Skilled nursing facility · CMS certification number 155814
BROOKE KNOLL VILLAGE
AVON, Indiana · Medicare and Medicaid
Certified beds, as filed in Care Compare: 117
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 November 5, 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $14,955,949 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,356,804 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $13,599,145 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $12,093,060 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $1,506,085 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | −$106,806 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,399,279 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,399,279 (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 | 117 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 42,822 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 4,344 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 18,335 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 6,410 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 29,089 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 105 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 51 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 93 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 249 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 41.37 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 359.51 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 116.82 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1441938, 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 27, 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $12,922,791 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$697,091 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $13,619,882 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,602,988 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $3,016,894 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $178,866 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $3,195,760 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $3,195,760 (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 | 117 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 27,863 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 140 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 37.35 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 670.34 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 199.02 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1396107, 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 August 31, 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $12,766,695 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$220,960 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $12,987,655 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,170,336 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $2,817,319 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | −$17,746 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $2,799,573 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $2,799,573 (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 | 117 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 29,510 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 119 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 41.57 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 921.24 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 247.98 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1363707, read from the public cost report file SNF10FY2022.zip.
Fiscal year 2021, ended December 31, 2021
Cost report for December 1, 2021 to December 31, 2021 — a reporting period of 30 days, not a full year, on form CMS-2540-10, settled, processed by CMS on March 23, 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $999,632 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$5,665 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $1,005,297 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,008,190 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$2,893 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | −$7,231 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$10,124 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$10,124 (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 | 117 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 2,757 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 18 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 52.13 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 895 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 153.17 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1344827, read from the public cost report file SNF10FY2022.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 13, 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,802,933 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$360,618 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $11,163,551 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $12,256,351 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,092,800 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,092,800 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 117 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 26,478 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 208 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 45.03 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 302.85 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 127.3 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1319298, 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 24, 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,268,695 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $729,878 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,538,817 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,548,801 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$9,984 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $9,984 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 117 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 29,971 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 148 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 35.45 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 759.57 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 202.51 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1295887, 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 14, 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,901,831 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $195,647 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $11,706,184 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $11,706,985 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$801 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $799 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$2 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$2 (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 | 117 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 35,232 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 185 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 58.07 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 922.19 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 190.44 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1240722, 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 | $12,485,071 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,600,756 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,884,315 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,886,837 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$2,522 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $6,367 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $3,845 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $3,845 (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 | 117 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 33,471 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 213 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 46.59 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 691.09 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 157.14 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1208224, read from the public cost report file SNF10FY2017.zip.
Fiscal year 2016, ended December 31, 2016
Cost report for January 1, 2016 to December 31, 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on August 4, 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $9,345,706 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,821,454 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,524,252 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,122,844 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$598,592 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | −$877 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$599,469 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$599,469 (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 | 117 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 28,340 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 135 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 49.77 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 810.33 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 209.93 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1172107, 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 4, 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,090,544 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,653,157 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,437,387 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,328,270 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $109,117 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $785 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $109,902 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $109,902 (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 | 117 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,926 | 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 | 66.84 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 354.34 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 189.77 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1139744, read from the public cost report file SNF10FY2015.zip.
Fiscal year 2014, ended December 31, 2014
Cost report for February 24, 2014 to December 31, 2014 — a reporting period of 310 days, on form CMS-2540-10, settled, processed by CMS on July 25, 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,179,101 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,108,605 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,070,496 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,760,971 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$690,475 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $12,385 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$678,090 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$678,090 (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 | 104 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 11,821 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 45 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 108.44 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 645 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 262.69 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1104046, read from the public cost report file SNF10FY2014.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 |
|---|---|---|---|---|
| WITHAM MEMORIAL HOSPITAL | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | 100% | since 12/01/2021 |
| HAFIDH, SAAD | ADP OF THE SNF | Individual | NOT APPLICABLE | since 12/11/2025 |
| MAGNOLIA HEALTH SYSTEMS 60, LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 12/11/2025 |
| MAGNOLIA HEALTH SYSTEMS 80, LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 12/11/2025 |
| MAGNOLIA HEALTH SYSTEMS INC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 12/01/2021 |
| T & N PARTNERSHIP, L.P. | ADP OF THE SNF | Organization | NOT APPLICABLE | since 01/01/2014 |
| WARD, JONATHAN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 12/01/2021 |
| WILSON, JESSICA | ADP OF THE SNF | Individual | NOT APPLICABLE | since 12/11/2025 |
| BAYSTON, BRETT | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 01/01/2023 |
| BRAND, JOHN | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 12/01/2021 |
| CASTETTER, ANDREA | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 01/01/2023 |
| HAWKINS, CLAUDE | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 12/01/2021 |
| HORNBECKER, MICHAEL | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 01/01/2024 |
| REAGAN, JULIE | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 09/25/2024 |
| BRAVERMAN, KELLY | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 12/01/2021 |
| SELLERS, DANIEL | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 06/21/2024 |
| ACCHIARDO, LISA | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | Individual | NOT APPLICABLE | since 12/11/2025 |
| RAMSEY, CHRIS | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | Individual | NOT APPLICABLE | since 12/11/2025 |
| RAMSEY, NEIL | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | Individual | NOT APPLICABLE | since 12/11/2025 |
| REED, MICHAEL | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | Individual | NOT APPLICABLE | since 12/11/2025 |
| HAFIDH, SAAD | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 01/01/2025 |
| MAGNOLIA HEALTH MANAGEMENT XXX, LLC | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | since 12/01/2021 |
| REED, STUART | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 12/01/2021 |
| WILSON, JESSICA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 01/01/2025 |
Medicare enrollment
As filed in the CMS file dated August 1, 2026 (Medicare enrollment ownership), under the enrollment of WITHAM MEMORIAL HOSPITAL (enrollment ID O20220321000234).
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 |
|---|---|---|---|---|---|
| WITHAM MEMORIAL HOSPITAL | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100 | 12/1/2021 | Private equity company: No Real estate investment trust: No Holding company: No |
| JESSICA WILSON | Individual | ADP OF THE SNF | Not stated in the filing | 12/11/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JONATHAN WARD | Individual | ADP OF THE SNF | Not stated in the filing | 12/1/2021 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MAGNOLIA HEALTH SYSTEMS 60, LLC | Organization | ADP OF THE SNF | Not stated in the filing | 12/11/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| MAGNOLIA HEALTH SYSTEMS 80, LLC | Organization | ADP OF THE SNF | Not stated in the filing | 12/11/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| MAGNOLIA HEALTH SYSTEMS INC | Organization | ADP OF THE SNF | Not stated in the filing | 12/1/2021 | Private equity company: No Real estate investment trust: No Holding company: No |
| SAAD A HAFIDH | Individual | ADP OF THE SNF | Not stated in the filing | 12/11/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| T & N PARTNERSHIP, L.P. | Organization | ADP OF THE SNF | Not stated in the filing | 1/1/2014 | Private equity company: No Real estate investment trust: No Holding company: No |
| ANDREA CASTETTER | Individual | CORPORATE DIRECTOR | Not stated in the filing | 1/1/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| BRETT BAYSTON | Individual | CORPORATE DIRECTOR | Not stated in the filing | 1/1/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| CLAUDE A HAWKINS | Individual | CORPORATE DIRECTOR | Not stated in the filing | 12/1/2021 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JOHN W BRAND | Individual | CORPORATE DIRECTOR | Not stated in the filing | 12/1/2021 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JULIE REAGAN | Individual | CORPORATE DIRECTOR | Not stated in the filing | 9/25/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MICHAEL JASON HORNBECKER | Individual | CORPORATE DIRECTOR | Not stated in the filing | 1/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DANIEL E SELLERS | Individual | CORPORATE OFFICER | 100 | 6/21/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KELLY BRAVERMAN | Individual | CORPORATE OFFICER | 100 | 12/1/2021 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JESSICA WILSON | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 1/1/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MAGNOLIA HEALTH MANAGEMENT XXX, LLC | Organization | OPERATIONAL/MANAGERIAL CONTROL | 100 | 12/1/2021 | Private equity company: No Real estate investment trust: No Holding company: No |
| SAAD A HAFIDH | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 1/1/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| STUART B REED | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 12/1/2021 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
Changes in ownership
- February 1, 2026: MEGAN MILLER no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: STEPHEN J BARDOCZI no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: MAGNOLIA HEALTH SYSTEMS 80, LLC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since December 11, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: MAGNOLIA HEALTH SYSTEMS 60, LLC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since December 11, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: SAAD A HAFIDH (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since December 11, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: SAAD A HAFIDH (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since January 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: JESSICA WILSON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since December 11, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: JESSICA WILSON (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since January 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: T & N PARTNERSHIP, L.P. (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since January 1, 2014. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: JULIE REAGAN (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since September 25, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: JONATHAN WARD (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since December 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: MAGNOLIA HEALTH SYSTEMS INC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since December 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: STUART B REED (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since December 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- September 1, 2024: GEORGE POGAS no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: DANIEL E SELLERS (OFFICER) first listed in CMS’s Medicare enrollment ownership file on September 1, 2024; associated with this enrollment since June 21, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- February 1, 2024: JOHN W BRAND no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-02-01.csv
- February 1, 2024: CLAUDE A HAWKINS no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-02-01.csv
- February 1, 2024: NANCY MORTON no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-02-01.csv
- February 1, 2024: MARGARET MCFRYE no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-02-01.csv
- February 1, 2024: BEVERLY NEWHART no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-02-01.csv
- February 1, 2024: JACK JONES no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-02-01.csv
- February 1, 2024: BRETT BAYSTON (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on February 1, 2024; associated with this enrollment since January 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2024-02-01.csv
- February 1, 2024: MAGNOLIA HEALTH MANAGEMENT XXX, LLC (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on February 1, 2024; associated with this enrollment since December 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2024-02-01.csv
- February 1, 2024: JOHN W BRAND (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on February 1, 2024; associated with this enrollment since December 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2024-02-01.csv
- February 1, 2024: CLAUDE A HAWKINS (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on February 1, 2024; associated with this enrollment since December 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2024-02-01.csv
- February 1, 2024: ANDREA CASTETTER (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on February 1, 2024; associated with this enrollment since January 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2024-02-01.csv
- February 1, 2024: MICHAEL JASON HORNBECKER (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on February 1, 2024; associated with this enrollment since January 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-02-01.csv
- February 1, 2024: STEPHEN J BARDOCZI (W-2 MANAGING EMPLOYEE) first listed in CMS’s Medicare enrollment ownership file on February 1, 2024; associated with this enrollment since December 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2024-02-01.csv
- January 1, 2023: DERON STEINER no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- January 1, 2023: TRACY CONROY no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- January 1, 2023: AMANDA RODEWALD no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- January 1, 2023: STEPHANIE J BLEVINS no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- January 1, 2023: DAVIESS COUNTY HOSPITAL no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- January 1, 2023: MEGAN MILLER (W-2 MANAGING EMPLOYEE) first listed in CMS’s Medicare enrollment ownership file on January 1, 2023; associated with this enrollment since December 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- January 1, 2023: JOHN W BRAND (OFFICER) first listed in CMS’s Medicare enrollment ownership file on January 1, 2023; associated with this enrollment since December 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- January 1, 2023: CLAUDE A HAWKINS (OFFICER) first listed in CMS’s Medicare enrollment ownership file on January 1, 2023; associated with this enrollment since December 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- January 1, 2023: GEORGE POGAS (OFFICER) first listed in CMS’s Medicare enrollment ownership file on January 1, 2023; associated with this enrollment since December 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- January 1, 2023: WITHAM MEMORIAL HOSPITAL (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on January 1, 2023; associated with this enrollment since December 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- January 1, 2023: NANCY MORTON (OFFICER) first listed in CMS’s Medicare enrollment ownership file on January 1, 2023; associated with this enrollment since December 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- January 1, 2023: MARGARET MCFRYE (OFFICER) first listed in CMS’s Medicare enrollment ownership file on January 1, 2023; associated with this enrollment since December 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- January 1, 2023: BEVERLY NEWHART (OFFICER) first listed in CMS’s Medicare enrollment ownership file on January 1, 2023; associated with this enrollment since December 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- January 1, 2023: KELLY BRAVERMAN (OFFICER) first listed in CMS’s Medicare enrollment ownership file on January 1, 2023; associated with this enrollment since December 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- January 1, 2023: JACK JONES (OFFICER) first listed in CMS’s Medicare enrollment ownership file on January 1, 2023; associated with this enrollment since December 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
Recent changes on this record
- February 1, 2026: MEGAN MILLER no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: STEPHEN J BARDOCZI no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: MAGNOLIA HEALTH SYSTEMS 80, LLC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since December 11, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: MAGNOLIA HEALTH SYSTEMS 60, LLC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since December 11, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: SAAD A HAFIDH (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since December 11, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: SAAD A HAFIDH (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since January 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: JESSICA WILSON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since December 11, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: JESSICA WILSON (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since January 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: T & N PARTNERSHIP, L.P. (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since January 1, 2014. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: JULIE REAGAN (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since September 25, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: JONATHAN WARD (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since December 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: MAGNOLIA HEALTH SYSTEMS INC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since December 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: STUART B REED (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since December 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- November 5, 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- September 27, 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- September 1, 2024: GEORGE POGAS no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: DANIEL E SELLERS (OFFICER) first listed in CMS’s Medicare enrollment ownership file on September 1, 2024; associated with this enrollment since June 21, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- February 1, 2024: JOHN W BRAND no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-02-01.csv
- February 1, 2024: CLAUDE A HAWKINS no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-02-01.csv
- February 1, 2024: NANCY MORTON no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-02-01.csv
- February 1, 2024: MARGARET MCFRYE no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-02-01.csv
- February 1, 2024: BEVERLY NEWHART no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-02-01.csv
- February 1, 2024: JACK JONES no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-02-01.csv
- February 1, 2024: BRETT BAYSTON (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on February 1, 2024; associated with this enrollment since January 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2024-02-01.csv
- February 1, 2024: MAGNOLIA HEALTH MANAGEMENT XXX, LLC (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on February 1, 2024; associated with this enrollment since December 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2024-02-01.csv
- February 1, 2024: JOHN W BRAND (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on February 1, 2024; associated with this enrollment since December 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2024-02-01.csv
- February 1, 2024: CLAUDE A HAWKINS (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on February 1, 2024; associated with this enrollment since December 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2024-02-01.csv
- February 1, 2024: ANDREA CASTETTER (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on February 1, 2024; associated with this enrollment since January 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2024-02-01.csv
- February 1, 2024: MICHAEL JASON HORNBECKER (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on February 1, 2024; associated with this enrollment since January 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-02-01.csv
- February 1, 2024: STEPHEN J BARDOCZI (W-2 MANAGING EMPLOYEE) first listed in CMS’s Medicare enrollment ownership file on February 1, 2024; associated with this enrollment since December 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2024-02-01.csv
- August 31, 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- March 23, 2023: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2022.zip
- March 10, 2023: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
- January 1, 2023: DERON STEINER no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- January 1, 2023: TRACY CONROY no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- January 1, 2023: AMANDA RODEWALD no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- January 1, 2023: STEPHANIE J BLEVINS no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- January 1, 2023: DAVIESS COUNTY HOSPITAL no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- January 1, 2023: MEGAN MILLER (W-2 MANAGING EMPLOYEE) first listed in CMS’s Medicare enrollment ownership file on January 1, 2023; associated with this enrollment since December 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- January 1, 2023: JOHN W BRAND (OFFICER) first listed in CMS’s Medicare enrollment ownership file on January 1, 2023; associated with this enrollment since December 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | April 9, 2026 | April 9, 2026 | 9 | 0 |
| 2 | March 27, 2025 | March 27, 2025 | 10 | 1 |
| 3 | January 25, 2024 | January 25, 2024 | 10 | 0 |
From the Care Compare inspection summary file NH_SurveySummary_Sep2026_2.csv, processed on September 1, 2026.
Deficiencies cited
29 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| April 9, 2026 | Health | F 0641 | Resident Assessment and Care Planning Deficiencies | Ensure each resident receives an accurate assessment. | D | No | Deficient, Provider has date of correction | May 16, 2026 |
| April 9, 2026 | Health | F 0655 | Resident Assessment and Care Planning Deficiencies | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | D | No | Deficient, Provider has date of correction | May 16, 2026 |
| April 9, 2026 | Health | F 0658 | Resident Assessment and Care Planning Deficiencies | Ensure services provided by the nursing facility meet professional standards of quality. | D | No | Deficient, Provider has date of correction | May 16, 2026 |
| April 9, 2026 | Health | F 0677 | Quality of Life and Care Deficiencies | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | No | Deficient, Provider has date of correction | May 16, 2026 |
| April 9, 2026 | Health | F 0761 | Pharmacy Service Deficiencies | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | No | Deficient, Provider has date of correction | May 16, 2026 |
| April 9, 2026 | Health | F 0842 | Resident Assessment and Care Planning Deficiencies | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | No | Deficient, Provider has date of correction | May 16, 2026 |
| April 9, 2026 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | E | No | Deficient, Provider has date of correction | May 16, 2026 |
| February 2, 2026 | Health | F 0692 | Quality of Life and Care Deficiencies | Provide enough food/fluids to maintain a resident's health. | D | Yes | Deficient, Provider has date of correction | February 27, 2026 |
| February 2, 2026 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | Yes | Deficient, Provider has date of correction | February 27, 2026 |
| August 13, 2025 | Health | F 0761 | Pharmacy Service Deficiencies | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | Yes | Deficient, Provider has date of correction | September 2, 2025 |
| March 27, 2025 | Health | F 0550 | Resident Rights Deficiencies | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | E | No | Deficient, Provider has date of correction | April 18, 2025 |
| March 27, 2025 | Health | F 0561 | Resident Rights Deficiencies | Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. | D | No | Deficient, Provider has date of correction | April 18, 2025 |
| March 27, 2025 | Health | F 0646 | Resident Assessment and Care Planning Deficiencies | Notify the appropriate authorities when residents with MD or ID services has a significant change in condition. | D | No | Deficient, Provider has date of correction | April 18, 2025 |
| March 27, 2025 | Health | F 0661 | Resident Assessment and Care Planning Deficiencies | Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. | D | No | Deficient, Provider has date of correction | April 18, 2025 |
| March 27, 2025 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | No | Deficient, Provider has date of correction | April 18, 2025 |
| March 27, 2025 | Health | F 0699 | Quality of Life and Care Deficiencies | Provide care or services that was trauma informed and/or culturally competent. | D | No | Deficient, Provider has date of correction | April 18, 2025 |
| March 27, 2025 | Health | F 0756 | Pharmacy Service Deficiencies | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | D | No | Deficient, Provider has date of correction | April 18, 2025 |
| March 27, 2025 | Health | F 0761 | Pharmacy Service Deficiencies | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | E | No | Deficient, Provider has date of correction | April 18, 2025 |
| March 27, 2025 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | E | No | Deficient, Provider has date of correction | April 18, 2025 |
| March 12, 2024 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Yes | Past Non-Compliance | February 22, 2024 |
| January 25, 2024 | Health | F 0558 | Resident Rights Deficiencies | Reasonably accommodate the needs and preferences of each resident. | E | No | Deficient, Provider has date of correction | January 26, 2024 |
| January 25, 2024 | Health | F 0641 | Resident Assessment and Care Planning Deficiencies | Ensure each resident receives an accurate assessment. | D | No | Deficient, Provider has date of correction | January 26, 2024 |
| January 25, 2024 | Health | F 0677 | Quality of Life and Care Deficiencies | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | No | Deficient, Provider has date of correction | January 26, 2024 |
| January 25, 2024 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | No | Deficient, Provider has date of correction | January 26, 2024 |
| January 25, 2024 | Health | F 0693 | Quality of Life and Care Deficiencies | Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. | D | No | Deficient, Provider has date of correction | January 26, 2024 |
| January 25, 2024 | Health | F 0695 | Quality of Life and Care Deficiencies | Provide safe and appropriate respiratory care for a resident when needed. | D | No | Deficient, Provider has date of correction | January 26, 2024 |
| January 25, 2024 | Health | F 0699 | Quality of Life and Care Deficiencies | Provide care or services that was trauma informed and/or culturally competent. | D | No | Deficient, Provider has date of correction | January 26, 2024 |
| January 25, 2024 | Health | F 0761 | Pharmacy Service Deficiencies | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | E | No | Deficient, Provider has date of correction | January 26, 2024 |
| January 25, 2024 | Health | F 0812 | Nutrition and Dietary Deficiencies | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | D | No | Deficient, Provider has date of correction | January 26, 2024 |
From the Care Compare health citations file NH_HealthCitations_Sep2026_2.csv, processed on September 1, 2026.
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 | Government - County |
| Legal Business Name | WITHAM MEMORIAL HOSPITAL |
| Date First Approved to Provide Medicare and Medicaid Services | 2014-02-24 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | Y |
| County/Parish | Hendricks |
| Telephone Number | 3172041100 |
| Chain Name | HCF MANAGEMENT INDIANA |
| Chain ID | 252 |
| Provider Changed Ownership in Last 12 Months | N |
| With a Resident and Family Council | Resident |
| Automatic Sprinkler Systems in All Required Areas | Yes |
| Number of Certified Beds | 117 |
| Average Number of Residents per Day | 88.4 |
| Overall Rating | 2 |
| Health Inspection Rating | 2 |
| QM Rating | 4 |
| Long-Stay QM Rating | 2 |
| Short-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.
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On November 5, 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. That is one line of the alert.
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The citable document for BROOKE KNOLL 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.
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Every figure on this page is printed as it appears in the CMS file named beside it. A figure that does not match its file? Tell us on the corrections page, quoting certification number 155814.