Skilled nursing facility · CMS certification number 515021
MADISON PARK HEALTHCARE
HUNTINGTON, West Virginia · Medicare and Medicaid
Certified beds, as filed in Care Compare: 41
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 28, 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,632,957 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $525,368 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,107,589 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,611,817 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $495,772 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $40,200 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $535,972 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $535,972 (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 | 67 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 24,522 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 1,665 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 11,054 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 4,539 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 17,258 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 21 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 16 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 24 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 61 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 79.29 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 690.88 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 282.92 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1435726, 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 October 16, 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,263,354 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,137,326 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,126,028 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,341,173 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $784,855 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $95,636 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $880,491 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $880,491 (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 | 67 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,626 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 36 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 101.7 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 961.77 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 489.61 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1396446, 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 July 31, 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,905,947 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $736,023 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,169,924 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,239,057 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $930,867 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $654,200 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,585,067 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,585,067 (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 | 67 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 18,268 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 47 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 75.61 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,116.09 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 388.68 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1360469, 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 August 30, 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,463,946 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $802,536 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,661,410 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,241,063 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $420,347 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $700,307 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,120,654 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,120,654 (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 | 67 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,493 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 71 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 63.86 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 579.79 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 274.55 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1330917, 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 July 22, 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,489,490 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $853,957 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,635,533 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,260,574 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $374,959 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $179,972 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $554,931 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $554,931 (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 | 67 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 18,879 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 44 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 76 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,408.89 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 429.07 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1327360, 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 June 9, 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,164,938 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $915,809 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,249,129 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,675,376 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $573,753 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $2,734 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $576,487 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $576,487 (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 | 67 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 18,842 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 63 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 47.27 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,014.25 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 299.08 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1257265, 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 July 22, 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,857,997 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $980,697 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,877,300 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,940,849 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $936,451 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $5,282 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $941,733 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $941,733 (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 | 67 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 18,469 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 54 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 63 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 838.29 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 342.02 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1237870, 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 August 22, 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,515,740 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $818,255 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,697,485 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,260,305 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $437,180 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $2,692 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $439,872 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $439,872 (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 | 67 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 18,219 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 89 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 81.39 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 320.74 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 204.71 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1210138, 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 July 17, 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,706,790 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,323,054 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,383,736 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,866,156 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $517,580 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,320 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $518,900 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $518,900 (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 | 67 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 18,883 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 78 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 97 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 281.95 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 242.09 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1169171, read from the public cost report file SNF10FY2016.zip.
Fiscal year 2015, ended December 31, 2015
Cost report for November 1, 2015 to December 31, 2015 — a reporting period of 60 days, not a full year, on form CMS-2540-10, settled, processed by CMS on June 16, 2016.
None of these figures is carried on this report.
CMS report record 1129197, read from the public cost report file SNF10FY2016.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 April 20, 2015.
None of these figures is carried on this report.
CMS report record 1088810, 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 March 28, 2014.
None of these figures is carried on this report.
CMS report record 1057702, 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 February 25, 2013.
None of these figures is carried on this report.
CMS report record 1025145, read from the public cost report file SNF10FY2012.zip.
Fiscal year 2011, ended December 31, 2011
Cost report for January 1, 2011 to December 31, 2011 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on October 30, 2012.
None of these figures is carried on this report.
CMS report record 1017592, read from the public cost report file SNF10FY2011.zip.
Fiscal year 2010, ended December 31, 2010
Cost report for January 1, 2010 to December 31, 2010 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on May 12, 2011.
None of these figures is carried on this report.
CMS report record 399220, read from the public cost report file SNFFY2010.zip.
Fiscal year 2009, ended December 31, 2009
Cost report for January 1, 2009 to December 31, 2009 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on February 23, 2010.
None of these figures is carried on this report.
CMS report record 364389, read from the public cost report file SNFFY2009.zip.
Fiscal year 2008, ended December 31, 2008
Cost report for January 1, 2008 to December 31, 2008 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on May 7, 2009.
None of these figures is carried on this report.
CMS report record 338682, read from the public cost report file SNFFY2008.zip.
Fiscal year 2007, ended December 31, 2007
Cost report for January 1, 2007 to December 31, 2007 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on June 18, 2008.
None of these figures is carried on this report.
CMS report record 315481, read from the public cost report file SNFFY2007.zip.
Fiscal year 2006, ended December 31, 2006
Cost report for January 1, 2006 to December 31, 2006 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on May 2, 2007.
None of these figures is carried on this report.
CMS report record 277828, read from the public cost report file SNFFY2006.zip.
Fiscal year 2004, ended December 31, 2004
Cost report for January 1, 2004 to December 31, 2004 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on July 11, 2005.
None of these figures is carried on this report.
CMS report record 227062, read from the public cost report file SNFFY2004.zip.
Fiscal year 2003, ended December 31, 2003
Cost report for January 1, 2003 to December 31, 2003 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on October 15, 2004.
None of these figures is carried on this report.
CMS report record 196954, read from the public cost report file SNFFY2003.zip.
Fiscal year 2001, ended December 13, 2001
Cost report for January 1, 2001 to December 13, 2001 — a reporting period of 346 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 138142, read from the public cost report file SNFFY2001.zip.
Fiscal year 2000, ended December 31, 2000
Cost report for January 1, 2000 to December 31, 2000 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on October 10, 2001.
None of these figures is carried on this report.
CMS report record 96940, read from the public cost report file SNFFY2000.zip.
Fiscal year 1998, ended December 31, 1998
Cost report for January 1, 1998 to December 31, 1998 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on July 8, 1999.
None of these figures is carried on this report.
CMS report record 96939, read from the public cost report file SNFFY1998.zip.
Fiscal year 1997, ended December 31, 1997
Cost report for January 1, 1997 to December 31, 1997 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on May 27, 1998.
None of these figures is carried on this report.
CMS report record 96938, read from the public cost report file SNFFY1997.zip.
Nurse staffing
Nurse staffing hours from the Payroll-Based Journal, quarter by quarter, are on this facility’s staffing page, each quarter with the file it came from.
Ownership, as filed with CMS
Care Compare
As filed in the CMS file dated September 1, 2026 (Care Compare ownership).
| Owner or manager | Role | Type | Ownership percentage | Association |
|---|---|---|---|---|
| COX, CHRISTOPHER | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/01/2023 |
| KAPPEN, KATRINA | ADP OF THE SNF | Individual | NOT APPLICABLE | since 04/08/2024 |
| MATHIS, MARY-JESSE | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/03/2019 |
| MITCHELL, GREGORY | ADP OF THE SNF | Individual | NOT APPLICABLE | since 02/01/2017 |
| PINSON, CYNTHIA | ADP OF THE SNF | Individual | NOT APPLICABLE | since 06/01/2024 |
| PROVIDENCE HEALTH, LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 04/08/2021 |
| SHELTON, JASON | ADP OF THE SNF | Individual | NOT APPLICABLE | since 04/21/2025 |
| STOCKTON, EDDY | ADP OF THE SNF | Individual | NOT APPLICABLE | since 07/31/2023 |
| THE PROVIDENCE GROUPS, LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 02/01/2017 |
| TICHENOR, HOLLY | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/01/2023 |
| YOUNG, CARMEN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 04/08/2021 |
| MITCHELL, GREGORY | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 02/01/2017 |
| MPH TRUST | DIRECT OWNERSHIP INTEREST | Organization | NOT APPLICABLE | since 01/01/2023 |
| BROWN, ERVIN | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | Individual | NOT APPLICABLE | since 12/05/2025 |
| COX, GRETCHEN | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | Individual | NOT APPLICABLE | since 12/05/2025 |
| KAPPEN, KATRINA | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 04/08/2024 |
| MATHIS, MARY-JESSE | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 05/03/2019 |
| SHELTON, JASON | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 04/21/2025 |
| STOCKTON, EDDY | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 07/31/2023 |
| TICHENOR, HOLLY | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 05/01/2023 |
| COX, CHRISTOPHER | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 05/01/2023 |
| KAPPEN, KATRINA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 04/08/2024 |
| MATHIS, MARY-JESSE | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 05/03/2019 |
| MITCHELL, GREGORY | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 02/01/2017 |
| PINSON, CYNTHIA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 06/01/2024 |
| SHELTON, JASON | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 04/21/2025 |
| STOCKTON, EDDY | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 07/31/2023 |
Medicare enrollment
As filed in the CMS file dated August 1, 2026 (Medicare enrollment ownership), under the enrollment of FAIRHAVEN OPCO, LLC (enrollment ID O20151120002749).
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 |
|---|---|---|---|---|---|
| CARMEN YOUNG | Individual | ADP OF THE SNF | Not stated in the filing | 4/8/2021 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| CHRISTOPHER COX | Individual | ADP OF THE SNF | Not stated in the filing | 5/1/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| CYNTHIA Z PINSON | Individual | ADP OF THE SNF | Not stated in the filing | 6/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| EDDY R STOCKTON | Individual | ADP OF THE SNF | Not stated in the filing | 7/31/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| GREGORY J MITCHELL | Individual | ADP OF THE SNF | Not stated in the filing | 2/1/2017 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| HOLLY TICHENOR | Individual | ADP OF THE SNF | Not stated in the filing | 5/1/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JASON SHELTON | Individual | ADP OF THE SNF | Not stated in the filing | 4/21/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KATRINA KAPPEN | Individual | ADP OF THE SNF | Not stated in the filing | 4/8/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MARY-JESSE MATHIS | Individual | ADP OF THE SNF | Not stated in the filing | 5/3/2019 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| PROVIDENCE HEALTH, LLC | Organization | ADP OF THE SNF | Not stated in the filing | 4/8/2021 | Private equity company: No Real estate investment trust: No Holding company: No |
| THE PROVIDENCE GROUPS, LLC | Organization | ADP OF THE SNF | Not stated in the filing | 2/1/2017 | Private equity company: No Real estate investment trust: No Holding company: No |
| No owner named in the filing | Organization | ADP OF THE SNF | Not stated in the filing | 11/10/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| No owner named in the filing | Organization | ADP OF THE SNF | Not stated in the filing | 10/31/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| No owner named in the filing | Organization | ADP OF THE SNF | Not stated in the filing | 10/31/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| No owner named in the filing | Organization | ADP OF THE SNF | Not stated in the filing | 11/10/2025 | Private equity company: No Real estate investment trust: Yes Holding company: No |
| No owner named in the filing | Organization | ADP OF THE SNF | Not stated in the filing | 11/10/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| GREGORY J MITCHELL | Individual | CORPORATE OFFICER | 0 | 2/1/2017 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MPH TRUST | Organization | DIRECT OWNERSHIP INTEREST | 100 | 1/1/2023 | Private equity company: No Real estate investment trust: No Holding company: No |
| EDDY R STOCKTON | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 7/31/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| HOLLY TICHENOR | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 5/1/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JASON SHELTON | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 4/21/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KATRINA KAPPEN | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 4/8/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MARY-JESSE MATHIS | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 5/3/2019 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| CHRISTOPHER COX | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 5/1/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| CYNTHIA Z PINSON | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 6/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| EDDY R STOCKTON | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 7/31/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| GREGORY J MITCHELL | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 2/1/2017 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JASON SHELTON | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 4/21/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KATRINA KAPPEN | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 4/8/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MARY-JESSE MATHIS | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 5/3/2019 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
Changes in ownership
- February 1, 2026: MPH TRUST 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: DOUGLAS P COX no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: DOUGLAS P COX no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: DOUGLAS P COX no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: HOLLY TICHENOR (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since May 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: HOLLY TICHENOR (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since May 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: CYNTHIA Z PINSON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since June 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: CYNTHIA Z PINSON (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since June 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: CHRISTOPHER COX (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since May 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: CHRISTOPHER COX (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since May 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: GREGORY J MITCHELL (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since February 1, 2017. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: GREGORY J MITCHELL (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since February 1, 2017. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: GREGORY J MITCHELL (CORPORATE OFFICER) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since February 1, 2017. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: EDDY R STOCKTON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since July 31, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: EDDY R STOCKTON (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since July 31, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: EDDY R STOCKTON (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since July 31, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: MPH TRUST (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since January 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: JASON SHELTON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since April 21, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: JASON SHELTON (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since April 21, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: JASON SHELTON (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since April 21, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: PROVIDENCE HEALTH, LLC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since April 8, 2021. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: CARMEN YOUNG (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since April 8, 2021. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: KATRINA KAPPEN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since April 8, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: KATRINA KAPPEN (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since April 8, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: KATRINA KAPPEN (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since April 8, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: THE PROVIDENCE GROUPS, LLC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since February 1, 2017. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: A listing under ADP OF THE SNF, with no owner named, first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since November 10, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: MARY-JESSE MATHIS (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since May 3, 2019. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: MARY-JESSE MATHIS (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since May 3, 2019. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: MARY-JESSE MATHIS (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since May 3, 2019. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- June 15, 2023: PROVIDENCE HOLDINGS GROUP LLC no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- June 15, 2023: PROVIDENCE HOLDINGS GROUP LLC no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- June 15, 2023: MPH TRUST (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on June 15, 2023; associated with this enrollment since January 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- March 15, 2023: JENNIFER JEFFREY no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
Recent changes on this record
- February 1, 2026: MPH TRUST 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: DOUGLAS P COX no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: DOUGLAS P COX no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: DOUGLAS P COX no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: HOLLY TICHENOR (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since May 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: HOLLY TICHENOR (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since May 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: CYNTHIA Z PINSON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since June 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: CYNTHIA Z PINSON (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since June 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: CHRISTOPHER COX (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since May 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: CHRISTOPHER COX (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since May 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: GREGORY J MITCHELL (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since February 1, 2017. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: GREGORY J MITCHELL (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since February 1, 2017. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: GREGORY J MITCHELL (CORPORATE OFFICER) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since February 1, 2017. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: EDDY R STOCKTON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since July 31, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: EDDY R STOCKTON (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since July 31, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: EDDY R STOCKTON (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since July 31, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: MPH TRUST (DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since January 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: JASON SHELTON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since April 21, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: JASON SHELTON (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since April 21, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: JASON SHELTON (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since April 21, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: PROVIDENCE HEALTH, LLC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since April 8, 2021. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: CARMEN YOUNG (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since April 8, 2021. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: KATRINA KAPPEN (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since April 8, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: KATRINA KAPPEN (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since April 8, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: KATRINA KAPPEN (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since April 8, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: THE PROVIDENCE GROUPS, LLC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since February 1, 2017. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: A listing under ADP OF THE SNF, with no owner named, first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since November 10, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: MARY-JESSE MATHIS (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since May 3, 2019. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: MARY-JESSE MATHIS (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since May 3, 2019. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- February 1, 2026: MARY-JESSE MATHIS (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on February 1, 2026; associated with this enrollment since May 3, 2019. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- August 28, 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- October 16, 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- July 31, 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- June 15, 2023: PROVIDENCE HOLDINGS GROUP LLC no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- June 15, 2023: PROVIDENCE HOLDINGS GROUP LLC no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- June 15, 2023: MPH TRUST (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on June 15, 2023; associated with this enrollment since January 1, 2023. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- March 15, 2023: JENNIFER JEFFREY no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- August 30, 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
- July 22, 2022: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
- June 9, 2020: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | January 14, 2026 | January 14, 2026 | 3 | 1 |
| 2 | August 5, 2024 | August 5, 2024 | 13 | 0 |
| 3 | October 5, 2022 | October 5, 2022 | 5 | 11 |
From the Care Compare inspection summary file NH_SurveySummary_Sep2026_2.csv, processed on September 1, 2026.
Deficiencies cited
21 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| January 14, 2026 | Health | F 0550 | Resident Rights Deficiencies | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | No | Deficient, Provider has date of correction | February 6, 2026 |
| January 14, 2026 | Health | F 0812 | Nutrition and Dietary Deficiencies | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | No | Deficient, Provider has date of correction | February 6, 2026 |
| January 14, 2026 | Health | F 0842 | Resident Assessment and Care Planning Deficiencies | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | No | Deficient, Provider has date of correction | February 6, 2026 |
| August 5, 2024 | Health | F 0622 | Resident Rights Deficiencies | Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged. | E | No | Deficient, Provider has date of correction | September 4, 2024 |
| August 5, 2024 | Health | F 0623 | Resident Rights Deficiencies | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | E | No | Deficient, Provider has date of correction | September 4, 2024 |
| August 5, 2024 | Health | F 0625 | Resident Rights Deficiencies | Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave. | D | No | Deficient, Provider has date of correction | September 4, 2024 |
| August 5, 2024 | 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 | September 4, 2024 |
| August 5, 2024 | 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 | September 4, 2024 |
| August 5, 2024 | 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 | September 4, 2024 |
| August 5, 2024 | Health | F 0756 | Pharmacy Service Deficiencies | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | D | No | Deficient, Provider has date of correction | September 4, 2024 |
| August 5, 2024 | Health | F 0761 | Pharmacy Service Deficiencies | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | E | No | Deficient, Provider has date of correction | September 4, 2024 |
| August 5, 2024 | Health | F 0812 | Nutrition and Dietary Deficiencies | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | No | Deficient, Provider has date of correction | September 4, 2024 |
| August 5, 2024 | Health | F 0842 | Resident Assessment and Care Planning Deficiencies | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | No | Deficient, Provider has date of correction | September 4, 2024 |
| August 5, 2024 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | E | No | Deficient, Provider has date of correction | September 4, 2024 |
| August 5, 2024 | Health | F 0883 | Infection Control Deficiencies | Develop and implement policies and procedures for flu and pneumonia vaccinations. | D | No | Deficient, Provider has date of correction | September 4, 2024 |
| August 5, 2024 | Health | F 0919 | Environmental Deficiencies | Make sure that a working call system is available in each resident's bathroom and bathing area. | D | No | Deficient, Provider has date of correction | September 4, 2024 |
| October 5, 2022 | Health | F 0641 | Resident Assessment and Care Planning Deficiencies | Ensure each resident receives an accurate assessment. | D | No | Deficient, Provider has date of correction | November 15, 2022 |
| October 5, 2022 | 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 | November 15, 2022 |
| October 5, 2022 | Health | F 0755 | Pharmacy Service Deficiencies | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | No | Deficient, Provider has date of correction | November 15, 2022 |
| October 5, 2022 | Health | F 0761 | Pharmacy Service Deficiencies | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | No | Deficient, Provider has date of correction | November 15, 2022 |
| October 5, 2022 | Health | F 0842 | Resident Assessment and Care Planning Deficiencies | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | No | Deficient, Provider has date of correction | November 15, 2022 |
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 | FAIRHAVEN OPCO, LLC |
| Date First Approved to Provide Medicare and Medicaid Services | 1967-03-23 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | Y |
| County/Parish | Cabell |
| Telephone Number | 3045220032 |
| Provider Changed Ownership in Last 12 Months | N |
| With a Resident and Family Council | Both |
| Automatic Sprinkler Systems in All Required Areas | Yes |
| Number of Certified Beds | 41 |
| Average Number of Residents per Day | 39.7 |
| Overall Rating | 5 |
| Health Inspection Rating | 5 |
| QM Rating | 4 |
| Long-Stay QM Rating | 4 |
| Processing Date | 2026-09-01 |
From the Care Compare Provider Information file NH_ProviderInfo_Sep2026_3.csv, processed on September 1, 2026.
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On August 28, 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. That is one line of the alert.
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The citable document for MADISON PARK HEALTHCARE
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 West Virginia 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 515021.