Skilled nursing facility · CMS certification number 345088
Trinity Glen
Winston-Salem, North Carolina · Medicare and Medicaid
Certified beds, as filed in Care Compare: 117
Finances, as filed
From this facility’s Medicare cost reports on form CMS-2540, each figure with the worksheet, line and column it was read from.
Cost report for 1 October 2023 to 30 September 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 10 October 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $19,211,157 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $6,032,283 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $13,178,874 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $13,187,350 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$8,476 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $356,358 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $347,882 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $347,882 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 117 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 42,822 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 1,256 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 25,378 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 10,037 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 36,671 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 25 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 46 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 219 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 290 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 50.24 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 551.7 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 126.45 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1440675, read from the public cost report file SNF10FY2024.zip.
Fiscal year 2023, ended 30 September 2023
Cost report for 1 October 2022 to 30 September 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 6 February 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $17,254,462 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $5,232,886 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $12,021,576 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $11,969,182 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $52,394 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $240,465 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $292,859 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $292,859 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 117 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 35,355 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 258 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 40.56 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 515.67 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 137.03 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1403290, read from the public cost report file SNF10FY2023.zip.
Fiscal year 2022, ended 30 September 2022
Cost report for 1 October 2021 to 30 September 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 24 January 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $14,332,691 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $3,120,774 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $11,211,917 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,819,860 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $392,057 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $2,158,437 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $2,550,494 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $2,550,494 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 117 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 35,400 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 218 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 73.71 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 546.98 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 162.39 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1372525, read from the public cost report file SNF10FY2022.zip.
Fiscal year 2021, ended 30 September 2021
Cost report for 1 October 2020 to 30 September 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 14 July 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,980,660 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,016,635 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,964,025 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $11,726,030 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$762,005 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $786,811 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $24,806 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $24,806 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 117 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 31,980 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 276 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 47.1 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 337.08 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 115.87 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1358503, read from the public cost report file SNF10FY2021.zip.
Fiscal year 2020, ended 30 September 2020
Cost report for 1 October 2019 to 30 September 2020 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 27 July 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $13,777,280 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,898,109 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,879,171 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,876,019 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $3,152 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $587,725 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $590,877 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $590,877 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 117 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 37,781 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 330 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 39.72 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 326.61 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 114.49 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1328079, read from the public cost report file SNF10FY2020.zip.
Fiscal year 2019, ended 30 September 2019
Cost report for 1 October 2018 to 30 September 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 16 September 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $14,407,056 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $4,779,627 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,627,429 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,197,146 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$569,717 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $180,043 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$389,674 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$389,674 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 117 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 39,698 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 321 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 47.91 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 469.15 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 123.67 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1299737, read from the public cost report file SNF10FY2019.zip.
Fiscal year 2018, ended 30 September 2018
Cost report for 1 October 2017 to 30 September 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 17 September 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $13,787,181 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $4,290,379 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,496,802 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,117,900 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$621,098 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $225,629 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$395,469 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$395,469 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 117 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 39,225 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 354 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 35.53 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 426.24 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 110.81 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1268433, read from the public cost report file SNF10FY2018.zip.
Fiscal year 2017, ended 30 September 2017
Cost report for 1 October 2016 to 30 September 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 15 August 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $13,571,076 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $3,899,587 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,671,489 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,923,930 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$252,441 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $135,656 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$116,785 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$116,785 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 117 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 40,229 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 340 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 36.82 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 508.08 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 118.32 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1240984, read from the public cost report file SNF10FY2017.zip.
Fiscal year 2016, ended 30 September 2016
Cost report for 1 October 2015 to 30 September 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 19 July 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $12,869,682 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $3,374,177 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,495,505 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,633,620 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$138,115 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $149,134 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $11,019 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $11,019 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 117 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 39,884 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 231 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 33.95 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 398.38 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 172.66 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1200474, read from the public cost report file SNF10FY2016.zip.
Fiscal year 2015, ended 30 September 2015
Cost report for 1 October 2014 to 30 September 2015 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 3 May 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $12,567,665 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $3,020,412 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,547,253 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,443,248 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $104,005 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $166,711 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $270,716 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $270,716 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 117 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 40,331 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 181 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 41.36 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 558.94 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 222.82 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1189286, read from the public cost report file SNF10FY2015.zip.
Fiscal year 2014, ended 30 September 2014
Cost report for 1 October 2013 to 30 September 2014 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 15 October 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $12,121,053 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $3,183,168 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $8,937,885 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,743,483 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$805,598 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $203,625 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$601,973 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$601,973 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 117 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 40,600 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 245 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 46.4 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 494.9 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 165.71 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1111464, read from the public cost report file SNF10FY2014.zip.
Fiscal year 2013, ended 30 September 2013
Cost report for 1 October 2012 to 30 September 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 17 April 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,344,700 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,476,192 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $8,868,508 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,215,691 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$347,183 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $201,449 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$145,734 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$145,734 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 117 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 40,376 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 167 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 59.6 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 444.25 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 241.77 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1088740, read from the public cost report file SNF10FY2013.zip.
Fiscal year 2012, ended 30 September 2012
Cost report for 1 October 2011 to 30 September 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 8 November 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $9,780,772 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,119,344 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,661,428 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,346,351 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$684,923 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $244,716 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$440,207 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$553,598 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 117 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 37,702 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 157 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 68 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 300.58 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 240.14 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1050454, read from the public cost report file SNF10FY2012.zip.
Fiscal year 2011, ended 30 September 2011
Cost report for 1 October 2010 to 30 September 2011 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 13 August 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $7,150,222 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,218,495 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$68,273 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $293,391 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $225,118 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 217 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 35,216 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 160 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 58.61 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 429.65 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 220.1 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 431503, read from the public cost report file SNFFY2011.zip.
Fiscal year 2010, ended 30 September 2010
Cost report for 1 October 2009 to 30 September 2010 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 14 February 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $7,265,569 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,292,372 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$26,803 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $280,665 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $19,893 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: $233,969 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 217 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 37,862 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 73 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 57.54 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,305.88 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 518.66 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 424628, read from the public cost report file SNFFY2010.zip.
Fiscal year 2009, ended 30 September 2009
Cost report for 1 October 2008 to 30 September 2009 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 15 March 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $7,324,236 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,063,699 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $260,537 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $123,351 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $383,888 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 217 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 39,463 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 169 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 51.27 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 502.13 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 233.51 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 395498, read from the public cost report file SNFFY2009.zip.
Fiscal year 2008, ended 30 September 2008
Cost report for 1 October 2007 to 30 September 2008 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 30 April 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $6,598,917 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,094,731 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$495,814 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $276,330 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$219,484 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 217 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 40,056 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 171 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 49.56 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 507.55 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 234.25 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 338142, read from the public cost report file SNFFY2008.zip.
Fiscal year 2007, ended 30 September 2007
Cost report for 1 October 2006 to 30 September 2007 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 15 October 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $6,688,595 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,820,675 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$132,080 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $82,660 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$49,420 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 217 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 39,808 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 208 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 17.08 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,125.97 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 191.38 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 326640, read from the public cost report file SNFFY2007.zip.
Fiscal year 2006, ended 30 September 2006
Cost report for 1 October 2005 to 30 September 2006 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 25 July 2007.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $5,805,130 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,645,687 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$840,557 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $6,353,616 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $67,308 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: $5,445,751 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 217 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 35,188 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 196 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 34.86 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 478.72 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 179.53 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 288741, read from the public cost report file SNFFY2006.zip.
Fiscal year 2005, ended 30 September 2005
Cost report for 1 October 2004 to 30 September 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 27 October 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $5,068,014 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,235,472 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$1,167,458 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $294,150 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $60,695 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: −$934,003 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 217 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 33,451 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 216 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 33.99 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 276.54 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 154.87 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 265292, read from the public cost report file SNFFY2005.zip.
Fiscal year 2004, ended 30 September 2004
Cost report for 1 October 2003 to 30 September 2004 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 19 May 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $5,217,929 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,247,204 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$1,029,275 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $57,898 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$971,377 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 217 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 33,152 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 145 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 73.9 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 295.14 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 228.63 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 249749, read from the public cost report file SNFFY2004.zip.
Fiscal year 2003, ended 30 September 2003
Cost report for 1 October 2002 to 30 September 2003 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 27 October 2005.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $5,260,285 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,790,664 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$530,379 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $90,118 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $229,644 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: −$669,905 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 217 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 34,063 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 112 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 86.39 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 400.49 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 304.13 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 235484, read from the public cost report file SNFFY2003.zip.
Fiscal year 2002, ended 30 September 2002
Cost report for 1 October 2001 to 30 September 2002 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 5 February 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,028,655 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,581,655 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$1,553,000 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $473,086 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$1,079,914 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 217 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 33,981 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 135 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 56.62 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 311.32 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 251.71 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 168544, read from the public cost report file SNFFY2002.zip.
Fiscal year 2001, ended 30 September 2001
Cost report for 1 October 2000 to 30 September 2001 — a reporting period of 364 days, on form CMS-2540-96, as submitted, processed by CMS on 12 February 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,897,323 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,523,527 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$626,204 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $17,812 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$608,392 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 217 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 42,864 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 122 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 19 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 348.43 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 351.34 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 117207, read from the public cost report file SNFFY2001.zip.
Fiscal year 2000, ended 30 September 2000
Cost report for 1 October 1999 to 30 September 2000 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 12 February 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,865,152 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,037,346 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$172,194 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $5,682 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$166,512 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 217 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 53,647 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 183 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 27.64 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 327.4 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 293.15 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 123929, read from the public cost report file SNFFY2000.zip.
Fiscal year 1999, ended 30 September 1999
Cost report for 1 October 1998 to 30 September 1999 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 12 December 2000.
Net income, stated at moderate confidence: $101,518 (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.
CMS report record 39788, read from the public cost report file SNFFY1999.zip.
Nurse staffing
Nurse staffing hours from the Payroll-Based Journal, quarter by quarter, are on this facility’s staffing page, each quarter with the file it came from.
Ownership, as filed with CMS
Care Compare
As filed in the CMS file dated 1 August 2026 (Care Compare ownership).
| Owner or manager | Role | Type | Ownership percentage | Association |
|---|---|---|---|---|
| HERMAN, CHRISTOPHER | ADP OF THE SNF | Individual | NOT APPLICABLE | since 06/20/2023 |
| LSA MANAGEMENT, INC. | ADP OF THE SNF | Organization | NOT APPLICABLE | since 04/14/2025 |
| LUTHERAN HOME WINSTON SALEM PROPERTY INC. | ADP OF THE SNF | Organization | NOT APPLICABLE | since 04/14/2025 |
| NICKERSON, KIRBY | ADP OF THE SNF | Individual | NOT APPLICABLE | since 10/01/2012 |
| SMITH, KESHA | ADP OF THE SNF | Individual | NOT APPLICABLE | since 10/01/2012 |
| WILMOUTH, LOGAN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 06/24/2023 |
| SMITH, KESHA | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 10/01/2012 |
| MADDRY, KAREN | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 04/30/2007 |
| NICKERSON, KIRBY | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 10/01/2012 |
| GOINS, TED | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 10/01/2004 |
| HERMAN, RICHARD | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 06/01/2021 |
| MADDRY, KAREN | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 04/30/2007 |
| NELSON, DOUGLAS | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 09/01/2022 |
| NICKERSON, KIRBY | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 10/01/2012 |
| GOINS, TED | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 10/01/2004 |
| HERMAN, CHRISTOPHER | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 06/20/2023 |
| LSA MANAGEMENT, INC. | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | since 07/29/2004 |
| LUTHERAN HOME WINSTON SALEM PROPERTY INC. | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | since 07/18/2006 |
| NICKERSON, KIRBY | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 06/25/2012 |
| SMITH, KESHA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 10/01/2012 |
| WILMOUTH, LOGAN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 06/24/2023 |
| GOINS, TED | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 10/01/2004 |
| HERMAN, RICHARD | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 06/01/2021 |
| LUTHERAN SERVICES FOR THE AGING, INC. | TRUSTEE OF THE SNF | Organization | NOT APPLICABLE | since 10/01/2004 |
| NELSON, DOUGLAS | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 09/01/2022 |
| NICKERSON, KIRBY | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 10/01/2012 |
Medicare enrollment
As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of LUTHERAN HOME-WINSTON-SALEM, INC. (enrollment ID O20040902000803).
| Owner | Individual or organization | Role | Ownership percentage | Association date | Described in the filing as |
|---|---|---|---|---|---|
| LUTHERAN SERVICES FOR THE AGING, INC. | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100 | 10/1/2004 | Private equity company: No Real estate investment trust: No Holding company: No |
| CHRISTOPHER M HERMAN | 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. | 6/20/2023 | 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. |
| KESHA L SMITH | 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. | 10/1/2012 | 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. |
| KIRBY NICKERSON | 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. | 10/1/2012 | 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. |
| LOGAN WILMOUTH | 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. | 6/24/2023 | 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. |
| LSA MANAGEMENT, 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. | 4/14/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| LUTHERAN HOME WINSTON SALEM PROPERTY 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. | 4/14/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| KESHA L SMITH | Individual | CORPORATE DIRECTOR | 0 | 10/1/2012 | 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. |
| KAREN MADDRY | Individual | CORPORATE OFFICER | 0 | 4/30/2007 | 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. |
| KIRBY NICKERSON | Individual | CORPORATE OFFICER | 0 | 10/1/2012 | 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. |
| DOUGLAS E NELSON | 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. | 9/1/2022 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| KAREN MADDRY | Individual | MANAGING CONTROL - GOVERNING BODY | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 4/30/2007 | 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. |
| KIRBY NICKERSON | 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. | 10/1/2012 | 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. |
| RICHARD HERMAN | 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. | 6/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| TED W GOINS | 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. | 10/1/2004 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| CHRISTOPHER M HERMAN | 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. | 6/20/2023 | 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. |
| KESHA L SMITH | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 10/1/2012 | 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. |
| KIRBY NICKERSON | 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. | 6/25/2012 | 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. |
| LOGAN WILMOUTH | 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. | 6/24/2023 | 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. |
| LSA MANAGEMENT, 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. | 7/29/2004 | Private equity company: No Real estate investment trust: No Holding company: No |
| LUTHERAN HOME WINSTON SALEM PROPERTY 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. | 7/18/2006 | Private equity company: No Real estate investment trust: No Holding company: No |
| TED W GOINS | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 10/1/2004 | 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. |
| DOUGLAS E NELSON | 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. | 9/1/2022 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| KIRBY NICKERSON | 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. | 10/1/2012 | 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. |
| LUTHERAN SERVICES FOR THE AGING, INC. | Organization | 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. | 10/1/2004 | Private equity company: No Real estate investment trust: No Holding company: No |
| RICHARD HERMAN | 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. | 6/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| TED W GOINS | 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. | 10/1/2004 | 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: KESHA L SMITH 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: KESHA L SMITH no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: KESHA L SMITH no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: KESHA L SMITH appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: KESHA L SMITH appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: KESHA L SMITH appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2025: KAREN MADDRY no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: BETTY LOHR no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: ERIC HOYLE no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: TED W GOINS no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: TED W GOINS no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: KESHA L SMITH no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: KESHA L SMITH no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: CYNTHIA D MCCOY no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: LOGAN WILMOUTH appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: LOGAN WILMOUTH appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: LSA MANAGEMENT, INC. appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: KIRBY NICKERSON appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: KIRBY NICKERSON appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: KIRBY NICKERSON appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: KIRBY NICKERSON appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: LUTHERAN SERVICES FOR THE AGING, INC. appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: KAREN MADDRY appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: LUTHERAN HOME WINSTON SALEM PROPERTY INC. appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: LUTHERAN HOME WINSTON SALEM PROPERTY INC. appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: DOUGLAS E NELSON appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: DOUGLAS E NELSON appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: CHRISTOPHER M HERMAN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: CHRISTOPHER M HERMAN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: TED W GOINS appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: TED W GOINS appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: TED W GOINS appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: RICHARD HERMAN appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: RICHARD HERMAN appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: KESHA L SMITH appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: KESHA L SMITH appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: KESHA L SMITH appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
Recent changes on this record
- 1 July 2026: KESHA L SMITH 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: KESHA L SMITH no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: KESHA L SMITH no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: KESHA L SMITH appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: KESHA L SMITH appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: KESHA L SMITH appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 10 October 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- 1 July 2025: KAREN MADDRY no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: BETTY LOHR no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: ERIC HOYLE no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: TED W GOINS no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: TED W GOINS no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: KESHA L SMITH no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: KESHA L SMITH no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: CYNTHIA D MCCOY no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: LOGAN WILMOUTH appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: LOGAN WILMOUTH appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: LSA MANAGEMENT, INC. appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: KIRBY NICKERSON appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: KIRBY NICKERSON appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: KIRBY NICKERSON appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: KIRBY NICKERSON appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: LUTHERAN SERVICES FOR THE AGING, INC. appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: KAREN MADDRY appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: LUTHERAN HOME WINSTON SALEM PROPERTY INC. appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: LUTHERAN HOME WINSTON SALEM PROPERTY INC. appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: DOUGLAS E NELSON appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: DOUGLAS E NELSON appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: CHRISTOPHER M HERMAN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: CHRISTOPHER M HERMAN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: TED W GOINS appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: TED W GOINS appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: TED W GOINS appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: RICHARD HERMAN appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: RICHARD HERMAN appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: KESHA L SMITH appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: KESHA L SMITH appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: KESHA L SMITH appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 6 February 2025: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- 24 January 2024: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | 2 April 2026 | 2 April 2026 | 2 | 1 |
| 2 | 24 January 2025 | 31 August 2023 | 0 | 3 |
| 3 | 31 August 2023 | 30 March 2022 | 0 | 0 |
From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.
Deficiencies cited
2 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| 2 April 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. | D | Yes | Deficient, Provider has date of correction | 3 April 2026 |
| 2 April 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. | D | No | Deficient, Provider has date of correction | 21 April 2026 |
From the Care Compare health citations file NH_HealthCitations_Aug2026.csv, processed on 1 August 2026.
Penalties
Not yet extracted for this facility.
Care Compare provider information
| Field | As filed |
|---|---|
| Provider Type | Medicare and Medicaid |
| Ownership Type | Non profit - Corporation |
| Legal Business Name | LUTHERAN HOME-WINSTON-SALEM, INC. |
| Date First Approved to Provide Medicare and Medicaid Services | 1973-04-01 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | Y |
| County/Parish | Forsyth |
| Telephone Number | 3365952166 |
| Chain Name | LUTHERAN SERVICES CAROLINAS |
| Chain ID | 327 |
| 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 | 117 |
| Average Number of Residents per Day | 107.0 |
| Overall Rating | 4 |
| Health Inspection Rating | 4 |
| 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 Trinity Glen: 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: KESHA L SMITH no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. That is one line of the alert.
What the alerts are, and what a day of them looks like, is on the alerts page.
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The citable document for Trinity Glen
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 North Carolina at the same fiscal year, listed by name; every change on the record rather than the recent ones below; the inspection and staffing history in blocks of their own; and a citation block naming every CMS file it was read from.
Every figure on this page is printed as it appears in the CMS file named beside it. A figure that does not match its file? Tell us on the corrections page, quoting certification number 345088.