Skilled nursing facility · CMS certification number 245613
WAVERLY GARDENS
NORTH OAKS, Minnesota · Medicare and Medicaid
Certified beds, as filed in Care Compare: 60
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: $113,312.00 · Payment denials: 0. The most recent penalty on file: May 29, 2026, Fine, $113,312. 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 October 1, 2023 to September 30, 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on February 3, 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,173,429 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $713,311 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,460,118 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $25,136,479 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$15,676,361 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $19,861,384 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $4,185,023 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $4,185,023 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 21,960 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 1,926 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 4,465 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 13,387 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 19,778 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 59 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 22 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 210 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 291 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 32.64 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 202.95 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 67.97 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1403055, read from the public cost report file SNF10FY2024.zip.
Fiscal year 2023, ended September 30, 2023
Cost report for October 1, 2022 to September 30, 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on January 30, 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,627,127 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $220,841 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $8,406,286 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $23,467,561 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$15,061,275 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $19,452,807 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $4,391,532 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $4,391,532 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,633 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 162 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 29.32 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 92.16 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 121.19 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1372727, read from the public cost report file SNF10FY2023.zip.
Fiscal year 2022, ended September 30, 2022
Cost report for October 1, 2021 to September 30, 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on April 20, 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,203,244 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $90,613 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $8,112,631 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $22,322,477 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$14,209,846 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $13,653,364 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$556,482 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$556,482 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,830 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 201 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 36.91 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 189.53 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 98.66 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1346088, read from the public cost report file SNF10FY2022.zip.
Fiscal year 2021, ended September 30, 2021
Cost report for October 1, 2020 to September 30, 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on May 3, 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,158,729 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$97,400 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $8,256,129 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $21,618,633 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$13,362,504 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $15,146,853 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,784,349 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,582,184 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,295 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 304 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 31.25 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 178.1 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 63.47 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1315216, read from the public cost report file SNF10FY2021.zip.
Fiscal year 2020, ended September 30, 2020
Cost report for October 1, 2019 to September 30, 2020 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on April 23, 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,538,777 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$85,307 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,624,084 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $20,988,940 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$13,364,856 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $14,724,505 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,359,649 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,359,649 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,179 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 364 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 32.18 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 117.04 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 52.69 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1282824, read from the public cost report file SNF10FY2020.zip.
Fiscal year 2019, ended September 30, 2019
Cost report for October 1, 2018 to September 30, 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on April 30, 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,999,228 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $279,180 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,720,048 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $20,386,806 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$12,666,758 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $15,035,154 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $2,368,396 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $2,370,396 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,935 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 345 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 38.7 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 104.04 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 60.68 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1254779, read from the public cost report file SNF10FY2019.zip.
Fiscal year 2018, ended September 30, 2018
Cost report for October 1, 2017 to September 30, 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on February 27, 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,639,918 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $214,975 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,424,943 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $19,717,013 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$12,292,070 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $15,220,705 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $2,928,635 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $2,928,635 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 21,088 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 374 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 29.27 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 71.69 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 56.39 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1220268, read from the public cost report file SNF10FY2018.zip.
Fiscal year 2017, ended September 30, 2017
Cost report for October 1, 2016 to September 30, 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on May 2, 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,362,313 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $252,442 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,109,871 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $19,822,632 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$12,712,761 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $8,589,231 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$4,123,530 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$4,123,530 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 21,039 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 357 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 24.32 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 131.19 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 58.93 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1187629, read from the public cost report file SNF10FY2017.zip.
Fiscal year 2016, ended September 30, 2016
Cost report for October 1, 2015 to September 30, 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on March 16, 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,047,316 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $249,405 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,797,911 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $20,536,986 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$13,739,075 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $14,929,460 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,190,385 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,190,385 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 21,322 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 265 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 24.84 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 230.67 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 80.46 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1154551, read from the public cost report file SNF10FY2016.zip.
Fiscal year 2015, ended September 30, 2015
Cost report for October 1, 2014 to September 30, 2015 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on May 5, 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,722,769 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $118,364 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,604,405 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $20,041,905 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$13,437,500 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $15,471,066 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $2,033,566 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $2,033,566 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 21,642 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 218 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 33.6 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 340.5 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 99.28 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1123316, read from the public cost report file SNF10FY2015.zip.
Fiscal year 2014, ended September 30, 2014
Cost report for October 1, 2013 to September 30, 2014 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on April 16, 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,528,295 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $156,785 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,371,510 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $19,850,074 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$13,478,564 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $13,714,369 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $235,805 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $235,628 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 21,360 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 309 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 32.47 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 398.17 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 69.13 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1088407, read from the public cost report file SNF10FY2014.zip.
Fiscal year 2013, ended September 30, 2013
Cost report for October 1, 2012 to September 30, 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on May 7, 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,113,211 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $56,676 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,056,535 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $20,253,035 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$14,196,500 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $12,270,546 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$1,925,954 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,938,861 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 21,129 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 274 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 39.93 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 119.04 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 77.11 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1059491, read from the public cost report file SNF10FY2013.zip.
Fiscal year 2012, ended September 30, 2012
Cost report for October 1, 2011 to September 30, 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on May 7, 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,824,811 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $134,502 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,690,309 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $17,240,842 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$11,550,533 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $12,493,870 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $943,337 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $943,337 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,910 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 242 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 40.83 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 275.69 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 86.4 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1028684, read from the public cost report file SNF10FY2012.zip.
Fiscal year 2011, ended September 30, 2011
Cost report for October 1, 2010 to September 30, 2011 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on May 8, 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $5,571,725 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $20,098,808 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$14,527,083 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $12,265,564 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: −$2,261,519 (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 | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,941 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 127 | 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 | 496.57 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 164.89 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 428746, read from the public cost report file SNFFY2011.zip.
Fiscal year 2010, ended September 30, 2010
Cost report for October 1, 2009 to September 30, 2010 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on May 4, 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $10,815,757 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $19,116,514 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$8,300,757 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $6,392,683 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: −$1,908,074 (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 | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,346 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 106 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 58.93 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 191.94 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 398699, read from the public cost report file SNFFY2010.zip.
Fiscal year 2009, ended September 30, 2009
Cost report for October 1, 2008 to September 30, 2009 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on May 6, 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $13,559,422 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $17,805,803 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$4,246,381 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $1,220,857 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $118,288 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$3,143,812 (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 | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 17,028 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 90 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 48.84 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 189.2 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 368971, read from the public cost report file SNFFY2009.zip.
Fiscal year 2008, ended September 30, 2008
Cost report for October 1, 2007 to September 30, 2008 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on May 13, 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $9,761,276 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $11,454,077 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$1,692,801 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $694,731 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $3,287,094 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$4,285,164 (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 | 59 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 12,873 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 23 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 82.69 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,082 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 559.7 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 338992, read from the public cost report file SNFFY2008.zip.
Fiscal year 2007, ended September 30, 2007
Cost report for October 1, 2006 to September 30, 2007 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on April 24, 2008.
None of these figures is carried on this report.
CMS report record 307505, read from the public cost report file SNFFY2007.zip.
Fiscal year 2006, ended September 30, 2006
Cost report for August 2, 2006 to September 30, 2006 — a reporting period of 59 days, not a full year, on form CMS-2540-96, settled, processed by CMS on August 13, 2008.
None of these figures is carried on this report.
CMS report record 323695, read from the public cost report file SNFFY2006.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 |
|---|---|---|---|---|
| PRESBYTERIAN HOMES AND SERVICES | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | 100% | since 03/17/2020 |
| COMPUTERSHARE CORPORATE TRUST COMPANY, NA | 5% OR GREATER MORTGAGE INTEREST | Organization | NOT APPLICABLE | since 07/01/2024 |
| COMPUTERSHARE CORPORATE TRUST COMPANY, NA | 5% OR GREATER SECURITY INTEREST | Organization | NOT APPLICABLE | since 07/01/2024 |
| FLETCHER, JONATHAN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 02/01/2025 |
| MEYER, MARK | ADP OF THE SNF | Individual | NOT APPLICABLE | since 03/11/2011 |
| PEDERSON, JANE | ADP OF THE SNF | Individual | NOT APPLICABLE | since 04/01/2021 |
| PETERSON, HEIDI | ADP OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2023 |
| PHS MANAGEMENT, LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 02/17/2026 |
| SAMMON, KATHERINE | ADP OF THE SNF | Individual | NOT APPLICABLE | since 11/21/2022 |
| FLETCHER, JONATHAN | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 02/01/2025 |
| PEDERSON, MARK | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 01/01/2023 |
| PETERSON, HEIDI | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 01/01/2023 |
| FLETCHER, JONATHAN | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 02/01/2025 |
| MEYER, MARK | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 03/30/2001 |
| FLETCHER, JONATHAN | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | Individual | NOT APPLICABLE | since 03/26/2026 |
| FLETCHER, JONATHAN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 02/01/2025 |
| MEYER, MARK | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 03/11/2011 |
| PEDERSON, JANE | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 04/01/2021 |
| PETERSON, HEIDI | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 01/01/2023 |
| PHS MANAGEMENT, LLC | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | since 03/11/2011 |
| SAMMON, KATHERINE | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 11/21/2022 |
Medicare enrollment
As filed in the CMS file dated August 1, 2026 (Medicare enrollment ownership), under the enrollment of PRESBYTERIAN HOMES OF NORTH OAKS INC, (enrollment ID O20110606000335).
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 |
|---|---|---|---|---|---|
| PRESBYTERIAN HOMES AND SERVICES | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100 | 3/17/2020 | Private equity company: No Real estate investment trust: No Holding company: No |
| COMPUTERSHARE CORPORATE TRUST COMPANY, NA | Organization | 5% OR GREATER MORTGAGE INTEREST | 75 | 7/1/2024 | Private equity company: No Real estate investment trust: No Holding company: No |
| COMPUTERSHARE CORPORATE TRUST COMPANY, NA | Organization | 5% OR GREATER SECURITY INTEREST | 75 | 7/1/2024 | Private equity company: No Real estate investment trust: No Holding company: No |
| HEIDI A PETERSON | Individual | ADP OF THE SNF | Not stated in the filing | 1/1/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JANE C PEDERSON | Individual | ADP OF THE SNF | Not stated in the filing | 4/1/2021 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JONATHAN DAVID FLETCHER | Individual | ADP OF THE SNF | Not stated in the filing | 2/1/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KATHERINE A SAMMON | Individual | ADP OF THE SNF | Not stated in the filing | 11/21/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MARK T MEYER | Individual | ADP OF THE SNF | Not stated in the filing | 3/11/2011 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| PHS MANAGEMENT, LLC | Organization | ADP OF THE SNF | Not stated in the filing | 2/17/2026 | Private equity company: No Real estate investment trust: No Holding company: No |
| HEIDI A PETERSON | Individual | CORPORATE DIRECTOR | 33 | 1/1/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JONATHAN DAVID FLETCHER | Individual | CORPORATE DIRECTOR | 33 | 2/1/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MARK A PEDERSON | Individual | CORPORATE DIRECTOR | 33 | 1/1/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JONATHAN DAVID FLETCHER | Individual | CORPORATE OFFICER | 50 | 2/1/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MARK T MEYER | Individual | CORPORATE OFFICER | 50 | 3/30/2001 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| HEIDI A PETERSON | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 1/1/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JANE C PEDERSON | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 4/1/2021 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JONATHAN DAVID FLETCHER | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 2/1/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KATHERINE A SAMMON | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 11/21/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MARK T MEYER | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 3/11/2011 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| PHS MANAGEMENT, LLC | Organization | OPERATIONAL/MANAGERIAL CONTROL | 100 | 3/11/2011 | Private equity company: No Real estate investment trust: No Holding company: No |
Changes in ownership
- May 1, 2026: DUANE W LARSON no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: WELLS FARGO BANK, N.A. no longer appears as 5% OR GREATER SECURITY INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: WELLS FARGO BANK, N.A. no longer appears as 5% OR GREATER MORTGAGE INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: DANIEL A LINDH no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: DANIEL A LINDH no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: KAREN M CASPER-ROBESON no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: MARK T MEYER no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: DANIEL C ERICKSON no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: JOHN M MEHRKENS no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: PRESBYTERIAN HOMES AND SERVICES (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since March 17, 2020. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: KATHERINE A SAMMON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since November 21, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: KATHERINE A SAMMON (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since November 21, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: HEIDI A PETERSON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since January 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: HEIDI A PETERSON (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since January 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: HEIDI A PETERSON (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since January 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: PHS MANAGEMENT, LLC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since February 17, 2026. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: JONATHAN DAVID FLETCHER (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since February 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: JONATHAN DAVID FLETCHER (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since February 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: JONATHAN DAVID FLETCHER (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since February 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: JONATHAN DAVID FLETCHER (CORPORATE OFFICER) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since February 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: JANE C PEDERSON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since April 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: JANE C PEDERSON (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since April 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: MARK A PEDERSON (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since January 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: MARK T MEYER (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since March 11, 2011. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: MARK T MEYER (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since March 11, 2011. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: COMPUTERSHARE CORPORATE TRUST COMPANY, NA (5% OR GREATER SECURITY INTEREST) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since July 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: COMPUTERSHARE CORPORATE TRUST COMPANY, NA (5% OR GREATER MORTGAGE INTEREST) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since July 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
Recent changes on this record
- August 19, 2026: An inspection was recorded in inspection cycle 1. NH_SurveySummary_Sep2026_2.csv
- May 1, 2026: DUANE W LARSON no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: WELLS FARGO BANK, N.A. no longer appears as 5% OR GREATER SECURITY INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: WELLS FARGO BANK, N.A. no longer appears as 5% OR GREATER MORTGAGE INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: DANIEL A LINDH no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: DANIEL A LINDH no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: KAREN M CASPER-ROBESON no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: MARK T MEYER no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: DANIEL C ERICKSON no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: JOHN M MEHRKENS no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: PRESBYTERIAN HOMES AND SERVICES (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since March 17, 2020. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: KATHERINE A SAMMON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since November 21, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: KATHERINE A SAMMON (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since November 21, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: HEIDI A PETERSON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since January 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: HEIDI A PETERSON (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since January 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: HEIDI A PETERSON (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since January 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: PHS MANAGEMENT, LLC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since February 17, 2026. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: JONATHAN DAVID FLETCHER (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since February 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: JONATHAN DAVID FLETCHER (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since February 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: JONATHAN DAVID FLETCHER (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since February 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: JONATHAN DAVID FLETCHER (CORPORATE OFFICER) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since February 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: JANE C PEDERSON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since April 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: JANE C PEDERSON (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since April 1, 2021. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: MARK A PEDERSON (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since January 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: MARK T MEYER (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since March 11, 2011. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: MARK T MEYER (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since March 11, 2011. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: COMPUTERSHARE CORPORATE TRUST COMPANY, NA (5% OR GREATER SECURITY INTEREST) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since July 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: COMPUTERSHARE CORPORATE TRUST COMPANY, NA (5% OR GREATER MORTGAGE INTEREST) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since July 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- February 3, 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- January 30, 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- April 20, 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- May 3, 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
- April 23, 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
- April 30, 2020: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
- February 27, 2019: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2018.zip
- May 2, 2018: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2017.zip
- March 16, 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2016.zip
- May 5, 2016: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2015.zip
- April 16, 2015: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2014.zip
- May 7, 2014: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2013.zip
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | August 19, 2026 | August 19, 2026 | 3 | 7 |
| 2 | September 26, 2024 | September 26, 2024 | 4 | 7 |
| 3 | August 24, 2023 | August 24, 2023 | 1 | 0 |
| 3 | May 25, 2022 | May 25, 2022 | 4 | 0 |
From the Care Compare inspection summary file NH_SurveySummary_Sep2026_2.csv, processed on September 1, 2026.
Deficiencies cited
11 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| May 29, 2026 | Health | F 0600 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | J | Yes | Deficient, Provider has date of correction | July 2, 2026 |
| May 29, 2026 | Health | F 0609 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Yes | Deficient, Provider has date of correction | July 2, 2026 |
| May 29, 2026 | Health | F 0610 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Respond appropriately to all alleged violations. | D | Yes | Deficient, Provider has date of correction | July 2, 2026 |
| September 26, 2024 | Health | F 0575 | Resident Rights Deficiencies | Post a list of names, addresses, and telephone numbers of all pertinent State agencies and advocacy groups and a statement that the resident may file a complaint with the State Survey Agency. | C | No | Deficient, Provider has date of correction | November 13, 2024 |
| September 26, 2024 | Health | F 0657 | Resident Assessment and Care Planning Deficiencies | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | No | Deficient, Provider has date of correction | November 13, 2024 |
| September 26, 2024 | Health | F 0688 | Quality of Life and Care Deficiencies | Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | D | No | Deficient, Provider has date of correction | November 13, 2024 |
| September 26, 2024 | Health | F 0756 | Pharmacy Service Deficiencies | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | D | No | Deficient, Provider has date of correction | November 13, 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. | G | Yes | Deficient, Provider has date of correction | March 5, 2024 |
| May 25, 2022 | Health | F 0684 | Quality of Life and Care Deficiencies | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | No | Deficient, Provider has date of correction | June 28, 2022 |
| May 25, 2022 | Health | F 0686 | Quality of Life and Care Deficiencies | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | No | Deficient, Provider has date of correction | June 28, 2022 |
| May 25, 2022 | Health | F 0759 | Pharmacy Service Deficiencies | Ensure medication error rates are not 5 percent or greater. | D | No | Deficient, Provider has date of correction | June 28, 2022 |
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 |
|---|---|---|---|---|---|
| May 29, 2026 | Fine | $113,312 | 140982 |
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 | PRESBYTERIAN HOMES OF NORTH OAKS INC, |
| Date First Approved to Provide Medicare and Medicaid Services | 2006-08-02 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | Y |
| County/Parish | Ramsey |
| Telephone Number | 6517654063 |
| Chain Name | PRESBYTERIAN HOMES & SERVICES |
| Chain ID | 412 |
| Provider Changed Ownership in Last 12 Months | N |
| With a Resident and Family Council | Both |
| Automatic Sprinkler Systems in All Required Areas | Yes |
| Number of Certified Beds | 60 |
| Average Number of Residents per Day | 57.4 |
| Overall Rating | 3 |
| Health Inspection Rating | 2 |
| QM Rating | 2 |
| Long-Stay QM Rating | 3 |
| Short-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 WAVERLY GARDENS: the field, the value before, the value after, and the date of the file that first showed it.
The facility alert follows this one record: a cost report filed or a figure on one changed, an inspection, a deficiency or a penalty recorded, an owner added or removed. The certification number arrives filled in.
On August 19, 2026: An inspection was recorded in inspection cycle 1. That is one line of the alert.
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The citable document for WAVERLY GARDENS
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 245613.