2017-09-25T10:35:26-05:00 2016-12-31 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2016-01-01 430863738 LACOBA HOMES INC % MICHAEL D BALDUS LACO 4172357895 PO BOX 885 MONETT MO 65708 MICHAEL D BALDUS EXECUTIVE DIRECTOR 4172357895 2017-08-08 true Brian D Todd P00422601 4178658701 167.68.126.162 43032920172685000000 2017-09-25 P C38732425DB7411744D9F7D4C14CD4EDB84044DF C38732425DB7411744D9F7D4C14CD4EDB84044DF 2016 2021-01-29 14:40:06Z MICHAEL D BALDUS PO BOX 885 MONETT MO 65708 5360783 false X N/A X 1966 MO LACOBA HOMES, INC., IS A 72 BED, 28 CHURCHES AFFILIATED, NOT-FOR-PROFIT SKILLED NURSING FACILITY. 13 13 171 50 5242 3996 7980 9636 5370760 5331147 -4427 0 5160 5242 5379473 5346025 0 0 0 0 2421131 2524034 0 0 0 2547949 2653442 4969080 5177476 410393 168549 8090075 8286836 220095 248307 7869980 8038529 X THE MISSION OF LACOBA IS TO ENABLE RESIDENTS TO RECOGNIZE AND ACHIEVE THEIR HIGHEST POTENTIAL ABILITY AFTER THE ONSET OF A DISABLING DISEASE OR THE NATURAL AGING PROCESS. SEE SCHEDULE O FOR MORE INFORMATION. false false 4105439 5331147 SKILLED NURSING AND REHABILITATION SERVICES - ON-SITE SERVICES INCLUDE ACTIVITIES, CLINICAL LAB, DENTAL, DIETARY, HOUSEKEEPING, MENTAL HEALTH, NURSING, OCCUPATIONAL THERAPY, PHARMACY, PHYSICAL THERAPY, PHYSICIAN, PODIATRY, SOCIAL WORK, SPEECH AND LANGUAGE PATHOLOGY, AND X-RAY SERVICES. LACOBA HOMES SERVED 62 RESIDENTS, WITH A 85.85% OCCUPANCY RATE. 4105439 true false false true false false false false true false true false false false true false false false false false false false false false false false false false false true false false false false false false false false false false false false true false false false false true 8 0 true 171 true true true false false false false false false false false false X 13 13 false true false false true true false true true false false true true true true true true true false false X MICHAEL D BALDUS 4172357895 PO BOX 885 MONETT MO 65708 RONNIE CROUCH PRESIDENT 1.0 0.0 X X 0 0 0 LARRY BROWN VICE PRESIDENT 1.0 0.0 X X 0 0 0 JOEL JUSTUS SECRETARY 1.0 0.0 X X 0 0 0 MARILYN KNIGHT TREASURER 1.0 0.0 X X 0 0 0 JOE BEAVER MEMBER 1.0 0.0 X 0 0 0 TIM RICE MEMBER 1.0 0.0 X 0 0 0 DORIS COLEWELL MEMBER 1.0 0.0 X 0 0 0 LOREN GILLASPY MEMBER 1.0 0.0 X 0 0 0 JOHN D WELDY MEMBER 1.0 0.0 X 0 0 0 ANTHONY GRIPKA MEMBER 1.0 0.0 X 0 0 0 KEN HAWKINS MEMBER 1.0 0.0 X 0 0 0 SHIRLEY ANDRUS MEMBER 1.0 0.0 X 0 0 0 JOHNNY TURNBULL MEMBER 1.0 0.0 X 0 0 0 MICHAEL D BALDUS EXECUTIVE DIRECTOR 40.0 0.0 X 191034 0 0 191034 0 0 1 false true false AEGIS THERAPIES 1000 FIANNA WAY FORT SMITH AR 72902 PT/OT/ST THERAPIES 616219 MANAGED CARE ALLIANCE 114 NORTH COMMERCE CRANE MO 65633 MGMT SRVCS 209028 HEALTHCARE SERVICES GROUP 3220 TILLMAN DR STE 300 BENSALEM PA 19020 HOUSEKEEPING/LAUNDRY 198766 BKD LLP 910 E ST LOUIS ST SPRINGFIELD MO 65801 TAX/CST RPT/CONSULT 126065 GUARDIAN PHARMACY 2103 E ROCKHURST SPRINGFIELD MO 65802 PHARMACY 174496 5 9636 9636 ROOM & BOARD 623000 5180603 5180603 ANCILLARY SERVICES 623000 135606 135606 MEALS 621910 9596 9596 OTHER 623000 5342 5342 5331147 0 0 0 20000 14758 5242 0 5242 5242 0 0 0 0 0 0 0 0 0 0 0 5346025 5321551 5242 9596 X 0 0 0 0 191034 191034 0 1985178 1837173 148005 24000 20335 3665 149854 126968 22886 173968 147399 26569 207785 207785 1494 1494 33250 33250 0 0 0 1015824 825169 190655 10839 2331 8508 409329 336611 72718 20617 20617 0 126253 93892 32361 18740 8971 9769 0 205 155 50 0 0 265478 197431 68047 27358 27358 NFRA FEES 311790 311790 MEDICAL SUPPLIES & DRUGS 185778 185778 NFAC FEES 11436 11436 LICENSES, DUES, SUBSCRIPTIONS 7266 7266 5177476 4105439 1072037 0 1194392 1256799 1122802 1225318 0 0 672272 703070 0 0 0 0 0 0 16132 15100 9537 9537 8011891 2934879 5074940 5077012 0 0 0 0 0 0 0 0 0 0 8090075 8286836 209543 238205 0 0 0 0 0 0 2977 1527 0 0 0 0 0 0 7575 8575 220095 248307 X 0 0 0 0 7869980 8038529 7869980 8038529 8090075 8286836 168549 X false false false X 3890 10753 15733 7980 9636 47992 5119659 5004044 5122181 5370760 5331147 25947791 0 0 0 5123549 5014797 5137914 5378740 5340783 25995783 0 0 0 25995783 1902 1902 0 1902 1902 7361 3915 5051 5160 5242 26729 0 5130910 5020614 5142965 5383900 5346025 26024414 0.99890 0.99943 0.00007 0.00026 X false false false false false false false false true 914 914 false SCHEDULE C, PART II, LINE 1I LOBBYING ACTIVITIES: THE ORGANIZATION PAYS DUES TO MISSOURI HEALTH CARE ASSOCIATION. $914 OF THESE DUES ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES. false true X 0 68278 68278 0 7096306 2268708 4827598 0 847307 666171 181136 5077012 0 VILLA DEPOSITS 8575 8575 SCHEDULE D, PART IV, LINE 2B ESCROW ACCOUNT: THE ORGANIZATION IS THE TRUSTEE OF FUNDS RECEIVED ON BEHALF OF VARIOUS RESIDENTS. THE ORGANIZATION HAS A FIDUCIARY RESPONSIBILITY FOR THE ADMINISTRATION OF THE BANK ACCOUNT AND THE DISTRIBUTION OF THE FUNDS TO RESIDENTS. X false false false false false false false true false MICHAEL D BALDUS EXECUTIVE DIRECTOR 176034 0 15000 0 0 0 0 0 0 0 191034 0 0 0 SCHEDULE J, PART 1, LINE 7 NON-FIXED PAYMENTS: THE BONUS PAID TO THE EXECUTIVE DIRECTOR IS DETERMINED AND APPROVED BY THE BOARD OF DIRECTORS. FORM 990, PART III, LINE 1 ORGANIZATION'S MISSION: THE MISSION OF LACOBA IS TO ENABLE RESIDENTS TO RECOGNIZE AND ACHIEVE THEIR HIGHEST POTENTIAL ABILITY AFTER THE ONSET OF A DISABLING DISEASE OR THE NATURAL AGING PROCESS. LACOBA STRIVES TO PROVIDE RESIDENTS WITH A SAFE, COMFORTABLE, AND PLEASANT LIVING ENVIRONMENT THAT ENCOURAGES INDEPENDENCE AND PROMOTES QUALITY OF LIFE. FORM 990, PART VI, SECTION A, LINE 3 MANAGEMENT DUTIES: THE ORGANIZATION HAS CONTRACTED WITH MANAGED CARE ALLIANCE TO PERFORM CERTAIN MANAGEMENT FUNCTIONS. MANAGED CARE ALLIANCE WORKS CLOSELY WITH THE EXECUTIVE DIRECTOR WITH VARIOUS DUTIES INCLUDING BUDGETING, STRATEGIC PLANNING, AND OTHER MANAGEMENT FUNCTIONS. FORM 990, PART VI, SECTION A, LINES 6 & 7A MEMBERS: THE ORGANIZATION HAS MEMBERS WHO MEET ANNUALLY FOR THE PURPOSE OF ELECTING DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE EXECUTIVE DIRECTOR THOROUGHLY REVIEWS THE 990 PRIOR TO FILING THE RETURN WITH THE IRS. THE BOARD OF DIRECTORS IS ALSO PROVIDED WITH A FULL COPY OF THE 990 BEFORE THE RETURN IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY COMPLIANCE: BIDS ARE INTERNALLY TESTED FOR ANY CONFLICT OF INTEREST WITH CURRENT BOARD MEMBERS. THE GOVERNING BOARD IS AWARE AND ADVISED OF ANY POTENTIAL CONFLICT. A PERSON WHO HAS A CONFLICT OF INTEREST IS NOT PERMITTED TO VOTE ON THE TRANSACTION, CONTRACT, OR ITEM IN CONFLICT, AND IS REQUIRED TO RECUSE FROM ANY DECISIONS REGARDING THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15A PROCESS FOR DETERMINING COMPENSATION OF OFFICERS: COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION OF DETERMINING COMPENSATION OF OFFICERS WERE RECORDED IN THE MINUTES OF THE BOARD MEETING. THIS OCCURS EACH CALENDAR YEAR, INCLUDING THE CALENDAR YEAR ENDING 12/31/2016. THE ANNUAL REVIEW IS CONDUCTED ALONGSIDE THE MANAGEMENT COMPANY AND THE RECOMMENDATIONS PROVIDED BY THE MANAGEMENT COMPANY ARE PROVIDED TO THE BOARD. THE COMPENSATION IS THEN APPROVED BY THE BOARD. FORM 990. PART VI, SECTION C, LINE 19 AVAILABILITY OF GOVERNING DOCUMENTS: A COPY OF THE CONFLICT OF INTEREST, GOVERNING DOCUMENTS, AND/OR FINANCIAL STATEMENTS WILL BE MADE AVAILABLE ON THE SAME DAY (MONDAY THROUGH FRIDAY) REQUEST IS MADE IN PERSON. IF A REQUEST IS MADE VIA US MAIL, OR PRIVATE CARRIER, LACOBA HOMES, INC., WILL RETURN A COPY WITHIN 30 DAYS OF THE RECEIPT OF THE REQUEST. FORM 990, PART IX, LINE 11G OTHER FEES: PURCHASED SERVICES 846,632 BILLING SERVICES 94,640 CONSULTING 51,610 CONTRACT LABOR 22,942 --------- TOTAL OTHER FEES 1,015,824 BRIDLE LANE LLC PO BOX 885 MONETT MO 65708 203157670 STORAGE RENT MO 325153 LACOBA HOMES