Skilled nursing facility · CMS certification number 355050
Maple Manor Care Center
LANGDON, North Dakota · Medicare and Medicaid
Certified beds, as filed in Care Compare: 45
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 6 March 2026.
None of these figures is carried on this report.
CMS report record 1448364, 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 23 January 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,744,171 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $6,857 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,737,314 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,002,284 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,264,970 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $307,815 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$957,155 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$957,155 (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 | 49 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 13,636 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 23 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 79.17 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 522.91 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 592.87 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1402590, 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 January 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,523,352 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$18,338 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,541,690 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,618,855 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,077,165 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,493,078 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $415,913 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $415,913 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 54 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,333 | 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 | 77.6 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 531.8 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 418.79 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1372210, 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 20 December 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,903,507 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$21,658 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,925,165 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,709,911 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$784,746 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $828,418 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $43,672 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $43,672 (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 | 49 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 14,968 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 27 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 51.55 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,087.88 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 554.37 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1338650, 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 4 February 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,287,968 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$86,650 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,374,618 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,042,184 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$667,566 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,117,649 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $450,083 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $450,083 (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 | 49 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 15,075 | 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 | 86.5 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,548.2 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 579.81 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1309949, 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 3 March 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,360,698 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$805,675 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,166,373 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,053,483 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$887,110 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $203,949 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$683,161 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$683,161 (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 | 58 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,144 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 34 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 359 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,267 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 474.82 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1280821, 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 27 January 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,929,120 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$879,484 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,808,604 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,145,412 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$336,808 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $524,958 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $188,150 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $188,150 (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 | 63 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,094 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 53 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 77.83 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 753.09 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 379.13 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1249926, 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 26 October 2018.
None of these figures is carried on this report.
CMS report record 1213338, 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 November 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,709,551 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$817,756 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,527,307 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,778,157 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$250,850 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $139,488 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$111,362 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$111,362 (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 | 63 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,552 | 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 | 65.69 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,082.14 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 630.71 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1178830, 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 14 December 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,120,078 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$404,018 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,524,096 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,468,765 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $55,331 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $119,018 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $174,349 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$81,416 (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 | 57 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,332 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 42 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 96.12 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 798.11 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 460.29 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1148649, 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 20 January 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,486,999 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$703,614 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,190,613 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,407,235 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$216,622 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $387,125 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $170,503 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$66,149 (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 | 57 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 18,478 | 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 | 456.5 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 737.2 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 596.06 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1117190, 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.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,728,364 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$707,231 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,435,595 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,232,357 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $203,238 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $414,901 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $618,139 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $397,373 (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 | 63 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 18,909 | 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 | 84.91 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,265 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 609.97 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1084002, 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 3 March 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,814,062 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$680,396 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,494,458 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,435,095 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $59,363 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $367,043 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $426,406 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $426,406 (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 | 63 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,460 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 33 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 80.56 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 813.8 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 589.7 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1056262, read from the public cost report file SNF10FY2012.zip.
Fiscal year 2012, ended 30 June 2012
Cost report for 1 July 2011 to 30 June 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 24 January 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,029,708 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $285,608 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,744,100 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,754,306 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,010,206 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $395,947 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$614,259 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$716,817 (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 | 63 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,446 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 42 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 71.5 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,855.8 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 463 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1024069, read from the public cost report file SNF10FY2011.zip.
Fiscal year 2011, ended 30 June 2011
Cost report for 1 July 2010 to 30 June 2011 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 18 January 2012.
None of these figures is carried on this report.
CMS report record 423235, 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 23 January 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,592,107 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,518,840 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $73,267 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $348,825 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $422,092 (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 | 63 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 21,567 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 33 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 90.06 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 870.11 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 653.55 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 393000, 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 8 February 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,140,015 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,912,511 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $227,504 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $88,487 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $211,383 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: $104,608 (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 | 63 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,746 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 32 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 69.08 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 889.88 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 648.31 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 363646, 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 26 January 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,078,442 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,028,718 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $49,724 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $98,264 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $147,988 (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 | 63 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,746 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 45 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 64.29 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 740.22 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 461.02 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 332616, 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.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,274,239 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,026,971 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $247,268 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $200,916 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $448,184 (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 | 63 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 21,844 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 77 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 81.71 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,658 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 283.69 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 300713, 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 18 September 2007.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,061,327 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,069,595 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$8,268 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $102,646 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $94,378 (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 | 63 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 22,233 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 31 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 42.77 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 717.19 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 293952, 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 21 November 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,087,059 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,061,833 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $25,226 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $96,902 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $122,128 (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 | 63 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 22,531 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 33 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 101.71 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 2,093.75 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 682.76 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 266799, 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 19 October 2005.
None of these figures is carried on this report.
CMS report record 235061, read from the public cost report file SNFFY2003.zip.
Fiscal year 2003, ended 30 June 2003
Cost report for 1 July 2002 to 30 June 2003 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 24 November 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,707,342 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,805,646 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$98,304 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $202,876 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $104,572 (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 | 63 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 22,957 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 21 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 45.17 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,257.5 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 1,093.19 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 200583, read from the public cost report file SNFFY2002.zip.
Fiscal year 2002, ended 30 June 2002
Cost report for 1 July 2001 to 30 June 2002 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 1 September 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 63 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 22,739 | 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 | 69.24 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 886 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 614.57 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 191362, read from the public cost report file SNFFY2001.zip.
Fiscal year 2001, ended 30 June 2001
Cost report for 1 July 2000 to 30 June 2001 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 7 April 2003.
None of these figures is carried on this report.
CMS report record 139271, read from the public cost report file SNFFY2000.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 |
|---|---|---|---|---|
| BROOKS, WILLIAM | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 01/01/2014 |
| BUNN, DAWN | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 07/01/2021 |
| JORDAN, CHARLES | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 01/01/2014 |
| BUNN, DAWN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 07/01/2022 |
| BRAATEN, JOHN | W-2 MANAGING EMPLOYEE | Individual | NOT APPLICABLE | since 07/01/2021 |
| HAKANSON, MEGAN | W-2 MANAGING EMPLOYEE | Individual | NOT APPLICABLE | since 07/01/2022 |
Medicare enrollment
As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of MAPLE MANOR CARE CENTER (enrollment ID O20080818000024).
| Owner | Individual or organization | Role | Ownership percentage | Association date | Described in the filing as |
|---|---|---|---|---|---|
| CHARLES JORDAN | Individual | CORPORATE OFFICER | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2014 | 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. |
| DAWN BUNN | Individual | CORPORATE OFFICER | 100 | 7/1/2021 | 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. |
| WILLIAM BROOKS | Individual | CORPORATE OFFICER | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2014 | 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. |
| DAWN BUNN | Individual | OPERATIONAL/MANAGERIAL CONTROL | 100 | 7/1/2022 | 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. |
| JOHN BRAATEN | Individual | W-2 MANAGING EMPLOYEE | 0 | 7/1/2021 | 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. |
| MEGAN HAKANSON | Individual | W-2 MANAGING EMPLOYEE | 0 | 7/1/2022 | 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. |
Changes in ownership
- 1 June 2025: ADRIAN OLSON no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- 15 February 2023: JASON CARLSON no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-02-15.csv
- 15 February 2023: JASON CARLSON no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-02-15.csv
- 15 February 2023: MEGAN HAKANSON appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-02-15.csv
- 15 February 2023: DAWN BUNN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-02-15.csv
- 15 February 2023: DAWN BUNN appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-02-15.csv
Recent changes on this record
- 6 March 2026: A cost report was filed for fiscal year 2025, on form CMS-2540-10. SNF10FY2024.zip
- 1 June 2025: ADRIAN OLSON no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
- 23 January 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2023.zip
- 18 January 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2022.zip
- 15 February 2023: JASON CARLSON no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-02-15.csv
- 15 February 2023: JASON CARLSON no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-02-15.csv
- 15 February 2023: MEGAN HAKANSON appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-02-15.csv
- 15 February 2023: DAWN BUNN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-02-15.csv
- 15 February 2023: DAWN BUNN appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-02-15.csv
- 20 December 2022: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2021.zip
- 4 February 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2020.zip
- 3 March 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2019.zip
- 27 January 2020: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2018.zip
- 26 October 2018: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2017.zip
- 23 November 2017: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2016.zip
- 14 December 2016: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2015.zip
- 20 January 2016: 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
- 3 March 2014: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2012.zip
- 24 January 2013: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2011.zip
- 18 January 2012: A cost report was filed for fiscal year 2011, on form CMS-2540-96. SNFFY2010.zip
- 23 January 2011: A cost report was filed for fiscal year 2010, on form CMS-2540-96. SNFFY2009.zip
- 8 February 2010: A cost report was filed for fiscal year 2009, on form CMS-2540-96. SNFFY2008.zip
- 26 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
- 18 September 2007: A cost report was filed for fiscal year 2006, on form CMS-2540-96. SNFFY2005.zip
- 21 November 2006: A cost report was filed for fiscal year 2005, on form CMS-2540-96. SNFFY2004.zip
- 19 October 2005: A cost report was filed for fiscal year 2004, on form CMS-2540-96. SNFFY2003.zip
- 24 November 2004: A cost report was filed for fiscal year 2003, on form CMS-2540-96. SNFFY2002.zip
- 1 September 2004: A cost report was filed for fiscal year 2002, on form CMS-2540-96. SNFFY2001.zip
- 7 April 2003: A cost report was filed for fiscal year 2001, on form CMS-2540-96. SNFFY2000.zip
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | 10 September 2025 | 10 September 2025 | 9 | 0 |
| 2 | 10 July 2024 | 10 July 2024 | 6 | 0 |
| 3 | 9 August 2023 | 9 August 2023 | 9 | 0 |
From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.
Deficiencies cited
24 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| 10 September 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 | Yes | Deficient, Provider has date of correction | 24 October 2025 |
| 10 September 2025 | Health | F 0658 | Resident Assessment and Care Planning Deficiencies | Ensure services provided by the nursing facility meet professional standards of quality. | D | Yes | Deficient, Provider has date of correction | 24 October 2025 |
| 10 September 2025 | Health | F 0688 | Quality of Life and Care Deficiencies | Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | D | No | Deficient, Provider has date of correction | 24 October 2025 |
| 10 September 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 | Yes | Deficient, Provider has date of correction | 24 October 2025 |
| 10 September 2025 | Health | F 0697 | Quality of Life and Care Deficiencies | Provide safe, appropriate pain management for a resident who requires such services. | G | Yes | Deficient, Provider has date of correction | 24 October 2025 |
| 10 September 2025 | Health | F 0801 | Nutrition and Dietary Deficiencies | Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician. | F | No | Deficient, Provider has date of correction | 24 October 2025 |
| 10 September 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. | E | Yes | Deficient, Provider has date of correction | 24 October 2025 |
| 10 September 2025 | Health | F 0868 | Administration Deficiencies | Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | F | No | Deficient, Provider has date of correction | 24 October 2025 |
| 10 September 2025 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | E | Yes | Deficient, Provider has date of correction | 24 October 2025 |
| 10 July 2024 | Health | F 0550 | Resident Rights Deficiencies | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | No | Deficient, Provider has date of correction | 20 August 2024 |
| 10 July 2024 | Health | F 0658 | Resident Assessment and Care Planning Deficiencies | Ensure services provided by the nursing facility meet professional standards of quality. | D | No | Deficient, Provider has date of correction | 20 August 2024 |
| 10 July 2024 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | No | Deficient, Provider has date of correction | 20 August 2024 |
| 10 July 2024 | Health | F 0690 | Quality of Life and Care Deficiencies | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | D | No | Deficient, Provider has date of correction | 20 August 2024 |
| 10 July 2024 | Health | F 0804 | Nutrition and Dietary Deficiencies | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | No | Deficient, Provider has date of correction | 20 August 2024 |
| 10 July 2024 | Health | F 0812 | Nutrition and Dietary Deficiencies | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | No | Deficient, Provider has date of correction | 20 August 2024 |
| 9 August 2023 | Health | F 0582 | Resident Rights Deficiencies | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | D | Yes | Deficient, Provider has date of correction | 22 September 2023 |
| 9 August 2023 | Health | F 0623 | Resident Rights Deficiencies | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | D | Yes | Deficient, Provider has date of correction | 22 September 2023 |
| 9 August 2023 | Health | F 0641 | Resident Assessment and Care Planning Deficiencies | Ensure each resident receives an accurate assessment. | D | Yes | Deficient, Provider has date of correction | 22 September 2023 |
| 9 August 2023 | Health | F 0644 | Resident Assessment and Care Planning Deficiencies | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | D | Yes | Deficient, Provider has date of correction | 22 September 2023 |
| 9 August 2023 | 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 | Yes | Deficient, Provider has date of correction | 22 September 2023 |
| 9 August 2023 | Health | F 0756 | Pharmacy Service Deficiencies | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | D | Yes | Deficient, Provider has date of correction | 22 September 2023 |
| 9 August 2023 | Health | F 0758 | Pharmacy Service Deficiencies | Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | D | Yes | Deficient, Provider has date of correction | 22 September 2023 |
| 9 August 2023 | Health | F 0868 | Administration Deficiencies | Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | D | Yes | Deficient, Provider has date of correction | 22 September 2023 |
| 9 August 2023 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | Yes | Deficient, Provider has date of correction | 22 September 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 |
|---|---|---|---|---|---|
| 9 September 2025 | Fine | $31,694 | 136249 |
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 | MAPLE MANOR CARE CENTER |
| Date First Approved to Provide Medicare and Medicaid Services | 1978-06-01 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | N |
| County/Parish | Cavalier |
| Telephone Number | 7012562987 |
| 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 | 45 |
| Average Number of Residents per Day | 36.2 |
| Overall Rating | 1 |
| Health Inspection Rating | 2 |
| QM Rating | 2 |
| Long-Stay QM Rating | 2 |
| Processing Date | 2026-08-01 |
From the Care Compare Provider Information file NH_ProviderInfo_Aug2026.csv, processed on 1 August 2026.
Get an email when this record changes
One email a day naming what moved on Maple Manor Care Center: the field, the value before, the value after, and the date of the file that first showed it.
The facility alert follows this one record: a cost report filed or a figure on one changed, an inspection, a deficiency or a penalty recorded, an owner added or removed. The certification number arrives filled in.
On 6 March 2026: A cost report was filed for fiscal year 2025, on form CMS-2540-10. That is one line of the alert.
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The citable document for Maple Manor Care Center
This page shows the record as it stands today. The report is the citable document: the same figures with the cell each came from, and beyond this page — five facilities of a similar size in North Dakota 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 355050.