2011-01-11T07:45:34-06:00 2008-12-31 DIXON HUGHES PLLC 500 Ridgefield Court Asheville NC 28806 990 2008-01-01 541929580 CCRC INC CCRC 4342004708 1920 ATHERHOLT ROAD LYNCHBURG VA 24501 LEWIS C ADDISON 4342004708 2011-01-10 1 Amy Bibby 8282542254 2008 2016-02-24 21:20:13Z X LEWIS C ADDISON 1920 ATHERHOLT ROAD LYNCHBURG VA 24501 3528539 0 X WWW.SUMMITLYNCHBURG.COM X 1998 VA CONTINUING CARE RETIREMENT CENTER 9 4 0 50 0 0 0 3514849 3402887 574948 -37232 0 4089797 3365655 0 0 547887 567239 0 0 3226692 3211597 3774579 3778836 315218 -413181 21960076 19928975 23092419 22662316 -1132343 -2733341 THE SUMMIT IS A SENIOR LIVING COMMUNITY PROVIDING AN ENVIRONMENT FOR EACH RESIDENT TO BE ENGAGED IN LIFE. 0 0 3390587 3402886 CCRC, INC. IS A CONTINUING CARE RETIREMENT COMMUNITY INCORPORATED ON DECEMBER 8, 1998 TO BUILD AND ESTABLISH A SENIOR LIVING COMMUNITY, THE SUMMIT, DEDICATED TO PROVIDING AN ENVIRONMENT FOR EACH RESIDENT TO BE ENGAGED IN LIFE.THE SUMMIT CONSISTS OF 85 INDEPENDENT LIVING APARTMENTS, 11 GARDEN HOMES AND A COMMUNITY CENTER ON A CAMPUS THAT INCLUDES AN 8.5 ACRE LAKE, WALKING TRAILS, AND OTHER LANDSCAPE FEATURES. AS SUCH, THE SUMMIT PROVIDES THE FACILITIES, SERVICES, AMENITIES, AND PROGRAMS TO SUPPORT AN ACTIVE LIFESTYLE FOR RESIDENTS.THE SUMMIT HOSTS SEVERAL SUPPORT GROUPS AND MEETINGS THAT BENEFIT BOTH RESIDENTS AND MEMBERS FROM THE LARGER COMMUNITY, INCLUDING THE CENTRAL VIRGINIA ALZHEIMER'S SUPPORT GROUP; THE CENTRAL VIRGINIA PARKINSON'S SUPPORT GROUP, AN ESSENTIAL TREMORS SUPPORT GROUP; THE VANHA BOARD OF DIRECTORS; AND THE AAHSA SENATE. THE SUMMIT HOSTS A QUARTERLY EVENT COORDINATED BY THE LYNCHBURG REGIONAL CHAMBER OF COMMERCE CALLED "BUSINESS AT BREAKFAST" THAT IS OPEN TO AREA BUSINESS PROFESSIONALS. STAFF PROVIDE VOLUNTEER SUPPORT FOR EACH OF THE ABOVE ORGANIZATIONS AND OTHERS INCLUDING THE WYNDHURST ASSOCIATION, PASTORAL COUNSELING SERVICES OF CENTRAL VIRGINIA, THE EXCHANGE CLUB, AND OTHERS. ADDITIONALLY, THE SUMMIT PROVIDES IN-KIND SERVICES TO EVENTS SPONSORED BY THE WYNDHURST ASSOCIATION AND OTHERS. 3390587 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 9 0 1 0 0 0 0 0 0 0 0 0 0 0 0 9 4 1 0 0 0 1 1 1 1 1 0 1 0 1 0 0 1 1 0 0 0 X X LEWIS C ADDISON 4342004708 1920 ATHERHOLT ROAD LYNCHBURG VA 24501 THOMAS C JIVIDEN 2.00 X X 0 376601 148388 MARILYN TAYLOR 2.00 X X 0 0 0 DAVID D ADAMS 2.00 X X 0 220822 49662 LEWIS C ADDISON 2.00 X 0 386573 152164 J ROBERT DAVENPORT 2.00 X 0 0 0 GEORGE W DAWSON 2.00 X 0 883153 154143 ROBERT MOOTY 2.00 X 0 0 0 LEE PARKER 2.00 X 0 0 0 DARRELL POWERS 2.00 X 0 61327 0 KENNETH BURGER 50.00 X 75772 0 20931 75772 1928476 525288 0 0 1 0 MERIWETHER GODSEY INC 4944 OLD BOONSBORO ROAD LYNCHBURG VA 24503 CATERING 492881 1 NET PATIENT SERVICE RE 623000 3402887 3402887 3402887 49987 49987 75665 162884 -87219 -87219 -87219 3365655 3315668 0 49987 89909 62936 26973 367325 254657 112668 110005 77888 32117 118 118 128384 128384 610490 610490 37916 37916 218028 211506 6522 945313 931228 14085 2086 2086 6222 6222 1220059 1201880 18179 42981 42981 3778836 3390587 388249 0 117151 461112 79190 60043 10958 7896 20057898 6369338 14628826 13688560 4818840 3555361 2305111 2156003 21960076 19928975 673733 525230 11046856 10944735 11100000 10935000 271830 257351 23092419 22662316 X 4400000 4400000 0 0 -5532343 -7133341 -1132343 -2733341 21960076 19928975 X 0 1 1 0 X X 0 0 0 CENTRA HEALTH INC 540715569 3 1 1 1 3085434 1 3085434 352816 352816 16073636 5177950 10895686 590948 329295 261653 3040498 862093 2178405 13688560 DEFERRED MARKETING COSTS 125078 UNAMORTIZED BOND FINANCING COSTS 546963 BOND FUNDS LIMITED TO USE 1329731 LAKE MAINTENANCE FUND 154231 2156003 DUE TO AFFILIATE, CENTRA HEALTH, INC. 103120 LAKE MAINTENANCE LIABILITY 154231 257351 3365655 3778836 -413181 -1187817 -1187817 -1600998 2177838 -1187817 -1187817 3365655 0 3365655 3778836 0 3778836 0 3778836 X 0 1 0 0 0 0 0 0 0 THOMAS C JIVIDEN 316567 55826 4208 127707 20681 524989 DAVID D ADAMS 188546 31924 352 30142 19520 270484 LEWIS C ADDISON 316259 67786 2528 132595 19569 538737 GEORGE W DAWSON 540616 51458 291079 138571 15572 1037296 Part I, Line 4a GEORGE DAWSON, ACCRUED $251,903 FOR 2008, INCLUDED IN TAXABLE WAGES. Form 990, Part VI, Section A, line 2 BOARD MEMBERS DAVID ADAMS, LEWIS ADDISON, GEORGE DAWSON, AND TOM JIVIDEN ALL SERVE TOGETHER ON THE BOARD OF DIRECTORS FOR BEDFORD MEMORIAL HOSPITAL, A 50% JOINT VENTURE OF CENTRA HEALTH, INC. BOARD MEMBERS LEWIS ADDISON AND GEORGE DAWSON ARE BOTH OFFICERS OF PIEDMONT COMMUNITY HEALTH PLAN, A 50% JOINT VENTURE OF CENTRA HEALTH, INC. BOARD MEMBERS DAVID ADAMS AND GEORGE DAWSON ARE BOTH DIRECTORS OF HEALTHWORKS CLINIC, A 50% JOINT VENTURE OF CENTRA HEALTH, INC. Form 990, Part VI, Section A, line 6 THE ORGANIZATION IS A NOT-FOR-PROFIT, STOCK COMPANY. AS OF THE END OF 2008, THERE WERE 363 SHARES OF COMMON STOCK AND ZERO SHARES OF PREFERRED STOCK OUTSTANDING. CENTRA HEALTH, INC. OWNS 91% OF THE COMMON STOCK. THE REMAINDER IS OWNED BY THE RETIREMENT CENTER OF THE CHRISTIAN CHURCH IN VIRGINIA, INC. Form 990, Part VI, Section A, line 7a CENTRA HEALTH, INC., AS THE MAJORITY OWNER OF THE CCRC, INC. STOCK, HAS THE RIGHT TO APPOINT THE MAJORITY OF CCRC, INC BOARD. Form 990, Part VI, Section A, line 7b CENTRA HEALTH, INC., AS THE MAJORITY OWNER OF THE CCRC, INC. STOCK, HAS THE RIGHT TO REVIEW AND APPROVE DECISIONS MADE BY THE GOVERNING BODY OF CCRC, INC. Form 990, Part VI, Section A, line 10 THE MANAGEMENT OF CCRC WILL REVIEW THE FORM 990 WITH THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS. AFTER THE FINANCE COMMITTEE HAS REVIEWED THE FORM 990, EACH VOTING BOARD MEMBER WILL RECEIVE A COPY FOR THEIR PERSONAL REVIEW PRIOR TO ITS FILING WITH THE IRS. Form 990, Part VI, Section B, line 12c CCRC, INC IS CURRENTLY GOVERNED BY THE CONFLICT OF INTEREST POLICY FOR CENTRA HEALTH, INC. THE ORGANIZATION IS IN THE PROCESS OF REVISING ITS POLICIES AND PROCEDURES TO ENSURE THAT THE POLICY IS REGULARLY AND CONSISTENTLY MONITORED AND ENFORCED FOR ALL ORGANIZATIONS. Form 990, Part VI, Section C, line 18 PHOTOCOPIES OF THE ORGANIZATION'S FORM 1023 AND RECENT FILINGS OF THE FORM 990 AND 990-T ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINSTRATIVE OFFICE. THE MOST RECENT FILING OF THE FORM 990 CAN ALSO BE FOUND ONLINE AT WWW.GUIDESTAR.ORG. Form 990, Part VI, Section C, line 19 PHOTOCOPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. FORM 990 AMENDED RETURN: AMENDMENTS HAVE BEEN MADE TO SCHEDULE J PART II OF THE FORM 990. THE AMENDMENTS INCLUDE THE RECLASSIFICATION OF COMPENSATION FROM "BASE COMPENSATION" TO "OTHER COMPENSATION" AND VICE VERSA IN ORDER TO MORE PROPERLY ALIGN THE PRESENTATION OF COMPENSATION ON THE FORM 990 WITH THE GUIDANCE SET FORTH IN THE 2009 IRS FORM 990 INSTRUCTIONS. THE TOTAL COMPENSATION AMOUNTS REPORTED ON THE FORM 990 AND RELATED SCHEDULE J HAVE NOT CHANGED FROM THE PREVIOUSLY FILED VERSION. CENTRA HEALTH INC 1920 ATHERHOLT ROAD LYNCHBURG VA 24501 540715569 HEALTHCARE VA 501(C)(3) HOSPITAL N/A CENTRA HEALTH FOUNDATION 1920 ATHERHOLT ROAD LYNCHBURG VA 24501 541604094 SUPPORTING ORGANIZATION VA 501(C)(3) 509(A)(3) CENTRA HEALTH INC LYNCHBURG FAMILY PRACTICE RESIDENCY PROGRAM INC 1920 ATHERHOLT ROAD LYNCHBURG VA 24501 541457983 HEALTHCARE VA 501(C)(3) 509(A)(3) CENTRA HEALTH INC SOUTHSIDE COMMUNITY HOSPITAL INC 1920 ATHERHOLT ROAD LYNCHBURG VA 24501 540555201 HEALTHCARE VA 501(C)(3) HOSPITAL CENTRA HEALTH INC THE VIRGINIA BAPTIST HOSPITAL AUXILIARY INC 1920 ATHERHOLT ROAD LYNCHBURG VA 24501 546060503 SUPPORTING ORGANIZATION VA 501(C)(3) 509(A)(3) CENTRA HEALTH INC AUXILIARY TO LYNCHBURG GENERAL HOSPITAL INC 1920 ATHERHOLT ROAD LYNCHBURG VA 24501 549047293 SUPPORTING ORGANIZATION VA 501(C)(3) 509(A)(3) CENTRA HEALTH INC VBH ASSOCIATES 1920 ATHERHOLT ROAD LYNCHBURG VA 24501 541292948 OPERATION OF MEDICAL BUILDING VA N/A GENERAL BUSINESS CONCERNS INC 1920 ATHERHOLT ROAD LYNCHBURG VA 24501 541299682 REAL ESTATE - PHYSICIANS OFFICES VA N/A C 0 0 0 0 1 0 0 0 0 0 0 0 1 1 1 0 0 0