Skilled nursing facility · CMS certification number 265770
GOOD SAMARITAN CARE CENTER
COLE CAMP, Missouri · 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 July 2024 to 30 June 2025 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 19 December 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,424,111 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$1,170,408 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,594,519 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,909,755 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$315,236 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $298,714 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$16,522 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$16,522 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 26,280 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 1,365 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 10,037 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 6,325 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 17,727 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 31 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 7 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 10 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 48 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 44.03 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,433.86 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 369.31 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1445113, read from the public cost report file SNF10FY2024.zip.
Fiscal year 2024, ended 30 June 2024
Cost report for 1 July 2023 to 30 June 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 7 January 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,240,461 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$970,530 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,210,991 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,560,654 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$349,663 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $295,184 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$54,479 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$54,479 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 18,833 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 32 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 53.89 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 3,529.33 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 588.53 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1401781, read from the public cost report file SNF10FY2023.zip.
Fiscal year 2023, ended 30 June 2023
Cost report for 1 July 2022 to 30 June 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 6 December 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,305,735 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$665,041 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,970,776 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,339,083 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$368,307 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $178,704 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$189,603 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$193,087 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,903 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 88 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 63.45 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 390.52 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 203.44 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1369735, read from the public cost report file SNF10FY2022.zip.
Fiscal year 2022, ended 30 June 2022
Cost report for 1 July 2021 to 30 June 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 17 January 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,090,715 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$360,532 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,451,247 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,858,839 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$407,592 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $666,507 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $258,915 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $258,915 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,034 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 122 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 45.49 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 444.38 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 139.62 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1339560, read from the public cost report file SNF10FY2021.zip.
Fiscal year 2021, ended 30 June 2021
Cost report for 1 July 2020 to 30 June 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 22 March 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,978,543 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$575,935 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,554,478 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,957,670 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$403,192 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $499,263 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $96,071 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $96,071 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,340 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 60 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 65.22 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,618.6 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 272.33 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1312699, read from the public cost report file SNF10FY2020.zip.
Fiscal year 2020, ended 30 June 2020
Cost report for 1 July 2019 to 30 June 2020 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 26 February 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,256,750 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$124,579 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,381,329 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,688,180 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$306,851 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $404,674 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $97,823 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $97,823 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,463 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 53 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 37.56 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 7,504 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 329.49 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1280650, read from the public cost report file SNF10FY2019.zip.
Fiscal year 2019, ended 30 June 2019
Cost report for 1 July 2018 to 30 June 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 5 February 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,486,548 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $82,300 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,404,248 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,683,313 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$279,065 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $138,588 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$140,477 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$140,376 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,605 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 63 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 43.37 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,009.14 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 279.44 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1250477, read from the public cost report file SNF10FY2018.zip.
Fiscal year 2018, ended 30 June 2018
Cost report for 1 July 2017 to 30 June 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 24 January 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,623,548 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $242,957 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,380,591 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,756,158 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$375,567 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $211,748 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$163,819 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$163,783 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 18,904 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 58 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 46.47 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,724.17 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 325.93 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1217747, read from the public cost report file SNF10FY2017.zip.
Fiscal year 2017, ended 30 June 2017
Cost report for 1 July 2016 to 30 June 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 18 January 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,581,793 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$38,716 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,620,509 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,757,455 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$136,946 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $145,170 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $8,224 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $8,122 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,553 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 72 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 30.39 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 2,208.6 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 285.46 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1182113, read from the public cost report file SNF10FY2016.zip.
Fiscal year 2016, ended 30 June 2016
Cost report for 1 July 2015 to 30 June 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 27 January 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,985,518 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $51,576 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,933,942 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,816,357 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $117,585 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $140,953 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $258,538 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $258,538 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 22,277 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 102 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 37.91 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 2,366.25 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 218.4 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1152088, read from the public cost report file SNF10FY2015.zip.
Fiscal year 2015, ended 30 June 2015
Cost report for 1 July 2014 to 30 June 2015 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 21 April 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,012,733 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $119,394 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,893,339 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,651,123 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $242,216 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $412,253 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $654,469 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $654,469 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 22,237 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 108 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 39.76 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 8,435 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 205.9 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1122556, read from the public cost report file SNF10FY2014.zip.
Fiscal year 2014, ended 30 June 2014
Cost report for 1 July 2013 to 30 June 2014 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 23 January 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,661,774 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $39,039 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,622,735 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,651,574 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$28,839 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $114,386 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $85,547 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $85,547 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 66 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 22,288 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 83 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 39.06 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,511 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 268.53 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1084860, read from the public cost report file SNF10FY2013.zip.
Fiscal year 2013, ended 30 June 2013
Cost report for 1 July 2012 to 30 June 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 27 January 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,667,166 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $118,386 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,548,780 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,516,240 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $32,540 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $111,821 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $144,361 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $144,361 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 66 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 22,226 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 69 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 45.18 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,054.38 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 322.12 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1054123, read from the public cost report file SNF10FY2012.zip.
Fiscal year 2012, ended 30 June 2012
Cost report for 1 July 2011 to 30 June 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 24 January 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,265,659 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $120,648 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,145,011 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,248,768 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$103,757 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $214,818 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $111,061 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $111,061 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 66 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,789 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 63 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 50 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,445.2 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 314.11 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1023944, read from the public cost report file SNF10FY2011.zip.
Fiscal year 2011, ended 30 June 2011
Cost report for 1 July 2010 to 30 June 2011 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 18 January 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,022,765 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,876,688 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $146,077 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $147,595 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $293,672 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,191 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 64 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 49.91 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,104.5 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 315.48 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 422842, read from the public cost report file SNFFY2010.zip.
Fiscal year 2010, ended 30 June 2010
Cost report for 1 July 2009 to 30 June 2010 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 13 January 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,048,475 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,826,038 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $222,437 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $146,970 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $369,407 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,134 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 59 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 59.91 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,301.33 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 341.25 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 392550, read from the public cost report file SNFFY2009.zip.
Fiscal year 2009, ended 30 June 2009
Cost report for 1 July 2008 to 30 June 2009 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 30 December 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,648,403 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,606,866 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $41,537 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $160,372 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $201,909 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 18,957 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 36 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 75.67 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 4,396.5 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 526.58 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 361887, read from the public cost report file SNFFY2008.zip.
Fiscal year 2008, ended 30 June 2008
Cost report for 1 July 2007 to 30 June 2008 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 28 January 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,678,470 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,539,834 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $138,636 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $155,919 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $294,555 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,193 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 49 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 69.16 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,084.13 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 412.1 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 332780, read from the public cost report file SNFFY2007.zip.
Fiscal year 2007, ended 30 June 2007
Cost report for 1 July 2006 to 30 June 2007 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 23 April 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,506,795 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,409,155 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | $97,640 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $144,327 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $241,967 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 19,957 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 59 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 51.71 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,090.75 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 338.25 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 306208, read from the public cost report file SNFFY2006.zip.
Fiscal year 2006, ended 30 June 2006
Cost report for 1 July 2005 to 30 June 2006 — a reporting period of 364 days, on form CMS-2540-96, as submitted, processed by CMS on 13 November 2007.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,392,191 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,261,136 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | $131,055 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $227,200 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $358,255 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 18,318 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 73 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 51.8 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 710.69 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 250.93 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 296241, read from the public cost report file SNFFY2005.zip.
Fiscal year 2005, ended 30 June 2005
Cost report for 1 July 2004 to 30 June 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 16 October 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,075,700 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,081,966 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$6,266 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $86,870 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $80,604 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 17,507 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 48 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 65.52 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,633.83 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 364.73 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 264254, read from the public cost report file SNFFY2004.zip.
Fiscal year 2004, ended 30 June 2004
Cost report for 1 December 2003 to 30 June 2004 — a reporting period of 212 days, not a full year, on form CMS-2540-96, settled, processed by CMS on 16 October 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,186,270 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,090,165 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | $96,105 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $71,426 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $167,531 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 10,455 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 49 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 92.25 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 616.75 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 213.37 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 264336, read from the public cost report file SNFFY2004.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.
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 |
|---|---|---|---|---|
| GOOD SAMARITAN NURSING HOME | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | 100% | since 10/11/2011 |
| ENGLES, MARY | ADP OF THE SNF | Individual | NOT APPLICABLE | since 09/19/2025 |
| GOOD SAMARITAN NURSING HOME | ADP OF THE SNF | Organization | NOT APPLICABLE | since 10/02/1967 |
| ROEHRS, MATTHEW | ADP OF THE SNF | Individual | NOT APPLICABLE | since 09/19/2025 |
| ENGLES, MARY | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 07/07/2023 |
| HARMS, RUSSELL | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 04/27/2021 |
| HOLMAN, CHRISTINA | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/27/2025 |
| KREISEL, TIMOTHY | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 04/27/2021 |
| LPSEN, MONA | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 04/27/2021 |
| POPPEN, KATHERINE | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 04/02/2024 |
| REHMER, FRANCIS | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 04/27/2021 |
| JACKSON, SARA | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 05/01/2021 |
| OSBURN, SANDRA | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 03/02/2020 |
| ROEHRS, MATTHEW | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 01/01/2023 |
| THORNTON, DEA | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 10/11/2023 |
| HARMS, RUSSELL | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 04/27/2021 |
| HOLMAN, CHRISTINA | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 05/27/2025 |
| KREISEL, TIMOTHY | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 04/27/2021 |
| LPSEN, MONA | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 04/27/2021 |
| POPPEN, KATHERINE | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 04/02/2024 |
| ENGLES, MARY | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 07/07/2023 |
| GOOD SAMARITAN NURSING HOME | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | since 10/02/1967 |
| HARMS, RUSSELL | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 04/27/2021 |
| HOLMAN, CHRISTINA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 05/27/2025 |
| JACKSON, SARA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 05/01/2021 |
| KREISEL, TIMOTHY | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 04/27/2021 |
| LPSEN, MONA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 04/27/2021 |
| OSBURN, SANDRA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 03/02/2020 |
| POPPEN, KATHERINE | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 04/02/2024 |
| REHMER, FRANCIS | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 04/27/2021 |
| ROEHRS, MATTHEW | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 01/01/2023 |
| THORNTON, DEA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 10/11/2023 |
Medicare enrollment
As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of GOOD SAMARITAN NURSING HOME (enrollment ID O20040507000700).
| Owner | Individual or organization | Role | Ownership percentage | Association date | Described in the filing as |
|---|---|---|---|---|---|
| GOOD SAMARITAN NURSING HOME | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100 | 10/11/2011 | Private equity company: No Real estate investment trust: No Holding company: No |
| GOOD SAMARITAN NURSING HOME | 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. | 10/2/1967 | Private equity company: No Real estate investment trust: No Holding company: No |
| MARY ENGLES | 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. | 9/19/2025 | 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. |
| MATTHEW D ROEHRS | 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. | 9/19/2025 | 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. |
| CHRISTINA HOLMAN | 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. | 5/27/2025 | 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. |
| FRANCIS REHMER | 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. | 4/27/2021 | 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. |
| KATHERINE POPPEN | 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. | 4/2/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| MARY ENGLES | Individual | CORPORATE DIRECTOR | 100 | 7/7/2023 | 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. |
| MONA LPSEN | 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. | 4/27/2021 | 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. |
| RUSSELL HARMS | 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. | 4/27/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| TIMOTHY KREISEL | 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. | 4/27/2021 | 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. |
| DEA THORNTON | 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. | 10/11/2023 | 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. |
| MATTHEW D ROEHRS | 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. | 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. |
| SANDRA OSBURN | 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. | 3/2/2020 | 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. |
| SARA JACKSON | 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. | 5/1/2021 | 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. |
| CHRISTINA HOLMAN | Individual | MANAGING CONTROL - GOVERNING BODY | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/27/2025 | 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. |
| KATHERINE POPPEN | Individual | MANAGING CONTROL - GOVERNING BODY | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 4/2/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| MONA LPSEN | Individual | MANAGING CONTROL - GOVERNING BODY | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 4/27/2021 | 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. |
| RUSSELL HARMS | Individual | MANAGING CONTROL - GOVERNING BODY | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 4/27/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| TIMOTHY KREISEL | Individual | MANAGING CONTROL - GOVERNING BODY | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 4/27/2021 | 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. |
| CHRISTINA HOLMAN | 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. | 5/27/2025 | 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. |
| DEA THORNTON | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 10/11/2023 | 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. |
| FRANCIS REHMER | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 4/27/2021 | 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. |
| GOOD SAMARITAN NURSING HOME | 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. | 10/2/1967 | Private equity company: No Real estate investment trust: No Holding company: No |
| KATHERINE POPPEN | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 4/2/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| MARY ENGLES | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 7/7/2023 | 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. |
| MATTHEW D ROEHRS | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2023 | 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. |
| MONA LPSEN | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 4/27/2021 | 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. |
| RUSSELL HARMS | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 4/27/2021 | 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. |
| SANDRA OSBURN | 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. | 3/2/2020 | 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. |
| SARA JACKSON | 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. | 5/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| TIMOTHY KREISEL | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 4/27/2021 | 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. |
Changes in ownership
- 1 November 2025: ANISA R BURDICK no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: AUDREA K WILLIAMS no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: AUDREA K WILLIAMS no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: JANA KENNEDY no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: MONA LPSEN appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: MONA LPSEN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: MATTHEW D ROEHRS appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: MATTHEW D ROEHRS appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: MATTHEW D ROEHRS appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: FRANCIS REHMER appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: GOOD SAMARITAN NURSING HOME appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: KATHERINE POPPEN appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: KATHERINE POPPEN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: KATHERINE POPPEN appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: TIMOTHY KREISEL appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: TIMOTHY KREISEL appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: MARY ENGLES appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: MARY ENGLES appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: MARY ENGLES appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: CHRISTINA HOLMAN appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: CHRISTINA HOLMAN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: CHRISTINA HOLMAN appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: SANDRA OSBURN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: SANDRA OSBURN appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: DEA THORNTON appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: DEA THORNTON appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: RUSSELL HARMS appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: RUSSELL HARMS appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: SARA JACKSON appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: SARA JACKSON appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
Recent changes on this record
- 19 December 2025: A cost report was filed for fiscal year 2025, on form CMS-2540-10. SNF10FY2024.zip
- 1 November 2025: ANISA R BURDICK no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: AUDREA K WILLIAMS no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: AUDREA K WILLIAMS no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: JANA KENNEDY no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: MONA LPSEN appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: MONA LPSEN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: MATTHEW D ROEHRS appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: MATTHEW D ROEHRS appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: MATTHEW D ROEHRS appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: FRANCIS REHMER appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: GOOD SAMARITAN NURSING HOME appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: KATHERINE POPPEN appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: KATHERINE POPPEN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: KATHERINE POPPEN appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: TIMOTHY KREISEL appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: TIMOTHY KREISEL appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: MARY ENGLES appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: MARY ENGLES appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: MARY ENGLES appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: CHRISTINA HOLMAN appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: CHRISTINA HOLMAN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: CHRISTINA HOLMAN appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: SANDRA OSBURN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: SANDRA OSBURN appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: DEA THORNTON appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: DEA THORNTON appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: RUSSELL HARMS appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: RUSSELL HARMS appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: SARA JACKSON appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 1 November 2025: SARA JACKSON appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-11-01.csv
- 7 January 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2023.zip
- 6 December 2023: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2022.zip
- 17 January 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2021.zip
- 22 March 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2020.zip
- 26 February 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2019.zip
- 5 February 2020: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2018.zip
- 24 January 2019: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2017.zip
- 18 January 2018: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2016.zip
- 27 January 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2015.zip
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | 6 September 2024 | 6 September 2024 | 0 | 0 |
| 2 | 19 October 2023 | 19 October 2023 | 3 | 1 |
| 3 | 14 July 2022 | 14 July 2022 | 0 | 1 |
From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.
Deficiencies cited
3 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| 19 October 2023 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | E | No | Deficient, Provider has date of correction | 24 November 2023 |
| 19 October 2023 | Health | F 0812 | Nutrition and Dietary Deficiencies | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | No | Deficient, Provider has date of correction | 28 November 2023 |
| 19 October 2023 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | 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
Not yet extracted for this facility.
Care Compare provider information
| Field | As filed |
|---|---|
| Provider Type | Medicare and Medicaid |
| Ownership Type | Government - County |
| Legal Business Name | GOOD SAMARITAN NURSING HOME |
| Date First Approved to Provide Medicare and Medicaid Services | 2003-12-01 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | N |
| County/Parish | Benton |
| Telephone Number | 6606684515 |
| 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 | 48.4 |
| Overall Rating | 5 |
| Health Inspection Rating | 5 |
| QM Rating | 2 |
| Long-Stay QM Rating | 3 |
| Short-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 GOOD SAMARITAN CARE CENTER: 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 19 December 2025: A cost report was filed for fiscal year 2025, on form CMS-2540-10. That is one line of the alert.
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The citable document for GOOD SAMARITAN CARE CENTER
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 Missouri 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.
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 265770.