Skilled nursing facility · CMS certification number 145712
PAVILION ON MAIN STREET, THE
SANDWICH, Illinois · Medicare and Medicaid
Certified beds, as filed in Care Compare: 113
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: 4 · Fines: 2 · Fines, total amount: $93,883.00 · Payment denials: 2. The most recent penalty on file: August 27, 2025, Fine, $52,234. 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 August 28, 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $15,060,257 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $4,878,593 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,181,664 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,427,969 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$246,305 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $383 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$245,922 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$245,922 (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 | 116 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 42,456 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 3,914 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 20,329 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 7,096 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 31,339 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 45 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 23 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 91 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 159 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 86.98 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 883.87 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 197.1 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1433442, read from the public cost report file SNF10FY2024.zip.
Fiscal year 2023, ended December 31, 2023
Cost report for December 19, 2022 to December 31, 2023 — a reporting period of 377 days, on form CMS-2540-10, settled, processed by CMS on September 20, 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $16,197,761 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $5,886,305 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,311,456 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $11,248,232 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$936,776 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $504,387 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$432,389 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$432,389 (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 | 116 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 31,715 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 106 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 108.89 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 885.17 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 299.2 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1395355, read from the public cost report file SNF10FY2023.zip.
Fiscal year 2022, ended December 18, 2022
Cost report for January 1, 2022 to December 18, 2022 — a reporting period of 351 days, on form CMS-2540-10, settled, processed by CMS on October 11, 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,173,814 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $11,173,814 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $11,083,128 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $90,686 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | $90,686 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $90,686 (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 | 116 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 30,458 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 175 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 63.78 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 234.24 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 174.05 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1366382, 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 22, 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,263,482 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $10,263,482 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,030,911 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $2,232,571 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | $2,232,571 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $2,232,571 (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 | 116 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 31,407 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 186 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 58.61 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 245.61 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 168.85 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1333547, 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 March 31, 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,956,472 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $8,956,472 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,603,195 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $353,277 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | $353,277 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $353,277 (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 | 116 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 31,125 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 176 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 85.18 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 234.03 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 176.85 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1313304, 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 October 14, 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,488,508 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $7,488,508 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,014,102 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$525,594 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | −$525,594 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$525,594 (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 | 116 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 32,548 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 223 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 65.11 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 189.8 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 145.96 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1270387, 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 12, 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,714,558 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $7,714,558 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,934,722 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$220,164 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | −$220,164 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$220,164 (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 | 116 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 33,430 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 230 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 56.09 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 246.51 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 145.35 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1240385, 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 July 31, 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,595,139 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $652,729 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,942,410 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,141,710 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$199,300 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $75,751 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$123,549 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$343,830 (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 | 116 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 35,162 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 472 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 59.16 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 74.5 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1203788, 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 July 20, 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,254,631 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,007,298 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $8,247,333 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,360,875 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$113,542 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $368,417 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $254,875 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $254,875 (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 | 116 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 38,046 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 450 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 71.1 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 84.55 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1170175, 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 July 27, 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $9,408,904 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,803,003 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,605,901 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,824,694 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$218,793 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $126,932 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$91,861 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$284,164 (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 | 116 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 35,606 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 407 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 51.69 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 87.48 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1138311, 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 July 25, 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $9,071,622 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,509,071 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,562,551 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,279,346 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $283,205 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $116,595 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $399,800 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $366,036 (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 | 116 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 34,911 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 382 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 62.55 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 91.39 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1105253, 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 July 25, 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,865,494 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,640,627 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,224,867 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,571,472 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$346,605 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $221,400 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$125,205 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$125,205 (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 | 116 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 36,395 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 377 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 48.82 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 96.54 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1073656, 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 August 29, 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,357,202 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $7,357,202 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,579,929 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $777,273 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $191,041 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $968,314 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $968,314 (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 | 116 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 36,952 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 366 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 68.77 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 100.96 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1077473, 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 April 19, 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,104,063 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $7,104,063 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,188,435 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $915,628 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $116,191 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,031,819 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $930,265 (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 | 116 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 35,952 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 353 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 61.69 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 101.85 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1027756, read from the public cost report file SNF10FY2011.zip.
Fiscal year 2010, ended December 31, 2010
Cost report for January 1, 2010 to December 31, 2010 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on January 18, 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $6,182,375 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,145,520 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $36,855 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $125,854 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $86,965 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $75,744 (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 | 116 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 36,414 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 334 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 56.19 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 161.59 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 109.02 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 422848, read from the public cost report file SNFFY2010.zip.
Fiscal year 2009, ended December 31, 2009
Cost report for January 1, 2009 to December 31, 2009 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on January 12, 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $5,277,507 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,299,623 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$22,116 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $61,305 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $98,327 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$59,138 (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 | 116 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 32,810 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 288 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 49 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 178.93 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 113.92 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 392481, read from the public cost report file SNFFY2009.zip.
Fiscal year 2008, ended December 31, 2008
Cost report for January 1, 2008 to December 31, 2008 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on May 18, 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $5,294,247 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,428,783 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$134,536 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $110,034 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $111,369 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$135,871 (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 | 116 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 33,224 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 267 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 38.47 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 220.37 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 124.43 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 369846, read from the public cost report file SNFFY2008.zip.
Fiscal year 2007, ended December 31, 2007
Cost report for January 1, 2007 to December 31, 2007 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on August 1, 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,958,050 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,013,757 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$55,707 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $63,224 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $41,021 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$33,504 (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 | 108 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 31,734 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 220 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 46.88 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 232.87 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 144.25 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 322554, read from the public cost report file SNFFY2007.zip.
Fiscal year 2006, ended December 31, 2006
Cost report for January 1, 2006 to December 31, 2006 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on July 27, 2007.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,702,472 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,683,480 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $18,992 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $73,849 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $14,892 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $77,949 (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 | 108 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 29,574 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 181 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 55.87 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 302.43 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 163.39 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 290051, read from the public cost report file SNFFY2006.zip.
Fiscal year 2005, ended December 31, 2005
Cost report for January 1, 2005 to December 31, 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on August 8, 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,526,287 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,389,330 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $136,957 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $12,353 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $149,310 (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 | 108 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 22,319 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 183 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 54.3 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 215.04 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 121.96 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 260716, read from the public cost report file SNFFY2005.zip.
Fiscal year 2004, ended December 31, 2004
Cost report for January 1, 2004 to December 31, 2004 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on July 15, 2005.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,609,339 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,314,454 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $294,885 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $30,788 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $3,623 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $322,050 (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 | 116 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 34,128 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 192 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 49.36 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 300.43 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 177.75 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 227884, read from the public cost report file SNFFY2004.zip.
Fiscal year 2003, ended December 31, 2003
Cost report for January 1, 2003 to December 31, 2003 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on July 22, 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,164,229 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,017,513 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $146,716 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $9,551 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $380 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $155,887 (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 | 116 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 35,679 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 177 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 32.67 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 355.62 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 201.58 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 188208, read from the public cost report file SNFFY2003.zip.
Fiscal year 2002, ended December 31, 2002
Cost report for January 1, 2002 to December 31, 2002 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on June 8, 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,089,986 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,066,061 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $23,925 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $22,153 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $46,078 (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 | 116 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 34,362 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 261 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 24.4 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 195.05 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 131.66 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 180446, read from the public cost report file SNFFY2002.zip.
Fiscal year 2001, ended December 31, 2001
Cost report for January 1, 2001 to December 31, 2001 — a reporting period of 364 days, on form CMS-2540-96, as submitted, processed by CMS on March 30, 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,828,389 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,720,997 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $107,392 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $13,127 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $5,808 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $114,711 (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 | 116 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 34,274 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 183 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 26.41 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 350.2 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 187.29 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 172361, read from the public cost report file SNFFY2001.zip.
Fiscal year 2000, ended December 31, 2000
Cost report for January 1, 2000 to December 31, 2000 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on February 28, 2002.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,639,279 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,536,801 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $102,478 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $74,373 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $176,851 (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 | 116 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 35,028 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 194 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 26.01 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 350.76 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 180.56 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 85998, read from the public cost report file SNFFY2000.zip.
Fiscal year 1999, ended December 31, 1999
Cost report for January 1, 1999 to December 31, 1999 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on May 7, 2001.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,293,097 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,257,095 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $36,002 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $12,252 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $48,254 (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 | 116 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 37,074 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 158 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 33 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 326.85 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 234.65 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 85996, read from the public cost report file SNFFY1999.zip.
Fiscal year 1997, ended December 31, 1997
Cost report for January 1, 1997 to December 31, 1997 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on May 3, 1999.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,616,873 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,289,113 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $327,760 | CMS-2540-96 worksheet G300000 line 500 column 100 |
Net income: $327,760 (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 | 116 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 38,793 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 173 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 34.69 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 335.08 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 224.24 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 85994, read from the public cost report file SNFFY1997.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 |
|---|---|---|---|---|
| ILANA D AARON TRUST C/U MAURICE AARON 2014 FAMILY GIFT TRUST | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | 12% | since 12/19/2022 |
| ILANA D AARON TRUST C/U MAURICE AARON 2014 LEGACY GIFT TRUST | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | 9% | since 12/19/2022 |
| MCDONALD, NANCY | ADP OF THE SNF | Individual | NOT APPLICABLE | since 04/22/2024 |
| ROBIN, JASON | ADP OF THE SNF | Individual | NOT APPLICABLE | since 07/01/2023 |
| GOLDSTEIN, SHIMON | DIRECT OWNERSHIP INTEREST | Individual | NOT APPLICABLE | since 07/01/2023 |
| GRAF, MARCELLA | DIRECT OWNERSHIP INTEREST | Individual | NOT APPLICABLE | since 12/19/2022 |
| GROSS, SHOSHANA | DIRECT OWNERSHIP INTEREST | Individual | NOT APPLICABLE | since 07/01/2023 |
| KROLL, GABRIEL | DIRECT OWNERSHIP INTEREST | Individual | NOT APPLICABLE | since 07/01/2023 |
| PROCTOR, KATHERINE | DIRECT OWNERSHIP INTEREST | Individual | NOT APPLICABLE | since 07/01/2023 |
| RIPSTEIN, KENNETH | DIRECT OWNERSHIP INTEREST | Individual | NOT APPLICABLE | since 07/01/2023 |
| STERN, TODD | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | Individual | NOT APPLICABLE | since 11/10/2025 |
| AARON, JONATHAN | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 12/19/2022 |
| AARON, JONATHAN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 12/19/2022 |
| GRAF, MARCELLA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 12/19/2022 |
| MCDONALD, NANCY | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 04/22/2024 |
| ROBIN, JASON | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 07/01/2023 |
Medicare enrollment
As filed in the CMS file dated August 1, 2026 (Medicare enrollment ownership), under the enrollment of PAVILION ON MAIN STREET LLC (enrollment ID O20230206001030).
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 |
|---|---|---|---|---|---|
| EMST LLC | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 15 | 7/1/2023 | Private equity company: No Real estate investment trust: No Holding company: No |
| ILANA D AARON TRUST C/U MAURICE AARON 2014 FAMILY GIFT TRUST | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 12.11 | 12/19/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| ILANA D AARON TRUST C/U MAURICE AARON 2014 LEGACY GIFT TRUST | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 9 | 12/19/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| JONATHAN H AARON REVOCABLE TRUST | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 23.5 | 7/1/2023 | Private equity company: No Real estate investment trust: No Holding company: No |
| STERN FAMILY INVESTMENT TR | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 13.8 | 7/1/2023 | Private equity company: No Real estate investment trust: No Holding company: No |
| TODD A STERN 2015 IRRV INS TR | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 13.81 | 7/1/2023 | Private equity company: No Real estate investment trust: No Holding company: No |
| JASON ROBIN | Individual | ADP OF THE SNF | Not stated in the filing | 7/1/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| NANCY MCDONALD | Individual | ADP OF THE SNF | Not stated in the filing | 4/22/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| GABRIEL KROLL | Individual | DIRECT OWNERSHIP INTEREST | 2 | 7/1/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KATHERINE A PROCTOR | Individual | DIRECT OWNERSHIP INTEREST | 1 | 7/1/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KENNETH RIPSTEIN | Individual | DIRECT OWNERSHIP INTEREST | 4.78 | 7/1/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MARCELLA GRAF | Individual | DIRECT OWNERSHIP INTEREST | 3 | 12/19/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| SHIMON GOLDSTEIN | Individual | DIRECT OWNERSHIP INTEREST | 1 | 7/1/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| SHOSHANA GROSS | Individual | DIRECT OWNERSHIP INTEREST | 1 | 7/1/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JONATHAN AARON | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 12/19/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JASON ROBIN | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 7/1/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JONATHAN AARON | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 12/19/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MARCELLA GRAF | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 12/19/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| NANCY MCDONALD | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 4/22/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
Changes in ownership
- January 1, 2026: RAPHAELA E STERN no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: KENNETH RIPSTEIN no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: JONATHAN AARON no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: MARCELLA GRAF no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: MARCELLA GRAF no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: TODD A STERN no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: SHOSHANA GROSS (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since July 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: SHIMON GOLDSTEIN (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since July 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: NANCY MCDONALD (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since April 22, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: NANCY MCDONALD (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since April 22, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: KATHERINE A PROCTOR (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since July 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: KENNETH RIPSTEIN (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since July 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: JONATHAN AARON (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since December 19, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: JONATHAN AARON (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since December 19, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: EMST LLC (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since July 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: JASON ROBIN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since July 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: JASON ROBIN (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since July 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: GABRIEL KROLL (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since July 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: JONATHAN H AARON REVOCABLE TRUST (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since July 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: MARCELLA GRAF (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since December 19, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: MARCELLA GRAF (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since December 19, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- July 17, 2023: STEVEN E LEVY no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: ESTHER MAUER no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: MARSHALL A MAUER no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: CHANA MAUER no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: SHIMON GOLDSTEIN no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: MAURICE I AARON no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: PAMELA S INGOLD no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: DYNAMIC HEALTH CARE CONSULTANTS INC no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: FRANCES MAUER no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: FRED L AARON no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: STERN FAMILY TRUST (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on July 17, 2023; associated with this enrollment since December 19, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: RAPHAELA E STERN (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on July 17, 2023; associated with this enrollment since December 19, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: KENNETH RIPSTEIN (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on July 17, 2023; associated with this enrollment since December 19, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: JONATHAN AARON (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on July 17, 2023; associated with this enrollment since December 19, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: TODD A. STERN 2015 IRREVOCABLE INSURANCE TRUST U/A/D 12/16/2015 (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on July 17, 2023; associated with this enrollment since December 19, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: ILANA D AARON TRUST C/U MAURICE AARON 2014 LEGACY GIFT TRUST (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on July 17, 2023; associated with this enrollment since December 19, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: MARCELLA GRAF (W-2 MANAGING EMPLOYEE) first listed in CMS’s Medicare enrollment ownership file on July 17, 2023; associated with this enrollment since December 19, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: MARCELLA GRAF (OFFICER) first listed in CMS’s Medicare enrollment ownership file on July 17, 2023; associated with this enrollment since December 19, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: TODD A STERN (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on July 17, 2023; associated with this enrollment since December 19, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: ILANA D AARON TRUST C/U MAURICE AARON 2014 FAMILY GIFT TRUST (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on July 17, 2023; associated with this enrollment since December 19, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
Recent changes on this record
- January 1, 2026: RAPHAELA E STERN no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: KENNETH RIPSTEIN no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: JONATHAN AARON no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: MARCELLA GRAF no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: MARCELLA GRAF no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: TODD A STERN no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: SHOSHANA GROSS (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since July 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: SHIMON GOLDSTEIN (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since July 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: NANCY MCDONALD (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since April 22, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: NANCY MCDONALD (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since April 22, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: KATHERINE A PROCTOR (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since July 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: KENNETH RIPSTEIN (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since July 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: JONATHAN AARON (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since December 19, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: JONATHAN AARON (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since December 19, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: EMST LLC (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since July 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: JASON ROBIN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since July 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: JASON ROBIN (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since July 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: GABRIEL KROLL (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since July 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: JONATHAN H AARON REVOCABLE TRUST (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since July 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: MARCELLA GRAF (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since December 19, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: MARCELLA GRAF (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since December 19, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- August 28, 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- September 20, 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- October 11, 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- July 17, 2023: STEVEN E LEVY no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: ESTHER MAUER no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: MARSHALL A MAUER no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: CHANA MAUER no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: SHIMON GOLDSTEIN no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: MAURICE I AARON no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: PAMELA S INGOLD no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: DYNAMIC HEALTH CARE CONSULTANTS INC no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: FRANCES MAUER no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: FRED L AARON no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: STERN FAMILY TRUST (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on July 17, 2023; associated with this enrollment since December 19, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: RAPHAELA E STERN (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on July 17, 2023; associated with this enrollment since December 19, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: KENNETH RIPSTEIN (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on July 17, 2023; associated with this enrollment since December 19, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: JONATHAN AARON (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on July 17, 2023; associated with this enrollment since December 19, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: TODD A. STERN 2015 IRREVOCABLE INSURANCE TRUST U/A/D 12/16/2015 (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on July 17, 2023; associated with this enrollment since December 19, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
- July 17, 2023: ILANA D AARON TRUST C/U MAURICE AARON 2014 LEGACY GIFT TRUST (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on July 17, 2023; associated with this enrollment since December 19, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-07-17.csv
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | August 27, 2025 | October 30, 2024 | 13 | 9 |
| 2 | October 30, 2024 | September 28, 2023 | 4 | 8 |
| 3 | September 28, 2023 | July 28, 2022 | 12 | 8 |
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 |
|---|---|---|---|---|---|---|---|---|
| October 9, 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. | D | Yes | Deficient, Provider has date of correction | October 10, 2025 |
| September 18, 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 | September 26, 2025 |
| September 18, 2025 | 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 | November 11, 2025 |
| August 27, 2025 | Health | F 0584 | Resident Rights Deficiencies | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | D | No | Deficient, Provider has date of correction | September 23, 2025 |
| August 27, 2025 | 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 | September 23, 2025 |
| August 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 | September 23, 2025 |
| August 27, 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 | No | Deficient, Provider has date of correction | September 23, 2025 |
| August 27, 2025 | Health | F 0692 | Quality of Life and Care Deficiencies | Provide enough food/fluids to maintain a resident's health. | G | No | Deficient, Provider has date of correction | September 23, 2025 |
| August 27, 2025 | Health | F 0759 | Pharmacy Service Deficiencies | Ensure medication error rates are not 5 percent or greater. | D | No | Deficient, Provider has date of correction | September 23, 2025 |
| August 27, 2025 | 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. | F | No | Deficient, Provider has date of correction | September 23, 2025 |
| August 27, 2025 | Health | F 0804 | Nutrition and Dietary Deficiencies | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | No | Deficient, Provider has date of correction | September 23, 2025 |
| August 27, 2025 | 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. | F | No | Deficient, Provider has date of correction | September 23, 2025 |
| August 27, 2025 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | No | Deficient, Provider has date of correction | September 23, 2025 |
| July 23, 2025 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | F | Yes | Deficient, Provider has date of correction | August 5, 2025 |
| July 23, 2025 | Health | F 0882 | Infection Control Deficiencies | Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. | F | Yes | Deficient, Provider has date of correction | August 5, 2025 |
| October 30, 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. | D | No | Deficient, Provider has date of correction | November 11, 2024 |
| October 30, 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 | November 11, 2024 |
| June 26, 2024 | 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 | Yes | Deficient, Provider has date of correction | July 5, 2024 |
| September 28, 2023 | 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 | October 23, 2023 |
| September 28, 2023 | 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 | October 23, 2023 |
| September 28, 2023 | Health | F 0686 | Quality of Life and Care Deficiencies | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | No | Deficient, Provider has date of correction | October 23, 2023 |
| September 28, 2023 | 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 | October 23, 2023 |
| September 28, 2023 | 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. | D | No | Deficient, Provider has date of correction | October 23, 2023 |
| September 28, 2023 | Health | F 0694 | Quality of Life and Care Deficiencies | Provide for the safe, appropriate administration of IV fluids for a resident when needed. | D | No | Deficient, Provider has date of correction | October 23, 2023 |
| September 28, 2023 | Health | F 0697 | Quality of Life and Care Deficiencies | Provide safe, appropriate pain management for a resident who requires such services. | G | No | Deficient, Provider has date of correction | October 23, 2023 |
| September 28, 2023 | Health | F 0725 | Nursing and Physician Services Deficiencies | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | F | No | Deficient, Provider has date of correction | October 23, 2023 |
| September 28, 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 | No | Deficient, Provider has date of correction | November 3, 2023 |
| September 28, 2023 | 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 | October 23, 2023 |
| September 28, 2023 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | No | Deficient, Provider has date of correction | October 23, 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 |
|---|---|---|---|---|---|
| August 27, 2025 | Fine | $52,234 | 135586 | ||
| August 27, 2025 | Payment Denial | September 24, 2025 | 48 | ||
| September 28, 2023 | Fine | $41,649 | 68814 | ||
| September 28, 2023 | Payment Denial | October 25, 2023 | 9 |
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 - Individual |
| Legal Business Name | PAVILION ON MAIN STREET LLC |
| Date First Approved to Provide Medicare and Medicaid Services | 1992-03-01 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | Y |
| County/Parish | De Kalb |
| Telephone Number | 8157868426 |
| Chain Name | PAVILION HEALTHCARE |
| Chain ID | 612 |
| 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 | 113 |
| Average Number of Residents per Day | 91.6 |
| Overall Rating | 3 |
| Health Inspection Rating | 3 |
| QM Rating | 3 |
| Long-Stay QM Rating | 4 |
| Short-Stay QM Rating | 3 |
| 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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The citable document for PAVILION ON MAIN STREET, THE
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