Skilled nursing facility · CMS certification number 245637
NORRIS SQUARE
COTTAGE GROVE, Minnesota · Medicare and Medicaid
Certified beds, as filed in Care Compare: 72
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: 0 · Fines, total amount: $0.00 · Payment denials: 1. The most recent penalty on file: November 3, 2023, Payment Denial. 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 13, 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,847,997 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $267,939 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,580,058 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $17,061,581 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$11,481,523 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $11,368,025 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$113,498 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$113,498 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 40 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 14,640 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 250 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 7,359 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 5,202 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 12,811 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 10 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 30 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 53 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 93 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 25 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 245.3 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 137.75 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1403607, 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 | $4,769,776 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $100,733 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,669,043 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $15,972,020 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$11,302,977 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $10,849,293 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$453,684 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$453,684 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 40 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 12,395 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 77 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 51.43 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 154.49 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 160.97 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1372729, 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 March 30, 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,516,641 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $43,328 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,473,313 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $15,540,034 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$11,066,721 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $10,545,497 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$521,224 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$521,224 (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 | 78 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 12,752 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 55 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 64.6 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 324.71 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 231.85 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1345192, 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 April 21, 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,149,313 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$20,604 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,169,917 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $15,874,768 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$9,704,851 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $9,295,616 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$409,235 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$409,235 (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 | 78 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,809 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 142 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 36.5 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 625.3 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 118.37 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1313962, 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 29, 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,437,915 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$60,164 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,498,079 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $14,200,888 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$9,702,809 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $8,636,088 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$1,066,721 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,066,721 (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 | 78 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 12,118 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 187 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 50.67 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 68.05 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 64.8 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1283074, read from the public cost report file SNF10FY2020.zip.
Fiscal year 2019, ended September 30, 2019
Cost report for May 13, 2019 to September 30, 2019 — a reporting period of 140 days, not a full year, on form CMS-2540-10, settled, processed by CMS on April 28, 2020.
None of these figures is carried on this report.
CMS report record 1254658, read from the public cost report file SNF10FY2019.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 07/25/2017 |
| TCF INVESTMENTS MANAGEMENT, INC. | 5% OR GREATER MORTGAGE INTEREST | Organization | NOT APPLICABLE | since 08/17/2017 |
| TCF INVESTMENTS MANAGEMENT, INC. | 5% OR GREATER SECURITY INTEREST | Organization | NOT APPLICABLE | since 08/17/2017 |
| KISPERT, CHRISTOPHER | ADP OF THE SNF | Individual | NOT APPLICABLE | since 08/28/2023 |
| MIELKE, JOHN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 08/29/2019 |
| PEDERSON, MARK | ADP OF THE SNF | Individual | NOT APPLICABLE | since 01/12/2025 |
| PETERSON, HEIDI | ADP OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2023 |
| PHS MANAGEMENT, LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 04/14/2025 |
| FLETCHER, JONATHAN | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 02/01/2025 |
| MEYER, MARK | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 02/09/2016 |
| PEDERSON, MARK | 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 02/09/2016 |
| KISPERT, CHRISTOPHER | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 08/28/2023 |
| MIELKE, JOHN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 08/29/2019 |
| PHS MANAGEMENT, LLC | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | since 08/17/2017 |
| PRESBYTERIAN HOMES HOUSING AND ASSISTED LIVING, INC. | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | since 11/18/2024 |
Medicare enrollment
As filed in the CMS file dated August 1, 2026 (Medicare enrollment ownership), under the enrollment of CG CARE CENTER LLC (enrollment ID O20180926000196).
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 | 7/25/2017 | Private equity company: No Real estate investment trust: No Holding company: No |
| TCF INVESTMENTS MANAGEMENT, INC. | Organization | 5% OR GREATER MORTGAGE INTEREST | 58.5 | 8/17/2017 | Private equity company: No Real estate investment trust: No Holding company: No |
| TCF INVESTMENTS MANAGEMENT, INC. | Organization | 5% OR GREATER SECURITY INTEREST | 58.5 | 8/17/2017 | Private equity company: No Real estate investment trust: No Holding company: No |
| CHRISTOPHER B KISPERT | Individual | ADP OF THE SNF | Not stated in the filing | 8/28/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| 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 |
| JOHN W MIELKE | Individual | ADP OF THE SNF | Not stated in the filing | 8/29/2019 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MARK A PEDERSON | Individual | ADP OF THE SNF | Not stated in the filing | 1/12/2025 | 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 | 4/14/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| No owner named in the filing | Organization | ADP OF THE SNF | Not stated in the filing | 1/21/2004 | Private equity company: No Real estate investment trust: No Holding company: No |
| 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 |
| MARK T MEYER | Individual | CORPORATE DIRECTOR | 33 | 2/9/2016 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| No owner named in the filing | Individual | CORPORATE DIRECTOR | Not stated in the filing | 12/1/2015 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| No owner named in the filing | Individual | CORPORATE DIRECTOR | Not stated in the filing | 12/13/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| No owner named in the filing | Individual | CORPORATE DIRECTOR | Not stated in the filing | 6/7/2021 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| No owner named in the filing | Individual | CORPORATE DIRECTOR | Not stated in the filing | 12/8/2020 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| No owner named in the filing | Individual | CORPORATE DIRECTOR | Not stated in the filing | 12/12/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| No owner named in the filing | Individual | CORPORATE DIRECTOR | Not stated in the filing | 12/12/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| No owner named in the filing | Individual | CORPORATE DIRECTOR | Not stated in the filing | 8/4/2020 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| No owner named in the filing | Individual | CORPORATE DIRECTOR | Not stated in the filing | 6/2/2020 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| No owner named in the filing | Individual | CORPORATE DIRECTOR | Not stated in the filing | 8/9/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| No owner named in the filing | Individual | CORPORATE DIRECTOR | Not stated in the filing | 10/8/2019 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| No owner named in the filing | Individual | CORPORATE DIRECTOR | Not stated in the filing | 8/9/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| No owner named in the filing | Individual | CORPORATE DIRECTOR | Not stated in the filing | 12/1/2015 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| No owner named in the filing | Individual | CORPORATE DIRECTOR | Not stated in the filing | 12/5/2017 | 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 | 2/9/2016 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| No owner named in the filing | Individual | CORPORATE OFFICER | Not stated in the filing | 12/1/2015 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| No owner named in the filing | Individual | CORPORATE OFFICER | Not stated in the filing | 6/7/2021 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| No owner named in the filing | Individual | CORPORATE OFFICER | Not stated in the filing | 12/12/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| CHRISTOPHER B KISPERT | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 8/28/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JOHN W MIELKE | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 8/29/2019 | 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 | Not stated in the filing | 8/17/2017 | Private equity company: No Real estate investment trust: No Holding company: No |
| PRESBYTERIAN HOMES HOUSING AND ASSISTED LIVING, INC. | Organization | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 11/18/2024 | Private equity company: No Real estate investment trust: No Holding company: No |
Changes in ownership
- August 1, 2025: DANIEL A LINDH no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: DANIEL A LINDH no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: BENJAMIN J VAN VOOREN no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: WILLIAM V HAGSTROM no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: CHRISTOPHER B KISPERT (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on August 1, 2025; associated with this enrollment since August 28, 2023. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: CHRISTOPHER B KISPERT (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on August 1, 2025; associated with this enrollment since August 28, 2023. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: HEIDI A PETERSON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on August 1, 2025; associated with this enrollment since January 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: PHS MANAGEMENT, LLC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on August 1, 2025; associated with this enrollment since April 14, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: JONATHAN DAVID FLETCHER (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on August 1, 2025; associated with this enrollment since February 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: JONATHAN DAVID FLETCHER (CORPORATE OFFICER) first listed in CMS’s Medicare enrollment ownership file on August 1, 2025; associated with this enrollment since February 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: MARK PEDERSON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on August 1, 2025; associated with this enrollment since January 12, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: MARK PEDERSON (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on August 1, 2025; associated with this enrollment since January 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: PRESBYTERIAN HOMES HOUSING AND ASSISTED LIVING, INC. (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on August 1, 2025; associated with this enrollment since November 18, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: A listing under ADP OF THE SNF, with no owner named, first listed in CMS’s Medicare enrollment ownership file on August 1, 2025; associated with this enrollment since January 21, 2004. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: A listing under CORPORATE DIRECTOR, with no owner named, first listed in CMS’s Medicare enrollment ownership file on August 1, 2025; associated with this enrollment since June 7, 2021. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: A listing under CORPORATE OFFICER, with no owner named, first listed in CMS’s Medicare enrollment ownership file on August 1, 2025; associated with this enrollment since June 7, 2021. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: JOHN W MIELKE (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on August 1, 2025; associated with this enrollment since August 29, 2019. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: JOHN W MIELKE (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on August 1, 2025; associated with this enrollment since August 29, 2019. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
Recent changes on this record
- August 1, 2025: DANIEL A LINDH no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: DANIEL A LINDH no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: BENJAMIN J VAN VOOREN no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: WILLIAM V HAGSTROM no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: CHRISTOPHER B KISPERT (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on August 1, 2025; associated with this enrollment since August 28, 2023. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: CHRISTOPHER B KISPERT (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on August 1, 2025; associated with this enrollment since August 28, 2023. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: HEIDI A PETERSON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on August 1, 2025; associated with this enrollment since January 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: PHS MANAGEMENT, LLC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on August 1, 2025; associated with this enrollment since April 14, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: JONATHAN DAVID FLETCHER (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on August 1, 2025; associated with this enrollment since February 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: JONATHAN DAVID FLETCHER (CORPORATE OFFICER) first listed in CMS’s Medicare enrollment ownership file on August 1, 2025; associated with this enrollment since February 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: MARK PEDERSON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on August 1, 2025; associated with this enrollment since January 12, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: MARK PEDERSON (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on August 1, 2025; associated with this enrollment since January 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: PRESBYTERIAN HOMES HOUSING AND ASSISTED LIVING, INC. (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on August 1, 2025; associated with this enrollment since November 18, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: A listing under ADP OF THE SNF, with no owner named, first listed in CMS’s Medicare enrollment ownership file on August 1, 2025; associated with this enrollment since January 21, 2004. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: A listing under CORPORATE DIRECTOR, with no owner named, first listed in CMS’s Medicare enrollment ownership file on August 1, 2025; associated with this enrollment since June 7, 2021. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: A listing under CORPORATE OFFICER, with no owner named, first listed in CMS’s Medicare enrollment ownership file on August 1, 2025; associated with this enrollment since June 7, 2021. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: JOHN W MIELKE (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on August 1, 2025; associated with this enrollment since August 29, 2019. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- August 1, 2025: JOHN W MIELKE (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on August 1, 2025; associated with this enrollment since August 29, 2019. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- February 13, 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
- March 30, 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- April 21, 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
- April 29, 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
- April 28, 2020: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | December 10, 2025 | December 10, 2025 | 3 | 2 |
| 2 | October 24, 2024 | October 24, 2024 | 2 | 3 |
| 3 | November 3, 2023 | November 3, 2023 | 8 | 9 |
From the Care Compare inspection summary file NH_SurveySummary_Sep2026_2.csv, processed on September 1, 2026.
Deficiencies cited
13 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| December 10, 2025 | Health | F 0565 | Resident Rights Deficiencies | Honor the resident's right to organize and participate in resident/family groups in the facility. | D | No | Deficient, Provider has date of correction | January 30, 2026 |
| December 10, 2025 | Health | F 0584 | Resident Rights Deficiencies | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | D | No | Deficient, Provider has date of correction | January 30, 2026 |
| December 10, 2025 | Health | F 0699 | Quality of Life and Care Deficiencies | Provide care or services that was trauma informed and/or culturally competent. | D | No | Deficient, Provider has date of correction | January 30, 2026 |
| October 24, 2024 | Health | F 0584 | Resident Rights Deficiencies | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | D | No | Deficient, Provider has date of correction | November 20, 2024 |
| October 24, 2024 | Health | F 0695 | Quality of Life and Care Deficiencies | Provide safe and appropriate respiratory care for a resident when needed. | D | No | Deficient, Provider has date of correction | November 20, 2024 |
| November 3, 2023 | Health | F 0585 | Resident Rights Deficiencies | Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. | D | No | Deficient, Provider has date of correction | November 28, 2023 |
| November 3, 2023 | Health | F 0604 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. | D | No | Deficient, Provider has date of correction | November 28, 2023 |
| November 3, 2023 | Health | F 0677 | Quality of Life and Care Deficiencies | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | No | Deficient, Provider has date of correction | November 28, 2023 |
| November 3, 2023 | Health | F 0679 | Quality of Life and Care Deficiencies | Provide activities to meet all resident's needs. | D | No | Deficient, Provider has date of correction | November 28, 2023 |
| November 3, 2023 | 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 | November 28, 2023 |
| November 3, 2023 | Health | F 0686 | Quality of Life and Care Deficiencies | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | G | No | Deficient, Provider has date of correction | November 28, 2023 |
| November 3, 2023 | Health | F 0755 | Pharmacy Service Deficiencies | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | Yes | Deficient, Provider has date of correction | November 28, 2023 |
| November 3, 2023 | Health | F 0756 | Pharmacy Service Deficiencies | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | D | No | Deficient, Provider has date of correction | November 28, 2023 |
From the Care Compare health citations file NH_HealthCitations_Sep2026_2.csv, processed on September 1, 2026.
Penalties
| Penalty date | Type | Fine amount | Payment denial began | Payment denial, days | Fine ID |
|---|---|---|---|---|---|
| November 3, 2023 | Payment Denial | November 29, 2023 | 16 |
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 | CG CARE CENTER LLC |
| Date First Approved to Provide Medicare and Medicaid Services | 2019-05-13 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | Y |
| County/Parish | Washington |
| Telephone Number | 6517696650 |
| Chain Name | PRESBYTERIAN HOMES & SERVICES |
| Chain ID | 412 |
| Provider Changed Ownership in Last 12 Months | N |
| With a Resident and Family Council | Resident |
| Automatic Sprinkler Systems in All Required Areas | Yes |
| Number of Certified Beds | 72 |
| Average Number of Residents per Day | 37.1 |
| Overall Rating | 5 |
| Health Inspection Rating | 4 |
| QM Rating | 2 |
| Long-Stay QM Rating | 2 |
| Processing Date | 2026-09-01 |
From the Care Compare Provider Information file NH_ProviderInfo_Sep2026_3.csv, processed on September 1, 2026.
Get an email when this record changes
One email a day naming what moved on NORRIS SQUARE: 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 February 13, 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. That is one line of the alert.
Following a list of facilities? The portfolio watch follows up to 100 certification numbers you name, on one subscription — on the alerts page.
The citable document for NORRIS SQUARE
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 245637.