Skilled nursing facility · CMS certification number 265828

PINE GROVE MANOR

SAINT LOUIS, Missouri · Medicare and Medicaid

Certified beds, as filed in Care Compare: 77

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 May 2025 to 31 August 2025 — a reporting period of 122 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 20 February 2026.

Revenue and expenses, fiscal year 2025
Figure	As filed	Where it comes from
Total patient revenue	$1,767,384	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$71,600	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$1,695,784	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$2,216,809	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$521,025	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$2,148	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$518,877	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$518,877 (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 2025
Figure	As filed	Where it comes from
Total facility beds, all components	77	CMS-2540-10 worksheet S300001 line 800 column 100
Bed days available, all components	9,471	CMS-2540-10 worksheet S300001 line 800 column 200
Medicare (Title XVIII) patient days	316	CMS-2540-10 worksheet S300001 line 800 column 400
Medicaid (Title XIX) patient days	6,098	CMS-2540-10 worksheet S300001 line 800 column 500
Total patient days, all components	6,414	CMS-2540-10 worksheet S300001 line 800 column 700
Medicare discharges	5	CMS-2540-10 worksheet S300001 line 800 column 900
Medicaid discharges	32	CMS-2540-10 worksheet S300001 line 800 column 1000
Total discharges, all components	37	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	63.2	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	173.35	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1447993, read from the public cost report file SNF10FY2025.zip.

Fiscal year 2024, ended 31 December 2024

Cost report for 1 January 2024 to 31 December 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 19 September 2025.

Revenue and expenses, fiscal year 2024
Figure	As filed	Where it comes from
Total patient revenue	$6,158,953	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$2,195,324	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$3,963,629	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$4,424,676	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$461,047	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$4,853	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$456,194	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$456,194 (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	77	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	19,981	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	64	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	11	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	312.2	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1439853, read from the public cost report file SNF10FY2024.zip.

Fiscal year 2023, ended 31 December 2023

Cost report for 1 January 2023 to 31 December 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 27 September 2024.

Revenue and expenses, fiscal year 2023
Figure	As filed	Where it comes from
Total patient revenue	$7,134,264	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$3,024,166	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$4,110,098	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$4,796,677	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$686,579	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$6,666	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$679,913	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$679,913 (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	77	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	24,063	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	85	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	17.5	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	283.09	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1396163, read from the public cost report file SNF10FY2023.zip.

Fiscal year 2022, ended 31 December 2022

Cost report for 1 January 2022 to 31 December 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 27 September 2023.

Revenue and expenses, fiscal year 2022
Figure	As filed	Where it comes from
Total patient revenue	$6,344,046	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$2,247,890	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$4,096,156	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$4,478,259	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$382,103	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$144,903	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$237,200	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$237,200 (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	77	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	22,250	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	104	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	106	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	213.94	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1365635, read from the public cost report file SNF10FY2022.zip.

Fiscal year 2021, ended 31 December 2021

Cost report for 1 January 2021 to 31 December 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 12 December 2022.

Revenue and expenses, fiscal year 2021
Figure	As filed	Where it comes from
Total patient revenue	$5,873,558	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$1,971,926	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$3,901,632	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$4,101,660	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$200,028	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$914,934	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$714,906	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $714,906 (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	77	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	20,083	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	104	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	52.21	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	193.11	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1337999, read from the public cost report file SNF10FY2021.zip.

Fiscal year 2020, ended 31 December 2020

Cost report for 1 January 2020 to 31 December 2020 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 22 July 2022.

Revenue and expenses, fiscal year 2020
Figure	As filed	Where it comes from
Total patient revenue	$5,863,188	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$2,236,895	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$3,626,293	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$4,454,054	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$827,761	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$9,945	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$817,816	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$821,132 (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	77	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	20,703	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	123	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	36.95	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	168.32	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1327238, read from the public cost report file SNF10FY2020.zip.

Fiscal year 2019, ended 31 December 2019

Cost report for 1 January 2019 to 31 December 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 30 December 2020.

Revenue and expenses, fiscal year 2019
Figure	As filed	Where it comes from
Total patient revenue	$5,814,983	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$1,406,956	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$4,408,027	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$4,065,761	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$342,266	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$20,160	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$362,426	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $362,426 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2019
Figure	As filed	Where it comes from
Total facility beds, all components	77	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	24,259	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	110	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	42.36	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	220.54	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1277822, read from the public cost report file SNF10FY2019.zip.

Fiscal year 2018, ended 31 December 2018

Cost report for 1 January 2018 to 31 December 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 29 August 2019.

Revenue and expenses, fiscal year 2018
Figure	As filed	Where it comes from
Total patient revenue	$6,255,993	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$2,041,990	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$4,214,003	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$3,964,811	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$249,192	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$7,782	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$256,974	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $256,974 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2018
Figure	As filed	Where it comes from
Total facility beds, all components	77	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	24,109	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	91	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	75.07	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	264.93	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1242814, read from the public cost report file SNF10FY2018.zip.

Fiscal year 2017, ended 31 December 2017

Cost report for 1 January 2017 to 31 December 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 23 August 2018.

Revenue and expenses, fiscal year 2017
Figure	As filed	Where it comes from
Total patient revenue	$5,933,503	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$1,864,225	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$4,069,278	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$3,746,296	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$322,982	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$2,040	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$325,022	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $325,022 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2017
Figure	As filed	Where it comes from
Total facility beds, all components	77	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	24,557	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	37.93	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	463.34	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1210273, read from the public cost report file SNF10FY2017.zip.

Fiscal year 2016, ended 31 December 2016

Cost report for 1 January 2016 to 31 December 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 3 August 2017.

Revenue and expenses, fiscal year 2016
Figure	As filed	Where it comes from
Total patient revenue	$5,612,939	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$1,884,529	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$3,728,410	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$3,526,498	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$201,912	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$7,267	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$209,179	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $209,179 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2016
Figure	As filed	Where it comes from
Total facility beds, all components	77	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	24,346	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	62	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	33.42	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	392.68	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1171779, read from the public cost report file SNF10FY2016.zip.

Fiscal year 2015, ended 31 December 2015

Cost report for 1 January 2015 to 31 December 2015 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 30 September 2016.

Revenue and expenses, fiscal year 2015
Figure	As filed	Where it comes from
Total patient revenue	$5,986,355	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$1,954,974	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$4,031,381	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$3,596,750	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$434,631	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$2,365	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$436,996	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $436,996 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2015
Figure	As filed	Where it comes from
Total facility beds, all components	77	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	25,228	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	110	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	40.25	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	229.35	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1143207, read from the public cost report file SNF10FY2015.zip.

Fiscal year 2014, ended 31 December 2014

Cost report for 1 January 2014 to 31 December 2014 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 24 August 2015.

Revenue and expenses, fiscal year 2014
Figure	As filed	Where it comes from
Total patient revenue	$5,588,682	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$1,751,110	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$3,837,572	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$3,550,266	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$287,306	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$3,159	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$290,465	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $290,465 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2014
Figure	As filed	Where it comes from
Total facility beds, all components	77	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	25,814	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	39	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	41.71	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	661.9	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1108660, read from the public cost report file SNF10FY2014.zip.

Fiscal year 2013, ended 31 December 2013

Cost report for 1 January 2013 to 31 December 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 30 July 2014.

Revenue and expenses, fiscal year 2013
Figure	As filed	Where it comes from
Total patient revenue	$5,869,475	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$1,742,950	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$4,126,525	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$3,402,819	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$723,706	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$1,576	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$725,282	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $725,282 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2013
Figure	As filed	Where it comes from
Total facility beds, all components	77	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	25,723	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	68	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	47.38	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	378.28	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1074193, read from the public cost report file SNF10FY2013.zip.

Fiscal year 2012, ended 31 December 2012

Cost report for 1 January 2012 to 31 December 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 26 August 2013.

Revenue and expenses, fiscal year 2012
Figure	As filed	Where it comes from
Total patient revenue	$5,565,456	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$1,664,487	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$3,900,969	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$3,182,118	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$718,851	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$2,637	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$721,488	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $715,249 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2012
Figure	As filed	Where it comes from
Total facility beds, all components	77	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	26,249	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	62	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	99.86	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	423.37	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1047371, read from the public cost report file SNF10FY2012.zip.

Fiscal year 2011, ended 31 December 2011

Cost report for 1 January 2011 to 31 December 2011 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 26 October 2012.

Revenue and expenses, fiscal year 2011
Figure	As filed	Where it comes from
Total patient revenue	$5,291,968	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$1,636,312	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$3,655,656	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$3,192,108	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$463,548	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$2,308	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$465,856	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $465,856 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2011
Figure	As filed	Where it comes from
Total facility beds, all components	77	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	24,861	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	68	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	55.95	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	365.6	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1013908, read from the public cost report file SNF10FY2011.zip.

Fiscal year 2010, ended 31 December 2010

Cost report for 1 January 2010 to 31 December 2010 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 4 August 2011.

Revenue and expenses, fiscal year 2010
Figure	As filed	Where it comes from
Total operating expenses	$2,849,655	CMS-2540-96 worksheet G200002 line 1500 column 200

Beds, days and discharges, fiscal year 2010
Figure	As filed	Where it comes from
Total facility beds, all components	77	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	24,131	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	51	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	67.93	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	605.17	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	473.16	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 414575, read from the public cost report file SNFFY2010.zip.

Fiscal year 2009, ended 31 December 2009

Cost report for 1 January 2009 to 31 December 2009 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 19 July 2010.

Revenue and expenses, fiscal year 2009
Figure	As filed	Where it comes from
Net patient revenue	$2,769,379	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$2,066,394	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	$702,985	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$1,734	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income, stated at moderate confidence: $704,719 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.

Beds, days and discharges, fiscal year 2009
Figure	As filed	Where it comes from
Total facility beds, all components	77	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	20,820	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	49.19	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	647.9	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	433.75	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 382286, read from the public cost report file SNFFY2009.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
BANKWELL BANK	5% OR GREATER SECURITY INTEREST	Organization	NOT APPLICABLE	since 05/01/2025
4359 TAFT AVE MO LLC	ADP OF THE SNF	Organization	NOT APPLICABLE	since 05/01/2025
BRENCICK, MARK	ADP OF THE SNF	Individual	NOT APPLICABLE	since 08/11/2025
ESDOV INVESTMENTS LLC	ADP OF THE SNF	Organization	NOT APPLICABLE	since 08/11/2025
FORVIS MAZARS LLP	ADP OF THE SNF	Organization	NOT APPLICABLE	since 06/01/2023
GAO, SHAWN	ADP OF THE SNF	Individual	NOT APPLICABLE	since 08/11/2025
HERALD ADVISORS LLC	ADP OF THE SNF	Organization	NOT APPLICABLE	since 08/11/2025
LINZ TRUST	ADP OF THE SNF	Organization	NOT APPLICABLE	since 08/11/2025
MIZZOU REALTY INVESTORS LLC	ADP OF THE SNF	Organization	NOT APPLICABLE	since 08/11/2025
OPCO CA SKILLED MGMT INC.	ADP OF THE SNF	Organization	NOT APPLICABLE	since 03/01/2024
PEASE BELL CPAS LLC	ADP OF THE SNF	Organization	NOT APPLICABLE	since 06/14/2018
TUSCANY HC TRUST	ADP OF THE SNF	Organization	NOT APPLICABLE	since 08/11/2025
ARCHES HEALTHCARE LLC	DIRECT OWNERSHIP INTEREST	Organization	NOT APPLICABLE	since 05/01/2025
GURWITZ, SOLOMON	DIRECT OWNERSHIP INTEREST	Individual	NOT APPLICABLE	since 03/01/2024
AMBER HC TRUST	INDIRECT OWNERSHIP INTEREST	Organization	NOT APPLICABLE	since 05/01/2025
FIRST SWEETZER HOLDINGS LLC	INDIRECT OWNERSHIP INTEREST	Organization	NOT APPLICABLE	since 05/01/2025
GARETZ, DAVID	INDIRECT OWNERSHIP INTEREST	Individual	NOT APPLICABLE	since 05/01/2025
KAPLAN, ESTHER	INDIRECT OWNERSHIP INTEREST	Individual	NOT APPLICABLE	since 05/01/2025
LUCENT ADVISORS LLC	INDIRECT OWNERSHIP INTEREST	Organization	NOT APPLICABLE	since 05/01/2025
RIMPAU HOLDINGS TRUST	INDIRECT OWNERSHIP INTEREST	Organization	NOT APPLICABLE	since 05/01/2025
SASEM INVESTMENTS LLC	INDIRECT OWNERSHIP INTEREST	Organization	NOT APPLICABLE	since 05/01/2025
HAGINS, ELIZABETH	INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF	Individual	NOT APPLICABLE	since 08/11/2025
MINDLE, ADAM	INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF	Individual	NOT APPLICABLE	since 08/11/2025
BRENCICK, MARK	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 05/01/2025
FORVIS MAZARS LLP	OPERATIONAL/MANAGERIAL CONTROL	Organization	NOT APPLICABLE	since 06/01/2023
GAO, SHAWN	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 05/01/2025
GARETZ, DAVID	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 05/01/2025
KAPLAN, ESTHER	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 05/01/2025
LITTLEFIELD-LEA, MELANIE	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 05/01/2025
OPCO CA SKILLED MGMT INC.	OPERATIONAL/MANAGERIAL CONTROL	Organization	NOT APPLICABLE	since 03/01/2024
PEASE BELL CPAS LLC	OPERATIONAL/MANAGERIAL CONTROL	Organization	NOT APPLICABLE	since 06/14/2018
UNGER, JEFFREY	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 05/01/2025
DAVIDOVICH, NIV	TRUSTEE OF THE SNF	Individual	NOT APPLICABLE	since 05/01/2025
STERNSHEIN, JENNIFER	TRUSTEE OF THE SNF	Individual	NOT APPLICABLE	since 05/01/2025

Medicare enrollment

As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of PINE GROVE MANOR LLC (enrollment ID O20250604001377).

Owner	Individual or organization	Role	Ownership percentage	Association date	Described in the filing as
BANKWELL BANK	Organization	5% OR GREATER SECURITY INTEREST	80	5/1/2025	Private equity company: No Real estate investment trust: No Holding company: No
4359 TAFT AVE MO 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.	5/1/2025	Private equity company: No Real estate investment trust: No Holding company: No
ESDOV INVESTMENTS 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.	8/11/2025	Private equity company: No Real estate investment trust: No Holding company: Yes
FORVIS MAZARS LLP	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.	6/1/2023	Private equity company: No Real estate investment trust: No Holding company: No
HERALD ADVISORS 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.	8/11/2025	Private equity company: No Real estate investment trust: No Holding company: Yes
LINZ TRUST	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.	8/11/2025	Private equity company: No Real estate investment trust: No Holding company: No
MARK BRENCICK	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.	8/11/2025	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.
MIZZOU REALTY INVESTORS 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.	8/11/2025	Private equity company: No Real estate investment trust: No Holding company: No
OPCO CA SKILLED MGMT INC.	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	3/1/2024	Private equity company: No Real estate investment trust: No Holding company: No
PEASE BELL CPAS 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.	6/14/2018	Private equity company: No Real estate investment trust: No Holding company: No
SHAWN MICHAEL GAO	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.	8/11/2025	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.
TUSCANY HC TRUST	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.	8/11/2025	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.	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	7/1/2023	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	6/14/2018	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
ARCHES HEALTHCARE LLC	Organization	DIRECT OWNERSHIP INTEREST	100	5/1/2025	Private equity company: No Real estate investment trust: No Holding company: No
SOLOMON L GURWITZ	Individual	DIRECT OWNERSHIP INTEREST	100	3/1/2024	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.
AMBER HC TRUST	Organization	INDIRECT OWNERSHIP INTEREST	61.31	5/1/2025	Private equity company: No Real estate investment trust: No Holding company: No
DAVID GARETZ	Individual	INDIRECT OWNERSHIP INTEREST	1	5/1/2025	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.
ESTHER KAPLAN	Individual	INDIRECT OWNERSHIP INTEREST	3.2	5/1/2025	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.
FIRST SWEETZER HOLDINGS LLC	Organization	INDIRECT OWNERSHIP INTEREST	1	5/1/2025	Private equity company: No Real estate investment trust: No Holding company: Yes
LUCENT ADVISORS LLC	Organization	INDIRECT OWNERSHIP INTEREST	99	5/1/2025	Private equity company: No Real estate investment trust: No Holding company: Yes
RIMPAU HOLDINGS TRUST	Organization	INDIRECT OWNERSHIP INTEREST	34.49	5/1/2025	Private equity company: No Real estate investment trust: No Holding company: No
SASEM INVESTMENTS LLC	Organization	INDIRECT OWNERSHIP INTEREST	3.2	5/1/2025	Private equity company: No Real estate investment trust: No Holding company: Yes
DAVID GARETZ	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.	5/1/2025	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.
ESTHER KAPLAN	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.	5/1/2025	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.
FORVIS MAZARS LLP	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.	6/1/2023	Private equity company: No Real estate investment trust: No Holding company: No
JEFFREY UNGER	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.	5/1/2025	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 BRENCICK	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.	5/1/2025	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.
MELANIE LITTLEFIELD-LEA	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.	5/1/2025	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.
OPCO CA SKILLED MGMT 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.	3/1/2024	Private equity company: No Real estate investment trust: No Holding company: No
PEASE BELL CPAS 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.	6/14/2018	Private equity company: No Real estate investment trust: No Holding company: No
SHAWN MICHAEL GAO	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.	5/1/2025	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.
JENNIFER STERNSHEIN	Individual	TRUSTEE OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	5/1/2025	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.
NIV DAVIDOVICH	Individual	TRUSTEE OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	5/1/2025	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.

Changes in ownership

1 July 2026: ESDOV INVESTMENTS LLC 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: A listing under ADP OF THE SNF 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: ESDOV INVESTMENTS LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 December 2025: JOHN BRENCICK no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: JOHN BRENCICK no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: JOHN BRENCICK no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: MIZZOU REALTY INVESTORS LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: DAVID GARETZ appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: DAVID GARETZ appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: JENNIFER STERNSHEIN appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: PEASE BELL CPAS LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: PEASE BELL CPAS LLC appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: LINZ TRUST appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: FORVIS MAZARS LLP appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: FORVIS MAZARS LLP appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: ESTHER KAPLAN appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: ESTHER KAPLAN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: 4359 TAFT AVE MO LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: TUSCANY HC TRUST appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: SHAWN MICHAEL GAO appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: SHAWN MICHAEL GAO appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: MELANIE LITTLEFIELD-LEA appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: NIV DAVIDOVICH appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: ARCHES HEALTHCARE LLC appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: AMBER HC TRUST appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: RIMPAU HOLDINGS TRUST appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: LUCENT ADVISORS LLC appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: MARK BRENCICK appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: MARK BRENCICK appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: JEFFREY UNGER appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: SASEM INVESTMENTS LLC appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: OPCO CA SKILLED MGMT INC. appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: OPCO CA SKILLED MGMT INC. appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: HERALD ADVISORS LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: SOLOMON L GURWITZ appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: BANKWELL BANK appears as 5% OR GREATER SECURITY INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: FIRST SWEETZER HOLDINGS LLC appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: ESDOV INVESTMENTS LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 January 2025: JPAM MANAGEMENT & CONSULTING INC no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv

Recent changes on this record

1 July 2026: ESDOV INVESTMENTS LLC 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: A listing under ADP OF THE SNF 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: ESDOV INVESTMENTS LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
20 February 2026: A cost report was filed for fiscal year 2025, on form CMS-2540-10. SNF10FY2025.zip
13 January 2026: A cost report was filed for fiscal year 2025, on form CMS-2540-10. SNF10FY2025.zip
1 December 2025: JOHN BRENCICK no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: JOHN BRENCICK no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: JOHN BRENCICK no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: MIZZOU REALTY INVESTORS LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: DAVID GARETZ appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: DAVID GARETZ appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: JENNIFER STERNSHEIN appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: PEASE BELL CPAS LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: PEASE BELL CPAS LLC appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: LINZ TRUST appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: FORVIS MAZARS LLP appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: FORVIS MAZARS LLP appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: ESTHER KAPLAN appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: ESTHER KAPLAN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: 4359 TAFT AVE MO LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: TUSCANY HC TRUST appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: SHAWN MICHAEL GAO appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: SHAWN MICHAEL GAO appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: MELANIE LITTLEFIELD-LEA appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: NIV DAVIDOVICH appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: ARCHES HEALTHCARE LLC appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: AMBER HC TRUST appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: RIMPAU HOLDINGS TRUST appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: LUCENT ADVISORS LLC appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: MARK BRENCICK appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: MARK BRENCICK appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: JEFFREY UNGER appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: SASEM INVESTMENTS LLC appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: OPCO CA SKILLED MGMT INC. appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: OPCO CA SKILLED MGMT INC. appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: HERALD ADVISORS LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: SOLOMON L GURWITZ appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: BANKWELL BANK appears as 5% OR GREATER SECURITY INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: FIRST SWEETZER HOLDINGS LLC appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv

Inspections

Inspection cycle	Health inspection	Fire safety inspection	Health deficiencies	Fire safety deficiencies
1	13 March 2026	13 March 2026	21	0
2	3 April 2024	3 April 2024	6	1
3	10 June 2022	10 June 2022	8	0

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

Deficiencies cited

35 deficiencies on file, newest inspection first

Inspection date	Inspection type	Tag	Category	What was cited	Scope and severity	Complaint	Corrected	Correction date
1 July 2026	Health	F 0689	Quality of Life and Care Deficiencies	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.	G	Yes	Past Non-Compliance
13 March 2026	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	Yes	Deficient, Provider has date of correction	28 March 2026
13 March 2026	Health	F 0658	Resident Assessment and Care Planning Deficiencies	Ensure services provided by the nursing facility meet professional standards of quality.	E	Yes	Deficient, Provider has date of correction	28 March 2026
13 March 2026	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.	E	Yes	Deficient, Provider has date of correction	28 March 2026
13 March 2026	Health	F 0679	Quality of Life and Care Deficiencies	Provide activities to meet all resident's needs.	E	Yes	Deficient, Provider has date of correction	28 March 2026
13 March 2026	Health	F 0684	Quality of Life and Care Deficiencies	Provide appropriate treatment and care according to orders, resident’s preferences and goals.	D	No	Deficient, Provider has date of correction	28 March 2026
13 March 2026	Health	F 0686	Quality of Life and Care Deficiencies	Provide appropriate pressure ulcer care and prevent new ulcers from developing.	D	No	Deficient, Provider has date of correction	28 March 2026
13 March 2026	Health	F 0693	Quality of Life and Care Deficiencies	Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.	D	No	Deficient, Provider has date of correction	28 March 2026
13 March 2026	Health	F 0695	Quality of Life and Care Deficiencies	Provide safe and appropriate respiratory care for a resident when needed.	D	No	Deficient, Provider has date of correction	28 March 2026
13 March 2026	Health	F 0697	Quality of Life and Care Deficiencies	Provide safe, appropriate pain management for a resident who requires such services.	D	No	Deficient, Provider has date of correction	28 March 2026
13 March 2026	Health	F 0732	Nursing and Physician Services Deficiencies	Post nurse staffing information every day.	D	No	Deficient, Provider has date of correction	28 March 2026
13 March 2026	Health	F 0740	Quality of Life and Care Deficiencies	Ensure each resident must receive and the facility must provide necessary behavioral health care and services.	D	No	Deficient, Provider has date of correction	28 March 2026
13 March 2026	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.	E	No	Deficient, Provider has date of correction	29 April 2026
13 March 2026	Health	F 0756	Pharmacy Service Deficiencies	Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.	E	No	Deficient, Provider has date of correction	28 March 2026
13 March 2026	Health	F 0761	Pharmacy Service Deficiencies	Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.	D	No	Deficient, Provider has date of correction	28 March 2026
13 March 2026	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.	E	No	Deficient, Provider has date of correction	28 March 2026
13 March 2026	Health	F 0883	Infection Control Deficiencies	Develop and implement policies and procedures for flu and pneumonia vaccinations.	D	Yes	Deficient, Provider has date of correction	28 March 2026
22 December 2025	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	Yes	Deficient, Provider has date of correction	23 December 2025
22 December 2025	Health	F 0678	Quality of Life and Care Deficiencies	Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.	J	Yes	Deficient, Provider has date of correction	23 December 2025
22 December 2025	Health	F 0684	Quality of Life and Care Deficiencies	Provide appropriate treatment and care according to orders, resident’s preferences and goals.	D	Yes	Deficient, Provider has date of correction	23 December 2025
22 December 2025	Health	F 0760	Pharmacy Service Deficiencies	Ensure that residents are free from significant medication errors.	E	Yes	Deficient, Provider has date of correction	23 December 2025
3 April 2024	Health	F 0679	Quality of Life and Care Deficiencies	Provide activities to meet all resident's needs.	E	No	Deficient, Provider has date of correction	7 May 2024
3 April 2024	Health	F 0680	Quality of Life and Care Deficiencies	Ensure the activities program is directed by a qualified professional.	E	No	Deficient, Provider has date of correction	7 May 2024
3 April 2024	Health	F 0689	Quality of Life and Care Deficiencies	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.	K	No	Deficient, Provider has date of correction	7 May 2024
3 April 2024	Health	F 0698	Quality of Life and Care Deficiencies	Provide safe, appropriate dialysis care/services for a resident who requires such services.	D	No	Deficient, Provider has date of correction	7 May 2024
3 April 2024	Health	F 0812	Nutrition and Dietary Deficiencies	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.	E	No	Deficient, Provider has date of correction	28 May 2024
3 April 2024	Health	F 0880	Infection Control Deficiencies	Provide and implement an infection prevention and control program.	E	No	Deficient, Provider has date of correction	7 May 2024
29 November 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.	D	Yes	Deficient, Provider has date of correction	6 December 2023
13 October 2023	Health	F 0600	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.	G	Yes	Past Non-Compliance	3 October 2023
10 June 2022	Health	F 0570	Resident Rights Deficiencies	Assure the security of all personal funds of residents deposited with the facility.	C	No	Deficient, Provider has date of correction	29 July 2022
10 June 2022	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.	E	No	Deficient, Provider has date of correction	20 July 2022
10 June 2022	Health	F 0678	Quality of Life and Care Deficiencies	Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.	E	No	Deficient, Provider has date of correction	20 July 2022
10 June 2022	Health	F 0804	Nutrition and Dietary Deficiencies	Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.	E	No	Deficient, Provider has date of correction	20 July 2022
10 June 2022	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	20 July 2022
10 June 2022	Health	F 0909	Environmental Deficiencies	Regularly inspect all bed frames, mattresses, and bed rails (if any) for safety; and all bed rails and mattresses must attach safely to the bed frame.	E	No	Deficient, Provider has date of correction	20 July 2022

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
22 December 2025	Fine	$9,510			138088
3 April 2024	Fine	$22,155			90555
3 April 2024	Payment Denial		15 May 2024	13

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

Care Compare provider information

Field	As filed
Provider Type	Medicare and Medicaid
Ownership Type	For profit - Corporation
Legal Business Name	PINE GROVE MANOR LLC
Date First Approved to Provide Medicare and Medicaid Services	2009-05-01
Provider Resides in Hospital	N
Continuing Care Retirement Community	N
Urban	Y
County/Parish	St. Louis City
Telephone Number	3147522022
Chain Name	OPCO SKILLED MANAGEMENT
Chain ID	773
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	77
Average Number of Residents per Day	51.9
Overall Rating	1
Health Inspection Rating	1
QM Rating	4
Long-Stay QM Rating	4
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 PINE GROVE MANOR: 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: ESDOV INVESTMENTS LLC no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. That is one line of the alert.

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The citable document for PINE GROVE MANOR

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.

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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 265828.