STRATEGY STUDIO / PUBLIC DATA EXPLORER

CCRC INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
CCRC INC (EIN 54-1929580)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-10-01
IRS object ID
202232749349300408
Schema version
2021v4.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2022-10-01T10:44:14-05:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BDO USA LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line18401 GREENSBORO DRIVE 800AddressLine1Txt
CityMCLEANCityNm
State AbbreviationVAStateAbbreviationCd
ZIP22102ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN541929580EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CCRC INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% TIM FRITZInCareOfNm
Business Name ControlCCRCBusinessNameControlTxt
Phone4342004712PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11920 Atherholt RoadAddressLine1Txt
CityLynchburgCityNm
State AbbreviationVAStateAbbreviationCd
ZIP24501ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJULIE SLEDDPersonNm
Person TitleSECRETARYPersonTitleTxt
Phone4342004712PhoneNum
Signature2022-09-30SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstJULIEPersonFirstNm
Person LastSLEDDPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMarc BergerPreparerPersonNm
PTINP01871563PTIN
Phone7038930600PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJULIE SLEDDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11920 Atherholt RoadAddressLine1Txt
CityLynchburgCityNm
State AbbreviationVAStateAbbreviationCd
ZIP24501ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$38,468,018GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.SUMMITLYNCHBURG.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1998FormationYr
Legal Domicile StateVALegalDomicileStateCd
Activity Or MissionCONTINUING CARE RETIREMENT CENTER.ActivityOrMissionDesc
Contract TerminationYes (X)ContractTerminationInd
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee24TotalEmployeeCnt
Total Volunteers22TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$3,442,068PYProgramServiceRevenueAmt
CY Program Service Revenue$3,074,337CYProgramServiceRevenueAmt
PY Investment Income$3,575,165PYInvestmentIncomeAmt
CY Investment Income$13,387,696CYInvestmentIncomeAmt
PY Other Revenue$896,994PYOtherRevenueAmt
CY Other Revenue$383,702CYOtherRevenueAmt
PY Total Revenue$7,914,227PYTotalRevenueAmt
CY Total Revenue$16,845,735CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$1,097,309PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$756,911CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$3,053,943PYOtherExpensesAmt
CY Other Expenses$2,171,603CYOtherExpensesAmt
PY Total Expenses$4,151,252PYTotalExpensesAmt
CY Total Expenses$2,928,514CYTotalExpensesAmt
PY Revenues Less Expenses$3,762,975PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$13,917,221CYRevenuesLessExpensesAmt
Total Assets BOY$26,405,664TotalAssetsBOYAmt
Total Assets EOY$3,215,074TotalAssetsEOYAmt
Total Liabilities BOY$25,938,399TotalLiabilitiesBOYAmt
Total Liabilities EOY$3,215,074TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$467,265NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$0NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionCCRC, INC. (THE SUMMIT) IS A SENIOR LIVING COMMUNITY PROVIDING AN ENVIRONMENT FOR EACH RESIDENT TO BE ENGAGED IN LIFE.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangeYes (true)SignificantChangeInd
Expense$1,660,527ExpenseAmt
Revenue$3,458,039RevenueAmt
DescCCRC, INC. WAS 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 CONSISTED OF 85 INDEPENDENT LIVING APARTMENTS, 16 GARDEN HOMES AND A COMMUNITY ROOM ON A CAMPUS THAT INCLUDES AN 8 1/2-ACRE LAKE, WALKING TRAILS AND OTHER LANDSCAPE FEATURES. (CONTINUED ON SCHEDULE O.)Desc
Total Program Service Expenses$1,660,527TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationYes (true)PartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document13IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee24EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonTIM FRITZPersonNm
Phone4342002578PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11920 ATHERHOLT ROADAddressLine1Txt
CityLYNCHBURGCityNm
State AbbreviationVAStateAbbreviationCd
ZIP24501ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeInd
JOSEPH ARCHAMBEAULT
DIRECTOR2.050.0Yes (X)$0$342,095$31,110
WILLIAM BASS JR
DIRECTOR2.050.0Yes (X)$0$293,436$18,654
JULIE SLEDD
SECRETARY2.050.0Yes (X)$0$249,203$50,779Yes (X)
TRACEY JENNINGS
PRESIDENT & CHAIRMAN2.050.0Yes (X)$0$258,332$26,199Yes (X)
GINA MEADOWS
DIR OF CCRC (THRU APR 2021)50.00.0$53,956$0$8,331Yes (X)
BILL SPANGLER-DUNNING
DIRECTOR2.00.0Yes (X)$0$0$0
REV STEPHANIE MCLEMORE
VICE CHAIRMAN2.00.0Yes (X)$0$0$0Yes (X)
LARRY HURT
DIRECTOR2.00.0Yes (X)$0$0$0
STEVE COATS
DIRECTOR2.00.0Yes (X)$0$0$0
R SACKETT WOOD
DIRECTOR2.00.0Yes (X)$0$0$0
BOB JOHNSON
DIRECTOR2.00.0Yes (X)$0$0$0
KEN BURGER
DIRECTOR2.00.0Yes (X)$0$0$0
DEVELYN JOHNSON
DIRECTOR2.00.0Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$53,956TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,143,066TotReportableCompRltdOrgAmt
Total Other Compensation$135,073TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
MERIWETHER-GODSEY INC
4944 OLD BOONSBORO ROADLYNCHBURGVA24503CATERING SERVICES$543,647
H2C
4655 EXECUTIVE DRIVE SUITE 280SAN DIEGOCA92121CONSULTING$411,066
HANCOCK DANIEL JOHNSON PC
PO BOX 72050RICHMONDVA23255CONSULTING$178,135
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
RESIDENT REVENUE623000$2,991,043$2,991,043
ANCILLARY REVENUE900099$83,294$83,294
FieldValueIRS element (for citing)
Total Program Service Revenue$3,074,337TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,049TotalRevenueColumnAmt
Exclusion$1,049ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$16,648,930SecuritiesAmt
Other$18,360,000OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$16,648,930SecuritiesAmt
Other$4,973,353OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$13,386,647OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$13,386,647TotalRevenueColumnAmt
Exclusion$13,386,647ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
GAIN/LOSS ON UNIT TURNOVER623000$376,588$376,588
MISCELLANEOUS623000$7,114$7,114
FieldValueIRS element (for citing)
Other Revenue Total$383,702OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$16,845,735TotalRevenueColumnAmt
Related Or Exempt Func Income$3,458,039RelatedOrExemptFuncIncomeAmt
Exclusion$13,387,696ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$62,287TotalAmt
Program Services$62,287ProgramServicesAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$532,822TotalAmt
Program Services$343,542ProgramServicesAmt
Management And General$189,280ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$13,793TotalAmt
Program Services$10,186ProgramServicesAmt
Management And General$3,607ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$148,009TotalAmt
Program Services$106,155ProgramServicesAmt
Management And General$41,854ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$97,785TotalAmt
Management And General$97,785ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$24,750TotalAmt
Management And General$24,750ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$8,176TotalAmt
Management And General$8,176ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$560,497TotalAmt
Program Services$509,147ProgramServicesAmt
Management And General$51,350ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$84,470TotalAmt
Program Services$480ProgramServicesAmt
Management And General$83,990ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$379,721TotalAmt
Program Services$275,811ProgramServicesAmt
Management And General$103,910ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$334,935TotalAmt
Program Services$326,519ProgramServicesAmt
Management And General$8,416ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$693TotalAmt
Program Services$693ProgramServicesAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$300TotalAmt
Program Services$50ProgramServicesAmt
Management And General$250ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$7,031TotalAmt
Management And General$7,031ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$624,949TotalAmt
Program Services$22,380ProgramServicesAmt
Management And General$602,569ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$44,619TotalAmt
Management And General$44,619ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescMEDICAL SUPPLIESDesc
Total$3,677TotalAmt
Program Services$3,277ProgramServicesAmt
Management And General$400ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$2,928,514TotalAmt
Program Services$1,660,527ProgramServicesAmt
Management And General$1,267,987ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,352,105BOYAmt
EOY$3,202,444EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$16,811BOYAmt
EOY$12,630EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$181,309BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$0LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$0LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$7,312,618BOYAmt
EOY$0EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$16,648,930BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$893,891BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$26,405,664BOYAmt
EOY$3,215,074EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$397,246BOYAmt
EOY$1,549,395EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$6,573,345BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$18,967,808BOYAmt
EOY$1,665,679EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$25,938,399BOYAmt
EOY$3,215,074EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow FASB117Yes (X)OrgDoesNotFollowFASB117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$4,400,000BOYAmt
EOY$0EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY-$3,932,735BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$467,265BOYAmt
EOY$0EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$26,405,664BOYAmt
EOY$3,215,074EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$13,917,221ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$14,384,486OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1CENTRA HEALTH INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN540715569EIN
Organization Type3OrganizationTypeCd
Governing Document ListedfalseGoverningDocumentListedInd
Support$1,663,827SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$1,663,827SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (true)ListedByNameGoverningDocInd
Suprt Org No IRS DeterminationfalseSuprtOrgNoIRSDeterminationInd
Supported Org Section C456falseSupportedOrgSectionC456Ind
Supported Org Not Organized USfalseSupportedOrgNotOrganizedUSInd
Organization Change Suprt OrgfalseOrganizationChangeSuprtOrgInd
Support Non Supported OrgfalseSupportNonSupportedOrgInd
Payment Substantial ContribtrfalsePaymentSubstantialContribtrInd
Loan Disqualified PersonfalseLoanDisqualifiedPersonInd
Controlled Disqualified PrsnfalseControlledDisqualifiedPrsnInd
Disqualified Prsn Controll IntfalseDisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr IntfalseDisqualifiedPrsnOwnrIntInd
Excess Business Holdings RulesfalseExcessBusinessHoldingsRulesInd
Contribution ControllerfalseContributionControllerInd
Contribution FamilyfalseContributionFamilyInd
Contribution35 ControlledfalseContribution35ControlledInd

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (true)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt OrgfalseOperateBenefitNonSuprtOrgInd

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp
LandLandGrp
BuildingsBuildingsGrp
Leasehold ImprovementsLeaseholdImprovementsGrp
EquipmentEquipmentGrp
Other Land BuildingsOtherLandBuildingsGrp
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescNOTE PAYABLE TO CENTRA HEALTHDesc
Amt$1,665,679Amt
FieldValueIRS element (for citing)
Total Liability$1,665,679TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule D, Part X, Line 2FormAndLineReferenceDesc
ExplanationACCORDING TO CENTRA HEALTH, INC.'S CONSOLIDATED 2021 AUDIT REPORT. CENTRA HEALTH, INC., CCRC, INC., FOUNDATION, SOUTHSIDE, AND BEDFORD ARE EXEMPT FROM INCOME TAX UNDER SECTION 501 (A) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO INCOME TAXES HAVE BEEN PROVIDED FOR THESE ENTITIES IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS EXCEPT FOR TAXES RELATED TO CERTAIN UNRELATED BUSINESS INCOME ENGAGED IN BY CENTRA. CENTRA HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF DECEMBER 31, 2021. CENTRA BELIEVES THEY ARE NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO DECEMBER 31, 2018.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
TRACEY JENNINGS
PRESIDENT & CHAIRMAN$0$170,451$0$46,067$0$41,814$0$7,036$0$19,163$0$284,531$0$0
JOSEPH ARCHAMBEAULT
DIRECTOR$0$228,957$0$10,000$0$103,138$0$8,632$0$22,478$0$373,205$0$0
JULIE SLEDD
SECRETARY$0$203,447$0$10,000$0$35,756$0$6,519$0$44,260$0$299,982$0$0
WILLIAM BASS JR
DIRECTOR$0$234,673$0$10,000$0$48,763$0$10,855$0$7,799$0$312,090$0$0
GINA MEADOWS
DIR OF CCRC (THRU APR 2021)$41,111$0$0$0$12,845$0$6,202$0$2,129$0$62,287$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PART I, LINE 3COMPENSATION STUDY: UNDER A MANAGEMENT AGREEMENT WITH CENTRA HEALTH, INC., THE ORGANIZATION'S EXECUTIVE DIRECTOR'S COMPENSATION WAS ESTABLISHED IN ACCORDANCE WITH CENTRA HEALTH, INC.'S EXECUTIVE COMPENSATION PRACTICES WHICH INCLUDED THE USE OF A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT(S) & COMPENSATION STUDY OR SURVEY.
SCHEDULE J, PART I, LINE 4BJoesph Archambeault RECEIVED A PAYOUT FROM A NONQUALIFIED RETIREMENT PLAN DURING FY 2021 of $30,530. NO INDIVIDUALS HAD AMOUNTS DEFERRED INTO A NONQUALIFIED RETIREMENT PLAN IN FY 2021.

Schedule N IRS990ScheduleN

FieldValueIRS element (for citing)
Liquidation Of Assets TableLiquidationOfAssetsTableGrp

Disposition Of Assets Detail DispositionOfAssetsDetail (8 entries)

Assets Distri Or Expnss PaidAssetsDistriOrExpnssPaidDescDistributionDistributionDtFair Market Value Of AssetFairMarketValueOfAssetAmtMethod Of FMV DeterminationMethodOfFMVDeterminationTxtEINEINAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdIRC SectionIRCSectionTxt
LifeSpire of Virginia
FIXED ASSETS & LAND2021-10-01$18,360,000MARKET STUDY5405344053961 STILLMAN PARKWAYGLEN ALLENVA23060501(C)(3)
H2C Securities Inc
TRANSACTION EXPENSES2021-10-01$422,264COST3633275214655 Executive DriveSAN DIEGOCA92121N/A
Hancock Daniel Johnson Pc
TRANSACTION EXPENSES2021-10-01$160,069COST7109166974701 Cox Rd Ste 400GLEN ALLENVA23060N/A
Woods Rogers Plc
TRANSACTION EXPENSES2021-10-01$12,300COST54129438610 S Jefferson StROANOKEVA24011N/A
Berkeley Research Group LLC
TRANSACTION EXPENSES2021-10-01$31,808COST271451273PO Box 676158DALLASTX75267N/A
CENTRA HEALTH INC
CASH2021-12-29$10,148,542MARKET5407155691920 ATHERHOLT ROADLYNCHBURGVA24501501(C)(3)
SEE PART III
CASH2021-10-04$1,000,000MARKET5405382171290 Enterprise DrLYNCHBURGVA24502501(C)(3)
SEE PART III
CASH2021-12-29$275,983MARKET5405382171290 Enterprise DrLYNCHBURGVA24502501(C)(3)
FieldValueIRS element (for citing)
Director Of Successor2falseDirectorOfSuccessor2Ind
Employee Of Successor2falseEmployeeOfSuccessor2Ind
Owner Of Successor2falseOwnerOfSuccessor2Ind
Receive Compensation2falseReceiveCompensation2Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE N, PART II, LINE 1 (7 & 8), COLUMN (F):FormAndLineReferenceDesc
ExplanationNAME OF RECIPIENT: Christian Church (Disciples of Christ) in VirginiaExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (17 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part III, Line 3On October 1, 2021 CCRC, Inc. sold substantially all of its operating assets. The purchasers assumed all obligations and rights under The Summit resident agreements. In connection with the same transaction, Centra sold The Summit's assisted living facility along with the furniture, fixture, and equipment, residency agreements, and contracts used in the operation of the assisted living facility to such purchasers. The company was officially dissolved on May 17, 2022.
Form 990, Part VI, Section A, Line 4AALSO INCLUDED ON CAMPUS WAS THE SUMMIT ASSISTED LIVING AND THE SUMMIT HEALTH AND REHABILITATION, BOTH WHOLLY OWNED AND OPERATED BY CENTRA HEALTH, INC. AS SUCH, THE SUMMIT PROVIDED THE FACILITIES, SERVICES, AMENITIES AND PROGRAMS TO SUPPORT AN ENGAGING LIFESTYLE FOR RESIDENTS. THE SUMMIT HOSTED SEVERAL GROUPS THAT BENEFITED BOTH RESIDENTS AND MEMBERS FROM THE LARGER COMMUNITY, INCLUDING THE INTERFAITH VISION SUPPORT GROUP, THE JAMERSON YMCA AND THE CENTRAL VIRGINIA PARKINSON'S SUPPORT GROUP. THE SUMMIT HOSTED SEVERAL ANNUAL WYNDHURST COMMUNITY EVENTS INCLUDING WYNDHURST WEDNESDAY FOOD TRUCK EVENTS AND AN ANNUAL FOURTH OF JULY FIREWORKS CELEBRATION. THE SUMMIT HOSTED EDUCATIONAL EVENTS IN COOPERATION WITH AREA NONPROFIT AGENCIES SUCH AS AARP, POPLAR FOREST REDEVOLOPMENT GROUP, THE CENTRA FOUNDATION, CENTRAL AND WESTERN VIRGINIA ALZHEIMER'S ASSOCAITION, JAMERSON FAMILY YMCA AND THE WYNDHURST ASSOCIATION. SEVERAL OF THE SUMMIT ACTIVITY PROGRAMS WERE OPEN TO BOTH RESIDENT AND NONRESIDENTS, INCLUDING WELLNESS PROGRAMING, USE OF OUR FITNESS CENTER, EDUCATIONAL AND CULTURAL EVENTS. THE SUMMIT WAS HOST TO THE AREA BIRD WATCHING ASSOCIATION AND WAS A DESIGNATED WILDLIFE HABITAT BY THE NATIONAL WILDLIFE FOUNDATION. THE SUMMIT HOSTED A WEEKLY WORSHIP SERVICE FOR RESIDENTS, INVITING AREA CLERGY TO PROVIDE LEADERSHIP. STAFF PROVIDED VOLUNTEER SUPPORT FOR EACH OF THE ABOVE ORGANIZATIONS AND OTHERS INCLUDING THE WYNDHURST ASSOCIATION, VANHA, LEADINGAGE, THE LYNCHBURG REGIONAL BUSINESS ALLIANCE, AND OTHERS. ADDITIONALLY, THE SUMMIT PROVIDES IN-KIND SERVICES TO EVENTS SPONSORED BY THE WYNDHURST ASSOCIATION. OPERATIONS FOR CCRC CEASED AS OF OCTOBER , 2021. ASSOCIATION. OPERATIONS FOR CCRC CEASED AS OF OCTOBER , 2021.
Form 990, Part VI, Section A, Line 6THE ORGANIZATION IS A NOT-FOR-PROFIT, STOCK COMPANY. AS OF THE END OF 2021, THERE WERE 363 SHARES OF COMMON STOCK AND ZERO SHARES OF PREFERRED STOCK OUTSTANDING. CENTRA HEALTH, INC. OWN 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 7ACENTRA HEALTH, INC., AS THE MAJORITY OWNER OF THE CCRC, INC. STOCK, HAS THE RIGHT TO APPOINT THE MAJORITY OF THE CCRC, INC. BOARD.
Form 990, Part VI, Section B, Line 7bCENTRA 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 B, Line 11BTHE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTANT WITH ASSISTANCE AND OVERSIGHT BY MANAGEMENT. COPIES OF THE FORM 990 HAVE BEEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD OF DIRECTORS, AND ANY QUESTIONS RAISED BY THE BOARD OF DIRECTORS HAVE BEEN ADDRESSED.
Form 990, Part VI, Section B, Line 12cALL CENTRA HEALTH, INC./CCRC, INC. OFFICERS AND DIRECTORS MUST COMPLETE A "POSSIBLE CONFLICT OF INTEREST" QUESTIONNAIRE ON AN ANNUAL BASIS, CERTIFYING THAT NEITHER THEY NOR ANY OF THEIR IMMEDIATE FAMILY MEMBERS HAVE ENGAGED IN ANY ACTIVITIES THAT COULD LEAD TO A POTENTIAL CONFLICT OF INTEREST. ADDITIONALLY, ALL OFFICERS AND DIRECTORS MUST AGREE TO PROMPTLY REPORT ANY POTENTIAL CONFLICTS OF INTEREST THAT ARISE DURING THE YEAR TO THE PRESIDENT OR CHAIRMAN OF THE BOARD OF DIRECTORS.
Form 990, Part VI, Section C, Line 15a and 15bFORM 990, PART VI, LINES 15A AND 15B WERE ANSWERED AS "NO", HOWEVER, UNDER A MANAGEMENT AGREEMENT WITH CENTRA HEALTH, INC., A RELATED PARTY AND 91% SHAREHOLDER OF CCRC, INC., THE ORGANIZATION'S EXECUTIVE DIRECTOR'S COMPENSATION WAS ESTABLISHED IN ACCORDANCE WITH CENTRA HEALTH'S EXECUTIVE COMPENSATION PRACTICES WHICH INCLUDE THE USE OF A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT(S), AND COMPENSATION STUDY OR SURVEY.
Form 990, Part VI, Section C, Line 18PHOTOCOPIES OF THE ORGANIZATION'S RECENT FILINGS OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. ADDITIONALLY, FILINGS OF THE FORM 990 CAN ALSO BE FOUND ONLINE AT WWW.GUIDESTAR.ORG.
Form 990, Part VI, Section C, Line 19PHOTOCOPIES 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, Part XI, Line 9RETURN OF CAPITAL DISTRIBUTIONS $-14,384,486
FORM 990 PART IX LINE 11GDESCRIPTION:CATERING SERVICES TOTAL FEES:470683
FORM 990 PART IX LINE 11GDESCRIPTION:RESIDENT SERVICES TOTAL FEES:29450
FORM 990 PART IX LINE 11GDESCRIPTION:OTHER MARKETING TOTAL FEES:1086
FORM 990 PART IX LINE 11GDESCRIPTION:HEALTHCARE BENEFITS TOTAL FEES:42350
FORM 990 PART IX LINE 11GDESCRIPTION:FACILITIES MAINTENANCE SVCS TOTAL FEES:7928
FORM 990 PART IX LINE 11GDESCRIPTION:SUMMIT BENEVOLENT FUND TOTAL FEES:9000

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
CENTRA HEALTH INC
1920 ATHERHOLT ROADLYNCHBURGVA24501540715569HEALTHCAREVA501(C)(3)3NAfalse
CENTRA HEALTH FOUNDATION
1920 ATHERHOLT ROADLYNCHBURGVA24501541604094SUPPORTINGVA501(C)(3)12ANAfalse
SOUTHSIDE COMMUNITY HOSPITAL
800 OAK STREETFARMVILLEVA23901540555201HEALTHCAREVA501(C)(3)3NAfalse
BEDFORD MEMORIAL HOSPITAL
1613 OAKWOOD STREETBEDFORDVA24523540566100HEALTHCAREVA501(C)(3)3NAfalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationInd
GENERAL BUSINESS CONCERNS INC
1920 ATHERHOLT ROADLYNCHBURGVA24501541299682REAL ESTATE/PHYSVANAC Corp$0$00.00000false
PCHP HOLDING INC
2316 ATHERHOLT ROADLYNCHBURGVA24501541749492HOLDING COMPANYVANAC Corp$0$00.00000false
PIEDMONT COMMUNITY HEALTH PLAN INC
2316 ATHERHOLT ROADLYNCHBURGVA24501541755768HEALTH INSURANCEVANAC Corp$0$00.00000false
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd