2021-03-05T13:47:10-06:00 2020-06-30 450250958 Eide Bailly LLP 1730 Burnt Boat Loop Ste 100 Bismarck ND 585030886 990 2019-07-01 450277390 Beulah Community Nursing Home BEUL 7018733175 118 22nd St NE Beulah ND 58523 Blake Kragnes Administrator 7018733175 2021-03-04 1 Lisa Chaffee CPA P00193453 7012551091 2021-03-04 2019 2022-09-23 18:48:47Z Knife River Care Center Blake Kragnes 118 22nd St NE Beulah ND 58523 9415428 0 X www.krcc-nd.net X 1960 ND To provide family centered compassionate care in a therapeutic and safe environment. 7 7 171 110 0 0 28545 199214 8860617 9214545 249 1669 0 0 8889411 9415428 0 360 0 0 5454781 5246577 0 0 0 3372893 3925019 8827674 9171956 61737 243472 7554210 8561699 8723299 9456058 -1169089 -894359 X To provide family-centered compassionate care in a therapeutic and safe environment, where the goal is quality of life. Knife River Care Center is dedicated to the preservation of dignity and respect to those we serve and employ. With great compassion, we strive to make excellence our standard. 0 0 8364414 360 9214545 Beulah Community Nursing Home, d/b/a Knife River Care Center, is a licensed 86-bed Long Term Care Nursing Facility, which provides skilled nursing care to the elderly in the Beulah, North Dakota area. The facility also provides a variety of services, which include, but are not limited to, I.V. therapy, physical therapy, occupational therapy, speech therapy, tube feedings, tracheotomy care, and wound care. The facility provides 24-hour services of a Licensed Social Worker in order to meet the varying psychosocial needs of all residents. Knife River Care Center is a participant in the State and Federal Medicare and Medicaid programs. All costs incurred for the fiscal year were related to providing the necessary services to those individuals who required the support of a long term care facility. 8364414 1 1 0 0 0 0 0 0 1 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 7 0 1 171 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 1 1 0 1 0 0 0 1 1 1 1 0 1 1 0 0 X Anna Wiest 7018733174 118 22nd St NE Beulah ND 58523 Rosanne Schmidt Interim Administrator 40.00 X 191620 0 0 Kareen Kim Sia Tan Nursing RN 60.50 X 132229 0 16624 Darrold Bertsch President 1.00 X X 0 0 0 Dena Kemmet Vice President 1.00 X X 0 0 0 Bruce Mohl Secretary 1.00 X X 0 0 0 Bonnie Knell Director 1.00 X 0 0 0 Bonnie Krause Director 1.00 X 0 0 0 Gary Emter Director 1.00 X 0 0 0 Leanne Stiefel Director 1.00 X 0 0 0 323849 0 16624 2 0 1 0 Dakota Travel Nurse 1200 Collins Ave Mandan ND 58554 Staffing 894084 Rosanne Schmidt 1420 Eagle Crest Loop Bismarck ND 58501 Interim Administrator Services 191620 Primetime Healthcare PO Box 3544 Omaha NE 68103 Staffing 180998 3 84927 114287 199214 Resident Service Reven 623000 9193559 9193559 Other Program Service 623000 20986 20986 9214545 1069 1069 600 0 600 600 600 9415428 9214545 0 1669 X 360 360 180593 180593 4276434 4073297 203137 166132 165370 762 244956 216143 28813 378462 332021 46441 8145 8145 47638 47638 1249146 1242842 6304 7390 7390 320942 313546 7396 106270 106270 533776 507993 25783 770 770 126988 126988 243713 226688 17025 608595 565993 42602 84659 84659 Food/Supplement Expense 269804 250918 18886 Pharmacy Expense 105628 105628 Repairs & Maintenance 95448 95448 Bad Debt -54061 -54061 170168 46638 123530 9171956 8364414 807542 0 200 200 44704 1128647 884167 912976 9132 13922 44849 38463 14290837 8166434 6147514 6124403 423644 343088 7554210 8561699 867627 675754 30549 383119 7526747 7152656 22544 30549 215832 48680 1165300 60000 0 8723299 9456058 X -1456233 -1212761 287144 318402 -1169089 -894359 7554210 8561699 X 243472 31258 X 0 1 X 0 0 X 438910 128578 81480 28545 199214 876727 438910 128578 81480 28545 199214 876727 876727 8649 37339 697 185 1069 47939 924666 43685868 0.94820 0.93830 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 49707 49707 6411891 2962277 3449614 7333782 4893504 2440278 495457 310653 184804 6124403 X 9446686 31258 31258 9415428 0 9415428 9171956 0 9171956 0 9171956 Part IV, Line 2b: The Care Center acts as custodian for the funds of the residents. These funds are included in cash and cash equivalents and accounts payable in the financial statements. Resident trust funds totaled $21,257 and $14,670 at June 30, 2020 and 2019. The Care Center also acts as custodian for funds of the Friends Club. Funds held for the Friends Club totaled $9,292 at June 30, 2020 and $7,874 at June 30, 2019. 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: Change in Interest in Net Assets of Knife River Care Center Foundation 31,258. X X 0 0 0 0 0 0 0 0 0 Rosanne Schmidt Interim Administrator 191620 0 0 0 0 0 0 0 0 0 191620 0 0 0 A City of Beulah North Dakota 450276796 000000000 2015-12-11 8705000 To refund bonds issued 04/06/2006 0 0 0 A 1357485 8705000 174100 636718 7894182 2015 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 0 1 0 0 0 0 A 0 Form 990, Part VI, Section A, line 6 Membership: The membership of Knife River Care Center (KRCC) shall be all persons over the age of 18 who are residing within Mercer county and adjacent counties in North Dakota, and family members of residents who are willing to assist the board of directors and officers of KRCC in the operation of KRCC. Form 990, Part VI, Section A, line 7a Member Voting Rights: The members of the organization vote yearly to elect the board of directors. Form 990, Part VI, Section A, line 8b Committees: There are no committees in place that may act on behalf of the board. Form 990, Part VI, Section B, line 11b Form 990 Review: Upon receipt of the draft Form 990, the organization will forward the draft to the board members for their review and comment prior to filing with the IRS. Form 990, Part VI, Section B, line 12c Procedures for addressing the conflict of interest: The chairperson of the board or committee shall, if appropriate, appoint a disinterested person or committee to investigate alternatives to the proposed transaction or arrangement. After exercising due diligence, the board or committee shall determine whether Knife River Care Center can obtain a more advantageous transaction with reasonable efforts from a person or entity that would not give rise to a conflict of interest. If a more advantageous transaction or arrangement is not reasonably attainable under circumstances that would not give rise to a conflict of interest, the board or committee shall determine by majority vote of the disinterested directors whether the transaction or arrangement is in Knife River Care Center's best interest and for its own benefit, and whether the transaction is fair and reasonable to Knife River Care Center, and shall make its decision as to whether to enter into the transaction or arrangement in conformity with such determination. Violations of the Conflicts of Interest Policy: If the board or committee has reasonable cause to believe that a member has failed to disclose actual or possible conflicts of interest, it shall inform the member of the basis for such belief and afford the member an opportunity to explain the alleged failure to disclose. If after hearing the response of the member and making such further investigation as may be warranted in the circumstances, the board or committee determines that the member has in fact failed to disclose an actual or possible conflict of interest, it shall take appropriate disciplinary and corrective action. Form 990, Part VI, Section B, line 15a Compensation for the Interim Administrator was determined by looking at comparable contract administrator fees. Consideration was given to reflect the hours the Interim Administrator would be working and negotiations were done to discount the rate. The proposed rate was then approved by the Board of Directors. During the fiscal year, the Interim Administrator served as both the top financial official and the top management official within the organization. Form 990, Part VI, Section C, line 19 The organization's governing documents, conflict of interest policy and financial statements are available if specifically requested. Form 990, Part IX, line 11g Contracted Services: Program service expenses 1,198,518. Management and general expenses 6,304. Fundraising expenses 0. Total expenses 1,204,822. Consultants: Program service expenses 44,324. Management and general expenses 0. Fundraising expenses 0. Total expenses 44,324. Form 990, Part XI, line 9: Change in Interest in Assets of Foundation 31,258. Knife River Care Center Friends Club 118 22nd St NE Beulah ND 58523 450277390 Staff Special Events ND 4943 9549 N/A