2018-11-13T12:28:59-06:00 2017-12-31 410746749 CLIFTONLARSONALLEN LLP 227 WEST TRADE STREET SUITE 800 CHARLOTTE NC 28202 990 2017-01-01 521368412 CULPEPER BAPTIST RETIREMENT COMMUNITY INC CULP 8045219206 3961 STILLMAN PARKWAY GLEN ALLEN VA 23060 JOSEPH KELLEY CFO 8045219206 2018-11-12 1 JOHN NORMAN P01506766 7049985200 2018-11-12 67.137.57.251 2018-11-12 14:32:02 ES P 967DCA4FABF3D6C7AE4D014617AEEE9CE601AE20 625448C0F55D99FA31EEB930CD4AF0F24507C48B 2017 2019-02-21 02:37:17Z THE CULPEPER JONATHAN COOK 3961 STILLMAN PARKWAY GLEN ALLEN VA 23060 9232794 0 X WWW.LIFESPIRELIVING.ORG X 1948 VA TO PROVIDE "DIGNITY IN LIVING" FOR SENIOR ADULTS WHO RESIDE IN THIS PLANNED SERVICES COMMUNITY. 17 17 196 41 0 0 339645 372427 8466297 8811486 69049 48881 -39221 0 8835770 9232794 394992 275117 0 0 5046301 5033509 0 0 0 3576754 3540864 9018047 8849490 -182277 383304 10384240 14961345 19993146 24990274 -9608906 -10028929 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 8244421 275117 8811486 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 $275,117 IN SUBSIDIES AND INDIGENCE ALLOWANCES TO OUR RESIDENTS IN 2017, PERTAINING TO 8 RESIDENTS. 8244421 1 1 0 1 0 0 0 0 0 1 1 1 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 39 0 196 1 0 0 0 0 0 0 0 0 0 0 X 17 17 0 0 0 0 1 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 VA X X JOSEPH KELLEY CFO 8045219206 3961 STILLMAN PARKWAY GLEN ALLEN VA 23060 MR ROBERT L MUSICK JR TRUSTEE 1.00 X 0 0 0 MR LEBRON J HOLDEN TRUSTEE 1.00 X 0 0 0 REV HERBERT O BROWNING TRUSTEE 1.00 X 0 0 0 MR CRAIG R HOPSON ESQ TRUSTEE 1.00 X 0 0 0 MR MICHAEL E KECK TRUSTEE 1.00 X 0 0 0 MR JOHN T KING TRUSTEE 1.00 X 0 0 0 MRS VALERIE CARTER TRUSTEE 1.00 X 0 0 0 MR ARNE W OWENS TRUSTEE 1.00 X 0 0 0 MRS SUSAN C RUCKER CHAIR/TRUSTEE 1.00 X X 0 0 0 MR MATTHEW SCOTT TRUSTEE 1.00 X 0 0 0 MR MICHAEL M SMITH TRUSTEE 1.00 X 0 0 0 MR NED STEPHENSON TRUSTEE 1.00 X 0 0 0 MR JOSEPH M TEEFEY TRUSTEE 1.00 X 0 0 0 MR CHARLES W TYSINGER TRUSTEE 1.00 X 0 0 0 J ROBERT YEAMAN III ESQ SECRETARY/TRUSTEE 1.00 X X 0 0 0 MR SCOTT CAVE VICE CHAIR/TRUSTEE 1.00 X X 0 0 0 REV DAN CARLTON TRUSTEE 1.00 X 0 0 0 JONATHAN COOK PRESIDENT & CEO 1.00 40.00 X 0 298828 18407 MICK FEAUTO COO 1.00 40.00 X 0 201706 48400 JOSEPH KELLEY CFO 1.00 40.00 X 0 178791 31673 JOHN P ROBINSON VP 1.00 40.00 X 0 205850 21386 DAVID BROWNING ASST TREASURER 1.00 40.00 X 0 104685 14795 JIM JACOBSEN EXECUTIVE DIRECTOR 40.00 X 149085 0 30686 149085 989860 165347 6 0 1 0 WM JORDAN COMPANY INC 11010 JEFFERSON AVE NEWPORT NEWS VA 23601 BUILDING CONTRACTOR 1644572 THW DESIGN 2100 RIVEREDGE PARKWAY ATLANTA GA 30328 CONTRACT DESIGNS 471572 REHABCARE GROUP INC CONTRACT THERAPY DIVISION ST LOUIS MO 631503534 THERAPY 455106 SYSCO FOOD SERVICES OF VIRGINIA LLC PO BOX 20020 HARRISONBURG VA 228017520 FOOD VENDOR 452223 GREENBRIER DEVELOPMENT 3232 MCKINNEY AVE SUITE 1160 DALLAS TX 75204 BUILDING CONTRACTOR 236389 6 259966 112461 372427 RESIDENTIAL SERVICES 623000 4852128 4852128 HEALTH CARE SERVICES 623000 3784937 3784937 174421 174421 8811486 48881 48881 9232794 8811486 0 48881 X 275117 275117 179770 179770 4132468 3898060 234408 62657 56027 6630 344204 307787 36417 314410 283278 31132 957875 957875 20592 20592 94601 94601 1519 1519 993943 993943 24144 24144 79830 79830 552327 552327 DIETARY SUPPLIES 522402 522402 PROGRAM SUPPLIES 211259 211259 82372 82372 8849490 8244421 605069 0 4372274 1165711 343569 368824 18094 2488 23099984 11932661 4378778 11167323 749649 783087 539970 1455818 10384240 14961345 739935 2386283 21802 27911 2120674 2057337 7526664 17110735 12992079 19993146 24990274 X -11664429 -12120979 1337124 1340213 718399 751837 -9608906 -10028929 10384240 14961345 X 383304 -803327 X X 0 1 X 1 0 X 315550 580618 412177 339645 372427 2020417 6296546 6542190 7285319 8466297 8811486 37401838 6612096 7122808 7697496 8805942 9183913 39422255 0 881920 226063 1107983 881920 226063 1107983 38314272 68516 55414 62973 69049 48881 304833 68516 55414 62973 69049 48881 304833 -39221 -39221 6680612 7178222 7760469 8835770 9232794 39687867 0.96540 0.95450 0.00770 0.00830 X 0 0 0 0 0 0 0 0 1 246 246 0 PART II-B, LINE 1: A PORTION OF THE ORGANIZATION'S ASSOCIATION FEES IS ALLOCATED TO LOBBYING. 1331892 1331892 1331892 1331892 1335123 3231 1331892 1325853 11000 1730 1335123 1398016 100 72263 1325853 1.00000 0 1 1 43647 43647 9236278 7178256 2058022 4441385 3971242 470143 9378674 783163 8595511 11167323 BENEFICIAL INTEREST IN PERPETUAL TRUST 751837 F OTHER INVESTMENTS 31250 F 783087 DUE FROM AFFILIATES 416395 DEFERRED FINANCING COSTS 1039423 1455818 DEFERRED ENTRANCE FEES 5008556 DUE TO AFFILIATES 7146508 SWAP OBLIGATIONS 837015 12992079 X PART V, LINE 4: THE ENDOWMENTS ARE HELD BY VIRGINIA BAPTIST HOMES FOUNDATION, INC. AND ARE TO BE USED TOWARDS THE CONTINUATION OF RESIDENT SERVICES. 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 8 275117 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 251272 0 38438 0 9118 0 15967 0 2440 0 317235 0 0 MICK FEAUTO COO 0 177116 0 16650 0 7940 0 42000 0 6400 0 250106 0 0 JOSEPH KELLEY CFO 0 153149 0 13952 0 11690 0 23938 0 7735 0 210464 0 0 JOHN P ROBINSON VP 0 143221 0 55097 0 7532 0 18000 0 3386 0 227236 0 0 JIM JACOBSEN EXECUTIVE DIRECTOR 124799 0 17243 0 7043 0 23996 0 6690 0 179771 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 372142 2429479 167290 37438 2224751 1 0 1 1 B 48112000 958866 7526664 39626470 0 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 1 1 SUNTRUST AND HUNTINGTON NATIONAL 8.000000000000 0 0 0 0 1 A 1 B 1 ISSUE A - EXPLANATION OF ISSUE PRICE THE BOND ISSUE WAS MADE TO SUPPORT MULTIPLE TAX-EXEMPT ENTITIES WITHIN THE LIFESPIRE OF VIRGINIA OBLIGATED GROUP. THE AMOUNT OF PROCEEDS REFLECTED IN PART II ONLY REFLECTS THE PORTION OF PROCEEDS ATTRIBUTABLE TO THE REPORTING ENTITY. 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. THIS PROCESS WAS MOST RECENTLY CONDUCTED IN 2017. 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 957,875. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 957,875. FORM 990, PART XI, LINE 9: CHANGE IN PV OF PERPETUAL TRUSTS 33,438. NET ASSETS RELEASED FROM RESTRICTIONS USED FOR OPERATIONS 250. CHANGE IN VALUE OF INTEREST RATE SWAP AGREEMENTS -837,015. FORM 990, PART XII, LINE 2C THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE ORGANIZATION HAS NOT CHANGED ITS OVERSIGHT PROCESS DURING THE TAX YEAR. VIRGINIA BAPTIST HOMES INC PO BOX 191 CULPEPER VA 22701 540534405 SENIOR LIVING MANAGEMENT VA 501(C)(3) LINE 12B, II N/A 0 VIRGINIA BAPTIST HOMES FOUNDATION INC PO BOX 191 CULPEPER VA 22701 521373103 FUND RAISING AND DEVELOPMENT VA 501(C)(3) LINE 12C, III-FI N/A 0 NEWPORT NEWS BAPTIST RETIREMENT COMMUNITY INC PO BOX 191 CULPEPER VA 22701 521368408 SENIOR LIVING COMMUNITY VA 501(C)(3) LINE 11 N/A 0 LAKEWOOD MANOR BAPTIST RETIREMENT COMMUNITY INC PO BOX 191 CULPEPER VA 22701 521368410 SENIOR LIVING COMMUNITY VA 501(C)(3) LINE 11 N/A 0 THE GLEBE INC PO BOX 191 CULPEPER VA 22701 541917966 SENIOR LIVING COMMUNITY VA 501(C)(3) LINE 11 N/A 0 0 0 1 1 1 0 0 0 0 0 1 0 1 0 0 0 1 0 0 VIRGINIA BAPTIST HOMES P 741240 CASH TRANSFERRED VIRGINIA BAPTIST HOMES C 259666 CASH TRANSFERRED VIRGINIA BAPTIST HOMES FOUNDATION C 76082 CASH TRANSFERRED