SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2017
Open to Public
Inspection
Name of the organization
CULPEPER BAPTIST RETIREMENT COMMUNITY
INC
Employer identification number

52-1368412
Return Reference Explanation
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.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2017


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