Facility record report · CMS certification number 245089
GOOD SAMARITAN SOCIETY - ROSEVILLE
ROSEVILLE, Minnesota
This certification number is not in CMS’s current Care Compare Provider Information file, processed on 1 August 2026.
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 2009 to 27 August 2009 — a reporting period of 238 days, not a full year, on form CMS-2540-96, settled, processed by CMS on 31 March 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,729,405 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,879,171 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$1,149,766 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $81,341 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $66,505 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: −$1,134,930 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 90 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Bed days available, all components | 21,510 | CMS-2540-96 worksheet S300001 line 900 column 200 |
| Medicare (Title XVIII) patient days | 1,474 | CMS-2540-96 worksheet S300001 line 900 column 400 |
| Medicaid (Title XIX) patient days | 7,682 | CMS-2540-96 worksheet S300001 line 900 column 500 |
| Other-payer patient days | 2,511 | CMS-2540-96 worksheet S300001 line 900 column 600 |
| Total patient days, all components | 11,667 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Medicare discharges | 66 | CMS-2540-96 worksheet S300001 line 900 column 900 |
| Medicaid discharges | 43 | CMS-2540-96 worksheet S300001 line 900 column 1000 |
| Other-payer discharges | 46 | CMS-2540-96 worksheet S300001 line 900 column 1100 |
| Total discharges, all components | 155 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 22.33 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 178.65 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 75.27 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 366822, read from the public cost report file SNFFY2009.zip.
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 1 June 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $5,760,061 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,455,695 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$695,634 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $201,889 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $72,032 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: −$565,777 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 90 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 27,563 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 345 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 28.34 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 112.17 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 79.89 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 371920, read from the public cost report file SNFFY2008.zip.
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 26 January 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $6,746,844 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,569,595 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$822,751 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $144,897 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $202,655 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: −$880,509 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 109 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 35,839 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 241 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 27.73 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 632.92 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 148.71 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 332610, read from the public cost report file SNFFY2007.zip.
Cost report for 1 January 2006 to 31 December 2006 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 23 May 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $6,509,347 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,212,251 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$702,904 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $85,543 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $13,412 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: −$630,773 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 109 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 37,592 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 186 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 25.38 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 964 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 202.11 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 309882, read from the public cost report file SNFFY2006.zip.
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 19 June 2007.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $6,102,644 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,629,189 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$526,545 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $104,008 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $20,690 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: −$443,227 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 109 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 37,293 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 244 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 30.68 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 556.61 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 152.84 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 285216, read from the public cost report file SNFFY2005.zip.
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 23 February 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $5,934,464 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,470,874 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$536,410 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $55,084 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $15,000 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: −$496,326 (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.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 123 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 39,524 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 93 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 32.13 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,425.5 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 424.99 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 243487, read from the public cost report file SNFFY2004.zip.
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 17 March 2005.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $6,186,504 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,417,930 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$231,426 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $44,113 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $7,452 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: −$194,765 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 123 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 43,872 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 93 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 32.98 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,700.61 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 471.74 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 211412, read from the public cost report file SNFFY2003.zip.
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 25 May 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $6,068,407 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,102,335 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$33,928 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $75,726 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $47,678 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: −$5,880 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 123 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 43,835 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 104 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 53.23 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 779.26 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 421.49 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 178053, read from the public cost report file SNFFY2002.zip.
Cost report for 1 January 2001 to 31 December 2001 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 13 February 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $5,828,843 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,104,539 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$275,696 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $166,047 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$109,649 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 123 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 44,030 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 137 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 38.42 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 681.17 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 321.39 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 126235, read from the public cost report file SNFFY2001.zip.
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 18 March 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $5,575,291 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,787,667 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$212,376 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $13,036 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$199,340 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 123 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 43,446 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 199 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 27.61 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 536.13 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 218.32 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 132953, read from the public cost report file SNFFY2000.zip.
Cost report for 1 January 1999 to 31 December 1999 — a reporting period of 364 days, on form CMS-2540-96, reopened, processed by CMS on 10 January 2002.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,994,287 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,257,063 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$262,776 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $90,128 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$172,648 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 123 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 41,997 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 213 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 26.08 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 298.23 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 197.17 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 1312, read from the public cost report file SNFFY1999.zip.
Cost report for 1 January 1998 to 31 December 1998 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 16 October 2000.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $5,363,393 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,435,868 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$72,475 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $152,347 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $79,872 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 133 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 46,644 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 146 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 39.88 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 561.14 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 319.48 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 1311, read from the public cost report file SNFFY1998.zip.
Cost report for 1 January 1997 to 31 December 1997 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 3 November 1999.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $5,428,723 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,349,504 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $79,219 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $109,548 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $188,767 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 133 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 46,333 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 137 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 82.69 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 992.47 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 338.2 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 18282, read from the public cost report file SNFFY1997.zip.
Cost report for 1 January 1996 to 31 December 1996 — a reporting period of 365 days, on form CMS-2540-96, reopened, processed by CMS on 31 March 1999.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $5,058,700 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,193,030 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$134,330 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $117,337 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$16,993 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 133 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 47,311 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 141 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 48.37 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 590.25 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 335.54 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 18280, read from the public cost report file SNFFY1996.zip.
Five facilities of a similar size in Minnesota, fiscal year 2009
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 |
|---|---|---|---|---|---|---|
| BETHANY HOME - ALEXANDRIA | 92 | 34,814 | $8,916,945 | $8,678,598 | $238,347 | 31 December 2009 |
| CERENITY CARE CTR-MARIAN OF ST PAUL | 90 | 32,114 | $9,650,174 | $10,392,735 | −$742,561 | 30 June 2009 |
| GOOD SAMARITAN SOCIETY - ROSEVILLE | 90 | 11,667 | $2,729,405 | $3,879,171 | −$1,149,766 | 27 August 2009 |
| HAVENWOOD CARE CENTER | 90 | 30,957 | $6,017,437 | $5,834,296 | $183,141 | 31 December 2009 |
| LUTHER HAVEN | 92 | 32,406 | $6,048,656 | $6,637,689 | −$589,033 | 31 December 2009 |
| MALA STRANA HEALTH CARE CENTER | 90 | 31,901 | $6,696,676 | $5,867,670 | $829,006 | 31 December 2009 |
Where each column comes from, on every filing in this table: Total facility beds: CMS-2540-96 worksheet S300001 line 900 column 100 · Total patient days: CMS-2540-96 worksheet S300001 line 900 column 700 · Net patient revenue: CMS-2540-96 worksheet G300000 line 300 column 100 · Total operating expenses: CMS-2540-96 worksheet G200002 line 1500 column 200 · Net income from service to patients: CMS-2540-96 worksheet G300000 line 500 column 100.
Ownership, as filed with CMS
Care Compare
Not yet extracted for this facility.
Medicare enrollment
Not yet extracted for this facility.
Changes in ownership
Not yet extracted for this facility.
Inspections
Not yet extracted for this facility.
Deficiencies cited
Not yet extracted for this facility.
Penalties
Not yet extracted for this facility.
Care Compare provider information
Not yet extracted for this facility.
Every change on this record
- 1 June 2010: A cost report was filed for fiscal year 2008, on form CMS-2540-96. SNFFY2008.zip
- 31 March 2010: A cost report was filed for fiscal year 2009, on form CMS-2540-96. SNFFY2009.zip
- 26 January 2009: A cost report was filed for fiscal year 2007, on form CMS-2540-96. SNFFY2007.zip
- 23 May 2008: A cost report was filed for fiscal year 2006, on form CMS-2540-96. SNFFY2006.zip
- 19 June 2007: A cost report was filed for fiscal year 2005, on form CMS-2540-96. SNFFY2005.zip
- 23 February 2006: A cost report was filed for fiscal year 2004, on form CMS-2540-96. SNFFY2004.zip
- 17 March 2005: A cost report was filed for fiscal year 2003, on form CMS-2540-96. SNFFY2003.zip
- 25 May 2004: A cost report was filed for fiscal year 2002, on form CMS-2540-96. SNFFY2002.zip
- 18 March 2003: A cost report was filed for fiscal year 2000, on form CMS-2540-96. SNFFY2000.zip
- 13 February 2003: A cost report was filed for fiscal year 2001, on form CMS-2540-96. SNFFY2001.zip
- 10 January 2002: A cost report was filed for fiscal year 1999, on form CMS-2540-96. SNFFY1999.zip
- 16 October 2000: A cost report was filed for fiscal year 1998, on form CMS-2540-96. SNFFY1998.zip
- 3 November 1999: A cost report was filed for fiscal year 1997, on form CMS-2540-96. SNFFY1997.zip
- 31 March 1999: A cost report was filed for fiscal year 1996, on form CMS-2540-96. SNFFY1996.zip
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, GOOD SAMARITAN SOCIETY - ROSEVILLE — facility record report, CMS certification number 245089. https://velarionrecords.com/facility/245089/report.
- Cost report figures: CMS Healthcare Cost Report Information System, form CMS-2540-96, publication year 2009, file
SNFFY2009.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.
Published by VELARIONAI LLC · Andrew Richardson, founder. Corrections: hello@velarionrecords.com, quoting certification number 245089. 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.
Not yet extracted for this facility.