Skilled nursing facility · CMS certification number 155717
ALPHA HOME - A WATERS COMMUNITY
INDIANAPOLIS, Indiana · Medicare and Medicaid
Certified beds, as filed in Care Compare: 86
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 26 January 2026.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,060,836 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $693,700 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,367,136 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,768,571 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $598,565 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $2,185 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $600,750 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $600,750 (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 | 86 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 31,476 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 967 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 15,406 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 3,416 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 19,789 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 7 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 9 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 16 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 32 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 138.14 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,711.78 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 618.41 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1446965, 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 13 February 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,586,671 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $902,070 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,684,601 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,164,849 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $519,752 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $2,730 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $522,482 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $522,482 (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 | 86 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,917 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 169 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 135.64 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 165.01 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 123.77 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1403581, 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 30 May 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,093,628 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $950,486 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,143,142 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,650,490 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $492,652 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $237,743 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $730,395 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $730,395 (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 | 86 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,185 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 238 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 78.07 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 84.81 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1379824, 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 5 December 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,212,544 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $762,211 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,450,333 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,907,551 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$457,218 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $117,022 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$340,196 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$340,196 (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 | 86 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,006 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 222 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 62.53 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 85.61 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1337315, read from the public cost report file SNF10FY2021.zip.
Fiscal year 2020, ended 31 December 2020
Cost report for 1 October 2020 to 31 December 2020 — a reporting period of 91 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 2 June 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,043,484 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $166,658 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $1,876,826 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,912,023 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$35,197 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $104,943 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $69,746 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $69,746 (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 | 86 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 4,033 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 19 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 104 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 284.1 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 212.26 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1317812, read from the public cost report file SNF10FY2021.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 30 June 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,011,127 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $249,010 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,762,117 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,232,077 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$469,960 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,390 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$468,570 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$468,570 (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 | 86 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,066 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 107 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 62.96 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 267.21 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 187.53 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1259179, 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 21 August 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,310,820 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $117,652 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,193,168 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,127,812 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $65,356 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $7,413 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $72,769 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $72,769 (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 | 86 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,700 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 56 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 62.75 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 316.07 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1241537, 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 1 August 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,138,827 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $303,581 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,835,246 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,107,170 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$271,924 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $3,476 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$268,448 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$268,448 (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 | 86 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 14,895 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 53 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 62.11 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 281.04 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1204115, 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 25 July 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,620,022 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $313,496 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,306,526 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,437,831 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$131,305 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $637 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$130,668 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$130,668 (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 | 86 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 10,931 | 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 | 56.5 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 475.26 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1170628, read from the public cost report file SNF10FY2016.zip.
Fiscal year 2015, ended 31 December 2015
Cost report for 22 May 2015 to 31 December 2015 — a reporting period of 223 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 27 February 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $1,875,343 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $196,424 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $1,678,919 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,090,966 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$412,047 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $231 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$411,816 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$411,816 (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 | 86 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 6,454 | 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 | 39.27 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 268.92 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1153512, 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 12 August 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,108,127 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $2,108,127 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,462,977 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$354,850 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $17,813 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$337,037 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$337,037 (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 | 86 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 12,025 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 39 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 28.26 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 308.33 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1107564, read from the public cost report file SNF10FY2014.zip.
Fiscal year 2013, ended 31 December 2013
Cost report for 1 January 2013 to 31 December 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 26 August 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,593,217 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $2,593,217 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,029,718 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$436,501 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $21,911 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$414,590 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$414,590 (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 | 86 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 14,799 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 74 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 49.95 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 199.99 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1076979, read from the public cost report file SNF10FY2013.zip.
Fiscal year 2012, ended 31 December 2012
Cost report for 1 January 2012 to 31 December 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 2 August 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,556,686 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $3,556,686 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,795,421 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$238,735 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $108,000 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$130,735 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$130,735 (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 | 86 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 18,442 | 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 | 73.53 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 614.73 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1045395, read from the public cost report file SNF10FY2012.zip.
Fiscal year 2011, ended 31 December 2011
Cost report for 1 January 2011 to 31 December 2011 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 26 October 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,065,342 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $4,065,342 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,942,491 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $122,851 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $39,107 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $161,958 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $161,958 (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 | 86 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 22,219 | 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 | 85.64 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 740.63 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1016986, read from the public cost report file SNF10FY2011.zip.
Fiscal year 2010, ended 31 December 2010
Cost report for 1 January 2010 to 31 December 2010 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 4 May 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,777,293 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,687,299 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $89,994 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $192,782 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $282,776 (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 | 86 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 21,966 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 29 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 73.64 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 757.45 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 428645, read from the public cost report file SNFFY2010.zip.
Fiscal year 2009, ended 31 December 2009
Cost report for 1 January 2009 to 31 December 2009 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 4 May 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,567,034 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,582,946 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$15,912 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $177,369 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $161,457 (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 | 86 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 21,506 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 29 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 60.64 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 741.59 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 398693, read from the public cost report file SNFFY2009.zip.
Fiscal year 2008, ended 31 December 2008
Cost report for 1 January 2008 to 31 December 2008 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 10 March 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,224,241 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,617,444 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$393,203 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $159,866 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$233,337 (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 | 86 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 21,915 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 24 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 83.26 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 913.13 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 365230, read from the public cost report file SNFFY2008.zip.
Fiscal year 2007, ended 31 December 2007
Cost report for 1 January 2007 to 31 December 2007 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 28 January 2009.
None of these figures is carried on this report.
CMS report record 332772, read from the public cost report file SNFFY2007.zip.
Fiscal year 2006, ended 31 December 2006
Cost report for 1 January 2006 to 31 December 2006 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 30 April 2008.
None of these figures is carried on this report.
CMS report record 307903, read from the public cost report file SNFFY2006.zip.
Fiscal year 2005, ended 31 December 2005
Cost report for 1 January 2005 to 31 December 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 1 February 2007.
None of these figures is carried on this report.
CMS report record 271551, read from the public cost report file SNFFY2005.zip.
Fiscal year 2004, ended 31 December 2004
Cost report for 1 January 2004 to 31 December 2004 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 16 February 2006.
None of these figures is carried on this report.
CMS report record 243096, read from the public cost report file SNFFY2004.zip.
Fiscal year 2003, ended 31 December 2003
Cost report for 1 January 2003 to 31 December 2003 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 21 October 2004.
None of these figures is carried on this report.
CMS report record 197730, read from the public cost report file SNFFY2003.zip.
Fiscal year 2002, ended 31 December 2002
Cost report for 11 October 2002 to 31 December 2002 — a reporting period of 81 days, not a full year, on form CMS-2540-96, settled, processed by CMS on 30 July 2004.
None of these figures is carried on this report.
CMS report record 188604, read from the public cost report file SNFFY2003.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 09/04/2014 |
| 2640 COLD SPRING ROAD, LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 05/22/2015 |
| ALPHA HOME - A WATERS COMMUNITY | ADP OF THE SNF | Organization | NOT APPLICABLE | since 05/22/2015 |
| MUSTAKLEM, MARWAN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 08/01/2020 |
| REED, DAVID | ADP OF THE SNF | Individual | NOT APPLICABLE | since 11/25/2024 |
| STRAWBERRY FIELDS REIT LTD | ADP OF THE SNF | Organization | NOT APPLICABLE | since 03/24/2026 |
| BRAMMER, DUANE | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 09/04/2014 |
| DYNES, SHELDON | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 09/04/2014 |
| PIDGEON, JOHN | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 09/04/2014 |
| SHORE, MARION | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 09/04/2014 |
| BRAMMER, DUANE | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 09/04/2014 |
| DYNES, SHELDON | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 09/04/2014 |
| PIDGEON, JOHN | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 09/04/2014 |
| BLISKO, MICHAEL | DIRECT OWNERSHIP INTEREST | Individual | NOT APPLICABLE | since 10/01/2020 |
| STRAWBERRY FIELDS REIT LTD | DIRECT OWNERSHIP INTEREST | Organization | NOT APPLICABLE | since 10/01/2020 |
| BLISKO ENTERPRISES LIMITED PARTNERSHIP | INDIRECT OWNERSHIP INTEREST | Organization | NOT APPLICABLE | since 10/01/2020 |
| GUBIN ENTERPRISES LIMITED PARTNERSHIP | INDIRECT OWNERSHIP INTEREST | Organization | NOT APPLICABLE | since 10/01/2020 |
| ALPHA HOME - A WATERS COMMUNITY | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | since 05/22/2015 |
| APERION CARE FORT WAYNE LLC | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | since 09/21/2018 |
| MUSTAKLEM, MARWAN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 08/01/2020 |
| REED, DAVID | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 11/25/2024 |
| RING, BRIAN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 08/01/2022 |
| 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 |
| RING, BRIAN | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 08/01/2022 |
| 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 O20141208000544).
| 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 | 9/4/2014 | Private equity company: No Real estate investment trust: No Holding company: No |
| 2640 COLD SPRING ROAD, 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. | 5/22/2015 | Private equity company: No Real estate investment trust: No Holding company: No |
| ALPHA HOME - A WATERS COMMUNITY | 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. | 5/22/2015 | Private equity company: No Real estate investment trust: No Holding company: No |
| DAVID K REED | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 11/25/2024 | 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. |
| MARWAN MUSTAKLEM | 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. | 8/1/2020 | 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. |
| STRAWBERRY FIELDS REIT LTD | 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. | 10/1/2020 | Private equity company: No Real estate investment trust: No Holding company: No |
| CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| DUANE E BRAMMER | Individual | CORPORATE DIRECTOR | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 9/4/2014 | 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 | CORPORATE DIRECTOR | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 9/4/2014 | 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 | CORPORATE DIRECTOR | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 9/4/2014 | 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 | CORPORATE DIRECTOR | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 9/4/2014 | 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. |
| DUANE E BRAMMER | 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. | 9/4/2014 | 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 | 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. | 9/4/2014 | 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 | 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. | 9/4/2014 | 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 BLISKO | Individual | DIRECT OWNERSHIP INTEREST | 50 | 10/1/2020 | 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. |
| STRAWBERRY FIELDS REIT LTD | Organization | DIRECT OWNERSHIP INTEREST | 100 | 10/1/2020 | Private equity company: No Real estate investment trust: No Holding company: No |
| BLISKO ENTERPRISES LIMITED PARTNERSHIP | Organization | INDIRECT OWNERSHIP INTEREST | 50 | 10/1/2020 | Private equity company: No Real estate investment trust: No Holding company: No |
| GUBIN ENTERPRISES LIMITED PARTNERSHIP | Organization | INDIRECT OWNERSHIP INTEREST | 50 | 10/1/2020 | Private equity company: No Real estate investment trust: No Holding company: No |
| ALPHA HOME - A WATERS COMMUNITY | Organization | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/22/2015 | Private equity company: No Real estate investment trust: No Holding company: No |
| APERION CARE FORT WAYNE LLC | Organization | OPERATIONAL/MANAGERIAL CONTROL | 100 | 9/21/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| 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. |
| DAVID K REED | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 11/25/2024 | 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. |
| MARWAN MUSTAKLEM | 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. | 8/1/2020 | 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 | 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. | 8/1/2022 | 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. |
| 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: MARWAN MUSTAKLEM 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: MARWAN MUSTAKLEM 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: 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 CORPORATE DIRECTOR 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 CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: GUBIN ENTERPRISES LIMITED PARTNERSHIP no longer appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: DUANE E BRAMMER no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: DUANE E BRAMMER no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: MARWAN MUSTAKLEM appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: MARWAN MUSTAKLEM 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 CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: JOHN D PIDGEON appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: GUBIN ENTERPRISES LIMITED PARTNERSHIP appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: DUANE E BRAMMER appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: DUANE E BRAMMER appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 May 2026: SHELDON L DYNES appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: SHELDON L DYNES appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: SHELDON L DYNES appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: BLISKO ENTERPRISES LIMITED PARTNERSHIP appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: DEBORAH WARE appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: APERION CARE FORT WAYNE LLC appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: STRAWBERRY FIELDS REIT LTD appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: STRAWBERRY FIELDS REIT LTD appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: HENRY COUNTY MEMORIAL HOSPITAL appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: DAVID K REED appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: DAVID K REED appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: ALPHA HOME - A WATERS COMMUNITY appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: ALPHA HOME - A WATERS COMMUNITY appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: BRIAN RING appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: BRIAN RING appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: MARION E SHORE appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: MARION E SHORE appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: MICHAEL BLISKO appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: 2640 COLD SPRING ROAD, LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: MARWAN MUSTAKLEM appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: MARWAN MUSTAKLEM appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: JOHN D PIDGEON appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: JOHN D PIDGEON appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: JOHN D PIDGEON appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: GUBIN ENTERPRISES LIMITED PARTNERSHIP appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: DUANE E BRAMMER appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: DUANE E BRAMMER appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 February 2025: SHELDON L DYNES no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-02-01.csv
- 1 February 2025: PAUL F JANSSEN no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-02-01.csv
- 1 February 2025: HENRY COUNTY MEMORIAL HOSPITAL no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-02-01.csv
- 1 February 2025: BENJAMIN FRENCH no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-02-01.csv
- 1 February 2025: ALPHA HOME - A WATERS COMMUNITY no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-02-01.csv
- 1 February 2025: MARION E SHORE no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-02-01.csv
- 1 February 2025: JOHN D PIDGEON no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-02-01.csv
- 1 January 2025: ARLICE HARRIS no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
Recent changes on this record
- 1 July 2026: MARWAN MUSTAKLEM 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: MARWAN MUSTAKLEM 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: 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 CORPORATE DIRECTOR 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 CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: GUBIN ENTERPRISES LIMITED PARTNERSHIP no longer appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: DUANE E BRAMMER no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: DUANE E BRAMMER no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: MARWAN MUSTAKLEM appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: MARWAN MUSTAKLEM 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 CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: JOHN D PIDGEON appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: GUBIN ENTERPRISES LIMITED PARTNERSHIP appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: DUANE E BRAMMER appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: DUANE E BRAMMER appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 May 2026: SHELDON L DYNES appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: SHELDON L DYNES appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: SHELDON L DYNES appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: BLISKO ENTERPRISES LIMITED PARTNERSHIP appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: DEBORAH WARE appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: APERION CARE FORT WAYNE LLC appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: STRAWBERRY FIELDS REIT LTD appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: STRAWBERRY FIELDS REIT LTD appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: HENRY COUNTY MEMORIAL HOSPITAL appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: DAVID K REED appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: DAVID K REED appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: ALPHA HOME - A WATERS COMMUNITY appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: ALPHA HOME - A WATERS COMMUNITY appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: BRIAN RING appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: BRIAN RING appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: MARION E SHORE appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: MARION E SHORE appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: MICHAEL BLISKO appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: 2640 COLD SPRING ROAD, LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: MARWAN MUSTAKLEM appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: MARWAN MUSTAKLEM appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: JOHN D PIDGEON appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: JOHN D PIDGEON appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | 5 December 2025 | 5 December 2025 | 12 | 5 |
| 2 | 26 September 2024 | 26 September 2024 | 18 | 3 |
| 3 | 11 August 2023 | 11 August 2023 | 11 | 8 |
From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.
Deficiencies cited
41 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| 27 April 2026 | Health | F 0627 | Resident Rights Deficiencies | Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge. | D | Yes | Deficient, Provider has date of correction | 9 June 2026 |
| 27 April 2026 | Health | F 0628 | Resident Rights Deficiencies | Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. | D | Yes | Deficient, Provider has date of correction | 9 June 2026 |
| 5 December 2025 | Health | F 0565 | Resident Rights Deficiencies | Honor the resident's right to organize and participate in resident/family groups in the facility. | E | No | Deficient, Provider has date of correction | 19 January 2026 |
| 5 December 2025 | Health | F 0604 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. | D | No | Deficient, Provider has date of correction | 19 January 2026 |
| 5 December 2025 | Health | F 0628 | Resident Rights Deficiencies | Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. | D | No | Deficient, Provider has date of correction | 19 January 2026 |
| 5 December 2025 | Health | F 0641 | Resident Assessment and Care Planning Deficiencies | Ensure each resident receives an accurate assessment. | D | No | Deficient, Provider has date of correction | 19 January 2026 |
| 5 December 2025 | Health | F 0645 | Resident Assessment and Care Planning Deficiencies | PASARR screening for Mental disorders or Intellectual Disabilities | D | No | Deficient, Provider has date of correction | 19 January 2026 |
| 5 December 2025 | Health | F 0677 | Quality of Life and Care Deficiencies | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | No | Deficient, Provider has date of correction | 19 January 2026 |
| 5 December 2025 | Health | F 0679 | Quality of Life and Care Deficiencies | Provide activities to meet all resident's needs. | E | No | Deficient, Provider has date of correction | 19 January 2026 |
| 5 December 2025 | 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 | 19 January 2026 |
| 5 December 2025 | 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. | E | No | Deficient, Provider has date of correction | 19 January 2026 |
| 5 December 2025 | Health | F 0772 | Administration Deficiencies | Have an agreement with an approved laboratory to obtain services, if on-site laboratory services aren't provided. | D | No | Deficient, Provider has date of correction | 19 January 2026 |
| 28 May 2025 | Health | F 0686 | Quality of Life and Care Deficiencies | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | G | Yes | Deficient, Provider has date of correction | 20 June 2025 |
| 28 May 2025 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Yes | Deficient, Provider has date of correction | 20 June 2025 |
| 28 May 2025 | Health | F 0761 | Pharmacy Service Deficiencies | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | Yes | Deficient, Provider has date of correction | 20 June 2025 |
| 26 September 2024 | Health | F 0550 | Resident Rights Deficiencies | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | No | Deficient, Provider has date of correction | 30 October 2024 |
| 26 September 2024 | Health | F 0565 | Resident Rights Deficiencies | Honor the resident's right to organize and participate in resident/family groups in the facility. | E | No | Deficient, Provider has date of correction | 30 October 2024 |
| 26 September 2024 | Health | F 0641 | Resident Assessment and Care Planning Deficiencies | Ensure each resident receives an accurate assessment. | E | No | Deficient, Provider has date of correction | 30 October 2024 |
| 26 September 2024 | Health | F 0656 | Resident Assessment and Care Planning Deficiencies | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | No | Deficient, Provider has date of correction | 30 October 2024 |
| 26 September 2024 | Health | F 0657 | Resident Assessment and Care Planning Deficiencies | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | No | Deficient, Provider has date of correction | 30 October 2024 |
| 26 September 2024 | 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 | 30 October 2024 |
| 26 September 2024 | Health | F 0688 | Quality of Life and Care Deficiencies | Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | D | No | Deficient, Provider has date of correction | 30 October 2024 |
| 26 September 2024 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | No | Past Non-Compliance | 18 January 2024 |
| 26 September 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 | 30 October 2024 |
| 26 September 2024 | Health | F 0758 | Pharmacy Service Deficiencies | Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | D | No | Deficient, Provider has date of correction | 30 October 2024 |
| 26 September 2024 | Health | F 0761 | Pharmacy Service Deficiencies | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | E | No | Deficient, Provider has date of correction | 30 October 2024 |
| 26 September 2024 | Health | F 0776 | Administration Deficiencies | Provide timely, approved x-ray services, or have an agreement with an approved provider to obtain them. | D | No | Deficient, Provider has date of correction | 30 October 2024 |
| 26 September 2024 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | No | Deficient, Provider has date of correction | 30 October 2024 |
| 26 September 2024 | Health | F 0883 | Infection Control Deficiencies | Develop and implement policies and procedures for flu and pneumonia vaccinations. | D | No | Deficient, Provider has date of correction | 30 October 2024 |
| 16 September 2024 | Health | F 0695 | Quality of Life and Care Deficiencies | Provide safe and appropriate respiratory care for a resident when needed. | D | Yes | Deficient, Provider has date of correction | 4 October 2024 |
| 31 January 2024 | Health | F 0602 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Protect each resident from the wrongful use of the resident's belongings or money. | D | Yes | Past Non-Compliance | 28 September 2023 |
| 11 August 2023 | Health | F 0558 | Resident Rights Deficiencies | Reasonably accommodate the needs and preferences of each resident. | D | No | Deficient, Provider has date of correction | 8 September 2023 |
| 11 August 2023 | Health | F 0578 | Resident Rights Deficiencies | Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | D | No | Deficient, Provider has date of correction | 8 September 2023 |
| 11 August 2023 | Health | F 0584 | Resident Rights Deficiencies | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | D | No | Deficient, Provider has date of correction | 8 September 2023 |
| 11 August 2023 | Health | F 0641 | Resident Assessment and Care Planning Deficiencies | Ensure each resident receives an accurate assessment. | B | No | Deficient, Provider has date of correction | 8 September 2023 |
| 11 August 2023 | Health | F 0657 | Resident Assessment and Care Planning Deficiencies | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | No | Deficient, Provider has date of correction | 8 September 2023 |
| 11 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. | E | No | Deficient, Provider has date of correction | 8 September 2023 |
| 11 August 2023 | Health | F 0692 | Quality of Life and Care Deficiencies | Provide enough food/fluids to maintain a resident's health. | D | No | Deficient, Provider has date of correction | 8 September 2023 |
| 11 August 2023 | Health | F 0695 | Quality of Life and Care Deficiencies | Provide safe and appropriate respiratory care for a resident when needed. | E | No | Deficient, Provider has date of correction | 8 September 2023 |
| 11 August 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 | No | Deficient, Provider has date of correction | 8 September 2023 |
| 11 August 2023 | Health | F 0805 | Nutrition and Dietary Deficiencies | Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. | D | No | Deficient, Provider has date of correction | 8 September 2023 |
From the Care Compare health citations file NH_HealthCitations_Aug2026.csv, processed on 1 August 2026.
Penalties
| Penalty date | Type | Fine amount | Payment denial began | Payment denial, days | Fine ID |
|---|---|---|---|---|---|
| 28 May 2025 | Fine | $22,386 | 134820 |
From the Care Compare penalties file NH_Penalties_Aug2026.csv, processed on 1 August 2026.
Care Compare provider information
| Field | As filed |
|---|---|
| Provider Type | Medicare and Medicaid |
| Ownership Type | For profit - Limited Liability company |
| Legal Business Name | HENRY COUNTY MEMORIAL HOSPITAL |
| Date First Approved to Provide Medicare and Medicaid Services | 2002-10-11 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | Y |
| County/Parish | Marion |
| Telephone Number | 3179231518 |
| Chain Name | INFINITY HEALTHCARE CONSULTING |
| Chain ID | 763 |
| 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 | 86 |
| Average Number of Residents per Day | 59.3 |
| Overall Rating | 1 |
| Health Inspection Rating | 1 |
| QM Rating | 4 |
| Long-Stay QM Rating | 4 |
| Processing Date | 2026-08-01 |
From the Care Compare Provider Information file NH_ProviderInfo_Aug2026.csv, processed on 1 August 2026.
Get an email when this record changes
One email a day naming what moved on ALPHA HOME - A WATERS COMMUNITY: 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: MARWAN MUSTAKLEM no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. That is one line of the alert.
What the alerts are, and what a day of them looks like, is on the alerts page.
Following a list of facilities? The portfolio watch follows up to 100 certification numbers you name, on one subscription — on the alerts page.
The citable document for ALPHA HOME - A WATERS COMMUNITY
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 155717.