2012-11-09T10:54:13-06:00 2012-03-31 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFILD COURT ASHEVILLE NC 28806 990 2011-04-01 540524902 COVENANT WOODS COVE 8045698173 7090 COVENANT WOODS DRIVE MECHANICSVILLE VA 23111 ERIK MAURITSEN 8045698173 2012-11-09 1 AMY BIBBY P00445891 8282542254 2011 2016-02-24 21:20:13Z TIMOTHY JOHNSON 7090 COVENANT WOODS DRIVE MECHANICSVILLE VA 23111 15642194 0 X WWW.COVENANTWOODS.COM X 1901 VA NOT-FOR-PROFIT CONTINUING CARE RETIREMENT COMMUNITY 21 21 276 180 0 0 93775 1921651 10607441 11271673 2414113 -226557 270659 260503 13385988 13227270 0 0 0 0 6560893 6708043 0 0 106538 6423466 6297279 12984359 13005322 401629 221948 84714451 84521573 56315931 55478978 28398520 29042595 X IT IS THE MISSION OF COVENANT WOODS, A NOT-FOR-PROFIT CONTINUING CARE RETIREMENT COMMUNITY, TO PROVIDE OUR RESIDENTS WITH EXCEPTIONAL CARE, QUALITY OF LIFE, AND SECURITY AND COMFORT IN KEEPING WITH THE BENEVOLENT VISION OF OUR METHODIST AND PRESBYTERIAN FOUNDERS IN 1883. 0 0 11136961 11168887 COVENANT WOODS (CW), A VIRGINIA NONSTOCK CORPORATION FOUNDED IN OCTOBER 1883, IS A NOT-FOR-PROFIT CONTINUING CARE RETIREMENT COMMUNITY IN MECHANICSVILLE, VA. CW CONSISTS OF 133 INDEPENDENT LIVING UNITS, 43 ASSISTED LIVING UNITS, AND 39 LICENSED NURSING BEDS.THE COST TO OPERATE CW DURING FY2012 APPROXIMATES $13,005,322. CW OFFERS SERVICES FOR THEIR RESIDENTS COMPARABLE TO OTHER CCRC'S IN THE STATE. UTILITIES SUCH AS WATER, ELECTRICITY, HEATING AND COOLING, AND BASIC CABLE ARE PROVIDED. HOUSEKEEPING OF ALL COTTAGES, APARTMENTS, ROOMS, LOBBIES, CORRIDORS AND OTHER COMMON AREAS AND BASIC GROUNDS KEEPING CARE, INCLUDING LAWN SERVICE AND SNOW REMOVAL FROM WALKWAYS ARE PROVIDED BY CW. NECESSARY REPAIRS, MAINTENANCE AND REPLACEMENT OF PROPERTY OWNED BY CW ARE PERFORMED. INDIVIDUAL MAIL BOXES ARE PROVIDED IN A CENTRAL LOCATION FOR ALL RESIDENTS. PROGRAMS OF SOCIAL, RECREATIONAL, AND RELIGIOUS ACTIVITIES ARE PROVIDED FOR ALL RESIDENTS' SPIRITUAL, PHYSICAL, SOCIAL AND PSYCHOLOGICAL NEEDS AS WELL AS FOR INTELLECTUAL APPOINTMENTS. A HEALTH CLINIC IS PROVIDED FOR RESIDENTS TO BE EXAMINED AND TREATED AS OUTPATIENTS. A PHYSICIAN IS AVAILABLE DURING SPECIFIED PERIODS OF THE WEEK.CW HAS A MISSION TO PROVIDE BENEVOLENT CARE TO THOSE RESIDENTS WHO NEED IT. THE CARE IS FUNDED THROUGH CW'S ENDOWMENT FUND THROUGH INVESTMENT EARNINGS OR THE SALE OF INVESTMENTS. THE AMOUNT OF BENEVOLENT CARE GIVEN IN FY2012 AMOUNTED TO APPROXIMATELY $397,000. 11136961 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 13 0 1 276 1 0 0 0 0 0 0 0 0 0 0 X 21 21 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X ERIK MAURITSEN 8045698002 7090 COVENANT WOODS DR MECHANICSVILLE VA 23111 CARLENE BASS 1.00 X X 0 0 0 O RANDOLPH ROLLINS 1.00 X X 0 0 0 JIMMY MILLS 1.00 X X 0 0 0 PATRICK BRADY 1.00 X 0 0 0 SUSAN DRUMWRIGHT 1.00 X 0 0 0 EMILY ELMORE 1.00 X 0 0 0 BRENDA COWLBECK 1.00 X 0 0 0 HELEN GATES 1.00 X 0 0 0 NATALIE KENT 1.00 X 0 0 0 ANNE DOWNING 1.00 X 0 0 0 JOSEPH MARSHBURN 1.00 X 0 0 0 KATHY MILLER 1.00 X 0 0 0 CHARLOTTE FORRESTER 1.00 X 0 0 0 JIM ELLIOT 1.00 X 0 0 0 JACOB MAST 1.00 X 0 0 0 HAROLD ROHRS 1.00 X 0 0 0 GENA WALLACE 1.00 X 0 0 0 DON TINDALL 1.00 X 0 0 0 MARGIE TURBYFILL 1.00 X 0 0 0 EDDIE STILES 1.00 X 0 0 0 THELMA WATSON 1.00 X 0 0 0 JAMES DARDEN 1.00 X 0 0 0 WILLIAM LAVECCHIA 1.00 X 0 0 0 BEVERLY LORDI 1.00 X 0 0 0 JACK WARD 1.00 X 0 0 0 MARY JANE WINTER 1.00 X 0 0 0 TIMOTHY JOHNSON 40.00 X 198607 0 53152 ERIK MAURITSEN 40.00 X 102890 0 5074 301497 0 58226 2 0 1 0 SB&A 207 W FRANKLIN ST RICHMOND VA 23220 MARKETING CONSULTANT 1131300 MORRISON'S SENIOR DINING PO BOX 102289 ATLANTA GA 30368 DINING 351302 SFCS 305 S JEFFERSON ST ROANOKE VA 24011 ARCHITECTURAL/DESIGN 158570 JLR 21929 WINDY OAKS SQUARE ASHBURN VA 20148 PROJECT MANAGER 153958 HANOVER SECURITY PO BOX 121 MECHANICSVILLE VA 23111 SECURITY 136414 5 1921651 1921651 RESIDENTIAL SERVICES 623990 5753890 5753890 HEALTH CARE SERVICES 624100 5414997 5414997 RESIDENT SERVICES 812900 102786 102786 11271673 805887 805887 20400 0 20400 20400 20400 1382480 2408839 6085 -1026359 -6085 -1032444 -1032444 MEAL/FOOD REVENUE 722210 131901 131901 DRUGS/MEDICAL SUPPLIES 900099 63658 63658 OTHER MISC. INCOME 900099 44544 44544 240103 13227270 11168887 0 136732 359723 107917 251806 4794257 3761271 954530 78456 199513 141679 52664 5170 927799 800435 127364 426751 309356 110432 6963 12328 12328 58764 58764 86046 86046 338643 315124 23519 79931 79931 2037629 1947217 73872 16540 59522 59522 779145 779145 13191 11406 1785 17384 16643 741 585671 585671 2000836 2000836 215618 215618 MISCELLANEOUS 12571 5190 7972 -591 13005322 11136961 1761823 106538 178171 165103 183434 240760 1381224 2739884 1620658 11866 6463 3394815 4428074 60263460 16563239 44535964 43700221 26674793 24761353 4103663 4115302 2891861 4102415 84714451 84521573 809959 1000725 24745374 23782631 29435000 28640000 1127857 1962692 197741 92930 56315931 55478978 X 26641249 25529217 2055 1833073 1755216 1680305 28398520 29042595 84714451 84521573 X 221948 422127 X X 0 1 1 X 0 X 84832 123567 100520 91720 1921651 2322290 21381885 9391863 9945828 10500712 11168887 62389175 929381 298569 217375 245214 340426 2030965 22396098 9813999 10263723 10837646 13430964 66742430 0 1708445 1708445 1708445 1708445 65033985 1932962 1358661 1146980 1288224 826287 6553114 1932962 1358661 1146980 1288224 826287 6553114 24329060 11172660 11410703 12125870 14257251 73295544 0.88730 0.90160 0.08940 0.09840 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 250 250 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: THE ORGANIZATION IS A MEMBER OF THE VIRGINIA ASSOCIATION OF NONPROFIT HOMES FOR THE AGING AND LEADING AGE. A SMALL PORTION OF THE DUES PAID TO THESE ORGANIZATIONS HAS BEEN ALLOCATED TO LOBBYING EXPENDITURES CONDUCTED BY THESE ORGANIZATIONS. 0 0 875000 3029683 3904683 45025266 14359870 30665396 3033140 967357 2065783 3875507 1236012 2639495 4424864 4424864 43700221 OTHER LIABILITIES 92930 92930 13227270 13005322 221948 -3468137 3890264 422127 644075 13649397 -3468137 3890264 422127 13227270 0 13227270 13005322 0 13005322 0 13005322 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE; ACCORDINGLY, THE ACCOMPANYING FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION OR LIABILITY FOR FEDERAL AND STATE INCOME TAXES. THE ORGANIZATION HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF MARCH 31, 2012. THE ORGANIZATION BELIEVES THAT IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE YEARS PRIOR TO MARCH 31, 2009. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN VALUE OF PERPETUAL TRUSTS -74,911. OTHER THAN TEMPORARY INVESTMENTS 3,975,175. CONTRIBUTION TO COMMUNITY FUND -10,000. TOTAL TO SCHEDULE D, PART XI, LINE 8: 3,890,264. PART XII, LINE 2D - OTHER ADJUSTMENTS: OTHER THAN TEMPORARY IMPAIREMENTS 3,975,175. CHANGE IN VALUE OF PERPETUAL TRUSTS -74,911. CONTRIBUTION TO COMMUNITY FUND -10,000. X X 0 0 0 1 0 0 0 0 0 TIMOTHY JOHNSON 182607 0 16000 0 0 0 38500 0 14652 0 251759 0 0 0 PART I, LINE 5 THE ORGANIZATION'S CEO AND CFO PARTICIPATE IN AN EXECUTIVE BONUS PLAN THAT CONSIDERS IMPROVEMENT IN NET OPERATING MARGIN AS ONE OF THE FACTORS FOR THE BONUS. ECONOMIC DEVELOPMENT AUTHORITY OF HANOVER COUNTY VA 2010-12-01 29435000 CURRENT REFUNDING OF BONDS ISSUED IN 1999 0 0 0 1750000 29575000 382432 29192568 1999 1 0 1 1 0 1 0 0 0 1 PART II, LINE 11 - OTHER SPENT PROCEEDS: TOTAL OF LINE 11 REPRESENTS AMOUNTS SPENT TO CURRENTLY REFUND A PRIOR ISSUE. FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE SHALL BE COMPOSED OF ALL OFFICERS OF THE CORPORATION WHO ARE DIRECTORS AND THE CHAIRMEN OF FINANCE, DEVELOPMENT, BUILDING/GROUNDS, NOMINATIONS/RESOURCES, ADMISSIONS AND COMMUNITY INVOLVEMENT COMMITTEES, IF SUCH COMMITTEE(S) THEN EXISTS, TO PROVIDE THE EXECUTIVE COMMITTEE WITH AT LEAST 9 MEMBERS. IF AT ANY TIME THE EXECUTIVE COMMITTEE HAS FEWER THAN 9 MEMBERS, THE EXECUTIVE COMMITTEE SHALL MAKE SUCH RECOMMENDATION TO THE BOARD OF DIRECTORS AS TO ADDITIONAL MEMBERS AS IT SHALL DETERMINE, AND THE BOARD OF DIRECTORS SHALL BY A RESOLUTION APPOINT SUCH ADDITIONAL MEMBERS AS IT MAY DETERMINE FOR A TERM OF NO MORE THAN TWO YEARS. THE CHAIRMAN OF THE CORPORATION SHALL BE CHAIRMAN OF THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE MAY MEET AND MAKE RECOMMENDATIONS AS IT SHALL DEEM ADVISABLE TO THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SHALL BE VESTED WITH FULL AND COMPLETE AUTHORITY WITH RESPECT TO THE BUSINESS AND AFFAIRS OF THE CORPORATION EXCEPT THAT IT SHALL NOT WITHOUT THE APPROVAL OF THE BOARD OF DIRECTORS: (1) FILL VACANCIES ON THE BOARD OR ON ANY OF ITS COMMITTEES; (2) AMEND THE ARTICLES OF INCORPORATION PURSUANT TO VIRGINIA CODE SECTION 13.1-885 (ALLOWING AMENDMENT OF THE ARTICLES OF INCORPORATION BY THE BOARD OF DIRECTORS); (3) ADOPT, AMEND, OR APPEAL THE BYLAWS; (4) APPROVE A PLAN OF MERGER; (5) SELL THE ASSETS OF THE CORPORATION OTHER THAN IN THE REGULAR COURSE OF BUSINESS; (6) DISSOLVE THE CORPORATION; OR ANY OTHER ACTIONS SPECIFIED IN VIRGINIA CODE SECTIONS 13.1-869, 13.1-885, 13.1-895, 13.1-900, 13.1-903 (OR THE EQUIVALENT SECTION OF ANY CODE OF LAW SUBSEQUENTLY ENACTED BY THE COMMONWEALTH OF VIRGINIA) OR ANY ACTION OTHERWISE PROHIBITED BY LAW. FORM 990, PART VI, SECTION B, LINE 11 THE FINANCE COMMITTEE REVIEWED THE 990. AFTER THEIR REVIEW, A COPY WAS SENT TO EACH BOARD MEMBER REQUESTING COMMENTS OR QUESTIONS TO BE DIRECTED TO THE CFO WITHIN 10 DAYS. AFTER THAT POINT IN TIME, THE 990 WAS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD IS POLLED ANNUALLY AND SURVEYS ARE COLLECTED BY THE EXECUTIVE SECRETARY AND CHECKED FOR COMPLIANCE WITH THE POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE CEO IS EVALUATED ANNUALLY BY THE EXECUTIVE COMMITTEE OF THE BOARD. EACH COMMITTEE MEMBER DOES AN INDEPENDENT EVALUATION, AND THE COMMITTEE CHAIRMAN COMPILES THE SCORE. THE CEO EVALUATES THE CFO WITH FEEDBACK FROM THE BOARD. THE BOARD CHAIR REQUESTS COMPARATIVE SALARY DATA THAT THE HR DIRECTOR ACQUIRES FROM VARIOUS LONG-TERM CARE GROUPS, WHICH IS USED TO DETERMINE BASE WAGE INCREASES. BONUS AMOUNTS ARE DETERMINED BASED ON HOW WELL THE CEO AND CFO EXECUTE THE STRATEGIC PLAN FOR THE YEAR - MEETING BUDGET, SATISFACTION, DEVELOPMENT, ETC. BONUS AMOUNTS ARE CAPPED AT 10% OF BASE SALARY. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION'S RECENT FORMS 990 ARE AVAILABLE AT WWW.GUIDESTAR.ORG AND UPON REQUEST AT THE ORGANIZATION'S OFFICE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY AVAILABLE FOR PUBLIC INSPECTION AT THIS TIME. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -3,468,137. CHANGE IN VALUE OF PERPETUAL TRUSTS -74,911. OTHER THAN TEMPORARY INVESTMENTS 3,975,175. CONTRIBUTION TO COMMUNITY FUND -10,000. TOTAL TO FORM 990, PART XI, LINE 5: 422,127. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.