Skilled nursing facility · CMS certification number 365417
COUNTRY CLUB CENTER I
DOVER, Ohio · Medicare and Medicaid
Certified beds, as filed in Care Compare: 72
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 17 November 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,246,374 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,750,792 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,495,582 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,955,700 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,460,118 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $3,284,053 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,823,935 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,823,935 (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 | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 26,352 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 886 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 15,145 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 4,220 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 20,251 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 37 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 142 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 31 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 210 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 23.95 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 106.65 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 96.43 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1442514, 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 22 May 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $9,461,459 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $3,001,503 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,459,956 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,882,606 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,422,650 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $2,011,634 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $588,984 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $588,984 (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 | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 21,797 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 208 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 33.39 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 139.31 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 104.79 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1424244, 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 16 January 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,144,482 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $3,215,786 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,928,696 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,323,586 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,394,890 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,706,608 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $311,718 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $311,718 (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 | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 23,968 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 282 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 36.9 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 92.39 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 84.99 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1371947, 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 22 May 2026.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,274,137 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $865,559 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,408,578 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,520,845 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $887,733 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $2,019,146 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $2,906,879 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $2,906,879 (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 | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,178 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 345 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 38.03 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 87.86 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 58.49 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1450014, 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 17 March 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,073,229 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $889,433 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,183,796 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,527,509 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $656,287 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,265,009 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,921,296 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,921,296 (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 | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,055 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 266 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 36.71 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 163.35 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 75.39 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1312430, 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 21 January 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,451,937 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,039,330 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,412,607 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,074,292 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $338,315 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $31,294 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $369,609 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $369,609 (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 | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 21,274 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 210 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 45.11 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 159.5 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 101.3 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1278762, read from the public cost report file SNF10FY2019.zip.
Fiscal year 2018, ended 31 December 2018
Cost report for 1 January 2018 to 31 December 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 26 September 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,285,818 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,633,045 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,652,773 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,085,773 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $567,000 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $51,427 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $618,427 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $618,427 (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 | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 22,491 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 514 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 43.72 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 63.49 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 43.76 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1243884, 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 | $7,233,126 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,336,915 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,896,211 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,174,002 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $722,209 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $37,571 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $759,780 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $759,780 (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 | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 23,019 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 228 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 39 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 166.92 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 100.96 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1207002, 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 16 November 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,017,135 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,702,090 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,315,045 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,577,422 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $737,623 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $91,891 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $829,514 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $829,514 (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 | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 24,630 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 221 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 45.04 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 183.91 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 111.45 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1178531, read from the public cost report file SNF10FY2016.zip.
Fiscal year 2015, ended 31 December 2015
Cost report for 1 January 2015 to 31 December 2015 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 2 March 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,057,145 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,457,560 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,599,585 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,625,495 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $974,090 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $54,829 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,028,919 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,028,919 (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 | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 22,405 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 189 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 33.79 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 414.46 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 118.54 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1153745, 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 31 March 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,858,606 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,115,678 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,742,928 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,355,130 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $387,798 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $44,880 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $432,678 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $432,678 (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 | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 18,882 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 145 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 40.05 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 547.59 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 130.22 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1121538, 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 20 February 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,994,301 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,190,660 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,803,641 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,465,459 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $338,182 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $94,887 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $433,069 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $433,069 (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 | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,243 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 207 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 45.02 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 125.82 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 92.96 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1086137, 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, as submitted, processed by CMS on 2 May 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,966,821 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,185,125 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,781,696 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,406,939 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $374,757 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $28,585 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $403,342 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $403,342 (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 | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,290 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 202 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 52.62 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 134.75 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 95.5 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1028509, 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 16 May 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,635,608 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,238,188 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,397,420 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,373,209 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $24,211 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $44,114 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $68,325 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $68,325 (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 | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,619 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 170 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 36.12 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 250.27 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 115.41 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1029464, 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 23 April 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,606,740 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,436,802 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $169,938 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $25,036 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $194,974 (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 | 72 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,312 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 257 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 27.68 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 207.38 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 79.04 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 428071, 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 7 March 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,571,357 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,682,673 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$111,316 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $58,401 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$52,915 (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 | 72 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 22,300 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 230 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 29.64 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 196.4 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 96.96 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 395108, 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 28 January 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,791,244 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,716,525 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $74,719 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $30,357 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $105,076 (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 | 72 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 23,260 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 274 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 35.57 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 181.58 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 84.89 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 363152, 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 24 November 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,329,987 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,339,016 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$9,029 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $18,355 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $9,326 (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 | 69 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 23,151 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 172 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 53.13 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 323 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 134.6 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 328712, 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 30 November 2007.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,093,424 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,128,553 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$35,129 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $10,741 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$24,388 (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 | 69 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 23,126 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 146 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 49.69 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 422.1 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 158.4 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 297232, 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 21 December 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,918,970 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,960,741 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$41,771 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $13,058 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$28,713 (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 | 69 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 23,659 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 117 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 56.77 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 319.2 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 202.21 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 269449, 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 5 December 2005.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,650,303 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,594,132 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $56,171 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $7,774 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $63,945 (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 | 29 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 23,844 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 104 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 67.8 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 363.65 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 229.27 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 238038, 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 8 February 2005.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,460,548 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,427,443 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $33,105 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $13,833 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $46,938 (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 | 68 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 24,427 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 115 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 54.46 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 442.83 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 212.41 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 206596, 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 28 May 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,335,765 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,231,476 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $104,289 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $7,503 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $111,792 (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 | 68 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 23,028 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 121 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 48.53 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 410.12 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 190.31 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 178716, read from the public cost report file SNFFY2002.zip.
Fiscal year 2001, ended 31 December 2001
Cost report for 1 January 2001 to 31 December 2001 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 7 May 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,126,634 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,929,071 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $197,563 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $28,335 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $225,898 (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 | 64 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 22,628 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 157 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 33.91 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 492.5 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 144.13 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 143482, 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 March 2002.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,768,275 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,653,820 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $114,455 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $24,223 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $138,678 (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 | 72 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 22,367 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 165 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 24.93 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 359.13 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 135.56 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 45695, 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 23 March 2001.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,499,345 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,501,472 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$2,127 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $11,508 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $9,381 (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 | 72 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 23,318 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 157 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 39.12 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 322.17 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 148.52 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 45693, 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 8 March 2000.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,324,868 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,355,976 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$31,108 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $90,665 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $59,557 (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 | 72 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 23,321 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 106 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 20.78 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,274.6 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 220.01 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 45691, 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 23 February 1999.
Net income, stated at moderate confidence: $11,020 (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 45689, 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 6 April 1998.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,308,638 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,234,453 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $74,185 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $17,745 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $91,930 (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 | 72 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 24,668 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 151 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 25.17 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 178.67 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 163.36 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 45688, 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 |
|---|---|---|---|---|
| HOLLAND, JOHN | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Individual | 50% | since 02/17/1976 |
| HARRIS, JANET | ADP OF THE SNF | Individual | NOT APPLICABLE | since 12/10/2024 |
| HOLLAND-GRESCOCK, TERESA | ADP OF THE SNF | Individual | NOT APPLICABLE | since 12/10/2024 |
| HOLLAND, JOHN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 12/10/2024 |
| LIEBER, PAUL | ADP OF THE SNF | Individual | NOT APPLICABLE | since 12/10/2024 |
| HARRIS, JANET | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 01/01/2008 |
| HARRIS, JANET | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 01/01/2008 |
| HOLLAND-GRESCOCK, TERESA | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 05/01/2002 |
| HOLLAND, JOHN | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 05/01/2002 |
| HOLLAND-GRESCOCK, TERESA | DIRECT OWNERSHIP INTEREST | Individual | NOT APPLICABLE | since 05/01/2002 |
| HARRIS, JANET | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 11/06/2024 |
| LIEBER, PAUL | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 11/18/2024 |
| LIEBER, PAUL | W-2 MANAGING EMPLOYEE | Individual | NOT APPLICABLE | since 07/01/2024 |
Medicare enrollment
As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of COUNTRY CLUB CENTER HOMES, INC (enrollment ID O20040226000133).
| Owner | Individual or organization | Role | Ownership percentage | Association date | Described in the filing as |
|---|---|---|---|---|---|
| JOHN HOLLAND | Individual | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 50 | 2/17/1976 | 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. |
| TERESA HOLLAND-GRESCOCK | Individual | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 50 | 5/1/2002 | 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. |
| JANET HARRIS | 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. | 12/10/2024 | 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. |
| JOHN HOLLAND | 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. | 12/10/2024 | 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. |
| PAUL LIEBER | 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. | 12/10/2024 | 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. |
| TERESA HOLLAND-GRESCOCK | 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. | 12/10/2024 | 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. | 12/10/2024 | 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. | 12/10/2024 | 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. |
| JANET HARRIS | Individual | CORPORATE DIRECTOR | 100 | 1/1/2008 | 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. |
| JANET HARRIS | Individual | CORPORATE OFFICER | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2008 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| JOHN HOLLAND | Individual | CORPORATE OFFICER | 50 | 5/1/2002 | 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. |
| TERESA HOLLAND-GRESCOCK | Individual | CORPORATE OFFICER | 50 | 5/1/2002 | 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. |
| TERESA HOLLAND-GRESCOCK | Individual | DIRECT OWNERSHIP INTEREST | 50 | 5/1/2002 | 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. |
| JANET HARRIS | 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. | 11/6/2024 | 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. |
| PAUL LIEBER | 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. | 11/18/2024 | 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. |
| PAUL LIEBER | Individual | W-2 MANAGING EMPLOYEE | 75 | 7/1/2024 | 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. |
Changes in ownership
- 1 July 2026: JOHN HOLLAND 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: JOHN HOLLAND no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: JOHN HOLLAND no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: JOHN HOLLAND appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: JOHN HOLLAND appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: JOHN HOLLAND appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 January 2025: JANET HARRIS no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: JANET HARRIS appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: JANET HARRIS appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: JANET HARRIS appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: PAUL LIEBER appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: PAUL LIEBER appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: PAUL LIEBER appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: TERESA HOLLAND-GRESCOCK appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: TERESA HOLLAND-GRESCOCK appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: TERESA HOLLAND-GRESCOCK appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: JOHN HOLLAND appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: JOHN HOLLAND appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
Recent changes on this record
- 1 July 2026: JOHN HOLLAND 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: JOHN HOLLAND no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: JOHN HOLLAND no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: JOHN HOLLAND appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: JOHN HOLLAND appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: JOHN HOLLAND appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 22 May 2026: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
- 17 November 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- 22 May 2025: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- 1 January 2025: JANET HARRIS no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: JANET HARRIS appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: JANET HARRIS appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: JANET HARRIS appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: PAUL LIEBER appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: PAUL LIEBER appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: PAUL LIEBER appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: TERESA HOLLAND-GRESCOCK appears as DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: TERESA HOLLAND-GRESCOCK appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: TERESA HOLLAND-GRESCOCK appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: JOHN HOLLAND appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: JOHN HOLLAND appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 16 January 2024: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- 17 March 2022: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
- 21 January 2021: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
- 26 September 2019: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2018.zip
- 21 August 2018: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2017.zip
- 16 November 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2016.zip
- 2 March 2017: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2015.zip
- 31 March 2016: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2014.zip
- 20 February 2015: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2013.zip
- 16 May 2013: A cost report was filed for fiscal year 2011, on form CMS-2540-10. SNF10FY2011.zip
- 2 May 2013: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2012.zip
- 23 April 2012: A cost report was filed for fiscal year 2010, on form CMS-2540-96. SNFFY2010.zip
- 7 March 2011: A cost report was filed for fiscal year 2009, on form CMS-2540-96. SNFFY2009.zip
- 28 January 2010: A cost report was filed for fiscal year 2008, on form CMS-2540-96. SNFFY2008.zip
- 24 November 2008: A cost report was filed for fiscal year 2007, on form CMS-2540-96. SNFFY2007.zip
- 30 November 2007: A cost report was filed for fiscal year 2006, on form CMS-2540-96. SNFFY2006.zip
- 21 December 2006: A cost report was filed for fiscal year 2005, on form CMS-2540-96. SNFFY2005.zip
- 5 December 2005: A cost report was filed for fiscal year 2004, on form CMS-2540-96. SNFFY2004.zip
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | 17 April 2026 | 17 April 2026 | 42 | 1 |
| 2 | 2 December 2024 | 2 December 2024 | 29 | 4 |
| 3 | 21 September 2022 | 21 September 2022 | 19 | 6 |
From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.
Deficiencies cited
90 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| 17 April 2026 | 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 | 8 June 2026 |
| 17 April 2026 | Health | F 0552 | Resident Rights Deficiencies | Ensure that residents are fully informed and understand their health status, care and treatments. | D | No | Deficient, Provider has date of correction | 8 June 2026 |
| 17 April 2026 | Health | F 0559 | Resident Rights Deficiencies | Honor the resident's right to share a room with spouse or roommate of choice and receive written notice before a change is made. | D | No | Deficient, Provider has date of correction | 8 June 2026 |
| 17 April 2026 | Health | F 0565 | Resident Rights Deficiencies | Honor the resident's right to organize and participate in resident/family groups in the facility. | F | No | Deficient, Provider has date of correction | 8 June 2026 |
| 17 April 2026 | Health | F 0577 | Resident Rights Deficiencies | Allow residents to easily view the nursing home's survey results and communicate with advocate agencies. | C | No | Deficient, Provider has date of correction | 8 June 2026 |
| 17 April 2026 | 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 | 8 June 2026 |
| 17 April 2026 | 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 | 8 June 2026 |
| 17 April 2026 | Health | F 0583 | Resident Rights Deficiencies | Keep residents' personal and medical records private and confidential. | E | No | Deficient, Provider has date of correction | 8 June 2026 |
| 17 April 2026 | 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 | 8 June 2026 |
| 17 April 2026 | Health | F 0600 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | G | Yes | Deficient, Provider has date of correction | 8 June 2026 |
| 17 April 2026 | Health | F 0605 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. | D | No | Deficient, Provider has date of correction | 8 June 2026 |
| 17 April 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 | Yes | Deficient, Provider has date of correction | 8 June 2026 |
| 17 April 2026 | Health | F 0610 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Respond appropriately to all alleged violations. | D | Yes | Deficient, Provider has date of correction | 8 June 2026 |
| 17 April 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 | Yes | Deficient, Provider has date of correction | 8 June 2026 |
| 17 April 2026 | Health | F 0636 | Resident Assessment and Care Planning Deficiencies | Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. | D | No | Deficient, Provider has date of correction | 8 June 2026 |
| 17 April 2026 | Health | F 0641 | Resident Assessment and Care Planning Deficiencies | Ensure each resident receives an accurate assessment. | D | No | Deficient, Provider has date of correction | 8 June 2026 |
| 17 April 2026 | 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 | 8 June 2026 |
| 17 April 2026 | 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 | 8 June 2026 |
| 17 April 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. | D | Yes | Deficient, Provider has date of correction | 8 June 2026 |
| 17 April 2026 | Health | F 0676 | Quality of Life and Care Deficiencies | Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. | D | Yes | Deficient, Provider has date of correction | 8 June 2026 |
| 17 April 2026 | 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 | 8 June 2026 |
| 17 April 2026 | 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 | 8 June 2026 |
| 17 April 2026 | Health | F 0684 | Quality of Life and Care Deficiencies | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | J | Yes | Deficient, Provider has date of correction | 8 June 2026 |
| 17 April 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 | 8 June 2026 |
| 17 April 2026 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Yes | Deficient, Provider has date of correction | 8 June 2026 |
| 17 April 2026 | Health | F 0695 | Quality of Life and Care Deficiencies | Provide safe and appropriate respiratory care for a resident when needed. | D | No | Deficient, Provider has date of correction | 8 June 2026 |
| 17 April 2026 | Health | F 0697 | Quality of Life and Care Deficiencies | Provide safe, appropriate pain management for a resident who requires such services. | G | No | Deficient, Provider has date of correction | 8 June 2026 |
| 17 April 2026 | 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. | F | Yes | Deficient, Provider has date of correction | 8 June 2026 |
| 17 April 2026 | Health | F 0757 | Pharmacy Service Deficiencies | Ensure each resident’s drug regimen must be free from unnecessary drugs. | E | No | Deficient, Provider has date of correction | 8 June 2026 |
| 17 April 2026 | Health | F 0760 | Pharmacy Service Deficiencies | Ensure that residents are free from significant medication errors. | D | Yes | Deficient, Provider has date of correction | 8 June 2026 |
| 17 April 2026 | Health | F 0804 | Nutrition and Dietary Deficiencies | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | F | No | Deficient, Provider has date of correction | 8 June 2026 |
| 17 April 2026 | Health | F 0805 | Nutrition and Dietary Deficiencies | Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. | E | Yes | Deficient, Provider has date of correction | 8 June 2026 |
| 17 April 2026 | 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. | F | No | Deficient, Provider has date of correction | 8 June 2026 |
| 17 April 2026 | Health | F 0842 | Resident Assessment and Care Planning Deficiencies | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | Yes | Deficient, Provider has date of correction | 8 June 2026 |
| 17 April 2026 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | No | Deficient, Provider has date of correction | 9 June 2026 |
| 17 April 2026 | Health | F 0883 | Infection Control Deficiencies | Develop and implement policies and procedures for flu and pneumonia vaccinations. | E | No | Deficient, Provider has date of correction | 8 June 2026 |
| 17 April 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. | E | No | Deficient, Provider has date of correction | 8 June 2026 |
| 2 February 2026 | Health | F 0583 | Resident Rights Deficiencies | Keep residents' personal and medical records private and confidential. | D | Yes | Deficient, Provider has date of correction | 11 February 2026 |
| 2 February 2026 | Health | F 0600 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | E | Yes | Deficient, Provider has date of correction | 11 February 2026 |
| 2 February 2026 | Health | F 0686 | Quality of Life and Care Deficiencies | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | G | Yes | Deficient, Provider has date of correction | 11 February 2026 |
| 10 December 2025 | Health | F 0585 | Resident Rights Deficiencies | Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. | E | Yes | Deficient, Provider has date of correction | 31 December 2025 |
| 10 December 2025 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | Yes | Deficient, Provider has date of correction | 31 December 2025 |
| 30 June 2025 | Health | F 0684 | Quality of Life and Care Deficiencies | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | Yes | Deficient, Provider has date of correction | 22 July 2025 |
| 30 June 2025 | Health | F 0804 | Nutrition and Dietary Deficiencies | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | F | Yes | Deficient, Provider has date of correction | 22 July 2025 |
| 1 May 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. | D | Yes | Deficient, Provider has date of correction | 6 May 2025 |
| 1 May 2025 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | Yes | Deficient, Provider has date of correction | 6 May 2025 |
| 2 December 2024 | Health | F 0558 | Resident Rights Deficiencies | Reasonably accommodate the needs and preferences of each resident. | D | No | Deficient, Provider has date of correction | 24 December 2024 |
| 2 December 2024 | 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 | 24 December 2024 |
| 2 December 2024 | 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 | 24 December 2024 |
| 2 December 2024 | Health | F 0661 | Resident Assessment and Care Planning Deficiencies | Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. | D | No | Deficient, Provider has date of correction | 24 December 2024 |
| 2 December 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 | 24 December 2024 |
| 2 December 2024 | 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 | 24 December 2024 |
| 2 December 2024 | Health | F 0695 | Quality of Life and Care Deficiencies | Provide safe and appropriate respiratory care for a resident when needed. | D | No | Deficient, Provider has date of correction | 24 December 2024 |
| 2 December 2024 | 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 | 24 December 2024 |
| 2 December 2024 | Health | F 0756 | Pharmacy Service Deficiencies | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | D | No | Deficient, Provider has date of correction | 24 December 2024 |
| 2 December 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 | 24 December 2024 |
| 2 December 2024 | Health | F 0758 | Pharmacy Service Deficiencies | Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | D | No | Deficient, Provider has date of correction | 24 December 2024 |
| 2 December 2024 | Health | F 0759 | Pharmacy Service Deficiencies | Ensure medication error rates are not 5 percent or greater. | D | No | Deficient, Provider has date of correction | 24 December 2024 |
| 2 December 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 | 24 December 2024 |
| 2 December 2024 | Health | F 0804 | Nutrition and Dietary Deficiencies | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | F | No | Deficient, Provider has date of correction | 24 December 2024 |
| 2 December 2024 | Health | F 0805 | Nutrition and Dietary Deficiencies | Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. | E | No | Deficient, Provider has date of correction | 24 December 2024 |
| 2 December 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. | F | No | Deficient, Provider has date of correction | 24 December 2024 |
| 2 December 2024 | Health | F 0814 | Nutrition and Dietary Deficiencies | Dispose of garbage and refuse properly. | F | No | Deficient, Provider has date of correction | 24 December 2024 |
| 2 December 2024 | Health | F 0848 | Administration Deficiencies | Provide a neutral and fair arbitration process and agree to arbitrator and venue. | D | No | Deficient, Provider has date of correction | 24 December 2024 |
| 2 December 2024 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | E | No | Deficient, Provider has date of correction | 24 December 2024 |
| 2 December 2024 | Health | F 0883 | Infection Control Deficiencies | Develop and implement policies and procedures for flu and pneumonia vaccinations. | D | No | Deficient, Provider has date of correction | 24 December 2024 |
| 2 December 2024 | 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. | E | No | Deficient, Provider has date of correction | 24 December 2024 |
| 24 October 2024 | Health | F 0851 | Administration Deficiencies | Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data. | F | Yes | Deficient, Provider has date of correction | 2 December 2024 |
| 24 October 2024 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | E | Yes | Deficient, Provider has date of correction | 24 December 2024 |
| 11 September 2024 | Health | F 0550 | Resident Rights Deficiencies | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | Yes | Deficient, Provider has date of correction | 25 September 2024 |
| 9 August 2024 | Health | F 0602 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Protect each resident from the wrongful use of the resident's belongings or money. | D | Yes | Past Non-Compliance | 27 June 2024 |
| 5 June 2024 | Health | F 0695 | Quality of Life and Care Deficiencies | Provide safe and appropriate respiratory care for a resident when needed. | D | Yes | Deficient, Provider has date of correction | 21 June 2024 |
| 28 December 2023 | Health | F 0558 | Resident Rights Deficiencies | Reasonably accommodate the needs and preferences of each resident. | D | Yes | Deficient, Provider has date of correction | 13 January 2024 |
| 28 December 2023 | 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 | Yes | Deficient, Provider has date of correction | 13 January 2024 |
| 28 December 2023 | 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 | Deficient, Provider has date of correction | 13 January 2024 |
| 28 December 2023 | 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 | Yes | Deficient, Provider has date of correction | 13 January 2024 |
| 28 December 2023 | 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. | F | Yes | Deficient, Provider has date of correction | 13 January 2024 |
| 28 December 2023 | Health | F 0842 | Resident Assessment and Care Planning Deficiencies | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | Yes | Deficient, Provider has date of correction | 13 January 2024 |
| 16 August 2023 | Health | F 0568 | Resident Rights Deficiencies | Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home. | D | Yes | Deficient, Provider has date of correction | 1 September 2023 |
| 16 August 2023 | Health | F 0585 | Resident Rights Deficiencies | Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. | D | Yes | Deficient, Provider has date of correction | 1 September 2023 |
| 16 August 2023 | 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 | 1 September 2023 |
| 16 August 2023 | Health | F 0610 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Respond appropriately to all alleged violations. | D | Yes | Deficient, Provider has date of correction | 1 September 2023 |
| 21 September 2022 | Health | F 0636 | Resident Assessment and Care Planning Deficiencies | Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. | E | No | Deficient, Provider has date of correction | 18 October 2022 |
| 21 September 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. | E | No | Deficient, Provider has date of correction | 18 October 2022 |
| 21 September 2022 | Health | F 0686 | Quality of Life and Care Deficiencies | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | H | No | Deficient, Provider has date of correction | 18 October 2022 |
| 21 September 2022 | 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 | 18 October 2022 |
| 21 September 2022 | Health | F 0690 | Quality of Life and Care Deficiencies | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | D | No | Deficient, Provider has date of correction | 18 October 2022 |
| 21 September 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 | 18 October 2022 |
| 21 September 2022 | Health | F 0695 | Quality of Life and Care Deficiencies | Provide safe and appropriate respiratory care for a resident when needed. | D | No | Deficient, Provider has date of correction | 18 October 2022 |
| 21 September 2022 | Health | F 0810 | Nutrition and Dietary Deficiencies | Provide special eating equipment and utensils for residents who need them and appropriate assistance. | D | No | Deficient, Provider has date of correction | 18 October 2022 |
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 |
|---|---|---|---|---|---|
| 17 April 2026 | Fine | $113,955 | 142377 | ||
| 17 April 2026 | Fine | $26,685 | 142379 | ||
| 17 April 2026 | Fine | $26,685 | 142381 | ||
| 17 April 2026 | Payment Denial | 14 May 2026 | 26 | ||
| 28 December 2023 | Fine | $26,462 | 77982 |
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 | For profit - Limited Liability company |
| Legal Business Name | COUNTRY CLUB CENTER HOMES, INC |
| Date First Approved to Provide Medicare and Medicaid Services | 1979-05-01 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | Y |
| Urban | N |
| County/Parish | Tuscarawas |
| Telephone Number | 3303435568 |
| Chain Name | COUNTRY CLUB REHABILITATION CAMPUS |
| Chain ID | 164 |
| Special Focus Status | SFF Candidate |
| 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 | 72 |
| Average Number of Residents per Day | 55.9 |
| Overall Rating | 2 |
| Health Inspection Rating | 1 |
| QM Rating | 5 |
| Long-Stay QM Rating | 5 |
| Short-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.
Get an email when this record changes
One email a day naming what moved on COUNTRY CLUB CENTER I: 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: JOHN HOLLAND no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. That is one line of the alert.
What the alerts are, and what a day of them looks like, is on the alerts page.
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The citable document for COUNTRY CLUB CENTER I
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 Ohio 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 365417.