Skilled nursing facility · CMS certification number 146035
NORTH ADAMS HOME
MENDON, Illinois
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.
This certification number is not in CMS’s current Care Compare Provider Information file, processed on August 1, 2026. Its Medicare enrollment, NORTH ADAMS HOME INC (enrollment ID O20111111000127), is not listed in the CMS enrollment file dated August 1, 2026.
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 November 1, 2017 to October 31, 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on June 26, 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,195,240 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $4,351 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,190,889 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,526,845 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$335,956 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $162,149 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$173,807 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$173,807 (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 | 92 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 33,580 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 1,170 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 11,828 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 6,819 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 19,817 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 69 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 14 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 46 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 129 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 16.96 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 844.86 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 153.62 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1232336, read from the public cost report file SNF10FY2018.zip.
Fiscal year 2017, ended October 31, 2017
Cost report for November 1, 2016 to October 31, 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on January 24, 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,576,301 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $16,875 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,559,426 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,103,642 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$544,216 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $185,691 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$358,525 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$358,525 (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 | 92 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,496 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 105 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 23.99 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 704.88 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 195.2 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1218103, read from the public cost report file SNF10FY2017.zip.
Fiscal year 2016, ended October 31, 2016
Cost report for November 1, 2015 to October 31, 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on June 8, 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,693,940 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $3,693,940 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,967,173 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$273,233 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $101,490 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$171,743 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$171,743 (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 | 92 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,519 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 121 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 25.89 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 665.06 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 169.58 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1160131, read from the public cost report file SNF10FY2016.zip.
Fiscal year 2015, ended October 31, 2015
Cost report for November 1, 2014 to October 31, 2015 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on May 20, 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,460,709 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $3,460,709 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,531,813 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$71,104 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $87,436 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $16,332 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $16,332 (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 | 92 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,970 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 111 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 28.87 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 485.35 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 179.91 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1124333, read from the public cost report file SNF10FY2015.zip.
Fiscal year 2014, ended October 31, 2014
Cost report for November 1, 2013 to October 31, 2014 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on February 1, 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,633,871 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $3,633,871 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,567,007 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $66,864 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $149,918 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $216,782 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $216,782 (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 | 92 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 21,717 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 97 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 31.52 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 962.69 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 223.89 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1118385, read from the public cost report file SNF10FY2014.zip.
Fiscal year 2013, ended October 31, 2013
Cost report for November 1, 2012 to October 31, 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on August 15, 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,264,936 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$60,693 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,325,629 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,454,729 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$129,100 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $119,687 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$9,413 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$9,413 (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 | 92 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 22,045 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 88 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 22.96 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 735.89 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 250.51 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1108023, read from the public cost report file SNF10FY2013.zip.
Fiscal year 2012, ended October 31, 2012
Cost report for November 1, 2011 to October 31, 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on September 23, 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,396,687 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $3,396,687 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,398,815 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$2,128 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $131,570 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $129,442 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $129,442 (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 | 92 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 21,347 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 93 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 22.75 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 857.2 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 229.54 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1078302, read from the public cost report file SNF10FY2012.zip.
Fiscal year 2011, ended October 31, 2011
Cost report for November 1, 2010 to October 31, 2011 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on March 21, 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,989,935 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,790,975 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $198,960 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $124,233 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $323,193 (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 | 92 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 25,676 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 132 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 22.27 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 699.38 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 194.52 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 434325, read from the public cost report file SNFFY2011.zip.
Fiscal year 2010, ended October 31, 2010
Cost report for November 1, 2009 to October 31, 2010 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on April 17, 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,720,474 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,596,003 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $124,471 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $48,395 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $172,866 (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 | 92 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 25,422 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 103 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 33.74 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 780.1 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 246.82 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 427226, read from the public cost report file SNFFY2010.zip.
Fiscal year 2009, ended October 31, 2009
Cost report for November 1, 2008 to October 31, 2009 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on May 25, 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,766,290 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,047,525 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$281,235 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $544,011 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $298 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $262,478 (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 | 99 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 26,629 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 110 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 38.93 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,423.25 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 242.08 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 400363, read from the public cost report file SNFFY2009.zip.
Fiscal year 2008, ended October 31, 2008
Cost report for November 1, 2007 to October 31, 2008 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on April 12, 2010.
None of these figures is carried on this report.
CMS report record 367150, read from the public cost report file SNFFY2008.zip.
Fiscal year 2007, ended October 31, 2007
Cost report for November 1, 2006 to October 31, 2007 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on March 19, 2009.
None of these figures is carried on this report.
CMS report record 335682, read from the public cost report file SNFFY2007.zip.
Fiscal year 2006, ended October 31, 2006
Cost report for November 1, 2005 to October 31, 2006 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on March 17, 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,660,159 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,176,717 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$516,558 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $154,137 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: −$362,421 (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 | 99 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 32,916 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 121 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 39.02 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 610.97 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 272.03 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 304713, read from the public cost report file SNFFY2006.zip.
Fiscal year 2005, ended October 31, 2005
Cost report for November 1, 2004 to October 31, 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on November 27, 2006.
None of these figures is carried on this report.
CMS report record 267119, read from the public cost report file SNFFY2005.zip.
Fiscal year 2004, ended October 31, 2004
Cost report for November 1, 2003 to October 31, 2004 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on November 10, 2005.
None of these figures is carried on this report.
CMS report record 236541, read from the public cost report file SNFFY2004.zip.
Fiscal year 2003, ended October 31, 2003
Cost report for October 1, 2002 to October 31, 2003 — a reporting period of 395 days, on form CMS-2540-96, settled, processed by CMS on March 1, 2005.
Net income: −$155,700 (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.
CMS report record 209242, read from the public cost report file SNFFY2003.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
Not listed in CMS’s Care Compare data.
Medicare enrollment
No owner listed for this facility in CMS’s Medicare enrollment ownership data.
Changes in ownership
- April 14, 2023: RICHARD MARTIN no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-04-14.csv
- April 14, 2023: DARON DUKE no longer appears as OTHER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-04-14.csv
- April 14, 2023: DEBORAH HULL no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-04-14.csv
- April 14, 2023: JAMES TOTSCH no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-04-14.csv
- April 14, 2023: PAUL TERWELP no longer appears as OTHER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-04-14.csv
- April 14, 2023: GERRI BUSS no longer appears as OTHER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-04-14.csv
- April 14, 2023: CAROL ANDERSON no longer appears as OTHER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-04-14.csv
- April 14, 2023: SUSAN YORK no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-04-14.csv
- April 14, 2023: TONIA HEMMING no longer appears as OTHER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-04-14.csv
- April 14, 2023: NANCY CROW no longer appears as OTHER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-04-14.csv
Recent changes on this record
- April 14, 2023: RICHARD MARTIN no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-04-14.csv
- April 14, 2023: DARON DUKE no longer appears as OTHER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-04-14.csv
- April 14, 2023: DEBORAH HULL no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-04-14.csv
- April 14, 2023: JAMES TOTSCH no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-04-14.csv
- April 14, 2023: PAUL TERWELP no longer appears as OTHER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-04-14.csv
- April 14, 2023: GERRI BUSS no longer appears as OTHER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-04-14.csv
- April 14, 2023: CAROL ANDERSON no longer appears as OTHER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-04-14.csv
- April 14, 2023: SUSAN YORK no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-04-14.csv
- April 14, 2023: TONIA HEMMING no longer appears as OTHER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-04-14.csv
- April 14, 2023: NANCY CROW no longer appears as OTHER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-04-14.csv
- June 26, 2019: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2018.zip
- January 24, 2019: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2017.zip
- June 8, 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2016.zip
- May 20, 2016: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2015.zip
- February 1, 2016: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2014.zip
- August 15, 2015: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2013.zip
- September 23, 2014: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2012.zip
- March 21, 2013: A cost report was filed for fiscal year 2011, on form CMS-2540-96. SNFFY2011.zip
- April 17, 2012: A cost report was filed for fiscal year 2010, on form CMS-2540-96. SNFFY2010.zip
- May 25, 2011: A cost report was filed for fiscal year 2009, on form CMS-2540-96. SNFFY2009.zip
- April 12, 2010: A cost report was filed for fiscal year 2008, on form CMS-2540-96. SNFFY2008.zip
- March 19, 2009: A cost report was filed for fiscal year 2007, on form CMS-2540-96. SNFFY2007.zip
- March 17, 2008: A cost report was filed for fiscal year 2006, on form CMS-2540-96. SNFFY2006.zip
- November 27, 2006: A cost report was filed for fiscal year 2005, on form CMS-2540-96. SNFFY2005.zip
- November 10, 2005: A cost report was filed for fiscal year 2004, on form CMS-2540-96. SNFFY2004.zip
- March 1, 2005: A cost report was filed for fiscal year 2003, on form CMS-2540-96. SNFFY2003.zip
Inspections
Not listed in CMS’s Care Compare data.
Deficiencies cited
Not listed in CMS’s Care Compare data.
Penalties
Not listed in CMS’s Care Compare data.
Care Compare provider information
Not listed in CMS’s Care Compare data.
Get an email when this record changes
One email a day naming what moved on NORTH ADAMS HOME: 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 June 26, 2019: A cost report was filed for fiscal year 2018, on form CMS-2540-10. That is one line of the alert.
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The citable document for NORTH ADAMS HOME
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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- WOOD DALE NORTH STP, CITY OF, WOOD DALE Water discharge permit
- GENEVA STP, CITY OF, GENEVA Water discharge permit
- WAUCONDA WWTF, WAUCONDA Water discharge permit
- HARVARD STP, CITY OF, HARVARD Water discharge permit
- MILAN STP, VILLAGE OF, MILAN Water discharge permit
- MANHATTAN STP, VILLAGE OF, MANHATTAN Water discharge permit
- FLORA STP, CITY OF, FLORA Water discharge permit
- SOLID ROCK FOUNDATIONS INC, EAST PEORIA Air emission source
- VERSA PRESS INC, EAST PEORIA Air emission source
- ROANOKE CONCRETE PRODUCTS CO, EAST PEORIA Air emission source
- BRADS AUTOBODY, ROANOKE Air emission source
- PARSONS CO INC, ROANOKE Air emission source
- EVERGREEN FS INC, ROANOKE Air emission source
- ROANOKE FARMERS ASSN, ROANOKE Air emission source
- EUREKA-GOODFIELD FIRE PROTECTION DISTRICT, EUREKA Air emission source
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 146035.