MAPLE LAWN NURSING HOME INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- MAPLE LAWN NURSING HOME INC (EIN 41-0870856)
- Tax period
- 2022-10-01 to 2023-09-30
- Filed
- 2024-03-13
- IRS object ID
- 202440739349300934
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-03-13T14:35:22-05:00 | ReturnTs |
| Tax Period End | 2023-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2689 COMMERCE DRIVE NW SUITE 201 | AddressLine1Txt |
| City | ROCHESTER | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410870856 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MAPLE LAWN NURSING HOME INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MAPL | BusinessNameControlTxt |
| Phone | 5074252571 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 7TH ST NE | AddressLine1Txt |
| City | FULDA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56131 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHELBY JASS | PersonNm |
| Person Title | ADMINISTRATOR/CEO | PersonTitleTxt |
| Phone | 5074252571 | PhoneNum |
| Signature | 2024-03-04 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | SHELBY | PersonFirstNm |
| Person Last | JASS | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KATHERINE LUTZKE CPA | PreparerPersonNm |
| PTIN | P01760889 | PTIN |
| Phone | 5072802300 | PhoneNum |
| Preparation | 2024-03-04 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MAPLE LAWN SENIOR CARE MAPLEWOOD | BusinessNameLine1Txt |
| Business Name Line2 | COURT MAPLEVIEW ESTATES | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SHELBY JASS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 7TH ST NE | AddressLine1Txt |
| City | FULDA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56131 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $5,907,398 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MAPLELAWN.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1962 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE FINE QUALITY HEALTHCARE, HOUSING AND SUPPORT SERVICES FOR AREA SENIORS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 114 | TotalEmployeeCnt |
| Total Volunteers | 20 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $415,158 | PYContributionsGrantsAmt |
| CY Contributions Grants | $99,504 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $5,534,501 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $5,704,894 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,279 | PYInvestmentIncomeAmt |
| CY Investment Income | $16,705 | CYInvestmentIncomeAmt |
| PY Other Revenue | $55,653 | PYOtherRevenueAmt |
| CY Other Revenue | $86,295 | CYOtherRevenueAmt |
| PY Total Revenue | $6,006,591 | PYTotalRevenueAmt |
| CY Total Revenue | $5,907,398 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $5,614 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $3,460 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,408,554 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,294,743 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,310,690 | PYOtherExpensesAmt |
| CY Other Expenses | $2,340,793 | CYOtherExpensesAmt |
| PY Total Expenses | $5,724,858 | PYTotalExpensesAmt |
| CY Total Expenses | $5,638,996 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $281,733 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $268,402 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,614,742 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,871,660 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $996,331 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $953,989 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,618,411 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,917,671 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE FINE QUALITY HEALTHCARE, HOUSING AND SUPPORT SERVICES FOR AREA SENIORS IN AN INDIVIDUALIZED, DIGNIFIED, AND HOMELIKE MANNER. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $5,088,645 | ExpenseAmt |
| Grant | $3,460 | GrantAmt |
| Revenue | $5,704,894 | RevenueAmt |
| Desc | MAPLE LAWN NURSING HOME, INC DBA MAPLE LAWN SENIOR CARE, IS A CAMPUS PROVIDING LONG TERM CARE SERVICES AT: MAPLE LAWN SENIOR CARE A 46 BED SKILLED NURSING FACILITY, MAPLEVIEW ESTATES A 24 ASSISTED LIVING APARTMENT FACILITY FOR SENIORS WHO NEED LIGHT ASSISTANCE TO MAINTAIN REASONABLY INDEPENDENT LIVES, AND MAPLEWOOD COURT ASSISTED LIVING A 15 APARTMENT FACILITY FOR SENIORS WHO NEED ASSISTANCE WITH ALL MEALS AND MEDICATIONS, BUT MAINTAIN INDEPENDENCE IN MANY OTHER CARE AREAS. AS OF JANUARY 1, 2022 THE NURSING FACILITY DELICENSED 4 BEDS ON LAYAWAY, DECREASING THE LICENSED BEDS FROM 54 TO 46. | Desc |
| Total Program Service Expenses | $5,088,645 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 25 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 114 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHELBY JASS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5074252571 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 7TH STREET NE | AddressLine1Txt |
| City | FULDA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56131 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| MIKE CROWLEY | ||||||
| PRESIDENT | 0.46 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| DON OLSEM | ||||||
| VICE PRESIDENT | 0.46 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JERRILD STEINER | ||||||
| DIRECTOR | 0.46 | Yes (X) | $0 | $0 | $0 | |
| LOUISE JOHNSON | ||||||
| DIRECTOR | 0.46 | Yes (X) | $0 | $0 | $0 | |
| SUSAN ZINS | ||||||
| DIRECTOR | 0.46 | Yes (X) | $0 | $0 | $0 | |
| JAMES ELSING | ||||||
| DIRECTOR | 0.46 | Yes (X) | $0 | $0 | $0 | |
| LINDA CLAUSON | ||||||
| DIRECTOR | 0.46 | Yes (X) | $0 | $0 | $0 | |
| SHERRI LUNDEEN | ||||||
| DIRECTOR | 0.46 | Yes (X) | $0 | $0 | $0 | |
| MELISSA GEHL | ||||||
| DIRECTOR | 0.46 | Yes (X) | $0 | $0 | $0 | |
| SHANNON HENNING | ||||||
| DIRECTOR | 0.46 | Yes (X) | $0 | $0 | $0 | |
| SHELBY JASS | ||||||
| ADMINISTRATOR/CEO | 40.00 | Yes (X) | $81,706 | $0 | $1,260 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $81,706 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,260 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ONESTAFF MEDICAL LLC | |||||
| 10802 FARNAM DR | OMAHA | NE | 68154 | AGENCY STAFF | $209,314 |
| PRAIRIE REHABILITATION SERVICES | |||||
| 1720 S CLIFF AVE | SIOUX FALLS | SD | 57105 | CONTRACTED THERAPY | $122,861 |
| RTG MEDICAL | |||||
| 4611 E 22ND ST | FREMONT | NE | 68025 | AGENCY STAFF | $117,200 |
| GRAPETREE MEDICAL STAFFING | |||||
| 2501 BOJI BEND DR SUITE 100 | MILFORD | IA | 51351 | AGENCY STAFF | $108,677 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $96,995 | GovernmentGrantsAmt |
| All Other Contributions | $2,509 | AllOtherContributionsAmt |
| Total Contributions | $99,504 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| RESIDENT SERVICES | 623000 | $4,511,740 | $4,511,740 |
| APARTMENT RENTAL | 623000 | $1,091,532 | $1,091,532 |
| ANCILLARY SERVICES | 623000 | $101,622 | $101,622 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $5,704,894 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,705 | TotalRevenueColumnAmt |
| Exclusion | $16,705 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| MISCELLANEOUS INCOME | 900099 | $54,115 | $54,115 |
| OTHER REVENUES | 623000 | $28,191 | $28,191 |
| GARAGE REVENUE | 623000 | $3,989 | $3,989 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $86,295 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,907,398 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,704,894 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $103,000 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $520 | TotalAmt |
| Program Services | $520 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,940 | TotalAmt |
| Program Services | $2,940 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,267 | TotalAmt |
| Program Services | $88,267 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,565,478 | TotalAmt |
| Program Services | $2,544,513 | ProgramServicesAmt |
| Management And General | $20,965 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,014 | TotalAmt |
| Program Services | $23,824 | ProgramServicesAmt |
| Management And General | $190 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $448,510 | TotalAmt |
| Program Services | $444,967 | ProgramServicesAmt |
| Management And General | $3,543 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $168,474 | TotalAmt |
| Program Services | $167,143 | ProgramServicesAmt |
| Management And General | $1,331 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $679 | TotalAmt |
| Management And General | $679 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,881 | TotalAmt |
| Management And General | $46,881 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $667,630 | TotalAmt |
| Program Services | $666,984 | ProgramServicesAmt |
| Management And General | $646 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,264 | TotalAmt |
| Management And General | $4,264 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,774 | TotalAmt |
| Management And General | $29,774 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $177,205 | TotalAmt |
| Program Services | $170,946 | ProgramServicesAmt |
| Management And General | $6,259 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $158,853 | TotalAmt |
| Management And General | $158,853 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,453 | TotalAmt |
| Management And General | $2,453 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,782 | TotalAmt |
| Program Services | $16,071 | ProgramServicesAmt |
| Management And General | $711 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $210,566 | TotalAmt |
| Program Services | $201,642 | ProgramServicesAmt |
| Management And General | $8,924 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $81,097 | TotalAmt |
| Program Services | $77,660 | ProgramServicesAmt |
| Management And General | $3,437 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $310,380 | $305,621 | $4,759 |
| OTHER EXPENSES | $270,224 | $13,587 | $256,637 |
| FOOD | $228,827 | $228,827 | |
| LICENSE SURCHARGE | $135,178 | $135,133 | $45 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,638,996 | TotalAmt |
| Program Services | $5,088,645 | ProgramServicesAmt |
| Management And General | $550,351 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $482,363 | BOYAmt |
| EOY | $704,543 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $634,865 | BOYAmt |
| EOY | $682,606 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $347,806 | BOYAmt |
| EOY | $554,754 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $85,547 | BOYAmt |
| EOY | $35,378 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,886,540 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,007,907 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,043,340 | BOYAmt |
| EOY | $1,878,633 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,821 | BOYAmt |
| EOY | $15,746 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,614,742 | BOYAmt |
| EOY | $3,871,660 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $412,466 | BOYAmt |
| EOY | $448,032 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $96,996 | BOYAmt |
| EOY | $204,880 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $397,546 | BOYAmt |
| EOY | $210,626 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,512 | BOYAmt |
| EOY | $16,100 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $70,811 | BOYAmt |
| EOY | $74,351 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $996,331 | BOYAmt |
| EOY | $953,989 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,607,411 | BOYAmt |
| EOY | $2,907,671 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,000 | BOYAmt |
| EOY | $10,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,618,411 | BOYAmt |
| EOY | $2,917,671 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,614,742 | BOYAmt |
| EOY | $3,871,660 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $268,402 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $30,858 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,710 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,795 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $857,735 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $415,158 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $99,504 | CurrentTaxYearAmt |
| Total | $1,384,902 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,251,862 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,553,617 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,296,560 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,534,501 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,704,894 | CurrentTaxYearAmt |
| Total | $27,341,434 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $35,475 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $31,464 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $48,825 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $42,818 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $58,104 | CurrentTaxYearAmt |
| Total | $216,686 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,298,047 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,586,876 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,203,120 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,992,477 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,862,502 | CurrentTaxYearAmt |
| Total | $28,943,022 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $542,869 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $771,358 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $485,522 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,025,567 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,213,178 | CurrentTaxYearAmt |
| Total | $4,038,494 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $542,869 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $771,358 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $485,522 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,025,567 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,213,178 | CurrentTaxYearAmt |
| Total | $4,038,494 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $24,904,528 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $19,598 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $11,462 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,562 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,279 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $16,705 | CurrentTaxYearAmt |
| Total | $54,606 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $19,598 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $11,462 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,562 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,279 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $16,705 | CurrentTaxYearAmt |
| Total | $54,606 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $30,669 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $26,689 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $36,073 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $13,235 | CurrentTaxYearMinus1YearAmt |
| Total | $106,666 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,348,314 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,625,027 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,244,755 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,006,991 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,879,207 | CurrentTaxYearAmt |
| Total | $29,104,294 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.85570 | PublicSupportCY509Pct |
| Public Support PY509 | 0.87350 | PublicSupportPY509Pct |
| Investment Income CY | 0.00190 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00180 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | MISCELLANEOUS REVENUES | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,864,277 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,279,111 | DepreciationAmt |
| Book Value | $1,585,166 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $366,450 | OtherCostOrOtherBasisAmt |
| Depreciation | $169,586 | DepreciationAmt |
| Book Value | $196,864 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,655,813 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,559,210 | DepreciationAmt |
| Book Value | $96,603 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,878,633 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ASSET RETIREMENT OBLIGATION | Desc |
| Amt | $74,351 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $74,351 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $5,938,256 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $30,858 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $30,858 | RevenueNotReportedAmt |
| Revenue Subtotal | $5,907,398 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $5,907,398 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $5,638,996 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $5,638,996 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $5,638,996 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | RESIDENTS MAKE A SECURITY DEPOSIT WHEN THEY MOVE INTO THE FACILITIES. EACH RESIDENT RECEIVES THEIR SECURITY DEPOSIT, WITH INTEREST, WHEN THEY LEAVE THE FACILITIES. RESIDENT TRUSTS ARE SMALL AMOUNTS THAT RESIDENTS HOLD WITH MAPLE LAWN FOR MINOR EXPENSES AND FOR USE IN RESIDENT OUTINGS. |
| PART X, LINE 2: | THE CORPORATION HAS BEEN GRANTED EXEMPT STATUS RELATIVE TO FEDERAL AND MINNESOTA CORPORATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND APPLICABLE STATE STATUTES. THE CORPORATION BELIEVES IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING THEIR ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE CORPORATION WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. THE CORPORATION'S ANNUAL TAX FILINGS ARE SUBJECT TO REVIEW BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE CORPORATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE CORPORATION IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OTHER TAXES. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF FULDA MINNESOTA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 416005177 | BondIssuerEIN |
| Bond Issued | 2012-10-01 | BondIssuedDt |
| Issue Price | $1,955,150 | IssuePriceAmt |
| Purpose | REFUND SERIES 2003 BONDS (NURSING HOME PROJECT) | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $1,742,293 | RetiredAmt |
| Total Proceeds | $1,955,150 | TotalProceedsAmt |
| Other Spent Proceeds | $1,955,150 | OtherSpentProceedsAmt |
| Substantial Completion | 2012 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | Yes (1) | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | Yes (1) | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE MEMBERSHIP OF THE ORGANIZATION CONSISTS OF ANY PERSON (AGE 21 OR OLDER) OR ORGANIZATION DONATING $100 OR MORE FOR THE PURPOSE OF MEMBERSHIP TO THE ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE ORGANIZATION'S MEMBERS ELECT THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE ORGANIZATION'S MEMBERS HAVE THE POWER TO AMEND THE ARTICLES AND BYLAWS AND TO TERMINATE MEMBERSHIPS. |
| FORM 990, PART VI, SECTION A, LINE 8B | THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION B, LINE 11B | A COPY OF THE FORM 990 WAS PROVIDED TO THE BOARD OF DIRECTORS AT A BOARD MEETING AND APPROVED PRIOR TO BEING FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE POLICY IS ANNUALLY REVIEWED AND SIGNED BY THE BOARD MEMBERS AND KEY STAFF MEMBERS. BOARD MEMBERS ARE REQUIRED TO SELF-DISCLOSE POTENTIAL OR REAL CONFLICTS OF INTEREST TO THE BOARD. IF A CONFLICT EXISTS THE INDIVIDUAL WILL NOT BE ALLOWED TO VOTE ON THE RELATED ISSUE. CONFLICTS ARE HANDLED ON A CASE BY CASE BASIS. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE BOARD USES COMPARATIVE DATA FROM THE LONG TERM CARE IMPERATIVE COMPENSATION REPORT AND COMPARATIVE INFORMATION FROM A MAJOR ACCOUNTING FIRM WHEN DETERMINING THE ADMINISTRATOR'S SALARY. INFORMATION IS REVIEWED BY THE FULL BOARD AND DOCUMENTED IN THE MINUTES. THIS WAS LAST COMPLETED IN 2018. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | OTHER FEES: PROGRAM SERVICE EXPENSES 666,984. MANAGEMENT AND GENERAL EXPENSES 646. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 667,630. |