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MAPLE LAWN NURSING HOME INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
MAPLE LAWN NURSING HOME INC (EIN 41-0870856)
Tax period
2015-10-01 to 2016-09-30
Filed
2017-08-11
IRS object ID
201722239349301712
Schema version
2015v3.0
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)
Return2017-08-11T13:50:47-05:00ReturnTs
Tax Period End2016-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1220 SOUTH SIXTH STREET SUITE 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55402ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN410870856EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MAPLE LAWN NURSING HOME INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMAPLBusinessNameControlTxt
Phone5074252571PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1400 SEVENTH STREET NEAddressLine1Txt
CityFULDACityNm
State AbbreviationMNStateAbbreviationCd
ZIP56131ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonARLAN SWANSONPersonNm
Person TitleADMINISTRATOR/CEOPersonTitleTxt
Phone5074252571PhoneNum
Signature2017-08-11SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonEMILY SCHEEVELPreparerPersonNm
PTINP01814921PTIN
Phone6123764500PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeYes (X)AddressChangeInd

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1MAPLE LAWN SENIOR CARE MAPLEWOODBusinessNameLine1Txt
Business Name Line2COURT MAPLEWOOD ESTATESBusinessNameLine2Txt
FieldValueIRS element (for citing)
Principal OfficerARLAN SWANSONPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1400 SEVENTH STREET NEAddressLine1Txt
CityFULDACityNm
State AbbreviationMNStateAbbreviationCd
ZIP56131ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$4,755,906GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MAPLELAWN.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1962FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionTO PROVIDE FINE QUALITY HEALTHCARE, HOUSING AND SUPPORT SERVICES FOR AREA SENIORS.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee157TotalEmployeeCnt
Total Volunteers62TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$194,906PYContributionsGrantsAmt
CY Contributions Grants$6,149CYContributionsGrantsAmt
PY Program Service Revenue$4,348,560PYProgramServiceRevenueAmt
CY Program Service Revenue$4,592,534CYProgramServiceRevenueAmt
PY Investment Income$13,443PYInvestmentIncomeAmt
CY Investment Income$12,874CYInvestmentIncomeAmt
PY Other Revenue$50,109PYOtherRevenueAmt
CY Other Revenue$144,349CYOtherRevenueAmt
PY Total Revenue$4,607,018PYTotalRevenueAmt
CY Total Revenue$4,755,906CYTotalRevenueAmt
PY Grants And Similar Paid$5,822PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$13,982CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$2,734,053PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$3,029,340CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$1,752,801PYOtherExpensesAmt
CY Other Expenses$1,955,092CYOtherExpensesAmt
PY Total Expenses$4,492,676PYTotalExpensesAmt
CY Total Expenses$4,998,414CYTotalExpensesAmt
PY Revenues Less Expenses$114,342PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$242,508CYRevenuesLessExpensesAmt
Total Assets BOY$4,332,574TotalAssetsBOYAmt
Total Assets EOY$3,852,139TotalAssetsEOYAmt
Total Liabilities BOY$2,096,278TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,842,983TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,236,296NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,009,156NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO PROVIDE FINE QUALITY HEALTHCARE, HOUSING AND SUPPORT SERVICES FOR AREA SENIORS IN AN INDIVIDUALIZED, DIGNIFIED, AND HOMELIKE MANNER.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$4,562,099ExpenseAmt
Grant$13,982GrantAmt
Revenue$4,592,534RevenueAmt
DescMAPLE LAWN NURSING HOME IS A CAMPUS OF LONG TERM CARE SERVICES THAT 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 - 54 MEDICARE-CERTIFIED SKILLED NURSING BEDS THAT 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. 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 54 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.Desc
Total Program Service Expenses$4,562,099TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit CounselingYes (1)CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document48IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee157EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or MisuseYes (1)MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ARLAN SWANSONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5074252571PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1400 NE SEVENTH STREETAddressLine1Txt
CityFULDACityNm
State AbbreviationMNStateAbbreviationCd
ZIP56131ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
JERRILD STEINER
PRESIDENT1.00Yes (X)Yes (X)$0$0$0
ELDEN GETTING
VICE PRESIDENT1.00Yes (X)Yes (X)$0$0$0
MARCINE ELDER
SECRETARY1.00Yes (X)Yes (X)$0$0$0
SHERRI BOEHNKE
DIRECTOR1.00Yes (X)$0$0$0
MARY FRAN BUSCH
DIRECTOR (ROTATED OFF JAN. 2016)1.00Yes (X)$0$0$0
BILL FUERSTENBERG
DIRECTOR1.00Yes (X)$0$0$0
RON JANSSEN
DIRECTOR1.00Yes (X)$0$0$0
LOUISE JOHNSON
DIRECTOR1.00Yes (X)$0$0$0
SHERRI LUNDEEN
DIRECTOR1.00Yes (X)$0$0$0
DEAN MCNEAL
DIRECTOR1.00Yes (X)$0$0$0
ARLAN SWANSON
ADMINISTRATOR/CEO50.00Yes (X)$92,430$0$6,975
FieldValueIRS element (for citing)
Total Reportable Comp From Org$92,430TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$6,975TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
PRAIRIE REHABILITATION SERVICES LLC
1720 S CLIFF AVESIOUX FALLSSD57105CONTRACTED THERAPY$266,275
US FOODS INC
PO BOX 1450MINNEAPOLISMN55485FOOD SERVICES$223,848
PRIME TIME HEALTH CARE LLC
14811 SHEPARD STOMAHANE68138STAFFING SERVICES$167,265
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt
All Other Contributions$6,149AllOtherContributionsAmt
Total Contributions$6,149TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
RESIDENT SERVICES623000$3,704,951$3,704,951
APARTMENT RENTAL623000$887,583$887,583
FieldValueIRS element (for citing)
Total Program Service Revenue$4,592,534TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$12,874TotalRevenueColumnAmt
Exclusion$12,874ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
MISCELLANEOUS INCOME900099$69,634$69,634
INSURANCE PROCEEDS900099$50,000$50,000
ANCILLARY SERVICES623000$16,310$16,310

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$8,405TotalRevenueColumnAmt
Exclusion$8,405ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$144,349OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,755,906TotalRevenueColumnAmt
Related Or Exempt Func Income$4,592,534RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$157,223ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$577TotalAmt
Program Services$577ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$13,405TotalAmt
Program Services$13,405ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$99,406TotalAmt
Program Services$9,941ProgramServicesAmt
Management And General$89,465ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$2,440,126TotalAmt
Program Services$2,432,861ProgramServicesAmt
Management And General$7,265ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$32,310TotalAmt
Program Services$32,207ProgramServicesAmt
Management And General$103ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$293,776TotalAmt
Program Services$292,891ProgramServicesAmt
Management And General$885ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$163,722TotalAmt
Program Services$163,236ProgramServicesAmt
Management And General$486ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$2,232TotalAmt
Management And General$2,232ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$29,539TotalAmt
Management And General$29,539ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$456,022TotalAmt
Program Services$455,742ProgramServicesAmt
Management And General$280ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$16,186TotalAmt
Management And General$16,186ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$25,029TotalAmt
Management And General$25,029ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$47,109TotalAmt
Management And General$47,109ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$160,502TotalAmt
Program Services$154,696ProgramServicesAmt
Management And General$5,806ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$235TotalAmt
Management And General$235ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$2,003TotalAmt
Management And General$2,003ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$40,429TotalAmt
Program Services$38,716ProgramServicesAmt
Management And General$1,713ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$213,368TotalAmt
Program Services$204,325ProgramServicesAmt
Management And General$9,043ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$36,177TotalAmt
Program Services$34,644ProgramServicesAmt
Management And General$1,533ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MISCELLANEOUS$310,217$114,737$195,480
FOOD$228,955$228,955
MEDICAL SUPPLIES$216,870$214,968$1,902
LICENSE SURCHARGE$170,219$170,198$21

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$4,998,414TotalAmt
Program Services$4,562,099ProgramServicesAmt
Management And General$436,315ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$735,630BOYAmt
EOY$113,251EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$971,349BOYAmt
EOY$484,653EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$256,549BOYAmt
EOY$266,340EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$21,642BOYAmt
EOY$37,659EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$7,195,979LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$4,289,814LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,302,277BOYAmt
EOY$2,906,165EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$20,072BOYAmt
EOY$17,842EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$25,055BOYAmt
EOY$26,229EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$4,332,574BOYAmt
EOY$3,852,139EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$487,263BOYAmt
EOY$379,205EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$6,005BOYAmt
EOY$1,517EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,554,098BOYAmt
EOY$1,394,326EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$18,258BOYAmt
EOY$15,095EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$30,654BOYAmt
EOY$52,840EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,096,278BOYAmt
EOY$1,842,983EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,218,296BOYAmt
EOY$1,992,156EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$18,000BOYAmt
EOY$17,000EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,236,296BOYAmt
EOY$2,009,156EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,332,574BOYAmt
EOY$3,852,139EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$242,508ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$15,368NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$18,761CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$9,628CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$27,797CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$194,906CurrentTaxYearMinus1YearAmt
Current Tax Year$6,149CurrentTaxYearAmt
Total$257,241TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,546,754CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,403,279CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,156,634CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,348,560CurrentTaxYearMinus1YearAmt
Current Tax Year$4,592,534CurrentTaxYearAmt
Total$22,047,761TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$9,403CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,405CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$9,135CurrentTaxYearMinus1YearAmt
Current Tax Year$24,715CurrentTaxYearAmt
Total$50,658TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,565,515CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,422,310CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,191,836CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,552,601CurrentTaxYearMinus1YearAmt
Current Tax Year$4,623,398CurrentTaxYearAmt
Total$22,355,660TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$183,248CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$315,376CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$528,492CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$294,384CurrentTaxYearMinus1YearAmt
Current Tax Year$501,472CurrentTaxYearAmt
Total$1,822,972TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$183,248CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$315,376CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$528,492CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$294,384CurrentTaxYearMinus1YearAmt
Current Tax Year$501,472CurrentTaxYearAmt
Total$1,822,972TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$20,532,688PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,690CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,569CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$6,455CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$13,443CurrentTaxYearMinus1YearAmt
Current Tax Year$12,874CurrentTaxYearAmt
Total$49,031TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,690CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,569CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$6,455CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$13,443CurrentTaxYearMinus1YearAmt
Current Tax Year$12,874CurrentTaxYearAmt
Total$49,031TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$17,777CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$17,173CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$20,844CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$40,974CurrentTaxYearMinus1YearAmt
Current Tax Year$119,634CurrentTaxYearAmt
Total$216,402TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,593,982CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,445,052CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,219,135CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,607,018CurrentTaxYearMinus1YearAmt
Current Tax Year$4,755,906CurrentTaxYearAmt
Total$22,621,093TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.90770PublicSupportCY509Pct
Public Support PY5090.92910PublicSupportPY509Pct
Investment Income CY0.00220InvestmentIncomeCYPct
Investment Income PY0.00200InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:FormAndLineReferenceDesc
ExplanationMISCELLANEOUS REVENUES INSURANCE PROCEEDSExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (1)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,864,595OtherCostOrOtherBasisAmt
Depreciation$3,030,006DepreciationAmt
Book Value$1,834,589BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$280,602OtherCostOrOtherBasisAmt
Depreciation$105,904DepreciationAmt
Book Value$174,698BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,310,057OtherCostOrOtherBasisAmt
Depreciation$1,153,904DepreciationAmt
Book Value$156,153BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$740,725OtherCostOrOtherBasisAmt
Book Value$740,725BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$2,906,165TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescASSET RETIREMENT OBLIGATIONDesc
Amt$52,840Amt
FieldValueIRS element (for citing)
Total Liability$52,840TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$4,771,274TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$15,368NetUnrealizedGainsInvstAmt
Revenue Not Reported$15,368RevenueNotReportedAmt
Revenue Subtotal$4,755,906RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$4,755,906TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$4,998,414TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$4,998,414ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$4,998,414TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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, LINE 2: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 BELIEVES IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING THEIR ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE CORPORATION WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. 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.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeSCHOLARSHIPSGrantTypeTxt
Recipient6RecipientCnt
Cash Grant$13,405CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationSCHOLARSHIP PAYMENTS ARE MADE DIRECTLY TO THE SCHOLARSHIP RECIPIENT'S COLLEGE TO ENSURE APPROPRIATE USE OF FUNDS.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1CITY OF FULDA MINNESOTABusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN416005177BondIssuerEIN
Bond Issued2012-10-01BondIssuedDt
Issue Price$1,955,150IssuePriceAmt
PurposeREFUND SERIES 2003 BONDS (NURSING HOME PROJECT)PurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$560,824RetiredAmt
Total Proceeds$1,955,150TotalProceedsAmt
Other Spent Proceeds$1,955,150OtherSpentProceedsAmt
Substantial Completion2012SubstantialCompletionYr
Current RefundingYes (1)CurrentRefundingInd
Advance Refunding0AdvanceRefundingInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd0ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To RebateYes (1)ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate IssueYes (1)VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor Reqs0WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective Action0ProceduresCorrectiveActionInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 5AN EMPLOYEE WRONGLY PURCHASED GIFT CARDS AND OTHER ITEMS THROUGH A VENDOR. APPROX. $150,000 WAS LOST. THE ORGANIZATION IMMEDIATELY TERMINATED THE EMPLOYEE AND SHE IS BEING PROSECUTED BY LOCAL LAW ENFORCEMENT. INSURANCE COVERED $50,000 OF THE LOSS. RESTITUTION WILL BE WORKED OUT WITH PROSECUTION. THE ORGANIZATION HAS CHANGED CRITICAL ACCOUNTING POLICY AND PROCEDURE AND INCREASED OVERSIGHT.
FORM 990, PART VI, SECTION A, LINE 6THE 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 7ATHE ORGANIZATION'S MEMBERS ELECT THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7BTHE ORGANIZATION'S MEMBERS HAVE THE POWER TO AMEND THE ARTICLES AND BYLAWS AND TO TERMINATE MEMBERSHIPS.
FORM 990, PART VI, SECTION B, LINE 11A COPY OF THE FORM 990 WAS 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 12CTHE 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 15ATHE 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 19THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.