Skilled nursing facility · CMS certification number 355111
GOOD SAMARITAN SOCIETY-CROSBY
CROSBY, North Dakota
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.
This certification number is not in CMS’s current Care Compare Provider Information file, processed on August 1, 2026.
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, 2012 to April 30, 2013 — a reporting period of 303 days, on form CMS-2540-10, settled, processed by CMS on October 14, 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,561,756 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $27,837 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,533,919 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,806,984 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$273,065 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $74,255 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$198,810 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$226,581 (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 | 58 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 17,632 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 315 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 3,359 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 10,101 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 13,775 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 4 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 9 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 18 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 31 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 78.75 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 373.22 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 444.35 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1078720, 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 November 26, 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,051,595 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $56,834 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,994,761 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,319,401 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$324,640 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $85,701 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$238,939 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$235,201 (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 | 58 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 18,146 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 39 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 48.14 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 485.58 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 465.28 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1020663, 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 | $2,863,558 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,940,281 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$76,723 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $118,097 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $44,773 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$3,399 (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 | 58 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 18,722 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 25 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 66.09 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 911.57 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 748.88 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 423097, 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 12, 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,947,506 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,777,574 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $169,932 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $105,357 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $62,255 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $213,034 (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 | 58 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 19,215 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 54 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 25.23 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 528.54 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 355.83 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 392188, 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 | $2,837,107 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,703,005 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $134,102 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $15,109 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $32,421 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $116,790 (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 | 58 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 19,666 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 73 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 18.81 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 475.13 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 269.4 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 361696, 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 January 20, 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,433,878 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,533,161 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$99,283 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $73,418 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $16,327 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$42,192 (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 | 57 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 16,409 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 77 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 15.74 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 393.1 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 213.1 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 332034, 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 11, 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,378,289 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,475,649 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$97,360 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $449,821 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $10,580 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $341,881 (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 | 55 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 16,456 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 60 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 17.06 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 744.36 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 274.27 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 302087, 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, as submitted, processed by CMS on January 24, 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,475,711 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,611,526 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$135,815 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $133,648 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $8,279 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$10,446 (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 | 62 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 18,334 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 109 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 103.4 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 543.6 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 168.2 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 299875, 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 April 21, 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,624,421 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,605,162 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $19,259 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $147,690 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $3,256 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $163,693 (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 | 62 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,123 | 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 | 21.58 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 338.56 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 176.52 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 247729, 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 17, 2005.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,666,476 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,777,672 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$111,196 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $98,992 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $3,519 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$15,723 (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 | 67 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,707 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 124 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 13.31 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 311.15 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 166.99 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 234669, 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 November 24, 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,832,812 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,799,397 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $33,415 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $178,960 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $5,203 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $207,172 (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 | 67 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 22,647 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 142 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 23.24 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 278.8 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 159.49 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 200505, 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 | $2,521,100 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,675,073 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$153,973 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $16,839 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $1 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$137,135 (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 | 67 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 22,974 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 106 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 26.34 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 442.45 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 216.74 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 143826, 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 | $2,375,430 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,357,258 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $18,172 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $41,729 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $59,901 (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 | 23,109 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 91 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 19.47 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 478.47 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 253.95 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 133392, 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, settled, processed by CMS on March 18, 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,371,458 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,395,459 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$24,001 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $75,259 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $51,258 (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 | 23,240 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 117 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 17.18 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 332.83 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 198.63 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 133286, 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, reopened, processed by CMS on September 1, 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,479,656 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,511,762 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$32,106 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $53,341 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $21,235 (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 | 24,905 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 120 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 18.46 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 207.54 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 192612, 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 | $2,461,357 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,480,516 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$19,159 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $103,863 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $84,704 (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 | 25,312 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 85 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 21.24 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,135.75 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 297.79 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 216828, read from the public cost report file SNFFY1997.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
Not listed in CMS’s Care Compare data.
Medicare enrollment
No owner listed for this facility in CMS’s Medicare enrollment ownership data.
Changes in ownership
No change in ownership appears in CMS’s ownership data for this facility.
Recent changes on this record
- October 14, 2014: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2012.zip
- November 26, 2012: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2011.zip
- January 18, 2012: A cost report was filed for fiscal year 2011, on form CMS-2540-96. SNFFY2010.zip
- January 12, 2011: A cost report was filed for fiscal year 2010, on form CMS-2540-96. SNFFY2009.zip
- December 24, 2009: A cost report was filed for fiscal year 2009, on form CMS-2540-96. SNFFY2008.zip
- January 20, 2009: A cost report was filed for fiscal year 2008, on form CMS-2540-96. SNFFY2007.zip
- February 11, 2008: A cost report was filed for fiscal year 2007, on form CMS-2540-96. SNFFY2006.zip
- January 24, 2008: A cost report was filed for fiscal year 2006, on form CMS-2540-96. SNFFY2005.zip
- April 21, 2006: A cost report was filed for fiscal year 2005, on form CMS-2540-96. SNFFY2004.zip
- October 17, 2005: A cost report was filed for fiscal year 2004, on form CMS-2540-96. SNFFY2003.zip
- May 13, 2005: A cost report was filed for fiscal year 1998, on form CMS-2540-96. SNFFY1997.zip
- November 24, 2004: A cost report was filed for fiscal year 2003, on form CMS-2540-96. SNFFY2002.zip
- September 1, 2004: A cost report was filed for fiscal year 1999, on form CMS-2540-96. SNFFY1998.zip
- May 7, 2003: A cost report was filed for fiscal year 2002, on form CMS-2540-96. SNFFY2001.zip
- March 18, 2003: A cost report was filed for fiscal year 2001, on form CMS-2540-96. SNFFY2000.zip
- March 18, 2003: A cost report was filed for fiscal year 2000, on form CMS-2540-96. SNFFY1999.zip
Inspections
Not listed in CMS’s Care Compare data.
Deficiencies cited
Not listed in CMS’s Care Compare data.
Penalties
Not listed in CMS’s Care Compare data.
Care Compare provider information
Not listed in CMS’s Care Compare data.
Get an email when this record changes
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The citable document for GOOD SAMARITAN SOCIETY-CROSBY
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 355111.