Skilled nursing facility · CMS certification number 525676
PINE HAVEN CHRISTIAN HOME
SHEBOYGAN FALLS, 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. Its Medicare enrollment, PINE HAVEN CHRISTIAN HOME INC (enrollment ID O20040406001276), is not listed in the CMS enrollment file dated 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 July 1, 2022 to April 23, 2023 — a reporting period of 296 days, not a full year, on form CMS-2540-10, settled, processed by CMS on September 19, 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,011,288 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $671,071 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,340,217 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,572,696 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$2,232,479 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $24,566 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$2,207,913 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$2,207,917 (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 | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 14,850 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 226 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 1,589 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 4,451 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 6,266 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 13 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 27 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 58 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 98 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 17.38 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 58.85 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 63.94 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1364991, read from the public cost report file SNF10FY2022.zip.
Fiscal year 2022, ended June 30, 2022
Cost report for July 1, 2021 to June 30, 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on December 14, 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,774,894 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,008,888 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,766,006 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,543,948 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,777,942 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $50,181 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$1,727,761 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,727,761 (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 | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 12,581 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 219 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 10.08 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 622.75 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 57.45 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1338249, read from the public cost report file SNF10FY2021.zip.
Fiscal year 2021, ended June 30, 2021
Cost report for July 1, 2020 to June 30, 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on January 25, 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,892,451 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,172,067 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,720,384 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,223,400 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,503,016 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $10,420 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$1,492,596 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,492,596 (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 | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 13,143 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 249 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 27.33 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 329.21 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 52.78 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1309353, read from the public cost report file SNF10FY2020.zip.
Fiscal year 2020, ended June 30, 2020
Cost report for July 1, 2019 to June 30, 2020 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on January 19, 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,480,853 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,463,895 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,016,958 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,660,183 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$643,225 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $5,811 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$637,414 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$637,414 (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 | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 15,096 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 226 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 27.48 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 264.57 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 66.8 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1278636, read from the public cost report file SNF10FY2019.zip.
Fiscal year 2019, ended June 30, 2019
Cost report for July 1, 2018 to June 30, 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on January 16, 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,877,532 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,130,812 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,746,720 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,437,210 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$690,490 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $5,365 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$685,125 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$685,125 (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 | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 15,173 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 148 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 25.5 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 614.85 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 102.52 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1249387, read from the public cost report file SNF10FY2018.zip.
Fiscal year 2018, ended June 30, 2018
Cost report for July 1, 2017 to June 30, 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on December 20, 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,948,179 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,471,885 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,476,294 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $17,712,454 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$12,236,160 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $13,014,920 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $778,760 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $778,760 (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 | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,303 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 173 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 37.22 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 224.42 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 100.02 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1216707, read from the public cost report file SNF10FY2017.zip.
Fiscal year 2017, ended June 30, 2017
Cost report for July 1, 2016 to June 30, 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on January 18, 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,769,923 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,686,377 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,083,546 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $16,702,193 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$11,618,647 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $12,403,626 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $784,979 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $784,979 (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 | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,514 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 205 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 34.64 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 306.84 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 80.56 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1182372, read from the public cost report file SNF10FY2016.zip.
Fiscal year 2016, ended June 30, 2016
Cost report for July 1, 2015 to June 30, 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on February 17, 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,039,222 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,730,847 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,308,375 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $16,695,452 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$11,387,077 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $12,384,726 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $997,649 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $857,033 (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 | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,128 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 189 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 38.7 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 355.38 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 90.62 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1153144, read from the public cost report file SNF10FY2015.zip.
Fiscal year 2015, ended June 30, 2015
Cost report for July 1, 2014 to June 30, 2015 — a reporting period of 364 days, on form CMS-2540-10, as submitted, processed by CMS on December 18, 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,070,221 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,340,010 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,730,211 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $13,285,120 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$8,554,909 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $10,020,578 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,465,669 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,465,669 (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 | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,268 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 108 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 36.49 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 691.62 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 159.89 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1115740, read from the public cost report file SNF10FY2014.zip.
Fiscal year 2014, ended June 30, 2014
Cost report for July 1, 2013 to June 30, 2014 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on February 10, 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,041,867 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $623,962 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,417,905 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $12,206,052 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$7,788,147 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $9,288,046 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,499,899 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,499,899 (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 | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,359 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 68 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 48.03 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,276.56 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 255.28 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1085678, read from the public cost report file SNF10FY2013.zip.
Fiscal year 2013, ended June 30, 2013
Cost report for July 1, 2012 to June 30, 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on May 19, 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,789,223 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $479,935 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,309,288 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $11,369,481 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$7,060,193 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $9,091,967 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $2,031,774 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $2,031,774 (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 | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,290 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 87 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 44.87 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 729.13 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 198.74 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1090909, read from the public cost report file SNF10FY2012.zip.
Fiscal year 2012, ended June 30, 2012
Cost report for July 1, 2011 to June 30, 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on January 24, 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,706,860 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $456,396 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,250,464 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,903,137 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$6,652,673 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $8,208,944 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,556,271 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,556,271 (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 | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,264 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 70 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 66.65 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 794.62 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 246.63 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1023911, read from the public cost report file SNF10FY2011.zip.
Fiscal year 2011, ended June 30, 2011
Cost report for July 1, 2010 to June 30, 2011 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on February 9, 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,674,365 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,016,178 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$6,341,813 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $7,592,959 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $1,251,146 (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 | 16,873 | 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 | 41.67 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 3,620.33 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 324.48 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 424534, read from the public cost report file SNFFY2010.zip.
Fiscal year 2010, ended June 30, 2010
Cost report for July 1, 2009 to June 30, 2010 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on January 26, 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,430,960 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,564,213 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$6,133,253 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $6,474,887 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $45,308 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $296,326 (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 | 17,795 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 58 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 31.71 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,244.1 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 306.81 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 393216, read from the public cost report file SNFFY2009.zip.
Fiscal year 2009, ended June 30, 2009
Cost report for July 1, 2008 to June 30, 2009 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on January 13, 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,333,862 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,169,904 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$5,836,042 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $5,903,084 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $120,783 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$53,741 (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 | 59 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 23,555 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 51 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 102.6 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,073.71 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 461.86 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 362210, read from the public cost report file SNFFY2008.zip.
Fiscal year 2008, ended June 30, 2008
Cost report for July 1, 2007 to June 30, 2008 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on May 28, 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,385,140 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,380,457 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$4,995,317 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $4,755,813 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $60,038 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$299,542 (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 | 71 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 25,424 | 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 | 77.7 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 905.33 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 410.06 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 340728, read from the public cost report file SNFFY2007.zip.
Fiscal year 2007, ended June 30, 2007
Cost report for July 1, 2006 to June 30, 2007 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on September 22, 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,201,921 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,108,838 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$3,906,917 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $4,180,626 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $273,709 (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 | 71 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 25,512 | 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 | 80.94 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 647.72 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 411.48 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 326059, read from the public cost report file SNFFY2006.zip.
Fiscal year 2006, ended June 30, 2006
Cost report for July 1, 2005 to June 30, 2006 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on August 27, 2007.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $7,728,397 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,458,722 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | $269,675 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $221,841 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $51,148 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $440,368 (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 | 71 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 25,473 | 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 | 102.67 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 502.62 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 410.85 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 292795, read from the public cost report file SNFFY2005.zip.
Fiscal year 2005, ended June 30, 2005
Cost report for October 1, 2004 to June 30, 2005 — a reporting period of 272 days, not a full year, on form CMS-2540-96, settled, processed by CMS on August 9, 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $6,913,332 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,595,417 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | $317,915 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $95,621 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $413,536 (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 | 71 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 25,499 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 36 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 132.33 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 824.1 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 708.31 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 260845, read from the public cost report file SNFFY2005.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
- September 15, 2023: MARY HUENINK no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: ROBERT NYHUIS no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: DARRELL HAUSE no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: CURTIS WAYNE HANCOCK no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: TIM GORTER no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: WISCONSIN BANK AND TRUST no longer appears as 5% OR GREATER MORTGAGE INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: ROBERT CALJOUW no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: RONALD WALVOORT no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: RONALD WALVOORT no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: JERITH BUTEYN-GIER no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: DENNIS BEACH no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: VIRGIL NAVIS no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: SHANNON M OTTEN no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: JACK HOFFMAN no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: NORENE HUIBREGTSE no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: LINDA EVRAETS no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: KEVIN VELDHORST no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: BRENDA LAMMERS no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
Recent changes on this record
- September 19, 2023: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2022.zip
- September 15, 2023: MARY HUENINK no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: ROBERT NYHUIS no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: DARRELL HAUSE no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: CURTIS WAYNE HANCOCK no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: TIM GORTER no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: WISCONSIN BANK AND TRUST no longer appears as 5% OR GREATER MORTGAGE INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: ROBERT CALJOUW no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: RONALD WALVOORT no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: RONALD WALVOORT no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: JERITH BUTEYN-GIER no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: DENNIS BEACH no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: VIRGIL NAVIS no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: SHANNON M OTTEN no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: JACK HOFFMAN no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: NORENE HUIBREGTSE no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: LINDA EVRAETS no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: KEVIN VELDHORST no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- September 15, 2023: BRENDA LAMMERS no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- December 14, 2022: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2021.zip
- January 25, 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2020.zip
- January 19, 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2019.zip
- January 16, 2020: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2018.zip
- December 20, 2018: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2017.zip
- January 18, 2018: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2016.zip
- February 17, 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2015.zip
- December 18, 2015: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2014.zip
- May 19, 2015: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2012.zip
- February 10, 2015: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2013.zip
- January 24, 2013: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2011.zip
- February 9, 2012: A cost report was filed for fiscal year 2011, on form CMS-2540-96. SNFFY2010.zip
- January 26, 2011: A cost report was filed for fiscal year 2010, on form CMS-2540-96. SNFFY2009.zip
- January 13, 2010: A cost report was filed for fiscal year 2009, on form CMS-2540-96. SNFFY2008.zip
- May 28, 2009: A cost report was filed for fiscal year 2008, on form CMS-2540-96. SNFFY2007.zip
- September 22, 2008: A cost report was filed for fiscal year 2007, on form CMS-2540-96. SNFFY2006.zip
- August 27, 2007: A cost report was filed for fiscal year 2006, on form CMS-2540-96. SNFFY2005.zip
- August 9, 2006: A cost report was filed for fiscal year 2005, on form CMS-2540-96. SNFFY2005.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
One email a day naming what moved on PINE HAVEN CHRISTIAN HOME: the field, the value before, the value after, and the date of the file that first showed it.
The facility alert follows this one record: a cost report filed or a figure on one changed, an inspection, a deficiency or a penalty recorded, an owner added or removed. The certification number arrives filled in.
On September 19, 2023: A cost report was filed for fiscal year 2023, on form CMS-2540-10. That is one line of the alert.
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The citable document for PINE HAVEN CHRISTIAN HOME
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 525676.