Facility record report · CMS certification number 235585

Covenant Skilled Nursing and Rehabilitation at Wel

Saginaw, Michigan · Medicare and Medicaid

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.

Revenue and expenses, fiscal year 2024
Figure	As filed	Where it comes from
Total patient revenue	$7,126,757	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$1,385,659	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$5,741,098	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$5,989,326	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$248,228	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$2,800	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$245,428	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$245,428 (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%).

Beds, days and discharges, fiscal year 2024
Figure	As filed	Where it comes from
Total facility beds, all components	39	CMS-2540-10 worksheet S300001 line 800 column 100
Bed days available, all components	14,274	CMS-2540-10 worksheet S300001 line 800 column 200
Medicare (Title XVIII) patient days	3,061	CMS-2540-10 worksheet S300001 line 800 column 400
Other-payer patient days	6,819	CMS-2540-10 worksheet S300001 line 800 column 600
Total patient days, all components	9,880	CMS-2540-10 worksheet S300001 line 800 column 700
Medicare discharges	182	CMS-2540-10 worksheet S300001 line 800 column 900
Other-payer discharges	423	CMS-2540-10 worksheet S300001 line 800 column 1100
Total discharges, all components	605	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	16.82	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	16.33	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1434351, read from the public cost report file SNF10FY2024.zip.

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 12 September 2024.

Revenue and expenses, fiscal year 2023
Figure	As filed	Where it comes from
Total patient revenue	$6,168,396	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$1,728,192	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$4,440,204	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$6,340,748	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$1,900,544	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$1,584	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$1,898,960	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$1,898,960 (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%).

Beds, days and discharges, fiscal year 2023
Figure	As filed	Where it comes from
Total facility beds, all components	39	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	8,569	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	545	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	18.06	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	15.72	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1394612, read from the public cost report file SNF10FY2023.zip.

Cost report for 5 July 2022 to 31 December 2022 — a reporting period of 179 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 27 September 2023.

Revenue and expenses, fiscal year 2022
Figure	As filed	Where it comes from
Total patient revenue	$2,549,810	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$747,202	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$1,802,608	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$3,488,191	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$1,685,583	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$2,671	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$1,682,912	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$1,682,912 (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%).

Beds, days and discharges, fiscal year 2022
Figure	As filed	Where it comes from
Total facility beds, all components	39	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	3,484	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	15.22	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	27.65	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1365603, read from the public cost report file SNF10FY2022.zip.

Five facilities of a similar size in Michigan, fiscal year 2024

Chosen for having certified bed counts closest to this facility’s, listed by name. Every one filed for the same fiscal year; the day each year ends differs and is shown. Each figure is that facility’s own filing.

Facility	Total facility beds	Total patient days	Net patient revenue	Total operating expenses	Net income from service to patients	Period ended
ALLEGAN COUNTY MEDICAL CARE FACILITY	39	11,597	$5,015,758	$6,854,324	−$1,838,566	31 December 2024
CONTINUING CARE AT FOX RUN	44	17,807	$9,060,222	$86,731,842	−$77,671,620	31 December 2024
FREEMAN NURSING AND REHABILITATION	45	11,211	$4,144,297	$3,877,341	$266,956	31 December 2024
KALAMAZOO OPCO LLC	39	13,765	$5,050,151	$4,833,183	$216,968	31 December 2024
RIVERSIDE HEALTHCARE CENTER LLC	39	13,059	$4,635,523	$3,796,452	$839,071	31 December 2024
TRANSITIONAL CARE COMMUNITY	39	9,880	$5,741,098	$5,989,326	−$248,228	31 December 2024

Where each column comes from, on every filing in this table: Total facility beds: CMS-2540-10 worksheet S300001 line 800 column 100 · Total patient days: CMS-2540-10 worksheet S300001 line 800 column 700 · Net patient revenue: CMS-2540-10 worksheet G300000 line 300 column 100 · Total operating expenses: CMS-2540-10 worksheet G300000 line 400 column 100 · Net income from service to patients: CMS-2540-10 worksheet G300000 line 500 column 100.

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
COVENANT MEDICAL CENTER, INC.	5% OR GREATER DIRECT OWNERSHIP INTEREST	Organization	50%	since 09/08/2021
WELLSPRING TCC LLC	5% OR GREATER DIRECT OWNERSHIP INTEREST	Organization	50%	since 09/08/2021
COVENANT HEALTHCARE SYSTEM	5% OR GREATER INDIRECT OWNERSHIP INTEREST	Organization	50%	since 09/08/2021
LUTHERAN HOMES OF MICHIGAN, INC	5% OR GREATER INDIRECT OWNERSHIP INTEREST	Organization	50%	since 09/08/2021
BIRCHMEIER, KEVIN	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 09/08/2021
GEHM, DAVID	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 09/08/2021
KALBFLEISCH, TIMOTHY	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 09/08/2021
TOMPA, ADAM	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 09/08/2021
BIRCHMEIER, KEVIN	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 08/04/2022
KALBFLEISCH, TIMOTHY	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 08/04/2022
CONZELMANN, NOELLE	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 07/05/2022
LUTHERAN HOMES OF MICHIGAN, INC	OPERATIONAL/MANAGERIAL CONTROL	Organization	NOT APPLICABLE	since 07/05/2022

Medicare enrollment

As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of TRANSITIONAL CARE COMMUNITY LLC (enrollment ID O20220708000409).

Owner	Individual or organization	Role	Ownership percentage	Association date	Described in the filing as
COVENANT MEDICAL CENTER, INC.	Organization	5% OR GREATER DIRECT OWNERSHIP INTEREST	50	9/8/2021	Private equity company: No Real estate investment trust: No Holding company: No
WELLSPRING TCC LLC	Organization	5% OR GREATER DIRECT OWNERSHIP INTEREST	50	9/8/2021	Private equity company: No Real estate investment trust: No Holding company: Yes
COVENANT HEALTHCARE SYSTEM	Organization	5% OR GREATER INDIRECT OWNERSHIP INTEREST	50	9/8/2021	Private equity company: No Real estate investment trust: No Holding company: No
LUTHERAN HOMES OF MICHIGAN, INC	Organization	5% OR GREATER INDIRECT OWNERSHIP INTEREST	50	9/8/2021	Private equity company: No Real estate investment trust: No Holding company: No
ADAM TOMPA	Individual	CORPORATE DIRECTOR	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	9/8/2021	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
DAVID M GEHM	Individual	CORPORATE DIRECTOR	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	9/8/2021	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
KEVIN BIRCHMEIER	Individual	CORPORATE DIRECTOR	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	9/8/2021	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
TIMOTHY ROBERT KALBFLEISCH	Individual	CORPORATE DIRECTOR	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	9/8/2021	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
KEVIN BIRCHMEIER	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.	8/4/2022	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.
TIMOTHY ROBERT KALBFLEISCH	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.	8/4/2022	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.
LUTHERAN HOMES OF MICHIGAN, INC	Organization	OPERATIONAL/MANAGERIAL CONTROL	100	7/5/2022	Private equity company: No Real estate investment trust: No Holding company: No
NOELLE M CONZELMANN	Individual	OPERATIONAL/MANAGERIAL CONTROL	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	7/5/2022	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

15 March 2023: DAVID M GEHM no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
15 March 2023: KEVIN BIRCHMEIER appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
30 November 2022: DAVID B MEYER no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: KEVIN S ALBOSTA no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: KEVIN S ALBOSTA no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: KEVIN BIRCHMEIER no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: BETHANY A CHARLTON no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: JOHN W SHELTON no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: KEVIN BIRCHMEIER appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: LUTHERAN HOMES OF MICHIGAN, INC appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: LUTHERAN HOMES OF MICHIGAN, INC appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: NOELLE M CONZELMANN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: ADAM TOMPA appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: TIMOTHY KALBFLEISCH appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: TIMOTHY KALBFLEISCH appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: COVENANT MEDICAL CENTER INC appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: COVENANT HEALTHCARE SYSTEM appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: DAVID M GEHM appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: DAVID M GEHM appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: WELLSPRING TCC LLC appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv

Inspections

Inspection cycle	Health inspection	Fire safety inspection	Health deficiencies	Fire safety deficiencies
1	25 March 2026	25 March 2026	10	5
2	14 February 2025	14 February 2025	6	5
3	22 February 2024	22 February 2024	4	3

From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.

Deficiencies cited

20 deficiencies on file, newest inspection first

Inspection date	Inspection type	Tag	Category	What was cited	Scope and severity	Complaint	Corrected	Correction date
25 March 2026	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	4 May 2026
25 March 2026	Health	F 0552	Resident Rights Deficiencies	Ensure that residents are fully informed and understand their health status, care and treatments.	D	No	Deficient, Provider has date of correction	4 May 2026
25 March 2026	Health	F 0584	Resident Rights Deficiencies	Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.	E	Yes	Deficient, Provider has date of correction	4 May 2026
25 March 2026	Health	F 0627	Resident Rights Deficiencies	Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge.	D	No	Deficient, Provider has date of correction	4 May 2026
25 March 2026	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	Yes	Deficient, Provider has date of correction	4 May 2026
25 March 2026	Health	F 0686	Quality of Life and Care Deficiencies	Provide appropriate pressure ulcer care and prevent new ulcers from developing.	D	No	Deficient, Provider has date of correction	4 May 2026
25 March 2026	Health	F 0809	Nutrition and Dietary Deficiencies	Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.	E	No	Deficient, Provider has date of correction	4 May 2026
25 March 2026	Health	F 0812	Nutrition and Dietary Deficiencies	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.	F	No	Deficient, Provider has date of correction	4 May 2026
25 March 2026	Health	F 0848	Administration Deficiencies	Provide a neutral and fair arbitration process and agree to arbitrator and venue.	D	No	Deficient, Provider has date of correction	4 May 2026
25 March 2026	Health	F 0880	Infection Control Deficiencies	Provide and implement an infection prevention and control program.	D	Yes	Deficient, Provider has date of correction	4 May 2026
3 April 2025	Health	F 0677	Quality of Life and Care Deficiencies	Provide care and assistance to perform activities of daily living for any resident who is unable.	D	Yes	Deficient, Provider has date of correction	26 April 2025
14 February 2025	Health	F 0684	Quality of Life and Care Deficiencies	Provide appropriate treatment and care according to orders, resident’s preferences and goals.	D	No	Deficient, Provider has date of correction	26 March 2025
14 February 2025	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.	E	No	Deficient, Provider has date of correction	26 March 2025
14 February 2025	Health	F 0761	Pharmacy Service Deficiencies	Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.	D	No	Deficient, Provider has date of correction	26 March 2025
14 February 2025	Health	F 0812	Nutrition and Dietary Deficiencies	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.	E	No	Deficient, Provider has date of correction	18 April 2025
17 September 2024	Health	F 0686	Quality of Life and Care Deficiencies	Provide appropriate pressure ulcer care and prevent new ulcers from developing.	D	Yes	Deficient, Provider has date of correction	15 October 2024
22 February 2024	Health	F 0578	Resident Rights Deficiencies	Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.	D	No	Deficient, Provider has date of correction	20 March 2024
22 February 2024	Health	F 0761	Pharmacy Service Deficiencies	Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.	D	No	Deficient, Provider has date of correction	20 March 2024
22 February 2024	Health	F 0812	Nutrition and Dietary Deficiencies	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.	F	No	Deficient, Provider has date of correction	20 March 2024
22 February 2024	Health	F 0921	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.	F	No	Deficient, Provider has date of correction	20 March 2024

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	TRANSITIONAL CARE COMMUNITY LLC
Date First Approved to Provide Medicare and Medicaid Services	1998-07-17
Provider Resides in Hospital	N
Continuing Care Retirement Community	N
Urban	Y
County/Parish	Saginaw
Telephone Number	9895838110
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	39
Average Number of Residents per Day	33.6
Overall Rating	4
Health Inspection Rating	3
QM Rating	4
Short-Stay QM Rating	4
Processing Date	2026-08-01

From the Care Compare Provider Information file NH_ProviderInfo_Aug2026.csv, processed on 1 August 2026.

Every change on this record

28 August 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
12 September 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
27 September 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
15 March 2023: DAVID M GEHM no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
15 March 2023: KEVIN BIRCHMEIER appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
30 November 2022: DAVID B MEYER no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: KEVIN S ALBOSTA no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: KEVIN S ALBOSTA no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: KEVIN BIRCHMEIER no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: BETHANY A CHARLTON no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: JOHN W SHELTON no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: KEVIN BIRCHMEIER appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: LUTHERAN HOMES OF MICHIGAN, INC appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: LUTHERAN HOMES OF MICHIGAN, INC appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: NOELLE M CONZELMANN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: ADAM TOMPA appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: TIMOTHY KALBFLEISCH appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: TIMOTHY KALBFLEISCH appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: COVENANT MEDICAL CENTER INC appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: COVENANT HEALTHCARE SYSTEM appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: DAVID M GEHM appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: DAVID M GEHM appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv
30 November 2022: WELLSPRING TCC LLC appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-11-30.csv

How to read this report

Every figure is printed as the CMS file it came from printed it. Each cost-report figure carries the worksheet, line and column of form CMS-2540 it was read from, so a reader holding the same public file can go to that cell; each Care Compare and Medicare enrollment section names its file and the date CMS stamped on it.

A figure the filing does not carry is left out, and so is a figure whose value the filing’s own arithmetic contradicts. Net income is printed with what the form’s own arithmetic shows about it — plainly where it follows from the lines above it, and, where it does not, beside what the form’s own lines leave unaccounted for. An ownership field left empty carries the dated sentence on CMS’s pause of the expanded Form CMS-855A disclosure. A source that holds nothing for this facility says so in its section.

This report carries no percentile and no score, and it does not place this facility above or below another. The five facilities above are the one comparison it draws: the nearest certified bed counts in the same state at the same fiscal year, listed by name. Nurse staffing is printed in its own section, on its own page, apart from the cost-report figures.

How to cite this report

Velarion Records, Covenant Skilled Nursing and Rehabilitation at Wel — facility record report, CMS certification number 235585. https://velarionrecords.com/facility/235585/report.

Cost report figures: CMS Healthcare Cost Report Information System, form CMS-2540-10, publication year 2024, file SNF10FY2024.zip.
Provider information, inspections, deficiencies and penalties: CMS Care Compare, file dated 1 August 2026.
Care Compare ownership: CMS file dated 1 August 2026.
Medicare enrollment ownership: CMS file dated 1 August 2026.
Nurse staffing: CMS Payroll-Based Journal, quarters 2017Q1 to 2026Q1.

Published by VELARIONAI LLC · Andrew Richardson, founder. Corrections: hello@velarionrecords.com, quoting certification number 235585. Velarion Records publishes these records as filed.

Nurse staffing, quarter by quarter

Hours this facility reported to CMS’s Payroll-Based Journal, one row per quarter, oldest first, each with how its figures are derived and the file it came from.

Nurse staffing hours by quarter
Quarter	Quarter ended	Days reported	Resident days	Registered nurse hours	Licensed practical nurse hours	Nurse aide hours	Total nurse hours
2017Q1	31 March 2017	90	1,585	4,162.3	1,813.4	4,958.3	10,934
2017Q2	30 June 2017	91	1,561	4,427.5	1,664.7	4,858.2	10,950.4
2017Q3	30 September 2017	92	1,628	4,278.9	1,957.9	5,038.2	11,275
2017Q4	31 December 2017	92	1,630	4,059.7	2,136.7	5,011.1	11,207.5
2018Q1	31 March 2018	90	1,526	3,962.9	1,985.5	4,634.1	10,582.5
2018Q2	30 June 2018	91	1,444	3,945.4	1,821.5	4,219.3	9,986.2
2018Q3	30 September 2018	92	1,744	4,198.7	2,013.1	5,052.9	11,264.7
2018Q4	31 December 2018	92	1,743	4,344.9	1,928.5	5,012.1	11,285.5
2019Q1	31 March 2019	90	1,646	4,125.5	2,238.6	4,870.96	11,235.06
2019Q2	30 June 2019	91	1,565	3,888.2	2,185	4,779.94	10,853.14
2019Q3	30 September 2019	92	1,614	3,789.6	2,147.6	4,727.6	10,664.8
2019Q4	31 December 2019	92	1,480	4,098	1,829.4	4,320.6	10,248
2020Q1	31 March 2020	91	1,539	3,945.2	2,151.8	4,613.7	10,710.7
2020Q2	30 June 2020	91	1,150	3,239.7	1,984.2	2,792.3	8,016.2
2020Q3	30 September 2020	92	1,207	3,352.6	1,918.7	3,114.9	8,386.2
2020Q4	31 December 2020	92	1,061	3,354.4	1,861.9	2,557.9	7,774.2
2021Q1	31 March 2021	90	1,114	3,351.9	1,617.6	2,557.45	7,526.95
2021Q2	30 June 2021	91	943	2,322.85	1,997.4	2,053.55	6,373.8
2021Q3	30 September 2021	92	855	2,316.79	2,038.75	3,599.45	7,954.99
2021Q4	31 December 2021	92	1,082	3,226.9	2,003.75	3,852.5	9,083.15
2022Q1	31 March 2022	90	1,439	4,415.1	2,506.5	5,302.5	12,224.1
2022Q2	30 June 2022	91	1,724	3,223.5	3,833.75	1,925.25	8,982.5
2022Q3	30 September 2022	92	1,791	3,362.26	5,741.26	1,099	10,202.52
2022Q4	31 December 2022	92	1,852	3,562.02	5,386.55	853	9,801.57
2023Q1	31 March 2023	90	2,043	3,837.75	5,463.28	8,330.52	17,631.55
2023Q2	30 June 2023	91	2,253	3,954.27	6,030.76	8,924.76	18,909.79
2023Q3	30 September 2023	92	2,111	3,626.25	5,283.85	7,693.51	16,603.61
2023Q4	31 December 2023	92	2,281	4,116.25	4,336.51	6,657.76	15,110.52
2024Q1	31 March 2024	91	2,383	4,348	3,763.52	6,349.25	14,460.77
2024Q2	30 June 2024	91	2,536	5,306.25	4,324.03	7,344.51	16,974.79
2024Q3	30 September 2024	92	2,546	4,701	4,280.77	7,555	16,536.77
2024Q4	31 December 2024	92	2,411	3,988.25	4,470.76	6,745	15,204.01
2025Q1	31 March 2025	90	3,125	3,837	4,976.25	6,634.25	15,447.5
2025Q2	30 June 2025	91	3,097	3,570.55	5,127.25	6,256.5	14,954.3
2025Q3	30 September 2025	92	3,182	3,405.89	4,935.13	7,068.2	15,409.22
2025Q4	31 December 2025	92	3,165	3,687.15	4,779.92	6,441.74	14,908.81
2026Q1	31 March 2026	90	3,024	4,270.1	4,595.75	6,132.75	14,998.6

Nurse staffing hours per resident day by quarter
Quarter	Registered nurse hours per resident day	Licensed practical nurse hours per resident day	Nurse aide hours per resident day	Total nurse hours per resident day
2017Q1	2.626057	1.144101	3.128265	6.898423
2017Q2	2.836323	1.066432	3.112236	7.01499
2017Q3	2.628317	1.202641	3.094717	6.925676
2017Q4	2.490613	1.310859	3.074294	6.875767
2018Q1	2.59692	1.301114	3.036763	6.934797
2018Q2	2.732271	1.261427	2.921953	6.915651
2018Q3	2.407511	1.1543	2.897305	6.459117
2018Q4	2.492771	1.106426	2.875559	6.474756
2019Q1	2.506379	1.360024	2.959271	6.825674
2019Q2	2.484473	1.396166	3.054275	6.934914
2019Q3	2.347955	1.330607	2.92912	6.607683
2019Q4	2.768919	1.236081	2.919324	6.924324
2020Q1	2.563483	1.398181	2.997856	6.959519
2020Q2	2.81713	1.725391	2.428087	6.970609
2020Q3	2.77763	1.589644	2.580696	6.94797
2020Q4	3.161546	1.754854	2.410839	7.327238
2021Q1	3.008887	1.452065	2.295736	6.756688
2021Q2	2.463256	2.118134	2.177678	6.759067
2021Q3	2.709696	2.384503	4.209883	9.304082
2021Q4	2.982348	1.851895	3.560536	8.394778
2022Q1	3.068172	1.741835	3.684851	8.494858
2022Q2	1.86978	2.223753	1.116734	5.210267
2022Q3	1.877309	3.205617	0.613624	5.696549
2022Q4	1.923337	2.908504	0.460583	5.292424
2023Q1	1.878488	2.674146	4.077592	8.630225
2023Q2	1.755113	2.676769	3.961278	8.39316
2023Q3	1.717788	2.503008	3.644486	7.865282
2023Q4	1.804581	1.901144	2.91879	6.624516
2024Q1	1.824591	1.57932	2.664394	6.068305
2024Q2	2.09237	1.705059	2.8961	6.693529
2024Q3	1.846426	1.681371	2.9674	6.495196
2024Q4	1.654189	1.854318	2.797594	6.306101
2025Q1	1.22784	1.5924	2.12296	4.9432
2025Q2	1.152906	1.655554	2.020181	4.828641
2025Q3	1.070361	1.550952	2.221307	4.842621
2025Q4	1.164976	1.510243	2.035305	4.710524
2026Q1	1.41207	1.519759	2.028026	4.959854

How each quarter is derived, and its file

2017Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-03-31.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. This file names the totals hrs_rn_donadmin, hrs_lpn_admin, hrs_na_trn; they are read as hrs_rndon, hrs_lpnadmin, hrs_natrn. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-03-31.csv
2017Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-06-30.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. This file names the totals hrs_lpn_admin; they are read as hrs_lpnadmin. CMS's file labels its last six hours columns hrs_medaide, hrs_medaide_emp, hrs_rn_donadmin, hrs_na_trn, hrs_natrn_emp, hrs_natrn_ctr; they are read by position as Hrs_MedAide_emp, Hrs_MedAide_ctr, Hrs_NAtrn, Hrs_NAtrn_emp, Hrs_NAtrn_ctr, Hrs_MedAide, the order in which each total equals its employee and contract parts on every row. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-06-30.csv
2017Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-09-30.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. This file names the totals hrs_lpn_admin, hrs_na_trn; they are read as hrs_lpnadmin, hrs_natrn. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-09-30.csv
2017Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-12-31.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. This file names the totals hrs_lpn_admin, hrs_na_trn; they are read as hrs_lpnadmin, hrs_natrn. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-12-31.csv
2018Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2018-03-31.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2018-03-31.csv
2018Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2018-06-30.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2018-06-30.csv
2018Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2018-09-30.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2018-09-30.csv
2018Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2018-12-13.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2018-12-13.csv
2019Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2019-03-13.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2019-03-13.csv
2019Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2019-06-30.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2019-06-30.csv
2019Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2019-09-30.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2019-09-30.csv
2019Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2019-12-31.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2019-12-31.csv
2020Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2020-03-31.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2020-03-31.csv
2020Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2020-06-30.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2020-06-30.csv
2020Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2020-09-30.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2020-09-30.csv
2020Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2020-12-31.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2020-12-31.csv
2021Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2021-03-31.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2021-03-31.csv
2021Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2021-06-30.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2021-06-30.csv
2021Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2021-09-30.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2021-09-30.csv
2021Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2021-12-31.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. The file's `incomplete` column flags 0 of this facility's days as 1; those days are included as filed. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2021-12-31.csv
2022Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2022-01-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2022-01-01.csv
2022Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2022-06-30.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2022-06-30.csv
2022Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2022-09-30.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2022-09-30.csv
2022Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2022-12-31.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2022-12-31.csv
2023Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2023-01-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2023-01-01.csv
2023Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2023-06-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2023-06-01.csv
2023Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2023-09-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2023-09-01.csv
2023Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2023-12-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2023-12-01.csv
2024Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-01-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-01-01.csv
2024Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-04-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-04-01.csv
2024Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-09-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-09-01.csv
2024Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-12-31.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-12-31.csv
2025Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-01-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-01-01.csv
2025Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-04-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-04-01.csv
2025Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-07-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-07-01.csv
2025Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-10-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-10-01.csv
2026Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2026-01-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2026-01-01.csv

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