Skilled nursing facility · CMS certification number 055756
CLOVERDALE HEALTHCARE CENTER
CLOVERDALE, California · Medicare and Medicaid
Certified beds, as filed in Care Compare: 72
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 1 January 2024 to 31 December 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 28 August 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,873,922 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $244,008 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,629,914 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,133,843 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $1,496,071 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $6,031 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,502,102 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,502,102 (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 | 70 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 25,620 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 4,050 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 10,810 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 2,533 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 17,393 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 98 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 25 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 67 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 190 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 41.33 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 432.4 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 91.54 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1433026, read from the public cost report file SNF10FY2024.zip.
Fiscal year 2023, ended 31 December 2023
Cost report for 1 January 2023 to 31 December 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 14 August 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,814,157 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$229,436 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,043,593 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,083,265 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $960,328 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,154 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $961,482 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $961,482 (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 | 70 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 15,233 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 181 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 37.57 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 492.61 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 84.16 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1392074, read from the public cost report file SNF10FY2023.zip.
Fiscal year 2022, ended 31 December 2022
Cost report for 1 January 2022 to 31 December 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 9 September 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,872,535 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$1,141,939 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $8,014,474 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,697,534 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $316,940 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,144 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $318,084 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $318,084 (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 | 70 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 14,610 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 109 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 46.37 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 958.1 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 134.04 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1363871, read from the public cost report file SNF10FY2022.zip.
Fiscal year 2021, ended 31 December 2021
Cost report for 1 January 2021 to 31 December 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 21 September 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,135,566 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$1,666,247 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $8,801,813 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,020,103 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $781,710 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $4,523 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $786,233 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $786,233 (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 | 70 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,235 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 148 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 38.63 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 3,686.33 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 109.7 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1333260, read from the public cost report file SNF10FY2021.zip.
Fiscal year 2020, ended 31 December 2020
Cost report for 1 January 2020 to 31 December 2020 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 16 September 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,493,795 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$1,852,541 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,346,336 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,783,729 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $1,562,607 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $3,875 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,566,482 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,565,817 (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 | 70 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 18,384 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 167 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 41.38 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,172 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 110.08 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1300297, read from the public cost report file SNF10FY2020.zip.
Fiscal year 2019, ended 31 December 2019
Cost report for 1 January 2019 to 31 December 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 15 January 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,876,461 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$264,234 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $8,140,695 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,239,439 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $901,256 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $9,190 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $910,446 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $910,446 (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 | 70 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,333 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 185 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 32.32 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,413.7 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 109.91 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1278252, read from the public cost report file SNF10FY2019.zip.
Fiscal year 2018, ended 31 December 2018
Cost report for 1 January 2018 to 31 December 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 2 August 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,276,102 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $232,232 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,043,870 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,307,590 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$263,720 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $9,427 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$254,293 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$254,553 (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 | 70 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 18,391 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 119 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 29.38 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,108.83 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 154.55 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1239220, read from the public cost report file SNF10FY2018.zip.
Fiscal year 2017, ended 31 December 2017
Cost report for 1 January 2017 to 31 December 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 21 August 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,507,462 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$214,003 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,721,465 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,413,699 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $307,766 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $35,847 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $343,613 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $343,613 (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 | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,605 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 163 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 32.68 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 697.1 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 120.28 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1208382, read from the public cost report file SNF10FY2017.zip.
Fiscal year 2016, ended 31 December 2016
Cost report for 1 January 2016 to 31 December 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 31 July 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,524,867 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$76,466 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,601,333 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,980,184 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $621,149 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $5,009 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $626,158 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $626,157 (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 | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,584 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 112 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 32.34 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,637.5 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 183.79 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1171309, read from the public cost report file SNF10FY2016.zip.
Fiscal year 2015, ended 31 December 2015
Cost report for 1 January 2015 to 31 December 2015 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 30 July 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,387,989 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $638,063 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,749,926 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,531,115 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $218,811 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $6,449 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $225,260 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $225,249 (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 | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 21,896 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 78 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 41.54 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 912.4 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 280.72 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1138977, read from the public cost report file SNF10FY2015.zip.
Fiscal year 2014, ended 31 December 2014
Cost report for 1 January 2014 to 31 December 2014 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 25 July 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,457,771 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $677,503 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,780,268 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,515,517 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $264,751 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $8,554 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $273,305 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $273,304 (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 | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 21,962 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 98 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 40.52 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 920.56 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 224.1 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1104181, read from the public cost report file SNF10FY2014.zip.
Fiscal year 2013, ended 31 December 2013
Cost report for 1 January 2013 to 31 December 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 29 July 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,822,731 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $414,101 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,408,630 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,334,483 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $74,147 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $5,144 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $79,291 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $79,290 (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 | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 21,364 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 93 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 44.12 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 720.52 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 229.72 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1074080, read from the public cost report file SNF10FY2013.zip.
Fiscal year 2012, ended 31 December 2012
Cost report for 1 January 2012 to 31 December 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 28 June 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,090,247 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $184,425 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,905,822 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,364,093 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $541,729 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $4,886 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $546,615 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $546,615 (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 | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 22,829 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 102 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 35.39 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,433.5 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 223.81 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1040527, read from the public cost report file SNF10FY2012.zip.
Fiscal year 2011, ended 31 December 2011
Cost report for 1 January 2011 to 31 December 2011 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 24 January 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,905,994 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $106,731 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,799,263 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,378,377 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $420,886 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $5,684 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $426,570 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $426,570 (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 | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 22,648 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 146 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 35.71 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 613.32 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 155.12 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1023549, read from the public cost report file SNF10FY2011.zip.
Fiscal year 2010, ended 31 December 2010
Cost report for 1 January 2010 to 31 December 2010 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 1 August 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $5,518,296 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,178,502 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $339,794 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $4,570 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $344,364 (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 | 72 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 23,271 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 100 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 48.22 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 114.18 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 232.71 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 414157, read from the public cost report file SNFFY2010.zip.
Fiscal year 2009, ended 31 December 2009
Cost report for 1 January 2009 to 31 December 2009 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 24 May 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $5,200,593 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,962,327 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $238,266 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $3,760 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $11,767 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: $230,259 (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 | 72 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 23,073 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 74 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 51.16 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 686.17 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 311.8 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 400239, read from the public cost report file SNFFY2009.zip.
Fiscal year 2008, ended 31 December 2008
Cost report for 1 January 2008 to 31 December 2008 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 14 July 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,835,584 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,879,767 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$44,183 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $2,033 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$42,150 (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 | 72 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 22,887 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 75 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 82.53 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 533.85 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 305.16 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 349675, read from the public cost report file SNFFY2008.zip.
Fiscal year 2007, ended 31 December 2007
Cost report for 1 January 2007 to 31 December 2007 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 30 July 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,778,501 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,671,042 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $107,459 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $1,790 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $109,249 (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 | 72 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 22,578 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 66 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 60 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 954.61 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 342.09 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 322142, read from the public cost report file SNFFY2007.zip.
Fiscal year 2006, ended 31 December 2006
Cost report for 1 January 2006 to 31 December 2006 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 28 November 2007.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,462,250 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,275,821 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $186,429 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $4,886 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $191,315 (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 | 72 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 22,883 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 67 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 44.32 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 672.77 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 341.54 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 297026, read from the public cost report file SNFFY2006.zip.
Fiscal year 2005, ended 31 December 2005
Cost report for 1 January 2005 to 31 December 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 15 September 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,630,310 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,629,942 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $368 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $4,528 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $4,896 (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 | 72 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 21,522 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 53 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 76.39 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 834 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 406.08 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 263151, read from the public cost report file SNFFY2005.zip.
Fiscal year 2004, ended 31 December 2004
Cost report for 1 January 2004 to 31 December 2004 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 30 November 2005.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,630,382 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,576,311 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $54,071 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $3,959 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $58,030 (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 | 72 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 21,757 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 89 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 44.27 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 621.76 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 244.46 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 237670, read from the public cost report file SNFFY2004.zip.
Fiscal year 2003, ended 31 December 2003
Cost report for 1 January 2003 to 31 December 2003 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 1 September 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,767,440 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,577,750 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $189,690 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $8,149 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $197,839 (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 | 72 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 23,349 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 149 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 32.67 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 319.06 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 156.7 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 192123, read from the public cost report file SNFFY2003.zip.
Fiscal year 2002, ended 31 December 2002
Cost report for 1 January 2002 to 31 December 2002 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 21 September 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,366,028 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,211,480 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $154,548 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $7,894 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $162,442 (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 | 72 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 23,474 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 88 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 37.97 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 621.96 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 266.75 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 194273, read from the public cost report file SNFFY2002.zip.
Fiscal year 2001, ended 31 December 2001
Cost report for 16 November 2001 to 31 December 2001 — a reporting period of 45 days, not a full year, on form CMS-2540-96, settled, processed by CMS on 19 February 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $297,306 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $330,397 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$33,091 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $214 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$32,877 (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 | 72 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 2,180 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 13 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 21 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 507.33 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 167.69 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 169271, read from the public cost report file SNFFY2002.zip.
Fiscal year 2000, ended 31 December 2000
Cost report for 1 January 2000 to 31 December 2000 — a reporting period of 365 days, on form CMS-2540-96, as submitted, processed by CMS on 5 July 2001.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,580,541 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,918,059 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$337,518 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | −$40,107 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$377,625 (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 | 72 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,801 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 113 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 28.34 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 184.08 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 63251, read from the public cost report file SNFFY2000.zip.
Fiscal year 1998, ended 31 December 1998
Cost report for 1 January 1998 to 31 December 1998 — a reporting period of 364 days, on form CMS-2540-96, as submitted, processed by CMS on 15 February 2000.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,525,355 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,402,233 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | $123,122 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $937 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $124,059 (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 | 72 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 24,024 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 127 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 50.21 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 189.17 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 63250, read from the public cost report file SNFFY1998.zip.
Fiscal year 1997, ended 31 December 1997
Cost report for 1 January 1997 to 31 December 1997 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 26 August 1999.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,766,212 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,509,961 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $256,251 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $7,236 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $263,487 (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 | 72 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 21,907 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 93 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 51.75 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 235.56 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 81335, read from the public cost report file SNFFY1997.zip.
Fiscal year 1996, ended 31 December 1996
Cost report for 1 January 1996 to 31 December 1996 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 24 March 1998.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,880,568 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,479,881 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $400,687 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $9,652 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $410,339 (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 | 72 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 22,457 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 120 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 48.71 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 397.59 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 187.14 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 81334, read from the public cost report file SNFFY1996.zip.
Nurse staffing
Nurse staffing hours from the Payroll-Based Journal, quarter by quarter, are on this facility’s staffing page, each quarter with the file it came from.
Ownership, as filed with CMS
Care Compare
As filed in the CMS file dated 1 August 2026 (Care Compare ownership).
| Owner or manager | Role | Type | Ownership percentage | Association |
|---|---|---|---|---|
| THE ENSIGN GROUP INC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | 100% | since 01/30/2006 |
| ENSIGN SERVICES INC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 11/17/2003 |
| GAMBLE, SHAWNDEE | ADP OF THE SNF | Individual | NOT APPLICABLE | since 11/15/2001 |
| RED BARN LAKESIDE HOLDINGS, LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 03/01/2019 |
| SERRANO, NOEL | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/01/2021 |
| TWOMAGNETS LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 11/15/2001 |
| BURNAM, SOON | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 02/01/2006 |
| KEETCH, CHAD | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 03/01/2011 |
| WILLITS, ADAM | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 11/15/2025 |
| PORT, BARRY | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | Individual | NOT APPLICABLE | since 08/20/2025 |
| GAMBLE, SHAWNDEE | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 11/15/2001 |
| SERRANO, NOEL | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 05/01/2021 |
| GAMBLE, SHAWNDEE | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 11/15/2001 |
| SERRANO, NOEL | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 05/01/2021 |
| TWOMAGNETS LLC | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | since 11/15/2001 |
Medicare enrollment
As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of ENSIGN CLOVERDALE LLC (enrollment ID O20120119000895).
| Owner | Individual or organization | Role | Ownership percentage | Association date | Described in the filing as |
|---|---|---|---|---|---|
| FLAGSTONE HEALTHCARE NORTH LLC | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100 | 2/1/2006 | Private equity company: No Real estate investment trust: No Holding company: No |
| THE ENSIGN GROUP INC | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100 | 1/30/2006 | Private equity company: No Real estate investment trust: No Holding company: No |
| ENSIGN SERVICES INC | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 11/17/2003 | Private equity company: No Real estate investment trust: No Holding company: No |
| NOEL SERRANO | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| RED BARN LAKESIDE HOLDINGS, LLC | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 3/1/2019 | Private equity company: No Real estate investment trust: No Holding company: No |
| SHAWNDEE GAMBLE | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 11/15/2001 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| TWOMAGNETS LLC | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 11/15/2001 | Private equity company: No Real estate investment trust: No Holding company: No |
| ADAM WILLITS | Individual | CORPORATE OFFICER | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 11/15/2025 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| CHAD KEETCH | Individual | CORPORATE OFFICER | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 3/1/2011 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| SOON BURNAM | Individual | CORPORATE OFFICER | 0 | 2/1/2006 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| NOEL SERRANO | Individual | MANAGING CONTROL - GOVERNING BODY | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| SHAWNDEE GAMBLE | Individual | MANAGING CONTROL - GOVERNING BODY | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 11/15/2001 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| NOEL SERRANO | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| SHAWNDEE GAMBLE | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 11/15/2001 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| TWOMAGNETS LLC | Organization | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 11/15/2001 | Private equity company: No Real estate investment trust: No Holding company: No |
Changes in ownership
- 1 July 2026: FLAGSTONE HEALTHCARE NORTH LLC no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: FLAGSTONE HEALTHCARE NORTH LLC appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 March 2026: SHAWNDEE GAMBLE no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: CRAIG FITCH no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: THE ENSIGN GROUP INC no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: BRADLEY WILLITS no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: SHAWNDEE GAMBLE appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: SHAWNDEE GAMBLE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: CHAD A KEETCH appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: NOEL SERRANO appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: NOEL SERRANO appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: NOEL SERRANO appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: TWOMAGNETS LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: TWOMAGNETS LLC appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: ADAM WILLITS appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: ENSIGN SERVICES INC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: THE ENSIGN GROUP INC appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: RED BARN LAKESIDE HOLDINGS, LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
Recent changes on this record
- 1 July 2026: FLAGSTONE HEALTHCARE NORTH LLC no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: FLAGSTONE HEALTHCARE NORTH LLC appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 March 2026: SHAWNDEE GAMBLE no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: CRAIG FITCH no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: THE ENSIGN GROUP INC no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: BRADLEY WILLITS no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: SHAWNDEE GAMBLE appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: SHAWNDEE GAMBLE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: CHAD A KEETCH appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: NOEL SERRANO appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: NOEL SERRANO appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: NOEL SERRANO appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: TWOMAGNETS LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: TWOMAGNETS LLC appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: ADAM WILLITS appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: ENSIGN SERVICES INC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: THE ENSIGN GROUP INC appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: RED BARN LAKESIDE HOLDINGS, LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 28 August 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- 14 August 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- 9 September 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- 21 September 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
- 16 September 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
- 15 January 2021: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
- 2 August 2019: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2018.zip
- 21 August 2018: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2017.zip
- 31 July 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2016.zip
- 30 July 2016: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2015.zip
- 25 July 2015: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2014.zip
- 29 July 2014: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2013.zip
- 28 June 2013: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2012.zip
- 24 January 2013: A cost report was filed for fiscal year 2011, on form CMS-2540-10. SNF10FY2011.zip
- 1 August 2011: A cost report was filed for fiscal year 2010, on form CMS-2540-96. SNFFY2010.zip
- 24 May 2011: A cost report was filed for fiscal year 2009, on form CMS-2540-96. SNFFY2009.zip
- 14 July 2009: A cost report was filed for fiscal year 2008, on form CMS-2540-96. SNFFY2008.zip
- 30 July 2008: A cost report was filed for fiscal year 2007, on form CMS-2540-96. SNFFY2007.zip
- 28 November 2007: A cost report was filed for fiscal year 2006, on form CMS-2540-96. SNFFY2006.zip
- 15 September 2006: A cost report was filed for fiscal year 2005, on form CMS-2540-96. SNFFY2005.zip
- 30 November 2005: A cost report was filed for fiscal year 2004, on form CMS-2540-96. SNFFY2004.zip
- 21 September 2004: A cost report was filed for fiscal year 2002, on form CMS-2540-96. SNFFY2002.zip
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | 19 December 2025 | 19 December 2025 | 4 | 1 |
| 2 | 9 January 2025 | 9 January 2025 | 2 | 3 |
| 3 | 21 October 2022 | 21 October 2022 | 7 | 1 |
From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.
Deficiencies cited
13 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| 19 December 2025 | Health | F 0628 | Resident Rights Deficiencies | Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. | D | No | Deficient, Provider has date of correction | 29 December 2025 |
| 19 December 2025 | Health | F 0658 | Resident Assessment and Care Planning Deficiencies | Ensure services provided by the nursing facility meet professional standards of quality. | D | No | Deficient, Provider has date of correction | 29 December 2025 |
| 19 December 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. | E | No | Deficient, Provider has date of correction | 29 December 2025 |
| 19 December 2025 | Health | F 0761 | Pharmacy Service Deficiencies | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | E | No | Deficient, Provider has date of correction | 29 December 2025 |
| 5 March 2025 | Health | F 0580 | Resident Rights Deficiencies | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | D | Yes | Deficient, Provider has date of correction | 17 March 2025 |
| 9 January 2025 | Health | F 0912 | Environmental Deficiencies | Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms. | B | No | Deficient, Provider has date of correction | 2 February 2025 |
| 21 October 2022 | Health | F 0658 | Resident Assessment and Care Planning Deficiencies | Ensure services provided by the nursing facility meet professional standards of quality. | D | No | Deficient, Provider has date of correction | 30 January 2023 |
| 21 October 2022 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | No | Deficient, Provider has date of correction | 30 January 2023 |
| 21 October 2022 | 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 | 30 January 2023 |
| 21 October 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 | 30 January 2023 |
| 21 October 2022 | Health | F 0802 | Nutrition and Dietary Deficiencies | Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. | D | No | Deficient, Provider has date of correction | 30 January 2023 |
| 21 October 2022 | 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 | 30 January 2023 |
| 21 October 2022 | 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 | 30 January 2023 |
From the Care Compare health citations file NH_HealthCitations_Aug2026.csv, processed on 1 August 2026.
Penalties
Not yet extracted for this facility.
Care Compare provider information
| Field | As filed |
|---|---|
| Provider Type | Medicare and Medicaid |
| Ownership Type | For profit - Limited Liability company |
| Legal Business Name | ENSIGN CLOVERDALE LLC |
| Date First Approved to Provide Medicare and Medicaid Services | 1974-07-16 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | Y |
| County/Parish | Sonoma |
| Telephone Number | 7078945201 |
| Chain Name | THE ENSIGN GROUP |
| Chain ID | 507 |
| Provider Changed Ownership in Last 12 Months | N |
| With a Resident and Family Council | None |
| Automatic Sprinkler Systems in All Required Areas | Yes |
| Number of Certified Beds | 72 |
| Average Number of Residents per Day | 55.8 |
| Overall Rating | 5 |
| Health Inspection Rating | 5 |
| QM Rating | 5 |
| Long-Stay QM Rating | 5 |
| Short-Stay QM Rating | 5 |
| Processing Date | 2026-08-01 |
From the Care Compare Provider Information file NH_ProviderInfo_Aug2026.csv, processed on 1 August 2026.
Get an email when this record changes
One email a day naming what moved on CLOVERDALE HEALTHCARE CENTER: 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 1 July 2026: FLAGSTONE HEALTHCARE NORTH LLC no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. That is one line of the alert.
What the alerts are, and what a day of them looks like, is on the alerts page.
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The citable document for CLOVERDALE HEALTHCARE CENTER
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.
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 055756.