2023-11-07T07:40:56-06:00 2022-12-31 540504608 BROWN EDWARDS & COMPANY LLP 3906 ELECTRIC ROAD ROANOKE VA 24018 990 2022-01-01 453230862 DELTA DENTAL OF VIRGINIA FOUNDATION DELT 5409898000 4818 STARKEY ROAD ROANOKE VA 24018 FRANK L LUCIA PRESIDENT & CEO 5409898000 2023-11-03 1 FRANK LUCIA 999009999 0 PATRICK PITTMAN P00587461 5403450936 2023-11-03 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z FRANK L LUCIA 4818 STARKEY ROAD ROANOKE VA 24018 1955207 0 X WWW.DELTADENTALVA.COM/DDVAFOUNDATION.ASPX X 2011 VA IMPROVE THE PUBLIC'S ORAL HEALTH IN THE COMMONWEALTH OF VIRGINIA. 5 4 0 0 0 0 1102155 1955207 0 0 0 0 0 0 1102155 1955207 727100 1491534 0 0 150451 207885 0 0 0 232375 239568 1109926 1938987 -7771 16220 1007043 483913 997737 458387 9306 25526 THE FOUNDATION WORKS TO IMPROVE THE ORAL HEALTH OF ALL VIRGINIANS THROUGH FINANCIAL SUPPORT OF RESEARCH AND EDUCATION INITIATIVES AND PROGRAMS THAT PROVIDE ACCESS TO CARE FOR THE UNDERSERVED. 0 0 1516361 1491534 PROMOTION OF ORAL HEALTH CARE THROUGH EDUCATION, RESEARCH AND INCREASED ACCESS TO ORAL HEALTH CARE IN THE COMMONWEALTH OF VIRGINIA. 1516361 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 5 4 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X RJAMES BARKER 5409898000 4818 STARKEY ROAD ROANOKE VA 24018 DR LEZLEY P MCILVEEN DIRECTOR 1.00 3.00 X 0 39197 0 DR A CAROLE PRATT DIRECTOR 1.00 3.00 X 0 29250 0 DR MCKINLEY L PRICE DIRECTOR 1.00 2.00 X 0 27750 0 MS JAN S SESSOR DIRECTOR 1.00 3.00 X 0 31500 0 MR FRANK L LUCIA PRESIDENT & CEO 1.00 41.00 X X 0 1391065 93488 0 1518762 93488 0 0 1 0 VIRGINIA HEALTH CATALYST 4200 INSLAKE DRIVE STE 202 GLEN ALLEN VA 23060 STRATEGIC PLANNING 134050 1 1955207 1955207 1955207 0 0 0 X 1491534 1491534 207885 207885 217435 24827 192608 16355 16355 4841 4841 BANK CHARGES 937 937 1938987 1516361 422626 0 904659 404853 100000 76603 2384 2457 1007043 483913 666100 445112 331637 13275 997737 458387 X 9306 25526 9306 25526 1007043 483913 16220 0 X X 0 1 X 1 0 X X 1 DELTA DENTAL OF VIRGINIA 540844477 10 1 1955207 0 1 1955207 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 SCHEDULE A, PART IV, LINE 3B DELTA DENTAL OF VIRGINIA FOUNDATION ANNUALLY REQUESTS FROM DELTA DENTAL A PRO FORMA FORM 990 SCHEDULE A TO VERIFY IT MEETS THE SECTION 509(A)(2) PUBLIC SUPPORT TEST FOR ITS MOST RECENT TAX YEAR. SCHEDULE A, PART IV, LINE 3C DELTA DENTAL OF VIRGINIA FOUNDATION HAS PROCEDURES IN PLACE TO ENSURE THAT ITS SUPPORT IS USED SOLELY FOR CHARITABLE PURPOSES. THE FOUNDATION MONITORS ALL GRANT MONIES AWARDED BY REQUIRING END-OF-YEAR UPDATES DETAILING HOW THE GRANT MONIES WERE USED. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 DUE TO RELATED PARTIES 13275 13275 1955207 0 1955207 0 1955207 1938987 0 1938987 0 1938987 1 ARLINGTON FREE CLINIC 2921 11TH STREET S ARLINGTON VA 22204 541671883 IRC 501(C)(3) 75000 0 SUPPORT FREE HEALTHCARE SERVICES TO LOW-INCOME, MEDICALLY UNINSURED PATIENTS BOYS & GIRLS CLUB OF SW VA 1714 9TH STREET SE ROANOKE VA 24013 541867366 IRC 501(C)(3) 50000 0 MATCH CHALLENGE GIFT BOYS & GIRLS CLUB OF THE PENINSULA 11825 ROCK LANDING DRIVE NEWPORT NEWS VA 23606 941552134 IRC 501(C)(3) 10000 0 SMART SMILES 5K BRADLEY FREE CLINIC 1240 3RD ST SW ROANOKE VA 24016 237380491 IRC 501(C)(3) 115000 0 EXPAND PATIENT CAPACITY & APPOINTMENT AVAILABILITY CHARLOTTESVILLE FREE CLINIC 1138 ROSE HILL DR 200 CHARLOTTESVILLE VA 22903 541610405 IRC 501(C)(3) 50000 0 ASSISTANCE CHESAPEAKE CARE CLINIC 2145 S MILITARY HWY CHESAPEAKE VA 23320 541642754 IRC 501(C)(3) 75000 0 ASSISTANCE CHIP OF ROANOKE VALLEY 1201 THIRD STREET SW ROANOKE VA 24016 541566451 IRC 501(C)(3) 65258 0 INTEGRATED DENTAL & MEDICAL CARE TO ENROLLED SPANISH SPEAKING FAMILIES CROSS-OVER MINISTRY INC 8600 QUIOCCASIN ROAD STE 101 RICHMOND VA 23229 541371067 IRC 501(C)(3) 85000 0 DENTAL SERVICES TO HIGH RISK PATIENTS GOOCHLANDCARES 2999 RIVER ROAD WEST GOOCHLAND VA 23063 541967650 IRC 501(C)(3) 42000 0 PROVIDE REIMBURSABLE DENTAL SERVICES TO ADULT MEDICAID RECIPIENTS LUCY CORR FOUNDATION 6800 LUCY CORR BOULEVARD CHESTERFIELD VA 23832 542010957 IRC 501(C)(3) 6000 0 PLANNING FOR A DENTAL PROGAM TARGETING THE HISPANIC ELDERLY POPULATION PARK PLACE HEALTH AND DENTAL CLINIC 606 W 29TH STREET NORFOLK VA 23508 453086608 IRC 501(C)(3) 25000 0 ASSISTANCE PIEDMONT REGIONAL DENTAL CLINIC 13296 JAMES MADISON HWY ORANGE VA 22960 270625764 IRC 501(C)(3) 77000 0 ASSISTANCE ROANOKE RESCUE MISSION 402 4TH STREET SE ROANOKE VA 24013 540573900 IRC 501(C)(3) 50000 0 COMMUNITY SHELTER FREDERICKSBURG AREA REGIONAL HEALTH COUNCIL INC 2300 FALL HILL AVE STE 416 FREDERICKSBURG VA 22401 541677934 IRC 501(C)(3) 56000 0 MEDICAL SERVICES COMMONWEALTH OF VA STATE BOARD OF HEALTH 109 GOVERNOR STREET STE 717W RICHMOND VA 23219 546001775 IRC 501(C)(3) 280000 0 HEALTH SERVICES ROC SOLID FOUNDATION 5164 W MILITARY HWY STE 100 CHESAPEAKE VA 23321 264082283 IRC 501(C)(3) 23000 0 PIF SPONSOR & READY BAGS VIRGINIA HEALTH CATALYST 4200 INNSLAKE DRIVE SUITE 202 GLEN ALLEN VA 23060 274082359 IRC 501(C)(3) 15000 0 CATALYST ANNUAL SUMMIT SPONSORSHIP LOCAL ENVIRONMENT AGRICULTURE PROJECT INC PO BOX 3249 ROANOKE VA 24015 271050909 IRC 501(C)(3) 10000 0 INVESTMENT IN LEAP'S FOOD INSECURITY PROGRAM VIRGINIA WESTERN CC EDUCATIONAL FOUNDATION 3093 COLONIAL AVE ROANOKE VA 24015 521200913 IRC 501(C)(3) 54000 0 2022 SCHOLARSHIP & ENDOWMENT OLD DOMINION UNIVERSITY EDUCATIONAL FOUNDATION 4417 MONARCH WAY 4TH FLOOR NORFOLK VA 23529 546052014 IRC 501(C)(3) 50000 0 ENDOWMENT SCHOLARSHIP WYTHEVILLE CC EDUCATIONAL FOUNDATION INC 1000 EAST MAIN STREET WYTHEVILLE VA 24382 541162381 IRC 501(C)(3) 50000 0 ENDOWMENT 2022 NOVA FOUNDATION 4001 WAKEFIELD CHAPEL ROAD 252 ANNANDALE VA 22003 510249730 IRC 501(C)(3) 54000 0 2022 ENDOWMENT AND FUND MISSION DENTAL VIRGINIA INC 616 CAMPUS DRIVE ABINGTON VA 24210 833820038 IRC 501(C)(3) 75000 0 ASSITANCE PART I, LINE 2: THE FOUNDATION REQUESTS A YEAR-END UPDATE OF HOW THE GRANT FUNDS WERE USED. 0 1 0 0 0 0 0 0 0 MR FRANK L LUCIA PRESIDENT & CEO 0 799027 0 574200 0 17838 0 61000 0 32488 0 1484553 0 0 PART I, LINE 1B NOT APPLICABLE PART I, LINE 4B THE PLANS WERE ESTABLISHED VIA THIS ORGANIZATION'S AND THE RELATED ORGANIZATION'S MANAGEMENT DEVELOPMENT & COMPENSATION COMMITTEE'S COMPENSATION AND BENEFIT REVIEW WHICH IS IN ACCORDANCE WITH THE PROCESS OUTLINED BY THE IRS FOR SETTING REASONABLE COMPENSATION. THESE PLANS ARE IN ACCORDANCE WITH SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS AS PER IRS SECTIONS 409(A). THERE WERE NO LUMP SUM PAYMENTS PAID FROM THIS ORGANIZATION NOR A RELATED ORGANIZATION IN 2022. FORM 990, PART VI, SECTION A, LINE 7A PURSUANT TO THE ARTICLES OF INCORPORATION, THE FOUNDATION'S BOARD OF DIRECTORS ARE APPOINTED BY THE BOARD OF THE SUPPORTED ORGANIZATION, DELTA DENTAL OF VIRGINIA. FORM 990, PART VI, SECTION B, LINE 11B THE FULL DOCUMENT IS MADE AVAILABLE TO THE BOARD OF DIRECTORS PRIOR TO FILING. ALSO, MEMBERS OF THE BOARD OF DIRECTORS REVIEW THE DOCUMENT AND PREPARATION PROCESS WITH SENIOR MEMBERS OF MANAGEMENT. FORM 990, PART VI, SECTION B, LINE 12C DELTA DENTAL OF VIRGINIA FOUNDATION REQUIRES CORPORATE OFFICERS AND EACH DIRECTOR ON THE BOARD OF DIRECTORS TO COMPLETE AN ANNUAL CONFLICT OF INTEREST DISCLOSURE STATEMENT THAT IS BASED ON IRS GUIDANCE. IN ADDITION, THE CONFLICT OF INTEREST POLICY REQUIRES DISCLOSURE OF ALL CONFLICTS, POTENTIAL CONFLICTS, OR ANY MATTER THAT MAY GIVE RISE TO THE APPEARANCE OF A CONFLICT. THE FORMS ARE REVIEWED BY THE COMPLIANCE OFFICER AND REPORTED TO THE CEO AND THE APPROPRIATE COMMITTEE(S) OF THE BOARD. THE FORMS ARE FURTHER AVAILABLE TO, AND REVIEWED BY, OUR AUDITORS AND THE BOI. FORM 990, PART VI, SECTION C, LINE 19 THE APPLICABLE FORMS ARE AVAILABLE FOR PUBLIC INSPECTION VIA REQUEST AND REGULATORY FILINGS. FORM 990, PART IX, LINE 11G PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 168,259. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 168,259. ADMINSTRATIVE OVERHEAD: PROGRAM SERVICE EXPENSES 24,827. MANAGEMENT AND GENERAL EXPENSES 24,349. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 49,176. FORM 990, PART XII, LINE 2C THERE HAVE BEEN NO CHANGES TO DELTA DENTAL OF VIRGINIA FOUNDATION'S OVERSIGHT PROCESS OF THE AUDIT OR ITS SELECTION OF AN INDEPENDENT AUDITOR. DELTA DENTAL OF VIRGINIA 4818 STARKEY ROAD ROANOKE VA 24018 540844477 ADVANCE PUBLIC'S ORAL HEALTH BY PROVIDING QUALITY DENTAL BENEFITS. VA 501(C)(4) CORVESTA INC 0 CORVESTA INC 4818 STARKEY ROAD ROANOKE VA 24018 205945158 HOLDING COMPANY VA 501(C)(4) 0 REVOLV INC 4818 STARKEY ROAD ROANOKE VA 24018 271018474 PROVIDES TPA SERVICES TO DENTAL INSURANCE COMPANIES VA N/A C 0 STRYDEN INC 4818 STARKEY ROAD ROANOKE VA 24018 352637734 PROVIDES VISION CARE INSURANCE VA N/A C 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 DELTA DENTAL OF VIRGINIA C 1955207 CORVESTA INC P 212727