2022-11-03T10:07:53-05:00 2021-12-31 410746749 CLIFTONLARSONALLEN LLP 227 WEST TRADE STREET SUITE 800 CHARLOTTE NC 28202 990 2021-01-01 521305909 WILLIAMSBURG LANDING INC WILL 7575656504 5700 WILLIAMSBURG LANDING DRIVE WILLIAMSBURG VA 23185 GREGORY T STORER PRESIDENT % CEO 7575656504 2022-10-24 1 GREGORY STORER 999009999 JOHN NORMAN P01506766 7049985200 2022-10-24 0 AAL1 IAL1 2021 2022-09-23 18:48:47Z GREGORY T STORER 5700 WILLIAMSBURG LANDING DRIVE WILLIAMSBURG VA 23185 45342775 0 X WWW. WILLIAMSBURGLANDING.ORG X 1982 VA WILLIAMSBURG LANDING- THE SENIOR COMMUNITY OF CHOICE: CELEBRATING EXCELLENCE, VALUING DIVERSITY, PURSUING INNOVATION, AND CARING FOR EACH OTHER. 18 18 470 0 0 0 1936809 4817931 39302994 39189985 857996 1290359 0 44500 42097799 45342775 239033 221295 0 0 17567816 15680206 0 0 274100 24366931 23899185 42173780 39800686 -75981 5542089 179284386 188766508 234464850 237269564 -55180464 -48503056 X WILLIAMSBURG LANDING OFFERS EXCELLENT FACILITIES AND SERVICES, PROMOTES INDEPENDENCE AND DIVERSITY, PROVIDES ACCESS TO A CONTINUUM OF QUALITY HEALTH SERVICES, AND ACTIVELY COLLABORATES WITH THE BROADER WILLIAMSBURG SENIOR COMMUNITY. 0 0 32710315 221295 39189985 WILLIAMSBURG LANDING, INC. IS A CONTINUING CARE RETIREMENT COMMUNITY LOCATED IN JAMES CITY COUNTY, VIRGINIA THAT CONTAINS 321 RESIDENTIAL UNITS, 73 ASSISTED LIVING UNITS, 24 SPECIAL CARE (DEMENTIA) UNITS, AND A 73-BED SKILLED NURSING CENTER THAT PROVIDES LIVING ACCOMMODATIONS AND CERTAIN HEALTH CARE SERVICES TO ITS RESIDENTS. WILLIAMSBURG LANDING OPERATES UNDER THE CONCEPT IN WHICH RESIDENTS ENTER INTO A RESIDENCY AGREEMENT THAT GENERALLY REQUIRES PAYMENT OF A ONE-TIME ADVANCE FEE AND MONTHLY SERVICE FEES. GENERALLY, THESE PAYMENTS ENTITLE RESIDENTS TO THE USE AND PRIVILEGES OF THE COMMUNITY FOR LIFE, INCLUDING THE RIGHT TO OCCUPY DESIGNATED RESIDENTIAL UNITS AND TO RECEIVE CERTAIN HEALTH CARE SERVICES. (CONTINUED ON SCHEDULE O)INDEPENDENT LIVING: FULL SERVICE ACCREDITED CONTINUING CARE COMMUNITY APPROPRIATE ACTIVITIES AND A HEALTHY LIFESTYLE PROGRAM PROVIDED IN THE 24,000 SQUARE FOOT DOJG HEALTH CLUB AND ELSEWHERE ON CAMPUS. FINE DINING IS AVAILABLE IN THE MAIN DINING ROOM WITH INFORMAL DINING IN THE COVE CAFE. WILLIAMSBURG LANDING PROVIDES FOR ACCESS TO AN ONSITE CLINIC SERVED BY A DOCTOR AND NURSE PRACTITIONER. TRANSPORTATION AND OTHER SERVICES PROVIDED AS NEEDED.HEALTH AND REHABILITATION SERVICES AT WILLIAMSBURG LANDING ENCOMPASSES ALL HIGHER LEVELS OF CARE, INCLUDING SKILLED NURSING (MEDICARE), LONG TERM CARE, RESPITE CARE, ASSISTED LIVING AND CARE FOR THOSE WITH MEMORY PROBLEMS. SERVICES ARE PROVIDED PRIMARILY FOR RESIDENTS. NON-RESIDENTS MAY BE ACCEPTED ON A SPACE AVAILABLE BASIS. SERVICES INCLUDE ACCESS TO A DOCTOR AND NURSE PRACTITIONER AND PHYSICAL REHAB, A DIETITIAN, ACTIVITIES AND OTHER SERVICES. A COMPREHENSIVE PROGRAM FOR RESIDENTS WITH MEMORY ISSUES ARE ALSO PROVIDED BY THE STAFF OF THE HEALTH AND REHABILITATION CENTER. MEMORY SUPPORT IS FOR THOSE WITH MORE ADVANCED MEMORY ISSUES.WILLIAMSBURG LANDING HAS A BENEVOLENCE PROGRAM TO PROVIDE FINANCIAL ASSISTANCE FOR THOSE RESIDENTS WHO OUTLIVE THEIR RESOURCES. THE RESIDENT MUST PROVIDE CONCLUSIVELY THAT THE INABILITY TO PAY IS DUE TO FINANCIAL REVERSES OVER WHICH THE RESIDENT HAS NO CONTROL OR IS DUE TO DEPLETION OF THE RESIDENT'S ASSETS IN A REASONABLE MANNER BY THE PASSAGE OF TIME. THE BENEVOLENCE FUND CURRENTLY HAS A BALANCE OF 4.10 MILLION. 32710315 1 1 0 0 0 0 0 0 0 0 1 1 1 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 0 1 0 0 0 1 80 0 470 1 0 0 0 0 0 0 0 0 0 0 0 0 X 18 18 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X JUANITA M PARKS CFO 7575656511 5700 WILLIAMSBURG LANDING DRIVE WILLIAMSBURG VA 23185 ALLISON J BRODY CHAIR 4.00 0.10 X X 0 0 0 ALFRED WOODS TREASURER 4.00 0.10 X X 0 0 0 JEANNE ZEIDLER VICE CHAIR 4.00 0.10 X X 0 0 0 THEODORE JURASCHEK DIRECTOR 3.00 0.10 X 0 0 0 DR CARLENE PITTMAN DIRECTOR 3.00 0.10 X 0 0 0 LOUISE CRANFIELD DIRECTOR 3.00 0.10 X 0 0 0 JOHN SADLER ESQ DIRECTOR 3.00 0.10 X 0 0 0 MICHAEL FOX DIRECTOR 3.00 0.10 X 0 0 0 ELIZABETH DAVIS DIRECTOR 3.00 0.10 X 0 0 0 VERNON GEDDY III ESQ DIRECTOR 3.00 0.10 X 0 0 0 TIMOTHY MILLS DIRECTOR 3.00 0.10 X 0 0 0 TERRY DRISCOLL BEGAN 052021 DIRECTOR 3.00 0.10 X 0 0 0 DONALD BUCKLESS BEGAN 052021 DIRECTOR 3.00 0.10 X 0 0 0 CONNIE MATTHEWS HARSHAW BEGAN 10202 DIRECTOR 3.00 0.10 X 0 0 0 DR MATTHEW T LAMBERT DIRECTOR 3.00 0.10 X 0 0 0 ROBERT J SINGLEY DIRECTOR 3.00 0.10 X 0 0 0 VADM TIMOTHY WRIGHT DIRECTOR 3.00 0.10 X 0 0 0 MR JOHN VANAKEN DIRECTOR 3.00 0.10 X 0 0 0 RICHARD COSTELLO THROUGH 052021 DIRECTOR 3.00 0.10 X 0 0 0 LARRY FOSTER THROUGH 052021 DIRECTOR 3.00 0.10 X 0 0 0 LINDA TAYLOR-STALLINGS THROUGH 0920 DIRECTOR 3.00 0.10 X 0 0 0 WILLIAMS KAUFMANN THROUGH 052021 DIRECTOR 3.00 0.10 X 0 0 0 PAUL GERHARDT SECRETARY 4.00 0.10 X X 0 0 0 GREGORY STORER PRESIDENT & CEO 60.00 1.00 X 335693 0 37002 VERNON BAKER COO 60.00 1.00 X 93838 0 5722 JAMES MICHAEL WILLIAMS COO 60.00 1.00 X 100474 0 15307 JUANITA PARKS CFO 60.00 1.00 X 206199 0 11894 BRANDY DAY CHIEF TALENT OFFICER 45.00 X 150226 0 25029 VONNIE ADAMS DIRECTOR OF ASST. LIVING 45.00 X 143239 0 16588 LISA BATES CHIEF MARKETING OFFICER 45.00 X 129597 0 17616 NATHAN YOWELL HEALTH CARE ADMIN. 45.00 X 120517 0 19205 CHARLES KNIGHT DIRECTOR OF IT 45.00 X 105699 0 18477 1385482 0 166840 9 0 1 0 SODEXO 10 EARHART DR WILLIAMSVILLE NY 14221 DINING SERVICES 3431099 HENDERSON INC PO BOX BM WILLIAMSBURG VA 23187 CONSTRUCTION 2179912 HEALTHPRO HERITAGE 536 OLD HOWELL RD GREENVILLE NC 29615 CONSULTING 953538 FAVORITE 7255 W 98TH TERR BLDG5 STE 150 OVERLAND PARK KS 66212 CONTRACT NURSING 455470 HAMPTON ROADS LAWN 12 HOLLINGSWORTH WAY POQUOSON VA 23662 LAWN SERVICES 293385 10 3412457 1405474 4817931 INDEPENDENT LIVING 623000 19089647 19089647 ASSISTED LIVING 623000 7830238 7830238 SKILLED NURSING 623000 6162594 6162594 AMORTIZATION OF ENTRANCE FEES 623000 5756441 5756441 ADULT DAY 623000 351065 351065 39189985 633552 633552 44500 0 44500 44500 44500 656807 0 656807 656807 656807 45342775 39189985 0 1334859 X 221295 221295 12773140 10245204 2456826 71110 1954672 1616458 326678 11536 952394 771129 175186 6079 4020 4020 209280 209280 88162 88162 4095781 3324061 766526 5194 175366 165493 9873 768929 630522 136817 1590 1898096 1516606 381490 30931 30799 132 3020344 2567292 453052 8589735 7301275 1288460 523753 445190 78563 DIETARY 1854297 1854297 HEALTHCARE SUPPLIES 1202534 1202534 REPAIRS 553287 453695 99592 LEASES AND RENTALS 340214 340214 544456 24251 351619 168586 39800686 32710315 6816271 274100 6652583 4553256 580450 365450 510011 442754 176651 550102 248284 273020 732119 857876 224646936 96432334 132069381 128214602 17202992 24186515 20937315 29088619 174600 234314 179284386 188766508 4833204 5555652 105216310 112513963 106072198 107245591 18343138 11954358 234464850 237269564 X -57249205 -50460419 2068741 1957363 -55180464 -48503056 179284386 188766508 X 5542089 1860362 -725043 X 0 1 X 1 1 1 X 453161 825241 1936809 4817931 8033142 31166256 34052739 38700940 41239803 39189985 184349723 31619417 34052739 39526181 43176612 44007916 192382865 14948 14948 0 14948 14948 192367917 2609937 461436 406034 532739 678052 4688198 2609937 461436 406034 532739 678052 4688198 34229354 34514175 39932215 43709351 44685968 197071063 0.97610 0.97490 0.02380 0.02510 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 7114165 7114165 163802690 62821577 100981113 36523468 23767609 12755859 17206613 9843148 7363465 128214602 RESTRICTED UNDER RESIDENCY AGREEMENTS 1478580 F RESTRICTED BY DONORS 436810 F RESTRICTED UNDER CONTINUING CARE (CASH EQUIV) 163239 F RESTRICTED UNDER CONTINUING CARE (MUTUAL FUNDS) 11696933 F RESTRICTED UNDER BOND AGREEMENT 5983938 F RESTRICTED FOR RESIDENT CARE 4095193 F RESTRICTED UNDER CHARITABLE GIFT ANNUITIES (FIXED INCOME) 331822 F 24186515 MUTUAL FUNDS 29088619 F 29088619 DUE TO AFFILIATE 11860171 CHARITABLE GIFT ANNUITIES 94187 11954358 X PART X, LINE 2: WILLIAMSBURG LANDING, INC. IS A NONPROFIT ORGANIZATION EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). WILLIAMSBURG LANDING, BIRCHWOOD IS SINGLE-MEMBER LIMITED LIABILITY COMPANY SOLELY OWNED BY WILLIAMSBURG LANDING, INC. AND IS CONSIDERED A DISREGARDED ENTITY FOR TAX PURPOSES. MANAGEMENT IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE THE TAX-EXEMPT STATUS OF ANY OF THE ENTITIES. MANAGEMENT IS NOT AWARE OF ANY SIGNIFICANT ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES FOR WILLIAMSBURG LANDING, INC. WILLIAMSBURG LANDING, INC. FOLLOWS GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE GUIDANCE HAS HAD NO IMPACT ON THE COMMUNITY'S CONSOLIDATED FINANCIAL STATEMENTS. 0 BENEVOLENCE - RESIDENT FINANCIAL ASSISTANCE 6 185097 EDUCATION FUND 23 36198 PART I, LINE 2: THE ORGANIZATION PROVIDES ASSISTANCE TO ITS RESIDENTS AND EMPLOYEES, AS NEEDED. X X X X X X 0 1 0 0 0 1 0 0 0 GREGORY STORER PRESIDENT & CEO 309693 0 26000 0 0 0 15767 0 21235 0 372695 0 0 0 JUANITA PARKS CFO 186699 0 19500 0 0 0 10003 0 1891 0 218093 0 0 0 BRANDY DAY CHIEF TALENT OFFICER 142298 0 7928 0 0 0 7928 0 17101 0 175255 0 0 0 VONNIE ADAMS DIRECTOR OF ASST. LIVING 134503 0 8736 0 0 0 7174 0 9414 0 159827 0 0 0 PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457 PLAN: GREGORY STORER $8,503 VERNON BAKER $2,380 JAMES MICHAEL WILLIAMS $2,573 JUANITA PARKS $5,169 BRANDY DAY $3,964 VONNIE ADAMS $3,534 LISA BATES $3,321 PART I, LINE 6 INCENTIVES ARE PAID TO KEY EMPLOYEES FOR ENTITY PERFORMANCE AGAINST BUDGET. A EDA WILLIAMSBURG VA 541696911 999999999 2007-11-14 9000000 PREPAY PRIOR OBLIGATION - EW, DOIG HC 0 0 0 B IDA MATHEWS COUNTY VA 546001417 999999999 2011-12-15 10000000 REFINANCE RENOVATIONS TO FACILITIES 0 0 0 C IDA OF MATHEWS COUNTY VA (SERIES 2012 546001417 2012-01-26 7500000 REFINANCE RENOVATIONS TO FACILITIES 0 0 0 D EDA OF MATHEWS COUNTY VA 546001417 2016-10-18 10000000 CONSTRUCTION OF MEMORY CARE, ASST. LIVING, AND REHAB UNITS 0 0 0 A 2265000 9000000 9000000 2008 1 0 1 1 B 1770000 1000000 100011 9899989 2013 0 0 1 1 C 1330000 7500000 60000 7440000 2013 0 0 1 1 D 598515 10000000 193564 9806436 2017 0 0 1 1 A 0 0 1 1 0 0 0 1 B 0 0 1 1 0 0 0 1 C 0 0 1 1 0 0 0 1 D 0 0 0 0 0 0 1 A 0 0 1 0 0 0 0 0 0 B 0 1 0 0 1 0 0 0 0 C 0 1 0 0 0 0 0 0 0 D 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 A EDA OF JAMES CITY COUNTY VA 541139263 2021-10-01 1300000 0 0 0 B EDA OF JAMES CITY COUNTY VA 541139263 47029WED5 2021-10-13 77240815 REFINANCE CERTAIN BONDS AND FINANCE OTHER CAPITAL PROJECTS 0 0 0 A 1300000 3750 1296250 1 0 1 1 B 77240815 5391715 1313974 70535126 1 0 0 1 A 0 0 0 0 0 0 1 B 0 0 1 1 0 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 FORM 990, PART VI, SECTION A, LINE 4 THE ARTICLES OF INCORPORATION WERE AMENDED TO CHANGE BOARD TERMS TO DECEMBER TO COINCIDE WITH THE YEAR END OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B FINANCE COMMITTEE COMPOSED OF BOARD MEMBRERS WILL REVIEW THE 990 BEFORE IT IS FILED WITH THE IRS. WE WILL REPORT THE RESULTS OF THE REVIEW TO THE FULL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS OF THE CORPORATION, SENIOR LEADERS AND DEPARTMENT LEADERS ARE REQUIRED TO SIGN A CONFLICT OF INTEREST FORM. THE OFFICE OF THE CEO IS RESPONSIBLE FOR SENDING OUT THE FORM AND INSURING THAT A SIGNED FORM IS RECEIVED EACH YEAR. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION USES AN INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO SET THE COMPENSATION FOR THE PRESIDENT/CEO AND OTHER KEY OFFICERS. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS ARE DISTRIBUTED QUARTERLY TO THE BOARD OF DIRECTORS, THE RESIDENTS' FINANCE COMMITTEE, AND RESIDENTS' ASSOCIATION MEETINGS. GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 3,324,061. MANAGEMENT AND GENERAL EXPENSES 766,526. FUNDRAISING EXPENSES 5,194. TOTAL EXPENSES 4,095,781. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF INTEREST RATE SWAP AGREEMENTS 356,071. LOSS ON THE EXTINGUISHMENT OF DEBT -1,104,007. OTHER GAINS (NONOPERATING) 295,930. GAIN ON INVESTMENT IN JOINT VENTURE 9,714. CHANGE IN VALUE OF CHARITABLE GIFT ANNUITIES 7,622. PAYMENTS ON CHARITABLE GIFT ANNUITIES -40,885. NET ASSETS RELEASED FROM RESTRICTIONS FOR OPERATIONS -249,488. BIRCHWOOD LAND LLC 5700 WILLIAMSBURG LANDING DR WILLIAMSBURG VA 23185 521305909 VA 44500 661310 WILLIAMSBURG LANDING INC WILLIAMSBURG LANDING CONTINUING CARE TRUST 5700 WILLIAMSBURG LANDING DR WILLIAMSBURG VA 23185 546433122 TRUST FOR RESIDENT FINANCIAL SECURITY VA 501(C)(3) LINE 12B, II 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0