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        <FormAndLineReferenceDesc>Schedule D, Part IV, Line 2b</FormAndLineReferenceDesc>
        <ExplanationTxt>Resident funds that are deposited with the Organization are held, safeguarded, managed, and accounted for by the Organization.</ExplanationTxt>
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      <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 endowment funds are reported on the related parties IRS Form 990 and are used based on the intention of the donor.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule D, Part X, Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>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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        <PersonNm>Steven Chizuk</PersonNm>
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        <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>
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      <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>
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      <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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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization's sole member is Niagara Lutheran Health System, Inc. The Organization's sole member elects the Board of Directors.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>Niagara Lutheran Health System Inc is the sole member for the Organization and elects the Board of Directors.</ExplanationTxt>
      </SupplementalInformationDetail>
      <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>
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      <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 (who are paid through Niagara Lutheran Health System, Inc. the sole member) 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>
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      <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>Other fees for services include the staffing agency fees for Registered Nurses for $50,503, Licensed Paratactical Nurses for $1,607,190, and Certified Nurses Aides for $1,036,926 that are not the facility's employees.</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>
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          <BusinessNameLine1Txt>Lutheran Church Home of Buffalo Inc</BusinessNameLine1Txt>
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          <AddressLine1Txt>5959 Broadway Street</AddressLine1Txt>
          <CityNm>Lancaster</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>140869523</ZIPCd>
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        <EIN>160763163</EIN>
        <PrimaryActivitiesTxt>To provide housing, meals, and other necessities for elderly residents of the home</PrimaryActivitiesTxt>
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        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
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        <PrimaryActivitiesTxt>Maintain and operate an enriched housing facility in Lancaster New York</PrimaryActivitiesTxt>
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        <PrimaryActivitiesTxt>The Organization provides a centralized administrative and afinancial service to related NFP Orgs</PrimaryActivitiesTxt>
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