Skilled nursing facility · CMS certification number 245622
MEADOWS ON FAIRVIEW
WYOMING, Minnesota · Medicare and Medicaid
Certified beds, as filed in Care Compare: 14
Download this facility’s record (CSV)
A CSV file of this facility’s record: its name and location, its Medicare cost-report finances year by year, its ownership, its inspections, deficiencies and penalties, and the Care Compare provider information — each figure with the worksheet, line and column or file it came from.
In Care Compare’s provider information: Penalties: 0 · Fines: 0 · Fines, total amount: $0.00 · Payment denials: 0. Every penalty on file ↓
For this facility: the citable document with full history — $295 · an email when this record changes — $99/month
Finances, as filed
From this facility’s Medicare cost reports on form CMS-2540, each figure with the worksheet, line and column it was read from.
Cost report for January 1, 2024 to December 31, 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on August 28, 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,009,501 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,963,214 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,046,287 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,794,673 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$3,748,386 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $4,635,355 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $886,969 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $886,969 (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 | 14 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 5,124 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 1,625 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 155 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 2,899 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 4,679 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 70 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 1 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 168 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 239 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 23.21 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 155 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 19.58 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1434459, read from the public cost report file SNF10FY2024.zip.
Fiscal year 2023, ended December 31, 2023
Cost report for January 1, 2023 to December 31, 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on July 23, 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,396,564 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,497,749 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,898,815 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,019,302 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$4,120,487 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $4,149,232 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $28,745 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $28,745 (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 | 14 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 4,703 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 220 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 18.95 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 93 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 21.38 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1390067, read from the public cost report file SNF10FY2023.zip.
Fiscal year 2022, ended December 31, 2022
Cost report for January 1, 2022 to December 31, 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on August 1, 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,171,508 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,490,585 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,680,923 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,269,641 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$588,718 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $186,449 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$402,269 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$402,269 (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 | 14 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 4,670 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 228 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 18.24 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 194 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 20.48 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1360588, read from the public cost report file SNF10FY2022.zip.
Fiscal year 2021, ended December 31, 2021
Cost report for January 1, 2021 to December 31, 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on September 16, 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,114,272 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,671,243 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,443,029 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,071,952 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$628,923 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $349,496 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$279,427 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$279,427 (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 | 14 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 4,391 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 216 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 18.22 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 264.5 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 20.33 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1332498, read from the public cost report file SNF10FY2021.zip.
Fiscal year 2020, ended December 31, 2020
Cost report for January 1, 2020 to December 31, 2020 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on September 21, 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,176,416 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,794,690 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,381,726 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,410,935 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$29,209 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $39,250 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $10,041 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $10,041 (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 | 14 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 4,313 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 224 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 15.87 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 203.5 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 19.25 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1300690, read from the public cost report file SNF10FY2020.zip.
Fiscal year 2019, ended December 31, 2019
Cost report for January 1, 2019 to December 31, 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on June 23, 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,604,376 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,394,219 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,210,157 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,418,080 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$207,923 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $46,282 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$161,641 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$161,641 (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 | 14 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 4,535 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 230 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 17.57 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 19.72 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1258674, read from the public cost report file SNF10FY2019.zip.
Fiscal year 2018, ended December 31, 2018
Cost report for January 1, 2018 to December 31, 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on July 17, 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,947,857 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,055,402 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,892,455 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,062,700 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$170,245 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $48,855 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$121,390 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$121,390 (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 | 14 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 4,667 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 233 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 17.74 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 224.5 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 20.03 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1237262, read from the public cost report file SNF10FY2018.zip.
Fiscal year 2017, ended December 31, 2017
Cost report for January 1, 2017 to December 31, 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on August 1, 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,571,753 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,033,588 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,538,165 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,003,357 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$465,192 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $53,302 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$411,890 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$411,890 (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 | 14 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 4,500 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 233 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 14.55 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 87 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 19.31 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1204137, read from the public cost report file SNF10FY2017.zip.
Fiscal year 2016, ended December 31, 2016
Cost report for January 1, 2016 to December 31, 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on August 31, 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,949,425 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $753,500 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,195,925 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,844,549 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$648,624 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $47,078 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$601,546 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$601,546 (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 | 14 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 4,267 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 225 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 17.98 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 25.18 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 18.96 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1175404, read from the public cost report file SNF10FY2016.zip.
Fiscal year 2015, ended December 31, 2015
Cost report for December 23, 2014 to December 31, 2015 — a reporting period of 373 days, on form CMS-2540-10, settled, processed by CMS on September 30, 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,212,975 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $560,177 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,652,798 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,429,063 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$776,265 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $21,424 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$754,841 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$754,841 (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 | 14 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 3,088 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 170 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 19.86 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 39.83 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 18.16 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1143130, read from the public cost report file SNF10FY2015.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 |
|---|---|---|---|---|
| CHEBLI, YASSER | ADP OF THE SNF | Individual | NOT APPLICABLE | since 04/16/2025 |
| EBENEZER MANAGEMENT SERVICES INC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 01/29/2025 |
| EBENEZER SOCIETY | ADP OF THE SNF | Organization | NOT APPLICABLE | since 11/01/2014 |
| LURAAS, KAYLA | ADP OF THE SNF | Individual | NOT APPLICABLE | since 07/22/2025 |
| CARLSON-WEINBERG, SUSAN | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/31/2019 |
| FAUST, KIM | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 01/01/2022 |
| HEREFORD, JAMES | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 08/01/2017 |
| JACOBSON, CAROLYN | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 10/01/2017 |
| KVENVOLD, GAYLE | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/23/2024 |
| LANDREVILLE, MARK | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 02/21/2024 |
| MILIUS, MARGARET | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 02/21/2024 |
| PIPER, KENNETH | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/27/2022 |
| WALKER, ROBERT | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/27/2022 |
| WORDELMAN, SCOTT | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 08/24/2017 |
| ANDERSON, BRETT | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 09/05/2024 |
| WILLETT, TODD | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 10/24/2016 |
| EBENEZER SOCIETY | DIRECT OWNERSHIP INTEREST | Organization | NOT APPLICABLE | since 11/01/2014 |
| EBENEZER MANAGEMENT SERVICES INC | INDIRECT OWNERSHIP INTEREST | Organization | NOT APPLICABLE | since 01/01/2018 |
| BELL, BRITTANY | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 09/06/2021 |
| CHEBLI, YASSER | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 01/01/2022 |
| EBENEZER MANAGEMENT SERVICES INC | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | since 01/01/2018 |
| LURAAS, KAYLA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 01/01/2024 |
Medicare enrollment
As filed in the CMS file dated August 1, 2026 (Medicare enrollment ownership), under the enrollment of EBENEZER LAKES ASSISTED LIVING (enrollment ID O20140702000102).
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 |
|---|---|---|---|---|---|
| EBENEZER SOCIETY | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100 | 6/26/2001 | Private equity company: No Real estate investment trust: No Holding company: No |
| EBENEZER MANAGEMENT SERVICES INC | Organization | ADP OF THE SNF | Not stated in the filing | 1/29/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| EBENEZER SOCIETY | Organization | ADP OF THE SNF | Not stated in the filing | 11/1/2014 | Private equity company: No Real estate investment trust: No Holding company: No |
| KAYLA LURAAS | Individual | ADP OF THE SNF | Not stated in the filing | 7/22/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| YASSER CHEBLI | Individual | ADP OF THE SNF | Not stated in the filing | 4/16/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| CAROLYN JACOBSON | Individual | CORPORATE DIRECTOR | 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 |
| GAYLE KVENVOLD | Individual | CORPORATE DIRECTOR | Not stated in the filing | 5/23/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JAMES HEREFORD | Individual | CORPORATE DIRECTOR | Not stated in the filing | 8/1/2017 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KENNETH PIPER | Individual | CORPORATE DIRECTOR | Not stated in the filing | 5/27/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KIM FAUST | Individual | CORPORATE DIRECTOR | 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 |
| MARGARET MILIUS | Individual | CORPORATE DIRECTOR | Not stated in the filing | 2/21/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MARK LANDREVILLE | Individual | CORPORATE DIRECTOR | Not stated in the filing | 2/21/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| ROBERT WALKER | Individual | CORPORATE DIRECTOR | Not stated in the filing | 5/27/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| SCOTT WORDELMAN | Individual | CORPORATE DIRECTOR | Not stated in the filing | 8/24/2017 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| SUSAN CARLSON-WEINBERG | Individual | CORPORATE DIRECTOR | Not stated in the filing | 5/31/2019 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| BRETT ANDERSON | Individual | CORPORATE OFFICER | Not stated in the filing | 9/5/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| EBENEZER SOCIETY | Organization | DIRECT OWNERSHIP INTEREST | 100 | 11/1/2014 | Private equity company: No Real estate investment trust: No Holding company: No |
| EBENEZER MANAGEMENT SERVICES INC | Organization | INDIRECT OWNERSHIP INTEREST | 0 | 1/1/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| TODD WILLETT | Individual | OFFICER | Not stated in the filing | 10/24/2016 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| BRITTANY BELL | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 9/6/2021 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| EBENEZER MANAGEMENT SERVICES INC | Organization | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 1/1/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| KAYLA LURAAS | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 1/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| YASSER CHEBLI | Individual | OPERATIONAL/MANAGERIAL CONTROL | 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 |
Changes in ownership
- April 1, 2026: BRITTANY BELL no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: DAVID K MCCRAY no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: EBENEZER SOCIETY no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: ROBB GRUMAN no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: THOMAS HOKR no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: TODD WILLETT no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: JONATHAN E LUNDBERG no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: JONATHAN E LUNDBERG no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: RICHARD HOWARD no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: CARL RUNCK no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: BRITTANY BELL (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since September 6, 2021. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: GAYLE KVENVOLD (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since May 23, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: EBENEZER SOCIETY (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since November 1, 2014. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: EBENEZER SOCIETY (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since November 1, 2014. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: KAYLA LURAAS (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since July 22, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: KAYLA LURAAS (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since January 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: KENNETH PIPER (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since May 27, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: MARK LANDREVILLE (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since February 21, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: ROBERT WALKER (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since May 27, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: MARGARET MILIUS (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since February 21, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: EBENEZER MANAGEMENT SERVICES INC (INDIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since January 1, 2018. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: EBENEZER MANAGEMENT SERVICES INC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since January 29, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: BRETT ANDERSON (CORPORATE OFFICER) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since September 5, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: YASSER CHEBLI (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since April 16, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: YASSER CHEBLI (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since January 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
Recent changes on this record
- April 1, 2026: BRITTANY BELL no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: DAVID K MCCRAY no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: EBENEZER SOCIETY no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: ROBB GRUMAN no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: THOMAS HOKR no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: TODD WILLETT no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: JONATHAN E LUNDBERG no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: JONATHAN E LUNDBERG no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: RICHARD HOWARD no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: CARL RUNCK no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: BRITTANY BELL (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since September 6, 2021. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: GAYLE KVENVOLD (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since May 23, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: EBENEZER SOCIETY (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since November 1, 2014. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: EBENEZER SOCIETY (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since November 1, 2014. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: KAYLA LURAAS (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since July 22, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: KAYLA LURAAS (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since January 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: KENNETH PIPER (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since May 27, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: MARK LANDREVILLE (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since February 21, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: ROBERT WALKER (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since May 27, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: MARGARET MILIUS (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since February 21, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: EBENEZER MANAGEMENT SERVICES INC (INDIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since January 1, 2018. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: EBENEZER MANAGEMENT SERVICES INC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since January 29, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: BRETT ANDERSON (CORPORATE OFFICER) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since September 5, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: YASSER CHEBLI (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since April 16, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: YASSER CHEBLI (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since January 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- August 28, 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- July 23, 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- August 1, 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- September 16, 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
- September 21, 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
- June 23, 2020: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
- July 17, 2019: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2018.zip
- August 1, 2018: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2017.zip
- August 31, 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2016.zip
- September 30, 2016: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2015.zip
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | June 2, 2026 | June 2, 2026 | 0 | 1 |
| 2 | April 16, 2025 | April 16, 2025 | 2 | 3 |
| 3 | July 24, 2024 | July 24, 2024 | 1 | 6 |
From the Care Compare inspection summary file NH_SurveySummary_Sep2026_2.csv, processed on September 1, 2026.
Deficiencies cited
3 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| April 16, 2025 | Health | F 0684 | Quality of Life and Care Deficiencies | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | No | Deficient, Provider has date of correction | May 23, 2025 |
| April 16, 2025 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | F | No | Deficient, Provider has date of correction | May 23, 2025 |
| July 24, 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 | August 20, 2024 |
From the Care Compare health citations file NH_HealthCitations_Sep2026_2.csv, processed on September 1, 2026.
Penalties
No penalty on file for this facility in CMS’s Care Compare penalties data.
Care Compare provider information
| Field | As filed |
|---|---|
| Provider Type | Medicare and Medicaid |
| Ownership Type | Non profit - Corporation |
| Legal Business Name | EBENEZER LAKES ASSISTED LIVING |
| Date First Approved to Provide Medicare and Medicaid Services | 2014-12-23 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | Y |
| County/Parish | Chisago |
| Telephone Number | 6514661300 |
| Chain Name | EBENEZER SENIOR LIVING |
| Chain ID | 784 |
| Provider Changed Ownership in Last 12 Months | N |
| With a Resident and Family Council | None |
| Automatic Sprinkler Systems in All Required Areas | Yes |
| Number of Certified Beds | 14 |
| Average Number of Residents per Day | 12.6 |
| Overall Rating | 4 |
| Health Inspection Rating | 5 |
| QM Rating | 4 |
| Short-Stay QM Rating | 4 |
| 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 MEADOWS ON FAIRVIEW: 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 28, 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. That is one line of the alert.
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The citable document for MEADOWS ON FAIRVIEW
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 245622.