Skilled nursing facility · CMS certification number 155741
FAIRWAY VILLAGE
INDIANAPOLIS, Indiana · Medicare and Medicaid
Certified beds, as filed in Care Compare: 53
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 | $5,912,599 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$867,450 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,780,049 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,238,608 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $541,441 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $33,492 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $574,933 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $574,933 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 19,398 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 182 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 14,095 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 2,546 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 16,823 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 1 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 38 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 9 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 48 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 182 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 370.92 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 350.48 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1433672, 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 | $4,318,603 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$902,417 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,221,020 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,263,940 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$42,920 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $667,618 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $624,698 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $624,698 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 15,254 | 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 | 75 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 391.64 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 317.79 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1395804, 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 28 May 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,442,026 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$551,490 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,993,516 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,759,382 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$765,866 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $8,500 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$757,366 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$757,366 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 13,043 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 46 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 131.5 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 249.48 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 283.54 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1379264, 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 | $3,435,981 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$244,947 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,680,928 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,796,102 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,115,174 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $7,487 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$1,107,687 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,107,687 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 13,201 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 31 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 248 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 544.44 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 425.84 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1334386, 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 9 June 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,775,220 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$393,259 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,168,479 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,150,857 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$982,378 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $427,212 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$555,166 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$555,166 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 13,348 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 31 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicaid, in days | 339.72 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 430.58 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1318894, 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 12 August 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,087,277 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$52,532 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,139,809 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,555,008 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$415,199 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $3,475 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$411,724 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$411,724 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 15,993 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 66 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 140 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 247.64 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 242.32 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1263290, 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 9 August 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,079,086 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$127,743 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,206,829 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,462,482 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$255,653 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $5,006 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$250,647 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$250,647 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,035 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 57 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 370 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 277.46 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 281.32 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1240244, 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 21 August 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,999,518 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$298,542 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,298,060 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,370,255 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$72,195 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $4,074 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$68,121 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$68,121 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,190 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 32 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 158.83 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 705.15 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 505.94 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1207468, 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 | $5,071,857 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $844,483 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,227,374 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,391,292 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$163,918 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $2,840 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$161,078 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$161,078 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,847 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 76 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 138.53 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 269.61 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 221.67 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1170631, read from the public cost report file SNF10FY2016.zip.
Fiscal year 2015, ended 31 December 2015
Cost report for 1 January 2015 to 31 December 2015 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 5 August 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,902,630 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $949,457 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,953,173 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,651,378 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$698,205 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $3,741 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$694,464 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$694,464 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 12,519 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 91 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 109.72 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 155.38 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 137.57 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1139935, read from the public cost report file SNF10FY2015.zip.
Fiscal year 2014, ended 31 July 2014
Cost report for 1 January 2014 to 31 July 2014 — a reporting period of 211 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 19 October 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $1,623,869 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $15,493 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $1,608,376 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,576,382 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $31,994 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,890 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $33,884 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $33,884 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 8,499 | 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 | 160.4 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 447.32 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1111694, 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 23 July 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,760,456 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $2,760,456 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,702,370 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $58,086 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | $58,086 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $58,086 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 15,111 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 65 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 41.27 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 232.48 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1073274, read from the public cost report file SNF10FY2013.zip.
Fiscal year 2012, ended 31 December 2012
Cost report for 1 January 2012 to 31 December 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 5 November 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,015,336 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $2,015,336 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,386,294 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$370,958 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $349 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$370,609 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$370,609 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,078 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 63.67 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 321.56 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1048849, 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 | $2,234,379 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $2,234,379 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,465,560 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$231,181 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $18,846 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$212,335 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$212,335 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,164 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 126 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 38.67 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 128.29 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1017006, 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 18 June 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,446,666 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,697,784 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$251,118 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $7,408 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$243,710 (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 | 53 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 16,266 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 43 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 53.73 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 378.28 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 430554, read from the public cost report file SNFFY2010.zip.
Fiscal year 2009, ended 31 December 2009
Cost report for 1 January 2009 to 31 December 2009 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 21 June 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,938,794 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,782,119 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $156,675 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $14,940 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $171,615 (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 | 53 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 16,759 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 37 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 86.41 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 452.95 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 406790, 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 12 April 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,490,291 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,505,621 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$15,330 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $47,268 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $31,938 (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 | 53 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 15,603 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 37 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 53.25 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 421.7 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 367096, 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 12 March 2009.
None of these figures is carried on this report.
CMS report record 335136, 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 23 April 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,918,460 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,070,080 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$151,620 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $1,288 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$150,332 (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 | 53 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 13,554 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 61 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 33.59 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 222.2 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 306539, read from the public cost report file SNFFY2006.zip.
Fiscal year 2005, ended 31 December 2005
Cost report for 18 October 2005 to 31 December 2005 — a reporting period of 74 days, not a full year, on form CMS-2540-96, settled, processed by CMS on 16 October 2006.
None of these figures is carried on this report.
CMS report record 264564, read from the public cost report file SNFFY2006.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 08/01/2024 |
| DICE, MARK | ADP OF THE SNF | Individual | NOT APPLICABLE | since 06/01/2023 |
| HURLEY, DANIEL | ADP OF THE SNF | Individual | NOT APPLICABLE | since 02/24/2025 |
| NGENE, PATRICK | ADP OF THE SNF | Individual | NOT APPLICABLE | since 02/24/2025 |
| SHANE, ANDREW | ADP OF THE SNF | Individual | NOT APPLICABLE | since 02/01/2023 |
| VAN CAMP, STEVEN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 06/01/2023 |
| RING, BRIAN | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 08/01/2022 |
| CHIES, STEVEN | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 08/01/2024 |
| DYNES, SHELDON | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 01/01/2013 |
| JACKSON, BLAKE | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 08/01/2024 |
| JACKSON, ETHAN | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 08/01/2024 |
| JACKSON, MARK | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 08/01/2024 |
| JACKSON, MICHAEL | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 08/01/2024 |
| JACKSON, WESSLEY | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 08/01/2024 |
| JUSTICE, DAVID | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 08/01/2024 |
| KELSEY, DONNA | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 08/01/2024 |
| 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 08/01/2024 |
| WARE, DEBORAH | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 01/01/2013 |
| WRIGHT, THERESSA | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 08/01/2024 |
| DICE, MARK | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 08/01/2024 |
| FEDELER, JENNIFER | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 01/21/2026 |
| HURLEY, DANIEL | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 08/01/2024 |
| NGENE, PATRICK | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 08/01/2024 |
| RING, BRIAN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 08/01/2022 |
| SHANE, ANDREW | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 08/01/2024 |
| VAN CAMP, STEVEN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 08/01/2024 |
| 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 01/01/2013 |
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 O20250603002242).
| 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 | 8/1/2024 | 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. |
| DANIEL J HURLEY | 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. | 2/24/2025 | 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. |
| 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. |
| PATRICK NGENE | 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. | 2/24/2025 | 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. |
| 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. | 3/17/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 7/31/2014 | 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. | 3/14/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| BRIAN RING | 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. | 8/1/2022 | 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. |
| 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. | 8/1/2024 | 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. |
| 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. | 8/1/2024 | 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. |
| 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. | 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. |
| 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. | 8/1/2024 | 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. | 8/1/2024 | 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. |
| 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. | 8/1/2024 | 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. |
| 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. | 8/1/2024 | 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. | 8/1/2024 | 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. |
| 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. | 8/1/2024 | 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. |
| 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. | 8/1/2024 | 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. |
| 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. | 8/1/2024 | 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. |
| 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. | 8/1/2024 | 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. |
| 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. |
| DANIEL J HURLEY | 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. | 8/1/2024 | 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. |
| JENNIFER FEDELER | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/21/2026 | 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 | 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. | 8/1/2024 | 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. |
| PATRICK NGENE | 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. | 8/1/2024 | 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. |
| 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. | 8/1/2024 | 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. |
| 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. | 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. |
| 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: 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: 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 March 2026: DANIEL BAU no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: JENNIFER FEDELER appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 December 2025: VIRGINIA A CAINE no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: PATRICK NGENE no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: AMERICAN SENIOR COMMUNITIES LLC no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: BRENDA HORN no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: THOMAS HANIFY no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: MONICA PAYNE no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: MARK E DICE no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: PAUL T BABCOCK no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: STEVEN A VAN CAMP no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: LISA E HARRIS no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: CARL L DRUMMER no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: GEETA MANTRAVADI no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: SHELDON L DYNES appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: SHELDON L DYNES appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: PATRICK NGENE appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: PATRICK NGENE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: DAVID JUSTICE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: ANDREW E SHANE appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: ANDREW E SHANE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: STEVEN E CHIES appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: DEBORAH WARE appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: DEBORAH WARE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: THERESSA WRIGHT appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: HENRY COUNTY MEMORIAL HOSPITAL appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: DANIEL J HURLEY appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: DANIEL J HURLEY appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: DANIEL BAU appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: STEPHEN STITLE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: ETHAN JACKSON appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: MARK E DICE appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: MARK E DICE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: STEVEN A VAN CAMP appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: STEVEN A VAN CAMP appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: WESSLEY JACKSON appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: DONNA G KELSEY appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: BLAKE JACKSON appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: BRIAN RING appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: BRIAN RING appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: MARION E SHORE appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: MARION E SHORE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: MICHAEL JACKSON appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: MARK A. JACKSON appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: JOHN D PIDGEON appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: JOHN D PIDGEON appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 3 June 2024: CATHERINE HASSAKIS-HICKS no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-06-03.csv
- 3 June 2024: DONNA G KELSEY no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-06-03.csv
- 3 June 2024: GREGORY S FEHRIBACH no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-06-03.csv
- 3 June 2024: BEVERLY MUKES-GAITHER no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-06-03.csv
- 3 June 2024: PATRICK NGENE appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-06-03.csv
- 3 June 2024: BRENDA HORN appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-06-03.csv
- 3 June 2024: MARK E DICE appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-06-03.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: 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: 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 March 2026: DANIEL BAU no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 March 2026: JENNIFER FEDELER appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
- 1 December 2025: VIRGINIA A CAINE no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: PATRICK NGENE no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: AMERICAN SENIOR COMMUNITIES LLC no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: BRENDA HORN no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: THOMAS HANIFY no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: MONICA PAYNE no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: MARK E DICE no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: PAUL T BABCOCK no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: STEVEN A VAN CAMP no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: LISA E HARRIS no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: CARL L DRUMMER no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: GEETA MANTRAVADI no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: SHELDON L DYNES appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: SHELDON L DYNES appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: PATRICK NGENE appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: PATRICK NGENE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: DAVID JUSTICE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: ANDREW E SHANE appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: ANDREW E SHANE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: STEVEN E CHIES appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: DEBORAH WARE appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: DEBORAH WARE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: THERESSA WRIGHT appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: HENRY COUNTY MEMORIAL HOSPITAL appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: DANIEL J HURLEY appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: DANIEL J HURLEY appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: DANIEL BAU appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: STEPHEN STITLE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: ETHAN JACKSON appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: MARK E DICE appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: MARK E DICE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | 20 March 2026 | 20 March 2026 | 0 | 1 |
| 2 | 26 February 2025 | 26 February 2025 | 0 | 0 |
| 3 | 1 May 2024 | 1 May 2024 | 0 | 0 |
From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.
Deficiencies cited
Not yet extracted for this facility.
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 | 2005-10-18 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | Y |
| County/Parish | Marion |
| Telephone Number | 3177878951 |
| Chain Name | AMERICAN SENIOR COMMUNITIES |
| Chain ID | 33 |
| Provider Changed Ownership in Last 12 Months | N |
| With a Resident and Family Council | None |
| Automatic Sprinkler Systems in All Required Areas | Yes |
| Number of Certified Beds | 53 |
| Average Number of Residents per Day | 46.0 |
| Overall Rating | 5 |
| Health Inspection Rating | 5 |
| 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.
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One email a day naming what moved on FAIRWAY VILLAGE: the field, the value before, the value after, and the date of the file that first showed it.
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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 FAIRWAY VILLAGE
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 155741.