GREEN COUNTRY VILLAGE INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: GREEN COUNTRY VILLAGE INC (EIN 73-1246126)
Tax period: 2012-01-01 to 2012-12-31
Filed: 2013-08-01
IRS object ID: 201342139349300709
Schema version: 2012v2.1
Source: Download XML · Original 990 at ProPublica

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

Return header
Form 990
Schedule A
Schedule D
Schedule K
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-08-01T07:59:40-05:00	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	ARCHAMBO & MUEGGENBORG PC	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	302 SE OSAGE AVE	AddressLine1
City	BARTLESVILLE	City
State	OK	State
ZIP Code	740033931	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	731246126	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	GREEN COUNTRY VILLAGE INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	GREE	NameControl
Phone	9183352086	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1025 SE SWAN DR	AddressLine1
City	BARTLESVILLE	City
State	OK	State
ZIP Code	74006	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	MIKE PELZER	Name
Title	EXECUTIVE DIRECTOR	Title
Phone	9183352086	Phone
Date Signed	2013-07-15	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	DEBORAH E MUEGGENBORG	Name
Phone	9183360008	Phone
Date Prepared	2013-08-01	DatePrepared

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)
Name Of Principal Officer Person	MIKE PELZER	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	1025 SE SWAN DR	AddressLine1
City	BARTLESVILLE	City
State	OK	State
ZIP Code	74006	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	4964065	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.GREENCOUNTRYVILLAGE.COM	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1981	YearFormation
State Legal Domicile	OK	StateLegalDomicile
Activity Or Mission Description	THE PURPOSE OF THE ORGANIZATION IS TO PROVIDE ELDERLY AND/OR HANDICAPPED PERSONS WITH HOUSING FACILITIES AND SERVICES SPECIALLY DESIGNED TO MEET THEIR PHYSICAL, SOCIAL, SPIRITUAL, AND PSYCHOLOGICAL NEEDS IN A RELIGIOUS SETTING, AND TO PROMOTE THE HEALTH, SECURITY, HAPPINESS, AND USEFULNESS IN LONGER LIVING OF THE RESIDENTS WITHOUT REGARD TO RACE, CREED, COLOR, OR NATIONAL ORIGIN. THE CHARGES FOR SUCH FACILITIES AND SERVICES ARE TO BE PREDICATED UPON THE PROVISION, MAINTENANCE, AND OPERATION THEREOF ON A NON -PROFIT BASIS.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	14	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	14	NbrIndependentVotingMembers
Total Nbr Employees	139	TotalNbrEmployees
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Prior Year	525	ContributionsGrantsPriorYear
Contributions Grants Current Year	609	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	4528473	ProgramServiceRevenuePriorYear
Program Service Revenue CY	4962275	ProgramServiceRevenueCY
Investment Income Prior Year	-10473	InvestmentIncomePriorYear
Investment Income Current Year	1181	InvestmentIncomeCurrentYear
Other Revenue Current Year	0	OtherRevenueCurrentYear
Total Revenue Prior Year	4518525	TotalRevenuePriorYear
Total Revenue Current Year	4964065	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	1948419	SalariesEtcPriorYear
Salaries Etc Current Year	2056783	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	2670228	OtherExpensePriorYear
Other Expenses Current Year	2727504	OtherExpensesCurrentYear
Total Expenses Prior Year	4618647	TotalExpensesPriorYear
Total Expenses Current Year	4784287	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	-100122	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	179778	RevenuesLessExpensesCY
Total Assets BOY	8546148	TotalAssetsBOY
Total Assets EOY	8416381	TotalAssetsEOY
Total Liabilities BOY	8348705	TotalLiabilitiesBOY
Total Liabilities EOY	8039160	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	197443	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	377221	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	THE PURPOSE OF THE ORGANIZATION IS TO PROVIDE ELDERLY AND/OR HANDICAPPED PERSONS WITH HOUSING FACILITIES AND SERVICES SPECIALLY DESIGNED TO MEET THEIR PHYSICAL, SOCIAL, SPIRITUAL, AND PSYCHOLOGICAL NEEDS IN A RELIGIOUS SETTING, AND TO PROMOTE THE HEALTH, SECURITY, HAPPINESS, AND USEFULNESS IN LONGER LIVING OF THE RESIDENTS WITHOUT REGARD TO RACE, CREED, COLOR, OR NATIONAL ORIGIN. THE CHARGES FOR SUCH FACILITIES AND SERVICES ARE TO BE PREDICATED UPON THE PROVISION, MAINTENANCE, AND OPERATION THEREOF ON A NON -PROFIT BASIS.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	3911994	Expense
Description	PROVIDE THE ELDERLY AND/OR HANDICAPPED PERSONS WITH HOUSING FACILITIES AND SPECIFIED SERVICES TO PROMOTE HEALTH, SECURITY, HAPPINESS AND USEFULNESS IN LONGER LIVING.	Description
Total Program Service Expense	3911994	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	false	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	false	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	true	ReportOtherAssets
Report Other Liabilities	false	ReportOtherLiabilities
Report Fin48 Footnote	false	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	true	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
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	false	ScheduleORequired
Number Forms Transmitted With1096	36	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	139	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	14	NbrVotingGoverningBodyMembers
Number Independent Voting Members	14	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	false	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	false	RegularMonitoringEnforcement
Whistleblower Policy	false	WhistleblowerPolicy
Document Retention Policy	false	DocumentRetentionPolicy
Compensation Process CEO	false	CompensationProcessCEO
Compensation Process Other	false	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
States Where Copy Of Return Is Filed	OK	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	LIFE CARE SERVICE LLC	NamePerson
Telephone Number	5158754545	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	400 LOCUST ST SUITE 820	AddressLine1
City	DES MOINES	City
State	IA	State
ZIP Code	503092334	ZIPCode

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

Form990 Part VII Section A Form990PartVIISectionA (14 entries)

TitleTitle	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation
WILLIAM DAUSSES
PRESIDENT	X	X	0	0	0
GINGER GRIFFIN
MEMBER	X		0	0	0
BERTHA LANCKRIET
MEMBER	X		0	0	0
H MICHAEL MAY
MEMBER	X		0	0	0
WILLIAM MILLIS
MEMBER	X		0	0	0
BECKY LIEHR
MEMBER	X		0	0	0
STEVE SMITH
MEMBER	X		0	0	0
ALLAN STOCKER
MEMBER	X		0	0	0
DONNA FENSTERMAKER
SECRETARY/TR	X	X	0	0	0
GLENDA GARRISON
VICE PRESIDE	X	X	0	0	0
DAVID NELSON
MEMBER	X		0	0	0
DOREA POTTER
MEMBER	X		0	0	0
ROGER SKELLY
MEMBER	X		0	0	0
DR CHRISTOPHER TAYLOR
MEMBER	X		0	0	0

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

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	LIFE CARE SERVICES LLC	BusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	400 LOCUST ST SUITE 820	AddressLine1
City	DES MOINES	City
State	IA	State
ZIP Code	50309	ZIPCode

Field	Value	IRS element (for citing)
Description Of Services	MANAGEMENT	DescriptionOfServices
Compensation	398527	Compensation

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	1	NumberOfContractorsGT100K
All Other Contributions	609	AllOtherContributions
Total Contributions	609	TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescription	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
ROOM & BOARD SERVICES	4923692	4923692
OTHER RESIDENT SERVICES	38583	38583

Field	Value	IRS element (for citing)
Total Program Service Revenue	4962275	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	1181	TotalRevenueColumn
Exclusion	$1,181	ExclusionAmount

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	4964065	TotalRevenueColumn
Related Or Exempt Function Income	4962275	RelatedOrExemptFunctionIncome
Exclusion	$1,181	ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	1688606	Total
Program Services	1478558	ProgramServices
Management And General	210048	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	242508	Total
Program Services	222011	ProgramServices
Management And General	20497	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	125669	Total
Program Services	111151	ProgramServices
Management And General	14518	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	192876	Total
Management And General	192876	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	628	Total
Management And General	628	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	14500	Total
Management And General	14500	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	224996	Total
Program Services	75557	ProgramServices
Management And General	149439	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	55317	Total
Management And General	55317	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	173233	Total
Program Services	141404	ProgramServices
Management And General	31829	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	11972	Total
Management And General	11972	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	222038	Total
Program Services	222038	ProgramServices

Travel Travel

Field	Value	IRS element (for citing)
Total	10388	Total
Program Services	5071	ProgramServices
Management And General	5317	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	35389	Total
Program Services	4705	ProgramServices
Management And General	30684	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	413019	Total
Program Services	412237	ProgramServices
Management And General	782	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	501023	Total
Program Services	501023	ProgramServices

Insurance Insurance

Field	Value	IRS element (for citing)
Total	82596	Total
Program Services	50769	ProgramServices
Management And General	31827	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
FOOD & BEVERAGE	394716	394716
REPAIR & MAINTENANCE	248142	223976	24166
TELEPHONE	50501		50501
ACTIVITIES	25289	25289

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	70881	Total
Program Services	43489	ProgramServices
Management And General	27392	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	4784287	Total
Program Services	3911994	ProgramServices
Management And General	872293	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	927229	BOY
EOY	949757	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	533163	BOY
EOY	764337	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	13226	BOY
EOY	22367	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	138693	BOY
EOY	131426	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	9392301	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	3717125	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	6063770	BOY
EOY	5675176	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	870067	BOY
EOY	873318	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	8546148	BOY
EOY	8416381	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	426088	BOY
EOY	364898	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	36629	BOY
EOY	44195	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	7878200	BOY
EOY	7628200	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	7788	BOY
EOY	1867	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	8348705	BOY
EOY	8039160	EOY

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

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	197443	BOY
EOY	377221	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	197443	BOY
EOY	377221	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	8546148	BOY
EOY	8416381	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	179778	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	true	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 Minus3 Years	126000	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	1637	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	525	CurrentTaxYearMinus1Year
Current Tax Year	609	CurrentTaxYear
Total	128771	Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	4680842	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	4724421	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	4735245	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	4528473	CurrentTaxYearMinus1Year
Current Tax Year	4962275	CurrentTaxYear
Total	23631256	Total

Total509 Total509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	4680842	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	4850421	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	4736882	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	4528998	CurrentTaxYearMinus1Year
Current Tax Year	4962884	CurrentTaxYear
Total	23760027	Total

Field	Value	IRS element (for citing)
Public Support Total509	23760027	PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	13686	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	2662	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	1641	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	1428	CurrentTaxYearMinus1Year
Current Tax Year	1181	CurrentTaxYear
Total	20598	Total

Investment Income And UBTI InvestmentIncomeAndUBTI

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	13686	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	2662	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	1641	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	1428	CurrentTaxYearMinus1Year
Current Tax Year	1181	CurrentTaxYear
Total	20598	Total

Total Support Total TotalSupportTotal

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	4694528	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	4853083	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	4738523	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	4530426	CurrentTaxYearMinus1Year
Current Tax Year	4964065	CurrentTaxYear
Total	23780625	Total

Field	Value	IRS element (for citing)
Public Support Percentage509	0.99910	PublicSupportPercentage509
Prior Year Support Percentage	0.99650	PriorYearSupportPercentage
Investment Income Percentage	0.00000	InvestmentIncomePercentage
Thirty Three Percnt Tests CY509	X	ThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	703859	OtherCostOrOtherBasis
Book Value	703859	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	703859	TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescription	Book ValueBookValue
BOND INDENTURES-HELD BY TRUSTEE	862793
CONSTRUCTION IN PROGRESS	10525

Field	Value	IRS element (for citing)
Total Book Value Other Assets	873318	TotalBookValueOtherAssets
Tot Revenue Etc Audited Fincl Stmt	4964065	TotRevenueEtcAuditedFinclStmt
Revenue Subtotal	4964065	RevenueSubtotal
Total Revenue Per Form990	4964065	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	4784287	TotExpensesEtcAuditedFinclStmt
Expenses Subtotal	4784287	ExpensesSubtotal
Total Expenses Per Form990	4784287	TotalExpensesPerForm990

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	REVENUE BONDS SERIES 2005	BusinessNameLine1

Field	Value	IRS element (for citing)
Date Issued	2005-01-01	DateIssued
Issue Price	9140000	IssuePrice
Description Of Purpose	REPLACE THE BARTLESVILLE DEVELOPMENT AUTHORITY REVENUE BONDS (GREEN COUNTRY	DescriptionOfPurpose
Defeased	false	Defeased
On Behalf Of Issuer	false	OnBehalfOfIssuer
Pool Financing	false	PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Current Refunding	false	CurrentRefunding
Advance Refunding	false	AdvanceRefunding
Final Allocation Made	false	FinalAllocationMade
Adequate Books And Recds Maintaind	false	AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	false	OwningBondFinancedProperty
Any Lease Arrangements	false	AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty	false	MngmentCntrctBondFinancdPrprty
Any Research Agreements	false	AnyResearchAgreements
Bond Iss Meet Prvt Security Pay Test	false	BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop	false	ChangeInUseBondFinancedProp
Remedial Action Taken	false	RemedialActionTaken
Non Qualified Bond Remed Procdrs	false	NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	false	Form8038TFiled
Rebate Not Due Yet	false	RebateNotDueYet
Exception To Rebate	false	ExceptionToRebate
No Rebate Due	false	NoRebateDue
Variable Rate Issue	false	VariableRateIssue
Hedge Identified In Books And Recds	false	HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC	false	GrossProceedsInvestedInGIC
Gross Proceeds Invested	false	GrossProceedsInvested
Written Proc To Monitor Reqs	false	WrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Proc To Undertk Corrective Action	false	ProcToUndertkCorrectiveAction

Form990 Schedule K Part VI Form990ScheduleKPartVI

Field	Value	IRS element (for citing)
Identifier	PURPOSE OF ISSUE DESCRIPTION	Identifier
Return Reference	SCHEDULE K	ReturnReference
Explanation	REVENUE BONDS SERIES 2005 VILLAGE INC PROJECT SERIES 1996 AND 1998A BONDS	Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
ORGANIZATION'S MISSION	FORM 990 - ORGANIZATION'S MISSION	THE PURPOSE OF THE ORGANIZATION IS TO PROVIDE ELDERLY AND/OR HANDICAPPED PERSONS WITH HOUSING FACILITIES AND SERVICES SPECIALLY DESIGNED TO MEET THEIR PHYSICAL, SOCIAL, SPIRITUAL, AND PSYCHOLOGICAL NEEDS IN A RELIGIOUS SETTING, AND TO PROMOTE THE HEALTH, SECURITY, HAPPINESS, AND USEFULNESS IN LONGER LIVING OF THE RESIDENTS WITHOUT REGARD TO RACE, CREED, COLOR, OR NATIONAL ORIGIN. THE CHARGES FOR SUCH FACILITIES AND SERVICES ARE TO BE PREDICATED UPON THE PROVISION, MAINTENANCE, AND OPERATION THEREOF ON A NON -PROFIT BASIS.
MANAGEMENT DELEGATED	FORM 990, PAGE 6, PART VI, LINE 3	LIFE CARE SERVICE, LLC, 400 LOCUST ST., SUITE 820, DES MOINES, IA 50309- 2334
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990	FORM 990, PAGE 6, PART VI, LINE 11B	NO REVIEW WAS OR WILL BE CONDUCTED.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION	FORM 990, PAGE 6, PART VI, LINE 19	NO DOCUMENTS AVAILABLE TO THE PUBLIC