Skilled nursing facility · CMS certification number 285249

St. Joseph's Villa, Inc.

David City, Nebraska · Medicare and Medicaid

Certified beds, as filed in Care Compare: 58

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 27 January 2026.

Revenue and expenses, fiscal year 2025
Figure	As filed	Where it comes from
Total patient revenue	$5,803,827	CMS-2540-10 worksheet G300000 line 100 column 100
Net patient revenue	$5,803,827	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$6,868,725	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$1,064,898	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$368,832	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$696,066	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$696,066 (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	58	CMS-2540-10 worksheet S300001 line 800 column 100
Bed days available, all components	21,170	CMS-2540-10 worksheet S300001 line 800 column 200
Medicare (Title XVIII) patient days	486	CMS-2540-10 worksheet S300001 line 800 column 400
Medicaid (Title XIX) patient days	11,353	CMS-2540-10 worksheet S300001 line 800 column 500
Other-payer patient days	5,507	CMS-2540-10 worksheet S300001 line 800 column 600
Total patient days, all components	17,346	CMS-2540-10 worksheet S300001 line 800 column 700
Medicare discharges	12	CMS-2540-10 worksheet S300001 line 800 column 900
Medicaid discharges	23	CMS-2540-10 worksheet S300001 line 800 column 1000
Other-payer discharges	26	CMS-2540-10 worksheet S300001 line 800 column 1100
Total discharges, all components	61	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	40.5	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	493.61	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	284.36	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1447037, 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 3 March 2025.

Revenue and expenses, fiscal year 2024
Figure	As filed	Where it comes from
Total patient revenue	$5,049,310	CMS-2540-10 worksheet G300000 line 100 column 100
Net patient revenue	$5,049,310	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$6,883,309	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$1,833,999	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$426,519	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$1,407,480	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$1,407,480 (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	58	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	14,278	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	9.57	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	541.69	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	167.98	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1404458, 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 18 March 2024.

Revenue and expenses, fiscal year 2023
Figure	As filed	Where it comes from
Total patient revenue	$5,164,607	CMS-2540-10 worksheet G300000 line 100 column 100
Net patient revenue	$5,164,607	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$6,129,616	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$965,009	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$1,805,372	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$840,363	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $840,363 (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	58	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	15,345	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	31	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	80.29	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	759	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	495	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1375144, 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.

Revenue and expenses, fiscal year 2022
Figure	As filed	Where it comes from
Total patient revenue	$4,952,420	CMS-2540-10 worksheet G300000 line 100 column 100
Net patient revenue	$4,952,420	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$6,125,479	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$1,173,059	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$196,958	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$976,101	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$1,443,738 (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	58	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	16,153	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	19.45	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	737.55	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	414.18	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1339797, 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 17 March 2022.

Revenue and expenses, fiscal year 2021
Figure	As filed	Where it comes from
Total patient revenue	$5,471,584	CMS-2540-10 worksheet G300000 line 100 column 100
Net patient revenue	$5,471,584	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$6,043,579	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$571,995	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$2,707,937	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$2,135,942	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $2,043,105 (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	58	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	18,992	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	26	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	18.8	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	1,690.33	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	730.46	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1312407, 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 16 February 2021.

Revenue and expenses, fiscal year 2020
Figure	As filed	Where it comes from
Total patient revenue	$5,256,890	CMS-2540-10 worksheet G300000 line 100 column 100
Net patient revenue	$5,256,890	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$5,581,917	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$325,027	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$308,427	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$16,600	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$62,000 (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	58	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	19,477	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	49	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	28.59	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	938.8	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	397.49	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1280213, 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 28 January 2020.

Revenue and expenses, fiscal year 2019
Figure	As filed	Where it comes from
Total patient revenue	$4,927,994	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$12,953	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$4,915,041	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$5,252,842	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$337,801	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$502,764	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$164,963	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$44,194 (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 2019
Figure	As filed	Where it comes from
Total facility beds, all components	58	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	18,667	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	54	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	35.27	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	1,126	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	345.69	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1250026, 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 5 February 2019.

Revenue and expenses, fiscal year 2018
Figure	As filed	Where it comes from
Total patient revenue	$4,834,651	CMS-2540-10 worksheet G300000 line 100 column 100
Net patient revenue	$4,834,651	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$5,275,356	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$440,705	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$733,253	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$292,548	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $23,125 (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	58	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	17,893	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	25	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	972.25	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	288.6	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1219041, 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 23 January 2018.

Revenue and expenses, fiscal year 2017
Figure	As filed	Where it comes from
Total patient revenue	$4,898,172	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$26,796	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$4,871,376	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$5,227,048	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$355,672	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$941,853	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$586,181	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $586,181 (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	58	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	18,586	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	50	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	36.78	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	1,003.88	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	371.72	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1182624, 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 19 January 2017.

Revenue and expenses, fiscal year 2016
Figure	As filed	Where it comes from
Total patient revenue	$4,754,765	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$30,873	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$4,723,892	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$4,826,848	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$102,956	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$118,135	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$15,179	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$237,923 (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	58	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	18,425	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	52	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	35	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	904.4	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	354.33	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1151654, 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 29 December 2015.

Revenue and expenses, fiscal year 2015
Figure	As filed	Where it comes from
Total patient revenue	$4,555,778	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$10,752	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$4,545,026	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$4,571,704	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$26,678	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$417,992	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$391,314	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $93,186 (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	58	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	17,960	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	20.9	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	739.92	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	249.44	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1116647, 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 14 January 2015.

Revenue and expenses, fiscal year 2014
Figure	As filed	Where it comes from
Total patient revenue	$4,533,237	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$19,510	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$4,513,727	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$4,619,254	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$105,527	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$1,069,437	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$963,910	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $961,731 (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	58	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	20,045	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	59	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	43.56	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	882.45	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	339.75	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1084344, 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 4 February 2014.

Revenue and expenses, fiscal year 2013
Figure	As filed	Where it comes from
Total patient revenue	$4,603,527	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$38,193	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$4,565,334	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$4,579,561	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$14,227	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$1,167,989	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$1,153,762	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $1,151,979 (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	58	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	19,748	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	57	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	41.44	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	531.56	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	346.46	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1055148, 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 31 January 2013.

Revenue and expenses, fiscal year 2012
Figure	As filed	Where it comes from
Total patient revenue	$4,259,051	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$18,615	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$4,240,436	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$4,162,313	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$78,123	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$166,030	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$244,153	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$32,913 (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 2012
Figure	As filed	Where it comes from
Total facility beds, all components	58	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	18,860	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	57	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	36.54	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	624.64	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	330.88	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1024243, 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 30 January 2012.

Revenue and expenses, fiscal year 2011
Figure	As filed	Where it comes from
Net patient revenue	$4,024,892	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$3,984,247	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	$40,645	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$834,944	CMS-2540-96 worksheet G300000 line 2600 column 100
Total other expenses	$1,524	CMS-2540-96 worksheet G300000 line 3100 column 100

Net income, stated at moderate confidence: $874,065 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.

Beds, days and discharges, fiscal year 2011
Figure	As filed	Where it comes from
Total facility beds, all components	58	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	19,409	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	69	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	31.47	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	599.76	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	281.29	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 424220, 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 20 January 2011.

Revenue and expenses, fiscal year 2010
Figure	As filed	Where it comes from
Net patient revenue	$3,983,938	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$3,799,175	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	$184,763	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$624,871	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income, stated at moderate confidence: $809,634 (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 2010
Figure	As filed	Where it comes from
Total facility beds, all components	58	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	19,196	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	40	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	118.44	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	945.92	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	479.9	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 392931, 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 13 January 2010.

Revenue and expenses, fiscal year 2009
Figure	As filed	Where it comes from
Net patient revenue	$4,153,779	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$3,646,898	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	$506,881	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$144,609	CMS-2540-96 worksheet G300000 line 2600 column 100
Total other expenses	$901,663	CMS-2540-96 worksheet G300000 line 3100 column 100

Net income, stated at moderate confidence: −$250,173 (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	58	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	19,785	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	63	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	77.36	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	573.47	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	314.05	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 362097, 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 20 January 2009.

Revenue and expenses, fiscal year 2008
Figure	As filed	Where it comes from
Net patient revenue	$3,548,576	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$3,515,784	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	$32,792	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$295,586	CMS-2540-96 worksheet G300000 line 2600 column 100
Total other expenses	$425,979	CMS-2540-96 worksheet G300000 line 3100 column 100

Net income, stated at moderate confidence: −$97,601 (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 2008
Figure	As filed	Where it comes from
Total facility beds, all components	58	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	18,198	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	68	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	58.4	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	439.89	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	267.62	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 332285, 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 24 January 2008.

Revenue and expenses, fiscal year 2007
Figure	As filed	Where it comes from
Net patient revenue	$3,613,205	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$3,629,757	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	−$16,552	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$736,913	CMS-2540-96 worksheet G300000 line 2600 column 100
Total other expenses	$3,741	CMS-2540-96 worksheet G300000 line 3100 column 100

Net income, stated at moderate confidence: $716,620 (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 2007
Figure	As filed	Where it comes from
Total facility beds, all components	58	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	20,633	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	55	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	91.33	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	361.69	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	375.15	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 300274, 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, settled, processed by CMS on 29 January 2007.

Revenue and expenses, fiscal year 2006
Figure	As filed	Where it comes from
Net patient revenue	$3,542,432	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$3,437,460	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	$104,972	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$363,189	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income, stated at moderate confidence: $468,161 (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 2006
Figure	As filed	Where it comes from
Total facility beds, all components	58	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	19,680	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	55	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	133.2	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	502	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	357.82	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 271254, 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 31 January 2006.

Revenue and expenses, fiscal year 2005
Figure	As filed	Where it comes from
Net patient revenue	$3,156,398	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$3,432,417	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	−$276,019	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$290,415	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income, stated at moderate confidence: $14,396 (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 2005
Figure	As filed	Where it comes from
Total facility beds, all components	58	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	17,688	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	86.63	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	713.71	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	491.33	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 241900, read from the public cost report file SNFFY2004.zip.

Fiscal year 2004, ended 30 June 2004

Cost report for 1 July 2003 to 30 June 2004 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 4 February 2005.

Revenue and expenses, fiscal year 2004
Figure	As filed	Where it comes from
Net patient revenue	$3,095,240	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$3,316,461	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	−$221,221	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$464,780	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income, stated at moderate confidence: $243,559 (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 2004
Figure	As filed	Where it comes from
Total facility beds, all components	58	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	19,449	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	37	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	102	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	904.33	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	525.65	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 206396, read from the public cost report file SNFFY2003.zip.

Fiscal year 2003, ended 30 June 2003

Cost report for 1 March 2003 to 30 June 2003 — a reporting period of 121 days, not a full year, on form CMS-2540-96, settled, processed by CMS on 18 April 2005.

Revenue and expenses, fiscal year 2003
Figure	As filed	Where it comes from
Net patient revenue	$1,016,343	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$1,037,906	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	−$21,563	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$493,072	CMS-2540-96 worksheet G300000 line 2600 column 100
Total other expenses	$160,797	CMS-2540-96 worksheet G300000 line 3100 column 100

Net income, stated at moderate confidence: $310,712 (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 2003
Figure	As filed	Where it comes from
Total facility beds, all components	58	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	6,224	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	8	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicaid, in days	617.8	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	778	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 213785, read from the public cost report file SNFFY2003.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
DARO, ROBERT	ADP OF THE SNF	Individual	NOT APPLICABLE	since 05/21/2025
LEPANT, VICKI	ADP OF THE SNF	Individual	NOT APPLICABLE	since 07/14/2008
ROSS, MATTHEW	ADP OF THE SNF	Individual	NOT APPLICABLE	since 07/14/2008
ROSS, RON	ADP OF THE SNF	Individual	NOT APPLICABLE	since 07/14/2008
RURAL HEALTH DEVELOPMENT INC.	ADP OF THE SNF	Organization	NOT APPLICABLE	since 04/25/2025
SHANNON, CHRISTINA	ADP OF THE SNF	Individual	NOT APPLICABLE	since 01/17/2025
KOBZA, LAURA	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 12/08/2015
ADAMY, MICHAEL	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 02/14/2017
BIRKEL, SUSAN	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 10/12/2021
HOEFT, JACKIE	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 10/12/2021
JAKUB, JEANNE	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 10/12/2021
MEISTER, GARY	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 10/01/2023
MORAVEC, ALLEN	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 12/13/2016
POLACEK, KENNETH	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 12/13/2016
PYTLIK, FRANCES	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 07/01/2003
ROSS, MATTHEW	INDIRECT OWNERSHIP INTEREST	Individual	NOT APPLICABLE	since 04/17/2025
PYTLIK, FRANCES	MANAGING CONTROL - GOVERNING BODY	Individual	NOT APPLICABLE	since 07/01/2003
DARO, ROBERT	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 12/27/2019
ROSS, MATTHEW	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 07/14/2008
ROSS, RON	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 07/14/2008
RURAL HEALTH DEVELOPMENT INC.	OPERATIONAL/MANAGERIAL CONTROL	Organization	NOT APPLICABLE	since 07/14/2008
SHANNON, CHRISTINA	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 01/17/2025

Medicare enrollment

As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of ST JOSEPHS VILLA INC (enrollment ID O20120210000397).

Owner	Individual or organization	Role	Ownership percentage	Association date	Described in the filing as
CHRISTINA SHANNON	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	1/17/2025	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 R ROSS	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.	7/14/2008	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
ROBERT AUSTIN DARO	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.	5/21/2025	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.
RON D ROSS	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.	7/14/2008	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.
RURAL HEALTH DEVELOPMENT 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.	4/25/2025	Private equity company: No Real estate investment trust: No Holding company: No
VICKI LEPANT	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.	7/14/2008	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.	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	4/25/2025	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.	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.
LAURA M KOBZA	Individual	CORPORATE DIRECTOR	0	12/8/2015	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
ALLEN MORAVEC	Individual	CORPORATE OFFICER	0	12/13/2016	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
FRANCES PYTLIK	Individual	CORPORATE OFFICER	0	7/1/2003	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
GARY MEISTER	Individual	CORPORATE OFFICER	0	10/1/2023	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.
JACKIE S HOEFT	Individual	CORPORATE OFFICER	0	10/12/2021	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.
JEANNE JAKUB	Individual	CORPORATE OFFICER	0	10/12/2021	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.
KENNETH POLACEK	Individual	CORPORATE OFFICER	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	12/13/2016	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
MICHAEL ADAMY	Individual	CORPORATE OFFICER	0	2/14/2017	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
SUSAN M BIRKEL	Individual	CORPORATE OFFICER	0	10/12/2021	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.
MATTHEW R ROSS	Individual	INDIRECT OWNERSHIP INTEREST	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	4/17/2025	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.
FRANCES PYTLIK	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.	7/1/2003	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 SHANNON	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.	1/17/2025	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 R ROSS	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.	7/14/2008	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
ROBERT AUSTIN DARO	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.	12/27/2019	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
RON D ROSS	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.	7/14/2008	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.
RURAL HEALTH DEVELOPMENT 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.	7/14/2008	Private equity company: No Real estate investment trust: No Holding company: No

Changes in ownership

1 July 2026: KENNETH POLACEK no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: KENNETH POLACEK appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 August 2025: WILLIAM M PONEC no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: KATHY A ENGEL no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: TRISHA STEAGER no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: VICKI LEPANT appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: RURAL HEALTH DEVELOPMENT INC. appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: GARY MEISTER appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: RON D ROSS appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: RON D ROSS appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: CHRISTINA SHANNON appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: CHRISTINA SHANNON appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: JACKIE S HOEFT appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: MATTHEW R ROSS appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: MATTHEW R ROSS appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: MATTHEW R ROSS appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: FRANCES PYTLIK appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: ROBERT AUSTIN DARO appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: ROBERT AUSTIN DARO appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv

Recent changes on this record

1 July 2026: KENNETH POLACEK no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: KENNETH POLACEK appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
27 January 2026: A cost report was filed for fiscal year 2025, on form CMS-2540-10. SNF10FY2024.zip
1 August 2025: WILLIAM M PONEC no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: KATHY A ENGEL no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: TRISHA STEAGER no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: VICKI LEPANT appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: RURAL HEALTH DEVELOPMENT INC. appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: GARY MEISTER appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: RON D ROSS appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: RON D ROSS appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: CHRISTINA SHANNON appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: CHRISTINA SHANNON appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: JACKIE S HOEFT appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: MATTHEW R ROSS appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: MATTHEW R ROSS appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: MATTHEW R ROSS appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: FRANCES PYTLIK appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: ROBERT AUSTIN DARO appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: ROBERT AUSTIN DARO appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
3 March 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2023.zip
18 March 2024: 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
17 March 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2020.zip
16 February 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2019.zip
28 January 2020: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2018.zip
5 February 2019: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2017.zip
23 January 2018: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2016.zip
19 January 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2015.zip
29 December 2015: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2014.zip
14 January 2015: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2013.zip
4 February 2014: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2012.zip
31 January 2013: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2011.zip
30 January 2012: A cost report was filed for fiscal year 2011, on form CMS-2540-96. SNFFY2010.zip
20 January 2011: A cost report was filed for fiscal year 2010, on form CMS-2540-96. SNFFY2009.zip
13 January 2010: A cost report was filed for fiscal year 2009, on form CMS-2540-96. SNFFY2008.zip
20 January 2009: A cost report was filed for fiscal year 2008, on form CMS-2540-96. SNFFY2007.zip
24 January 2008: A cost report was filed for fiscal year 2007, on form CMS-2540-96. SNFFY2006.zip
29 January 2007: A cost report was filed for fiscal year 2006, on form CMS-2540-96. SNFFY2005.zip

Inspections

Inspection cycle	Health inspection	Fire safety inspection	Health deficiencies	Fire safety deficiencies
1	12 August 2025	12 August 2025	6	7
2	4 September 2024	4 September 2024	6	3
3	5 October 2023	5 October 2023	2	5

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

Deficiencies cited

14 deficiencies on file, newest inspection first

Inspection date	Inspection type	Tag	Category	What was cited	Scope and severity	Complaint	Corrected	Correction date
12 August 2025	Health	F 0657	Resident Assessment and Care Planning Deficiencies	Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.	D	No	Deficient, Provider has date of correction	29 August 2025
12 August 2025	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	29 August 2025
12 August 2025	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	No	Deficient, Provider has date of correction	29 August 2025
12 August 2025	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	29 August 2025
12 August 2025	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	29 August 2025
12 August 2025	Health	F 0880	Infection Control Deficiencies	Provide and implement an infection prevention and control program.	D	Yes	Deficient, Provider has date of correction	29 August 2025
24 October 2024	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	18 November 2024
26 September 2024	Health	F 0609	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.	D	Yes	Deficient, Provider has date of correction	17 October 2024
4 September 2024	Health	F 0636	Resident Assessment and Care Planning Deficiencies	Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.	D	Yes	Deficient, Provider has date of correction	20 September 2024
4 September 2024	Health	F 0645	Resident Assessment and Care Planning Deficiencies	PASARR screening for Mental disorders or Intellectual Disabilities	D	Yes	Deficient, Provider has date of correction	20 September 2024
4 September 2024	Health	F 0695	Quality of Life and Care Deficiencies	Provide safe and appropriate respiratory care for a resident when needed.	D	Yes	Deficient, Provider has date of correction	20 September 2024
4 September 2024	Health	F 0880	Infection Control Deficiencies	Provide and implement an infection prevention and control program.	E	Yes	Deficient, Provider has date of correction	20 September 2024
5 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	Yes	Deficient, Provider has date of correction	27 October 2023
5 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	27 October 2023

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

Penalties

Penalty date	Type	Fine amount	Payment denial began	Payment denial, days	Fine ID
26 September 2024	Fine	$27,115			85954
26 September 2024	Payment Denial		15 November 2024	3

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

Care Compare provider information

Field	As filed
Provider Type	Medicare and Medicaid
Ownership Type	Non profit - Corporation
Legal Business Name	ST JOSEPHS VILLA INC
Date First Approved to Provide Medicare and Medicaid Services	2003-01-01
Provider Resides in Hospital	N
Continuing Care Retirement Community	N
Urban	N
County/Parish	Butler
Telephone Number	4023673045
Chain Name	RURAL HEALTH DEVELOPMENT
Chain ID	879
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	58
Average Number of Residents per Day	54.9
Overall Rating	2
Health Inspection Rating	2
QM Rating	2
Long-Stay QM Rating	4
Short-Stay QM Rating	1
Processing Date	2026-08-01

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

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On 1 July 2026: KENNETH POLACEK no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. That is one line of the alert.

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The citable document for St. Joseph's Villa, Inc.

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