Skilled nursing facility · CMS certification number 365368
JAMESTOWN PLACE HEALTH AND REHAB
JAMESTOWN, Ohio · Medicare and Medicaid
Certified beds, as filed in Care Compare: 50
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 January 2024 to 31 December 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 29 August 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,489,731 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $70,693 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,419,038 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,867,613 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$448,575 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,512 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$447,063 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$447,063 (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 | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 18,300 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 433 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 2,428 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 10,132 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 12,993 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 7 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 15 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 79 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 101 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 61.86 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 161.87 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 128.64 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1437612, read from the public cost report file SNF10FY2024.zip.
Fiscal year 2023, ended 31 December 2023
Cost report for 1 January 2023 to 31 December 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 23 July 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,812,822 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $122,054 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,690,768 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,635,749 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $55,019 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $163,865 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $218,884 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $218,884 (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 | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 15,081 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 132 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 20.24 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 159.67 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 114.25 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1390093, read from the public cost report file SNF10FY2023.zip.
Fiscal year 2022, ended 31 December 2022
Cost report for 1 January 2022 to 31 December 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 8 August 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,150,345 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,070,686 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,079,659 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,232,594 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$152,935 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $161,299 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $8,364 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $8,364 (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 | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 14,607 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 114 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 55 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 165.62 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 128.13 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1361371, read from the public cost report file SNF10FY2022.zip.
Fiscal year 2021, ended 31 December 2021
Cost report for 1 January 2021 to 31 December 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 29 December 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,790,367 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,349,085 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,441,282 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,001,802 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$560,520 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $150,433 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$410,087 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$410,087 (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 | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 12,453 | 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 | 40.75 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 167.77 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 135.36 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1339199, read from the public cost report file SNF10FY2021.zip.
Fiscal year 2020, ended 31 December 2020
Cost report for 1 January 2020 to 31 December 2020 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 29 July 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,116,644 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,483,540 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,633,104 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,855,904 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$222,800 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $300,431 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $77,631 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $77,631 (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 | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 13,021 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 75 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 63.25 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 222.67 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 173.61 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1291020, read from the public cost report file SNF10FY2020.zip.
Fiscal year 2019, ended 31 December 2019
Cost report for 1 January 2019 to 31 December 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 15 April 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,783,362 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,021,692 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,761,670 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,552,883 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $208,787 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $612 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $209,399 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $209,399 (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 | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 14,509 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 109 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 42.85 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 163.64 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 133.11 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1253878, read from the public cost report file SNF10FY2019.zip.
Fiscal year 2018, ended 31 December 2018
Cost report for 1 May 2018 to 31 December 2018 — a reporting period of 244 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 18 July 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,826,603 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,273,451 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,553,152 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,547,116 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $6,036 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | $6,036 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $6,036 (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 | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 9,703 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 57 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 43.27 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 94.7 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 170.23 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1237469, read from the public cost report file SNF10FY2018.zip.
Fiscal year 2017, ended 31 December 2017
Cost report for 1 January 2017 to 31 December 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 21 August 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,761,219 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $699,687 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,061,532 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,695,518 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $366,014 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | $366,014 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $366,014 (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 | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 15,207 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 89 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 39.75 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,135 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 170.87 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1207684, read from the public cost report file SNF10FY2017.zip.
Fiscal year 2016, ended 31 December 2016
Cost report for 1 January 2016 to 31 December 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 9 November 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,684,794 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $696,371 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,988,423 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,793,040 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $195,383 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | $195,383 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $195,383 (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 | 43 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 15,041 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 100 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 46.28 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 385 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 150.41 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1178133, read from the public cost report file SNF10FY2016.zip.
Fiscal year 2015, ended 30 September 2015
Cost report for 1 January 2015 to 30 September 2015 — a reporting period of 272 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 20 October 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,877,159 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $460,384 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,416,775 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,198,261 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $218,514 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $7,292 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $225,806 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $225,806 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 56 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 9,618 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 80 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 28.86 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 462.69 | 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 1145251, read from the public cost report file SNF10FY2015.zip.
Fiscal year 2014, ended 31 December 2014
Cost report for 1 January 2014 to 31 December 2014 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 25 February 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,579,393 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $510,762 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,068,631 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,054,885 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $13,746 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $10,413 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $24,159 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $24,159 (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 | 56 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 12,476 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 119 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 33.81 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 266.38 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 104.84 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1119503, read from the public cost report file SNF10FY2014.zip.
Fiscal year 2013, ended 31 December 2013
Cost report for 1 January 2013 to 31 December 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 12 March 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,397,850 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $374,645 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,023,205 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,059,586 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$36,381 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $10,411 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$25,970 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$25,970 (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 | 56 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 12,603 | 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 | 44.14 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 339.68 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 136.99 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1087012, read from the public cost report file SNF10FY2013.zip.
Fiscal year 2012, ended 31 December 2012
Cost report for 1 January 2012 to 31 December 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 27 January 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,049,716 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $569,662 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,480,054 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,283,771 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $196,283 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $12,346 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $208,629 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $208,629 (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 | 56 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 15,507 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 144 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 23.05 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 188.55 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 107.69 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1054548, read from the public cost report file SNF10FY2012.zip.
Fiscal year 2011, ended 31 December 2011
Cost report for 1 January 2011 to 31 December 2011 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 9 May 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,990,132 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $426,537 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,563,595 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,381,566 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $182,029 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $14,129 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $196,158 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $196,158 (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 | 56 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,484 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 113 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 37.94 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 287.1 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 145.88 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1028821, read from the public cost report file SNF10FY2011.zip.
Fiscal year 2010, ended 31 December 2010
Cost report for 1 January 2010 to 31 December 2010 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 24 September 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,539,827 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,531,384 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $8,443 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $17,872 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $26,315 (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 | 100 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 17,561 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 92 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 50.54 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 342.76 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 190.88 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 432369, read from the public cost report file SNFFY2010.zip.
Fiscal year 2009, ended 31 December 2009
Cost report for 1 January 2009 to 31 December 2009 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 17 September 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,508,498 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,470,079 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $38,419 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $19,472 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $57,891 (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 | 100 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 17,611 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 109 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 48.9 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 370 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 161.57 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 387914, read from the public cost report file SNFFY2009.zip.
Fiscal year 2008, ended 31 December 2008
Cost report for 1 January 2008 to 31 December 2008 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 4 November 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,732,345 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,515,504 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $216,841 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $17,598 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $234,439 (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 | 100 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 19,783 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 109 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 45.88 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 315.22 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 181.5 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 358617, read from the public cost report file SNFFY2008.zip.
Fiscal year 2007, ended 31 December 2007
Cost report for 1 January 2007 to 31 December 2007 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 20 January 2009.
None of these figures is carried on this report.
CMS report record 332313, read from the public cost report file SNFFY2007.zip.
Fiscal year 2006, ended 31 December 2006
Cost report for 1 January 2006 to 31 December 2006 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 5 March 2008.
None of these figures is carried on this report.
CMS report record 303700, read from the public cost report file SNFFY2006.zip.
Fiscal year 2005, ended 31 December 2005
Cost report for 1 January 2005 to 31 December 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 25 January 2007.
None of these figures is carried on this report.
CMS report record 271068, read from the public cost report file SNFFY2005.zip.
Fiscal year 2004, ended 31 December 2004
Cost report for 1 January 2004 to 31 December 2004 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 23 January 2006.
None of these figures is carried on this report.
CMS report record 241025, read from the public cost report file SNFFY2004.zip.
Fiscal year 2003, ended 31 December 2003
Cost report for 1 January 2003 to 31 December 2003 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 20 January 2005.
None of these figures is carried on this report.
CMS report record 204481, read from the public cost report file SNFFY2003.zip.
Fiscal year 2002, ended 31 December 2002
Cost report for 1 January 2002 to 31 December 2002 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 6 January 2004.
None of these figures is carried on this report.
CMS report record 166406, read from the public cost report file SNFFY2002.zip.
Fiscal year 2001, ended 31 December 2001
Cost report for 1 July 2001 to 31 December 2001 — a reporting period of 183 days, not a full year, on form CMS-2540-96, settled, processed by CMS on 7 April 2003.
None of these figures is carried on this report.
CMS report record 138989, read from the public cost report file SNFFY2001.zip.
Fiscal year 2000, ended 31 December 2000
Cost report for 1 January 2000 to 31 December 2000 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 28 February 2002.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,086,899 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,162,609 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$75,710 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $18,890 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$56,820 (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 | 100 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 19,983 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 64 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 65.13 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 505.11 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 312.23 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 45444, read from the public cost report file SNFFY2000.zip.
Fiscal year 1999, ended 31 December 1999
Cost report for 1 January 1999 to 31 December 1999 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 3 May 2001.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,165,304 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,108,427 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $56,877 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $23,042 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $79,919 (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 | 100 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 22,363 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 82 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 31.54 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 654.96 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 272.72 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 45442, read from the public cost report file SNFFY1999.zip.
Fiscal year 1998, ended 31 December 1998
Cost report for 1 January 1998 to 31 December 1998 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 1 March 2000.
Net income, stated at moderate confidence: $89,064 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
CMS report record 45440, read from the public cost report file SNFFY1998.zip.
Fiscal year 1997, ended 31 December 1997
Cost report for 1 January 1997 to 31 December 1997 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 30 November 1998.
Net income, stated at moderate confidence: $72,405 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
CMS report record 45438, read from the public cost report file SNFFY1997.zip.
Fiscal year 1996, ended 31 December 1996
Cost report for 1 January 1996 to 31 December 1996 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 1 April 1998.
Net income, stated at moderate confidence: $139,658 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
CMS report record 45437, read from the public cost report file SNFFY1996.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 |
|---|---|---|---|---|
| FLYER 5 OPERATIONS HOLDINGS LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | 100% | since 09/29/2022 |
| ACM ASHEM HOLDINGS, LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | Organization | NO PERCENTAGE PROVIDED | since 09/29/2022 |
| FLYER 5 HOLDINGS LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | Organization | NO PERCENTAGE PROVIDED | since 09/29/2022 |
| FTK FLYER OH, LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | Organization | NO PERCENTAGE PROVIDED | since 09/29/2022 |
| ZANZIPER FAMILY TRUST | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | Organization | NO PERCENTAGE PROVIDED | since 09/29/2022 |
| JAMESTOWN PLACE PROPERTY LLC | 5% OR GREATER MORTGAGE INTEREST | Organization | NOT APPLICABLE | since 09/29/2022 |
| ACM ASHEM HOLDINGS, LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 09/29/2022 |
| CITRIN COOPERMAN ADVISORS LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 09/29/2022 |
| CRAGER, MARK | ADP OF THE SNF | Individual | NOT APPLICABLE | since 01/02/2025 |
| FASTEN HALBERSTAM LLP | ADP OF THE SNF | Organization | NOT APPLICABLE | since 09/29/2022 |
| FLYER 5 HOLDINGS LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 09/29/2022 |
| FTK FLYER OH, LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 09/29/2022 |
| GALE HEALTHCARE SOLUTIONS LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 09/29/2022 |
| HARRISON, QUIANA | ADP OF THE SNF | Individual | NOT APPLICABLE | since 08/15/2024 |
| MED-NET COMPLIANCE LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 11/01/2018 |
| NPNH1 LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 09/29/2022 |
| OVATION REHABILITATION SERVICES LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 09/29/2022 |
| SHS KEREN LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 09/29/2022 |
| THE PAVILION MANAGMENT COMPANY LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 09/29/2022 |
| VERACITY RESOURCING AND SERVICES LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 09/29/2022 |
| ZANZIPER FAMILY TRUST | ADP OF THE SNF | Organization | NOT APPLICABLE | since 09/29/2022 |
| ZANZIPER, NAFTALI | ADP OF THE SNF | Individual | NOT APPLICABLE | since 09/29/2022 |
| BIRNBAUM, EZRA | INDIRECT OWNERSHIP INTEREST | Individual | NOT APPLICABLE | since 09/29/2022 |
| HIRSCH, SHAYE | INDIRECT OWNERSHIP INTEREST | Individual | NOT APPLICABLE | since 09/29/2022 |
| MOERMAN, RAFAEL | INDIRECT OWNERSHIP INTEREST | Individual | NOT APPLICABLE | since 09/29/2022 |
| SINGER, SIMON | INDIRECT OWNERSHIP INTEREST | Individual | NOT APPLICABLE | since 09/29/2022 |
| ZANZIPER, NATALIE | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | Individual | NOT APPLICABLE | since 03/26/2025 |
| HARRISON, QUIANA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 08/15/2024 |
| KRIESER, AKIVA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 09/29/2022 |
| MOERMAN, RAFAEL | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 09/29/2022 |
Medicare enrollment
As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of CT OHIO JAMESTOWN LLC (enrollment ID O20180712002951).
| Owner | Individual or organization | Role | Ownership percentage | Association date | Described in the filing as |
|---|---|---|---|---|---|
| FLYER 5 OPERATIONS HOLDINGS LLC | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100 | 9/29/2022 | Private equity company: No Real estate investment trust: No Holding company: Yes |
| ACM ASHEM HOLDINGS, LLC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 50 | 9/29/2022 | Private equity company: No Real estate investment trust: No Holding company: Yes |
| FLYER 5 HOLDINGS LLC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100 | 9/29/2022 | Private equity company: No Real estate investment trust: No Holding company: Yes |
| FTK FLYER OH, LLC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 15 | 9/29/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| NAFTALI ZANZIPER | Individual | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 7.5 | 9/29/2022 | 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. |
| NPNH1 LLC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 15 | 9/29/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| SHS KEREN LLC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 5 | 9/29/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| ZANZIPER FAMILY TRUST | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 7.5 | 9/29/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| JAMESTOWN PLACE PROPERTY LLC | Organization | 5% OR GREATER MORTGAGE INTEREST | 100 | 9/29/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| ACM ASHEM HOLDINGS, 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. | 9/29/2022 | Private equity company: No Real estate investment trust: No Holding company: Yes |
| CITRIN COOPERMAN ADVISORS 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. | 9/29/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| FASTEN HALBERSTAM LLP | 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. | 9/29/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| FLYER 5 HOLDINGS 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. | 9/29/2022 | Private equity company: No Real estate investment trust: No Holding company: Yes |
| FTK FLYER OH, 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. | 9/29/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| GALE HEALTHCARE SOLUTIONS 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. | 9/29/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| MARK A. CRAGER | 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. | 1/2/2025 | 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. |
| MED-NET COMPLIANCE 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. | 11/1/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| NAFTALI ZANZIPER | 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. | 9/29/2022 | 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. |
| NPNH1 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. | 9/29/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| OVATION REHABILITATION SERVICES 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. | 9/29/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| QUIANA HARRISON | 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. | 8/15/2024 | 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. |
| SHS KEREN 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. | 9/29/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| THE PAVILION MANAGMENT COMPANY 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. | 9/29/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| VERACITY RESOURCING AND SERVICES 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. | 9/29/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| ZANZIPER FAMILY TRUST | 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. | 9/29/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| EZRA BIRNBAUM | Individual | INDIRECT OWNERSHIP INTEREST | 15 | 9/29/2022 | 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. |
| RAFAEL MOERMAN | Individual | INDIRECT OWNERSHIP INTEREST | 50 | 9/29/2022 | 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. |
| SHAYE HIRSCH | Individual | INDIRECT OWNERSHIP INTEREST | 5 | 9/29/2022 | 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. |
| SIMON SINGER | Individual | INDIRECT OWNERSHIP INTEREST | 15 | 9/29/2022 | 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. |
| AKIVA KRIESER | 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. | 9/29/2022 | 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. |
| QUIANA HARRISON | 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. | 8/15/2024 | 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. |
| RAFAEL MOERMAN | 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. | 9/29/2022 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
Changes in ownership
- 1 July 2026: THE PAVILION MANAGMENT COMPANY LLC 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: THE PAVILION MANAGMENT COMPANY LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2025: RAFAEL MOERMAN no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: RAFAEL MOERMAN no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: JAMESTOWN PLACE PROPERTY LLC appears as 5% OR GREATER MORTGAGE INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: SHS KEREN LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: OVATION REHABILITATION SERVICES LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: FASTEN HALBERSTAM LLP appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: QUIANA HARRISON appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: QUIANA HARRISON appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: MED-NET COMPLIANCE LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: RAFAEL MOERMAN appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: CITRIN COOPERMAN ADVISORS appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: SHAYE HIRSCH appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: NAFTALI ZANZIPER appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: AKIVA KRIESER appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: FLYER 5 HOLDINGS LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: ZANZIPER FAMILY TRUST appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: ZANZIPER FAMILY TRUST appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: SIMON SINGER appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: ACM HASHEM HOLDINGS, LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: VERACITY RESOURCING AND SERVICES LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: MARK A. CRAGER appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: EZRA BIRNBAUM appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: FTK FLYER OH, LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: NPNH1 LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: GALE HEALTHCARE SOLUTIONS LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: THE PAVILION MANAGMENT COMPANY LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 15 March 2023: MELISSA L GREEN no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- 15 March 2023: MELISSA L GREEN no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- 15 March 2023: TRIO HEALTHCARE HOLDINGS LLC no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- 15 March 2023: DAVID RUBENSTEIN no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- 15 March 2023: DAVID RUBENSTEIN no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- 15 March 2023: TRIO HEALTHCARE LLC no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- 15 March 2023: HOKE RICH no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- 15 March 2023: CT TRIO OHIO HOLDINGS, LLC no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- 15 March 2023: BOYD P GENTRY no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- 15 March 2023: BOYD P GENTRY no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- 15 March 2023: MARYANNE LAVIGNE no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- 15 March 2023: TRIO HEALTHCARE INVESTORS LLC no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- 15 March 2023: SHS KEREN LLC appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- 15 March 2023: RAFAEL MOERMAN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- 15 March 2023: RAFAEL MOERMAN appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- 15 March 2023: RAFAEL MOERMAN appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- 15 March 2023: NAFTALI ZANZIPER appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- 15 March 2023: FLYER 5 HOLDINGS LLC appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- 15 March 2023: ACM HASHEM HOLDINGS, LLC appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- 15 March 2023: FLYER 5 OPERATIONS HOLDINGS LLC appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- 15 March 2023: FTK FLYER OH, LLC appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- 15 March 2023: NPNH1 LLC appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
Recent changes on this record
- 1 July 2026: THE PAVILION MANAGMENT COMPANY LLC 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: THE PAVILION MANAGMENT COMPANY LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 29 August 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- 1 July 2025: RAFAEL MOERMAN no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: RAFAEL MOERMAN no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: JAMESTOWN PLACE PROPERTY LLC appears as 5% OR GREATER MORTGAGE INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: SHS KEREN LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: OVATION REHABILITATION SERVICES LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: FASTEN HALBERSTAM LLP appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: QUIANA HARRISON appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: QUIANA HARRISON appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: MED-NET COMPLIANCE LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: RAFAEL MOERMAN appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: CITRIN COOPERMAN ADVISORS appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: SHAYE HIRSCH appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: NAFTALI ZANZIPER appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: AKIVA KRIESER appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: FLYER 5 HOLDINGS LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: ZANZIPER FAMILY TRUST appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: ZANZIPER FAMILY TRUST appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: SIMON SINGER appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: ACM HASHEM HOLDINGS, LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: VERACITY RESOURCING AND SERVICES LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: MARK A. CRAGER appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: EZRA BIRNBAUM appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: FTK FLYER OH, LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: NPNH1 LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: GALE HEALTHCARE SOLUTIONS LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 1 July 2025: THE PAVILION MANAGMENT COMPANY LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-07-01.csv
- 23 July 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- 8 August 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- 15 March 2023: MELISSA L GREEN no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- 15 March 2023: MELISSA L GREEN no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- 15 March 2023: TRIO HEALTHCARE HOLDINGS LLC no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- 15 March 2023: DAVID RUBENSTEIN no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- 15 March 2023: DAVID RUBENSTEIN no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- 15 March 2023: TRIO HEALTHCARE LLC no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- 15 March 2023: HOKE RICH no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- 15 March 2023: CT TRIO OHIO HOLDINGS, LLC no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
- 15 March 2023: BOYD P GENTRY no longer appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-03-15.csv
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | 27 January 2026 | 27 January 2026 | 31 | 7 |
| 2 | 4 October 2022 | 4 October 2022 | 7 | 11 |
| 3 | 5 September 2019 | 5 September 2019 | 5 | 3 |
From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.
Deficiencies cited
43 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| 27 January 2026 | Health | F 0580 | Resident Rights Deficiencies | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | D | No | Deficient, Provider has date of correction | 4 March 2026 |
| 27 January 2026 | Health | F 0607 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | D | No | Deficient, Provider has date of correction | 4 March 2026 |
| 27 January 2026 | Health | F 0609 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | No | Deficient, Provider has date of correction | 4 March 2026 |
| 27 January 2026 | Health | F 0610 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Respond appropriately to all alleged violations. | D | No | Deficient, Provider has date of correction | 4 March 2026 |
| 27 January 2026 | Health | F 0628 | Resident Rights Deficiencies | Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. | D | No | Deficient, Provider has date of correction | 4 March 2026 |
| 27 January 2026 | Health | F 0637 | Resident Assessment and Care Planning Deficiencies | Assess the resident when there is a significant change in condition | D | No | Deficient, Provider has date of correction | 4 March 2026 |
| 27 January 2026 | Health | F 0638 | Resident Assessment and Care Planning Deficiencies | Assure that each resident’s assessment is updated at least once every 3 months. | E | No | Deficient, Provider has date of correction | 4 March 2026 |
| 27 January 2026 | Health | F 0656 | Resident Assessment and Care Planning Deficiencies | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | No | Deficient, Provider has date of correction | 4 March 2026 |
| 27 January 2026 | 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. | E | No | Deficient, Provider has date of correction | 4 March 2026 |
| 27 January 2026 | Health | F 0684 | Quality of Life and Care Deficiencies | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | No | Deficient, Provider has date of correction | 4 March 2026 |
| 27 January 2026 | Health | F 0686 | Quality of Life and Care Deficiencies | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | No | Deficient, Provider has date of correction | 4 March 2026 |
| 27 January 2026 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | E | No | Deficient, Provider has date of correction | 4 March 2026 |
| 27 January 2026 | Health | F 0692 | Quality of Life and Care Deficiencies | Provide enough food/fluids to maintain a resident's health. | D | No | Deficient, Provider has date of correction | 4 March 2026 |
| 27 January 2026 | Health | F 0698 | Quality of Life and Care Deficiencies | Provide safe, appropriate dialysis care/services for a resident who requires such services. | D | No | Deficient, Provider has date of correction | 4 March 2026 |
| 27 January 2026 | 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 | 4 March 2026 |
| 27 January 2026 | Health | F 0759 | Pharmacy Service Deficiencies | Ensure medication error rates are not 5 percent or greater. | D | No | Deficient, Provider has date of correction | 4 March 2026 |
| 27 January 2026 | Health | F 0773 | Administration Deficiencies | Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results. | D | No | Deficient, Provider has date of correction | 4 March 2026 |
| 27 January 2026 | Health | F 0791 | Quality of Life and Care Deficiencies | Provide or obtain dental services for each resident. | D | No | Deficient, Provider has date of correction | 4 March 2026 |
| 27 January 2026 | Health | F 0808 | Nutrition and Dietary Deficiencies | Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law. | D | No | Deficient, Provider has date of correction | 4 March 2026 |
| 27 January 2026 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | E | No | Deficient, Provider has date of correction | 4 March 2026 |
| 27 January 2026 | Health | F 0887 | Infection Control Deficiencies | Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status. | D | No | Deficient, Provider has date of correction | 4 March 2026 |
| 3 November 2025 | Health | F 0921 | Environmental Deficiencies | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | F | Yes | Deficient, Provider has date of correction | 10 December 2025 |
| 18 September 2025 | Health | F 0557 | Resident Rights Deficiencies | Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. | D | Yes | Deficient, Provider has date of correction | 10 December 2025 |
| 18 September 2025 | Health | F 0565 | Resident Rights Deficiencies | Honor the resident's right to organize and participate in resident/family groups in the facility. | D | Yes | Deficient, Provider has date of correction | 10 December 2025 |
| 18 September 2025 | Health | F 0584 | Resident Rights Deficiencies | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | E | Yes | Deficient, Provider has date of correction | 10 December 2025 |
| 18 September 2025 | Health | F 0609 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Yes | Deficient, Provider has date of correction | 10 December 2025 |
| 18 September 2025 | Health | F 0677 | Quality of Life and Care Deficiencies | Provide care and assistance to perform activities of daily living for any resident who is unable. | E | Yes | Deficient, Provider has date of correction | 10 December 2025 |
| 18 September 2025 | Health | F 0679 | Quality of Life and Care Deficiencies | Provide activities to meet all resident's needs. | D | Yes | Deficient, Provider has date of correction | 10 December 2025 |
| 18 September 2025 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Yes | Past Non-Compliance | 10 September 2025 |
| 18 September 2025 | Health | F 0692 | Quality of Life and Care Deficiencies | Provide enough food/fluids to maintain a resident's health. | E | Yes | Deficient, Provider has date of correction | 10 December 2025 |
| 18 September 2025 | Health | F 0725 | Nursing and Physician Services Deficiencies | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | D | Yes | Deficient, Provider has date of correction | 10 December 2025 |
| 4 October 2022 | Health | F 0578 | Resident Rights Deficiencies | Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | D | No | Deficient, Provider has date of correction | 2 November 2022 |
| 4 October 2022 | Health | F 0582 | Resident Rights Deficiencies | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | D | No | Deficient, Provider has date of correction | 2 November 2022 |
| 4 October 2022 | Health | F 0656 | Resident Assessment and Care Planning Deficiencies | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | No | Deficient, Provider has date of correction | 2 November 2022 |
| 4 October 2022 | Health | F 0657 | Resident Assessment and Care Planning Deficiencies | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | No | Deficient, Provider has date of correction | 2 November 2022 |
| 4 October 2022 | Health | F 0677 | Quality of Life and Care Deficiencies | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | No | Deficient, Provider has date of correction | 2 November 2022 |
| 4 October 2022 | Health | F 0692 | Quality of Life and Care Deficiencies | Provide enough food/fluids to maintain a resident's health. | D | No | Deficient, Provider has date of correction | 2 November 2022 |
| 4 October 2022 | Health | F 0882 | Infection Control Deficiencies | Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. | F | No | Deficient, Provider has date of correction | 2 November 2022 |
| 5 September 2019 | Health | F 0550 | Resident Rights Deficiencies | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | No | Deficient, Provider has date of correction | 24 September 2019 |
| 5 September 2019 | Health | F 0569 | Resident Rights Deficiencies | Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death. | D | No | Deficient, Provider has date of correction | 24 September 2019 |
| 5 September 2019 | Health | F 0655 | Resident Assessment and Care Planning Deficiencies | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | D | No | Deficient, Provider has date of correction | 24 September 2019 |
| 5 September 2019 | Health | F 0687 | Quality of Life and Care Deficiencies | Provide appropriate foot care. | D | No | Deficient, Provider has date of correction | 24 September 2019 |
| 5 September 2019 | Health | F 0693 | Quality of Life and Care Deficiencies | Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. | D | No | Deficient, Provider has date of correction | 24 September 2019 |
From the Care Compare health citations file NH_HealthCitations_Aug2026.csv, processed on 1 August 2026.
Penalties
Not yet extracted for this facility.
Care Compare provider information
| Field | As filed |
|---|---|
| Provider Type | Medicare and Medicaid |
| Ownership Type | For profit - Limited Liability company |
| Legal Business Name | CT OHIO JAMESTOWN LLC |
| Date First Approved to Provide Medicare and Medicaid Services | 1977-11-01 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | Y |
| County/Parish | Greene |
| Telephone Number | 9376753311 |
| Chain Name | SIMCHA HYMAN & NAFTALI ZANZIPER |
| Chain ID | 580 |
| 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 | 50 |
| Average Number of Residents per Day | 31.4 |
| Overall Rating | 2 |
| Health Inspection Rating | 1 |
| QM Rating | 5 |
| Long-Stay QM Rating | 5 |
| Processing Date | 2026-08-01 |
From the Care Compare Provider Information file NH_ProviderInfo_Aug2026.csv, processed on 1 August 2026.
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