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      <TotalBookValueOtherAssetsAmt>15200439</TotalBookValueOtherAssetsAmt>
      <FederalIncomeTaxLiabilityAmt>0</FederalIncomeTaxLiabilityAmt>
      <TotalLiabilityAmt>0</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule D, Part V, Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>Niagara Lutheran Health Foundation, Inc., the Organization's related party, holds endowment funds for the benefit of the Organization and its related organizations. The uses of the endowments are reported on the related parties IRS Form 990 and are used based on the intention of the donor.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule D, Part X, Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Income Taxes: The entities comprising the Organization are all not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code (the Code), and accordingly, are exempt from Federal income taxes on related income pursuant to Section 501(a) of the Code. Accordingly, no provision for income taxes has been reflected in the accompanying consolidated financial statements. The Organization accounts for uncertain tax positions in accordance with US GAAP, which requires the recognition and measurement of uncertain tax positions that the Organization has taken or expects to take in the Organization's tax returns.</ExplanationTxt>
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    </IRS990ScheduleD>
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      <WrittenPolicyRefTAndEExpnssInd>0</WrittenPolicyRefTAndEExpnssInd>
      <SubstantiationRequiredInd>1</SubstantiationRequiredInd>
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <Form990OfOtherOrganizationsInd>X</Form990OfOtherOrganizationsInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
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      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
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        <PersonNm>Christopher E Koenig</PersonNm>
        <TitleTxt>President/CEO and Board Member</TitleTxt>
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        <DeferredCompensationFlngOrgAmt>6600</DeferredCompensationFlngOrgAmt>
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        <TotalCompensationFilingOrgAmt>403591</TotalCompensationFilingOrgAmt>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Steven Chizuk</PersonNm>
        <TitleTxt>Chief Financial Officer/Board Member</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <TotalCompensationFilingOrgAmt>244683</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 1a</FormAndLineReferenceDesc>
        <ExplanationTxt>Social club dues are paid by the Organization in order to conduct certain board meetings, staff meetings and other health care meetings with similar organizations in the area. In addition, various fund raising events are held at the social club. The President CEO is in attendance at all meetings held at the social club.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 1b</FormAndLineReferenceDesc>
        <ExplanationTxt>Social club dues were approved by the executive committee of the Board of Directors and are included in the minutes of the meeting. No formal policy exists.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part II</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization does not compensate for Board Service. The salaries listed are for services provided as employees of the organization.</ExplanationTxt>
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    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="R000006" softwareId="23018249" softwareVersionNum="v1.00">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The board of directors is supplied with a copy of the draft form IRS 990 and applicable schedules prior to being filed with time to review and ask questions to management. Any questions which arise as a result of the review by the board of directors are reviewed by management and changes are made as needed prior to filing. The draft form IRS 990 is also reviewed by independent accountants prior to filing.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>The conflict of interest policy is reviewed annually with the board of directors. Questionnaires are filled out by the board and key personnel and reviewed by the corporate compliance officer on an annual basis. If any conflicts of interest or related matters arise as a result of the review, the corporate compliance officer will address with the board of directors.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>Compensation of the officers and other key employees of the Organization is approved by the executive committee of the board of directors. The process for determining includes a review by the executive committee of the board of directors and the personnel committee of the board of directors. The review includes information from the Form 990 of other organizations and compensation surveys conducted from independent sources.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization does not make available to the public its governing documents, conflict of interest policy, and Financial Statements.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Includes service fees for Pastoral Care, Finance Consulting and Human Resources Consulting.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 24e</FormAndLineReferenceDesc>
        <ExplanationTxt>This is the home office allocation of expenses charged to the related organizations.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9</FormAndLineReferenceDesc>
        <ExplanationTxt>Amount represents change in interest in the Niagara Lutheran Health Foundation, Inc., a related party for $1,955,716.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XII, Line 2c</FormAndLineReferenceDesc>
        <ExplanationTxt>The process for audit oversight and auditor selection has not changed from the prior year.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Niagara Lutheran Development Inc</BusinessNameLine1Txt>
          <BusinessNameLine2Txt>dba Greenfield Health and Rehabilitation Center Inc</BusinessNameLine2Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>5959 Broadway Street</AddressLine1Txt>
          <CityNm>Lancaster</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>140869523</ZIPCd>
        </USAddress>
        <EIN>161502150</EIN>
        <PrimaryActivitiesTxt>Skilled Nursing Facilities</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Niagara Lutheran Health System Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Lutheran Church Home of Buffalo Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>5959 Broadway Street</AddressLine1Txt>
          <CityNm>Lancaster</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>140869523</ZIPCd>
        </USAddress>
        <EIN>160763163</EIN>
        <PrimaryActivitiesTxt>To provide housing, meals, and other necessities for the elderly residents of the home</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Niagara Lutheran Health System Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Greenfield Manor Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>5959 Broadway Street</AddressLine1Txt>
          <CityNm>Lancaster</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>140869523</ZIPCd>
        </USAddress>
        <EIN>161564089</EIN>
        <PrimaryActivitiesTxt>Senior Independent Living Facility</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>Niagara Lutheran Health System Inc</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>1</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Lutheran Church Home at Greenfield Inc</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>5959 Broadway Street</AddressLine1Txt>
          <CityNm>Lancaster</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>140869523</ZIPCd>
        </USAddress>
        <EIN>161579391</EIN>
        <PrimaryActivitiesTxt>Maintain and operate an enriched housing facility in Lancaster New York</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>Niagara Lutheran Health System Inc</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>1</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
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        <EIN>161315868</EIN>
        <PrimaryActivitiesTxt>Fund raising on behalf of affiliated not for profit organizations</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
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        <PublicCharityStatusTxt>12a</PublicCharityStatusTxt>
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      <GiftGrntCapContriFromOthOrgInd>1</GiftGrntCapContriFromOthOrgInd>
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      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
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        <TransactionTypeTxt>p</TransactionTypeTxt>
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        <MethodOfAmountDeterminationTxt>Amount includes expenses paid for by the Organization using different methodology depending on the type of expense. The methodology used follows Medicare guidelines. Examples include direct method using actual expenses, percentage of time spent, revenue, and number of beds.</MethodOfAmountDeterminationTxt>
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        <MethodOfAmountDeterminationTxt>Amount includes expenses paid for by the Organization using different methodology depending on the type of expense. The methodology used follows Medicare guidelines. Examples include direct method using actual expenses, percentage of time spent, revenue, and number of beds.</MethodOfAmountDeterminationTxt>
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          <BusinessNameLine1Txt>Lutheran Church Home at Greenfield Inc</BusinessNameLine1Txt>
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        <TransactionTypeTxt>p</TransactionTypeTxt>
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        <MethodOfAmountDeterminationTxt>Amount includes expenses paid for by the Organization using different methodology depending on the type of expense. The methodology used follows Medicare guidelines. Examples include direct method using actual expenses, percentage of time spent, revenue, and number of beds.</MethodOfAmountDeterminationTxt>
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          <BusinessNameLine1Txt>Niagara Lutheran Health Foundation Inc</BusinessNameLine1Txt>
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        <InvolvedAmt>253828</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Amount includes expenses paid for by the Organization using different methodology depending on the type of expense. The methodology used follows Medicare guidelines. Examples include direct method using actual expenses, percentage of time spent, revenue, and number of beds.</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Lutheran Church Home of Buffalo Inc</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>p</TransactionTypeTxt>
        <InvolvedAmt>476755</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Amount includes expenses paid for by the Organization using different methodology depending on the type of expense. The methodology used follows Medicare guidelines. Examples include direct method using actual expenses, percentage of time spent, revenue, and number of beds.</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Niagara Lutheran Health Foundation Inc</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>c</TransactionTypeTxt>
        <InvolvedAmt>672</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Operating contributions from the Organization's related party Niagara Lutheran Health Foundation.</MethodOfAmountDeterminationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule R, Part V, Line 1o</FormAndLineReferenceDesc>
        <ExplanationTxt>Niagara Lutheran Health Foundation, Inc., employees are paid by Niagara Lutheran Health System, Inc. and all salary and benefit expenses related to the Foundation are allocated to Niagara Lutheran Health Foundation properly.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule R, Part V, Line 1q</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization is reimbursed by all its related parties for expenses which are paid on behalf of the related parties including workers compensation insurance, pension expense, and other general and administrative expenses.</ExplanationTxt>
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