DISCLOSURE STATEMENT - NC

DISCLOSURE STATEMENT

Dated: December 15, 2019

NAME OF COMMUNITY: Pennybyrn at Maryfield

LOCATION:

109 Penny Road High Point, North Carolina 27260

TELEPHONE NUMBER: (336) 821-4000

In accordance with Chapter 58, Article 64 of the North Carolina General Statutes of the State of North Carolina:

This Disclosure Statement may be delivered until revised, but not after May 14, 2021;

Delivery of this Disclosure Statement to a contracting party before execution of a contract for continuing care is required;

This Disclosure Statement has not been reviewed or approved by any government agency or representative to ensure accuracy or completeness of the information set out.

MARYFIELD, INC. d.b.a.

"PENNYBYRN AT MARYFIELD" 109 Penny Road

HIGH POINT, NORTH CAROLINA 27260

TABLE OF CONTENTS

I. ORGANIZATION ................................................................................................................1

A. GENERAL ............................................................................................................................ 1 B. COMPOSITION ..................................................................................................................... 1

II. COMMUNITY INFORMATION .....................................................................................10

A. LOCATION ..............................................................................................................................10 B. COMMUNITY EXPANSION.................................................................................................. 10 C. LAYOUT AND TYPES OF ACCOMMODATION....................................................................... 10 D. ESTIMATED NUMBER OF RESIDENTS ................................................................................. 11 E. AMENITIES ....................................................................................................................... 11

III. SERVICES ........................................................................................................................12

A. STANDARD SERVICES FOR INDEPENDENT LIVING ................................................................ 12 B. SERVICES AVAILABLE AT AN EXTRA CHARGE ............................................................... 12 C. HEALTH SERVICES AVAILABLE......................................................................................... 13 D. PERSONAL SERVICES AVAILABLE ..................................................................................... 13

IV. POLICIES ...........................................................................................................................14

A. AGE CRITERIA .................................................................................................................. 14 B. HEALTH CRITERIA ............................................................................................................ 14 C. FINANCIAL CRITERIA ........................................................................................................ 14 D. INSURANCE CRITERIA ....................................................................................................... 14 E. CHANGES OF CONDITION PRIOR TO OCCUPANCY .............................................................. 14 F. TERMINATION BY RESIDENT ............................................................................................. 15 G. TERMINATION BY PENNYBYRN AT MARYFIELD AFTER OCCUPANCY ............................... 16 H. TRANSFERS OR CHANGES IN LEVELS OF CARE .................................................................. 16 I. REFUNDS .......................................................................................................................... 17 J. MOVES ............................................................................................................................. 17 K. MARRIAGES/NEW SECOND OCCUPANT ............................................................................. 18 L. INABILITY TO PAY............................................................................................................. 18

V. FEES ....................................................................................................................................19

A. ENTRANCE FEES ............................................................................................................... 20 B. MONTHLY SERVICE FEES.................................................................................................. 21 C. HEALTH CENTER FEES ...................................................................................................... 22 D. APPLICATION / REGISTRATION FEES.................................................................................. 24 E. NOTIFICATION OF FEE INCREASES ..................................................................................... 25

F. CHANGES IN FEES FOR THE PREVIOUSFIVE YEARS ..........................................................25

VI. FINANCIAL INFORMATION ...................................................................................... 26

A. AUDITED FINANCIAL STATEMENTS ..................................................................................26 B. PROJECTED FINANCIAL STATEMENTS...............................................................................26 C. COMPARISON OF ACUTAL RESULTS TO FORECAST ...........................................................26 D. INTERIM FINANCIAL STATEMENTS ...................................................................................26 E. RESERVES ........................................................................................................................26 F. INVESTMENT OFOPERATING RESERVE .............................................................................27

VII. OTHER MATERIAL INFORMATION........................................................................ 27

A. LITIGATION AND OTHER LEGAL MATTERS .......................................................................27 B. LONG TERM DEBT........................................................................................................... .27 C. EXPANSION PROJECT.........................................................................28

EXHIBITS

A. Residency and Care agreement B. Multi-Unit Assisted Housing with Services Agreement C. Licensed Assisted Living Agreement to Reside D. Financial Statements E. Compilations of Financial Projection F. Comparison of Actual Results with Forecasted Projections

1 ? 22 1 ? 39 1 ? 43 1 ? 27 1 ? 29 1 - 4

MARYFIELD, INC. d.b.a. "PENNYBYRN AT MARYFIELD"

109 Penny Road HIGH POINT, NORTH CAROLINA 27260

I.

ORGANIZATION

General

Maryfield, Inc. d.b.a. Pennybyrn at Maryfield (the "Corporation") was founded in November l947 by the Poor Servants of the Mother of God, a Catholic Congregation of Sisters, and incorporated under the laws and regulations of the State of North Carolina as a non-profit organization in l950 to provide housing and long-term care for the elderly.

The Corporation has been determined to be exempt from Federal income taxation under Section 501(c)(3) of the Internal Revenue Code of 1986, as amended. The Corporation is also tax-exempt under North Carolina law.

The Corporation currently owns and operates a continuing care retirement community ("CCRC") on a 72-acre campus in High Point, North Carolina consisting of a 131unit independent living apartment building (with attached community center and wellness center), 49 independent living cottages, 24 assisted living apartments, 24 assisted living memory support units and 125 skilled nursing care beds.

Composition

AFFILIATION

The Corporation is sponsored by the Poor Servants of the Mother of God, Mother House in Rome, Italy, and Generalate in Roehampton, London, England ("SMG"). The Corporation is not affiliated with or owned by any other religious, charitable or other non-profit organizations.

The Corporation is solely responsible for all the financial and contractual obligations incurred by the Corporation. The Corporation does not have subsidiaries and holds no ownership position in any other organization in the State of North Carolina.

The Corporation has memberships in the following trade associations: Leading Age, Leading Age North Carolina, Catholic Health Care Association, North Carolina Assisted Living Association, and the North Carolina Health Care Facilities Association.

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MEMBERS

Participation in the affairs of the Corporation is governed by the Members thereof. The bylaws of the Corporation provide that all Members of SMG who live at Pennybyrn at Maryfield or who render compensated or uncompensated services to the Corporation are automatically Members of the Corporation during the period of such residency or service. The Regional Superior and the local leader are also automatically Members of the Corporation. In addition, the Superior General of SMG may at any time, and from time to time, appoint any other member(s) of such religious order as Member(s) of the Corporation to serve at the discretion of the Superior General.

The current Members of the Corporation are as follows:

Sr. Mona Comaskey, SMG Sr. Julianne Cunnane, SMG Sr. Anne Curran, SMG Sr. Lucy Hennessy, SMG Sr. Gabriella Hogan, SMG Sr. Loretta O'Connor, SMG Sr. Rosarii O'Connor, SMG

Sr. Margaret Cashman, SMG

Sr. Kathleen Coleman, SMG

Sr. Margaret Herlihy, SMG

Sr. Meki Ngemu, SMG

High Point, NC High Point, NC High Point, NC High Point, NC High Point, NC High Point, NC London, England

London, England

London, England

London, England

London, England

BOARD OF DIRECTORS OF THE CORPORATION

The Board of Directors of the Corporation establishes policy and goals and serves in an oversight capacity for the management and operation of the Corporation. Notwithstanding the foregoing, however, without the prior approval of at least a majority of the Members of the Corporation, the Board of Directors is not empowered or authorized to establish any policy or goal that is contrary to or in violation of the Ethical and Religious Directives for Catholic Health Care Services as approved by the U.S. Catholic Bishops in 1994.

Members of the Corporation appoint the members of the Board of Directors. The following are the current members of the Board of Directors:

Sister Lucy Hennessy, SMG, Chairperson 109 Penny Road, High Point, NC 27260 Sr. Lucy is the current Chairman of the Board and Mission Leader of Pennybyrn at Maryfield. She is a member of the Congregation of the Poor Servants of the Mother of God, and holds a Bachelor of Science Degree in Business Administration from High Point University and a Master's Degree in Health Administration from St. Louis University. She was formerly the Treasurer of Maryfield, Inc., and the nursing home administrator for nearly 20 years. Sr. Lucy joined the Board in 1987.

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