Skilled nursing facility · CMS certification number 345314

Fair Haven of Forest City, LLC

Forest City, North Carolina · Medicare and Medicaid

Certified beds, as filed in Care Compare: 100

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 October 1, 2023 to September 30, 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on March 6, 2025.

Revenue and expenses, fiscal year 2024
Figure	As filed	Where it comes from
Total patient revenue	$14,934,317	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$3,653,008	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$11,281,309	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$11,187,491	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$93,818	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$164,667	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$258,485	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $258,485 (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%).

Beds, days and discharges, fiscal year 2024
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-10 worksheet S300001 line 800 column 100
Bed days available, all components	46,848	CMS-2540-10 worksheet S300001 line 800 column 200
Medicare (Title XVIII) patient days	2,315	CMS-2540-10 worksheet S300001 line 800 column 400
Medicaid (Title XIX) patient days	21,055	CMS-2540-10 worksheet S300001 line 800 column 500
Other-payer patient days	15,347	CMS-2540-10 worksheet S300001 line 800 column 600
Total patient days, all components	38,717	CMS-2540-10 worksheet S300001 line 800 column 700
Medicare discharges	101	CMS-2540-10 worksheet S300001 line 800 column 900
Medicaid discharges	36	CMS-2540-10 worksheet S300001 line 800 column 1000
Other-payer discharges	147	CMS-2540-10 worksheet S300001 line 800 column 1100
Total discharges, all components	284	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	22.92	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	584.86	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	136.33	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1404783, 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 March 13, 2024.

Revenue and expenses, fiscal year 2023
Figure	As filed	Where it comes from
Total patient revenue	$14,363,129	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$3,052,317	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$11,310,812	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$10,731,572	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$579,240	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$1,789,726	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$2,368,966	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $2,368,966 (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%).

Beds, days and discharges, fiscal year 2023
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	38,475	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	29.57	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	580.55	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	174.89	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1374882, 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 February 16, 2023.

Revenue and expenses, fiscal year 2022
Figure	As filed	Where it comes from
Total patient revenue	$12,617,200	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$2,926,898	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$9,690,302	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$9,680,996	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$9,306	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$40,322	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$49,628	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $49,628 (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%).

Beds, days and discharges, fiscal year 2022
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	34,708	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	207	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	22.52	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	626.06	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	167.67	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1342574, 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 24, 2023.

Revenue and expenses, fiscal year 2021
Figure	As filed	Where it comes from
Total patient revenue	$10,572,370	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	−$428,145	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$11,000,515	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$9,411,259	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$1,589,256	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$187,533	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$1,776,789	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $1,776,789 (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%).

Beds, days and discharges, fiscal year 2021
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	33,703	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	105	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	53.04	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	1,045.45	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	320.98	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1348249, 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 August 4, 2022.

Revenue and expenses, fiscal year 2020
Figure	As filed	Where it comes from
Total patient revenue	$12,166,795	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$2,849,411	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$9,317,384	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$9,134,816	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$182,568	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$671,182	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$853,750	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $853,750 (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%).

Beds, days and discharges, fiscal year 2020
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	39,924	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	175	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	56.42	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	526.51	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	228.14	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1328918, 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 June 25, 2021.

Revenue and expenses, fiscal year 2019
Figure	As filed	Where it comes from
Total patient revenue	$12,123,075	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$3,215,884	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$8,907,191	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$8,476,378	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$430,813	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$6,347	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$437,160	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $437,160 (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%).

Beds, days and discharges, fiscal year 2019
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	40,884	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	241	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	43.16	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	391.68	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	169.64	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1287626, 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 July 30, 2020.

Revenue and expenses, fiscal year 2018
Figure	As filed	Where it comes from
Total patient revenue	$10,692,853	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$2,415,751	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$8,277,102	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$8,360,921	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$83,819	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$7,312	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$76,507	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$76,507 (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%).

Beds, days and discharges, fiscal year 2018
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	39,482	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	246	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	41.33	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	460.12	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	160.5	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1262041, 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 June 27, 2019.

Revenue and expenses, fiscal year 2017
Figure	As filed	Where it comes from
Total patient revenue	$10,210,922	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$2,013,098	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$8,197,824	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$7,725,252	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$472,572	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$7,630	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$480,202	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $480,202 (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%).

Beds, days and discharges, fiscal year 2017
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	40,363	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	241	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	44.13	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	382.89	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	167.48	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1233473, read from the public cost report file SNF10FY2017.zip.

Fiscal year 2016, ended September 30, 2016

Cost report for December 1, 2015 to September 30, 2016 — a reporting period of 304 days, on form CMS-2540-10, reopened, processed by CMS on January 16, 2020.

Revenue and expenses, fiscal year 2016
Figure	As filed	Where it comes from
Total patient revenue	$7,897,029	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$1,878,052	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$6,018,977	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$6,051,596	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$32,619	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$6,289	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$26,330	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$26,330 (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%).

Beds, days and discharges, fiscal year 2016
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	32,658	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	194	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	42.17	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	339.25	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	168.34	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1249483, read from the public cost report file SNF10FY2016.zip.

Fiscal year 2015, ended November 30, 2015

Cost report for July 1, 2015 to November 30, 2015 — a reporting period of 152 days, not a full year, on form CMS-2540-10, settled, processed by CMS on May 2, 2018.

Revenue and expenses, fiscal year 2015
Figure	As filed	Where it comes from
Total patient revenue	$10,317,083	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$7,188,949	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$3,128,134	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$3,189,507	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$61,373	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$697	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$60,676	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$60,676 (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%).

Beds, days and discharges, fiscal year 2015
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	16,348	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	79	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	35.02	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	879.92	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	206.94	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1188065, read from the public cost report file SNF10FY2015.zip.

Fiscal year 2014, ended April 30, 2014

Cost report for October 1, 2013 to April 30, 2014 — a reporting period of 211 days, not a full year, on form CMS-2540-10, settled, processed by CMS on August 25, 2015.

Revenue and expenses, fiscal year 2014
Figure	As filed	Where it comes from
Total patient revenue	$4,954,986	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$1,088,974	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$3,866,012	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$4,340,227	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$474,215	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$71,233	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$402,982	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$402,982 (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%).

Beds, days and discharges, fiscal year 2014
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	22,841	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	303	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	38.05	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	88.7	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	75.38	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1108736, 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 October 14, 2014.

Revenue and expenses, fiscal year 2013
Figure	As filed	Where it comes from
Total patient revenue	$9,185,480	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$2,122,144	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$7,063,336	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$7,609,798	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$546,462	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$192,334	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$354,128	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$354,128 (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%).

Beds, days and discharges, fiscal year 2013
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	41,510	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	378	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	36.96	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	145.31	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	109.81	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1078735, 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 July 25, 2013.

Revenue and expenses, fiscal year 2012
Figure	As filed	Where it comes from
Total patient revenue	$8,959,023	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$1,870,305	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$7,088,718	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$7,715,757	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$627,039	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$215,622	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$411,417	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$411,417 (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%).

Beds, days and discharges, fiscal year 2012
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	41,478	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	376	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	33.86	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	151.46	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	110.31	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1043739, 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 March 28, 2013.

Revenue and expenses, fiscal year 2011
Figure	As filed	Where it comes from
Net patient revenue	$7,205,745	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$7,543,812	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	−$338,067	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$197,032	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income: −$141,035 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.

Beds, days and discharges, fiscal year 2011
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	40,989	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	355	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	39.8	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	157.35	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	115.46	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 434378, 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 with audit, processed by CMS on November 10, 2011.

Revenue and expenses, fiscal year 2010
Figure	As filed	Where it comes from
Net patient revenue	$7,177,389	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$7,415,292	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	−$237,903	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$194,635	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income: −$43,268 (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.

Beds, days and discharges, fiscal year 2010
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	42,012	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	250	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	39.38	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	282.32	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	168.05	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 420150, 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 March 15, 2011.

Revenue and expenses, fiscal year 2009
Figure	As filed	Where it comes from
Net patient revenue	$6,852,418	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$7,187,267	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	−$334,849	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$174,100	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income: −$160,749 (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.

Beds, days and discharges, fiscal year 2009
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	40,609	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	175	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	68.17	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	284.92	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	232.05	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 395482, 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 August 27, 2010.

Revenue and expenses, fiscal year 2008
Figure	As filed	Where it comes from
Net patient revenue	$6,810,462	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$6,891,290	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	−$80,828	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$201,652	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income: $120,824 (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.

Beds, days and discharges, fiscal year 2008
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	42,376	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	175	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	68.85	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	295.92	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	242.15	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 386461, 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 October 15, 2008.

Revenue and expenses, fiscal year 2007
Figure	As filed	Where it comes from
Net patient revenue	$6,394,104	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$6,649,486	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	−$255,382	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$201,263	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income: −$54,119 (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.

Beds, days and discharges, fiscal year 2007
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	42,263	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	175	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	80.45	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	295.48	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	241.5	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 326606, read from the public cost report file SNFFY2007.zip.

Fiscal year 2006, ended September 30, 2006

Cost report for October 1, 2005 to September 30, 2006 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on June 12, 2007.

Revenue and expenses, fiscal year 2006
Figure	As filed	Where it comes from
Net patient revenue	$6,299,739	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$6,545,057	CMS-2540-96 worksheet G200002 line 1500 column 100
Net income from service to patients	−$245,318	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$185,113	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income: −$60,205 (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.

Beds, days and discharges, fiscal year 2006
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	41,872	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	175	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	90.44	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	285.11	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	239.27	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 282857, read from the public cost report file SNFFY2006.zip.

Fiscal year 2005, ended September 30, 2005

Cost report for October 1, 2004 to September 30, 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on November 8, 2006.

Revenue and expenses, fiscal year 2005
Figure	As filed	Where it comes from
Net patient revenue	$5,984,385	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$6,360,755	CMS-2540-96 worksheet G200002 line 1500 column 100
Net income from service to patients	−$376,370	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$154,672	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income: −$221,698 (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.

Beds, days and discharges, fiscal year 2005
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	40,261	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	175	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	82.33	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	278.67	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	230.06	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 265889, read from the public cost report file SNFFY2005.zip.

Fiscal year 2004, ended September 30, 2004

Cost report for October 1, 2003 to September 30, 2004 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on February 1, 2006.

Revenue and expenses, fiscal year 2004
Figure	As filed	Where it comes from
Net patient revenue	$6,284,525	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$6,518,753	CMS-2540-96 worksheet G200002 line 1500 column 100
Net income from service to patients	−$234,228	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$177,521	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income: −$56,707 (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.

Beds, days and discharges, fiscal year 2004
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	42,624	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	175	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	91.7	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	270.35	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	243.57	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 242051, read from the public cost report file SNFFY2004.zip.

Fiscal year 2003, ended September 30, 2003

Cost report for October 1, 2002 to September 30, 2003 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on April 25, 2005.

Revenue and expenses, fiscal year 2003
Figure	As filed	Where it comes from
Net patient revenue	$5,839,907	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$5,897,720	CMS-2540-96 worksheet G200002 line 1500 column 100
Net income from service to patients	−$57,813	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$150,732	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income: $92,919 (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.

Beds, days and discharges, fiscal year 2003
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	41,441	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	175	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	76.27	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	273.03	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	236.81	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 214979, read from the public cost report file SNFFY2003.zip.

Fiscal year 2002, ended September 30, 2002

Cost report for October 1, 2001 to September 30, 2002 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on September 1, 2004.

Revenue and expenses, fiscal year 2002
Figure	As filed	Where it comes from
Net patient revenue	$5,512,645	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$5,638,804	CMS-2540-96 worksheet G200002 line 1500 column 100
Net income from service to patients	−$126,159	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$133,792	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income: $7,633 (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.

Beds, days and discharges, fiscal year 2002
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	40,081	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	175	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	65.82	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	286.19	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	229.03	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 192755, read from the public cost report file SNFFY2002.zip.

Fiscal year 2001, ended September 30, 2001

Cost report for October 1, 2000 to September 30, 2001 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on February 13, 2003.

Revenue and expenses, fiscal year 2001
Figure	As filed	Where it comes from
Net patient revenue	$4,952,946	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$5,190,560	CMS-2540-96 worksheet G200002 line 1500 column 100
Net income from service to patients	−$237,614	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$95,827	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income: −$141,787 (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.

Beds, days and discharges, fiscal year 2001
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	41,514	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	175	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	45.06	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	332.35	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	237.22	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 130160, read from the public cost report file SNFFY2001.zip.

Fiscal year 2000, ended September 30, 2000

Cost report for October 1, 1999 to September 30, 2000 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on February 12, 2003.

Revenue and expenses, fiscal year 2000
Figure	As filed	Where it comes from
Net patient revenue	$4,372,482	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$4,686,981	CMS-2540-96 worksheet G200002 line 1500 column 100
Net income from service to patients	−$314,499	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$104,098	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income: −$210,401 (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.

Beds, days and discharges, fiscal year 2000
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	40,337	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	116	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	55.41	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	473.34	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	347.73	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 123942, read from the public cost report file SNFFY2000.zip.

Fiscal year 1999, ended September 30, 1999

Cost report for May 1, 1999 to September 30, 1999 — a reporting period of 152 days, not a full year, on form CMS-2540-96, settled, processed by CMS on February 13, 2003.

Revenue and expenses, fiscal year 1999
Figure	As filed	Where it comes from
Net patient revenue	$1,547,298	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$1,746,868	CMS-2540-96 worksheet G200002 line 1500 column 100
Net income from service to patients	−$199,570	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$39,702	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income: −$159,868 (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.

Beds, days and discharges, fiscal year 1999
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	16,113	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	123	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	19.75	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	196.82	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	131	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 129639, read from the public cost report file SNFFY1999.zip.

Fiscal year 1998, ended September 30, 1998

Cost report for October 1, 1997 to September 30, 1998 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on September 7, 2000.

Revenue and expenses, fiscal year 1998
Figure	As filed	Where it comes from
Net patient revenue	$2,855,269	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$3,013,731	CMS-2540-96 worksheet G200002 line 1500 column 100
Net income from service to patients	−$158,462	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$11,355	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income: −$147,107 (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.

Beds, days and discharges, fiscal year 1998
Figure	As filed	Where it comes from
Total facility beds, all components	88	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	30,278	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	94	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	51	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	321.16	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	322.11	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 40794, read from the public cost report file SNFFY1998.zip.

Fiscal year 1997, ended September 30, 1997

Cost report for October 1, 1996 to September 30, 1997 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on February 1, 1999.

Revenue and expenses, fiscal year 1997
Figure	As filed	Where it comes from
Net patient revenue	$2,619,788	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$2,792,750	CMS-2540-96 worksheet G200002 line 1500 column 100
Net income from service to patients	−$172,962	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$14,357	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income: −$158,605 (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.

Beds, days and discharges, fiscal year 1997
Figure	As filed	Where it comes from
Total facility beds, all components	88	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	30,973	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	87	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	119.43	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	321.86	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	356.01	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 40792, read from the public cost report file SNFFY1997.zip.

Fiscal year 1996, ended September 30, 1996

Cost report for October 1, 1995 to September 30, 1996 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on July 31, 1998.

Revenue and expenses, fiscal year 1996
Figure	As filed	Where it comes from
Net patient revenue	$2,610,711	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$2,610,081	CMS-2540-96 worksheet G200002 line 1500 column 100
Net income from service to patients	$630	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$9,817	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income: $10,447 (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.

Beds, days and discharges, fiscal year 1996
Figure	As filed	Where it comes from
Total facility beds, all components	88	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	30,707	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	75	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	91.25	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	530.06	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	409.43	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 40790, read from the public cost report file SNFFY1996.zip.

Nurse staffing

Nurse staffing hours from the Payroll-Based Journal, quarter by quarter, are on this facility’s staffing page, each quarter with the file it came from.

The staffing record →

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
CILONE, JOHN	ADP OF THE SNF	Individual	NOT APPLICABLE	since 12/01/2015
MCKEITHAN, CHARLES	ADP OF THE SNF	Individual	NOT APPLICABLE	since 12/01/2015
MCKEITHAN, DANIEL	ADP OF THE SNF	Individual	NOT APPLICABLE	since 12/01/2015
MCKEITHAN, EMMETT	ADP OF THE SNF	Individual	NOT APPLICABLE	since 12/01/2015
CILONE, JOHN	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 12/01/2015
MCKEITHAN, CHARLES	DIRECT OWNERSHIP INTEREST	Individual	NOT APPLICABLE	since 12/01/2015
MCKEITHAN, DANIEL	DIRECT OWNERSHIP INTEREST	Individual	NOT APPLICABLE	since 12/01/2015
MCKEITHAN, EMMETT	DIRECT OWNERSHIP INTEREST	Individual	NOT APPLICABLE	since 12/01/2015
MCKEITHAN, CHARLES	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 12/01/2015
MCKEITHAN, DANIEL	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 12/01/2015
MCKEITHAN, EMMETT	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 12/01/2015

Medicare enrollment

As filed in the CMS file dated August 1, 2026 (Medicare enrollment ownership), under the enrollment of FAIR HAVEN OF FOREST CITY LLC (enrollment ID O20151211000502).

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
CHARLES MCKEITHAN	Individual	5% OR GREATER DIRECT OWNERSHIP INTEREST	20	12/1/2015	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
DANIEL MCKEITHAN	Individual	5% OR GREATER DIRECT OWNERSHIP INTEREST	20	12/1/2015	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
EMMETT MCKEITHAN	Individual	5% OR GREATER DIRECT OWNERSHIP INTEREST	20	12/1/2015	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
CHARLES MCKEITHAN	Individual	ADP OF THE SNF	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
DANIEL MCKEITHAN	Individual	ADP OF THE SNF	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
EMMETT MCKEITHAN	Individual	ADP OF THE SNF	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
JOHN CILONE	Individual	ADP OF THE SNF	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	ADP OF THE SNF	Not stated in the filing	2/11/2025	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
No owner named in the filing	Individual	ADP OF THE SNF	Not stated in the filing	8/4/2016	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	ADP OF THE SNF	Not stated in the filing	10/1/2022	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
JOHN CILONE	Individual	CORPORATE OFFICER	0	12/1/2015	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
CHARLES MCKEITHAN	Individual	DIRECT OWNERSHIP INTEREST	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
DANIEL MCKEITHAN	Individual	DIRECT OWNERSHIP INTEREST	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
EMMETT MCKEITHAN	Individual	DIRECT OWNERSHIP INTEREST	33.34	12/1/2015	Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS
CHARLES MCKEITHAN	Individual	OPERATIONAL/MANAGERIAL CONTROL	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
DANIEL MCKEITHAN	Individual	OPERATIONAL/MANAGERIAL CONTROL	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
EMMETT MCKEITHAN	Individual	OPERATIONAL/MANAGERIAL CONTROL	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

Changes in ownership

April 1, 2026: SUZANNE HENSLEY 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: SUZANNE HENSLEY no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
April 1, 2026: JOHN CILONE 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: JOHN CILONE no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
April 1, 2026: EMMETT MCKEITHAN (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since December 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
April 1, 2026: EMMETT MCKEITHAN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since December 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
April 1, 2026: DANIEL MCKEITHAN (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since December 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
April 1, 2026: DANIEL MCKEITHAN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since December 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
April 1, 2026: A listing under ADP OF THE SNF, with no owner named, first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since February 11, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
April 1, 2026: CHARLES MCKEITHAN (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since December 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
April 1, 2026: CHARLES MCKEITHAN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since December 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
April 1, 2026: JOHN CILONE (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since December 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
April 1, 2026: JOHN CILONE (CORPORATE OFFICER) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since December 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
October 2, 2023: FAIR HAVEN OF FOREST CITY LLC no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
October 2, 2023: FAIR HAVEN OF FOREST CITY LLC no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv

Recent changes on this record

April 2, 2026: An inspection was recorded in inspection cycle 1. NH_SurveySummary_Sep2026_2.csv
April 1, 2026: SUZANNE HENSLEY 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: SUZANNE HENSLEY no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
April 1, 2026: JOHN CILONE 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: JOHN CILONE no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
April 1, 2026: EMMETT MCKEITHAN (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since December 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
April 1, 2026: EMMETT MCKEITHAN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since December 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
April 1, 2026: DANIEL MCKEITHAN (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since December 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
April 1, 2026: DANIEL MCKEITHAN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since December 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
April 1, 2026: A listing under ADP OF THE SNF, with no owner named, first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since February 11, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
April 1, 2026: CHARLES MCKEITHAN (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since December 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
April 1, 2026: CHARLES MCKEITHAN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since December 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
April 1, 2026: JOHN CILONE (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since December 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
April 1, 2026: JOHN CILONE (CORPORATE OFFICER) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since December 1, 2015. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
March 6, 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
February 13, 2025: An inspection was recorded in inspection cycle 2. NH_SurveySummary_Sep2026_2.csv
March 13, 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
November 16, 2023: An inspection was recorded in inspection cycle 3. NH_SurveySummary_Sep2026_2.csv
October 2, 2023: FAIR HAVEN OF FOREST CITY LLC no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
October 2, 2023: FAIR HAVEN OF FOREST CITY LLC no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
May 24, 2023: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
February 16, 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
August 4, 2022: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
June 25, 2021: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
July 30, 2020: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2018.zip
January 16, 2020: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2016.zip
June 27, 2019: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2017.zip
May 2, 2018: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2015.zip
May 24, 2017: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2014.zip
August 25, 2015: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2014.zip
May 7, 2015: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2014.zip
October 14, 2014: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2013.zip
July 25, 2013: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2012.zip
March 28, 2013: A cost report was filed for fiscal year 2011, on form CMS-2540-96. SNFFY2011.zip
November 10, 2011: A cost report was filed for fiscal year 2010, on form CMS-2540-96. SNFFY2010.zip
March 15, 2011: A cost report was filed for fiscal year 2009, on form CMS-2540-96. SNFFY2009.zip
August 27, 2010: A cost report was filed for fiscal year 2008, on form CMS-2540-96. SNFFY2008.zip
October 15, 2008: A cost report was filed for fiscal year 2007, on form CMS-2540-96. SNFFY2007.zip
June 12, 2007: A cost report was filed for fiscal year 2006, on form CMS-2540-96. SNFFY2006.zip
November 8, 2006: A cost report was filed for fiscal year 2005, on form CMS-2540-96. SNFFY2005.zip

Inspections

Inspection cycle	Health inspection	Fire safety inspection	Health deficiencies	Fire safety deficiencies
1	April 2, 2026	February 13, 2025	3	2
1	April 2, 2026	April 2, 2026	3	5
2	February 13, 2025	November 16, 2023	1	3
2	February 13, 2025	February 13, 2025	1	2
3	November 16, 2023	June 9, 2022	2	4
3	November 16, 2023	November 16, 2023	2	3

From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on August 1, 2026.

Deficiencies cited

6 deficiencies on file, newest inspection first

Inspection date	Inspection type	Tag	Category	What was cited	Scope and severity	Complaint	Corrected	Correction date
April 2, 2026	Health	F 0552	Resident Rights Deficiencies	Ensure that residents are fully informed and understand their health status, care and treatments.	D	No	Deficient, Provider has date of correction	April 25, 2026
April 2, 2026	Health	F 0645	Resident Assessment and Care Planning Deficiencies	PASARR screening for Mental disorders or Intellectual Disabilities	D	No	Deficient, Provider has date of correction	April 25, 2026
April 2, 2026	Health	F 0656	Resident Assessment and Care Planning Deficiencies	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.	D	No	Deficient, Provider has date of correction	April 25, 2026
February 13, 2025	Health	F 0689	Quality of Life and Care Deficiencies	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.	D	No	Deficient, Provider has date of correction	March 1, 2025
November 16, 2023	Health	F 0690	Quality of Life and Care Deficiencies	Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.	D	Yes	Deficient, Provider has date of correction	December 11, 2023
November 16, 2023	Health	F 0812	Nutrition and Dietary Deficiencies	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.	E	Yes	Deficient, Provider has date of correction	December 11, 2023

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	For profit - Limited Liability company
Legal Business Name	FAIR HAVEN OF FOREST CITY LLC
Date First Approved to Provide Medicare and Medicaid Services	1990-04-06
Provider Resides in Hospital	N
Continuing Care Retirement Community	N
Urban	N
County/Parish	Rutherford
Telephone Number	8282452852
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	100
Average Number of Residents per Day	84.5
Overall Rating	4
Health Inspection Rating	4
QM Rating	2
Long-Stay QM Rating	2
Short-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.

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The citable document for Fair Haven of Forest City, LLC

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 North Carolina 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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