Skilled nursing facility · CMS certification number 525606
CRYSTAL LAKE MANOR
STRUM, Wisconsin
Download this facility’s record (CSV)
A CSV file of this facility’s record: its name and location, its Medicare cost-report finances year by year, its ownership, its inspections, deficiencies and penalties, and the Care Compare provider information — each figure with the worksheet, line and column or file it came from.
This certification number is not in CMS’s current Care Compare Provider Information file, processed on August 1, 2026.
For this facility: the citable document with full history — $295 · an email when this record changes — $99/month
Finances, as filed
From this facility’s Medicare cost reports on form CMS-2540, each figure with the worksheet, line and column it was read from.
Cost report for January 1, 2017 to November 18, 2017 — a reporting period of 321 days, on form CMS-2540-10, settled, processed by CMS on May 29, 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $1,725,439 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $1,725,439 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,079,173 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$353,734 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $4,010 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$349,724 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$422,654 (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 | 46 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 14,812 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 386 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 5,651 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 2,888 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 8,925 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 10 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 32 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 31 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 73 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 38.6 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 176.59 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 122.26 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1190401, 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 17, 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,550,707 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $2,550,707 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,457,584 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $93,123 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $7,956 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $101,079 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $7,239 (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 | 46 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 12,420 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 80 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 38.28 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 466.94 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 155.25 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1173585, 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 1, 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,658,382 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $2,658,382 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,930,684 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$272,302 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $9,540 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$262,762 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$356,602 (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 | 46 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 13,079 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 48 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 83.91 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 791.5 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 272.48 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1139174, 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 August 11, 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,311,033 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $3,311,033 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,162,187 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $148,846 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $5,847 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $154,693 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $60,853 (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 | 46 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 15,370 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 83 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 37.61 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 442.25 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 185.18 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1107387, 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 14, 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,725,961 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $2,725,961 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,761,616 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$35,655 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $8,025 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$27,630 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$27,630 (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 | 46 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 13,780 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 90 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 87.22 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 530.67 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 153.11 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1076051, 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 | $2,382,614 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $2,382,614 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,545,535 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$162,921 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,889 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$161,032 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$166,185 (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 | 46 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 12,034 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 103 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 30.73 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 228.61 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 116.83 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1046429, 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 31, 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,464,366 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $2,464,366 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,503,188 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$38,822 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $7,040 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$31,782 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$31,782 (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 | 46 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 12,843 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 91 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 36.12 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 207.24 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 141.13 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1018065, 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 8, 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,151,295 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,160,403 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$9,108 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $18,473 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $9,365 (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 | 36 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 11,069 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 76 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 38.41 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 289.29 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 145.64 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 417447, 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 12, 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,441,594 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,260,402 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $181,192 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $9,561 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $190,753 (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 | 50 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 12,935 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 92 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 38.44 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 200.82 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 140.6 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 385452, 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 July 28, 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,095,771 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,057,271 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $38,500 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $9,245 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $47,745 (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 | 50 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 13,143 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 95 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 18.59 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 325.19 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 138.35 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 352973, 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 November 21, 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,186,858 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,075,024 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $111,834 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $3,374 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $115,208 (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 | 50 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 14,791 | 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 | 15.52 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 145.01 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 328697, 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 June 9, 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,261,952 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,029,428 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $232,524 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $489 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $2,181 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $230,832 (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 | 50 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 16,203 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 57 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 79.78 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 284.26 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 312233, 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 | $2,041,816 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,793,760 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | $248,056 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $3,028 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $251,084 (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 | 50 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 14,910 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 62 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 40.69 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 240.48 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 274389, 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 June 14, 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,921,553 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,714,027 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | $207,526 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $2,153 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $1,653 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $208,026 (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 | 50 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 14,157 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 52 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 60.83 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 272.25 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 253686, read from the public cost report file SNFFY2004.zip.
Fiscal year 2003, ended June 30, 2003
Cost report for July 1, 2002 to June 30, 2003 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on December 8, 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,630,782 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,604,707 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | $26,075 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $2,460 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $28,535 (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 | 50 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 13,894 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 48 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 71.9 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 289.46 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 268260, read from the public cost report file SNFFY2002.zip.
Fiscal year 2002, ended June 30, 2002
Cost report for July 1, 2001 to June 30, 2002 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on October 28, 2004.
None of these figures is carried on this report.
CMS report record 198329, read from the public cost report file SNFFY2001.zip.
Fiscal year 2001, ended June 30, 2001
Cost report for July 1, 2000 to June 30, 2001 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on May 7, 2003.
Net income: $19,224 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
CMS report record 144126, read from the public cost report file SNFFY2000.zip.
Fiscal year 2000, ended June 30, 2000
Cost report for June 1, 2000 to June 30, 2000 — a reporting period of 29 days, not a full year, on form CMS-2540-96, settled, processed by CMS on February 12, 2003.
Net income: −$4,691 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
CMS report record 122173, read from the public cost report file SNFFY2000.zip.
Fiscal year 1999, ended June 30, 1999
Cost report for July 1, 1998 to June 30, 1999 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on April 23, 2001.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,217,368 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,259,970 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$42,602 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $39,030 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: −$3,572 (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 | 50 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 13,027 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 37 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 24.13 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 352.08 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 72877, read from the public cost report file SNFFY1998.zip.
Fiscal year 1998, ended June 30, 1998
Cost report for July 1, 1997 to June 30, 1998 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on February 13, 2003.
Net income: −$23,314 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
CMS report record 130423, 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
Not listed in CMS’s Care Compare data.
Medicare enrollment
No owner listed for this facility in CMS’s Medicare enrollment ownership data.
Changes in ownership
No change in ownership appears in CMS’s ownership data for this facility.
Recent changes on this record
- May 29, 2018: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2017.zip
- August 17, 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2016.zip
- August 1, 2016: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2015.zip
- August 11, 2015: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2014.zip
- August 14, 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
- October 31, 2012: A cost report was filed for fiscal year 2011, on form CMS-2540-10. SNF10FY2011.zip
- September 8, 2011: A cost report was filed for fiscal year 2010, on form CMS-2540-96. SNFFY2010.zip
- August 12, 2010: A cost report was filed for fiscal year 2009, on form CMS-2540-96. SNFFY2009.zip
- July 28, 2009: A cost report was filed for fiscal year 2008, on form CMS-2540-96. SNFFY2008.zip
- November 21, 2008: A cost report was filed for fiscal year 2007, on form CMS-2540-96. SNFFY2007.zip
- June 9, 2008: 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
- December 8, 2006: A cost report was filed for fiscal year 2003, on form CMS-2540-96. SNFFY2002.zip
- June 14, 2006: A cost report was filed for fiscal year 2004, on form CMS-2540-96. SNFFY2004.zip
- May 18, 2005: A cost report was filed for fiscal year 2003, on form CMS-2540-96. SNFFY2003.zip
- October 28, 2004: A cost report was filed for fiscal year 2002, on form CMS-2540-96. SNFFY2001.zip
- May 7, 2003: A cost report was filed for fiscal year 2001, on form CMS-2540-96. SNFFY2000.zip
- February 13, 2003: A cost report was filed for fiscal year 1998, on form CMS-2540-96. SNFFY1997.zip
- February 12, 2003: A cost report was filed for fiscal year 2000, on form CMS-2540-96. SNFFY2000.zip
- February 12, 2003: A cost report was filed for fiscal year 2000, on form CMS-2540-96. SNFFY1999.zip
- April 23, 2001: A cost report was filed for fiscal year 1999, on form CMS-2540-96. SNFFY1998.zip
Inspections
Not listed in CMS’s Care Compare data.
Deficiencies cited
Not listed in CMS’s Care Compare data.
Penalties
Not listed in CMS’s Care Compare data.
Care Compare provider information
Not listed in CMS’s Care Compare data.
Get an email when this record changes
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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 May 29, 2018: A cost report was filed for fiscal year 2017, on form CMS-2540-10. That is one line of the alert.
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The citable document for CRYSTAL LAKE MANOR
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.
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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 525606.