Form990-PF


Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
For calendar year 2021, or tax year beginning 04-01-2021 , and ending 03-31-2022
Name of foundation
OBICI HEALTHCARE FOUNDATION INC
 
Number and street (or P.O. box number if mail is not delivered to street address)106 W FINNEY AVENUE
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
SUFFOLK, VA23434
A Employer identification number

51-0249728
B Telephone number (see instructions)

(757) 539-8810
C bullet
G Check all that apply:

D 1. Foreign organizations, check here............. bullet
2. Foreign organizations meeting the 85%
test, check here and attach computation ... bullet
E bullet
H Check type of organization:
F bullet
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$146,896,996J Accounting method:
 
(Part I, column (d) must be on cash basis.)
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).) (a) Revenue and
expenses per
books 		(b) Net investment
income 		(c) Adjusted net
income 		(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule) 84,357
2 Check bullet.............
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities... 125,832 125,832  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 6,342,753
b Gross sales price for all assets on line 6a 9,576,387
7 Capital gain net income (from Part IV, line 2)... 6,342,753
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule)....... Click to see attachment 1,118 9,588,815 0
12 Total. Add lines 1 through 11........ 6,554,060 16,057,400 0
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 354,964 0 0 354,964
14 Other employee salaries and wages...... 358,893 0 0 358,893
15 Pension plans, employee benefits....... 152,086 0 0 183,386
16a Legal fees (attach schedule)......... Click to see attachment 2,380 0 0 2,380
b Accounting fees (attach schedule)....... Click to see attachment 63,355 0 0 63,358
c Other professional fees (attach schedule).... Click to see attachment 720,871 720,871 0 0
17 Interest............... 40,193 0 0 0
18 Taxes (attach schedule) (see instructions)... Click to see attachment 142,051 0 0 205
19 Depreciation (attach schedule) and depletion... 80,461 0 0
20 Occupancy.............. 87,495 0 0 87,201
21 Travel, conferences, and meetings....... 22,107 0 0 21,734
22 Printing and publications.......... 30,061 0 0 29,958
23 Other expenses (attach schedule)....... Click to see attachment 470,158 0 0 444,935
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 2,525,075 720,871 0 1,547,014
25 Contributions, gifts, grants paid....... 2,911,842 4,462,821
26 Total expenses and disbursements. Add lines 24 and 25 5,436,917 720,871 0 6,009,835
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 1,117,143
b Net investment income (if negative, enter -0-) 15,336,529
c Adjusted net income (if negative, enter -0-)... 0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2021)
Form 990-PF (2021)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.) 		Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing............. 159,352 356,428 356,428
2 Savings and temporary cash investments......... 7,599,266 1,548,165 1,548,165
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet        
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable................. 14,298 8,820 8,820
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges.......... 29,003 12,812 12,812
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule)....... 8,024,054 Click to see attachment7,519,418 7,519,418
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 125,729,135 Click to see attachment135,764,780 135,764,780
14 Land, buildings, and equipment: basis bullet2,452,236
Less: accumulated depreciation (attach schedule) bullet1,163,332 1,333,056 1,288,904 1,288,904
15 Other assets (describe bullet) Click to see attachment741,506 Click to see attachment397,669 Click to see attachment397,669
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 143,629,670 146,896,996 146,896,996
Liabilities 17 Accounts payable and accrued expenses.......... 86,996 68,022
18 Grants payable................. 2,345,029 819,331
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)...... 1,030,006 935,975
22 Other liabilities (describe bullet) Click to see attachment707,910 Click to see attachment690,120
23 Total liabilities (add lines 17 through 22)......... 4,169,941 2,513,448
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here bullet
and complete lines 24, 25, 29 and 30.
24 Net assets without donor restrictions........... 139,459,729 144,383,548
25 Net assets with donor restrictions............    
Foundations that do not follow FASB ASC 958, check here bullet
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........    
27 Paid-in or capital surplus, or land, bldg., and equipment fund    
28 Retained earnings, accumulated income, endowment, or other funds    
29 Total net assets or fund balances (see instructions)..... 139,459,729 144,383,548
30 Total liabilities and net assets/fund balances (see instructions). 143,629,670 146,896,996
Part III
Analysis of Changes in Net Assets or Fund Balances
1
Total net assets or fund balances at beginning of year—Part II, column (a), line 29 (must agree with end-of-year figure reported on prior year’s return) ...............
1
139,459,729
2
Enter amount from Part I, line 27a .....................
2
1,117,143
3
Other increases not included in line 2 (itemize) bulletClick to see attachment
3
4,091,247
4
Add lines 1, 2, and 3 ..........................
4
144,668,119
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
284,571
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
144,383,548
Form 990-PF (2021)
Form 990-PF (2021)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)		 (b)
How acquired
P—Purchase
D—Donation 		(c)
Date acquired
(mo., day, yr.) 		(d)
Date sold
(mo., day, yr.)
1 a NET GAINS/LOSSES FROM SALES OF SECURITIES P   2022-03-30
b FOREIGN CORPORATION REDEMPTIONS P   2022-03-30
c
d
e
(e)
Gross sales price 		(f)
Depreciation allowed
(or allowable) 		(g)
Cost or other basis
plus expense of sale 		(h)
Gain or (loss)
(e) plus (f) minus (g)
a 691,499     691,499
b 8,884,888   3,233,634 5,651,254
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69 		(j)
Adjusted basis
as of 12/31/69 		(k)
Excess of col. (i)
over col. (j), if any
a       691,499
b       5,651,254
c
d
e
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2 6,342,753
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ................... 		Bracket 3 6,342,753
Form 990-PF (2021)
Form 990-PF (2021)
Page 4
Part V
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket for line 1a
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2........................... 3 213,178
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4 0
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 213,178
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 159,200
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 100,000
d Backup withholding erroneously withheld ........... 6d 0
7 Total credits and payments. Add lines 6a through 6d.............. 7 259,200
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8 0
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 46,022
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet46,022 RefundedBullet 11 0
Part VI-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$ 0(2) On foundation managers.bullet$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$ 0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?.........
4a
Yes
 
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
Yes
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XIV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletVA
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2021 or the taxable year beginning in 2021? See the instructions for Part XIII.
    If "Yes," complete Part XIII .............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    10
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 5
    Part VI-A
    Statements Regarding Activities (continued)
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement. See instructions.................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbulletHTTP://WWW.OBICIHCF.ORG
    14
    The books are in care ofbulletTHE ORGANIZATION Telephone no.bullet (757) 539-8810

    Located atbullet106 W FINNEY AVENUESUFFOLKVA ZIP+4bullet23434
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2021, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person? ...........
    1a(1)
     
    No
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person? ..............................
    1a(2)
     
    No
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........
    1a(3)
     
    No
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............
    1a(4)
    Yes
     
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)? ......................
    1a(5)
     
    No
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.) ...............
    1a(6)
     
    No
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ..........
    1b
     
    No
    c
    ........bullet
    d
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2021? .............
    1d
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2021, did the foundation have any undistributed income (lines 6d
    and 6e, Part XII) for tax year(s) beginning before 2021?....................
    2a
     
    No
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year? ..............................
    3a
     
    No
    b
    If "Yes," did it have excess business holdings in 2021 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2021.) .....................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2021? ..
    4b
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 6
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? ..........
    5a(1)
     
    No
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive? ....................
    5a(2)
     
    No
    (3) Provide a grant to an individual for travel, study, or other similar purposes? .............
    5a(3)
     
    No
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions ........................
    5a(4)
     
    No
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals? .............
    5a(5)
     
    No
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ........
    5b
     
     
    c
    .........bullet
    d
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant? .................
    5d
     
     
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract? .............................
    6a
     
    No
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    7a
     
    No
    b
    If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? .....
    7b
     
     
    8
    Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
    excess parachute payment during the year? .........................
    8
     
    No
    Part VII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation. See instructions
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation
     (If not paid, enter
    -0-)     		(d) Contributions to employee benefit plans and deferred compensation (e) Expense account,
    other allowances
    THOMAS WOODWARD III CHAIRMAN
    1.00     		0 0 0
    106 W FINNEY AVENUE
    SUFFOLK,VA23434
    LYNNE RABIL BOARD OF DIRECTORS
    1.00     		0 0 0
    106 W FINNEY AVENUE
    SUFFOLK,VA23434
    ROBERT C BARCLAY IV VICE-CHAIRMAN
    1.00     		0 0 0
    106 W FINNEY AVENUE
    SUFFOLK,VA23434
    R SCOTT CARR BOARD OF DIRECTORS
    1.00     		0 0 0
    106 W FINNEY AVENUE
    SUFFOLK,VA23434
    WAYNE SCOTT BOARD OF DIRECTORS
    1.00     		0 0 0
    106 W FINNEY AVENUE
    SUFFOLK,VA23434
    PAT EDWARDS BOARD OF DIRECTORS
    1.00     		0 0 0
    106 W FINNEY AVENUE
    SUFFOLK,VA23434
    MIKE PONDER BOARD OF DIRECTORS
    1.00     		0 0 0
    106 W FINNEY AVENUE
    SUFFOLK,VA23434
    RALPH HOWELL JR TREASURER
    1.00     		0 0 0
    106 W FINNEY AVENUE
    SUFFOLK,VA23434
    BILL PEAK BOARD OF DIRECTORS
    1.00     		0 0 0
    106 W FINNEY AVENUE
    SUFFOLK,VA23434
    MELISSA ROLLINS BOARD OF DIRECTORS
    1.00     		0 0 0
    106 W FINNEY AVENUE
    SUFFOLK,VA23434
    JANICE WHITE BOARD OF DIRECTORS
    1.00     		0 0 0
    106 W FINNEY AVENUE
    SUFFOLK,VA23434
    ANNETTE C BEUCHLER PRESIDENT & CEO / BOARD SECRETARY
    40.00     		171,911 14,230 0
    106 W FINNEY AVENUE
    SUFFOLK,VA23434
    VICTORIA MASTON DIRECTOR OF FINANCE
    23.00     		26,088 3,599 0
    106 W FINNEY AVENUE
    SUFFOLK,VA23434
    ALONZO CRAWLEY DIRECTOR OF FINANCE
    40.00     		79,965 10,713 0
    106 W FINNEY AVENUE
    SUFFOLK,VA23434
    CHRISTINE MORRIS INTERIM CEO
    24.00     		77,000 0 0
    106 W FINNEY AVENUE
    SUFFOLK,VA23434
    MARY HADDAD BOARD OF DIRECTORS
    1.00     		0 0 0
    106 W FINNEY AVENUE
    SUFFOLK,VA23434
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation     		(e) Expense account,
    other allowances
    JESSICA MULLEN PROGRAM OFFICER
    40.00     		92,888 14,586 0
    106 W FINNEY AVENUE
    SUFFOLK,VA23434
    FIONA CHARLES PROGRAM OFFICER
    40.00     		84,590 12,330 0
    106 W FINNEY AVENUE
    SUFFOLK,VA23434
    KELVIN TURNER PROGRAM OFFICER
    40.00     		69,013 10,273 0
    106 W FINNEY AVENUE
    SUFFOLK,VA23434
    GINA LILLEY OFFICE MANAGER
    40.00     		56,852 18,019 0
    106 W FINNEY AVENUE
    SUFFOLK,VA23434
    Total number of other employees paid over $50,000...................bullet 0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 7
    Part VII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors (continued)
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    CORNERSTONE PARTNERS LLC INVESTMENT MANAGEMENT 614,316
    675 PETER JEFFERSON PKWY STE 160
    CHARLOTTESVILLE,VA22911
    THE CURTIS GROUP FUNDRAISING CONSULTANT-NFP PARTNERS 138,000
    2512 SHEPHERDS LANE
    VIRGINIA BEACH,VA23454
    THE NORTHERN TRUST COMPANY INVESTMENT CUSTODIAN 106,555
    50 S LASALLE ST
    CHICAGO,IL60675
    CATCHAFIRE INC PLATFORM FEES FOR CAPACITY BUILDING SUPPORT 95,000
    31 E 32ND STREET 3RD FLOOR
    NEW YORK,NY10016
    WITTKIEFFER INC RECRUITING SERVICES 76,167
    2015 SPRING ROAD SUITE 510
    OAK BROOK,IL60523
    Total number of others receiving over $50,000 for professional services.............bullet1
    Part VIII-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1 STRENGTHENING THE SAFETY NET 1,013,876
    2 EARLY CHILDHOOD EDUCATION 709,584
    3 CAPACITY BUILDING 432,717
    4 HEALTHY BEHAVIORS 396,655
    Part VIII-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 8
    Part IX
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    143,653,836
    b
    Average of monthly cash balances.......................
    1b
    3,762,971
    c
    Fair market value of all other assets (see instructions)................
    1c
    409,526
    d
    Total (add lines 1a, b, and c).........................
    1d
    147,826,333
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
    0
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d.........................
    3
    147,826,333
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    2,217,395
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    145,608,938
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    7,280,447
    Part X
    Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here right arrow and do not complete this part.)
    1
    Minimum investment return from Part IX, line 6..................
    1
    7,280,447
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    213,178
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    213,178
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    7,067,269
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    25,279
    5
    Add lines 3 and 4............................
    5
    7,092,548
    6
    Deduction from distributable amount (see instructions).................
    6
    0
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1 ...
    7
    7,092,548
    Part XI
    Qualifying Distributions (see instructions)
    1
    Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:
    a
    Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........
    1a
     
    b
    Program-related investments—total from Part VIII-B..................
    1b
     
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
     
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part XII, line 4.
    4
     
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 9
    Part XII
    Undistributed Income (see instructions)
    (a)
    Corpus     		(b)
    Years prior to 2020     		(c)
    2020     		(d)
    2021
    1 Distributable amount for 2021 from Part X, line 7 7,092,548
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only....... 6,014,324
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2021:
    a From 2016......  
    b From 2017......  
    c From 2018......  
    d From 2019......  
    e From 2020......  
    f Total of lines 3a through e ........ 0
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 6,046,143
    a Applied to 2020, but not more than line 2a 6,014,324
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		0
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		0
    d Applied to 2021 distributable amount..... 31,819
    e Remaining amount distributed out of corpus 0
    5 Excess distributions carryover applied to 2021. 0 0
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 0
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		0
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		0
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		0
    e Undistributed income for 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		0
    f Undistributed income for 2021. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2022 ..........     		7,060,729
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		0
    8 Excess distributions carryover from 2016 not
    applied on line 5 or line 7 (see instructions) ...     		0
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		0
    10 Analysis of line 9:
    a Excess from 2017....  
    b Excess from 2018....  
    c Excess from 2019....  
    d Excess from 2020....  
    e Excess from 2021....  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 10
    Part XIII
    Private Operating Foundations (see instructions and Part VI-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2021, enter the date of the ruling ....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 2021 (b) 2020 (c) 2019 (d) 2018
             
    b 85% (0.85) of line 2a .........          
    c Qualifying distributions from Part XI,
    line 4 for each year listed .....     		         
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ..........     		         
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		         
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)    		          
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part IX, line 6 for each year listed ..     		         
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		         
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		         
    (3) Largest amount of support
    from an exempt organization    		          
    (4) Gross investment income          
    Part XIV
    Supplementary Information (Complete this part only if the foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
    GRANTS MANAGER
    106 W FINNEY AVENUE
    SUFFOLK,VA23434
    (757) 539-8810
    bThe form in which applications should be submitted and information and materials they should include:
    APPLICATIONS MUST BE SUBMITTED THROUGH THE FOUNDATION'S GRANT PORTAL ACCESSED THROUGH THE OBICI HEALTHCARE FOUNDATION WEBSITE: HTTPS://OBICIHCF.ORG/HOW-TO-APPLY/ THE FOLLOWING MATERIALS MUST ACCOMPANY THE PRIORITY GRANT APPLICATION: 1. IRS DETERMINATION LETTER OR A WRITTEN DOCUMENT CERTIFYING TAX EXEMPT STATUS 2. PROPOSAL COVER SHEET 3. PROJECT NARRATIVE 4. BUDGET WORKSHEET AND BUDGET NARRATIVE 5. CURRENT AUDITED FINANCIAL STATEMENTS OR 990 6. ANY OTHER SUPPLEMENTAL MATERIAL DETAILED IN THE RFP
    cAny submission deadlines:
    PRIORITY GRANTS - DEADLINES VARY BY RFP COMMUNITY ENGAGEMENT GRANTS - NO DEADLINE
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    1. LOBBYING OR POLITICAL PROGRAMS OR EVENTS 2. ACTIVITIES THAT EXCLUSIVELY BENEFIT THE MEMBERS OF SECTARIAN OR RELIGIOUS ORGANIZATIONS 3. ORGANIZATIONS THAT DISCRIMINATE BY RACE, COLOR, CREED, GENDER OR NATIONAL ORIGIN 4. BIOMEDICAL, CLINICAL OR EDUCATIONAL RESEARCH 5. INDIVIDUAL SCHOLARSHIPS 6. DIRECT SUPPORT TO ENDOWMENTS 7. FUNDING THAT SUPPLANTS EXISTING SOURCES OF SUPPORT 8. INDIVIDUALS, INCLUDING PATIENT ASSISTANCE FUNDS 9. PROJECTS OUTSIDE OF THE FOUNDATION'S SERVICE AREA 10. MEETINGS AND CONFERENCES, UNLESS THEY ARE ESSENTIAL TO A LARGER PROJECT 11. DIRECT FUNDING FOR MEDICAL OR SOCIAL SERVICES THAT ARE ALREADY FUNDED THROUGH EXISTING THIRD-PARTY REIMBURSEMENT SOURCES 12. ORGANIZATIONS THAT DO NOT HAVE 501(C)(3) STATUS OR ARE NOT A PUBLIC ENTITY 13. PROJECTS NOT RELATED TO THE FOUNDATION'S MISSION STATEMENT
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 11
    Part XIV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    		 Foundation
    status of
    recipient     		Purpose of grant or
    contribution     		Amount
    Name and address (home or business)
    aPaid during the year
    ZOO-NYE CLOSET
    P O BOX 61
    ZUNI,VA23898     		N/A PC COMMUNITY ENGAGEMENT GRANT 5,000
    AMERICAN NATIONAL RED CROSS
    611 W BRAMBLETON AVENUE
    NORFOLK,VA23510     		N/A PC COMMUNITY ENGAGEMENT GRANT 3,000
    ALBEMARLE AREA UNITED WAY INC
    PO BOX 293
    ELIZABETH CITY,NC27907     		N/A PC COMMUNITY ENGAGEMENT GRANT 3,000
    WESTERN TIDEWATER TENNIS ASSOCIATION
    136 WYNNWOOD DRIVE
    FRANKLIN,VA23851     		N/A PC COMMUNITY ENGAGEMENT GRANT 4,000
    JDRF MID-ATLANTIC
    1400 K STREET NW SUITE 1200
    WASHINGTON,DC20005     		N/A PC COMMUNITY ENGAGEMENT GRANT 5,000
    NATIONAL KIDNEY FOUNDATION
    1622 E PARHAM RD
    RICHMOND,VA23228     		N/A PC COMMUNITY ENGAGEMENT GRANT 1,500
    PENINSULA COMMUNITY FOUNDATION OF VIRGINIA
    1 ENTERPRISE PARKWAY
    HAMPTON,VA23666     		N/A PC COMMUNITY ENGAGEMENT GRANT 1,000
    YOUNG AUDIENCES OF VIRGINIA INC
    420 NORTH CENTER DRIVE
    NORFOLK,VA23502     		N/A PC COMMUNITY ENGAGEMENT GRANT 2,500
    ALZHEIMER'S ASSOCIATION - SOUTHEASTERN VIRGINIA CHAPTER
    6350 CENTER DRIVE SUITE 102
    NORFOLK,VA23502     		N/A PC COMMUNITY ENGAGEMENT GRANT 1,000
    SOUTHAMPTON COUNTY PUBLIC SCHOOLS
    21308 PLANK ROAD
    COURTLAND,VA23837     		N/A GOV COMMUNITY ENGAGEMENT GRANT 5,000
    HOPE CENTER MINISTRIES
    517 KILBY SHORES DR
    SUFFOLK,VA23434     		N/A PC COMMUNITY ENGAGEMENT GRANT 5,000
    PAUL D CAMP COMMUNITY COLLEGE FOUNDATION
    100 NORTH COLLEGE DRIVE
    FRANKLIN,VA23851     		N/A PC COMMUNITY ENGAGEMENT GRANT 5,000
    TIDEWATER FRIENDS OF FOSTER CARE INC
    999 WATERSIDE DR STE 430
    NORFOLK,VA23510     		N/A PC COMMUNITY ENGAGEMENT GRANT 2,500
    ARMED SERVICES YMCA OF HAMPTON ROADS
    1465 LAKESIDE ROAD
    VIRGINIA BEACH,VA23455     		N/A PC COMMUNITY ENGAGEMENT GRANT 5,000
    COURTLAND COMMUNITY CENTER
    PO BOX 165
    COURTLAND,VA23837     		N/A PC COMMUNITY ENGAGEMENT GRANT 2,500
    SMART BEGINNINGS WESTERN TIDEWATER
    601 NORTH MECHANIC STREET
    FRANKLIN,VA23851     		N/A PC COMMUNITY ENGAGEMENT GRANT 5,000
    ISLE OF WIGHT COMMUNITY FOUNDATION
    PO BOX 38
    SMITHFIELD,VA23430     		N/A PC COMMUNITY ENGAGEMENT GRANT 2,500
    EAST END BAPTIST CHURCH
    111 CROSS TERRACE
    SUFFOLK,VA23434     		N/A PC COMMUNITY ENGAGEMENT GRANT 2,000
    VOICES FOR KIDS CASA PROGRAM OF SOUTHEAST VIRGINIA
    P O BOX 949 409 MAIN STREET
    SMITHFIELD,VA23431     		N/A PC COMMUNITY ENGAGEMENT GRANT 3,250
    OLD DOMINION UNIVERSITY RESEARCH FOUNDATION
    4111 MONARCH WAY
    NORFOLK,VA23508     		N/A PC COMMUNITY ENGAGEMENT GRANT 5,000
    HABITAT FOR HUMANITY OF SOUTH HAMPTON ROAD
    900 TIDEWATER DRIVE
    NORFOLK,VA23504     		N/A PC COMMUNITY ENGAGEMENT GRANT 5,000
    YMCA OF SOUTH HAMPTON ROADS
    920 CORPORATE LN
    CHESAPEAKE,VA23320     		N/A PC COMMUNITY ENGAGEMENT GRANT 5,000
    THE DOORWAYS FORMERLY HOSPITALITY HOUSE OF RICHMOND INC
    612 E MARSHALL STREET
    RICHMOND,VA23219     		N/A PC COMMUNITY ENGAGEMENT GRANT 2,500
    SMART BEGINNINGS SOUTHEAST
    209 E CAWSON ST
    HOPEWELL,VA23860     		N/A PC HEALTHY BEHAVIORS 99,328
    THE MICRO-NONPROFIT NETWORK INC
    1712 ROKEBY AVE
    CHESAPEAKE,VA23320     		N/A PC COMMUNITY ENGAGEMENT GRANT 5,000
    FRANKLIN LITTLE LEAGUE FOOTBALL INC
    PO BOX 536
    FRANKLIN,VA23851     		N/A PC COMMUNITY ENGAGEMENT GRANT 3,000
    VIRGINIA SUPPORTIVE HOUSING
    P O BOX 8585
    RICHMOND,VA23226     		N/A PC COMMUNITY ENGAGEMENT GRANT 5,000
    THE CHILDREN'S CENTER
    700 CAMPBELL AVE
    FRANKLIN,VA23851     		N/A PC EARLY CHILDHOOD EDUCATION 13,550
    SOUTHAMPTON COUNTY PUBLIC SCHOOLS
    21308 PLANK ROAD
    COURTLAND,VA23837     		N/A GOV EARLY CHILDHOOD EDUCATION 15,000
    ISLE OF WIGHT COUNTY SCHOOLS
    820 W MAIN ST
    SMITHFIELD,VA23430     		N/A GOV EARLY CHILDHOOD EDUCATION 18,830
    FRANKLIN CITY PUBLIC SCHOOLS
    207 W SECOND AVENUE
    FRANKLIN,VA23851     		N/A GOV EARLY CHILDHOOD EDUCATION 14,069
    SUFFOLK PUBLIC SCHOOLS
    100 NORTH MAIN STREET PO BOX 1549
    SUFFOLK,VA23434     		N/A GOV EARLY CHILDHOOD EDUCATION 54,872
    SURRY COUNTY PUBLIC SCHOOLS
    45 SCHOOL ST
    SURRY,VA23883     		N/A GOV EARLY CHILDHOOD EDUCATION 14,502
    MAKE-A-WISH GREATER VIRGINIA
    2810 N PARHAM RD
    RICHMOND,VA23294     		N/A PC COMMUNITY ENGAGEMENT GRANT 5,000
    POWER OF THE MIND INC
    PO BOX 112
    GATES,NC27937     		N/A PC COMMUNITY ENGAGEMENT GRANT 5,000
    ISLE OF WIGHT COUNTY VIRGINIA
    17090 MONUMENT CIRCLE
    ISLE OF WIGHT,VA23397     		N/A GOV COMMUNITY ENGAGEMENT GRANT 5,000
    THE CHILDREN'S CENTER
    700 CAMPBELL AVE
    FRANKLIN,VA23851     		N/A PC MATERNAL CHILD HEALTH 66,398
    WESTERN TIDEWATER HEALTH DISTRICT
    135 HALL AVENUE
    SUFFOLK,VA23434     		N/A GOV MATERNAL CHILD HEALTH 145,852
    THE UP CENTER
    150 BOUSH STREET SUITE 500
    NORFOLK,VA23510     		N/A PC STRENGTHENING THE SAFETY NET 79,597
    VIRGINIA LEGAL AID SOCIETY INC
    513 CHURCH ST
    LYNCHBURG,VA24504     		N/A PC STRENGTHENING THE SAFETY NET 109,800
    WESTERN TIDEWATER FREE CLINIC
    2019 MEADE PARKWAY
    SUFFOLK,VA23434     		N/A PC STRENGTHENING THE SAFETY NET 301,951
    THE SUFFOLK FOUNDATION
    110 W FINNEY AVE
    SUFFOLK,VA23434     		N/A PC COMMUNITY ENGAGEMENT GRANT 5,000
    FORKIDS INC
    PO BOX 6044
    NORFOLK,VA23508     		N/A PC STRENGTHENING THE SAFETY NET 24,000
    RX DRUG ACCESS PARTNERSHIP
    1500 FOREST AVE
    RICHMOND,VA23229     		N/A PC STRENGTHENING THE SAFETY NET 12,000
    OUR BROTHERS KEEPER
    5250 CHALLEDON DR
    VIRGINIA BEACH,VA23462     		N/A PC COMMUNITY ENGAGEMENT GRANT 4,200
    HORIZON HEALTH SERVICES INC
    8314 MAIN STREET
    IVOR,VA23866     		N/A PC STRENGTHENING THE SAFETY NET 102,000
    WESTERN TIDEWATER COMMUNITY SERVICES BOARD
    7025 HARBOUR VIEW BLVD SUITE 119
    SUFFOLK,VA23435     		N/A PC STRENGTHENING THE SAFETY NET 127,414
    ASSOCIATION OF FUNDRAISING PROFESSIONAL HAMPTON ROADS
    101 W MAIN STREET
    NORFOLK,VA23510     		N/A PC COMMUNITY ENGAGEMENT GRANT 1,000
    UNIVERSITY OF VIRGINIA
    PO BOX 400195
    CHARLOTTESVILLE,VA22904     		N/A PC EARLY CHILDHOOD EDUCATION 198,056
    DOWN THE MIDDLE FOUNDATION
    33350 EDGEHILL DRIVE
    FRANKLIN,VA23851     		N/A PC COMMUNITY ENGAGEMENT GRANT 5,000
    SURRY COUNTY
    45 SCHOOL STREET
    SURRY,VA23883     		N/A GOV HEALTHY BEHAVIORS 100,000
    GIRL SCOUT COUNCIL OF THE COLONIAL COAST
    912 CEDAR RD
    CHESAPEAKE,VA23322     		N/A PC COMMUNITY ENGAGEMENT GRANT 2,000
    ISLE OF WIGHT CHRISTIAN OUTREACH PROGRAM
    402 GRACE STREET
    SMITHFIELD,VA23430     		N/A PC COMMUNITY ENGAGEMENT GRANT 5,000
    MISSIONARY OUTREACH
    811 SEMINOLE DRIVE
    SUFFOLK,VA23434     		N/A PC COMMUNITY ENGAGEMENT GRANT 5,000
    TOFT INC
    6210 OAKGLEN DRIVE
    SUFFOLK,VA23435     		N/A PC COMMUNITY ENGAGEMENT GRANT 5,000
    AMERICAN DIABETES ASSOCIATION
    237 HANBURY ROAD EAST SUITE 17 108
    CHESAPEAKE,VA23322     		N/A PC COMMUNITY ENGAGEMENT GRANT 5,000
    CITY OF SUFFOLK
    442 WASHINGTON STREET
    SUFFOLK,VA23434     		N/A GOV COMMUNITY ENGAGEMENT GRANT 2,500
    WALK IN IT INC
    PO BOX 1447
    SUFFOLK,VA23439     		N/A PC INNOVATION GRANT 60,000
    TIDEWATER FRIENDS OF FOSTER CARE INC
    999 WATERSIDE DR STE 430
    NORFOLK,VA23510     		N/A PC INNOVATION GRANT 75,000
    NURSING CAP INC
    PO BOX 5593
    SUFFOLK,VA23435     		N/A PC INNOVATION GRANT 34,500
    COMMUNITY HARVEST OUTREACH
    22404 COURTHOUSE HWY
    WINDSOR,VA23487     		N/A PC INNOVATION GRANT 25,000
    WESTERN TIDEWATER FREE CLINIC
    2019 MEADE PARKWAY
    SUFFOLK,VA23434     		N/A PC INNOVATION GRANT 500,000
    CHILDREN'S HEALTH INVESTMENT PROGRAM OF SOUTH HAMPTON ROADS
    1302 JEFFERSON STREET
    CHESAPEAKE,VA23324     		N/A PC INNOVATION GRANT 241,842
    VIRGINIA LEGAL AID SOCIETY INC
    513 CHURCH ST
    LYNCHBURG,VA24504     		N/A PC INNOVATION GRANT 250,000
    GIRLS ON THE RUN OF SOUTH HAMPTON ROADS
    5817 WESLEYAN DRIVE
    VIRGINIA BEACH,VA23455     		N/A PC HEALTHY BEHAVIORS 100,000
    UNIVERSITY OF VIRGINIA
    PO BOX 400195
    CHARLOTTESVILLE,VA22904     		N/A PC EARLY CHILDHOOD EDUCATION 132,037
    WESTERN TIDEWATER COMMUNITY SERVICES BOARD
    7025 HARBOUR VIEW BLVD SUITE 119
    SUFFOLK,VA23435     		N/A PC COVID-19 RESPONSE FUND 27,019
    SUFFOLK CHRISTIAN FELLOWSHIP CENTER
    211 E WASHINGTON ST
    SUFFOLK,VA23434     		N/A PC COVID-19 RESPONSE FUND 17,800
    VIRGINIA LEGAL AID SOCIETY INC
    513 CHURCH ST
    LYNCHBURG,VA24504     		N/A PC COVID-19 RESPONSE FUND 45,450
    FORKIDS INC
    PO BOX 6044
    NORFOLK,VA23508     		N/A PC COVID-19 RESPONSE FUND 25,000
    GATES COUNTY PUBLIC SCHOOLS
    205 MAIN STREET
    GATESVILLE,NC27938     		N/A GOV HEALTHY BEHAVIORS 49,993
    YMCA OF SOUTH HAMPTON ROADS
    920 CORPORATE LN
    CHESAPEAKE,VA23320     		N/A PC HEALTHY BEHAVIORS 50,000
    THE UP CENTER
    150 BOUSH STREET SUITE 500
    NORFOLK,VA23510     		N/A PC STRENGTHENING THE SAFETY NET 22,437
    WESTERN TIDEWATER FREE CLINIC
    2019 MEADE PARKWAY
    SUFFOLK,VA23434     		N/A PC STRENGTHENING THE SAFETY NET 32,225
    ISLE OF WIGHT CHRISTIAN OUTREACH PROGRAM
    402 GRACE STREET
    SMITHFIELD,VA23430     		N/A PC COVID-19 RESPONSE FUND 20,000
    THE GENIEVE SHELTER
    2480 PRUDEN STREET SUITE A
    SUFFOLK,VA23434     		N/A PC STRENGTHENING THE SAFETY NET 58,953
    WESTERN TIDEWATER COMMUNITY SERVICES BOARD
    7025 HARBOUR VIEW BLVD SUITE 119
    SUFFOLK,VA23435     		N/A PC STRENGTHENING THE SAFETY NET 84,942
    HORIZON HEALTH SERVICES INC
    8314 MAIN STREET
    IVOR,VA23866     		N/A PC STRENGTHENING THE SAFETY NET 68,000
    FORKIDS INC
    PO BOX 6044
    NORFOLK,VA23508     		N/A PC STRENGTHENING THE SAFETY NET 16,000
    VIRGINIA LEGAL AID SOCIETY INC
    513 CHURCH ST
    LYNCHBURG,VA24504     		N/A PC STRENGTHENING THE SAFETY NET 73,200
    WESTERN TIDEWATER FREE CLINIC
    2019 MEADE PARKWAY
    SUFFOLK,VA23434     		N/A PC STRENGTHENING THE SAFETY NET 201,301
    RX DRUG ACCESS PARTNERSHIP
    1500 FOREST AVE
    RICHMOND,VA23229     		N/A PC STRENGTHENING THE SAFETY NET 8,000
    THE UP CENTER
    150 BOUSH STREET SUITE 500
    NORFOLK,VA23510     		N/A PC STRENGTHENING THE SAFETY NET 53,064
    THE UP CENTER
    150 BOUSH STREET SUITE 500
    NORFOLK,VA23510     		N/A PC STRENGTHENING THE SAFETY NET 22,437
    THE CHILDREN'S CENTER
    700 CAMPBELL AVE
    FRANKLIN,VA23851     		N/A PC MATERNAL CHILD HEALTH 89,278
    WESTERN TIDEWATER HEALTH DISTRICT
    135 HALL AVENUE
    SUFFOLK,VA23434     		N/A GOV MATERNAL CHILD HEALTH 155,380
    WESTERN TIDEWATER COMMUNITY SERVICES BOARD
    7025 HARBOUR VIEW BLVD SUITE 119
    SUFFOLK,VA23435     		N/A PC COVID-19 RESPONSE FUND 27,019
    FORKIDS INC
    PO BOX 6044
    NORFOLK,VA23508     		N/A PC COVID-19 RESPONSE FUND 55,000
    ISLE OF WIGHT CHRISTIAN OUTREACH PROGRAM
    402 GRACE STREET
    SMITHFIELD,VA23430     		N/A PC COVID-19 RESPONSE FUND 20,000
    VIRGINIA LEGAL AID SOCIETY INC
    513 CHURCH ST
    LYNCHBURG,VA24504     		N/A PC COVID-19 RESPONSE FUND 79,550
    SUFFOLK PUBLIC SCHOOLS
    100 NORTH MAIN STREET PO BOX 1549
    SUFFOLK,VA23434     		N/A GOV HEALTHY BEHAVIORS 64,000
    WESTERN TIDEWATER FREE CLINIC
    2019 MEADE PARKWAY
    SUFFOLK,VA23434     		N/A PC STRENGTHENING THE SAFETY NET 32,225
    Total .................................bullet 3a 4,462,821
    bApproved for future payment
    YMCA OF SOUTH HAMPTON ROADS
    2769 GODWIN BLVD
    SUFFOLK,VA23434     		N/A PC HEALTHY BEHAVIORS 100,000
    THE GENIEVE SHELTER
    2480 PRUDEN STREET SUITE A
    SUFFOLK,VA23434     		N/A PC STRENGTHENING THE SAFETY NET 58,953
    UNIVERSITY OF VIRGINIA
    PO BOX 400195
    CHARLOTTESVILLE,VA22904     		N/A PC EARLY CHILDHOOD EDUCATION 90,964
    SMART BEGINNINGS SOUTHEAST
    209 E CAWSON ST
    HOPEWELL,VA23860     		N/A PC HEALTHY BEHAVIORS 98,015
    SUFFOLK PUBLIC SCHOOLS
    100 NORTH MAIN STREET
    SUFFOLK,VA23434     		N/A GOV HEALTHY BEHAVIORS 36,000
    THE CHILDREN'S CENTER
    700 CAMPBELL AVE
    FRANKLIN,VA23851     		N/A PC MATERNAL CHILD HEALTH 59,518
    WESTERN TIDEWATER HEALTH DISTRICT
    135 HALL AVENUE
    SUFFOLK,VA23434     		N/A GOV MATERNAL CHILD HEALTH 103,586
    SURRY COUNTY
    45 SCHOOL ST
    SURRY,VA23883     		N/A GOV HEALTHY BEHAVIORS 100,000
    UNIVERSITY OF VIRGINIA
    PO BOX 400195
    CHARLOTTESVILLE,VA22904     		N/A PC EARLY CHILDHOOD EDUCATION 60,643
    UNIVERSITY OF VIRGINIA
    PO BOX 400195
    CHARLOTTESVILLE,VA22904     		N/A PC EARLY CHILDHOOD EDUCATION 12,631
    SMART BEGINNINGS SOUTHEAST
    209 E CAWSON ST
    HOPEWELL,VA23860     		N/A PC HEALTHY BEHAVIORS 99,021
    Total .................................bullet 3b 819,331
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 12
    Part XV-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments ....          
    3 Interest on savings and temporary cash
    investments ...........     		         
    4 Dividends and interest from securities ....          
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6 Net rental income or (loss) from personal property          
    7 Other investment income .....          
    8 Gain or (loss) from sales of assets other than
    inventory ............     		    18 6,342,753  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e) .. 0 6,469,703 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    6,469,703
    (See worksheet in line 13 instructions to verify calculations.)
    Part XV-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow     		Explain below how each activity for which income is reported in column (e) of Part XV-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 13
    Part XVI
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........
    b
    If "Yes," complete the following schedule.

    (a) Name of organization (b) Type of organization (c) Description of relationship
    Sign Here
    Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
    Bullet Bullet
    May the IRS discuss this return
    with the preparer shown below?
    See instructions.
    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's name SmallBullet
    		 Firm's EIN SmallBullet
    Firm's address SmallBullet


    		 Phone no.
    Form 990-PF (2021)
    Additional Data


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description
    Schedule B
    (Form 990)
    Department of the Treasury
    Internal Revenue Service
    Schedule of Contributors

    Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
    Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
    OMB No. 1545-0047
    2021
    Name of the organization
    OBICI HEALTHCARE FOUNDATION INC
     
    Employer identification number

    51-0249728
    Organization type (check one):
    Filers of:
    Section:
    Form 990 or 990-EZ






    Form 990-PF




    Check if your organization is covered by the General Rule or a Special Rule.  
    Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
    General Rule
    Special Rules
    ......... Arrow Bullet $  
    Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
    990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
    or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
    990-EZ, or 990-PF).
    For Paperwork Reduction Act Notice, see the Instructions
    for Form 990, 990-EZ, or 990-PF.
    Cat. No. 30613XSchedule B (Form 990) (2021)
    Schedule B (Form 990) (2021) Page 2
    Name of organization
    OBICI HEALTHCARE FOUNDATION INC
          		Employer identification number
    51-0249728
    Part I
    Contributors
    Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
    1
    VIRGINIA EARLY CHILDHOOD FOUNDATION
     
    1703 N PARHAM RD 110
     
    RICHMOND, VA23229

    		$ 84,357


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    (a)
    No.    		 (b)
    Name, address, and ZIP + 4    		 (c)
    Total contributions    		 (d)
    Type of contribution
     
     
     
     

    		$  


    (Complete Part II for noncash contributions.)
    Schedule B (Form 990) (2021)
    Schedule B (Form 990) (2021)
    Page 3
    Name of organization
    OBICI HEALTHCARE FOUNDATION INC
          		Employer identification number

    51-0249728
    Part II
    Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    (a)
    No. from Part I    		 (b)
    Description of noncash property given    		 (c)
    FMV (or estimate)
    (See instructions)     		(d)
    Date received
     
    		$    
    Schedule B (Form 990) (2021)
    Schedule B (Form 990) (2021)
    Page 4
    Name of organization
    OBICI HEALTHCARE FOUNDATION INC
          		Employer identification number

    51-0249728
    Part III
    Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
    Use duplicate copies of Part III if additional space is needed.
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    (a)
    No. from Part I    		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
     
    (e) Transfer of gift
    Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
     
     
         
     
    Schedule B (Form 990) (2021)
    Additional Data


    Software ID:  
    Software Version:  

    TY 2021 AccountingFeesSchedule
    Name:
    OBICI HEALTHCARE FOUNDATION INC
    EIN:
    51-0249728
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ACCOUNTING FEES 63,355 0 0 63,358

    TY 2021 InvestmentsCorpStockSchedule
    Name:
    OBICI HEALTHCARE FOUNDATION INC
    EIN:
    51-0249728
    Name of Stock End of Year Book Value End of Year Fair Market Value
    EXCHANGE-TRADED FUNDS AND MUTUAL FUNDS 7,519,418 7,519,418

    TY 2021 InvestmentsOtherSchedule2
    Name:
    OBICI HEALTHCARE FOUNDATION INC
    EIN:
    51-0249728
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    ALTERNATIVE INVESTMENTS - FOREIGN CORPORATIONS FMV 71,123,240 71,123,240
    ALTERNATIVE INVESTMENTS - LIMITED PARTNERSHIPS AND CORPORATIONS FMV 64,641,540 64,641,540

    TY 2021 LegalFeesSchedule
    Name:
    OBICI HEALTHCARE FOUNDATION INC
    EIN:
    51-0249728
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    LEGAL EXPENSES 2,380 0 0 2,380


    TY 2021 OtherAssetsSchedule
    Name:
    OBICI HEALTHCARE FOUNDATION INC
    EIN:
    51-0249728
    Description Beginning of Year - Book Value End of Year - Book Value End of Year - Fair Market Value
    ART COLLECTION 658,240 373,669 373,669
    CEMETARY LOTS 24,000 24,000 24,000
    ACCRUED INTEREST ON INVESTMENTS 66 0 0
    REFUNDABE EXCISE TAXES 59,200 0 0


    TY 2021 OtherDecreasesSchedule
    Name:
    OBICI HEALTHCARE FOUNDATION INC
    EIN:
    51-0249728
    Description Amount
    IMPAIRMENT ON ART COLLECTION 284,571


    TY 2021 OtherExpensesSchedule
    Name:
    OBICI HEALTHCARE FOUNDATION INC
    EIN:
    51-0249728
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    PROGRAM DEVELOPMENT 323,341 0 0 317,828
    INSURANCE 13,043 0 0 4,352
    CONTRACTED SERVICES/RECRUITING 79,038 0 0 79,038
    MISC. EXPENSES 2,967 0 0 3,097
    DUES & SUBSCRIPTIONS 34,144 0 0 32,052
    TECHNOLOGY EXPENSES 17,625 0 0 8,568


    TY 2021 OtherIncomeSchedule2
    Name:
    OBICI HEALTHCARE FOUNDATION INC
    EIN:
    51-0249728
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    OTHER INCOME 1,118 0 0
    INCOME FROM PARTNERSHIPS 0 9,588,815 0


    TY 2021 OtherIncreasesSchedule
    Name:
    OBICI HEALTHCARE FOUNDATION INC
    EIN:
    51-0249728
    Description Amount
    UNREALIZED GAINS/LOSSES IN INVESTMENTS, PARTNERSHIPS & FOREIGN INVESTMENTS 4,091,247


    TY 2021 OtherLiabilitiesSchedule
    Name:
    OBICI HEALTHCARE FOUNDATION INC
    EIN:
    51-0249728
    Description Beginning of Year - Book Value End of Year - Book Value
    DEFERRED TAXES PAYABLE 707,910 636,142
    EXCISE TAX PAYABLE 0 53,978


    TY 2021 OtherProfessionalFeesSchedule
    Name:
    OBICI HEALTHCARE FOUNDATION INC
    EIN:
    51-0249728
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INVESTMENT FEES 720,871 720,871 0 0


    TY 2021 TaxesSchedule
    Name:
    OBICI HEALTHCARE FOUNDATION INC
    EIN:
    51-0249728
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    EXCISE TAXES 141,846 0 0 0
    OTHER TAXES AND FEES 205 0 0 205