FURP.ORG / PUBLIC DATA EXPLORER

COTTAGE GROVE PLACE: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
COTTAGE GROVE PLACE (EIN 42-1412375)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-05-14
IRS object ID
201331349349305913
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)
Timestamp2013-05-14T14:57:27-05:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN420946155EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1HONKAMP KRUEGER & CO PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1P O BOX 699AddressLine1
CityDUBUQUECity
StateIAState
ZIP Code520040699ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN421412375EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1COTTAGE GROVE PLACEBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCOTTNameControl
Phone3193632420Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12115 FIRST AVENUE SEAddressLine1
CityCEDAR RAPIDSCity
StateIAState
ZIP Code52402ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARK BAILEYName
TitleEXECUTIVE DIRECTORTitle
Phone3193632420Phone
Date Signed2013-05-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameHEATHER D VETTERName
PTINP01355913PTIN
Phone5635560123Phone
Date Prepared2013-05-13DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMARK BAILEYNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12115 FIRST AVENUE SEAddressLine1
CityCEDAR RAPIDSCity
StateIAState
ZIP Code52402ZIPCode
FieldValueIRS element (for citing)
Gross Receipts16645315GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.COTTAGEGROVEPLACE.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1992YearFormation
State Legal DomicileIAStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE HOUSING, HEALTH CARE, AND OTHER RELATED SERVICES TO RESIDENTS THROUGH THE OPERATION OF A RETIREMENT FACILITYActivityOrMissionDescription
Nbr Voting Members Governing Body20NbrVotingMembersGoverningBody
Nbr Independent Voting Members20NbrIndependentVotingMembers
Total Nbr Employees250TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year11099540ProgramServiceRevenuePriorYear
Program Service Revenue CY11860780ProgramServiceRevenueCY
Investment Income Prior Year29008InvestmentIncomePriorYear
Investment Income Current Year25600InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year4758935OtherRevenueCurrentYear
Total Revenue Prior Year11128548TotalRevenuePriorYear
Total Revenue Current Year16645315TotalRevenueCurrentYear
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 Year4473445SalariesEtcPriorYear
Salaries Etc Current Year4833620SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year6278066OtherExpensePriorYear
Other Expenses Current Year6696786OtherExpensesCurrentYear
Total Expenses Prior Year10751511TotalExpensesPriorYear
Total Expenses Current Year11530406TotalExpensesCurrentYear
Revenues Less Expenses Prior Year377037RevenuesLessExpensesPriorYear
Revenues Less Expenses CY5114909RevenuesLessExpensesCY
Total Assets BOY29870501TotalAssetsBOY
Total Assets EOY27127419TotalAssetsEOY
Total Liabilities BOY52584419TotalLiabilitiesBOY
Total Liabilities EOY44766231TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-22713918NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-17638812NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE HOUSING, HEALTH CARE, AND OTHER RELATED SERVICES TO RESIDENTS THROUGH THE OPERATION OF A RETIREMENT FACILITYMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense8109119Expense
Revenue11860780Revenue
DescriptionTHE RETIREMENT FACILITIES CONTAIN 166 INDEPENDENT LIVING UNITS, 19 ASSISTED LIVING UNITS, 40 NURSING CARE BEDS, AND 12 MEMORY CARE UNITS FOR ITS RESIDENTS. THERE ARE 228 OF THESE UNITS THAT ARE CURRENTLY OCCUPIED.Description
Total Program Service Expense8109119TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109634NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees250NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members20NbrVotingGoverningBodyMembers
Number Independent Voting Members20NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1GREG OLBEKSONBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3192975754TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12115 FIRST AVENUE SEAddressLine1
CityCEDAR RAPIDSCity
StateIAState
ZIP Code52402ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
ROBERT A SEDLACEK
TRUSTEE1.20X000
DOUGLAS HEATH
TRUSTEE1.20X000
HAROLD G SCHAEFER
TRUSTEE1.20X000
RUSSELL H ANTHONY
TRUSTEE1.20X000
WILLIAM S ELLIOTT
TRUSTEE1.20X000
JOHN C WAGOR
TRUSTEE1.20X000
CARL E HALLBERG
TRUSTEE1.20X000
PHIL MORRIS
TRUSTEE1.20X000
KATHY TOBORG
TRUSTEE1.20X000
RALPH H PALMER
TRUSTEE1.20X000
TAD COOPER
TRUSTEE1.20X000
MARTIN DWYER
TRUSTEE1.20X000
CRYSTAL USHER
TRUSTEE1.20X000
JAN ALTORFER
TRUSTEE1.20X000
ROBERT SILBER
TRUSTEE1.20X000
JIM BURR
TRUSTEE1.20X000
DAVID BEY
TREASURER1.20000X
BILL JACOBSON
CHAIRMAN1.20000X
DICK HEFT
SECRETARY1.20000X
B D COOPER
VICE CHAIRMAN1.20000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
LIFE CARE SERVICES LLC
400 LOCUST STREET SUITE 820DES MOINESIA50309MANAGEMENT711451
REHABCARE GROUP
680 SOUTH FOURTH STREETLOUISVILLEKY40202REHABILITATION318877
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionRESIDENT SERVICESDescription
Business Code623000BusinessCode
Total Revenue Column11860780TotalRevenueColumn
Related Or Exempt Function Income11860780RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue11860780TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column25600TotalRevenueColumn
Exclusion$25,600ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionDEBT FORGIVENESS INCOMEDescription
Business Code623000BusinessCode
Total Revenue Column4758935TotalRevenueColumn
Related Or Exempt Function Income4758935RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue4758935TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column16645315TotalRevenueColumn
Related Or Exempt Function Income16619715RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$25,600ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total338472Total
Program Services278834ProgramServices
Management And General59638ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total3587279Total
Program Services2955204ProgramServices
Management And General632075ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total543429Total
Program Services460050ProgramServices
Management And General83379ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total364440Total
Program Services321439ProgramServices
Management And General43001ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total294948Total
Management And General294948ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total8169Total
Management And General8169ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total42575Total
Management And General42575ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total101983Total
Program Services101983ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total211594Total
Management And General211594ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total645707Total
Program Services600622ProgramServices
Management And General45085ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total65003Total
Program Services38280ProgramServices
Management And General26723ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1427824Total
Program Services1060047ProgramServices
Management And General367777ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1775162Total
Program Services686478ProgramServices
Management And General1088684ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total256590Total
Program Services97216ProgramServices
Management And General159374ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
FOOD579802579802
MEDICAL EXPENSE465547465547
PROPERTY TAXES25655917668779872
MISCELLANEOUS EXPENSE165756814164942

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total399567Total
Program Services286116ProgramServices
Management And General113451ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total11530406Total
Program Services8109119ProgramServices
Management And General3421287ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY640937BOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY537332EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY263653BOY
EOY390266EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY20012BOY
EOY41703EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY110018BOY
EOY107715EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis37585544LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec14043493LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY24211733BOY
EOY23542051EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY4624148BOY
EOY2508352EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY29870501BOY
EOY27127419EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2340510BOY
EOY1165029EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY10414193BOY
EOY10837899EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY28306108BOY
EOY21837857EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY11523608BOY
EOY10925446EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY52584419BOY
EOY44766231EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-22713918BOY
EOY-17638812EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-22713918BOY
EOY-17638812EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY29870501BOY
EOY27127419EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses5114909ReconcilationRevenueExpenses
Reconcilation Other Changes-39803ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10421187CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years10500854CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10443927CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year11099540CurrentTaxYearMinus1Year
Current Tax Year11860780CurrentTaxYear
Total54326288Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10421187CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years10500854CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10443927CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year11099540CurrentTaxYearMinus1Year
Current Tax Year11860780CurrentTaxYear
Total54326288Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years129380CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years285658CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years200622CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year386465CurrentTaxYearMinus1Year
Current Tax Year110494CurrentTaxYear
Total1112619Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years129380CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years285658CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years200622CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year386465CurrentTaxYearMinus1Year
Current Tax Year110494CurrentTaxYear
Total1112619Total
FieldValueIRS element (for citing)
Public Support Total50953213669PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years106849CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years61226CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years41427CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year29008CurrentTaxYearMinus1Year
Current Tax Year25600CurrentTaxYear
Total264110Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years106849CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years61226CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years41427CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year29008CurrentTaxYearMinus1Year
Current Tax Year25600CurrentTaxYear
Total264110Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year4758935CurrentTaxYear
Total4758935Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10528036CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years10562080CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10485354CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year11128548CurrentTaxYearMinus1Year
Current Tax Year16645315CurrentTaxYear
Total59349333Total
FieldValueIRS element (for citing)
Public Support Percentage5090.89660PublicSupportPercentage509
Prior Year Support Percentage0.99160PriorYearSupportPercentage
Investment Income Percentage0.00450InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00840PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis4016275OtherCostOrOtherBasis
Book Value4016275BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis27808427OtherCostOrOtherBasis
Depreciation10374535Depreciation
Book Value17433892BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis2888799OtherCostOrOtherBasis
Depreciation1305405Depreciation
Book Value1583394BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis348807OtherCostOrOtherBasis
Depreciation232795Depreciation
Book Value116012BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2523236OtherCostOrOtherBasis
Depreciation2130758Depreciation
Book Value392478BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings23542051TotalOfBookValueLandBuildings

Other Assets OtherAssets (5 entries)

DescriptionDescriptionBook ValueBookValue
ASSETS LIMITED AS TO USE750023
DEFERRED FINANCING EXPENSES961226
CASH SURRENDER VALUE OF LIFE INSURANCE425317
BENEFICIAL INTEREST IN CHARITABLE REMAINDER TRUST329551
CONSTRUCTION IN PROGRESS42235
FieldValueIRS element (for citing)
Total Book Value Other Assets2508352TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
REFUNDABLE ENTRANCE FEES$10,738,980
DEPOSITS$160,615
CAPITAL LEASES$25,851
FieldValueIRS element (for citing)
Total Of Amounts10925446TotalOfAmounts

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1CITY OF CEDAR RAPIDS IOWABusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN426004336IssuerEIN
CUSIP Number0150571AJCUSIPNumber
Date Issued2004-03-01DateIssued
Issue Price5310000IssuePrice
Description Of PurposeCOSTS OF 2004 PROJECT-HEALTH CENTERDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Total Proceeds5310000TotalProceeds
Issuance Costs From Proceeds219785IssuanceCostsFromProceeds
Capital Expenditures5090215CapitalExpenditures
Year Of Subst Completion2004YearOfSubstCompletion
Current Refunding0CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Bond Iss Meet Prvt Security Pay Test1BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop0ChangeInUseBondFinancedProp
Non Qualified Bond Remed Procdrs0NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed1Form8038TFiled
Variable Rate Issue0VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Written Proc To Monitor Reqs0WrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Proc To Undertk Corrective Action1ProcToUndertkCorrectiveAction

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 2B D COOPER (VICE CHAIRMAN) IS THE FATHER OF TAD COOPER (TRUSTEE).
FORM 990, PART VI, SECTION A, LINE 3MANAGEMENT DUTIES FOR THE ORGANIZATION ARE HANDLED BY THE MANAGEMENT COMPANY - LIFE CARE SERVICES LLC.
FORM 990, PART VI, SECTION B, LINE 11THE ORGANIZATION'S FORM 990 IS REVIEWED BY THE BOARD AND THE EXECUTIVE DIRECTOR.
FORM 990, PART VI, SECTION B, LINE 12CBOARD MEMBERS ARE REQUIRED TO DISCLOSE EVERY YEAR POTENTIAL CONFLICTS WITH BUSINESSES THEY ARE ASSOCIATED WITH.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9:UNREALIZED LOSS ON INVESTMENTS -24,232. INCREASE IN CASH SURRENDER VALUE OF LIFE INSURANCE -15,571.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 2CTHERE WERE NO CHANGES IN THE PROCEDURES FOR THE OVERSIGHT OF THE AUDIT.AUDIT COMMITTEE PROCEDURES