2022-11-10T12:24:21-06:00 2021-12-31 410746749 CLIFTONLARSONALLEN LLP 227 WEST TRADE STREET SUITE 800 CHARLOTTE NC 28202 990 2021-01-01 521368412 CULPEPER BAPTIST RETIREMENT COMMUNITY INC CULP 8045219206 3961 STILLMAN PARKWAY GLEN ALLEN VA 23060 CHRISTOPHER M MARKWITH SVP AND CFO 8045219206 2022-11-08 1 CHRISTOPHER MARKWITH 999009999 JOHN NORMAN P01506766 7049985200 2022-11-08 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z THE CULPEPER JONATHAN COOK 3961 STILLMAN PARKWAY GLEN ALLEN VA 23060 15427505 0 X WWW.LIFESPIRELIVING.ORG X 1948 VA TO PROVIDE "DIGNITY IN LIVING" FOR SENIOR ADULTS WHO RESIDE IN THIS PLANNED SERVICES COMMUNITY. 19 19 0 34 0 0 1202745 1863505 13347086 13560325 1841 3675 0 0 14551672 15427505 221250 225172 0 0 7179597 7619806 0 0 0 7484706 8333187 14885553 16178165 -333881 -750660 52528934 85756806 67844123 101390170 -15315189 -15633364 X THE CULPEPER PROVIDES DIGNITY IN LIVING FOR SENIOR ADULTS LIVING IN OUR COMMUNITIES, SOME OF WHOM CANNOT AFFORD TO PAY THE FULL COST OF THEIR CARE. PROVIDED SERVICES INCLUDE HIGH QUALITY HOUSING, HEALTH CARE, WELLNESS PROGRAMS, AND OTHER SERVICES. WE PRACTICE SERVANT LEADERSHIP BY ATTRACTING AND RETAINING PROFESSIONAL AND CARING STAFF COMMITTED TO OUR RESIDENTS' NEEDS. WE PROVIDE EXCELLENT FACILITIES AND SERVICES WHILE EMBRACING INNOVATION THAT HONORS OUR TRADITIONAL PRACTICES. OUR FAITH-BASED, NONPROFIT, SERVICE-ORIENTED IDENTITY IN OUR MARKET AREAS SETS US APART FROM OTHER SENIOR CARE PROVIDERS, AND WE ARE INTEGRAL PARTNERS WITH A VARIETY OF CHURCHES, SCHOOLS, HUMAN SERVICE ORGANIZATIONS, AND BUSINESS ORGANIZATIONS THAT SERVE THE REGIONS WHERE WE OPERATE. WE HAVE BEEN GUIDED SINCE OUR FOUNDING BY A VOLUNTEER BOARD AND PROFESSIONAL MANAGEMENT TEAM COMMITTED TO EXCELLENCE IN SERVICE TO SENIORS. 0 0 15310990 225172 13252741 WE PROVIDED BOTH RESIDENTIAL AND HEALTH CARE SERVICES TO OUR RESIDENTS, SOME OF WHOM ARE UNABLE TO COVER THE FULL COST OF THEIR CARE. WE PROVIDED $225,172 IN SUBSIDIES AND INDIGENCE ALLOWANCES TO OUR RESIDENTS IN 2021, PERTAINING TO 17 RESIDENTS. 15310990 1 1 0 0 0 0 0 0 0 1 1 0 0 1 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 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 19 19 0 0 0 0 1 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 VA X X CHRIS MARKWITH CFO 8045219206 39614 STILLMAN PARKWAY GLEN ALLEN VA 23060 MR SCOTT CAVE TRUSTEE 1.00 X 0 0 0 REVDAN CARLTON TRUSTEE 1.00 X 0 0 0 MR JAMES BALES TRUSTEE 1.00 X 0 0 0 MSSHARON BROOKS TRUSTEE 1.00 X 0 0 0 REVBERT BROWNING TRUSTEE 1.00 X 0 0 0 DRVALERIE CARTER TRUSTEE 1.00 X 0 0 0 DRTIFFANY FRANKS TRUSTEE 1.00 X 0 0 0 REVNELSON HARRIS TRUSTEE 1.00 X 0 0 0 MR JOHN JUNG TRUSTEE 1.00 X 0 0 0 MR MIKE KECK TRUSTEE 1.00 X 0 0 0 MRSSALLIE MARCHELLO TRUSTEE 1.00 X 0 0 0 MR ROBERT MUSICK TRUSTEE 1.00 X 0 0 0 MR SAMUEL OAKEY TRUSTEE 1.00 X 0 0 0 MR ARNIE OWENS TRUSTEE 1.00 X 0 0 0 DRPAM PARSONS TRUSTEE 1.00 X 0 0 0 MR JOHN POMA TRUSTEE 1.00 X 0 0 0 MRSSUSAN RUCKER TRUSTEE 1.00 X 0 0 0 MR MATTHEW SCOTT TRUSTEE 1.00 X 0 0 0 MR MIKE SMITH TRUSTEE 1.00 X 0 0 0 JONATHAN COOK PRESIDENT & CEO 1.00 39.00 X 0 621904 35909 DONALD FISHER COO 1.00 39.00 X 0 160283 11861 TRACEY JENNINGS 121-1231 COO 1.00 39.00 X 0 18756 940 CHRIS MARKWITH CFO 1.00 39.00 X 0 266015 27128 JOHN P ROBINSON VP 1.00 39.00 X 0 237604 30826 JAMES JACOBSEN EXECUTIVE DIRECTOR 40.00 X 174478 0 35588 174478 1304562 142252 1 0 1 0 SYSCO FOOD SERVICES OF VIRGINIA LLC PO BOX 20020 HARRISONBURG VA 22801 FOOD VENDOR 534271 SELECT REHABILITATION LLC PO BOX 71985 CHICAGO IL 60694 THERAPY PROVIDER 480571 CURA HOSPITALITY PO BOX 743676 ATLANTA GA 30374 FOOD SERVICE PROVIDER 285417 RCA LABORATORY SERVICES DBA GENETWORX PO BOX 2386 HICKSVILLE NY 11802 LAB SERVICES 176605 REMEDI SENIORCARE OF VIRGINIA PO BOX 75700 BALTIMORE MD 21275 PHARMACY PROVIDER 130881 5 461393 1395851 6261 1863505 RESIDENTIAL SERVICES 623000 7838782 7838782 HEALTH CARE SERVICES 623000 5413959 5413959 307584 307584 13560325 3675 3675 15427505 13252741 0 311259 X 225172 225172 174478 174478 6335897 5976502 359395 134280 120072 14208 521438 466270 55168 453713 408787 44926 1735847 1735847 83032 83032 135968 135968 1540106 1540106 14974 14974 2068573 2068573 1631230 1631230 DIETARY SUPPLIES 605422 605422 PROGRAM SUPPLIES 392747 392747 MISCELLANEOUS 125288 125288 16178165 15310990 867175 0 -203229 -169484 568892 821399 407200 37184 32124 59512874 6538353 47200941 52974521 852974 990811 60188 40921 4011984 30659314 52528934 85756806 1814609 1200333 2973129 1788589 45471605 56641649 17584780 41759599 67844123 101390170 X -17807021 -18505515 2491832 2872151 -15315189 -15633364 52528934 85756806 X -750660 432485 X 0 1 X 1 0 X 372427 558540 883580 1202745 1863505 4880797 8811486 9022742 10459873 13347086 13560325 55201512 9183913 9581282 11343453 14549831 15423830 60082309 0 0 0 60082309 48881 34248 35551 1841 3675 124196 48881 34248 35551 1841 3675 124196 9232794 9615530 11379004 14551672 15427505 60206505 0.99790 0.99720 0.00210 0.00350 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 321 321 0 PART II-B, LINE 1: A PORTION OF THE ORGANIZATION'S ASSOCIATION DUES IS ALLOCATED TO LOBBYING. 5388249 223241 5611490 5265183 123066 5388249 5396282 58293 -189392 5265183 5335266 102715 -41699 5396282 5264415 49009 21842 5335266 1.00000 0 1 1 43647 43647 53375740 5506252 47869488 1122244 629265 492979 4971243 402836 4568407 52974521 DUE FROM AFFILIATES 11588919 DEPOSITS AND OTHER 182985 ASSETS WHOSE USE IS LIMITED 18887410 30659314 DEFERRED ENTRANCE FEES 8964709 DUE TO AFFILIATES 32794890 41759599 X PART V, LINE 4: VIRGINIA BAPTIST HOMES FOUNDATION, INC., A RELATED ORGANIZATION, HOLDS AND ADMINISTERS ENDOWMENTS FOR ALL OF THE RELATED ORGANIZATIONS LISTED IN SCHEDULE R. THE ENDOWMENTS ARE TO BE USED TOWARDS THE CONTINUATION OF RESIDENT SERVICES. THE AMOUNTS SHOWN IN PART V REPRESENT THE AGGREGATE BALANCE OF THE DONOR-RESTRICTED ASSETS HELD BY THE FOUNDATION ON BEHALF OF ALL RELATED ORGANIZATIONS. PART X, LINE 2: THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE ORGANIZATION IS NOT AWARE OF ANY SIGNIFICANT ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. THE ORGANIZATION ADOPTED ACCOUNTING GUIDANCE REGARDING RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE IMPLEMENTATION HAS HAD NO IMPACT ON THE ORGANIZATION'S FINANCIAL STATEMENTS. 1 BENEVOLENT ASSISTANCE 17 225172 PART I, LINE 2: THE ORGANIZATION GRANTS ASSISTANCE TOWARDS MONTHLY FEES THROUGH A FINANCIAL AID APPLICATION PROCESS. GRANTS ARE AWARDED IN THE FORM OF A REDUCTION OF RESIDENT MONTHLY FEES. X X 0 0 0 1 1 0 0 0 0 JONATHAN COOK PRESIDENT & CEO 0 387717 0 234187 0 0 0 26000 0 9909 0 657813 0 0 CHRIS MARKWITH CFO 0 230015 0 36000 0 0 0 26000 0 1128 0 293143 0 0 JOHN P ROBINSON VP 0 179952 0 57652 0 0 0 19500 0 11326 0 268430 0 0 JAMES JACOBSEN EXECUTIVE DIRECTOR 151175 0 23303 0 0 0 26000 0 9588 0 210066 0 0 0 DONALD FISHER COO 0 139662 0 20621 0 0 0 7186 0 4675 0 172144 0 0 PART I, LINE 5 EFFECTIVE IN 2016 THE BOARD OF TRUSTEES IMPLEMENTED AN INCENTIVE COMPENSATION PLAN BASE ON SEVERAL SPECIFIED FACTORS, ONE OF WHICH IS ADJUSTED NET OPERATING INCOME. A EDA OF NEWPORT NEWS 521290859 65225PAM8 2016-10-12 91459243 TO REFUND 2006 TAX-EXEMPT BONDS 0 0 1 B VIRGINIA SMALL BUSINESS FINANCING AUTHORITY 541300845 NONEAVAIL 2021-08-18 77875000 REFINANCE 2017A AND 2017B BONDS, PURCHASE OF THE SUMMIT, OTHER CAPITAL EXP. 0 0 1 A 1754890 2429479 167290 37438 2224751 1 0 1 1 B 50099675 895239 3732832 45471604 1 0 0 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 1 1 1 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 PART II, LINE 3, COLUMN B THE 2021 BOND ISSUE APPLIES TO MULTIPLE RELATED ORGANIZATIONS. THE AMOUNT REPORTED ON LINE 3 IS THE PORTION OF THE TOTAL BOND PROCEEDS ISSUED THAT ARE ATTRIBUTABLE TO THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 6 VIRGINIA BAPTIST HOMES, INC. IS THE SOLE MEMBER OF CULPEPER BAPTIST RETIREMENT COMMUNITY, INC. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S FORM 990 IS PREPARED BY THE ORGANIZATION'S EXTERNAL FINANCIAL AUDIT FIRM FROM INFORMATION THE ORGANIZATION FURNISHED, AND REVIEWED BY THE ORGANIZATION'S CHIEF FINANCIAL EXECUTIVE AND CONTROLLER PRIOR TO SUBMISSION TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES AND THE VIRGINIA BAPTIST HOMES, INC. COMPLIANCE OFFICER MONITOR AND ENFORCE THE CONFLICT OF INTEREST POLICY, IN ACCORDANCE WITH THE VBH CORPORATE COMPLIANCE PROGRAM. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE ORGANIZATION'S CEO, OFFICERS AND KEY EMPLOYEES IS SET BY THE BOARD OF TRUSTEES AFTER DELIBERATION, INCLUDING REVIEW OF THE "CHIEF EXECUTIVE OF MULTI-FACILITY ORGANIZATIONS COMPENSATION REPORT AND OTHER SENIOR LIVING INDUSTRY COMPARABILITY REPORTS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FORM 990 AND ASSOCIATED MATERIALS ARE MADE AVAILABLE AT, OR BY REQUEST TO, EITHER THE BUSINESS' LOCATION OR THE HEADQUARTERS OF VIRGINIA BAPTIST HOMES, INC. THE FORM 990 MAY ALSO BE VIEWED ON CERTAIN THIRD PARTY WEB SITES. FORM 990, PART IX, LINE 11G OTHER: PROGRAM SERVICE EXPENSES 1,735,847. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,735,847. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF INTEREST RATE SWAP AGREEMENTS 294,648. CHANGE IN PRESENT VALUE OF PERPETUAL TRUSTS 137,837. VIRGINIA BAPTIST HOMES INC 1900 LAUDERDALE DR RICHMOND VA 23238 540534405 SENIOR LIVING COMMUNITY VA 501(C)(3) LINE 12A, I N/A 0 VIRGINIA BAPTIST HOMES FOUNDATION INC 1900 LAUDERDALE DR RICHMOND VA 23238 521373103 SENIOR LIVING COMMUNITY VA 501(C)(3) LINE 12B, II N/A 0 NEWPORT NEWS BAPTIST RETIREMENT COMMUNITY INC 955 HARPERVILLE RD NEWPORT NEWS VA 23601 521368408 SENIOR LIVING COMMUNITY VA 501(C)(3) LINE 10 N/A 0 LAKEWOOD MANOR BAPTIST RETIREMENT COMMUNITY INC 1900 LAUDERDALE DR RICHMOND VA 23238 521368410 SENIOR LIVING COMMUNITY VA 501(C)(3) LINE 10 N/A 0 THE GLEBE INC 200 THE GLEBE BLVD DALEVILLE VA 24083 541917966 SENIOR LIVING COMMUNITY VA 501(C)(3) LINE 10 N/A 0 THE SUMMIT 1300 ENTERPRISE DR LYNCHBURG VA 24502 871532163 SENIOR LIVING COMMUNITY VA 501(C)(3) LINE 10 N/A 0 0 0 1 1 1 0 0 0 0 0 1 0 1 1 0 1 0 0 0 VIRGINIA BAPTIST HOMES FOUNDATION INC C 461393 BOOK