Skilled nursing facility · CMS certification number 155741
FAIRWAY VILLAGE
INDIANAPOLIS, Indiana · Medicare and Medicaid
Certified beds, as filed in Care Compare: 53
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: 0 · Fines: 0 · Fines, total amount: $0.00 · Payment denials: 0. 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 | $5,912,599 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$867,450 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,780,049 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,238,608 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $541,441 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $33,492 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $574,933 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $574,933 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 19,398 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 182 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 14,095 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 2,546 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 16,823 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 1 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 38 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 9 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 48 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 182 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 370.92 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 350.48 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1433672, read from the public cost report file SNF10FY2024.zip.
Fiscal year 2023, ended December 31, 2023
Cost report for January 1, 2023 to December 31, 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on September 25, 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,318,603 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$902,417 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,221,020 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,263,940 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$42,920 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $667,618 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $624,698 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $624,698 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 15,254 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 48 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 75 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 391.64 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 317.79 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1395804, read from the public cost report file SNF10FY2023.zip.
Fiscal year 2022, ended December 31, 2022
Cost report for January 1, 2022 to December 31, 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on May 28, 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,442,026 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$551,490 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,993,516 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,759,382 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$765,866 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $8,500 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$757,366 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$757,366 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 13,043 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 46 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 131.5 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 249.48 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 283.54 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1379264, 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 28, 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,435,981 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$244,947 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,680,928 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,796,102 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,115,174 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $7,487 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$1,107,687 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,107,687 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 13,201 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 31 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 248 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 544.44 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 425.84 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1334386, 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 June 9, 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,775,220 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$393,259 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,168,479 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,150,857 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$982,378 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $427,212 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$555,166 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$555,166 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 13,348 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 31 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicaid, in days | 339.72 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 430.58 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1318894, 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 August 12, 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,087,277 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$52,532 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,139,809 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,555,008 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$415,199 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $3,475 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$411,724 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$411,724 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 15,993 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 66 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 140 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 247.64 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 242.32 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1263290, 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 9, 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,079,086 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$127,743 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,206,829 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,462,482 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$255,653 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $5,006 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$250,647 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$250,647 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,035 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 57 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 370 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 277.46 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 281.32 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1240244, read from the public cost report file SNF10FY2018.zip.
Fiscal year 2017, ended December 31, 2017
Cost report for January 1, 2017 to December 31, 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on August 21, 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,999,518 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$298,542 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,298,060 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,370,255 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$72,195 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $4,074 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$68,121 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$68,121 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,190 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 32 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 158.83 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 705.15 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 505.94 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1207468, 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 25, 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,071,857 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $844,483 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,227,374 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,391,292 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$163,918 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $2,840 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$161,078 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$161,078 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,847 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 76 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 138.53 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 269.61 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 221.67 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1170631, read from the public cost report file SNF10FY2016.zip.
Fiscal year 2015, ended December 31, 2015
Cost report for January 1, 2015 to December 31, 2015 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on August 5, 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,902,630 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $949,457 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,953,173 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,651,378 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$698,205 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $3,741 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$694,464 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$694,464 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 12,519 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 91 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 109.72 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 155.38 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 137.57 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1139935, read from the public cost report file SNF10FY2015.zip.
Fiscal year 2014, ended July 31, 2014
Cost report for January 1, 2014 to July 31, 2014 — a reporting period of 211 days, not a full year, on form CMS-2540-10, settled, processed by CMS on October 19, 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $1,623,869 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $15,493 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $1,608,376 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,576,382 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $31,994 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,890 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $33,884 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $33,884 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 8,499 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 19 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 160.4 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 447.32 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1111694, 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 23, 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,760,456 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $2,760,456 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,702,370 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $58,086 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | $58,086 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $58,086 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 15,111 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 65 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 41.27 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 232.48 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1073274, read from the public cost report file SNF10FY2013.zip.
Fiscal year 2012, ended December 31, 2012
Cost report for January 1, 2012 to December 31, 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on November 5, 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,015,336 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $2,015,336 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,386,294 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$370,958 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $349 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$370,609 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$370,609 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,078 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 63.67 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 321.56 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1048849, 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 October 26, 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,234,379 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $2,234,379 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,465,560 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$231,181 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $18,846 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$212,335 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$212,335 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,164 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 126 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 38.67 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 128.29 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1017006, 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 June 18, 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,446,666 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,697,784 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$251,118 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $7,408 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: −$243,710 (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 | 53 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 16,266 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 43 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 53.73 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 378.28 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 430554, 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 June 21, 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,938,794 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,782,119 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $156,675 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $14,940 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $171,615 (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 | 53 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 16,759 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 37 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 86.41 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 452.95 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 406790, 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 April 12, 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,490,291 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,505,621 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$15,330 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $47,268 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $31,938 (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 | 53 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 15,603 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 37 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 53.25 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 421.7 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 367096, 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 March 12, 2009.
None of these figures is carried on this report.
CMS report record 335136, 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 April 23, 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,918,460 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,070,080 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$151,620 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $1,288 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: −$150,332 (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 | 53 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 13,554 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 61 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 33.59 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 222.2 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 306539, read from the public cost report file SNFFY2006.zip.
Fiscal year 2005, ended December 31, 2005
Cost report for October 18, 2005 to December 31, 2005 — a reporting period of 74 days, not a full year, on form CMS-2540-96, settled, processed by CMS on October 16, 2006.
None of these figures is carried on this report.
CMS report record 264564, read from the public cost report file SNFFY2006.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 |
|---|---|---|---|---|
| HENRY COUNTY MEMORIAL HOSPITAL | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | 100% | since 08/01/2024 |
| DICE, MARK | ADP OF THE SNF | Individual | NOT APPLICABLE | since 06/01/2023 |
| HURLEY, DANIEL | ADP OF THE SNF | Individual | NOT APPLICABLE | since 02/24/2025 |
| NGENE, PATRICK | ADP OF THE SNF | Individual | NOT APPLICABLE | since 02/24/2025 |
| SHANE, ANDREW | ADP OF THE SNF | Individual | NOT APPLICABLE | since 02/01/2023 |
| VAN CAMP, STEVEN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 06/01/2023 |
| RING, BRIAN | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 08/01/2022 |
| CHIES, STEVEN | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 08/01/2024 |
| DYNES, SHELDON | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 01/01/2013 |
| JACKSON, BLAKE | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 08/01/2024 |
| JACKSON, ETHAN | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 08/01/2024 |
| JACKSON, MARK | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 08/01/2024 |
| JACKSON, MICHAEL | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 08/01/2024 |
| JACKSON, WESSLEY | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 08/01/2024 |
| JUSTICE, DAVID | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 08/01/2024 |
| KELSEY, DONNA | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 08/01/2024 |
| PIDGEON, JOHN | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 01/01/2013 |
| SHORE, MARION | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 01/01/2013 |
| STITLE, STEPHEN | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 08/01/2024 |
| WARE, DEBORAH | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 01/01/2013 |
| WRIGHT, THERESSA | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 08/01/2024 |
| DICE, MARK | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 08/01/2024 |
| FEDELER, JENNIFER | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 01/21/2026 |
| HURLEY, DANIEL | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 08/01/2024 |
| NGENE, PATRICK | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 08/01/2024 |
| RING, BRIAN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 08/01/2022 |
| SHANE, ANDREW | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 08/01/2024 |
| VAN CAMP, STEVEN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 08/01/2024 |
| DYNES, SHELDON | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2013 |
| PIDGEON, JOHN | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2013 |
| SHORE, MARION | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2013 |
| WARE, DEBORAH | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2013 |
Medicare enrollment
As filed in the CMS file dated August 1, 2026 (Medicare enrollment ownership), under the enrollment of HENRY COUNTY MEMORIAL HOSPITAL (enrollment ID O20250603002242).
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 |
|---|---|---|---|---|---|
| HENRY COUNTY MEMORIAL HOSPITAL | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100 | 8/1/2024 | Private equity company: No Real estate investment trust: No Holding company: No |
| ANDREW SHANE | Individual | ADP OF THE SNF | Not stated in the filing | 2/1/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DANIEL J HURLEY | Individual | ADP OF THE SNF | Not stated in the filing | 2/24/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MARK DICE | Individual | ADP OF THE SNF | Not stated in the filing | 6/1/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| PATRICK NGENE | Individual | ADP OF THE SNF | Not stated in the filing | 2/24/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| STEVEN VAN CAMP | Individual | ADP OF THE SNF | Not stated in the filing | 6/1/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| No owner named in the filing | Organization | ADP OF THE SNF | Not stated in the filing | 3/17/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| No owner named in the filing | Organization | ADP OF THE SNF | Not stated in the filing | 7/31/2014 | Private equity company: No Real estate investment trust: No Holding company: No |
| No owner named in the filing | Organization | ADP OF THE SNF | Not stated in the filing | 3/14/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| BRIAN RING | Individual | CORPORATE OFFICER | Not stated in the filing | 8/1/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| BLAKE JACKSON | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 8/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DAVID JUSTICE | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 8/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DEBORAH WARE | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 1/1/2013 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DONNA KELSEY | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 8/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| ETHAN I JACKSON | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 8/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JOHN D PIDGEON | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 1/1/2013 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MARION E SHORE | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 1/1/2013 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MARK JACKSON | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 8/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MICHAEL L JACKSON | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 8/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| SHELDON L DYNES | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 1/1/2013 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| STEPHEN STITLE | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 8/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| STEVEN CHIES | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 8/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| THERESSA WRIGHT | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 8/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| WESSLEY JACKSON | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 8/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| ANDREW SHANE | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 8/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| BRIAN RING | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 8/1/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DANIEL J HURLEY | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 8/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JENNIFER FEDELER | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 1/21/2026 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MARK DICE | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 8/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| PATRICK NGENE | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 8/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| STEVEN VAN CAMP | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 8/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DEBORAH WARE | Individual | TRUSTEE OF THE SNF | Not stated in the filing | 1/1/2013 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JOHN D PIDGEON | Individual | TRUSTEE OF THE SNF | Not stated in the filing | 1/1/2013 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MARION E SHORE | Individual | TRUSTEE OF THE SNF | Not stated in the filing | 1/1/2013 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| SHELDON L DYNES | Individual | TRUSTEE OF THE SNF | Not stated in the filing | 1/1/2013 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
Changes in ownership
- March 1, 2026: DANIEL BAU no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- March 1, 2026: JENNIFER FEDELER (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on March 1, 2026; associated with this enrollment since January 21, 2026. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- December 1, 2025: VIRGINIA A CAINE no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: PATRICK NGENE no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: AMERICAN SENIOR COMMUNITIES LLC no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: BRENDA HORN no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: THOMAS HANIFY no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: MONICA PAYNE no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: MARK E DICE no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: PAUL T BABCOCK no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: STEVEN A VAN CAMP no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: LISA E HARRIS no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: CARL L DRUMMER no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: GEETA MANTRAVADI no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: SHELDON L DYNES (TRUSTEE OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since January 1, 2013. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: SHELDON L DYNES (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since January 1, 2013. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: PATRICK NGENE (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since February 24, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: PATRICK NGENE (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: DAVID JUSTICE (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: ANDREW E SHANE (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since February 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: ANDREW E SHANE (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: STEVEN E CHIES (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: DEBORAH WARE (TRUSTEE OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since January 1, 2013. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: DEBORAH WARE (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since January 1, 2013. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: THERESSA WRIGHT (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: HENRY COUNTY MEMORIAL HOSPITAL (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: DANIEL J HURLEY (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since February 24, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: DANIEL J HURLEY (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: DANIEL BAU (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: STEPHEN STITLE (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: ETHAN JACKSON (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: MARK E DICE (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since June 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: MARK E DICE (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: STEVEN A VAN CAMP (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since June 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: STEVEN A VAN CAMP (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: WESSLEY JACKSON (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: DONNA G KELSEY (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: BLAKE JACKSON (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: BRIAN RING (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: BRIAN RING (CORPORATE OFFICER) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: MARION E SHORE (TRUSTEE OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since January 1, 2013. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: MARION E SHORE (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since January 1, 2013. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: MICHAEL JACKSON (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: MARK A. JACKSON (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: A listing under ADP OF THE SNF, with no owner named, first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since March 14, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: JOHN D PIDGEON (TRUSTEE OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since January 1, 2013. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: JOHN D PIDGEON (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since January 1, 2013. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- June 3, 2024: CATHERINE HASSAKIS-HICKS no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-06-03.csv
- June 3, 2024: DONNA G KELSEY no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-06-03.csv
- June 3, 2024: GREGORY S FEHRIBACH no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-06-03.csv
- June 3, 2024: BEVERLY MUKES-GAITHER no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-06-03.csv
- June 3, 2024: PATRICK NGENE (CONTRACTED MANAGING EMPLOYEE) first listed in CMS’s Medicare enrollment ownership file on June 3, 2024; associated with this enrollment since March 6, 2023. Skilled_Nursing_Facility_All_Owners_:_2024-06-03.csv
- June 3, 2024: BRENDA HORN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on June 3, 2024; associated with this enrollment since December 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2024-06-03.csv
- June 3, 2024: MARK E DICE (CONTRACTED MANAGING EMPLOYEE) first listed in CMS’s Medicare enrollment ownership file on June 3, 2024; associated with this enrollment since June 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2024-06-03.csv
Recent changes on this record
- March 1, 2026: DANIEL BAU no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- March 1, 2026: JENNIFER FEDELER (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on March 1, 2026; associated with this enrollment since January 21, 2026. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- December 1, 2025: VIRGINIA A CAINE no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: PATRICK NGENE no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: AMERICAN SENIOR COMMUNITIES LLC no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: BRENDA HORN no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: THOMAS HANIFY no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: MONICA PAYNE no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: MARK E DICE no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: PAUL T BABCOCK no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: STEVEN A VAN CAMP no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: LISA E HARRIS no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: CARL L DRUMMER no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: GEETA MANTRAVADI no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: SHELDON L DYNES (TRUSTEE OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since January 1, 2013. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: SHELDON L DYNES (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since January 1, 2013. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: PATRICK NGENE (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since February 24, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: PATRICK NGENE (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: DAVID JUSTICE (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: ANDREW E SHANE (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since February 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: ANDREW E SHANE (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: STEVEN E CHIES (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: DEBORAH WARE (TRUSTEE OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since January 1, 2013. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: DEBORAH WARE (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since January 1, 2013. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: THERESSA WRIGHT (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: HENRY COUNTY MEMORIAL HOSPITAL (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: DANIEL J HURLEY (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since February 24, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: DANIEL J HURLEY (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: DANIEL BAU (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: STEPHEN STITLE (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: ETHAN JACKSON (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: MARK E DICE (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since June 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: MARK E DICE (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: STEVEN A VAN CAMP (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since June 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: STEVEN A VAN CAMP (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: WESSLEY JACKSON (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: DONNA G KELSEY (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: BLAKE JACKSON (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- December 1, 2025: BRIAN RING (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on December 1, 2025; associated with this enrollment since August 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | March 20, 2026 | March 20, 2026 | 0 | 1 |
| 2 | February 26, 2025 | February 26, 2025 | 0 | 0 |
| 3 | May 1, 2024 | May 1, 2024 | 0 | 0 |
From the Care Compare inspection summary file NH_SurveySummary_Sep2026_2.csv, processed on September 1, 2026.
Deficiencies cited
No deficiency on file for this facility in CMS’s Care Compare health citations data.
Penalties
No penalty on file for this facility in CMS’s Care Compare penalties data.
Care Compare provider information
| Field | As filed |
|---|---|
| Provider Type | Medicare and Medicaid |
| Ownership Type | For profit - Corporation |
| Legal Business Name | HENRY COUNTY MEMORIAL HOSPITAL |
| Date First Approved to Provide Medicare and Medicaid Services | 2005-10-18 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | Y |
| County/Parish | Marion |
| Telephone Number | 3177878951 |
| Chain Name | AMERICAN SENIOR COMMUNITIES |
| Chain ID | 33 |
| Provider Changed Ownership in Last 12 Months | N |
| With a Resident and Family Council | None |
| Automatic Sprinkler Systems in All Required Areas | Yes |
| Number of Certified Beds | 53 |
| Average Number of Residents per Day | 46.0 |
| Overall Rating | 5 |
| Health Inspection Rating | 5 |
| QM Rating | 5 |
| Long-Stay QM Rating | 5 |
| Processing Date | 2026-09-01 |
From the Care Compare Provider Information file NH_ProviderInfo_Sep2026_3.csv, processed on September 1, 2026.
Get an email when this record changes
One email a day naming what moved on FAIRWAY VILLAGE: 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 March 1, 2026: DANIEL BAU no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. That is one line of the alert.
Following a list of facilities? The portfolio watch follows up to 100 certification numbers you name, on one subscription — on the alerts page.
The citable document for FAIRWAY VILLAGE
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 Indiana 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.
Other public records in Indiana
- ALEXANDRIA WWTP, ALEXANDRIA Water discharge permit
- DANVILLE WWTP, DANVILLE Water discharge permit
- PORTLAND WWTP, PORTLAND Water discharge permit
- GREENFIELD WWTP, GREENFIELD Water discharge permit
- GREENSBURG WWTP, GREENSBURG Water discharge permit
- YORKTOWN WWTP, TOWN OF, YORKTOWN Water discharge permit
- NOBLESVILLE WWTP, CITY OF, NOBLESVILLE Water discharge permit
- MONTICELLO WWTP, MONTICELLO Water discharge permit
- RIETH RILEY CONSTRUCTION COMPANY INCORPORATED, TIPTON Air emission source
- LAP WOOD PRODUCTS, MONTEREY Air emission source
- CALCAR QUARRY, PAOLI Air emission source
- E & B PAVING, LLC, NOBLESVILLE Air emission source
- JENSTAR ASPHALT LLC, GARY Air emission source
- DAVIESS COUNTY MUNICIPAL HIGHWAY DEPARTMENT, MONTGOMERY Air emission source
- RIETH-RILEY CONSTRUCTION COMPANY INCORPORATED, FREMONT Air emission source
- JH RUDOLPH & COMPANY INCORPORATED PETERSBURG, DALE 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 155741.