2020-06-30T15:07:37-05:00 2019-12-31 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2019-01-01 521305909 WILLIAMSBURG LANDING INC WILL 7575656504 5700 WILLIAMSBURG LANDING DRIVE WILLIAMSBURG VA 23185 GREGORY T STORER PRESIDENT & CEO 7575656504 2020-06-25 1 AMY CIMINELLO P00796388 6148493000 2020-06-25 65.24.98.214 2020-06-25 09:27:46 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 0E91126D0FB3B5231D35CFCADBE487908A76FDB7 2019 2020-09-23 17:36:50Z GREGORY T STORER 5700 WILLIAMSBURG LANDING DRIVE WILLIAMSBURG VA 23185 54381827 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 18 590 217 0 0 0 825241 34052739 37875699 1264998 4607475 0 0 35317737 43308415 190777 167853 0 0 16798893 17747611 0 0 150108 20238734 24312276 37228404 42227740 -1910667 1080675 175740631 181661223 231948655 238393308 -56208024 -56732085 AS AN INNOVATIVE, NONPROFIT, LIFE PLAN COMMUNITY, WILLIAMSBURG LANDING OFFERS A FULL SPECTRUM OF OPPORTUNITIES TO FOSTER INDEPENDENCE, CONNECTION AND SECURITY. 0 0 11241647 0 22487305 INDEPENDENT LIVING:FULL SERVICE ACCREDITED CONTINUING CARE COMMUNITY APPROPRIATE ACTIVITIES AND A HEALTHY LIFESTYLE PROGRAM PROVIDED IN THE 24,000 SQFT DOIG 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. 23825547 0 15012891 HEALTH AND REHABILITATION SERVICES AT WILLIAMSBURG LANDING ENCOMPASSES ALL HIGHER LEVEL 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 AND A COMPREHENSIVE PROGRAM FOR RESIDENTS WITH MEMORY ISSUES ARE ALSO PROVIDED BY THE STAFF OF HEALTH AND REHABILITATION CENTER. MEMORY SUPPORT IS FOR THOSE WITH MORE ADVANCED MEMORY ISSUES. 167853 167853 375503 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 3.04 MILLION 35235047 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 1 1 0 0 0 1 96 0 1 590 1 0 0 0 0 0 0 0 0 0 0 0 0 X 18 18 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 VA X JUANITA M PARKS CFO 7575656511 5700 WILLIAMSBURG LANDING DRIVE WILLIAMSBURG VA 23185 VIRGINIA MCLAUGHIN DIRECTOR 3.00 0.10 X 0 0 0 ROBERT SINGLEY CHAIR 3.00 0.10 X X 0 0 0 ALFRED WOODS TREASURER AND CHAIR OF FINANCE 3.00 0.10 X X 0 0 0 ALLISON BRODY VICE CHAIR AND GOVERNANCE CHAIR 3.00 0.10 X X 0 0 0 TED JURASCHEK CHAIR OF HEALTH AND WELLNESS 3.00 0.10 X 0 0 0 TRACEY DOWLING CHAIR OF AUDIT RISK AND COMP (THROUGH 06/2019) 3.00 0.10 X 0 0 0 RICHARD COSTELLO CHAIR OF PLANT OPERATIONS 3.00 0.10 X 0 0 0 JAMES EASTON CHAIR OF MARKETING 3.00 0.10 X 0 0 0 DR CARLANE PITTMAN DIRECTOR 3.00 0.10 X 0 0 0 DAVE MASTERSON DIRECTOR (THROUGH 06/2019) 3.00 0.10 X 0 0 0 LOUISE CANFIELD CHAIR OF DEVELOPMENT 3.00 0.10 X 0 0 0 ED SCHUMACHER DIRECTOR 3.00 0.10 X 0 0 0 LARRY FOSTER CHAIR OF EXECUTIVE COMP 3.00 0.10 X 0 0 0 JOHN SADLER ESQ DIRECTOR 3.00 0.10 X 0 0 0 JEANNE ZEIDLER DIRECTOR (BEGAN 06/2019) 3.00 0.10 X 0 0 0 ELIZABETH DAVIS DIRECTOR (BEGAN 06/2019) 3.00 0.10 X 0 0 0 LINDA TAYLOR-STALLINGS DIRECTOR 3.00 0.10 X 0 0 0 MICHAEL FOX DIRECTOR 3.00 0.10 X 0 0 0 WILLIAM KAUFMANN DIRECTOR 3.00 0.10 X 0 0 0 TIMOTHY WRIGHT DIRECTOR (BEGAN 06/2019) 3.00 0.10 X 0 0 0 PRESSLY MCCANCE JR DIRECTOR (THROUGH 06/2019) 3.00 0.10 X 0 0 0 PAUL GERHARDT SECRETARY 3.00 0.10 X 0 0 0 GREGORY STORER PRESIDENT AND CEO 54.00 1.00 X 260792 0 24120 VERNON BAKER COO 54.00 1.00 X 200724 0 15716 CHESTER TELLIS CFO (THROUGH 11/2019) 54.00 1.00 X 149413 0 20242 JUANITA PARKS CFO (BEGAN 12/2019) 54.00 1.00 X 108994 0 4332 VONNIE ADAMS ASSISTED LIVING ADMINISTRATOR 55.00 0.00 X 111863 0 11622 NANCY BARCHITE SENIOR DIRECTOR OF INDEPENDENT LIVING HEALTH SERVI 55.00 0.00 X 110774 0 19108 NATHAN YOWELL HEALTH CARE ADMINISTRATOR 55.00 0.00 X 109649 0 13475 BRANDY DAY CHIEF TALENT OFFICER 55.00 0.00 X 120574 0 27606 KEVIN KOLDA DIRECTOR OF FACILITIES (THROUGH 11/2019) 55.00 0.00 X 120064 0 17897 1292847 0 154118 10 0 1 0 HENDERSON INC PO BOX BM WILLIAMSBURG VA 23187 CONSTRUCTION 2066564 SODEXO 10 EARHART DRIVE WILLIAMSVILLE NY 14221 DINING SERVICES 1849335 MORRISON MANAGEMENT SPECIALIST 2400 YORKMONT ROAD CHARLOTTE NC 28217 DINING SERVICES 1345536 HEALTH PRO HERITAGE LLC 536 OLD HOWELL RD GREENVILLE NC 29615 CONSULTING/THERAPY 989523 WARRICK MECHANICAL PO BOX 1367 NEWPORT NEWS VA 23601 CONSTRUCTION 468772 30 797836 27405 825241 RESIDENTIAL SERVICES 623000 27101775 27101775 HEALTH CARE SERVICES 623000 9117137 9117137 ADULT DAY REVENUE 623000 270433 270433 TELEPHONE AND CABLE SERVICES 623000 195700 195700 MEALS AND CATERING 623000 195177 195177 995477 995477 37875699 406034 406034 15271463 3390 11068131 5281 4203332 -1891 4201441 4201441 43308415 37875699 0 4607475 X 167853 167853 784332 196083 588249 12304567 10966885 1265070 72612 3598099 3133242 440384 24473 1060613 912553 142285 5775 236793 4084 232709 69900 3350 66550 3787348 2691945 1067713 27690 194328 5957 175707 12664 9767 6902 2865 2170025 2058151 111874 159287 87411 71698 178 3764337 3199686 564651 8383755 7126192 1257563 392674 333773 58901 DIETARY COSTS 1900537 1891197 9340 SUPPLIES 1059143 943332 115173 638 REPAIRS 560305 558200 2105 VEHICLE EXPENSES 107375 107375 1516702 840876 669748 6078 42227740 35235047 6842585 150108 1847991 4431196 605450 605450 712621 814156 888990 217782 225188 237107 370251 470076 219817151 83339746 139332220 136477405 13413829 19281424 18184291 18959627 159800 167000 175740631 181661223 5677395 9746965 104703814 104199696 106568804 108002959 14998642 16443688 231948655 238393308 X -57887859 -58810565 1679835 2078480 -56208024 -56732085 175740631 181661223 X 1080675 -2273468 668732 X X 0 1 X 1 0 X 263337 435391 453161 825241 1977130 28656557 29463338 30713095 34052739 37875699 160761428 28919894 29898729 31166256 34052739 38700940 162738558 0 0 0 162738558 429987 494173 2609937 461436 406034 4401567 429987 494173 2609937 461436 406034 4401567 29349881 30392902 33776193 34514175 39106974 167140125 0.97370 0.94300 0.02630 0.02860 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 7114165 7114165 159835927 54816692 105019235 34758365 19452717 15305648 18108694 9070337 9038357 136477405 ASSETS LIMITED AS TO USE 19281424 F 19281424 INVESTMENT 18959627 F 18959627 DEPOSITS 10155279 REFUNDABLE ADVANCE FEES 5400000 OTHER 888409 16443688 X PART X, LINE 2: WILLIAMSBURG LANDING, INC. IS A NOT-FOR-PROFIT CORPORATION AND IS EXEMPT FROM TAX UNDER THE PROVISIONS OF INTERNAL REVENUE CODE SECTION 501(C)(3). ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ENTITY AND RECOGNIZE A TAX LIABILITY IF THE ENTITY HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE ENTITY AND HAS CONCLUDED THAT, AS OF DECEMBER 31, 2019 AND 2018, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. BIRCHWOOD AND WILLIAMSBURG LANDING HOME HEALTH ARE SINGLE-MEMBER LIMITED LIABILITY COMPANIES SOLELY OWNED BY WILLIAMSBURG LANDING, INC. AS SUCH, THEY ARE CONSIDERED DISREGARDED ENTITIES FOR TAX PURPOSES. 1 BENEVOLENCE - PATIENT ASSISTANCE 4 137651 EDUCATION FUND 27 30202 PART I, LINE 2: GRANTS SUPPORT RESIDENTS OR EMPLOYEES THAT DEMONSTRATE NEED, AS WELL AS CERTAIN CHARITABLE ORGANIZATIONS IN THE LOCAL COMMUNITY. X X X X 1 0 0 0 0 0 0 1 0 GREGORY STORER PRESIDENT AND CEO 239135 0 21657 0 0 0 7823 0 16297 0 284912 0 0 0 VERNON BAKER COO 191861 0 8863 0 0 0 6021 0 9695 0 216440 0 0 0 CHESTER TELLIS CFO (THROUGH 11/2019) 131156 0 7580 0 10677 0 7204 0 13038 0 169655 0 0 0 PART I, LINE 7 EXECUTIVES OF WILLIAMSBURG LANDING ARE ELIGIBLE FOR A YEARLY BONUS. THE BONUS IS REVIEWED AND APPROVED BY THE BOARD EACH YEAR AND THE EXECUTIVES MUST ACCOMPLISH A LIST OF PRE-DETERMINED GOALS IN ORDER TO RECEIVE A PAYOUT. PART 1 LINE 4A CHESTER TELLIS RECEIVED $10,677 IN SEVERANCE PAYMENTS DURING THE 2019 CALENDAR YEAR. 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 2007-12-12 5515000 REFUND 2003 B BONDS 0 0 0 C IDA MATHEWS COUNTY VA 546001417 999999999 2011-12-15 10000000 REFINANCE RENOVATIONS TO FACILITIES 0 0 0 D IDA OF ESSEX COUNTY (SERIES 2012B) 542033575 2012-12-19 3300000 REFINANCE/REFUND 2003 BONDS 0 0 0 A 8045000 9000000 2008 1 0 1 1 B 5515000 110300 2439 5404700 2008 1 0 1 1 C 9300000 100011 9899989 2013 0 0 1 1 D 1362500 35453 3264546 2013 1 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 1 0 0 0 0 0 B 1 0 0 0 0 0 C 0 1 0 0 1 0 0 0 0 D 0 1 1 0 0 0 0 0 0 A 1 B 1 C 1 D 1 A EDA OF THE CITY OF WILLIAMSBURG VA (SERIES 2012C) 541696911 2012-12-19 4820000 REFINANCE/REFUND 2003 BONDS 0 0 0 B EDA OF GLOUCESTER COUNTY VA (SERIES 2012D) 541189758 2012-12-19 10000000 REFINANCE/REFUND 2003 BONDS 0 0 0 C IDA OF MATHEWS COUNTY VA (SERIES 2012) 546001417 2012-01-26 7500000 REFINANCE RENOVATIONS TO FACILITIES 0 0 0 D IDA MATHEWS COUNTY VA 546001417 2013-01-10 9780000 REFINANCE/REFUND 2003 BONDS 0 0 0 A 4820000 75883 4744117 2013 1 0 1 1 B 7668011 153225 9846775 2013 1 0 1 1 C 6980000 60000 7440000 2013 0 0 1 1 D 9780000 138365 9641635 2013 1 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 1 0 0 0 0 0 0 B 0 1 1 0 0 0 0 0 0 C 0 1 0 0 1 0 0 0 0 D 0 1 1 0 0 0 0 0 0 A 1 B 1 C 1 D 1 A EDA JAMES CITY COUNTY 541139263 2013-01-10 3680000 REVENUE BOND 0 0 0 B IDA MATHEWS COUNTY VA 546001417 2015-06-04 10000000 REVENUE AND REFUNDING BOND 0 0 0 C IDA NORTHHAMPTON COUNTY 521298458 2015-06-04 10000000 REVENUE AND REFUNDING BOND 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 3680000 64965 3615035 2013 0 0 1 1 B 9949603 142500 1346012 8511488 1 0 0 1 C 9949603 142500 1346012 8511488 0 0 0 1 D 10000000 193564 9806436 0 0 0 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 1 0 0 0 0 0 0 B 1 0 0 0 0 0 C 1 0 0 0 0 0 D 0 1 0 0 1 0 0 0 0 A 1 B 1 C 1 D 1 A EDA OF LANCASTER COUNTY VA 800232104 2016-10-18 10000000 CONSTRUCTION OF MEMORY CARE, ASST. LIVING, AND REHAB UNITS 0 0 0 B EDA OF THE CITY OF WILLIAMSBURG VA 541696911 2016-10-18 10000000 CONSTRUCTION OF MEMORY CARE, ASST. LIVING, AND REHAB UNITS 0 0 0 C EDA OF NORTHHAMPTON 521298458 2016-10-18 8758630 CONSTRUCTION OF MEMORY CARE, ASST. LIVING, AND REHAB UNITS 0 0 0 A 10000000 165497 9834503 0 0 0 1 B 10000000 186747 9813523 0 0 0 1 C 8758630 131815 8626815 0 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 0 1 0 0 0 0 B 0 0 0 1 1 0 0 0 0 C 0 0 0 0 1 0 0 1 A 1 B 1 C 1 FORM 990, PART VI, SECTION B, LINE 11B THE AUDIT, RISK, AND COMPLIANCE COMMITTEE COMPOSED OF BOARD MEMBERS WILL REVIEW THE 990 BEFORE IT IS FILED WITH THE IRS. THE COMMITTEE 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. BOARD MEMBERS ARE REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICT OF INTERESTS ONCE PERSONALLY IDENTIFIED. DURING EACH COMMITTEE MEETING, BOARD MEMBERS ARE DIRECTLY ASKED ABOUT ANY POTENTIAL CONFLICTS OF INTERESTS. IF CONFLICT OCCURS, IT MUST BE DISCLOSED AND THE INDIVIDUAL IS EXCUSED FROM VOTING. FORM 990, PART VI, SECTION B, LINE 15 A REVIEW WAS PERFORMED FOR THE CEO, COO, CFO, CHIEF TALENT OFFICER, CHIEF MARKETING OFFICER, AND SENIOR DIRECTORS OF COMMUNITY SERVICES AND DEVELOPMENT IN 2019. THE REVIEW IS COMPLETED BY AN INDEPENDENT CONSULTANT AND INCLUDES USE OF A COMPENSATION SURVEY REVIEW AND COMPARABILITY DATA. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS ARE DISTRIBUTED QUARTERLY TO THE BOARD OF DIRECTORS, THE RESIDENTS' FINANCE COMMITTEE, AND THE ENTIRE RESIDENT BODY AT RESIDENTS' ASSOCIATIONS MEETINGS. GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICIES ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX (D) FUNDRAISING EFFORTS ARE FOCUSED ON RESTRICTED CONTRIBUTIONS. FORM 990, PART XI, LINE 9: CHANGE IN FAIR MARKET VALUE OF INTEREST RATE SWAP AGREEMENTS -784,887. CHANGE IN VALUE OF CHARITABLE GIFT ANNUITIES 48,662. WITHDRAW OF QUARTERLY PAYMENTS FOR CHARITABLE GIFT ANNUITIES -40,556. INTEREST INCOME 7,720. NET ASSETS RELEASED FROM RESTRICTIONS FOR OPERATING PURPOSES -216,979. RESTRICTED CASH 367,408. WILLIAMSBURG LANDING CONTINUING CARE TRUST ACTIVITY 1,287,364. PART XII, LINE 2C NO CHANGE FROM PRIOR YEAR. BIRCHWOOD LAND LLC 5700 WILLIAMSBURG LANDING DRIVE WILLIAMSBURG VA 23185 521305909 HOLD LAND AND BUILDINGS VA 5277 618983 WILLIAMSBURG LANDING INC WILLIAMSBURG LANDING LLC 5700 WILLIAMSBURG LANDING DRIVE WILLIAMSBURG VA 23185 473819400 HOME HEALTH CARE SERVICES VA -80876 776641 WILLIAMSBURG LANDING INC WILLIAMSBURG LANDING CONTINUING CARE TRUST 5700 WILLIAMSBURG LANDING DRIVE WILLIAMSBURG VA 23185 546433122 TRUST FOR RESIDENT FINANCIAL SECURITY VA 501(C)(3) 509(A)(3) N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0