Skilled nursing facility · CMS certification number 235588
Maple Valley Nursing Home
Maple Valley, Michigan · Medicare and Medicaid
Certified beds, as filed in Care Compare: 25
Download this facility’s record (CSV)
A CSV file of this facility’s record: its name and location, its Medicare cost-report finances year by year, its ownership, its inspections, deficiencies and penalties, and the Care Compare provider information — each figure with the worksheet, line and column or file it came from.
In Care Compare’s provider information: Penalties: 3 · Fines: 2 · Fines, total amount: $119,265.00 · Payment denials: 1. The most recent penalty on file: August 20, 2024, Fine, $68,045. 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 September 11, 2025.
None of these figures is carried on this report.
CMS report record 1439119, 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 July 31, 2024.
None of these figures is carried on this report.
CMS report record 1390688, 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 25, 2023.
None of these figures is carried on this report.
CMS report record 1363225, 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.
None of these figures is carried on this report.
CMS report record 1334440, 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 21, 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,044,792 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $45,162 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $1,999,630 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,403,157 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$403,527 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $590,446 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $186,919 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $186,919 (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 | 25 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 7,091 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 9 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 68 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 787.89 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1300686, 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 October 14, 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,153,323 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $6,545 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,146,778 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,054,254 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $92,524 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $195 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $92,719 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $92,719 (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 | 25 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 7,302 | 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 | 40 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,247.8 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 317.48 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1270423, 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 July 15, 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,122,303 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $5,298 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,117,005 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,032,727 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $84,278 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,173 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $85,451 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $85,451 (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 | 25 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 7,537 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 11 | 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 | 3,246 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 685.18 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1236894, 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.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,003,011 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $17,982 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $1,985,029 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,830,886 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $154,143 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $696 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $154,839 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $154,839 (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 | 25 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 7,884 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 14 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 18.43 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,844.75 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 563.14 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1201102, read from the public cost report file SNF10FY2017.zip.
Fiscal year 2016, ended December 31, 2016
Cost report for January 1, 2016 to December 31, 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on August 16, 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $1,693,343 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $52,434 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $1,640,909 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,726,451 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$85,542 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,785 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$83,757 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$83,757 (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 | 25 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 6,848 | 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 | 38 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 1,141.33 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1173419, 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 1, 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $1,862,745 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $20,495 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $1,842,250 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,775,821 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $66,429 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $605 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $67,034 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $67,034 (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 | 25 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 7,311 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 15 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 34 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,191.6 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 487.4 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1139083, 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 25, 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $1,781,550 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $1,781,550 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,718,139 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $63,411 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,520 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $64,931 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $64,931 (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 | 25 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 8,056 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 7 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 37 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 2,177.33 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 1,150.86 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1105322, 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 August 8, 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $1,766,417 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $1,766,417 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,687,604 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $78,813 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $3,576 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $82,389 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $82,389 (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 | 25 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 7,543 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 11 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 62 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 2,985.5 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 685.73 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1075306, 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 August 15, 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $1,801,085 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $1,801,085 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,737,903 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $63,182 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $418 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $63,600 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $63,600 (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 | 25 | 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 | 24 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 48.15 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 757.43 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 319.96 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1046453, 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 November 5, 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $1,586,754 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $1,586,754 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,673,255 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$86,501 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $2,858 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$83,643 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$83,643 (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 | 25 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 6,793 | 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 | 51.7 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 801.14 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 295.35 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1018676, 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 September 8, 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,670,434 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,630,908 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $39,526 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $1,800 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $41,326 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 25 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 7,392 | 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 | 40 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 509.08 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 231 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 417165, 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 27, 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,720,484 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,573,179 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $147,305 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $3,628 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $150,933 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 25 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 8,517 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 16 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 102.6 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 957.43 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 532.31 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 384114, 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 August 24, 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,512,393 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,450,694 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $61,699 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $802 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $62,501 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 25 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 7,256 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 33 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 39.25 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 488.91 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 219.88 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 355243, 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 October 15, 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,571,209 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,518,638 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $52,571 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $5,298 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $57,869 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 25 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 7,961 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 40 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 45.15 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 495.73 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 199.03 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 326354, 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 May 1, 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,486,625 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,584,581 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$97,956 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $288 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: −$97,668 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 25 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 7,750 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 25 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 72.9 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 434.5 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 310 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 308089, 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 1, 2007.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,503,154 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,510,351 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$7,197 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $302 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: −$6,895 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 25 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 8,467 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 29 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 60.56 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 449.17 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 291.97 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 280326, 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 10, 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,586,486 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,527,820 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | $58,666 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $585 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $59,251 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 25 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 8,604 | 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 | 61.08 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 350.31 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 268.88 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 248943, 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 October 15, 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,306,470 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,315,545 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$9,075 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $768 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $350 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$8,657 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 25 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 8,665 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 29 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 63.13 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 547.83 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 298.79 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 197467, 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 July 1, 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,302,203 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,283,707 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | $18,496 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $2,744 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $21,240 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 25 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 8,752 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 28 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 63.2 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 893.86 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 312.57 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 186387, read from the public cost report file SNFFY2002.zip.
Fiscal year 2000, ended December 31, 2000
Cost report for January 1, 2000 to December 31, 2000 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on February 13, 2003.
Net income: $16,386 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
CMS report record 126892, read from the public cost report file SNFFY2000.zip.
Fiscal year 1999, ended December 31, 1999
Cost report for January 1, 1999 to December 31, 1999 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on March 21, 2001.
Net income: −$2,557 (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.
CMS report record 69625, read from the public cost report file SNFFY1999.zip.
Nurse staffing
Nurse staffing hours from the Payroll-Based Journal, quarter by quarter, are on this facility’s staffing page, each quarter with the file it came from.
Ownership, as filed with CMS
Care Compare
As filed in the CMS file dated September 1, 2026 (Care Compare ownership).
| Owner or manager | Role | Type | Ownership percentage | Association |
|---|---|---|---|---|
| KASBEN, DONNA | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Individual | 50% | since 03/08/1996 |
| KASBEN, JOHN | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Individual | 50% | since 03/08/1996 |
| KASBEN, DONNA | ADP OF THE SNF | Individual | NOT APPLICABLE | since 03/08/1996 |
| KASBEN, JOHN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 07/02/2019 |
| LANGLOIS, MARK | ADP OF THE SNF | Individual | NOT APPLICABLE | since 02/01/2020 |
| PORTER, MISTY | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/01/2001 |
| KASBEN, DONNA | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 03/08/1996 |
| KASBEN, JOHN | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 03/08/1996 |
| CLEMENS GRAY, MICHELLE | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 04/03/2024 |
| DYKSTRA, SANTIAGO | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 09/24/2023 |
| HULBERT, AMY | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 01/30/2022 |
| HULBERT, RICHARD | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 11/13/2023 |
| KASBEN, JENNIFER | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 07/29/2019 |
| KASBEN, JOHN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 03/08/1996 |
| KASBEN, SERENA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 10/15/1997 |
| LANGLOIS, MARK | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 02/01/2020 |
| MOORE, KENDRA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 10/20/2024 |
| PORTER, MISTY | 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 MAPLE VALLEY NURSING HOME OF MAPLE CITY, INC. (enrollment ID O20111109000553).
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 |
|---|---|---|---|---|---|
| DONNA KASBEN | Individual | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 50 | 3/8/1996 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JOHN KASBEN | Individual | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 50 | 3/8/1996 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DONNA KASBEN | Individual | ADP OF THE SNF | Not stated in the filing | 3/8/1996 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JOHN KASBEN | Individual | ADP OF THE SNF | Not stated in the filing | 7/2/2019 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MARK A LANGLOIS | Individual | ADP OF THE SNF | Not stated in the filing | 2/1/2020 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MISTY MAE PORTER | Individual | ADP OF THE SNF | Not stated in the filing | 5/1/2001 | 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 | 6/17/2024 | 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 | 1/1/2023 | 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 | 1/1/2018 | 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 | 1/1/1996 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| No owner named in the filing | Organization | ADP OF THE SNF | Not stated in the filing | 3/25/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| No owner named in the filing | Organization | ADP OF THE SNF | Not stated in the filing | 3/25/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| No owner named in the filing | Organization | ADP OF THE SNF | Not stated in the filing | 3/25/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| No owner named in the filing | Organization | ADP OF THE SNF | Not stated in the filing | 3/25/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| No owner named in the filing | Organization | ADP OF THE SNF | Not stated in the filing | 4/29/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| DONNA KASBEN | Individual | CORPORATE OFFICER | 50 | 3/8/1996 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JOHN KASBEN | Individual | CORPORATE OFFICER | 50 | 3/8/1996 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| AMY HULBERT | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 1/30/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JENNIFER KASBEN | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 7/29/2019 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JOHN KASBEN | Individual | OPERATIONAL/MANAGERIAL CONTROL | 50 | 3/8/1996 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KENDRA MOORE | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 10/20/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MARK A LANGLOIS | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 2/1/2020 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MICHELLE R CLEMENS GRAY | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 4/3/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MISTY MAE PORTER | Individual | OPERATIONAL/MANAGERIAL CONTROL | 50 | 1/1/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| RICHARD HULBERT | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 11/13/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| SANTIAGO DYKSTRA | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 9/24/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| SERENA KASBEN | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 10/15/1997 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
Changes in ownership
- June 1, 2025: MISTY MAE PORTER no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: JOHN KASBEN no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: DONNA KASBEN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since March 8, 1996. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: SERENA KASBEN (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since October 15, 1997. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: JENNIFER KASBEN (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since July 29, 2019. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: MICHELLE R CLEMENS GRAY (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since April 3, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: RICHARD HULBERT (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since November 13, 2023. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: AMY HULBERT (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since January 30, 2022. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: SANTIAGO DYKSTRA (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since September 24, 2023. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: MISTY MAE PORTER (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since May 1, 2001. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: MARK A LANGLOIS (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since February 1, 2020. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: MARK A LANGLOIS (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since February 1, 2020. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: A listing under ADP OF THE SNF, with no owner named, first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since June 17, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: KENDRA MOORE (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since October 20, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: JOHN KASBEN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since July 2, 2019. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- October 31, 2022: MISTY MAE PORTER (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on October 31, 2022; associated with this enrollment since January 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2022-10-31.csv
- October 31, 2022: JOHN KASBEN (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on October 31, 2022; associated with this enrollment since January 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2022-10-31.csv
- October 31, 2022: JOHN KASBEN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 31, 2022; associated with this enrollment since July 2, 2019. Skilled_Nursing_Facility_All_Owners_:_2022-10-31.csv
Recent changes on this record
- September 11, 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- June 1, 2025: MISTY MAE PORTER no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: JOHN KASBEN no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: DONNA KASBEN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since March 8, 1996. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: SERENA KASBEN (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since October 15, 1997. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: JENNIFER KASBEN (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since July 29, 2019. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: MICHELLE R CLEMENS GRAY (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since April 3, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: RICHARD HULBERT (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since November 13, 2023. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: AMY HULBERT (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since January 30, 2022. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: SANTIAGO DYKSTRA (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since September 24, 2023. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: MISTY MAE PORTER (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since May 1, 2001. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: MARK A LANGLOIS (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since February 1, 2020. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: MARK A LANGLOIS (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since February 1, 2020. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: A listing under ADP OF THE SNF, with no owner named, first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since June 17, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: KENDRA MOORE (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since October 20, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- June 1, 2025: JOHN KASBEN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on June 1, 2025; associated with this enrollment since July 2, 2019. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- July 31, 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- August 25, 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- October 31, 2022: MISTY MAE PORTER (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on October 31, 2022; associated with this enrollment since January 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2022-10-31.csv
- October 31, 2022: JOHN KASBEN (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on October 31, 2022; associated with this enrollment since January 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2022-10-31.csv
- October 31, 2022: JOHN KASBEN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 31, 2022; associated with this enrollment since July 2, 2019. Skilled_Nursing_Facility_All_Owners_:_2022-10-31.csv
- September 28, 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
- September 21, 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
- October 14, 2020: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
- July 15, 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
- August 16, 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2016.zip
- August 1, 2016: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2015.zip
- July 25, 2015: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2014.zip
- August 8, 2014: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2013.zip
- August 15, 2013: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2012.zip
- November 5, 2012: A cost report was filed for fiscal year 2011, on form CMS-2540-10. SNF10FY2011.zip
- September 8, 2011: A cost report was filed for fiscal year 2010, on form CMS-2540-96. SNFFY2010.zip
- July 27, 2010: A cost report was filed for fiscal year 2009, on form CMS-2540-96. SNFFY2009.zip
- August 24, 2009: A cost report was filed for fiscal year 2008, on form CMS-2540-96. SNFFY2008.zip
- October 15, 2008: A cost report was filed for fiscal year 2007, on form CMS-2540-96. SNFFY2007.zip
- May 1, 2008: A cost report was filed for fiscal year 2006, on form CMS-2540-96. SNFFY2006.zip
- June 1, 2007: A cost report was filed for fiscal year 2005, on form CMS-2540-96. SNFFY2005.zip
- May 10, 2006: A cost report was filed for fiscal year 2004, on form CMS-2540-96. SNFFY2004.zip
- October 15, 2004: A cost report was filed for fiscal year 2003, on form CMS-2540-96. SNFFY2003.zip
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | May 6, 2026 | May 6, 2026 | 7 | 4 |
| 2 | April 10, 2025 | April 10, 2025 | 10 | 5 |
| 3 | April 25, 2024 | April 25, 2024 | 28 | 6 |
From the Care Compare inspection summary file NH_SurveySummary_Sep2026_2.csv, processed on September 1, 2026.
Deficiencies cited
45 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| May 6, 2026 | Health | F 0602 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Protect each resident from the wrongful use of the resident's belongings or money. | D | Yes | Deficient, Provider has date of correction | June 18, 2026 |
| May 6, 2026 | Health | F 0628 | Resident Rights Deficiencies | Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. | D | No | Deficient, Provider has date of correction | June 18, 2026 |
| May 6, 2026 | Health | F 0658 | Resident Assessment and Care Planning Deficiencies | Ensure services provided by the nursing facility meet professional standards of quality. | D | No | Deficient, Provider has date of correction | June 18, 2026 |
| May 6, 2026 | Health | F 0684 | Quality of Life and Care Deficiencies | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | No | Deficient, Provider has date of correction | June 18, 2026 |
| May 6, 2026 | Health | F 0695 | Quality of Life and Care Deficiencies | Provide safe and appropriate respiratory care for a resident when needed. | D | No | Deficient, Provider has date of correction | June 18, 2026 |
| May 6, 2026 | Health | F 0756 | Pharmacy Service Deficiencies | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | E | No | Deficient, Provider has date of correction | June 18, 2026 |
| May 6, 2026 | 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. | F | No | Deficient, Provider has date of correction | June 18, 2026 |
| April 10, 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 | No | Deficient, Provider has date of correction | May 19, 2025 |
| April 10, 2025 | Health | F 0658 | Resident Assessment and Care Planning Deficiencies | Ensure services provided by the nursing facility meet professional standards of quality. | D | Yes | Deficient, Provider has date of correction | May 19, 2025 |
| April 10, 2025 | Health | F 0678 | Quality of Life and Care Deficiencies | Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives. | D | No | Deficient, Provider has date of correction | May 19, 2025 |
| April 10, 2025 | Health | F 0684 | Quality of Life and Care Deficiencies | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | No | Deficient, Provider has date of correction | May 19, 2025 |
| April 10, 2025 | Health | F 0756 | Pharmacy Service Deficiencies | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | D | No | Deficient, Provider has date of correction | May 19, 2025 |
| April 10, 2025 | Health | F 0760 | Pharmacy Service Deficiencies | Ensure that residents are free from significant medication errors. | D | Yes | Deficient, Provider has date of correction | May 19, 2025 |
| April 10, 2025 | Health | F 0812 | Nutrition and Dietary Deficiencies | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | No | Deficient, Provider has date of correction | May 19, 2025 |
| April 10, 2025 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | F | No | Deficient, Provider has date of correction | May 19, 2025 |
| April 10, 2025 | 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 | May 19, 2025 |
| January 22, 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 | February 10, 2025 |
| August 20, 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 | August 29, 2024 |
| April 25, 2024 | Health | F 0600 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | J | No | Deficient, Provider has date of correction | June 30, 2024 |
| April 25, 2024 | Health | F 0604 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. | D | No | Deficient, Provider has date of correction | July 19, 2024 |
| April 25, 2024 | 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 date of correction | June 3, 2024 |
| April 25, 2024 | Health | F 0610 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Respond appropriately to all alleged violations. | D | No | Deficient, Provider has date of correction | June 3, 2024 |
| April 25, 2024 | Health | F 0623 | Resident Rights Deficiencies | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | D | No | Deficient, Provider has date of correction | June 3, 2024 |
| April 25, 2024 | Health | F 0625 | Resident Rights Deficiencies | Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave. | D | No | Deficient, Provider has date of correction | June 3, 2024 |
| April 25, 2024 | Health | F 0638 | Resident Assessment and Care Planning Deficiencies | Assure that each resident’s assessment is updated at least once every 3 months. | D | No | Deficient, Provider has date of correction | June 3, 2024 |
| April 25, 2024 | Health | F 0645 | Resident Assessment and Care Planning Deficiencies | PASARR screening for Mental disorders or Intellectual Disabilities | D | No | Deficient, Provider has date of correction | June 3, 2024 |
| April 25, 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 | No | Deficient, Provider has date of correction | June 3, 2024 |
| April 25, 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. | E | No | Deficient, Provider has date of correction | July 19, 2024 |
| April 25, 2024 | Health | F 0684 | Quality of Life and Care Deficiencies | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | No | Deficient, Provider has date of correction | June 3, 2024 |
| April 25, 2024 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | No | Deficient, Provider has date of correction | June 3, 2024 |
| April 25, 2024 | Health | F 0699 | Quality of Life and Care Deficiencies | Provide care or services that was trauma informed and/or culturally competent. | D | No | Deficient, Provider has date of correction | June 12, 2024 |
| April 25, 2024 | Health | F 0700 | Quality of Life and Care Deficiencies | Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail. | D | No | Deficient, Provider has date of correction | June 3, 2024 |
| April 25, 2024 | Health | F 0740 | Quality of Life and Care Deficiencies | Ensure each resident must receive and the facility must provide necessary behavioral health care and services. | D | No | Deficient, Provider has date of correction | June 3, 2024 |
| April 25, 2024 | 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 | No | Deficient, Provider has date of correction | June 3, 2024 |
| April 25, 2024 | Health | F 0756 | Pharmacy Service Deficiencies | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | E | No | Deficient, Provider has date of correction | July 19, 2024 |
| April 25, 2024 | Health | F 0812 | Nutrition and Dietary Deficiencies | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | No | Deficient, Provider has date of correction | July 19, 2024 |
| April 25, 2024 | Health | F 0835 | Administration Deficiencies | Administer the facility in a manner that enables it to use its resources effectively and efficiently. | F | No | Deficient, Provider has date of correction | June 3, 2024 |
| April 25, 2024 | Health | F 0842 | Resident Assessment and Care Planning Deficiencies | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | No | Deficient, Provider has date of correction | June 3, 2024 |
| April 25, 2024 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | No | Deficient, Provider has date of correction | June 3, 2024 |
| April 25, 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. | F | No | Deficient, Provider has date of correction | June 3, 2024 |
| April 25, 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 | June 3, 2024 |
| April 25, 2024 | Health | F 0942 | Resident Rights Deficiencies | Ensure that staff members are educated on resident rights and facility responsibilities to properly care for its residents. | E | No | Deficient, Provider has date of correction | July 19, 2024 |
| April 25, 2024 | Health | F 0943 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation. | D | No | Deficient, Provider has date of correction | July 19, 2024 |
| April 25, 2024 | Health | F 0945 | Infection Control Deficiencies | Include as part of its infection prevention and control program, mandatory training that includes written standards, policies, and procedures for the program. | E | No | Deficient, Provider has date of correction | July 19, 2024 |
| March 13, 2024 | Health | F 0600 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | G | Yes | Deficient, Provider has date of correction | June 30, 2024 |
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 |
|---|---|---|---|---|---|
| August 20, 2024 | Fine | $68,045 | 59023 | ||
| March 13, 2024 | Fine | $51,220 | 59003 | ||
| March 13, 2024 | Payment Denial | May 24, 2024 | 56 |
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 | For profit - Corporation |
| Legal Business Name | MAPLE VALLEY NURSING HOME OF MAPLE CITY, INC. |
| Date First Approved to Provide Medicare and Medicaid Services | 1998-12-15 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | Y |
| County/Parish | Leelanau |
| Telephone Number | 2312285895 |
| 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 | 25 |
| Average Number of Residents per Day | 19.2 |
| Overall Rating | 3 |
| Health Inspection Rating | 3 |
| QM Rating | 2 |
| Long-Stay QM Rating | 2 |
| Processing Date | 2026-09-01 |
From the Care Compare Provider Information file NH_ProviderInfo_Sep2026_3.csv, processed on September 1, 2026.
Get an email when this record changes
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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 September 11, 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 Maple Valley Nursing Home
This page shows the record as it stands today. The report is the citable document: the same figures with the cell each came from, and beyond this page — five facilities of a similar size in Michigan 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 235588.