2016-08-08T08:03:45-05:00 2015-12-31 420946155 HONKAMP KRUEGER & CO PC P O BOX 699 DUBUQUE IA 520040699 990 2015-01-01 421412375 COTTAGE GROVE PLACE COTT 3193632420 2115 FIRST AVENUE SE CEDAR RAPIDS IA 52402 MARK BAILEY EXECUTIVE DIRECTOR 3193632420 2016-07-14 1 KEVIN R SCHMITT CPA P00139899 5635560123 2016-07-14 2015 2016-12-15 16:53:06Z MARK BAILEY 2115 FIRST AVENUE SE CEDAR RAPIDS IA 52402 13600944 0 X WWW.COTTAGEGROVEPLACE.COM X 1992 IA TO PROVIDE HOUSING, HEALTH CARE, AND OTHER RELATED SERVICES TO RESIDENTS THROUGH THE OPERATION OF A RETIREMENT FACILITY 15 15 270 13 0 0 0 0 12854359 13583315 12097 17629 0 0 12866456 13600944 0 0 0 0 5200747 5185414 0 0 0 5702111 5963649 10902858 11149063 1963598 2451881 30349777 31650029 43719045 42567416 -13369268 -10917387 TO PROVIDE HOUSING, HEALTH CARE, AND OTHER RELATED SERVICES TO RESIDENTS THROUGH THE OPERATION OF A RETIREMENT FACILITY 0 0 9319558 13585115 THE RETIREMENT FACILITIES CONTAIN 166 INDEPENDENT LIVING UNITS, 19 ASSISTED LIVING UNITS, AND 52 HEALTH CENTER UNITS FOR ITS RESIDENTS. INDEPENDENT LIVING WAS 94.31% OCCUPIED AT DECEMBER 31ST, ASSISTED LIVING WAS 79.47% OCCUPIED AND THE HEALTH CENTER WAS 81.38% OCCUPIED. 9319558 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 38 0 1 270 1 0 0 0 0 0 0 0 0 0 0 X 15 15 1 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X GREG OLBEKSON 3192975754 2115 FIRST AVENUE SE CEDAR RAPIDS IA 52402 DOUGLAS HEATH TRUSTEE 1.00 X 0 0 0 HAROLD G SCHAEFER TRUSTEE 1.00 X 0 0 0 RUSSELL H ANTHONY TRUSTEE 1.00 X 0 0 0 WILLIAM S ELLIOTT TRUSTEE 1.00 X 0 0 0 JOHN C WAGOR TRUSTEE 1.00 X 0 0 0 CARL E HALLBERG TRUSTEE 1.00 X 0 0 0 PHIL MORRIS TRUSTEE 1.00 X 0 0 0 KATHY TOBORG TRUSTEE 1.00 X 0 0 0 RALPH H PALMER TRUSTEE 1.00 X 0 0 0 TAD COOPER TRUSTEE 1.00 X 0 0 0 JAN ALTORFER TRUSTEE 1.00 X 0 0 0 ROBERT SILBER TRUSTEE 1.00 X 0 0 0 CRYSTAL USHER TRUSTEE 1.00 X 0 0 0 DON MOSIER TRUSTEE 1.00 X 0 0 0 DAVID BEY TREASURER 2.50 X 0 0 0 BILL JACOBSON CHAIRMAN 2.50 X 0 0 0 DICK HEFT SECRETARY 2.50 X 0 0 0 B D COOPER VICE CHAIRMAN 2.50 X 0 0 0 GREG OLBEKSON ACCOUNTING DIRECTOR 45.00 X 64339 0 5971 64339 0 5971 0 0 0 0 REHABCARE GROUP 680 SOUTH FOURTH STREET LOUISVILLE KY 40202 REHABILITATION 400985 LIFE CARE SERVICES LLC 400 LOCUST STREET SUITE 820 DES MOINES IA 50309 MANAGEMENT 195352 GRAFTON MAINTENANCE & CONSTRUCTION INC 5731 SANDEN RD NE CEDAR RAPIDS IA 52411 CONSTRUCTION 154378 3 RESIDENT SERVICES 623000 13583315 13583315 13583315 15829 15829 1800 0 1800 1800 1800 13600944 13585115 0 15829 304286 304286 3887667 3169614 718053 29734 22588 7146 640475 566794 73681 323252 287031 36221 52851 52851 41492 41492 484668 163076 321592 173836 103422 70414 707643 675068 32575 39754 26042 13712 907858 907858 1167882 1132846 35036 263887 110743 153144 FOOD 672524 672524 MEDICAL EXPENSE 551926 551926 PROPERTY TAXES 285766 285766 DEPARTMENT SUPPLIES 138456 138456 475106 201518 273588 11149063 9319558 1829505 0 -3 1203864 1130158 169068 237528 62268 66688 146488 158548 40295637 16909851 22986347 23385786 5781745 6671321 30349777 31650029 903666 956857 11580714 12622553 20808385 19494504 10426280 9493502 43719045 42567416 X -13369268 -10917387 -13369268 -10917387 30349777 31650029 2451881 0 X X 0 1 X 1 0 X 11099540 11860780 13058526 12854359 13583315 62456520 11099540 11860780 13058526 12854359 13583315 62456520 0 0 0 62456520 29008 25600 4780 15100 15829 90317 29008 25600 4780 15100 15829 90317 4758935 4758935 11128548 16645315 13063306 12869459 13599144 67305772 0.92800 0.92410 0.00130 0.00180 X 4016275 4016275 28756163 12502277 16253886 4138630 1927106 2211524 531372 334630 196742 2853197 2145838 707359 23385786 ASSETS LIMITED AS TO USE 5898609 BENEFICIAL INTEREST IN TRUST 252498 CASH VALUE OF LIFE INSURANCE 520214 6671321 REFUNDABLE ENTRANCE FEES 9493502 9493502 X PART X, LINE 2: THE INTERNAL REVENUE SERVICE HAS RECOGNIZED COTTAGE GROVE PLACE AND COTTAGE GROVE PLACE FOUNDATION AS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE. MANAGEMENT HAS DETERMINED THAT THE CORPORATION DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS AND ASSOCIATED UNRECOGNIZED BENEFITS THAT MATERIALLY IMPACT THE FINANCIAL STATEMENTS OR RELATED DISCLOSURES. SINCE TAX MATTERS ARE SUBJECT TO SOME DEGREE OF UNCERTAINTY, THERE CAN BE NO ASSURANCE THAT THE CORPORATION OR ITS SHAREHOLDERS WILL NOT BE SUBJECT TO ADDITIONAL TAX, PENALTIES, AND INTEREST AS A RESULT OF AN IRS EXAMINATION. GENERALLY, THE CORPORATION IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL, STATE, OR LOCAL TAX AUTHORITIES FOR YEARS BEFORE 2012. FORM 990, PART VI, SECTION A, LINE 2 B D COOPER (VICE CHAIRMAN) IS THE FATHER OF TAD COOPER (TRUSTEE). FORM 990, PART VI, SECTION A, LINE 3 COTTAGE GROVE PLACE IS MANAGED BY LIFECARE SERVICES. THE EXECUTIVE DIRECTOR AND HEALTH CENTER ADMINISTRATOR POSITIONS ARE EMPLOYEES OF LIFE CARE SERVICES. LCS OVERSEES MANAGEMENT OF THE COMMUNITY, AND THE USE THEIR CUSTOM COMPUTER PROGRAMS AND RESOURCES. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION'S FORM 990 IS REVIEWED BY THE BOARD AND THE EXECUTIVE DIRECTOR. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO DISCLOSE EVERY YEAR POTENTIAL CONFLICTS WITH BUSINESSES THEY ARE ASSOCIATED WITH. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 2C THERE WERE NO CHANGES IN THE PROCEDURES FOR THE OVERSIGHT OF THE AUDIT.