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  5. MEDINA NURSING CENTER, INC.

MEDINA NURSING CENTER, INC.

Company Details

Entity Name: MEDINA NURSING CENTER, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 21 Oct 1976
Company Number: CORP_51011201
File Number: 51011201
Place of Formation: ILLINOIS

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
GKDXDC4EEGP3 2025-02-20 402 S CENTER ST, DURAND, IL, 61024, 9590, USA 402 S CENTER ST, DURAND, IL, 61024, 9590, USA

Business Information
Congressional District 16
State/Country of Incorporation IL, USA
Activation Date 2024-02-26
Initial Registration Date 2012-05-24
Entity Start Date 1965-05-17
Fiscal Year End Close Date Dec 31

Service Classifications
NAICS Codes 623110
Product and Service Codes Q402

Points of Contacts
Electronic Business
Title PRIMARY POC
Name PEGGY LAUER
Role ADMINISTRATOR
Address 402 S CENTER, DURAND, IL, 61024, 9590, USA
Title ALTERNATE POC
Name DAWN JOHNSON
Address 402 S CENTER, DURAND, IL, 61024, 9590, USA
Government Business
Title PRIMARY POC
Name PEGGY LAUER
Role ADMINTRATOR
Address 402 S CENTER, DURAND, IL, 61024, 9590, USA
Title ALTERNATE POC
Name LORI HIGGS
Role FINANCIAL CONTROLLER
Address 402 S CENTER, DURAND, IL, 61024, 9590, USA
Past Performance
Title PRIMARY POC
Name PEGGY LAUER
Address 402 S CENTER, DURAND, IL, 61024, 9590, USA
Title ALTERNATE POC
Name LORI HIGGS
Role FINANCIAL CONTROLLER
Address 402 S CENTER, DURAND, IL, 61024, USA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MEDINA MANOR'S 401(K) RETIREMENT PLAN 2023 362887017 2024-06-03 MEDINA NURSING CENTER, INC. 59
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 8152482151
Plan sponsor’s address 402 SOUTH CENTER STREET, DURAND, IL, 61024

Signature of
Role Plan administrator
Date 2024-06-03
Name of individual signing PEGGY LAUER
Valid signature Filed with authorized/valid electronic signature
MEDINA MANOR'S 401(K) RETIREMENT PLAN 2022 362887017 2023-09-07 MEDINA NURSING CENTER, INC. 57
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 8152482151
Plan sponsor’s address 402 SOUTH CENTER STREET, DURAND, IL, 61024

Signature of
Role Plan administrator
Date 2023-09-07
Name of individual signing PEGGY LAUER
Valid signature Filed with authorized/valid electronic signature
MEDINA MANOR'S 401(K) RETIREMENT PLAN 2021 362887017 2022-03-14 MEDINA NURSING CENTER, INC. 59
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 8152482151
Plan sponsor’s address 402 SOUTH CENTER STREET, DURAND, IL, 61024
MEDINA MANOR'S 401(K) RETIREMENT PLAN 2020 362887017 2021-06-02 MEDINA NURSING CENTER, INC. 63
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 8152482151
Plan sponsor’s address 402 SOUTH CENTER STREET, DURAND, IL, 61024
MEDINA MANOR'S 401(K) RETIREMENT PLAN 2019 362887017 2020-07-08 MEDINA NURSING CENTER, INC. 73
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 8152482151
Plan sponsor’s address 402 SOUTH CENTER STREET, DURAND, IL, 61024
MEDINA MANOR'S 401(K) RETIREMENT PLAN 2018 362887017 2019-07-10 MEDINA NURSING CENTER, INC. 73
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 8152482151
Plan sponsor’s address 402 SOUTH CENTER STREET, DURAND, IL, 61024

Signature of
Role Plan administrator
Date 2019-07-10
Name of individual signing HOLGEIR OKSNEVAD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-07-10
Name of individual signing HOLGEIR OKSNEVAD
Valid signature Filed with authorized/valid electronic signature
MEDINA MANOR'S 401(K) RETIREMENT PLAN 2017 362887017 2018-05-03 MEDINA NURSING CENTER, INC. 69
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 8152482151
Plan sponsor’s address 402 SOUTH CENTER STREET, DURAND, IL, 61024

Signature of
Role Plan administrator
Date 2018-05-03
Name of individual signing HOLGEIR OKSNEVAD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-05-03
Name of individual signing HOLGEIR OKSNEVAD
Valid signature Filed with authorized/valid electronic signature
MEDINA MANOR'S 401(K) RETIREMENT PLAN 2016 362887017 2017-06-07 MEDINA NURSING CENTER, INC. 75
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 8152482151
Plan sponsor’s address 402 SOUTH CENTER STREET, DURAND, IL, 61024

Signature of
Role Plan administrator
Date 2017-06-07
Name of individual signing HOLGEIR OKSNEVAD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-06-07
Name of individual signing HOLGEIR OKSNEVAD
Valid signature Filed with authorized/valid electronic signature
MEDINA MANOR'S 401(K) RETIREMENT PLAN 2015 362887017 2016-06-20 MEDINA NURSING CENTER, INC. 76
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 8152482151
Plan sponsor’s address 402 SOUTH CENTER STREET, DURAND, IL, 61024

Signature of
Role Plan administrator
Date 2016-06-20
Name of individual signing HOLGEIR OKSNEVAD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-06-20
Name of individual signing HOLGEIR OKSNEVAD
Valid signature Filed with authorized/valid electronic signature
MEDINA MANOR'S 401(K) RETIREMENT PLAN 2014 362887017 2015-05-08 MEDINA NURSING CENTER, INC. 75
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 8152482151
Plan sponsor’s address 402 SOUTH CENTER STREET, DURAND, IL, 61024

Signature of
Role Plan administrator
Date 2015-05-08
Name of individual signing HOLGEIR OKSNEVAD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-05-08
Name of individual signing HOLGEIR OKSNEVAD
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
HOLGEIR J OKSNEVAD, 402 SOUTH CENTER ST, DURAND, 61024, WINNEBAGO Agent 2010-11-24

President

Name and Address Role
HOLGEIR J OSKNEVAD, 1405 OTTERCREEK DR DURAND 61024 President

Secretary

Name and Address Role
HOLGEIR J OKSNEVAD Secretary

Assumed Names

Name Type Effective Date Cancellation Date Cancellation Type Last Renewal Date
MEDINA NURSING & REHAB Assume Name 2020-08-31 No data No data No data
THERAPY FIRST BY MEDINA Assume Name 2010-06-29 No data No data No data
CNA FIRST BY MEDINA No data 2010-06-29 2012-10-09 Voluntary Cancellation No data
CNA FIRST No data 2009-06-22 2010-06-29 Voluntary Cancellation No data
MEDINA MANOR Assume Name 2005-11-16 No data No data No data

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMM No data Voting Rights 100000 1000000 1

OSHA's Inspections within Industry

Inspection Nr Report ID Date Opened Site Address
122108624 0521400 1994-08-03 402 SOUTH CENTER, DURAND, IL, 61024
Inspection Type Unprog Rel
Scope Partial
Safety/Health Health
Close Conference 1994-08-03
Case Closed 1994-09-12

Related Activity
Type Inspection
Activity Nr 122106180

Violation Items
Citation ID 01001
Citaton Type Other
Standard Cited 19101200 E01
Issuance Date 1994-08-10
Abatement Due Date 1994-09-12
Nr Instances 1
Nr Exposed 20
Gravity 01
Citation ID 01002
Citaton Type Other
Standard Cited 19101200 H
Issuance Date 1994-08-10
Abatement Due Date 1994-09-12
Nr Instances 1
Nr Exposed 20
Gravity 01

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
5261377001 2020-04-05 0507 PPP 402 S CENTER ST, DURAND, IL, 61024-9590
Loan Status Date 2020-12-10
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 714200
Loan Approval Amount (current) 714200
Undisbursed Amount 0
Franchise Name -
Lender Location ID 124041
Servicing Lender Name State Bank
Servicing Lender Address 1718 S Dirck Dr, FREEPORT, IL, 61032-6707
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address DURAND, WINNEBAGO, IL, 61024-9590
Project Congressional District IL-16
Number of Employees 102
NAICS code 623110
Borrower Race White
Borrower Ethnicity Unknown/NotStated
Business Type Subchapter S Corporation
Originating Lender ID 124041
Originating Lender Name State Bank
Originating Lender Address FREEPORT, IL
Gender Male Owned
Veteran Veteran
Forgiveness Amount 718247.13
Forgiveness Paid Date 2020-11-05
2156348309 2021-01-20 0507 PPS 402 S Center St, Durand, IL, 61024-9590
Loan Status Date 2021-11-10
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 720044
Loan Approval Amount (current) 720044
Undisbursed Amount 0
Franchise Name -
Lender Location ID 21176
Servicing Lender Name State Bank of Davis
Servicing Lender Address 100 Rte 75, DAVIS, IL, 61019
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Durand, WINNEBAGO, IL, 61024-9590
Project Congressional District IL-16
Number of Employees 102
NAICS code 623110
Borrower Race White
Borrower Ethnicity Unknown/NotStated
Business Type Subchapter S Corporation
Originating Lender ID 21176
Originating Lender Name State Bank of Davis
Originating Lender Address DAVIS, IL
Gender Male Owned
Veteran Veteran
Forgiveness Amount 725324.32
Forgiveness Paid Date 2021-10-20

U.S. Small Business Administration Profile

Status User ID Name of Firm Trade Name UEI Address
Active P1659508 MEDINA NURSING CENTER INC - GKDXDC4EEGP3 402 S CENTER ST, DURAND, IL, 61024-9590
Capabilities Statement Link -
Phone Number 815-306-8051
Fax Number 815-306-8051
E-mail Address plauer@medinafirst.com
WWW Page -
E-Commerce Website -
Contact Person PEGGY LAUER
County Code (3 digit) 201
Congressional District 16
Metropolitan Statistical Area 6880
CAGE Code 6REZ8
Year Established 1965
Accepts Government Credit Card Yes
Legal Structure Corporation
Ownership and Self-Certifications -
Business Development Servicing Office ILLINOIS DISTRICT OFFICE (SBA office code 0507)
Capabilities Narrative (none given)
Special Equipment/Materials (none given)
Business Type Percentages (none given)
Keywords (none given)
Quality Assurance Standards (none given)
Electronic Data Interchange capable -

SBA Federal Certifications
HUBZone Certified No
Women Owned Certified No
Women Owned Pending No
Economically Disadvantaged Women Owned Certified No
Economically Disadvantaged Women Owned Pending No
Veteran-Owned Small Business Certified No
Veteran-Owned Small Business Joint Venture No
Service-Disabled Veteran-Owned Small Business Certified No
Service-Disabled Veteran-Owned Small Business Joint Venture No

Bonding Levels
Description Construction Bonding Level (per contract)
Level (none given)
Description Construction Bonding Level (aggregate)
Level (none given)
Description Service Bonding Level (per contract)
Level (none given)
Description Service Bonding Level (aggregate)
Level (none given)

NAICS Codes with Size Determinations by NAICS
Primary Yes
Code 623110
NAICS Code's Description Nursing Care Facilities (Skilled Nursing Facilities)
Small Yes

Export Profile (Trade Mission Online)
Exporter Firm hasn't answered this question yet
Export Business Activities (none given)
Exporting to (none given)
Desired Export Business Relationships (none given)
Description of Export Objective(s) (none given)

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 13 Mar 2025

Sources: Illinois Office of the Secretary of State

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