Skilled nursing facility · CMS certification number 035277

HAVEN OF LAKESIDE

LAKESIDE, Arizona · Medicare and Medicaid

Certified beds, as filed in Care Compare: 112

A CSV file of this facility’s record: its name and location, its Medicare cost-report finances year by year, its ownership, its inspections, deficiencies and penalties, and the Care Compare provider information — each figure with the worksheet, line and column or file it came from.

In Care Compare’s provider information: Penalties: 1 · Fines: 1 · Fines, total amount: $8,278.00 · Payment denials: 0. The most recent penalty on file: June 11, 2025, Fine, $8,278. Every penalty on file ↓

For this facility: the citable document with full history — $295 · an email when this record changes — $99/month

Finances, as filed

From this facility’s Medicare cost reports on form CMS-2540, each figure with the worksheet, line and column it was read from.

Cost report for January 1, 2024 to December 31, 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on December 5, 2025.

Revenue and expenses, fiscal year 2024
Figure	As filed	Where it comes from
Total patient revenue	$19,774,172	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$6,916,157	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$12,858,015	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$11,293,364	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$1,564,651	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$10,084	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$1,574,735	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $1,574,735 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2024
Figure	As filed	Where it comes from
Total facility beds, all components	112	CMS-2540-10 worksheet S300001 line 800 column 100
Bed days available, all components	40,992	CMS-2540-10 worksheet S300001 line 800 column 200
Medicare (Title XVIII) patient days	4,821	CMS-2540-10 worksheet S300001 line 800 column 400
Medicaid (Title XIX) patient days	21,521	CMS-2540-10 worksheet S300001 line 800 column 500
Other-payer patient days	8,121	CMS-2540-10 worksheet S300001 line 800 column 600
Total patient days, all components	34,463	CMS-2540-10 worksheet S300001 line 800 column 700
Medicare discharges	147	CMS-2540-10 worksheet S300001 line 800 column 900
Medicaid discharges	168	CMS-2540-10 worksheet S300001 line 800 column 1000
Other-payer discharges	240	CMS-2540-10 worksheet S300001 line 800 column 1100
Total discharges, all components	555	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	32.8	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	128.1	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	62.1	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1443699, read from the public cost report file SNF10FY2024.zip.

Fiscal year 2023, ended December 31, 2023

Cost report for January 1, 2023 to December 31, 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on April 22, 2025.

Revenue and expenses, fiscal year 2023
Figure	As filed	Where it comes from
Total patient revenue	$17,650,368	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$5,754,784	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$11,895,584	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$10,466,137	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$1,429,447	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$19,996	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$1,449,443	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $1,449,443 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2023
Figure	As filed	Where it comes from
Total facility beds, all components	112	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	31,849	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	421	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	34.57	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	260.78	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	75.65	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1419758, read from the public cost report file SNF10FY2023.zip.

Fiscal year 2022, ended December 31, 2022

Cost report for January 1, 2022 to December 31, 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on September 9, 2023.

Revenue and expenses, fiscal year 2022
Figure	As filed	Where it comes from
Total patient revenue	$15,301,325	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$5,105,317	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$10,196,008	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$8,866,158	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$1,329,850	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$3,195	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$1,333,045	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $1,333,045 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2022
Figure	As filed	Where it comes from
Total facility beds, all components	112	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	28,838	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	494	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	26.31	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	242.21	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	58.38	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1363869, read from the public cost report file SNF10FY2022.zip.

Fiscal year 2021, ended December 31, 2021

Cost report for January 1, 2021 to December 31, 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on September 16, 2022.

Revenue and expenses, fiscal year 2021
Figure	As filed	Where it comes from
Total patient revenue	$12,687,684	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$4,190,047	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$8,497,637	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$7,951,741	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$545,896	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$466,012	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$1,011,908	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $1,011,908 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2021
Figure	As filed	Where it comes from
Total facility beds, all components	112	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	24,782	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	312	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	33.51	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	346.45	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	79.43	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1332096, read from the public cost report file SNF10FY2021.zip.

Fiscal year 2020, ended December 31, 2020

Cost report for January 1, 2020 to December 31, 2020 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on February 15, 2023.

Revenue and expenses, fiscal year 2020
Figure	As filed	Where it comes from
Total patient revenue	$9,173,951	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$1,525,828	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$7,648,123	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$7,911,616	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$263,493	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$709,573	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$446,080	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $446,080 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2020
Figure	As filed	Where it comes from
Total facility beds, all components	112	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	26,980	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	196	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	28.68	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	258.9	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	137.65	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1342435, read from the public cost report file SNF10FY2020.zip.

Fiscal year 2019, ended December 31, 2019

Cost report for January 1, 2019 to December 31, 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on January 13, 2022.

Revenue and expenses, fiscal year 2019
Figure	As filed	Where it comes from
Total patient revenue	$11,333,353	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$2,001,046	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$9,332,307	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$8,930,200	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$402,107	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$113,944	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$516,051	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $516,051 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2019
Figure	As filed	Where it comes from
Total facility beds, all components	112	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	33,059	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	281	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	28.9	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	424.15	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	117.65	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1308809, read from the public cost report file SNF10FY2019.zip.

Fiscal year 2018, ended December 31, 2018

Cost report for January 1, 2018 to December 31, 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on July 28, 2020.

Revenue and expenses, fiscal year 2018
Figure	As filed	Where it comes from
Total patient revenue	$11,606,933	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$2,339,156	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$9,267,777	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$8,764,677	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$503,100	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$1,651	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$504,751	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $504,751 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2018
Figure	As filed	Where it comes from
Total facility beds, all components	112	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	35,117	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	277	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	31.62	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	412.8	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	126.78	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1261563, read from the public cost report file SNF10FY2018.zip.

Fiscal year 2017, ended December 31, 2017

Cost report for January 1, 2017 to December 31, 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on August 21, 2018.

Revenue and expenses, fiscal year 2017
Figure	As filed	Where it comes from
Total patient revenue	$10,106,044	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$2,085,028	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$8,021,016	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$8,072,832	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$51,816	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$375	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$51,441	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$51,441 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2017
Figure	As filed	Where it comes from
Total facility beds, all components	112	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	31,899	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	300	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	29.3	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	272.28	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	106.33	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1208295, read from the public cost report file SNF10FY2017.zip.

Fiscal year 2016, ended December 31, 2016

Cost report for January 1, 2016 to December 31, 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on August 25, 2017.

Revenue and expenses, fiscal year 2016
Figure	As filed	Where it comes from
Total patient revenue	$8,467,027	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$1,910,201	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$6,556,826	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$6,586,258	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$29,432	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$15,555	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$13,877	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$13,877 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2016
Figure	As filed	Where it comes from
Total facility beds, all components	112	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	28,458	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	369	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	20.69	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	156.62	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	77.12	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1174923, read from the public cost report file SNF10FY2016.zip.

Fiscal year 2015, ended February 28, 2015

Cost report for January 1, 2015 to February 28, 2015 — a reporting period of 58 days, not a full year, on form CMS-2540-10, settled, processed by CMS on October 19, 2016.

Revenue and expenses, fiscal year 2015
Figure	As filed	Where it comes from
Total patient revenue	$1,236,651	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$294,162	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$942,489	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$1,074,792	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$132,303	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$13,610	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$118,693	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$118,693 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2015
Figure	As filed	Where it comes from
Total facility beds, all components	112	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	4,944	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	40	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	42.54	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	123.6	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1144784, read from the public cost report file SNF10FY2015.zip.

Fiscal year 2014, ended December 31, 2014

Cost report for January 1, 2014 to December 31, 2014 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on May 26, 2016.

Revenue and expenses, fiscal year 2014
Figure	As filed	Where it comes from
Total patient revenue	$11,137,961	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$3,855,726	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$7,282,235	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$8,349,161	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$1,066,926	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$566,112	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$500,814	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$500,814 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2014
Figure	As filed	Where it comes from
Total facility beds, all components	112	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	35,553	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	318	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	36.74	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	111.8	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1124854, read from the public cost report file SNF10FY2014.zip.

Fiscal year 2013, ended December 31, 2013

Cost report for January 1, 2013 to December 31, 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on October 15, 2015.

Revenue and expenses, fiscal year 2013
Figure	As filed	Where it comes from
Total patient revenue	$10,300,481	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$3,544,673	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$6,755,808	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$7,628,413	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$872,605	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$223,604	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$649,001	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$649,001 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2013
Figure	As filed	Where it comes from
Total facility beds, all components	112	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	33,463	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	339	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	33.11	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	98.71	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1111374, read from the public cost report file SNF10FY2013.zip.

Fiscal year 2012, ended December 31, 2012

Cost report for January 1, 2012 to December 31, 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on November 21, 2014.

Revenue and expenses, fiscal year 2012
Figure	As filed	Where it comes from
Total patient revenue	$10,761,179	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$4,420,269	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$6,340,910	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$7,695,597	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$1,354,687	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$509,892	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$844,795	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$844,795 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2012
Figure	As filed	Where it comes from
Total facility beds, all components	112	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	31,272	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	380	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	31.53	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	82.29	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1080791, read from the public cost report file SNF10FY2012.zip.

Fiscal year 2011, ended December 31, 2011

Cost report for January 1, 2011 to December 31, 2011 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on August 30, 2013.

Revenue and expenses, fiscal year 2011
Figure	As filed	Where it comes from
Total patient revenue	$6,403,399	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$1,267,638	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$5,135,761	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$7,385,662	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$2,249,901	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$128,970	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$2,120,931	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$2,120,931 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2011
Figure	As filed	Where it comes from
Total facility beds, all components	112	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	24,745	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	329	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	29.25	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	75.21	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1047606, read from the public cost report file SNF10FY2011.zip.

Fiscal year 2010, ended December 31, 2010

Cost report for November 2, 2010 to December 31, 2010 — a reporting period of 59 days, not a full year, on form CMS-2540-96, settled, processed by CMS on August 29, 2011.

Revenue and expenses, fiscal year 2010
Figure	As filed	Where it comes from
Net patient revenue	$270,358	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$923,426	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	−$653,068	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$7,063	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income: −$646,005 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.

Beds, days and discharges, fiscal year 2010
Figure	As filed	Where it comes from
Total facility beds, all components	112	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	1,147	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	22	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	42.13	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, all patients, in days	52.14	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 416495, read from the public cost report file SNFFY2011.zip.

Nurse staffing

Nurse staffing hours from the Payroll-Based Journal, quarter by quarter, are on this facility’s staffing page, each quarter with the file it came from.

The staffing record →

Ownership, as filed with CMS

Care Compare

As filed in the CMS file dated September 1, 2026 (Care Compare ownership).

Owner or manager	Role	Type	Ownership percentage	Association
HAVEN HEALTH PROPERTIES LLC	5% OR GREATER MORTGAGE INTEREST	Organization	NOT APPLICABLE	since 03/01/2015
HAVEN LAKESIDE REAL ESTATE LLC	5% OR GREATER MORTGAGE INTEREST	Organization	NOT APPLICABLE	since 03/01/2015
CLARK GLOBALMED, LLC	ADP OF THE SNF	Organization	NOT APPLICABLE	since 01/13/2025
CLARK, RANDOLPH	ADP OF THE SNF	Individual	NOT APPLICABLE	since 03/01/2015
ESPINOSA, STEPHANIE	ADP OF THE SNF	Individual	NOT APPLICABLE	since 01/13/2025
FAIR, RYAN	ADP OF THE SNF	Individual	NOT APPLICABLE	since 08/21/2019
FRAGOSO, LINDSAY	ADP OF THE SNF	Individual	NOT APPLICABLE	since 01/13/2025
HANSEN, CALEB	ADP OF THE SNF	Individual	NOT APPLICABLE	since 06/23/2020
HAVEN HEALTH PROPERTIES LLC	ADP OF THE SNF	Organization	NOT APPLICABLE	since 11/25/2024
HAVEN LAKESIDE REAL ESTATE LLC	ADP OF THE SNF	Organization	NOT APPLICABLE	since 11/26/2024
HEALTH GROUP MANAGEMENT LLC	ADP OF THE SNF	Organization	NOT APPLICABLE	since 11/25/2024
LONGHURST, STOCK	ADP OF THE SNF	Individual	NOT APPLICABLE	since 11/15/2020
ROBERTSON, BRETT	ADP OF THE SNF	Individual	NOT APPLICABLE	since 01/13/2025
SAMUELIAN, ROBERT	ADP OF THE SNF	Individual	NOT APPLICABLE	since 01/13/2025
SAMUELIAN, SPENCER	ADP OF THE SNF	Individual	NOT APPLICABLE	since 01/13/2025
SAMUELIAN, STEPHEN	ADP OF THE SNF	Individual	NOT APPLICABLE	since 01/13/2025
SEASTRAND, JASON	ADP OF THE SNF	Individual	NOT APPLICABLE	since 03/01/2015
WEST, CHRISTIAN	ADP OF THE SNF	Individual	NOT APPLICABLE	since 01/13/2025
ESPINOSA, STEPHANIE	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 10/14/2024
FRAGOSO, LINDSAY	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 05/10/2021
ROBERTSON, BRETT	DIRECT OWNERSHIP INTEREST	Individual	NOT APPLICABLE	since 03/01/2015
SAMUELIAN, ROBERT	DIRECT OWNERSHIP INTEREST	Individual	NOT APPLICABLE	since 03/01/2015
SAMUELIAN, SPENCER	DIRECT OWNERSHIP INTEREST	Individual	NOT APPLICABLE	since 03/01/2015
SAMUELIAN, STEPHEN	DIRECT OWNERSHIP INTEREST	Individual	NOT APPLICABLE	since 03/01/2015
SEASTRAND, JASON	DIRECT OWNERSHIP INTEREST	Individual	NOT APPLICABLE	since 03/01/2015
WEST, CHRISTIAN	DIRECT OWNERSHIP INTEREST	Individual	NOT APPLICABLE	since 03/01/2015
CLARK GLOBALMED, LLC	OPERATIONAL/MANAGERIAL CONTROL	Organization	NOT APPLICABLE	since 01/13/2025
CLARK, RANDOLPH	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 03/01/2015
ESPINOSA, STEPHANIE	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 01/13/2025
FAIR, RYAN	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 08/21/2019
FRAGOSO, LINDSAY	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 01/13/2025
HANSEN, CALEB	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 06/20/2023
HEALTH GROUP MANAGEMENT LLC	OPERATIONAL/MANAGERIAL CONTROL	Organization	NOT APPLICABLE	since 11/25/2024
LONGHURST, STOCK	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 11/15/2020
ROBERTSON, BRETT	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 01/13/2025
SAMUELIAN, ROBERT	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 01/13/2025
SAMUELIAN, SPENCER	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 01/13/2025
SAMUELIAN, STEPHEN	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 01/13/2025
SEASTRAND, JASON	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 03/01/2015
WEST, CHRISTIAN	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 01/13/2025

Medicare enrollment

As filed in the CMS file dated August 1, 2026 (Medicare enrollment ownership), under the enrollment of HAVEN OF LAKESIDE LLC (enrollment ID O20150506002578).

CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; where the private equity, real estate investment trust or holding company field below has not been filed under the current cycle, it reads “Paused by CMS”.

Owner	Individual or organization	Role	Ownership percentage	Association date	Described in the filing as
BRETT P ROBERTSON	Individual	5% OR GREATER DIRECT OWNERSHIP INTEREST	7.61	2/1/2015	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
CHRISTIAN R WEST	Individual	5% OR GREATER DIRECT OWNERSHIP INTEREST	6.4	3/1/2015	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
HAVEN HEALTH GROUP LLC	Organization	5% OR GREATER DIRECT OWNERSHIP INTEREST	100	3/1/2015	Private equity company: No Real estate investment trust: No Holding company: No
ROBERT SAMUELIAN	Individual	5% OR GREATER DIRECT OWNERSHIP INTEREST	20.13	3/1/2015	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
SPENCER R SAMUELIAN	Individual	5% OR GREATER DIRECT OWNERSHIP INTEREST	25.21	3/1/2015	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
STEPHEN SAMUELIAN	Individual	5% OR GREATER DIRECT OWNERSHIP INTEREST	36.73	3/1/2015	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
HAVEN HEALTH PROPERTIES LLC	Organization	5% OR GREATER MORTGAGE INTEREST	100	3/1/2015	Private equity company: No Real estate investment trust: No Holding company: No
HAVEN LAKESIDE REAL ESTATE LLC	Organization	5% OR GREATER MORTGAGE INTEREST	100	3/1/2015	Private equity company: No Real estate investment trust: No Holding company: No
BRETT P ROBERTSON	Individual	ADP OF THE SNF	Not stated in the filing	1/13/2025	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
CALEB HANSEN	Individual	ADP OF THE SNF	Not stated in the filing	6/23/2020	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
CHRISTIAN R WEST	Individual	ADP OF THE SNF	Not stated in the filing	1/13/2025	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
CLARK GLOBALMED, LLC	Organization	ADP OF THE SNF	Not stated in the filing	1/13/2025	Private equity company: No Real estate investment trust: No Holding company: No
HAVEN HEALTH PROPERTIES LLC	Organization	ADP OF THE SNF	Not stated in the filing	11/25/2024	Private equity company: No Real estate investment trust: No Holding company: No
HAVEN LAKESIDE REAL ESTATE LLC	Organization	ADP OF THE SNF	Not stated in the filing	11/26/2024	Private equity company: No Real estate investment trust: No Holding company: No
HEALTH GROUP MANAGEMENT LLC	Organization	ADP OF THE SNF	Not stated in the filing	11/25/2024	Private equity company: No Real estate investment trust: No Holding company: No
JASON J SEASTRAND	Individual	ADP OF THE SNF	Not stated in the filing	3/1/2015	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
LINDSAY FRAGOSO	Individual	ADP OF THE SNF	Not stated in the filing	1/13/2025	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
RANDOLPH CLARK	Individual	ADP OF THE SNF	Not stated in the filing	3/1/2015	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
ROBERT SAMUELIAN	Individual	ADP OF THE SNF	Not stated in the filing	1/13/2025	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
RYAN FAIR	Individual	ADP OF THE SNF	Not stated in the filing	8/21/2019	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
SPENCER R SAMUELIAN	Individual	ADP OF THE SNF	Not stated in the filing	1/13/2025	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
STEPHANIE ESPINOSA	Individual	ADP OF THE SNF	Not stated in the filing	1/13/2025	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
STEPHEN SAMUELIAN	Individual	ADP OF THE SNF	Not stated in the filing	1/13/2025	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
STOCK LONGHURST	Individual	ADP OF THE SNF	Not stated in the filing	11/15/2020	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
LINDSAY FRAGOSO	Individual	CORPORATE OFFICER	0	5/10/2021	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
STEPHANIE ESPINOSA	Individual	CORPORATE OFFICER	0	10/14/2024	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
BRETT P ROBERTSON	Individual	DIRECT OWNERSHIP INTEREST	7.61	3/1/2015	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
CHRISTIAN R WEST	Individual	DIRECT OWNERSHIP INTEREST	6.4	3/1/2015	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
JASON J SEASTRAND	Individual	DIRECT OWNERSHIP INTEREST	3.92	3/1/2015	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
ROBERT SAMUELIAN	Individual	DIRECT OWNERSHIP INTEREST	20.13	3/1/2015	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
SPENCER R SAMUELIAN	Individual	DIRECT OWNERSHIP INTEREST	25.21	3/1/2015	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
STEPHEN SAMUELIAN	Individual	DIRECT OWNERSHIP INTEREST	36.73	3/1/2015	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
BRETT P ROBERTSON	Individual	OPERATIONAL/MANAGERIAL CONTROL	Not stated in the filing	1/13/2025	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
CALEB HANSEN	Individual	OPERATIONAL/MANAGERIAL CONTROL	Not stated in the filing	6/20/2023	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
CHRISTIAN R WEST	Individual	OPERATIONAL/MANAGERIAL CONTROL	Not stated in the filing	1/13/2025	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
CLARK GLOBALMED, LLC	Organization	OPERATIONAL/MANAGERIAL CONTROL	Not stated in the filing	1/13/2025	Private equity company: No Real estate investment trust: No Holding company: No
HEALTH GROUP MANAGEMENT LLC	Organization	OPERATIONAL/MANAGERIAL CONTROL	Not stated in the filing	11/25/2024	Private equity company: No Real estate investment trust: No Holding company: No
JASON J SEASTRAND	Individual	OPERATIONAL/MANAGERIAL CONTROL	Not stated in the filing	3/1/2015	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
LINDSAY FRAGOSO	Individual	OPERATIONAL/MANAGERIAL CONTROL	Not stated in the filing	1/13/2025	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
RANDOLPH CLARK	Individual	OPERATIONAL/MANAGERIAL CONTROL	Not stated in the filing	3/1/2015	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
ROBERT SAMUELIAN	Individual	OPERATIONAL/MANAGERIAL CONTROL	Not stated in the filing	1/13/2025	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
RYAN FAIR	Individual	OPERATIONAL/MANAGERIAL CONTROL	Not stated in the filing	8/21/2019	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
SPENCER R SAMUELIAN	Individual	OPERATIONAL/MANAGERIAL CONTROL	Not stated in the filing	1/13/2025	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
STEPHANIE ESPINOSA	Individual	OPERATIONAL/MANAGERIAL CONTROL	Not stated in the filing	1/13/2025	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
STEPHEN SAMUELIAN	Individual	OPERATIONAL/MANAGERIAL CONTROL	Not stated in the filing	1/13/2025	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
STOCK LONGHURST	Individual	OPERATIONAL/MANAGERIAL CONTROL	Not stated in the filing	11/15/2020	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS

Changes in ownership

May 1, 2025: JASON J SEASTRAND no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: DONNA L MUDER no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: TRENT CUNNINGHAM no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: CHRISTIAN R WEST (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: CHRISTIAN R WEST (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: HEALTH GROUP MANAGEMENT LLC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since November 25, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: HEALTH GROUP MANAGEMENT LLC (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since November 25, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: STOCK LONGHURST (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since November 15, 2020. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: STOCK LONGHURST (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since November 15, 2020. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: BRETT P ROBERTSON (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since March 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: BRETT P ROBERTSON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: BRETT P ROBERTSON (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: LINDSAY FRAGOSO (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: LINDSAY FRAGOSO (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: LINDSAY FRAGOSO (CORPORATE OFFICER) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since May 10, 2021. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: JASON J SEASTRAND (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since March 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: JASON J SEASTRAND (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since March 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: JASON J SEASTRAND (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since March 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: RANDOLPH CLARK (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since March 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: RANDOLPH CLARK (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since March 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: STEPHANIE ESPINOSA (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: STEPHANIE ESPINOSA (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: STEPHANIE ESPINOSA (CORPORATE OFFICER) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since October 14, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: SPENCER R SAMUELIAN (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since March 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: SPENCER R SAMUELIAN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: SPENCER R SAMUELIAN (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: CLARK GLOBALMED, LLC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: CLARK GLOBALMED, LLC (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: ROBERT SAMUELIAN (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since March 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: ROBERT SAMUELIAN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: ROBERT SAMUELIAN (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: RYAN FAIR (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since August 21, 2019. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: RYAN FAIR (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since August 21, 2019. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: STEPHEN SAMUELIAN (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since March 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: STEPHEN SAMUELIAN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: STEPHEN SAMUELIAN (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: CALEB HANSEN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since June 23, 2020. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: CALEB HANSEN (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since June 20, 2023. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: HAVEN LAKESIDE REAL ESTATE LLC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since November 26, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: HAVEN LAKESIDE REAL ESTATE LLC (5% OR GREATER MORTGAGE INTEREST) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since March 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: HAVEN HEALTH PROPERTIES LLC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since November 25, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: HAVEN HEALTH PROPERTIES LLC (5% OR GREATER MORTGAGE INTEREST) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since March 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: CHRISTIAN R WEST (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since March 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv

Recent changes on this record

December 5, 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
May 1, 2025: JASON J SEASTRAND no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: DONNA L MUDER no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: TRENT CUNNINGHAM no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: CHRISTIAN R WEST (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: CHRISTIAN R WEST (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: HEALTH GROUP MANAGEMENT LLC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since November 25, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: HEALTH GROUP MANAGEMENT LLC (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since November 25, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: STOCK LONGHURST (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since November 15, 2020. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: STOCK LONGHURST (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since November 15, 2020. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: BRETT P ROBERTSON (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since March 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: BRETT P ROBERTSON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: BRETT P ROBERTSON (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: LINDSAY FRAGOSO (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: LINDSAY FRAGOSO (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: LINDSAY FRAGOSO (CORPORATE OFFICER) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since May 10, 2021. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: JASON J SEASTRAND (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since March 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: JASON J SEASTRAND (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since March 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: JASON J SEASTRAND (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since March 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: RANDOLPH CLARK (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since March 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: RANDOLPH CLARK (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since March 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: STEPHANIE ESPINOSA (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: STEPHANIE ESPINOSA (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: STEPHANIE ESPINOSA (CORPORATE OFFICER) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since October 14, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: SPENCER R SAMUELIAN (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since March 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: SPENCER R SAMUELIAN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: SPENCER R SAMUELIAN (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: CLARK GLOBALMED, LLC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: CLARK GLOBALMED, LLC (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: ROBERT SAMUELIAN (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since March 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: ROBERT SAMUELIAN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: ROBERT SAMUELIAN (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: RYAN FAIR (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since August 21, 2019. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: RYAN FAIR (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since August 21, 2019. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: STEPHEN SAMUELIAN (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since March 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: STEPHEN SAMUELIAN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: STEPHEN SAMUELIAN (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since January 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: CALEB HANSEN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since June 23, 2020. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: CALEB HANSEN (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since June 20, 2023. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
May 1, 2025: HAVEN LAKESIDE REAL ESTATE LLC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2025; associated with this enrollment since November 26, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv

Inspections

Inspection cycle	Health inspection	Fire safety inspection	Health deficiencies	Fire safety deficiencies
1	November 19, 2025	November 19, 2025	19	2
2	June 6, 2024	June 6, 2024	15	2
3	December 8, 2022	December 8, 2022	14	0

From the Care Compare inspection summary file NH_SurveySummary_Sep2026_2.csv, processed on September 1, 2026.

Deficiencies cited

48 deficiencies on file, newest inspection first

Inspection date	Inspection type	Tag	Category	What was cited	Scope and severity	Complaint	Corrected	Correction date
January 27, 2026	Health	F 0686	Quality of Life and Care Deficiencies	Provide appropriate pressure ulcer care and prevent new ulcers from developing.	D	Yes	Deficient, Provider has date of correction	March 1, 2026
January 27, 2026	Health	F 0842	Resident Assessment and Care Planning Deficiencies	Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.	D	Yes	Deficient, Provider has date of correction	March 1, 2026
January 21, 2026	Health	F 0607	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Develop and implement policies and procedures to prevent abuse, neglect, and theft.	D	Yes	Deficient, Provider has date of correction	March 1, 2026
January 21, 2026	Health	F 0609	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.	D	Yes	Deficient, Provider has date of correction	March 1, 2026
January 21, 2026	Health	F 0610	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Respond appropriately to all alleged violations.	D	Yes	Deficient, Provider has date of correction	March 1, 2026
November 19, 2025	Health	F 0578	Resident Rights Deficiencies	Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.	D	No	Deficient, Provider has date of correction	December 5, 2025
November 19, 2025	Health	F 0645	Resident Assessment and Care Planning Deficiencies	PASARR screening for Mental disorders or Intellectual Disabilities	D	No	Deficient, Provider has date of correction	December 5, 2025
November 19, 2025	Health	F 0658	Resident Assessment and Care Planning Deficiencies	Ensure services provided by the nursing facility meet professional standards of quality.	E	No	Deficient, Provider has date of correction	December 5, 2025
November 19, 2025	Health	F 0680	Quality of Life and Care Deficiencies	Ensure the activities program is directed by a qualified professional.	E	No	Deficient, Provider has date of correction	December 5, 2025
November 19, 2025	Health	F 0684	Quality of Life and Care Deficiencies	Provide appropriate treatment and care according to orders, resident’s preferences and goals.	D	No	Deficient, Provider has date of correction	December 5, 2025
November 19, 2025	Health	F 0688	Quality of Life and Care Deficiencies	Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.	D	No	Deficient, Provider has date of correction	December 5, 2025
November 19, 2025	Health	F 0732	Nursing and Physician Services Deficiencies	Post nurse staffing information every day.	E	No	Deficient, Provider has date of correction	December 5, 2025
November 19, 2025	Health	F 0759	Pharmacy Service Deficiencies	Ensure medication error rates are not 5 percent or greater.	E	No	Deficient, Provider has date of correction	December 5, 2025
November 19, 2025	Health	F 0761	Pharmacy Service Deficiencies	Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.	D	No	Deficient, Provider has date of correction	December 5, 2025
November 19, 2025	Health	F 0940	Administration Deficiencies	Develop, implement, and/or maintain an effective training program for all new and existing staff members.	E	No	Deficient, Provider has date of correction	December 5, 2025
November 19, 2025	Health	F 0942	Resident Rights Deficiencies	Ensure that staff members are educated on resident rights and facility responsibilities to properly care for its residents.	E	No	Deficient, Provider has date of correction	December 5, 2025
November 19, 2025	Health	F 0943	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.	E	No	Deficient, Provider has date of correction	December 5, 2025
November 19, 2025	Health	F 0945	Infection Control Deficiencies	Include as part of its infection prevention and control program, mandatory training that includes written standards, policies, and procedures for the program.	D	No	Deficient, Provider has date of correction	December 5, 2025
November 19, 2025	Health	F 0949	Administration Deficiencies	Provide behavior health training consistent with the requirements and as determined by a facility assessment.	D	No	Deficient, Provider has date of correction	December 5, 2025
July 16, 2025	Health	F 0600	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.	D	Yes	Past Non-Compliance	August 16, 2024
July 9, 2025	Health	F 0609	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.	D	Yes	Deficient, Provider has date of correction	August 8, 2025
July 9, 2025	Health	F 0610	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Respond appropriately to all alleged violations.	D	Yes	Deficient, Provider has date of correction	August 8, 2025
June 11, 2025	Health	F 0689	Quality of Life and Care Deficiencies	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.	G	Yes	Deficient, Provider has date of correction	July 10, 2025
March 4, 2025	Health	F 0607	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Develop and implement policies and procedures to prevent abuse, neglect, and theft.	D	Yes	Deficient, Provider has date of correction	April 4, 2025
March 4, 2025	Health	F 0684	Quality of Life and Care Deficiencies	Provide appropriate treatment and care according to orders, resident’s preferences and goals.	D	Yes	Deficient, Provider has date of correction	April 4, 2025
March 4, 2025	Health	F 0842	Resident Assessment and Care Planning Deficiencies	Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.	D	Yes	Deficient, Provider has date of correction	April 4, 2025
February 21, 2025	Health	F 0600	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.	E	Yes	Deficient, Provider has date of correction	March 28, 2025
February 6, 2025	Health	F 0600	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.	D	Yes	Deficient, Provider has date of correction	March 28, 2025
October 1, 2024	Health	F 0600	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.	D	Yes	Deficient, Provider has date of correction	November 12, 2024
June 6, 2024	Health	F 0561	Resident Rights Deficiencies	Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.	D	No	Deficient, Provider has date of correction	August 16, 2024
June 6, 2024	Health	F 0600	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.	D	Yes	Deficient, Provider has date of correction	August 16, 2024
June 6, 2024	Health	F 0609	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.	D	No	Deficient, Provider has date of correction	August 16, 2024
June 6, 2024	Health	F 0677	Quality of Life and Care Deficiencies	Provide care and assistance to perform activities of daily living for any resident who is unable.	D	No	Deficient, Provider has date of correction	August 16, 2024
June 6, 2024	Health	F 0868	Administration Deficiencies	Have the Quality Assessment and Assurance group have the required members and meet at least quarterly	E	No	Deficient, Provider has date of correction	August 16, 2024
December 8, 2022	Health	F 0623	Resident Rights Deficiencies	Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.	D	No	Deficient, Provider has date of correction	February 24, 2023
December 8, 2022	Health	F 0625	Resident Rights Deficiencies	Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.	D	No	Deficient, Provider has date of correction	February 24, 2023
December 8, 2022	Health	F 0636	Resident Assessment and Care Planning Deficiencies	Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.	D	No	Deficient, Provider has date of correction	February 24, 2023
December 8, 2022	Health	F 0641	Resident Assessment and Care Planning Deficiencies	Ensure each resident receives an accurate assessment.	D	No	Deficient, Provider has date of correction	February 24, 2023
December 8, 2022	Health	F 0655	Resident Assessment and Care Planning Deficiencies	Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted	E	No	Deficient, Provider has date of correction	February 24, 2023
December 8, 2022	Health	F 0657	Resident Assessment and Care Planning Deficiencies	Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.	E	No	Deficient, Provider has date of correction	February 24, 2023
December 8, 2022	Health	F 0680	Quality of Life and Care Deficiencies	Ensure the activities program is directed by a qualified professional.	D	No	Deficient, Provider has date of correction	February 24, 2023
December 8, 2022	Health	F 0688	Quality of Life and Care Deficiencies	Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.	D	No	Deficient, Provider has date of correction	February 24, 2023
December 8, 2022	Health	F 0689	Quality of Life and Care Deficiencies	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.	E	No	Deficient, Provider has date of correction	February 24, 2023
December 8, 2022	Health	F 0690	Quality of Life and Care Deficiencies	Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.	E	No	Deficient, Provider has date of correction	February 24, 2023
December 8, 2022	Health	F 0697	Quality of Life and Care Deficiencies	Provide safe, appropriate pain management for a resident who requires such services.	D	No	Deficient, Provider has date of correction	February 24, 2023
December 8, 2022	Health	F 0726	Nursing and Physician Services Deficiencies	Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.	E	No	Deficient, Provider has date of correction	February 24, 2023
December 8, 2022	Health	F 0758	Pharmacy Service Deficiencies	Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.	E	No	Deficient, Provider has date of correction	February 24, 2023
December 8, 2022	Health	F 0803	Nutrition and Dietary Deficiencies	Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.	D	No	Deficient, Provider has date of correction	February 24, 2023

From the Care Compare health citations file NH_HealthCitations_Sep2026_2.csv, processed on September 1, 2026.

Penalties

Penalty date	Type	Fine amount	Payment denial began	Payment denial, days	Fine ID
June 11, 2025	Fine	$8,278			134107

From the Care Compare penalties file NH_Penalties_Sep2026_2.csv, processed on September 1, 2026.

Care Compare provider information

Field	As filed
Provider Type	Medicare and Medicaid
Ownership Type	For profit - Limited Liability company
Legal Business Name	HAVEN OF LAKESIDE LLC
Date First Approved to Provide Medicare and Medicaid Services	2010-11-02
Provider Resides in Hospital	N
Continuing Care Retirement Community	N
Urban	N
County/Parish	Navajo
Telephone Number	9283682060
Chain Name	HAVEN HEALTH
Chain ID	249
Provider Changed Ownership in Last 12 Months	N
With a Resident and Family Council	Resident
Automatic Sprinkler Systems in All Required Areas	Yes
Number of Certified Beds	112
Average Number of Residents per Day	96.7
Overall Rating	1
Health Inspection Rating	1
QM Rating	1
Long-Stay QM Rating	1
Processing Date	2026-09-01

From the Care Compare Provider Information file NH_ProviderInfo_Sep2026_3.csv, processed on September 1, 2026.

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One email a day naming what moved on HAVEN OF LAKESIDE: the field, the value before, the value after, and the date of the file that first showed it.

The facility alert follows this one record: a cost report filed or a figure on one changed, an inspection, a deficiency or a penalty recorded, an owner added or removed. The certification number arrives filled in.

On December 5, 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. That is one line of the alert.

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The citable document for HAVEN OF LAKESIDE

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