Skilled nursing facility · CMS certification number 115727
Jeffersonville Care Center LLC
Jeffersonville, Georgia · Medicare and Medicaid
Certified beds, as filed in Care Compare: 131
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, as submitted, processed by CMS on 23 June 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,792,386 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$370,010 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $11,162,396 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $11,390,542 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$228,146 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $5,042 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$223,104 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$223,104 (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 | 131 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 47,946 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 2,390 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 25,968 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 2,285 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 30,643 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 32 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 140 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 50 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 222 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 74.69 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 185.49 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 138.03 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1429803, 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 11 September 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,785,474 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $865,600 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,919,874 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,438,147 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$518,273 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $100,161 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$418,112 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$418,112 (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 | 131 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 34,857 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 429 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 67.47 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 95.69 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 81.25 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1438736, 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 12 June 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,658,994 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,122,069 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,536,925 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $11,155,441 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$618,516 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $38,579 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$579,937 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$579,937 (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 | 131 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 38,425 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 380 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 60.85 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 116.69 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 101.12 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1382882, read from the public cost report file SNF10FY2022.zip.
Fiscal year 2021, ended 31 December 2021
Cost report for 1 January 2021 to 31 December 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 12 December 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,790,432 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $159,403 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,631,029 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,583,556 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $47,473 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,324,366 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,371,839 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,371,839 (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 | 131 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 35,187 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 435 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 70.53 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 100.48 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 80.89 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1337981, 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 August 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,877,374 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,080,155 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,797,219 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,294,412 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$497,193 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $722,812 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $225,619 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $225,619 (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 | 131 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 35,095 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 437 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 82.96 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 91.83 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 80.31 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1328447, 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 13 December 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $9,287,013 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $402,027 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $8,884,986 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,793,882 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $91,104 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | −$14,951 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $76,153 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $76,153 (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 | 131 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 35,966 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 232 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 89.33 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 210.9 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 155.03 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1306948, 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 8 December 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,578,179 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $507,364 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $8,070,815 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,910,002 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $160,813 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | −$10,296 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $150,517 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $150,517 (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 | 131 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 33,358 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 453 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 45.81 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 94.01 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 73.64 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1275251, read from the public cost report file SNF10FY2018.zip.
Fiscal year 2017, ended 31 December 2017
Cost report for 12 December 2016 to 31 December 2017 — a reporting period of 384 days, on form CMS-2540-10, settled, processed by CMS on 20 December 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,458,660 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $553,231 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,905,429 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,290,399 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$384,970 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | −$11,494 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$396,464 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$396,464 (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 | 131 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,843 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 200 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 55.33 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 104.79 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 84.22 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1248424, read from the public cost report file SNF10FY2017.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 |
|---|---|---|---|---|
| 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. | Ownership Data Not Available | 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. | 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. | 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. |
Medicare enrollment
As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of JV JEFFERSONVILLE LLC (enrollment ID O20161229000744).
| Owner | Individual or organization | Role | Ownership percentage | Association date | Described in the filing as |
|---|---|---|---|---|---|
| DAVID K LEMCKE | Individual | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 30 | 11/14/2016 | 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. |
| KAREN D FORRISTER | Individual | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 70 | 11/14/2016 | 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. |
| DAVID K LEMCKE | Individual | CORPORATE OFFICER | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 2/16/2023 | 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. |
| KAREN D FORRISTER | Individual | CORPORATE OFFICER | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 11/14/2016 | 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. |
| KAREN D FORRISTER | 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. | 2/16/2023 | 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. |
| PEACH HEALTH GROUP LLC | Organization | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 6/17/2016 | Private equity company: No Real estate investment trust: No Holding company: No |
| LINTON HOLLEMAN | Individual | W-2 MANAGING EMPLOYEE | 100 | 7/16/2021 | 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
- 15 June 2023: CAROLYN E DISHER no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- 15 June 2023: PEACH HEALTH GROUP LLC appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- 15 June 2023: KAREN D FORRISTER appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- 15 June 2023: LINTON HOLLEMAN appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- 15 June 2023: DAVID K LEMCKE appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
Recent changes on this record
- 11 September 2025: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- 23 June 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- 12 June 2024: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- 15 June 2023: CAROLYN E DISHER no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- 15 June 2023: PEACH HEALTH GROUP LLC appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- 15 June 2023: KAREN D FORRISTER appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- 15 June 2023: LINTON HOLLEMAN appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- 15 June 2023: DAVID K LEMCKE appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- 12 December 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
- 1 August 2022: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
- 13 December 2021: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
- 8 December 2020: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2018.zip
- 20 December 2019: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2017.zip
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | 9 April 2026 | 9 April 2026 | 6 | 16 |
| 2 | 20 February 2025 | 20 February 2025 | 5 | 13 |
| 3 | 24 August 2023 | 24 August 2023 | 7 | 10 |
From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.
Deficiencies cited
18 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| 9 April 2026 | Health | F 0568 | Resident Rights Deficiencies | Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home. | F | No | Deficient, Provider has date of correction | 6 May 2026 |
| 9 April 2026 | Health | F 0600 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | G | Yes | Deficient, Provider has date of correction | 6 May 2026 |
| 9 April 2026 | 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. | E | No | Deficient, Provider has date of correction | 6 May 2026 |
| 9 April 2026 | Health | F 0761 | Pharmacy Service Deficiencies | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | No | Deficient, Provider has date of correction | 6 May 2026 |
| 9 April 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 | 6 May 2026 |
| 3 February 2026 | Health | F 0609 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Yes | Deficient, Provider has date of correction | 10 March 2026 |
| 20 February 2025 | Health | F 0584 | Resident Rights Deficiencies | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | D | Yes | Deficient, Provider has date of correction | 2 April 2025 |
| 20 February 2025 | Health | F 0677 | Quality of Life and Care Deficiencies | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | Yes | Deficient, Provider has date of correction | 2 April 2025 |
| 20 February 2025 | Health | F 0695 | Quality of Life and Care Deficiencies | Provide safe and appropriate respiratory care for a resident when needed. | D | Yes | Deficient, Provider has date of correction | 2 April 2025 |
| 20 February 2025 | Health | F 0761 | Pharmacy Service Deficiencies | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | Yes | Deficient, Provider has date of correction | 2 April 2025 |
| 20 February 2025 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | Yes | Deficient, Provider has date of correction | 2 April 2025 |
| 24 August 2023 | Health | F 0623 | Resident Rights Deficiencies | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | D | Yes | Deficient, Provider has date of correction | 5 October 2023 |
| 24 August 2023 | Health | F 0626 | Resident Rights Deficiencies | Permit a resident to return to the nursing home after hospitalization or therapeutic leave that exceeds bed-hold policy. | D | Yes | Deficient, Provider has date of correction | 5 October 2023 |
| 24 August 2023 | Health | F 0640 | Resident Assessment and Care Planning Deficiencies | Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment. | D | No | Deficient, Provider has date of correction | 5 October 2023 |
| 24 August 2023 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | No | Deficient, Provider has date of correction | 5 October 2023 |
| 24 August 2023 | 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 October 2023 |
| 24 August 2023 | 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 | 5 October 2023 |
| 24 August 2023 | Health | F 0919 | Environmental Deficiencies | Make sure that a working call system is available in each resident's bathroom and bathing area. | D | No | Deficient, Provider has date of correction | 5 October 2023 |
From the Care Compare health citations file NH_HealthCitations_Aug2026.csv, processed on 1 August 2026.
Penalties
| Penalty date | Type | Fine amount | Payment denial began | Payment denial, days | Fine ID |
|---|---|---|---|---|---|
| 24 August 2023 | Fine | $4,119 | 36922 |
From the Care Compare penalties file NH_Penalties_Aug2026.csv, processed on 1 August 2026.
Care Compare provider information
| Field | As filed |
|---|---|
| Provider Type | Medicare and Medicaid |
| Ownership Type | For profit - Corporation |
| Legal Business Name | Legal Business Name Not Available |
| Date First Approved to Provide Medicare and Medicaid Services | 2016-12-12 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | Y |
| County/Parish | Twiggs |
| Telephone Number | 4782986700 |
| 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 | 131 |
| Average Number of Residents per Day | 96.3 |
| Overall Rating | 2 |
| Health Inspection Rating | 2 |
| QM Rating | 3 |
| Long-Stay QM Rating | 4 |
| Short-Stay QM Rating | 2 |
| Processing Date | 2026-08-01 |
From the Care Compare Provider Information file NH_ProviderInfo_Aug2026.csv, processed on 1 August 2026.
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The citable document for Jeffersonville Care Center LLC
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 Georgia 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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