2020-11-04T15:05:12-06:00 2019-12-31 540737372 PBMARES LLP 558 SOUTH MAIN STREET HARRISONBURG VA 22801 990 2019-01-01 521366700 CULPEPER WELLNESS FOUNDATION INC CULP 5404312397 311 S EAST ST NO 100 CULPEPER VA 22701 SHARI J LANDRY PRESIDENT 5404312397 2020-11-02 1 EDWARD T YODER P00239134 5404345975 2020-11-02 X 209.10.80.132 2020-11-02 10:31:38 ES P 89D56321E5BD240AE65E23F242A0E0C3A1AA6112 140AAC1571E0BACDA7217E895E30099BE04199AE 2019 2021-01-29 14:40:06Z SHARI J LANDRY 311 S EAST ST NO 100 CULPEPER VA 22701 9332085 0 X WWW.CULPEPERWELLNESSFOUNDATION.ORG X 1985 VA THE MISSION OF CULPEPER WELLNESS FOUNDATION IS TO IMPROVE HEALTH AND PROMOTE WELLNESS IN CULPEPER, MADISON AND ORANGE COUNTIES. 14 14 128 50 0 0 840169 1088721 2265391 2416301 972520 1836613 439231 381605 4517311 5723240 565824 1092077 0 0 1962133 2005088 0 0 10168 2169835 2489771 4697792 5586936 -180481 136304 33541124 36868842 216005 267344 33325119 36601498 THE MISSION OF CULPEPER WELLNESS FOUNDATION IS TO IMPROVE HEALTH AND PROMOTE WELLNESS IN CULPEPER, MADISON AND ORANGE COUNTIES. 0 0 2995066 65320 2415850 THE POWELL WELLNESS CENTER HELPS INDIVIDUALS ACHIEVE PHYSICAL AND EMOTIONAL WELL-BEING THROUGH EXERCISE, PHYSICAL ACTIVITY, AND MEDICALLY INTEGRATED SERVICES. CULPEPER SPORT AND FITNESS HELPS INDIVIDUALS - WITH AN EMPHASIS ON YOUTH - IMPROVE THEIR HEALTH AND WELLNESS THROUGH PARTICIPATION IN FITNESS PROGRAMS AND ACTIVITIES. 1137636 68356 THE FREE CLINIC OF CULPEPER DELIVERS HIGH-QUALITY MEDICAL CARE TO UNINSURED ADULTS IN CULPEPER COUNTY. 958401 958401 THE FOUNDATION SEEKS TO IMPROVE HEATH AND PROMOTE WELLNESS THROUGH LOCAL COLLABORATIONS AND HEALTH-RELATED INITIATIVES AS WELL AS THROUGH GRANTS TO LOCAL NONPROFITS WORKING IN SUPPORT OF ITS MISSION. 5091103 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 1 27 0 1 128 1 0 0 0 0 0 1 1 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 0 0 X DEBRA DODSON 5404455412 311 S EAST STREET SUITE 100 CULPEPER VA 22701 DAVID JONES CHAIR 4.00 X X 0 0 0 TRIPP BUTLER VICE CHAIR 2.00 X X 0 0 0 DEBBIE BENNETT TREASURER 2.00 X X 0 0 0 LAURA GRIGSBY SECRETARY 2.00 X X 0 0 0 CHARLES BARRELL DIRECTOR 2.00 X 0 0 0 SHIRLEY ANN BAYNE DIRECTOR 2.00 X 0 0 0 KELSEY CARLSON SETTLE DIRECTOR 2.00 X 0 0 0 MORT CHILDS MD DIRECTOR 2.00 X 0 0 0 CATHY DALRYMPLE DIRECTOR 2.00 X 0 0 0 SPENCER DEJARNETTE DIRECTOR 2.00 X 0 0 0 RICHARD HARRINGTON DIRECTOR 2.00 X 0 0 0 JEFF HETMANSKI DIRECTOR 2.00 X 0 0 0 DR THOMAS REYNOLDS MD DIRECTOR 2.00 X 0 0 0 ED SCOTT DIRECTOR 2.00 X 0 0 0 SHARI J LANDRY PRESIDENT 40.00 X 152672 0 18861 152672 0 18861 1 0 1 0 0 64634 12000 1012087 557182 1088721 MEMBERSHIP DUES 713940 1900468 1900468 OTHER FEE REVENUE 713940 515833 515833 2416301 484563 484563 620072 213191 406881 406881 406881 3281415 1374308 2905212 398461 376203 975847 1352050 1352050 22605 64634 37152 -14547 -14547 44100 54829 -10729 -10729 5723240 2405572 0 2228947 1092077 1092077 171533 171533 1565928 1565928 16695 16695 125054 125054 125878 116251 9627 3184 625 2559 60906 52293 8613 161359 161359 87405 58953 28452 42265 27708 4389 10168 235573 223444 12129 693193 633236 59957 22442 19929 2513 502372 488424 13948 58739 50833 7906 MEDICAL SUPPLIES AND DR 553894 553894 PROGRAM SUPPLIES 53348 53348 DUES & SUBSCRIPTIONS 7817 5137 2680 LAUNDRY 7274 7274 5586936 5091103 485665 10168 564631 343332 2371000 1956000 59397 88945 26284 20549 650 60182 18023848 7393470 12027617 10630378 18418430 23717668 49660 43930 23455 7858 33541124 36868842 179897 227634 10089 14398 26019 25312 216005 267344 X 30954119 34645498 2371000 1956000 33325119 36601498 33541124 36868842 X 136304 3150678 -10603 X X 0 1 X 1 0 X 218962 398274 541751 808782 1084712 3052481 456652 1880888 1971947 2315804 2459949 9085240 675614 2279162 2513698 3124586 3544661 12137721 0 0 0 12137721 752913 1032751 1140300 1135244 1104635 5165843 752913 1032751 1140300 1135244 1104635 5165843 1428527 3311913 3653998 4259830 4649296 17303564 0.70150 0.68670 0.29850 0.31330 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2662346 232000 615672 3510018 2796386 37500 145658 90717 2662346 2406784 127500 390095 125993 2796386 2413628 216855 223699 2406784 2399295 28018 13685 2413628 1.00000 0 0 1979272 1979272 14781668 6495474 8286194 141059 72344 68715 914226 717903 196323 207623 107749 99874 10630378 ANNUITY PAYABLE 25312 25312 X 10852565 3150678 1834834 305172 5290684 5561881 161359 161359 5723240 7576186 1834834 315775 2150609 5425577 161359 161359 5586936 PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER CODE SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE). IN ADDITION, CWF QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A) OF THE CODE AND HAS BEEN CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE ORGANIZATION UNDER CODE SECTION 509(A)(2). PWC IS A LIMITED LIABILITY COMPANY THAT HAS NOT ELECTED TO BE TAXED AS A CORPORATION UNDER CURRENT INTERNAL REVENUE SERVICE REGULATIONS. AS SUCH, PWC IS A DISREGARDED ENTITY FOR FEDERAL INCOME TAX PURPOSES AND DOES NOT HAVE TO FILE AN ANNUAL FEDERAL RETURN. RATHER, ITS TAX RESULTS ARE REFLECTED ON THE ANNUAL TAX FILINGS OF ITS MEMBER AS IF THE ACTIVITIES OF PWC WERE ACTIVITIES OF THE MEMBER. PRIOR TO OCTOBER 1, 2014, THE ORGANIZATION WAS CLASSIFIED AS A FUNCTIONALLY RELATED SUPPORTING ORGANIZATION OF CULPEPER REGIONAL HOSPITAL. DURING 2014, THE ORGANIZATION'S INTEREST IN THE HOSPITAL WAS ACQUIRED BY ANOTHER HOSPITAL SYSTEM. THE ORGANIZATION HAS SINCE TRANSITIONED TO SERVE A GREATER PUBLIC INTEREST AND RECEIVED A CHANGE IN EXEMPT CLASSIFICATION WITH THE INTERNAL REVENUE SERVICE TO ACCOMMODATE ITS CHANGE IN MISSION. MANAGEMENT EVALUATED THE ORGANIZATION'S TAX POSITIONS AND DETERMINED THAT THE ORGANIZATION HAS NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS AT DECEMBER 31, 2019. THE ORGANIZATION FILES FORM 990, RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX, ANNUALLY WITH THE UNITED STATES DEPARTMENT OF THE TREASURY. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 213,191. FUNDRAISING EVENT EXPENSES 37,152. COST OF GOODS SOLD 54,829. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSE 213,191. FUNDRAISING EXPENSE 37,152. COST OF GOODS SOLD 54,829. LOSS ON UNCOLLECTIBLE PLEDGES 10,603. SCHEDULE D, PART V, LINE 4 QUASI-ENDOWMENT FUNDS ARE INTENDED TO PROVIDE INCOME TO SUPPLEMENT GRANTS AWARDED AND OTHER GENERAL FOUNDATION OPERATIONS. OYSTER FEST 75690 56920 18770 6850 18770 600 1746 TURKEY TROT 11549 7714 3835 426 2385 144 6231 87239 64634 22605 426 9235 18914 600 7977 37152 -14547 1 AGING TOGETHER CORPORATION PO BOX 367 CULPEPER VA 22701 462046459 10000 TRANSPORTATION FOR ELDERLY ADULTS. BOYS AND GIRLS CLUB OF CENTRAL VIRGINIA PO BOX 707 CHARLOTTESVILLE VA 22902 541602004 10000 HEALTH/WELLNESS PROGRAMS IN MADISON AND ORANGE CULPEPER COUNTY HIGH SCHOOL CYCLING CLUB 14240 ACHIEVEMENT DRIVE CULPEPER VA 22701 546001238 7500 GENERAL SUPPORT CULPEPER COUNTY PUBLIC SCHOOLS 450 RADIO LANE CULPEPER VA 22701 546001238 25000 2020 YOUTH RISK BEHAVIOR SURVEY CULPEPER HOUSING AND SHELTER SERVICES 602 MAIN STREET SUITE 3 CULPEPER VA 22701 541463631 5000 SHELTER FOR HOMELESS CULPEPER MID-DAY LIONS CLUB PO BOX 777 CULPEPER VA 22701 823072719 10000 DIABETES SCREENING AND EDUCATION FRIENDS OF THE CULPEPER COUNTY LIBRARY 271 SUOTHGRATE SHOPPING CENTER CULPEPER VA 22701 541870477 10000 EMERGENCY ASSISTANCE FOR RE-ENTRY PERSONS HERO'S BRIDGE 5150 PARK LAKE DRIVE MIDLAND VA 22728 812827604 10000 BATTLE BUDDY COMMUNITY HEALTH WORKER LAKE OF THE WOODS FIRE AND RESCUE 104 LAKEVIEW PARKWAY LOCUST GROVE VA 22508 237222171 10000 ACQUISITION OF HEAVY RESCUE RESPONSE EQUIPMENT MADISON EMERGENCY SERVICES ASSOC 927 ORANGE ROAD MADISON VA 22727 541226851 5000 FOOD PANTRY AND EMERGENCY SUPPORT NORTHERN PIEDMONT COMM FOUNDATION PO BOX 5 CULPEPER VA 22701 311742955 25000 CWF H & W SCHOLARSHIP NOVANT HEALTH UVA HEALTH SYSTEMS CULPEPER MEDICAL CENTER 501 SUNSET LANE CULPEPER VA 22701 540622371 15000 GENERAL SUPPORT ORANGE COUNTY FREE CLINIC PO BOX 441 ORANGE VA 22960 251922019 15000 DENTAL VOUCHERS AND SERVICES PARTNERSHIPS FOR STRATEGIC IMPACT PO BOX 5211 CHARLOTTESVILLE VA 22905 832802397 9297 ASSESSMENT OF NEEDS AND DESIRES OF YOUTH PIEDMONT REGIONAL DENTAL CARE 13296 JAMES MADISON HWY ORANGE VA 22960 270625764 10000 DENTAL CARE FOR WINTER HEAT SHELTER PROGRAM PARTICIPANTS RAPPAHANNOCK RAPIDAN COMM SERVICES PO BOX 1568 CULPEPER VA 22701 237238218 100000 TO ESTABLISH OXFORD HOUSE - CULPEPER. RAPPU INC PO BOX 35 SPERRYVILLE VA 22740 474370354 10000 SCHOLARSHIPS FOR CULPEPER AND MADISON STUDENTS APPLYING FOR HEALTHCARE TRAINING COURSES REVA VOLUNTEER FIRE & RESCUE 18230 BIRMINGHAM ROAD CULPEPER VA 22701 541771287 7809 ACQUISITION OF EQUIPMENT TO ASSIST WITH HANDLING OF BARIATRIC PATIENTS. SERVICES TO ABUSED FAMILES PO BOX 402 CULPEPER VA 22701 521227834 15000 ASSIST WITH RENOVATION OF DONATED HOMES. GENERAL SHELTER AND SUPPORT FOR VICTIMS OF DOMESTIC VIOLENCE AND SEXUAL ASSAULT. SEX DRUGS AND GOD 15191 MONTANUS DR 139 CULPEPER VA 22701 821988558 7500 MOBILE ADDICTION TO CONNECT RECOVERY SEEKING INDIVIDUALS SKYLINE CAP INC PO BOX 588 MADISON VA 22727 541570712 5000 UTILITY ASSISTANCE ST LUKE EVANGELICAL LUTHERAN CHURCH PO BOX 1262 CULPEPER VA 22701 541704431 10000 DENTURES AND PARTIALS FOR HOMELESS INDIVIDUALS; CWHS CASE WORKER THE SALVATION ARMY 133 E CULPEPER STREET CULPEPER VA 22701 580660607 5000 UTILITY ASSISTANCE VA CONSORTIUM FOR HEALTHCARE PHIL 4801 COURTHOUSE ST STE 200 WILLIAMSBURG VA 23188 541822359 10000 ADULT MEDICAID DENTAL ADVOCACY PROJECT COMMUNITY HEALTH SOLUTIONS 4200 INNSLAKE STE 103 GLEN ALLEN VA 23060 542031229 10000 PLANNING DIST. 9 COMMUNITY HEALTH NEEDS. TOWN OF CULPEPER POLICE DEPARTMENT 740 OLD BRANDY DRIVE CULPEPER VA 22701 546001234 8000 PEER SUPPORT PROGRAM POSTPARTUM SUPPORT VIRGINIA PO BOX 7521 ARLINGTON VA 22207 263029233 10000 GENERAL SUPPORT CULPEPER HUMAN SERVICES PO BOX 1355 CULPEPER VA 22701 546001236 8000 EMERGENCY SUPPORT FOR ELDERLY, CHILDREN'S PLAYGROUND; PIEDMONT CRUSH 28 PART I, LINE 2: THE ORGANIZATION MAINTAINS CLEAR CRITERIA FOR THE HEALTHY LIVING GRANT PROGRAM AND STRATEGIC GRANTS ARE MADE ONLY BY BOARD APPROVAL. THE ORGANIZATION MANDATES THAT FUNDS AWARDED MUST BE USED WITHIN 90 DAYS OF BEING GRANTED AND STAYS IN CLOSE COMMUNICATION WITH GRANTEES TO MONITOR THEIR USE. GRANTEES MUST PROVIDE A FINAL ACCOUNTING ON THE USE OF FUNDS, INCLUDING THE POPULATION SERVED AND HEALTH IMPACT. REPORTS MUST BE COMPLETED WITHIN 30 DAYS OF PROJECT COMPLETION. X 1 0 0 0 0 0 0 0 0 0 0 SHARI J LANDRY PRESIDENT 152672 0 0 0 0 0 6358 0 12503 0 171533 0 0 0 JEFF HETMANSKI DIRECTOR 518648 THE DIRECTOR IS AN EMPLOYEE OF NOVANT HEALTH UVA HEALTH SYSTEM CULPEPER MEDICAL CENTER WHICH PAYS RENT TO POWELL WELLNESS CENTER AND CULPEPER WELLNESS FOUNDATION. 0 CHARLES BARRELL DIRECTOR 518648 THE DIRECTOR IS A VOTING MEMBER OF NOVANT HEALTH UVA HEALTH SYSTEM CULPEPER MEDICAL CENTER WHICH PAYS RENT TO POWELL WELLNESS CENTER AND CULPEPER WELLNESS FOUNDATION. 0 RICHARD HARRINGTON DIRECTOR 518648 THE DIRECTOR IS A NON-VOTING MEMBER OF NOVANT HEALTH UVA HEALTH SYSTEM CULPEPER MEDICAL CENTER WHICH PAYS RENT TO POWELL WELLNESS CENTER AND CULPEPER WELLNESS FOUNDATION. 0 DR THOMAS REYNOLDS DIRECTOR 518648 THE DIRECTOR IS A VOTING MEMBER OF NOVANT HEALTH UVA HEALTH SYSTEM CULPEPER MEDICAL CENTER WHICH PAYS RENT TO POWELL WELLNESS CENTER AND CULPEPER WELLNESS FOUNDATION. 0 X 1657 557182 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM, REVIEWED BY THE CHIEF EXECUTIVE OFFICER AND MADE AVAILABLE TO THE BOARD MEMBERS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO AFFIRM THEIR COMMITMENT TO UPHOLD THE CONFLICT OF INTEREST POLICY ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD WILL REVIEW AND DETERMINE ANNUALLY COMPENSATION OF OFFICERS OR KEY EMPLOYEES. FOR THIS REPORTING PERIOD, COMPENSATION WAS DETERMINED BY BOARD APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: LOSS ON UNCOLLECTED PLEDGES -10,603. FORM 990, PART XII, LINE 2C THE ORGANIZATION HAS NOT CHANGED ITS PROCESS FOR THE SELECTION AND OVERSIGHT OF AN INDEPENDENT ACCOUNTANT. POWELL WELLNESS CENTER 1005 GOLF DRIVE CULPEPER VA 22701 204803079 WELLNESS CENTER VA -601587 7061963 CWF