2022-11-15T08:37:36-07:00 2021-12-31 990 2021-01-01 161584941 ORCHARD PARK CCRC INC ORCH 7166625001 One Fox Run Lane Orchard Park NY 14127 William Wlodarczyk Chief Executive Officer 7166625001 2022-11-15 1 11 1 AAL2 2021 2022-09-23 18:48:47Z Fox Run at Orchard Park William Wlodarczyk One Fox Run Lane Orchard Park NY 14127 19429496 0 X www.foxrunorchardpark.com X 2002 NY Consistent with God's love, Fox Run at Orchard Park offers an exceptional living option where seniors may age with grace and dignity. We are committed to providing a lifecare environment where our residents enjoy security and peace of mind within a community of caring people. 11 10 308 27 0 0 1579356 7196 18000027 18105044 307719 222487 0 0 19887102 18334727 0 0 0 0 8455380 8462544 0 0 0 9189194 8946488 17644574 17409032 2242528 925695 80031728 79217375 100510058 98867544 -20478330 -19650169 Consistent with God's love, Fox Run at Orchard Park offers an exceptional living option where seniors may age with grace and dignity. We are committed to providing a lifecare environment where our residents enjoy security and peace of mind within a community of caring people. 0 0 15338853 0 18105334 Operated a continuing care retirement community located in Orchard Park, New York. The community consists of 180 Independent living units, a 34 unit assisted living facility, an 18 unit memory care facility and a 60 bed skilled nursing facility, all located in a campus environment. 0 0 0 15338853 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 24 0 1 308 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X X Jill L Szalach 7166625001 One Fox Run Lane Orchard Park NY 14127 William Wlodarczyk Chief Executive Officer 37.5 0 X 202195 0 21146 Jill Szalach Chief Financial Officer 37.5 0 X 150835 0 10348 Mary Lou Letina-Land Director of Sales and Marketing 37.5 0 X 115824 0 17652 Barbara Troy RN 37.5 0 X 101660 0 14698 Ronald Witt Board Member President 2 0 X X 0 0 0 John Sherman Board Member Vice President 2 0 X X 0 0 0 Jill Ortner Board Member Secretary 2 0 X X 0 0 0 Richard Holmes Board Member Treasurer 2 0 X X 0 0 0 Mark Moldenhauer Board Member 2 0 X 0 0 0 Benjamin Rand Board Member 2 0 X 0 0 0 Maureen Lehsten Board Member through March 2021 2 0 X 0 0 0 George Herbert Board Member 2 0 X 0 0 0 Marja Coons-Torn Board Member 2 0 X 0 0 0 Gretchen Librock Board Member 2 0 X 0 0 0 Craig Clark Board member 2 0 X 0 0 0 Theresa Hart Board Member 2 0 X 0 0 0 570514 0 63844 4 0 1 0 Morrison Management Specialists PO Box 102289 Atlanta GA 30368 Dining Services Management 614087 Mattuci Design 540 Olean Rd East Aurora NY 14052 Landscaping Business 150494 Quest Diagnostics 500 Plaza Drive Secaucus NJ 07094 Lab Services 310500 4 0 0 0 0 0 7196 0 7196 Net Resident Service Revenue 623000 16711053 16711053 0 0 Earned entrance fee 623000 1393991 1393991 0 0 0 0 0 0 18105044 192556 0 0 192556 0 0 0 0 0 0 0 0 0 0 1124700 0 1094769 0 29931 0 29931 0 0 29931 0 0 18334727 18105044 0 222487 0 0 0 0 0 0 0 0 353030 176515 176515 0 0 0 0 0 6435780 5418469 1017311 0 44385 25111 19274 0 1125799 927442 198357 0 503550 417674 85876 0 0 0 0 0 17138 0 17138 0 60545 0 60545 0 1849 0 1849 0 0 0 42088 0 42088 0 1061887 980782 81105 0 121186 0 121186 0 82309 36695 45614 0 173427 55470 117957 0 0 0 0 0 0 0 0 0 7653 776 6877 0 0 0 0 0 0 0 0 0 1715885 1715885 0 0 16800 0 16800 0 2673983 2673983 0 0 325988 325988 0 0 Food 715680 715680 0 0 Supplies 651514 630057 21457 0 Real Estate Taxes 613419 613419 0 0 Utilities 602324 602324 0 0 62813 22583 40230 0 17409032 15338853 2070179 0 17842286 17777225 0 0 99850 49811 648511 875122 0 0 0 0 0 0 0 0 457738 406152 80856530 33530858 49024398 47325672 6973468 7079586 0 0 0 0 0 0 4985477 5703807 80031728 79217375 1448844 1117234 0 0 8048191 8232180 39416260 37960139 0 0 0 0 0 0 0 0 51596763 51557991 100510058 98867544 X -20728311 -19856791 249981 206622 -20478330 -19650169 80031728 79217375 925695 -97534 0 0 0 0 X 0 1 X 1 0 X 44502 304456 14640 1579356 7196 1950150 16165457 16155803 17076913 18000027 18105344 85503544 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16209959 16460259 17091553 19579383 18112540 87453694 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87453694 188229 218032 352577 264716 192256 1215810 0 0 0 0 0 0 188229 218032 352577 264716 192256 1215810 0 0 0 0 0 0 0 0 0 0 0 0 16398188 16678291 17444130 19844099 18304796 88669504 0.98629 0.98610 0.01371 0.01390 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1849 1849 0 Schedule C, Part II-B, Line 1 The Organization recognizes a portion of dues paid to Leadingage NY (12.6%) and National Leadingage (2.9%) as considered to be related to lobbying activities. 249981 6686 0 0 50045 0 206622 203265 131447 0 0 84731 0 249981 339113 14357 0 0 150205 0 203265 66687 272426 0 0 0 0 339113 36637 30050 0 0 0 0 66687 0 0 1 0 0 0 1839000 1839000 0 69833812 26176663 43657149 0 0 0 0 0 5387585 4615082 772503 0 3796133 2739113 1057020 47325672 Assets limited as to use 5703807 5703807 0 Deposits from prospective residents 1737050 Refundable advance fees 49820941 51557991 X 18237193 -97534 0 0 0 -97534 18334727 0 0 0 18334727 17409032 0 0 0 0 0 17409032 0 0 0 17409032 Schedule D, Part V, Line 4 The Community Fund's goal is to support quality of life improvements at Fox Run. Improvements may include but are not limited to capital projects, and program enrichments that may not be included in the normal operating budget. The Community Fund may also supplement those Community Members whose resources have been depleted. Schedule D, Part X, Line 2 The Company is a not-for-profit Organization as described in Section 501(c )3 of the Internal Revenue Code and, accordingly, is exempt from Federal income taxes on related income pursuant to Section 501(a ) of the Code. X X X 0 0 0 0 0 0 0 0 0 William Wlodarczyk Chief Executive Officer 202195 0 0 0 0 0 4044 0 17102 0 223341 0 0 0 Jill Szalach Chief Financial Officer 150835 0 0 0 0 0 3017 0 7331 0 161183 0 0 0 Schedule J, Part I, Line 3 The Organization has in place a process for determining the compensation of the Organizations CEO which includes a review by a compensation committee and approval process. The review includes the comparison of compensation of similar positions in the region as well as review of IRS Form 990 of similar organizations. A Buffalo and Erie County Industrial Land Development Corporation Revenue Refunding Bonds Series 2015 222413596 11943KCR1 2015-09-08 47592610 To refinance the outstanding principal amount of the ECIDA 2006 Revenue Bonds Series 2006A 0 0 0 A 0 0 47592610 3276250 0 0 889800 0 0 1880409 41546151 0 2015 0 1 1 1 A 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 1 Schedule K, Part I, Column f-09/08/2015 47,592,610 Buffalo and Erie County Industrial Land Developme The series 2015 Bonds were issued to refinance the outstanding principal amount of the ECIDA 44,235,000 original principal amount revenue bonds series 2006A which financed the construction of the original facility, finance or reimburse the cost of the 2015 equipment with respect to the original facility and pay all or a portion of the costs incidental to the issuance of the Series 2015 Bonds including any reserve funds as may be necessary to secure the Series 2015 Bonds. Form 990, Part VI, Section A, Line 6 The United Church Home Society, Inc is the Sole Member of Orchard Park CCRC, Inc Form 990, Part VI, Section B, Line 11b The Form 990 is prepared by the Chief Financial Officer and reviewed by the independent accountants. A draft is then reviewed and approved by the Chief Executive Officer and is presented to the board of directors for review. A board vote is taken to approve the draft prior to filing. Form 990, Part VI, Section B, Line 12c Each officer and director is required to disclose on an annual basis, material interests or affiliations that could potentially conflict with his or her duties as an officer or director of the Organization and to disclose any such interests or affiliations at the point a potential conflict arises. Form 990, Part VI, Section B, Line 15 The Organization has in place a process for determining the compensation of the Organizations CEO which includes a review by a compensation committee and approval process. The review includes the comparison of compensation of similar positions in the region as well as review of IRS Form 990 of similar organizations. Form 990, Part VI, Section C, Line 19 The Organization makes its governing documents, conflict of interest policy, and Financial Statements available to the public upon request. United Church Home Society Inc One Fox Run Lane Orchard Park NY 14127 161157086 Expressing God's love in human care by offering housing and related services NY 501(c)3 Line 10 N/A 0 United Church Manor Housing Development Fund 50 North Avenue West Seneca NY 14224 222321997 Provide low-income housing for the aging and disabled NY 501(c)3 Line 10 United Church Home Society Inc 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0