MASON CITY AREA NURSING HOME ASSOCIATION INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: MASON CITY AREA NURSING HOME ASSOCIATION INC (EIN 37-1168043)
Tax period: 2012-01-01 to 2012-12-31
Filed: 2013-07-31
IRS object ID: 201342129349300204
Schema version: 2012v2.0
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
Form 990
Schedule A
Schedule B
Schedule D
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-07-31T06:38:11-07:00	Timestamp
Tax Period End Date	2012-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JM Abbott & Associates Ltd	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	207 S McLean St	AddressLine1
City	Lincoln	City
State	IL	State
ZIP Code	62656	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	371168043	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	MASON CITY AREA NURSING HOME	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	MASO	NameControl
Phone	2174825022	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	520 NORTH PRICE AVENUE	AddressLine1
City	MASON CITY	City
State	IL	State
ZIP Code	62664	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	REV JIM SPRINKEL	Name
Title	President	Title
Date Signed	2013-07-18	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	Clayton GeorgeCPA	Name
PTIN	P00052565	PTIN
Phone	2177351576	Phone

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Gross Receipts	4206133	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
All Affiliates Included	false	AllAffiliatesIncluded
Organization501c3	X	Organization501c3
Web Site	N/A	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1989	YearFormation
State Legal Domicile	IL	StateLegalDomicile
Activity Or Mission Description	NURSING HOME OPERATIONS	ActivityOrMissionDescription
Nbr Voting Members Governing Body	7	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	7	NbrIndependentVotingMembers
Total Nbr Employees	119	TotalNbrEmployees
Total Nbr Volunteers	45	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Prior Year	25241	ContributionsGrantsPriorYear
Contributions Grants Current Year	29680	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	4116195	ProgramServiceRevenuePriorYear
Program Service Revenue CY	4174079	ProgramServiceRevenueCY
Investment Income Prior Year	7242	InvestmentIncomePriorYear
Investment Income Current Year	2374	InvestmentIncomeCurrentYear
Other Revenue Current Year	0	OtherRevenueCurrentYear
Total Revenue Prior Year	4148678	TotalRevenuePriorYear
Total Revenue Current Year	4206133	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	2631937	SalariesEtcPriorYear
Salaries Etc Current Year	2654378	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	4286	TotalFundrsngExpCurrentYear
Other Expense Prior Year	1430795	OtherExpensePriorYear
Other Expenses Current Year	1530640	OtherExpensesCurrentYear
Total Expenses Prior Year	4062732	TotalExpensesPriorYear
Total Expenses Current Year	4185018	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	85946	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	21115	RevenuesLessExpensesCY
Total Assets BOY	2643482	TotalAssetsBOY
Total Assets EOY	2759374	TotalAssetsEOY
Total Liabilities BOY	365393	TotalLiabilitiesBOY
Total Liabilities EOY	460170	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	2278089	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	2299204	NetAssetsOrFundBalancesEOY
Mission Description	NURSING HOME OPERATIONS	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	3664421	Expense
Revenue	4174088	Revenue
Description	NURSING HOME - SKILLED AND INTERMEDIATE HEALTHCARE	Description
Total Program Service Expense	3664421	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	true	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	false	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	true	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	false	ReportOtherLiabilities
Report Fin48 Footnote	true	ReportFin48Footnote
Independent Audit Financial Stmt	true	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	false	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Invest Tax Exempt Bonds	false	InvestTaxExemptBonds
Escrow Account	false	EscrowAccount
On Behalf Of Issuer	false	OnBehalfOfIssuer
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	false	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	18	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	119	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Form990-T Filed	false	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
Number Of8282 Filed	0	NumberOf8282Filed
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Form8899 Filed	false	Form8899Filed
Form1098 C Filed	false	Form1098CFiled
Excess Business Holdings	false	ExcessBusinessHoldings
Taxable Distributions	false	TaxableDistributions
Distribution To Donor	false	DistributionToDonor
Filed Lieu1041	false	FiledLieu1041
Licensed More Than One State	false	LicensedMoreThanOneState
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	7	NbrVotingGoverningBodyMembers
Number Independent Voting Members	7	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	true	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	false	MembersOrStockholders
Election Of Board Members	false	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
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
States Where Copy Of Return Is Filed	IL	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	HERITAGE OPERATIONS GROUP LLC	NamePerson
Telephone Number	3098284361	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	115 W JEFFERSON	AddressLine1
City	BLOOMINGTON	City
State	IL	State
ZIP Code	61701	ZIPCode

Field	Value	IRS element (for citing)
No Listed Persons Compensated	X	NoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (7 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Average Hours Per Week RelatedAverageHoursPerWeekRelated	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation
BONNIE DUNKER
Treasurer	1.00	0.00	X	X	0	0	0
REV JIM SPRINKEL
President	1.00	0.00	X	X	0	0	0
ROBERT GRIFFIN
Director	1.00	0.00	X		0	0	0
SUZANNE LOWERS
Director	1.00	0.00	X		0	0	0
DAN SHEPHERD
Director	1.00	0.00	X		0	0	0
KAREN DUCKWORTH
Director	1.00	0.00	X		0	0	0
KRAIG KRAUSE
Director	1.00	0.00	X		0	0	0

Field	Value	IRS element (for citing)
Number Individuals GT100 K	0	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	false	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
SELECT REHABILITATION INC
PO BOX 809056	CHICAGO	IL	606809056	REHAB SERVICES	108770
PROFESSIONAL THERAPY SERVICES INC
2810 FRANK SCOTT PARKWAY WEST	BELLVILLE	IL	62223	THERAPY	176419
HERITAGE ENTERPRISES INC
115 W JEFFERSON STE 401	BLOOMINGTON	IL	617023188	MANAGEMENT	276273
HEALTHCARE SERVICE CORPORATION
PO BOX 1186	CHICAGO	IL	606901186	GROUP INSURANCE	240233

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	4	NumberOfContractorsGT100K
All Other Contributions	29680	AllOtherContributions
Total Contributions	29680	TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NURSING HOME OPERATIONS	623000	1528108	1528108
Fees & Contracts Gov Agencies	623000	2645971	2645971

Field	Value	IRS element (for citing)
Total Program Service Revenue	4174079	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	2374	TotalRevenueColumn
Exclusion	$2,374	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

Net Rental Income Or Loss NetRentalIncomeOrLoss

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

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	4206133	TotalRevenueColumn
Related Or Exempt Function Income	4174079	RelatedOrExemptFunctionIncome
Exclusion	$2,374	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	0	Total

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	2195141	Total
Program Services	2011732	ProgramServices
Management And General	181517	ManagementAndGeneral
Fundraising	1892	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	21066	Total
Program Services	19306	ProgramServices
Management And General	1742	ManagementAndGeneral
Fundraising	18	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	255530	Total
Program Services	234177	ProgramServices
Management And General	21133	ManagementAndGeneral
Fundraising	220	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	182641	Total
Program Services	163813	ProgramServices
Management And General	18494	ManagementAndGeneral
Fundraising	334	Fundraising

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	108000	Total
Management And General	108000	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	7975	Total
Management And General	7975	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	418105	Total
Program Services	376325	ProgramServices
Management And General	40001	ManagementAndGeneral
Fundraising	1779	Fundraising

Advertising Advertising

Field	Value	IRS element (for citing)
Total	27421	Total
Management And General	27421	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	25457	Total
Program Services	9711	ProgramServices
Management And General	15746	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	33761	Total
Management And General	33761	ManagementAndGeneral

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	79291	Total
Program Services	74326	ProgramServices
Management And General	4965	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	3052	Total
Program Services	3052	ProgramServices

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	3250	Total
Program Services	3155	ProgramServices
Management And General	95	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	0	Total

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	120936	Total
Program Services	114889	ProgramServices
Management And General	6047	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	112109	Total
Program Services	104842	ProgramServices
Management And General	7224	ManagementAndGeneral
Fundraising	43	Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Management And GeneralManagementAndGeneral	Program ServicesProgramServices
LICENSES AND FEES	37343	37343
REPAIRS AND MAINTENANCE	115312	4847	110465
FOOD EXPENSE	176553		176553
SUPPLIES	211980		211980

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	50095	Total
Program Services	50095	ProgramServices

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	4185018	Total
Program Services	3664421	ProgramServices
Management And General	516311	ManagementAndGeneral
Fundraising	4286	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	1000	BOY
EOY	1000	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	436484	BOY
EOY	582527	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
EOY	0	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	605275	BOY
EOY	692208	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
EOY	0	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

Field	Value	IRS element (for citing)
EOY	0	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
EOY	0	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	46791	BOY
EOY	31281	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	16969	BOY
EOY	33720	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	3940745	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	2522107	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	1536963	BOY
EOY	1418638	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
EOY	0	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
EOY	0	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
EOY	0	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
EOY	0	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
EOY	0	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	2643482	BOY
EOY	2759374	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	365393	BOY
EOY	460170	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	365393	BOY
EOY	460170	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	2278089	BOY
EOY	2274204	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
EOY	25000	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	2278089	BOY
EOY	2299204	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	2643482	BOY
EOY	2759374	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	21115	ReconcilationRevenueExpenses
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Separate	X	FinancialStatementSeparate

Field	Value	IRS element (for citing)
Audit Committee	false	AuditCommittee
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	8055	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	14839	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	15851	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	25241	CurrentTaxYearMinus1Year
Current Tax Year	29680	CurrentTaxYear
Total	93666	Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	3516812	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	3703322	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	3724824	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	4116195	CurrentTaxYearMinus1Year
Current Tax Year	4174079	CurrentTaxYear
Total	19235232	Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

Field	Value	IRS element (for citing)
Total	0	Total

Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509

Field	Value	IRS element (for citing)
Total	0	Total

Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt

Field	Value	IRS element (for citing)
Total	0	Total

Total509 Total509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	3524867	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	3718161	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	3740675	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	4141436	CurrentTaxYearMinus1Year
Current Tax Year	4203759	CurrentTaxYear
Total	19328898	Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Amts From Subst Contributors AmtsFromSubstContributors

Field	Value	IRS element (for citing)
Total	0	Total

Field	Value	IRS element (for citing)
Public Support Total509	19328898	PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	14631	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	11301	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	10252	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	7242	CurrentTaxYearMinus1Year
Current Tax Year	2374	CurrentTaxYear
Total	45800	Total

Post1975 UBTI Post1975UBTI

Field	Value	IRS element (for citing)
Total	0	Total

Investment Income And UBTI InvestmentIncomeAndUBTI

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	14631	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	11301	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	10252	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	7242	CurrentTaxYearMinus1Year
Current Tax Year	2374	CurrentTaxYear
Total	45800	Total

Net Income From Other UBI NetIncomeFromOtherUBI

Field	Value	IRS element (for citing)
Total	0	Total

Other Income509 OtherIncome509

Field	Value	IRS element (for citing)
Total	0	Total

Total Support Total TotalSupportTotal

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	3539498	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	3729462	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	3750927	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	4148678	CurrentTaxYearMinus1Year
Current Tax Year	4206133	CurrentTaxYear
Total	19374698	Total

Field	Value	IRS element (for citing)
Public Support Percentage509	0.99760	PublicSupportPercentage509
Prior Year Support Percentage	0.99700	PriorYearSupportPercentage
Investment Income Percentage	0.00240	InvestmentIncomePercentage
Prior Yr Invest Income Percentage	0.00300	PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509	X	ThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

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

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Contributions	25000	Contributions
End Of Year Balance	25000	EndOfYearBalance

Field	Value	IRS element (for citing)
Term Endowment EOY Balance	1.00000	TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs	false	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	false	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	false	AreRelatedOrgsListedScheduleR

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	71000	OtherCostOrOtherBasis
Book Value	71000	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	3198433	OtherCostOrOtherBasis
Depreciation	1911396	Depreciation
Book Value	1287037	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	671312	OtherCostOrOtherBasis
Depreciation	610711	Depreciation
Book Value	60601	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	1418638	TotalOfBookValueLandBuildings
Footnote In Part XIII	X	FootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt	4206133	TotRevenueEtcAuditedFinclStmt
Revenue Subtotal	4206133	RevenueSubtotal
Total Revenue Per Form990	4206133	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	4185018	TotExpensesEtcAuditedFinclStmt
Expenses Subtotal	4185018	ExpensesSubtotal
Total Expenses Per Form990	4185018	TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Part X	Part X : FIN48 Footnote	NOTE I TO THE AUDITED FINANCIAL STATEMENTS READS AS FOLLOWS: THE NURSING HOME IS CHARTERED AS AN ILLINOIS NOT-FOR-PROFIT CORPORATION AND IS EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE NURSING HOME IS REQUIRED TO FILE FEDERAL AND STATE INFORMATIONAL RETURNS. WITH LIMITED EXCEPTIONS, THE NURSING HOME IS NO LONGER SUBJECT TO INCOME TAX EXAMINATION FOR ANY YEARS EARLIER THAN 2008 FOR FEDERAL AND STATE PURPOSES. MANAGEMENT HAS PERFORMED ITS EVALUATION OF ALL OTHER INCOME TAX POSITIONS TAKEN ON ALL OPEN INFORMATIONAL RETURNS AND HAS DETERMINED THAT THERE WERE NO POSITIONS TAKEN THAT DO NOT MEET THE "MORE LIKELY THAN NOT" STANDARD. ACCORDINGLY, THERE ARE NO PROVISIONS FOR INCOME TAXES, PENALTIES OR INTEREST RECEIVABLE OR PAYABLE RELATING TO UNCERTAIN INCOME TAX PROVISIONS IN THE ACCOMPANYING FINANCIAL STATEMENTS.
Part V, Line 4	Part V, Line 4: Intended uses of the endowment fund.	PURCHASE VAN.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Form 990, Part VI, Line 19	Form 990, Part VI, Line 19: Other Organization Documents Publicly Available	THE DOCUMENTS ARE HELD IN THE NURSING HOME BUSINESS OFFICE, WHICH IS OPEN DURING NORMAL BUSINESS HOURS.
Form 990, Part VI, Line 15b	Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees	BOARD REVIEWS OTHER AREA NURSING HOMES AND INDUSTRY STANDARDS FOR COMPUTING COMPENSATION.
Form 990, Part VI, Line 15a	Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management	BOARD REVIEWS OTHER AREA NURSING HOMES AND INDUSTRY STANDARDS FOR COMPUTING COMPENSATION.
Form 990, Part VI, Line 12c	Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts	OFFICERS AND DIRECTORS ARE REQUIRED TO DISCLOSE CONFLICTS OF INTEREST ANNUALLY. KEY EMPLOYEES SIGNED AN ACKNOWLEDGEMENT STATEMENT UPON HIRE THAT THEY WOULD FOLLOW THE ORGANIZATION'S CODE OF ETHICS WHICH INCLUDES DISCLOSING CONFLICTS OF INTEREST.
Form 990, Part VI, Line 11b	Form 990, Part VI, Line 11b: Form 990 Review Process	THE BOARD REVIEWS THE 990 AND APPROVES AT THEIR BOARD MEETING.
Form 990, Part VI, Line 3	Form 990, Part VI, Line 3: Description of Delegated Duties to Management Company	HERITAGE ENTERPRISES INDEPENDENTLY MANAGES MASON CITY AREA NURSING HOME FOR A MANAGEMENT FEE.