Skilled nursing facility · CMS certification number 245600
GOOD SAMARITAN SOCIETY - BLACKDUCK
BLACKDUCK, Minnesota · Medicare and Medicaid
Certified beds, as filed in Care Compare: 30
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: 1 · Fines: 1 · Fines, total amount: $22,205.00 · Payment denials: 0. The most recent penalty on file: July 1, 2026, Fine, $22,205. 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 May 1, 2024 to April 30, 2025 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on September 26, 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,395,681 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $299,243 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,096,438 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,655,111 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $441,327 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $31,318 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $472,645 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $405,445 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 18,250 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 234 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 6,809 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 9,715 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 16,758 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 3 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 33 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 34 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 70 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 78 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 206.33 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 239.4 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1440232, read from the public cost report file SNF10FY2024.zip.
Fiscal year 2024, ended April 30, 2024
Cost report for May 1, 2023 to April 30, 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on September 30, 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,057,907 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $419,400 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,638,507 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,433,898 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $204,609 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $76,924 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $281,533 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $137,009 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,500 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 70 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 40.08 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 208.36 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 235.71 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1396268, read from the public cost report file SNF10FY2023.zip.
Fiscal year 2023, ended April 30, 2023
Cost report for May 1, 2022 to April 30, 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on December 20, 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,494,790 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $422,271 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,072,519 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,043,349 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $29,170 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $105,400 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $134,570 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $86,007 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 15,883 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 99 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 36.38 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 179.95 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 160.43 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1370965, read from the public cost report file SNF10FY2022.zip.
Fiscal year 2022, ended April 30, 2022
Cost report for May 1, 2021 to April 30, 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on November 18, 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,108,283 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $488,519 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,619,764 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,589,838 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $29,926 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $23,790 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $53,716 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $891 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 11,291 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 90 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 41.13 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 171.61 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 125.46 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1336571, read from the public cost report file SNF10FY2021.zip.
Fiscal year 2021, ended April 30, 2021
Cost report for May 1, 2020 to April 30, 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on November 10, 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,703,139 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $138,910 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,564,229 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,527,718 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $36,511 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $25,049 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $61,560 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $20,875 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 13,919 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 123 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 35.5 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 117.23 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 113.16 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1303547, read from the public cost report file SNF10FY2020.zip.
Fiscal year 2020, ended April 30, 2020
Cost report for May 1, 2019 to April 30, 2020 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on January 15, 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,904,395 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $362,310 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,542,085 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,454,961 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $87,124 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $30,364 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $117,488 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $97,371 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,067 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 52 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 50.82 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 668.89 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 308.98 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1278461, read from the public cost report file SNF10FY2019.zip.
Fiscal year 2019, ended April 30, 2019
Cost report for May 1, 2018 to April 30, 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on November 15, 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,687,884 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $485,756 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,202,128 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,498,456 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$296,328 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $325,112 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $28,784 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$38,406 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,230 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 194 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 32.35 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 129.78 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 83.66 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1245719, read from the public cost report file SNF10FY2018.zip.
Fiscal year 2018, ended April 30, 2018
Cost report for May 1, 2017 to April 30, 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on August 31, 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,870,994 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $504,503 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,366,491 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,417,515 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$51,024 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $345,504 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $294,480 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $287,245 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,914 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 129 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 38.15 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 146 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 131.12 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1211188, read from the public cost report file SNF10FY2017.zip.
Fiscal year 2017, ended April 30, 2017
Cost report for May 1, 2016 to April 30, 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on October 26, 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,320,283 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $295,278 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,025,005 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,136,295 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$111,290 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $322,472 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $211,182 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $214,231 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,921 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 108 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 38.05 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 219.67 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 156.68 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1177530, read from the public cost report file SNF10FY2016.zip.
Fiscal year 2016, ended April 30, 2016
Cost report for May 1, 2015 to April 30, 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on October 31, 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,826,061 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $201,292 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,624,769 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,919,397 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$294,628 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $324,427 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $29,799 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$2,345 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,658 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 80 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 42.06 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 306.32 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 220.73 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1145714, read from the public cost report file SNF10FY2015.zip.
Fiscal year 2015, ended April 30, 2015
Cost report for May 1, 2014 to April 30, 2015 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on January 20, 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,892,913 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $291,482 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,601,431 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,854,292 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$252,861 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $262,506 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $9,645 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$47,386 (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 | 52 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,800 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 94 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 40.68 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 562.64 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 189.36 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1117545, read from the public cost report file SNF10FY2014.zip.
Fiscal year 2014, ended April 30, 2014
Cost report for May 1, 2013 to April 30, 2014 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on November 7, 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,945,405 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $358,093 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,587,312 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,865,679 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$278,367 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $159,099 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$119,268 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$177,573 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 52 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,334 | 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 | 22.06 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 661 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 385.2 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1079877, read from the public cost report file SNF10FY2013.zip.
Fiscal year 2013, ended April 30, 2013
Cost report for May 1, 2012 to April 30, 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on January 27, 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,695,932 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $252,035 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,443,897 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,766,057 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$322,160 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $41,535 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$280,625 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$316,554 (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 | 52 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 15,967 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 71 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 39.33 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 366.86 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 224.89 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1053831, read from the public cost report file SNF10FY2012.zip.
Fiscal year 2012, ended April 30, 2012
Cost report for May 1, 2011 to April 30, 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on September 9, 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,744,652 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $311,922 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,432,730 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,856,588 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$423,858 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $62,899 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$360,959 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$337,654 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 14,917 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 94 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 35.58 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 380.5 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 158.69 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1047628, read from the public cost report file SNF10FY2011.zip.
Fiscal year 2011, ended April 30, 2011
Cost report for May 1, 2010 to April 30, 2011 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on December 17, 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,318,055 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,624,586 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$306,531 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $29,736 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $4,182 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$280,977 (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 | 50 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 13,837 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 107 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 31.74 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 260.96 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 129.32 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 433944, read from the public cost report file SNFFY2010.zip.
Fiscal year 2010, ended April 30, 2010
Cost report for May 1, 2009 to April 30, 2010 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on October 21, 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,465,888 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,612,155 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$146,267 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $25,783 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $23,597 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$144,081 (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 | 55 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 14,552 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 91 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 73.08 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 370.96 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 159.91 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 419105, read from the public cost report file SNFFY2009.zip.
Fiscal year 2009, ended April 30, 2009
Cost report for May 1, 2008 to April 30, 2009 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on August 13, 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,224,540 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,185,386 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $39,154 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $99,199 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $26,000 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $112,353 (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 | 35 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 11,900 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 78 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 49.94 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 278.72 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 152.56 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 385472, read from the public cost report file SNFFY2008.zip.
Fiscal year 2008, ended April 30, 2008
Cost report for May 1, 2007 to April 30, 2008 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on October 13, 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,134,595 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,156,867 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$22,272 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $8,238 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $12,521 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$26,555 (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 | 35 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 12,421 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 58 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 102.14 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 391.83 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 214.16 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 357653, read from the public cost report file SNFFY2007.zip.
Fiscal year 2007, ended April 30, 2007
Cost report for May 1, 2006 to April 30, 2007 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on September 9, 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,041,314 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,113,154 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$71,840 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $91,071 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $8,726 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $10,505 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 35 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 12,409 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 117 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 36.35 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 190.85 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 106.06 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 325539, read from the public cost report file SNFFY2006.zip.
Fiscal year 2006, ended April 30, 2006
Cost report for May 1, 2005 to April 30, 2006 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on October 16, 2007.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,284,197 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,242,152 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $42,045 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $66,460 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $12,038 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $96,467 (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 | 42 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 13,944 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 161 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 38.77 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 119.56 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 86.61 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 294341, read from the public cost report file SNFFY2005.zip.
Fiscal year 2005, ended April 30, 2005
Cost report for May 1, 2004 to April 30, 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on May 11, 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,152,667 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,154,078 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$1,411 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $35,486 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $11,192 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $22,883 (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 | 42 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 13,825 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 173 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 34.67 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 128.56 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 79.91 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 249074, read from the public cost report file SNFFY2004.zip.
Fiscal year 2004, ended April 30, 2004
Cost report for May 1, 2003 to April 30, 2004 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on July 28, 2005.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,467,193 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,306,416 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $160,777 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $72,921 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $4,287 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $229,411 (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 | 48 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 15,374 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 201 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 39.72 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 108.4 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 76.49 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 229303, read from the public cost report file SNFFY2003.zip.
Fiscal year 2003, ended April 30, 2003
Cost report for May 1, 2002 to April 30, 2003 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on May 12, 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,430,478 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,311,456 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $119,022 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $11,070 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $19,195 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $110,897 (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 | 55 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 16,485 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 140 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 46.79 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 183.06 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 117.75 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 176031, read from the public cost report file SNFFY2002.zip.
Fiscal year 2002, ended April 30, 2002
Cost report for May 1, 2001 to April 30, 2002 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on May 7, 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,385,721 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,240,364 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $145,357 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $51,004 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $10,129 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $186,232 (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 | 55 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 17,244 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 125 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 37.33 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 202.68 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 137.95 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 143018, read from the public cost report file SNFFY2001.zip.
Fiscal year 2001, ended April 30, 2001
Cost report for May 1, 2000 to April 30, 2001 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on March 18, 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,251,261 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,130,052 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $121,209 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $20,647 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $9 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $141,847 (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 | 55 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 17,919 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 128 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 32.79 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 257.25 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 139.99 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 133014, read from the public cost report file SNFFY2000.zip.
Fiscal year 2000, ended April 30, 2000
Cost report for May 1, 1999 to April 30, 2000 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on March 18, 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,751,513 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,821,999 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$70,486 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $66,451 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: −$4,035 (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 | 70 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 16,837 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 107 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 44.52 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 281.26 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 157.36 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 132969, read from the public cost report file SNFFY1999.zip.
Fiscal year 1999, ended April 30, 1999
Cost report for May 1, 1998 to April 30, 1999 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on August 17, 2001.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,910,382 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,072,539 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$162,157 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $59,905 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: −$102,252 (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 | 70 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 19,152 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 86 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 37.26 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 667.11 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 222.7 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 1502, read from the public cost report file SNFFY1998.zip.
Fiscal year 1998, ended April 30, 1998
Cost report for May 1, 1997 to April 30, 1998 — a reporting period of 364 days, on form CMS-2540-96, reopened, processed by CMS on May 13, 2005.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,318,896 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,403,601 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$84,705 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $101,744 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $17,039 (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 | 70 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 21,534 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 101 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 41.63 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 397.86 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 213.21 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 216767, read from the public cost report file SNFFY1997.zip.
Fiscal year 1997, ended April 30, 1997
Cost report for May 1, 1996 to April 30, 1997 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on November 2, 1999.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,300,835 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,272,226 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $28,609 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $80,594 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $109,203 (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 | 70 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 23,478 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 121 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 44.6 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 651.56 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 194.03 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 18436, read from the public cost report file SNFFY1996.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 |
|---|---|---|---|---|
| SANFORD | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | 100% | since 01/01/2019 |
| THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | Organization | 100% | since 01/01/2019 |
| BILLUPS, SHERRY | ADP OF THE SNF | Individual | NOT APPLICABLE | since 08/14/2018 |
| BJERKE, BRANDON | ADP OF THE SNF | Individual | NOT APPLICABLE | since 04/12/2021 |
| BROWN, GEORGE | ADP OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2025 |
| DTN STAFFING INC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 08/02/2024 |
| DYKHOUSE, DANA | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/30/2024 |
| ENGBRECHT, WESLEY | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/30/2024 |
| FLUIT, JOEL | ADP OF THE SNF | Individual | NOT APPLICABLE | since 10/01/2022 |
| FOCUSONE SOLUTIONS | ADP OF THE SNF | Organization | NOT APPLICABLE | since 03/04/2024 |
| GASSEN, WILLIAM | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/30/2024 |
| GRAPE TREE MEDICAL STAFFING LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 04/13/2018 |
| GULSVIG, NEIL | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/30/2024 |
| HERSETH SANDLIN, STEPHANIE | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/30/2024 |
| LUNDEEN, MARK | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/30/2024 |
| MCCAUSLAND, MAUREEN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2025 |
| MIDDLETON, AIMEE | ADP OF THE SNF | Individual | NOT APPLICABLE | since 01/27/2022 |
| MOLBERT, LAURIS | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/30/2024 |
| MORRISON, TONY | ADP OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2019 |
| NORTH, ANDREW | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/30/2024 |
| OLSON, NICHOLAS | ADP OF THE SNF | Individual | NOT APPLICABLE | since 04/08/2024 |
| SANDGREN, DEEANDRA | ADP OF THE SNF | Individual | NOT APPLICABLE | since 07/16/2023 |
| SANFORD | ADP OF THE SNF | Organization | NOT APPLICABLE | since 11/07/2025 |
| SCHEMA, NATHAN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2022 |
| SCHIEFFER, KEVIN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2025 |
| SHULKIN, DAVID | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/30/2024 |
| TEIKEN, BRENT | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/30/2024 |
| THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | ADP OF THE SNF | Organization | NOT APPLICABLE | since 01/01/2019 |
| VENTLING-HERRMANN, MARNIE | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/30/2024 |
| WENZEL, THOMAS | ADP OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2025 |
| BROWN, GEORGE | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 01/01/2025 |
| DYKHOUSE, DANA | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| ENGBRECHT, WESLEY | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| GASSEN, WILLIAM | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| GULSVIG, NEIL | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| HERSETH SANDLIN, STEPHANIE | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| LUNDEEN, MARK | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| MCCAUSLAND, MAUREEN | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 01/01/2025 |
| MOLBERT, LAURIS | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| NORTH, ANDREW | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| SCHIEFFER, KEVIN | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 01/01/2025 |
| SHULKIN, DAVID | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| TEIKEN, BRENT | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| VENTLING-HERRMANN, MARNIE | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| WENZEL, THOMAS | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 01/01/2025 |
| FLUIT, JOEL | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 10/01/2022 |
| GASSEN, WILLIAM | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 05/30/2024 |
| MIDDLETON, AIMEE | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 01/27/2022 |
| OLSON, NICHOLAS | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 04/08/2024 |
| SCHEMA, NATHAN | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 01/01/2022 |
| FLUIT, JOEL | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | Individual | NOT APPLICABLE | since 04/13/2026 |
| BILLUPS, SHERRY | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 08/14/2018 |
| BJERKE, BRANDON | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 04/12/2021 |
| MORRISON, TONY | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 01/01/2019 |
| SANDGREN, DEEANDRA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 07/16/2023 |
| SANFORD | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | since 01/01/2019 |
| THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | since 01/01/2019 |
Medicare enrollment
As filed in the CMS file dated August 1, 2026 (Medicare enrollment ownership), under the enrollment of THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (enrollment ID O20070910000789).
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 |
|---|---|---|---|---|---|
| SANFORD | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100 | 1/1/2019 | Private equity company: No Real estate investment trust: No Holding company: No |
| THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100 | 1/1/2019 | Private equity company: No Real estate investment trust: No Holding company: No |
| AIMEE NICOLE MIDDLETON | Individual | ADP OF THE SNF | Not stated in the filing | 1/27/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| ANDREW STEWART NORTH | Individual | ADP OF THE SNF | Not stated in the filing | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| BRANDON BJERKE | Individual | ADP OF THE SNF | Not stated in the filing | 4/12/2021 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| BRENT GERARD TEIKEN | Individual | ADP OF THE SNF | Not stated in the filing | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DANA JAMES DYKHOUSE | Individual | ADP OF THE SNF | Not stated in the filing | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DAVID JONATHAN SHULKIN | Individual | ADP OF THE SNF | Not stated in the filing | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DEEANDRA DAWN SANDGREN | Individual | ADP OF THE SNF | Not stated in the filing | 7/16/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DTN STAFFING INC | Organization | ADP OF THE SNF | Not stated in the filing | 8/2/2024 | Private equity company: No Real estate investment trust: No Holding company: No |
| FOCUSONE SOLUTIONS | Organization | ADP OF THE SNF | Not stated in the filing | 3/4/2024 | Private equity company: No Real estate investment trust: No Holding company: No |
| GEORGE JOSEPH BROWN | Individual | ADP OF THE SNF | Not stated in the filing | 1/1/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| GRAPE TREE MEDICAL STAFFING LLC | Organization | ADP OF THE SNF | Not stated in the filing | 4/13/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| JOEL ADAM FLUIT | Individual | ADP OF THE SNF | Not stated in the filing | 10/1/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KEVIN VICTOR SCHIEFFER | Individual | ADP OF THE SNF | Not stated in the filing | 1/1/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| LAURIS NELSON MOLBERT | Individual | ADP OF THE SNF | Not stated in the filing | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MARK ALLEN LUNDEEN | Individual | ADP OF THE SNF | Not stated in the filing | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MARNIE LYNN VENTLING-HERRMANN | Individual | ADP OF THE SNF | Not stated in the filing | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MAUREEN PATRICIA MCCAUSLAND | Individual | ADP OF THE SNF | Not stated in the filing | 1/1/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| NATHAN THOMAS SCHEMA | Individual | ADP OF THE SNF | Not stated in the filing | 1/1/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| NEIL LESLIE GULSVIG | Individual | ADP OF THE SNF | Not stated in the filing | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| NICHOLAS WAYNE OLSON | Individual | ADP OF THE SNF | Not stated in the filing | 4/8/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| SANFORD | Organization | ADP OF THE SNF | Not stated in the filing | 11/7/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| SHERRY S BILLUPS | Individual | ADP OF THE SNF | Not stated in the filing | 8/14/2018 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| STEPHANIE MARIE HERSETH SANDLIN | Individual | ADP OF THE SNF | Not stated in the filing | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | Organization | ADP OF THE SNF | Not stated in the filing | 1/1/2019 | Private equity company: No Real estate investment trust: No Holding company: No |
| THOMAS RICHARD WENZEL | Individual | ADP OF THE SNF | Not stated in the filing | 1/1/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| TONY LEE MORRISON | Individual | ADP OF THE SNF | Not stated in the filing | 1/1/2019 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| WESLEY OWEN ENGBRECHT | Individual | ADP OF THE SNF | Not stated in the filing | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| WILLIAM JOSEPH GASSEN | Individual | ADP OF THE SNF | Not stated in the filing | 5/30/2024 | 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 | 10/1/2017 | 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 | 3/12/2018 | 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 | 4/14/2024 | 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 | 2/1/2024 | 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 | 10/1/2017 | 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 | 10/1/2017 | 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 | 3/25/2022 | 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 | 10/1/2017 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| ANDREW STEWART NORTH | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| BRENT GERARD TEIKEN | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DANA JAMES DYKHOUSE | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DAVID JONATHAN SHULKIN | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| GEORGE JOSEPH BROWN | Individual | CORPORATE DIRECTOR | 0 | 1/1/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KEVIN VICTOR SCHIEFFER | Individual | CORPORATE DIRECTOR | 0 | 1/1/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| LAURIS NELSON MOLBERT | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MARK ALLEN LUNDEEN | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MARNIE LYNN VENTLING-HERRMANN | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MAUREEN PATRICIA MCCAUSLAND | Individual | CORPORATE DIRECTOR | 0 | 1/1/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| NEIL LESLIE GULSVIG | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| STEPHANIE MARIE HERSETH SANDLIN | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| THOMAS RICHARD WENZEL | Individual | CORPORATE DIRECTOR | 0 | 1/1/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| WESLEY OWEN ENGBRECHT | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| WILLIAM JOSEPH GASSEN | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| AIMEE NICOLE MIDDLETON | Individual | CORPORATE OFFICER | 0 | 1/27/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JOEL ADAM FLUIT | Individual | CORPORATE OFFICER | 0 | 10/1/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| NATHAN THOMAS SCHEMA | Individual | CORPORATE OFFICER | 0 | 1/1/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| NICHOLAS WAYNE OLSON | Individual | CORPORATE OFFICER | 0 | 4/8/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| WILLIAM JOSEPH GASSEN | Individual | CORPORATE OFFICER | 0 | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| BRANDON BJERKE | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 4/12/2021 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DEEANDRA DAWN SANDGREN | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 7/16/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| SANFORD | Organization | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 1/1/2019 | Private equity company: No Real estate investment trust: No Holding company: No |
| SHERRY S BILLUPS | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 8/14/2018 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | Organization | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 1/1/2019 | Private equity company: No Real estate investment trust: No Holding company: No |
| TONY LEE MORRISON | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 1/1/2019 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
Changes in ownership
- July 1, 2026: THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since January 1, 2019. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: NICHOLAS WAYNE OLSON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since April 8, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: LAURIS NELSON MOLBERT (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: KEVIN VICTOR SCHIEFFER (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since January 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: NEIL LESLIE GULSVIG (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: DEEANDRA DAWN SANDGREN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since July 16, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: DEEANDRA DAWN SANDGREN (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since July 16, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: DAVID JONATHAN SHULKIN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: THOMAS RICHARD WENZEL (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since January 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: NATHAN THOMAS SCHEMA (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since January 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: SANFORD (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since November 7, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: SANFORD (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since January 1, 2019. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: MAUREEN PATRICIA MCCAUSLAND (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since January 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: WESLEY OWEN ENGBRECHT (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: GEORGE JOSEPH BROWN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since January 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: WILLIAM JOSEPH GASSEN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: GRAPE TREE MEDICAL STAFFING LLC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since April 13, 2018. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: STEPHANIE MARIE HERSETH SANDLIN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: AIMEE NICOLE MIDDLETON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since January 27, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: ANDREW STEWART NORTH (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: DTN STAFFING INC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since August 2, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: MARK ALLEN LUNDEEN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: DANA JAMES DYKHOUSE (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: JOEL ADAM FLUIT (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since October 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: A listing under ADP OF THE SNF, with no owner named, first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since October 1, 2017. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: BRENT GERARD TEIKEN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: FOCUSONE SOLUTIONS (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since March 4, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since January 1, 2019. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (5% OR GREATER INDIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since January 1, 2019. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: MARNIE LYNN VENTLING-HERRMANN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- April 1, 2025: MICHAEL ROGERS no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: SHERRY S BILLUPS no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: JAMES EDWARD CAIN no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: TONY LEE MORRISON no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: BRANDON BJERKE no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: KEVIN VICTOR SCHIEFFER (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since January 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: THOMAS RICHARD WENZEL (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since January 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: MAUREEN PATRICIA MCCAUSLAND (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since January 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: GEORGE JOSEPH BROWN (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since January 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: SHERRY S BILLUPS (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since August 14, 2018. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: SHERRY S BILLUPS (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since August 14, 2018. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: TONY LEE MORRISON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since January 1, 2019. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: TONY LEE MORRISON (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since January 1, 2019. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: BRANDON BJERKE (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since April 12, 2021. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: BRANDON BJERKE (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since April 12, 2021. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- September 1, 2024: DEAN LOUIS BRESCIANI no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: THOMAS PHILLIP KOOP no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: MATTHEW RYAN HOCKS no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: SANFORD no longer appears as OTHER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: AIMEE NICOLE MIDDLETON no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: MICHAEL ROGERS no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: SCOTT CHARLES PETERSEN no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: WILLIAM D MARLETTE no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: WILLIAM D MARLETTE no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: TONY LEE MORRISON no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: DARRELL EVAN SCHMITH no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: LINDA OLAYINKA NORMAN no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: DAVID AUSTAD no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: HELEN ISABELLA MELLAND no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: MARNIE LYNN VENTLING-HERRMANN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on September 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: NICHOLAS WAYNE OLSON (OFFICER) first listed in CMS’s Medicare enrollment ownership file on September 1, 2024; associated with this enrollment since April 8, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: LAURIS NELSON MOLBERT (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on September 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: NEIL LESLIE GULSVIG (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on September 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: DAVID JONATHAN SHULKIN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on September 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: SANFORD (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on September 1, 2024; associated with this enrollment since January 1, 2019. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: WESLEY OWEN ENGBRECHT (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on September 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: WILLIAM JOSEPH GASSEN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on September 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: WILLIAM JOSEPH GASSEN (OFFICER) first listed in CMS’s Medicare enrollment ownership file on September 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: STEPHANIE MARIE HERSETH SANDLIN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on September 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: ANDREW STEWART NORTH (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on September 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: MICHAEL ROGERS (OFFICER) first listed in CMS’s Medicare enrollment ownership file on September 1, 2024; associated with this enrollment since June 13, 2022. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: DANA JAMES DYKHOUSE (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on September 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: SHERRY S BILLUPS (CONTRACTED MANAGING EMPLOYEE) first listed in CMS’s Medicare enrollment ownership file on September 1, 2024; associated with this enrollment since August 14, 2018. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: BRENT GERARD TEIKEN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on September 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: JAMES EDWARD CAIN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on September 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: BRANDON BJERKE (W-2 MANAGING EMPLOYEE) first listed in CMS’s Medicare enrollment ownership file on September 1, 2024; associated with this enrollment since April 12, 2021. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- September 1, 2024: MARK ALLEN LUNDEEN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on September 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- March 1, 2024: DAVID A BRECHTELSBAUER no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-03-01.csv
- March 1, 2024: NATHAN THOMAS SCHEMA no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-03-01.csv
- October 2, 2023: LISA MELBY no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: NORVAL BUCKNEBERG no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: MICHELLE ANN BRUHN no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: CHAD JUNGMAN no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: ERIC VANDEN HULL no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: ERIC VANDEN HULL no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: MICHELLE MARIE MICKA no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: MICHELLE MARIE MICKA no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: STEPHANIE MARIE SWENSON no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: JOLYN JOY MUNSON no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: KARIN LOUISE DULSKI no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: TRACI WOOLFOLK no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: MARNIE LYNN VENTLING-HERRMANN no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: DUSTIN ALLEN SCHOLZ no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: DEAN LOUIS BRESCIANI (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 2, 2023; associated with this enrollment since June 13, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: AIMEE NICOLE MIDDLETON (W-2 MANAGING EMPLOYEE) first listed in CMS’s Medicare enrollment ownership file on October 2, 2023; associated with this enrollment since January 27, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: AIMEE NICOLE MIDDLETON (OFFICER) first listed in CMS’s Medicare enrollment ownership file on October 2, 2023; associated with this enrollment since January 27, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: MICHAEL ROGERS (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 2, 2023; associated with this enrollment since June 13, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: JOEL FLUIT (OFFICER) first listed in CMS’s Medicare enrollment ownership file on October 2, 2023; associated with this enrollment since October 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: WILLIAM D MARLETTE (W-2 MANAGING EMPLOYEE) first listed in CMS’s Medicare enrollment ownership file on October 2, 2023; associated with this enrollment since June 14, 2023. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: WILLIAM D MARLETTE (OFFICER) first listed in CMS’s Medicare enrollment ownership file on October 2, 2023; associated with this enrollment since June 14, 2023. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
Recent changes on this record
- July 1, 2026: THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since January 1, 2019. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: NICHOLAS WAYNE OLSON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since April 8, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: LAURIS NELSON MOLBERT (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: KEVIN VICTOR SCHIEFFER (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since January 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: NEIL LESLIE GULSVIG (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: DEEANDRA DAWN SANDGREN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since July 16, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: DEEANDRA DAWN SANDGREN (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since July 16, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: DAVID JONATHAN SHULKIN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: THOMAS RICHARD WENZEL (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since January 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: NATHAN THOMAS SCHEMA (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since January 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: SANFORD (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since November 7, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: SANFORD (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since January 1, 2019. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: MAUREEN PATRICIA MCCAUSLAND (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since January 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: WESLEY OWEN ENGBRECHT (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: GEORGE JOSEPH BROWN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since January 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: WILLIAM JOSEPH GASSEN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: GRAPE TREE MEDICAL STAFFING LLC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since April 13, 2018. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: STEPHANIE MARIE HERSETH SANDLIN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: AIMEE NICOLE MIDDLETON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since January 27, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: ANDREW STEWART NORTH (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: DTN STAFFING INC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since August 2, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: MARK ALLEN LUNDEEN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: DANA JAMES DYKHOUSE (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: JOEL ADAM FLUIT (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since October 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: A listing under ADP OF THE SNF, with no owner named, first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since October 1, 2017. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: BRENT GERARD TEIKEN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: FOCUSONE SOLUTIONS (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since March 4, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since January 1, 2019. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (5% OR GREATER INDIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since January 1, 2019. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: MARNIE LYNN VENTLING-HERRMANN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on July 1, 2026; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- September 26, 2025: A cost report was filed for fiscal year 2025, on form CMS-2540-10. SNF10FY2024.zip
- April 1, 2025: MICHAEL ROGERS no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: SHERRY S BILLUPS no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: JAMES EDWARD CAIN no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: TONY LEE MORRISON no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: BRANDON BJERKE no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: KEVIN VICTOR SCHIEFFER (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since January 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: THOMAS RICHARD WENZEL (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since January 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: MAUREEN PATRICIA MCCAUSLAND (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since January 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: GEORGE JOSEPH BROWN (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since January 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | August 20, 2025 | August 20, 2025 | 9 | 6 |
| 2 | June 13, 2024 | June 13, 2024 | 6 | 2 |
| 3 | August 10, 2023 | August 10, 2023 | 7 | 9 |
From the Care Compare inspection summary file NH_SurveySummary_Sep2026_2.csv, processed on September 1, 2026.
Deficiencies cited
23 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| July 1, 2026 | Health | F 0803 | Nutrition and Dietary Deficiencies | Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | J | Yes | Past Non-Compliance | June 11, 2026 |
| October 31, 2025 | Health | F 0641 | Resident Assessment and Care Planning Deficiencies | Ensure each resident receives an accurate assessment. | D | Yes | Deficient, Provider has date of correction | December 26, 2025 |
| October 31, 2025 | Health | F 0655 | Resident Assessment and Care Planning Deficiencies | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | D | Yes | Deficient, Provider has date of correction | December 26, 2025 |
| October 31, 2025 | Health | F 0686 | Quality of Life and Care Deficiencies | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | Yes | Deficient, Provider has date of correction | December 26, 2025 |
| August 20, 2025 | Health | F 0605 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. | D | No | Deficient, Provider has date of correction | September 24, 2025 |
| August 20, 2025 | 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 | September 24, 2025 |
| August 20, 2025 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | No | Deficient, Provider has date of correction | September 24, 2025 |
| August 20, 2025 | Health | F 0690 | Quality of Life and Care Deficiencies | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | D | No | Deficient, Provider has date of correction | September 24, 2025 |
| August 20, 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 | September 24, 2025 |
| June 13, 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 | July 22, 2024 |
| June 13, 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 | July 22, 2024 |
| June 13, 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 22, 2024 |
| June 13, 2024 | Health | F 0865 | Administration Deficiencies | Have a plan that describes the process for conducting QAPI and QAA activities. | F | No | Deficient, Provider has date of correction | July 22, 2024 |
| June 13, 2024 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | F | No | Deficient, Provider has date of correction | July 22, 2024 |
| June 13, 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 | July 22, 2024 |
| February 7, 2024 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Yes | Deficient, Provider has date of correction | March 13, 2024 |
| August 10, 2023 | Health | F 0554 | Resident Rights Deficiencies | Allow residents to self-administer drugs if determined clinically appropriate. | D | Yes | Deficient, Provider has date of correction | September 20, 2023 |
| August 10, 2023 | Health | F 0640 | Resident Assessment and Care Planning Deficiencies | Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment. | D | No | Deficient, Provider has date of correction | September 20, 2023 |
| August 10, 2023 | Health | F 0641 | Resident Assessment and Care Planning Deficiencies | Ensure each resident receives an accurate assessment. | B | No | Deficient, Provider has date of correction | September 20, 2023 |
| August 10, 2023 | Health | F 0661 | Resident Assessment and Care Planning Deficiencies | Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. | D | No | Deficient, Provider has date of correction | September 20, 2023 |
| August 10, 2023 | 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 | September 20, 2023 |
| August 10, 2023 | Health | F 0758 | Pharmacy Service Deficiencies | Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | E | No | Deficient, Provider has date of correction | September 20, 2023 |
| August 10, 2023 | 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 | September 20, 2023 |
From the Care Compare health citations file NH_HealthCitations_Sep2026_2.csv, processed on September 1, 2026.
Penalties
| Penalty date | Type | Fine amount | Payment denial began | Payment denial, days | Fine ID |
|---|---|---|---|---|---|
| July 1, 2026 | Fine | $22,205 | 141703 |
From the Care Compare penalties file NH_Penalties_Sep2026_2.csv, processed on September 1, 2026.
Care Compare provider information
| Field | As filed |
|---|---|
| Provider Type | Medicare and Medicaid |
| Ownership Type | Non profit - Corporation |
| Legal Business Name | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY |
| Date First Approved to Provide Medicare and Medicaid Services | 1992-04-01 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | N |
| County/Parish | Beltrami |
| Telephone Number | 2188353410 |
| Chain Name | GOOD SAMARITAN SOCIETY |
| Chain ID | 726 |
| 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 | 30 |
| Average Number of Residents per Day | 27.6 |
| Overall Rating | 1 |
| Health Inspection Rating | 2 |
| QM Rating | 1 |
| Long-Stay QM Rating | 1 |
| 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 GOOD SAMARITAN SOCIETY - BLACKDUCK: 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 September 26, 2025: A cost report was filed for fiscal year 2025, on form CMS-2540-10. That is one line of the alert.
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The citable document for GOOD SAMARITAN SOCIETY - BLACKDUCK
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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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 245600.