Skilled nursing facility · CMS certification number 165307
Pillar of Cedar Valley
Waterloo, Iowa · Medicare and Medicaid
Certified beds, as filed in Care Compare: 114
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 29 August 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $20,057,931 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $71,137 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $19,986,794 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $20,748,810 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$762,016 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | −$497,131 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$1,259,147 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,259,147 (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 | 208 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 76,128 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 276 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 63,862 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 1,025 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 65,163 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 2 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 35 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 5 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 42 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 138 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 1,551.5 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1436761, 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 | $19,973,672 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$57,102 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $20,030,774 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $19,023,537 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $1,007,237 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $120,233 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,127,470 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,127,470 (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 | 200 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 65,530 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 51 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 114.5 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 1,284.9 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1395807, 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 26 September 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $17,934,707 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$23,390 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $17,958,097 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $19,090,968 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,132,871 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | −$51,214 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$1,184,085 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,184,085 (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 | 200 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 63,563 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 58 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 82 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 1,095.91 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1365440, 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 22 September 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $17,388,487 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$91,583 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $17,480,070 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $17,220,206 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $259,864 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,182,529 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,442,393 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,442,393 (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 | 200 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 61,782 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 54 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 99 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 1,144.11 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1333613, 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 25 November 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $16,703,907 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$169,310 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $16,873,217 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $18,298,994 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,425,777 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,560,009 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $134,232 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $134,232 (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 | 200 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 58,316 | 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 | 261.2 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 1,100.3 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1305517, 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 7 December 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $13,077,697 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $73,651 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $13,004,046 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $12,975,824 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $28,222 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $23,347 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $51,569 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $51,569 (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 | 168 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 49,734 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 58 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 83.42 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 857.48 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1275171, read from the public cost report file SNF10FY2019.zip.
Fiscal year 2018, ended 31 December 2018
Cost report for 1 July 2018 to 31 December 2018 — a reporting period of 183 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 9 May 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,774,389 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $85,727 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,688,662 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,694,081 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,005,419 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $16,776 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$988,643 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,115,267 (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 | 168 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 21,612 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 27 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 34 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 800.44 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1223970, read from the public cost report file SNF10FY2018.zip.
Fiscal year 2017, ended 30 June 2017
Cost report for 1 July 2016 to 30 June 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 5 December 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $13,469,222 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $437,656 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $13,031,566 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $13,738,307 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$706,741 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $37,801 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$668,940 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$668,940 (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 | 168 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 53,467 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 64 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 36.21 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 835.42 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1179336, read from the public cost report file SNF10FY2016.zip.
Fiscal year 2016, ended 30 June 2016
Cost report for 1 July 2015 to 30 June 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 17 January 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $13,463,227 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $428,285 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $13,034,942 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $13,730,253 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$695,311 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $75,718 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$619,593 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$890,909 (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 | 168 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 54,078 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 134 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 43.11 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 403.57 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1151047, read from the public cost report file SNF10FY2015.zip.
Fiscal year 2015, ended 30 June 2015
Cost report for 1 July 2014 to 30 June 2015 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 20 January 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $13,564,116 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $467,491 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $13,096,625 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $12,918,102 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $178,523 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $102,128 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $280,651 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $24,488 (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 | 168 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 55,329 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 43 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 41.9 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 1,286.72 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1117455, read from the public cost report file SNF10FY2014.zip.
Fiscal year 2014, ended 30 June 2014
Cost report for 1 July 2013 to 30 June 2014 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 29 December 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,475,022 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $80,528 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $11,394,494 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $12,625,402 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,230,908 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,021,789 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$209,119 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$209,119 (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 | 168 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 58,853 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 90 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 28.82 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 653.92 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1083677, read from the public cost report file SNF10FY2013.zip.
Fiscal year 2013, ended 30 June 2013
Cost report for 1 July 2012 to 30 June 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 27 January 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,850,510 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $95,678 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $11,754,832 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $12,234,542 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$479,710 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $629,827 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $150,117 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $150,117 (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 | 168 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 57,881 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 99 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 19.69 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 584.66 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1053922, read from the public cost report file SNF10FY2012.zip.
Fiscal year 2012, ended 30 June 2012
Cost report for 1 July 2011 to 30 June 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 24 January 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,845,640 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $135,680 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $11,709,960 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $11,464,983 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $244,977 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,345,964 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,590,941 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,590,941 (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 | 168 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 57,982 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 127 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 18.1 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 456.55 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1023350, read from the public cost report file SNF10FY2011.zip.
Fiscal year 2011, ended 30 June 2011
Cost report for 1 July 2010 to 30 June 2011 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 18 January 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $10,995,861 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $11,293,970 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$298,109 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $1,081,757 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $783,648 (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 | 168 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 56,839 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 78 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 100 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 877.1 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 728.71 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 422974, read from the public cost report file SNFFY2010.zip.
Fiscal year 2010, ended 30 June 2010
Cost report for 1 July 2009 to 30 June 2010 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 25 January 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $10,311,545 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $11,354,962 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$1,043,417 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $455,740 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$587,677 (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 | 168 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 55,382 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 70 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 36.22 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,256.44 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 791.17 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 393111, read from the public cost report file SNFFY2009.zip.
Fiscal year 2009, ended 30 June 2009
Cost report for 1 July 2008 to 30 June 2009 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 13 January 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $10,216,299 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,735,998 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$519,699 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $141,871 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$377,828 (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 | 168 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 55,360 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 95 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 19.44 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 818.77 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 582.74 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 362157, read from the public cost report file SNFFY2008.zip.
Fiscal year 2008, ended 30 June 2008
Cost report for 1 July 2007 to 30 June 2008 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 15 December 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $9,520,109 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,399,300 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$879,191 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $54,137 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$825,054 (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 | 168 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 51,244 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 70 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 12.44 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,216.79 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 732.06 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 360957, read from the public cost report file SNFFY2007.zip.
Fiscal year 2007, ended 30 June 2007
Cost report for 1 July 2006 to 30 June 2007 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 19 September 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $9,420,432 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,685,807 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$1,265,375 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $85,061 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$1,180,314 (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 | 168 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 51,790 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 79 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 39.07 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 912.13 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 655.57 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 325989, read from the public cost report file SNFFY2006.zip.
Fiscal year 2006, ended 30 June 2006
Cost report for 1 July 2005 to 30 June 2006 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 14 December 2007.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $9,237,343 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,387,916 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$1,150,573 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $101,794 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$1,048,779 (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 | 168 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 53,335 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 95 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 30.73 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 773.7 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 561.42 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 298485, read from the public cost report file SNFFY2005.zip.
Fiscal year 2005, ended 30 June 2005
Cost report for 1 July 2004 to 30 June 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 25 October 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $8,544,909 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,951,493 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$1,406,584 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $68,222 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$1,338,362 (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 | 168 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 50,874 | 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 | 31.64 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,178.28 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 834 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 265138, read from the public cost report file SNFFY2004.zip.
Fiscal year 2004, ended 30 June 2004
Cost report for 1 July 2003 to 30 June 2004 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 31 October 2005.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $8,466,160 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,646,580 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$1,180,420 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $63,838 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$1,116,582 (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 | 168 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 52,924 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 94 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 41.7 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 464.3 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 563.02 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 235758, read from the public cost report file SNFFY2003.zip.
Fiscal year 2003, ended 30 June 2003
Cost report for 1 July 2002 to 30 June 2003 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 28 June 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $7,963,577 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,252,400 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$1,288,823 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $64,620 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$1,224,203 (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 | 168 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 54,696 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 66 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 109.6 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 759.24 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 828.73 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 184598, read from the public cost report file SNFFY2002.zip.
Fiscal year 2002, ended 30 June 2002
Cost report for 1 July 2001 to 30 June 2002 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 22 September 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $7,498,535 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,632,691 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$1,134,156 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $73,298 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$1,060,858 (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 | 168 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 51,926 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 113 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 57.93 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 459.52 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 160284, read from the public cost report file SNFFY2001.zip.
Fiscal year 2001, ended 30 June 2001
Cost report for 1 July 2000 to 30 June 2001 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 20 May 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $7,141,675 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,619,211 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$1,477,536 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $70,759 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$1,406,777 (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 | 168 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 52,907 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 107 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 45.03 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 701.75 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 494.46 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 145651, read from the public cost report file SNFFY2000.zip.
Fiscal year 2000, ended 30 June 2000
Cost report for 1 July 1999 to 30 June 2000 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 26 December 2001.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $6,911,049 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,765,554 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$854,505 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $99,461 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$755,044 (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 | 166 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 52,539 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 111 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 40.21 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 492.4 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 473.32 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 87071, read from the public cost report file SNFFY1999.zip.
Fiscal year 1999, ended 30 June 1999
Cost report for 1 July 1998 to 30 June 1999 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 7 May 2001.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $6,659,739 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,696,419 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$1,036,680 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $103,336 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$933,344 (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 | 181 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 54,284 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 117 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 52.93 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 800.22 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 463.97 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 87069, read from the public cost report file SNFFY1998.zip.
Fiscal year 1998, ended 30 June 1998
Cost report for 1 July 1997 to 30 June 1998 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 15 June 2000.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $6,131,221 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,317,719 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$1,186,498 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $101,964 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$1,084,534 (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 | 181 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 55,287 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 101 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 26.41 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 927.6 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 547.4 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 87067, read from the public cost report file SNFFY1997.zip.
Fiscal year 1997, ended 30 June 1997
Cost report for 1 April 1997 to 30 June 1997 — a reporting period of 90 days, not a full year, on form CMS-2540-96, settled, processed by CMS on 15 October 1998.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $5,981,465 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,774,659 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$793,194 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $98,401 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$694,793 (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 | 181 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 55,237 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 53 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 80.5 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,210.36 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 1,042.21 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 87065, read from the public cost report file SNFFY1997.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 |
|---|---|---|---|---|
| TAMID WATERLOO LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | 100% | since 12/15/2022 |
| TAMID HEALTHCARE NFP | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | Organization | 100% | since 12/15/2022 |
| KUZMENKO, MICHAEL | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 12/15/2022 |
| SHIR, ANATOLIY | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 12/15/2022 |
| MESSING, MICHAEL | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 12/15/2022 |
| PILLAR SENIOR CARE LLC | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | since 12/15/2022 |
| TARNOFF, MICHAEL | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 12/15/2022 |
| ARENDS, HILARY | W-2 MANAGING EMPLOYEE | Individual | NOT APPLICABLE | since 04/03/2022 |
Medicare enrollment
As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of BLACK HAWK NURSING AND REHABILITATION LLC (enrollment ID O20190121000985).
| Owner | Individual or organization | Role | Ownership percentage | Association date | Described in the filing as |
|---|---|---|---|---|---|
| TAMID WATERLOO LLC | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100 | 12/15/2022 | Private equity company: No Real estate investment trust: No Holding company: Yes |
| TAMID HEALTHCARE NFP | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100 | 12/15/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| ANATOLIY SHIR | Individual | CORPORATE OFFICER | 100 | 12/15/2022 | 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. |
| MICHAEL KUZMENKO | Individual | 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. | 12/15/2022 | 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. |
| MICHAEL B TARNOFF | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 12/15/2022 | 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. |
| MICHAEL MESSING | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 12/15/2022 | 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. |
| PILLAR SENIOR CARE LLC | 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. | 12/15/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| ANATOLIY SHIR | Individual | OTHER | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 12/15/2022 | 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. |
| GS MANAGEMENT LLC | Organization | OTHER | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 12/15/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| VADIM MUCHNIK | Individual | OTHER | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 12/15/2022 | 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. |
| HILARY ARENDS | Individual | W-2 MANAGING EMPLOYEE | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 4/3/2022 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
Changes in ownership
- 1 July 2026: ANATOLIY SHIR no longer appears as OTHER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: ANATOLIY SHIR no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: ANATOLIY SHIR appears as OTHER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: ANATOLIY SHIR appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 November 2023: GS MANAGEMENT LLC no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: ILYA SHULMAN no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: ILYA SHULMAN no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: SHERI AMES no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: DAN FEINSTEIN no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: DMITRY GODIN no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: AARON COHEN no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: MICHAEL MESSING appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: GS MANAGEMENT LLC appears as OTHER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: TAMID WATERLOO LLC appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: MICHAEL B TARNOFF appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: TAMID HEALTHCARE NFP appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: PILLAR SENIOR CARE LLC appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: VADIM MUCHNIK appears as OTHER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: MICHAEL KUZMENKO appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: HILARY ARENDS appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: ANATOLIY SHIR appears as OTHER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: ANATOLIY SHIR appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
Recent changes on this record
- 1 July 2026: ANATOLIY SHIR no longer appears as OTHER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: ANATOLIY SHIR no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: ANATOLIY SHIR appears as OTHER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: ANATOLIY SHIR appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 29 August 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- 25 September 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- 1 November 2023: GS MANAGEMENT LLC no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: ILYA SHULMAN no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: ILYA SHULMAN no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: SHERI AMES no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: DAN FEINSTEIN no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: DMITRY GODIN no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: AARON COHEN no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: MICHAEL MESSING appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: GS MANAGEMENT LLC appears as OTHER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: TAMID WATERLOO LLC appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: MICHAEL B TARNOFF appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: TAMID HEALTHCARE NFP appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: PILLAR SENIOR CARE LLC appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: VADIM MUCHNIK appears as OTHER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: MICHAEL KUZMENKO appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: HILARY ARENDS appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: ANATOLIY SHIR appears as OTHER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 1 November 2023: ANATOLIY SHIR appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-11-01.csv
- 26 September 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- 22 September 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
- 25 November 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
- 7 December 2020: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
- 9 May 2019: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2018.zip
- 5 November 2018: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2017.zip
- 5 December 2017: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2016.zip
- 17 January 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2015.zip
- 20 January 2016: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2014.zip
- 29 December 2014: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2013.zip
- 27 January 2014: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2012.zip
- 24 January 2013: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2011.zip
- 18 January 2012: A cost report was filed for fiscal year 2011, on form CMS-2540-96. SNFFY2010.zip
- 25 January 2011: A cost report was filed for fiscal year 2010, on form CMS-2540-96. SNFFY2009.zip
- 13 January 2010: A cost report was filed for fiscal year 2009, on form CMS-2540-96. SNFFY2008.zip
- 15 December 2009: A cost report was filed for fiscal year 2008, on form CMS-2540-96. SNFFY2007.zip
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | 17 November 2025 | 17 November 2025 | 11 | 3 |
| 2 | 3 October 2024 | 3 October 2024 | 11 | 6 |
| 3 | 29 June 2023 | 29 June 2023 | 2 | 8 |
From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.
Deficiencies cited
24 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| 11 June 2026 | 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 | 1 July 2026 |
| 23 December 2025 | Health | F 0600 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | Yes | Deficient, Provider has date of correction | 20 January 2026 |
| 23 December 2025 | Health | F 0609 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Yes | Deficient, Provider has date of correction | 20 January 2026 |
| 23 December 2025 | Health | F 0610 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Respond appropriately to all alleged violations. | D | Yes | Deficient, Provider has date of correction | 20 January 2026 |
| 17 November 2025 | Health | F 0640 | Resident Assessment and Care Planning Deficiencies | Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment. | D | No | Deficient, Provider has date of correction | 1 December 2025 |
| 17 November 2025 | 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 | 1 December 2025 |
| 17 November 2025 | Health | F 0688 | Quality of Life and Care Deficiencies | Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | D | No | Deficient, Provider has date of correction | 1 December 2025 |
| 17 November 2025 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | No | Deficient, Provider has date of correction | 1 December 2025 |
| 17 November 2025 | Health | F 0695 | Quality of Life and Care Deficiencies | Provide safe and appropriate respiratory care for a resident when needed. | D | No | Deficient, Provider has date of correction | 1 December 2025 |
| 17 November 2025 | Health | F 0760 | Pharmacy Service Deficiencies | Ensure that residents are free from significant medication errors. | D | No | Deficient, Provider has date of correction | 1 December 2025 |
| 17 November 2025 | Health | F 0908 | Environmental Deficiencies | Keep all essential equipment working safely. | D | No | Deficient, Provider has date of correction | 1 December 2025 |
| 3 October 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 | 31 October 2024 |
| 3 October 2024 | Health | F 0577 | Resident Rights Deficiencies | Allow residents to easily view the nursing home's survey results and communicate with advocate agencies. | E | No | Deficient, Provider has date of correction | 31 October 2024 |
| 3 October 2024 | Health | F 0658 | Resident Assessment and Care Planning Deficiencies | Ensure services provided by the nursing facility meet professional standards of quality. | D | No | Deficient, Provider has date of correction | 31 October 2024 |
| 3 October 2024 | Health | F 0684 | Quality of Life and Care Deficiencies | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | Yes | Deficient, Provider has date of correction | 31 October 2024 |
| 3 October 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. | D | Yes | Deficient, Provider has date of correction | 31 October 2024 |
| 3 October 2024 | Health | F 0693 | Quality of Life and Care Deficiencies | Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. | D | No | Deficient, Provider has date of correction | 31 October 2024 |
| 3 October 2024 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | F | No | Deficient, Provider has date of correction | 31 October 2024 |
| 3 October 2024 | Health | F 0912 | Environmental Deficiencies | Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms. | D | No | Deficient, Provider has date of correction | 31 October 2024 |
| 3 October 2024 | Health | F 0913 | Environmental Deficiencies | Provide bedrooms that have direct access to an exit hallway. | D | No | Deficient, Provider has date of correction | 31 October 2024 |
| 3 October 2024 | Health | F 0914 | Environmental Deficiencies | Provide bedrooms that don't allow residents to see each other when privacy is needed. | D | No | Deficient, Provider has date of correction | 31 October 2024 |
| 3 October 2024 | Health | F 0919 | Environmental Deficiencies | Make sure that a working call system is available in each resident's bathroom and bathing area. | D | No | Deficient, Provider has date of correction | 31 October 2024 |
| 29 June 2023 | Health | F 0676 | Quality of Life and Care Deficiencies | Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. | D | No | Deficient, Provider has date of correction | 21 July 2023 |
| 29 June 2023 | 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 | 21 July 2023 |
From the Care Compare health citations file NH_HealthCitations_Aug2026.csv, processed on 1 August 2026.
Penalties
Not yet extracted for this facility.
Care Compare provider information
| Field | As filed |
|---|---|
| Provider Type | Medicare and Medicaid |
| Ownership Type | Non profit - Corporation |
| Legal Business Name | BLACK HAWK NURSING AND REHABILITATION LLC |
| Date First Approved to Provide Medicare and Medicaid Services | 1997-03-13 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | Y |
| County/Parish | Black Hawk |
| Telephone Number | 3192912509 |
| 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 | 114 |
| Average Number of Residents per Day | 133.2 |
| Overall Rating | 1 |
| Health Inspection Rating | 2 |
| QM Rating | 1 |
| Long-Stay QM Rating | 1 |
| 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 Pillar of Cedar Valley: 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: ANATOLIY SHIR no longer appears as OTHER in the Medicare enrollment ownership file. That is one line of the alert.
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The citable document for Pillar of Cedar Valley
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 Iowa 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 165307.