FURP.ORG / PUBLIC DATA EXPLORER

LACOBA HOMES INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
LACOBA HOMES INC (EIN 43-0863738)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-08
IRS object ID
201323129349302052
Schema version
2012v2.1
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)
Timestamp2013-11-08T14:30:05-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1910 E ST LOUIS 200/PO BOX 1190AddressLine1
CitySPRINGFIELDCity
StateMOState
ZIP Code658062523ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN430863738EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1LACOBA HOMES INCBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% MICHAEL D BALDUSInCareOfName
Name ControlLACONameControl
Phone4172357895Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 885AddressLine1
Address Line2SuiteAddressLine2
CityMONETTCity
StateMOState
ZIP Code65708ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMICHAEL D BALDUSName
TitleEXECUTIVE DIRECTORTitle
Phone4172357895Phone
Date Signed2013-10-17DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBrian D ToddName
Phone4178658701Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMICHAEL D BALDUSNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 885AddressLine1
CityMONETTCity
StateMOState
ZIP Code65708ZIPCode
FieldValueIRS element (for citing)
Gross Receipts5144209GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1966YearFormation
State Legal DomicileMOStateLegalDomicile
Activity Or Mission DescriptionLACOBA HOMES, INC., IS A 72 BED, 28 CHURCHES AFFILIATED, NOT-FOR-PROFIT SKILLED NURSING FACILITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees146TotalNbrEmployees
Total Nbr Volunteers73TotalNbrVolunteers
Total Gross UBI7361TotalGrossUBI
Contributions Grants Prior Year255922ContributionsGrantsPriorYear
Contributions Grants Current Year3890ContributionsGrantsCurrentYear
Program Service Revenue Prior Year5194524ProgramServiceRevenuePriorYear
Program Service Revenue CY5119659ProgramServiceRevenueCY
Investment Income Prior Year-6353InvestmentIncomePriorYear
Investment Income Current Year-1715InvestmentIncomeCurrentYear
Other Revenue Prior Year-13287OtherRevenuePriorYear
Other Revenue Current Year7361OtherRevenueCurrentYear
Total Revenue Prior Year5430806TotalRevenuePriorYear
Total Revenue Current Year5129195TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year2367693SalariesEtcPriorYear
Salaries Etc Current Year2399452SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year2319398OtherExpensePriorYear
Other Expenses Current Year2440138OtherExpensesCurrentYear
Total Expenses Prior Year4687091TotalExpensesPriorYear
Total Expenses Current Year4839590TotalExpensesCurrentYear
Revenues Less Expenses Prior Year743715RevenuesLessExpensesPriorYear
Revenues Less Expenses CY289605RevenuesLessExpensesCY
Total Assets BOY6883348TotalAssetsBOY
Total Assets EOY7253755TotalAssetsEOY
Total Liabilities BOY280949TotalLiabilitiesBOY
Total Liabilities EOY361751TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY6602399NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY6892004NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE 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.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense3847286Expense
Revenue5111535Revenue
DescriptionSKILLED 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 & LANGUAGE PATHOLOGY, AND X-RAY SERVICES. LACOBA HOMES SERVED 140 RESIDENTS, WITH AN 65% OCCUPANCY RATE.Description
Total Program Service Expense3847286TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingtrueCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10965NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees146NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMICHAEL D BALDUSNamePerson
Telephone Number4172357895TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 885AddressLine1
CityMONETTCity
StateMOState
ZIP Code65708ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (14 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
LEE MILLER
BOARD MEMBER1.0X
WILLARD BENBROOK
BOARD MEMBER1.0X
JANE JOHNSON
SECRETARY1.0XX
CW PHILLIPS
BOARD MEMBER1.0X
WAYNE CONWAY
BOARD MEMBER1.0X
JOE BEAVER
BOARD MEMBER1.0X
DORIS COLWELL
BOARD MEMBER1.0X
ANTHONY GRIPKA
PRESIDENT1.0XX
LOREN GILLASPY
BOARD MEMBER1.0X
JOHN WELDY
BOARD MEMBER1.0X
STEVEN STRAUCH
BOARD MEMBER1.0X
RONNIE CROUCH
VICE PRESIDENT1.0XX
MARILYN KNIGHT
TREASURER1.0XX
MICHAEL D BALDUS
EXECUTIVE DIRECTOR60.0X161625015558
FieldValueIRS element (for citing)
Total Reportable Comp From Org161625TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation15558TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Description Of ServicesDescriptionOfServicesCompensationCompensation
AEGIS THERAPIES
THERAPIES PT.OT.ST586200
MANAGED CARE ALLIANCE
MGMT COMPANY193974
HEALTHCARE SERVICES
HOUSEKEEPING/LAUNDRY193014
UVANTA PHARMACY
PHARMACY163986
BKD LLP
BILLING/CONSULTING127219
FieldValueIRS element (for citing)
Number Of Contractors GT100 K6NumberOfContractorsGT100K
All Other Contributions3890AllOtherContributions
Total Contributions3890TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
ROOM & BOARD62300048830124883012
ANCILLIARY SERVICES623000226958226958
MEALS6230008124$8,124
OTHER62300015651565
FieldValueIRS element (for citing)
Total Program Service Revenue5119659TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real20660Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real13299Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real7361Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column7361TotalRevenueColumn
Unrelated Business Revenue7361UnrelatedBusinessRevenue

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other1715Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-1715Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-1715TotalRevenueColumn
Exclusion-$1,715ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column5129195TotalRevenueColumn
Related Or Exempt Function Income5111535RelatedOrExemptFunctionIncome
Unrelated Business Revenue7361UnrelatedBusinessRevenue
Exclusion$6,409ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total177183Total
Management And General177183ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total1880012Total
Program Services1676681ProgramServices
Management And General203331ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total23829Total
Management And General23829ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total170423Total
Program Services152985ProgramServices
Management And General17438ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total148005Total
Program Services121746ProgramServices
Management And General26259ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total193791Total
Management And General193791ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total21702Total
Management And General21702ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total992997Total
Program Services853275ProgramServices
Management And General139722ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total3722Total
Program Services739ProgramServices
Management And General2983ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total399156Total
Program Services326592ProgramServices
Management And General72564ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total9093Total
Management And General9093ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total101728Total
Program Services79038ProgramServices
Management And General22690ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total20421Total
Program Services10092ProgramServices
Management And General10329ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total2908Total
Program Services1319ProgramServices
Management And General1589ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total432Total
Program Services336ProgramServices
Management And General96ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total192314Total
Program Services149419ProgramServices
Management And General42895ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total20573Total
Management And General20573ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
NFAC FEES1028510285
LICENSES, DUES, SUBSCRIPTIONS62376237
MEDICAL SUPPLIES & DRUGS185106185106
NFRA FEES279673279673

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total4839590Total
Program Services3847286ProgramServices
Management And General992304ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY540244BOY
EOY806932EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2536968BOY
EOY2536446EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY726021BOY
EOY966772EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY16127BOY
EOY14732EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY9537BOY
EOY9537EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis5046582LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec2127246LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY3054451BOY
EOY2919336EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY6883348BOY
EOY7253755EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY270306BOY
EOY353516EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY4259BOY
EOY2660EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY6384BOY
EOY5575EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY280949BOY
EOY361751EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY6602399BOY
EOY6892004EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY6602399BOY
EOY6892004EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY6883348BOY
EOY7253755EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses289605ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedfalseFSAudited
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years14576CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8111CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year255922CurrentTaxYearMinus1Year
Current Tax Year3890CurrentTaxYear
Total282499Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years4825653CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years5076289CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years4797942CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year5194524CurrentTaxYearMinus1Year
Current Tax Year5119659CurrentTaxYear
Total25014067Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Total0Total

Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509

FieldValueIRS element (for citing)
Total0Total

Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt

FieldValueIRS element (for citing)
Total0Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years4825653CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years5090865CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years4806053CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year5450446CurrentTaxYearMinus1Year
Current Tax Year5123549CurrentTaxYear
Total25296566Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50925296566PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years13488CurrentTaxYearMinus4Years
Current Tax Year Minus2 Years208CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4756CurrentTaxYearMinus1Year
Total18452Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Total0Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years13488CurrentTaxYearMinus4Years
Current Tax Year Minus2 Years208CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4756CurrentTaxYearMinus1Year
Total18452Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3475CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6684CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6191CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year-13287CurrentTaxYearMinus1Year
Current Tax Year7361CurrentTaxYear
Total10424Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Total0Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years4842616CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years5097549CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years4812452CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year5441915CurrentTaxYearMinus1Year
Current Tax Year5130910CurrentTaxYear
Total25325442Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99886PublicSupportPercentage509
Prior Year Support Percentage0.99685PriorYearSupportPercentage
Investment Income Percentage0.00073InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00230PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$992OtherActivitiesAmount
Total Lobbying Expenditures IIB992TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierLOBBYING ACTIVITIESIdentifier
Return ReferenceSCHEDULE C, PART II, LINE 1IReturnReference
ExplanationTHE ORGANIZATION PAYS DUES TO MISSOURI HEALTH CARE ASSOCIATION. $992 OF THESE DUES ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FStrueIncludedOnFS
Current Year Minus3 YearsCurrentYearMinus3Years
Current Year Minus4 YearsCurrentYearMinus4Years

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis68278OtherCostOrOtherBasis
Book Value68278BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis4232612OtherCostOrOtherBasis
Depreciation1632019Depreciation
Book Value2600593BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis731917OtherCostOrOtherBasis
Depreciation495227Depreciation
Book Value236690BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis13775OtherCostOrOtherBasis
Book Value13775BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings2919336TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDEPOSITSDescription
Amount$5,575Amount
FieldValueIRS element (for citing)
Total Of Amounts5575TotalOfAmounts

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierESCROW ACCOUNTIdentifier
Return ReferenceSCHEDULE D, PART IV, LINE 2BReturnReference
ExplanationTHE 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.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonMICHAEL D BALDUSNamePerson
TitleEXECUTIVE DIRECTORTitle
Base Compensation Filing Org161625BaseCompensationFilingOrg
Comp Based On Related Orgs0CompBasedOnRelatedOrgs
Bonus Filing Org0BonusFilingOrg
Bonus Related Orgs0BonusRelatedOrgs
Other Compensation Filing Org0OtherCompensationFilingOrg
Other Compensation Related Orgs0OtherCompensationRelatedOrgs
Deferred Comp Filing Org0DeferredCompFilingOrg
Deferred Comp Related Orgs0DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org15558NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs0NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org177183TotalCompensationFilingOrg
Total Compensation Related Orgs0TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org0CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs0CompReportPrior990RelatedOrgs

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSIONFORM 990, PART III, LINE 1THE 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.
MANAGEMENT DUTIESFORM 990, PART VI, SECTION A, LINE 3THE 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.
MEMBERSFORM 990, PART VI, SECTION A, LINE 6 & 7ATHE ORGANIZATION HAS MEMBERS WHO MEET ANNUALLY FOR THE PURPOSE OF ELECTING DIRECTORS.
FORM 990 REVIEW PROCESSFORM 990, PART VI, SECTION B, LINE 11BTHE 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. AFTER THIS REVIEW, THE BOARD RECEIVES A COPY OF THE FORM 990 AND IS GIVEN THE OPPORTUNITY TO MAKE COMMENTS AND ASK QUESTIONS BEFORE THE RETURN IS FILED.
CONFLICT OF INTEREST POLICY COMPLIANCEFORM 990, PART VI, SECTION B, LINE 12CBIDS 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.
PROCESS FOR DETERMINING COMPENSATION OF OFFICERSFORM 990, PART VI, SECTION B, LINE 15ACOMPARABILITY 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 12/31/2012. 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.
AVAILABILITY OF GOVERNING DOCUMENTSFORM 990, PART VI, SECTION C, LINE 19A 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.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1BRIDLE LANE LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 885AddressLine1
CityMONETTCity
StateMOState
ZIP Code65708ZIPCode
FieldValueIRS element (for citing)
EIN203157670EIN
Primary ActivitiesSTORAGE RENTPrimaryActivities
Legal Domicile StateMOLegalDomicileState
Total Income7361TotalIncome
EOY Assets325696EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1LACOBA HOMESBusinessNameLine1