Skilled nursing facility · CMS certification number 155853
PARK PLACE AT ST JOHN
SAINT JOHN, Indiana
Download this facility’s record (CSV)
A CSV file of this facility’s record: its name and location, its Medicare cost-report finances year by year, its ownership, its inspections, deficiencies and penalties, and the Care Compare provider information — each figure with the worksheet, line and column or file it came from.
This certification number is not in CMS’s current Care Compare Provider Information file, processed on August 1, 2026. Its Medicare enrollment, PARK PLACE CHRISTIAN COMMUNITY OF ST. JOHN, INC. (enrollment ID O20160824002249), is not listed in the CMS enrollment file dated August 1, 2026.
For this facility: the citable document with full history — $295 · an email when this record changes — $99/month
Finances, as filed
From this facility’s Medicare cost reports on form CMS-2540, each figure with the worksheet, line and column it was read from.
Cost report for January 1, 2024 to August 7, 2024 — a reporting period of 219 days, not a full year, on form CMS-2540-10, settled, processed by CMS on March 12, 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,574,416 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $511,970 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,062,446 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,297,681 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,235,235 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $10 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$1,235,225 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,235,225 (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 | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 11,000 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 848 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Other-payer patient days | 9,178 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 10,026 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 27 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Other-payer discharges | 32 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 59 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 31.41 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 169.93 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1405085, 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 10, 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $9,285,370 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,602,310 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,683,060 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,183,934 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,500,874 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | −$1,500,874 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,500,875 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,807 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 379 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 28.79 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 44.35 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1394369, 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 July 31, 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,550,960 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,991,120 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $8,559,840 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,747,289 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,187,449 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | −$1,187,449 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,187,449 (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 | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,262 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 455 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 31.02 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 37.94 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1390672, 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 | $9,636,261 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,800,407 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,835,854 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,159,745 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,323,891 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $83,152 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$1,240,739 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,240,739 (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 | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,759 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 570 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 31.51 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 29.4 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1334389, 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 October 20, 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,921,430 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,327,536 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,593,894 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,778,574 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,184,680 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,126,951 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$57,729 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$57,729 (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 | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,118 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 427 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 33.9 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 37.75 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1302450, 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 December 7, 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $9,794,274 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,475,335 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,318,939 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,624,380 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,305,441 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $3,076 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$1,302,365 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,302,365 (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 | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,780 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 511 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 28.06 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 32.84 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1275168, 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 19, 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,253,445 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,001,861 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,251,584 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,459,632 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$2,208,048 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $70 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$2,207,978 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$2,207,978 (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 | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 12,781 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 295 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 35.98 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 43.33 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1241218, read from the public cost report file SNF10FY2018.zip.
Fiscal year 2017, ended December 31, 2017
Cost report for January 1, 2017 to December 31, 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on July 25, 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,605,613 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $919,146 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,686,467 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,771,256 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$2,084,789 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | −$2,084,789 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$2,084,789 (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 | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 8,156 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 177 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 35.56 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 46.08 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1202638, read from the public cost report file SNF10FY2017.zip.
Fiscal year 2016, ended December 31, 2016
Cost report for November 3, 2016 to December 31, 2016 — a reporting period of 58 days, not a full year, on form CMS-2540-10, settled, processed by CMS on August 10, 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $236,911 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $3,111 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $233,800 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $626,557 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$392,757 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | −$392,757 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$392,757 (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 | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 498 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 6 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 76.8 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 83 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1172680, read from the public cost report file SNF10FY2017.zip.
Nurse staffing
Nurse staffing hours from the Payroll-Based Journal, quarter by quarter, are on this facility’s staffing page, each quarter with the file it came from.
Ownership, as filed with CMS
Care Compare
Not listed in CMS’s Care Compare data.
Medicare enrollment
No owner listed for this facility in CMS’s Medicare enrollment ownership data.
Changes in ownership
- October 1, 2024: PATRICIA L JABAAY no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: KYLE YONKER no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: WILLIAM ZANDSTRA no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: EMILY MCMASTER no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: KAREN HUIZENGA no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: DAVID TIEMERSMA no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: SHERYL HAMMER no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: DAVID VOSS no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: BARRY VANDERGENUGTEN no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: ROGER BOEREMA no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: JACOB J GROENEWOLD no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: EDWARD DAMSTRA no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: THEODORE EARLE FEENSTRA no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: PAUL KATS no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: PAUL BUIKEMA no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: DARREN VAN ESSEN no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: JOHANNA ZANDSTRA no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: JOHANNA ZANDSTRA no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOME no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: KENNETH ALAN HOVING no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- March 15, 2023: KEN SCHOON no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: ROBERT WORKMAN no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: JUSTIN KATS no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: DON VAN DYK no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: TIM BREEMS no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: RICH VANHATTEM no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: NANCY VANDRUNEN no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: CAL TAMELING no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: PATRICIA L JABAAY (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on March 15, 2023; associated with this enrollment since April 2, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: KYLE YONKER (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on March 15, 2023; associated with this enrollment since April 2, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: WILLIAM ZANDSTRA (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on March 15, 2023; associated with this enrollment since April 2, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: EMILY MCMASTER (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on March 15, 2023; associated with this enrollment since April 2, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: KAREN HUIZENGA (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on March 15, 2023; associated with this enrollment since April 2, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: DAVID TIEMERSMA (W-2 MANAGING EMPLOYEE) first listed in CMS’s Medicare enrollment ownership file on March 15, 2023; associated with this enrollment since April 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: SHERYL HAMMER (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on March 15, 2023; associated with this enrollment since April 2, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: DAVID VOSS (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on March 15, 2023; associated with this enrollment since April 2, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: ROGER BOEREMA (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on March 15, 2023; associated with this enrollment since April 2, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: JACOB J GROENEWOLD (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on March 15, 2023; associated with this enrollment since April 2, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: EDWARD DAMSTRA (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on March 15, 2023; associated with this enrollment since April 2, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: THEODORE EARLE FEENSTRA (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on March 15, 2023; associated with this enrollment since April 2, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: PAUL KATS (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on March 15, 2023; associated with this enrollment since April 2, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: PAUL BUIKEMA (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on March 15, 2023; associated with this enrollment since April 2, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: DARREN VAN ESSEN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on March 15, 2023; associated with this enrollment since April 2, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: KENNETH ALAN HOVING (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on March 15, 2023; associated with this enrollment since April 2, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
Recent changes on this record
- March 12, 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- October 1, 2024: PATRICIA L JABAAY no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: KYLE YONKER no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: WILLIAM ZANDSTRA no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: EMILY MCMASTER no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: KAREN HUIZENGA no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: DAVID TIEMERSMA no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: SHERYL HAMMER no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: DAVID VOSS no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: BARRY VANDERGENUGTEN no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: ROGER BOEREMA no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: JACOB J GROENEWOLD no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: EDWARD DAMSTRA no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: THEODORE EARLE FEENSTRA no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: PAUL KATS no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: PAUL BUIKEMA no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: DARREN VAN ESSEN no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: JOHANNA ZANDSTRA no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: JOHANNA ZANDSTRA no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOME no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: KENNETH ALAN HOVING no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- September 10, 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- July 31, 2024: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- March 15, 2023: KEN SCHOON no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: ROBERT WORKMAN no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: JUSTIN KATS no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: DON VAN DYK no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: TIM BREEMS no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: RICH VANHATTEM no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: NANCY VANDRUNEN no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: CAL TAMELING no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: PATRICIA L JABAAY (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on March 15, 2023; associated with this enrollment since April 2, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: KYLE YONKER (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on March 15, 2023; associated with this enrollment since April 2, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: WILLIAM ZANDSTRA (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on March 15, 2023; associated with this enrollment since April 2, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: EMILY MCMASTER (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on March 15, 2023; associated with this enrollment since April 2, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: KAREN HUIZENGA (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on March 15, 2023; associated with this enrollment since April 2, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: DAVID TIEMERSMA (W-2 MANAGING EMPLOYEE) first listed in CMS’s Medicare enrollment ownership file on March 15, 2023; associated with this enrollment since April 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: SHERYL HAMMER (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on March 15, 2023; associated with this enrollment since April 2, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: DAVID VOSS (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on March 15, 2023; associated with this enrollment since April 2, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- March 15, 2023: ROGER BOEREMA (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on March 15, 2023; associated with this enrollment since April 2, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
Inspections
Not listed in CMS’s Care Compare data.
Deficiencies cited
Not listed in CMS’s Care Compare data.
Penalties
Not listed in CMS’s Care Compare data.
Care Compare provider information
Not listed in CMS’s Care Compare data.
Get an email when this record changes
One email a day naming what moved on PARK PLACE AT ST JOHN: 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 12, 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 PARK PLACE AT ST JOHN
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 155853.