2025-01-16T09:29:44-06:00 2023-12-31 593070669 MSL PA 255 S ORANGE AVENUE SUITE 600 ORLANDO FL 32801 990 2023-01-01 882625724 FORT WORTH SENIOR CARE LLC FORT 8174518001 4062 PEACHTREE RD NE A501 BROOKHAVEN GA 303193021 MAURICE M ROSENBAUM DIRECTOR 4042761337 2025-01-16 1 1 PETER C GUBLER P00190185 4077405400 2023 2024-10-15 13:58:12Z MAURICE M ROSENBAUM 4062 PEACHTREE RD NE A501 BROOKHAVEN GA 303193021 6238541 0 X WWW.CHRISTIANCARETEXAS.ORG/CCCS-FORT-WORT X 2022 DE SEE SCHEDULE O.FORT WORTH SENIOR CARE OPERATES A RETIREMENT COMMUNITY LOCATED AT 5100 RANDOL MILL ROAD, FORT WORTH, TEXAS 76112 WHICH PROVIDES PERSONS 55 AND OLDER WITH A CONTINUUM OF CARE INCLUDING INDEPENDENT LIVING, ASSISTED LIVING, MEMORY CARE, AND SKILLED NURSING CARE FACILITIES. 4 1 179 0 0 0 0 40324 505872 6178985 623 8 468 19224 506963 6238541 0 0 0 0 264533 3819030 0 0 0 325387 3896673 589920 7715703 -82957 -1477162 534643 2029443 617600 3589562 -82957 -1560119 FORT WORTH SENIOR CARE OPERATES A RETIREMENT COMMUNITY PROVIDING PERSONS 55 AND OLDER A CONTINUUM OF CARE INCLUDING INDEPENDENT LIVING, ASSISTED LIVING, AND MEMORY CARE. 0 0 6638421 6178985 FORT WORTH IS A CONTINUING CARE RETIREMENT COMMUNITY CONSISTING OF 161 INDEPENDENT LIVING APARTMENT UNITS, 42 NEWLY RENOVATED ASSISTED LIVING APARTMENTS AND 15 PRIVATE MEMORY CARE APARTMENTS. 6638421 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 179 1 0 0 0 0 0 0 0 0 0 0 0 0 X 4 1 0 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 TX X OAKDALE SENIORS ALLIANCE 4238837920 118 LEE PARKWAY DRIVE SUITE 160 CHATTANOOGA TN 37421 MAURICE ROSENBAUM CHAIRMAN 1.00 19.00 X X 0 30500 0 AMELIA WALLER BAKER JD SECRETARY 1.00 7.00 X X 0 12500 0 FRANK CORRIGAN DIRECTOR 1.00 7.00 X 0 12000 0 SIMRAN SINGH DIRECTOR 1.00 7.00 X 0 3000 0 STEPHANIE PAUL INTERIM EXECUTIVE DIRECTOR 20.00 20.00 X 0 122476 5028 THOMAS WILLIAM BAKER FORMER CHAIRMAN (END 10/23) 1.00 42.00 X 0 78000 0 0 258476 5028 0 1 0 0 0 40324 40324 INDEPENDENT LIVING FEE 623000 3548275 3548275 ASSISTED LIVING FEES 623000 1379143 1379143 MEMORY CARE FEES 623000 1015518 1015518 OUTPATIENT SERVICES 623000 236049 236049 6178985 8 8 8038 0 8038 8038 8038 MISCELLANEOUS INCOME 623000 11186 11186 11186 6238541 6178985 0 19232 3227060 2913674 313386 322825 290440 32385 269145 242231 26914 470654 217404 253250 558 253 305 13200 5993 7207 373965 171459 202506 60690 51030 9660 74825 62913 11912 1920858 1732782 188076 14415 12121 2294 57541 51787 5754 2157 1814 343 160120 144108 16012 DIETARY 413830 413830 MEDICAL SUPPLIES AND EQ 321729 321729 OTHER EXPENSES 12131 4853 7278 7715703 6638421 1077282 0 443507 23876 158859 11406 20662 27711 46598 1831467 534643 2029443 315949 674796 1000000 301651 1914766 617600 3589562 X -82957 -1560119 -82957 -1560119 534643 2029443 -1477162 0 X X 0 1 X 1 0 X 40324 40324 505872 6178985 6684857 468 468 506340 6219309 6725649 0 0 0 6725649 623 6046 6669 623 6046 6669 506963 6225355 6732318 X 0 DUE FROM AFFILIATES 60240 DEPOSITS 168383 DUE FROM LANDLORD 88068 RIGHT-OF-USE LEASE ASSET 1514776 1831467 DUE TO AFFILIATES 270016 DUE TO LANDLORD 102772 RIGHT-OF-USE LEASE OBLIGATION 1541978 1914766 X PART X, LINE 2: FORT WORTH SENIOR CARE IS ORGANIZED AS NOT-FOR-PROFIT, SINGLE MEMBER LLC. DURING 2023, FORT WORTH SENIOR CARE OBTAINED A DETERMINATION LETTER FROM THE IRS RECOGNIZING ITS EXEMPT ORGANIZATION STATUS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. PRIOR TO RECEIVING ITS DETERMINATION LETTERS, FORT WORTH SENIOR CARE OPERATED AS A DIS-REGARDED TAX-EXEMPT ENTITY UNDER THE EXEMPTION OF THE PARENT. ACCORDINGLY, INCOME EARNED IN FURTHERANCE OF FORT WORTH SENIOR CARE'S TAX-EXEMPT PURPOSE IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES. AS A RESULT, FORT WORTH SENIOR CARE'S FINANCIAL STATEMENTS INCLUDE NO PROVISION OR LIABILITY FOR INCOME TAXES. 0 0 0 0 0 0 0 0 0 THOMAS WILLIAM BAKER FORMER CHAIRMAN (END 10/23) 0 78000 0 0 0 0 0 0 0 0 0 78000 0 0 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, TO PROVIDE THE DAY-TO-DAY OPERATIONAL MANAGEMENT SERVICES. FORM 990, PART VI, SECTION A, LINE 6 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 OF FORT WORTH SENIOR CARE LLC. 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 ARE AVAILABLE FROM THE MANAGING MEMBER. UPON REQUEST, COPIES ARE SHOWN, MAILED, FAXED OR EMAILED TO THE INQUIRER. 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 0 INDIANAPOLIS SENIOR CARE LLC DBA ROBIN RUN 4062 PEACHTREE RD NE SUITE A501 BROOKHAVEN GA 30319 863038399 SENIOR LIVING OPERATOR DE 501(C)(3) LINE 10 BONCREST RESOURCE GROUP INC 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 0 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 0 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 BONCREST BRIDGE CITY INC 4062 PEACHTREE RD NE SUITE A501 BROOKHAVEN GA 30319 934561866 SENIOR LIVING FACILITY DE 501(C)(3) LINE 10 BONCREST RESOURCE GROUP INC 0 BONCREST FOUNDATION INC 4062 PEACHTREE RD NE SUITE A501 BROOKHAVEN GA 30319 932948585 PROVIDING SUPPORT TO BONCREST RESOURCE GROUP AND AFFILIATES GA 501(C)(3) LINE 7 BONCREST RESOURCE GROUP INC 0 0 0 0 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 0