Skilled nursing facility · CMS certification number 115311
FORUM HEALTH @ MOUNT BERRY
ROME, Georgia
This certification number is not in CMS’s current Care Compare Provider Information file, processed on 1 August 2026.
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 July 2005 to 30 June 2006 — a reporting period of 364 days, on form CMS-2540-96, as submitted, processed by CMS on 30 May 2007.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,676,291 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,396,863 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$720,572 | CMS-2540-96 worksheet G300000 line 500 column 100 |
Net income, stated at moderate confidence: −$720,572 (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 | 100 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Bed days available, all components | 36,500 | CMS-2540-96 worksheet S300001 line 900 column 200 |
| Medicare (Title XVIII) patient days | 2,765 | CMS-2540-96 worksheet S300001 line 900 column 400 |
| Other-payer patient days | 30,115 | CMS-2540-96 worksheet S300001 line 900 column 600 |
| Total patient days, all components | 32,880 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Medicare discharges | 294 | CMS-2540-96 worksheet S300001 line 900 column 900 |
| Other-payer discharges | 1 | CMS-2540-96 worksheet S300001 line 900 column 1100 |
| Total discharges, all components | 295 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 9.4 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 111.46 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 279783, read from the public cost report file SNFFY2005.zip.
Fiscal year 2005, ended 30 June 2005
Cost report for 1 July 2004 to 30 June 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 12 January 2007.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,333,008 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,525,672 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $807,336 | CMS-2540-96 worksheet G300000 line 500 column 100 |
Net income, stated at moderate confidence: $807,336 (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 | 100 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 34,549 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 118 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 51.09 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 292.79 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 270408, read from the public cost report file SNFFY2004.zip.
Fiscal year 2004, ended 30 June 2004
Cost report for 1 July 2003 to 30 June 2004 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 17 May 2005.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,114,587 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,567,006 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $1,547,581 | CMS-2540-96 worksheet G300000 line 500 column 100 |
Net income, stated at moderate confidence: $1,547,581 (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 | 100 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 35,916 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 11 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 1,085 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 3,265.09 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 217027, read from the public cost report file SNFFY2003.zip.
Fiscal year 2003, ended 30 April 2003
Cost report for 1 January 2003 to 30 April 2003 — a reporting period of 119 days, not a full year, on form CMS-2540-96, settled, processed by CMS on 23 May 2005.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,317,946 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,580,844 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$262,898 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $4,398 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$258,500 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 100 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 11,830 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 32 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 52.15 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 369.69 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 217755, read from the public cost report file SNFFY2003.zip.
Fiscal year 2002, ended 31 December 2002
Cost report for 1 January 2002 to 31 December 2002 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 26 November 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,198,235 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,951,959 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $246,276 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $105 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $246,381 (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 | 100 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 36,006 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 214 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 45.55 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 168.25 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 164095, 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 28 July 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,802,394 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,670,599 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $131,795 | CMS-2540-96 worksheet G300000 line 500 column 100 |
Net income, stated at moderate confidence: $131,795 (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 | 100 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 36,090 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 166 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 49.42 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 217.41 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 154613, 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 7 April 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,796,960 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,451,866 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $345,094 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $18 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $345,112 (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 | 100 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 23,104 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 167 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 48.66 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 138.35 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 137223, 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 | $3,524,912 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,832,881 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$307,969 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $1,451 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$306,518 (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 | 100 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 35,209 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 153 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 35.57 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 230.12 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 83694, 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 | $1,711,170 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,820,467 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$109,297 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $788 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$108,509 (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 | 100 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 17,741 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 66 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 56.15 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 725.21 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 268.8 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 83693, 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 11 March 1999.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,111,029 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,389,643 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$278,614 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $5,114 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$273,500 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 100 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 35,158 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 169 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 60.98 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 295.3 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 208.04 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 83691, read from the public cost report file SNFFY1996.zip.
Fiscal year 1996, ended 30 June 1996
Cost report for 1 July 1995 to 30 June 1996 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 24 March 1998.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,796,909 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,818,746 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$21,837 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $4,595 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$17,242 (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 | 100 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 35,703 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 73 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 55 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,658.29 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 489.08 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 83689, read from the public cost report file SNFFY1995.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
Not yet extracted for this facility.
Medicare enrollment
Not yet extracted for this facility.
Changes in ownership
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Recent changes on this record
- 30 May 2007: A cost report was filed for fiscal year 2006, on form CMS-2540-96. SNFFY2005.zip
- 12 January 2007: A cost report was filed for fiscal year 2005, on form CMS-2540-96. SNFFY2004.zip
- 23 May 2005: A cost report was filed for fiscal year 2003, on form CMS-2540-96. SNFFY2003.zip
- 17 May 2005: A cost report was filed for fiscal year 2004, on form CMS-2540-96. SNFFY2003.zip
- 18 April 2005: A cost report was filed for fiscal year 2003, on form CMS-2540-96. SNFFY2003.zip
- 26 November 2003: A cost report was filed for fiscal year 2002, on form CMS-2540-96. SNFFY2002.zip
- 28 July 2003: A cost report was filed for fiscal year 2001, on form CMS-2540-96. SNFFY2001.zip
- 7 April 2003: A cost report was filed for fiscal year 2000, on form CMS-2540-96. SNFFY2000.zip
- 29 July 2000: A cost report was filed for fiscal year 1999, on form CMS-2540-96. SNFFY1999.zip
- 21 April 2000: A cost report was filed for fiscal year 1998, on form CMS-2540-96. SNFFY1998.zip
- 2 November 1999: A cost report was filed for fiscal year 1998, on form CMS-2540-96. SNFFY1997.zip
- 11 March 1999: A cost report was filed for fiscal year 1997, on form CMS-2540-96. SNFFY1996.zip
- 24 March 1998: A cost report was filed for fiscal year 1996, on form CMS-2540-96. SNFFY1995.zip
Inspections
Not yet extracted for this facility.
Deficiencies cited
Not yet extracted for this facility.
Penalties
Not yet extracted for this facility.
Care Compare provider information
Not yet extracted for this facility.
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The citable document for FORUM HEALTH @ MOUNT BERRY
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