Skilled nursing facility · CMS certification number 165438

Stacyville Community Nursing Home

Stacyville, Iowa · Medicare and Medicaid

Certified beds, as filed in Care Compare: 34

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: 2 · Fines: 1 · Fines, total amount: $21,986.00 · Payment denials: 1. The most recent penalty on file: July 17, 2024, Fine, $21,986. 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 October 20, 2025.

Revenue and expenses, fiscal year 2024
Figure	As filed	Where it comes from
Total patient revenue	$3,458,303	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$273,382	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$3,184,921	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$3,115,635	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$69,286	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$203,235	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$272,521	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $221,776 (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%).

Beds, days and discharges, fiscal year 2024
Figure	As filed	Where it comes from
Total facility beds, all components	34	CMS-2540-10 worksheet S300001 line 800 column 100
Bed days available, all components	12,444	CMS-2540-10 worksheet S300001 line 800 column 200
Medicare (Title XVIII) patient days	974	CMS-2540-10 worksheet S300001 line 800 column 400
Medicaid (Title XIX) patient days	3,864	CMS-2540-10 worksheet S300001 line 800 column 500
Other-payer patient days	4,657	CMS-2540-10 worksheet S300001 line 800 column 600
Total patient days, all components	9,495	CMS-2540-10 worksheet S300001 line 800 column 700
Medicare discharges	19	CMS-2540-10 worksheet S300001 line 800 column 900
Medicaid discharges	11	CMS-2540-10 worksheet S300001 line 800 column 1000
Other-payer discharges	48	CMS-2540-10 worksheet S300001 line 800 column 1100
Total discharges, all components	78	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	51.26	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	351.27	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	121.73	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1441086, 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 30, 2024.

Revenue and expenses, fiscal year 2023
Figure	As filed	Where it comes from
Total patient revenue	$1,846,990	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$230,841	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$1,616,149	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$2,490,863	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$874,714	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$707,196	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$167,518	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$198,619 (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%).

Beds, days and discharges, fiscal year 2023
Figure	As filed	Where it comes from
Total facility beds, all components	34	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	6,040	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	37	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	43.14	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	365.75	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	163.24	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1396247, 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 29, 2023.

Revenue and expenses, fiscal year 2022
Figure	As filed	Where it comes from
Total patient revenue	$1,727,500	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$122,727	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$1,604,773	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$2,217,366	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$612,593	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$141,594	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$470,999	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$483,886 (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%).

Beds, days and discharges, fiscal year 2022
Figure	As filed	Where it comes from
Total facility beds, all components	34	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	6,220	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	25	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	45.18	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	115.75	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	248.8	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1363411, 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 October 20, 2022.

Revenue and expenses, fiscal year 2021
Figure	As filed	Where it comes from
Total patient revenue	$2,046,130	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$90,940	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$1,955,190	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$2,125,276	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$170,086	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$103,732	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$66,354	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$80,050 (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%).

Beds, days and discharges, fiscal year 2021
Figure	As filed	Where it comes from
Total facility beds, all components	34	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	7,693	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	16	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	41.1	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	958.5	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	480.81	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1335511, 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 September 22, 2021.

Revenue and expenses, fiscal year 2020
Figure	As filed	Where it comes from
Total patient revenue	$2,032,189	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$18,722	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$2,013,467	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$2,216,006	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$202,539	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$670,060	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$467,521	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $467,521 (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%).

Beds, days and discharges, fiscal year 2020
Figure	As filed	Where it comes from
Total facility beds, all components	52	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	9,534	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	23	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	91.25	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	563	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	414.52	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1300757, 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 June 19, 2020.

Revenue and expenses, fiscal year 2019
Figure	As filed	Where it comes from
Total patient revenue	$2,334,067	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$4,205	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$2,329,862	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$2,313,758	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$16,104	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$63,331	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$79,435	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $79,435 (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%).

Beds, days and discharges, fiscal year 2019
Figure	As filed	Where it comes from
Total facility beds, all components	52	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	12,528	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	58	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	26.1	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	229.5	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	216	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1258444, 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 June 5, 2019.

Revenue and expenses, fiscal year 2018
Figure	As filed	Where it comes from
Total patient revenue	$1,871,288	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$1,729	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$1,869,559	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$2,018,097	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$148,538	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$79,141	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$69,397	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$69,397 (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%).

Beds, days and discharges, fiscal year 2018
Figure	As filed	Where it comes from
Total facility beds, all components	52	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	11,098	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	47	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	22.42	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	2,675	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	236.13	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1226271, 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 19, 2018.

Revenue and expenses, fiscal year 2017
Figure	As filed	Where it comes from
Total patient revenue	$1,594,535	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$11,034	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$1,583,501	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$1,755,989	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$172,488	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$196,229	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$23,741	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $23,741 (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%).

Beds, days and discharges, fiscal year 2017
Figure	As filed	Where it comes from
Total facility beds, all components	52	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	10,472	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	34	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	20.92	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	554.75	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	308	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1198897, 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 June 14, 2017.

Revenue and expenses, fiscal year 2016
Figure	As filed	Where it comes from
Total patient revenue	$1,764,570	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$594	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$1,763,976	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$1,686,014	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$77,962	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$58,315	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$136,277	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $136,277 (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%).

Beds, days and discharges, fiscal year 2016
Figure	As filed	Where it comes from
Total facility beds, all components	52	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	11,699	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	37	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	26.08	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	1,285	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	316.19	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1161815, 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 3, 2016.

Revenue and expenses, fiscal year 2015
Figure	As filed	Where it comes from
Total patient revenue	$1,551,781	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$10,728	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$1,541,053	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$1,466,296	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$74,757	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$375,325	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$450,082	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $450,082 (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%).

Beds, days and discharges, fiscal year 2015
Figure	As filed	Where it comes from
Total facility beds, all components	52	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	10,622	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	37	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	25.53	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	362	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	287.08	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1139538, read from the public cost report file SNF10FY2015.zip.

Fiscal year 2014, ended December 31, 2014

Cost report for January 1, 2014 to December 31, 2014 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on July 24, 2015.

Revenue and expenses, fiscal year 2014
Figure	As filed	Where it comes from
Total patient revenue	$1,134,868	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$76,778	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$1,058,090	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$1,306,877	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$248,787	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$75,045	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$173,742	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$173,742 (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%).

Beds, days and discharges, fiscal year 2014
Figure	As filed	Where it comes from
Total facility beds, all components	52	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	8,308	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	33	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	23.29	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	739.5	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	251.76	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1101668, read from the public cost report file SNF10FY2014.zip.

Fiscal year 2013, ended December 31, 2013

Cost report for January 1, 2013 to December 31, 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on July 23, 2014.

Revenue and expenses, fiscal year 2013
Figure	As filed	Where it comes from
Total patient revenue	$1,246,083	CMS-2540-10 worksheet G300000 line 100 column 100
Net patient revenue	$1,246,083	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$1,287,004	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$40,921	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$49,908	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$8,987	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $8,987 (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%).

Beds, days and discharges, fiscal year 2013
Figure	As filed	Where it comes from
Total facility beds, all components	52	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	8,435	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	32	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	90.43	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	263.59	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1073227, read from the public cost report file SNF10FY2013.zip.

Fiscal year 2012, ended December 31, 2012

Cost report for January 1, 2012 to December 31, 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on July 23, 2013.

Revenue and expenses, fiscal year 2012
Figure	As filed	Where it comes from
Total patient revenue	$1,094,575	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$97	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$1,094,478	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$1,234,980	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$140,502	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$55,611	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$84,891	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$84,891 (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%).

Beds, days and discharges, fiscal year 2012
Figure	As filed	Where it comes from
Total facility beds, all components	52	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	7,434	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	38	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	38	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	720.6	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	195.63	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1043163, read from the public cost report file SNF10FY2012.zip.

Fiscal year 2011, ended December 31, 2011

Cost report for January 1, 2011 to December 31, 2011 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on September 27, 2012.

Revenue and expenses, fiscal year 2011
Figure	As filed	Where it comes from
Total patient revenue	$1,124,268	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$12,496	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$1,111,772	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$1,224,097	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$112,325	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$30,836	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$81,489	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$81,489 (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%).

Beds, days and discharges, fiscal year 2011
Figure	As filed	Where it comes from
Total facility beds, all components	52	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	7,679	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	36	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	34.43	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	329	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	213.31	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1012699, read from the public cost report file SNF10FY2011.zip.

Fiscal year 2010, ended December 31, 2010

Cost report for January 1, 2010 to December 31, 2010 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on July 20, 2011.

Revenue and expenses, fiscal year 2010
Figure	As filed	Where it comes from
Net patient revenue	$1,328,774	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$1,326,145	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	$2,629	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$39,708	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income: $42,337 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.

Beds, days and discharges, fiscal year 2010
Figure	As filed	Where it comes from
Total facility beds, all components	52	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	10,788	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	44	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	115	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	735.25	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	245.18	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 411689, read from the public cost report file SNFFY2010.zip.

Fiscal year 2009, ended December 31, 2009

Cost report for January 1, 2009 to December 31, 2009 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on July 14, 2010.

Revenue and expenses, fiscal year 2009
Figure	As filed	Where it comes from
Net patient revenue	$1,307,276	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$1,404,747	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	−$97,471	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$21,067	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income: −$76,404 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.

Beds, days and discharges, fiscal year 2009
Figure	As filed	Where it comes from
Total facility beds, all components	52	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	9,609	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	36	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	82	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	557.8	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	266.92	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 380958, read from the public cost report file SNFFY2009.zip.

Fiscal year 2008, ended December 31, 2008

Cost report for January 1, 2008 to December 31, 2008 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on June 30, 2009.

Revenue and expenses, fiscal year 2008
Figure	As filed	Where it comes from
Net patient revenue	$1,262,316	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$1,386,022	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	−$123,706	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$26,056	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income: −$97,650 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.

Beds, days and discharges, fiscal year 2008
Figure	As filed	Where it comes from
Total facility beds, all components	52	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	9,861	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	43	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	35.83	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	531	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	229.33	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 348188, read from the public cost report file SNFFY2008.zip.

Fiscal year 2007, ended December 31, 2007

Cost report for January 1, 2007 to December 31, 2007 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on July 23, 2008.

Revenue and expenses, fiscal year 2007
Figure	As filed	Where it comes from
Net patient revenue	$1,341,007	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$1,349,119	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	−$8,112	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$51,452	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income: $43,340 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.

Beds, days and discharges, fiscal year 2007
Figure	As filed	Where it comes from
Total facility beds, all components	52	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	10,878	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	66	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	90	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	387.71	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	164.82	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 318742, read from the public cost report file SNFFY2007.zip.

Fiscal year 2006, ended December 31, 2006

Cost report for January 1, 2006 to December 31, 2006 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on January 24, 2008.

Revenue and expenses, fiscal year 2006
Figure	As filed	Where it comes from
Net patient revenue	$1,143,785	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$1,248,393	CMS-2540-96 worksheet G200002 line 1500 column 100
Net income from service to patients	−$104,608	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$89,546	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income: −$15,062 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.

Beds, days and discharges, fiscal year 2006
Figure	As filed	Where it comes from
Total facility beds, all components	52	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	10,855	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	61	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	45.85	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	219	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	177.95	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 300536, read from the public cost report file SNFFY2006.zip.

Fiscal year 2005, ended December 31, 2005

Cost report for January 1, 2005 to December 31, 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on June 14, 2007.

Revenue and expenses, fiscal year 2005
Figure	As filed	Where it comes from
Net patient revenue	$1,333,843	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$1,292,149	CMS-2540-96 worksheet G200002 line 1500 column 100
Net income from service to patients	$41,694	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$28,863	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income: $70,557 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.

Beds, days and discharges, fiscal year 2005
Figure	As filed	Where it comes from
Total facility beds, all components	52	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	13,162	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	36	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	70.8	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	487.14	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	365.61	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 283578, read from the public cost report file SNFFY2005.zip.

Fiscal year 2004, ended December 31, 2004

Cost report for January 1, 2004 to December 31, 2004 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on May 17, 2006.

Revenue and expenses, fiscal year 2004
Figure	As filed	Where it comes from
Net patient revenue	$1,416,394	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$1,351,690	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	$64,704	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$36,004	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income: $100,708 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.

Beds, days and discharges, fiscal year 2004
Figure	As filed	Where it comes from
Total facility beds, all components	52	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	14,347	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	41	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	69.9	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	1,115.67	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	349.93	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 249483, read from the public cost report file SNFFY2004.zip.

Fiscal year 2003, ended December 31, 2003

Cost report for January 1, 2003 to December 31, 2003 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on June 29, 2005.

Revenue and expenses, fiscal year 2003
Figure	As filed	Where it comes from
Net patient revenue	$1,213,117	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$1,257,783	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	−$44,666	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$29,161	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income: −$15,505 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.

Beds, days and discharges, fiscal year 2003
Figure	As filed	Where it comes from
Total facility beds, all components	52	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	14,218	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	41	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	34.22	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, all patients, in days	346.78	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 225995, read from the public cost report file SNFFY2003.zip.

Fiscal year 2002, ended December 31, 2002

Cost report for January 1, 2002 to December 31, 2002 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on May 14, 2004.

Revenue and expenses, fiscal year 2002
Figure	As filed	Where it comes from
Net patient revenue	$1,265,868	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$1,287,618	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	−$21,750	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$104,061	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income: $82,311 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.

Beds, days and discharges, fiscal year 2002
Figure	As filed	Where it comes from
Total facility beds, all components	52	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	15,763	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	43	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	88.5	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, all patients, in days	366.58	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 176341, read from the public cost report file SNFFY2002.zip.

Fiscal year 2001, ended December 31, 2001

Cost report for April 1, 2001 to December 31, 2001 — a reporting period of 274 days, not a full year, on form CMS-2540-96, settled, processed by CMS on September 10, 2003.

Revenue and expenses, fiscal year 2001
Figure	As filed	Where it comes from
Net patient revenue	$910,817	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$941,004	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	−$30,187	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$23,295	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income: −$6,892 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.

Beds, days and discharges, fiscal year 2001
Figure	As filed	Where it comes from
Total facility beds, all components	52	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	12,126	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	32	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	51	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, all patients, in days	378.94	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 159119, read from the public cost report file SNFFY2001.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.

The staffing record →

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
LENTZ, HALEY	ADP OF THE SNF	Individual	NOT APPLICABLE	since 12/09/2025
ROSS, KELLY	ADP OF THE SNF	Individual	NOT APPLICABLE	since 01/01/2023
BISSEN, LAWRENCE	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 03/01/2016
EMERSON, MELANIE	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 04/01/2022
PITZEN, RONNIE	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 04/01/2022
WEIS, MARLENE	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 03/01/2020
BISSEN, LAWRENCE	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 03/01/2022
BRUMM, KAREN	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 03/31/2015
HEMANN, KURT	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 03/11/2024
STREIT, PHIL	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 03/01/2022
LENTZ, HALEY	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 10/16/2024
POINTCLICKCARE TECHNOLOGIES, INC.	OPERATIONAL/MANAGERIAL CONTROL	Organization	NOT APPLICABLE	since 01/01/2023
ROSS, KELLY	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 01/01/2023

Medicare enrollment

As filed in the CMS file dated August 1, 2026 (Medicare enrollment ownership), under the enrollment of STACYVILLE COMMUNITY NURSING HOME (enrollment ID O20120117000561).

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
HALEY LENTZ	Individual	ADP OF THE SNF	Not stated in the filing	12/9/2025	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
KELLY DEE ROSS	Individual	ADP OF THE SNF	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
No owner named in the filing	Individual	ADP OF THE SNF	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
LAWRENCE BISSEN	Individual	CORPORATE DIRECTOR	Not stated in the filing	3/1/2016	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
MARLENE WEIS	Individual	CORPORATE DIRECTOR	14	3/1/2020	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
MELANIE EMERSON	Individual	CORPORATE DIRECTOR	14	4/1/2022	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
RONNIE PITZEN	Individual	CORPORATE DIRECTOR	14	4/1/2022	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
KAREN BRUMM	Individual	CORPORATE OFFICER	14	3/31/2015	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
KURT HEMANN	Individual	CORPORATE OFFICER	Not stated in the filing	3/11/2024	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
LAWRENCE BISSEN	Individual	CORPORATE OFFICER	14	3/1/2022	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
PHIL STREIT	Individual	CORPORATE OFFICER	14	3/1/2022	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
HALEY LENTZ	Individual	OPERATIONAL/MANAGERIAL CONTROL	Not stated in the filing	10/16/2024	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
KELLY DEE ROSS	Individual	OPERATIONAL/MANAGERIAL CONTROL	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
POINTCLICKCARE TECHNOLOGIES, INC.	Organization	OPERATIONAL/MANAGERIAL CONTROL	Not stated in the filing	1/1/2023	Private equity company: No Real estate investment trust: No Holding company: No

Changes in ownership

March 1, 2026: JILL SCHUTZ no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
March 1, 2026: VAL SMITH no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
March 1, 2026: HALEY LENTZ (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on March 1, 2026; associated with this enrollment since December 9, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
March 1, 2026: HALEY LENTZ (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on March 1, 2026; associated with this enrollment since October 16, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
March 1, 2026: A listing under ADP OF THE SNF, with no owner named, first listed in CMS’s Medicare enrollment ownership file on March 1, 2026; associated with this enrollment since January 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
March 1, 2026: POINTCLICKCARE TECHNOLOGIES, INC. (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on March 1, 2026; associated with this enrollment since January 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
March 1, 2026: KURT HEMANN (CORPORATE OFFICER) first listed in CMS’s Medicare enrollment ownership file on March 1, 2026; associated with this enrollment since March 11, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
March 1, 2026: KELLY DEE ROSS (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on March 1, 2026; associated with this enrollment since January 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
March 1, 2026: KELLY DEE ROSS (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on March 1, 2026; associated with this enrollment since January 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
June 15, 2023: ELAINE LANDHERR no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
June 15, 2023: STEPHEN MCCARTHY no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
June 15, 2023: SANDRA ADAMS no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
June 15, 2023: KAY FRAVEL no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
June 15, 2023: DENISE MAYER no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
June 15, 2023: DIANE MAYER no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
June 15, 2023: JILL SCHUTZ (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 15, 2023; associated with this enrollment since August 22, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
June 15, 2023: LAWRENCE BISSEN (OFFICER) first listed in CMS’s Medicare enrollment ownership file on June 15, 2023; associated with this enrollment since March 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
June 15, 2023: MARLENE WEIS (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on June 15, 2023; associated with this enrollment since March 1, 2020. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
June 15, 2023: VAL SMITH (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on June 15, 2023; associated with this enrollment since March 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
June 15, 2023: MELANIE EMERSON (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on June 15, 2023; associated with this enrollment since April 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
June 15, 2023: RONNIE PITZEN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on June 15, 2023; associated with this enrollment since April 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
June 15, 2023: PHIL STREIT (OFFICER) first listed in CMS’s Medicare enrollment ownership file on June 15, 2023; associated with this enrollment since March 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv

Recent changes on this record

August 6, 2026: A deficiency was cited under tag F 0641, scope and severity D. NH_HealthCitations_Sep2026_2.csv
August 6, 2026: A deficiency was cited under tag F 0605, scope and severity D. NH_HealthCitations_Sep2026_2.csv
August 6, 2026: An inspection was recorded in inspection cycle 1. NH_SurveySummary_Sep2026_2.csv
March 1, 2026: JILL SCHUTZ no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
March 1, 2026: VAL SMITH no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
March 1, 2026: HALEY LENTZ (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on March 1, 2026; associated with this enrollment since December 9, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
March 1, 2026: HALEY LENTZ (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on March 1, 2026; associated with this enrollment since October 16, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
March 1, 2026: A listing under ADP OF THE SNF, with no owner named, first listed in CMS’s Medicare enrollment ownership file on March 1, 2026; associated with this enrollment since January 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
March 1, 2026: POINTCLICKCARE TECHNOLOGIES, INC. (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on March 1, 2026; associated with this enrollment since January 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
March 1, 2026: KURT HEMANN (CORPORATE OFFICER) first listed in CMS’s Medicare enrollment ownership file on March 1, 2026; associated with this enrollment since March 11, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
March 1, 2026: KELLY DEE ROSS (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on March 1, 2026; associated with this enrollment since January 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
March 1, 2026: KELLY DEE ROSS (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on March 1, 2026; associated with this enrollment since January 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
October 20, 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
September 30, 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
August 29, 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
June 15, 2023: ELAINE LANDHERR no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
June 15, 2023: STEPHEN MCCARTHY no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
June 15, 2023: SANDRA ADAMS no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
June 15, 2023: KAY FRAVEL no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
June 15, 2023: DENISE MAYER no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
June 15, 2023: DIANE MAYER no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
June 15, 2023: JILL SCHUTZ (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 15, 2023; associated with this enrollment since August 22, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
June 15, 2023: LAWRENCE BISSEN (OFFICER) first listed in CMS’s Medicare enrollment ownership file on June 15, 2023; associated with this enrollment since March 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
June 15, 2023: MARLENE WEIS (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on June 15, 2023; associated with this enrollment since March 1, 2020. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
June 15, 2023: VAL SMITH (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on June 15, 2023; associated with this enrollment since March 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
June 15, 2023: MELANIE EMERSON (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on June 15, 2023; associated with this enrollment since April 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
June 15, 2023: RONNIE PITZEN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on June 15, 2023; associated with this enrollment since April 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
June 15, 2023: PHIL STREIT (OFFICER) first listed in CMS’s Medicare enrollment ownership file on June 15, 2023; associated with this enrollment since March 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
October 20, 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
September 22, 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
June 19, 2020: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
June 5, 2019: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2018.zip
July 19, 2018: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2017.zip
June 14, 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2016.zip
August 3, 2016: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2015.zip
July 24, 2015: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2014.zip
July 23, 2014: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2013.zip
July 23, 2013: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2012.zip
September 27, 2012: A cost report was filed for fiscal year 2011, on form CMS-2540-10. SNF10FY2011.zip
July 20, 2011: A cost report was filed for fiscal year 2010, on form CMS-2540-96. SNFFY2010.zip

Inspections

Inspection cycle	Health inspection	Fire safety inspection	Health deficiencies	Fire safety deficiencies
1	August 6, 2026	August 6, 2026	4	0
2	June 5, 2025	June 5, 2025	20	3
3	July 17, 2024	July 17, 2024	14	6
3	May 18, 2023	May 18, 2023	5	6

From the Care Compare inspection summary file NH_SurveySummary_Sep2026_2.csv, processed on September 1, 2026.

Deficiencies cited

41 deficiencies on file, newest inspection first

Inspection date	Inspection type	Tag	Category	What was cited	Scope and severity	Complaint	Corrected	Correction date
August 6, 2026	Health	F 0605	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.	D	No	Deficient, Provider has date of correction	August 7, 2026
August 6, 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	August 7, 2026
April 22, 2026	Health	F 0755	Pharmacy Service Deficiencies	Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.	D	Yes	Deficient, Provider has date of correction	April 23, 2026
April 22, 2026	Health	F 0760	Pharmacy Service Deficiencies	Ensure that residents are free from significant medication errors.	D	Yes	Deficient, Provider has date of correction	April 23, 2026
June 5, 2025	Health	F 0609	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.	D	No	Deficient, Provider has plan of correction	June 28, 2025
June 5, 2025	Health	F 0637	Resident Assessment and Care Planning Deficiencies	Assess the resident when there is a significant change in condition	D	No	Deficient, Provider has plan of correction	June 28, 2025
June 5, 2025	Health	F 0641	Resident Assessment and Care Planning Deficiencies	Ensure each resident receives an accurate assessment.	D	No	Deficient, Provider has plan of correction	June 28, 2025
June 5, 2025	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 plan of correction	June 28, 2025
April 1, 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.	D	Yes	Deficient, Provider has date of correction	April 25, 2025
April 1, 2025	Health	F 0657	Resident Assessment and Care Planning Deficiencies	Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.	D	Yes	Deficient, Provider has date of correction	April 25, 2025
April 1, 2025	Health	F 0688	Quality of Life and Care Deficiencies	Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.	D	Yes	Deficient, Provider has date of correction	April 25, 2025
April 1, 2025	Health	F 0755	Pharmacy Service Deficiencies	Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.	D	Yes	Deficient, Provider has date of correction	April 25, 2025
April 1, 2025	Health	F 0865	Administration Deficiencies	Have a plan that describes the process for conducting QAPI and QAA activities.	F	Yes	Deficient, Provider has date of correction	April 25, 2025
February 7, 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	Yes	Deficient, Provider has date of correction	April 25, 2025
February 7, 2025	Health	F 0609	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.	D	Yes	Deficient, Provider has date of correction	March 3, 2025
February 7, 2025	Health	F 0684	Quality of Life and Care Deficiencies	Provide appropriate treatment and care according to orders, resident’s preferences and goals.	D	Yes	Deficient, Provider has date of correction	March 3, 2025
February 7, 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	Yes	Deficient, Provider has date of correction	March 3, 2025
February 7, 2025	Health	F 0725	Nursing and Physician Services Deficiencies	Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.	F	Yes	Deficient, Provider has date of correction	March 3, 2025
February 7, 2025	Health	F 0726	Nursing and Physician Services Deficiencies	Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.	F	Yes	Deficient, Provider has date of correction	March 3, 2025
February 7, 2025	Health	F 0727	Nursing and Physician Services Deficiencies	Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.	F	Yes	Deficient, Provider has date of correction	March 3, 2025
February 7, 2025	Health	F 0755	Pharmacy Service Deficiencies	Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.	E	Yes	Deficient, Provider has date of correction	April 25, 2025
February 7, 2025	Health	F 0835	Administration Deficiencies	Administer the facility in a manner that enables it to use its resources effectively and efficiently.	F	Yes	Deficient, Provider has date of correction	March 3, 2025
February 7, 2025	Health	F 0865	Administration Deficiencies	Have a plan that describes the process for conducting QAPI and QAA activities.	F	Yes	Deficient, Provider has date of correction	April 25, 2025
February 7, 2025	Health	F 0908	Environmental Deficiencies	Keep all essential equipment working safely.	E	Yes	Deficient, Provider has date of correction	March 3, 2025
July 17, 2024	Health	F 0641	Resident Assessment and Care Planning Deficiencies	Ensure each resident receives an accurate assessment.	B	Yes	Deficient, Provider has date of correction	August 16, 2024
July 17, 2024	Health	F 0644	Resident Assessment and Care Planning Deficiencies	Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.	D	Yes	Deficient, Provider has date of correction	August 16, 2024
July 17, 2024	Health	F 0656	Resident Assessment and Care Planning Deficiencies	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.	D	Yes	Deficient, Provider has date of correction	August 16, 2024
July 17, 2024	Health	F 0657	Resident Assessment and Care Planning Deficiencies	Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.	D	Yes	Deficient, Provider has date of correction	August 16, 2024
July 17, 2024	Health	F 0660	Resident Assessment and Care Planning Deficiencies	Plan the resident's discharge to meet the resident's goals and needs.	D	Yes	Deficient, Provider has date of correction	August 16, 2024
July 17, 2024	Health	F 0727	Nursing and Physician Services Deficiencies	Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.	F	Yes	Deficient, Provider has date of correction	August 16, 2024
July 17, 2024	Health	F 0758	Pharmacy Service Deficiencies	Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.	D	No	Deficient, Provider has date of correction	August 16, 2024
July 17, 2024	Health	F 0760	Pharmacy Service Deficiencies	Ensure that residents are free from significant medication errors.	G	Yes	Deficient, Provider has date of correction	August 16, 2024
July 17, 2024	Health	F 0851	Administration Deficiencies	Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.	C	No	Deficient, Provider has date of correction	August 16, 2024
July 17, 2024	Health	F 0880	Infection Control Deficiencies	Provide and implement an infection prevention and control program.	D	No	Deficient, Provider has date of correction	August 16, 2024
July 17, 2024	Health	F 0882	Infection Control Deficiencies	Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.	D	Yes	Deficient, Provider has date of correction	August 16, 2024
July 17, 2024	Health	F 0883	Infection Control Deficiencies	Develop and implement policies and procedures for flu and pneumonia vaccinations.	D	No	Deficient, Provider has date of correction	August 16, 2024
February 15, 2024	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.	D	Yes	Deficient, Provider has date of correction	March 15, 2024
February 15, 2024	Health	F 0689	Quality of Life and Care Deficiencies	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.	G	Yes	Deficient, Provider has date of correction	March 15, 2024
May 18, 2023	Health	F 0644	Resident Assessment and Care Planning Deficiencies	Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.	D	No	Deficient, Provider has date of correction	June 30, 2023
May 18, 2023	Health	F 0686	Quality of Life and Care Deficiencies	Provide appropriate pressure ulcer care and prevent new ulcers from developing.	D	No	Deficient, Provider has date of correction	June 30, 2023
May 18, 2023	Health	F 0758	Pharmacy Service Deficiencies	Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.	D	No	Deficient, Provider has date of correction	June 30, 2023

From the Care Compare health citations file NH_HealthCitations_Sep2026_2.csv, processed on September 1, 2026.

Penalties

Penalty date	Type	Fine amount	Payment denial began	Payment denial, days	Fine ID
July 17, 2024	Fine	$21,986			79475
February 15, 2024	Payment Denial		March 7, 2024	8

From the Care Compare penalties file NH_Penalties_Sep2026_2.csv, processed on September 1, 2026.

Care Compare provider information

Field	As filed
Provider Type	Medicare and Medicaid
Ownership Type	Non profit - Corporation
Legal Business Name	STACYVILLE COMMUNITY NURSING HOME
Date First Approved to Provide Medicare and Medicaid Services	2001-04-01
Provider Resides in Hospital	N
Continuing Care Retirement Community	N
Urban	N
County/Parish	Mitchell
Telephone Number	6417102215
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	34
Average Number of Residents per Day	21.4
Overall Rating	3
Health Inspection Rating	2
QM Rating	3
Long-Stay QM Rating	3
Processing Date	2026-08-01

From the Care Compare Provider Information file NH_ProviderInfo_Aug2026.csv, processed on August 1, 2026.

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On August 6, 2026: A deficiency was cited under tag F 0641, scope and severity D. That is one line of the alert.

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