Facility record report · CMS certification number 355113
EVANGELICAL LUTHERAN GOOD SAM SOC
ARTHUR, North Dakota
This certification number is not in CMS’s current Care Compare Provider Information file, processed on 1 August 2026.
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 2016 to 30 June 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 24 January 2018.
None of these figures is carried on this report.
CMS report record 1182676, read from the public cost report file SNF10FY2016.zip.
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 | $3,612,428 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $356,795 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,255,633 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,990,722 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$735,089 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $103,651 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$631,438 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$659,182 (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 | 62 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,653 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 97 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 49.75 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 192.18 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 171.68 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1148661, read from the public cost report file SNF10FY2015.zip.
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 16 October 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,527,367 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $187,530 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,339,837 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,670,891 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$331,054 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $288,307 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$42,747 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$77,543 (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 | 62 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 18,544 | 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 | 48.25 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 846.57 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 686.81 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1111655, read from the public cost report file SNF10FY2014.zip.
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 21 November 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,907,592 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $349,382 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,558,210 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,812,815 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$254,605 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $556,484 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $301,879 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $250,104 (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 | 62 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,111 | 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 | 115.4 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 289.3 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 478.83 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1080781, read from the public cost report file SNF10FY2013.zip.
Cost report for 1 July 2012 to 30 June 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 27 January 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,441,952 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $109,899 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,332,053 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,535,673 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$203,620 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $428,797 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $225,177 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $186,300 (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 | 62 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,391 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 52 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 40.11 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 372.69 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 392.13 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1053836, read from the public cost report file SNF10FY2012.zip.
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 27 November 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,730,627 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $265,677 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,464,950 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,785,371 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$320,421 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $395,748 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $75,327 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $36,398 (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 | 62 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,705 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 38.9 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 475.09 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 414.1 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1020910, read from the public cost report file SNF10FY2011.zip.
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 28 November 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,133,812 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,377,731 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$243,919 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $384,566 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $90,869 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: $49,778 (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 | 73 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 19,179 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 68 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 57.1 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 202.33 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 282.04 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 420656, read from the public cost report file SNFFY2010.zip.
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 3 February 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,035,563 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,444,453 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$408,890 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $324,372 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $41,484 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: −$126,002 (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 | 67 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 19,411 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 78 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 29.35 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 277.39 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 248.86 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 393580, read from the public cost report file SNFFY2009.zip.
Cost report for 1 July 2008 to 30 June 2009 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 30 November 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,196,105 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,552,213 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$356,108 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | −$10,123 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $43,094 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: −$409,325 (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 | 67 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,452 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 88 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 25.44 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 234.66 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 232.41 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 359683, read from the public cost report file SNFFY2008.zip.
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 21 November 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,349,411 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,617,591 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$268,180 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $251,910 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $36,457 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: −$52,727 (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 | 67 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 23,231 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 51 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 30.94 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 893.36 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 455.51 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 328656, read from the public cost report file SNFFY2007.zip.
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 2 February 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,078,699 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,498,489 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$419,790 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $488,407 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $35,453 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: $33,164 (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 | 67 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 22,044 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 35 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 115 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 815.82 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 629.83 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 301612, read from the public cost report file SNFFY2006.zip.
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 24 January 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,104,922 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,508,255 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$403,333 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $509,963 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $5,783 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: $100,847 (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 | 67 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 22,463 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 51 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 78.1 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 631.31 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 440.45 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 299876, read from the public cost report file SNFFY2005.zip.
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 12 July 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,849,878 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,200,265 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$350,387 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $316,689 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $7,500 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: −$41,198 (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 | 67 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,572 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 65 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 68.33 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 541.63 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 316.49 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 258320, read from the public cost report file SNFFY2004.zip.
Cost report for 1 July 2003 to 30 June 2004 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 4 November 2005.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,775,820 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,191,134 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$415,314 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $534,862 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $21,550 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: $97,998 (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 | 79 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 19,216 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 84 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 59.47 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 405.83 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 228.76 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 236174, read from the public cost report file SNFFY2003.zip.
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 18 November 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,202,962 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,427,742 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$224,780 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $250,023 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $15,350 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: $9,893 (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 | 83 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 22,609 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 117 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 52.75 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 456.71 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 193.24 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 199925, read from the public cost report file SNFFY2002.zip.
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 28 July 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,211,321 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,363,620 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$152,299 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $34,286 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$118,013 (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 | 73 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 23,141 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 83 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 63.95 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 875.94 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 278.81 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 155116, read from the public cost report file SNFFY2001.zip.
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 18 March 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,964,677 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,255,514 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$290,837 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $168,212 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$122,625 (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 | 90 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 23,755 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 25 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 49.18 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 3,170.2 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 950.2 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 133381, read from the public cost report file SNFFY2000.zip.
Cost report for 1 July 1999 to 30 June 2000 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 18 March 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,163,706 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,311,832 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$148,126 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $253,679 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $105,553 (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 | 121 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 37,903 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 91 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 90.69 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 890.74 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 416.52 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 133296, read from the public cost report file SNFFY1999.zip.
Cost report for 1 July 1998 to 30 June 1999 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 16 July 2001.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,076,154 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,118,473 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$42,319 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $174,123 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $131,804 (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 | 90 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 29,613 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 123 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 108.71 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 240.76 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 1722, read from the public cost report file SNFFY1998.zip.
Cost report for 1 July 1997 to 30 June 1998 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 16 October 2000.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,031,629 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,021,095 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $10,534 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $222,849 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $233,383 (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 | 90 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 30,512 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 117 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 30.41 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 747.08 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 260.79 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 1721, read from the public cost report file SNFFY1997.zip.
Five facilities of a similar size in North Dakota, fiscal year 2017
No other facility in North Dakota has a cost report on file for fiscal year 2017 with a bed count to set beside this one.
Ownership, as filed with CMS
Care Compare
Not yet extracted for this facility.
Medicare enrollment
Not yet extracted for this facility.
Changes in ownership
Not yet extracted for this facility.
Inspections
Not yet extracted for this facility.
Deficiencies cited
Not yet extracted for this facility.
Penalties
Not yet extracted for this facility.
Care Compare provider information
Not yet extracted for this facility.
Every change on this record
- 24 January 2018: 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
- 16 October 2015: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2014.zip
- 21 November 2014: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2013.zip
- 27 January 2014: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2012.zip
- 27 November 2012: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2011.zip
- 28 November 2011: A cost report was filed for fiscal year 2011, on form CMS-2540-96. SNFFY2010.zip
- 3 February 2011: A cost report was filed for fiscal year 2010, on form CMS-2540-96. SNFFY2009.zip
- 30 November 2009: A cost report was filed for fiscal year 2009, on form CMS-2540-96. SNFFY2008.zip
- 21 November 2008: A cost report was filed for fiscal year 2008, on form CMS-2540-96. SNFFY2007.zip
- 2 February 2008: A cost report was filed for fiscal year 2007, on form CMS-2540-96. SNFFY2006.zip
- 24 January 2008: A cost report was filed for fiscal year 2006, on form CMS-2540-96. SNFFY2005.zip
- 12 July 2006: A cost report was filed for fiscal year 2005, on form CMS-2540-96. SNFFY2004.zip
- 4 November 2005: A cost report was filed for fiscal year 2004, on form CMS-2540-96. SNFFY2003.zip
- 18 November 2004: A cost report was filed for fiscal year 2003, on form CMS-2540-96. SNFFY2002.zip
- 28 July 2003: A cost report was filed for fiscal year 2002, on form CMS-2540-96. SNFFY2001.zip
- 18 March 2003: A cost report was filed for fiscal year 2001, on form CMS-2540-96. SNFFY2000.zip
- 18 March 2003: A cost report was filed for fiscal year 2000, on form CMS-2540-96. SNFFY1999.zip
- 16 July 2001: A cost report was filed for fiscal year 1999, on form CMS-2540-96. SNFFY1998.zip
- 16 October 2000: A cost report was filed for fiscal year 1998, on form CMS-2540-96. SNFFY1997.zip
How to read this report
Every figure is printed as the CMS file it came from printed it. Each cost-report figure carries the worksheet, line and column of form CMS-2540 it was read from, so a reader holding the same public file can go to that cell; each Care Compare and Medicare enrollment section names its file and the date CMS stamped on it.
A figure the filing does not carry is left out, and so is a figure whose value the filing’s own arithmetic contradicts. Net income is printed with what the form’s own arithmetic shows about it — plainly where it follows from the lines above it, and, where it does not, beside what the form’s own lines leave unaccounted for. An ownership field left empty carries the dated sentence on CMS’s pause of the expanded Form CMS-855A disclosure. A source that holds nothing for this facility says so in its section.
This report carries no percentile and no score, and it does not place this facility above or below another. The five facilities above are the one comparison it draws: the nearest certified bed counts in the same state at the same fiscal year, listed by name. Nurse staffing is printed in its own section, on its own page, apart from the cost-report figures.
How to cite this report
Velarion Records, EVANGELICAL LUTHERAN GOOD SAM SOC — facility record report, CMS certification number 355113. https://velarionrecords.com/facility/355113/report.
- Cost report figures: CMS Healthcare Cost Report Information System, form CMS-2540-10, publication year 2016, file
SNF10FY2016.zip. - Provider information, inspections, deficiencies and penalties: CMS Care Compare, file dated 1 August 2026.
- Care Compare ownership: CMS file dated 1 August 2026.
- Medicare enrollment ownership: CMS file dated 1 August 2026.
Published by VELARIONAI LLC · Andrew Richardson, founder. Corrections: hello@velarionrecords.com, quoting certification number 355113. Velarion Records publishes these records as filed.
Nurse staffing, quarter by quarter
Hours this facility reported to CMS’s Payroll-Based Journal, one row per quarter, oldest first, each with how its figures are derived and the file it came from.
Not yet extracted for this facility.