2022-02-15T11:32:33-06:00 2021-03-31 410746749 CLIFTONLARSONALLEN LLP 227 WEST TRADE STREET SUITE 800 CHARLOTTE NC 28202 990 2020-04-01 540524902 COVENANT WOODS COVE 8045698000 7090 COVENANT WOODS DRIVE MECHANICSVILLE VA 23111 ERIK MAURITSEN CFO 8045698173 2022-02-14 1 ERIK MAURITSEN XXX-XX-XXXX JOHN NORMAN P01506766 7049985200 2022-02-14 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z JOHN DWYER 7090 COVENANT WOODS DRIVE MECHANICSVILLE VA 23111 38428640 0 X WWW.COVENANTWOODS.COM X 1901 VA NOT-FOR-PROFIT CONTINUING CARE RETIREMENT COMMUNITY. 14 14 431 144 4500 3500 404800 3391990 27320032 31422309 2603480 2706393 553387 769506 30881699 38290198 334492 289000 0 0 13993715 18555366 0 0 111957 19226118 20661749 33554325 39506115 -2672626 -1215917 173785224 176119723 153996316 147700857 19788908 28418866 X IT IS THE MISSION OF COVENANT WOODS, A NOT-FOR-PROFIT CONTINUING CARERETIREMENT COMMUNITY, TO PROVIDE OUR RESIDENTS WITH EXCEPTIONAL CARE,QUALITY OF LIFE, AND SECURITY AND COMFORT IN KEEPING WITH THE BENEVOLENT VISION OF OUR METHODIST AND PRESBYTERIAN FOUNDERS IN 1883. 1 0 24658712 289000 27094295 COVENANT WOODS (CW), A VIRGINIA NONSTOCK CORPORATION FOUNDED IN OCTOBER, 1883, IS A NOT-FOR-PROFIT CONTINUING CARE RETIREMENT COMMUNITY IN MECHANICSVILLE, VA. CW CONSISTS OF 231 INDEPENDENT LIVING UNITS, 60 ASSISTED LIVING UNITS, AND 62 LICENSED NURSING BEDS. THE COST TO OPERATE CW DURING FY2021 APPROXIMATES $33,424,155. CW IS A NOT-FOR-PROFIT SENIOR LIVING COMMUNITY OFFERING ACTIVE LIFESTYLES, PERSONAL FREEDOM IN DAILY LIFE, AND FINANCIAL AND PHYSICAL SECURITY WITHIN AN EXTENSIVE CONTINUUM OF CARE. LOCATED ON 90 PRIVATE ACRES, COVENANT WOODS' HANOVER COUNTY CAMPUS FACILITATES A BROAD WELLNESS PROGRAM INCLUDING EXTENSIVE WALKING TRAILS AND OUTDOOR ACTIVITY SPACES, AS WELL AS MUSICAL PERFORMANCES, LECTURES, CLASSES, AND SOCIAL GATHERINGS. (CONTINUED ON SCHEDULE O)COVENANT WOODS PROVIDES MAINTENANCE-FREE LIVING WITH INTERIOR AND EXTERIOR MAINTENANCE, LAWN CARE AND SNOW REMOVAL, AND HOUSEKEEPING INCLUDED. NUMEROUS RESOURCES ARE AVAILABLE TO RESIDENTS INCLUDING FOUR DIFFERENT DINING VENUE CHOICES IN INDEPENDENT LIVING, PRIVATE DINING ROOMS, A FITNESS CENTER AND INDOOR SALTWATER SWIMMING POOL, GAME AND EVENT SPACES, BILLIARDS ROOM, ART STUDIO, GARDENING AREAS, WOOD WORKING AND POTTERY SHOPS, AND A PAVED WALKING TRAIL SURROUNDING A STOCKED POND. COVENANT WOODS OFFERS TRANSPORTATION SERVICES, 24-HOUR SECURITY AND A PERSONAL EMERGENCY ALERT SYSTEM, THERAPY, AND CLINIC SERVICES. 3322624 4328014 IN JANUARY 2020, COVENANT WOODS ACQUIRED ADVANCE CARE LLC, A HOME HEALTH AGENCY LOCATED IN CHESTERFIELD COUNTY. ADVANCE CARE SERVES THE HOME HEALTH NEEDS FOR INDIVIDUALS WITHIN A 50-MILE RADIUS OF ITS OFFICE LOCATION, WHICH INCLUDES ALL OF THE METRO RICHMOND AREA. THEY ARE BOTH MEDICARE AND MEDICAID CERTIFIED AND ARE ACCREDITED BY JCHAO. THEIR SERVICES ARE ALSO OFFERED TO RESIDENTS OF COVENANT WOODS WHO QUALIFY AND REQUEST THESE SERVICES. 0 0 IN SEPTEMBER 2020, COVENANT WOODS CREATED ADVANCE CARE HOSPICE LLC, A HOSPICE AGENCY LOCATED IN CHESTERFIELD COUNTY. ADVANCE CARE HOSPICE WILL SERVE THE HOSPICE NEEDS FOR INDIVIDUALS WITHIN A 50-MILE RADIUS OF ITS OFFICE LOCATION, WHICH INCLUDES ALL OF THE METRO RICHMOND AREA. AS OF MARCH 31, 2021 ADVANCE CARE HOSPICE HAD NOT APPLIED FOR ITS LICENSE TO ACCEPT PATIENTS. 27981336 1 1 0 1 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 95 0 1 431 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 VA X X X ERIK MAURITSEN 8045698000 7090 COVENANT WOODS DR MECHANICSVILLE VA 23111 MICHAEL CARTER CHAIR 1.00 X X 0 0 0 ROGER BOWERS BOARD MEMBER 1.00 X 0 0 0 CHARLES GRAVES BOARD MEMBER 1.00 X 0 0 0 KAREN COOK VICE CHAIR 1.00 X X 0 0 0 DAVID FULLER SECRETARY 1.00 X X 0 0 0 JACK HILL BOARD MEMBER 1.00 X 0 0 0 THELMA WATSON BOARD MEMBER 1.00 X 0 0 0 NATALIE KENT BOARD MEMBER 1.00 X 0 0 0 MICHAEL SMITH BOARD MEMBER 1.00 X 0 0 0 JOHN E DWYER JR PRESIDENT/CEO 40.00 1.00 X X 410065 0 56162 MELISSA BALL BOARD MEMBER 1.00 X 0 0 0 ED CLINGMAN BOARD MEMBER 1.00 X 0 0 0 KELSEY MANSMANN BOARD MEMBER 1.00 X 0 0 0 LINDA PEARSON BOARD MEMBER 1.00 X 0 0 0 MICHELE SATTERLUND BOARD MEMBER 1.00 X 0 0 0 EMILY BENNETT BOARD MEMBER 1.00 X 0 0 0 ERIK MAURITSEN CFO 40.00 1.00 X 247678 0 16296 CARRIE DAVIS ADMINISTRATOR 40.00 X 148846 0 28941 ELIZABETH RICHARDSON DIRECTOR OF MARKETING AND 40.00 X 138857 0 14030 MICHAEL SCHEFF DIRECTOR OF DINING 40.00 X 142651 0 13373 TOM DIEHL DIRECTOR OF IT 40.00 X 133145 0 31002 EMILY ROBINSON ENDERT DIRECTOR OF HUMAN RESOURCE 40.00 X 123040 0 38290 1344282 0 198094 7 0 1 0 PFG - PERFORMANCE FOOD SERVICE 7420 RANCO ROAD RICHMOND VA 23228 FOOD SERVICES 1056460 ADMIRAL SECURITY - RED COATS INC PO BOX 79776 BALTIMORE MD 21279 379549 DMA FLOORS INC PO BOX 7893 RICHMOND VA 23231 333078 LANDCARE PO BOX 46189 HOUSTON TX 77210 280541 VICOM - VA INTEGRATED COMMUNICATION 5361 CLEVELAND STREET VIRGINIA BEACH VA 23462 IT INFRASTRUCTURE IMPROVEMENT 269542 16 3136417 255573 3391990 RESIDENTIAL SERVICES 623990 15617894 15617894 HEALTHCARE SERVICES 624100 11476401 11476401 HOME HEALTH SERVICES 621610 4328014 4328014 31422309 1476802 4500 1472302 18062 0 18062 18062 18062 1314858 53175 0 138442 1314858 -85267 1229591 1229591 MISCELLANEOUS INCOME 900099 376516 376516 MEAL/FOOD REVENUE 722513 353510 353510 DRUGS/MEDICAL SUPPLIES 900099 18863 18863 2555 2555 751444 38290198 31422309 4500 3471399 289000 289000 748356 224507 523849 13438483 9476490 3900696 61297 508621 309063 194987 4571 2853291 2921024 -83504 15771 1006615 685868 313827 6920 57573 2611 54962 51921 51921 87915 2165 85750 1043872 786452 257420 237029 9199 227830 3948676 2747507 1178542 22627 86870 86870 2338249 2323215 15034 137041 123220 13821 44412 5373 38268 771 4521737 2929010 1592727 6726975 4206686 2520289 505015 434438 70577 MISCELLANEOUS 864769 505508 359261 BAD DEBT 9695 9695 39506115 27981336 11412822 111957 298650 526624 1378092 1468918 4470 4470 1898740 1143387 50488 38101 265409 304319 164705657 46049884 123480085 118655773 30106609 35510929 11344003 12593021 2000328 2446719 2958350 3427462 173785224 176119723 3723448 3821868 56393962 53143676 88970763 86926073 417383 233500 4490760 3575740 153996316 147700857 X 16410603 24040461 3378305 4378405 19788908 28418866 173785224 176119723 X -1215917 8691558 1154317 X 0 1 X 1 0 X 421666 245172 190278 404800 2880432 4142348 22445183 24046719 24565462 27320032 31133309 129510705 326050 338186 395484 523337 769506 2352563 23192899 24630077 25151224 28248169 34783247 136005616 0 0 0 136005616 1354833 1478252 1951793 1338177 1385086 7508141 4246 -8701 29248 31238 56031 1359079 1478252 1943092 1367425 1416324 7564172 24551978 26108329 27094316 29615594 36199571 143569788 0.94730 0.94040 0.05270 0.05960 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 558 558 0 PART II-B, LINE 1: THE ORGANIZATION IS A MEMBER OF LEADINGAGE VIRGINIA. A SMALL PORTION OF THE DUES PAID TO THIS ORGANIZATION HAS BEEN ALLOCATED TO LOBBYING EXPENDITURES CONDUCTED BY THESE ORGANIZATIONS. IN THE 2020 FY, 3% OF THE LEADINGAGE ANNUAL DUES ARE RELATED TO LOBBYING. 0 1 X 4734221 4734221 140795760 46049884 94745876 7117958 7117958 8324667 8324667 3733051 3733051 118655773 2012 SERIES BOND TRUSTEE FUND 3180 C SIGULER GUFF DISTRESS OPP FUND III, L.P. 429705 C LINGERFELT FUND 753900 C PORTFOLIO ADVISORS 631041 C NORTHGATE IV, L.P. 759257 C PRINCIPAL FUND 987091 C INTEREST FUND 1061935 C PERMANENTLY RESTRICTED TRUSTS 1644430 C RESERVE FUND 5562520 C CHARLES SCHWAB 707299 F WOODHOUSE CATERING, INC 52663 C 12593021 REFUNDABLE ADVANCE FEES 3528990 OTHER LIABILITIES 750 ADVANCED DEPOSIT FEES 46000 3575740 X PART IV, LINE 2B: FUNDS HELD BY ESCROW AGENT ARE ALL ADVANCED FEE DEPOSITS FROM POTENTIAL FUTURE RESIDENTS FOR UNITS THAT ARE NOT YET AVAILABLE FOR OCCUPANCY. THESE DEPOSITED FUNDS ARE KEPT AND MAINTAINED IN AN ACCOUNT SEPARATE FROM THE ORGANIZATION'S BUSINESS ACCOUNT AS REQUIRED BY LAW. PART X, LINE 2: THE ORGANIZATION IS A TAX-EXEMPT ORGANIZATION AS DEFINED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL AND STATE AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS OR ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME, EXCISE OR OTHER TAXES. THE ORGANIZATION FOLLOWS THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS. THIS STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THIS STANDARD HAD NO IMPACT ON THE ORGANIZATION'S FINANCIAL STATEMENTS FOR THE YEARS ENDED MARCH 31, 2021 AND 2020. PART XII, LINE 4B - OTHER ADJUSTMENTS: BENEVOLENT ASSISTANCE 1 COVENANT PROGRAM/BENEVOLENT CARE 6 289000 PART I, LINE 2: COVENANT WOODS PROVIDES BENEVOLENCE FUNDS UNDER THE COVENANT PROGRAM TO RESIDENTS WITHIN THE ORGANIZATION WHO CAN NO LONGER AFFORD TO PAY FOR THEIR CARE. THE PROGRAM IS DESIGNED TO PRESERVE THE DIGNITY OF THE PARTICIPANTS AND TO ENHANCE THEIR QUALITY OF LIFE IN KEEPING WITH THE MISSION OF COVENANT WOODS. THE IDENTITY OF PERSONS RECEIVING COVENANT PROGRAM ASSISTANCE IS STRICTLY CONFIDENTIAL. FROM THE INFORMATION PROVIDED BY THE APPLICANT, A DETERMINATION WILL BE MADE BY THE CFO AND CEO REGARDING WHETHER OR NOT THE RESIDENT QUALIFIES FOR FINANCIAL ASSISTANCE FROM THE COVENANT PROGRAM, AND IF SO, HOW MUCH. ASSISTANCE MAY BE PROVIDED IN TWO FORMS: MONTHLY FEE ASSISTANCE OR MEDICAL EXPENSE ASSISTANCE. 1 X X 0 0 0 0 0 0 0 0 0 JOHN E DWYER JR PRESIDENT/CEO 372000 0 25600 0 12465 0 52750 0 3412 0 466227 0 0 0 ERIK MAURITSEN CFO 225000 0 13193 0 9485 0 13744 0 2552 0 263974 0 0 0 CARRIE DAVIS ADMINISTRATOR 133326 0 7797 0 7723 0 26904 0 2037 0 177787 0 0 0 TOM DIEHL DIRECTOR OF IT 117052 0 11310 0 4783 0 29654 0 1348 0 164147 0 0 0 EMILY ROBINSON ENDERT DIRECTOR OF HUMAN RESOURCE 112000 0 10522 0 518 0 29898 0 8392 0 161330 0 0 0 MICHAEL SCHEFF DIRECTOR OF DINING 125900 0 9833 0 6918 0 12025 0 1348 0 156024 0 0 0 ELIZABETH RICHARDSON DIRECTOR OF MARKETING AND 121798 0 5911 0 11148 0 11479 0 2551 0 152887 0 0 0 A EDA OF HANOVER COUNTY 541228097 41077CAM7 2012-12-20 101980603 SEE PART VI 0 0 0 B EDA OF HANOVER 541228097 41077CAS4 2018-07-31 30200000 FINANCE AND REFINANCE VARIOUS CAPITAL PROJECTS 0 0 0 A 44700603 101980603 3891200 1826631 68227772 28035000 2014 0 0 1 1 B 185000 30200000 1678054 638182 10950502 18778516 3176 2019 1 0 1 1 A 0 1 1 1 0 0 0 1 B 0 0 0 0 0 0 1 A 0 1 0 0 1 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 PART I, ISSUE A, COLUMN (F) DESCRIPTION OF PURPOSES THE PURPOSE OF THE BOND PROCEEDS WAS TO FINANCE THE ACQUISITION, CONSTRUCTION, AND EQUIPPING OF 106 INDEPENDENT LIVING UNITS, ADDITIONAL COMMUNITY LIVING SPACE INCLUDING PARKING AND DINING FACILITIES, RENOVATIONS TO EXISTING FACILITIES AND FINANCE OTHER COSTS ASSOCIATED WITH ISSUANCE OF THE BOND. PART II, COLUMN A, LINE 12 THE BOND ISSUE WAS STRUCTURED AS A DRAW DOWN. THEREFORE, OTHER UNSPENT PROCEEDS SHOWN ON LINE 12 REPRESENT FUNDS THAT ARE AVAILABLE, BUT HAVE NOT BEEN ACCESSED BY THE ORGANIZATION. FORM 990, PART III, LINE 2 CREATED ADVANCE CARE HOSPICE LLC. ADDED WOODHOUSE. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 WAS REVIEWED BY MANAGEMENT AND SENT TO EACH BOARD MEMBER PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD IS POLLED ANNUALLY, AND SURVEYS ARE COLLECTED BY THE EXECUTIVE SECRETARY AND CHECKED FOR COMPLIANCE WITH THE POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE CEO IS EVALUATED ANNUALLY BY THE EXECUTIVE COMMITTEE OF THE BOARD. EACH COMMITTEE MEMBER DOES AN INDEPENDENT EVALUATION, AND THE COMMITTEE CHAIRMAN COMPILES THE SCORE. THE CEO EVALUATES THE CFO WITH FEEDBACK FROM THE BOARD. THE BOARD CHAIR REQUESTS COMPARATIVE SALARY DATA THAT THE HR DIRECTOR ACQUIRES FROM VARIOUS LONG-TERM CARE GROUPS, WHICH IS USED TO DETERMINE BASE WAGE INCREASES. BONUS AMOUNTS ARE DETERMINED BASED ON HOW WELL THE CEO AND CFO EXECUTE THE STRATEGIC PLAN FOR THE YEAR - MEETING BUDGET, SATISFACTION, DEVELOPMENT, ETC. BONUS AMOUNTS ARE CAPPED AT 20% OF BASE SALARY FOR THE CEO AND 15% OF BASE SALARY FOR THE CFO. THE CFO AND DIRECTOR OF HR REVIEW COMPARATIVE SALARY DATA THAT THE HR DIRECTOR ACQUIRES FROM VARIOUS LONG-TERM CARE GROUPS, WHICH IS USED TO DETERMINE BASE WAGE INCREASES. BONUS AMOUNTS ARE DETERMINED BY THE KEY EMPLOYEES ACHIEVING BENCHMARKS SET BY THE CEO (MEETING BUDGET, COMPLETING PROJECTS, SATISFACTION SCORES ON SURVEYS, ETC.). THESE BENCHMARKS ARE REVIEWED BY THE CEO EACH YEAR AND THE BONUS IS CAPPED AT 10% OF BASE SALARY. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION'S RECENT FORMS 990 ARE AVAILABLE AT WWW.GUIDESTAR.ORG, UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE FOR PUBLIC INSPECTION AT THIS TIME. FINANCIAL STATEMENTS ARE PROVIDED TO WWW.EMMA.ORG. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF PERPETUAL TRUSTS 451,476. RELEASES FROM RESTRICTIONS -92,889. INTERCOMPANY ELIMINATIONS 795,730. PARKER & GREGG LLC 7090 COVENANT WOODS DRIVE MECHANICSVILLE VA 23111 540524902 INVESTMENT HOLDING VA 84413 793817 COVENANT WOODS ADVANCE CARE LLC 585 SOUTHLAKE BLVD UNIT B RICHMOND VA 23236 205417657 HOME HEALTH SERVICES VA 4881761 3159229 COVENANT WOODS ADVANCE CARE HOSPICE LLC 585 SOUTHLAKE BLVD UNIT A RICHMOND VA 23236 853017045 HOSPICE SERVICES VA 0 407465 CONVENANT WOODS WOODHOUSE CATERING INC 7090 COVENANT WOODS DRIVE MECHANICSVILLE VA 23111 853395404 CATERING AND FOOD SERVICES VA 51942 63829 PARKER & GREGG WOODHOUSE CATERING INC 7090 COVENANT WOODS DR MECHANICSVILLE VA 23111 853395404 CATERING VA COVENANT WOODS C 63829 1.00000 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 1 1 ADVANCE CARE LLC A 1400 AC OUTPATIENT THERAPY PAYS CW RE ADVANCE CARE LLC L 20715 CW PAYS AC $76.00 PER DIEM FOR ME ADVANCE CARE LLC O 90195 AC PAYS CW A MANAGEMENT FEE. FEE WOODHOUSE CATERING LLC O 2555 WH PAYS CW A MANAGEMENT FEE. FEE ADVANCE CARE LLC S 529991 AMOUNT AC OWES CW FOR CASH ADVANC PARKER & GREGG R 50000 P&G COMMON STOCK AND ADDITIONAL P