MAPLE LAWN NURSING HOME INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
MAPLE LAWN NURSING HOME INC (EIN 41-0870856)
Tax period
2018-10-01 to 2019-09-30
Filed
2020-08-06
IRS object ID
202042199349300324
Schema version
2018v3.2
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 ReturnHeader

FieldValueIRS element (for citing)
Return2020-08-06T11:47:59-05:00ReturnTs
Tax Period End2019-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1220 S 6TH STREET SUITE 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55402ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN410870856EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MAPLE LAWN NURSING HOME INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMAPLBusinessNameControlTxt
Phone5074252571PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1400 7TH ST NEAddressLine1Txt
CityFULDACityNm
State AbbreviationMNStateAbbreviationCd
ZIP56131ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonARLAN SWANSONPersonNm
Person TitleADMINISTRATOR/CEOPersonTitleTxt
Phone5074252571PhoneNum
Signature2020-08-06SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCORY RUTLEDGEPreparerPersonNm
PTINP01329381PTIN
Phone6123764500PhoneNum
Preparation2020-08-05PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address66.188.188.148IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-08-06IPDt
IP Tm09:39:05IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id64D167D091931D8555FA058DC075EC7E31BCB1E3AtSubmissionCreationDeviceId
At Submission Filing Device Id8DF0D5A1DBF8E44DE93554FEEDBEEE801640FE4CAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-09-23 17:36:50ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1MAPLE LAWN SENIOR CARE MAPLEWOODBusinessNameLine1Txt
Business Name Line2COURT MAPLEVIEW ESTATESBusinessNameLine2Txt
FieldValueIRS element (for citing)
Principal OfficerARLAN SWANSONPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1400 7TH ST NEAddressLine1Txt
CityFULDACityNm
State AbbreviationMNStateAbbreviationCd
ZIP56131ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$5,348,314GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MAPLELAWN.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1962FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionTO PROVIDE FINE QUALITY HEALTHCARE, HOUSING AND SUPPORT SERVICES FOR AREA SENIORS IN AN INDIVIDUALIZED, DIGNIFIED AND HOMELIKE MANNER.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee142TotalEmployeeCnt
Total Volunteers65TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$5,025PYContributionsGrantsAmt
CY Contributions Grants$10,710CYContributionsGrantsAmt
PY Program Service Revenue$5,182,602PYProgramServiceRevenueAmt
CY Program Service Revenue$5,251,862CYProgramServiceRevenueAmt
PY Investment Income$13,314PYInvestmentIncomeAmt
CY Investment Income$19,598CYInvestmentIncomeAmt
PY Other Revenue$60,767PYOtherRevenueAmt
CY Other Revenue$66,144CYOtherRevenueAmt
PY Total Revenue$5,261,708PYTotalRevenueAmt
CY Total Revenue$5,348,314CYTotalRevenueAmt
PY Grants And Similar Paid$14,710PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$6,897CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$3,313,292PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$3,306,131CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$1,912,198PYOtherExpensesAmt
CY Other Expenses$2,020,887CYOtherExpensesAmt
PY Total Expenses$5,240,200PYTotalExpensesAmt
CY Total Expenses$5,333,915CYTotalExpensesAmt
PY Revenues Less Expenses$21,508PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$14,399CYRevenuesLessExpensesAmt
Total Assets BOY$3,638,080TotalAssetsBOYAmt
Total Assets EOY$3,493,092TotalAssetsEOYAmt
Total Liabilities BOY$1,526,526TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,366,530TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,111,554NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,126,562NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO PROVIDE FINE QUALITY HEALTHCARE, HOUSING AND SUPPORT SERVICES FOR AREA SENIORS IN AN INDIVIDUALIZED, DIGNIFIED, AND HOMELIKE MANNER.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$4,969,411ExpenseAmt
Grant$6,897GrantAmt
Revenue$5,251,862RevenueAmt
DescMAPLE LAWN NURSING HOME IS A CAMPUS OF LONG TERM CARE SERVICES THAT INCLUDE:MAPLEVIEW ESTATES - 24 APARTMENTS FOR SENIORS WHO NEED LIGHT ASSISTANCE ALLOWING THEM TO MAINTAIN REASONABLY INDEPENDENT LIVES. THESE SERVICES INCLUDE A HIGH-QUALITY NOON MEAL AND ASSISTANCE FOR HOUSEKEEPING AND OTHER LIGHT TASKS. MAPLEWOOD COURT ASSISTED LIVING - 15 APARTMENTS FOR SENIORS WHO NEED ASSISTANCE WITH ALL MEALS AND MEDICATIONS, BUT MAINTAIN INDEPENDENCE IN MANY OTHER CARE AREAS. MAPLE LAWN NURSING HOME - 54 MEDICARE-CERTIFIED SKILLED NURSING BEDS THAT PROVIDE CARE FOR A BROAD SPECTRUM OF RESIDENTS WITH NEEDS FROM POST-ACUTE REHAB THERAPY TO MEMORY CARE. THE CAMPUS PROVIDES CARE FOR OVER 100 LOCAL INDIVIDUALS AT ANY POINT IN TIME, IN THIS RURAL COMMUNITY OF 1,300. APPROXIMATELY 180 DIFFERENT PERSONS ARE SERVED DURING EACH YEAR. MANY WOULD NOT BE ABLE TO FIND CARE ANYWHERE ELSE. THE ORGANIZATION HAS STEADILY GROWN AND IMPROVED DURING ITS 55 YEARS OF SERVICE TO THIS COMMUNITY - FILLING THIS COMMUNITY'S NEED FOR FINE QUALITY HOUSING AND HEALTH CARE SERVICES AND PROVIDING THEM IN AN INDIVIDUALIZED AND HOMELIKE MANNER.Desc
Total Program Service Expenses$4,969,411TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit CounselingYes (1)CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document32IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee142EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ARLAN SWANSONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5074252571PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1400 7TH STREET NEAddressLine1Txt
CityFULDACityNm
State AbbreviationMNStateAbbreviationCd
ZIP56131ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
JERRILD STEINER
PRESIDENT1.00Yes (X)Yes (X)$0$0$0
SHERRI LUNDEEN
VICE PRESIDENT1.00Yes (X)Yes (X)$0$0$0
MARCINE ELDER
SECRETARY1.00Yes (X)Yes (X)$0$0$0
SHERRI BOEHNKE
DIRECTOR1.00Yes (X)$0$0$0
RON JANSSEN
DIRECTOR (THROUGH FEB 2019)1.00Yes (X)$0$0$0
JOE GRANDGEORGE
DIRECTOR1.00Yes (X)$0$0$0
LOUISE JOHNSON
DIRECTOR1.00Yes (X)$0$0$0
SUSAN A ZINS
DIRECTOR1.00Yes (X)$0$0$0
LINDA CLAUSEN
DIRECTOR1.00Yes (X)$0$0$0
ELDEN GETTING
DIRECTOR (THROUGH FEB 2019)1.00Yes (X)$0$0$0
BILL FUERSTENBERG
DIRECTOR (THROUGH FEB 2019)1.00Yes (X)$0$0$0
ARLAN SWANSON
ADMINISTRATOR/CEO45.00Yes (X)$101,063$0$13,820
FieldValueIRS element (for citing)
Total Reportable Comp From Org$101,063TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$13,820TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PRAIRIE REHABILITATIONBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line11720 S CLIFF AVEAddressLine1Txt
CitySIOUX FALLSCityNm
State AbbreviationSDStateAbbreviationCd
ZIP57105ZIPCd
FieldValueIRS element (for citing)
ServicesCONTRACTED THERAPYServicesDesc
Compensation$158,043CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
All Other Contributions$10,710AllOtherContributionsAmt
Total Contributions$10,710TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
RESIDENT SERVICES623000$4,235,713$4,235,713
APARTMENT RENTAL623000$1,016,149$1,016,149
FieldValueIRS element (for citing)
Total Program Service Revenue$5,251,862TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$19,598TotalRevenueColumnAmt
Exclusion$19,598ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
MISCELLANEOUS INCOME900099$30,669$30,669
ANCILLARY SERVICES623000$25,818$25,818
GARAGE REVENUE623000$4,800$4,800

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,857TotalRevenueColumnAmt
Exclusion$4,857ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$66,144OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,348,314TotalRevenueColumnAmt
Related Or Exempt Func Income$5,251,862RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$85,742ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$647TotalAmt
Program Services$647ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$6,250TotalAmt
Program Services$6,250ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$114,883TotalAmt
Program Services$11,488ProgramServicesAmt
Management And General$103,395ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$2,590,942TotalAmt
Program Services$2,572,180ProgramServicesAmt
Management And General$18,762ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$30,463TotalAmt
Program Services$30,211ProgramServicesAmt
Management And General$252ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$393,766TotalAmt
Program Services$390,858ProgramServicesAmt
Management And General$2,908ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$176,077TotalAmt
Program Services$174,807ProgramServicesAmt
Management And General$1,270ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$2,232TotalAmt
Management And General$2,232ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$32,467TotalAmt
Management And General$32,467ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$569,265TotalAmt
Program Services$569,066ProgramServicesAmt
Management And General$199ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$9,641TotalAmt
Management And General$9,641ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$26,344TotalAmt
Management And General$26,344ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$63,841TotalAmt
Management And General$63,841ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$183,356TotalAmt
Program Services$176,941ProgramServicesAmt
Management And General$6,415ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$512TotalAmt
Management And General$512ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$2,698TotalAmt
Management And General$2,698ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$38,323TotalAmt
Program Services$36,699ProgramServicesAmt
Management And General$1,624ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$267,860TotalAmt
Program Services$256,508ProgramServicesAmt
Management And General$11,352ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$42,250TotalAmt
Program Services$40,459ProgramServicesAmt
Management And General$1,791ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
FOOD$231,979$231,979
MEDICAL SUPPLIES$206,435$203,900$2,535
MISCELLANEOUS$185,093$108,874$76,219
LICENSE SURCHARGE$158,591$158,544$47

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$5,333,915TotalAmt
Program Services$4,969,411ProgramServicesAmt
Management And General$364,504ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$157,333BOYAmt
EOY$131,307EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$499,059BOYAmt
EOY$488,615EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$234,357BOYAmt
EOY$240,570EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$56,238BOYAmt
EOY$54,355EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$7,620,679LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$5,056,341LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,673,054BOYAmt
EOY$2,564,338EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$18,039BOYAmt
EOY$13,907EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$3,638,080BOYAmt
EOY$3,493,092EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$367,498BOYAmt
EOY$371,115EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,082,733BOYAmt
EOY$920,339EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$18,039BOYAmt
EOY$13,907EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$58,256BOYAmt
EOY$61,169EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,526,526BOYAmt
EOY$1,366,530EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,096,554BOYAmt
EOY$2,112,562EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$15,000BOYAmt
EOY$14,000EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,111,554BOYAmt
EOY$2,126,562EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,638,080BOYAmt
EOY$3,493,092EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$14,399ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$609NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$194,906CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$6,149CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,076CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,025CurrentTaxYearMinus1YearAmt
Current Tax Year$10,710CurrentTaxYearAmt
Total$225,866TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,348,560CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,592,534CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,997,307CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,182,602CurrentTaxYearMinus1YearAmt
Current Tax Year$5,251,862CurrentTaxYearAmt
Total$24,372,865TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$9,135CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$24,715CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$39,873CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$41,250CurrentTaxYearMinus1YearAmt
Current Tax Year$35,475CurrentTaxYearAmt
Total$150,448TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,552,601CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,623,398CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,046,256CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,228,877CurrentTaxYearMinus1YearAmt
Current Tax Year$5,298,047CurrentTaxYearAmt
Total$24,749,179TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$294,384CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$501,472CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$519,963CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$660,652CurrentTaxYearMinus1YearAmt
Current Tax Year$542,869CurrentTaxYearAmt
Total$2,519,340TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$294,384CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$501,472CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$519,963CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$660,652CurrentTaxYearMinus1YearAmt
Current Tax Year$542,869CurrentTaxYearAmt
Total$2,519,340TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$22,229,839PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,443CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$12,874CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$12,161CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$13,314CurrentTaxYearMinus1YearAmt
Current Tax Year$19,598CurrentTaxYearAmt
Total$71,390TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,443CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$12,874CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$12,161CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$13,314CurrentTaxYearMinus1YearAmt
Current Tax Year$19,598CurrentTaxYearAmt
Total$71,390TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$40,974CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$119,634CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$27,886CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$19,517CurrentTaxYearMinus1YearAmt
Current Tax Year$30,669CurrentTaxYearAmt
Total$238,680TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,607,018CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,755,906CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,086,303CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,261,708CurrentTaxYearMinus1YearAmt
Current Tax Year$5,348,314CurrentTaxYearAmt
Total$25,059,249TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.88710PublicSupportCY509Pct
Public Support PY5090.88760PublicSupportPY509Pct
Investment Income CY0.00280InvestmentIncomeCYPct
Investment Income PY0.00240InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:FormAndLineReferenceDesc
ExplanationMISCELLANEOUS REVENUESExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (1)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,775,843OtherCostOrOtherBasisAmt
Depreciation$3,582,078DepreciationAmt
Book Value$2,193,765BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$323,048OtherCostOrOtherBasisAmt
Depreciation$130,783DepreciationAmt
Book Value$192,265BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,521,788OtherCostOrOtherBasisAmt
Depreciation$1,343,480DepreciationAmt
Book Value$178,308BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$2,564,338TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescASSET RETIREMENT OBLIGATIONDesc
Amt$61,169Amt
FieldValueIRS element (for citing)
Total Liability$61,169TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$5,348,923TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$609NetUnrealizedGainsInvstAmt
Revenue Not Reported$609RevenueNotReportedAmt
Revenue Subtotal$5,348,314RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$5,348,314TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$5,333,915TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$5,333,915ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$5,333,915TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeSCHOLARSHIPSGrantTypeTxt
Recipient14RecipientCnt
Cash Grant$6,250CashGrantAmt
Non Cash AssistanceNURSING SCHOLARSHIPSNonCashAssistanceDesc

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationSCHOLARSHIP 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

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1CITY OF FULDA MINNESOTABusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN416005177BondIssuerEIN
Bond Issued2012-10-01BondIssuedDt
Issue Price$1,955,150IssuePriceAmt
PurposeREFUND SERIES 2003 BONDS (NURSING HOME PROJECT)PurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$1,023,660RetiredAmt
Total Proceeds$1,955,150TotalProceedsAmt
Other Spent Proceeds$1,955,150OtherSpentProceedsAmt
Substantial Completion2012SubstantialCompletionYr
Refunding Tax Exempt BondsYes (1)RefundingTaxExemptBondsInd
Refunding Taxable Bonds0RefundingTaxableBondsInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd0ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To RebateYes (1)ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate IssueYes (1)VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor Reqs0WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective Action0ProceduresCorrectiveActionInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6THE 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 7ATHE ORGANIZATION'S MEMBERS ELECT THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7BTHE ORGANIZATION'S MEMBERS HAVE THE POWER TO AMEND THE ARTICLES AND BYLAWS AND TO TERMINATE MEMBERSHIPS.
FORM 990, PART VI, SECTION B, LINE 11BA 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 12CTHE 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 15ATHE 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 DECEMBER 2017 AND IS EFFECTIVE JANUARY 2018.
FORM 990, PART VI, SECTION C, LINE 19THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11GOTHER FEES: PROGRAM SERVICE EXPENSES 569,066. MANAGEMENT AND GENERAL EXPENSES 199. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 569,265.

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