MAPLE LAWN NURSING HOME INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization: MAPLE LAWN NURSING HOME INC (EIN 41-0870856)
Tax period: 2021-10-01 to 2022-09-30
Filed: 2023-06-28
IRS object ID: 202341799349300509
Schema version: 2021v4.2
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
Form 990
Schedule A
Schedule B
Schedule D
Schedule I
Schedule K
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2023-06-28T09:12:55-05:00	ReturnTs
Tax Period End	2022-09-30	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	201 N RIVERFRONT DR SUITE 300	AddressLine1Txt
City	MANKATO	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	56001	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2021-10-01	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	2023-06-20	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

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	JOSH SHERBURNE	PreparerPersonNm
PTIN	P02039400	PTIN
Phone	5073868800	PhoneNum
Preparation	2023-06-20	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	2021	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	$6,006,591	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	152	TotalEmployeeCnt
Total Volunteers	30	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$857,735	PYContributionsGrantsAmt
CY Contributions Grants	$415,158	CYContributionsGrantsAmt
PY Program Service Revenue	$5,296,560	PYProgramServiceRevenueAmt
CY Program Service Revenue	$5,534,501	CYProgramServiceRevenueAmt
PY Investment Income	$8,804	PYInvestmentIncomeAmt
CY Investment Income	$1,279	CYInvestmentIncomeAmt
PY Other Revenue	$84,898	PYOtherRevenueAmt
CY Other Revenue	$55,653	CYOtherRevenueAmt
PY Total Revenue	$6,247,997	PYTotalRevenueAmt
CY Total Revenue	$6,006,591	CYTotalRevenueAmt
PY Grants And Similar Paid	$13,149	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$5,614	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$3,950,865	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$3,408,554	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$1,969,579	PYOtherExpensesAmt
CY Other Expenses	$2,310,690	CYOtherExpensesAmt
PY Total Expenses	$5,933,593	PYTotalExpensesAmt
CY Total Expenses	$5,724,858	CYTotalExpensesAmt
PY Revenues Less Expenses	$314,404	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$281,733	CYRevenuesLessExpensesAmt
Total Assets BOY	$3,848,153	TotalAssetsBOYAmt
Total Assets EOY	$3,614,742	TotalAssetsEOYAmt
Total Liabilities BOY	$1,452,143	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$996,331	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$2,396,010	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$2,618,411	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	$5,213,195	ExpenseAmt
Grant	$5,614	GrantAmt
Revenue	$5,534,501	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.	Desc
Total Program Service Expenses	$5,213,195	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	Yes (1)	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	23	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	152	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	Yes (1)	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 (15 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt
RICK GOEDTKE
PRESIDENT (AS OF 2/22)	0.46	Yes (X)	Yes (X)	$0	$0	$0
LINDA CLAUSON
PRESIDENT (UNTIL 2/22)	0.46	Yes (X)	Yes (X)	$0	$0	$0
MIKE CROWLEY
VICE PRESIDENT (AS OF 2/22)	0.46	Yes (X)	Yes (X)	$0	$0	$0
RICK GOEDTKE
VICE PRESIDENT (UNTIL 2/22)	0.46	Yes (X)	Yes (X)	$0	$0	$0
JERRILD STEINER
SECRETARY/TREASURER	0.46	Yes (X)	Yes (X)	$0	$0	$0
LOUISE JOHNSON
DIRECTOR	0.46	Yes (X)		$0	$0	$0
SUZIE A ZINS
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
DON OLSEM
DIRECTOR	0.46	Yes (X)		$0	$0	$0
SHERRI LUNDEEN
DIRECTOR (PART-YEAR)	0.46	Yes (X)		$0	$0	$0
JOE GRANDGEORGE
DIRECTOR (PART-YEAR)	0.46	Yes (X)		$0	$0	$0
SHELBY JASS
ADMINISTRATOR/CEO	40.00		Yes (X)	$88,000	$0	$2,000
ARLAN SWANSON
ADMINISTRATOR/CEO (UNTIL 2/22)	0.46		Yes (X)	$123,465	$0	$21,628

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$211,465	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$23,628	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	1	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	0	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	PRAIRIE REHABILITATION SERVICES	BusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1720 S CLIFF AVE	AddressLine1Txt
City	SIOUX FALLS	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	57105	ZIPCd

Field	Value	IRS element (for citing)
Services	CONTRACTED THERAPY	ServicesDesc
Compensation	$160,643	CompensationAmt

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	1	CntrctRcvdGreaterThan100KCnt
Government Grants	$414,878	GovernmentGrantsAmt
All Other Contributions	$280	AllOtherContributionsAmt
Total Contributions	$415,158	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
RESIDENT SERVICES	623000	$4,354,835	$4,354,835
APARTMENT RENTAL	623000	$1,044,320	$1,044,320
ANCILLARY SERVICES	623000	$135,346	$135,346

Field	Value	IRS element (for citing)
Total Program Service Revenue	$5,534,501	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,279	TotalRevenueColumnAmt
Exclusion	$1,279	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
MISCELLANEOUS INCOME	900099	$38,382	$38,382
OTHER REVENUES	623000	$13,235	$13,235
GARAGE REVENUE	623000	$4,036	$4,036

Field	Value	IRS element (for citing)
Other Revenue Total	$55,653	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$6,006,591	TotalRevenueColumnAmt
Related Or Exempt Func Income	$5,534,501	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$56,932	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	$545	TotalAmt
Program Services	$545	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$5,069	TotalAmt
Program Services	$5,069	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$114,277	TotalAmt
Program Services	$114,277	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$2,547,046	TotalAmt
Program Services	$2,525,623	ProgramServicesAmt
Management And General	$21,423	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$28,990	TotalAmt
Program Services	$28,761	ProgramServicesAmt
Management And General	$229	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$515,041	TotalAmt
Program Services	$510,972	ProgramServicesAmt
Management And General	$4,069	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$203,200	TotalAmt
Program Services	$201,594	ProgramServicesAmt
Management And General	$1,606	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$2,232	TotalAmt
Management And General	$2,232	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$55,087	TotalAmt
Management And General	$55,087	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$636,690	TotalAmt
Program Services	$636,219	ProgramServicesAmt
Management And General	$471	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$6,152	TotalAmt
Management And General	$6,152	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$30,512	TotalAmt
Management And General	$30,512	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$84,952	TotalAmt
Management And General	$84,952	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$181,358	TotalAmt
Program Services	$175,062	ProgramServicesAmt
Management And General	$6,296	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$369	TotalAmt
Management And General	$369	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$1,819	TotalAmt
Management And General	$1,819	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$22,997	TotalAmt
Program Services	$22,022	ProgramServicesAmt
Management And General	$975	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$222,239	TotalAmt
Program Services	$212,820	ProgramServicesAmt
Management And General	$9,419	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$57,956	TotalAmt
Program Services	$55,500	ProgramServicesAmt
Management And General	$2,456	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
OTHER MISC EXPENSES	$333,902	$108,418	$225,484
FOOD	$245,568	$245,568
MEDICAL SUPPLIES	$210,836	$208,960	$1,876
LICENSE SURCHARGE	$143,109	$143,061	$48

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$74,912	TotalAmt
Program Services	$18,724	ProgramServicesAmt
Management And General	$56,188	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$5,724,858	TotalAmt
Program Services	$5,213,195	ProgramServicesAmt
Management And General	$511,663	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$602,887	BOYAmt
EOY	$482,363	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$716,908	BOYAmt
EOY	$634,865	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$231,803	BOYAmt
EOY	$347,806	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$89,808	BOYAmt
EOY	$85,547	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$7,840,680	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$5,797,340	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$2,189,937	BOYAmt
EOY	$2,043,340	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$16,810	BOYAmt
EOY	$20,821	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,848,153	BOYAmt
EOY	$3,614,742	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$436,917	BOYAmt
EOY	$412,466	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$352,600	BOYAmt
EOY	$96,996	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$577,980	BOYAmt
EOY	$397,546	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$17,207	BOYAmt
EOY	$18,512	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$67,439	BOYAmt
EOY	$70,811	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,452,143	BOYAmt
EOY	$996,331	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	$2,384,010	BOYAmt
EOY	$2,607,411	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$12,000	BOYAmt
EOY	$11,000	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$2,396,010	BOYAmt
EOY	$2,618,411	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$3,848,153	BOYAmt
EOY	$3,614,742	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$281,733	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$59,332	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
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	$5,025	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$10,710	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$1,795	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$857,735	CurrentTaxYearMinus1YearAmt
Current Tax Year	$415,158	CurrentTaxYearAmt
Total	$1,290,423	TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$5,182,602	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$5,251,862	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$5,553,617	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$5,296,560	CurrentTaxYearMinus1YearAmt
Current Tax Year	$5,534,501	CurrentTaxYearAmt
Total	$26,819,142	TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$41,250	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$35,475	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$31,464	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$48,825	CurrentTaxYearMinus1YearAmt
Current Tax Year	$42,818	CurrentTaxYearAmt
Total	$199,832	TotalAmt

Total509 Total509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$5,228,877	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$5,298,047	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$5,586,876	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$6,203,120	CurrentTaxYearMinus1YearAmt
Current Tax Year	$5,992,477	CurrentTaxYearAmt
Total	$28,309,397	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	$660,652	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$542,869	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$771,358	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$485,522	CurrentTaxYearMinus1YearAmt
Current Tax Year	$965,497	CurrentTaxYearAmt
Total	$3,425,898	TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$660,652	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$542,869	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$771,358	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$485,522	CurrentTaxYearMinus1YearAmt
Current Tax Year	$965,497	CurrentTaxYearAmt
Total	$3,425,898	TotalAmt

Field	Value	IRS element (for citing)
Public Support Total509	$24,883,499	PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$13,314	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$19,598	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$11,462	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$5,562	CurrentTaxYearMinus1YearAmt
Current Tax Year	$1,279	CurrentTaxYearAmt
Total	$51,215	TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$13,314	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$19,598	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$11,462	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$5,562	CurrentTaxYearMinus1YearAmt
Current Tax Year	$1,279	CurrentTaxYearAmt
Total	$51,215	TotalAmt

Other Income509 OtherIncome509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$19,517	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$30,669	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$26,689	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$36,073	CurrentTaxYearMinus1YearAmt
Current Tax Year	$13,235	CurrentTaxYearAmt
Total	$126,183	TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$5,261,708	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$5,348,314	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$5,625,027	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$6,244,755	CurrentTaxYearMinus1YearAmt
Current Tax Year	$6,006,991	CurrentTaxYearAmt
Total	$28,486,795	TotalAmt

Field	Value	IRS element (for citing)
Public Support CY509	0.87350	PublicSupportCY509Pct
Public Support PY509	0.88450	PublicSupportPY509Pct
Investment Income CY	0.00180	InvestmentIncomeCYPct
Investment Income PY	0.00230	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	$5,848,238	OtherCostOrOtherBasisAmt
Depreciation	$4,119,189	DepreciationAmt
Book Value	$1,729,049	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$366,450	OtherCostOrOtherBasisAmt
Depreciation	$159,639	DepreciationAmt
Book Value	$206,811	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,625,992	OtherCostOrOtherBasisAmt
Depreciation	$1,518,512	DepreciationAmt
Book Value	$107,480	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$2,043,340	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	ASSET RETIREMENT OBLIGATION	Desc
Amt	$70,811	Amt

Field	Value	IRS element (for citing)
Total Liability	$70,811	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$5,947,259	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	-$59,332	NetUnrealizedGainsInvstAmt
Revenue Not Reported	-$59,332	RevenueNotReportedAmt
Revenue Subtotal	$6,006,591	RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt	$0	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$6,006,591	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$5,724,858	TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported	$0	ExpensesNotReportedAmt
Expenses Subtotal	$5,724,858	ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt	$0	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$5,724,858	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 I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

Field	Value	IRS element (for citing)
Grant Type	SCHOLARSHIPS	GrantTypeTxt
Recipient	2	RecipientCnt
Cash Grant	$5,069	CashGrantAmt
Non Cash Assistance	NURSING SCHOLARSHIPS	NonCashAssistanceDesc

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	SCHOLARSHIP PAYMENTS ARE MADE DIRECTLY TO THE SCHOLARSHIP RECIPIENT'S COLLEGE TO ENSURE APPROPRIATE USE OF FUNDS.	ExplanationTxt

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	$1,553,143	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 (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 4	THE ARTICLES AND BYLAWS WERE REVISED FOR CLEANER WORDING AND UP-TO-DATE TERMINOLOGY, FOR THE FIRST TIME SINCE OPENING IN 1964. MAJOR CHANGES WERE MADE TO BOTH DOCUMENTS.
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 636,219. MANAGEMENT AND GENERAL EXPENSES 471. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 636,690.
FORM 990, PART XII, LINE 2C:	THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.