Skilled nursing facility · CMS certification number 365778
CMS certification number 365778
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 January 1, 2007 to December 31, 2007 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on February 20, 2009.
None of these figures is carried on this report.
CMS report record 333970, read from the public cost report file SNFFY2007.zip.
Fiscal year 2006, ended December 31, 2006
Cost report for January 1, 2006 to December 31, 2006 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on March 12, 2008.
None of these figures is carried on this report.
CMS report record 304335, read from the public cost report file SNFFY2006.zip.
Fiscal year 2005, ended December 31, 2005
Cost report for January 1, 2005 to December 31, 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on March 22, 2007.
None of these figures is carried on this report.
CMS report record 275640, read from the public cost report file SNFFY2005.zip.
Fiscal year 2004, ended December 31, 2004
Cost report for January 1, 2004 to December 31, 2004 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on February 21, 2006.
None of these figures is carried on this report.
CMS report record 243307, read from the public cost report file SNFFY2004.zip.
Fiscal year 2003, ended December 31, 2003
Cost report for January 1, 2003 to December 31, 2003 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on April 16, 2005.
None of these figures is carried on this report.
CMS report record 213210, read from the public cost report file SNFFY2003.zip.
Fiscal year 2002, ended December 31, 2002
Cost report for January 1, 2002 to December 31, 2002 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on July 16, 2004.
None of these figures is carried on this report.
CMS report record 186788, read from the public cost report file SNFFY2002.zip.
Fiscal year 2001, ended December 31, 2001
Cost report for January 1, 2001 to December 31, 2001 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on April 7, 2003.
None of these figures is carried on this report.
CMS report record 139140, read from the public cost report file SNFFY2001.zip.
Fiscal year 2000, ended December 31, 2000
Cost report for January 1, 2000 to December 31, 2000 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on February 12, 2003.
None of these figures is carried on this report.
CMS report record 123809, read from the public cost report file SNFFY2000.zip.
Fiscal year 1999, ended December 31, 1999
Cost report for January 1, 1999 to December 31, 1999 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on December 18, 2000.
Net income: −$257,797 (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.
CMS report record 47844, read from the public cost report file SNFFY1999.zip.
Fiscal year 1997, ended December 31, 1997
Cost report for January 1, 1997 to December 31, 1997 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on December 23, 1998.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,203,372 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,222,424 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$19,052 | CMS-2540-96 worksheet G300000 line 500 column 100 |
Net income: −$19,052 (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 | 42 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 13,230 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 26 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 62 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 846.8 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 508.85 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 47842, read from the public cost report file SNFFY1997.zip.
Fiscal year 1996, ended December 31, 1996
Cost report for January 1, 1996 to December 31, 1996 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on April 27, 1998.
Net income: −$26,465 (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.
CMS report record 47841, 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
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
- February 20, 2009: A cost report was filed for fiscal year 2007, on form CMS-2540-96. SNFFY2007.zip
- March 12, 2008: A cost report was filed for fiscal year 2006, on form CMS-2540-96. SNFFY2006.zip
- March 22, 2007: A cost report was filed for fiscal year 2005, on form CMS-2540-96. SNFFY2005.zip
- February 21, 2006: A cost report was filed for fiscal year 2004, on form CMS-2540-96. SNFFY2004.zip
- April 16, 2005: A cost report was filed for fiscal year 2003, on form CMS-2540-96. SNFFY2003.zip
- July 16, 2004: A cost report was filed for fiscal year 2002, on form CMS-2540-96. SNFFY2002.zip
- April 7, 2003: A cost report was filed for fiscal year 2001, on form CMS-2540-96. SNFFY2001.zip
- February 12, 2003: A cost report was filed for fiscal year 2000, on form CMS-2540-96. SNFFY2000.zip
- December 18, 2000: A cost report was filed for fiscal year 1999, on form CMS-2540-96. SNFFY1999.zip
- December 23, 1998: A cost report was filed for fiscal year 1997, on form CMS-2540-96. SNFFY1997.zip
- April 27, 1998: A cost report was filed for fiscal year 1996, on form CMS-2540-96. SNFFY1996.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
One email a day naming what moved on CMS certification number 365778: the field, the value before, the value after, and the date of the file that first showed it.
The facility alert follows this one record: a cost report filed or a figure on one changed, an inspection, a deficiency or a penalty recorded, an owner added or removed. The certification number arrives filled in.
On February 20, 2009: A cost report was filed for fiscal year 2007, on form CMS-2540-96. That is one line of the alert.
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The citable document for CMS certification number 365778
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 the same state 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.
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 365778.