LACOBA HOMES INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization: LACOBA HOMES INC (EIN 43-0863738)
Tax period: 2010-01-01 to 2010-12-31
Filed: 2011-10-04
IRS object ID: 201142779349300609
Schema version: 2010v3.4
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule C
Schedule D
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2011-10-04T11:01:44-05:00	Timestamp
Tax Period End Date	2010-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

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

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	910 E ST LOUIS 200/PO BOX 1190	AddressLine1
City	SPRINGFIELD	City
State	MO	State
ZIP Code	658062523	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2010-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	430863738	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	LACOBA HOMES INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	LACO	NameControl
Phone	4172357895	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 885	AddressLine1
City	MONETT	City
State	MO	State
ZIP Code	65708	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	MIKE BALDUS	Name
Title	EXECUTIVE DIRECTOR	Title
Date Signed	2011-08-23	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	Brian D Todd	Name
Phone	4178658701	Phone

Field	Value	IRS element (for citing)
Tax Year	2010	TaxYear
Build TS	2016-03-07 17:11:31Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	MIKE BALDUS	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	PO BOX 885	AddressLine1
City	MONETT	City
State	MO	State
ZIP Code	65708	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	4825831	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	N/A	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1966	YearFormation
State Legal Domicile	MO	StateLegalDomicile
Activity Or Mission Description	LACOBA HOMES, INC., IS A 72 BED, 28 CHURCHES AFFILIATED, NOT-FOR-PROFIT SKILLED NURSING FACILITY. SEE SCHEDULE O FOR ADDITIONAL INFORMATION.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	13	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	13	NbrIndependentVotingMembers
Total Nbr Employees	164	TotalNbrEmployees
Total Nbr Volunteers	63	TotalNbrVolunteers
Total Gross UBI	6191	TotalGrossUBI
Net Unrelated Business Txbl Income	4889	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	14576	ContributionsGrantsPriorYear
Contributions Grants Current Year	8111	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	5085657	ProgramServiceRevenuePriorYear
Program Service Revenue CY	4797942	ProgramServiceRevenueCY
Investment Income Prior Year	0	InvestmentIncomePriorYear
Investment Income Current Year	208	InvestmentIncomeCurrentYear
Other Revenue Prior Year	6684	OtherRevenuePriorYear
Other Revenue Current Year	6191	OtherRevenueCurrentYear
Total Revenue Prior Year	5106917	TotalRevenuePriorYear
Total Revenue Current Year	4812452	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	2176298	SalariesEtcPriorYear
Salaries Etc Current Year	2250758	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	2334849	OtherExpensePriorYear
Other Expenses Current Year	2294678	OtherExpensesCurrentYear
Total Expenses Prior Year	4511147	TotalExpensesPriorYear
Total Expenses Current Year	4545436	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	595770	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	267016	RevenuesLessExpensesCY
Total Assets BOY	5893169	TotalAssetsBOY
Total Assets EOY	6174292	TotalAssetsEOY
Total Liabilities BOY	301501	TotalLiabilitiesBOY
Total Liabilities EOY	315608	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	5591668	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	5858684	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	THE 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.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	3401724	Expense
Revenue	4790704	Revenue
Description	SKILLED 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 66 RESIDENTS, WITH A 92% OCCUPANCY RATE.	Description
Total Program Service Expense	3401724	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	false	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	true	LobbyingActivities
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	true	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	false	ReportFin48Footnote
Independent Audit Financial Stmt	false	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	false	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	false	Hospital
Grants To Organizations	false	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	true	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	true	DisregardedEntity
Related Entity	false	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transaction Related Entity	false	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	7	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	164	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	true	UnrelatedBusinessIncome
Form990-T Filed	true	Form990-TFiled
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	false	QuidProQuoContributions
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	13	NbrVotingGoverningBodyMembers
Number Independent Voting Members	13	NumberIndependentVotingMembers
Family Or Business Relationship	true	FamilyOrBusinessRelationship
Delegation Of Management Duties	true	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	true	MembersOrStockholders
Election Of Board Members	true	ElectionOfBoardMembers
Decisions Subject To Approval	false	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Investment In Joint Venture	false	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	MIKE BALDUS	NamePerson
Telephone Number	4172357895	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	PO BOX 885	AddressLine1
City	MONETT	City
State	MO	State
ZIP Code	65708	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (15 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation
LEE MILLER
PRESIDENT	1.0	X	X	0	0	0
WILLARD BENBROOK
VICE PRESIDENT	1.0	X	X	0	0	0
JANE JOHNSON
SECRETARY	1.0	X	X	0	0	0
CW PHILLIPS
TREASURER	1.0	X	X	0	0	0
WAYNE CONWAY
BOARD MEMBER	1.0	X		0	0	0
JOE BEAVER
BOARD MEMBER	1.0	X		0	0	0
DORIS COLWELL
BOARD MEMBER	1.0	X		0	0	0
DAVE GILLASPY
BOARD MEMBER UNTIL 05/2010	1.0	X		0	0	0
ANTHONY GRIPKA
BOARD MEMBER	1.0	X		0	0	0
LOREN GILLASPY
BOARD MEMBER	1.0	X		0	0	0
JOHN WELDY
BOARD MEMBER	1.0	X		0	0	0
STEVEN STRAUCH
BOARD MEMBER	1.0	X		0	0	0
RONNIE CROUCH
BOARD MEMBER	1.0	X		0	0	0
MARILYN KNIGHT
BOARD MEMBER BEG 05/2010	1.0	X		0	0	0
MICHAEL D BALDUS
EXECUTIVE DIRECTOR	60.0		X	177613	0	12561

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	177613	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	12561	TotalOtherCompensation
Number Individuals GT100 K	1	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Description Of ServicesDescriptionOfServices	CompensationCompensation
AEGIS THERAPIES
THERAPIES PT.OT.ST	598157
HEALTHCARE SERVICES GROUP
LAUNDRY/HOUSEKEEPING	189523
MANAGED CARE ALLIANCE
MGMT COMPANY	183322
BKD LLP
BILLING/CONSULTING	120080

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	4	NumberOfContractorsGT100K
All Other Contributions	8111	AllOtherContributions
Total Contributions	8111	TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	ExclusionExclusionAmount
ROOM AND BOARD	623000	4482963	4482963
MEALS	623000	7238		$7,238
ANCILLARY SERVICES	623000	307657	307657
OTHER INCOME	623000	84	84

Field	Value	IRS element (for citing)
Total Program Service Revenue	4797942	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	208	TotalRevenueColumn
Exclusion	$208	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	19570	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	13379	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	6191	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	6191	TotalRevenueColumn
Unrelated Business Revenue	6191	UnrelatedBusinessRevenue

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Field	Value	IRS element (for citing)
Total Other Revenue	0	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	4812452	TotalRevenueColumn
Related Or Exempt Function Income	4790704	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	6191	UnrelatedBusinessRevenue
Exclusion	$7,446	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	0	Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	0	Total

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	0	Total

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	190174	Total
Management And General	190174	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	1759106	Total
Program Services	1591766	ProgramServices
Management And General	167340	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	21996	Total
Program Services	18078	ProgramServices
Management And General	3918	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	135447	Total
Program Services	121646	ProgramServices
Management And General	13801	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	144035	Total
Program Services	118381	ProgramServices
Management And General	25654	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	183322	Total
Management And General	183322	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	480	Total
Management And General	480	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	23341	Total
Management And General	23341	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	971722	Total
Program Services	732479	ProgramServices
Management And General	239243	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	4555	Total
Program Services	923	ProgramServices
Management And General	3632	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	298562	Total
Program Services	207655	ProgramServices
Management And General	90907	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	9926	Total
Management And General	9926	ManagementAndGeneral

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	118323	Total
Program Services	69717	ProgramServices
Management And General	48606	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	17096	Total
Program Services	8026	ProgramServices
Management And General	9070	ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	6473	Total
Program Services	1104	ProgramServices
Management And General	5369	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	4681	Total
Program Services	2758	ProgramServices
Management And General	1923	ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	186910	Total
Program Services	110128	ProgramServices
Management And General	76782	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	43214	Total
Management And General	43214	ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
MEDICAL SUPPLIES & DRUGS	189350	189350
NFRA FEES	215163	215163
NFAC FEES	14550	14550
LICENSES, DUES & SUBSCRIPTIONS	6143		6143
MISCELLANEOUS	867		867

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	4545436	Total
Program Services	3401724	ProgramServices
Management And General	1143712	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	810745	BOY
EOY	1064716	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	1162581	BOY
EOY	1162581	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	618614	BOY
EOY	746766	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	17540	BOY
EOY	15160	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	9537	BOY
EOY	9537	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	5063059	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	1887527	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	3274152	BOY
EOY	3175532	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	5893169	BOY
EOY	6174292	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	289966	BOY
EOY	301955	EOY

Escrow Account Liability EscrowAccountLiability

Field	Value	IRS element (for citing)
BOY	6035	BOY
EOY	5895	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	5500	BOY
EOY	7758	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	301501	BOY
EOY	315608	EOY

Field	Value	IRS element (for citing)
Do Not Follow SFAS117	X	DoNotFollowSFAS117

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

Field	Value	IRS element (for citing)
BOY	5591668	BOY
EOY	5858684	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	5591668	BOY
EOY	5858684	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	5893169	BOY
EOY	6174292	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	267016	ReconcilationRevenueExpenses
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	false	FSAudited
Federal Grant Audit Required	false	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	32927	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	21020	CurrentTaxYearMinus3Years
Current Tax Year Minus1 Year	14576	CurrentTaxYearMinus1Year
Current Tax Year	8111	CurrentTaxYear
Total	76634	Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	4250805	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	4537969	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	4825653	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	5076289	CurrentTaxYearMinus1Year
Current Tax Year	4797942	CurrentTaxYear
Total	23488658	Total

Total509 Total509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	4283732	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	4558989	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	4825653	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	5090865	CurrentTaxYearMinus1Year
Current Tax Year	4806053	CurrentTaxYear
Total	23565292	Total

Field	Value	IRS element (for citing)
Public Support Total509	23565292	PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	9093	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	38514	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	13488	CurrentTaxYearMinus2Years
Current Tax Year	208	CurrentTaxYear
Total	61303	Total

Investment Income And UBTI InvestmentIncomeAndUBTI

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	9093	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	38514	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	13488	CurrentTaxYearMinus2Years
Current Tax Year	208	CurrentTaxYear
Total	61303	Total

Net Income From Other UBI NetIncomeFromOtherUBI

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	17365	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	18100	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	3475	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	6684	CurrentTaxYearMinus1Year
Current Tax Year	6191	CurrentTaxYear
Total	51815	Total

Total Support Total TotalSupportTotal

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	4310190	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	4615603	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	4842616	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	5097549	CurrentTaxYearMinus1Year
Current Tax Year	4812452	CurrentTaxYear
Total	23678410	Total

Field	Value	IRS element (for citing)
Public Support Percentage509	0.99522	PublicSupportPercentage509
Prior Year Support Percentage	0.99465	PriorYearSupportPercentage
Investment Income Percentage	0.00259	InvestmentIncomePercentage
Prior Yr Invest Income Percentage	0.00286	PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509	X	ThirtyThreePercntTestsCY509

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbying
Total Direct Lobbying		TotalDirectLobbying
Total Lobbying Expenditures		TotalLobbyingExpenditures
Other Exempt Purpose Expenditures		OtherExemptPurposeExpenditures
Total Exempt Purpose Expenditures		TotalExemptPurposeExpenditures
Lobbying Nontaxable		LobbyingNontaxableAmount
Grassroots Nontaxable		GrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non Tx		TotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying Nontx		TotLobbyExpendMnsLobbyingNontx
Volunteers	false	Volunteers
Paid Staff Or Management	false	PaidStaffOrManagement
Media Advertisements	false	MediaAdvertisements
Mailings Members	false	MailingsMembers
Publications Or Broadcast	false	PublicationsOrBroadcast
Grants Other Organizations	false	GrantsOtherOrganizations
Direct Contact Legislators	false	DirectContactLegislators
Rallies Demonstrations	false	RalliesDemonstrations
Other Activities	true	OtherActivities
Other Activities	$1,021	OtherActivitiesAmount
Total Lobbying Expenditures IIB	1021	TotalLobbyingExpendituresIIB
Not Described In501c3	false	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	LOBBYING ACTIVITIES	Identifier
Return Reference	SCHEDULE C, PART II, LINE 1I	ReturnReference
Explanation	THE ORGANIZATION PAYS DUES TO MISSOURI HEALTH CARE ASSOCIATION. $1,021 OF THESE DUES ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES.	Explanation

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amts		ArtPublicExhibitionAmts
Held Works Of Art Amts		HeldWorksOfArtAmts
Agent Trustee Etc	false	AgentTrusteeEtc
Included On FS	true	IncludedOnFS

Land Land

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	0	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	68278	OtherCostOrOtherBasis
Book Value	68278	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	0	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	4177207	OtherCostOrOtherBasis
Depreciation	1373776	Depreciation
Book Value	2803431	BookValue

Field	Value	IRS element (for citing)
Leasehold Improvements		LeaseholdImprovements

Equipment Equipment

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	0	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	806871	OtherCostOrOtherBasis
Depreciation	513751	Depreciation
Book Value	293120	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	0	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	10703	OtherCostOrOtherBasis
Depreciation	0	Depreciation
Book Value	10703	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	3175532	TotalOfBookValueLandBuildings
Federal Income Tax Liability	0	FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
Description	DEPOSITS	Description
Amount	$7,758	Amount

Field	Value	IRS element (for citing)
Total Of Amounts	7758	TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

Field	Value	IRS element (for citing)
Identifier	ESCROW ACCOUNT	Identifier
Return Reference	SCHEDULE D, PART IV, LINE 2B	ReturnReference
Explanation	THE 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

Field	Value	IRS element (for citing)
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	false	SeverancePayment
Supplemental Nonqual Retire Plan	false	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	false	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	false	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	false	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	false	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	false	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	false	AnyNonFixedPayments
Initial Contract Exception	false	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

Field	Value	IRS element (for citing)
Name Person	MICHAEL D BALDUS	NamePerson
Base Compensation Filing Org	177613	BaseCompensationFilingOrg
Comp Based On Related Orgs	0	CompBasedOnRelatedOrgs
Bonus Filing Org	0	BonusFilingOrg
Bonus Related Orgs	0	BonusRelatedOrgs
Other Compensation Filing Org	0	OtherCompensationFilingOrg
Other Compensation Related Orgs	0	OtherCompensationRelatedOrgs
Deferred Comp Filing Org	0	DeferredCompFilingOrg
Deferred Comp Related Orgs	0	DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org	12561	NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs	0	NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org	190174	TotalCompensationFilingOrg
Total Compensation Related Orgs	0	TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org	0	CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs	0	CompReportPrior990RelatedOrgs

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
ORGANIZATION'S MISSION	FORM 990, PART III, LINE 1	THE 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.
FAMILY RELATIONSHIP	FORM 990, PART VI, SECTION A, LINE 2	DAVE GILLASPY, BOARD MEMBER, AND LOREN GILLASPY, BOARD MEMBER, ARE FATHER AND SON.
MANAGEMENT DUTIES	FORM 990, PART VI, SECTION A, LINE 3	THE 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.
MEMBERS	FORM 990, PART VI, SECTION A, LINE 6 & 7A	THE ORGANIZATION HAS MEMBERS WHO MEET ANNUALLY FOR THE PURPOSE OF ELECTING DIRECTORS.
FORM 990 REVIEW PROCESS	FORM 990, PART VI, SECTION B, LINE 11B	THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE EXECUTIVE DIRECTOR THOROUGHLY REVIEWS THE 990. AFTER THIS REVIEW, THE FORM 990 IS PRESENTED TO THE BOARD WHO IS GIVEN THE OPPORTUNITY TO MAKE COMMENTS AND ASK QUESTIONS BEFORE THE RETURN IS FILED.
CONFLICT OF INTEREST POLICY COMPLIANCE	FORM 990, PART VI, SECTION B, LINE 12C	BIDS 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 OFFICERS	FORM 990, PART VI, SECTION B, LINE 15A	COMPARABILITY 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 CALENDAR YEAR ENDING 12/31/2010. 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 DOCUMENTS	FORM 990, PART VI, SECTION C, LINE 19	A 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

Field	Value	IRS element (for citing)
Business Name Line1	BRIDLE LANE LLC	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	PO BOX 885	AddressLine1
City	MONETT	City
State	MO	State
ZIP Code	65708	ZIPCode

Field	Value	IRS element (for citing)
EIN	203157670	EIN
Primary Activities	STORAGE RENT	PrimaryActivities
Legal Domicile State	MO	LegalDomicileState
Total Income	19570	TotalIncome
EOY Assets	327197	EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

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