Velarion Records

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Skilled nursing facility · CMS certification number 245491

MOOSE LAKE VILLAGE

MOOSE LAKE, Minnesota · Medicare and Medicaid

Certified beds, as filed in Care Compare: 60

Finances, as filed

From this facility’s Medicare cost reports on form CMS-2540, each figure with the worksheet, line and column it was read from.

Cost report for 1 January 2024 to 31 December 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 28 August 2025.

Revenue and expenses, fiscal year 2024
FigureAs filedWhere it comes from
Total patient revenue$9,182,165CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$840,406CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$8,341,759CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$8,641,024CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients−$299,265CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$633,997CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$334,732CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $334,732 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2024
FigureAs filedWhere it comes from
Total facility beds, all components72CMS-2540-10 worksheet S300001 line 800 column 100
Bed days available, all components26,352CMS-2540-10 worksheet S300001 line 800 column 200
Medicare (Title XVIII) patient days1,596CMS-2540-10 worksheet S300001 line 800 column 400
Medicaid (Title XIX) patient days10,522CMS-2540-10 worksheet S300001 line 800 column 500
Other-payer patient days7,185CMS-2540-10 worksheet S300001 line 800 column 600
Total patient days, all components19,303CMS-2540-10 worksheet S300001 line 800 column 700
Medicare discharges44CMS-2540-10 worksheet S300001 line 800 column 900
Medicaid discharges19CMS-2540-10 worksheet S300001 line 800 column 1000
Other-payer discharges55CMS-2540-10 worksheet S300001 line 800 column 1100
Total discharges, all components118CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days36.27CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days553.79CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days163.58CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1434445, 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 6 August 2024.

Revenue and expenses, fiscal year 2023
FigureAs filedWhere it comes from
Total patient revenue$9,272,005CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$977,809CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$8,294,196CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$7,880,157CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients$414,039CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$7,765CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$421,804CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $421,804 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2023
FigureAs filedWhere it comes from
Total facility beds, all components72CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components18,989CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components144CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days37.18CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days312.23CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days131.87CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1391209, 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 13 June 2023.

Revenue and expenses, fiscal year 2022
FigureAs filedWhere it comes from
Total patient revenue$7,654,209CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$764,736CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$6,889,473CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$7,250,190CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients−$360,717CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$161,057CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income−$199,660CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$348,310 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2022
FigureAs filedWhere it comes from
Total facility beds, all components72CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components18,256CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components126CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days51.54CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days352.88CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days144.89CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1351085, 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 11 August 2022.

Revenue and expenses, fiscal year 2021
FigureAs filedWhere it comes from
Total patient revenue$6,984,541CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$582,749CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$6,401,792CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$7,619,009CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients−$1,217,217CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$1,048,582CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income−$168,635CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$206,162 (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 2021
FigureAs filedWhere it comes from
Total facility beds, all components72CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components19,861CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components112CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days49.18CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days351.59CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days177.33CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1329526, 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 28 September 2021.

Revenue and expenses, fiscal year 2020
FigureAs filedWhere it comes from
Total patient revenue$7,012,759CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$436,636CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$6,576,123CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$7,351,312CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients−$775,189CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$792,679CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$17,490CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $17,490 (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
FigureAs filedWhere it comes from
Total facility beds, all components72CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components20,536CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components112CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days47.44CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days1,161.67CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days183.36CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1301261, read from the public cost report file SNF10FY2020.zip.

Fiscal year 2019, ended 31 December 2019

Cost report for 1 October 2019 to 31 December 2019 — a reporting period of 91 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 23 November 2020.

Revenue and expenses, fiscal year 2019
FigureAs filedWhere it comes from
Total patient revenue$1,735,256CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$53,143CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$1,682,113CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$1,702,433CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients−$20,320CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$5,238CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income−$15,082CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$15,082 (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
FigureAs filedWhere it comes from
Total facility beds, all components72CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components5,764CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components28CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days27.23CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days1,601CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days205.86CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1274232, read from the public cost report file SNF10FY2020.zip.

Fiscal year 2018, ended 30 September 2018

Cost report for 1 October 2017 to 30 September 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 27 June 2019.

Revenue and expenses, fiscal year 2018
FigureAs filedWhere it comes from
Total patient revenue$7,126,790CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$541,592CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$6,585,198CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$6,704,980CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients−$119,782CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$21,151CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income−$98,631CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$98,631 (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
FigureAs filedWhere it comes from
Total facility beds, all components72CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components23,109CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components228CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days34.46CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days272.07CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days101.36CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1233395, read from the public cost report file SNF10FY2018.zip.

Fiscal year 2017, ended 30 September 2017

Cost report for 1 October 2016 to 30 September 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 2 May 2018.

Revenue and expenses, fiscal year 2017
FigureAs filedWhere it comes from
Total patient revenue$6,873,529CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$512,480CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$6,361,049CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$6,803,062CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients−$442,013CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$430,710CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income−$11,303CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$11,303 (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
FigureAs filedWhere it comes from
Total facility beds, all components72CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components24,965CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components125CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days42.05CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days799.47CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days199.72CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1187689, read from the public cost report file SNF10FY2017.zip.

Fiscal year 2016, ended 30 September 2016

Cost report for 1 October 2015 to 30 September 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 2 May 2017.

Revenue and expenses, fiscal year 2016
FigureAs filedWhere it comes from
Total patient revenue$6,450,410CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$434,353CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$6,016,057CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$6,522,945CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients−$506,888CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$965,180CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$458,292CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $458,292 (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
FigureAs filedWhere it comes from
Total facility beds, all components72CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components24,066CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components239CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days28.67CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days368.56CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days100.69CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1156604, read from the public cost report file SNF10FY2016.zip.

Fiscal year 2015, ended 30 September 2015

Cost report for 1 October 2014 to 30 September 2015 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 6 May 2016.

Revenue and expenses, fiscal year 2015
FigureAs filedWhere it comes from
Total patient revenue$5,989,986CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$386,846CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$5,603,140CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$5,765,453CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients−$162,313CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$553,926CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$391,613CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $391,613 (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
FigureAs filedWhere it comes from
Total facility beds, all components72CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components24,700CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components206CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days37.36CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days491.58CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days119.9CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1123447, read from the public cost report file SNF10FY2015.zip.

Fiscal year 2014, ended 30 September 2014

Cost report for 1 October 2013 to 30 September 2014 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 25 February 2016.

Revenue and expenses, fiscal year 2014
FigureAs filedWhere it comes from
Total patient revenue$5,715,417CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$355,950CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$5,359,467CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$5,252,101CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients$107,366CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$622,676CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$730,042CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $730,042 (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
FigureAs filedWhere it comes from
Total facility beds, all components72CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components23,705CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components221CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days34.36CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days465.13CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days107.26CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1119583, read from the public cost report file SNF10FY2014.zip.

Fiscal year 2013, ended 30 September 2013

Cost report for 1 October 2012 to 30 September 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 30 April 2014.

Revenue and expenses, fiscal year 2013
FigureAs filedWhere it comes from
Total patient revenue$5,448,900CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$247,349CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$5,201,551CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$5,168,463CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients$33,088CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$488,963CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$522,051CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $522,051 (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
FigureAs filedWhere it comes from
Total facility beds, all components80CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components23,975CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components205CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days32.04CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days447.15CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days116.95CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1059066, read from the public cost report file SNF10FY2013.zip.

Fiscal year 2012, ended 30 September 2012

Cost report for 1 October 2011 to 30 September 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 19 September 2014.

Revenue and expenses, fiscal year 2012
FigureAs filedWhere it comes from
Total patient revenue$5,650,858CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$341,894CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$5,308,964CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$5,208,754CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients$100,210CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$404,547CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$504,757CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $504,757 (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 2012
FigureAs filedWhere it comes from
Total facility beds, all components80CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components25,329CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components214CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days29.98CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days434.1CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days118.36CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1078219, read from the public cost report file SNF10FY2012.zip.

Fiscal year 2011, ended 30 September 2011

Cost report for 1 September 2010 to 30 September 2011 — a reporting period of 394 days, on form CMS-2540-96, settled, processed by CMS on 21 May 2013.

Revenue and expenses, fiscal year 2011
FigureAs filedWhere it comes from
Net patient revenue$6,189,137CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses$5,840,648CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients$348,489CMS-2540-96 worksheet G300000 line 500 column 100
Total other income$3,361,370CMS-2540-96 worksheet G300000 line 2600 column 100
Total other expenses$200CMS-2540-96 worksheet G300000 line 3100 column 100

Net income, stated at moderate confidence: $3,709,659 (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 2011
FigureAs filedWhere it comes from
Total facility beds, all components80CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components28,984CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components243CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days36.83CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days467.42CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days119.28CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 434671, read from the public cost report file SNFFY2010.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 managerRoleTypeOwnership percentageAssociation
CASSIA5% OR GREATER DIRECT OWNERSHIP INTERESTOrganization100%since 01/01/2018
DAHL, ROBERTCORPORATE DIRECTORIndividualNOT APPLICABLEsince 01/01/2018
KERN, MATTHEWCORPORATE DIRECTORIndividualNOT APPLICABLEsince 01/01/2018
STADTHERR, SEELOCHANICORPORATE DIRECTORIndividualNOT APPLICABLEsince 01/01/2018
YOUNGQUIST, KATHRYNCORPORATE DIRECTORIndividualNOT APPLICABLEsince 01/01/2018
MACKAY, MARSHALLCORPORATE OFFICERIndividualNOT APPLICABLEsince 01/01/2018
NYE, GERALDCORPORATE OFFICERIndividualNOT APPLICABLEsince 01/01/2018
PARKS, CHARLESCORPORATE OFFICERIndividualNOT APPLICABLEsince 01/01/2018
RAMSDALE, SCOTTCORPORATE OFFICERIndividualNOT APPLICABLEsince 01/01/2018
WILKERSON, GARYCORPORATE OFFICERIndividualNOT APPLICABLEsince 01/01/2018
CASSIAOPERATIONAL/MANAGERIAL CONTROLOrganizationNOT APPLICABLEsince 01/01/2018
SMITH, SHAWNAW-2 MANAGING EMPLOYEEIndividualNOT APPLICABLEsince 01/01/2018

Medicare enrollment

As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of AUGUSTANA MERCY CARE CENTER LLC (enrollment ID O20101019000790).

OwnerIndividual or organizationRoleOwnership percentageAssociation dateDescribed in the filing as
CASSIAOrganization5% OR GREATER DIRECT OWNERSHIP INTEREST1001/1/2018
Private equity company: No
Real estate investment trust: No
Holding company: No
KATHRYN LEE YOUNGQUISTIndividualCORPORATE DIRECTORCMS paused 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.
MATTHEW RAY KERNIndividualCORPORATE DIRECTORCMS paused 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.
ROBERT MAHLON DAHLIndividualCORPORATE DIRECTORCMS paused 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.
SEELOCHANI NMN STADTHERRIndividualCORPORATE DIRECTORCMS paused 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.
CHARLES THOMAS PARKSIndividualCORPORATE OFFICERCMS paused 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.
GARY ALBERT WILKERSONIndividualCORPORATE OFFICERCMS paused 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.
GERALD THOMAS NYEIndividualCORPORATE OFFICERCMS paused 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.
MARSHALL ALLAN MACKAYIndividualCORPORATE OFFICERCMS paused 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.
SCOTT GERALD RAMSDALEIndividualCORPORATE OFFICERCMS paused 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.
CASSIAOrganizationOPERATIONAL/MANAGERIAL CONTROL1001/1/2018
Private equity company: No
Real estate investment trust: No
Holding company: No
AUGUSTANA MERCY CARE CENTER LLCOrganizationOTHERCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.9/1/2020
Private equity company: No
Real estate investment trust: No
Holding company: No
SHAWNA RAE SMITHIndividualW-2 MANAGING EMPLOYEECMS paused 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.

Changes in ownership

Recent changes on this record

  • 1 July 2026: SEELOCHANI NMN STADTHERR no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
  • 1 July 2026: SEELOCHANI NMN STADTHERR appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
  • 28 August 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
  • 6 August 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
  • 13 June 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
  • 11 August 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
  • 28 September 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
  • 23 November 2020: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2020.zip
  • 15 April 2020: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
  • 27 June 2019: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2018.zip
  • 2 May 2018: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2017.zip
  • 2 May 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2016.zip
  • 6 May 2016: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2015.zip
  • 25 February 2016: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2014.zip
  • 19 September 2014: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2012.zip
  • 30 April 2014: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2013.zip
  • 21 May 2013: A cost report was filed for fiscal year 2011, on form CMS-2540-96. SNFFY2010.zip

Inspections

Inspection cycleHealth inspectionFire safety inspectionHealth deficienciesFire safety deficiencies
19 July 20269 July 202652
215 May 202515 May 2025610
314 March 202414 March 202432

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

Deficiencies cited

14 deficiencies on file, newest inspection first
Inspection dateInspection typeTagCategoryWhat was citedScope and severityComplaintCorrectedCorrection date
9 July 2026HealthF 0554Resident Rights DeficienciesAllow residents to self-administer drugs if determined clinically appropriate.DNoDeficient, Provider has no plan of correction
9 July 2026HealthF 0684Quality of Life and Care DeficienciesProvide appropriate treatment and care according to orders, resident’s preferences and goals.DNoDeficient, Provider has no plan of correction
9 July 2026HealthF 0761Pharmacy Service DeficienciesEnsure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.ENoDeficient, Provider has no plan of correction
9 July 2026HealthF 0812Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.FNoDeficient, Provider has no plan of correction
9 July 2026HealthF 0880Infection Control DeficienciesProvide and implement an infection prevention and control program.ENoDeficient, Provider has no plan of correction
15 May 2025HealthF 0568Resident Rights DeficienciesProperly hold, secure, and manage each resident's personal money which is deposited with the nursing home.DNoDeficient, Provider has date of correction27 June 2025
15 May 2025HealthF 0657Resident Assessment and Care Planning DeficienciesDevelop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.DNoDeficient, Provider has date of correction27 June 2025
15 May 2025HealthF 0689Quality of Life and Care DeficienciesEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.ENoDeficient, Provider has date of correction27 June 2025
15 May 2025HealthF 0699Quality of Life and Care DeficienciesProvide care or services that was trauma informed and/or culturally competent.DNoDeficient, Provider has date of correction27 June 2025
15 May 2025HealthF 0757Pharmacy Service DeficienciesEnsure each resident’s drug regimen must be free from unnecessary drugs.ENoDeficient, Provider has date of correction27 June 2025
15 May 2025HealthF 0812Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.DNoDeficient, Provider has date of correction27 June 2025
14 March 2024HealthF 0578Resident Rights DeficienciesHonor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.DNoDeficient, Provider has date of correction17 April 2024
14 March 2024HealthF 0761Pharmacy Service DeficienciesEnsure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.DNoDeficient, Provider has date of correction17 April 2024
9 November 2023HealthF 0580Resident Rights DeficienciesImmediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.DYesDeficient, Provider has date of correction9 January 2024

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

Penalties

Not yet extracted for this facility.

Care Compare provider information

FieldAs filed
Provider TypeMedicare and Medicaid
Ownership TypeNon profit - Corporation
Legal Business NameAUGUSTANA MERCY CARE CENTER LLC
Date First Approved to Provide Medicare and Medicaid Services1987-07-01
Provider Resides in HospitalN
Continuing Care Retirement CommunityN
UrbanY
County/ParishCarlton
Telephone Number2183519400
Provider Changed Ownership in Last 12 MonthsN
With a Resident and Family CouncilResident
Automatic Sprinkler Systems in All Required AreasYes
Number of Certified Beds60
Average Number of Residents per Day53.1
Overall Rating4
Health Inspection Rating3
QM Rating3
Long-Stay QM Rating2
Short-Stay QM Rating3
Processing Date2026-08-01

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

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On 1 July 2026: SEELOCHANI NMN STADTHERR no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. That is one line of the alert.

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The citable document for MOOSE LAKE VILLAGE

This page shows the record as it stands today. The report is the citable document: the same figures with the cell each came from, and beyond this page — five facilities of a similar size in Minnesota at the same fiscal year, listed by name; every change on the record rather than the recent ones below; the inspection and staffing history in blocks of their own; and a citation block naming every CMS file it was read from.

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