2025-11-14T11:10:19-06:00 2024-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2024-01-01 273111617 Boundary Waters Care Center BOUN 2183658705 200 W Conan St Ely MN 55731 Roger Pekuri President 2183658705 2025-11-13 1 1 Heidi M Sachs CPA P01273512 6122536500 2025-11-13 2024 2025-03-06 01:10:19Z Roger Pekuri 200 W Conan St Ely MN 55731 5468042 0 X www.boundarywaterscc.com X 2011 MN Provision of long term care for the elderly. 5 5 65 5 0 0 251370 246860 4428044 5220972 15 210 0 0 4679429 5468042 0 0 0 0 3006248 3082215 0 0 0 1991951 2192087 4998199 5274302 -318770 193740 2035625 2675366 1584085 2065626 451540 609740 X Boundary Waters Care Center is committed to the core values of hospitality, stewardship, integrity, respect, and humor. These values, in addition to the significance and impact of the services we provide, determine our priorities, influence our decisions, and represent stability to those we serve. 0 0 4254775 5064029 Boundary Waters Care Center operates a 42-bed nursing facility for the elderly of Ely, Minnesota. The Care Center also provides services designated to meet the physical, social, and psychological needs of the residents. 117555 156943 Boundary Waters Care Center provides meal services to residents and a local non-profit organization through a meals on wheels program. The Care Center also provides dietary services, catering and activity services to the area hospital. 4372330 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 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 17 0 1 65 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 0 0 MN X Health Dimensions Group 7635375700 12900 Whitewater Drive Suite 201 Minneapolis MN 55343 X Roger Pekuri President 1.00 X X 0 0 0 Joneene Lobe Vice President 1.00 X X 0 0 0 Mike Forsman Director 1.00 X 0 0 0 Kathy Champa Director 1.00 X 0 0 0 Lisa Porthan Director 1.00 X 0 0 0 Adam Masloski Executive Director 40.00 X 0 0 0 Victoria Carlson RN 45.00 X 108941 0 0 Dana Fernilius RN 45.00 X 109369 0 0 John Nyarieko CNA 45.00 X 132716 0 0 Shadrack Masaki CNA 45.00 X 150877 0 0 501903 0 0 3 0 1 0 Health Dimensions Group 12900 Whitewater Drive STE 201 Minneapolis MN 55343 Management Services 319152 KareKrest LLC 5701 Shingle Creek Parkway Suite 25 Brooklyn Center MN 55430 Nurse agency Staffing 144158 BSG Maintenance Inc PO Box 165 Newburg WI 53060 Housekeeping & Laundry Services 136689 3 228492 18368 246860 Net Resident Service R 623000 4958103 4958103 Cafeteria 722514 189919 189919 72950 72950 5220972 210 210 5468042 5220972 0 210 2659371 2548147 111224 199232 181717 17515 223612 203954 19658 412183 412183 38816 38816 462646 429681 32965 7439 7439 2715 2715 69120 69120 115334 103092 12242 133699 133699 4399 4399 89023 82625 6398 46335 43005 3330 Medical Supplies and Fo 527195 516667 10528 DHS Surcharge 123290 123290 Repairs and Maintenance 91055 84511 6544 Bad Debts 51000 51000 17838 1926 15912 5274302 4372330 901972 0 764195 1275060 465680 422473 48305 128475 924150 385819 401729 538331 355716 311027 2035625 2675366 475935 521008 842559 813176 15591 6442 0 250000 725000 1584085 2065626 X 111415 305155 340125 304585 451540 609740 2035625 2675366 X 193740 -35540 X X 0 0 0 X 242703 573866 236659 251370 246860 1551458 3620844 3542497 3862447 4428044 5220972 20674804 3863547 4116363 4099106 4679414 5467832 22226262 0 1187156 1165055 1580564 2117590 2453599 8503964 1187156 1165055 1580564 2117590 2453599 8503964 13722298 2437 2027 991 15 210 5680 2437 2027 991 15 210 5680 3865984 4118390 4100097 4679429 5468042 22231942 0.61720 0.64990 0.00030 0.00030 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 410191 158218 251973 513959 227601 286358 538331 Contributed Use of Property 304585 Resident Trust Accounts 6442 311027 Part IV, Line 2b: The Care Center acts as a custodian for the funds of the residents of the Care Center. These funds are included as an asset and a corresponding liability in the accompanying balance sheets. 0 0 0 0 0 0 0 0 0 Shadrack Masaki CNA 150877 0 0 0 0 0 0 0 0 0 150877 0 0 0 Part I, Line 3 The organization relies upon Health Dimensions Consulting, Inc, an unrelated management organization, to determine the compensation for the Executive Director through their management agreement. Form 990, Part VI, Section A, line 3 Boundary Waters Care Center (BWCC) has entered into a contract with Health Dimensions Consulting, Inc. (dba Health Dimensions Group) for certain management services. Adam Masloski received $134,378 in compensation and benefits for services as Executive Director. Form 990, Part VI, Section A, line 8b There are no committees with the authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b The 990 is reviewed by the Financial Services Manager and the Senior Accountant of the management company. The 990 is also provided to Boundary Waters Care Center board for review and approval prior to filing. Form 990, Part VI, Section B, line 12c The organization provides annual training on the code of conduct, which includes the conflict of interest policy. The organization also has a compliance hotline in which any/all complaints are investigated. Board members and key employees are asked to complete a conflict of interest questionnaire annually. The board determines if a conflict of interest is present. If a conflict is identified, the impacted individual must abstain from voting. Form 990, Part VI, Section B, line 15a Health Dimensions Group (HDG) engages a third party on a periodic basis to conduct market analysis and to provide recommendations on compensation ranges for administrators. The Human Resources department coordinates this activity with the third party vendor, and provides financial recommendations to the HDG CEO. Administrators are not involved with any aspect of conducting market analysis, establishing compensation ranges or determining their respective salary. Form 990, Part VI, Section C, line 19 The governing documents and financial statements are available upon request. Form 990, Part XI, line 9: Amortization of Promise to Give-Lease Space -35,540. Form 990, Part XII, Line 2b The organization is in the process of obtaining independent audited financial statements. At the time of filing the Form 990 the audit was not issued.