MAPLE LAWN NURSING HOME INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: MAPLE LAWN NURSING HOME INC (EIN 41-0870856)
Tax period: 2016-10-01 to 2017-09-30
Filed: 2018-07-31
IRS object ID: 201802129349300615
Schema version: 2016v3.0
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
Form 990
Schedule A
Schedule D
Schedule I
Schedule K
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2018-07-31T08:58:09-05:00	ReturnTs
Tax Period End	2017-09-30	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	220 SOUTH SIXTH STREET SUITE 300	AddressLine1Txt
City	MINNEAPOLIS	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	55402	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2016-10-01	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 SEVENTH STREET BOX 278	AddressLine1Txt
City	FULDA	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	56131	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	ARLAN SWANSON	PersonNm
Person Title	ADMINISTRATOR/CEO	PersonTitleTxt
Phone	5074252571	PhoneNum
Signature	2018-07-26	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	EMILY SCHEEVEL	PreparerPersonNm
PTIN	P01814921	PTIN
Phone	6123764500	PhoneNum

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2022-09-23 18:48:47Z	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 MAPLEWOOD ESTATES	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
Principal Officer	ARLAN SWANSON	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	400 SEVENTH STREET BOX 278	AddressLine1Txt
City	FULDA	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	56131	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$5,086,303	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	158	TotalEmployeeCnt
Total Volunteers	58	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$6,149	PYContributionsGrantsAmt
CY Contributions Grants	$9,076	CYContributionsGrantsAmt
PY Program Service Revenue	$4,592,534	PYProgramServiceRevenueAmt
CY Program Service Revenue	$4,997,307	CYProgramServiceRevenueAmt
PY Investment Income	$12,874	PYInvestmentIncomeAmt
CY Investment Income	$12,161	CYInvestmentIncomeAmt
PY Other Revenue	$144,349	PYOtherRevenueAmt
CY Other Revenue	$67,759	CYOtherRevenueAmt
PY Total Revenue	$4,755,906	PYTotalRevenueAmt
CY Total Revenue	$5,086,303	CYTotalRevenueAmt
PY Grants And Similar Paid	$13,982	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$13,645	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$3,029,340	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$3,248,944	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$1,955,092	PYOtherExpensesAmt
CY Other Expenses	$1,756,751	CYOtherExpensesAmt
PY Total Expenses	$4,998,414	PYTotalExpensesAmt
CY Total Expenses	$5,019,340	CYTotalExpensesAmt
PY Revenues Less Expenses	-$242,508	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$66,963	CYRevenuesLessExpensesAmt
Total Assets BOY	$3,834,297	TotalAssetsBOYAmt
Total Assets EOY	$3,758,858	TotalAssetsEOYAmt
Total Liabilities BOY	$1,825,141	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$1,663,392	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$2,009,156	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$2,095,466	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
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	$4,708,347	ExpenseAmt
Grant	$13,645	GrantAmt
Revenue	$4,997,307	RevenueAmt
Desc	MAPLE 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	$4,708,347	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	0	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
Temp Or Permanent Endowments	0	TempOrPermanentEndowmentsInd
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 With Officer Ent	0	BusinessRlnWithOfficerEntInd
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	27	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	158	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
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	Yes (1)	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	ARLAN SWANSON	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	5074252571	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	400 NE SEVENTH STREET	AddressLine1Txt
City	FULDA	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	56131	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt
ELDEN GETTING
PRESIDENT	1.00	Yes (X)	Yes (X)	$0	$0	$0
RON JANSSEN
VICE PRESIDENT	1.00	Yes (X)	Yes (X)	$0	$0	$0
MARCINE ELDER
SECRETARY	1.00	Yes (X)	Yes (X)	$0	$0	$0
SHERRI BOEHNKE
DIRECTOR	1.00	Yes (X)		$0	$0	$0
BILL FUERSTENBERG
DIRECTOR	1.00	Yes (X)		$0	$0	$0
LOUISE JOHNSON
DIRECTOR	1.00	Yes (X)		$0	$0	$0
SHERRI LUNDEEN
DIRECTOR	1.00	Yes (X)		$0	$0	$0
DEAN MCNEAL
DIRECTOR	1.00	Yes (X)		$0	$0	$0
JERRILD STEINER
DIRECTOR	1.00	Yes (X)		$0	$0	$0
ARLAN SWANSON
ADMINISTRATOR/CEO	50.00		Yes (X)	$106,923	$0	$12,636

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$106,923	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$12,636	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 LLC	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	$237,628	CompensationAmt

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	1	CntrctRcvdGreaterThan100KCnt
All Other Contributions	$9,076	AllOtherContributionsAmt
Total Contributions	$9,076	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
RESIDENT SERVICES	623000	$4,093,735	$4,093,735
APARTMENT RENTAL	623000	$903,572	$903,572

Field	Value	IRS element (for citing)
Total Program Service Revenue	$4,997,307	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$12,161	TotalRevenueColumnAmt
Exclusion	$12,161	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
ANCILLARY SERVICES	623000	$30,511	$30,511
MISCELLANEOUS INCOME	900099	$27,886	$27,886
GARAGE REVENUE	623000	$4,793	$4,793

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$4,569	TotalRevenueColumnAmt
Exclusion	$4,569	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$67,759	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,086,303	TotalRevenueColumnAmt
Related Or Exempt Func Income	$4,997,307	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$79,920	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$745	TotalAmt
Program Services	$745	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$12,900	TotalAmt
Program Services	$12,900	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$119,559	TotalAmt
Program Services	$11,956	ProgramServicesAmt
Management And General	$107,603	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$2,590,330	TotalAmt
Program Services	$2,583,347	ProgramServicesAmt
Management And General	$6,983	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$24,462	TotalAmt
Program Services	$24,369	ProgramServicesAmt
Management And General	$93	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$338,750	TotalAmt
Program Services	$337,834	ProgramServicesAmt
Management And General	$916	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$175,843	TotalAmt
Program Services	$175,371	ProgramServicesAmt
Management And General	$472	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	$27,994	TotalAmt
Management And General	$27,994	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$381,738	TotalAmt
Program Services	$381,583	ProgramServicesAmt
Management And General	$155	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$13,663	TotalAmt
Management And General	$13,663	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$20,874	TotalAmt
Management And General	$20,874	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$53,061	TotalAmt
Management And General	$53,061	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$169,273	TotalAmt
Program Services	$163,340	ProgramServicesAmt
Management And General	$5,933	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$170	TotalAmt
Management And General	$170	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$2,087	TotalAmt
Management And General	$2,087	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$49,025	TotalAmt
Program Services	$46,947	ProgramServicesAmt
Management And General	$2,078	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$238,755	TotalAmt
Program Services	$228,636	ProgramServicesAmt
Management And General	$10,119	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$40,392	TotalAmt
Program Services	$38,680	ProgramServicesAmt
Management And General	$1,712	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
FOOD	$215,132	$215,132
MEDICAL SUPPLIES	$202,300	$200,194	$2,106
MISCELLANEOUS	$181,382	$128,658	$52,724
LICENSE SURCHARGE	$158,673	$158,655	$18

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$5,019,340	TotalAmt
Program Services	$4,708,347	ProgramServicesAmt
Management And General	$310,993	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$113,251	BOYAmt
EOY	$85,420	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$484,653	BOYAmt
EOY	$491,779	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$266,340	BOYAmt
EOY	$250,569	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$37,659	BOYAmt
EOY	$54,523	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$7,382,969	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$4,526,338	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$2,906,165	BOYAmt
EOY	$2,856,631	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$26,229	BOYAmt
EOY	$19,936	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,834,297	BOYAmt
EOY	$3,758,858	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$379,205	BOYAmt
EOY	$362,255	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$1,517	BOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,376,484	BOYAmt
EOY	$1,225,719	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$15,095	BOYAmt
EOY	$19,936	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$52,840	BOYAmt
EOY	$55,482	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,825,141	BOYAmt
EOY	$1,663,392	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,992,156	BOYAmt
EOY	$2,079,466	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$17,000	BOYAmt
EOY	$16,000	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$2,009,156	BOYAmt
EOY	$2,095,466	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$3,834,297	BOYAmt
EOY	$3,758,858	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$66,963	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$19,347	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	$9,628	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$27,797	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$194,906	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$6,149	CurrentTaxYearMinus1YearAmt
Current Tax Year	$9,076	CurrentTaxYearAmt
Total	$247,556	TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$4,403,279	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$4,156,634	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$4,348,560	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$4,592,534	CurrentTaxYearMinus1YearAmt
Current Tax Year	$4,997,307	CurrentTaxYearAmt
Total	$22,498,314	TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$9,403	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$7,405	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$9,135	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$24,715	CurrentTaxYearMinus1YearAmt
Current Tax Year	$39,873	CurrentTaxYearAmt
Total	$90,531	TotalAmt

Total509 Total509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$4,422,310	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$4,191,836	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$4,552,601	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$4,623,398	CurrentTaxYearMinus1YearAmt
Current Tax Year	$5,046,256	CurrentTaxYearAmt
Total	$22,836,401	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	$315,376	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$528,492	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$294,384	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$501,472	CurrentTaxYearMinus1YearAmt
Current Tax Year	$519,963	CurrentTaxYearAmt
Total	$2,159,687	TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$315,376	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$528,492	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$294,384	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$501,472	CurrentTaxYearMinus1YearAmt
Current Tax Year	$519,963	CurrentTaxYearAmt
Total	$2,159,687	TotalAmt

Field	Value	IRS element (for citing)
Public Support Total509	$20,676,714	PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$5,569	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$6,455	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$13,443	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$12,874	CurrentTaxYearMinus1YearAmt
Current Tax Year	$12,161	CurrentTaxYearAmt
Total	$50,502	TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$5,569	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$6,455	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$13,443	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$12,874	CurrentTaxYearMinus1YearAmt
Current Tax Year	$12,161	CurrentTaxYearAmt
Total	$50,502	TotalAmt

Other Income509 OtherIncome509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$17,173	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$20,844	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$40,974	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$119,634	CurrentTaxYearMinus1YearAmt
Current Tax Year	$27,886	CurrentTaxYearAmt
Total	$226,511	TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$4,445,052	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$4,219,135	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$4,607,018	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$4,755,906	CurrentTaxYearMinus1YearAmt
Current Tax Year	$5,086,303	CurrentTaxYearAmt
Total	$23,113,414	TotalAmt

Field	Value	IRS element (for citing)
Public Support CY509	0.89460	PublicSupportCY509Pct
Public Support PY509	0.90770	PublicSupportPY509Pct
Investment Income CY	0.00220	InvestmentIncomeCYPct
Investment Income PY	0.00220	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 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	$5,689,450	OtherCostOrOtherBasisAmt
Depreciation	$3,199,465	DepreciationAmt
Book Value	$2,489,985	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$280,602	OtherCostOrOtherBasisAmt
Depreciation	$114,217	DepreciationAmt
Book Value	$166,385	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,412,917	OtherCostOrOtherBasisAmt
Depreciation	$1,212,656	DepreciationAmt
Book Value	$200,261	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$2,856,631	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	ASSET RETIREMENT OBLIGATION	Desc
Amt	$55,482	Amt

Field	Value	IRS element (for citing)
Total Liability	$55,482	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$5,105,650	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	$19,347	NetUnrealizedGainsInvstAmt
Revenue Not Reported	$19,347	RevenueNotReportedAmt
Revenue Subtotal	$5,086,303	RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt	$0	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$5,086,303	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$5,019,340	TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported	$0	ExpensesNotReportedAmt
Expenses Subtotal	$5,019,340	ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt	$0	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$5,019,340	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	10	RecipientCnt
Cash Grant	$12,900	CashGrantAmt

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	$713,820	RetiredAmt
Total Proceeds	$1,955,150	TotalProceedsAmt
Other Spent Proceeds	$1,955,150	OtherSpentProceedsAmt
Substantial Completion	2012	SubstantialCompletionYr
Current Refunding	Yes (1)	CurrentRefundingInd
Advance Refunding	0	AdvanceRefundingInd
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 (8 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 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 DECEMBER 2017 AND IS EFFECTIVE JANUARY 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.
PART XII, LINE 2C	THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT.