbor Acres must have the cooperation of (and compliance with 

Arbor Acres' applicable policies, rules and regulations by) Resident's family, 

friends, responsible party. and other associates. Any continuing or repeated failure 

or refusal by any such persons to so cooperate and comply may result in a 

determination by Arbor Acres that it is impossible for Arbor Acres to continue to 

accommodate Resident as a resident. Upon such determination. Arbor Acres will 

have a right to terminate Resident's residency at Arbor Acres. 

(g) 

Termination ofResidency for Health Conditions Beyond 

Arbor Acres Capacity to Serve. 

If Resident's physical andlor mental condition or needs cannot 

be served legally or adequately in facilities or programs available at Arbor Acres, 

Arbor Acres reserves the right to terminate Resident's residency. Arbor Acres will 

discuss the matter tboroughly with Resident andlor Resident's responsible party in 

an effort to determine what should be done in Resident's best interest. Arbor 

Acres ",ill provide guidance and transitional support to Resident and Resident's 

responsible party to facilitate an orderly transfer of Resident to another more 

appropriate facility or setting. 

(h) 

Right ofAppeal ofTransfer or Termination Decisions 

'While Arbor Acres must and does reserve the right to terminate 

Resident's residency at Arbor Acres for failure to comply with (b), (d), (e), and (f) 

above; and as stated in (g) above, or for failure to comply with any other provision 

of this Agreement, Arbor Acres shall exercise such right only as a last resort and 

after having ftrst attempted to work out satisfactory solutions with the Resident 

andlor Resident's responsible party. Ifagreement cannot be reached between the 

President and Resident andlor Resident's responsible party, the President will refer 

99

the matter to the Executive Committee for hearing and decision. The Executive 

Committee shall afford Resident an opportunity to be heard, and shall render a 

decision with respect to the matter referred to it. The decision of the Executive 

Committee shall be put in writing and shall be signed by the President or, in the 

absence of the President, the Chair. It is understood and agreed that the written, 

signed decision ofthe Executive Committee shall be final and binding. 

(i) 

Terms and Conditions of Initial Residency and Continued 

Residency 

Arbor Acres reserves the right to relocate Resident to an 

accommodation comparable to the Resident's Accommodation, when deemed 

absolutely necessary in order for Arbor Acres to fulfill its strategic financial and 

other obligations to the whole of the Arbor Acres community. Arbor Acres will 

exercise this right only under extraordinary circ\J!rJSlances, and only when all other 

reasonable options to avoid relocating Resident have been considered. Any such 

decision to relocate Resident will be discussed thoroughly with Resident in order 

to enlist Resident's understanding of the need for and cooperation with the 

relocation. Arbor Acres will pay all required packing and moving costs, and all 

reasonable refurbishing costs necessary to achieve comparability between the 

Accommodation and any new accommodation to which Resident may be relocated. 

Any decision to relocate resident for the sake of enabling Arbor Acres to fulfill its 

strategic financial and other obligations to the whole of the Arbor Acres 

community may be appealed to the Executive Committee as outlined in (h) above. 

9. Standard Services to be Provided. 

Arbor Acres agrees to provide standard services to Resident, and has 

informed Resident ofthese services and other services through ",Titten information 

available to all residents At the time of execution of this Agreement, standard 

services include: 

(1) Maintenance of buildings and grounds, including maintenance 

ofall standard equipment in the Accommodation; 

(2) Utilities as described below; 

(3) Basic cable television service; 

(4) Emergency call system and nursing assessment and assistance 

in emergencies; 

(5) Routine consultation regarding health concerns with nursing 

personnel in the Clinic; 

1i23!0491v4 

100

(6) Recreational, educational, cultural, welJness and spiritual life 

programs; 

(7) Transportation to routine, non-emergency medical 

appointments within Winston-Salem (transportation by 

ambulance not included); 

(8) In-patient care in the Health Center with limited days at no 

additional charge; 

(9) Weekly housekeeping and annual deep cleaning of all 

residential accommodations; 

(10) Laundering of bed and bath linens furnished by Arbor Acres; 

(II) SecuritY parsonnel on dutY around the clock in the Welcome 

Center; and 

(12) Dining services with meals or a meal allowance included in the 

monthly fee. 

Water and sewer services are included. Electricity is included except 

for residents in accommodations that are individually metered who are billed 

directly by the service provider. Resident has been informed that the 

Accommodation is (is not) individually metered. Resident has been informed in 

writing of the terms applicable to Resident's meal plan. 

Arbor Acres residents pay monthly fees and charges to cover services 

provided by Arbor Acres. At least annually, during budget preparation, Arbor 

Acres reviews services and costs of operation, and the need fur any changes in 

services or in Arbor Acres' schedule of fees and charges. Arbor Acres reserves the 

right to change when deemed necessary the services provided to residents and the 

associated fees and charges. Arbor Acres will strive always to deliver services 

efficiently and economically, and to keep costs affordable and in line with the 

prevailing market for continuing care services. 

10. United Methodist Affiliation. 

Arbor Acres is affiliated with the Western North Carolina Annual 

Conference of The United Methodist Church, which is not responsible for the 

financial and contractual obligations ofArbor Acres. 

11. Not Certified for Medicare and Medicaid. 

Arbor Acres SJdlJed Nursing Facility (The Fitzgerald Health Center) 

is not certified to accept Medicare or Medicaid payment for the daily room rate. 

Arbor Acres is licensed by the State of North Carolina to provide both Skilled 

112310491v4 

101

Nursing care and Assisted Living, and does so on behalf of residents who need 

those seNices and who are required to pay daily fees associated with receiving 

those services, 

12, &!;quired Documents, 

Resident agrees to keep in effect an appropriate Power of Attorney or 

other designation of responsible party, and agrees to provide copies of the 

following documents to Arbor Acres by the first day of residency: (i) Health care 

insurance coverage information; (ii) copy ofcurrent Durable Power of Attorney for 

business management; and (iii) if applicable, copy of current Health Care Power of 

Attorney and Living Will. 

13. Entire Agreement. 

Resident. 

This Agreement contains the entire agreement of Arbor Acres and 

J4. Amendments and Modifications. 

This Agreement shall not he modified, amended or changed in any 

respect except in writing signed by Arbor Acres and Resident. Each waives any 

right to amend this Agreement in any other way. 

15. Assignment. 

This Agreement may not he assigned. 

16. Governing Law. 

This Agreement shall he governed by, interpreted, construed and 

enforced in accordance with the laws ofthe State ofNorth Carolina. 

17. Mandatory Arbitration. 

In the event of any dispute, claim or controversy arising out of 

or relating to this Agreement that cannot be otherwise resolved, Resident and 

Arbor Acres agree to submit such dispute, claim or controversy to final and 

binding arbitration to he conducted by a single arbitrator selected by the parties. If 

Resident and Arbor Acres cannot agree upon an arbitrator, the arbitrator will be 

selected in accordance with the then-current commercial arbitration rules of the 

..231M9}v4 

102

American Arbitration Association ("AAA"). Such arbitration shall be conducted in 

accordance with all commercial arbitration rules of AM except to the extent that 

such rules are inconsistent with the provisions ofthis Agreement. 

All c

NORm CAROLINA) 

) AGREEMENT 

FORSYTIi COUNTY) 

nns AGREEMENI,IllOAle and entered into this _ day of---' 20-, by .... d 

between of Counly, Stale of , herein called the (Resident), 

and ARBOR ACRES UNTIED MEmODIST RETIREMENT COMMUNITY,INC., a llOIlpI!Ofit 

corpo!1IIlon organized and existing under the laws of North Carolina located at Winston-Salem, 

Forsyth CounIy, North Carolina, herein called (Arbor Amls); , 

WITNESSETH: 

WHEREAS, (a) Resident has applied and been approved for residency at A.rbot 

Amls, and (b) Resident has received from Arbor Acres. copy ofthe revised Disclosure i 

Statement (per North Carolina General Statutes, Sectioo 58-64-20) dated June I, 20_; 

, 

NOW, TIiEREFORE, in consideration ofthe terms, covenants, and conditions! 

hereina:ftlor contained to be perlformed by the Resident and Arbor Acres, the parties coottact arid 

agree as fullOWl!: 

i 

! 

I. Ent!ltm:!l Fill! lIlld Rescission 9fAlil'eem!mt. The Entrance Fee estsblis!\ed 

by Arbor Acres for residency in Assisted Living. where it is anticipated Resident will reside, ;j; 

ONE mOUSAND DOllARS AND NOli 00 Dollars ($1,000.00), the amount being paid J>t 

Resident herewith in full. (The Entrance Fee is separate and distinct from Arbor Amls' fees and 

charges to residents for food. maintenance, medical, nursing and «her services.) . 

The $1,000.00 Entrance Fee for residency in Assisted Living is a non-refundable 

fee except as provided in JlIII'IIIlIIlPh I(a). . 

(a) 

IfResident moves wlndependentLiving, the Entrance Fee wiII:be 

applied wwan! the Entrance Fee for that UDit as provided in JlIII'IIIlIIlPh 4(f). IfResident should 

die before moving w Arbor Acres, or if. on account ofillness, injmy or incapacity, Resident • 

should be precluded from moving w Arbor Acres under the terms ofthis Agreement, this : 

Agreement shall be automatically canceled and Resident or Resident's legal representIIlive ~ 

be entitled to a full refund ofthe $1,000.00 Entrance Fee. . 

(bl 

Resident has been advised and understands that Resident (i) 1m. a 

right to rescind this Agreement within thirty (30) cloys from the date ofthis Agreement (ill"I 

Resident is not required w move w Arbor Amls before the expir.at!oo ofthirty (30) dsys frotl1 the 

dale ofthis Agreement. Notwitbstandi:ng these rights, Resident has decided to proceed with 

plans wmove to Arbor Acres 00 the date set forth in JlIII'IIIlIIlPh 3, below. IfResident, within. 

thirty (30) cloys from the dale ofthis Agreement, delivers w Arbor Acres written notificallon that 

Resident is rescinding this Agreement, this Agreement will be rescinded and automatieally 

cancelled. Resident shall not be entitled w a refund ofthe $1,000.00 Entrance Fee, ifthis 

Agreement is rescinded, but Resident shall have no further ()bligation to Arbor Acres other than 

i 

, 

104

payment ofany rees and charges incurred during the period ofoccupancy ifResident moved 1h 

Arbor Acres prior to rescinding the Agreement. ! 

2. Room ~t. Resident understands that Resident acquires no . 

ownership illtenlst in any property at Arbor Acres under this Agreement; also, that no parlicuiar 

room or unit in Assisted Living is subject to reservation or pmnanent assignmOllt, and that:!:: 

Ae.res may change Resident's room assignment in Assisted Living. Though Arbor Acres 

the right to change Resident's room assignmOllt, Arbor Acres agrees thet it will make change 

only as Arbor Acres finds such changes to be nee......,. or advisable. 

3. Date ofOccypw;y. 

(a) Resident plans to move.to Arbor Acres (that is, into Assisted 

Living at Arbor A=) on the _ day of__, 20_ (the Occupancy Date), and Arbor Acres 

agrees to bave a place available for Resident in Assisted Living on the Occupancy Date. . 

I 

(1)) IfResident abould wish to change the Occupancy Date Resident 

will advise Arbor Acres inunediately (on or before me Occupancy Date). Upon receipt of 

Resident's request, and if Arbor Acres determines that another dle is feasible, Arbor Acres-¥II 

undertake to walk out wi1h Resident another mutually agreeable Occupancy Date. ! 

I 

(0) Resident agrees to pay Arbor Acres' monthly fees and charges for 

use ofthe unit from the dle ofactual occupancy or from the 31st day after the dale ofthis ! 

Agraement, whichever is earlier (even Ifme uniHs not actually occupied by Resident), until1jW 

Agraement is terminated. 

I , 

4. Condjtions of Residency. Resident shall have the right to reside in ~ 

Acres' Assisted Living or the skilled nursing fiIciIity for and during the term ofme life of . 

Resident. subjeet to the foregoing provisions ofthis AfIreement and sul!jeet to the following 

understanding. terms and conditions: 

(a) 

; 

At the time ofthe execution ofthis AgreemOllt, Arbor Acres has 

derermined that Resident qualifies for resideoey in Assisted Living beth with respeet to 

Resident's mental and physical condjtion and Resident's ability to take ""'" ofanticipated fef' 

and charges. It is understood that It will be necessary for Resident to continue to meet such I 

qualifications at the time Resident becomes a resident of Arbor Acres. Ifat thet time Reside!)t is 

not qualified to occupy an Assisted Living unit as contemplated under this Agreement, but is' 

qualified to reside in the skilled nursing fiIciIity and is financially qualified for such resid~, 

Resident will be entitled to such other accommodation, subject to there being a vacaney. 

(b) In order to operate Arbor Acres in the best in_ofthe entire 

Arbor Acres community, it is understood 1bat Arbor Acres has established policies, rules and 

regulations relating to residency in Arbor Acre.. whicb are sulliect to modification from time to 

time as deemed appropriate by Arbor Acres. Among others, Arbor Acres' rules and regulaticlns 

may requba 1bat residents carry Medi""", and/or certain other health ""'" insurance, keep in • 

effect an appropriate Power of Attorney and/or other designation ofa responsible party, and ; 

' 

·105· 

N1004268

provide periodic fiDanciaJ or other statements ofresidents' ability to meet financial obligatiruls to 

Arbor Acres. Resident agrees 10 provide copies oflile following documents 10 Arnor Acres ~y 

IIIe first day ofresidency: (i) Medicare andIor certain other heal1h care insurance covemge i 

information; (ii) copy ofcurrent Durable Power ofAttmney for business management; and (iii) if 

applicable, copy ofcummt Health em: Power ofAttmney and Living Will. 

i 

Resident has received infonnation as 10 cur:rent policies, rules and 

regulations relating to residency at Arbor Acres in th. Disclosure Statement As new policies, 

ruJes and regulations are adopted Arbor Acres will inform Resident 1hereof; also, copies of 

particular policies, rules and n>gUilllions relating to residency will be furnished 10 Resident 01) 

request. Resident agrees to comply wi1h Arbor Acres' policies, rules and regulations applica1>le 

to residency in Arbor Acres. . 

Resident Ullderstand. and agrees ther: (i) in order for Arnor Acre. to 

operate in the best interest ofboth Resident and the entire Arbor Acres community, it is OSSI:l)tiaJ 

ther Arbor Acres have the cooperation of (and compliance with Arbor Acres' applicable poli4ies, 

rules and resuJations by) Resident's f1mriIy, mands, responsible party, and others who may ; 

intervene, speak or act. or pwport to intervene, speak or act. for or on behalf ofResident, or +mo 

may come on the premises ofArbor Acres in any capacity or for any purpose in connection With 

or as. result ofResident's residency 01 Arbor Acres; (il) • continuing or repeated failure or I 

refusal by any such persons to so cooperote and comply may result in • detennination by Arbpr 

Acres ther it is impracticable or impossible for Arbor Acres to conlin"" to accommodate i 

Resident as aresident ofArbor Acres; and (ill) upon such detennination by Arnor Acres, A1'Ilor 

Acres sbalJ have a right to terminate Resident's residency at Arbor Acres. ! 

(e) In order to operate Arbor Acres on a fiscaJly sound, nonprofit i 

basis, it is understood ther Arbor Acres has establisbed schednles offees and charges to be paid 

by residents ofArbor Acres, which are subject to modification from time to time as deemed . 

necessary and appropriate by Arbor Acres. Resident agrees to pay when due the applicable fees 

and chatges of Arbor Acres as from time to time estsblisbed and charged. Resident has rece\ived 

from Arbor Acres a schednI. ofcummt fees and charges. 

(d) 

While Arbor Acres must and does reserve the right to terminatt the 

Resident's residency at Arbor Acres fur 1hilure to oe 

mOlter to the Executive Committee for hearing and decision as provided in paragraph 4(1)) of this 

Agreeroent Resident nnderstsnds aod agrees ther the decision of the Executive Committee ~ 

be final and binding. 

, 

(0) Temporary absences because ofillness or otherwise shall oot atfect 

the Resident's right to retain a place ofresidency in Assisted Living; however, Resident sbalJ 

continue to be charged and to pay Arbor Acres' applicable fees and charges dnriogsuch abs$loe. 

I 

-' i 

-106 

'1004261

, 

, 

(I) If Resident's health should improve sufficiently 1 permit Resi4ent 

to live in a residential unit at Arllor Acres other 1ltan in the skilled nursing facility or Assisted 

Living, such a move may he made subject to availability ofa unit, payment oflhe Entrance F~ 

established for the unit, less $1000.00, and execution ofan appropriate Supplemental Agreerqent. 

IfResident shell incur a pbysical or mental iIlDel!s, or • condition or 

infumltylhat requires closer attention to Resident', needs or ahigber level ofcare1ltan is 

available at the unit where Resident resides, and such closer attention or higber level ofcare 4an 

he provided in a different residential unit at Arbor Acres (for example, ifResident is in. 

Assis1ed Living unit and needs lhe higber level ofcare available in the skilled nursing filcillt)!), 

Resident may he required to make such move. Arbor Acres shell not require any """b move , 

unless Arbor Acres determines lhat it is necessary in the best interest, first and foremost, of i 

Resident and, secoodarily, of Arllor Acres' residential oommunity as. whole. Before any s':fh 

move is required it shell be discussed lhoroughly with Resident andIor Resident's responsible 

party. Ifagreement is reached between Resident and the Executive Director oonceming. . 

proposed move, Arbor Acres will proeeed with arrangemeots for the move. Such move wi1hin 

Arbor Acres shaJJ not require any additional Entmnce Fee, but shell require payment by Resi4ent 

ofArbor Acres' fees and charges for services applicable to the unit or facility to which Residimt 

is moved. If Resident and the Executive Director are unable to reach agreement on a proposed 

move, the Executive Director shell refer the matter to lbe Executive Committee for bearing al!d 

decision, as provided in paragraph 4(h) of1hls Agreement. Resident understands and agrees !hat 

lbe decision oflbe Executive Committee shell be final and hioding. ! 

Arbor Acres assumes DO obligation or responsibility fur lbe 

(g) 

provision of residential or nursing or heallb care facilities or services to Resident beyond lho"" 

facilities and services from time to lhne established and provided by Arbor Acres. 

Ifit sbould appesrlhat Resident's physical andIormentaJ condition has 

become such as to make it necessary to terminate Resident's residency at Arbor Acres bee"",!e 

Resident'. condition requires filcillties andIor services beyond 1hosc avsilable at Arbor ACl'OIJ, the 

Executive Director and lh. Health Care Administrator shell discuss the matter lhoroughJy v.ith 

Resident andlor Resident's responsible party and, jfavailable, wi1h Resident's physician, al!d 

shall try to reach agreement as 1 what sbould he done in Resident's best interest. Ifthey are! 

unable to reach an agreement. the Executive Director shell refer lb. matter to lhe Executive i 

Committee for bearing and decision (as provided in paragrapb 4(h) of1hi. Agreement) as to ! 

whether Resident'. condition is such as to necessitate termination ofResident' • residency at i 

Arbor Acres. Resident understands and agrees lhat lh. decision oflh. Executive Committee, 

shell he final and hioding. . 

IfResident must terminate residency because Resident's needs for services 

or facilities exceed those provided by Arllor Acres, Arllor Acres will, at the request ofResi

(11) Ifa mauer is referred to tile Executive Committee for hearing ¥ 

decision under any oftile foregoing provisions ofthis Agreement, tile Executive Committee !jhaI1 

have a hearing, sball afford RJ:sident an opportunity to be heard, and sball render a decision With 

respOct to the matter referred to it The decision ofthe Executive Committee sball be put in ' 

writing and sball be signed by tile President or, in the absence oftile President, tile Vice 

President It is understood and "8I"f'd that the written, signed decision ofthe Executive 

Committee .baIl be final and binding. 

5. NQJiQe ofTermipatjoo of Occul!(IIIQ'· IfRJ:sident, after moving to Artior 

Acres, should decide to terminate this Agreement and residency at Atbor Acres, Resident shall 

give Arbor Acres a mininllDll ofthirty (30) days advance notice, in writing. including in the . 

notice the date on which Resident plans 10 terminate residency at Atbor Acres. This Agreem~ 

and RJ:sidenl's obligation to pay Atbor Acres' fees and cha!ges, sball continue in effect until' 

Resident vacates the unit in which RJ:sident resides and removes all ofRJ:sident's personal ' 

property from tile premises or until tile end ofthe thirty (30) dey notice period, whichever is ! 

longer. IfRJ:sident should die while residing at Arbor Acres, this Agreement will terminate '\Dd 

Resident', family members or responsible parties wiU be advised of Arbor Acres' current I 

policies on removal ofpersonal properl;y. 

' 

6. Services to be Provided. Services to be provided by Arbor Acres undojr 

this Agreement (hased on Arbor Acres' present facilities. operations, costs and schedules of ~ 

and charges) ioclude: 

I 

(1) Maintenance ofbuildings and grounds, iocluding room oocupi.\d 

byRJ:sident ! 

(2) Utilities: beat, all conditioniog, electricity, water and sewer; , 

telephone jack iocluded, boIDot personal telephone handset or 

telepbone service 

(3) B.esic cable television (not television set) 

(4) 

(5) RJ:creational, educational, culmmi and spiritual life progrsms ; 

(6) Transportation to routine non-emergency medical appointtnen1!l 

within Wmston-Salem (transportation by ambulance not inclu4ed) 

(7) Umited in-patient infirmary care 

(S) 

Around-the-clock nursing supervision (m accordance with 

regulatory standards; does nol include private duty or individesi 

n1lX!!e for each resident), prescribed medication administration and 

limited assistance with activities ofdally living 

·108· 

11004168

(9) Daily housekeeping assistance 

(10) Laundering ofbed and bath linens furnished by Arbor Acres 

(II) 

Laundering ofpen!O!llIi clothing (washing, drying and folding, ilot 

ironing or dry cleaning) 

(12) Staffed entrance gate 

(13) Foodservice(3moalsdaily). 

, 

Services provided by Arbor Acres are directly and inextrioably oed to the monjbIy 

fees and charges paid by residents. At least annually, during budget preparation, Arbor Acre!l 

reviews services and costs of operation, and the need for any changes in Arbor Acres' schedule 

offees and charges, Arbor Acres i. committed to provide quality, caring services; to contain; 

costs, which must be reflected in charges to residents; and to operate on a fiscally sound, nont 

profit basis. Consistent with these commitments, Arbor Acres reserves the right to make suciI 

changes, modifications and adjustments in services provided by Arbor Acres as are deemed • 

necessaIY or desirable in the best interest ofboth Arbor Acres and the residents. Arbor Acres 

shall make such changes, modifications and adjustments only after carefully balancing costs .pm 

benefits, the service needs ofresidents and the commitment ofArbor Acres to operate a carin/! 

retirement community on a fiscally sound, nonprofit basis. , , 

I 

7. United M!IIhodist Af6Ji.uon. Arbor Acres is affiliated with the Westejn 

North Carolina Annual Conference oiThe United Methodist Church (the Cooference) as IllOI!e 

fully set out in the Disclosure Statement. The Conference is not responsible for the financial ~ 

contrectual obligations of Arbor Acres. 

8. No R~ for PIIblic Amslancc;. There is no requirement that 

Resident apply for Medicaid, public assistance or any public benefit program. Arbor Acres is not 

• Medicare facility and fiterefore, Medicare will not pay the daily room fee in the skilled nursjug 

facility at Arbor Acres. 

9. Entjre Amement. This Agreement contains the entire agreement of Atbor 

Acres and Resident with respect to RoaIdent', reservation and """"I""" ofthe Unit. 

10. AIlIlMmImIs and Mo!lificatjons. This Agreement shail not be modified, 

amended or changed in any respect except in writing signed by Arbor Acres and Resident ~ 

esch party hereby waives any right to amend this Agreement in any other way. 

II. 

Assi!!!I!!Jent This Agreement may not be aasigned. 

12. Qovemills Law. This Agreement and the !ran...c\ions contemplated herein 

shail be gnverned by, interpreted, consIruod and enforced in accordance with the laws ofthe State 

ofNorth CaroJina. 

-109 

#-)00426&

! 

IN WITNESS WllEREOF, R

Skilled Nursing -1,I21C'! 

NORTII CAROLINA) 

) AGREEMENT 

FORSYTII COUNTY) 

TIllS AGREEMENT, made and entered into this __ day of , 20_, by 

and between of County, State of , herein called the 

"Resident", and ARBOR ACRES UNITED METiiODlST RETIREMENT COMMUNITY, 

INC., a nonprofit corpiJration organized and existing under the laws of North Carolina, located.1 

Winston·Salem, Forsyth County, North Carolina, herein called "Arbor Acres"; 

"'!HEREAS, (a) Resident has applied and heen approved fur residency at Arbor 

Acres, and (b) Resident has received from Arbor Acres a copy of the Disclosure Statement (per 

North Carolina General Statutes, Section 58·64·20) dated ,20 ; 

NOW, THEREFORE, in consideration of the terms, covenants, and conditions, 

hereinafter contained to be pcrfonned by the Resident and Arbor Acres, the parties contract and 

agree as follows; 

1. Entrance F" and Rescission of Agreement. The Entrance Fee established 

by Arbor Acres for residancy in Arbor Acres' skilled nursing care facility in the Fittgerald Health 

Center (herein called hSlcilled Nursing"), \\rbere it is anticipated Resident will reside, is One 

Thousand and NO/lOO Dollars ($1,000.00), the atnount being paid by Residen1 herewith in fulL 

(The Entrance Fee is separate and distinct from Arbor Acres' fees and charges to residents for 

food, maintenance, medical~ nursing and other services.) 

The $1,000.00 Entrance Fee for residency in Skilled Nursing is a nOD·refundable 

fee except as provided in paragraph I(a). 

(a) IfResident moves to Independent Living, the Entrance Fee will be 

applied toward the Entrance fee for that unit as provided in paragraph 4(J). If Resident should 

die before moving to Arbor Acres, or if, on account of illness, injury or incapacity. Resident 

should be precluded from moving to Arbor Acres under the terms of thi, Agreement, this 

Agreement shall be automatically canceled and Resident or Resident's legal representative shall 

be entitled to. full refund ofthe $1,000.00 Entrance Fee. 

(h) Resident has been advised and understands that Resident (i) has a 

right to rescind this Agreement within thirty (30) days from the date of this Agreement and (ii) 

Resident is not required to move to Arbor Acres before the expiration ofthirty (30) days from the 

date of this Agreement. Notv.ithstanding these rights, Resident has decided to proceed with 

plans to move to Arbor Acres on the date set forth in paragraph 3, below, If Resident, "ithin 

thirty (30) days from the date o[thi, Agreement, delivers to tubar Acres written notification that 

Resident is rescinding this Agreement" this Agreement will be rescinded and automatically 

cancelled. Resident shall not be e01itled to a refund of the $1,000.00 Entrance Fee, if this 

111

Agreement is rescinded, but Resident shall have DO further obligation to Aroor Acres other than 

payment of any fees or charges incurred during the period of occupancy if Resident moved to 

Arbor Acres prior to rescinding !he Agreement. 

2. RoQm Assignme-nt. Resident understands that Resident acquires no 

ownership interest in any property at Arbor Acres under this Agreement; also, that no particular 

room or unit in Skilled Nursing is subject to reservation or permanent assignment, and that Arbor 

Acres may change Resident's room assignment in Skilled Nursing. Though Arbor Acres retains 

the right to change Resident's room assignment, Arbor Acres agrees that h will make changes 

only as Arbor Acres finds such changes to be necessary or advisable. 

3. Date ofOcC!!llMcy. 

(al Resident plans to move to Arbor Acres (that is, into Skilled 

Nursing at Arbor Acres) on !he _ day of , 20_ (tlte "Occupancy Date"), and Arbor 

Acres agrees to bave a place available for Resident in Skilled Nursing on !he Occupancy Date. 

(b) If Resident should wish to change !he Occupancy Date Resident 

will advise Arbor Acres inunediately (on or before the Occupancy Date). Upon receipt of 

Resident's request, and if Arbor Acres detonnines that another dale is feasible, Arbor Acres will 

undertake to work out with Residem another mutually agreeable Occupancy Date. 

(c) 

Resident agrees to pay Arbor Acres' monthly fees and charges for 

use of !he unit from the dale ofactUJli occupancy or from the 31 st day after the date of this 

Agreement, whichever is earlier (even if the unit is not actually occupied by Resident), until this 

Agreement is terminated. 

4. Conditi~esideocy. Resident shall bave the right to reside in Arbor 

Acres' ShU.d Nursing for and during the term of the life of Resident, subject to the foregoing 

provisions ofthis Agreement and subject to the following understandings, terms and conditions: 

(a) At the time of the execution of this ,\greernenl, Arbor Acres has 

determined that Resident qualifies for residency in Skilled Nursing both with respect to 

Resident's mental and physical condition and Resident's ability to take care of anticipated fees 

and cbarges. It is understood !bat it will be necessary for Resident to continue to meet such 

qualifications at the time Resident becomes a resident ofArbor Acres, 

(b) In order to operate Arbor Acres in the best interest ofthe entire 

Arbor Acres community, jt is understood that Arbor Acres Vv111 :from time to time ~""tablish 

policies, rules and regulations relating to residency in Arbor Acres, which are subject to 

modification from time to time as deemed appropriate by Arbor Acres. Among others, Arbor 

Acres' ndes and regulations may require that residents carry Medicare and/or other certain health 

care insurance, keep in effect an appropriate Power of Attorney and/or other designation of 

responsible party, and provide periodic financial or other Statements of resident's ability to meet 

financial obligation. to Arbor Acres. Resident agrees to pro,ide copies of the following 

decuments to Arbor Acres by the first day of residency: (i) Medicare andlor certain other health 

care insurance coverage infonnation; (ii) copy ofcurrent Durable Power of Attorney for business 

#11)12081 v4 

112

lIllUlIlj!ement; and (iii) if applicable, copy of current Health Care Power of Attorney and Living 

Will. 

Resident has received information as to current policies. rules and 

regulations relating to residency in Arbor Acres in the Disclosure Statement As new policies, 

rules and regulations are adopted Arbor Actes will inform Resident thereof; also, copies of 

particular policies, rules and regulations relating to residency will be furnisbed to Resident upon 

request. Resident agrees to comply with Arbor Acres' policies, rules and regulations applicable 

to residency in Aroor Acres. 

Resident understands and agrees that: (i) in order for Arbor Acres to 

operate in the best interest of both Resident and the entire community, it is essential that Arbor 

Acres have the cooperation of (and compliance ",th Arbor Acres' applicable policies, rules and 

regulations by) Resident's family, friends, respollilible party and others who may intervene, speak 

or act, or purpon to intervene, speak or act, for or on behalf of Resident. or who may come on the 

premises of Arbor Acres in any capacity or for any purpose in connection with or as a result of 

Resident's residency a1 Arhor Acres; (ii) a continuing or repeated failure or refusal by any such 

persons to so cooperate and comply may result in a determination by Arbor Acres that it is 

impracticable or impossible for Arbor Acres to continue to accommodate Resident as a resident 

of Arbor Acres; and (iii) upon such detennination by Arbor Acres, Arbor Acres shall have a right 

to terminate Resident"s residency at Arbor Acres. 

(0) In order to operate Arhor Acres on a fiscally SOUlJd. nonprofit 

basis. it is UlJderstood that Arbor Acres has established schedules of fees and charges to be paid 

by residents of Arbor Acres, which are subject to modification from time to time as deemed 

necessary and appropriate by Arbor Acres. Resident agrees to pay when dna the applicable fees 

and charges of Arbor Acres as from time to time established and charged. Resident has received 

from Arbor Acres a schedule of current fees and charges. 

(d) While Arbor Acres must and does reserve the right to tannin.te the 

Resident's residency a1 Arbor Acres for failure to comply wjth (b) or ( c) above, or failure to 

comply \"ith any other provision oftbis Agreement,. Arbor Acres shall exercise such right only as 

• last reSOrt and after having first attempted to work out satisfactory solutions with the Resident 

andIor Resident's responsible party. If agreement cannot be reached berv.een the President and 

Resident andlor Resident's responsible party, the President shall refer the matter to the Executive 

Conunittee for hearing and decision as provided in paragraph 4(h) of this Agreement. Resident 

understands and agrees that the decision of the Executive Conunittee shall be final and binding. 

(oJ Temporary absenees because ofillness or otherwise shall no! affect 

the Resident's right to retain a place of residency in Skilled Nursing; however. Resident shall 

continue to be charged and to pay Arbor Acres' applicable fees and charges during such absence. 

(f) If Resident's health should improve sufficiently to pecmit Resident 

to live in a residential urut at Arbor Acres other than in Skilled NursiIl& such a move may be 

made subject to availability of a unit, payment of the Entrance Fee established for the unit, less 

$1000.00, and execution of an appropriate Supplemental Agreement. 

#i(I12f)g1 v4 

113

(g) Arbor Acres assumes no obligation or responsibility for the 

provision of nursing or health care facilities and services to Resident beyond those facilities and 

.senices from time to time established and provided at Arbor Acres. 

If it should appear that Resident's physical andlor mental condition has 

become such as to make it necessary to terminate Resident's residency at Arbor Acres because 

Residentls condition requires facilities and/or services beyond those available at Arbor Acres. the 

President and the Health Care Administrator shall discuss the matter thoroughly ",;th Resident 

andlor Resident's responsible party and, if available, with Resident's physician, and shall try to 

reach agreement as to what should be done in Resident's best interest Ifthey are unable to reach 

an agreement, the President shall refer the matter to the Executive Committee for hearing and 

decision (as provided in paragrnph 4(h) of this Agreement) as to whether Resident's condition is 

such as to necessitate termination ofResidenes residency at .A.rbor Acres. Resident understands 

and agrees that the decision ofthe Executive Committee shall be final and binding. 

IfResldent must tenninate residency because Resident's needs for services 

ar facilities exceed those provided by Arbor Acres, Arbor Acres "ill, at the request ofResident, 

assist Resident in finding some other facility (outside Arbor Acres) that would be appropriate to 

Resident~s needs, it being understood that all costs of care and residency at a facility outside 

Arbor Acre, shall be borne by Resident. 

(h) If a matter is referred to the Executive Committee for hearing and 

decision under any ofthe foregoing provisions of this Agreement, the Executive Committee shall 

have a hearing, shall mond Resident an opportunity to be heard, and shall render a decision willi 

respect to the matter referred 10 il. The decision of the Executive Committee shall be put in 

writing and shall be signed by the President or, in tbe absence of the President, the Vice 

President. lt is understood and agreed that the written, signed decision of the Executive 

Committee shall be fmal and binding, 

5, Notice of T ermimuion of OcCUP!jllC)'. If Resident, after moving to Arbor 

Acres, should decide to terminate this Agreement and residency at Arbor Acres, this Agreement, 

and Resident's obligation to pay .o\rbot Acres! fees and charges~ shall 'Continue in effect until 

Resident vacates the unit in which Resident resides and removes all of Resident's personal 

property from the premises. If Resident should die while residing at Arbor Acres, this 

Agreement will terminate and Resident's family members or responsible parties will be advised 

of Arbor Acres' current policies on removal of personal property. 

6, ServiC\l§ to be Provided, Services to be provided by Arbor Acres under 

this Agreement (based on Arbor Acres~ present facilities., operations. costs and schedu1es of fees 

and cberges) include: 

(I) 

Maintenance of buildinga and grounds, including room occupied 

by Resident 

(2) Utilities: heat, air conditioning, electricity, water and sewer; 

telephone j""k included, but not persoaal telephone handset or 

telephone service 

il(l12{1SI v4 

114

(3) Basic cable television (not television set) 

(4) Nurse call system 

(5) Recreational, educational, cultural and spiritual life programs 

(6) Transportation to routine non-emergency medical appointments 

within Winston-Salem (transportation by ambulance not included) 

(7) Around-the-clock nursing care (in accordance v.ith regulatory 

standards; does not include private dury or individual nurse for 

each resident) 

(8) Daily housekeeping assistance 

(9) Laundering of bed and bath linens furnished by Arbor Acres 

(10) Laundering of persoual clothing (washing, drying and folding, not 

ironing or dry cleaning) 

(II) 

Staffed entrance gate 

(12) Food service (3 meals daily and routine between meal 

nourishments), Note: Administration of physician-prescribed 

gastric tube feeding included; cost of prescribed food substitutes 

and supplements not included. 

Services provided by Arbor Acres are directiy and inextricably tied to the monthly 

fees and charges paid by residents. At least armually, during budget preparation, Arbor Acres 

reviev,.·s services and costs of operation, and the need for any changes in Arbor Acres' schedule 

of fees and charges. Arbor Acres is committed to provide quality, caring services; to contain 

costs. which must be reflected in charges to residents; and to operate on a fiscally sound, non~ 

profit basis, Consistent with these oommi1ments, Arbor Acres reserves the right to make such 

cbanges, modifications and adjustments in services provided by Arbor Acres as are deemed 

necessary or desirable in the best interest of both Arbor Acres and the residents. Arbor Acres 

shall make such changes, modifications and adjuslrtll!nts only after carefully balancing costs and 

benefits. the service needs of residents and the commitment of Arbor Acres to operate a caring 

retirement community on a fiscally sound; nonprofit basis, 

7. United MethQllist Affiliation. .'\rhor Acres is affiliated with the Western 

North Carolina Annual Conference of The United Merbodist Church (the Conference) as more 

fully set out in the Disclosure Statement. The Conference is not responsible for the financial and 

contractual obligations of Arbor Acres, 

8. ~o Roouirement for Public Assistance. There is no requirement that 

Resident apply for Medicaid, public assistance or any public benefit program. Arbor Acres is not 

#iOl2@lv4 

115

a Medicare facility and therefore, Medicare will not pay the daily room fee in the skilled nursing 

facility at Arbor Acres. 

9. Entire Agreement. Tbis Agreement contains the entire agreement of Arbor 

Acres and Resident with respect to Resident's reservation and occupancy ofthe Unit. 

10. Amendments and Modifications. This Agreement shan not be modified, 

amended or changed in any respect except in writing signed by Arbor Acres and Resident and 

each party hereby waives any right to amend-this Agreement in any other way. 

11. Assignment. Ibis Agreement may not be assigned. 

12. Governing Law. This Agreement and the transactions contemplated 

herein shall be governed by, interpreted, construed and enforced in accordance with the laws of 

the State ofNorth Carolina. 

IN WITNESS WHEREOF, Resident has executed this Agreement and Arbor 

Acres has caused this Agreement to be executed in its name by its President as of the day and 

year first above written. 

====--__________,(SEAL) 

RESIDENT: 

ARBOR ACRES UNITED METHODIST RETIREMENT 

COMMUNITY, INC. 

ATTEST: 

By:_====__________ 

PRESIDENT 

Corporate Secretary 

[Corporate Seal] 

#1012081 v4 

116

Arbor res - Arbor Acres

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