| Form 990, Part VI, Section A, line 2 |
Nathan Lunde and Mark Lunde have a family relationship. Nicole Johnson and Barbara Anderson 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 Johnson, 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, Barbara Anderson, is an employee of Cooperstown Medical Center (CMC), an unrelated organization. Barbara's compensation is determined by an agreement of both the board of directors of CMC and the Organization. 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. |
Attach to Form 990 or 990-EZ.