Skilled nursing facility · CMS certification number 145979
GIBSON COMMUNITY HSP ANNEX
GIBSON CITY, Illinois · Medicare and Medicaid
Certified beds, as filed in Care Compare: 16
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: $20,046.00 · Payment denials: 0. The most recent penalty on file: March 13, 2024, Fine, $20,046. 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, 1999 to December 31, 1999 — a reporting period of 364 days, on form CMS-2540-96, as submitted, processed by CMS on August 10, 2000.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,072,055 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,561,942 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$489,887 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $1,690 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: −$488,197 (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 | 50 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Bed days available, all components | 18,300 | CMS-2540-96 worksheet S300001 line 900 column 200 |
| Medicare (Title XVIII) patient days | 2,785 | CMS-2540-96 worksheet S300001 line 900 column 400 |
| Medicaid (Title XIX) patient days | 8,839 | CMS-2540-96 worksheet S300001 line 900 column 500 |
| Other-payer patient days | 4,333 | CMS-2540-96 worksheet S300001 line 900 column 600 |
| Total patient days, all components | 15,957 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Medicare discharges | 113 | CMS-2540-96 worksheet S300001 line 900 column 900 |
| Medicaid discharges | 25 | CMS-2540-96 worksheet S300001 line 900 column 1000 |
| Other-payer discharges | 3 | CMS-2540-96 worksheet S300001 line 900 column 1100 |
| Total discharges, all components | 160 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 24.65 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 353.56 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 99.73 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 17479, read from the public cost report file SNFFY1999.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 |
|---|---|---|---|---|
| BENNETT, KATHLEEN | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 11/01/2010 |
| HUDSON, ANDY | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 10/01/2022 |
| KELLY, STEVEN | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 11/01/2005 |
| LEE, ELLEN | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 11/01/1990 |
| MARTIN, MARGO | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 11/01/1999 |
| NUSS, MARTY | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 11/01/2010 |
| PETERSEN, MIKE | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 03/01/2018 |
| REESE, DONALD | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 02/21/2021 |
| SEYMOUR, KEVIN | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 03/01/2018 |
| STEIDINGER, BRIAN | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 11/16/2016 |
| SWAN, JUSTIN | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 10/01/2022 |
| TAYLOR, JUSTIN | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 03/01/2018 |
| YOUNG, MICHAEL | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 11/01/2001 |
| SCHMITT, ROBERT | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 12/09/2002 |
| REESE, DONALD | W-2 MANAGING EMPLOYEE | Individual | NOT APPLICABLE | since 10/01/2022 |
| SCHMITT, ROBERT | W-2 MANAGING EMPLOYEE | Individual | NOT APPLICABLE | since 12/09/2002 |
Medicare enrollment
As filed in the CMS file dated August 1, 2026 (Medicare enrollment ownership), under the enrollment of GIBSON COMMUNITY HOSPITAL ASSOCIATION (enrollment ID O20170313001024).
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 |
|---|---|---|---|---|---|
| ANDY HUDSON | Individual | CORPORATE DIRECTOR | Not stated in the filing | 10/1/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DONALD P REESE | Individual | CORPORATE DIRECTOR | Not stated in the filing | 2/21/2021 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| ELLEN M LEE | Individual | CORPORATE DIRECTOR | Not stated in the filing | 11/1/1990 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JUSTIN SWAN | Individual | CORPORATE DIRECTOR | Not stated in the filing | 10/1/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JUSTIN TAYLOR | Individual | CORPORATE DIRECTOR | Not stated in the filing | 3/1/2018 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KATHLEEN J BENNETT | Individual | CORPORATE DIRECTOR | Not stated in the filing | 11/1/2010 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KEVIN D SEYMOUR | Individual | CORPORATE DIRECTOR | Not stated in the filing | 3/1/2018 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MARGO C MARTIN | Individual | CORPORATE DIRECTOR | Not stated in the filing | 11/1/1999 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MARTY A NUSS | Individual | CORPORATE DIRECTOR | Not stated in the filing | 11/1/2010 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MICHAEL E YOUNG | Individual | CORPORATE DIRECTOR | Not stated in the filing | 11/1/2001 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MIKE E PETERSEN | Individual | CORPORATE DIRECTOR | Not stated in the filing | 3/1/2018 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| STEVEN P KELLY | Individual | CORPORATE DIRECTOR | Not stated in the filing | 11/1/2005 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| ROBERT C SCHMITT | Individual | CORPORATE OFFICER | Not stated in the filing | 12/9/2002 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| BRIAN E STEIDINGER | Individual | DIRECTOR | Not stated in the filing | 11/16/2016 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DONALD P REESE | Individual | W-2 MANAGING EMPLOYEE | Not stated in the filing | 10/1/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| ROBERT C SCHMITT | Individual | W-2 MANAGING EMPLOYEE | Not stated in the filing | 12/9/2002 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
Changes in ownership
- August 1, 2023: DARRIN M RAY no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- August 1, 2023: ROBIN L ROSE no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- August 1, 2023: ROBIN L ROSE no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- August 1, 2023: MATTHEW R ERTEL no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- August 1, 2023: MATTHEW R ERTEL no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- August 1, 2023: TERESA L GARDNER no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- August 1, 2023: DAVID J HAGAN no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- August 1, 2023: DAVID J HAGAN no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- August 1, 2023: CARL E HUDSON no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- August 1, 2023: GRANT W KUMMEROW no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- August 1, 2023: NANCY L KRUMWIEDE no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- August 1, 2023: JUSTIN SWAN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on August 1, 2023; associated with this enrollment since October 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- August 1, 2023: ANDY HUDSON (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on August 1, 2023; associated with this enrollment since October 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- August 1, 2023: DONALD P REESE (W-2 MANAGING EMPLOYEE) first listed in CMS’s Medicare enrollment ownership file on August 1, 2023; associated with this enrollment since October 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- August 1, 2023: DONALD P REESE (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on August 1, 2023; associated with this enrollment since February 21, 2021. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
Recent changes on this record
- August 1, 2023: DARRIN M RAY no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- August 1, 2023: ROBIN L ROSE no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- August 1, 2023: ROBIN L ROSE no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- August 1, 2023: MATTHEW R ERTEL no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- August 1, 2023: MATTHEW R ERTEL no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- August 1, 2023: TERESA L GARDNER no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- August 1, 2023: DAVID J HAGAN no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- August 1, 2023: DAVID J HAGAN no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- August 1, 2023: CARL E HUDSON no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- August 1, 2023: GRANT W KUMMEROW no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- August 1, 2023: NANCY L KRUMWIEDE no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- August 1, 2023: JUSTIN SWAN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on August 1, 2023; associated with this enrollment since October 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- August 1, 2023: ANDY HUDSON (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on August 1, 2023; associated with this enrollment since October 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- August 1, 2023: DONALD P REESE (W-2 MANAGING EMPLOYEE) first listed in CMS’s Medicare enrollment ownership file on August 1, 2023; associated with this enrollment since October 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- August 1, 2023: DONALD P REESE (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on August 1, 2023; associated with this enrollment since February 21, 2021. Skilled_Nursing_Facility_All_Owners_:_2023-08-01.csv
- August 10, 2000: A cost report was filed for fiscal year 1999, on form CMS-2540-96. SNFFY1999.zip
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | December 10, 2025 | March 13, 2024 | 0 | 0 |
| 2 | March 13, 2024 | June 5, 2023 | 7 | 0 |
| 3 | June 5, 2023 | July 21, 2022 | 4 | 0 |
From the Care Compare inspection summary file NH_SurveySummary_Sep2026_2.csv, processed on September 1, 2026.
Deficiencies cited
11 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| March 13, 2024 | Health | F 0641 | Resident Assessment and Care Planning Deficiencies | Ensure each resident receives an accurate assessment. | D | No | Deficient, Provider has date of correction | March 25, 2024 |
| March 13, 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. | D | No | Deficient, Provider has date of correction | March 22, 2024 |
| March 13, 2024 | 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 | April 4, 2024 |
| March 13, 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. | D | No | Deficient, Provider has date of correction | April 4, 2024 |
| March 13, 2024 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | F | No | Deficient, Provider has date of correction | April 4, 2024 |
| March 13, 2024 | Health | F 0881 | Infection Control Deficiencies | Implement a program that monitors antibiotic use. | E | No | Deficient, Provider has date of correction | April 4, 2024 |
| March 13, 2024 | Health | F 0887 | Infection Control Deficiencies | Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status. | D | No | Deficient, Provider has date of correction | April 4, 2024 |
| June 5, 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. | J | No | Deficient, Provider has date of correction | June 6, 2023 |
| June 5, 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 | June 26, 2023 |
| June 5, 2023 | 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 | June 26, 2023 |
| June 5, 2023 | Health | F 0881 | Infection Control Deficiencies | Implement a program that monitors antibiotic use. | D | No | Deficient, Provider has date of correction | June 26, 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 |
|---|---|---|---|---|---|
| March 13, 2024 | Fine | $20,046 | 69563 |
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 | Non profit - Corporation |
| Legal Business Name | GIBSON COMMUNITY HOSPITAL ASSOCIATION |
| Date First Approved to Provide Medicare and Medicaid Services | 1999-05-19 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | Y |
| County/Parish | Ford |
| Telephone Number | 2177842566 |
| 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 | 16 |
| Average Number of Residents per Day | 12.7 |
| Overall Rating | 5 |
| Health Inspection Rating | 5 |
| QM Rating | 4 |
| Long-Stay QM Rating | 4 |
| 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 GIBSON COMMUNITY HSP ANNEX: 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 August 10, 2000: A cost report was filed for fiscal year 1999, on form CMS-2540-96. That is one line of the alert.
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The citable document for GIBSON COMMUNITY HSP ANNEX
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 Illinois 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 145979.