2023-12-04T07:19:56-06:00 2022-12-31 593070669 MSL PA 255 S ORANGE AVENUE SUITE 600 ORLANDO FL 32801 990 2022-01-01 863038399 INDIANAPOLIS SR CARE LLC INDI 4042761337 4062 PEACHTREE ROAD NE A501 BROOKHAVEN GA 30319 MAURICE M ROSENBAUM DIRECTOR 4042761337 2023-12-04 1 MAURICE ROSENBAUM 999009999 1 HARRY E HARP CPA P00176471 4077405400 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z X ROBIN RUN VILLAGE MAURICE M ROSENBAUM 4062 PEACHTREE ROAD NE A501 BROOKHAVEN GA 30319 19251628 0 X WWW.ROBINRUNSENIORLIVING.COM X 2021 DE OPERATING THE ROBIN RUN VILLAGE SENIOR LIVING COMMUNITY LOCATED AT 5354 WEST 62ND STREET, INDIANAPOLIS, INDIANA 46268 (THE COMMUNITY) WHICH PROVIDES PERSONS 55 AND OLDER WITH A CONTINUUM OF CARE INCLUDING INDEPENDENT LIVING, ASSISTED LIVING, MEMORY CARE, AND SKILLED NURSING CARE. THE COMMUNITY HAS 228 GARDEN HOMES AND 186 APARTMENTS DESIGNED SPECIFICALLY FOR OLDER ADULTS, AN 84-BED LICENSED SKILLED NURSING FACILITY, AND A 68 UNIT ASSISTED LIVING AND MEMORY CARE FACILITY. 3 0 411 0 0 0 0 0 9853323 16745971 1003 142 0 2505515 9854326 19251628 0 0 0 0 5959983 10340873 0 0 0 6552272 10876484 12512255 21217357 -2657929 -1965729 3141052 6055321 30552278 35182276 -27411226 -29126955 X INDIANAPOLIS SENIOR CARE, LLC (DBA ROBIN RUN VILLAGE) OPERATES A CONTINUING CARE RETIREMENT COMMUNITY PROVIDING A CONTINUUM OF CARE INCLUDING INDEPENDENT LIVING, ASSISTED LIVING, MEMORY CARE, AND SKILLED NURSING FACILITIES. ROBIN RUN VILLAGE PROVIDES ACTIVITIES AND PROGRAMS THAT PROMOTE THE PHYSICAL HEALTH, EMOTIONAL HEALTH, BEHAVIORAL HEALTH, WELLNESS, AND SOCIAL WELL-BEING OF THE INDIVIDUALS, FAMILIES, COMMUNITIES, AND POPULATIONS SERVED. 0 0 18128864 16745971 ROBIN RUN VILLAGE IS A CONTINUING CARE RETIREMENT COMMUNITY CONSISTING OF 186 INDEPENDENT LIVING APARTMENT UNITS, 146 INDEPENDENT LIVING GARDEN HOMES, 94 LICENSED ASSISTED LIVING AND MEMORY CARE BEDS (CURRENTLY OPERATING IN 70 UNITS), AN 84-BED LICENSED SKILLED NURSING FACILITY THAT IS CURRENTLY OPERATING AS A 54-BED FACILITY. THERE ARE ADDITIONAL 82 GARDEN HOMES ON THE CAMPUS OWNED OUTRIGHT BY THE RESIDENTS. THE GARDEN HOME RESIDENT HOMEOWNERS PAY MONTHLY FEES FOR LIMITED SERVICES AND HAVE ELIGIBILITY FOR PREFERENTIAL ADMITTANCE TO THE SKILLED NURSING FACILITY. UNDER THE CONTINUING CARE CONCEPT, RESIDENTS ENTER INTO AN OCCUPANCY AGREEMENT, WHICH REQUIRES PAYMENT OF A ONE-TIME ENTRANCE FEE AND A MONTHLY SERVICE FEE. THESE PAYMENTS ENTITLE RESIDENTS TO THE USE AND PRIVILEGES OF THE COMMUNITY FOR LIFE, INCLUDING CERTAIN DISCOUNTED PRICING FOR ASSISTED LIVING OR SKILLED NURSING SERVICES THE OCCUPANCY AGREEMENT DOES NOT ENTITLE THE RESIDENTS TO AN INTEREST IN THE REAL ESTATE OR ANY PROPERTY OF THE RETIREMENT COMMUNITY. 18128864 1 0 0 0 0 0 0 0 1 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 41 0 1 411 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 3 0 0 1 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IN X OAKDALE SENIORS ALLIANCE 4238837920 118 LEE PARKWAY DRIVE SUITE 160 CHATTANOOGA TN 37421 THOMAS WILLIAM BAKER MANAGER/DIRECTOR 4.00 36.00 X X 0 36000 0 MAURICE M ROSENBAUM DIRECTOR 2.00 13.00 X 0 24000 0 FRANK E CORRIGAN JR DIRECTOR 1.00 2.00 X 0 12000 0 AMAL KOZMAN ADMINISTRATION 40.00 X 138111 0 0 DAVID PRUETT ADMINISTRATION 40.00 X 124258 0 0 CATHY OSLOS ADMINISTRATION 40.00 X 111788 0 0 SUSAN GOODWIN ADMINISTRATION 40.00 X 105982 0 0 TRACY CORNFORTH ADMINISTRATION 40.00 X 104398 0 431 584537 72000 431 5 0 0 0 GARY A WARFIELD PAINTING LLC 8424 LOCKWOOD LANE INDIANAPOLIS IN 46217 PAINTING SERVICES 158810 NETWORKS CONNECT HEALTHCARE STAFFING LLC 7930 CASTLEWAY DRIVE INDIANAPOLIS IN 46250 STAFFING SERVICES 123153 2 INDEPENDENT LIVING FEES 623000 7828298 7828298 HEALTH CARE SERVICE FEES 623000 4267675 4267675 ASSISTED LIVING FEES 623000 1956349 1956349 EARNED ENTRANCE FEES 623000 1303510 1303510 MEMORY CENTER FEES 623000 987831 987831 402308 402308 16745971 142 142 PPP LOAN FORGIVENESS 623000 1661400 1661400 PROVIDER RELIEF FUNDS 623000 844115 844115 2505515 19251628 16745971 0 2505657 8568259 7711433 856826 26567 23910 2657 1080632 972569 108063 665415 598874 66541 1054710 1054710 7100 7100 30106 30106 1128750 1128720 30 160345 134824 25521 36620 30792 5828 218931 184086 34845 5472995 4925695 547300 64082 53883 10199 211862 190676 21186 87974 79177 8797 616528 554875 61653 FOOD SUPPLIES 920438 773941 146497 MEDICAL SUPPLIES AND SE 290607 244354 46253 MISCELLANEOUS EXPENSES 227976 191691 36285 SUPPLIES 216079 181688 34391 131381 110470 20911 21217357 18128864 3088493 0 510736 127900 752860 614049 175042 79370 25979 25979 289745 263856 736214 87974 1076074 648240 310616 4295927 3141052 6055321 1628973 1879913 8235852 7061178 5022 1627600 4250000 1661400 2210304 17398453 19775859 30552278 35182276 X -27411226 -29126955 -27411226 -29126955 3141052 6055321 X -1965729 250000 X X 0 1 X 1 0 X 9853323 16745971 26599294 2505515 2505515 9853323 19251486 29104809 0 0 0 29104809 1003 142 1145 1003 142 1145 9854326 19251628 29105954 X 0 1 X 661618 78986 582632 74596 8988 65608 648240 DUE FROM AFFILIATE 195458 DEPOSITS 440300 ROU OPERATING LEASE 3630130 OTHER ASSETS 30039 4295927 REFUNDABLE ENTRANCE FEES 16145729 ROU LEASE OBLIGATION 3630130 19775859 X 19501628 250000 250000 19251628 0 19251628 21217357 0 21217357 0 21217357 PART IV, LINE 2B: THE ORGANIZATION IS A TRUSTEE FOR RESIDENT FUNDS WHICH ARE EXPENDED ON BEHALF OF RESIDENTS. THE AMOUNT OF RESIDENT FUNDS HELD AT DECEMBER 31, 2022 HAS BEEN REPORTED ON PART X, LINE 21. PART X, LINE 2: THE ORGANIZATION (ROBIN RUN) IS ORGANIZED AS A SINGLE MEMBER LLC IN WHICH BONCREST RESOURCE GROUP, INC, AN ENTITY THAT IS EXEMPT FROM TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE IS THE SOLE MEMBER AND IS CONSIDERED A "DISREGARDED ENTITY" UNDER THE INTERNAL REVENUE CODE. THE ORGANIZATION SEPARATELY RECEIVED A SECTION 501(C)(3) TAX EXEMPT DETERMINATION LETTER ON FEBRUARY 3, 2003. THE ACTIVITY OF ROBIN RUN IS REPORTED ON A CONSOLIDATED BASIS BY THE PARENT WHICH HAS BEEN GRANTED RECOGNITION OF ITS TAX-EXEMPT STATUS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, INCOME EARNED IN FURTHERANCE OF ROBIN RUN'S TAX-EXEMPT PURPOSE IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES. AS A RESULT, THESE FINANCIAL STATEMENTS INCLUDE NO PROVISION OR LIABILITY FOR INCOME TAXES. PART XI, LINE 2D - OTHER ADJUSTMENTS: ADJUSTMENT FOR ASSUMED LIABILITIES 250,000. FORM 990, PART VI, SECTION A, LINE 1A THE MANAGER HAS THE AUTHORITY TO ACT FOR THE BOARD OF DIRECTORS BETWEEN REGULAR MEETINGS OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION ENTERED INTO A MANAGEMENT AGREEMENT WITH AN INDEPENDENT MANAGEMENT COMPANY. TOTAL MANAGEMENT FEES WERE APPROXIMATELY $1,055,000 AND $637,000 FOR THE YEAR ENDED DECEMBER 31, 2022 AND THE PERIOD MAY 17, 2021 THROUGH DECEMBER 31, 2021, RESPECTIVELY. FORM 990, PART VI, SECTION A, LINE 7A THE BUSINESS AFFAIRS OF THE COMPANY SHALL BE MANAGED BY THE GOVERNING BOARD APPOINTED BY THE ORGANZIATION'S SOLE MEMBER BONCREST. THE GOVERNING BOARD SHALL HAVE FULL AND COMPLETE AUTHORITY, POWER, AND DISCRETION TO MANAGE AND CONTROL THE BUSINESS. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER AND GENERAL COUNSEL MATERIALLY ENGAGES WITH THE ORGANIZATION'S CERTIFIED PUBLIC ACCOUNTANTS IN RESPONDING TO ALL ITEMS COVERED IN THE FORM 990. WHEN ALL OF THE INFORMATION IS COMPILED INTO THE FORM 990 IT IS PRESENTED TO THE ENTIRE GOVERNING BOARD FOR REVIEW AND APPROVAL BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 15B THE BOARD WILL OVERSEE AN ANNUAL REVIEW OF EXECUTIVE PERFORMANCE BASED ON A REPORT FROM EACH EXECUTIVE REGARDING THE EXECUTIVE'S PROGRESS AGAINST GOALS. AS A PART OF THE REVIEW PROCESS, THE EXECUTIVE AND THE BOARD DISCUSS AND FORMALIZE GOALS FOR PERFORMANCE FOR THE NEXT YEAR. THESE GOALS ARE ROOTED IN ORGANIZATIONAL PERFORMANCE AGAINST STRATEGIC GOALS, AS WELL AS THE OVERALL LEADERSHIP OF THE EXECUTIVE. THE BONCREST RESOURCE GROUP COMPENSATION COMMITTEE WILL ANNUALLY REVIEW EACH EXECUTIVE COMPENSATION ARRANGEMENT BASED ON COMPARABLE SALARY AND BENEFITS DATA, SUCH AS DATA AVAILABLE FROM SALARY AND BENEFIT SURVEYS, WRITTEN JOB OFFERS FOR POSITIONS AT SIMILAR ORGANIZATIONS, AND REVIEWING INFORMATION OBTAINED FROM IRS FORM 990 FILINGS OF SIMILAR ORGANIZATIONS IN AN EFFORT TO LEARN WHAT NONPROFIT EMPLOYERS WITH SIMILAR MISSIONS OF A SIMILAR BUDGET SIZE THAT ARE LOCATED IN THE SAME OR SIMILAR GEOGRAPHIC REGION PAY THEIR EXECUTIVE OFFICERS AND LEADERS. BASED ON THE REVIEW THE COMPENSATION COMMITTEE WILL MAKE A RECOMMENDATION TO THE FULL BOARD FOR COMPENSATION INCLUDING SALARY AND BENEFITS FOR ALL BONCREST RESOURCE GROUP EXECUTIVE OFFICERS. THE COMPENSATION COMMITTEE SHALL MAINTAIN MINUTES OF THE MEETINGS AND DELIBERATIONS AND THE PROCESS USED TO CONDUCT THE REVIEW. BASED ON THE COMPENSATION COMMITTEE'S RECOMMENDATION, THE FULL BOARD OF DIRECTORS SHALL DELIBERATE AND APPROVE EACH EXECUTIVE COMPENSATION ARRANGEMENT, SUBJECT TO RECUSALS FOR EXECUTIVES WITH CONFLICTS OF INTEREST DURING ALL DELIBERATIONS REGARDING THE COMPENSATION ARRANGEMENTS, AND THE PROCESS FOR SUCH APPROVAL SHALL BE DOCUMENTED IN THE BOARD MEETING MINUTES. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY EACH BOARD MEMBER IS GIVEN THE CONFLICT OF INTEREST POLICY AND THE CEO EXPLAINS THE POLICY IN DETAIL PRIOR TO THE BOARD MEMBER'S SIGNATURE. ALL VENDORS RECEIVE AND MUST SIGN A FORM DISCLOSING ANY RELATED PARTIES INVOLVED PRIOR TO DOING BUSINESS WITH THE ORGANIZATION. ANYONE WITH A CONFLICT OF INTEREST IS PROHIBITED FROM VOTING ON MATTERS RELATED TO THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE CEO IS DETERMINED BY THE COMPENSATION COMMITTEE OF THE BOARD. THE COMPENSATION COMMITTEE'S RESPONSIBILITIES SHALL INCLUDE (A) TO ESTABLISH THE COMPENSATION OF THE CEO OF THE ORGANIZATION; (B) REVIEW THE COMPENSATION OF THE CEO UTILIZING COMPARABILITY DATA AND ESTABLISH MERIT INCREASES, IF ANY, IN SALARY, INCENTIVE BONUS, ETC.; AND (C) APPROVE A WRITTEN EMPLOYMENT CONTRACT WITH THE CEO AND ANY CONTRACT REVISIONS. FORM 990, PART VI, SECTION C, LINE 19 ALL DOCUMENTS ARE AVAILABLE FROM THE MANAGING MEMBER. UPON REQUEST, COPIES ARE SHOWN, MAILED, FAXED OR EMAILED TO THE INQUIRER. FORM 990, PART XI, LINE 9: ADJUSTMENT FOR ASSUMED LIABILITIES 250,000. FORM 990, PART XII, LINE 2C THE BOARD IS RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. RAYMORE SENIOR CARE LLC DBA FOXWOOD SPRINGS 4062 PEACHTREE RD NE SUITE A501 BROOKHAVEN GA 30319 863022330 SENIOR LIVING FACILITY DE 501(C)(3) LINE 10 BONCREST RESOURCE GROUP INC 1 BONCREST RESOURCE GROUP INC 4062 PEACHTREE RD NE SUITE A501 BROOKHAVEN GA 30319 815401208 SENIOR LIVING OPERATOR GA 501(C)(3) LINE 10 N/A 0 ALLEN SENIOR CARE LLC 4062 PEACHTREE RD NE SUITE A501 BROOKHAVEN GA 30319 882696909 SENIOR LIVING FACILITY DE 501(C)(3) LINE 10 BONCREST RESOURCE GROUP INC 1 FORT WORTH SENIOR CARE LLC 4062 PEACHTREE RD NE SUITE A501 BROOKHAVEN GA 30319 882625724 SENIOR LIVING FACILITY DE 501(C)(3) LINE 10 BONCREST RESOURCE GROUP INC 1 MESQUITE SENIOR CARE LLC 4062 PEACHTREE RD NE SUITE A501 BROOKHAVEN GA 30319 882719886 SENIOR LIVING FACILITY DE 501(C)(3) LINE 10 BONCREST RESOURCE GROUP INC 1 0 0 0 1 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0