Skilled nursing facility · CMS certification number 145866
HICKORY VLG NRSG & RHB
HICKORY HILLS, Illinois · Medicare and Medicaid
Certified beds, as filed in Care Compare: 74
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 6 January 2026.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,854,147 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $5,854,147 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,140,753 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$286,606 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $232,408 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$54,198 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$54,198 (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 | 74 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 27,084 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 1,017 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 21,980 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 263 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 23,260 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 6 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 20 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 2 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 28 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 169.5 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 830.71 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1446005, 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 16 October 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,057,913 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $582,957 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,474,956 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,384,172 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$909,216 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $50,149 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$859,067 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$859,067 (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 | 74 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 23,157 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 65 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 97.07 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 356.26 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1396700, read from the public cost report file SNF10FY2023.zip.
Fiscal year 2022, ended 31 December 2022
Cost report for 1 July 2022 to 31 December 2022 — a reporting period of 183 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 4 August 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,828,266 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $31,042 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,797,224 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,179,219 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$381,995 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $61,661 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$320,334 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$320,334 (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 | 74 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 11,298 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 32 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 109.38 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 353.06 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1360966, 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 23 September 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,721,390 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $3,721,390 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,306,236 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$584,846 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $759,924 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $175,078 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $175,078 (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 | 74 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 21,989 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 134 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 55.75 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 164.1 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1333793, 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 18 November 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,932,620 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $3,932,620 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,229,951 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$297,331 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $615,108 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $317,777 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $317,777 (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 | 74 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 23,444 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 132 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 171.5 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 177.61 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1304854, 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 3 March 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,971,336 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $3,971,336 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,700,871 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $270,465 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,548 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $272,013 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $272,013 (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 | 74 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 23,829 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 202 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 75.91 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 117.97 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1280790, 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 10 July 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,533,867 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $140,423 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,393,444 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,438,572 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$45,128 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $7,498 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$37,630 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$37,630 (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 | 74 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 21,262 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 208 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 49.54 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 102.22 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1234724, 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 27 June 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,443,463 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $208,365 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,235,098 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,285,208 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$50,110 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $5,352 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$44,758 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$44,758 (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 | 74 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,304 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 155 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 50.76 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 124.54 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1196206, 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 9 May 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,506,219 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $127,806 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,378,413 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,254,420 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $123,993 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $651 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $124,644 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $124,644 (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 | 74 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 21,784 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 123 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 70.25 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 177.11 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1156898, 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 25 July 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,661,046 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $189,895 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,471,151 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,386,729 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $84,422 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,768 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $86,190 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $84,422 (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 | 74 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 22,975 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 127 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 54.87 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 180.91 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1138071, 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 25 July 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,000,344 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $261,862 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,738,482 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,653,832 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $84,650 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $74,788 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $159,438 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $159,438 (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 | 74 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 23,359 | 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 | 43.63 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 206.72 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1104058, 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 27 May 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,933,293 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $263,614 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,669,679 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,499,374 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $170,305 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $115,567 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $285,872 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $285,847 (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 | 74 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 23,735 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 127 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 49.78 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 186.89 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1060851, 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 5 March 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,859,490 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $3,859,490 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,555,589 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $303,901 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $89,439 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $393,340 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $393,340 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 74 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 22,452 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 146 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 45.64 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 153.78 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1056393, 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 25 September 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,332,266 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $3,332,266 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,044,330 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $287,936 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $28,031 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $315,967 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $315,967 (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 | 74 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 23,314 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 148 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 37.8 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 157.53 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1011708, 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 24 April 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,185,941 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,044,683 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $141,258 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $141,319 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $1,958 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: $280,619 (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 | 74 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 23,126 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 148 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 69.86 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 166.37 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 156.26 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 428121, 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 21 April 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,309,069 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,927,671 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $381,398 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $94,113 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $383 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: $475,128 (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 | 74 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 24,484 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 155 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 68.29 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 170.53 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 157.96 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 397769, read from the public cost report file SNFFY2009.zip.
Fiscal year 2008, ended 31 December 2008
Cost report for 1 January 2008 to 31 December 2008 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 21 October 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,077,150 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,811,816 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $265,334 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $53,269 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $318,603 (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 | 74 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 23,530 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 179 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 63.33 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 144.01 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 131.45 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 358064, 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 13 August 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,496,204 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,557,034 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$60,830 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $35,672 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $342 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: −$25,500 (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 | 74 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,728 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 165 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 42.21 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 136.06 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 125.62 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 323771, 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 2 August 2007.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,542,121 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,576,413 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$34,292 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $57,250 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $22,958 (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 | 74 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 21,638 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 239 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 19.49 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 107.49 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 90.54 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 290880, read from the public cost report file SNFFY2006.zip.
Fiscal year 2005, ended 31 December 2005
Cost report for 31 January 2005 to 31 December 2005 — a reporting period of 334 days, on form CMS-2540-96, settled, processed by CMS on 7 August 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,489,308 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,451,077 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $38,231 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $89,898 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $8,930 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: $119,199 (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 | 74 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,721 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 196 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 31.06 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 121.19 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 105.72 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 260632, 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 3 August 2005.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,434,671 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,378,448 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $56,223 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $6,852 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $18,260 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: $44,815 (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 | 74 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,873 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 206 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 22.37 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 120.93 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 101.33 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 229772, 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 1 September 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,606,334 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,372,436 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $233,898 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $6,385 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $12,958 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: $227,325 (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 | 74 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 21,210 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 194 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 55.55 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 120.86 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 109.33 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 192054, 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 21 September 2004.
None of these figures is carried on this report.
CMS report record 194477, 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 5 September 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,494,361 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,304,260 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $190,101 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $10,255 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $815 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: $199,541 (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 | 74 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,998 | 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 | 97.6 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 160.07 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 154.4 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 158657, 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 15 March 2002.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,452,476 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,216,336 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $236,140 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $26,404 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $262,544 (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 | 74 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 21,337 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 115 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 78.47 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 203.04 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 185.54 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 86213, 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, settled, processed by CMS on 13 June 2001.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,445,422 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,204,276 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $241,146 | CMS-2540-96 worksheet G300000 line 500 column 100 |
Net income, stated at moderate confidence: $241,146 (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 | 74 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 22,262 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 149 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 31.58 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 179.87 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 149.41 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 86211, read from the public cost report file SNFFY1999.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 |
|---|---|---|---|---|
| MIDLAND STATES BANCORP INC | 5% OR GREATER SECURITY INTEREST | Organization | NOT APPLICABLE | since 12/11/2024 |
| DAVEY, JENNIFER | ADP OF THE SNF | Individual | NOT APPLICABLE | since 07/01/2022 |
| GAUTAM, SAGUN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 07/01/2022 |
| JADE FINANCIAL SERVICES LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 07/01/2022 |
| LIPSHITZ, RITA | ADP OF THE SNF | Individual | NOT APPLICABLE | since 07/01/2022 |
| MASHIACH, RHONDA | ADP OF THE SNF | Individual | NOT APPLICABLE | since 07/01/2022 |
| MASHIACH, YAACOV | ADP OF THE SNF | Individual | NOT APPLICABLE | since 07/01/2022 |
| MASHIACH, YECHIEL | ADP OF THE SNF | Individual | NOT APPLICABLE | since 07/01/2022 |
| LIPSHITZ, RITA | DIRECT OWNERSHIP INTEREST | Individual | NOT APPLICABLE | since 07/01/2022 |
| MASHIACH, RHONDA | DIRECT OWNERSHIP INTEREST | Individual | NOT APPLICABLE | since 07/01/2022 |
| MASHIACH, YAACOV | DIRECT OWNERSHIP INTEREST | Individual | NOT APPLICABLE | since 07/01/2022 |
| MASHIACH, YECHIEL | DIRECT OWNERSHIP INTEREST | Individual | NOT APPLICABLE | since 07/01/2022 |
| WISSATI IRREVOCABLE TRUST | DIRECT OWNERSHIP INTEREST | Organization | NOT APPLICABLE | since 07/01/2022 |
| DAVEY, JENNIFER | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 07/01/2022 |
| GAUTAM, SAGUN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 07/01/2022 |
| MASHIACH, YAACOV | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 07/01/2022 |
| MASHIACH, YECHIEL | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 07/01/2022 |
| GRASSO, ALBERT | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 07/01/2022 |
| MIRETZKY, STEVEN | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 07/01/2022 |
Medicare enrollment
As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of HICKORY VILLAGE NURSING AND REHABILITATION CENTER LLC (enrollment ID O20220914001386).
| Owner | Individual or organization | Role | Ownership percentage | Association date | Described in the filing as |
|---|---|---|---|---|---|
| MIDLAND STATES BANCORP INC | Organization | 5% OR GREATER SECURITY INTEREST | 0 | 12/11/2024 | Private equity company: No Real estate investment trust: No Holding company: No |
| JADE FINANCIAL SERVICES 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. | 7/1/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| JENNIFER DAVEY | 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. | 7/1/2022 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| RHONDA MASHIACH | 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. | 7/1/2022 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| RITA LIPSHITZ | 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. | 7/1/2022 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| SAGUN GAUTAM | 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. | 7/1/2022 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| YAACOV MASHIACH | 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. | 7/1/2022 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| YECHIEL MASHIACH | 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. | 7/1/2022 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| 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. | 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. | 7/1/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| 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. | 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. | 7/1/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| RHONDA MASHIACH | Individual | DIRECT OWNERSHIP INTEREST | 10 | 7/1/2022 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| RITA LIPSHITZ | Individual | DIRECT OWNERSHIP INTEREST | 10 | 7/1/2022 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| WISSATI IRREVOCABLE TRUST | Organization | DIRECT OWNERSHIP INTEREST | 33.34 | 7/1/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| YAACOV MASHIACH | Individual | DIRECT OWNERSHIP INTEREST | 23.33 | 7/1/2022 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| YECHIEL MASHIACH | Individual | DIRECT OWNERSHIP INTEREST | 23.33 | 7/1/2022 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| JENNIFER DAVEY | 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. | 7/1/2022 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| SAGUN GAUTAM | 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. | 7/1/2022 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| YAACOV MASHIACH | 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. | 7/1/2022 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| YECHIEL MASHIACH | 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. | 7/1/2022 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| ALBERT GRASSO | Individual | TRUSTEE 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. | 7/1/2022 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| STEVEN MIRETZKY | Individual | TRUSTEE 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. | 7/1/2022 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
Changes in ownership
- 1 July 2026: YECHIEL MASHIACH no longer appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: YECHIEL MASHIACH no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: YECHIEL MASHIACH no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: YECHIEL MASHIACH appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: YECHIEL MASHIACH appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: YECHIEL MASHIACH appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 January 2026: A listing under ADP OF THE SNF no longer appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: JADE FINANCIAL SERVICES LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 August 2025: RHONDA MASHIACH no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: RITA LIPSHITZ no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: NATHAN AND SHIRLEY ROTHNER FAMILY TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: ARTHUR WILKINS no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: YAACOV MASHIACH no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: ATIED ASSOCIATES LLC no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: B & Z GRANDCHILDREN ACCUMULATION TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: YECHIEL MASHIACH no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: RHONDA MASHIACH appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: RHONDA MASHIACH appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: JENNIFER DAVEY appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: JENNIFER DAVEY appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: RITA LIPSHITZ appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: RITA LIPSHITZ appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: STEVEN MIRETZKY appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: MIDLAND STATES BANCORP INC appears as 5% OR GREATER SECURITY INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: WISSATI IRREVOCABLE TRUST appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: ALBERT GRASSO appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: YAACOV MASHIACH appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: YAACOV MASHIACH appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: YAACOV MASHIACH appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: SAGUN GAUTAM appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: SAGUN GAUTAM appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: YECHIEL MASHIACH appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: YECHIEL MASHIACH appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: YECHIEL MASHIACH appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 15 June 2023: ABRAHAM J STERN no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- 15 June 2023: HICKORY NURSING PAVILION no longer appears as LIMITED PARTNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- 15 June 2023: HICKORY NURSING PAVILION no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- 15 June 2023: DEBORAH R WENGROW no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- 15 June 2023: HOWARD L WENGROW 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: HOWARD L WENGROW no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- 15 June 2023: MAURICE I AARON no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- 15 June 2023: SARA WEBSTER no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- 15 June 2023: MIRIAM LATINIK no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- 15 June 2023: JEFFREY J WEBSTER no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- 15 June 2023: RHONDA MASHIACH appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- 15 June 2023: RITA LIPSHITZ appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- 15 June 2023: NATHAN & SHIRLEY ROTHNER FAMILY TRUST appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- 15 June 2023: ARTHUR WILKINS appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- 15 June 2023: YAACOV MASHIACH appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- 15 June 2023: ATIED ASSOCIATES LLC appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- 15 June 2023: B & Z GRANDCHILDREN ACCUMULATION TRUST appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
- 15 June 2023: YECHIEL MASHIACH appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
Recent changes on this record
- 1 July 2026: YECHIEL MASHIACH no longer appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: YECHIEL MASHIACH no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: YECHIEL MASHIACH no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: YECHIEL MASHIACH appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: YECHIEL MASHIACH appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: YECHIEL MASHIACH appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 6 January 2026: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- 1 January 2026: A listing under ADP OF THE SNF no longer appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: JADE FINANCIAL SERVICES LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 August 2025: RHONDA MASHIACH no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: RITA LIPSHITZ no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: NATHAN AND SHIRLEY ROTHNER FAMILY TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: ARTHUR WILKINS no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: YAACOV MASHIACH no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: ATIED ASSOCIATES LLC no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: B & Z GRANDCHILDREN ACCUMULATION TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: YECHIEL MASHIACH no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: RHONDA MASHIACH appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: RHONDA MASHIACH appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: JENNIFER DAVEY appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: JENNIFER DAVEY appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: RITA LIPSHITZ appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: RITA LIPSHITZ appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: STEVEN MIRETZKY appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: MIDLAND STATES BANCORP INC appears as 5% OR GREATER SECURITY INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: WISSATI IRREVOCABLE TRUST appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: ALBERT GRASSO appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: YAACOV MASHIACH appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: YAACOV MASHIACH appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: YAACOV MASHIACH appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: SAGUN GAUTAM appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: SAGUN GAUTAM appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: YECHIEL MASHIACH appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: YECHIEL MASHIACH appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: YECHIEL MASHIACH appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 16 October 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- 4 August 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- 14 July 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- 15 June 2023: ABRAHAM J STERN no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-06-15.csv
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | 21 March 2025 | 21 March 2025 | 2 | 3 |
| 2 | 16 May 2024 | 16 May 2024 | 12 | 11 |
| 3 | 28 April 2023 | 28 April 2023 | 9 | 10 |
From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.
Deficiencies cited
23 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| 17 June 2025 | Health | F 0921 | Environmental Deficiencies | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | F | Yes | Deficient, Provider has date of correction | 2 July 2025 |
| 21 March 2025 | Health | F 0568 | Resident Rights Deficiencies | Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home. | D | No | Deficient, Provider has date of correction | 8 April 2025 |
| 21 March 2025 | 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 | 8 April 2025 |
| 7 February 2025 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | J | Yes | Deficient, Provider has date of correction | 8 February 2025 |
| 14 January 2025 | Health | F 0580 | Resident Rights Deficiencies | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | D | Yes | Deficient, Provider has date of correction | 31 January 2025 |
| 14 January 2025 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | Yes | Deficient, Provider has date of correction | 31 January 2025 |
| 19 December 2024 | Health | F 0600 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | Yes | Deficient, Provider has date of correction | 30 December 2024 |
| 25 September 2024 | Health | F 0600 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | Yes | Deficient, Provider has date of correction | 22 October 2024 |
| 25 September 2024 | Health | F 0609 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Yes | Deficient, Provider has date of correction | 15 October 2024 |
| 25 September 2024 | Health | F 0656 | Resident Assessment and Care Planning Deficiencies | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | Yes | Deficient, Provider has date of correction | 15 October 2024 |
| 25 September 2024 | Health | F 0741 | Quality of Life and Care Deficiencies | Ensure that the facility has sufficient staff members who possess the competencies and skills to meet the behavioral health needs of residents. | D | Yes | Deficient, Provider has date of correction | 15 October 2024 |
| 19 July 2024 | Health | F 0600 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | Yes | Deficient, Provider has date of correction | 7 August 2024 |
| 16 May 2024 | Health | F 0759 | Pharmacy Service Deficiencies | Ensure medication error rates are not 5 percent or greater. | D | No | Deficient, Provider has date of correction | 7 June 2024 |
| 16 May 2024 | 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 June 2024 |
| 16 May 2024 | Health | F 0882 | Infection Control Deficiencies | Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. | F | No | Deficient, Provider has date of correction | 7 June 2024 |
| 25 January 2024 | 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. | J | Yes | Deficient, Provider has date of correction | 7 February 2024 |
| 2 November 2023 | 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. | J | Yes | Deficient, Provider has date of correction | 27 November 2023 |
| 2 November 2023 | 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 | 27 November 2023 |
| 2 November 2023 | Health | F 0684 | Quality of Life and Care Deficiencies | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | Yes | Deficient, Provider has date of correction | 27 November 2023 |
| 2 November 2023 | Health | F 0921 | Environmental Deficiencies | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | E | Yes | Deficient, Provider has date of correction | 27 November 2023 |
| 28 April 2023 | Health | F 0692 | Quality of Life and Care Deficiencies | Provide enough food/fluids to maintain a resident's health. | D | No | Deficient, Provider has date of correction | 19 May 2023 |
| 28 April 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 | 19 May 2023 |
| 28 April 2023 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | F | No | Deficient, Provider has date of correction | 19 May 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 |
|---|---|---|---|---|---|
| 14 January 2025 | Fine | $131,763 | 70366 | ||
| 14 January 2025 | Payment Denial | 7 February 2025 | 1 | ||
| 25 January 2024 | Fine | $79,590 | 69343 | ||
| 2 November 2023 | Fine | $139,319 | 69001 |
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 - Limited Liability company |
| Legal Business Name | HICKORY VILLAGE NURSING AND REHABILITATION CENTER LLC |
| Date First Approved to Provide Medicare and Medicaid Services | 1996-02-05 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | Y |
| County/Parish | Cook |
| Telephone Number | 7085984040 |
| Chain Name | WISSATI IRREVOCABLE TRUST |
| Chain ID | 861 |
| 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 | 74 |
| Average Number of Residents per Day | 66.4 |
| Overall Rating | 3 |
| Health Inspection Rating | 3 |
| QM Rating | 3 |
| Long-Stay QM Rating | 3 |
| 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 HICKORY VLG NRSG & RHB: 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 July 2026: YECHIEL MASHIACH no longer appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. That is one line of the alert.
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The citable document for HICKORY VLG NRSG & RHB
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 Illinois 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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