2025-05-15T08:19:32-05:00 2024-06-30 450250958 Eide Bailly LLP 4585 Coleman St Ste 200 Bismarck ND 58503 990 2023-07-01 900741090 Griggs County Nursing Home GRIG 7017861700 107 12th St S Cooperstown ND 584254501 Nicole Lindsey CEO/Administrator 7017861700 2025-05-14 1 1 Lisa Chaffee CPA P00193453 7012551091 2025-05-14 2023 2025-03-06 01:10:19Z Griggs County Care Center Nicole Lindsey 107 12th St S Cooperstown ND 584254501 5056038 0 X www.dakotaregional.com X 2011 ND To provide 24 hour skilled nursing care services for individuals with degenerative conditions, dementia, and a variety of medically complex conditions. 4 4 103 5 0 0 1531425 5700 4435666 5033060 4154 17278 0 0 5971245 5056038 347 717 0 0 3254112 3003369 0 0 0 1249633 2319074 4504092 5323160 1467153 -267122 12335234 13064784 9177027 10173699 3158207 2891085 None 0 0 4527534 717 5033060 Griggs County Care Center is licensed as a 41-bed skilled nursing facility. The Facility provides 24 hour care for individuals with degenerative conditions, dementia, and a variety of medically complex conditions. Residents are cared for by a highly trained and skilled staff of professionals, who are, for the most part their friends, neighbors, or family members. Nursing home care is available for long-term care stays, convalescent care, and short-term stays. Emphasis is placed on a resident's remaining skills, not on lost skills. Residents are allowed to retain their independence and dignity with assistance to succeed in daily tasks. The nursing home had 12,807 bed days of service for individuals. 4527534 1 0 0 0 0 0 0 0 1 0 1 0 0 1 1 1 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 1 5 0 1 103 1 0 0 0 0 0 0 0 0 0 0 0 0 X 4 4 1 0 0 0 1 1 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X Judy Monson 7017861700 107 12th St S Cooperstown ND 584254501 Nicole Lindsey CEO/Administrator 28.00 X 203991 0 42257 Oreana Wilson CNA 40.00 X 112760 0 0 Judy Monson CFO 12.00 X 39598 0 10305 Jayne Ott President (July-Nov) 1.00 X X 0 0 0 Janice Johnson SecTreas July- Nov)/President (Starting Nov) 1.00 X X 0 0 0 Mark Lunde Vice President (July-Aug) 1.00 X X 0 0 0 Daniel Larson Director July-Aug VP (Starting Aug) 1.00 X X 0 0 0 Joann Larson Secretary/Treasurer (Starting Nov) 1.00 X X 0 0 0 Ben Halvorson Director 1.00 X 0 0 0 356349 0 52562 2 0 1 1 Cooperstown Medical Center 107 12th St S Cooperstown ND 58425 Shared Employee SVC 275361 Fusion Medical Staffing PO Box 30131 Omaha NE 68103 CNA/Nurse Staffing 150225 DTN Staffing Inc 1200 Collins Ave Mandan ND 58554 CNA/Nurse Staffing 140436 3 3000 2700 5700 Resident Revenue 623000 4840937 4840937 Contract Health Servic 623000 189747 189747 Guest Meals 900099 999 999 1377 1377 5033060 17278 17278 5056038 5033060 0 17278 X 717 717 293280 293280 2257623 2200522 57101 34198 34198 241607 241607 176661 165626 11035 1818 1818 34728 34728 637418 468147 169271 830 830 64807 54340 10467 65077 65077 4258 4258 4296 1423 2873 8576 5824 2752 378379 337669 40710 306473 273499 32974 32329 32329 ERC Credit Payback 248272 248272 Bad Debt Expenses 209068 209068 Food 168044 168044 Medical Supplies 98927 98927 55774 15393 40381 5323160 4527534 795626 0 981702 1802175 805445 446763 32078 23817 14380 13990 585211 198843 387755 386368 10113874 10391671 12335234 13064784 328341 249655 7587 13727 8841099 9910317 9177027 10173699 X 3158207 2891085 3158207 2891085 12335234 13064784 -267122 0 X 0 1 X 1 0 X 157839 710542 553961 1531425 5700 2959467 3881206 3648161 4343946 4435666 5033060 21342039 4039045 4358703 4897907 5967091 5038760 24301506 0 1820016 1535926 2057516 1285121 2482649 9181228 1820016 1535926 2057516 1285121 2482649 9181228 15120278 352 909 1186 5842 17278 25567 352 909 1186 5842 17278 25567 4039397 4359612 4899093 5972933 5056038 24327073 0.62150 0.63590 0.00110 0.00040 X 0 1 X 8288 29 8259 10170 3641 6529 566753 195173 371580 386368 Finance Lease ROU Assets 9699026 ERC Receivable 692645 10391671 Finance Lease Liability 9858909 Cooperstown Medical Center Payable 41408 Cooperstown Medical Center Foundation payable 10000 9910317 X 4807766 -248272 -248272 5056038 0 5056038 5074888 0 5074888 248272 248272 5323160 Part IV, Line 2b: The organization acts as custodian for the funds of the nursing facility residents. The funds are included in cash and accounts payable in the financial statements. Resident trust funds totaled $13,727 and $7,587 at June 30, 2024 and 2023. Part X, Line 2: The Care Center believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Care Center 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. Part XI, Line 2d - Other Adjustments: ERC Credit Payback -248,272. Part XII, Line 4b - Other Adjustments: ERC Credit Payback 248,272. X X 0 0 0 0 0 0 0 0 0 Nicole Lindsey CEO/Administrator 203991 0 0 0 0 0 8332 0 35468 0 247791 0 0 0 Judy Monson CFO 39598 0 0 0 0 0 128 0 10581 0 50307 0 0 0 Schedule J, Part I, Line 3: Nicole Lindsey's compensation is determined by an agreement of both the board of directors of the Organization and the Cooperstown Medical Center (CMC), an unrelated organization. She is paid by the Organization and thirty percent of her compensation is billed to and reimbursed by CMC for her services to CMC. The amounts reported in Part VII, on Schedule J and on Part IX, line 5 represent all of her compensation including the thirty percent that is billed to CMC. Schedule J, Part II: The CFO, Judy Monson, is an employee of Cooperstown Medical Center (CMC), an unrelated organization. Judy's compensation is paid by CMC and 30 percent of her compensation is billed by CMC to the Organization. The amounts reported in Part VII and on schedule J represent 30 percent of her compensation. Form 990, Part VI, Section A, line 2 Nicole Lindsey and Judy Monson have a business relationship. Form 990, Part VI, Section A, line 6 Members consist of those persons who are 18 years of age or above residing in the area served by the Griggs County Nursing Home. Form 990, Part VI, Section A, line 7a Members elect the members of the governing body. Form 990, Part VI, Section A, line 8b The organization's bylaws allows for an Executive Committee. Form 990, Part VI, Section B, line 11b The Form 990 is presented for review and approval to the Board of Directors electronically or during a regularly scheduled board meeting. The acting CEO/Administrator and the contracted financial service provider review the Form 990 prior to filing with the Internal Revenue Service. Form 990, Part VI, Section B, line 12c Board members, senior management, and employees may not use their positions and affiliations with the Griggs County Nursing Home for personal benefit, and are required to disclose actual and potential conflicts related to any financial or business interests that may impact operations of the Cooperstown Medical Center & Griggs County Nursing Home. Upon disclosure of a potential conflict of interest and all material facts, the board member, or CEO making such disclosure is asked to leave while the item is discussed and voted upon. The remaining board or committee members decide if a conflict of interest exists. In the case of disclosure by employees, the Administrator/CEO determines based on the facts and circumstances disclosed if a conflict exists. In matters related to a board member or the CEO, the chairman of the board, and in matters related to an employee, the Administrator/CEO shall if appropriate appoint a disinterested person or committee to investigate alternatives to the proposed transaction or arrangement. After exercising due diligence, they shall determine if a more advantageous transaction or arrangement is available which would not give rise to a conflict of interest. Form 990, Part VI, Section B, line 15 The Administrator, Nicole Lindsey, was compensated for her services to the Organization as well as her services to Cooperstown Medical Center (CMC), an unrelated organization. Her compensation was determined by an agreement between both the Organization's board of directors and that of CMC. Thirty percent of her compensation is billed to and reimbursed by CMC. The CFO, Judy Monson, is an employee of Cooperstown Medical Center (CMC), an unrelated organization. Judy's compensation is determined by the Nicole Lindsey (Administrator for the Organization and CEO for CMC) and in part based on the ND Hospital Association Annual Salary surveys. She is paid by CMC and 30 percent of her compensation is billed by CMC to the Organization. The amounts reported in Part VII and on schedule J represent 30 percent of her compensation. Form 990, Part VI, Section C, line 19 All governing documents, conflict of interest policy, and financial statements are available to the public upon request. Form 990, Part IX, line 11g Contracted Services: Program service expenses 460,889. Management and general expenses 166,301. Fundraising expenses 0. Total expenses 627,190. Consultant Fees: Program service expenses 7,258. Management and general expenses 0. Fundraising expenses 0. Total expenses 7,258. Other Fees: Program service expenses 0. Management and general expenses 2,970. Fundraising expenses 0. Total expenses 2,970.