Skilled nursing facility · CMS certification number 355089
GOOD SAMARITAN SOCIETY - PARK RIVER
PARK RIVER, North Dakota · Medicare and Medicaid
Certified beds, as filed in Care Compare: 44
Download this facility’s record (CSV)
A CSV file of this facility’s record: its name and location, its Medicare cost-report finances year by year, its ownership, its inspections, deficiencies and penalties, and the Care Compare provider information — each figure with the worksheet, line and column or file it came from.
In Care Compare’s provider information: Penalties: 1 · Fines: 1 · Fines, total amount: $27,417.00 · Payment denials: 0. The most recent penalty on file: January 14, 2026, Fine, $27,417. 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 July 1, 2024 to June 30, 2025 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on October 22, 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,234,396 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $390,596 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,843,800 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,550,686 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $293,114 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $535,206 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $828,320 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $458,411 (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 | 56 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 20,440 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 482 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 8,865 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 6,708 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 16,055 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 11 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 89 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 77 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 177 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 43.82 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 99.61 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 90.71 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1441254, read from the public cost report file SNF10FY2024.zip.
Fiscal year 2024, ended June 30, 2024
Cost report for July 1, 2023 to June 30, 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on February 6, 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,537,838 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $245,527 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,292,311 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,512,175 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$219,864 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $342,194 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $122,330 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$104,735 (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 | 66 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 15,458 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 146 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 59.25 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 117.02 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 105.88 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1403302, read from the public cost report file SNF10FY2023.zip.
Fiscal year 2023, ended June 30, 2023
Cost report for July 1, 2022 to June 30, 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on February 6, 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,877,653 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $213,948 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,663,705 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,729,758 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,066,053 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $402,390 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$663,663 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$739,284 (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 | 66 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 15,206 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 111 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 49.65 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 195.61 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 136.99 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1373058, read from the public cost report file SNF10FY2022.zip.
Fiscal year 2022, ended June 30, 2022
Cost report for July 1, 2021 to June 30, 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on March 7, 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,999,285 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $157,795 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,841,490 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,589,242 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$747,752 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $244,427 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$503,325 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$540,184 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 66 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,490 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 66 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 55.08 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 309.7 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 265 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1343928, read from the public cost report file SNF10FY2021.zip.
Fiscal year 2021, ended June 30, 2021
Cost report for July 1, 2020 to June 30, 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on March 17, 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,817,306 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $104,746 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,712,560 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,790,558 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$77,998 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $309,958 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $231,960 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $227,759 (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 | 66 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 18,317 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 71 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 79.27 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 162.26 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 257.99 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1312424, read from the public cost report file SNF10FY2020.zip.
Fiscal year 2020, ended June 30, 2020
Cost report for July 1, 2019 to June 30, 2020 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on March 11, 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,707,538 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $146,211 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,561,327 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,056,039 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$494,712 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $508,036 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $13,324 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$6,719 (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 | 66 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,476 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 53 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 197 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 290.76 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 386.34 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1281161, read from the public cost report file SNF10FY2019.zip.
Fiscal year 2019, ended June 30, 2019
Cost report for July 1, 2018 to June 30, 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on November 25, 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,965,486 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $145,827 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,819,659 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,769,183 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $50,476 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $303,178 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $353,654 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $390,084 (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 | 66 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 21,838 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 99 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 89.8 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 266.46 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 220.59 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1246169, read from the public cost report file SNF10FY2018.zip.
Fiscal year 2018, ended June 30, 2018
Cost report for July 1, 2017 to June 30, 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on November 21, 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,014,162 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $246,971 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,767,191 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,607,829 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $159,362 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $200,068 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $359,430 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $346,075 (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 | 66 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 21,316 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 107 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 84.2 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 404.88 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 199.21 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1214218, read from the public cost report file SNF10FY2017.zip.
Fiscal year 2017, ended June 30, 2017
Cost report for July 1, 2016 to June 30, 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on October 26, 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,829,695 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $198,060 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,631,635 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,618,981 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $12,654 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $185,394 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $198,048 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $177,118 (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 | 66 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 22,073 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 102 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 75.27 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 364.97 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 216.4 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1177535, read from the public cost report file SNF10FY2016.zip.
Fiscal year 2016, ended June 30, 2016
Cost report for July 1, 2015 to June 30, 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on December 14, 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,836,569 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $245,085 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,591,484 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,512,375 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $79,109 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $261,724 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $340,833 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $302,726 (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 | 66 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 21,812 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 80 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 67.14 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 464.47 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 272.65 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1148653, read from the public cost report file SNF10FY2015.zip.
Fiscal year 2015, ended June 30, 2015
Cost report for July 1, 2014 to June 30, 2015 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on September 28, 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,304,390 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $201,030 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,103,360 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,256,654 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$153,294 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $147,278 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$6,016 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$25,642 (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 | 66 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 21,195 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 41 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 79.9 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 772.4 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 516.95 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1110856, read from the public cost report file SNF10FY2014.zip.
Fiscal year 2014, ended June 30, 2014
Cost report for July 1, 2013 to June 30, 2014 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on January 14, 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,188,030 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $204,810 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,983,220 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,178,488 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$195,268 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $399,013 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $203,745 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $182,998 (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 | 66 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 21,176 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 63 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 102.73 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 312.15 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 336.13 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1084185, read from the public cost report file SNF10FY2013.zip.
Fiscal year 2013, ended June 30, 2013
Cost report for July 1, 2012 to June 30, 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on January 27, 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,235,283 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $232,977 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,002,306 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,801,630 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $200,676 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $310,882 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $511,558 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $502,873 (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 | 66 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,996 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 123 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 61.76 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 384.81 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 170.7 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1053834, read from the public cost report file SNF10FY2012.zip.
Fiscal year 2012, ended June 30, 2012
Cost report for July 1, 2011 to June 30, 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on December 31, 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,964,464 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $145,662 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,818,802 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,651,162 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $167,640 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $140,151 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $307,791 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $283,700 (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 | 73 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,357 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 53 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 87.82 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 647 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 365.23 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1022680, read from the public cost report file SNF10FY2011.zip.
Fiscal year 2011, ended June 30, 2011
Cost report for July 1, 2010 to June 30, 2011 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on January 18, 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,661,137 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,689,575 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$28,438 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $307,339 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | −$9,190 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $288,091 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 73 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 18,914 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 84 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 77.29 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 307.55 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 225.17 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 423090, read from the public cost report file SNFFY2010.zip.
Fiscal year 2010, ended June 30, 2010
Cost report for July 1, 2009 to June 30, 2010 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on January 17, 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,858,518 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,820,711 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $37,807 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $262,363 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $3,538 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $296,632 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 73 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 21,577 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 102 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 22.16 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 355.5 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 211.54 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 392735, read from the public cost report file SNFFY2009.zip.
Fiscal year 2009, ended June 30, 2009
Cost report for July 1, 2008 to June 30, 2009 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on December 24, 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,949,619 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,939,694 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $9,925 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $134,752 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $17,078 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $127,599 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 76 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 23,974 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 167 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 17.21 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 256.41 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 143.56 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 361693, read from the public cost report file SNFFY2008.zip.
Fiscal year 2008, ended June 30, 2008
Cost report for July 1, 2007 to June 30, 2008 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on November 21, 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,088,880 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,997,326 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $91,554 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $104,969 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $15,161 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $181,362 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 80 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 26,799 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 131 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 20.98 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 342.61 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 204.57 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 328652, read from the public cost report file SNFFY2007.zip.
Fiscal year 2007, ended June 30, 2007
Cost report for July 1, 2006 to June 30, 2007 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on February 2, 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,077,952 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,895,127 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $182,825 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $255,918 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $6,478 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $432,265 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 80 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 26,033 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 132 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 22.15 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 403.19 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 197.22 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 301607, read from the public cost report file SNFFY2006.zip.
Fiscal year 2006, ended June 30, 2006
Cost report for July 1, 2005 to June 30, 2006 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on October 16, 2007.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,692,464 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,525,727 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $166,737 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $255,744 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $6,344 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $416,137 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 74 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 24,788 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 135 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 65.13 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 420.06 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 183.61 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 294782, read from the public cost report file SNFFY2005.zip.
Fiscal year 2005, ended June 30, 2005
Cost report for July 1, 2004 to June 30, 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on July 24, 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,419,369 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,588,668 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$169,299 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $135,989 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $7,459 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$40,769 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 74 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 24,087 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 165 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 77.63 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 290.3 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 145.98 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 259572, read from the public cost report file SNFFY2004.zip.
Fiscal year 2004, ended June 30, 2004
Cost report for July 1, 2003 to June 30, 2004 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on October 21, 2005.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,698,638 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,720,245 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$21,607 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $176,555 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $14,597 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $140,351 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 80 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 28,053 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 71 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 57.06 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 848.42 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 395.11 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 235176, read from the public cost report file SNFFY2003.zip.
Fiscal year 2003, ended June 30, 2003
Cost report for July 1, 2002 to June 30, 2003 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on October 29, 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,702,015 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,582,868 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $119,147 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $172,630 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $13,213 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $278,564 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 80 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 27,923 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 186 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 67.67 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 280.58 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 150.12 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 198413, read from the public cost report file SNFFY2002.zip.
Fiscal year 2002, ended June 30, 2002
Cost report for July 1, 2001 to June 30, 2002 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on May 7, 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,543,907 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,485,339 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $58,568 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $112,989 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $171,557 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 80 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 27,773 | 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 | 79 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 499.33 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 225.8 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 143135, read from the public cost report file SNFFY2001.zip.
Fiscal year 2001, ended June 30, 2001
Cost report for July 1, 2000 to June 30, 2001 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on March 18, 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,048,686 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,106,195 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$57,509 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $79,423 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $21,914 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 80 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 28,490 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 163 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 50.17 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 351.47 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 174.79 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 133352, read from the public cost report file SNFFY2000.zip.
Fiscal year 2000, ended June 30, 2000
Cost report for July 1, 1999 to June 30, 2000 — a reporting period of 365 days, on form CMS-2540-96, as submitted, processed by CMS on December 19, 2000.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,762,457 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,842,018 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$79,561 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $59,694 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: −$19,867 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 98 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 32,041 | 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 | 17.62 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 515 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 276.22 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 1682, read from the public cost report file SNFFY1999.zip.
Fiscal year 1999, ended June 30, 1999
Cost report for July 1, 1998 to June 30, 1999 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on August 1, 2001.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,651,800 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,645,702 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $6,098 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $86,938 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $93,036 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 80 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 27,565 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 154 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 42.45 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 178.99 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 1681, read from the public cost report file SNFFY1998.zip.
Fiscal year 1998, ended June 30, 1998
Cost report for July 1, 1997 to June 30, 1998 — a reporting period of 364 days, on form CMS-2540-96, reopened, processed by CMS on May 13, 2005.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,524,052 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,484,044 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $40,008 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $126,929 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $166,937 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 80 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 28,564 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 118 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 152.91 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 499.13 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 242.07 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 216822, read from the public cost report file SNFFY1997.zip.
Fiscal year 1997, ended June 30, 1997
Cost report for July 1, 1996 to June 30, 1997 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on November 2, 1999.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,345,360 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,322,817 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $22,543 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $89,818 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $112,361 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 80 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 26,903 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 114 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 277.78 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 235.99 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 18566, read from the public cost report file SNFFY1996.zip.
Nurse staffing
Nurse staffing hours from the Payroll-Based Journal, quarter by quarter, are on this facility’s staffing page, each quarter with the file it came from.
Ownership, as filed with CMS
Care Compare
As filed in the CMS file dated September 1, 2026 (Care Compare ownership).
| Owner or manager | Role | Type | Ownership percentage | Association |
|---|---|---|---|---|
| SANFORD | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | 100% | since 01/01/2019 |
| THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | Organization | 100% | since 01/01/2019 |
| JOHNSON, JOEL | CONTRACTED MANAGING EMPLOYEE | Individual | NOT APPLICABLE | since 01/09/2013 |
| CAIN, JAMES | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| DYKHOUSE, DANA | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| ENGBRECHT, WESLEY | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| GASSEN, WILLIAM | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| GULSVIG, NEIL | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| HERSETH SANDLIN, STEPHANIE | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| LUNDEEN, MARK | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| MOLBERT, LAURIS | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| NORTH, ANDREW | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| SHULKIN, DAVID | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| TEIKEN, BRENT | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| VENTLING-HERRMANN, MARNIE | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| FLUIT, JOEL | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 10/01/2022 |
| GASSEN, WILLIAM | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 05/30/2024 |
| MIDDLETON, AIMEE | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 01/27/2022 |
| OLSON, NICHOLAS | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 04/08/2024 |
| ROGERS, MICHAEL | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 06/13/2022 |
| SCHEMA, NATHAN | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 01/01/2022 |
| CARLSON, LARA | W-2 MANAGING EMPLOYEE | Individual | NOT APPLICABLE | since 07/17/2022 |
| MORRISON, TONY | W-2 MANAGING EMPLOYEE | Individual | NOT APPLICABLE | since 01/01/2019 |
Medicare enrollment
As filed in the CMS file dated August 1, 2026 (Medicare enrollment ownership), under the enrollment of THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (enrollment ID O20070806000160).
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; where the private equity, real estate investment trust or holding company field below has not been filed under the current cycle, it reads “Paused by CMS”.
| Owner | Individual or organization | Role | Ownership percentage | Association date | Described in the filing as |
|---|---|---|---|---|---|
| SANFORD | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100 | 1/1/2019 | Private equity company: No Real estate investment trust: No Holding company: No |
| THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100 | 1/1/2019 | Private equity company: No Real estate investment trust: No Holding company: No |
| JOEL J JOHNSON | Individual | CONTRACTED MANAGING EMPLOYEE | 0 | 1/9/2013 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| ANDREW STEWART NORTH | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| BRENT GERARD TEIKEN | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DANA JAMES DYKHOUSE | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DAVID JONATHAN SHULKIN | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JAMES EDWARD CAIN | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| LAURIS NELSON MOLBERT | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MARK ALLEN LUNDEEN | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MARNIE LYNN VENTLING-HERRMANN | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| NEIL LESLIE GULSVIG | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| STEPHANIE MARIE HERSETH SANDLIN | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| WESLEY OWEN ENGBRECHT | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| WILLIAM JOSEPH GASSEN | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| AIMEE NICOLE MIDDLETON | Individual | CORPORATE OFFICER | 0 | 1/27/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JOEL ADAM FLUIT | Individual | CORPORATE OFFICER | 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 |
| MICHAEL ROGERS | Individual | CORPORATE OFFICER | 0 | 6/13/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| NATHAN THOMAS SCHEMA | Individual | CORPORATE OFFICER | 0 | 1/1/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| NICHOLAS WAYNE OLSON | Individual | CORPORATE OFFICER | 0 | 4/8/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| WILLIAM JOSEPH GASSEN | Individual | CORPORATE OFFICER | 0 | 5/30/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| LARA CARLSON | Individual | W-2 MANAGING EMPLOYEE | 0 | 7/17/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| TONY LEE MORRISON | Individual | W-2 MANAGING EMPLOYEE | 0 | 1/1/2019 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
Changes in ownership
- October 1, 2024: DAVID A BRECHTELSBAUER no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: DEAN LOUIS BRESCIANI no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: THOMAS PHILLIP KOOP no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: NATHAN THOMAS SCHEMA no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: MATTHEW RYAN HOCKS no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: SANFORD no longer appears as OTHER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: MICHAEL ROGERS no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: SCOTT CHARLES PETERSEN no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: WILLIAM D MARLETTE no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: WILLIAM D MARLETTE no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: TONY LEE MORRISON no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: DARRELL EVAN SCHMITH no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: LINDA OLAYINKA NORMAN no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: DAVID AUSTAD no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: HELEN ISABELLA MELLAND no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: MARNIE LYNN VENTLING-HERRMANN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: JOEL J JOHNSON (CONTRACTED MANAGING EMPLOYEE) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since January 9, 2013. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: NICHOLAS WAYNE OLSON (OFFICER) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since April 8, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: LAURIS NELSON MOLBERT (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: NEIL LESLIE GULSVIG (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: DAVID JONATHAN SHULKIN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: SANFORD (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since January 1, 2019. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: WESLEY OWEN ENGBRECHT (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: WILLIAM JOSEPH GASSEN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: WILLIAM JOSEPH GASSEN (OFFICER) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: STEPHANIE MARIE HERSETH SANDLIN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: ANDREW STEWART NORTH (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: LARA CARLSON (W-2 MANAGING EMPLOYEE) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since July 17, 2022. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: MICHAEL ROGERS (OFFICER) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since June 13, 2022. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: DANA JAMES DYKHOUSE (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: BRENT GERARD TEIKEN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (5% OR GREATER INDIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since January 1, 2019. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: JAMES EDWARD CAIN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: MARK ALLEN LUNDEEN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 2, 2023: LISA MELBY no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: NORVAL BUCKNEBERG no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: MICHELLE ANN BRUHN no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: CHAD JUNGMAN no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: ERIC VANDEN HULL no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: MICHELLE MARIE MICKA no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: MICHELLE MARIE MICKA no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: STEPHANIE MARIE SWENSON no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: JOLYN JOY MUNSON no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: KARIN LOUISE DULSKI no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: TRACI WOOLFOLK no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: MARNIE LYNN VENTLING-HERRMANN no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: DUSTIN ALLEN SCHOLZ no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: DEAN LOUIS BRESCIANI (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 2, 2023; associated with this enrollment since June 13, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: MICHAEL ROGERS (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 2, 2023; associated with this enrollment since June 13, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: SCOTT CHARLES PETERSEN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 2, 2023; associated with this enrollment since June 26, 2018. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: JOEL FLUIT (OFFICER) first listed in CMS’s Medicare enrollment ownership file on October 2, 2023; associated with this enrollment since October 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: WILLIAM D MARLETTE (W-2 MANAGING EMPLOYEE) first listed in CMS’s Medicare enrollment ownership file on October 2, 2023; associated with this enrollment since June 14, 2023. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: WILLIAM D MARLETTE (OFFICER) first listed in CMS’s Medicare enrollment ownership file on October 2, 2023; associated with this enrollment since June 14, 2023. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
Recent changes on this record
- October 22, 2025: A cost report was filed for fiscal year 2025, on form CMS-2540-10. SNF10FY2024.zip
- February 6, 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2023.zip
- October 1, 2024: DAVID A BRECHTELSBAUER no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: DEAN LOUIS BRESCIANI no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: THOMAS PHILLIP KOOP no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: NATHAN THOMAS SCHEMA no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: MATTHEW RYAN HOCKS no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: SANFORD no longer appears as OTHER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: MICHAEL ROGERS no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: SCOTT CHARLES PETERSEN no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: WILLIAM D MARLETTE no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: WILLIAM D MARLETTE no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: TONY LEE MORRISON no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: DARRELL EVAN SCHMITH no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: LINDA OLAYINKA NORMAN no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: DAVID AUSTAD no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: HELEN ISABELLA MELLAND no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: MARNIE LYNN VENTLING-HERRMANN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: JOEL J JOHNSON (CONTRACTED MANAGING EMPLOYEE) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since January 9, 2013. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: NICHOLAS WAYNE OLSON (OFFICER) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since April 8, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: LAURIS NELSON MOLBERT (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: NEIL LESLIE GULSVIG (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: DAVID JONATHAN SHULKIN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: SANFORD (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since January 1, 2019. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: WESLEY OWEN ENGBRECHT (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: WILLIAM JOSEPH GASSEN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: WILLIAM JOSEPH GASSEN (OFFICER) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: STEPHANIE MARIE HERSETH SANDLIN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: ANDREW STEWART NORTH (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: LARA CARLSON (W-2 MANAGING EMPLOYEE) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since July 17, 2022. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: MICHAEL ROGERS (OFFICER) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since June 13, 2022. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: DANA JAMES DYKHOUSE (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: BRENT GERARD TEIKEN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (5% OR GREATER INDIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since January 1, 2019. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: JAMES EDWARD CAIN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- October 1, 2024: MARK ALLEN LUNDEEN (DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on October 1, 2024; associated with this enrollment since May 30, 2024. Skilled_Nursing_Facility_All_Owners_:_2024-10-01.csv
- February 6, 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2022.zip
- October 2, 2023: LISA MELBY no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- October 2, 2023: NORVAL BUCKNEBERG no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | August 21, 2025 | August 21, 2025 | 6 | 7 |
| 2 | July 11, 2024 | July 11, 2024 | 11 | 3 |
| 3 | June 8, 2023 | June 8, 2023 | 12 | 1 |
From the Care Compare inspection summary file NH_SurveySummary_Sep2026_2.csv, processed on September 1, 2026.
Deficiencies cited
29 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| December 4, 2025 | Health | F 0600 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | Yes | Past Non-Compliance | September 25, 2025 |
| August 21, 2025 | Health | F 0657 | Resident Assessment and Care Planning Deficiencies | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | Yes | Deficient, Provider has date of correction | September 25, 2025 |
| August 21, 2025 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | No | Deficient, Provider has date of correction | September 25, 2025 |
| August 21, 2025 | Health | F 0725 | Nursing and Physician Services Deficiencies | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | E | Yes | Deficient, Provider has date of correction | September 25, 2025 |
| August 21, 2025 | Health | F 0761 | Pharmacy Service Deficiencies | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | No | Deficient, Provider has date of correction | September 25, 2025 |
| August 21, 2025 | 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 | September 25, 2025 |
| February 19, 2025 | 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 | Yes | Deficient, Provider has date of correction | March 24, 2025 |
| February 19, 2025 | Health | F 0690 | Quality of Life and Care Deficiencies | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | D | Yes | Deficient, Provider has date of correction | March 24, 2025 |
| February 19, 2025 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | Yes | Deficient, Provider has date of correction | March 24, 2025 |
| July 11, 2024 | Health | F 0580 | Resident Rights Deficiencies | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | D | Yes | Deficient, Provider has date of correction | August 9, 2024 |
| July 11, 2024 | Health | F 0582 | Resident Rights Deficiencies | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | D | Yes | Deficient, Provider has date of correction | August 9, 2024 |
| July 11, 2024 | Health | F 0641 | Resident Assessment and Care Planning Deficiencies | Ensure each resident receives an accurate assessment. | E | Yes | Deficient, Provider has date of correction | August 9, 2024 |
| July 11, 2024 | Health | F 0657 | Resident Assessment and Care Planning Deficiencies | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | Yes | Deficient, Provider has date of correction | August 9, 2024 |
| July 11, 2024 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Yes | Deficient, Provider has date of correction | August 9, 2024 |
| July 11, 2024 | Health | F 0759 | Pharmacy Service Deficiencies | Ensure medication error rates are not 5 percent or greater. | D | Yes | Deficient, Provider has date of correction | August 9, 2024 |
| July 11, 2024 | Health | F 0761 | Pharmacy Service Deficiencies | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | Yes | Deficient, Provider has date of correction | August 9, 2024 |
| July 11, 2024 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | Yes | Deficient, Provider has date of correction | August 9, 2024 |
| March 12, 2024 | Health | F 0550 | Resident Rights Deficiencies | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | E | Yes | Deficient, Provider has date of correction | April 16, 2024 |
| March 12, 2024 | Health | F 0558 | Resident Rights Deficiencies | Reasonably accommodate the needs and preferences of each resident. | D | Yes | Deficient, Provider has date of correction | April 16, 2024 |
| March 12, 2024 | 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 | Yes | Deficient, Provider has date of correction | April 16, 2024 |
| March 12, 2024 | Health | F 0657 | Resident Assessment and Care Planning Deficiencies | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | Yes | Deficient, Provider has date of correction | April 16, 2024 |
| March 12, 2024 | Health | F 0686 | Quality of Life and Care Deficiencies | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | Yes | Deficient, Provider has date of correction | April 16, 2024 |
| March 12, 2024 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Yes | Deficient, Provider has date of correction | April 16, 2024 |
| March 12, 2024 | 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 | April 16, 2024 |
| March 12, 2024 | Health | F 0725 | Nursing and Physician Services Deficiencies | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | E | Yes | Deficient, Provider has date of correction | April 16, 2024 |
| March 12, 2024 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | Yes | Deficient, Provider has date of correction | April 16, 2024 |
| June 8, 2023 | Health | F 0578 | Resident Rights Deficiencies | Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | E | No | Deficient, Provider has date of correction | July 12, 2023 |
| June 8, 2023 | Health | F 0658 | Resident Assessment and Care Planning Deficiencies | Ensure services provided by the nursing facility meet professional standards of quality. | D | No | Deficient, Provider has date of correction | July 12, 2023 |
| June 8, 2023 | 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 | July 12, 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 |
|---|---|---|---|---|---|
| January 14, 2026 | Fine | $27,417 | 136918 |
From the Care Compare penalties file NH_Penalties_Sep2026_2.csv, processed on September 1, 2026.
Care Compare provider information
| Field | As filed |
|---|---|
| Provider Type | Medicare and Medicaid |
| Ownership Type | Non profit - Corporation |
| Legal Business Name | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY |
| Date First Approved to Provide Medicare and Medicaid Services | 1984-01-01 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | N |
| County/Parish | Walsh |
| Telephone Number | 7012847115 |
| Chain Name | GOOD SAMARITAN SOCIETY |
| Chain ID | 726 |
| Provider Changed Ownership in Last 12 Months | N |
| With a Resident and Family Council | Resident |
| Automatic Sprinkler Systems in All Required Areas | Yes |
| Number of Certified Beds | 44 |
| Average Number of Residents per Day | 42.8 |
| Overall Rating | 2 |
| Health Inspection Rating | 2 |
| QM Rating | 2 |
| Long-Stay QM Rating | 2 |
| Short-Stay QM Rating | 3 |
| Processing Date | 2026-09-01 |
From the Care Compare Provider Information file NH_ProviderInfo_Sep2026_3.csv, processed on September 1, 2026.
Get an email when this record changes
One email a day naming what moved on GOOD SAMARITAN SOCIETY - PARK RIVER: 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 October 22, 2025: A cost report was filed for fiscal year 2025, 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 GOOD SAMARITAN SOCIETY - PARK RIVER
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 Dakota 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 355089.