2021-11-12T10:14:32-06:00 2020-12-31 410746749 CLIFTONLARSONALLEN LLP 227 WEST TRADE STREET SUITE 800 CHARLOTTE NC 28202 990 2020-01-01 521368412 CULPEPER BAPTIST RETIREMENT COMMUNITY INC CULP 8045219206 3961 STILLMAN PARKWAY GLEN ALLEN VA 23060 CHRISTOPHER M MARKWITH SVP AND CFO 8045219206 2021-11-11 1 CHRISTOPHER MARKWITH 999009999 JOHN NORMAN P01506766 7049985200 2021-11-06 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z THE CULPEPER JONATHAN COOK 3961 STILLMAN PARKWAY GLEN ALLEN VA 23060 14551672 0 X WWW.LIFESPIRELIVING.ORG X 1948 VA TO PROVIDE "DIGNITY IN LIVING" FOR SENIOR ADULTS WHO RESIDE IN THIS PLANNED SERVICES COMMUNITY. 19 19 250 30 0 0 883580 1202745 10459873 13347086 -476334 1841 0 0 10867119 14551672 264570 221250 0 0 6884219 7179597 0 0 0 5122340 7484706 12271129 14885553 -1404010 -333881 47881429 52528934 60634233 67844123 -12752804 -15315189 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 14047788 221250 13082359 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 $221,250 IN SUBSIDIES AND INDIGENCE ALLOWANCES TO OUR RESIDENTS IN 2020, PERTAINING TO 14 RESIDENTS. 14047788 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 36 0 250 1 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 0 0 VA X X CHRIS MARKWITH CFO 8045219206 39614 STILLMAN PARKWAY GLEN ALLEN VA 23060 MRJAMES BALES TRUSTEE 1.00 X 0 0 0 MS SHARON BROOKS TRUSTEE 1.00 X 0 0 0 DR HERBERT O BROWNING JR TRUSTEE 1.00 X 0 0 0 REV DANIEL CARLTON TRUSTEE 1.00 X 0 0 0 DR VALERIE CARTER TRUSTEE 1.00 X 0 0 0 MR SCOTT CAVE TRUSTEE 1.00 X 0 0 0 DR TIFFANY FRANKS TRUSTEE 1.00 X 0 0 0 REV NELSON 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 MRS SALLIE MARCHELLO TRUSTEE 1.00 X 0 0 0 MR ROBERT MUSICK TRUSTEE 1.00 X 0 0 0 MR SAMUEL G OAKEY III TRUSTEE 1.00 X 0 0 0 MR ARNIE OWENS TRUSTEE 1.00 X 0 0 0 DR PAM PARSONS TRUSTEE 1.00 X 0 0 0 MR JOHN POMA TRUSTEE 1.00 X 0 0 0 MRS SUSAN 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 532262 26420 RAY FISHER COO 1.00 39.00 X 0 283164 34748 CHRIS MARKWITH CFO 1.00 39.00 X 0 240129 26000 JOHN P ROBINSON VP 1.00 39.00 X 0 194684 19500 JIM JACOBSEN EXECUTIVE DIRECTOR 40.00 X 166660 0 4061 166660 1250239 110729 1 0 1 0 SYSCO FOOD SERVICES OF VIRGINIA LLC PO BOX 20020 HARRISONBURG VA 22801 FOOD VENDOR 534476 REHABCARE GROUP INC PO BOX 71985 CHICAGO IL 60694 THERAPY PROVIDER 516115 REMEDI SENIORCARE OF VIRGINIA PO BOX 75700 BALTIMORE MD 21275 PHARMACY PROVIDER 122499 MEDLINE INDUSTRIES INC DEPT CH 14400 PALATINE IL 60055 MEDICAL SUPPLY PROVIDER 115769 GLYNN DEVINS 8880 WARD PKWY STE 400 KANSAS CITY MO 64114 MARKETING 109540 5 884163 318582 1202745 RESIDENTIAL SERVICES 623000 7378953 7378953 HEALTH CARE SERVICES 623000 5703406 5703406 264727 264727 13347086 1841 1841 14551672 13082359 0 266568 221250 221250 166660 166660 5926155 5590002 336153 121807 108919 12888 532022 475734 56288 432953 390083 42870 1267436 1267436 102661 102661 119337 119337 908 908 1312248 1312248 14020 14020 1833066 1833066 1672965 1672965 DIETARY SUPPLIES 560633 560633 PROGRAM SUPPLIES 478485 478485 MISCELLANEOUS 122947 122947 14885553 14047788 837765 0 -24746 -203229 475061 568892 13516 37184 52116825 4915884 45736644 47200941 834007 852974 73100 60188 773847 4011984 47881429 52528934 3126054 1814609 1926937 2973129 43711979 45471605 11869263 17584780 60634233 67844123 X -14743257 -17807021 1990453 2491832 -12752804 -15315189 47881429 52528934 X -333881 -2228504 X 0 1 X 1 0 X 339645 372427 558540 883580 1202745 3356937 8466297 8811486 9022742 10459873 13347086 50107484 8805942 9183913 9581282 11343453 14549831 53464421 0 0 0 53464421 69049 48881 34248 35551 1841 189570 69049 48881 34248 35551 1841 189570 -39221 -39221 8835770 9232794 9615530 11379004 14551672 53614770 0.99720 0.99550 0.00350 0.00540 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 295 295 0 PART II-B, LINE 1: A PORTION OF THE ORGANIZATION'S ASSOCIATION DUES IS ALLOCATED TO LOBBYING. 5265183 123066 5388249 5396282 58293 -189392 5265183 5335266 102715 -41699 5396282 5264415 49009 21842 5335266 4975201 270686 18528 5264415 1.00000 0 1 1 43647 43647 48593612 4056077 44537535 331626 107914 223712 1384593 751893 632700 1763347 1763347 47200941 DUE FROM AFFILIATES 3617252 DEPOSITS AND OTHER 394732 4011984 DEFERRED ENTRANCE FEES 5501290 DUE TO AFFILIATES 7600943 SWAP OBLIGATIONS 5196585 DEFERRED FINANCING COSTS -714038 17584780 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 14 221250 BOOK REDUCTION TO MONTHLY FEES 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 467293 0 64969 0 0 0 19500 0 6920 0 558682 0 0 RAY FISHER COO 0 254964 0 28200 0 0 0 26000 0 8748 0 317912 0 0 CHRIS MARKWITH CFO 0 226479 0 13650 0 0 0 26000 0 0 0 266129 0 0 JOHN P ROBINSON VP 0 162538 0 32146 0 0 0 19500 0 0 0 214184 0 0 JIM JACOBSEN EXECUTIVE DIRECTOR 156102 0 10558 0 0 0 1408 0 2653 0 170721 0 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 ECONOMIC DEVELOPMENT AUTHORITY OF CULPEPER COUNTY VIRGINIA 383854138 NONEAVAIL 2017-07-26 48112000 TO FUND THE PROJECT COSTS OF THE CULPEPER RENOVATIONS 0 0 0 A 640890 2429479 167290 37438 2224751 1 0 1 1 B 1526395 48112000 958866 43711980 3326625 114529 0 0 0 0 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 1 1 SUNTRUST AND HUNTINGTON NATIONAL 7.000000000000 0 0 0 0 1 A 1 B 1 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 15A 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. THIS PROCESS WAS MOST RECENTLY CONDUCTED IN 2020. . 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 XI, LINE 9: CHANGE IN VALUE OF INTEREST RATE SWAP AGREEMENTS -2,247,471. CHANGE IN PRESENT VALUE OF PERPETUAL TRUSTS 18,967. 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 0 0 1 1 1 0 0 0 0 0 1 0 1 0 0 1 0 0 0 VIRGINIA BAPTIST HOMES INC C 181560 BOOK VIRGINIA BAPTIST HOMES FOUNDATION INC C 702583 BOOK VIRGINIA BAPTIST HOMES INC P 992908 BOOK