Skilled nursing facility · CMS certification number 375341
COUNTRYSIDE ESTATES
WARNER, Oklahoma · Medicare and Medicaid
Certified beds, as filed in Care Compare: 111
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: $3,145.00 · Payment denials: 0. The most recent penalty on file: October 23, 2023, Fine, $3,145. 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 May 6, 2026.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,931,480 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $10,931,480 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,477,635 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $1,453,845 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | $1,453,845 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,453,845 (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 | 111 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 40,515 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 1,497 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 20,133 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 2,148 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 23,778 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 29 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 23 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 8 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 60 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 51.62 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 875.35 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 396.3 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1448951, 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 January 8, 2026.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $14,541,074 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $14,541,074 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $12,756,350 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $1,784,724 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | $1,784,724 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,784,724 (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 patient days, all components | 26,995 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 256 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 40.89 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 122.78 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 105.45 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1446217, 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 January 7, 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,734,735 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $8,734,735 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,713,363 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $1,021,372 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | $1,021,372 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,021,372 (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 patient days, all components | 25,955 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 318 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 33.45 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 95.86 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 81.62 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1401930, 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 July 14, 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,315,612 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $8,315,612 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,437,351 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $878,261 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $419,015 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,297,276 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,297,276 (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 patient days, all components | 24,535 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 262 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 107.71 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 97.82 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 93.65 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1358331, 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 February 28, 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,607,545 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $7,607,545 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,988,928 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $618,617 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,502,615 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $2,121,232 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $2,121,232 (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 patient days, all components | 25,490 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 248 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 57.71 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 108.39 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 102.78 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1343397, 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 October 20, 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,646,933 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $7,646,933 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,294,035 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $1,352,898 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | $1,352,898 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,352,898 (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 patient days, all components | 28,634 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 273 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 42.18 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 121.64 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 104.89 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1302164, 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 February 5, 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,199,870 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $6,199,870 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,223,493 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$23,623 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | −$23,623 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$23,623 (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 patient days, all components | 27,981 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 340 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 52.83 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 91.5 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 82.3 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1279796, 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 October 18, 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,002,305 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $6,002,305 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,464,116 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $538,189 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | $538,189 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $538,189 (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 patient days, all components | 27,556 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 316 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 34.2 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 103.21 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 87.2 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1244697, 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 June 10, 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $1,095,985 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $1,095,985 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,780,680 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$4,684,695 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | −$4,684,695 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$4,684,695 (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 patient days, all components | 29,859 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 273 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 38.91 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 135.23 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 109.37 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1227409, 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 October 17, 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,464,854 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $933,626 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,531,228 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,550,149 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $981,079 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $771 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $981,850 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $981,850 (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 | 111 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 30,165 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 124 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 42.07 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 436.15 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 243.27 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1176693, 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 January 25, 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,233,184 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $67,445 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,165,739 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,852,566 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $1,313,173 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | −$3,398 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,309,775 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,309,775 (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 | 111 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 31,107 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 271 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 59.92 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 132.18 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 114.79 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1117932, 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 March 30, 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,259,471 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $86,580 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,172,891 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,322,409 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $850,482 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $53,628 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $904,110 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $904,110 (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 | 111 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 29,645 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 307 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 39.59 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 107.86 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 96.56 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1121454, 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 June 15, 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,280,260 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $720,528 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,559,732 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,866,019 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $693,713 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $5,406 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $699,119 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $699,119 (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 | 111 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 28,608 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 309 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 46.47 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 120.1 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 92.58 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1096884, 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 May 1, 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,600,935 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $42,911 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,558,024 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,532,193 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $25,831 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $30,230 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $56,061 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $56,061 (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 | 111 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 26,399 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 182 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 51.5 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 145.05 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1059091, 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 June 11, 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $5,277,955 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,200,975 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $1,076,980 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $3,183 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $1,080,163 (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 | 111 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 26,361 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 50 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 51.46 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,267.95 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 527.22 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 434819, 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 October 21, 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,950,167 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,547,256 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $402,911 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $883 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $403,794 (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 | 111 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 21,489 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 39 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 43.33 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,182.81 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 551 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 418778, 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 July 22, 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,780,818 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,810,775 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$29,957 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $854 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: −$29,103 (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 | 111 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,464 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 51 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 38.41 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 842 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 401.25 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 383153, 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 December 30, 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,925,149 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,491,424 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $433,725 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $9,901 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $443,626 (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 | 111 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 22,599 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 63 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 124.5 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 407.07 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 358.71 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 331186, 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 January 24, 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,217,089 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,150,213 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $66,876 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $17,230 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $84,106 (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 | 111 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 21,106 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 23 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 85.38 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,205.29 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 917.65 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 299815, 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 December 21, 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,066,558 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,941,670 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $124,888 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $2,845 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $127,733 (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 | 111 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 22,436 | 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 | 37.5 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,651.08 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 862.92 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 269408, 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 January 30, 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,877,286 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,657,959 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $219,327 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $11,196 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $230,523 (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 | 111 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 22,585 | 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 | 24.3 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 489.22 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 309.38 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 241742, 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, as submitted, processed by CMS on December 16, 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,558,608 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,329,895 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $228,713 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $10,523 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $239,236 (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 | 111 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 21,756 | 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 | 46.95 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 444.41 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 306.42 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 202782, 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 May 25, 2005.
None of these figures is carried on this report.
CMS report record 217993, 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 January 30, 2004.
None of these figures is carried on this report.
CMS report record 168028, 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 April 7, 2003.
None of these figures is carried on this report.
CMS report record 138914, 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 15, 2002.
Net income: $131,978 (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 93881, 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, as submitted, processed by CMS on April 14, 2000.
Net income: $112,264 (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 93880, read from the public cost report file SNFFY1998.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 |
|---|---|---|---|---|
| COUNTRYSIDE ESTATES INC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | NO PERCENTAGE PROVIDED | since 07/18/2013 |
| COUNTRYSIDE HEALTH SERVICES LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | NO PERCENTAGE PROVIDED | since 07/01/1998 |
| COUNTRYSIDE ESTATES INC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 09/15/2025 |
| COUNTRYSIDE HEALTH SERVICES LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 09/15/2025 |
| REYNOLDS, RYAN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 12/03/2025 |
| ROGERS, JACE | ADP OF THE SNF | Individual | NOT APPLICABLE | since 06/15/2025 |
| ROGERS, JOHN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 09/01/2024 |
| ROGERS, JUSTIN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 09/01/2024 |
| ROGERS, JOHN | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 09/01/2024 |
| ROGERS, JUSTIN | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 11/27/2000 |
| ROGERS, JOHN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 09/01/2024 |
Medicare enrollment
As filed in the CMS file dated August 1, 2026 (Medicare enrollment ownership), under the enrollment of COUNTRYSIDE HEALTH SERVICES LLC (enrollment ID O20050802000619).
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 |
|---|---|---|---|---|---|
| COUNTRYSIDE ESTATES INC | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100 | 7/18/2013 | Private equity company: No Real estate investment trust: No Holding company: No |
| COUNTRYSIDE HEALTH SERVICES LLC | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100 | 7/1/1998 | Private equity company: No Real estate investment trust: No Holding company: No |
| JOHN E ROGERS | Individual | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 50 | 9/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JUSTIN TODD ROGERS | Individual | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 50 | 9/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| COUNTRYSIDE ESTATES INC | Organization | ADP OF THE SNF | Not stated in the filing | 9/15/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| COUNTRYSIDE HEALTH SERVICES LLC | Organization | ADP OF THE SNF | Not stated in the filing | 9/15/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| JACE CLARK ROGERS | Individual | ADP OF THE SNF | Not stated in the filing | 6/15/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JOHN E ROGERS | Individual | ADP OF THE SNF | Not stated in the filing | 9/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JUSTIN TODD ROGERS | Individual | ADP OF THE SNF | Not stated in the filing | 9/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| RYAN REYNOLDS | Individual | ADP OF THE SNF | Not stated in the filing | 12/3/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JOHN E ROGERS | Individual | CORPORATE OFFICER | 50 | 9/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JUSTIN TODD ROGERS | Individual | CORPORATE OFFICER | 25 | 11/27/2000 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JOHN E ROGERS | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 9/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
Changes in ownership
- February 1, 2026: JACK S ROGERS no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: JACK S ROGERS no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: JACK S ROGERS no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: RYAN REYNOLDS (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since December 3, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: JOHN E ROGERS (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since September 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: JOHN E ROGERS (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since September 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: COUNTRYSIDE ESTATES INC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since September 15, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: JUSTIN TODD ROGERS (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since September 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: JACE CLARK ROGERS (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since June 15, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: COUNTRYSIDE HEALTH SERVICES LLC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since September 15, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: COUNTRYSIDE HEALTH SERVICES LLC (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since July 1, 1998. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
Recent changes on this record
- September 1, 2026: provider_name: Countryside Estates (capital letters changed). NH_ProviderInfo_Sep2026_3.csv
- July 28, 2026: A deficiency was cited under tag F 0882, scope and severity F. NH_HealthCitations_Sep2026_2.csv
- July 15, 2026: A deficiency was cited under tag F 0689, scope and severity D. NH_HealthCitations_Sep2026_2.csv
- May 6, 2026: A cost report was filed for fiscal year 2025, on form CMS-2540-10. SNF10FY2024.zip
- February 1, 2026: JACK S ROGERS no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: JACK S ROGERS no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: JACK S ROGERS no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: RYAN REYNOLDS (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since December 3, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: JOHN E ROGERS (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since September 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: JOHN E ROGERS (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since September 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: COUNTRYSIDE ESTATES INC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since September 15, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: JUSTIN TODD ROGERS (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since September 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: JACE CLARK ROGERS (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since June 15, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: COUNTRYSIDE HEALTH SERVICES LLC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since September 15, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: COUNTRYSIDE HEALTH SERVICES LLC (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since July 1, 1998. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- January 8, 2026: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2023.zip
- January 7, 2025: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2022.zip
- July 14, 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2021.zip
- February 28, 2023: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2020.zip
- October 20, 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2019.zip
- February 5, 2021: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2018.zip
- October 18, 2019: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2017.zip
- June 10, 2019: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2016.zip
- October 17, 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2015.zip
- March 30, 2016: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2013.zip
- January 25, 2016: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2014.zip
- June 15, 2015: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2012.zip
- May 1, 2014: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2011.zip
- June 11, 2013: A cost report was filed for fiscal year 2011, on form CMS-2540-96. SNFFY2010.zip
- October 21, 2011: A cost report was filed for fiscal year 2010, on form CMS-2540-96. SNFFY2009.zip
- July 22, 2010: A cost report was filed for fiscal year 2009, on form CMS-2540-96. SNFFY2008.zip
- December 30, 2008: A cost report was filed for fiscal year 2008, on form CMS-2540-96. SNFFY2007.zip
- January 24, 2008: A cost report was filed for fiscal year 2007, on form CMS-2540-96. SNFFY2006.zip
- December 21, 2006: A cost report was filed for fiscal year 2006, on form CMS-2540-96. SNFFY2005.zip
- January 30, 2006: A cost report was filed for fiscal year 2005, on form CMS-2540-96. SNFFY2004.zip
- May 25, 2005: A cost report was filed for fiscal year 2003, on form CMS-2540-96. SNFFY2002.zip
- December 16, 2004: A cost report was filed for fiscal year 2004, on form CMS-2540-96. SNFFY2003.zip
- January 30, 2004: A cost report was filed for fiscal year 2002, on form CMS-2540-96. SNFFY2001.zip
- April 7, 2003: A cost report was filed for fiscal year 2001, on form CMS-2540-96. SNFFY2000.zip
- March 15, 2002: A cost report was filed for fiscal year 2000, on form CMS-2540-96. SNFFY1999.zip
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | January 9, 2025 | January 9, 2025 | 6 | 0 |
| 2 | October 27, 2023 | October 27, 2023 | 7 | 2 |
| 3 | February 7, 2022 | February 7, 2022 | 3 | 3 |
From the Care Compare inspection summary file NH_SurveySummary_Sep2026_2.csv, processed on September 1, 2026.
Deficiencies cited
16 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| July 28, 2026 | Health | F 0882 | Infection Control Deficiencies | Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. | F | Yes | Deficient, Provider has plan of correction | August 17, 2026 |
| July 15, 2026 | 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 7, 2026 |
| January 9, 2025 | 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 | February 11, 2025 |
| January 9, 2025 | Health | F 0604 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. | E | No | Deficient, Provider has date of correction | February 11, 2025 |
| January 9, 2025 | Health | F 0656 | Resident Assessment and Care Planning Deficiencies | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | No | Deficient, Provider has date of correction | February 11, 2025 |
| January 9, 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 | No | Deficient, Provider has date of correction | February 11, 2025 |
| October 27, 2023 | Health | F 0626 | Resident Rights Deficiencies | Permit a resident to return to the nursing home after hospitalization or therapeutic leave that exceeds bed-hold policy. | D | Yes | Deficient, Provider has date of correction | December 20, 2023 |
| October 27, 2023 | Health | F 0644 | Resident Assessment and Care Planning Deficiencies | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | D | No | Deficient, Provider has date of correction | December 20, 2023 |
| October 27, 2023 | Health | F 0688 | Quality of Life and Care Deficiencies | Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | E | Yes | Deficient, Provider has date of correction | December 20, 2023 |
| October 27, 2023 | Health | F 0699 | Quality of Life and Care Deficiencies | Provide care or services that was trauma informed and/or culturally competent. | D | No | Deficient, Provider has date of correction | December 20, 2023 |
| October 27, 2023 | Health | F 0812 | Nutrition and Dietary Deficiencies | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | No | Deficient, Provider has date of correction | December 20, 2023 |
| October 27, 2023 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | E | No | Deficient, Provider has date of correction | December 20, 2023 |
| October 27, 2023 | Health | F 0909 | Environmental Deficiencies | Regularly inspect all bed frames, mattresses, and bed rails (if any) for safety; and all bed rails and mattresses must attach safely to the bed frame. | E | No | Deficient, Provider has date of correction | December 20, 2023 |
| February 7, 2022 | 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 | April 6, 2022 |
| February 7, 2022 | Health | F 0656 | Resident Assessment and Care Planning Deficiencies | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | No | Deficient, Provider has date of correction | April 6, 2022 |
| February 7, 2022 | 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. | E | No | Deficient, Provider has date of correction | April 6, 2022 |
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 |
|---|---|---|---|---|---|
| October 23, 2023 | Fine | $3,145 | 97894 |
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 | For profit - Limited Liability company |
| Legal Business Name | COUNTRYSIDE HEALTH SERVICES LLC |
| Date First Approved to Provide Medicare and Medicaid Services | 1998-07-01 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | N |
| County/Parish | Muskogee |
| Telephone Number | 9184635143 |
| 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 | 111 |
| Average Number of Residents per Day | 78.0 |
| Overall Rating | 2 |
| Health Inspection Rating | 3 |
| QM Rating | 2 |
| Long-Stay QM Rating | 1 |
| 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 COUNTRYSIDE ESTATES: 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 September 1, 2026: provider_name: Countryside Estates (capital letters changed). 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 COUNTRYSIDE ESTATES
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 Oklahoma 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 375341.