Facility record report · CMS certification number 115620
CMS certification number 115620
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 October 2000 to 30 September 2001 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 16 January 2002.
None of these figures is carried on this report.
CMS report record 84829, read from the public cost report file SNFFY2001.zip.
Cost report for 1 October 1999 to 30 September 2000 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 7 April 2003.
None of these figures is carried on this report.
CMS report record 138163, read from the public cost report file SNFFY2000.zip.
Cost report for 1 October 1998 to 30 September 1999 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 23 July 2001.
| 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 | 21,713 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 25 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicaid, in days | 833.35 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 868.52 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 84827, read from the public cost report file SNFFY1999.zip.
Cost report for 1 October 1997 to 30 September 1998 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 21 April 2000.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,506,695 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,759,776 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$253,081 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $15,400 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$237,681 (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 | 16,262 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 568 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 25 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 28.98 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 28.63 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 84825, read from the public cost report file SNFFY1998.zip.
Cost report for 1 October 1996 to 30 September 1997 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 13 April 1999.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,466,033 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,681,765 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$215,732 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $7,129 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$208,603 (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 | 21,217 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 39 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 54 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 523.79 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 544.03 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 84823, read from the public cost report file SNFFY1997.zip.
Five facilities of a similar size in , fiscal year 2001
No other facility in has a cost report on file for fiscal year 2001 with a bed count to set beside this one.
Ownership, as filed with CMS
Care Compare
Not yet extracted for this facility.
Medicare enrollment
Not yet extracted for this facility.
Changes in ownership
Not yet extracted for this facility.
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.
Every change on this record
- 7 April 2003: A cost report was filed for fiscal year 2000, on form CMS-2540-96. SNFFY2000.zip
- 16 January 2002: A cost report was filed for fiscal year 2001, on form CMS-2540-96. SNFFY2001.zip
- 23 July 2001: 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
- 13 April 1999: A cost report was filed for fiscal year 1997, on form CMS-2540-96. SNFFY1997.zip
How to read this report
Every figure is printed as the CMS file it came from printed it. Each cost-report figure carries the worksheet, line and column of form CMS-2540 it was read from, so a reader holding the same public file can go to that cell; each Care Compare and Medicare enrollment section names its file and the date CMS stamped on it.
A figure the filing does not carry is left out, and so is a figure whose value the filing’s own arithmetic contradicts. Net income is printed with what the form’s own arithmetic shows about it — plainly where it follows from the lines above it, and, where it does not, beside what the form’s own lines leave unaccounted for. An ownership field left empty carries the dated sentence on CMS’s pause of the expanded Form CMS-855A disclosure. A source that holds nothing for this facility says so in its section.
This report carries no percentile and no score, and it does not place this facility above or below another. The five facilities above are the one comparison it draws: the nearest certified bed counts in the same state at the same fiscal year, listed by name. Nurse staffing is printed in its own section, on its own page, apart from the cost-report figures.
How to cite this report
Velarion Records, CMS certification number 115620 — facility record report, CMS certification number 115620. https://velarionrecords.com/facility/115620/report.
- Cost report figures: CMS Healthcare Cost Report Information System, form CMS-2540-96, publication year 2001, file
SNFFY2001.zip. - Provider information, inspections, deficiencies and penalties: CMS Care Compare, file dated 1 August 2026.
- Care Compare ownership: CMS file dated 1 August 2026.
- Medicare enrollment ownership: CMS file dated 1 August 2026.
Published by VELARIONAI LLC · Andrew Richardson, founder. Corrections: hello@velarionrecords.com, quoting certification number 115620. Velarion Records publishes these records as filed.
Nurse staffing, quarter by quarter
Hours this facility reported to CMS’s Payroll-Based Journal, one row per quarter, oldest first, each with how its figures are derived and the file it came from.
Not yet extracted for this facility.