Skilled nursing facility · CMS certification number 445500
Pavilion-Ths, Llc
LEBANON, Tennessee · Medicare and Medicaid
Certified beds, as filed in Care Compare: 60
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: 0 · Fines: 0 · Fines, total amount: $0.00 · Payment denials: 0. Every penalty on file ↓
For this facility: the citable document with full history — $295 · an email when this record changes — $99/month
Finances, as filed
From this facility’s Medicare cost reports on form CMS-2540, each figure with the worksheet, line and column it was read from.
Cost report for January 1, 2024 to December 31, 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on August 29, 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,959,189 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $270,382 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,688,807 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,495,892 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $192,915 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $8,832 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $201,747 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $201,747 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 21,960 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 4,554 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 6,875 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 8,501 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 19,930 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 134 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 16 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 139 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 289 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 33.99 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 429.69 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 68.96 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1438025, read from the public cost report file SNF10FY2024.zip.
Fiscal year 2023, ended December 31, 2023
Cost report for January 1, 2023 to December 31, 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on August 19, 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,156,576 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $254,208 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,902,368 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,112,294 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$209,926 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $18,662 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$191,264 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$191,264 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,557 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 264 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 28.35 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,050.83 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 74.08 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1392510, read from the public cost report file SNF10FY2023.zip.
Fiscal year 2022, ended December 31, 2022
Cost report for January 1, 2022 to December 31, 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on September 9, 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,769,333 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $172,913 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,596,420 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,826,880 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$230,460 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $29,928 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$200,532 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$200,532 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,465 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 197 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 30.92 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 103.88 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1363930, read from the public cost report file SNF10FY2022.zip.
Fiscal year 2021, ended December 31, 2021
Cost report for January 1, 2021 to December 31, 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on July 22, 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,096,283 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $228,692 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,867,591 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,197,025 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$329,434 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $712,261 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $382,827 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $382,827 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,714 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 193 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 35.05 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 911.63 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 91.78 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1326828, read from the public cost report file SNF10FY2021.zip.
Fiscal year 2020, ended December 31, 2020
Cost report for January 1, 2020 to December 31, 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 | $6,266,982 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $341,569 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,925,413 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,155,724 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$230,311 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,337,260 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,106,949 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $991,575 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,938 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 205 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 22.69 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 712.27 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 97.26 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1302425, read from the public cost report file SNF10FY2020.zip.
Fiscal year 2019, ended December 31, 2019
Cost report for January 1, 2019 to December 31, 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on November 10, 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,687,861 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $632,778 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,055,083 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,966,492 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $88,591 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $23,966 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $112,557 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $112,557 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,168 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 328 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 23.93 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 477.5 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 61.49 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1273171, read from the public cost report file SNF10FY2019.zip.
Fiscal year 2018, ended December 31, 2018
Cost report for January 1, 2018 to December 31, 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on August 16, 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,176,501 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $139,987 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,036,514 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,741,127 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $295,387 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $75,509 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $370,896 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $370,896 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,732 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 329 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 25.79 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 663.38 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 59.98 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1241149, read from the public cost report file SNF10FY2018.zip.
Fiscal year 2017, ended December 31, 2017
Cost report for January 1, 2017 to December 31, 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on January 22, 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,632,577 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $5,632,577 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,035,822 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $596,755 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $17,381 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $614,136 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $614,136 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,329 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 292 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 27.68 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 387 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 69.62 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1249709, read from the public cost report file SNF10FY2017.zip.
Fiscal year 2016, ended December 31, 2016
Cost report for January 1, 2016 to December 31, 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on January 24, 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,371,763 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $5,371,763 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,731,251 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $640,512 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $20,383 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $660,895 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $660,895 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,460 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 291 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 26.91 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 570.73 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 70.31 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1217283, read from the public cost report file SNF10FY2016.zip.
Fiscal year 2015, ended December 31, 2015
Cost report for January 1, 2015 to December 31, 2015 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on December 15, 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,136,549 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $5,136,549 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,639,984 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $496,565 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $38,291 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $534,856 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $534,856 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,946 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 245 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 29.03 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 857.5 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 85.49 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1180432, read from the public cost report file SNF10FY2015.zip.
Fiscal year 2014, ended December 31, 2014
Cost report for January 1, 2014 to December 31, 2014 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on December 22, 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,717,013 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $4,717,013 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,156,960 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $560,053 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $84,523 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $644,576 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $644,576 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 21,309 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 175 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 29.78 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 816 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 121.77 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1149982, read from the public cost report file SNF10FY2014.zip.
Fiscal year 2013, ended December 31, 2013
Cost report for January 1, 2013 to December 31, 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on December 24, 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,442,871 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $4,442,871 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,338,857 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $104,014 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $115,512 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $219,526 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $219,526 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 21,576 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 165 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 33.79 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 668.33 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 130.76 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1116368, read from the public cost report file SNF10FY2013.zip.
Fiscal year 2012, ended December 31, 2012
Cost report for January 1, 2012 to December 31, 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on July 30, 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,334,165 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $4,334,165 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,301,738 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $32,427 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | $32,427 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $32,427 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 21,675 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 120 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 44.76 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 582.38 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 180.63 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1074276, read from the public cost report file SNF10FY2012.zip.
Fiscal year 2011, ended December 31, 2011
Cost report for December 17, 2010 to December 31, 2011 — a reporting period of 379 days, on form CMS-2540-10, settled, processed by CMS on April 19, 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $1,316,555 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $1,316,555 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,541,542 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$2,224,987 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $12,523 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$2,212,464 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$2,212,464 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,773 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 86 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 45.24 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 547.69 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 229.92 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1027309, read from the public cost report file SNF10FY2011.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 |
|---|---|---|---|---|
| PAVILION-THS, LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | 100% | since 11/19/2011 |
| BONE, HAROLD | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 08/22/2011 |
| BONE, MARGARET | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 08/22/2011 |
| L4 LIFESTYLES LLC | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | since 01/01/2019 |
| NJEZIC, JOSEPH | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 01/01/2019 |
| POUND, KEVIN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 11/19/2011 |
| STEIN & ASSOCIATES LLC | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | since 11/19/2011 |
| NJEZIC, JOSEPH | W-2 MANAGING EMPLOYEE | Individual | NOT APPLICABLE | since 11/19/2011 |
Medicare enrollment
As filed in the CMS file dated August 1, 2026 (Medicare enrollment ownership), under the enrollment of PAVILION-THS, LLC (enrollment ID O20120607000718).
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 |
|---|---|---|---|---|---|
| PAVILION-THS, LLC | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100 | 11/19/2011 | Private equity company: No Real estate investment trust: No Holding company: No |
| HAROLD GORDON BONE | Individual | CORPORATE OFFICER | Not stated in the filing | 8/22/2011 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MARGARET SUANNE BONE | Individual | CORPORATE OFFICER | Not stated in the filing | 8/22/2011 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JOSEPH NJEZIC | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 1/1/2019 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KEVIN POUND | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 11/19/2011 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| L4 LIFESTYLES LLC | Organization | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 1/1/2019 | Private equity company: No Real estate investment trust: No Holding company: No |
| STEIN & ASSOCIATES LLC | Organization | OPERATIONAL/MANAGERIAL CONTROL | 0 | 11/19/2011 | Private equity company: No Real estate investment trust: No Holding company: No |
| JOSEPH NJEZIC | Individual | W-2 MANAGING EMPLOYEE | Not stated in the filing | 11/19/2011 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
Changes in ownership
No change in ownership appears in the CMS files on record since September 20, 2022.
Recent changes on this record
- June 17, 2026: A deficiency was cited under tag F 0880, scope and severity D. NH_HealthCitations_Sep2026_2.csv
- June 17, 2026: A deficiency was cited under tag F 0695, scope and severity D. NH_HealthCitations_Sep2026_2.csv
- June 17, 2026: A deficiency was cited under tag F 0686, scope and severity D. NH_HealthCitations_Sep2026_2.csv
- June 17, 2026: An inspection was recorded in inspection cycle 1. NH_SurveySummary_Sep2026_2.csv
- August 29, 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- August 19, 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- September 9, 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- July 22, 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
- October 20, 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
- November 10, 2020: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
- January 22, 2020: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2017.zip
- August 16, 2019: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2018.zip
- January 24, 2019: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2016.zip
- December 15, 2017: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2015.zip
- December 22, 2016: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2014.zip
- December 24, 2015: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2013.zip
- July 30, 2014: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2012.zip
- April 19, 2013: A cost report was filed for fiscal year 2011, on form CMS-2540-10. SNF10FY2011.zip
- October 26, 2012: A cost report was filed for fiscal year 2011, on form CMS-2540-10. SNF10FY2011.zip
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | June 17, 2026 | June 17, 2026 | 3 | 1 |
| 2 | March 27, 2025 | March 27, 2025 | 4 | 3 |
| 3 | October 29, 2019 | October 29, 2019 | 1 | 1 |
| 3 | November 7, 2018 | November 7, 2018 | 3 | 2 |
From the Care Compare inspection summary file NH_SurveySummary_Sep2026_2.csv, processed on September 1, 2026.
Deficiencies cited
11 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| June 17, 2026 | Health | F 0686 | Quality of Life and Care Deficiencies | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | No | Deficient, Provider has date of correction | July 17, 2026 |
| June 17, 2026 | Health | F 0695 | Quality of Life and Care Deficiencies | Provide safe and appropriate respiratory care for a resident when needed. | D | No | Deficient, Provider has date of correction | July 17, 2026 |
| June 17, 2026 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | No | Deficient, Provider has date of correction | July 17, 2026 |
| March 27, 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. | D | No | Deficient, Provider has date of correction | April 21, 2025 |
| March 27, 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. | E | No | Deficient, Provider has date of correction | April 21, 2025 |
| March 27, 2025 | Health | F 0684 | Quality of Life and Care Deficiencies | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | No | Deficient, Provider has date of correction | April 21, 2025 |
| March 27, 2025 | Health | F 0921 | Environmental Deficiencies | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | D | No | Deficient, Provider has date of correction | April 21, 2025 |
| October 29, 2019 | 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. | D | No | Deficient, Provider has date of correction | November 15, 2019 |
| November 7, 2018 | Health | F 0695 | Quality of Life and Care Deficiencies | Provide safe and appropriate respiratory care for a resident when needed. | D | No | Deficient, Provider has date of correction | November 23, 2018 |
| November 7, 2018 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | No | Deficient, Provider has date of correction | November 23, 2018 |
| November 7, 2018 | Health | F 0908 | Environmental Deficiencies | Keep all essential equipment working safely. | D | No | Deficient, Provider has date of correction | November 23, 2018 |
From the Care Compare health citations file NH_HealthCitations_Sep2026_2.csv, processed on September 1, 2026.
Penalties
No penalty on file for this facility in CMS’s Care Compare penalties data.
Care Compare provider information
| Field | As filed |
|---|---|
| Provider Type | Medicare and Medicaid |
| Ownership Type | For profit - Limited Liability company |
| Legal Business Name | PAVILION-THS, LLC |
| Date First Approved to Provide Medicare and Medicaid Services | 2010-12-17 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | Y |
| County/Parish | Wilson |
| Telephone Number | 6154444343 |
| 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 | 60 |
| Average Number of Residents per Day | 56.2 |
| Overall Rating | 5 |
| Health Inspection Rating | 4 |
| QM Rating | 4 |
| Long-Stay QM Rating | 2 |
| Short-Stay QM Rating | 5 |
| 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 Pavilion-Ths, Llc: 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 June 17, 2026: A deficiency was cited under tag F 0880, scope and severity D. That is one line of the alert.
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The citable document for Pavilion-Ths, Llc
This page shows the record as it stands today. The report is the citable document: the same figures with the cell each came from, and beyond this page — five facilities of a similar size in Tennessee 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 445500.