Skilled nursing facility · CMS certification number 245637

NORRIS SQUARE

COTTAGE GROVE, Minnesota · Medicare and Medicaid

Certified beds, as filed in Care Compare: 72

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 October 2023 to 30 September 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 13 February 2025.

Revenue and expenses, fiscal year 2024
Figure	As filed	Where it comes from
Total patient revenue	$5,847,997	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$267,939	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$5,580,058	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$17,061,581	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$11,481,523	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$11,368,025	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$113,498	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$113,498 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2024
Figure	As filed	Where it comes from
Total facility beds, all components	40	CMS-2540-10 worksheet S300001 line 800 column 100
Bed days available, all components	14,640	CMS-2540-10 worksheet S300001 line 800 column 200
Medicare (Title XVIII) patient days	250	CMS-2540-10 worksheet S300001 line 800 column 400
Medicaid (Title XIX) patient days	7,359	CMS-2540-10 worksheet S300001 line 800 column 500
Other-payer patient days	5,202	CMS-2540-10 worksheet S300001 line 800 column 600
Total patient days, all components	12,811	CMS-2540-10 worksheet S300001 line 800 column 700
Medicare discharges	10	CMS-2540-10 worksheet S300001 line 800 column 900
Medicaid discharges	30	CMS-2540-10 worksheet S300001 line 800 column 1000
Other-payer discharges	53	CMS-2540-10 worksheet S300001 line 800 column 1100
Total discharges, all components	93	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	25	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	245.3	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	137.75	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1403607, read from the public cost report file SNF10FY2024.zip.

Fiscal year 2023, ended 30 September 2023

Cost report for 1 October 2022 to 30 September 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 30 January 2024.

Revenue and expenses, fiscal year 2023
Figure	As filed	Where it comes from
Total patient revenue	$4,769,776	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$100,733	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$4,669,043	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$15,972,020	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$11,302,977	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$10,849,293	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$453,684	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$453,684 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2023
Figure	As filed	Where it comes from
Total facility beds, all components	40	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	12,395	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	77	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	51.43	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	154.49	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	160.97	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1372729, read from the public cost report file SNF10FY2023.zip.

Fiscal year 2022, ended 30 September 2022

Cost report for 1 October 2021 to 30 September 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 30 March 2023.

Revenue and expenses, fiscal year 2022
Figure	As filed	Where it comes from
Total patient revenue	$4,516,641	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$43,328	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$4,473,313	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$15,540,034	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$11,066,721	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$10,545,497	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$521,224	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$521,224 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2022
Figure	As filed	Where it comes from
Total facility beds, all components	78	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	12,752	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	55	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	64.6	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	324.71	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	231.85	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1345192, read from the public cost report file SNF10FY2022.zip.

Fiscal year 2021, ended 30 September 2021

Cost report for 1 October 2020 to 30 September 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 21 April 2022.

Revenue and expenses, fiscal year 2021
Figure	As filed	Where it comes from
Total patient revenue	$6,149,313	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	−$20,604	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$6,169,917	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$15,874,768	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$9,704,851	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$9,295,616	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$409,235	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$409,235 (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
Figure	As filed	Where it comes from
Total facility beds, all components	78	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	16,809	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	142	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	36.5	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	625.3	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	118.37	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1313962, read from the public cost report file SNF10FY2021.zip.

Fiscal year 2020, ended 30 September 2020

Cost report for 1 October 2019 to 30 September 2020 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 29 April 2021.

Revenue and expenses, fiscal year 2020
Figure	As filed	Where it comes from
Total patient revenue	$4,437,915	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	−$60,164	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$4,498,079	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$14,200,888	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$9,702,809	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$8,636,088	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$1,066,721	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$1,066,721 (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	78	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	12,118	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	187	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	50.67	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	68.05	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	64.8	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1283074, read from the public cost report file SNF10FY2020.zip.

Fiscal year 2019, ended 30 September 2019

Cost report for 13 May 2019 to 30 September 2019 — a reporting period of 140 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 28 April 2020.

None of these figures is carried on this report.

CMS report record 1254658, read from the public cost report file SNF10FY2019.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
PRESBYTERIAN HOMES AND SERVICES	5% OR GREATER DIRECT OWNERSHIP INTEREST	Organization	100%	since 07/25/2017
TCF INVESTMENTS MANAGEMENT, INC.	5% OR GREATER MORTGAGE INTEREST	Organization	NOT APPLICABLE	since 08/17/2017
TCF INVESTMENTS MANAGEMENT, INC.	5% OR GREATER SECURITY INTEREST	Organization	NOT APPLICABLE	since 08/17/2017
KISPERT, CHRISTOPHER	ADP OF THE SNF	Individual	NOT APPLICABLE	since 08/28/2023
MIELKE, JOHN	ADP OF THE SNF	Individual	NOT APPLICABLE	since 08/29/2019
PEDERSON, MARK	ADP OF THE SNF	Individual	NOT APPLICABLE	since 01/12/2025
PETERSON, HEIDI	ADP OF THE SNF	Individual	NOT APPLICABLE	since 01/01/2023
PHS MANAGEMENT, LLC	ADP OF THE SNF	Organization	NOT APPLICABLE	since 04/14/2025
FLETCHER, JONATHAN	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 02/01/2025
MEYER, MARK	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 02/09/2016
PEDERSON, MARK	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 01/01/2023
FLETCHER, JONATHAN	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 02/01/2025
MEYER, MARK	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 02/09/2016
KISPERT, CHRISTOPHER	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 08/28/2023
MIELKE, JOHN	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 08/29/2019
PHS MANAGEMENT, LLC	OPERATIONAL/MANAGERIAL CONTROL	Organization	NOT APPLICABLE	since 08/17/2017
PRESBYTERIAN HOMES HOUSING AND ASSISTED LIVING, INC.	OPERATIONAL/MANAGERIAL CONTROL	Organization	NOT APPLICABLE	since 11/18/2024

Medicare enrollment

As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of CG CARE CENTER LLC (enrollment ID O20180926000196).

Owner	Individual or organization	Role	Ownership percentage	Association date	Described in the filing as
PRESBYTERIAN HOMES AND SERVICES	Organization	5% OR GREATER DIRECT OWNERSHIP INTEREST	100	7/25/2017	Private equity company: No Real estate investment trust: No Holding company: No
TCF INVESTMENTS MANAGEMENT, INC.	Organization	5% OR GREATER MORTGAGE INTEREST	58.5	8/17/2017	Private equity company: No Real estate investment trust: No Holding company: No
TCF INVESTMENTS MANAGEMENT, INC.	Organization	5% OR GREATER SECURITY INTEREST	58.5	8/17/2017	Private equity company: No Real estate investment trust: No Holding company: No
CHRISTOPHER B KISPERT	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.	8/28/2023	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.
HEIDI A PETERSON	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.
JOHN W MIELKE	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.	8/29/2019	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.
MARK A PEDERSON	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.	1/12/2025	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.
PHS MANAGEMENT, LLC	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.	4/14/2025	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.	1/21/2004	Private equity company: No Real estate investment trust: No Holding company: No
JONATHAN DAVID FLETCHER	Individual	CORPORATE DIRECTOR	33	2/1/2025	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 PEDERSON	Individual	CORPORATE DIRECTOR	33	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.
MARK T MEYER	Individual	CORPORATE DIRECTOR	33	2/9/2016	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	CORPORATE DIRECTOR	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	12/1/2015	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	CORPORATE DIRECTOR	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	12/13/2022	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.
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	CORPORATE DIRECTOR	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	6/7/2021	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
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	CORPORATE DIRECTOR	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	12/8/2020	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.
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	CORPORATE DIRECTOR	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	12/12/2023	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	CORPORATE DIRECTOR	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	12/12/2023	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	CORPORATE DIRECTOR	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	8/4/2020	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.
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	CORPORATE DIRECTOR	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	6/2/2020	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.
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	CORPORATE DIRECTOR	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	8/9/2022	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.
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	CORPORATE DIRECTOR	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	10/8/2019	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.
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	CORPORATE DIRECTOR	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	8/9/2022	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.
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	CORPORATE DIRECTOR	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	12/1/2015	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	CORPORATE DIRECTOR	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	12/5/2017	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.
JONATHAN DAVID FLETCHER	Individual	CORPORATE OFFICER	50	2/1/2025	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 T MEYER	Individual	CORPORATE OFFICER	50	2/9/2016	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	CORPORATE OFFICER	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	12/1/2015	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	CORPORATE OFFICER	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	6/7/2021	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
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	CORPORATE OFFICER	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	12/12/2023	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.
CHRISTOPHER B KISPERT	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.	8/28/2023	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.
JOHN W MIELKE	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.	8/29/2019	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.
PHS MANAGEMENT, LLC	Organization	OPERATIONAL/MANAGERIAL CONTROL	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	8/17/2017	Private equity company: No Real estate investment trust: No Holding company: No
PRESBYTERIAN HOMES HOUSING AND ASSISTED LIVING, INC.	Organization	OPERATIONAL/MANAGERIAL CONTROL	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	11/18/2024	Private equity company: No Real estate investment trust: No Holding company: No

Changes in ownership

1 July 2026: A listing under CORPORATE DIRECTOR no longer appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: A listing under CORPORATE OFFICER no longer appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: JOHN W MIELKE 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 W MIELKE 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 W MIELKE 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 W MIELKE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: A listing under CORPORATE DIRECTOR appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: A listing under CORPORATE OFFICER appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 August 2025: DANIEL A LINDH no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: DANIEL A LINDH no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: BENJAMIN J VAN VOOREN no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: WILLIAM V HAGSTROM no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: CHRISTOPHER B KISPERT appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: CHRISTOPHER B KISPERT appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: HEIDI A PETERSON appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: PHS MANAGEMENT, LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: JONATHAN DAVID FLETCHER appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: JONATHAN DAVID FLETCHER appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: MARK PEDERSON appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: MARK PEDERSON appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: PRESBYTERIAN HOMES HOUSING AND ASSISTED LIVING, INC. appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: A listing under CORPORATE DIRECTOR appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: A listing under CORPORATE OFFICER appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: JOHN W MIELKE appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: JOHN W MIELKE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv

Recent changes on this record

1 July 2026: A listing under CORPORATE DIRECTOR no longer appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: A listing under CORPORATE OFFICER no longer appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: JOHN W MIELKE 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 W MIELKE 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 W MIELKE 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 W MIELKE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: A listing under CORPORATE DIRECTOR appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: A listing under CORPORATE OFFICER appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 August 2025: DANIEL A LINDH no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: DANIEL A LINDH no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: BENJAMIN J VAN VOOREN no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: WILLIAM V HAGSTROM no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: CHRISTOPHER B KISPERT appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: CHRISTOPHER B KISPERT appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: HEIDI A PETERSON appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: PHS MANAGEMENT, LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: JONATHAN DAVID FLETCHER appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: JONATHAN DAVID FLETCHER appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: MARK PEDERSON appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: MARK PEDERSON appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: PRESBYTERIAN HOMES HOUSING AND ASSISTED LIVING, INC. appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: A listing under CORPORATE DIRECTOR appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: A listing under CORPORATE OFFICER appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: JOHN W MIELKE appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: JOHN W MIELKE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
13 February 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
30 January 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
30 March 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
21 April 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
29 April 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
28 April 2020: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip

Inspections

Inspection cycle	Health inspection	Fire safety inspection	Health deficiencies	Fire safety deficiencies
1	10 December 2025	10 December 2025	3	2
2	24 October 2024	24 October 2024	2	3
3	3 November 2023	3 November 2023	8	9

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

Deficiencies cited

13 deficiencies on file, newest inspection first

Inspection date	Inspection type	Tag	Category	What was cited	Scope and severity	Complaint	Corrected	Correction date
10 December 2025	Health	F 0565	Resident Rights Deficiencies	Honor the resident's right to organize and participate in resident/family groups in the facility.	D	No	Deficient, Provider has date of correction	30 January 2026
10 December 2025	Health	F 0584	Resident Rights Deficiencies	Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.	D	No	Deficient, Provider has date of correction	30 January 2026
10 December 2025	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	30 January 2026
24 October 2024	Health	F 0584	Resident Rights Deficiencies	Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.	D	No	Deficient, Provider has date of correction	20 November 2024
24 October 2024	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	20 November 2024
3 November 2023	Health	F 0585	Resident Rights Deficiencies	Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.	D	No	Deficient, Provider has date of correction	28 November 2023
3 November 2023	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	28 November 2023
3 November 2023	Health	F 0677	Quality of Life and Care Deficiencies	Provide care and assistance to perform activities of daily living for any resident who is unable.	D	No	Deficient, Provider has date of correction	28 November 2023
3 November 2023	Health	F 0679	Quality of Life and Care Deficiencies	Provide activities to meet all resident's needs.	D	No	Deficient, Provider has date of correction	28 November 2023
3 November 2023	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	28 November 2023
3 November 2023	Health	F 0686	Quality of Life and Care Deficiencies	Provide appropriate pressure ulcer care and prevent new ulcers from developing.	G	No	Deficient, Provider has date of correction	28 November 2023
3 November 2023	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	Yes	Deficient, Provider has date of correction	28 November 2023
3 November 2023	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	28 November 2023

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
3 November 2023	Payment Denial		29 November 2023	16

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	Non profit - Corporation
Legal Business Name	CG CARE CENTER LLC
Date First Approved to Provide Medicare and Medicaid Services	2019-05-13
Provider Resides in Hospital	N
Continuing Care Retirement Community	N
Urban	Y
County/Parish	Washington
Telephone Number	6517696650
Chain Name	PRESBYTERIAN HOMES & SERVICES
Chain ID	412
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	72
Average Number of Residents per Day	37.1
Overall Rating	5
Health Inspection Rating	4
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.

Get an email when this record changes

One email a day naming what moved on NORRIS SQUARE: the field, the value before, the value after, and the date of the file that first showed it.

The facility alert follows this one record: a cost report filed or a figure on one changed, an inspection, a deficiency or a penalty recorded, an owner added or removed. The certification number arrives filled in.

On 1 July 2026: A listing under CORPORATE DIRECTOR no longer appears in the Medicare enrollment ownership file, with no owner named. That is one line of the alert.

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The citable document for NORRIS SQUARE

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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Every figure on this page is printed as it appears in the CMS file named beside it. A figure that does not match its file? Tell us on the corrections page, quoting certification number 245637.