Skilled nursing facility · CMS certification number 105826
PAVILION AT JACKSONVILLE, THE
JACKSONVILLE, Florida · Medicare and Medicaid
Certified beds, as filed in Care Compare: 60
Finances, as filed
From this facility’s Medicare cost reports on form CMS-2540, each figure with the worksheet, line and column it was read from.
Cost report for 1 January 2024 to 31 December 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 28 August 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,870,583 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $303,424 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,567,159 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,916,304 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$349,145 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $38,674 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$310,471 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$310,471 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 21,960 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 1,657 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 17,605 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 1,561 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 20,823 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 26 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 72 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 60 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 158 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 63.73 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 244.51 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 131.79 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1433293, 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 7 August 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,413,611 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $194,086 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,219,525 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,742,336 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$522,811 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $45,532 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$477,279 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$477,279 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,109 | 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 | 68.54 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 304.87 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 177.96 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1391305, 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 8 August 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,337,927 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$197,440 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,535,367 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,207,629 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $327,738 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $66,420 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $394,158 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $394,158 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 21,054 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 126 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 105.7 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 579.04 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 167.1 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1361274, read from the public cost report file SNF10FY2022.zip.
Fiscal year 2021, ended 31 December 2021
Cost report for 1 May 2021 to 31 December 2021 — a reporting period of 244 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 29 September 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,155,755 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$129,463 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,285,218 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,951,099 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $334,119 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $49,608 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $383,727 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $383,727 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 13,999 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 70 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 90.56 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 406.27 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 199.99 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1334591, 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 1 June 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,769,224 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,089,733 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,679,491 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,165,009 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $514,482 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | −$102,937 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $411,545 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $411,545 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,289 | 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 | 114.39 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 469.97 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 253.8 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1317591, 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 12 May 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,451,358 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $950,629 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,500,729 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,872,952 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $627,777 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $15,764 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $643,541 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $643,541 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,242 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 75 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 62.89 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 528.34 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 269.89 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1283691, 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 28 August 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,876,431 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $777,014 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,099,417 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,869,748 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $229,669 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $16,602 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $246,271 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $246,271 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,179 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 100 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 78.58 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 341.57 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 191.79 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1242599, 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 31 July 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,200,282 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,064,224 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,136,058 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,973,072 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $162,986 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | −$56,007 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $106,979 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $106,979 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,299 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 119 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 88.14 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 280.66 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 162.18 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1203771, 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 15 August 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,123,160 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $900,442 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,222,718 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,853,251 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $369,467 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $32,902 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $402,369 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $402,369 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,806 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 114 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 89.89 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 17.59 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 173.74 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1173311, 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 10 August 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,983,094 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $808,868 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,174,226 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,995,335 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $178,891 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $4,104 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $182,995 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $182,995 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,133 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 94 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 63.84 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 374.26 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 214.18 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1140543, 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 24 July 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,217,329 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,123,323 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,094,006 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,893,917 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $200,089 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | −$48,476 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $151,613 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $151,778 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,422 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 94 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 58.15 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 356.2 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 217.26 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1102614, 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 5 August 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,088,816 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $989,513 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,099,303 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,673,428 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $425,875 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $8,083 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $433,958 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $433,958 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,954 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 67 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 67.29 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,224.29 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 312.75 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1074980, 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 6 June 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,812,544 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $876,570 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,935,974 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,648,462 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $287,512 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $18,721 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $306,233 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $306,233 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,633 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 90 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 138.53 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 336.13 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 229.26 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1062631, 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 23 May 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,403,214 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $496,349 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,906,865 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,701,753 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $205,112 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $62,517 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $267,629 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $267,629 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,317 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 88 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 93.13 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 544.32 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 230.88 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1030098, read from the public cost report file SNF10FY2011.zip.
Fiscal year 2010, ended 31 December 2010
Cost report for 1 January 2010 to 31 December 2010 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 1 November 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,947,085 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,700,691 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $246,394 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $100,571 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $346,965 (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 | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,497 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 136 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 56.16 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 368.05 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 150.71 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 419703, 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 18 February 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,631,410 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,291,715 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $339,695 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $162,585 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $502,280 (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 | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,433 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 92 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 62.28 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 386.02 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 222.1 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 394175, 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 26 February 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,023,708 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,446,299 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$422,591 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | −$53,794 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$476,385 (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 | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,496 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 107 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 49.23 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 317.42 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 191.55 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 364572, read from the public cost report file SNFFY2008.zip.
Fiscal year 2007, ended 31 December 2007
Cost report for 1 January 2007 to 31 December 2007 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 30 December 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,263,074 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,866,723 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$603,649 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $4,284 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$599,365 (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 | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,123 | 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 | 42.44 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 281.91 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 176.52 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 331165, 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 3 August 2007.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,599,258 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,564,492 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $34,766 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $222 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $34,988 (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 | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,879 | 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 | 32.21 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 281.23 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 143.01 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 290973, read from the public cost report file SNFFY2006.zip.
Fiscal year 2005, ended 31 December 2005
Cost report for 1 January 2005 to 31 December 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 15 September 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,410,369 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,572,748 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$162,379 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $593 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$161,786 (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 | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,786 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 147 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 27.82 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 268.14 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 141.4 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 263114, 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 22 July 2005.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,501,778 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,620,315 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$118,537 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $14,639 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$103,898 (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 | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,712 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 182 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 28.68 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 282.95 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 113.8 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 228677, 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 29 October 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,301,415 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,120,458 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $180,957 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $1,689 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $182,646 (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 | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,637 | 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 | 35.46 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 276.9 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 129.79 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 198475, read from the public cost report file SNFFY2003.zip.
Fiscal year 2002, ended 15 May 2002
Cost report for 1 January 2002 to 15 May 2002 — a reporting period of 134 days, not a full year, on form CMS-2540-96, settled, processed by CMS on 21 September 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,098,657 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,218,768 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$120,111 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $4,644 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$115,467 (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 | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 7,710 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 96 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, all patients, in days | 80.31 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 194162, read from the public cost report file SNFFY2002.zip.
Fiscal year 2001, ended 31 December 2001
Cost report for 1 January 2001 to 31 December 2001 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 27 April 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,638,773 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,985,885 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$347,112 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $2,664 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$344,448 (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 | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,267 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 102 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 26.57 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 198.7 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 173788, read from the public cost report file SNFFY2001.zip.
Fiscal year 2000, ended 31 December 2000
Cost report for 1 January 2000 to 31 December 2000 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 11 February 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,788,057 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,828,213 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$40,156 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | −$53,950 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$94,106 (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 | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,879 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 143 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 29.96 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 146.01 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 113595, read from the public cost report file SNFFY2000.zip.
Fiscal year 1999, ended 31 December 1999
Cost report for 1 January 1999 to 31 December 1999 — a reporting period of 364 days, on form CMS-2540-96, as submitted, processed by CMS on 29 July 2000.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,760,571 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,357,640 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$597,069 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $246 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$596,823 (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 | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,550 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 174 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 34.49 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 118.1 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 83453, read from the public cost report file SNFFY1999.zip.
Fiscal year 1998, ended 31 December 1998
Cost report for 1 July 1998 to 31 December 1998 — a reporting period of 183 days, not a full year, on form CMS-2540-96, as submitted, processed by CMS on 21 April 2000.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,686,434 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,811,138 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$124,704 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $876 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$123,828 (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 | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 10,396 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 53 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 49.81 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 196.15 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 83452, read from the public cost report file SNFFY1998.zip.
Fiscal year 1997, ended 30 June 1997
Cost report for 1 July 1996 to 30 June 1997 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 18 March 1999.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,564,230 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,719,716 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$155,486 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $558 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$154,928 (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 | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,190 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 298 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 55.23 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 68.4 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 67.75 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 83450, read from the public cost report file SNFFY1996.zip.
Fiscal year 1996, ended 30 June 1996
Cost report for 1 June 1996 to 30 June 1996 — a reporting period of 29 days, not a full year, on form CMS-2540-96, settled, processed by CMS on 24 March 1998.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $182,200 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $169,512 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $12,688 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $16 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $12,704 (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 | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 1,764 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 5 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 58.5 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 352.8 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 83448, 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 |
|---|---|---|---|---|
| FASTEN HALBERSTAM LLP | ADP OF THE SNF | Organization | NOT APPLICABLE | since 05/28/2021 |
| FTK CAPITAL LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 05/01/2021 |
| INZELBUCH, AZRIEL | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/01/2021 |
| LEWIS, JOSEPH | ADP OF THE SNF | Individual | NOT APPLICABLE | since 02/26/2024 |
| MOERMAN, RAFAEL | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/01/2021 |
| NPNH1 LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 05/01/2021 |
| PAVILION HOLDINGS LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 03/03/2021 |
| PAVILION MANAGEMENT GROUP LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 05/28/2021 |
| POWERBACK REHABILITATION LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 05/28/2021 |
| RICHARDS MITCHELL & CROSS PA | ADP OF THE SNF | Organization | NOT APPLICABLE | since 05/28/2021 |
| SHS KEREN LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 05/01/2021 |
| YU, ZHI | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/28/2021 |
| PAVILION HOLDINGS LLC | DIRECT OWNERSHIP INTEREST | Organization | NOT APPLICABLE | since 03/03/2021 |
| BIRNBAUM, EZRA | INDIRECT OWNERSHIP INTEREST | Individual | NOT APPLICABLE | since 05/01/2021 |
| FTK CAPITAL LLC | INDIRECT OWNERSHIP INTEREST | Organization | NOT APPLICABLE | since 05/01/2021 |
| HIRSCH, SHAYE | INDIRECT OWNERSHIP INTEREST | Individual | NOT APPLICABLE | since 05/01/2021 |
| INZELBUCH, AZRIEL | INDIRECT OWNERSHIP INTEREST | Individual | NOT APPLICABLE | since 05/01/2021 |
| MOERMAN, RAFAEL | INDIRECT OWNERSHIP INTEREST | Individual | NOT APPLICABLE | since 05/01/2021 |
| NPNH1 LLC | INDIRECT OWNERSHIP INTEREST | Organization | NOT APPLICABLE | since 05/01/2021 |
| SHS KEREN LLC | INDIRECT OWNERSHIP INTEREST | Organization | NOT APPLICABLE | since 05/01/2021 |
| SINGER, SIMON | INDIRECT OWNERSHIP INTEREST | Individual | NOT APPLICABLE | since 05/01/2021 |
| KRIESER, AKIVA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 05/01/2021 |
| LEWIS, JOSEPH | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 02/26/2024 |
| MOERMAN, RAFAEL | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 05/01/2021 |
Medicare enrollment
As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of THE PAVILION AT JACKSONVILLE FOR NURSING AND REHABILITATION LLC (enrollment ID O20210517000103).
| Owner | Individual or organization | Role | Ownership percentage | Association date | Described in the filing as |
|---|---|---|---|---|---|
| EZRA BIRNBAUM | Individual | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 22.5 | 5/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| AZRIEL INZELBUCH | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| FASTEN HALBERSTAM LLP | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/28/2021 | Private equity company: No Real estate investment trust: No Holding company: No |
| FTK CAPITAL LLC | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/1/2021 | Private equity company: No Real estate investment trust: No Holding company: No |
| JOSEPH H LEWIS | 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. | 2/26/2024 | 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. |
| NPNH1 LLC | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/1/2021 | Private equity company: No Real estate investment trust: No Holding company: No |
| PAVILION HOLDINGS LLC | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 3/3/2021 | Private equity company: No Real estate investment trust: No Holding company: Yes |
| PAVILION MANAGEMENT GROUP LLC | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/28/2021 | Private equity company: No Real estate investment trust: No Holding company: No |
| POWERBACK REHABILITATION LLC | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/28/2021 | Private equity company: No Real estate investment trust: No Holding company: No |
| RAFAEL MOERMAN | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| RICHARDS MITCHELL & CROSS PA | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/28/2021 | Private equity company: No Real estate investment trust: No Holding company: No |
| SHS KEREN LLC | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/1/2021 | Private equity company: No Real estate investment trust: No Holding company: No |
| ZHI J YU | 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. | 5/28/2021 | 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. |
| PAVILION HOLDINGS LLC | Organization | DIRECT OWNERSHIP INTEREST | 100 | 3/3/2021 | Private equity company: No Real estate investment trust: No Holding company: Yes |
| AZRIEL INZELBUCH | Individual | INDIRECT OWNERSHIP INTEREST | 15 | 5/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| EZRA BIRNBAUM | Individual | INDIRECT OWNERSHIP INTEREST | 22.5 | 5/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| FTK CAPITAL LLC | Organization | INDIRECT OWNERSHIP INTEREST | 22.5 | 5/1/2021 | Private equity company: No Real estate investment trust: No Holding company: No |
| NPNH1 LLC | Organization | INDIRECT OWNERSHIP INTEREST | 22.5 | 5/1/2021 | Private equity company: No Real estate investment trust: No Holding company: No |
| RAFAEL MOERMAN | Individual | INDIRECT OWNERSHIP INTEREST | 35 | 5/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| SHAYE HIRSCH | Individual | INDIRECT OWNERSHIP INTEREST | 5 | 5/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| SHS KEREN LLC | Organization | INDIRECT OWNERSHIP INTEREST | 5 | 5/1/2021 | Private equity company: No Real estate investment trust: No Holding company: No |
| SIMON SINGER | Individual | INDIRECT OWNERSHIP INTEREST | 22.5 | 5/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| AKIVA KRIESER | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| JOSEPH H LEWIS | 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. | 2/26/2024 | 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. |
| RAFAEL MOERMAN | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
Changes in ownership
- 1 October 2025: PAVILION HOLDINGS LLC no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: FTK CAPITAL LLC no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: 2020 NORTHEAST HOLDINGS TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: RAFAEL MOERMAN no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: RAFAEL MOERMAN no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: JESSA DICKERMAN no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: SHAYE HIRSCH no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: SIMON SINGER no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: AZRIEL INZELBUCH no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: NPNH1 LLC no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: PAVILION MANAGEMENT GROUP LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: SHS KEREN LLC appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: SHS KEREN LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: PAVILION HOLDINGS LLC appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: PAVILION HOLDINGS LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: FTK CAPITAL LLC appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: FTK CAPITAL LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: FASTEN HALBERSTAM LLP appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: RAFAEL MOERMAN appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: RAFAEL MOERMAN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: RAFAEL MOERMAN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: SHAYE HIRSCH appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: RICHARDS, MITCHELL & CROSS, P.A. appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: AKIVA KRIESER appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: SIMON SINGER appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: AZRIEL INZELBUCH appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: AZRIEL INZELBUCH appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: JOSEPH H LEWIS appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: JOSEPH H LEWIS appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: POWERBACK REHABILITATION LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: EZRA BIRNBAUM appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: NPNH1 LLC appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: NPNH1 LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: ZHI J YU appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
Recent changes on this record
- 1 October 2025: PAVILION HOLDINGS LLC no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: FTK CAPITAL LLC no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: 2020 NORTHEAST HOLDINGS TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: RAFAEL MOERMAN no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: RAFAEL MOERMAN no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: JESSA DICKERMAN no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: SHAYE HIRSCH no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: SIMON SINGER no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: AZRIEL INZELBUCH no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: NPNH1 LLC no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: PAVILION MANAGEMENT GROUP LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: SHS KEREN LLC appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: SHS KEREN LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: PAVILION HOLDINGS LLC appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: PAVILION HOLDINGS LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: FTK CAPITAL LLC appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: FTK CAPITAL LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: FASTEN HALBERSTAM LLP appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: RAFAEL MOERMAN appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: RAFAEL MOERMAN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: RAFAEL MOERMAN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: SHAYE HIRSCH appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: RICHARDS, MITCHELL & CROSS, P.A. appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: AKIVA KRIESER appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: SIMON SINGER appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: AZRIEL INZELBUCH appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: AZRIEL INZELBUCH appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: JOSEPH H LEWIS appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: JOSEPH H LEWIS appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: POWERBACK REHABILITATION LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: EZRA BIRNBAUM appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: NPNH1 LLC appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: NPNH1 LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: ZHI J YU appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 28 August 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- 7 August 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- 8 August 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- 29 September 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
- 4 August 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
- 1 June 2022: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | 12 March 2026 | 12 March 2026 | 4 | 14 |
| 2 | 2 May 2024 | 2 May 2024 | 3 | 5 |
| 3 | 12 May 2022 | 12 May 2022 | 4 | 0 |
From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.
Deficiencies cited
11 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| 12 March 2026 | 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. | F | No | Deficient, Provider has date of correction | 7 May 2026 |
| 12 March 2026 | 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 | 7 May 2026 |
| 12 March 2026 | Health | F 0842 | Resident Assessment and Care Planning Deficiencies | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | No | Deficient, Provider has date of correction | 7 May 2026 |
| 12 March 2026 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | No | Deficient, Provider has date of correction | 7 May 2026 |
| 2 May 2024 | Health | F 0644 | Resident Assessment and Care Planning Deficiencies | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | D | No | Deficient, Provider has date of correction | 31 May 2024 |
| 2 May 2024 | Health | F 0661 | Resident Assessment and Care Planning Deficiencies | Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. | D | Yes | Deficient, Provider has date of correction | 31 May 2024 |
| 2 May 2024 | Health | F 0801 | Nutrition and Dietary Deficiencies | Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician. | D | No | Deficient, Provider has date of correction | 31 May 2024 |
| 2 May 2024 | Health | F 0804 | Nutrition and Dietary Deficiencies | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | F | No | Deficient, Provider has date of correction | 31 May 2024 |
| 12 May 2022 | Health | F 0757 | Pharmacy Service Deficiencies | Ensure each resident’s drug regimen must be free from unnecessary drugs. | D | No | Deficient, Provider has date of correction | 5 June 2022 |
| 12 May 2022 | Health | F 0760 | Pharmacy Service Deficiencies | Ensure that residents are free from significant medication errors. | D | No | Deficient, Provider has date of correction | 5 June 2022 |
| 12 May 2022 | Health | F 0812 | Nutrition and Dietary Deficiencies | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | No | Deficient, Provider has date of correction | 5 June 2022 |
From the Care Compare health citations file NH_HealthCitations_Aug2026.csv, processed on 1 August 2026.
Penalties
Not yet extracted for this facility.
Care Compare provider information
| Field | As filed |
|---|---|
| Provider Type | Medicare and Medicaid |
| Ownership Type | For profit - Limited Liability company |
| Legal Business Name | THE PAVILION AT JACKSONVILLE FOR NURSING AND REHABILITATION LLC |
| Date First Approved to Provide Medicare and Medicaid Services | 1993-08-01 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | Y |
| County/Parish | Duval |
| Telephone Number | 9047667436 |
| Chain Name | THE PAVILION GROUP |
| Chain ID | 514 |
| Provider Changed Ownership in Last 12 Months | N |
| With a Resident and Family Council | Resident |
| Automatic Sprinkler Systems in All Required Areas | Yes |
| Number of Certified Beds | 60 |
| Average Number of Residents per Day | 57.3 |
| Overall Rating | 4 |
| Health Inspection Rating | 3 |
| QM Rating | 5 |
| Long-Stay QM Rating | 5 |
| Short-Stay QM Rating | 4 |
| Processing Date | 2026-08-01 |
From the Care Compare Provider Information file NH_ProviderInfo_Aug2026.csv, processed on 1 August 2026.
Get an email when this record changes
One email a day naming what moved on PAVILION AT JACKSONVILLE, THE: the field, the value before, the value after, and the date of the file that first showed it.
The facility alert follows this one record: a cost report filed or a figure on one changed, an inspection, a deficiency or a penalty recorded, an owner added or removed. The certification number arrives filled in.
On 1 October 2025: PAVILION HOLDINGS LLC no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. That is one line of the alert.
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The citable document for PAVILION AT JACKSONVILLE, THE
This page shows the record as it stands today. The report is the citable document: the same figures with the cell each came from, and beyond this page — five facilities of a similar size in Florida at the same fiscal year, listed by name; every change on the record rather than the recent ones below; the inspection and staffing history in blocks of their own; and a citation block naming every CMS file it was read from.
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