Skilled nursing facility · CMS certification number 155353
HICKORY CREEK AT GREENSBURG
GREENSBURG, Indiana · Medicare and Medicaid
Certified beds, as filed in Care Compare: 36
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 28 August 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,010,804 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$344,118 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,354,922 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,541,308 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$186,386 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $30,118 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$156,268 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$156,268 (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 | 36 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 13,176 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 227 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 9,051 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 1,057 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 10,335 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 1 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 36 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 10 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 47 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 227 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 251.42 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 219.89 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1433567, 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 25 September 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,849,328 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$269,997 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,119,325 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,113,794 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $5,531 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $13,285 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $18,816 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $18,816 (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 | 36 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 10,443 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 59 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 119 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 192.55 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 177 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1395790, 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 19 July 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,218,330 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$476,277 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,694,607 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,042,463 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$347,856 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $121,122 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$226,734 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$226,734 (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 | 36 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 9,381 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 110 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 31.07 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 110.15 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 85.28 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1389779, 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 28 September 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,180,681 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$252,175 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,432,856 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,746,959 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$314,103 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $41,260 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$272,843 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$272,843 (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 | 36 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 8,730 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 24 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 139.5 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 381.78 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 363.75 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1334365, 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 28 September 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,236,179 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$345,260 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,581,439 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,789,901 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$208,462 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $125,875 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$82,587 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$82,587 (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 | 36 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 10,948 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 23 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 36.25 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 476 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1301225, 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 11 August 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,370,237 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$433,949 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,804,186 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,865,607 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$61,421 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $9,247 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$52,174 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$52,174 (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 | 36 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 11,080 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 25 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 102.2 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 443.2 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1292856, 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 | $2,155,245 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$276,259 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,431,504 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,646,175 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$214,671 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $8,019 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$206,652 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$206,652 (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 | 36 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 9,135 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 26 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 71 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 351.35 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1236249, 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 July 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,266,834 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$427,872 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,694,706 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,594,377 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $100,329 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $5,112 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $105,441 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $105,441 (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 | 36 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 10,512 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 48 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 52.88 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 219 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1203411, 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 29 June 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,472,985 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$279,638 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,752,623 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,581,850 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $170,773 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $7,367 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $178,140 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $178,140 (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 | 36 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 11,840 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 22 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 65.43 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 538.18 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1167234, 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 | $2,389,487 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$305,808 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,695,295 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,470,017 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $225,278 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $4,535 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $229,813 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $229,813 (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 | 36 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 12,420 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 27 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 70.2 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 460 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1135246, 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 | $2,246,273 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$115,166 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,361,439 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,318,237 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $43,202 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $5,685 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $48,887 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $48,887 (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 | 36 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 10,760 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 30 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 61 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 358.67 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1105360, read from the public cost report file SNF10FY2014.zip.
Fiscal year 2013, ended 31 December 2013
Cost report for 1 August 2013 to 31 December 2013 — a reporting period of 152 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 5 June 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $762,440 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $19,434 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $743,006 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $951,427 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$208,421 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $2,406 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$206,015 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$206,015 (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 | 36 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 3,758 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 10 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 110 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 375.8 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1062224, read from the public cost report file SNF10FY2013.zip.
Fiscal year 2012, ended 31 December 2012
Cost report for 1 May 2012 to 31 December 2012 — a reporting period of 244 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 7 August 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $1,247,030 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $39,651 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $1,207,379 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,233,289 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$25,910 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $4,724 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$21,186 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$21,186 (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 | 36 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 7,047 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 26 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 71 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 271.04 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1045806, read from the public cost report file SNF10FY2012.zip.
Fiscal year 2011, ended 30 April 2011
Cost report for 1 May 2010 to 30 April 2011 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 20 September 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,693,643 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,716,138 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$22,495 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $6,371 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$16,124 (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 | 36 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 9,770 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 34 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 60.89 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 287.35 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 432299, read from the public cost report file SNFFY2010.zip.
Fiscal year 2010, ended 30 April 2010
Cost report for 1 May 2009 to 30 April 2010 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 27 September 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,826,860 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,770,787 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $56,073 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $3,146 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $59,219 (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 | 38 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 10,894 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 38 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 50.94 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 286.68 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 418413, read from the public cost report file SNFFY2009.zip.
Fiscal year 2009, ended 30 April 2009
Cost report for 1 May 2008 to 30 April 2009 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 17 June 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,890,256 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,785,750 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $104,506 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $2,229 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $106,735 (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 | 38 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 10,654 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 42 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 50.53 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 253.67 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 375655, read from the public cost report file SNFFY2008.zip.
Fiscal year 2008, ended 30 April 2008
Cost report for 1 May 2007 to 30 April 2008 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 15 July 2009.
None of these figures is carried on this report.
CMS report record 350502, read from the public cost report file SNFFY2007.zip.
Fiscal year 2007, ended 30 April 2007
Cost report for 1 May 2006 to 30 April 2007 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 9 September 2008.
None of these figures is carried on this report.
CMS report record 325410, read from the public cost report file SNFFY2006.zip.
Fiscal year 2006, ended 30 April 2006
Cost report for 1 May 2005 to 30 April 2006 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 16 May 2007.
None of these figures is carried on this report.
CMS report record 278615, read from the public cost report file SNFFY2005.zip.
Fiscal year 2005, ended 30 April 2005
Cost report for 1 May 2004 to 30 April 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 10 February 2006.
None of these figures is carried on this report.
CMS report record 242707, read from the public cost report file SNFFY2004.zip.
Fiscal year 2004, ended 30 April 2004
Cost report for 1 May 2003 to 30 April 2004 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 21 March 2005.
None of these figures is carried on this report.
CMS report record 211799, read from the public cost report file SNFFY2003.zip.
Fiscal year 2003, ended 30 April 2003
Cost report for 1 May 2002 to 30 April 2003 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 27 April 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,538,294 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,526,359 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $11,935 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $730 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $12,665 (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 | 38 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 12,969 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 26 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 110 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 498.81 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 173725, read from the public cost report file SNFFY2002.zip.
Fiscal year 2002, ended 30 April 2002
Cost report for 1 November 2001 to 30 April 2002 — a reporting period of 180 days, not a full year, on form CMS-2540-96, settled, processed by CMS on 7 May 2003.
None of these figures is carried on this report.
CMS report record 142946, read from the public cost report file SNFFY2002.zip.
Fiscal year 2001, ended 31 October 2001
Cost report for 1 January 2001 to 31 October 2001 — a reporting period of 303 days, on form CMS-2540-96, settled, processed by CMS on 13 February 2003.
None of these figures is carried on this report.
CMS report record 131088, 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 11 February 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,269,301 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,423,162 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$153,861 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $4,801 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$149,060 (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 | 40 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 11,581 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 28 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 157.4 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 413.61 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 114438, read from the public cost report file SNFFY2000.zip.
Fiscal year 1999, ended 31 December 1999
Cost report for 4 October 1999 to 31 December 1999 — a reporting period of 88 days, not a full year, on form CMS-2540-96, as submitted, processed by CMS on 15 March 2001.
Net income, stated at moderate confidence: $64,962 (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.
CMS report record 13256, read from the public cost report file SNFFY2000.zip.
Fiscal year 1998, ended 31 December 1998
Cost report for 1 January 1998 to 31 December 1998 — a reporting period of 364 days, on form CMS-2540-96, reopened, processed by CMS on 20 September 2001.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,295,149 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,321,817 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$26,668 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $678 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$25,990 (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 | 39 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 11,022 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 17 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 86.08 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 648.35 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 13252, read from the public cost report file SNFFY1998.zip.
Fiscal year 1997, ended 31 December 1997
Cost report for 1 January 1997 to 31 December 1997 — a reporting period of 364 days, on form CMS-2540-96, reopened, processed by CMS on 19 September 2001.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,226,497 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,205,683 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $20,814 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $1,984 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $22,798 (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 | 40 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 10,745 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 25 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 79.08 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 429.8 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 13249, read from the public cost report file SNFFY1997.zip.
Fiscal year 1996, ended 31 December 1996
Cost report for 1 February 1996 to 31 December 1996 — a reporting period of 334 days, on form CMS-2540-96, reopened, processed by CMS on 18 January 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $998,658 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $938,997 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $59,661 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $1,358 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $61,019 (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 | 40 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 9,540 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 25 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 56.15 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 381.6 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 423485, read from the public cost report file SNFFY1996.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 |
|---|---|---|---|---|
| HENRY COUNTY MEMORIAL HOSPITAL | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | 100% | since 08/01/2013 |
| AMERICAN SENIOR COMMUNITIES LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 03/24/2025 |
| DICE, MARK | ADP OF THE SNF | Individual | NOT APPLICABLE | since 06/01/2023 |
| SHANE, ANDREW | ADP OF THE SNF | Individual | NOT APPLICABLE | since 02/01/2023 |
| THIES, BROOKE | ADP OF THE SNF | Individual | NOT APPLICABLE | since 03/24/2025 |
| VAN CAMP, STEVEN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 06/01/2023 |
| WOLFRAM, DONALD | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/26/2026 |
| CROSBY, FRANCIS | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 08/01/2013 |
| RING, BRIAN | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 08/01/2022 |
| CHIES, STEVEN | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 03/01/2021 |
| DYNES, SHELDON | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 01/01/2013 |
| JACKSON, BLAKE | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 03/01/2021 |
| JACKSON, ETHAN | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 03/01/2021 |
| JACKSON, MARK | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 03/01/2021 |
| JACKSON, MICHAEL | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 05/14/2024 |
| JACKSON, WESSLEY | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 03/01/2021 |
| JUSTICE, DAVID | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 03/01/2021 |
| KELSEY, DONNA | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 07/18/2024 |
| PIDGEON, JOHN | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 01/01/2013 |
| SHORE, MARION | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 01/01/2013 |
| STITLE, STEPHEN | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 03/01/2021 |
| WARE, DEBORAH | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 08/27/2021 |
| WRIGHT, THERESSA | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 05/21/2021 |
| AMERICAN SENIOR COMMUNITIES LLC | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | since 03/01/2021 |
| CROSBY, FRANCIS | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 08/01/2013 |
| DICE, MARK | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 06/01/2023 |
| GROW, BRIANNA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 07/16/2024 |
| RING, BRIAN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 08/01/2022 |
| SHANE, ANDREW | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 02/01/2023 |
| THIES, BROOKE | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 12/28/2022 |
| VAN CAMP, STEVEN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 06/01/2023 |
| WOLFRAM, DONALD | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 05/01/2026 |
| DYNES, SHELDON | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2013 |
| PIDGEON, JOHN | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2013 |
| SHORE, MARION | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2013 |
| WARE, DEBORAH | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 08/27/2021 |
Medicare enrollment
As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of HENRY COUNTY MEMORIAL HOSPITAL (enrollment ID O20131009000273).
| Owner | Individual or organization | Role | Ownership percentage | Association date | Described in the filing as |
|---|---|---|---|---|---|
| HENRY COUNTY MEMORIAL HOSPITAL | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100 | 8/1/2013 | Private equity company: No Real estate investment trust: No Holding company: No |
| AMERICAN SENIOR COMMUNITIES 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. | 3/24/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| ANDREW SHANE | 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. | 2/1/2023 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| BROOKE THIES | 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. | 3/24/2025 | 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. |
| DONALD WOLFRAM | 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. | 5/26/2026 | 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. |
| MARK DICE | 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. | 6/1/2023 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| STEVEN VAN CAMP | 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. | 6/1/2023 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| 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. | 3/1/2021 | Private equity company: No Real estate investment trust: No Holding company: Yes |
| 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. | 3/1/2021 | Private equity company: No Real estate investment trust: No Holding company: Yes |
| 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. | 3/1/2021 | Private equity company: No Real estate investment trust: No Holding company: Yes |
| 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. | 3/1/2021 | Private equity company: No Real estate investment trust: No Holding company: No |
| BRIAN RING | Individual | CORPORATE OFFICER | 0 | 8/1/2022 | 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. |
| FRANCIS J CROSBY | Individual | CORPORATE OFFICER | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 8/1/2013 | 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. |
| BLAKE JACKSON | Individual | MANAGING CONTROL - GOVERNING BODY | 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. | 3/1/2021 | 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. |
| DAVID JUSTICE | Individual | MANAGING CONTROL - GOVERNING BODY | 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. | 3/1/2021 | 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. |
| DEBORAH WARE | Individual | MANAGING CONTROL - GOVERNING BODY | 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. | 8/27/2021 | 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. |
| DONNA KELSEY | Individual | MANAGING CONTROL - GOVERNING BODY | 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. | 7/18/2024 | 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. |
| ETHAN I JACKSON | Individual | MANAGING CONTROL - GOVERNING BODY | 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. | 3/1/2021 | 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. |
| JOHN D PIDGEON | Individual | MANAGING CONTROL - GOVERNING BODY | 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. | 1/1/2013 | 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. |
| MARION E SHORE | Individual | MANAGING CONTROL - GOVERNING BODY | 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. | 1/1/2013 | 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. |
| MARK JACKSON | Individual | MANAGING CONTROL - GOVERNING BODY | 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. | 3/1/2021 | 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. |
| MICHAEL L JACKSON | Individual | MANAGING CONTROL - GOVERNING BODY | 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. | 5/14/2024 | 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. |
| SHELDON L DYNES | Individual | MANAGING CONTROL - GOVERNING BODY | 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. | 1/1/2013 | 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. |
| STEPHEN STITLE | Individual | MANAGING CONTROL - GOVERNING BODY | 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. | 3/1/2021 | 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. |
| STEVEN CHIES | Individual | MANAGING CONTROL - GOVERNING BODY | 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. | 3/1/2021 | 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. |
| THERESSA WRIGHT | Individual | MANAGING CONTROL - GOVERNING BODY | 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. | 5/21/2021 | 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. |
| WESSLEY JACKSON | Individual | MANAGING CONTROL - GOVERNING BODY | 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. | 3/1/2021 | 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. |
| AMERICAN SENIOR COMMUNITIES LLC | Organization | OPERATIONAL/MANAGERIAL CONTROL | 100 | 3/1/2021 | Private equity company: No Real estate investment trust: No Holding company: No |
| ANDREW SHANE | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 2/1/2023 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| BRIAN RING | 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. | 8/1/2022 | 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. |
| BRIANNA GROW | 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. | 7/16/2024 | 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. |
| BROOKE THIES | 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. | 12/28/2022 | 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. |
| DONALD WOLFRAM | 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. | 5/1/2026 | 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. |
| FRANCIS J CROSBY | 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. | 8/1/2013 | 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. |
| MARK DICE | 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. | 6/1/2023 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| STEVEN VAN CAMP | 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. | 6/1/2023 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| DEBORAH WARE | 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. | 8/27/2021 | 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. |
| JOHN D PIDGEON | 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. | 1/1/2013 | 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. |
| MARION E SHORE | 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. | 1/1/2013 | 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. |
| SHELDON L DYNES | 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. | 1/1/2013 | 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: 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_:_2026-07-01.csv
- 1 July 2026: JOHN D PIDGEON no longer appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: JOHN D PIDGEON no longer appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: CHARLES M JANSSENS 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: CHARLES M JANSSENS 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: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: DONALD WOLFRAM appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: DONALD WOLFRAM appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: JOHN D PIDGEON appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: JOHN D PIDGEON appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 November 2025: KEVIN D NEESE no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: KEVIN D NEESE no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: CHARLES M JANSSENS appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: CHARLES M JANSSENS appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 August 2025: SHELDON L DYNES no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: DEBORAH WARE no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: GREGORY SCHIAVONE 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: DONNA G KELSEY no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: MARION E SHORE no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: FRANCIS J CROSBY no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: LINDA YOUNG 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: JOHN D PIDGEON no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: SHELDON L DYNES appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: SHELDON L DYNES appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: DAVID JUSTICE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: AMERICAN SENIOR COMMUNITIES LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: BRIANNA GROW appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: ANDREW E SHANE appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: ANDREW E SHANE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: KEVIN D NEESE appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: KEVIN D NEESE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: STEVEN E CHIES appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: DEBORAH WARE appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: DEBORAH WARE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: THERESSA WRIGHT appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: STEPHEN STITLE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: ETHAN JACKSON appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: MARK E DICE appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: MARK E DICE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: STEVEN A VAN CAMP appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: WESSLEY JACKSON appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: BROOKE THIES appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: BROOKE THIES appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: DONNA G KELSEY appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: BLAKE JACKSON appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: BRIAN RING appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: MARION E SHORE appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: MARION E SHORE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: MICHAEL JACKSON appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: MARK A. JACKSON appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: FRANCIS J CROSBY 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: JOHN D PIDGEON appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: JOHN D PIDGEON appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 15 February 2023: PAUL F JANSSEN no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-02-15.csv
- 15 February 2023: NATALIE BERGMAN no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-02-15.csv
- 15 February 2023: CHRISTINA RUSSELL no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-02-15.csv
- 15 February 2023: GREGORY SCHIAVONE appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-02-15.csv
- 15 February 2023: BRIAN RING appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-02-15.csv
- 15 February 2023: LINDA YOUNG appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-02-15.csv
Recent changes on this record
- 1 July 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_:_2026-07-01.csv
- 1 July 2026: JOHN D PIDGEON no longer appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: JOHN D PIDGEON no longer appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: CHARLES M JANSSENS 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: CHARLES M JANSSENS 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: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: DONALD WOLFRAM appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: DONALD WOLFRAM appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: JOHN D PIDGEON appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: JOHN D PIDGEON appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 November 2025: KEVIN D NEESE no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: KEVIN D NEESE no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: CHARLES M JANSSENS appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: CHARLES M JANSSENS appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 28 August 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- 1 August 2025: SHELDON L DYNES no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: DEBORAH WARE no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: GREGORY SCHIAVONE 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: DONNA G KELSEY no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: MARION E SHORE no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: FRANCIS J CROSBY no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: LINDA YOUNG 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: JOHN D PIDGEON no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: SHELDON L DYNES appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: SHELDON L DYNES appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: DAVID JUSTICE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: AMERICAN SENIOR COMMUNITIES LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: BRIANNA GROW appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: ANDREW E SHANE appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: ANDREW E SHANE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: KEVIN D NEESE appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: KEVIN D NEESE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: STEVEN E CHIES appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: DEBORAH WARE appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: DEBORAH WARE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: THERESSA WRIGHT appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: STEPHEN STITLE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: ETHAN JACKSON appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: MARK E DICE appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
- 1 August 2025: MARK E DICE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | 22 September 2025 | 22 September 2025 | 5 | 5 |
| 2 | 11 October 2024 | 11 October 2024 | 4 | 2 |
| 3 | 10 August 2023 | 10 August 2023 | 9 | 6 |
From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.
Deficiencies cited
18 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| 22 September 2025 | Health | F 0577 | Resident Rights Deficiencies | Allow residents to easily view the nursing home's survey results and communicate with advocate agencies. | C | No | Deficient, Provider has date of correction | 12 December 2025 |
| 22 September 2025 | Health | F 0686 | Quality of Life and Care Deficiencies | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | No | Deficient, Provider has date of correction | 12 December 2025 |
| 22 September 2025 | Health | F 0711 | Nursing and Physician Services Deficiencies | Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit. | D | No | Deficient, Provider has date of correction | 12 December 2025 |
| 22 September 2025 | Health | F 0770 | Administration Deficiencies | Provide timely, quality laboratory services/tests to meet the needs of residents. | D | No | Deficient, Provider has date of correction | 12 December 2025 |
| 22 September 2025 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | No | Deficient, Provider has date of correction | 12 December 2025 |
| 11 October 2024 | 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 | 1 November 2024 |
| 11 October 2024 | Health | F 0727 | Nursing and Physician Services Deficiencies | Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. | F | No | Waiver has been granted | 1 November 2024 |
| 11 October 2024 | Health | F 0757 | Pharmacy Service Deficiencies | Ensure each resident’s drug regimen must be free from unnecessary drugs. | D | No | Deficient, Provider has date of correction | 1 November 2024 |
| 11 October 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 | 1 November 2024 |
| 28 September 2023 | Health | F 0744 | Quality of Life and Care Deficiencies | Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia. | D | Yes | Deficient, Provider has date of correction | 27 October 2023 |
| 10 August 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 | 10 September 2023 |
| 10 August 2023 | Health | F 0686 | Quality of Life and Care Deficiencies | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | No | Deficient, Provider has date of correction | 10 September 2023 |
| 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. | D | No | Deficient, Provider has date of correction | 10 September 2023 |
| 10 August 2023 | 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 | 10 September 2023 |
| 10 August 2023 | Health | F 0698 | Quality of Life and Care Deficiencies | Provide safe, appropriate dialysis care/services for a resident who requires such services. | D | No | Deficient, Provider has date of correction | 10 September 2023 |
| 10 August 2023 | Health | F 0757 | Pharmacy Service Deficiencies | Ensure each resident’s drug regimen must be free from unnecessary drugs. | D | No | Deficient, Provider has date of correction | 10 September 2023 |
| 10 August 2023 | Health | F 0812 | Nutrition and Dietary Deficiencies | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | No | Deficient, Provider has date of correction | 10 September 2023 |
| 10 August 2023 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | No | Deficient, Provider has date of correction | 10 September 2023 |
From the Care Compare health citations file NH_HealthCitations_Aug2026.csv, processed on 1 August 2026.
Penalties
Not yet extracted for this facility.
Care Compare provider information
| Field | As filed |
|---|---|
| Provider Type | Medicare and Medicaid |
| Ownership Type | For profit - Corporation |
| Legal Business Name | HENRY COUNTY MEMORIAL HOSPITAL |
| Date First Approved to Provide Medicare and Medicaid Services | 1990-03-15 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | N |
| County/Parish | Decatur |
| Telephone Number | 8126637503 |
| Chain Name | AMERICAN SENIOR COMMUNITIES |
| Chain ID | 33 |
| 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 | 36 |
| Average Number of Residents per Day | 28.1 |
| Overall Rating | 5 |
| Health Inspection Rating | 4 |
| QM Rating | 5 |
| Long-Stay QM Rating | 5 |
| 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 CREEK AT GREENSBURG: 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: A listing under ADP OF THE SNF no longer appears in the Medicare enrollment ownership file, with no owner named. That is one line of the alert.
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The citable document for HICKORY CREEK AT GREENSBURG
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 Indiana 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 155353.