2013-08-14T10:29:11-05:00 2012-12-31 410746749 CLIFTONLARSONALLEN LLP 101 N TRYON STREET SUITE 1000 CHARLOTTE NC 28246 990 2012-01-01 521368412 CULPEPER BAPTIST RETIREMENT COMMUNITY INC CULP 5408251569 PO BOX 191 CULPEPER VA 22701 DR RANDALL ROBINSON 5408251569 2013-08-12 1 JOHN NORMAN P01506766 7049985200 2012 2016-02-24 21:20:13Z RANDALL ROBINSON PO BOX 191 CULPEPER VA 22701 7713676 0 X WWW.VBH.ORG X 1948 VA TO PROVIDE "DIGNITY IN LIVING" FOR SENIOR ADULTS WHO RESIDE IN THIS PLANNED SERVICES COMMUNITY. 12 12 185 60 0 0 393911 1366569 6862509 6289654 76863 62685 28407 -5232 7361690 7713676 307800 271810 0 0 4214268 4350228 0 0 0 3031556 2779787 7553624 7401825 -191934 311851 4766883 6294932 10580545 11720229 -5813662 -5425297 TO PROVIDE "DIGNITY IN LIVING" FOR SENIOR ADULTS WHO RESIDE IN THIS PLANNED SERVICES COMMUNITY, SOME OF WHOM CANNOT AFFORD TO PAY THE FULL COST OF THEIR CARE. 0 0 6779066 271810 6289654 WE WERE ABLE TO PROVIDE BOTH RESIDENTIAL AND HEALTH CARE SERVICES TO OUR RESIDENTS, SOME OF WHOM ARE UNABLE TO COVER THE FULL COST OF THEIR CARE. WE PROVIDED $271,810 IN SUBSIDIES AND INDIGENCE ALLOWANCES TO OUR RESIDENTS IN 2012, PERTAINING TO 18 RESIDENTS. 6779066 1 1 0 1 0 0 0 0 0 0 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 29 0 1 185 1 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 VA X X JOSEPH KELLEY ACTING CFO 5408251569 PO BOX 191 CULPEPER VA 22701 DR JAMES E BAUCOM 1.00 X 0 0 0 DR HERBERT O BROWNING JR 1.00 X 0 0 0 REV LAWRENCE A DAVIES 1.00 X 0 0 0 REV C NELSON HARRIS 1.00 X 0 0 0 MR LEBRON J HOLDEN 1.00 X 0 0 0 MR MICHAEL E KECK 1.00 X 0 0 0 MR JOHN T KING 1.00 X 0 0 0 MR MAURICE C LAW 1.00 X 0 0 0 MR ROBERT L MUSICK JR 1.00 X 0 0 0 MR NED STEPHENSON 1.00 X 0 0 0 MR WILLIAM F TRIMBLE JR 1.00 X 0 0 0 MR CHARLES W TYSENGER 1.00 X 0 0 0 DR RANDALL ROBINSON 1.00 X 0 294743 10155 MS MONICA HILLERY 1.00 X 0 97701 6927 MR KENT M PHILLIPS 1.00 X 0 177107 8457 MR ROBERT BUSWELL 1.00 X 0 98168 6873 MR JOHN P ROBINSON 1.00 X 0 140535 7440 ROBERT S MCELMURRAY 40.00 X 141045 0 4050 141045 808254 43902 1 0 1 0 REHABCARE GROUP INC PO BOX 503534 ST LOUIS MO 63150 THERAPY SERVICES 436425 SYSCO FOOD SERVICES OF VIRGINIA LLC PO BOX 2002 HARRISONBURG VA 22801 FOOD PURCHASED 387312 OPTIMA HEALTH - LARGE GROUP PO BOX 791148 BALTIMORE MD 21279 EMPLOYEE HEALTH INSURANCE 194407 EL SMITH BUILDING CONTRACTOR 13434 CHESTERFIELD LANE CULPEPER VA 22701 BUILDING CONTRACTOR 186950 RAPPAHANNOCK ELECTRIC COOPERATIVE PO BOX 7388 FREDERICKSBURG VA 22404 ELECTRIC UTILITIES 104282 5 164653 1201916 1366569 RESIDENTIAL SERVICES 623000 3040002 3040002 HEALTH CARE SERVICES 623000 3035412 3035412 214240 214240 6289654 62156 62156 529 0 529 529 529 AFFILIATE DEBT CANCELA 900099 -5232 -5232 -5232 7713676 6289654 0 57453 271810 271810 141045 141045 3607051 3351516 255535 47854 42791 5063 281520 251733 29787 272758 243898 28860 214 214 562306 562306 48494 48494 62705 62705 4372 4372 791673 791673 25403 25403 125566 125566 305031 305031 DIETARY SUPPLIES 446521 446521 PROGRAM SUPPLIES 319079 319079 EQUIPMENT 34454 34454 DUES AND SUBSCRIPTIONS 28537 28537 25432 7285 18147 7401825 6779066 622759 0 30921 345867 190677 1258813 319634 243178 52800 334484 20287 20131 11969225 9941232 1900748 2027993 665808 745592 1586008 1318874 4766883 6294932 644278 744534 2349332 2286654 7586935 8689041 10580545 11720229 X -7851858 -7537652 1372388 1398016 665808 714339 -5813662 -5425297 4766883 6294932 X 311851 76514 X X 0 1 X 1 0 X 321185 384480 389637 393911 1366569 2855782 5521158 6306092 6597967 6660468 6289654 31375339 5842343 6690572 6987604 7054379 7656223 34231121 0 207972 139332 297910 147374 355473 1148061 207972 139332 297910 147374 355473 1148061 33083060 -3383 33068 25116 76531 62156 193488 -3383 33068 25116 76531 62156 193488 69878 9566 16747 28407 -5232 119366 5908838 6733206 7029467 7159317 7713147 34543975 0.95770 0.96260 0.00560 0.00670 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 214 214 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: A PORTION OF THE ORGANIZATION'S ASSOCIATION FEES IS ALLOCATED TO LOBBYING. 1372388 27980 2325 1398016 1320681 101160 49453 1372388 1320681 1.00000 0 1 1 43647 43647 7224215 5924519 1299696 3790181 3331111 459070 911182 685602 225580 2027993 INVESTMENTS 714342 F 31250 F 745592 DUE FROM AFFILIATES 1270290 DEFERRED FINANCING COSTS 47253 DEPOSITS AND OTHER 1331 1318874 DEFERRED ENTRANCE FEES 2883981 DUE TO AFFILIATES 5805060 8689041 X DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE ENDOWMENTS ARE HELD BY VIRGINIA BAPTIST HOMES FOUNDATION, INC. AND TO BE USED TOWARDS THE CONTINUATION OF RESIDENT SERVICES. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: SHOULD THE TAX-EXEMPT STATUS OF THE ORGANIZATION BE CHALLENGED IN THE FUTURE, THE 2010, 2011, AND 2012 TAX YEARS ARE OPEN FOR EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. 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 RESIDENT ASSISTANCE 18 271810 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, 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 0 0 0 0 0 0 DR RANDALL ROBINSON 0 259907 0 0 0 34836 0 6275 0 3880 0 304898 0 0 MR KENT M PHILLIPS 0 175516 0 0 0 1591 0 4810 0 3647 0 185564 0 0 A PENINSULA PORTS AUTHORITY OF VIRGINIA 237002328 707167AA0 2003-01-24 2493128 REFUND OUTSTANDING SERIES 2000 BONDS A 1 0 1 B PENINSULA PORTS AUTHORITY OF VIRGINIA 237002328 707167AQ5 2006-05-24 2214021 DEFEASE AND REPLACE PORTION OF OUTSTANDING BONDS 1 0 1 A 2341652 2493128 2493128 1 0 1 1 B 78843 2214021 2170717 43034 1 1 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 0 0 A 0 B 0 FORM 990, PART VI, SECTION B, LINE 11 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 2012. 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 (E.G., GUIDESTAR). CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN PV OF PERPETUAL TRUSTS 48,534. TEMPORARILY RESTRICTED GIFTS 27,980. 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 OR SELECTION PROCESS DURING THE TAX YEAR. VIRGINIA BAPTIST HOMES INC PO BOX 191 CULPEPER VA 22701 540534405 SENIOR LIVING MANAGEMENT VA 501(C)(3) LINE 11A, I N/A 0 VIRGINIA BAPTIST HOMES FOUNDATION INC PO BOX 191 CULPEPER VA 22701 521373103 FUND RAISING AND DEVELOPMENT VA 501(C)(3) LINE 11D, III-O N/A 0 NEWPORT NEWS BAPTIST RETIREMENT COMMUNITY INC PO BOX 191 CULPEPER VA 22701 521368408 SENIOR LIVING COMMUNITY VA 501(C)(3) LINE 9 N/A 0 LAKEWOOD MANOR BAPTIST RETIREMENT COMMUNITY INC PO BOX 191 CULPEPER VA 22701 521368410 SENIOR LIVING COMMUNITY VA 501(C)(3) LINE 9 N/A 0 THE GLEBE INC PO BOX 191 CULPEPER VA 22701 541917966 SENIOR LIVING COMMUNITY VA 501(C)(3) LINE 9 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 86055 OFFICER APPROVAL VIRGINIA BAPTIST HOMES INC P 579840 INTERCOMPANY TRANSFER VIRGINIA BAPTIST HOMES FOUNDATION INC C 78598 INTERCOMPANY TRANSFER