MAPLETON COMMUNITY HOME: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: MAPLETON COMMUNITY HOME (EIN 41-6031905)
Tax period: 2011-10-01 to 2012-09-30
Filed: 2013-02-14
IRS object ID: 201320459349302132
Schema version: 2011v1.2
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 D
Schedule K
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-02-14T15:09:19-06:00	Timestamp
Tax Period End Date	2012-09-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	410746749	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CLIFTONLARSONALLEN LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 217	AddressLine1
City	AUSTIN	City
State	MN	State
ZIP Code	55912	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-10-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	416031905	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	MAPLETON COMMUNITY HOME	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	MAPL	NameControl
Phone	5075243315	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	301 TROENDLE STREET	AddressLine1
City	MAPLETON	City
State	MN	State
ZIP Code	56065	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	ROXANNE GOSSON	Name
Title	ADMINISTRATOR	Title
Phone	5075243155	Phone
Date Signed	2013-01-24	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	TRENT FAST	Name
PTIN	P00692704	PTIN
Phone	5074347000	Phone

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-03-07 17:11:31Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	ROXANNE GOSSON	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	301 TROENDLE STREET	AddressLine1
City	MAPLETON	City
State	MN	State
ZIP Code	56065	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	3655973	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	N/A	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1962	YearFormation
State Legal Domicile	MN	StateLegalDomicile
Activity Or Mission Description	TO PROVIDE THE ELDERLY WITH HOUSING AND NURSING FACILITIES WITH REHABILITATIVE CARE	ActivityOrMissionDescription
Nbr Voting Members Governing Body	11	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	11	NbrIndependentVotingMembers
Total Nbr Employees	155	TotalNbrEmployees
Total Nbr Volunteers	65	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	10699	ContributionsGrantsPriorYear
Contributions Grants Current Year	2550	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	3618260	ProgramServiceRevenuePriorYear
Program Service Revenue CY	3634259	ProgramServiceRevenueCY
Investment Income Prior Year	-2617	InvestmentIncomePriorYear
Investment Income Current Year	11433	InvestmentIncomeCurrentYear
Other Revenue Prior Year	9668	OtherRevenuePriorYear
Other Revenue Current Year	7731	OtherRevenueCurrentYear
Total Revenue Prior Year	3636010	TotalRevenuePriorYear
Total Revenue Current Year	3655973	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	0	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	2345215	SalariesEtcPriorYear
Salaries Etc Current Year	2444839	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	3123	TotalFundrsngExpCurrentYear
Other Expense Prior Year	1144832	OtherExpensePriorYear
Other Expenses Current Year	1635070	OtherExpensesCurrentYear
Total Expenses Prior Year	3490047	TotalExpensesPriorYear
Total Expenses Current Year	4079909	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	145963	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	-423936	RevenuesLessExpensesCY
Total Assets BOY	7802903	TotalAssetsBOY
Total Assets EOY	6461176	TotalAssetsEOY
Total Liabilities BOY	5174747	TotalLiabilitiesBOY
Total Liabilities EOY	4256956	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	2628156	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	2204220	NetAssetsOrFundBalancesEOY
Mission Description	THE PURPOSE OF MAPLETON COMMUNITY HOME, INC. IS TO PROVIDE ELDERLY AND HANDICAPPED PEOPLE WITH HOUSING FACILITIES AND NURSING SERVICES; TO MEET THE PHYSICAL, SOCIAL AND PSYCHOLOGICAL NEEDS OF THE RESIDENTS; AND TO CONTRIBUTE TO THE RESIDENT'S HEALTH, SECURITY, AND HAPPINESS.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	3651682	Expense
Revenue	3634259	Revenue
Description	MAPLETON COMMUNITY HOME IS A RESIDENCE FOR 65 INDIVIDUALS NEEDING SKILLED NURSING CARE. THE HOME SERVES MEDICARE PART A, PART B, MEDICAL ASSISTANCE AND PRIVATE PAYING INDIVIDUALS. THE HOME OFFERS OUTPATIENT REHAILITATION FOR THE COMMUNITY AND DAILY ACTIVITIES FOR THE RESIDENTS. A SOCIAL WORKER IS ON STAFF FOR EMOTIONAL NEEDS AND THE NURSING DEPARTMENT STAFFS 24 HOURS PER DAY. DURING JANUARY, 2012 THE ORGANIZATION COMPLETED THE CONSTRUCTION OF AND PLACED INTO SERVICE A 20 UNIT ASSISTED LIVING FACILITY ADJOINING THE NURSING FACILITY.	Description
Total Program Service Expense	3651682	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	0	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	0	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	0	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	0	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	1	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	0	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	0	Hospital
Grants To Organizations	0	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	0	ScheduleJRequired
Tax Exempt Bonds	1	TaxExemptBonds
Invest Tax Exempt Bonds	0	InvestTaxExemptBonds
Escrow Account	0	EscrowAccount
On Behalf Of Issuer	0	OnBehalfOfIssuer
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	0	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	0	RelatedEntity
Related Org Controlled Entity	0	RelatedOrgControlledEntity
Transaction Related Entity	0	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	3	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	155	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	0	UnrelatedBusinessIncome
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	11	NbrVotingGoverningBodyMembers
Number Independent Voting Members	11	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	0	MembersOrStockholders
Election Of Board Members	0	ElectionOfBoardMembers
Decisions Subject To Approval	0	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	0	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
States Where Copy Of Return Is Filed	MN	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	ROXANNE GOSSON	NamePerson
Telephone Number	5075243155	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	301 TROENDLE ST PO BOX 307	AddressLine1
City	MAPLETON	City
State	MN	State
ZIP Code	56065	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (13 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer
BRUCE SELLERS
PRESIDENT	0.50	X	0	0	0
BILL DALY
VICE PRESIDENT	0.50	X	0	0	0
GINA MASSOP
SECRETARY/TREASURER	0.50	X	0	0	0
JEANETTE BRANDT
DIRECTOR	0.50	X	0	0	0
NANCY DOERING
DIRECTOR	0.50	X	0	0	0
KATHI REID
VICE SECRETARY/TREASURER	0.50	X	0	0	0
SHARON GRUNZKE
DIRECTOR	0.50	X	0	0	0
MARY JACOBSEN
DIRECTOR	0.50	X	0	0	0
DAVID PROEHL
DIRECTOR	0.50	X	0	0	0
JULIE JOHNSON
DIRECTOR	0.50	X	0	0	0
PAUL LANDSTEINER
DIRECTOR	0.50	X	0	0	0
JAN BRINDLEY
DIRECTOR	0.50	X	0	0	0
ROXANNE GOSSON
ADMINISTRATOR	40.00		84991	0	5608	X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	84991	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	5608	TotalOtherCompensation
Number Individuals GT100 K	0	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	0	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	REHABCARE GROUP	BusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	PO BOX 503534	AddressLine1
City	ST LOUIS	City
State	MO	State
ZIP Code	63150	ZIPCode

Field	Value	IRS element (for citing)
Description Of Services	REHAB SERVICES	DescriptionOfServices
Compensation	173560	Compensation

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	1	NumberOfContractorsGT100K
All Other Contributions	2550	AllOtherContributions
Total Contributions	2550	TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEDICARE/MEDICAID PAYM	623000	1797957	1797957
RESIDENT REVENUE	623000	1752470	1752470
APARTMENT REVENUE	623000	83832	83832

Field	Value	IRS element (for citing)
Total Program Service Revenue	3634259	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	11433	TotalRevenueColumn
Exclusion	$11,433	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount
VENDING INCOME	623000	4404	$4,404
GUEST/EMPLOYEE MEAL RE	623000	3089	$3,089
MISCELLANEOUS INCOME	623000	238	$238

Field	Value	IRS element (for citing)
Total Other Revenue	7731	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	3655973	TotalRevenueColumn
Related Or Exempt Function Income	3634259	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$19,164	ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	86678	Total
Management And General	86678	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	2038173	Total
Program Services	1955433	ProgramServices
Management And General	82740	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	58508	Total
Program Services	54654	ProgramServices
Management And General	3854	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	93630	Total
Program Services	87421	ProgramServices
Management And General	6209	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	167850	Total
Program Services	156504	ProgramServices
Management And General	11346	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	5026	Total
Management And General	5026	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	23365	Total
Management And General	23365	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	40779	Total
Program Services	33644	ProgramServices
Management And General	7135	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	63233	Total
Management And General	63233	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	235628	Total
Program Services	207376	ProgramServices
Management And General	28252	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	150802	Total
Program Services	150802	ProgramServices

Travel Travel

Field	Value	IRS element (for citing)
Total	4318	Total
Management And General	4318	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	15962	Total
Program Services	4703	ProgramServices
Management And General	11259	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	199542	Total
Program Services	199542	ProgramServices

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	293304	Total
Program Services	293304	ProgramServices

Insurance Insurance

Field	Value	IRS element (for citing)
Total	45563	Total
Management And General	45563	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
SPECIAL ASSESSMENTS	172491	172491
THERAPY EXPENSE	172304	172304
FOOD COSTS	135836	135836
PRE-ADMISSION SCREENING	15314		15314

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	61603	Total
Program Services	27668	ProgramServices
Management And General	30812	ManagementAndGeneral
Fundraising	3123	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	4079909	Total
Program Services	3651682	ProgramServices
Management And General	425104	ManagementAndGeneral
Fundraising	3123	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	430745	BOY
EOY	223901	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	3433295	BOY
EOY	1217019	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	182683	BOY
EOY	252929	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	22021	BOY
EOY	37421	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	7385194	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	2846670	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	3537093	BOY
EOY	4538524	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	197066	BOY
EOY	191382	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	7802903	BOY
EOY	6461176	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	1229747	BOY
EOY	292101	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	3945000	BOY
EOY	3964855	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	5174747	BOY
EOY	4256956	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	2615028	BOY
EOY	2191092	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	13128	BOY
EOY	13128	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	2628156	BOY
EOY	2204220	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	7802903	BOY
EOY	6461176	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	-423936	ReconcilationRevenueExpenses
Reconcilation Other Changes	0	ReconcilationOtherChanges
Info In Schedule O Part XII	X	InfoInScheduleOPartXII
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited
Audit Committee	1	AuditCommittee
Financial Statement Separate	X	FinancialStatementSeparate
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org509a2	X	PubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	11563	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	12729	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	9733	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	10699	CurrentTaxYearMinus1Year
Current Tax Year	2550	CurrentTaxYear
Total	47274	Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	3696619	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	3634867	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	3424925	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	3618260	CurrentTaxYearMinus1Year
Current Tax Year	3634259	CurrentTaxYear
Total	18008930	Total

Total509 Total509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	3708182	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	3647596	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	3434658	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	3628959	CurrentTaxYearMinus1Year
Current Tax Year	3636809	CurrentTaxYear
Total	18056204	Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Amts From Subst Contributors AmtsFromSubstContributors

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	1339380	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	1431240	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	1558656	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	1543293	CurrentTaxYearMinus1Year
Current Tax Year	855684	CurrentTaxYear
Total	6728253	Total

Support From DQ Ps Etc SupportFromDQPsEtc

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	1339380	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	1431240	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	1558656	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	1543293	CurrentTaxYearMinus1Year
Current Tax Year	855684	CurrentTaxYear
Total	6728253	Total

Field	Value	IRS element (for citing)
Public Support Total509	11327951	PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	33452	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	25133	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	21414	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	11119	CurrentTaxYearMinus1Year
Current Tax Year	11433	CurrentTaxYear
Total	102551	Total

Investment Income And UBTI InvestmentIncomeAndUBTI

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	33452	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	25133	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	21414	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	11119	CurrentTaxYearMinus1Year
Current Tax Year	11433	CurrentTaxYear
Total	102551	Total

Other Income509 OtherIncome509

Field	Value	IRS element (for citing)
Current Tax Year Minus1 Year	9668	CurrentTaxYearMinus1Year
Current Tax Year	7731	CurrentTaxYear
Total	17399	Total

Total Support Total TotalSupportTotal

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	3741634	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	3672729	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	3456072	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	3649746	CurrentTaxYearMinus1Year
Current Tax Year	3655973	CurrentTaxYear
Total	18176154	Total

Field	Value	IRS element (for citing)
Public Support Percentage509	0.62320	PublicSupportPercentage509
Prior Year Support Percentage	0.58790	PriorYearSupportPercentage
Investment Income Percentage	0.00560	InvestmentIncomePercentage
Prior Yr Invest Income Percentage	0.00660	PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509	X	ThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	55314	OtherCostOrOtherBasis
Book Value	55314	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	5906691	OtherCostOrOtherBasis
Depreciation	1836437	Depreciation
Book Value	4070254	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1423189	OtherCostOrOtherBasis
Depreciation	1010233	Depreciation
Book Value	412956	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	4538524	TotalOfBookValueLandBuildings
Total Revenue	3655973	TotalRevenue
Total Expenses	4079909	TotalExpenses
Excess Or Deficit For Year	-423936	ExcessOrDeficitForYear
Excess Or Deficit Per FS	-423936	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	3655973	TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F990	0	RevenueNotRptdF990
Revenue Subtotal	3655973	RevenueSubtotal
Revenue Not Rptd On Fin Stmt	0	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	3655973	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	4079909	TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F990	0	ExpensesNotRptdF990
Expenses Subtotal	4079909	ExpensesSubtotal
Expenses Not Rptd On Fin Stmt	0	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	4079909	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

Field	Value	IRS element (for citing)
Identifier	DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:	Identifier
Return Reference	PART X:	ReturnReference
Explanation	THE ORGANIZATION HAS BEEN GRANTED EXEMPT STATUS FROM FEDERAL AND STATE CORPORATE INCOME TAXES UNDER SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE AND APPLICABLE STATE CODES. THE ORGANIZATION FOLLOWS THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. NO LIABILITY HAS BEEN RECOGNIZED BY THE ORGANIZATION AS A RESULT OF THIS STANDARD. THE ORGANIZATION FILES AS A TAX-EXEMPT ORGANIZATION. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, ALL YEARS SINCE INCEPTION COULD BE SUBJECT TO REVIEW BY THE IRS. THE 2009, 2010 AND 2011 TAX YEARS OF THE ORGANIZATION ARE OPEN FOR EXAMINATION BY THE IRS.	Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	CITY OF MAPLETON MN	BusinessNameLine1

Field	Value	IRS element (for citing)
Issuer EIN	416005347	IssuerEIN
CUSIP Number	565468AES	CUSIPNumber
Date Issued	2011-05-19	DateIssued
Issue Price	3945000	IssuePrice
Description Of Purpose	SEE PART VI	DescriptionOfPurpose
Defeased	0	Defeased
On Behalf Of Issuer	0	OnBehalfOfIssuer
Pool Financing	0	PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

Field	Value	IRS element (for citing)
Total Proceeds	3945000	TotalProceeds
Amount In Reserve Fund	311238	AmountInReserveFund
Capitalized Interest	257521	CapitalizedInterest
Issuance Costs From Proceeds	198961	IssuanceCostsFromProceeds
Capital Expenditures	2632000	CapitalExpenditures
Year Of Subst Completion	2012	YearOfSubstCompletion
Current Refunding	1	CurrentRefunding
Advance Refunding	0	AdvanceRefunding
Final Allocation Made	1	FinalAllocationMade
Adequate Books And Recds Maintaind	1	AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

Field	Value	IRS element (for citing)
Owning Bond Financed Property	0	OwningBondFinancedProperty
Any Lease Arrangements	0	AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty	0	MngmentCntrctBondFinancdPrprty
Any Research Agreements	0	AnyResearchAgreements
Prcntge Prvt Business Use By Others	0.00000	PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI	0.00000	PercentageOfPrvtBusinessReUBI
Total Private Business Use	0.00000	TotalPrivateBusinessUse
Post Issuance Compliance Procdrs	1	PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

Field	Value	IRS element (for citing)
Form8038 T Filed	0	Form8038TFiled
Variable Rate Issue	0	VariableRateIssue
Hedge Identified In Books And Recds	0	HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC	0	GrossProceedsInvestedInGIC
Exception To Rebate	0	ExceptionToRebate

Form990 Schedule K Part VI Form990ScheduleKPartVI

Field	Value	IRS element (for citing)
Explanation	THE PROCEEDS WERE USED TO CONSTRUCT A NEW SENIOR APARTMENT COMPLEX AND REMODEL THE EXISTING NURSING FACILITY AND WAS ALSO USED TO PAY OFF EXISTING DEBT OF THE NURSING FACILITY.	Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

Return ReferenceReturnReference	ExplanationExplanation
FORM 990, PART VI, SECTION B, LINE 11	PRIOR TO BEING FILED WITH THE IRS, A COPY OF THE IRS FORM 990 AND RELATED SCHEDULES ARE REVIEWED BY THE ADMINISTRATOR, INCLUDING A CONFIRMATION OF THE ACCURACY OF EVERY ANSWER AND OVERSIGHT OF APPROPRIATE CHANGES. UPON COMPLETION OF THE ADMINISTRATOR'S REVIEW, THE FORMS ARE REVIEWED AND APPROVED AT A BOARD MEETING PRIOR TO SUBMITTAL TO THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C	BOARD MEMBERS AND KEY EMPLOYEES ANNUALLY COMPLETE A SURVEY RELATED TO BUSINESS RELATIONSHIPS AND FAMILY MEMBERS THAT COULD, OR DO, CREATE A CONFLICT OF INTEREST. THESE ARE SUMMARIZED AND FILED ALONG WITH BOARD MEETING MINUTES. CONFLICTS OF INTEREST ARE DETERMINED BY A REVIEW OF THE POTENTIAL CONFLICTS BY THE ADMINISTRATOR AND THE BOARD OF DIRECTORS. IF A CONFLICT EXISTS, THEN THE CONFLICTED BOARD MEMBER OR KEY EMPLOYEE IS EXCLUDED FROM DISCUSSIONS AND VOTES RELATED TO ANY POTENTIAL OR EXISTING RELATIONSHIPS INVOLVING THE CONFLICT OF INTEREST. IF IT IS DETERMINED THAT A CONFLICT OF INTEREST WAS INTENTIONALLY HIDDEN BY A BOARD MEMBER, THEN THE SITUATION WOULD BE INVESTIGATED AND THE BOARD MEMBER COULD BE SUSPENDED AND SUBJECT TO DISMISSAL. ADDITIONALLY, THE REMAINING BOARD MEMBERS AND KEY EMPLOYEES WILL REVIEW, FOR FAIRNESS, ALL PAST TRANSACTIONS INVOLVING THE CONFLICT OF INTERESTS. IF A TRANSACTION APPEARS TO LACK ARMS-LENGTH, EITHER TO THE DETRIMENT OF THE ORGANIZATION, OR TO THE UNFAIR ADVANTAGE OF THE BOARD MEMBER, THEN ALL LEGAL REMEDIES WILL BE CONSIDERED.
FORM 990, PART VI, SECTION B, LINE 15	THE PROCESS USED TO SET THE ADMINISTRATOR'S ANNUAL SALARY IS BASED ON A COMBINATION OF COMPARISON TO COMPARABLE ORGANIZATIONS THROUGH USE OF OUR TRADE ORGANIZATION'S ANNUAL COMPENSATION SURVEY AND ATTAINMENT IN THE CURRENT YEAR OF PREDEFINED PERFORMANCE OBJECTIVES SET FOR THE ADMINISTRATOR PERSONALLY AND THE ORGANIZATION. ALSO, THE STATE OF MINNESOTA HAS IN MOST YEARS GIVEN COMPENSATION ADJUSTMENTS TO EMPLOYEES AND WE HAVE ALSO CONSIDERED THIS AMOUNT IN DETERMINING TOP MANAGEMENT COMPENSATION. THIS PROCESS IS PERFORMED BY THE BOARD AND WAS LAST APPROVED AT THE JUNE 25, 2012 BOARD MEETING.
FORM 990, PART VI, SECTION C, LINE 19	CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST.
	FORM 990, PART XII, LINE 2C: THE ORGANIZATION'S BOARD OF DIRECTORS ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF ITS INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.