Skilled nursing facility · CMS certification number 355125
GOOD SAMARITAN SOCIETY AUGUSTA PLACE A PROSPERA CO
BISMARCK, North Dakota · Medicare and Medicaid
Certified beds, as filed in Care Compare: 48
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 22 December 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $9,983,760 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,308,072 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $8,675,688 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,462,108 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $213,580 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $109,018 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $322,598 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $421,769 (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 | 82 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 29,930 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 923 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 10,228 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 12,693 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 23,844 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 21 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 46 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 64 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 131 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 43.95 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 222.35 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 182.02 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1445233, 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 4 February 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $9,888,786 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,394,213 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $8,494,573 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,078,673 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $415,900 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $325,175 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $741,075 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $628,373 (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 | 82 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 28,064 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 146 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 70 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 207.55 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 192.22 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1403137, 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 15 February 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $9,351,417 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,538,079 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,813,338 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,567,761 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $245,577 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $536,426 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $782,003 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $720,200 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 82 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 22,363 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 186 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 37.98 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 199.75 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 120.23 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1373437, 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 15 February 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,997,150 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,342,883 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,654,267 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,364,437 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $289,830 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $65,327 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $355,157 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $487,896 (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 | 82 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 24,464 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 148 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 49.14 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 300.78 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 165.3 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1342485, 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 3 March 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,237,208 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $678,385 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,558,823 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,980,037 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $578,786 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $158,228 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $737,014 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $482,430 (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 | 82 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 26,474 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 64 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 72.88 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 410.97 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 413.66 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1311257, 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 5 March 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,365,682 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $779,249 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,586,433 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,208,780 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $377,653 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $103,675 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $481,328 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $366,506 (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 | 82 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 27,990 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 103 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 49.03 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 212.26 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 271.75 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1280957, 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 16 January 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,382,954 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $959,245 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,423,709 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,372,296 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $51,413 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $116,337 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $167,750 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $54,431 (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 | 82 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 27,796 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 200 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 47.48 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 317.64 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 138.98 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1249145, 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 30 November 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,473,217 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,198,506 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,274,711 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,548,514 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$273,803 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $54,791 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$219,012 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$425,430 (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 | 82 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 27,515 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 177 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 50.73 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 128.71 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 155.45 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1214643, read from the public cost report file SNF10FY2017.zip.
Fiscal year 2017, ended 30 June 2017
Cost report for 1 January 2017 to 30 June 2017 — a reporting period of 180 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 31 October 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,189,223 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $607,974 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,581,249 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,791,007 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$209,758 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $8,836 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$200,922 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$276,611 (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 | 82 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 13,739 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 35 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 44 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,733 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 392.54 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1177671, read from the public cost report file SNF10FY2017.zip.
Fiscal year 2016, ended 31 December 2016
Cost report for 1 July 2016 to 31 December 2016 — a reporting period of 183 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 21 August 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,287,996 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $514,781 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,773,215 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,757,187 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $16,028 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $10,960 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $26,988 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$5,690 (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 | 80 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 14,494 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 60 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 81.8 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 311.35 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 241.57 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1174264, read from the public cost report file SNF10FY2016.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 15 October 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,544,586 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,284,242 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,260,344 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,119,396 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$859,052 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $88,523 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$770,529 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$816,759 (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 | 80 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 27,631 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 92 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 54.26 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 512.88 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 300.34 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1111361, 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 | $6,694,364 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $813,570 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,880,794 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,544,886 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$664,092 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $86,068 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$578,024 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$648,227 (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 | 82 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 27,802 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 81 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 50.73 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 426.26 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 343.23 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1084253, 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 27 January 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,501,947 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $628,188 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,873,759 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,052,323 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$178,564 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $108,446 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$70,118 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$96,988 (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 | 80 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 28,534 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 60 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 57.5 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 507.18 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 475.57 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1053837, 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 | $6,235,503 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $581,500 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,654,003 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,347,189 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$693,186 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $82,991 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$610,195 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$674,186 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 80 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 27,927 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 54 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 51.81 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 711.33 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 517.17 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1022981, read from the public cost report file SNF10FY2011.zip.
Fiscal year 2011, ended 30 June 2011
Cost report for 9 June 2010 to 30 June 2011 — a reporting period of 386 days, on form CMS-2540-96, settled, processed by CMS on 12 March 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,362,244 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,797,652 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$1,435,408 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $96,916 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | −$3,824 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: −$1,334,668 (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 | 80 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 21,716 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 40 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 227 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 748.86 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 542.9 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 425903, read from the public cost report file SNFFY2010.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 |
|---|---|---|---|---|
| SANFORD | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | NO PERCENTAGE PROVIDED | since 01/01/2019 |
| THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | NO PERCENTAGE PROVIDED | since 01/01/2019 |
| THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | Organization | 100% | since 01/01/2019 |
| AL RABADI, ISSA | ADP OF THE SNF | Individual | NOT APPLICABLE | since 12/01/2021 |
| BROWN, GEORGE | ADP OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2025 |
| DTN STAFFING INC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 08/02/2024 |
| DYKHOUSE, DANA | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/30/2024 |
| ENGBRECHT, WESLEY | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/30/2024 |
| FLUIT, JOEL | ADP OF THE SNF | Individual | NOT APPLICABLE | since 10/01/2022 |
| FOCUSONE SOLUTIONS | ADP OF THE SNF | Organization | NOT APPLICABLE | since 03/04/2024 |
| GASSEN, WILLIAM | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/30/2024 |
| GRAPE TREE MEDICAL STAFFING LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 04/13/2018 |
| GULSVIG, NEIL | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/30/2024 |
| HERSETH SANDLIN, STEPHANIE | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/30/2024 |
| LUNDEEN, MARK | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/30/2024 |
| MCCAUSLAND, MAUREEN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2025 |
| MIDDLETON, AIMEE | ADP OF THE SNF | Individual | NOT APPLICABLE | since 01/27/2022 |
| MOLBERT, LAURIS | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/30/2024 |
| MORRISON, TONY | ADP OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2019 |
| NORTH, ANDREW | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/30/2024 |
| OLSON, NICHOLAS | ADP OF THE SNF | Individual | NOT APPLICABLE | since 04/08/2024 |
| SANDGREN, DEEANDRA | ADP OF THE SNF | Individual | NOT APPLICABLE | since 07/16/2023 |
| SANFORD | ADP OF THE SNF | Organization | NOT APPLICABLE | since 01/01/2019 |
| SCHEMA, NATHAN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2022 |
| SCHIEFFER, KEVIN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2025 |
| SHULKIN, DAVID | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/30/2024 |
| TEIKEN, BRENT | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/30/2024 |
| THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | ADP OF THE SNF | Organization | NOT APPLICABLE | since 01/01/2019 |
| TROY, PETER | ADP OF THE SNF | Individual | NOT APPLICABLE | since 08/08/2022 |
| VENTLING-HERRMANN, MARNIE | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/30/2024 |
| WENZEL, THOMAS | ADP OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2025 |
| BROWN, GEORGE | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 01/01/2025 |
| DYKHOUSE, DANA | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| ENGBRECHT, WESLEY | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| GASSEN, WILLIAM | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| GULSVIG, NEIL | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| HERSETH SANDLIN, STEPHANIE | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| LUNDEEN, MARK | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| MCCAUSLAND, MAUREEN | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 01/01/2025 |
| MOLBERT, LAURIS | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| NORTH, ANDREW | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| SCHIEFFER, KEVIN | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 01/01/2025 |
| SHULKIN, DAVID | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| TEIKEN, BRENT | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| VENTLING-HERRMANN, MARNIE | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 05/30/2024 |
| WENZEL, THOMAS | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 01/01/2025 |
| FLUIT, JOEL | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 10/01/2022 |
| GASSEN, WILLIAM | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 05/30/2024 |
| MIDDLETON, AIMEE | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 01/27/2022 |
| OLSON, NICHOLAS | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 04/08/2024 |
| SCHEMA, NATHAN | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 01/01/2022 |
| FLUIT, JOEL | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | Individual | NOT APPLICABLE | since 11/25/2025 |
| AL RABADI, ISSA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 12/01/2021 |
| MORRISON, TONY | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 01/01/2019 |
| SANDGREN, DEEANDRA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 07/16/2023 |
| TROY, PETER | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 08/08/2022 |
Medicare enrollment
As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (enrollment ID O20200629003641).
| Owner | Individual or organization | Role | Ownership percentage | Association date | Described in the filing as |
|---|---|---|---|---|---|
| SANFORD | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100 | 1/1/2019 | Private equity company: No Real estate investment trust: No Holding company: No |
| THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100 | 1/1/2019 | Private equity company: No Real estate investment trust: No Holding company: No |
| THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100 | 1/1/2019 | Private equity company: No Real estate investment trust: No Holding company: No |
| AIMEE NICOLE MIDDLETON | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/27/2022 | 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. |
| ANDREW STEWART NORTH | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/30/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| BRENT GERARD TEIKEN | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/30/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| DANA JAMES DYKHOUSE | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/30/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| DAVID JONATHAN SHULKIN | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/30/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| DEEANDRA DAWN SANDGREN | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 7/16/2023 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| DTN STAFFING INC | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 8/2/2024 | Private equity company: No Real estate investment trust: No Holding company: No |
| FOCUSONE SOLUTIONS | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 3/4/2024 | Private equity company: No Real estate investment trust: No Holding company: No |
| GEORGE JOSEPH BROWN | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2025 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| GRAPE TREE MEDICAL STAFFING LLC | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 4/13/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| ISSA Y AL RABADI | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 12/1/2021 | 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. |
| JOEL ADAM FLUIT | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 10/1/2022 | 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. |
| KEVIN VICTOR SCHIEFFER | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2025 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| LAURIS NELSON MOLBERT | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/30/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| MARK ALLEN LUNDEEN | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/30/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| MARNIE LYNN VENTLING-HERRMANN | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/30/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| MAUREEN PATRICIA MCCAUSLAND | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2025 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| NATHAN THOMAS SCHEMA | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2022 | 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. |
| NEIL LESLIE GULSVIG | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/30/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| NICHOLAS WAYNE OLSON | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 4/8/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| PETER TROY | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 8/8/2022 | 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. |
| SANFORD | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2019 | Private equity company: No Real estate investment trust: No Holding company: No |
| STEPHANIE MARIE HERSETH SANDLIN | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/30/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2019 | Private equity company: No Real estate investment trust: No Holding company: No |
| THOMAS RICHARD WENZEL | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2025 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| TONY LEE MORRISON | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2019 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| WESLEY OWEN ENGBRECHT | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/30/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| WILLIAM JOSEPH GASSEN | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/30/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 10/1/2017 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 10/1/2017 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 10/1/2017 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 10/1/2017 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 2/1/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 8/2/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 3/12/2018 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 4/14/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| ANDREW STEWART NORTH | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| BRENT GERARD TEIKEN | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| DANA JAMES DYKHOUSE | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| DAVID JONATHAN SHULKIN | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| GEORGE JOSEPH BROWN | Individual | CORPORATE DIRECTOR | 0 | 1/1/2025 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| KEVIN VICTOR SCHIEFFER | Individual | CORPORATE DIRECTOR | 0 | 1/1/2025 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| LAURIS NELSON MOLBERT | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| MARK ALLEN LUNDEEN | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| MARNIE LYNN VENTLING-HERRMANN | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| MAUREEN PATRICIA MCCAUSLAND | Individual | CORPORATE DIRECTOR | 0 | 1/1/2025 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| NEIL LESLIE GULSVIG | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| STEPHANIE MARIE HERSETH SANDLIN | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| THOMAS RICHARD WENZEL | Individual | CORPORATE DIRECTOR | 0 | 1/1/2025 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| WESLEY OWEN ENGBRECHT | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| WILLIAM JOSEPH GASSEN | Individual | CORPORATE DIRECTOR | 0 | 5/30/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| AIMEE NICOLE MIDDLETON | Individual | CORPORATE OFFICER | 0 | 1/27/2022 | 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. |
| JOEL ADAM FLUIT | Individual | CORPORATE OFFICER | 0 | 10/1/2022 | 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. |
| NATHAN THOMAS SCHEMA | Individual | CORPORATE OFFICER | 0 | 1/1/2022 | 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. |
| NICHOLAS WAYNE OLSON | Individual | CORPORATE OFFICER | 0 | 4/8/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| WILLIAM JOSEPH GASSEN | Individual | CORPORATE OFFICER | 0 | 5/30/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| DEEANDRA DAWN SANDGREN | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 7/16/2023 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| ISSA Y AL RABADI | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 12/1/2021 | 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. |
| PETER TROY | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 8/8/2022 | 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. |
| TONY LEE MORRISON | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2019 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
Changes in ownership
- 1 July 2026: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: MARK ALLEN LUNDEEN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: MARK ALLEN LUNDEEN appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: A listing under ADP OF THE SNF no longer appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: MARK ALLEN LUNDEEN no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: MARK ALLEN LUNDEEN no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 January 2026: MICHAEL ROGERS no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: PETER TROY no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: ISSA Y AL RABADI no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: JAMES EDWARD CAIN no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: TONY LEE MORRISON no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: TONY LEE MORRISON appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: NICHOLAS WAYNE OLSON appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: LAURIS NELSON MOLBERT appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: KEVIN VICTOR SCHIEFFER appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: KEVIN VICTOR SCHIEFFER appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: NEIL LESLIE GULSVIG appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: DEEANDRA DAWN SANDGREN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: DEEANDRA DAWN SANDGREN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: DAVID JONATHAN SHULKIN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: THOMAS RICHARD WENZEL appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: THOMAS RICHARD WENZEL appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: NATHAN THOMAS SCHEMA appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: SANFORD appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: MAUREEN PATRICIA MCCAUSLAND appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: MAUREEN PATRICIA MCCAUSLAND appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: WESLEY OWEN ENGBRECHT appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: GEORGE JOSEPH BROWN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: GEORGE JOSEPH BROWN appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: WILLIAM JOSEPH GASSEN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: GRAPE TREE MEDICAL STAFFING, LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: STEPHANIE MARIE HERSETH SANDLIN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: AIMEE NICOLE MIDDLETON appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: ANDREW STEWART NORTH appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: DTN STAFFING INC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: DANA JAMES DYKHOUSE appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: JOEL ADAM FLUIT appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: BRENT GERARD TEIKEN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: FOCUSONE SOLUTIONS appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: PETER TROY appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: PETER TROY appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: ISSA Y AL RABADI appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: ISSA Y AL RABADI appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: TONY LEE MORRISON appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: MARNIE LYNN VENTLING-HERRMANN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: MARK ALLEN LUNDEEN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 September 2024: DEAN LOUIS BRESCIANI no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: THOMAS PHILLIP KOOP no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: MATTHEW RYAN HOCKS no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: SANFORD no longer appears as OTHER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: AIMEE NICOLE MIDDLETON no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: SCOTT CHARLES PETERSEN no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: TONY LEE MORRISON no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: DARRELL EVAN SCHMITH no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: LINDA OLAYINKA NORMAN no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: SCOTT WOOTEN no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: SCOTT WOOTEN no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: DAVID AUSTAD no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: HELEN ISABELLA MELLAND no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: MARNIE LYNN VENTLING-HERRMANN appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: NICHOLAS WAYNE OLSON appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: LAURIS NELSON MOLBERT appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: NEIL LESLIE GULSVIG appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: DAVID JONATHAN SHULKIN appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: SANFORD appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: WESLEY OWEN ENGBRECHT appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: WILLIAM JOSEPH GASSEN appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: WILLIAM JOSEPH GASSEN appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: STEPHANIE MARIE HERSETH SANDLIN appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: ANDREW STEWART NORTH appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: DANA JAMES DYKHOUSE appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: BRENT GERARD TEIKEN appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: PETER TROY appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: ISSA Y AL RABADI appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: JAMES EDWARD CAIN appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 September 2024: MARK ALLEN LUNDEEN appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-09-01.csv
- 1 May 2024: MICHAEL ROGERS no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-05-01.csv
- 1 May 2024: WILLIAM D MARLETTE no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-05-01.csv
- 1 May 2024: WILLIAM D MARLETTE no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-05-01.csv
- 1 May 2024: MICHAEL ROGERS appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-05-01.csv
- 1 May 2024: SCOTT WOOTEN appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-05-01.csv
- 1 May 2024: SCOTT WOOTEN appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-05-01.csv
- 1 March 2024: DAVID A BRECHTELSBAUER no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-03-01.csv
- 1 March 2024: TONY LEE MORRISON no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-03-01.csv
- 1 March 2024: TONY LEE MORRISON appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2024-03-01.csv
- 2 October 2023: KELBY K KRABBENHOFT no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: LISA MELBY no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: JOANN L KUNKEL no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: JOANN L KUNKEL no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: NORVAL BUCKNEBERG no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: JAVIER ESPINOSA no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: JILL SCHUMANN no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: CHAD JUNGMAN no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: ALAN GARD no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: ERIC VANDEN HULL no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: ERIC VANDEN HULL no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: MICHELLE MARIE MICKA no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: MICHELLE MARIE MICKA no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: STEPHANIE MARIE SWENSON no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: STEPHANIE MARIE SWENSON no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: PATRICIA CAMERO no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: JOLYN JOY MUNSON no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: JOLYN JOY MUNSON no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: RANDY BURY no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: RANDY BURY no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: KARIN LOUISE DULSKI no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: KARIN LOUISE DULSKI no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: MARNIE LYNN VENTLING-HERRMANN no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: DALE M THOMPSON no longer appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: DEAN LOUIS BRESCIANI appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: THOMAS PHILLIP KOOP appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: MATTHEW RYAN HOCKS appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: AIMEE NICOLE MIDDLETON appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: AIMEE NICOLE MIDDLETON appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: MICHAEL ROGERS appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: JOEL FLUIT appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: WILLIAM D MARLETTE appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: LINDA OLAYINKA NORMAN appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
- 2 October 2023: HELEN ISABELLA MELLAND appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-10-02.csv
Recent changes on this record
- 1 July 2026: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: MARK ALLEN LUNDEEN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: MARK ALLEN LUNDEEN appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: A listing under ADP OF THE SNF no longer appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: MARK ALLEN LUNDEEN no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: MARK ALLEN LUNDEEN no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 January 2026: MICHAEL ROGERS no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: PETER TROY no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: ISSA Y AL RABADI no longer appears as CONTRACTED MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: JAMES EDWARD CAIN no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: TONY LEE MORRISON no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: TONY LEE MORRISON appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: NICHOLAS WAYNE OLSON appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: LAURIS NELSON MOLBERT appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: KEVIN VICTOR SCHIEFFER appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: KEVIN VICTOR SCHIEFFER appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: NEIL LESLIE GULSVIG appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: DEEANDRA DAWN SANDGREN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: DEEANDRA DAWN SANDGREN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: DAVID JONATHAN SHULKIN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: THOMAS RICHARD WENZEL appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: THOMAS RICHARD WENZEL appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: NATHAN THOMAS SCHEMA appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: SANFORD appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: MAUREEN PATRICIA MCCAUSLAND appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: MAUREEN PATRICIA MCCAUSLAND appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: WESLEY OWEN ENGBRECHT appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: GEORGE JOSEPH BROWN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: GEORGE JOSEPH BROWN appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: WILLIAM JOSEPH GASSEN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: GRAPE TREE MEDICAL STAFFING, LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: STEPHANIE MARIE HERSETH SANDLIN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: AIMEE NICOLE MIDDLETON appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: ANDREW STEWART NORTH appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: DTN STAFFING INC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: DANA JAMES DYKHOUSE appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: JOEL ADAM FLUIT appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: BRENT GERARD TEIKEN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: FOCUSONE SOLUTIONS appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
- 1 January 2026: PETER TROY appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | 11 February 2026 | 11 February 2026 | 0 | 2 |
| 2 | 30 January 2025 | 30 January 2025 | 5 | 0 |
| 3 | 18 January 2024 | 18 January 2024 | 8 | 0 |
From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.
Deficiencies cited
13 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| 30 January 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 | 6 March 2025 |
| 30 January 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 | 6 March 2025 |
| 30 January 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 | 6 March 2025 |
| 30 January 2025 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | E | Yes | Deficient, Provider has date of correction | 6 March 2025 |
| 1 August 2024 | Health | F 0760 | Pharmacy Service Deficiencies | Ensure that residents are free from significant medication errors. | G | Yes | Past Non-Compliance | 31 July 2024 |
| 9 May 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. | G | Yes | Past Non-Compliance | 8 May 2024 |
| 18 January 2024 | Health | F 0641 | Resident Assessment and Care Planning Deficiencies | Ensure each resident receives an accurate assessment. | D | No | Deficient, Provider has date of correction | 22 February 2024 |
| 18 January 2024 | 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 | No | Deficient, Provider has date of correction | 22 February 2024 |
| 18 January 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 | 22 February 2024 |
| 18 January 2024 | Health | F 0757 | Pharmacy Service Deficiencies | Ensure each resident’s drug regimen must be free from unnecessary drugs. | D | No | Deficient, Provider has date of correction | 22 February 2024 |
| 18 January 2024 | Health | F 0761 | Pharmacy Service Deficiencies | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | No | Deficient, Provider has date of correction | 22 February 2024 |
| 18 January 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 | 22 February 2024 |
| 18 January 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. | D | No | Deficient, Provider has date of correction | 22 February 2024 |
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 |
|---|---|---|---|---|---|
| 1 August 2024 | Fine | $8,018 | 99650 | ||
| 9 May 2024 | Fine | $8,018 | 99662 |
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 | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY |
| Date First Approved to Provide Medicare and Medicaid Services | 2010-06-09 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | Y |
| County/Parish | Burleigh |
| Telephone Number | 7012551084 |
| Chain Name | GOOD SAMARITAN SOCIETY |
| Chain ID | 726 |
| 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 | 48 |
| Average Number of Residents per Day | 47.0 |
| Overall Rating | 5 |
| Health Inspection Rating | 4 |
| QM Rating | 3 |
| Long-Stay QM Rating | 3 |
| Short-Stay QM Rating | 4 |
| Processing Date | 2026-08-01 |
From the Care Compare Provider Information file NH_ProviderInfo_Aug2026.csv, processed on 1 August 2026.
Get an email when this record changes
One email a day naming what moved on GOOD SAMARITAN SOCIETY AUGUSTA PLACE A PROSPERA CO: the field, the value before, the value after, and the date of the file that first showed it.
The facility alert follows this one record: a cost report filed or a figure on one changed, an inspection, a deficiency or a penalty recorded, an owner added or removed. The certification number arrives filled in.
On 1 July 2026: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. That is one line of the alert.
What the alerts are, and what a day of them looks like, is on the alerts page.
Following a list of facilities? The portfolio watch follows up to 100 certification numbers you name, on one subscription — on the alerts page.
The citable document for GOOD SAMARITAN SOCIETY AUGUSTA PLACE A PROSPERA CO
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 355125.