Skilled nursing facility · CMS certification number 555710
TICE VALLEY POST ACUTE
WALNUT CREEK, California · 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 February 1, 2024 to December 31, 2024 — a reporting period of 334 days, on form CMS-2540-10, settled, processed by CMS on May 6, 2026.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $41,521,899 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $19,243,763 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $22,278,136 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $20,454,916 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $1,823,220 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $3,699 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,826,919 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,826,919 (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 | 40,200 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 4,885 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 1,886 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 31,399 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 38,170 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 131 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 11 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 437 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 579 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 37.29 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 171.45 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 65.92 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1448929, read from the public cost report file SNF10FY2024.zip.
Fiscal year 2023, ended May 31, 2023
Cost report for June 1, 2022 to May 31, 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on November 30, 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $24,247,692 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $4,819,164 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $19,428,528 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $23,183,778 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$3,755,250 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $107,747 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$3,647,503 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$3,647,503 (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 | 39,586 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 1,014 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 18.9 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 96.06 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 39.04 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1369065, read from the public cost report file SNF10FY2022.zip.
Fiscal year 2022, ended May 31, 2022
Cost report for June 1, 2021 to May 31, 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on October 28, 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $22,698,809 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $4,367,913 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $18,330,896 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $23,329,562 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$4,998,666 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $11,453 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$4,987,213 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$4,987,213 (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 | 37,819 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 899 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 23.24 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 101.03 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 42.07 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1335887, read from the public cost report file SNF10FY2021.zip.
Fiscal year 2021, ended May 31, 2021
Cost report for June 1, 2020 to May 31, 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on December 10, 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $18,400,020 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $3,652,073 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $14,747,947 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $18,856,753 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$4,108,806 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $299,955 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$3,808,851 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$3,808,851 (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 | 31,293 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 749 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 30.45 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 103.89 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 41.78 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1306905, read from the public cost report file SNF10FY2020.zip.
Fiscal year 2020, ended May 31, 2020
Cost report for June 1, 2019 to May 31, 2020 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on December 17, 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $23,814,160 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $5,891,740 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $17,922,420 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $18,701,464 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$779,044 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $754,572 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$24,472 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$24,472 (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 | 39,113 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 1,242 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 22.7 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 107.32 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 31.49 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1276705, read from the public cost report file SNF10FY2019.zip.
Fiscal year 2019, ended May 31, 2019
Cost report for June 1, 2018 to May 31, 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on November 21, 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $26,637,576 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $7,323,112 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $19,314,464 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $19,698,696 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$384,232 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $25,543 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$358,689 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$358,689 (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 | 39,950 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 1,567 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 15.84 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 116.69 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 25.49 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1246011, read from the public cost report file SNF10FY2018.zip.
Fiscal year 2018, ended May 31, 2018
Cost report for June 1, 2017 to May 31, 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on November 29, 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $26,370,120 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $7,278,933 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $19,091,187 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $20,685,143 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,593,956 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $23,246 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$1,570,710 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,570,710 (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 | 39,450 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 1,546 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 17.72 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 109.99 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 25.52 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1214579, read from the public cost report file SNF10FY2017.zip.
Fiscal year 2017, ended May 31, 2017
Cost report for June 1, 2016 to May 31, 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on November 9, 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $26,846,415 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $7,823,276 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $19,023,139 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $20,015,215 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$992,076 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $26,721 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$965,355 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$965,355 (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 | 39,238 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 1,528 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 20.09 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 157.17 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 25.68 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1178126, read from the public cost report file SNF10FY2016.zip.
Fiscal year 2016, ended May 31, 2016
Cost report for June 1, 2015 to May 31, 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on February 9, 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $26,619,276 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $7,844,997 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $18,774,279 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $19,590,354 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$816,075 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $22,649 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$793,426 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$793,426 (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 | 38,787 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 1,532 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 22.17 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 156.45 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 25.32 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1152614, read from the public cost report file SNF10FY2015.zip.
Fiscal year 2015, ended May 31, 2015
Cost report for June 1, 2014 to May 31, 2015 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on September 30, 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $26,440,242 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $7,319,547 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $19,120,695 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $18,759,592 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $361,103 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $32,535 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $393,638 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $393,638 (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 | 40,143 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 1,407 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 26.56 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 156.96 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 28.53 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1143805, read from the public cost report file SNF10FY2014.zip.
Fiscal year 2014, ended May 31, 2014
Cost report for June 1, 2013 to May 31, 2014 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on December 4, 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $28,745,061 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $8,658,684 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $20,086,377 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $19,455,742 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $630,635 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $27,983 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $658,618 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $658,618 (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 | 39,974 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 1,691 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 25.33 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 203.89 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 23.64 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1081683, read from the public cost report file SNF10FY2013.zip.
Fiscal year 2013, ended May 31, 2013
Cost report for June 1, 2012 to May 31, 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on May 29, 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $26,605,618 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $6,871,203 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $19,734,415 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $19,777,681 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$43,266 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $27,800 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$15,466 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$15,466 (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 | 40,419 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 1,789 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 22.52 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 167.61 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 22.59 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1061192, read from the public cost report file SNF10FY2012.zip.
Fiscal year 2012, ended May 31, 2012
Cost report for June 1, 2011 to May 31, 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on August 29, 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $25,628,726 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $5,742,340 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $19,886,386 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $18,616,854 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $1,269,532 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $34,832 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,304,364 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,304,364 (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 | 39,792 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 1,700 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 26.66 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 173.02 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 23.41 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1047558, read from the public cost report file SNF10FY2011.zip.
Fiscal year 2011, ended May 31, 2011
Cost report for June 1, 2010 to May 31, 2011 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on December 21, 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $19,966,100 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $18,575,664 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $1,390,436 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $44,707 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $1,435,143 (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 | 120 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 39,894 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 1,569 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 25.85 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 445.74 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 25.43 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 422412, read from the public cost report file SNFFY2010.zip.
Fiscal year 2010, ended May 31, 2010
Cost report for June 1, 2009 to May 31, 2010 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on December 22, 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $19,163,551 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $17,865,103 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $1,298,448 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $52,424 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $1,350,872 (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 | 120 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 40,797 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 1,265 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 34.79 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 535.53 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 32.25 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 391672, read from the public cost report file SNFFY2009.zip.
Fiscal year 2009, ended May 31, 2009
Cost report for June 1, 2008 to May 31, 2009 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on December 23, 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $17,460,713 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $16,078,161 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $1,382,552 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $48,085 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $1,430,637 (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 | 120 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 40,186 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 1,192 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 30.78 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 739.5 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 33.71 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 361628, read from the public cost report file SNFFY2008.zip.
Fiscal year 2008, ended May 31, 2008
Cost report for December 21, 2007 to May 31, 2008 — a reporting period of 162 days, not a full year, on form CMS-2540-96, settled, processed by CMS on December 18, 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $7,196,248 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,825,748 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $370,500 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $21,145 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $54 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $391,591 (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 | 120 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 17,813 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 390 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 30.05 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 208.58 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 45.67 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 330609, read from the public cost report file SNFFY2008.zip.
Fiscal year 2007, ended December 20, 2007
Cost report for June 1, 2007 to December 20, 2007 — a reporting period of 202 days, not a full year, on form CMS-2540-96, settled, processed by CMS on September 12, 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $8,059,742 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,885,409 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $174,333 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $22,431 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $196,764 (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 | 120 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 21,633 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 424 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 26.34 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 273.9 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 51.02 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 325774, read from the public cost report file SNFFY2007.zip.
Fiscal year 2006, ended May 31, 2006
Cost report for June 1, 2005 to May 31, 2006 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on August 30, 2007.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $12,208,600 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $12,013,174 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $195,426 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $48,828 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $244,254 (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 | 120 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 37,694 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 590 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 29.99 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 385.89 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 63.89 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 293107, read from the public cost report file SNFFY2005.zip.
Fiscal year 2005, ended May 31, 2005
Cost report for June 1, 2004 to May 31, 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on August 17, 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $11,144,262 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,966,339 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $177,923 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $63,927 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $241,850 (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 | 120 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 40,939 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 537 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 24.49 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 463.85 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 76.24 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 261416, read from the public cost report file SNFFY2004.zip.
Fiscal year 2004, ended May 31, 2004
Cost report for June 1, 2003 to May 31, 2004 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on May 3, 2005.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $9,740,131 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,396,021 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $344,110 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $72,667 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $416,777 (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 | 120 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 38,372 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 391 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 30.26 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 766.92 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 98.14 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 215691, read from the public cost report file SNFFY2003.zip.
Fiscal year 2003, ended May 31, 2003
Cost report for June 1, 2002 to May 31, 2003 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on September 24, 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $9,155,044 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,348,500 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $806,544 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $79,150 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $885,694 (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 | 120 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 37,931 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 339 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 30.24 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 664.6 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 111.89 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 195798, read from the public cost report file SNFFY2002.zip.
Fiscal year 2002, ended May 31, 2002
Cost report for June 1, 2001 to May 31, 2002 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on October 28, 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $8,201,101 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,110,000 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $91,101 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $76,874 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $167,975 (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 | 120 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 35,953 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 248 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 35.87 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 721.3 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 144.97 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 161867, read from the public cost report file SNFFY2001.zip.
Fiscal year 2001, ended May 31, 2001
Cost report for January 1, 2001 to May 31, 2001 — a reporting period of 150 days, not a full year, on form CMS-2540-96, settled, processed by CMS on April 3, 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,475,662 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,916,232 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $559,430 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $36,127 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $75,947 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $519,610 (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 | 120 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 15,809 | 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 | 36.64 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 2,872 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 154.99 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 134256, read from the public cost report file SNFFY2001.zip.
Fiscal year 2000, ended December 31, 2000
Cost report for June 1, 2000 to December 31, 2000 — a reporting period of 213 days, not a full year, on form CMS-2540-96, settled, processed by CMS on February 28, 2002.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,216,090 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,733,919 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $482,171 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $50,235 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $79,551 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $452,855 (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 | 120 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 21,960 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 139 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 33.08 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 157.99 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 98802, read from the public cost report file SNFFY2000.zip.
Fiscal year 1999, ended May 31, 1999
Cost report for June 1, 1998 to May 31, 1999 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on October 16, 2000.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $6,023,308 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,173,363 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $849,945 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $80,980 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $1,943 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: $928,982 (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 | 120 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 30,298 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 424 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 16.74 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 301.5 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 71.46 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 98798, read from the public cost report file SNFFY1998.zip.
Fiscal year 1998, ended May 31, 1998
Cost report for August 7, 1997 to May 31, 1998 — a reporting period of 297 days, not a full year, on form CMS-2540-96, settled, processed by CMS on November 12, 1999.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,881,259 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,100,926 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$219,667 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $110,694 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: −$108,973 (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 | 120 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 18,742 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 210 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 25.8 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 89.25 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 98796, read from the public cost report file SNFFY1997.zip.
Nurse staffing
Nurse staffing hours from the Payroll-Based Journal, quarter by quarter, are on this facility’s staffing page, each quarter with the file it came from.
Ownership, as filed with CMS
Care Compare
As filed in the CMS file dated September 1, 2026 (Care Compare ownership).
| Owner or manager | Role | Type | Ownership percentage | Association |
|---|---|---|---|---|
| TRUIST BANK | 5% OR GREATER MORTGAGE INTEREST | Organization | NOT APPLICABLE | since 12/07/2023 |
| LONDONO, ADRIANO | ADP OF THE SNF | Individual | NOT APPLICABLE | since 08/03/2025 |
| OYLER, ABRAHAM | ADP OF THE SNF | Individual | NOT APPLICABLE | since 12/05/2025 |
| PATEL, ASHISH | ADP OF THE SNF | Individual | NOT APPLICABLE | since 12/05/2025 |
| PROVIDENCE ADMINISTRATIVE CONSULTING SERVICES INC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 02/01/2024 |
| JERGENSEN, JOSHUA | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 02/01/2024 |
| LONDONO, ADRIANO | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 08/03/2025 |
| MITCHELL, JOHN | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 02/01/2024 |
| PATEL, ASHISH | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 01/01/2025 |
| JERGENSEN, JOSHUA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 01/01/2024 |
| LONDONO, ADRIANO | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 08/03/2025 |
| MITCHELL, JOHN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 01/01/2024 |
| OYLER, ABRAHAM | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 02/01/2025 |
| PATEL, ASHISH | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 04/01/2024 |
Medicare enrollment
As filed in the CMS file dated August 1, 2026 (Medicare enrollment ownership), under the enrollment of TICE VALLEY COMMUNITY HEALTHCARE LLC (enrollment ID O20240409004396).
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 |
|---|---|---|---|---|---|
| PROVIDENCE GROUP NH, LLC | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100 | 2/1/2024 | Private equity company: No Real estate investment trust: No Holding company: Yes |
| JASON H MURRAY | Individual | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 35.2 | 2/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MARK D HANCOCK | Individual | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 35.2 | 2/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| PACS GROUP, INC. | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100 | 2/1/2024 | Private equity company: No Real estate investment trust: No Holding company: No |
| PACS HOLDINGS, LLC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100 | 2/1/2024 | Private equity company: No Real estate investment trust: No Holding company: Yes |
| TRUIST BANK | Organization | 5% OR GREATER MORTGAGE INTEREST | 100 | 12/7/2023 | Private equity company: No Real estate investment trust: No Holding company: No |
| ABRAHAM OYLER | Individual | ADP OF THE SNF | Not stated in the filing | 12/5/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| ADRIANO LONDONO | Individual | ADP OF THE SNF | Not stated in the filing | 8/3/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| ASHISH PATEL | Individual | ADP OF THE SNF | Not stated in the filing | 12/5/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| PROVIDENCE ADMINISTRATIVE CONSULTING SERVICES INC | Organization | ADP OF THE SNF | Not stated in the filing | 2/1/2024 | 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 | 7/28/2023 | Private equity company: No Real estate investment trust: No Holding company: No |
| ADRIANO LONDONO | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 8/3/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| ASHISH PATEL | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 1/1/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JOHN T MITCHELL | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 2/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JOSHUA O JERGENSEN | Individual | MANAGING CONTROL - GOVERNING BODY | Not stated in the filing | 2/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| ABRAHAM OYLER | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 2/1/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| ADRIANO LONDONO | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 8/3/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| ASHISH PATEL | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 4/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JOHN T MITCHELL | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 1/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JOSHUA O JERGENSEN | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 1/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
Changes in ownership
- January 1, 2026: PROMEDICA HEALTH SYSTEM, INC no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: DAMIAN RODGERS no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: HCR III HEALTHCARE, LLC no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: MAGGIE YOUSSEF no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: TIMOTHY ROBERTS no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: HCR MANORCARE, INC. no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: ANDREA SYPE no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: HCR II HEALTHCARE, LLC no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: HCR IV HEALTHCARE, LLC no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: KATHRYN H HOOPS no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: LUKE PILE no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: DEAN SHIPMAN no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: HCR HEALTHCARE, LLC no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: HCR MANOR CARE SERVICES LLC no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: MARTIN D ALLEN no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: MARTIN D ALLEN no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: ABRAHAM OYLER appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: ABRAHAM OYLER (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since February 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: MARK D HANCOCK (5% OR GREATER INDIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since February 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: PACS GROUP, INC. (5% OR GREATER INDIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since February 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: ASHISH PATEL appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: ASHISH PATEL (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since January 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: ASHISH PATEL (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since April 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: ADRIANO LONDONO (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since August 3, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: ADRIANO LONDONO (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since August 3, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: ADRIANO LONDONO (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since August 3, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: JOSHUA O JERGENSEN (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since February 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: JOSHUA O JERGENSEN (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since January 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: TRUIST BANK (5% OR GREATER MORTGAGE INTEREST) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since December 7, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: A listing under ADP OF THE SNF, with no owner named, first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since July 28, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: PROVIDENCE ADMINISTRATIVE CONSULTING SERVICES INC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since February 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: PACS HOLDINGS, LLC (5% OR GREATER INDIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since February 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: PROVIDENCE GROUP NH, LLC (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since February 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: JOHN T MITCHELL (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since February 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: JOHN T MITCHELL (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since January 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: JASON H MURRAY (5% OR GREATER INDIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since February 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- December 1, 2023: ROBERT SHARON no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-12-01.csv
- December 1, 2023: RAMI UBAYDI no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-12-01.csv
- December 1, 2023: THOMAS R KILE no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-12-01.csv
- December 1, 2023: TIMOTHY ROBERTS (OFFICER) first listed in CMS’s Medicare enrollment ownership file on December 1, 2023; associated with this enrollment since August 31, 2021. Skilled_Nursing_Facility_All_Owners_:_2023-12-01.csv
- December 1, 2023: LUKE PILE (OFFICER) first listed in CMS’s Medicare enrollment ownership file on December 1, 2023; associated with this enrollment since January 31, 2021. Skilled_Nursing_Facility_All_Owners_:_2023-12-01.csv
Recent changes on this record
- May 6, 2026: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- February 19, 2026: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2023.zip
- January 1, 2026: PROMEDICA HEALTH SYSTEM, INC no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: DAMIAN RODGERS no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: HCR III HEALTHCARE, LLC no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: MAGGIE YOUSSEF no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: TIMOTHY ROBERTS no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: HCR MANORCARE, INC. no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: ANDREA SYPE no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: HCR II HEALTHCARE, LLC no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: HCR IV HEALTHCARE, LLC no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: KATHRYN H HOOPS no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: LUKE PILE no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: DEAN SHIPMAN no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: HCR HEALTHCARE, LLC no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: HCR MANOR CARE SERVICES LLC no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: MARTIN D ALLEN no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: MARTIN D ALLEN no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: ABRAHAM OYLER appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: ABRAHAM OYLER (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since February 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: MARK D HANCOCK (5% OR GREATER INDIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since February 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: PACS GROUP, INC. (5% OR GREATER INDIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since February 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: ASHISH PATEL appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: ASHISH PATEL (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since January 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: ASHISH PATEL (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since April 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: ADRIANO LONDONO (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since August 3, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: ADRIANO LONDONO (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since August 3, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: ADRIANO LONDONO (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since August 3, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: JOSHUA O JERGENSEN (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since February 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: JOSHUA O JERGENSEN (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since January 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: TRUIST BANK (5% OR GREATER MORTGAGE INTEREST) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since December 7, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: A listing under ADP OF THE SNF, with no owner named, first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since July 28, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: PROVIDENCE ADMINISTRATIVE CONSULTING SERVICES INC (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since February 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: PACS HOLDINGS, LLC (5% OR GREATER INDIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since February 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: PROVIDENCE GROUP NH, LLC (5% OR GREATER DIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since February 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: JOHN T MITCHELL (MANAGING CONTROL - GOVERNING BODY) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since February 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: JOHN T MITCHELL (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since January 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: JASON H MURRAY (5% OR GREATER INDIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on January 1, 2026; associated with this enrollment since February 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- January 1, 2026: enrollment_id: O20080218000740 → O20240409004396. Skilled_Nursing_Facility_Enrollments_:_2026-01-01.csv
- December 1, 2023: ROBERT SHARON no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-12-01.csv
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | December 11, 2025 | December 11, 2025 | 8 | 6 |
| 2 | June 20, 2024 | June 20, 2024 | 6 | 12 |
| 3 | March 4, 2022 | March 4, 2022 | 12 | 3 |
From the Care Compare inspection summary file NH_SurveySummary_Sep2026_2.csv, processed on September 1, 2026.
Deficiencies cited
28 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| June 17, 2026 | Health | F 0755 | Pharmacy Service Deficiencies | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | Yes | Deficient, Provider has date of correction | July 15, 2026 |
| June 17, 2026 | Health | F 0836 | Administration Deficiencies | Ensure the facility is licensed under applicable State and local law and operates and provides services in compliance with all applicable Federal, State, and local laws, regulations, and codes, and with accepted professional standards. | F | Yes | Past Non-Compliance | August 27, 2025 |
| May 7, 2026 | 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 | Yes | Deficient, Provider has date of correction | May 28, 2026 |
| December 11, 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 | February 23, 2026 |
| December 11, 2025 | Health | F 0698 | Quality of Life and Care Deficiencies | Provide safe, appropriate dialysis care/services for a resident who requires such services. | D | No | Deficient, Provider has date of correction | February 23, 2026 |
| December 11, 2025 | Health | F 0805 | Nutrition and Dietary Deficiencies | Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. | D | No | Deficient, Provider has date of correction | February 23, 2026 |
| December 11, 2025 | Health | F 0836 | Administration Deficiencies | Ensure the facility is licensed under applicable State and local law and operates and provides services in compliance with all applicable Federal, State, and local laws, regulations, and codes, and with accepted professional standards. | F | No | Deficient, Provider has date of correction | February 23, 2026 |
| December 11, 2025 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | No | Deficient, Provider has date of correction | February 23, 2026 |
| January 15, 2025 | 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 | Yes | Deficient, Provider has date of correction | February 9, 2025 |
| June 20, 2024 | Health | F 0676 | Quality of Life and Care Deficiencies | Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. | D | No | Deficient, Provider has date of correction | July 18, 2024 |
| June 20, 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. | E | No | Deficient, Provider has date of correction | July 18, 2024 |
| June 20, 2024 | Health | F 0761 | Pharmacy Service Deficiencies | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | E | No | Deficient, Provider has date of correction | July 18, 2024 |
| June 20, 2024 | Health | F 0812 | Nutrition and Dietary Deficiencies | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | No | Deficient, Provider has date of correction | July 18, 2024 |
| June 20, 2024 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | E | No | Deficient, Provider has date of correction | July 18, 2024 |
| May 17, 2024 | 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 | Yes | Deficient, Provider has date of correction | June 17, 2024 |
| September 12, 2023 | Health | F 0842 | Resident Assessment and Care Planning Deficiencies | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | Yes | Deficient, Provider has date of correction | October 11, 2023 |
| August 16, 2023 | 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 | September 15, 2023 |
| August 16, 2023 | 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 15, 2023 |
| March 4, 2022 | Health | F 0584 | Resident Rights Deficiencies | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | D | No | Deficient, Provider has date of correction | April 24, 2022 |
| March 4, 2022 | 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. | E | No | Deficient, Provider has date of correction | April 24, 2022 |
| March 4, 2022 | Health | F 0692 | Quality of Life and Care Deficiencies | Provide enough food/fluids to maintain a resident's health. | E | No | Deficient, Provider has date of correction | April 24, 2022 |
| March 4, 2022 | Health | F 0695 | Quality of Life and Care Deficiencies | Provide safe and appropriate respiratory care for a resident when needed. | E | No | Deficient, Provider has date of correction | April 24, 2022 |
| March 4, 2022 | Health | F 0756 | Pharmacy Service Deficiencies | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | D | No | Deficient, Provider has date of correction | April 24, 2022 |
| March 4, 2022 | Health | F 0758 | Pharmacy Service Deficiencies | Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | D | No | Deficient, Provider has date of correction | April 24, 2022 |
| March 4, 2022 | Health | F 0759 | Pharmacy Service Deficiencies | Ensure medication error rates are not 5 percent or greater. | E | No | Deficient, Provider has date of correction | April 24, 2022 |
| March 4, 2022 | Health | F 0761 | Pharmacy Service Deficiencies | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | E | No | Deficient, Provider has date of correction | April 24, 2022 |
| March 4, 2022 | Health | F 0804 | Nutrition and Dietary Deficiencies | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | No | Deficient, Provider has date of correction | April 24, 2022 |
| March 4, 2022 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | E | No | Deficient, Provider has date of correction | April 24, 2022 |
From the Care Compare health citations file NH_HealthCitations_Sep2026_2.csv, processed on September 1, 2026.
Penalties
No penalty on file for this facility in CMS’s Care Compare penalties data.
Care Compare provider information
| Field | As filed |
|---|---|
| Provider Type | Medicare and Medicaid |
| Ownership Type | For profit - Limited Liability company |
| Legal Business Name | TICE VALLEY COMMUNITY HEALTHCARE LLC |
| Date First Approved to Provide Medicare and Medicaid Services | 1997-08-07 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | Y |
| County/Parish | Contra Costa |
| Telephone Number | 9259060200 |
| Chain Name | PACS GROUP |
| Chain ID | 690 |
| 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 | 116.5 |
| Overall Rating | 5 |
| Health Inspection Rating | 4 |
| QM Rating | 5 |
| Long-Stay QM Rating | 5 |
| Short-Stay QM Rating | 4 |
| Processing Date | 2026-09-01 |
From the Care Compare Provider Information file NH_ProviderInfo_Sep2026_3.csv, processed on September 1, 2026.
Get an email when this record changes
One email a day naming what moved on TICE VALLEY POST ACUTE: 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 May 6, 2026: A cost report was filed for fiscal year 2024, 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 TICE VALLEY POST ACUTE
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 California 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 California
- NAVARRO'S BROS INC, MANTECA Motor carrier
- ALSTERLIND CONSTRUCTION, SAN RAFAEL Motor carrier
- SIMON JUSTO CALDERON, MADERA Motor carrier
- PARMINDER SINGH, FRESNO Motor carrier
- VENTURA COUNTY FCD/MS4, VENTURA COUNTY Water discharge permit
- LONG BEACH MS4, LONG BEACH Water discharge permit
- LOS ANGELES FCD/MS4, LOS ANGELES COUNTY Water discharge permit
- SACRAMENTO COUNTY MS4, RANCHO CORDOVA Water discharge permit
- US MINE CO. - IONE PLANT, IONE Air emission source
- AMPINE: A DIVISION OF TIMBER PRODUCTS COMPANY, MARTELL Air emission source
- NORTHROP GRUMMAN CORP, PALMDALE Air emission source
- LANDCASTER LANDFILL, LANCASTER Air emission source
- GAGANPRIT SINGH, Fremont Hazardous waste handler
- H AND D TRUCKING, San Leandro Hazardous waste handler
- SAN FRANCISCO COUNTY/EMERG RESPONSE ONLY, -- Hazardous waste handler
- GOLDEN STATE WATER COMPANY, San Luis Obispo Hazardous waste handler
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 555710.