Skilled nursing facility · CMS certification number 146169
FARGO HEALTH CARE CENTER
CHICAGO, Illinois · Medicare and Medicaid
Certified beds, as filed in Care Compare: 99
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 11 September 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,527,766 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $8,527,766 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,965,050 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $562,716 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $3,857 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $566,573 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $566,573 (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 | 99 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 36,234 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 476 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 33,609 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 524 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 34,609 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 9 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 40 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 5 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 54 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 52.89 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 640.91 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1439190, 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 22 October 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,914,127 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $6,914,127 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,647,593 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$733,466 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $366,255 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$367,211 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$367,211 (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 | 99 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 32,716 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 84 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 99.44 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 389.48 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1441218, read from the public cost report file SNF10FY2023.zip.
Fiscal year 2022, ended 31 December 2022
Cost report for 1 January 2022 to 31 December 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 11 April 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,286,674 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $6,286,674 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,504,504 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$217,830 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $201,438 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$16,392 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$16,392 (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 | 99 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 31,878 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 115 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 173.75 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 277.2 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1376242, 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 15 June 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,717,740 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $5,717,740 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,415,410 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$697,670 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $131,485 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$566,185 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$566,185 (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 | 99 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 32,090 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 158 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 49.71 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 203.1 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1351655, 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 29 June 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,694,204 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $5,694,204 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,691,372 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $2,832 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $681,312 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $684,144 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $684,144 (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 | 99 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 30,920 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 206 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 150.5 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 150.1 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1323608, 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 29 December 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,808,699 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $5,808,699 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,233,471 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $575,228 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $3,600 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $578,828 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $578,828 (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 | 99 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 32,118 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 210 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 145 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 152.94 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1308086, 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 26 September 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,497,595 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $198,623 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,298,972 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,852,583 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $446,389 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $52,472 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $498,861 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $498,861 (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 | 99 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 33,478 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 167 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 132.17 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 200.47 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1243834, 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 17 April 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,495,824 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $269,887 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,225,937 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,781,660 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $444,277 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $18,709 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $462,986 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $462,986 (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 | 99 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 33,650 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 276 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 95.36 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 121.92 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1222258, 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 16 May 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,041,958 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $242,729 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,799,229 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,438,903 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $360,326 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $34,000 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $394,326 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $394,326 (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 | 99 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 32,410 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 251 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 58.13 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 129.12 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1189693, 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 5 December 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,628,312 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $149,734 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,478,578 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,235,752 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $242,826 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $52,027 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $294,853 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $284,335 (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 | 99 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 32,540 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 275 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 38.23 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 118.33 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1179289, read from the public cost report file SNF10FY2015.zip.
Fiscal year 2014, ended 31 December 2014
Cost report for 13 June 2014 to 31 December 2014 — a reporting period of 201 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 4 November 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,653,458 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $113,942 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,539,516 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,375,602 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $163,914 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $6,504 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $170,418 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $170,418 (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 | 99 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 18,989 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 143 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 69.8 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 132.79 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1145915, read from the public cost report file SNF10FY2014.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 |
|---|---|---|---|---|
| 1512 W FARGO AVE LLC | 5% OR GREATER SECURITY INTEREST | Organization | NOT APPLICABLE | since 01/01/2021 |
| 1512 W FARGO AVE LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 01/03/2025 |
| BRAUNSTEIN, EPHRAIM | ADP OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2021 |
| DIENA, AHARON | ADP OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2021 |
| GAUTAM, SAGUN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2021 |
| RICHARDSON, DELLA | ADP OF THE SNF | Individual | NOT APPLICABLE | since 11/19/2024 |
| BRAUNSTEIN, EPHRAIM | DIRECT OWNERSHIP INTEREST | Individual | NOT APPLICABLE | since 01/01/2021 |
| BRAUNSTEIN, EPHRAIM | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 01/01/2021 |
| DIENA, AHARON | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 01/01/2021 |
| GAUTAM, SAGUN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 01/01/2021 |
| RICHARDSON, DELLA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 11/19/2024 |
Medicare enrollment
As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of FARGO HEALTH CARE CENTER LLC (enrollment ID O20210114000299).
| Owner | Individual or organization | Role | Ownership percentage | Association date | Described in the filing as |
|---|---|---|---|---|---|
| AHARON DIENA | Individual | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 45 | 1/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| 1512 W FARGO AVE LLC | Organization | 5% OR GREATER SECURITY INTEREST | 100 | 1/1/2021 | Private equity company: No Real estate investment trust: No Holding company: No |
| 1512 W FARGO AVE 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. | 1/3/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| AHARON DIENA | 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. | 1/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| DELLA R RICHARDSON | 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. | 11/19/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| EPHRAIM BRAUNSTEIN | 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. | 1/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| 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. | 1/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| EPHRAIM BRAUNSTEIN | Individual | DIRECT OWNERSHIP INTEREST | 50 | 1/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| AHARON DIENA | 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. | 1/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| DELLA R RICHARDSON | 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. | 11/19/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| EPHRAIM BRAUNSTEIN | 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. | 1/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| 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. | 1/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
Changes in ownership
- 1 September 2025: AHARON DIENA no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: EPHRAIM BRAUNSTEIN no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: EPHRAIM BRAUNSTEIN no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: DEBORAH R VEGE no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: AHARON DIENA appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: AHARON DIENA appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: EPHRAIM BRAUNSTEIN appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: EPHRAIM BRAUNSTEIN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: EPHRAIM BRAUNSTEIN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: SAGUN GAUTAM appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: SAGUN GAUTAM appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: DELLA R RICHARDSON appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: DELLA R RICHARDSON appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: 1512 W FARGO AVE LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
Recent changes on this record
- 22 October 2025: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- 11 September 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- 1 September 2025: AHARON DIENA no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: EPHRAIM BRAUNSTEIN no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: EPHRAIM BRAUNSTEIN no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: DEBORAH R VEGE no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: AHARON DIENA appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: AHARON DIENA appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: EPHRAIM BRAUNSTEIN appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: EPHRAIM BRAUNSTEIN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: EPHRAIM BRAUNSTEIN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: SAGUN GAUTAM appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: SAGUN GAUTAM appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: DELLA R RICHARDSON appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: DELLA R RICHARDSON appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: 1512 W FARGO AVE LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 11 April 2024: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- 15 June 2023: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
- 29 June 2022: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
- 29 December 2021: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
- 26 September 2019: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2018.zip
- 17 April 2019: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2017.zip
- 16 May 2018: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2016.zip
- 5 December 2017: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2015.zip
- 4 November 2016: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2014.zip
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | 15 August 2025 | 23 May 2024 | 15 | 0 |
| 2 | 23 May 2024 | 29 June 2023 | 15 | 0 |
| 3 | 29 June 2023 | 19 August 2022 | 12 | 3 |
From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.
Deficiencies cited
42 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| 26 March 2026 | Health | F 0600 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | G | Yes | Deficient, Provider has date of correction | 14 April 2026 |
| 7 February 2026 | Health | F 0627 | Resident Rights Deficiencies | Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge. | D | Yes | Deficient, Provider has date of correction | 6 March 2026 |
| 7 February 2026 | Health | F 0740 | Quality of Life and Care Deficiencies | Ensure each resident must receive and the facility must provide necessary behavioral health care and services. | D | Yes | Deficient, Provider has date of correction | 6 March 2026 |
| 23 November 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 | 12 December 2025 |
| 29 August 2025 | Health | F 0550 | Resident Rights Deficiencies | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | E | Yes | Deficient, Provider has date of correction | 12 September 2025 |
| 15 August 2025 | Health | F 0550 | Resident Rights Deficiencies | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | No | Deficient, Provider has date of correction | 12 September 2025 |
| 15 August 2025 | Health | F 0688 | Quality of Life and Care Deficiencies | Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | D | No | Deficient, Provider has date of correction | 5 September 2025 |
| 15 August 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. | D | No | Deficient, Provider has date of correction | 5 September 2025 |
| 15 August 2025 | Health | F 0690 | Quality of Life and Care Deficiencies | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | D | No | Deficient, Provider has date of correction | 5 September 2025 |
| 15 August 2025 | Health | F 0695 | Quality of Life and Care Deficiencies | Provide safe and appropriate respiratory care for a resident when needed. | D | No | Deficient, Provider has date of correction | 5 September 2025 |
| 15 August 2025 | Health | F 0759 | Pharmacy Service Deficiencies | Ensure medication error rates are not 5 percent or greater. | E | No | Deficient, Provider has date of correction | 5 September 2025 |
| 15 August 2025 | Health | F 0761 | Pharmacy Service Deficiencies | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | E | No | Deficient, Provider has date of correction | 5 September 2025 |
| 15 August 2025 | Health | F 0803 | Nutrition and Dietary Deficiencies | Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | F | No | Deficient, Provider has date of correction | 5 September 2025 |
| 15 August 2025 | Health | F 0812 | Nutrition and Dietary Deficiencies | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | No | Deficient, Provider has date of correction | 5 September 2025 |
| 15 August 2025 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | F | No | Deficient, Provider has date of correction | 5 September 2025 |
| 24 June 2025 | 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 | 18 July 2025 |
| 24 June 2025 | 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 | 18 July 2025 |
| 9 January 2025 | Health | F 0600 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | G | Yes | Deficient, Provider has date of correction | 30 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. | G | Yes | Deficient, Provider has date of correction | 30 January 2025 |
| 19 December 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 | 8 January 2025 |
| 6 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. | G | Yes | Deficient, Provider has date of correction | 27 September 2024 |
| 23 May 2024 | Health | F 0558 | Resident Rights Deficiencies | Reasonably accommodate the needs and preferences of each resident. | E | No | Deficient, Provider has date of correction | 7 June 2024 |
| 23 May 2024 | Health | F 0578 | Resident Rights Deficiencies | Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | D | No | Deficient, Provider has date of correction | 7 June 2024 |
| 23 May 2024 | Health | F 0584 | Resident Rights Deficiencies | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | D | No | Deficient, Provider has date of correction | 7 June 2024 |
| 23 May 2024 | Health | F 0676 | Quality of Life and Care Deficiencies | Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. | D | No | Deficient, Provider has date of correction | 7 June 2024 |
| 23 May 2024 | 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 | No | Deficient, Provider has date of correction | 7 June 2024 |
| 23 May 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. | E | No | Deficient, Provider has date of correction | 7 June 2024 |
| 23 May 2024 | Health | F 0742 | Quality of Life and Care Deficiencies | Provide the appropriate treatment and services to a resident who displays or is diagnosed with mental disorder or psychosocial adjustment difficulty, or who has a history of trauma and/or post-traumatic stress disorder. | E | No | Deficient, Provider has date of correction | 7 June 2024 |
| 23 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 |
| 23 May 2024 | 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 | No | Deficient, Provider has date of correction | 7 June 2024 |
| 26 April 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. | G | Yes | Deficient, Provider has date of correction | 8 May 2024 |
| 26 April 2024 | Health | F 0925 | Environmental Deficiencies | Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | F | Yes | Deficient, Provider has date of correction | 8 May 2024 |
| 10 August 2023 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | Yes | Deficient, Provider has date of correction | 1 September 2023 |
| 29 June 2023 | Health | F 0658 | Resident Assessment and Care Planning Deficiencies | Ensure services provided by the nursing facility meet professional standards of quality. | D | No | Deficient, Provider has date of correction | 25 July 2023 |
| 29 June 2023 | Health | F 0676 | Quality of Life and Care Deficiencies | Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. | D | No | Deficient, Provider has date of correction | 25 July 2023 |
| 29 June 2023 | Health | F 0677 | Quality of Life and Care Deficiencies | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | No | Deficient, Provider has date of correction | 25 July 2023 |
| 29 June 2023 | Health | F 0684 | Quality of Life and Care Deficiencies | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | No | Deficient, Provider has date of correction | 25 July 2023 |
| 29 June 2023 | Health | F 0761 | Pharmacy Service Deficiencies | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | F | No | Deficient, Provider has date of correction | 25 July 2023 |
| 29 June 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 | 25 July 2023 |
| 29 June 2023 | Health | F 0814 | Nutrition and Dietary Deficiencies | Dispose of garbage and refuse properly. | F | No | Deficient, Provider has date of correction | 25 July 2023 |
| 29 June 2023 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | No | Deficient, Provider has date of correction | 25 July 2023 |
| 29 June 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 | No | Deficient, Provider has date of correction | 25 July 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 |
|---|---|---|---|---|---|
| 26 March 2026 | Fine | $111,930 | 139241 | ||
| 19 December 2024 | Fine | $74,003 | 70244 | ||
| 19 December 2024 | Payment Denial | 14 January 2025 | 16 | ||
| 6 September 2024 | Fine | $33,023 | 70012 | ||
| 26 April 2024 | Fine | $26,871 | 69722 | ||
| 26 April 2024 | Payment Denial | 17 May 2024 | 21 |
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 | FARGO HEALTH CARE CENTER LLC |
| Date First Approved to Provide Medicare and Medicaid Services | 2014-06-13 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | Y |
| County/Parish | Cook |
| Telephone Number | 7734657751 |
| Chain Name | LINEAGE HEALTHCARE |
| Chain ID | 854 |
| 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 | 99 |
| Average Number of Residents per Day | 93.3 |
| Overall Rating | 2 |
| Health Inspection Rating | 2 |
| QM Rating | 4 |
| Long-Stay QM Rating | 4 |
| Processing Date | 2026-08-01 |
From the Care Compare Provider Information file NH_ProviderInfo_Aug2026.csv, processed on 1 August 2026.
Get an email when this record changes
One email a day naming what moved on FARGO HEALTH CARE CENTER: 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 22 October 2025: A cost report was filed for fiscal year 2023, on form CMS-2540-10. That is one line of the alert.
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The citable document for FARGO HEALTH CARE CENTER
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.
Every figure on this page is printed as it appears in the CMS file named beside it. A figure that does not match its file? Tell us on the corrections page, quoting certification number 146169.