EXECUTIVE DIRECTOR

2012-05-15T12:04:58-05:00 2011-12-31 420946155 HONKAMP KRUEGER & CO PC P O BOX 188 HIAWATHA IA 52233 990 2011-01-01 421412375 COTTAGE GROVE PLACE COTT 3193632420 2115 FIRST AVENUE SE CEDAR RAPIDS IA 52402 MATTHEW CARPENTER EXECUTIVE DIRECTOR 3193632420 2012-05-07 1 DALE J LEIBFRIED CPA P00139912 3193783370 2012-05-07 2011 2016-02-24 21:20:13Z MATTHEW CARPENTER 2115 FIRST AVENUE SE CEDAR RAPIDS IA 52402 11128548 0 X WWW.COTTAGEGROVEPLACE.COM X 1992 IA TO PROVIDE HOUSING, HEALTH CARE, AND OTHER RELATED SERVICES TO RESIDENTS THROUGH THE OPERATION OF A RETIREMENT FACILITY 17 17 252 0 0 0 0 0 10443927 11099540 41427 29008 0 0 10485354 11128548 0 0 0 0 4316121 4473445 0 0 0 6279109 6278066 10595230 10751511 -109876 377037 30447580 29870501 53488375 52584419 -23040795 -22713918 TO PROVIDE HOUSING, HEALTH CARE, AND OTHER RELATED SERVICES TO RESIDENTS THROUGH THE OPERATION OF A RETIREMENT FACILITY 0 0 5980673 11099540 THE RETIREMENT FACILITIES CONTAIN 166 INDEPENDENT LIVING UNITS, 19 ASSISTED LIVING UNITS, 40 NURSING CARE BEDS, AND 12 MEMORY CARE UNITS FOR ITS RESIDENTS. THE FACILITIES CURRENTLY HOUSE 151 RESIDENTS. 5980673 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 32 0 1 252 1 0 0 0 0 0 0 0 0 0 0 X 17 17 1 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X GREG OLBEKSON 3192975754 2115 FIRST AVENUE SE CEDAR RAPIDS IA 52402 X ROBERT A SEDLACEK TRUSTEE 1.20 X 0 0 0 DOUGLAS HEATH TRUSTEE 1.20 X 0 0 0 HAROLD G SCHAEFER TRUSTEE 1.20 X 0 0 0 RUSSELL H ANTHONY TRUSTEE 1.20 X 0 0 0 WILLIAM S ELLIOTT TRUSTEE 1.20 X 0 0 0 JOHN C WAGOR TRUSTEE 1.20 X 0 0 0 CARL E HALLBERG TRUSTEE 1.20 X 0 0 0 PHIL MORRIS TRUSTEE 1.20 X 0 0 0 KATHY TOBORG TRUSTEE 1.20 X 0 0 0 RALPH H PALMER TRUSTEE 1.20 X 0 0 0 TAD COOPER TRUSTEE 1.20 X 0 0 0 MARTIN DWYER TRUSTEE 1.20 X 0 0 0 CRYSTAL USHER TRUSTEE 1.20 X 0 0 0 JAN ALTORFER TRUSTEE 1.20 X 0 0 0 ROBERT SILBER TRUSTEE 1.20 X 0 0 0 JIM BURR TRUSTEE 1.20 X 0 0 0 DAVID BEY TREASURER 1.20 X 0 0 0 BILL JACOBSON CHAIRMAN 1.20 X 0 0 0 DICK HEFT SECRETARY 1.20 X 0 0 0 B D COOPER VICE CHAIRMAN 1.20 X 0 0 0 0 0 0 0 0 0 0 LIFE CARE SERVICES LLC 400 LOCUST STREET SUITE 820 DES MOINES IA 50309 MANAGEMENT COMPANY 555636 1 RESIDENT SERVICES 623000 11099540 11099540 11099540 29008 29008 11128548 11099540 0 29008 313500 273911 39589 3284521 2869750 414771 495688 419365 76323 379736 336057 43679 448997 448997 109602 87514 22088 167948 167948 643765 603578 40187 63117 46167 16950 1690812 1690812 1105476 1105476 242925 85705 157220 FOOD 588509 588509 MEDICAL EXPENSE 424952 424952 PROPERTY TAXES 257564 257564 MISCELLANEOUS EXPENSE 200436 1960 198476 333963 243205 90758 10751511 5980673 4770838 0 715064 640937 264975 263653 23060 20012 115187 110018 37220323 13008590 24742970 24211733 4586324 4624148 30447580 29870501 1944612 2340510 10071820 10414193 29207994 28306108 12263949 11523608 53488375 52584419 X -23040795 -22713918 -23040795 -22713918 30447580 29870501 X 377037 -50160 X X 0 1 1 X 0 X 9508572 10421187 10500854 10443927 11099540 51974080 9508572 10421187 10500854 10443927 11099540 51974080 0 0 0 51974080 203827 106849 61226 41427 29008 442337 203827 106849 61226 41427 29008 442337 9712399 10528036 10562080 10485354 11128548 52416417 0.99160 0.98860 0.00840 0.01140 X 4016275 4016275 27808427 9679108 18129319 2681028 1083478 1597550 257997 202343 55654 2456596 2043661 412935 24211733 ASSETS LIMITED AS TO USE 3181765 DEFERRED FINANCING EXPENSES 524855 CASH SURRENDER VALUE OF LIFE INSURANCE 393523 BENEFICIAL INTEREST IN CHARITABLE REMAINDER TRUST 330447 ORGANIZATIONAL COSTS, NET 193558 4624148 REFUNDABLE ENTRANCE FEES 11379175 DEPOSITS 98239 CAPITAL LEASES 46194 11523608 CITY OF CEDAR RAPIDS IOWA 426004336 0150571AJ 2004-03-01 5310000 COSTS OF 2004 PROJECT-HEALTH CENTER 0 0 0 5310000 219785 5090215 2004 0 0 1 1 0 0 0 0 1 1 0 0 0 0 1 FORM 990, PART VI, SECTION A, LINE 2 B D COOPER (VICE CHAIRMAN) IS THE FATHER OF TAD COOPER (TRUSTEE). FORM 990, PART VI, SECTION A, LINE 3 MANAGEMENT DUTIES FOR THE ORGANIZATION ARE HANDLED BY THE MANAGEMENT COMPANY - LIFE CARE SERVICES LLC. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION'S FORM 990 IS REVIEWED BY THE BOARD AND THE EXECUTIVE DIRECTOR. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO DISCLOSE EVERY YEAR POTENTIAL CONFLICTS WITH BUSINESSES THEY ARE ASSOCIATED WITH. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: UNREALIZED LOSS ON INVESTMENTS -22,515. INCREASE IN CASH SURRENDER VALUE OF LIFE INSURANCE -27,645. TOTAL TO FORM 990, PART XI, LINE 5: -50,160. AUDIT COMMITTEE PROCEDURES FORM 990, PART XI, LINE 2C THERE WERE NO CHANGES IN THE PROCEDURES FOR THE OVERSIGHT OF THE AUDIT.