Skilled nursing facility · CMS certification number 055850
PINE RIDGE CARE CENTER
SAN RAFAEL, California · Medicare and Medicaid
Certified beds, as filed in Care Compare: 101
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 23 September 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $19,981,024 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $3,541,806 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $16,439,218 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $15,832,624 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $606,594 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $3,263 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $609,857 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $609,857 (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 | 101 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 36,966 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 3,767 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 25,104 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 4,628 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 33,499 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 69 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 57 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 84 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 210 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 54.59 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 440.42 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 159.52 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1439970, 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 23 September 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $16,272,525 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,689,615 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $14,582,910 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $15,532,276 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$949,366 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $854,026 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$95,340 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$95,340 (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 | 101 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 32,431 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 155 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 85.12 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 416.72 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 209.23 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1395456, 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 7 August 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $15,990,781 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $15,990,781 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $16,112,673 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$121,892 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,477,920 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,356,028 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,356,028 (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 | 101 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 34,408 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 165 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 90.29 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 398.28 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 208.53 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1391294, 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 26 September 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $14,586,779 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,272,929 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $13,313,850 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $14,893,113 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,579,263 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $2,036,814 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $457,551 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $457,551 (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 | 101 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 33,669 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 186 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 56.36 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 335.32 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 181.02 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1333961, 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 24 November 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $14,408,971 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,446,759 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $11,962,212 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $12,646,135 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$683,923 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $62,909 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$621,014 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$621,014 (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 | 101 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 32,806 | 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 | 122.38 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 471.42 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 334.76 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1305282, 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 16 September 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $15,014,055 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $3,643,459 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $11,370,596 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $12,038,590 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$667,994 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $195 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$667,799 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$667,799 (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 | 101 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 34,980 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 97 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 41.32 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 3,424.67 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 360.62 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1298240, 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 26 August 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $14,883,715 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $3,495,918 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $11,387,797 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $11,426,240 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$38,443 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,543 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$36,900 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$36,900 (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 | 101 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 35,005 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 113 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 59.86 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 710.58 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 309.78 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1242271, 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 | $14,193,207 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $3,092,984 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $11,100,223 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $11,279,652 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$179,429 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $449 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$178,980 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$178,980 (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 | 101 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 34,610 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 141 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 63.9 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 456.63 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 245.46 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1208391, 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 3 August 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $14,875,427 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $3,244,399 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $11,631,028 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,750,045 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $880,983 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $611 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $881,594 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $881,590 (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 | 101 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 34,029 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 198 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 81.31 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 458.03 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 171.86 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1171696, 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 22 August 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $12,793,179 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $3,145,827 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,647,352 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,968,797 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$321,445 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $2,877 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$318,568 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$318,568 (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 | 101 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 33,988 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 127 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 62.15 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 822.25 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 267.62 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1142172, 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 10 August 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $12,905,203 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,982,047 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,923,156 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,700,487 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $222,669 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $493 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $223,162 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $223,162 (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 | 93 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 32,551 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 92 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 64.54 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 2,186.92 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 353.82 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1107194, 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 26 August 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,335,486 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,281,283 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,054,203 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,474,809 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$420,606 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $249 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$420,357 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$420,357 (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 | 93 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 32,136 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 76 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 75.6 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,340.47 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 422.84 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1077051, 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 1 August 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,946,917 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,633,588 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,313,329 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,673,753 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $639,576 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $148 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $639,724 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $639,724 (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 | 93 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 33,255 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 140 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 75.82 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 439.14 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 237.54 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1044735, 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 16 November 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,573,201 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,344,813 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,228,388 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,631,385 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $597,003 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $55 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $597,058 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $597,058 (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 | 93 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 31,965 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 165 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 49.06 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 436.54 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 193.73 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1020346, 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 31 May 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $9,386,444 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,513,481 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $872,963 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | −$63 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $872,900 (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 | 101 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 32,053 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 132 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 73.57 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 493.8 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 242.83 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 429676, 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 17 June 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $8,209,396 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,025,722 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $183,674 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $1,554 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $185,228 (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 | 101 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 30,945 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 142 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 69.94 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 447.06 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 217.92 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 405227, 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 21 August 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $7,348,784 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,482,654 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$133,870 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $2,368 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$131,502 (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 | 101 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 29,943 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 164 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 39.69 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 519.32 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 182.58 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 355127, 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 20 January 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $7,851,092 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,701,682 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $149,410 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $308 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $149,718 (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 | 101 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 31,885 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 206 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 37.31 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 607.12 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 154.78 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 331722, 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 20 March 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $7,611,731 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,029,328 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $582,403 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | −$7,283 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $575,120 (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 | 101 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 32,530 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 208 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 48.18 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 374.79 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 156.39 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 305139, 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 1 May 2007.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $6,612,593 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,235,956 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $376,637 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $7,788 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $384,425 (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 | 101 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 32,737 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 181 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 39.87 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 511.7 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 180.87 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 277240, 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 23 December 2005.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $5,487,068 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,714,424 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$227,356 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $12,223 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$215,133 (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 | 101 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 31,358 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 130 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 47.86 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 771.45 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 241.22 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 239999, 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 30 November 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,936,705 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,338,643 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$401,938 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $9,781 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$392,157 (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 | 101 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 30,899 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 159 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 36.89 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 394.95 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 194.33 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 200968, read from the public cost report file SNFFY2003.zip.
Fiscal year 2002, ended 31 December 2002
Cost report for 1 June 2002 to 31 December 2002 — a reporting period of 213 days, not a full year, on form CMS-2540-96, settled, processed by CMS on 27 April 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,474,186 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,594,055 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$119,869 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $6,369 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$113,500 (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 | 101 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 15,772 | 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 | 41.38 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 330.97 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 213.14 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 173756, read from the public cost report file SNFFY2002.zip.
Fiscal year 2001, ended 31 May 2001
Cost report for 1 June 2000 to 31 May 2001 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 13 May 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,404,143 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,615,526 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$211,383 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $10,886 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$200,497 (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 | 101 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 30,949 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 121 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 39.09 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 436.53 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 255.78 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 145101, read from the public cost report file SNFFY2000.zip.
Fiscal year 2000, ended 31 May 2000
Cost report for 1 June 1999 to 31 May 2000 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 2 November 2001.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,148,866 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,208,035 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$59,169 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $12,323 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$46,846 (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 | 101 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 32,321 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 114 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 36.58 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,375.82 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 283.52 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 81426, read from the public cost report file SNFFY1999.zip.
Fiscal year 1999, ended 31 May 1999
Cost report for 1 June 1998 to 31 May 1999 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 1 August 2000.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,165,533 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,929,291 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $236,242 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $24,380 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $260,622 (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 | 101 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 33,701 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 233 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 24.49 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 495.1 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 144.64 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 81425, read from the public cost report file SNFFY1998.zip.
Fiscal year 1998, ended 31 May 1998
Cost report for 1 January 1998 to 31 May 1998 — a reporting period of 150 days, not a full year, on form CMS-2540-96, as submitted, processed by CMS on 18 December 2000.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,688,564 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,435,299 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $253,265 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $9,863 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $8,936 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: $254,192 (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 | 99 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 14,630 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 65 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 16.82 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 475.64 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 225.08 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 81424, 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 11 March 1999.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,984,540 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,385,523 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $599,017 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $20,098 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | −$43,574 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: $662,689 (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 | 99 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 35,188 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 146 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 20.45 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 509.39 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 241.01 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 81422, 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 | $3,813,511 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,208,886 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $604,625 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $12,650 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | −$68,320 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: $685,595 (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 | 99 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 33,459 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 181 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 27.12 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 422.93 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 184.86 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 81421, 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 |
|---|---|---|---|---|
| GC HOLDING COMPANY 3, LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | 99% | since 08/01/2022 |
| GRANCARE LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | Organization | NO PERCENTAGE PROVIDED | since 12/21/2005 |
| GRUNSTEIN, EMILY | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | Individual | NO PERCENTAGE PROVIDED | since 02/06/2019 |
| MARINER HEALTH CARE, INC. | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | Organization | NO PERCENTAGE PROVIDED | since 12/21/2015 |
| MHC HOLDING COMPANY | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | Organization | NO PERCENTAGE PROVIDED | since 12/21/2005 |
| MHC WEST HOLDING COMPANY | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | Organization | NO PERCENTAGE PROVIDED | since 12/21/2005 |
| NATIONAL SENIOR CARE, INC. | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | Organization | NO PERCENTAGE PROVIDED | since 12/21/2005 |
| CAPITAL FUNDING GROUP, LLC | 5% OR GREATER SECURITY INTEREST | Organization | NOT APPLICABLE | since 11/01/2021 |
| MELIJOY, ADAN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 08/27/2012 |
| MONROE, MICHAEL | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/24/2022 |
| SARCAUGA, DENNIS | ADP OF THE SNF | Individual | NOT APPLICABLE | since 02/06/2025 |
| SERRANO, NOEL | ADP OF THE SNF | Individual | NOT APPLICABLE | since 12/01/2021 |
| SAN RAFAEL OPERATING COMPANY GP, LLC | GENERAL PARTNERSHIP INTEREST | Organization | NOT APPLICABLE | since 12/21/2005 |
| GC HOLDING COMPANY 3, LLC | LIMITED PARTNERSHIP INTEREST | Organization | NOT APPLICABLE | since 08/01/2022 |
| MELIJOY, ADAN | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 08/27/2012 |
| MONROE, MICHAEL | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 05/24/2022 |
| SARCAUGA, DENNIS | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 02/06/2025 |
| MELIJOY, ADAN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 08/27/2012 |
| MONROE, MICHAEL | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 05/24/2022 |
| SARCAUGA, DENNIS | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 02/06/2025 |
| SERRANO, NOEL | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 12/01/2021 |
Medicare enrollment
As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of SAN RAFAEL OPERATING COMPANY LP (enrollment ID O20131112001077).
| Owner | Individual or organization | Role | Ownership percentage | Association date | Described in the filing as |
|---|---|---|---|---|---|
| GC HOLDING COMPANY 3, LLC | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 99 | 8/1/2022 | Private equity company: No Real estate investment trust: No Holding company: Yes |
| EMILY GRUNSTEIN | Individual | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100 | 2/6/2019 | 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. |
| GRANCARE LLC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100 | 12/21/2005 | Private equity company: No Real estate investment trust: No Holding company: No |
| MARINER HEALTH CARE, INC. | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100 | 12/21/2015 | Private equity company: No Real estate investment trust: No Holding company: No |
| MHC HOLDING COMPANY | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100 | 12/21/2005 | Private equity company: No Real estate investment trust: No Holding company: Yes |
| MHC WEST HOLDING COMPANY | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100 | 12/21/2005 | Private equity company: No Real estate investment trust: No Holding company: Yes |
| NATIONAL SENIOR CARE, INC. | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100 | 12/21/2005 | Private equity company: No Real estate investment trust: No Holding company: No |
| CAPITAL FUNDING GROUP, LLC | Organization | 5% OR GREATER SECURITY INTEREST | 100 | 11/1/2021 | Private equity company: No Real estate investment trust: No Holding company: No |
| ADAN MELIJOY | 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. | 8/27/2012 | 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. |
| DENNIS SARCAUGA | 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. | 2/6/2025 | 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. |
| MICHAEL MONROE | 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. | 5/24/2022 | 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 | 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. | 12/1/2021 | 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. |
| SAN RAFAEL OPERATING COMPANY GP, LLC | Organization | GENERAL PARTNERSHIP INTEREST | 1 | 12/21/2005 | Private equity company: No Real estate investment trust: No Holding company: Yes |
| GC HOLDING COMPANY 3, LLC | Organization | LIMITED PARTNERSHIP INTEREST | 99 | 8/1/2022 | Private equity company: No Real estate investment trust: No Holding company: Yes |
| ADAN MELIJOY | 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. | 8/27/2012 | 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. |
| DENNIS SARCAUGA | 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. | 2/6/2025 | 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. |
| MICHAEL MONROE | 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. | 5/24/2022 | 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. |
| ADAN MELIJOY | 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. | 8/27/2012 | 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. |
| DENNIS SARCAUGA | 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. | 2/6/2025 | 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. |
| MICHAEL MONROE | 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. | 5/24/2022 | 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. | 12/1/2021 | 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. |
Changes in ownership
- 1 April 2026: ADAN MELIJOY no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- 1 April 2026: MICHAEL MONROE no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- 1 April 2026: NOEL SERRANO no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- 1 April 2026: LINDA W TAETZ no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- 1 April 2026: ADAN MELIJOY appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- 1 April 2026: ADAN MELIJOY appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- 1 April 2026: ADAN MELIJOY appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- 1 April 2026: DENNIS SARCAUGA appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- 1 April 2026: DENNIS SARCAUGA appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- 1 April 2026: DENNIS SARCAUGA appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- 1 April 2026: MICHAEL MONROE appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- 1 April 2026: MICHAEL MONROE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- 1 April 2026: MICHAEL MONROE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- 1 April 2026: NOEL SERRANO appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- 1 January 2025: NOEL SERRANO appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: NOEL SERRANO appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 15 September 2023: LANCASTER POLLARD MORTGAGE COMPANY LLC no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- 15 September 2023: DEVIN M EHRLICH no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- 15 September 2023: HENRY G BRUMLEY no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- 15 September 2023: SAN RAFAEL OPERATING COMPANY LP no longer appears as GENERAL PARTNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- 15 September 2023: MICHAEL MONROE appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- 15 September 2023: CAPITAL FUNDING BANCORP INC appears as 5% OR GREATER SECURITY INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- 1 January 2023: GRANCARE LLC no longer appears as LIMITED PARTNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- 1 January 2023: GRANCARE LLC no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- 1 January 2023: SAN RAFAEL OPERATING COMPANY GP, LLC appears as GENERAL PARTNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- 1 January 2023: GC HOLDING COMPANY 3, LLC appears as LIMITED PARTNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- 1 January 2023: GC HOLDING COMPANY 3, LLC appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- 1 January 2023: GRANCARE LLC appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
Recent changes on this record
- 1 April 2026: ADAN MELIJOY no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- 1 April 2026: MICHAEL MONROE no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- 1 April 2026: NOEL SERRANO no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- 1 April 2026: LINDA W TAETZ no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- 1 April 2026: ADAN MELIJOY appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- 1 April 2026: ADAN MELIJOY appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- 1 April 2026: ADAN MELIJOY appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- 1 April 2026: DENNIS SARCAUGA appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- 1 April 2026: DENNIS SARCAUGA appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- 1 April 2026: DENNIS SARCAUGA appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- 1 April 2026: MICHAEL MONROE appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- 1 April 2026: MICHAEL MONROE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- 1 April 2026: MICHAEL MONROE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- 1 April 2026: NOEL SERRANO appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
- 23 September 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- 1 January 2025: NOEL SERRANO appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: NOEL SERRANO appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 23 September 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- 7 August 2024: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- 15 September 2023: LANCASTER POLLARD MORTGAGE COMPANY LLC no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- 15 September 2023: DEVIN M EHRLICH no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- 15 September 2023: HENRY G BRUMLEY no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- 15 September 2023: SAN RAFAEL OPERATING COMPANY LP no longer appears as GENERAL PARTNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- 15 September 2023: MICHAEL MONROE appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- 15 September 2023: CAPITAL FUNDING BANCORP INC appears as 5% OR GREATER SECURITY INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-09-15.csv
- 1 January 2023: GRANCARE LLC no longer appears as LIMITED PARTNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- 1 January 2023: GRANCARE LLC no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- 1 January 2023: SAN RAFAEL OPERATING COMPANY GP, LLC appears as GENERAL PARTNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- 1 January 2023: GC HOLDING COMPANY 3, LLC appears as LIMITED PARTNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- 1 January 2023: GC HOLDING COMPANY 3, LLC appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- 1 January 2023: GRANCARE LLC appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- 26 September 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
- 24 November 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
- 16 September 2021: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
- 26 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
- 3 August 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2016.zip
- 22 August 2016: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2015.zip
- 10 August 2015: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2014.zip
- 26 August 2014: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2013.zip
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | 5 December 2025 | 5 December 2025 | 18 | 9 |
| 2 | 12 December 2024 | 12 December 2024 | 7 | 10 |
| 3 | 12 August 2021 | 12 August 2021 | 18 | 6 |
From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.
Deficiencies cited
43 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| 12 February 2026 | Health | F 0600 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | E | Yes | Deficient, Provider has date of correction | 4 March 2026 |
| 12 February 2026 | Health | F 0641 | Resident Assessment and Care Planning Deficiencies | Ensure each resident receives an accurate assessment. | D | Yes | Deficient, Provider has date of correction | 4 March 2026 |
| 8 January 2026 | Health | F 0557 | Resident Rights Deficiencies | Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. | D | Yes | Deficient, Provider has date of correction | 3 February 2026 |
| 5 December 2025 | Health | F 0578 | Resident Rights Deficiencies | Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | E | No | Deficient, Provider has date of correction | 4 January 2026 |
| 5 December 2025 | Health | F 0627 | Resident Rights Deficiencies | Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge. | D | Yes | Deficient, Provider has date of correction | 4 January 2026 |
| 5 December 2025 | 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. | D | No | Deficient, Provider has date of correction | 4 January 2026 |
| 5 December 2025 | Health | F 0657 | Resident Assessment and Care Planning Deficiencies | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | E | No | Deficient, Provider has date of correction | 4 January 2026 |
| 5 December 2025 | Health | F 0676 | Quality of Life and Care Deficiencies | Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. | D | No | Deficient, Provider has date of correction | 4 January 2026 |
| 5 December 2025 | Health | F 0699 | Quality of Life and Care Deficiencies | Provide care or services that was trauma informed and/or culturally competent. | D | No | Deficient, Provider has date of correction | 4 January 2026 |
| 5 December 2025 | Health | F 0756 | Pharmacy Service Deficiencies | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | F | No | Deficient, Provider has date of correction | 4 January 2026 |
| 5 December 2025 | Health | F 0804 | Nutrition and Dietary Deficiencies | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | No | Deficient, Provider has date of correction | 4 January 2026 |
| 5 December 2025 | Health | F 0807 | Nutrition and Dietary Deficiencies | Ensure each resident receives and the facility provides drinks consistent with resident needs and preferences and sufficient to maintain resident hydration. | E | No | Deficient, Provider has date of correction | 4 January 2026 |
| 5 December 2025 | 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. | F | No | Deficient, Provider has date of correction | 4 January 2026 |
| 5 December 2025 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | No | Deficient, Provider has date of correction | 4 January 2026 |
| 8 September 2025 | Health | F 0600 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | Yes | Deficient, Provider has date of correction | 25 September 2025 |
| 4 August 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 | 29 August 2025 |
| 4 August 2025 | Health | F 0655 | Resident Assessment and Care Planning Deficiencies | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | D | Yes | Deficient, Provider has date of correction | 29 August 2025 |
| 4 August 2025 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Yes | Deficient, Provider has date of correction | 29 August 2025 |
| 16 July 2025 | 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 | 4 August 2025 |
| 17 April 2025 | Health | F 0658 | Resident Assessment and Care Planning Deficiencies | Ensure services provided by the nursing facility meet professional standards of quality. | D | Yes | Deficient, Provider has date of correction | 22 May 2025 |
| 17 April 2025 | Health | F 0678 | Quality of Life and Care Deficiencies | Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives. | E | Yes | Deficient, Provider has date of correction | 22 May 2025 |
| 12 December 2024 | Health | F 0638 | Resident Assessment and Care Planning Deficiencies | Assure that each resident’s assessment is updated at least once every 3 months. | D | No | Deficient, Provider has date of correction | 2 January 2025 |
| 12 December 2024 | Health | F 0676 | Quality of Life and Care Deficiencies | Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. | D | No | Deficient, Provider has date of correction | 2 January 2025 |
| 12 December 2024 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | No | Deficient, Provider has date of correction | 2 January 2025 |
| 12 December 2024 | 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. | D | No | Waiver has been granted | 2 January 2025 |
| 28 May 2024 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Yes | Deficient, Provider has date of correction | 29 July 2024 |
| 19 March 2024 | 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 | 3 May 2024 |
| 11 September 2023 | Health | F 0684 | Quality of Life and Care Deficiencies | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | Yes | Deficient, Provider has date of correction | 27 October 2023 |
| 12 August 2021 | Health | F 0576 | Resident Rights Deficiencies | Ensure residents have reasonable access to and privacy in their use of communication methods. | F | No | Deficient, Provider has date of correction | 13 October 2021 |
| 12 August 2021 | Health | F 0577 | Resident Rights Deficiencies | Allow residents to easily view the nursing home's survey results and communicate with advocate agencies. | E | No | Deficient, Provider has date of correction | 13 October 2021 |
| 12 August 2021 | Health | F 0585 | Resident Rights Deficiencies | Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. | E | No | Deficient, Provider has date of correction | 13 October 2021 |
| 12 August 2021 | 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 | No | Deficient, Provider has date of correction | 13 October 2021 |
| 12 August 2021 | 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. | E | No | Deficient, Provider has date of correction | 13 October 2021 |
| 12 August 2021 | Health | F 0692 | Quality of Life and Care Deficiencies | Provide enough food/fluids to maintain a resident's health. | E | No | Deficient, Provider has date of correction | 13 October 2021 |
| 12 August 2021 | Health | F 0756 | Pharmacy Service Deficiencies | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | E | No | Deficient, Provider has date of correction | 13 October 2021 |
| 12 August 2021 | Health | F 0758 | Pharmacy Service Deficiencies | Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | E | No | Deficient, Provider has date of correction | 13 October 2021 |
| 12 August 2021 | 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. | E | No | Deficient, Provider has date of correction | 13 October 2021 |
| 12 August 2021 | Health | F 0803 | Nutrition and Dietary Deficiencies | Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | E | No | Deficient, Provider has date of correction | 13 October 2021 |
| 12 August 2021 | 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 | 13 October 2021 |
| 12 August 2021 | Health | F 0841 | Nursing and Physician Services Deficiencies | Designate a physician to serve as medical director responsible for implementation of resident care policies and coordination of medical care in the facility. | E | No | Deficient, Provider has date of correction | 13 October 2021 |
| 12 August 2021 | Health | F 0865 | Administration Deficiencies | Have a plan that describes the process for conducting QAPI and QAA activities. | E | No | Deficient, Provider has date of correction | 13 October 2021 |
| 12 August 2021 | Health | F 0867 | Administration Deficiencies | Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | E | No | Deficient, Provider has date of correction | 13 October 2021 |
| 12 August 2021 | Health | F 0921 | Environmental Deficiencies | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | E | No | Deficient, Provider has date of correction | 13 October 2021 |
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 - Partnership |
| Legal Business Name | SAN RAFAEL OPERATING COMPANY LP |
| Date First Approved to Provide Medicare and Medicaid Services | 1967-11-01 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | Y |
| County/Parish | Marin |
| Telephone Number | 4154793610 |
| Chain Name | MARINER HEALTH CARE |
| Chain ID | 334 |
| 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 | 101 |
| Average Number of Residents per Day | 86.5 |
| Overall Rating | 5 |
| Health Inspection Rating | 3 |
| 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.
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On 1 April 2026: ADAN MELIJOY no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. That is one line of the alert.
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