MAPLE LAWN NURSING HOME INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- MAPLE LAWN NURSING HOME INC (EIN 41-0870856)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-05-13
- IRS object ID
- 201331339349304153
- Schema version
- 2011v1.5
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-13T15:43:10-05:00 | 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 | 220 SOUTH SIXTH STREET SUITE 300 | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 55402 | 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 | 410870856 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MAPLE LAWN NURSING HOME INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MAPL | NameControl |
| Phone | 5074252571 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 SEVENTH STREET BOX 278 | AddressLine1 |
| City | FULDA | City |
| State | MN | State |
| ZIP Code | 56131 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ARLAN SWANSON ADMINISTRATOR | Name |
| Title | ADMINISTRATOR | Title |
| Phone | 5074252571 | Phone |
| Date Signed | 2013-05-07 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KOREY BOELTER | Name |
| PTIN | P00047306 | PTIN |
| Phone | 6123764500 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | ARLAN SWANSON | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 SEVENTH STREET BOX 278 | AddressLine1 |
| City | FULDA | City |
| State | MN | State |
| ZIP Code | 56131 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 4593982 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MAPLELAWN.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1962 | YearFormation |
| State Legal Domicile | MN | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE FINE QUALITY HEALTHCARE, HOUSING AND SUPPORT SERVICES FOR AREA SENIORS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 140 | TotalNbrEmployees |
| Total Nbr Volunteers | 130 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 7550 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 18761 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 4358488 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 4546754 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 9308 | InvestmentIncomePriorYear |
| Investment Income Current Year | 10690 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 21764 | OtherRevenuePriorYear |
| Other Revenue Current Year | 17777 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 4397110 | TotalRevenuePriorYear |
| Total Revenue Current Year | 4593982 | 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 | 2491888 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 2411941 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1760107 | OtherExpensePriorYear |
| Other Expenses Current Year | 1858798 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 4251995 | TotalExpensesPriorYear |
| Total Expenses Current Year | 4270739 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 145115 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 323243 | RevenuesLessExpensesCY |
| Total Assets BOY | 4292658 | TotalAssetsBOY |
| Total Assets EOY | 4481433 | TotalAssetsEOY |
| Total Liabilities BOY | 2505740 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 2371272 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 1786918 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 2110161 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | TO PROVIDE FINE QUALITY HEALTHCARE, HOUSING AND SUPPORT SERVICES FOR AREA SENIORS IN AN INDIVIDUALIZED, DIGNIFIED, AND HOMELIKE MANNER. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 4007210 | Expense |
| Grants | 0 | Grants |
| Revenue | 4546754 | Revenue |
| Description | MAPLE LAWN NURSING HOME, A CAMPUS OF LONG TERM CARE SERVICES:CAMPUS SERVICES 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 - 62 MEDICARE CERTIFIED SKILLED NURSING BEDS WHICH 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. NORMALLY 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 48 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. | Description |
| Total Program Service Expense | 4007210 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | 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 | 1 | 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 | 1 | 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 | 44 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 140 | 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 | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | 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 | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | 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 | 0 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | 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
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ARLAN SWANSON | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5074252571 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 SEVENTH STREET NE | AddressLine1 |
| City | FULDA | City |
| State | MN | State |
| ZIP Code | 56131 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (10 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| ELDEN GETTING | ||||||
| PRESIDENT | 1.00 | X | X | 0 | 0 | 0 |
| JERRILD STEINER | ||||||
| VICE PRESIDENT | 1.00 | X | X | 0 | 0 | 0 |
| MARCINE ELDER | ||||||
| SECRETARY | 1.00 | X | X | 0 | 0 | 0 |
| MARY FRAN BUSCH | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| SHIRLEY BUSCHENA | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| JEFF ZINS | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| CLEONE RAMERTH | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| DEAN MCNEAL | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| RON JANSSEN | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| ARLAN SWANSON | ||||||
| ADMINISTRATOR | 50.00 | X | 81412 | 0 | 1980 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 81412 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1980 | 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 | PRAIRIE REHABILITATION SERVICES LLC | BusinessNameLine1 |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1720 S CLIFF AVENUE | AddressLine1 |
| City | SIOUX FALLS | City |
| State | SD | State |
| ZIP Code | 57105 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | CONTRACTED THERAPY | DescriptionOfServices |
| Compensation | 221798 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| All Other Contributions | 18761 | AllOtherContributions |
| Total Contributions | 18761 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| RESIDENT SERVICES | 623000 | 3676074 | 3676074 |
| APARTMENT RENTAL | 623000 | 870680 | 870680 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 4546754 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 10690 | TotalRevenueColumn |
| Exclusion | $10,690 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| MISCELLANEOUS INCOME | 623000 | 8728 | $8,728 |
| MEAL INCOME | 623000 | 4770 | $4,770 |
| GARAGE REVENUE | 623000 | 4279 | $4,279 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 17777 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4593982 | TotalRevenueColumn |
| Related Or Exempt Function Income | 4546754 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $28,467 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 80970 | Total |
| Program Services | 80970 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1930907 | Total |
| Program Services | 1925206 | ProgramServices |
| Management And General | 5701 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17550 | Total |
| Program Services | 17500 | ProgramServices |
| Management And General | 50 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 241639 | Total |
| Program Services | 240954 | ProgramServices |
| Management And General | 685 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 140875 | Total |
| Program Services | 140476 | ProgramServices |
| Management And General | 399 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 320 | Total |
| Management And General | 320 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 35094 | Total |
| Management And General | 35094 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 437989 | Total |
| Program Services | 417108 | ProgramServices |
| Management And General | 20881 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10641 | Total |
| Management And General | 10641 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 162628 | Total |
| Program Services | 137643 | ProgramServices |
| Management And General | 24985 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 132832 | Total |
| Program Services | 128179 | ProgramServices |
| Management And General | 4653 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12785 | Total |
| Management And General | 12785 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 88273 | Total |
| Program Services | 84532 | ProgramServices |
| Management And General | 3741 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 198748 | Total |
| Program Services | 190325 | ProgramServices |
| Management And General | 8423 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 55594 | Total |
| Program Services | 53238 | ProgramServices |
| Management And General | 2356 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| FOOD | 251234 | 251234 | |
| LICENSE SURCHARGE | 180014 | 179998 | 16 |
| MEDICAL SUPPLIES | 127371 | 127371 | |
| BAD DEBT | 85437 | 85437 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 79838 | Total |
| Program Services | 32476 | ProgramServices |
| Management And General | 47362 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4270739 | Total |
| Program Services | 4007210 | ProgramServices |
| Management And General | 263529 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 977092 | BOY |
| EOY | 1409951 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 522450 | BOY |
| EOY | 348714 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 75348 | BOY |
| EOY | 53357 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 6104442 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 3464586 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2687839 | BOY |
| EOY | 2639856 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12117 | BOY |
| EOY | 6069 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17812 | BOY |
| EOY | 23486 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4292658 | BOY |
| EOY | 4481433 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 363389 | BOY |
| EOY | 360660 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2102334 | BOY |
| EOY | 1967729 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14967 | BOY |
| EOY | 16801 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25050 | BOY |
| EOY | 26082 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2505740 | BOY |
| EOY | 2371272 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1786918 | BOY |
| EOY | 2110161 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1786918 | BOY |
| EOY | 2110161 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4292658 | BOY |
| EOY | 4481433 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 323243 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| 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 | 6300 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 3926 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 6020 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 7550 | CurrentTaxYearMinus1Year |
| Current Tax Year | 18761 | CurrentTaxYear |
| Total | 42557 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 4121994 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 4322019 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 4242701 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 4358488 | CurrentTaxYearMinus1Year |
| Current Tax Year | 4546754 | CurrentTaxYear |
| Total | 21591956 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 4128294 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 4325945 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 4248721 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 4366038 | CurrentTaxYearMinus1Year |
| Current Tax Year | 4565515 | CurrentTaxYear |
| Total | 21634513 | 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 | 122225 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 132885 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 80415 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 93455 | CurrentTaxYearMinus1Year |
| Current Tax Year | 183248 | CurrentTaxYear |
| Total | 612228 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 122225 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 132885 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 80415 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 93455 | CurrentTaxYearMinus1Year |
| Current Tax Year | 183248 | CurrentTaxYear |
| Total | 612228 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 21022285 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 11943 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 6771 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 16546 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 9308 | CurrentTaxYearMinus1Year |
| Current Tax Year | 10690 | CurrentTaxYear |
| Total | 55258 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 11943 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 6771 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 16546 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 9308 | CurrentTaxYearMinus1Year |
| Current Tax Year | 10690 | CurrentTaxYear |
| Total | 55258 | Total |
Other Income509 OtherIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 26443 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 30385 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 26153 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 21764 | CurrentTaxYearMinus1Year |
| Current Tax Year | 17777 | CurrentTaxYear |
| Total | 122522 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 4166680 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 4363101 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 4291420 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 4397110 | CurrentTaxYearMinus1Year |
| Current Tax Year | 4593982 | CurrentTaxYear |
| Total | 21812293 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.96380 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.96940 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00250 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00290 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
| General Explanation | SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUES | GeneralExplanation |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtc |
| Included On FS | 1 | IncludedOnFS |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4777041 | OtherCostOrOtherBasis |
| Depreciation | 2429478 | Depreciation |
| Book Value | 2347563 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 254721 | OtherCostOrOtherBasis |
| Depreciation | 74505 | Depreciation |
| Book Value | 180216 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1072680 | OtherCostOrOtherBasis |
| Depreciation | 960603 | Depreciation |
| Book Value | 112077 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 2639856 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | ASSET RETIREMENT OBLIGATION | Description |
| Amount | $26,082 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 26082 | TotalOfAmounts |
| Total Revenue | 4593982 | TotalRevenue |
| Total Expenses | 4270739 | TotalExpenses |
| Excess Or Deficit For Year | 323243 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | 323243 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 4593982 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 4593982 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 4593982 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 4270739 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 4270739 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 4270739 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| 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: | 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'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. THE TAX FILINGS FOR THE YEARS 2009 THROUGH 2011 ARE OPEN TO EXAMINATION BY FEDERAL, LOCAL OR STATE AUTHORITIES. | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF FULDA MINNESOTA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 416005177 | IssuerEIN |
| Date Issued | 2003-09-24 | DateIssued |
| Issue Price | 2865000 | IssuePrice |
| Description Of Purpose | REFUND SERIES 1995 BONDS & FUND NEW CONSTRUCTION OF ASSISTED LIVING FACILITY | 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) |
|---|---|---|
| Amount Retired | 1019744 | AmountRetired |
| Total Proceeds | 2865000 | TotalProceeds |
| Refunding Escrow | 1265000 | RefundingEscrow |
| Issuance Costs From Proceeds | 57000 | IssuanceCostsFromProceeds |
| Capital Expenditures | 1543000 | CapitalExpenditures |
| Year Of Subst Completion | 2004 | YearOfSubstCompletion |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 1 | 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 |
| 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 | 1 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 0 | ExceptionToRebate |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| 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 ARTICLES AND BYLAWS AND TERMINATE MEMBERSHIPS. |
| FORM 990, PART VI, SECTION B, LINE 11 | MANAGEMENT PROVIDED INFORMATION FOR PREPARATION OF THE FORM 990. A COPY OF THE FORM 990 IS 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 2012. |
| 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. |
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