Skilled nursing facility · CMS certification number 245138
BOUNDARY WATERS CARE CENTER
ELY, Minnesota · Medicare and Medicaid
Certified beds, as filed in Care Compare: 38
Download this facility’s record (CSV)
A CSV file of this facility’s record: its name and location, its Medicare cost-report finances year by year, its ownership, its inspections, deficiencies and penalties, and the Care Compare provider information — each figure with the worksheet, line and column or file it came from.
In Care Compare’s provider information: Penalties: 0 · Fines: 0 · Fines, total amount: $0.00 · Payment denials: 0. Every penalty on file ↓
For this facility: the citable document with full history — $295 · an email when this record changes — $99/month
Finances, as filed
From this facility’s Medicare cost reports on form CMS-2540, each figure with the worksheet, line and column it was read from.
Cost report for January 1, 2024 to December 31, 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on August 29, 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,991,405 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $33,302 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,958,103 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,329,297 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$371,194 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $564,935 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $193,741 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $193,741 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 42 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 15,372 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 309 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 7,253 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 4,395 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 11,957 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 4 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 6 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 35 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 45 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 77.25 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,208.83 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 265.71 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1437177, 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 August 1, 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,231,781 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $36,497 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,195,284 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,053,195 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$857,911 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $634,142 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$223,769 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$223,769 (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 | 42 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 11,807 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 45 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 28.39 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 647 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 262.38 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1390823, 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 9, 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,721,654 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $40,493 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,681,161 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,839,132 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,157,971 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $423,163 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$734,808 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$734,808 (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 | 42 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 11,320 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 61 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 58.17 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 684.57 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 185.57 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1361542, 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 August 2, 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,364,850 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $6,493 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,358,357 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,901,211 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$542,854 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $815,918 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $273,064 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $273,064 (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 | 42 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 10,814 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 59 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 65.29 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 751.63 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 183.29 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1328591, read from the public cost report file SNF10FY2021.zip.
Fiscal year 2020, ended December 31, 2020
Cost report for January 1, 2020 to December 31, 2020 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on October 28, 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,534,497 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $28,762 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,505,735 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,900,360 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$394,625 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $415,245 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $20,620 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $20,620 (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 | 42 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 12,329 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 72 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 42.72 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 453.33 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 171.24 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1303343, 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 November 10, 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,588,079 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $99,310 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,488,769 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,574,114 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$85,345 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $189,487 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $104,142 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $102,463 (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 | 42 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 13,065 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 100 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 33.48 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 675.33 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 130.65 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1273267, 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 11, 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,455,238 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $61,823 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,393,415 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,457,294 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$63,879 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $208,614 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $144,735 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $144,735 (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 | 42 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 14,059 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 76 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 51.56 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 377.7 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 184.99 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1236467, read from the public cost report file SNF10FY2018.zip.
Fiscal year 2017, ended December 31, 2017
Cost report for January 1, 2017 to December 31, 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on August 22, 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,403,083 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $75,260 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,327,823 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,419,934 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$92,111 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $198,766 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $106,655 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $106,655 (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 | 42 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 14,319 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 67 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 42.88 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 381.92 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 213.72 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1210040, 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 23, 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,590,565 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $150,788 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,439,777 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,381,227 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $58,550 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $217,018 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $275,568 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $274,733 (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 | 40 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 14,375 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 49 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 52.15 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,057.89 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 293.37 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1174597, 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 30, 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,099,524 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $214,800 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,884,724 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,871,895 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $12,829 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $218,947 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $231,776 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $231,776 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 40 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 11,977 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 56 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 44.34 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,129.17 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 213.88 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1142954, 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 August 15, 2015.
None of these figures is carried on this report.
CMS report record 1108018, 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 31, 2014.
None of these figures is carried on this report.
CMS report record 1074321, read from the public cost report file SNF10FY2013.zip.
Fiscal year 2012, ended December 31, 2012
Cost report for January 1, 2012 to December 31, 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on November 20, 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,859,737 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $82,724 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,777,013 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,836,702 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,059,689 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $511,421 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$548,268 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$548,268 (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 | 58 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 15,333 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 86 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 30.79 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 736 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 178.29 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1080628, read from the public cost report file SNF10FY2012.zip.
Fiscal year 2011, ended December 31, 2011
Cost report for October 1, 2011 to December 31, 2011 — a reporting period of 91 days, not a full year, on form CMS-2540-10, settled, processed by CMS on October 30, 2012.
None of these figures is carried on this report.
CMS report record 1017577, read from the public cost report file SNF10FY2012.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 |
|---|---|---|---|---|
| ELY-BLOOMENSON COMMUNITY HOSPITAL | ADP OF THE SNF | Organization | NOT APPLICABLE | since 09/30/2011 |
| HEALTH DIMENSIONS CONSULTING INC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 07/08/2025 |
| MASLOSKI, ADAM | ADP OF THE SNF | Individual | NOT APPLICABLE | since 06/01/2016 |
| SCHWINGHAMER, JOSEPH | ADP OF THE SNF | Individual | NOT APPLICABLE | since 10/01/2011 |
| CHAMPA, KATHLEEN | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 06/01/2022 |
| FORSMAN, MICHAEL | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 04/01/2015 |
| JOHNSON, WARREN | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 07/01/2024 |
| LOBE, JONEENE | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 10/01/2011 |
| PEKURI, ROGER | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 01/01/2015 |
| LOBE, JONEENE | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 10/01/2011 |
| PEKURI, ROGER | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 01/01/2015 |
| CHAMPA, KATHLEEN | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 06/01/2022 |
| FORSMAN, MICHAEL | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 04/01/2015 |
| JOHNSON, WARREN | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 07/01/2024 |
| LOBE, JONEENE | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 02/01/2023 |
| PEKURI, ROGER | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 01/01/2015 |
| BRISCOE, DAVID | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 03/07/2011 |
| BRISCOE, PATRICIA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 03/07/2011 |
| ELY-BLOOMENSON COMMUNITY HOSPITAL | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | since 09/30/2011 |
| HEALTH DIMENSIONS CONSULTING INC | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | since 03/17/2011 |
| HENNESSEY, ERIN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 01/01/2020 |
| MASLOSKI, ADAM | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 06/01/2016 |
| ROGOTZKE, AMBER | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 03/07/2011 |
| SCHWINGHAMER, JOSEPH | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 10/01/2011 |
| SHVETZOFF, SERGEI | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 03/07/2011 |
| SHVETZOFF, TAMI | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 03/17/2011 |
Medicare enrollment
As filed in the CMS file dated August 1, 2026 (Medicare enrollment ownership), under the enrollment of BOUNDARY WATERS CARE CENTER (enrollment ID O20111010000335).
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 |
|---|---|---|---|---|---|
| ADAM MASLOSKI | Individual | ADP OF THE SNF | Not stated in the filing | 6/1/2016 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| ELY-BLOOMENSON COMMUNITY HOSPITAL | Organization | ADP OF THE SNF | Not stated in the filing | 9/30/2011 | Private equity company: No Real estate investment trust: No Holding company: No |
| HEALTH DIMENSIONS CONSULTING INC | Organization | ADP OF THE SNF | Not stated in the filing | 7/8/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| JOSEPH MICHAEL SCHWINGHAMER | Individual | ADP OF THE SNF | Not stated in the filing | 10/1/2011 | 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 | 5/27/2015 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JONEENE LOBE | Individual | CORPORATE DIRECTOR | Not stated in the filing | 10/1/2011 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KATHLEEN CHAMPA | Individual | CORPORATE DIRECTOR | Not stated in the filing | 6/1/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MICHAEL FORSMAN | Individual | CORPORATE DIRECTOR | Not stated in the filing | 4/1/2015 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| ROGER PEKURI | Individual | CORPORATE DIRECTOR | Not stated in the filing | 1/1/2015 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| WARREN DANIEL JOHNSON | Individual | CORPORATE DIRECTOR | Not stated in the filing | 7/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JONEENE LOBE | Individual | CORPORATE OFFICER | Not stated in the filing | 10/1/2011 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| ROGER PEKURI | Individual | CORPORATE OFFICER | Not stated in the filing | 1/1/2015 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JONEENE LOBE | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 2/1/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KATHLEEN CHAMPA | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 6/1/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MICHAEL FORSMAN | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 4/1/2015 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| ROGER PEKURI | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 1/1/2015 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| WARREN DANIEL JOHNSON | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 7/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| ADAM MASLOSKI | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 6/1/2016 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| AMBER ROGOTZKE | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 3/7/2011 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DAVID LINDSAY BRISCOE | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 3/7/2011 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| ELY-BLOOMENSON COMMUNITY HOSPITAL | Organization | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 9/30/2011 | Private equity company: No Real estate investment trust: No Holding company: No |
| ERIN LEIGH SHVETZOFF HENNESSEY | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 1/1/2020 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| HEALTH DIMENSIONS CONSULTING INC | Organization | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 3/17/2011 | Private equity company: No Real estate investment trust: No Holding company: No |
| JOSEPH MICHAEL SCHWINGHAMER | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 10/1/2011 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| PATRICIA LYNN BRISCOE | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 3/7/2011 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| SERGEI NICHOLAS SHVETZOFF | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 3/7/2011 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| TAMI LYN SHVETZOFF | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 3/17/2011 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
Changes in ownership
- May 1, 2026: ADAM MASLOSKI no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: HELEN P TOME no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: TAMI LYN SHVETZOFF (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since March 17, 2011. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: AMBER ROGOTZKE (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since March 7, 2011. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: ADAM MASLOSKI (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since June 1, 2016. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: ADAM MASLOSKI (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since June 1, 2016. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: A listing under ADP OF THE SNF, with no owner named, first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since May 27, 2015. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: WARREN DANIEL JOHNSON (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since July 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: WARREN DANIEL JOHNSON (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since July 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: ROGER PEKURI (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since January 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: JOSEPH MICHAEL SCHWINGHAMER (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since October 1, 2011. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: JOSEPH MICHAEL SCHWINGHAMER (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since October 1, 2011. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: DAVID LINDSAY BRISCOE (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since March 7, 2011. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: ERIN LEIGH SHVETZOFF HENNESSEY (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since January 1, 2020. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: KATHLEEN CHAMPA (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since June 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: KATHLEEN CHAMPA (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since June 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: PATRICIA LYNN BRISCOE (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since March 7, 2011. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: JONEENE LOBE (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since February 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: HEALTH DIMENSIONS CONSULTING INC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since July 8, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: MICHAEL FORSMAN (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since April 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: SERGEI NICHOLAS SHVETZOFF (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since March 7, 2011. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: ELY-BLOOMENSON COMMUNITY HOSPITAL (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since September 30, 2011. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: ELY-BLOOMENSON COMMUNITY HOSPITAL (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since September 30, 2011. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- September 1, 2024: ANTHONY PECHA no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: BETTY ERICKSON no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
Recent changes on this record
- May 1, 2026: ADAM MASLOSKI no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: HELEN P TOME no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: TAMI LYN SHVETZOFF (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since March 17, 2011. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: AMBER ROGOTZKE (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since March 7, 2011. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: ADAM MASLOSKI (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since June 1, 2016. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: ADAM MASLOSKI (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since June 1, 2016. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: A listing under ADP OF THE SNF, with no owner named, first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since May 27, 2015. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: WARREN DANIEL JOHNSON (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since July 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: WARREN DANIEL JOHNSON (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since July 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: ROGER PEKURI (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since January 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: JOSEPH MICHAEL SCHWINGHAMER (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since October 1, 2011. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: JOSEPH MICHAEL SCHWINGHAMER (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since October 1, 2011. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: DAVID LINDSAY BRISCOE (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since March 7, 2011. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: ERIN LEIGH SHVETZOFF HENNESSEY (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since January 1, 2020. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: KATHLEEN CHAMPA (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since June 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: KATHLEEN CHAMPA (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since June 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: PATRICIA LYNN BRISCOE (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since March 7, 2011. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: JONEENE LOBE (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since February 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: HEALTH DIMENSIONS CONSULTING INC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since July 8, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: MICHAEL FORSMAN (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since April 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: SERGEI NICHOLAS SHVETZOFF (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since March 7, 2011. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: ELY-BLOOMENSON COMMUNITY HOSPITAL (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since September 30, 2011. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: ELY-BLOOMENSON COMMUNITY HOSPITAL (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since September 30, 2011. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- August 29, 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- September 1, 2024: ANTHONY PECHA no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: BETTY ERICKSON no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- August 1, 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- August 9, 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- August 2, 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
- October 28, 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
- November 10, 2020: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
- July 11, 2019: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2018.zip
- August 22, 2018: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2017.zip
- August 23, 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2016.zip
- August 30, 2016: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2015.zip
- August 15, 2015: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2014.zip
- November 20, 2014: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2012.zip
- July 31, 2014: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2013.zip
- October 30, 2012: A cost report was filed for fiscal year 2011, on form CMS-2540-10. SNF10FY2012.zip
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | December 11, 2025 | December 11, 2025 | 0 | 2 |
| 2 | October 16, 2024 | October 16, 2024 | 5 | 6 |
| 3 | January 25, 2024 | January 25, 2024 | 6 | 8 |
From the Care Compare inspection summary file NH_SurveySummary_Sep2026_2.csv, processed on September 1, 2026.
Deficiencies cited
11 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| October 16, 2024 | Health | F 0580 | Resident Rights Deficiencies | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | D | No | Deficient, Provider has date of correction | November 18, 2024 |
| October 16, 2024 | 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 | No | Deficient, Provider has date of correction | November 18, 2024 |
| October 16, 2024 | Health | F 0695 | Quality of Life and Care Deficiencies | Provide safe and appropriate respiratory care for a resident when needed. | D | No | Deficient, Provider has date of correction | November 18, 2024 |
| October 16, 2024 | Health | F 0809 | Nutrition and Dietary Deficiencies | Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times. | F | No | Deficient, Provider has date of correction | November 18, 2024 |
| October 16, 2024 | Health | F 0825 | Quality of Life and Care Deficiencies | Provide or get specialized rehabilitative services as required for a resident. | D | No | Deficient, Provider has date of correction | November 18, 2024 |
| January 25, 2024 | Health | F 0582 | Resident Rights Deficiencies | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | D | No | Deficient, Provider has date of correction | February 24, 2024 |
| January 25, 2024 | Health | F 0583 | Resident Rights Deficiencies | Keep residents' personal and medical records private and confidential. | F | No | Deficient, Provider has date of correction | February 24, 2024 |
| January 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 | February 24, 2024 |
| January 25, 2024 | 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 | February 24, 2024 |
| January 25, 2024 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | No | Deficient, Provider has date of correction | February 24, 2024 |
| January 25, 2024 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | E | No | Deficient, Provider has date of correction | February 24, 2024 |
From the Care Compare health citations file NH_HealthCitations_Sep2026_2.csv, processed on September 1, 2026.
Penalties
No penalty on file for this facility in CMS’s Care Compare penalties data.
Care Compare provider information
| Field | As filed |
|---|---|
| Provider Type | Medicare and Medicaid |
| Ownership Type | Non profit - Corporation |
| Legal Business Name | BOUNDARY WATERS CARE CENTER |
| Date First Approved to Provide Medicare and Medicaid Services | 1967-07-24 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | Y |
| County/Parish | St. Louis |
| Telephone Number | 2183658705 |
| Chain Name | HEALTH DIMENSIONS GROUP |
| Chain ID | 821 |
| 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 | 38 |
| Average Number of Residents per Day | 28.5 |
| Overall Rating | 5 |
| Health Inspection Rating | 5 |
| QM Rating | 5 |
| Long-Stay QM Rating | 5 |
| Processing Date | 2026-09-01 |
From the Care Compare Provider Information file NH_ProviderInfo_Sep2026_3.csv, processed on September 1, 2026.
Get an email when this record changes
One email a day naming what moved on BOUNDARY WATERS CARE CENTER: the field, the value before, the value after, and the date of the file that first showed it.
The facility alert follows this one record: a cost report filed or a figure on one changed, an inspection, a deficiency or a penalty recorded, an owner added or removed. The certification number arrives filled in.
On August 29, 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. That is one line of the alert.
Following a list of facilities? The portfolio watch follows up to 100 certification numbers you name, on one subscription — on the alerts page.
The citable document for BOUNDARY WATERS CARE CENTER
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 Minnesota 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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- LUVERNE WASTEWATER TREATMENT FACILITY, LUVERNE Water discharge permit
- NEW PRAGUE, NEW PRAGUE Water discharge permit
- DETROIT LAKES, DETROIT LAKES Water discharge permit
- SAINT MICHAEL, SAINT MICHAEL Water discharge permit
- NORTH KOOCHICHING AREA SAN DIS, INTERNATIONAL FALLS Water discharge permit
- MELROSE, MELROSE Water discharge permit
- CENTRAL SPECIALTIES INC - PLANT 6, ALEXANDRIA Air emission source
- CENTRAL SPECIALTIES INC - PLANT 5, ALEXANDRIA Air emission source
- CENTRAL SPECIALTIES INC - PLANT 4, ALEXANDRIA Air emission source
- CENTRAL SPECIALTIES INC - PLANT 3, ALEXANDRIA Air emission source
- INTEX CORP, ALBERTVILLE Air emission source
- HAWKINSON CONSTRUCTION CO INC - PLANT 2, GRAND RAPIDS Air emission source
- TRI CITY PAVING INC, LITTLE FALLS Air emission source
- KNIFE RIVER CORP N CENTRAL - PLANT 7, LITTLE FALLS Air emission source
Every figure on this page is printed as it appears in the CMS file named beside it. A figure that does not match its file? Tell us on the corrections page, quoting certification number 245138.