Skilled nursing facility · CMS certification number 525326
PINE CREST HEALTH AND MEMORY CARE
MERRILL, Wisconsin · Medicare and Medicaid
Certified beds, as filed in Care Compare: 120
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, 2025 to August 12, 2025 — a reporting period of 223 days, not a full year, on form CMS-2540-10, settled, processed by CMS on June 1, 2026.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,094,394 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$232,162 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,326,556 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,465,206 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,138,650 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $720,492 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$418,158 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$418,158 (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 | 120 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 26,880 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 636 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 11,931 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 3,419 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 15,986 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 28 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 7 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 8 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 43 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 22.71 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,704.43 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 371.77 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1450114, read from the public cost report file SNF10FY2025.zip.
Fiscal year 2024, ended December 31, 2024
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 | $11,901,968 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$968,931 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $12,870,899 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $14,414,467 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,543,568 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $950,679 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$592,889 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$592,889 (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 | 120 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 29,375 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 110.81 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 2,549.22 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 587.5 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1438165, 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 September 10, 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,167,701 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$447,720 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $11,615,421 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $13,687,491 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$2,072,070 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $2,576,157 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $504,087 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $504,087 (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 | 120 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 30,067 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 75 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 58.14 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 4,833.4 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 400.89 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1394431, 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 August 24, 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $91,680,958 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $34,244,285 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $57,436,673 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $91,581,081 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$34,144,408 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $37,659,166 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $3,514,758 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $3,514,758 (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 | 120 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 31,153 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 75 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 65.06 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 4,313.67 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 415.37 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1363161, 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 September 19, 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $83,078,384 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $28,124,250 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $54,954,134 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $86,806,175 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$31,852,041 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $27,667,645 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$4,184,396 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$4,184,396 (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 | 160 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 33,297 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 140 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 39.72 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,940.14 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 237.84 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1332852, 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 28, 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $85,892,983 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $29,978,269 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $55,914,714 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $89,256,280 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$33,341,566 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $29,388,633 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$3,952,933 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$3,952,933 (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 | 160 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 44,182 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 213 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 56.7 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 461.69 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 207.43 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1303378, 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 July 20, 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,837,742 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $275,256 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $11,562,486 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $16,200,144 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$4,637,658 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $2,921,169 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$1,716,489 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,720,742 (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 | 180 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 55,188 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 282 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 35.23 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,560.82 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 195.7 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1260735, 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 22, 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,999,919 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $374,911 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,625,008 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $14,962,615 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$4,337,607 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $2,944,334 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$1,393,273 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,406,612 (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 | 180 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 56,973 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 251 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 38.04 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,446.06 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 226.98 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1241820, 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 September 17, 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,315,201 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $390,074 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,925,127 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $13,710,812 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$3,785,685 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,830,708 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$1,954,977 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$2,004,971 (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 | 180 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 57,248 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 178 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 45.94 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,448.29 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 321.62 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1211328, 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 August 11, 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,335,553 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $262,837 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,072,716 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $13,241,871 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$3,169,155 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,638,089 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$1,531,066 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,538,694 (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 | 180 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 59,262 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 163 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 45.33 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,463.85 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 363.57 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1172800, 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 August 16, 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,664,087 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $378,522 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,285,565 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $12,886,794 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$2,601,229 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,961,194 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$640,035 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$651,416 (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 | 180 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 59,412 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 184 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 78.1 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,431.36 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 322.89 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1141405, 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 July 25, 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,580,713 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $305,598 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,275,115 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $12,460,499 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$2,185,384 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,699,530 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$485,854 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$494,070 (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 | 180 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 60,591 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 158 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 79.43 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 775.98 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 383.49 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1105324, 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 August 13, 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,439,565 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $338,609 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,100,956 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $12,193,014 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$2,092,058 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,665,749 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$426,309 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$426,547 (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 | 180 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 61,242 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 158 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 94.32 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 613.15 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 387.61 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1075813, 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 August 15, 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,179,420 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $264,774 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,914,646 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $12,042,496 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$2,127,850 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,974,735 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$153,115 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$154,653 (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 | 180 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 62,459 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 130 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 81.52 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,169.09 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 480.45 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1046464, 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 November 6, 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,269,441 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $91,841 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,177,600 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $12,231,562 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$2,053,962 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,545,698 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$508,264 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$508,264 (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 | 180 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 61,397 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 150 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 98.64 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 699.84 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 409.31 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1018774, 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 September 27, 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $10,001,910 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $11,898,051 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$1,896,141 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $1,585,229 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: −$310,912 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 61,818 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 146 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 109.68 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 481.97 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 423.41 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 418440, 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 August 27, 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $9,580,350 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $11,254,111 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$1,673,761 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $1,636,668 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $4,433 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$41,526 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 62,864 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 89 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 94.91 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 885.89 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 706.34 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 386631, 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 August 21, 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $9,326,341 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,953,206 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$1,626,865 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $1,311,546 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $10,833 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$326,152 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 63,271 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 93 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 61.29 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 2,591.4 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 680.33 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 355178, 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 12, 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $8,780,582 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,376,859 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$1,596,277 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $1,161,375 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: −$434,902 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 63,287 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 94 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 70.16 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,351.41 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 673.27 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 344099, 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 December 28, 2007.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $8,748,664 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,876,943 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$1,128,279 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $1,087,103 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $4,406 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$45,582 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 63,069 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 87 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 83.59 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 2,537.43 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 724.93 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 299634, read from the public cost report file SNFFY2006.zip.
Fiscal year 2005, ended December 31, 2005
Cost report for January 1, 2005 to December 31, 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on March 12, 2007.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $8,599,622 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,546,137 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$946,515 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $987,593 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $4,190 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $36,888 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 62,168 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 146 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 53.68 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,148.69 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 425.81 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 274370, read from the public cost report file SNFFY2005.zip.
Fiscal year 2004, ended December 31, 2004
Cost report for January 1, 2004 to December 31, 2004 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on March 24, 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $8,211,842 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,076,829 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$864,987 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $1,103,134 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $238,147 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 61,560 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 166 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 64.59 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,480.86 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 370.84 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 245905, 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 January 19, 2005.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $7,907,931 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,932,874 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$1,024,943 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $1,074,394 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $4,467 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $44,984 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 61,583 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 452 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 42.29 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 136.25 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 204222, read from the public cost report file SNFFY2003.zip.
Fiscal year 2002, ended December 31, 2002
Cost report for January 1, 2002 to December 31, 2002 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on December 12, 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $8,107,097 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,490,258 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$383,161 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $23,213 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $107 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$360,055 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 60,995 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 132 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 29.19 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 462.08 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 165258, read from the public cost report file SNFFY2002.zip.
Fiscal year 2001, ended December 31, 2001
Cost report for January 1, 2001 to December 31, 2001 — a reporting period of 364 days, on form CMS-2540-96, as submitted, processed by CMS on February 13, 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $7,536,256 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,892,142 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$355,886 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $125,109 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $10,507 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$241,284 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 61,225 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 74 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 73.5 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 827.36 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 125734, read from the public cost report file SNFFY2001.zip.
Fiscal year 2000, ended December 31, 2000
Cost report for January 1, 2000 to December 31, 2000 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on February 12, 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $6,895,263 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,240,344 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$345,081 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $61,505 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: −$283,576 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 59,544 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 102 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 35.5 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 583.76 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 122282, read from the public cost report file SNFFY2000.zip.
Fiscal year 1999, ended December 31, 1999
Cost report for January 1, 1999 to December 31, 1999 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on June 18, 2001.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $6,868,071 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,773,909 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | $94,162 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $21,522 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $115,684 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 61,682 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 87 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 56.14 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 708.99 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 71342, read from the public cost report file SNFFY1999.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 November 21, 2000.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $7,072,642 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,011,145 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | $61,497 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $13,512 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $75,009 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 63,322 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 98 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 96.38 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 646.14 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 71340, 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 November 12, 1999.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $6,585,063 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,760,562 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$175,499 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $15,913 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: −$159,586 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 63,698 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 61 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 261.18 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 1,044.23 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 71338, read from the public cost report file SNFFY1997.zip.
Fiscal year 1996, ended December 31, 1996
Cost report for January 1, 1996 to December 31, 1996 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on August 31, 1998.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $6,322,880 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,637,114 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$314,234 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $13,484 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | −$15 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$300,735 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 62,842 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 63 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 68.53 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 997.49 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 71337, read from the public cost report file SNFFY1996.zip.
Nurse staffing
Nurse staffing hours from the Payroll-Based Journal, quarter by quarter, are on this facility’s staffing page, each quarter with the file it came from.
Ownership, as filed with CMS
Care Compare
As filed in the CMS file dated September 1, 2026 (Care Compare ownership).
| Owner or manager | Role | Type | Ownership percentage | Association |
|---|---|---|---|---|
| ENSIGN SERVICES INC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 04/29/2025 |
| HANSON, RYAN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 08/13/2025 |
| MERRILL HEALTH HOLDINGS LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 08/13/2025 |
| SMITH, DANIEL | ADP OF THE SNF | Individual | NOT APPLICABLE | since 08/13/2025 |
| STANDARD BEARER HEALTHCARE OP, LP | ADP OF THE SNF | Organization | NOT APPLICABLE | since 12/12/2025 |
| THE ENSIGN GROUP INC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 12/12/2025 |
| BURNAM, SOON | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 04/29/2025 |
| KEETCH, CHAD | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 03/01/2011 |
| PORT, BARRY | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | Individual | NOT APPLICABLE | since 08/18/2025 |
| BURNAM, SOON | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 04/29/2025 |
| JORGENSEN, DAVID | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 04/29/2025 |
| HANSON, RYAN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 08/13/2025 |
| SMITH, DANIEL | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 08/13/2025 |
Medicare enrollment
As filed in the CMS file dated August 1, 2026 (Medicare enrollment ownership), under the enrollment of JACK PINES HEALTHCARE LLC (enrollment ID O20260203002866).
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 |
|---|---|---|---|---|---|
| GATEWAY HEALTHCARE LLC | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100 | 4/29/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| THE ENSIGN GROUP INC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100 | 4/29/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| DANIEL JOSEPH SMITH | Individual | ADP OF THE SNF | Not stated in the filing | 8/13/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| ENSIGN SERVICES INC | Organization | ADP OF THE SNF | Not stated in the filing | 4/29/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| MERRILL HEALTH HOLDINGS LLC | Organization | ADP OF THE SNF | Not stated in the filing | 8/13/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| RYAN A HANSON | Individual | ADP OF THE SNF | Not stated in the filing | 8/13/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| STANDARD BEARER HEALTHCARE OP, LP | Organization | ADP OF THE SNF | Not stated in the filing | 12/12/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| THE ENSIGN GROUP INC | Organization | ADP OF THE SNF | Not stated in the filing | 12/12/2025 | 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 | 12/12/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| SOON BURNAM | Individual | CORPORATE DIRECTOR | 0 | 4/29/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| CHAD KEETCH | Individual | CORPORATE OFFICER | Not stated in the filing | 3/1/2011 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DAVID JORGENSEN | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 4/29/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| SOON BURNAM | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 4/29/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DANIEL JOSEPH SMITH | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 8/13/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| RYAN A HANSON | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 8/13/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
Changes in ownership
- May 1, 2026: COUNTY OF LINCOLN no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: RYAN A HANSON no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: RYAN A HANSON no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: A listing under ADP OF THE SNF, with no owner named, first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since December 12, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: SOON BURNAM (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since April 29, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: SOON BURNAM (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since April 29, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: MERRILL HEALTH HOLDINGS LLC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since August 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: STANDARD BEARER HEALTHCARE OP, LP (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since December 12, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: CHAD KEETCH (CORPORATE OFFICER) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since March 1, 2011. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: DANIEL JOSEPH SMITH (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since August 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: DANIEL JOSEPH SMITH (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since August 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: GATEWAY HEALTHCARE LLC (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since April 29, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: DAVID JORGENSEN (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since April 29, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: RYAN A HANSON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since August 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: RYAN A HANSON (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since August 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: ENSIGN SERVICES INC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since April 29, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: THE ENSIGN GROUP INC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since December 12, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: THE ENSIGN GROUP INC (5% OR GREATER INDIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since April 29, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
Recent changes on this record
- June 1, 2026: A cost report was filed for fiscal year 2025, on form CMS-2540-10. SNF10FY2025.zip
- May 1, 2026: COUNTY OF LINCOLN no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: RYAN A HANSON no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: RYAN A HANSON no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: A listing under ADP OF THE SNF, with no owner named, first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since December 12, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: SOON BURNAM (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since April 29, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: SOON BURNAM (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since April 29, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: MERRILL HEALTH HOLDINGS LLC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since August 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: STANDARD BEARER HEALTHCARE OP, LP (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since December 12, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: CHAD KEETCH (CORPORATE OFFICER) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since March 1, 2011. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: DANIEL JOSEPH SMITH (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since August 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: DANIEL JOSEPH SMITH (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since August 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: GATEWAY HEALTHCARE LLC (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since April 29, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: DAVID JORGENSEN (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since April 29, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: RYAN A HANSON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since August 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: RYAN A HANSON (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since August 13, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: ENSIGN SERVICES INC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since April 29, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: THE ENSIGN GROUP INC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since December 12, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: THE ENSIGN GROUP INC (5% OR GREATER INDIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on May 1, 2026; associated with this enrollment since April 29, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- May 1, 2026: enrollment_id: O20111108000367 → O20260203002866. Skilled_Nursing_Facility_Enrollments_:_2026-05-01.csv
- August 29, 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- September 10, 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- August 24, 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- September 19, 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
- October 28, 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
- July 20, 2020: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
- August 22, 2019: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2018.zip
- September 17, 2018: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2017.zip
- August 11, 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2016.zip
- August 16, 2016: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2015.zip
- July 25, 2015: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2014.zip
- August 13, 2014: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2013.zip
- August 15, 2013: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2012.zip
- November 6, 2012: A cost report was filed for fiscal year 2011, on form CMS-2540-10. SNF10FY2011.zip
- September 27, 2011: A cost report was filed for fiscal year 2010, on form CMS-2540-96. SNFFY2010.zip
- August 27, 2010: A cost report was filed for fiscal year 2009, on form CMS-2540-96. SNFFY2009.zip
- August 21, 2009: A cost report was filed for fiscal year 2008, on form CMS-2540-96. SNFFY2008.zip
- June 12, 2009: A cost report was filed for fiscal year 2007, on form CMS-2540-96. SNFFY2007.zip
- December 28, 2007: A cost report was filed for fiscal year 2006, on form CMS-2540-96. SNFFY2006.zip
- March 12, 2007: A cost report was filed for fiscal year 2005, on form CMS-2540-96. SNFFY2005.zip
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | June 4, 2026 | June 4, 2026 | 8 | 3 |
| 2 | May 1, 2025 | May 1, 2025 | 9 | 5 |
| 3 | March 6, 2024 | March 6, 2024 | 3 | 3 |
From the Care Compare inspection summary file NH_SurveySummary_Sep2026_2.csv, processed on September 1, 2026.
Deficiencies cited
20 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| June 4, 2026 | Health | F 0627 | Resident Rights Deficiencies | Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge. | F | No | Deficient, Provider has date of correction | July 1, 2026 |
| June 4, 2026 | Health | F 0628 | Resident Rights Deficiencies | Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. | F | No | Deficient, Provider has date of correction | July 1, 2026 |
| June 4, 2026 | 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 | July 1, 2026 |
| June 4, 2026 | Health | F 0687 | Quality of Life and Care Deficiencies | Provide appropriate foot care. | E | No | Deficient, Provider has date of correction | July 1, 2026 |
| June 4, 2026 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | No | Deficient, Provider has date of correction | July 1, 2026 |
| June 4, 2026 | Health | F 0694 | Quality of Life and Care Deficiencies | Provide for the safe, appropriate administration of IV fluids for a resident when needed. | D | No | Deficient, Provider has date of correction | July 1, 2026 |
| June 4, 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. | F | No | Deficient, Provider has date of correction | July 1, 2026 |
| June 4, 2026 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | F | No | Deficient, Provider has date of correction | July 1, 2026 |
| August 27, 2025 | 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 | Yes | Deficient, Provider has date of correction | September 25, 2025 |
| June 18, 2025 | Health | F 0600 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | Yes | Deficient, Provider has date of correction | July 9, 2025 |
| May 1, 2025 | Health | F 0580 | Resident Rights Deficiencies | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | D | No | Deficient, Provider has date of correction | May 27, 2025 |
| May 1, 2025 | Health | F 0677 | Quality of Life and Care Deficiencies | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | No | Deficient, Provider has date of correction | May 27, 2025 |
| May 1, 2025 | Health | F 0697 | Quality of Life and Care Deficiencies | Provide safe, appropriate pain management for a resident who requires such services. | D | No | Deficient, Provider has date of correction | May 27, 2025 |
| May 1, 2025 | Health | F 0732 | Nursing and Physician Services Deficiencies | Post nurse staffing information every day. | C | No | Deficient, Provider has date of correction | May 27, 2025 |
| May 1, 2025 | 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 | May 27, 2025 |
| May 1, 2025 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | No | Deficient, Provider has date of correction | May 27, 2025 |
| October 14, 2024 | Health | F 0806 | Nutrition and Dietary Deficiencies | Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | D | Yes | Deficient, Provider has date of correction | November 16, 2024 |
| August 20, 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 | Yes | Deficient, Provider has date of correction | September 10, 2024 |
| March 6, 2024 | 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 | March 29, 2024 |
| March 6, 2024 | Health | F 0882 | Infection Control Deficiencies | Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. | C | No | Deficient, Provider has date of correction | March 29, 2024 |
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 - Corporation |
| Legal Business Name | JACK PINES HEALTHCARE LLC |
| Date First Approved to Provide Medicare and Medicaid Services | 1983-01-19 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | N |
| County/Parish | Lincoln |
| Telephone Number | 7155360355 |
| Chain Name | THE ENSIGN GROUP |
| Chain ID | 507 |
| 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 | 120 |
| Average Number of Residents per Day | 90.2 |
| Overall Rating | 3 |
| Health Inspection Rating | 3 |
| QM Rating | 3 |
| Long-Stay QM Rating | 3 |
| Short-Stay QM Rating | 3 |
| Processing Date | 2026-09-01 |
From the Care Compare Provider Information file NH_ProviderInfo_Sep2026_3.csv, processed on September 1, 2026.
Get an email when this record changes
One email a day naming what moved on PINE CREST HEALTH AND MEMORY CARE: 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 1, 2026: A cost report was filed for fiscal year 2025, on form CMS-2540-10. That is one line of the alert.
Following a list of facilities? The portfolio watch follows up to 100 certification numbers you name, on one subscription — on the alerts page.
The citable document for PINE CREST HEALTH AND MEMORY CARE
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 Wisconsin 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.
Other public records in Wisconsin
- POLO POINT/THE FOUNTAINS DEVEL, GREEN BAY Water discharge permit
- CITY OF MILWAUKEE, MILWAUKEE Water discharge permit
- IEIDM, STRATFORD Water discharge permit
- WAL-MART SUPERCENTER STORE, MONONA Water discharge permit
- COUNTY PROJECT 583500: COUNTY HIGHWAY U: CTH S - CTH EE, DE PERE Water discharge permit
- CULTURE PARK PROPERTY REPAIRS, GREEN BAY Water discharge permit
- GASLYN PONDS, WEBSTER Water discharge permit
- ONEIDA APPLE ORCHARDS BUILDING, HOBART Water discharge permit
- PITLIK AND WICK, INC. - CRUSHER #4, EAGLE RIVER Air emission source
- ERCO WORLDWIDE (USA) INC - PORT EDWARDS PLT, NEKOOSA Air emission source
- ANR PIPELINE CO - MARSHFIELD COMPRESSOR, MARSHFIELD Air emission source
- MATALCO WISCONSIN LLC, WISCONSIN RAPIDS Air emission source
- UNIFIRST CORP, WISCONSIN RAPIDS Air emission source
- MARSHFIELD UTILITIES COMBUSTION TURBINE, MARSHFIELD Air emission source
- ECC CORROSION INC, WISCONSIN RAPIDS Air emission source
- ND WQC LLC, WISCONSIN RAPIDS Air emission source
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 525326.