Skilled nursing facility · CMS certification number 555793
VI AT LA JOLLA VILLAGE
SAN DIEGO, California · Medicare
Certified beds, as filed in Care Compare: 60
Download this facility’s record (CSV)
A CSV file of this facility’s record: its name and location, its Medicare cost-report finances year by year, its ownership, its inspections, deficiencies and penalties, and the Care Compare provider information — each figure with the worksheet, line and column or file it came from.
In Care Compare’s provider information: Penalties: 0 · Fines: 0 · Fines, total amount: $0.00 · Payment denials: 0. Every penalty on file ↓
For this facility: the citable document with full history — $295 · an email when this record changes — $99/month
Finances, as filed
From this facility’s Medicare cost reports on form CMS-2540, each figure with the worksheet, line and column it was read from.
Cost report for January 1, 2024 to December 31, 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on August 29, 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $20,814,960 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $8,254,317 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $12,560,643 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $30,515,389 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$17,954,746 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $48,482,581 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $30,527,835 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $575,473 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 21,960 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 6,187 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Other-payer patient days | 12,381 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 18,568 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 198 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Other-payer discharges | 74 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 272 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 31.25 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 68.26 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1438330, read from the public cost report file SNF10FY2024.zip.
Fiscal year 2023, ended December 31, 2023
Cost report for January 1, 2023 to December 31, 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on August 19, 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $18,675,689 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $8,105,617 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,570,072 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $28,177,236 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$17,607,164 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $46,107,885 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $28,500,721 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $653,291 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,286 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 220 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 31.86 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 78.57 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1392537, read from the public cost report file SNF10FY2023.zip.
Fiscal year 2022, ended December 31, 2022
Cost report for January 1, 2022 to December 31, 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on September 9, 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $17,529,840 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $7,036,335 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,493,505 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $29,863,226 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$19,369,721 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $41,849,601 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $22,479,880 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$2,143,430 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,261 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 226 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 26.9 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 76.38 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1364228, read from the public cost report file SNF10FY2022.zip.
Fiscal year 2021, ended December 31, 2021
Cost report for January 1, 2021 to December 31, 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on September 23, 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $16,212,663 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $7,011,714 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,200,949 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $29,418,776 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$20,217,827 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $40,787,616 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $20,569,789 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$2,216,776 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 15,955 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 190 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 29.51 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 83.97 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1333923, read from the public cost report file SNF10FY2021.zip.
Fiscal year 2020, ended December 31, 2020
Cost report for January 1, 2020 to December 31, 2020 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on October 20, 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $13,611,672 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $5,475,659 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $8,136,013 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $28,764,668 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$20,628,655 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $40,976,981 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $20,348,326 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$2,279,770 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 13,180 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 225 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 24.85 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 58.58 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1302438, read from the public cost report file SNF10FY2020.zip.
Fiscal year 2019, ended December 31, 2019
Cost report for January 1, 2019 to December 31, 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on August 19, 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $15,360,268 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $5,756,938 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,603,330 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $28,289,592 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$18,686,262 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $39,683,793 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $20,997,531 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$743,159 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,613 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 316 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 23.75 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 52.57 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1264279, read from the public cost report file SNF10FY2019.zip.
Fiscal year 2018, ended December 31, 2018
Cost report for January 1, 2018 to December 31, 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on August 2, 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $14,401,701 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $5,976,049 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $8,425,652 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $27,265,797 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$18,840,145 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $38,606,788 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $19,766,643 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,280,633 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 15,924 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 316 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 24.58 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 50.39 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1239387, read from the public cost report file SNF10FY2018.zip.
Fiscal year 2017, ended December 31, 2017
Cost report for January 1, 2017 to December 31, 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on August 21, 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $14,756,586 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $6,030,832 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $8,725,754 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $26,171,456 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$17,445,702 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $38,126,268 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $20,680,566 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$4,193,392 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,710 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 348 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 21.69 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 50.89 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1208942, read from the public cost report file SNF10FY2017.zip.
Fiscal year 2016, ended December 31, 2016
Cost report for January 1, 2016 to December 31, 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on August 3, 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $16,440,632 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $6,733,977 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,706,655 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $26,533,599 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$16,826,944 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $35,890,557 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $19,063,613 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $114,810 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,060 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 342 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 25.07 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 58.65 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1171732, read from the public cost report file SNF10FY2016.zip.
Fiscal year 2015, ended December 31, 2015
Cost report for January 1, 2015 to December 31, 2015 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on August 25, 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $15,812,338 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $6,229,794 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,582,544 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $25,695,775 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$16,113,231 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $34,073,145 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $17,959,914 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,608,194 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,919 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 349 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 25.6 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 57.07 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1142529, read from the public cost report file SNF10FY2015.zip.
Fiscal year 2014, ended December 31, 2014
Cost report for January 1, 2014 to December 31, 2014 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on September 22, 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $15,171,299 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $5,875,758 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,295,541 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $25,145,005 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$15,849,464 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $30,448,158 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $14,598,694 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,589,722 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,273 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 339 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 25.85 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 56.85 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1110384, read from the public cost report file SNF10FY2014.zip.
Fiscal year 2013, ended December 31, 2013
Cost report for January 1, 2013 to December 31, 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on July 29, 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $15,277,095 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $6,138,731 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,138,364 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $24,450,924 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$15,312,560 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $27,194,849 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $11,882,289 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$2,241,130 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,091 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 358 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 27.6 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 53.33 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1074085, read from the public cost report file SNF10FY2013.zip.
Fiscal year 2012, ended December 31, 2012
Cost report for January 1, 2012 to December 31, 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on July 23, 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $13,225,532 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $4,138,710 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,086,822 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $24,469,606 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$15,382,784 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $24,790,851 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $9,408,067 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$3,285,137 (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 | 139 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,398 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 457 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 20.88 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 42.45 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1042453, read from the public cost report file SNF10FY2012.zip.
Fiscal year 2011, ended December 31, 2011
Cost report for January 1, 2011 to December 31, 2011 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on January 31, 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $13,033,990 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $4,561,791 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $8,472,199 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $25,086,029 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$16,613,830 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $24,777,634 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $8,163,804 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$5,973,059 (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 | 139 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,549 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 369 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 23.76 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 52.98 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1024420, read from the public cost report file SNF10FY2011.zip.
Fiscal year 2010, ended December 31, 2010
Cost report for January 1, 2010 to December 31, 2010 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on July 19, 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $8,644,369 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $24,768,200 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$16,123,831 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $25,523,350 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $14,683,248 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$5,283,729 (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 | 139 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 19,147 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 411 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 22.98 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 46.59 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 411455, read from the public cost report file SNFFY2010.zip.
Fiscal year 2009, ended December 31, 2009
Cost report for January 1, 2009 to December 31, 2009 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on July 27, 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $7,116,319 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $18,008,937 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$10,892,618 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $27,314,514 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $23,342,930 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$6,921,034 (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 | 139 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 18,978 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 359 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 25.76 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 52.86 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 383851, read from the public cost report file SNFFY2009.zip.
Fiscal year 2008, ended December 31, 2008
Cost report for January 1, 2008 to December 31, 2008 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on September 11, 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $8,174,510 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $16,346,668 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$8,172,158 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $22,997,490 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $24,155,018 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$9,329,686 (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 | 139 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 18,440 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 358 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 24.27 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 51.51 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 356512, read from the public cost report file SNFFY2008.zip.
Fiscal year 2007, ended December 31, 2007
Cost report for January 1, 2007 to December 31, 2007 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on July 23, 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $8,150,969 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $14,614,226 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$6,463,257 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $15,290,060 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $11,524,096 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income: −$2,697,293 (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 | 139 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,071 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 298 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 19.46 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 67.35 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 318918, read from the public cost report file SNFFY2007.zip.
Fiscal year 2006, ended December 31, 2006
Cost report for January 1, 2006 to December 31, 2006 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on August 14, 2007.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $8,388,242 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $14,481,995 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$6,093,753 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $6,015,063 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: −$78,690 (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 | 139 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 19,958 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 340 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 20.52 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 58.7 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 291883, read from the public cost report file SNFFY2006.zip.
Fiscal year 2005, ended December 31, 2005
Cost report for January 1, 2005 to December 31, 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on August 10, 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $8,311,922 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,632,205 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$320,283 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $108,227 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: −$212,056 (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 | 139 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 38,147 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 479 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 25.22 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 79.64 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 260914, read from the public cost report file SNFFY2005.zip.
Fiscal year 2004, ended December 31, 2004
Cost report for February 1, 2004 to December 31, 2004 — a reporting period of 334 days, on form CMS-2540-96, settled, processed by CMS on July 26, 2005.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $14,766,126 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $15,610,615 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$844,489 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $143,530 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: −$700,959 (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 | 139 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 32,675 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 291 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 21.21 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 112.29 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 228954, read from the public cost report file SNFFY2004.zip.
Fiscal year 2003, ended January 31, 2003
Cost report for June 26, 2002 to January 31, 2003 — a reporting period of 219 days, not a full year, on form CMS-2540-96, settled, processed by CMS on February 15, 2005.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $5,745,148 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,333,928 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$1,588,780 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $49,481 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: −$1,539,299 (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 | 139 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 12,032 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 112 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 53.4 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 107.43 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 207581, read from the public cost report file SNFFY2002.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 |
|---|---|---|---|---|
| CC LA JOLLA LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | 100% | since 04/03/1998 |
| CC DEVELOPMENT GROUP II LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | Organization | 100% | since 05/01/2026 |
| BLYS, ELLEN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 10/26/2015 |
| BOUDREAU, STEPHANIE | ADP OF THE SNF | Individual | NOT APPLICABLE | since 03/15/2011 |
| CLASSIC RESIDENCE MANAGEMENT LIMITED PARTNERSHIP | ADP OF THE SNF | Organization | NOT APPLICABLE | since 09/25/2025 |
| COPE, TARA | ADP OF THE SNF | Individual | NOT APPLICABLE | since 06/01/2018 |
| EVRAETS, MELISSA | ADP OF THE SNF | Individual | NOT APPLICABLE | since 08/31/2020 |
| KOSZYLKO, TOMEK | ADP OF THE SNF | Individual | NOT APPLICABLE | since 10/15/2018 |
| MASLOW, CARY | ADP OF THE SNF | Individual | NOT APPLICABLE | since 08/01/2019 |
| MUSZYNSKI, THOMAS | ADP OF THE SNF | Individual | NOT APPLICABLE | since 06/01/2022 |
| PATTERSON, AMY | ADP OF THE SNF | Individual | NOT APPLICABLE | since 02/13/2023 |
| RAWI, TAIB | ADP OF THE SNF | Individual | NOT APPLICABLE | since 02/01/2019 |
| SMITH, GARY | ADP OF THE SNF | Individual | NOT APPLICABLE | since 06/01/2022 |
| WHITE, KELLY | ADP OF THE SNF | Individual | NOT APPLICABLE | since 04/21/2024 |
| WILLIAMS, BRIDGET | ADP OF THE SNF | Individual | NOT APPLICABLE | since 12/01/2022 |
| COPE, TARA | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 05/01/2026 |
| BLYS, ELLEN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 10/26/2015 |
| BOUDREAU, STEPHANIE | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 03/15/2011 |
| CLASSIC RESIDENCE MANAGEMENT LIMITED PARTNERSHIP | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | since 10/26/2005 |
| EVRAETS, MELISSA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 08/31/2020 |
| KOSZYLKO, TOMEK | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 10/15/2018 |
| MASLOW, CARY | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 08/01/2019 |
| MUSZYNSKI, THOMAS | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 06/01/2022 |
| PATTERSON, AMY | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 02/13/2023 |
| RAWI, TAIB | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 02/01/2019 |
| SMITH, GARY | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 06/01/2022 |
| WHITE, KELLY | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 04/21/2024 |
| WILLIAMS, BRIDGET | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 12/01/2022 |
Medicare enrollment
As filed in the CMS file dated August 1, 2026 (Medicare enrollment ownership), under the enrollment of CCW LA JOLLA, LLC (enrollment ID O20100819000721).
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 |
|---|---|---|---|---|---|
| CC LA JOLLA LLC | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100 | 4/3/1998 | Private equity company: No Real estate investment trust: No Holding company: No |
| CC DEVELOPMENT GROUP II LLC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100 | 5/1/2026 | Private equity company: No Real estate investment trust: No Holding company: No |
| CC LIVING HOLDING COMPANY LLC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100 | 5/1/2026 | Private equity company: No Real estate investment trust: No Holding company: No |
| AMY PATTERSON | Individual | ADP OF THE SNF | Not stated in the filing | 2/13/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| BRIDGET WILLIAMS | Individual | ADP OF THE SNF | Not stated in the filing | 12/1/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| CARY MASLOW | Individual | ADP OF THE SNF | Not stated in the filing | 8/1/2019 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| CLASSIC RESIDENCE MANAGEMENT LIMITED PARTNERSHIP | Organization | ADP OF THE SNF | Not stated in the filing | 9/25/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| ELLEN M. BLYS | Individual | ADP OF THE SNF | Not stated in the filing | 10/26/2015 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| GARY SMITH | Individual | ADP OF THE SNF | Not stated in the filing | 6/1/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KELLY WHITE | Individual | ADP OF THE SNF | Not stated in the filing | 4/21/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MELISSA G EVRAETS | Individual | ADP OF THE SNF | Not stated in the filing | 8/31/2020 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| STEPHANIE BOUDREAU | Individual | ADP OF THE SNF | Not stated in the filing | 3/15/2011 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| TAIB RAWI | Individual | ADP OF THE SNF | Not stated in the filing | 2/1/2019 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| TARA COPE | Individual | ADP OF THE SNF | Not stated in the filing | 6/1/2018 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| THOMAS J MUSZYNSKI | Individual | ADP OF THE SNF | Not stated in the filing | 6/1/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| TOMEK KOSZYLKO | Individual | ADP OF THE SNF | Not stated in the filing | 10/15/2018 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| No owner named in the filing | Individual | ADP OF THE SNF | 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 |
| No owner named in the filing | Individual | ADP OF THE SNF | Not stated in the filing | 11/1/2017 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| No owner named in the filing | Organization | ADP OF THE SNF | Not stated in the filing | 9/25/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| No owner named in the filing | Organization | ADP OF THE SNF | Not stated in the filing | 9/25/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| No owner named in the filing | Individual | ADP OF THE SNF | Not stated in the filing | 7/1/2019 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| TARA COPE | Individual | CORPORATE OFFICER | 0 | 5/1/2026 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| AMY PATTERSON | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 2/13/2023 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| BRIDGET WILLIAMS | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 12/1/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| CARY MASLOW | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 8/1/2019 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| CLASSIC RESIDENCE MANAGEMENT LIMITED PARTNERSHIP | Organization | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 10/26/2005 | Private equity company: No Real estate investment trust: No Holding company: No |
| ELLEN M. BLYS | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 10/26/2015 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| GARY SMITH | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 6/1/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KELLY WHITE | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 4/21/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| MELISSA G EVRAETS | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 8/31/2020 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| STEPHANIE BOUDREAU | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 3/15/2011 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| TAIB RAWI | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 2/1/2019 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| THOMAS J MUSZYNSKI | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 6/1/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| TOMEK KOSZYLKO | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 10/15/2018 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
Changes in ownership
- September 1, 2026: CC LIVING HOLDING COMPANY LLC no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Care Compare ownership file. NH_Ownership_Sep2026_2.csv
- July 1, 2026: P. G. - TONY TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: P. G. - JOHNNY TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: P. G. - KAREN TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: PRITZKER PUCKER FAMILY FOUNDATION NO. 2 no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: P. G. - LINDA TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: MARGOT AND TOM PRITZKER FOUNDATION no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: P. G. - NICHOLAS TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: TARA COPE no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: P. G. - JIM TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: P. G. - DANIEL TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: CC-DEVELOPMENT GROUP, INC. no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: ALEXANDER HIBBS no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: ALEXANDER HIBBS no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: NEAL P BOYLE no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: NEAL P BOYLE no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: P. G. - DON #3 TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: STEVEN DALE FOWLER no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: STEVEN DALE FOWLER no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: CC DEVELOPMENT GROUP II LLC appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: TARA COPE appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: CC LIVING HOLDING COMPANY LLC appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- April 1, 2026: ELLEN M. BLYS no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: STEPHANIE BOUDREAU no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: P. G. - TOM TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: DARRELL P BALTIMORE no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: BRIDGET WILLIAMS no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: P. G. - JEAN TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: AMY PATTERSON no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: KELLY WHITE (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since April 21, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: KELLY WHITE (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since April 21, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: ELLEN M. BLYS (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since October 26, 2015. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: ELLEN M. BLYS (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since October 26, 2015. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: CLASSIC RESIDENCE MANAGEMENT LIMITED PARTNERSHIP (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since September 25, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: GARY SMITH (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since June 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: GARY SMITH (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since June 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: STEPHANIE BOUDREAU (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since March 15, 2011. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: STEPHANIE BOUDREAU (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since March 15, 2011. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: MELISSA G EVRAETS (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since August 31, 2020. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: MELISSA G EVRAETS (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since August 31, 2020. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: TAIB RAWI (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since February 1, 2019. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: TAIB RAWI (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since February 1, 2019. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: PRITZKER PUCKER FAMILY FOUNDATION NO. 2 (5% OR GREATER INDIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since May 22, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: MARGOT AND TOM PRITZKER FOUNDATION (5% OR GREATER INDIRECT OWNERSHIP INTEREST) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since May 22, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: BRIDGET WILLIAMS (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since December 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: BRIDGET WILLIAMS (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since December 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: TARA COPE (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since June 1, 2018. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: TARA COPE (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since June 1, 2018. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: TOMEK KOSZYLKO (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since October 15, 2018. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: TOMEK KOSZYLKO (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since October 15, 2018. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: ALEXANDER HIBBS (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since June 20, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: ALEXANDER HIBBS (CORPORATE OFFICER) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since June 20, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: THOMAS J MUSZYNSKI (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since June 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: THOMAS J MUSZYNSKI (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since June 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: NEAL P BOYLE (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since February 14, 2020. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: AMY PATTERSON (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since February 13, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: AMY PATTERSON (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since February 13, 2023. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: CARY MASLOW (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since August 1, 2019. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: CARY MASLOW (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since August 1, 2019. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: STEVEN DALE FOWLER (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since October 11, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: STEVEN DALE FOWLER (CORPORATE OFFICER) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since October 11, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: A listing under ADP OF THE SNF, with no owner named, first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since November 1, 2017. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 14, 2023: TARA COPE no longer appears as OTHER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-04-14.csv
- April 14, 2023: THOMAS J MUSZYNSKI no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-04-14.csv
- April 14, 2023: CARY MASLOW no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-04-14.csv
- April 14, 2023: CARY MASLOW no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-04-14.csv
- April 14, 2023: DARRELL P BALTIMORE (OFFICER) first listed in CMS’s Medicare enrollment ownership file on April 14, 2023; associated with this enrollment since June 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-04-14.csv
- April 14, 2023: BRIDGET WILLIAMS (W-2 MANAGING EMPLOYEE) first listed in CMS’s Medicare enrollment ownership file on April 14, 2023; associated with this enrollment since December 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2023-04-14.csv
- April 14, 2023: AMY PATTERSON (W-2 MANAGING EMPLOYEE) first listed in CMS’s Medicare enrollment ownership file on April 14, 2023; associated with this enrollment since February 13, 2023. Skilled_Nursing_Facility_All_Owners_:_2023-04-14.csv
Recent changes on this record
- September 1, 2026: CC LIVING HOLDING COMPANY LLC no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Care Compare ownership file. NH_Ownership_Sep2026_2.csv
- July 1, 2026: P. G. - TONY TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: P. G. - JOHNNY TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: P. G. - KAREN TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: PRITZKER PUCKER FAMILY FOUNDATION NO. 2 no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: P. G. - LINDA TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: MARGOT AND TOM PRITZKER FOUNDATION no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: P. G. - NICHOLAS TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: TARA COPE no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: P. G. - JIM TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: P. G. - DANIEL TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: CC-DEVELOPMENT GROUP, INC. no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: ALEXANDER HIBBS no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: ALEXANDER HIBBS no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: NEAL P BOYLE no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: NEAL P BOYLE no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: P. G. - DON #3 TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: STEVEN DALE FOWLER no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: STEVEN DALE FOWLER no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: CC DEVELOPMENT GROUP II LLC appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: TARA COPE appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- July 1, 2026: CC LIVING HOLDING COMPANY LLC appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- April 1, 2026: ELLEN M. BLYS no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: STEPHANIE BOUDREAU no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: P. G. - TOM TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: DARRELL P BALTIMORE no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: BRIDGET WILLIAMS no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: P. G. - JEAN TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: AMY PATTERSON no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: KELLY WHITE (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since April 21, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: KELLY WHITE (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since April 21, 2024. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: ELLEN M. BLYS (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since October 26, 2015. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: ELLEN M. BLYS (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since October 26, 2015. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: CLASSIC RESIDENCE MANAGEMENT LIMITED PARTNERSHIP (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since September 25, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: GARY SMITH (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since June 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: GARY SMITH (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since June 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: STEPHANIE BOUDREAU (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since March 15, 2011. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: STEPHANIE BOUDREAU (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since March 15, 2011. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: MELISSA G EVRAETS (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since August 31, 2020. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- April 1, 2026: MELISSA G EVRAETS (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2026; associated with this enrollment since August 31, 2020. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | August 28, 2025 | August 28, 2025 | 6 | 8 |
| 2 | September 1, 2023 | September 1, 2023 | 6 | 5 |
| 3 | November 8, 2019 | November 8, 2019 | 3 | 5 |
From the Care Compare inspection summary file NH_SurveySummary_Sep2026_2.csv, processed on September 1, 2026.
Deficiencies cited
15 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| August 28, 2025 | Health | F 0552 | Resident Rights Deficiencies | Ensure that residents are fully informed and understand their health status, care and treatments. | D | No | Deficient, Provider has date of correction | September 10, 2025 |
| August 28, 2025 | Health | F 0605 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. | D | No | Deficient, Provider has date of correction | September 10, 2025 |
| August 28, 2025 | Health | F 0679 | Quality of Life and Care Deficiencies | Provide activities to meet all resident's needs. | D | No | Deficient, Provider has date of correction | September 10, 2025 |
| August 28, 2025 | Health | F 0755 | Pharmacy Service Deficiencies | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | No | Deficient, Provider has date of correction | September 10, 2025 |
| August 28, 2025 | Health | F 0757 | Pharmacy Service Deficiencies | Ensure each resident’s drug regimen must be free from unnecessary drugs. | D | No | Deficient, Provider has date of correction | September 10, 2025 |
| August 28, 2025 | Health | F 0761 | Pharmacy Service Deficiencies | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | No | Deficient, Provider has date of correction | September 10, 2025 |
| August 12, 2025 | Health | F 0583 | Resident Rights Deficiencies | Keep residents' personal and medical records private and confidential. | E | Yes | Deficient, Provider has date of correction | August 27, 2025 |
| May 7, 2025 | Health | F 0760 | Pharmacy Service Deficiencies | Ensure that residents are free from significant medication errors. | D | Yes | Deficient, Provider has date of correction | May 25, 2025 |
| October 19, 2023 | Health | F 0609 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Yes | Deficient, Provider has date of correction | October 20, 2023 |
| September 22, 2023 | Health | F 0656 | Resident Assessment and Care Planning Deficiencies | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | E | Yes | Deficient, Provider has date of correction | October 6, 2023 |
| September 1, 2023 | Health | F 0684 | Quality of Life and Care Deficiencies | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | No | Deficient, Provider has date of correction | September 29, 2023 |
| September 1, 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 | No | Deficient, Provider has date of correction | September 29, 2023 |
| September 1, 2023 | Health | F 0761 | Pharmacy Service Deficiencies | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | No | Deficient, Provider has date of correction | September 29, 2023 |
| September 1, 2023 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | No | Deficient, Provider has date of correction | September 29, 2023 |
| November 8, 2019 | Health | F 0697 | Quality of Life and Care Deficiencies | Provide safe, appropriate pain management for a resident who requires such services. | D | No | Deficient, Provider has date of correction | November 9, 2019 |
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 |
| Ownership Type | For profit - Limited Liability company |
| Legal Business Name | CCW LA JOLLA, LLC |
| Date First Approved to Provide Medicare and Medicaid Services | 2002-06-26 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | Y |
| Urban | Y |
| County/Parish | San Diego |
| Telephone Number | 8586463400 |
| Chain Name | VI LIVING |
| Chain ID | 548 |
| 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 | 60 |
| Average Number of Residents per Day | 55.5 |
| Overall Rating | 5 |
| Health Inspection Rating | 5 |
| QM Rating | 5 |
| Long-Stay QM Rating | 5 |
| Short-Stay QM Rating | 5 |
| 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 VI AT LA JOLLA VILLAGE: the field, the value before, the value after, and the date of the file that first showed it.
The facility alert follows this one record: a cost report filed or a figure on one changed, an inspection, a deficiency or a penalty recorded, an owner added or removed. The certification number arrives filled in.
On September 1, 2026: CC LIVING HOLDING COMPANY LLC no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Care Compare ownership file. That is one line of the alert.
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The citable document for VI AT LA JOLLA VILLAGE
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.
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Every figure on this page is printed as it appears in the CMS file named beside it. A figure that does not match its file? Tell us on the corrections page, quoting certification number 555793.