Skilled nursing facility · CMS certification number 055361
VISTA PACIFICA CONVALESCENT HOSPITAL
JURUPA VALLEY, California · Medicare and Medicaid
Certified beds, as filed in Care Compare: 49
Download this facility’s record (CSV)
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: $52,611.00 · Payment denials: 0. The most recent penalty on file: February 12, 2024, Fine, $52,611. 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 April 25, 2025.
None of these figures is carried on this report.
CMS report record 1419779, 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 August 21, 2024.
None of these figures is carried on this report.
CMS report record 1392742, 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 July 17, 2023.
None of these figures is carried on this report.
CMS report record 1358909, 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 August 23, 2022.
None of these figures is carried on this report.
CMS report record 1330316, 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 October 20, 2021.
None of these figures is carried on this report.
CMS report record 1301968, 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 September 9, 2020.
None of these figures is carried on this report.
CMS report record 1265708, 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 August 23, 2019.
None of these figures is carried on this report.
CMS report record 1241902, 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 29, 2018.
None of these figures is carried on this report.
CMS report record 1210894, 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 4, 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,502,983 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$213,506 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,716,489 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,046,671 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$330,182 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $585,440 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $255,258 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $255,258 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 49 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,493 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 76 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 77 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 109.69 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 230.17 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1172017, read from the public cost report file SNF10FY2016.zip.
Fiscal year 2015, ended December 31, 2015
Cost report for January 1, 2015 to December 31, 2015 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on August 22, 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,548,336 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $232,120 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,316,216 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,692,728 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$376,512 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $343,358 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$33,154 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$33,154 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 49 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,491 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 66 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 330.5 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 271.43 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 265.02 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1142039, 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 August 23, 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,449,016 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$20,443 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,469,459 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,514,879 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$45,420 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $6,693 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$38,727 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$65,077 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 49 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,640 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 33 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 67.1 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 737.83 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 534.55 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1108525, 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 August 22, 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,317,753 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $217,344 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,100,409 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,380,673 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$280,264 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $15,255 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$265,009 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$269,202 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 49 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,724 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 38 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 66.88 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 758.57 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 466.42 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1076731, read from the public cost report file SNF10FY2013.zip.
Fiscal year 2012, ended December 31, 2012
Cost report for October 1, 2012 to December 31, 2012 — a reporting period of 91 days, not a full year, on form CMS-2540-10, settled, processed by CMS on August 16, 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $845,571 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $47,471 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $798,100 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $810,978 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$12,878 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $847 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$12,031 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$12,859 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 49 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 4,499 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 3 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 37 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 4,243 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 1,499.67 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1046541, read from the public cost report file SNF10FY2013.zip.
Fiscal year 2011, ended September 30, 2011
Cost report for October 1, 2010 to September 30, 2011 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on March 30, 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,005,829 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,223,895 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$218,066 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $3,068 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $3,020 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$218,018 (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.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 49 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 17,535 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 15 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 116.75 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 2,114.63 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 1,169 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 426919, read from the public cost report file SNFFY2011.zip.
Fiscal year 2010, ended September 30, 2010
Cost report for October 1, 2009 to September 30, 2010 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on April 20, 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,978,101 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,328,410 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$350,309 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $3,996 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $12,986 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$359,299 (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.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 49 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 17,662 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 21 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 223.5 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,183.21 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 841.05 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 397591, read from the public cost report file SNFFY2010.zip.
Fiscal year 2009, ended September 30, 2009
Cost report for October 1, 2008 to September 30, 2009 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on March 16, 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,136,086 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,317,082 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$180,996 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $12,009 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: −$168,987 (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.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 49 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 17,637 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 26 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 345.33 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 899.28 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 678.35 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 365998, read from the public cost report file SNFFY2009.zip.
Fiscal year 2008, ended September 30, 2008
Cost report for October 1, 2007 to September 30, 2008 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on April 14, 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,948,357 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,069,059 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$120,702 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $7,865 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $3,619 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$116,456 (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.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 49 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 17,587 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 32 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 252.5 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 710.09 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 549.59 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 337149, read from the public cost report file SNFFY2008.zip.
Fiscal year 2007, ended September 30, 2007
Cost report for October 1, 2006 to September 30, 2007 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on April 24, 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,781,094 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,956,068 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$174,974 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $11,736 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $9,612 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$172,850 (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.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 49 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 17,157 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 37 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 213.4 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 788.32 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 463.7 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 307482, read from the public cost report file SNFFY2007.zip.
Fiscal year 2006, ended September 30, 2006
Cost report for October 1, 2005 to September 30, 2006 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on May 7, 2007.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,776,713 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,908,355 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$131,642 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $24,593 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: −$107,049 (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.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 49 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 17,532 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 41 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 50 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,161.85 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 427.61 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 278078, read from the public cost report file SNFFY2006.zip.
Fiscal year 2005, ended September 30, 2005
Cost report for October 1, 2004 to September 30, 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on May 2, 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,639,692 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,744,228 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$104,536 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $10,234 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $7,255 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$101,557 (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.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 49 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 16,881 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 54 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 234 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 361.45 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 312.61 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 248364, read from the public cost report file SNFFY2005.zip.
Fiscal year 2004, ended September 30, 2004
Cost report for October 1, 2003 to September 30, 2004 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on March 18, 2005.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,062,212 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,029,413 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $32,799 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $20,594 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $461 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $52,932 (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.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 49 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 17,331 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 32 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 77 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 855.33 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 541.59 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 211588, read from the public cost report file SNFFY2004.zip.
Fiscal year 2003, ended September 30, 2003
Cost report for October 1, 2002 to September 30, 2003 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on May 5, 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,920,076 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,000,910 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$80,834 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $10,693 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: −$70,141 (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.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 49 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 16,035 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 36 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 92 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 542.11 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 445.42 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 175305, read from the public cost report file SNFFY2003.zip.
Fiscal year 2002, ended September 30, 2002
Cost report for October 1, 2001 to September 30, 2002 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on April 1, 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,937,356 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,786,637 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $150,719 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $30,348 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $181,067 (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.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 49 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 16,551 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 56 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 17.88 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 452.23 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 295.55 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 172806, read from the public cost report file SNFFY2002.zip.
Fiscal year 2001, ended September 30, 2001
Cost report for October 1, 2000 to September 30, 2001 — a reporting period of 364 days, on form CMS-2540-96, settled with audit, processed by CMS on August 26, 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,966,535 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,821,823 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $144,712 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $57,896 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $202,608 (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.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 49 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 17,333 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 38 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 18.64 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 951.27 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 456.13 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 158064, read from the public cost report file SNFFY2001.zip.
Fiscal year 2000, ended September 30, 2000
Cost report for October 1, 1999 to September 30, 2000 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on December 17, 2001.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,666,904 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,898,170 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$231,266 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $142,732 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: −$88,534 (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.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 49 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 16,610 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 39 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 19.33 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 578.08 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 425.9 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 80732, read from the public cost report file SNFFY2000.zip.
Fiscal year 1999, ended September 30, 1999
Cost report for October 1, 1998 to September 30, 1999 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on May 3, 2001.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,575,712 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,655,811 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$80,099 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $33,611 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $12,352 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$58,840 (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.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 49 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 16,521 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 43 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 25.6 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 503.93 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 384.21 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 80731, read from the public cost report file SNFFY1999.zip.
Fiscal year 1998, ended September 30, 1998
Cost report for October 1, 1997 to September 30, 1998 — a reporting period of 364 days, on form CMS-2540-96, as submitted, processed by CMS on November 3, 1999.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,516,158 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,440,496 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $75,662 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $33,341 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $29,747 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $79,256 (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.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 49 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 16,484 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 39 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 26 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 876.06 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 422.67 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 80730, read from the public cost report file SNFFY1998.zip.
Fiscal year 1997, ended September 30, 1997
Cost report for October 1, 1996 to September 30, 1997 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on March 11, 1999.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,547,905 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,462,709 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $85,196 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $12,675 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $97,871 (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.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 49 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 17,253 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 31 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 71.6 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 556.55 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 80728, read from the public cost report file SNFFY1997.zip.
Fiscal year 1996, ended September 30, 1996
Cost report for October 1, 1995 to September 30, 1996 — a reporting period of 365 days, on form CMS-2540-96, as submitted, processed by CMS on April 18, 1997.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,522,936 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,467,448 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $55,488 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $1,260 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $56,748 (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.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 49 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 16,857 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 34 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 26.29 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 495.79 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 80727, read from the public cost report file SNFFY1996.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.
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 |
|---|---|---|---|---|
| CHERYL JUMONVILLE LEGACY TRUST | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | 96% | since 12/31/2013 |
| JUMONVILLE, CHERYL | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Individual | NO PERCENTAGE PROVIDED | since 12/31/2013 |
| JUMONVILLE, CHERYL | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 06/07/1989 |
| JUMONVILLE, CHERYL | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 12/31/2015 |
| JUMONVILLE, CHERYL | W-2 MANAGING EMPLOYEE | Individual | NOT APPLICABLE | since 06/07/1989 |
Medicare enrollment
As filed in the CMS file dated August 1, 2026 (Medicare enrollment ownership), under the enrollment of VISTA PACIFICA ENTERPRISES INC. (enrollment ID O20120529000616).
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 |
|---|---|---|---|---|---|
| CHERYL BRASWELL JUMONVILLE | Individual | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 3.98 | 12/31/2013 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| CHERYL JUMONVILLE LEGACY TRUST | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 96.02 | 12/31/2013 | Private equity company: No Real estate investment trust: No Holding company: No |
| CHERYL BRASWELL JUMONVILLE | Individual | CORPORATE OFFICER | Not stated in the filing | 6/7/1989 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| CHERYL BRASWELL JUMONVILLE | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 12/31/2015 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| CHERYL BRASWELL JUMONVILLE | Individual | W-2 MANAGING EMPLOYEE | Not stated in the filing | 6/7/1989 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
Changes in ownership
No change in ownership appears in the CMS files on record since September 20, 2022.
Recent changes on this record
- April 25, 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- August 21, 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- July 17, 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- August 23, 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
- October 20, 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
- September 9, 2020: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
- August 23, 2019: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2018.zip
- August 29, 2018: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2017.zip
- August 4, 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2016.zip
- August 22, 2016: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2015.zip
- August 23, 2015: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2014.zip
- August 22, 2014: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2013.zip
- August 16, 2013: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2013.zip
- March 28, 2013: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2012.zip
- March 30, 2012: A cost report was filed for fiscal year 2011, on form CMS-2540-96. SNFFY2011.zip
- April 20, 2011: A cost report was filed for fiscal year 2010, on form CMS-2540-96. SNFFY2010.zip
- March 16, 2010: A cost report was filed for fiscal year 2009, on form CMS-2540-96. SNFFY2009.zip
- April 14, 2009: A cost report was filed for fiscal year 2008, on form CMS-2540-96. SNFFY2008.zip
- April 24, 2008: A cost report was filed for fiscal year 2007, on form CMS-2540-96. SNFFY2007.zip
- May 7, 2007: A cost report was filed for fiscal year 2006, on form CMS-2540-96. SNFFY2006.zip
- May 2, 2006: A cost report was filed for fiscal year 2005, on form CMS-2540-96. SNFFY2005.zip
- March 18, 2005: A cost report was filed for fiscal year 2004, on form CMS-2540-96. SNFFY2004.zip
- May 5, 2004: A cost report was filed for fiscal year 2003, on form CMS-2540-96. SNFFY2003.zip
- April 1, 2004: A cost report was filed for fiscal year 2002, on form CMS-2540-96. SNFFY2002.zip
- August 26, 2003: A cost report was filed for fiscal year 2001, on form CMS-2540-96. SNFFY2001.zip
- December 17, 2001: A cost report was filed for fiscal year 2000, on form CMS-2540-96. SNFFY2000.zip
- May 3, 2001: A cost report was filed for fiscal year 1999, on form CMS-2540-96. SNFFY1999.zip
- November 3, 1999: A cost report was filed for fiscal year 1998, on form CMS-2540-96. SNFFY1998.zip
- March 11, 1999: A cost report was filed for fiscal year 1997, on form CMS-2540-96. SNFFY1997.zip
- April 18, 1997: A cost report was filed for fiscal year 1996, on form CMS-2540-96. SNFFY1996.zip
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | February 27, 2025 | February 27, 2025 | 5 | 0 |
| 2 | February 12, 2024 | February 12, 2024 | 14 | 6 |
| 3 | February 11, 2022 | February 11, 2022 | 10 | 5 |
From the Care Compare inspection summary file NH_SurveySummary_Sep2026_2.csv, processed on September 1, 2026.
Deficiencies cited
29 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| February 27, 2025 | Health | F 0637 | Resident Assessment and Care Planning Deficiencies | Assess the resident when there is a significant change in condition | D | No | Deficient, Provider has date of correction | March 14, 2025 |
| February 27, 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 | March 21, 2025 |
| February 27, 2025 | Health | F 0727 | Nursing and Physician Services Deficiencies | Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. | D | No | Deficient, Provider has date of correction | February 27, 2025 |
| February 27, 2025 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | E | No | Deficient, Provider has date of correction | March 26, 2025 |
| February 27, 2025 | Health | F 0912 | Environmental Deficiencies | Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms. | B | No | Waiver has been granted | February 27, 2025 |
| February 12, 2024 | Health | F 0656 | Resident Assessment and Care Planning Deficiencies | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | E | No | Deficient, Provider has date of correction | February 28, 2024 |
| February 12, 2024 | 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. | K | No | Deficient, Provider has date of correction | February 12, 2024 |
| February 12, 2024 | Health | F 0695 | Quality of Life and Care Deficiencies | Provide safe and appropriate respiratory care for a resident when needed. | D | No | Deficient, Provider has date of correction | March 1, 2024 |
| February 12, 2024 | Health | F 0710 | Nursing and Physician Services Deficiencies | Obtain a doctor's order to admit a resident and ensure the resident is under a doctor's care. | E | No | Deficient, Provider has date of correction | February 29, 2024 |
| February 12, 2024 | Health | F 0727 | Nursing and Physician Services Deficiencies | Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. | E | No | Deficient, Provider has date of correction | February 27, 2024 |
| February 12, 2024 | Health | F 0755 | Pharmacy Service Deficiencies | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | No | Deficient, Provider has date of correction | March 1, 2024 |
| February 12, 2024 | Health | F 0756 | Pharmacy Service Deficiencies | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | E | No | Deficient, Provider has date of correction | March 1, 2024 |
| February 12, 2024 | Health | F 0757 | Pharmacy Service Deficiencies | Ensure each resident’s drug regimen must be free from unnecessary drugs. | D | No | Deficient, Provider has date of correction | March 1, 2024 |
| February 12, 2024 | 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 | March 1, 2024 |
| February 12, 2024 | Health | F 0759 | Pharmacy Service Deficiencies | Ensure medication error rates are not 5 percent or greater. | D | No | Deficient, Provider has date of correction | March 1, 2024 |
| February 12, 2024 | Health | F 0812 | Nutrition and Dietary Deficiencies | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | No | Deficient, Provider has date of correction | March 4, 2024 |
| February 12, 2024 | Health | F 0865 | Administration Deficiencies | Have a plan that describes the process for conducting QAPI and QAA activities. | E | No | Deficient, Provider has date of correction | February 28, 2024 |
| February 12, 2024 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | No | Deficient, Provider has date of correction | March 1, 2024 |
| February 12, 2024 | Health | F 0912 | Environmental Deficiencies | Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms. | B | No | Waiver has been granted | February 12, 2024 |
| October 2, 2023 | Health | F 0755 | Pharmacy Service Deficiencies | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | Yes | Deficient, Provider has date of correction | October 12, 2023 |
| September 14, 2023 | Health | F 0755 | Pharmacy Service Deficiencies | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | Yes | Deficient, Provider has date of correction | October 12, 2023 |
| February 11, 2022 | Health | F 0658 | Resident Assessment and Care Planning Deficiencies | Ensure services provided by the nursing facility meet professional standards of quality. | D | No | Deficient, Provider has date of correction | March 9, 2022 |
| February 11, 2022 | 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 | March 9, 2022 |
| February 11, 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 | March 9, 2022 |
| February 11, 2022 | Health | F 0806 | Nutrition and Dietary Deficiencies | Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | E | No | Deficient, Provider has date of correction | March 9, 2022 |
| February 11, 2022 | Health | F 0812 | Nutrition and Dietary Deficiencies | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | No | Deficient, Provider has date of correction | March 9, 2022 |
| February 11, 2022 | Health | F 0814 | Nutrition and Dietary Deficiencies | Dispose of garbage and refuse properly. | F | No | Deficient, Provider has date of correction | March 9, 2022 |
| February 11, 2022 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | E | No | Deficient, Provider has date of correction | March 9, 2022 |
| February 11, 2022 | Health | F 0912 | Environmental Deficiencies | Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms. | B | No | Deficient, Provider has date of correction | March 9, 2022 |
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 |
|---|---|---|---|---|---|
| February 12, 2024 | Fine | $52,611 | 130113 |
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 - Corporation |
| Legal Business Name | VISTA PACIFICA ENTERPRISES INC. |
| Date First Approved to Provide Medicare and Medicaid Services | 1971-12-31 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | Y |
| County/Parish | Riverside |
| Telephone Number | 9516824833 |
| 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 | 49 |
| Average Number of Residents per Day | 48.5 |
| Overall Rating | 4 |
| Health Inspection Rating | 3 |
| QM Rating | 5 |
| Long-Stay QM Rating | 5 |
| Processing Date | 2026-09-01 |
From the Care Compare Provider Information file NH_ProviderInfo_Sep2026_3.csv, processed on September 1, 2026.
Get an email when this record changes
One email a day naming what moved on VISTA PACIFICA CONVALESCENT HOSPITAL: 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 April 25, 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 VISTA PACIFICA CONVALESCENT HOSPITAL
This page shows the record as it stands today. The report is the citable document: the same figures with the cell each came from, and beyond this page — five facilities of a similar size in California at the same fiscal year, listed by name; every change on the record rather than the recent ones below; the inspection and staffing history in blocks of their own; and a citation block naming every CMS file it was read from.
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Every figure on this page is printed as it appears in the CMS file named beside it. A figure that does not match its file? Tell us on the corrections page, quoting certification number 055361.