Skilled nursing facility · CMS certification number 235588

Maple Valley Nursing Home

Maple Valley, Michigan · Medicare and Medicaid

Certified beds, as filed in Care Compare: 25

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 11 September 2025.

None of these figures is carried on this report.

CMS report record 1439119, 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 31 July 2024.

None of these figures is carried on this report.

CMS report record 1390688, 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 25 August 2023.

None of these figures is carried on this report.

CMS report record 1363225, read from the public cost report file SNF10FY2022.zip.

Fiscal year 2021, ended 31 December 2021

Cost report for 1 January 2021 to 31 December 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 28 September 2022.

None of these figures is carried on this report.

CMS report record 1334440, 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 21 September 2021.

Revenue and expenses, fiscal year 2020
Figure	As filed	Where it comes from
Total patient revenue	$2,044,792	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$45,162	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$1,999,630	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$2,403,157	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$403,527	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$590,446	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$186,919	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $186,919 (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 2020
Figure	As filed	Where it comes from
Total facility beds, all components	25	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	7,091	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	9	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	68	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	787.89	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1300686, 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 14 October 2020.

Revenue and expenses, fiscal year 2019
Figure	As filed	Where it comes from
Total patient revenue	$2,153,323	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$6,545	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$2,146,778	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$2,054,254	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$92,524	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$195	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$92,719	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $92,719 (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 2019
Figure	As filed	Where it comes from
Total facility beds, all components	25	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	7,302	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	23	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	40	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	1,247.8	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	317.48	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1270423, read from the public cost report file SNF10FY2019.zip.

Fiscal year 2018, ended 31 December 2018

Cost report for 1 January 2018 to 31 December 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 15 July 2019.

Revenue and expenses, fiscal year 2018
Figure	As filed	Where it comes from
Total patient revenue	$2,122,303	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$5,298	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$2,117,005	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$2,032,727	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$84,278	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$1,173	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$85,451	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $85,451 (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 2018
Figure	As filed	Where it comes from
Total facility beds, all components	25	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	7,537	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	11	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	38	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	3,246	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	685.18	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1236894, read from the public cost report file SNF10FY2018.zip.

Fiscal year 2017, ended 31 December 2017

Cost report for 1 January 2017 to 31 December 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 19 July 2018.

Revenue and expenses, fiscal year 2017
Figure	As filed	Where it comes from
Total patient revenue	$2,003,011	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$17,982	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$1,985,029	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$1,830,886	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$154,143	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$696	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$154,839	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $154,839 (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 2017
Figure	As filed	Where it comes from
Total facility beds, all components	25	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	7,884	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	14	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	18.43	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	1,844.75	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	563.14	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1201102, read from the public cost report file SNF10FY2017.zip.

Fiscal year 2016, ended 31 December 2016

Cost report for 1 January 2016 to 31 December 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 16 August 2017.

Revenue and expenses, fiscal year 2016
Figure	As filed	Where it comes from
Total patient revenue	$1,693,343	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$52,434	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$1,640,909	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$1,726,451	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$85,542	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$1,785	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$83,757	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$83,757 (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 2016
Figure	As filed	Where it comes from
Total facility beds, all components	25	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	6,848	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	6	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	38	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	1,141.33	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1173419, read from the public cost report file SNF10FY2016.zip.

Fiscal year 2015, ended 31 December 2015

Cost report for 1 January 2015 to 31 December 2015 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 1 August 2016.

Revenue and expenses, fiscal year 2015
Figure	As filed	Where it comes from
Total patient revenue	$1,862,745	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$20,495	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$1,842,250	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$1,775,821	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$66,429	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$605	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$67,034	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $67,034 (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 2015
Figure	As filed	Where it comes from
Total facility beds, all components	25	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	7,311	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	15	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, Medicaid, in days	1,191.6	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	487.4	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1139083, read from the public cost report file SNF10FY2015.zip.

Fiscal year 2014, ended 31 December 2014

Cost report for 1 January 2014 to 31 December 2014 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 25 July 2015.

Revenue and expenses, fiscal year 2014
Figure	As filed	Where it comes from
Total patient revenue	$1,781,550	CMS-2540-10 worksheet G300000 line 100 column 100
Net patient revenue	$1,781,550	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$1,718,139	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$63,411	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$1,520	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$64,931	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $64,931 (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 2014
Figure	As filed	Where it comes from
Total facility beds, all components	25	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	8,056	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	7	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	37	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	2,177.33	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	1,150.86	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1105322, read from the public cost report file SNF10FY2014.zip.

Fiscal year 2013, ended 31 December 2013

Cost report for 1 January 2013 to 31 December 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 8 August 2014.

Revenue and expenses, fiscal year 2013
Figure	As filed	Where it comes from
Total patient revenue	$1,766,417	CMS-2540-10 worksheet G300000 line 100 column 100
Net patient revenue	$1,766,417	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$1,687,604	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$78,813	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$3,576	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$82,389	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $82,389 (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 2013
Figure	As filed	Where it comes from
Total facility beds, all components	25	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	7,543	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	11	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	62	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	2,985.5	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	685.73	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1075306, read from the public cost report file SNF10FY2013.zip.

Fiscal year 2012, ended 31 December 2012

Cost report for 1 January 2012 to 31 December 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 15 August 2013.

Revenue and expenses, fiscal year 2012
Figure	As filed	Where it comes from
Total patient revenue	$1,801,085	CMS-2540-10 worksheet G300000 line 100 column 100
Net patient revenue	$1,801,085	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$1,737,903	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$63,182	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$418	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$63,600	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $63,600 (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 2012
Figure	As filed	Where it comes from
Total facility beds, all components	25	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	7,679	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	24	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	48.15	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	757.43	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	319.96	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1046453, read from the public cost report file SNF10FY2012.zip.

Fiscal year 2011, ended 31 December 2011

Cost report for 1 January 2011 to 31 December 2011 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 5 November 2012.

Revenue and expenses, fiscal year 2011
Figure	As filed	Where it comes from
Total patient revenue	$1,586,754	CMS-2540-10 worksheet G300000 line 100 column 100
Net patient revenue	$1,586,754	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$1,673,255	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$86,501	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$2,858	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$83,643	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$83,643 (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 2011
Figure	As filed	Where it comes from
Total facility beds, all components	25	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	6,793	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	23	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	51.7	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	801.14	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	295.35	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1018676, read from the public cost report file SNF10FY2011.zip.

Fiscal year 2010, ended 31 December 2010

Cost report for 1 January 2010 to 31 December 2010 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 8 September 2011.

Revenue and expenses, fiscal year 2010
Figure	As filed	Where it comes from
Net patient revenue	$1,670,434	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$1,630,908	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	$39,526	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$1,800	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income, stated at moderate confidence: $41,326 (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.

Beds, days and discharges, fiscal year 2010
Figure	As filed	Where it comes from
Total facility beds, all components	25	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	7,392	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	32	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	40	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	509.08	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	231	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 417165, read from the public cost report file SNFFY2010.zip.

Fiscal year 2009, ended 31 December 2009

Cost report for 1 January 2009 to 31 December 2009 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 27 July 2010.

Revenue and expenses, fiscal year 2009
Figure	As filed	Where it comes from
Net patient revenue	$1,720,484	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$1,573,179	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	$147,305	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$3,628	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income, stated at moderate confidence: $150,933 (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.

Beds, days and discharges, fiscal year 2009
Figure	As filed	Where it comes from
Total facility beds, all components	25	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	8,517	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	16	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	102.6	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	957.43	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	532.31	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 384114, read from the public cost report file SNFFY2009.zip.

Fiscal year 2008, ended 31 December 2008

Cost report for 1 January 2008 to 31 December 2008 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 24 August 2009.

Revenue and expenses, fiscal year 2008
Figure	As filed	Where it comes from
Net patient revenue	$1,512,393	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$1,450,694	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	$61,699	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$802	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income, stated at moderate confidence: $62,501 (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.

Beds, days and discharges, fiscal year 2008
Figure	As filed	Where it comes from
Total facility beds, all components	25	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	7,256	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	33	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	39.25	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	488.91	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	219.88	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 355243, read from the public cost report file SNFFY2008.zip.

Fiscal year 2007, ended 31 December 2007

Cost report for 1 January 2007 to 31 December 2007 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 15 October 2008.

Revenue and expenses, fiscal year 2007
Figure	As filed	Where it comes from
Net patient revenue	$1,571,209	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$1,518,638	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	$52,571	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$5,298	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income, stated at moderate confidence: $57,869 (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.

Beds, days and discharges, fiscal year 2007
Figure	As filed	Where it comes from
Total facility beds, all components	25	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	7,961	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	40	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	45.15	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	495.73	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	199.03	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 326354, read from the public cost report file SNFFY2007.zip.

Fiscal year 2006, ended 31 December 2006

Cost report for 1 January 2006 to 31 December 2006 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 1 May 2008.

Revenue and expenses, fiscal year 2006
Figure	As filed	Where it comes from
Net patient revenue	$1,486,625	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$1,584,581	CMS-2540-96 worksheet G200002 line 1500 column 100
Net income from service to patients	−$97,956	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$288	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income, stated at moderate confidence: −$97,668 (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.

Beds, days and discharges, fiscal year 2006
Figure	As filed	Where it comes from
Total facility beds, all components	25	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	7,750	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	25	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	72.9	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	434.5	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	310	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 308089, read from the public cost report file SNFFY2006.zip.

Fiscal year 2005, ended 31 December 2005

Cost report for 1 January 2005 to 31 December 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 1 June 2007.

Revenue and expenses, fiscal year 2005
Figure	As filed	Where it comes from
Net patient revenue	$1,503,154	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$1,510,351	CMS-2540-96 worksheet G200002 line 1500 column 100
Net income from service to patients	−$7,197	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$302	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income, stated at moderate confidence: −$6,895 (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.

Beds, days and discharges, fiscal year 2005
Figure	As filed	Where it comes from
Total facility beds, all components	25	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	8,467	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	29	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	60.56	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	449.17	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	291.97	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 280326, read from the public cost report file SNFFY2005.zip.

Fiscal year 2004, ended 31 December 2004

Cost report for 1 January 2004 to 31 December 2004 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 10 May 2006.

Revenue and expenses, fiscal year 2004
Figure	As filed	Where it comes from
Net patient revenue	$1,586,486	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$1,527,820	CMS-2540-96 worksheet G200002 line 1500 column 100
Net income from service to patients	$58,666	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$585	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income, stated at moderate confidence: $59,251 (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.

Beds, days and discharges, fiscal year 2004
Figure	As filed	Where it comes from
Total facility beds, all components	25	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	8,604	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	32	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	61.08	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	350.31	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	268.88	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 248943, read from the public cost report file SNFFY2004.zip.

Fiscal year 2003, ended 31 December 2003

Cost report for 1 January 2003 to 31 December 2003 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 15 October 2004.

Revenue and expenses, fiscal year 2003
Figure	As filed	Where it comes from
Net patient revenue	$1,306,470	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$1,315,545	CMS-2540-96 worksheet G200002 line 1500 column 100
Net income from service to patients	−$9,075	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$768	CMS-2540-96 worksheet G300000 line 2600 column 100
Total other expenses	$350	CMS-2540-96 worksheet G300000 line 3100 column 100

Net income, stated at moderate confidence: −$8,657 (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.

Beds, days and discharges, fiscal year 2003
Figure	As filed	Where it comes from
Total facility beds, all components	25	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	8,665	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	29	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	63.13	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	547.83	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	298.79	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 197467, read from the public cost report file SNFFY2003.zip.

Fiscal year 2002, ended 31 December 2002

Cost report for 1 January 2002 to 31 December 2002 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 1 July 2004.

Revenue and expenses, fiscal year 2002
Figure	As filed	Where it comes from
Net patient revenue	$1,302,203	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$1,283,707	CMS-2540-96 worksheet G200002 line 1500 column 100
Net income from service to patients	$18,496	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$2,744	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income, stated at moderate confidence: $21,240 (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.

Beds, days and discharges, fiscal year 2002
Figure	As filed	Where it comes from
Total facility beds, all components	25	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	8,752	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	28	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	63.2	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	893.86	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	312.57	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 186387, read from the public cost report file SNFFY2002.zip.

Fiscal year 2000, ended 31 December 2000

Cost report for 1 January 2000 to 31 December 2000 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 13 February 2003.

Net income, stated at moderate confidence: $16,386 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.

CMS report record 126892, read from the public cost report file SNFFY2000.zip.

Fiscal year 1999, ended 31 December 1999

Cost report for 1 January 1999 to 31 December 1999 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 21 March 2001.

Net income, stated at moderate confidence: −$2,557 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.

CMS report record 69625, read from the public cost report file SNFFY1999.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.

The staffing record →

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
KASBEN, DONNA	5% OR GREATER DIRECT OWNERSHIP INTEREST	Individual	50%	since 03/08/1996
KASBEN, JOHN	5% OR GREATER DIRECT OWNERSHIP INTEREST	Individual	50%	since 03/08/1996
KASBEN, DONNA	ADP OF THE SNF	Individual	NOT APPLICABLE	since 03/08/1996
KASBEN, JOHN	ADP OF THE SNF	Individual	NOT APPLICABLE	since 07/02/2019
LANGLOIS, MARK	ADP OF THE SNF	Individual	NOT APPLICABLE	since 02/01/2020
PORTER, MISTY	ADP OF THE SNF	Individual	NOT APPLICABLE	since 05/01/2001
KASBEN, DONNA	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 03/08/1996
KASBEN, JOHN	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 03/08/1996
CLEMENS GRAY, MICHELLE	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 04/03/2024
DYKSTRA, SANTIAGO	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 09/24/2023
HULBERT, AMY	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 01/30/2022
HULBERT, RICHARD	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 11/13/2023
KASBEN, JENNIFER	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 07/29/2019
KASBEN, JOHN	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 03/08/1996
KASBEN, SERENA	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 10/15/1997
LANGLOIS, MARK	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 02/01/2020
MOORE, KENDRA	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 10/20/2024
PORTER, MISTY	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 01/01/2023

Medicare enrollment

As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of MAPLE VALLEY NURSING HOME OF MAPLE CITY, INC. (enrollment ID O20111109000553).

Owner	Individual or organization	Role	Ownership percentage	Association date	Described in the filing as
DONNA KASBEN	Individual	5% OR GREATER DIRECT OWNERSHIP INTEREST	50	3/8/1996	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
JOHN KASBEN	Individual	5% OR GREATER DIRECT OWNERSHIP INTEREST	50	3/8/1996	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
DONNA KASBEN	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	3/8/1996	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
JOHN KASBEN	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	7/2/2019	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
MARK A LANGLOIS	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	2/1/2020	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
MISTY MAE PORTER	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	5/1/2001	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	6/17/2024	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	1/1/2023	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	1/1/2018	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	1/1/1996	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	3/25/2025	Private equity company: No Real estate investment trust: No Holding company: No
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	3/25/2025	Private equity company: No Real estate investment trust: No Holding company: No
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	3/25/2025	Private equity company: No Real estate investment trust: No Holding company: No
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	3/25/2025	Private equity company: No Real estate investment trust: No Holding company: No
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	4/29/2025	Private equity company: No Real estate investment trust: No Holding company: No
DONNA KASBEN	Individual	CORPORATE OFFICER	50	3/8/1996	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
JOHN KASBEN	Individual	CORPORATE OFFICER	50	3/8/1996	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.
AMY HULBERT	Individual	OPERATIONAL/MANAGERIAL CONTROL	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	1/30/2022	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.
JENNIFER KASBEN	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.	7/29/2019	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
JOHN KASBEN	Individual	OPERATIONAL/MANAGERIAL CONTROL	50	3/8/1996	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.
KENDRA MOORE	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.	10/20/2024	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
MARK A LANGLOIS	Individual	OPERATIONAL/MANAGERIAL CONTROL	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	2/1/2020	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
MICHELLE R CLEMENS GRAY	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.	4/3/2024	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
MISTY MAE PORTER	Individual	OPERATIONAL/MANAGERIAL CONTROL	50	1/1/2023	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
RICHARD HULBERT	Individual	OPERATIONAL/MANAGERIAL CONTROL	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	11/13/2023	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
SANTIAGO DYKSTRA	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.	9/24/2023	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
SERENA KASBEN	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.	10/15/1997	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: KENDRA MOORE no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: JOHN KASBEN no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: JOHN KASBEN no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: KENDRA MOORE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: JOHN KASBEN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: JOHN KASBEN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 June 2025: MISTY MAE PORTER no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
1 June 2025: JOHN KASBEN no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
1 June 2025: DONNA KASBEN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
1 June 2025: SERENA KASBEN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
1 June 2025: JENNIFER KASBEN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
1 June 2025: MICHELLE R CLEMENS GRAY appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
1 June 2025: RICHARD HULBERT appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
1 June 2025: AMY HULBERT appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
1 June 2025: SANTIAGO DYKSTRA appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
1 June 2025: MISTY MAE PORTER appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
1 June 2025: MARK A LANGLOIS appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
1 June 2025: MARK A LANGLOIS appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
1 June 2025: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
1 June 2025: KENDRA MOORE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
1 June 2025: JOHN KASBEN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
31 October 2022: MISTY MAE PORTER appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-10-31.csv
31 October 2022: JOHN KASBEN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-10-31.csv
31 October 2022: JOHN KASBEN appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-10-31.csv

Recent changes on this record

1 July 2026: KENDRA MOORE no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: JOHN KASBEN no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: JOHN KASBEN no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: KENDRA MOORE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: JOHN KASBEN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: JOHN KASBEN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
11 September 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
1 June 2025: MISTY MAE PORTER no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
1 June 2025: JOHN KASBEN no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
1 June 2025: DONNA KASBEN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
1 June 2025: SERENA KASBEN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
1 June 2025: JENNIFER KASBEN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
1 June 2025: MICHELLE R CLEMENS GRAY appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
1 June 2025: RICHARD HULBERT appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
1 June 2025: AMY HULBERT appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
1 June 2025: SANTIAGO DYKSTRA appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
1 June 2025: MISTY MAE PORTER appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
1 June 2025: MARK A LANGLOIS appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
1 June 2025: MARK A LANGLOIS appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
1 June 2025: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
1 June 2025: KENDRA MOORE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
1 June 2025: JOHN KASBEN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
31 July 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
25 August 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
31 October 2022: MISTY MAE PORTER appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-10-31.csv
31 October 2022: JOHN KASBEN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-10-31.csv
31 October 2022: JOHN KASBEN appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2022-10-31.csv
28 September 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
21 September 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
14 October 2020: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
15 July 2019: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2018.zip
19 July 2018: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2017.zip
16 August 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2016.zip
1 August 2016: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2015.zip
25 July 2015: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2014.zip
8 August 2014: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2013.zip
15 August 2013: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2012.zip
5 November 2012: A cost report was filed for fiscal year 2011, on form CMS-2540-10. SNF10FY2011.zip
8 September 2011: A cost report was filed for fiscal year 2010, on form CMS-2540-96. SNFFY2010.zip
27 July 2010: A cost report was filed for fiscal year 2009, on form CMS-2540-96. SNFFY2009.zip

Inspections

Inspection cycle	Health inspection	Fire safety inspection	Health deficiencies	Fire safety deficiencies
1	6 May 2026	6 May 2026	7	4
2	10 April 2025	10 April 2025	11	5
3	25 April 2024	25 April 2024	27	6

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

Deficiencies cited

45 deficiencies on file, newest inspection first

Inspection date	Inspection type	Tag	Category	What was cited	Scope and severity	Complaint	Corrected	Correction date
6 May 2026	Health	F 0602	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Protect each resident from the wrongful use of the resident's belongings or money.	D	Yes	Deficient, Provider has date of correction	18 June 2026
6 May 2026	Health	F 0628	Resident Rights Deficiencies	Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.	D	No	Deficient, Provider has date of correction	18 June 2026
6 May 2026	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	18 June 2026
6 May 2026	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	18 June 2026
6 May 2026	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	18 June 2026
6 May 2026	Health	F 0756	Pharmacy Service Deficiencies	Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.	E	No	Deficient, Provider has date of correction	18 June 2026
6 May 2026	Health	F 0851	Administration Deficiencies	Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.	F	No	Deficient, Provider has date of correction	18 June 2026
10 April 2025	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	19 May 2025
10 April 2025	Health	F 0658	Resident Assessment and Care Planning Deficiencies	Ensure services provided by the nursing facility meet professional standards of quality.	D	Yes	Deficient, Provider has date of correction	19 May 2025
10 April 2025	Health	F 0678	Quality of Life and Care Deficiencies	Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.	D	No	Deficient, Provider has date of correction	19 May 2025
10 April 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	19 May 2025
10 April 2025	Health	F 0756	Pharmacy Service Deficiencies	Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.	D	No	Deficient, Provider has date of correction	19 May 2025
10 April 2025	Health	F 0760	Pharmacy Service Deficiencies	Ensure that residents are free from significant medication errors.	D	Yes	Deficient, Provider has date of correction	19 May 2025
10 April 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.	F	No	Deficient, Provider has date of correction	19 May 2025
10 April 2025	Health	F 0880	Infection Control Deficiencies	Provide and implement an infection prevention and control program.	F	No	Deficient, Provider has date of correction	19 May 2025
10 April 2025	Health	F 0883	Infection Control Deficiencies	Develop and implement policies and procedures for flu and pneumonia vaccinations.	D	No	Deficient, Provider has date of correction	19 May 2025
22 January 2025	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	10 February 2025
20 August 2024	Health	F 0689	Quality of Life and Care Deficiencies	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.	G	Yes	Deficient, Provider has date of correction	29 August 2024
25 April 2024	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.	J	No	Deficient, Provider has date of correction	30 June 2024
25 April 2024	Health	F 0604	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.	D	No	Deficient, Provider has date of correction	19 July 2024
25 April 2024	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	No	Deficient, Provider has date of correction	3 June 2024
25 April 2024	Health	F 0610	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Respond appropriately to all alleged violations.	D	No	Deficient, Provider has date of correction	3 June 2024
25 April 2024	Health	F 0623	Resident Rights Deficiencies	Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.	D	No	Deficient, Provider has date of correction	3 June 2024
25 April 2024	Health	F 0625	Resident Rights Deficiencies	Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.	D	No	Deficient, Provider has date of correction	3 June 2024
25 April 2024	Health	F 0638	Resident Assessment and Care Planning Deficiencies	Assure that each resident’s assessment is updated at least once every 3 months.	D	No	Deficient, Provider has date of correction	3 June 2024
25 April 2024	Health	F 0645	Resident Assessment and Care Planning Deficiencies	PASARR screening for Mental disorders or Intellectual Disabilities	D	No	Deficient, Provider has date of correction	3 June 2024
25 April 2024	Health	F 0656	Resident Assessment and Care Planning Deficiencies	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.	D	No	Deficient, Provider has date of correction	3 June 2024
25 April 2024	Health	F 0657	Resident Assessment and Care Planning Deficiencies	Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.	E	No	Deficient, Provider has date of correction	19 July 2024
25 April 2024	Health	F 0684	Quality of Life and Care Deficiencies	Provide appropriate treatment and care according to orders, resident’s preferences and goals.	D	No	Deficient, Provider has date of correction	3 June 2024
25 April 2024	Health	F 0689	Quality of Life and Care Deficiencies	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.	G	No	Deficient, Provider has date of correction	3 June 2024
25 April 2024	Health	F 0699	Quality of Life and Care Deficiencies	Provide care or services that was trauma informed and/or culturally competent.	D	No	Deficient, Provider has date of correction	12 June 2024
25 April 2024	Health	F 0700	Quality of Life and Care Deficiencies	Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.	D	No	Deficient, Provider has date of correction	3 June 2024
25 April 2024	Health	F 0740	Quality of Life and Care Deficiencies	Ensure each resident must receive and the facility must provide necessary behavioral health care and services.	D	No	Deficient, Provider has date of correction	3 June 2024
25 April 2024	Health	F 0755	Pharmacy Service Deficiencies	Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.	D	No	Deficient, Provider has date of correction	3 June 2024
25 April 2024	Health	F 0756	Pharmacy Service Deficiencies	Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.	E	No	Deficient, Provider has date of correction	19 July 2024
25 April 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	19 July 2024
25 April 2024	Health	F 0835	Administration Deficiencies	Administer the facility in a manner that enables it to use its resources effectively and efficiently.	F	No	Deficient, Provider has date of correction	3 June 2024
25 April 2024	Health	F 0842	Resident Assessment and Care Planning Deficiencies	Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.	D	No	Deficient, Provider has date of correction	3 June 2024
25 April 2024	Health	F 0880	Infection Control Deficiencies	Provide and implement an infection prevention and control program.	D	No	Deficient, Provider has date of correction	3 June 2024
25 April 2024	Health	F 0882	Infection Control Deficiencies	Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.	F	No	Deficient, Provider has date of correction	3 June 2024
25 April 2024	Health	F 0883	Infection Control Deficiencies	Develop and implement policies and procedures for flu and pneumonia vaccinations.	D	No	Deficient, Provider has date of correction	3 June 2024
25 April 2024	Health	F 0942	Resident Rights Deficiencies	Ensure that staff members are educated on resident rights and facility responsibilities to properly care for its residents.	E	No	Deficient, Provider has date of correction	19 July 2024
25 April 2024	Health	F 0943	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.	D	No	Deficient, Provider has date of correction	19 July 2024
25 April 2024	Health	F 0945	Infection Control Deficiencies	Include as part of its infection prevention and control program, mandatory training that includes written standards, policies, and procedures for the program.	E	No	Deficient, Provider has date of correction	19 July 2024
13 March 2024	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.	G	Yes	Deficient, Provider has date of correction	30 June 2024

From the Care Compare health citations file NH_HealthCitations_Aug2026.csv, processed on 1 August 2026.

Penalties

Penalty date	Type	Fine amount	Payment denial began	Payment denial, days	Fine ID
20 August 2024	Fine	$68,045			59023
13 March 2024	Fine	$51,220			59003
13 March 2024	Payment Denial		24 May 2024	56

From the Care Compare penalties file NH_Penalties_Aug2026.csv, processed on 1 August 2026.

Care Compare provider information

Field	As filed
Provider Type	Medicare and Medicaid
Ownership Type	For profit - Corporation
Legal Business Name	MAPLE VALLEY NURSING HOME OF MAPLE CITY, INC.
Date First Approved to Provide Medicare and Medicaid Services	1998-12-15
Provider Resides in Hospital	N
Continuing Care Retirement Community	N
Urban	Y
County/Parish	Leelanau
Telephone Number	2312285895
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	25
Average Number of Residents per Day	19.2
Overall Rating	3
Health Inspection Rating	3
QM Rating	2
Long-Stay QM Rating	2
Processing Date	2026-08-01

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

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On 1 July 2026: KENDRA MOORE no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. That is one line of the alert.

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The citable document for Maple Valley Nursing Home

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