2019-08-14T11:44:55-05:00 2018-12-31 540737372 PBMARES LLP 558 SOUTH MAIN STREET HARRISONBURG VA 22801 990 2018-01-01 521366700 CULPEPER WELLNESS FOUNDATION INC CULP 5404312397 311 S EAST ST NO 100 CULPEPER VA 22701 SHARI J LANDRY PRESIDENT 5404312397 2019-08-13 1 KEVIN HUMPHRIES P00168667 5404345975 2019-08-13 X 209.10.80.132 2019-08-13 12:37:56 ED P 0CD500D61E63C9BEF9A26F14A66EA0E6F9C673DF 50C539A4451AFBFB1AFF376C49F51610FD3C4593 2018 2019-02-21 02:37:17Z SHARI J LANDRY 311 S EAST ST NO 100 CULPEPER VA 22701 4855188 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. 13 13 133 34 0 0 560571 840169 1910296 2265391 780781 972520 519135 439231 3770783 4517311 197285 565824 0 0 1794005 1962133 0 0 0 1893347 2169835 3884637 4697792 -113854 -180481 35265868 33541124 238354 216005 35027514 33325119 THE MISSION OF CULPEPER WELLNESS FOUNDATION IS TO IMPROVE HEALTH AND PROMOTE WELLNESS IN CULPEPER, MADISON AND ORANGE COUNTIES. 0 0 2728528 2272127 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. 902219 THE FREE CLINIC OF CULPEPER DELIVERS HIGH-QUALITY MEDICAL CARE TO UNINSURED ADULTS IN CULPEPER COUNTY. 565823 565823 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. 4196570 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 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 32 0 133 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 13 13 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 CATHY DALRYMPLE DIRECTOR 2.00 X 0 0 0 RICHARD HARRINGTON CHAIR 4.00 X X 0 0 0 CHARLES BARRELL DIRECTOR 2.00 X 0 0 0 TRIPP BUTLER TREASURER 2.00 X X 0 0 0 SHIRLEY ANN BAYNE DIRECTOR 2.00 X 0 0 0 JAMIE CLANCEY DIRECTOR 2.00 X 0 0 0 LAURA GRIGSBY DIRECTOR 2.00 X 0 0 0 DEBBIE BENNETT DIRECTOR 2.00 X 0 0 0 DAVID JONES VICE CHAIR 2.00 X X 0 0 0 DR THOMAS REYNOLDS MD SECRETARY 2.00 X X 0 0 0 MORT CHILDS MD DIRECTOR 2.00 X 0 0 0 SPENCER DEJARNETTE DIRECTOR 2.00 X 0 0 0 JEFF HETMANSKI DIRECTOR 2.00 X 0 0 0 SHARI J LANDRY PRESIDENT 40.00 X 145029 0 18134 145029 0 18134 1 0 1 0 0 15643 52009 12000 760517 439772 840169 MEMBERSHIP DUES 713940 1777057 1777057 OTHER FEE REVENUE 713940 488334 488334 2265391 434965 434965 700279 253758 446521 446521 446521 543347 0 5792 543347 -5792 537555 537555 20624 52009 34650 -14026 -14026 50413 43677 6736 6736 4517311 2272127 0 1405015 565824 565824 145029 145029 1525740 1525740 31881 25701 6180 138642 130912 7730 120841 111288 9553 1463 188 1275 60291 51765 8526 154777 154777 99937 59015 40922 64786 62909 1877 122806 96202 26604 577649 519841 57808 24437 18519 5918 492781 475045 17736 59970 48306 11664 MEDICAL SUPPLIES AND DR 433106 433106 PROGRAM SUPPLIES 63538 60296 3242 LAUNDRY 9007 9007 DUES & SUBSCRIPTIONS 5287 2906 2381 4697792 4196570 501222 0 550779 564631 2856000 2371000 63357 59397 24492 26284 4267 650 19870495 7842878 12391150 12027617 19311179 18418430 55390 49660 9254 23455 35265868 33541124 193783 179897 18043 10089 26528 26019 238354 216005 X 32171514 30954119 2856000 2371000 35027514 33325119 35265868 33541124 X -180481 -1509873 -12041 X X 0 1 X 1 0 X 861426 218962 398274 541751 808782 2829195 1808690 456652 1880888 1971947 2315804 8433981 2670116 675614 2279162 2513698 3124586 11263176 0 0 0 11263176 1077263 752913 1032751 1140300 1135244 5138471 1077263 752913 1032751 1140300 1135244 5138471 3747379 1428527 3311913 3653998 4259830 16401647 0.68670 0.68570 0.31330 0.31430 X 2796386 37500 145658 90717 2662346 2406784 127500 390095 125993 2796386 2413628 216855 223699 2406784 2399295 28018 13685 2413628 201667 -201667 1.00000 0 0 2378632 2378632 16005286 6842602 9162684 141059 42316 98743 1096986 857551 239435 248532 100409 148123 12027617 ANNUITY PAYABLE 26019 26019 X 4491807 -1509873 1307013 332133 129273 4362534 154777 154777 4517311 6194203 1307013 344175 1651188 4543015 154777 154777 4697792 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, 2018. 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 253,758. FUNDRAISING EVENT EXPENSES 34,650. COST OF GOODS SOLD 43,677. ROUNDING 48. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSE 253,758. FUNDRAISING EXPENSE 34,650. COST OF GOODS SOLD 43,677. LOSS ON UNCOLLECTIBLE PLEDGES 12,041. ROUNDING 49. 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 65698 48896 16802 9158 16802 400 1944 TURKEY TROT 6935 3113 3822 182 6164 72633 52009 20624 9158 16984 400 8108 34650 -14026 1 BOYS AND GIRLS CLUB OF CENTRAL VIRGINIA PO BOX 707 CHARLOTTESVILLE VA 22902 541602004 10000 HEALTH/WELLNESS PROGRAMS IN MADISON AND ORANGE COMMUNITY RESOURCES UNITED TO STOP HEROIN (CRUSH) PO BOX 1355 CULPEPER VA 22701 546001236 5000 SUPPORT FOR HEROIN ADDICTION CULPEPER HOUSING AND SHELTER SERVICES 602 MAIN STREET SUITE 3 CULPEPER VA 22701 541704431 5000 2018 YEAR END UNRESTRICTED GRANT CULPEPER LITERACY COUNCIL 415 S MAIN STREET SUITE 204 CULPEPER VA 22701 541446838 6150 TRAINING TO IMPLEMENT A HEALTH LITERACY PROGRAM CULPEPER MID-DAY LIONS CLUB PO BOX 777 CULPEPER VA 22701 823072719 10000 HEARING AIDE REPLACEMENT AND DISTRIBUTION FRIENDS OF THE CULPEPER COUNTY LIBRARY 271 SUOTHGRATE SHOPPING CENTER CULPEPER VA 22701 541870477 8101 A COLLABORATIVE HEATH AND WELLNESS PROGRAM CALLED LET'S GET HEALTHY GIRLS ON THE RUN PO BOX 245 WARRENTON VA 20186 463737841 5000 A ONE WEEK PRGRAM FOR ELEMENTARY SCHOOL GIRLS LAKE OF THE WOODS FIRE AND RESCUE 104 LAKEVIEW PARKWAY LOCUST GROVE VA 22508 237222171 10000 ACQUISITION OF AUTOMATED CARIOPULMONARY RESUSCITATION DEVICE MANNA MINISTRY 215 S MAIN STREET CULPEPER VA 22701 546044240 12302 KITCHEN UPGRADES AND FUNDS FOR FRESH FRUIT/VEGGIES NORTHERN PIEDMONT COMM FOUNDATION PO BOX 5 CULPEPER VA 22701 311742955 25000 CWF H & W SCHOLARSHIP ORANGE COUNTY FREE CLINIC PO BOX 441 ORANGE VA 22960 251922019 15000 DENTAL VOUCHERS PARTNERSHIPS FOR STRATEGIC IMPACT PO BOX 5211 CHARLOTTESVILLE VA 22905 832802397 31813 ASSESSMENT OF NEEDS AND DESIRES OF YOUTH PATH FOUNDATION 321 WALKER DR SUITE 301 WARRENTON VA 20186 300219424 5000 MENTAL HEALTH TRAINING PAUL STEFAN FOUNDATION OLOG PO BOX 754 LOCUST GROVE VA 22508 205111635 6200 FIRE ESCAPE FOR THE REGIONAL HOUSING AND EDUCATIONAL CENTER PIEDMONT REGIONAL DENTAL CARE PO BOX 151 ORANGE VA 22960 270625764 10000 DENTAL CARE FOR WINTER HEAT SHELTER PROGRAM PARTICIPANTS RAPPU INC PO BOX 181 WASHINGTON VA 22747 474370354 7500 SCHOLARSHIPS FOR CULPEPER AND MADISON STUDENTS APPLYING FOR HEALTHCARE TRAINING COURSES SERVICES TO ABUSED FAMILES PO BOX 402 CULPEPER VA 22701 521227834 5000 2018 YEAR END UNRESTRICTED GRANT SEX DRUGS AND GOD 5409 RIXEYVILLE RD RIXEYVILLE VA 22737 821988558 6000 MOBILE ADDICTION TOWN OF CULPEPER 400 S MAIN STREET SUITE 109 CULPEPER VA 22701 546001234 260000 OBSTACLE COURSE/DASH/BOULDERING WALL CENTER FOR NONPROFIT EXCELLENCE 1701-A ALLIED STRET CHARLOTTESVILLE VA 22903 203412827 8600 WORKSHOPS I AND II 20 0 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 145029 0 0 0 0 0 6180 0 11954 0 163163 0 0 0 JEFF HETMANSKI DIRECTOR 374204 2018 OPPT RENT PAID BY NOVANT HEALTH UVA HEALTH SYSTEM CULPEPER MEDICAL CENTER TO POWELL WELLNESS CENTER 0 CHARLES BARRELL DIRECTOR 374204 2018 OPPT RENT PAID BY NOVANT HEALTH UVA HEALTH SYSTEM CULPEPER MEDICAL CENTER TO POWELL WELLNESS CENTER 0 X 40 439772 FREE CLINIC RECORDS 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 -12,041. 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 -119544 7855385 CWF