Skilled nursing facility · CMS certification number 365809
GRANDE LAKE HEALTHCARE CENTER
ST MARYS, Ohio · Medicare and Medicaid
Certified beds, as filed in Care Compare: 45
Finances, as filed
From this facility’s Medicare cost reports on form CMS-2540, each figure with the worksheet, line and column it was read from.
Cost report for 1 January 2024 to 31 December 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 28 August 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,304,372 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $508,254 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,796,118 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,917,558 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$121,440 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $486 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$120,954 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$120,954 (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 | 78 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 28,548 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 469 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 12,408 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 5,447 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 18,324 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 8 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 26 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 51 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 85 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 58.63 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 477.23 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 215.58 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1435057, 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 18 April 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,962,158 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $879,511 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,082,647 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,012,649 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$930,002 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | −$31 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$930,033 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$930,033 (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 | 78 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,006 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 142 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 42.48 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 119.76 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1420676, 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 7 March 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,579,420 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $684,659 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,894,761 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,231,364 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$336,603 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $396,983 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $60,380 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $60,380 (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 | 78 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,663 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 151 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 57.63 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 110.35 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1374599, 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 7 November 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,163,725 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $944,263 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,219,462 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,287,655 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$68,193 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $245,429 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $177,236 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $177,236 (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 | 78 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 13,970 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 115 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 65.4 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 121.48 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1367528, 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 January 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,240,508 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $978,782 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,261,726 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,357,605 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,095,879 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $269,575 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$826,304 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$826,304 (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 | 78 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,521 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 93 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 56.79 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 379.36 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 177.65 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1340139, read from the public cost report file SNF10FY2020.zip.
Fiscal year 2019, ended 31 December 2019
Cost report for 1 January 2019 to 31 December 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 15 July 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,289,079 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,043,110 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,245,969 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,018,050 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$772,081 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $233 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$771,848 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$771,848 (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 | 78 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,111 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 158 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 35.95 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 97.19 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 101.97 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1288094, read from the public cost report file SNF10FY2019.zip.
Fiscal year 2018, ended 31 December 2018
Cost report for 1 March 2018 to 31 December 2018 — a reporting period of 305 days, on form CMS-2540-10, settled, processed by CMS on 19 December 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,635,288 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $815,590 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,819,698 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,930,962 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$111,264 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $521 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$110,743 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$110,743 (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 | 78 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 13,804 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 68 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 34.38 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 304.63 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 203 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1248339, 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 20 September 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,223,664 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $678,097 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,545,567 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,086,256 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$540,689 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $11,591 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$529,098 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$529,098 (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 | 45 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 10,798 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 89 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 26.88 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 263.63 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 121.33 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1212087, 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 2 May 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,351,361 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $840,637 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,510,724 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,771,260 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$260,536 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $21,433 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$239,103 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$239,103 (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 | 78 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,428 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 122 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 39.14 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 377.57 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 142.85 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1189004, 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 10 November 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,094,701 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,050,389 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,044,312 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,131,492 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$87,180 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $21,791 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$65,389 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$65,389 (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 | 83 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,157 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 115 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 40.78 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,180.5 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 175.28 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1146216, 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 18 February 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,990,520 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $953,869 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,036,651 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,112,686 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$76,035 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $26,024 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$50,011 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$50,011 (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 | 83 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 21,297 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 105 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 40.67 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,620.17 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 202.83 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1119174, 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 August 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,955,629 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $877,567 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,078,062 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,006,653 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $71,409 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $21,873 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $93,282 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $93,282 (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 | 78 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,909 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 148 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 38.05 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,025.75 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 134.52 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1108391, read from the public cost report file SNF10FY2013.zip.
Fiscal year 2012, ended 31 December 2012
Cost report for 1 January 2012 to 31 December 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 16 May 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,738,026 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $767,615 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,970,411 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,954,243 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $16,168 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $18,898 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $35,066 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $35,066 (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 | 78 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,690 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 108 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 33.16 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,009.71 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 191.57 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1059965, 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 24 September 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,116,201 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $404,452 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,711,749 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,674,256 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $37,493 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $12,762 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $50,255 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $50,255 (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 | 78 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 18,581 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 95 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 46.38 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 698.1 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 195.59 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1011281, 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 13 August 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,960,874 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,436,405 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$475,531 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $46,779 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$428,752 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 83 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 16,904 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 66 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 48.89 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 928.22 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 256.12 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 431537, 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 19 January 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,357,458 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,516,459 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$159,001 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $19,066 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$139,935 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 83 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 18,319 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 83 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 36.78 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 2,008.75 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 220.71 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 392860, 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 27 April 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,559,775 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,742,638 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$182,863 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $582 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$182,281 (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 | 50 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 12,242 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 96 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 38.31 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 380.95 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 127.52 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 368250, read from the public cost report file SNFFY2008.zip.
Fiscal year 2007, ended 31 December 2007
Cost report for 1 January 2007 to 31 December 2007 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 20 February 2009.
None of these figures is carried on this report.
CMS report record 333974, 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 28 March 2008.
None of these figures is carried on this report.
CMS report record 305805, 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 22 March 2007.
None of these figures is carried on this report.
CMS report record 275644, read from the public cost report file SNFFY2005.zip.
Fiscal year 2004, ended 31 December 2004
Cost report for 1 January 2004 to 31 December 2004 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 23 January 2006.
None of these figures is carried on this report.
CMS report record 241068, read from the public cost report file SNFFY2004.zip.
Fiscal year 2003, ended 31 December 2003
Cost report for 1 January 2003 to 31 December 2003 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 20 January 2005.
None of these figures is carried on this report.
CMS report record 204505, 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 26 January 2004.
None of these figures is carried on this report.
CMS report record 167637, 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 13 February 2003.
None of these figures is carried on this report.
CMS report record 130525, 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 14 November 2001.
Net income, stated at moderate confidence: $2,151,015 (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 48027, 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 21 March 2001.
Net income, stated at moderate confidence: −$159,501 (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 48025, 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, as submitted, processed by CMS on 26 November 1999.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,284,322 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,405,300 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$120,978 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $22,463 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$98,515 (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 | 50 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 15,770 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 82 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 33.83 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 508.35 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 192.32 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 48024, read from the public cost report file SNFFY1998.zip.
Fiscal year 1997, ended 31 December 1997
Cost report for 1 November 1997 to 31 December 1997 — a reporting period of 60 days, not a full year, on form CMS-2540-96, settled, processed by CMS on 23 February 1999.
Net income, stated at moderate confidence: −$17,878 (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 48022, read from the public cost report file SNFFY1998.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 27 April 1998.
Net income, stated at moderate confidence: −$188,894 (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 48019, 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 |
|---|---|---|---|---|
| SXCY MSTR LSCO, LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | 100% | since 01/01/2022 |
| HEALTH CARE LEASE FACILITIES, LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | Organization | NO PERCENTAGE PROVIDED | since 03/01/2018 |
| SXCY HOLDINGS, LLC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | Organization | NO PERCENTAGE PROVIDED | since 01/01/2022 |
| C.R. STOLTZ FAMILY INVESTMENT COMPANY INC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 03/01/2018 |
| C.R. STOLTZ IRREVOCABLE TRUST | ADP OF THE SNF | Organization | NOT APPLICABLE | since 03/01/2018 |
| HEALTH CARE LEASE FACILITIES, LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 03/01/2018 |
| I. ROSEDALE IRREVOCABLE TRUST | ADP OF THE SNF | Organization | NOT APPLICABLE | since 03/01/2018 |
| INDIANA MGT CO., LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 05/16/2025 |
| PEYTON, JOSEPH | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/15/2025 |
| R.S. WILHEIM IRREVOCABLE TRUST | ADP OF THE SNF | Organization | NOT APPLICABLE | since 03/01/2018 |
| RONALD S WILHEIM 2012 SPOUSAL TRUST | ADP OF THE SNF | Organization | NOT APPLICABLE | since 03/01/2018 |
| ROSEDALE FAMILY INVESTMENT COMPANY, INC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 03/01/2018 |
| RRW, LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 03/01/2018 |
| S.L. ROSEDALE IRREVOCABLE TRUST | ADP OF THE SNF | Organization | NOT APPLICABLE | since 03/01/2018 |
| SKILLED HC HOLDINGS, LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 03/01/2018 |
| SXCY HOLDINGS, LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 01/01/2022 |
| TAYLOR, JANE | ADP OF THE SNF | Individual | NOT APPLICABLE | since 05/15/2025 |
| WILHEIM FAMILY INVESTMENT COMPANY, INC. | ADP OF THE SNF | Organization | NOT APPLICABLE | since 03/01/2018 |
| ROMEO, DOMINIC | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 04/01/2023 |
| STOLTZ, CHARLES | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 03/01/2018 |
| WILHEIM, RONALD | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 03/01/2018 |
| GROVES, DONNA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 04/14/2023 |
| INDIANA MGT CO., LLC | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | since 03/01/2018 |
| PEYTON, JOSEPH | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 09/28/2022 |
| ROMEO, DOMINIC | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 04/01/2023 |
| TAYLOR, JANE | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 03/01/2021 |
Medicare enrollment
As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of INDIANA LEASING CO LLC (enrollment ID O20180508000390).
| Owner | Individual or organization | Role | Ownership percentage | Association date | Described in the filing as |
|---|---|---|---|---|---|
| SXCY MSTR LSCO, LLC | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100 | 1/1/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| C.R. STOLTZ FAMILY INVESTMENT COMPANY INC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 6.52 | 3/1/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| C.R. STOLTZ IRREVOCABLE TRUST | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 6.52 | 3/1/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| HEALTH CARE LEASE FACILITIES, LLC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100 | 3/1/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| I. ROSEDALE IRREVOCABLE TRUST | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 31.16 | 3/1/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| R.S. WILHEIM IRREVOCABLE TRUST | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 15.89 | 3/1/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| RONALD S WILHEIM 2012 SPOUSAL TRUST | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 15.27 | 3/1/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| ROSEDALE FAMILY INVESTMENT COMPANY, INC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 31.16 | 3/1/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| RRW, LLC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 93.48 | 3/1/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| S.L. ROSEDALE IRREVOCABLE TRUST | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 31.16 | 3/1/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| SKILLED HC HOLDINGS, LLC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 93.48 | 3/1/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| SXCY HOLDINGS, LLC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100 | 1/1/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| WILHEIM FAMILY INVESTMENT COMPANY, INC. | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 31.16 | 3/1/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| C.R. STOLTZ FAMILY INVESTMENT COMPANY INC | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 3/1/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| C.R. STOLTZ IRREVOCABLE TRUST | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 3/1/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| HEALTH CARE LEASE FACILITIES, LLC | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 3/1/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| I. ROSEDALE IRREVOCABLE TRUST | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 3/1/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| INDIANA MGT CO., LLC | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/16/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| JANE E TAYLOR | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/15/2025 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| JOSEPH S PEYTON | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 5/15/2025 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| R.S. WILHEIM IRREVOCABLE TRUST | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 3/1/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| RONALD S WILHEIM 2012 SPOUSAL TRUST | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 3/1/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| ROSEDALE FAMILY INVESTMENT COMPANY, INC | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 3/1/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| RRW, LLC | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 3/1/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| S.L. ROSEDALE IRREVOCABLE TRUST | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 3/1/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| SKILLED HC HOLDINGS, LLC | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 3/1/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| SXCY HOLDINGS, LLC | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| WILHEIM FAMILY INVESTMENT COMPANY, INC. | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 3/1/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 6/5/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2022 | Private equity company: No Real estate investment trust: No Holding company: No |
| CHARLES STOLTZ | 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. | 3/1/2018 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| DOMINIC A ROMEO | 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. | 4/1/2023 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| RONALD WILHEIM | 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. | 3/1/2018 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| DOMINIC A ROMEO | 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. | 4/1/2023 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| DONNA GROVES | 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. | 4/14/2023 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| INDIANA MGT CO., LLC | Organization | 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. | 3/1/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| JANE E TAYLOR | 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. | 3/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| JOSEPH S PEYTON | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 9/28/2022 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
Changes in ownership
- 1 July 2026: RONALD S WILHEIM 2012 SPOUSAL TRUST 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: RONALD S WILHEIM 2012 SPOUSAL TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: RONALD S WILHEIM 2012 SPOUSAL TRUST appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: RONALD S WILHEIM 2012 SPOUSAL TRUST appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 October 2025: HEALTH CARE FACILITY MANAGEMENT, LLC no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: RICHARD ODENTHAL no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: C R STOLTZ II LLC no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: HEALTH CARE HOLDINGS, LLC no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: JANE E TAYLOR no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: R.S. WILHEIM IRREVOCABLE TRUST appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: HEALTH CARE LEASE FACILITIES, LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: HEALTH CARE LEASE FACILITIES, LLC appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: S.L. ROSEDALE IRREVOCABLE TRUST appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: ROSEDALE FAMILY INVESTMENT COMPANY, INC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: JOSEPH S PEYTON appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: JOSEPH S PEYTON appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: DONNA GROVES appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: SKILLED HC HOLDINGS, LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: SKILLED HC HOLDINGS, LLC appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: RRW, LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: WILHEIM FAMILY INVESTMENT COMPANY, INC. appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: C.R. STOLTZ IRREVOCABLE TRUST appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: DOMINIC A ROMEO appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: DOMINIC A ROMEO appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: C.R. STOLTZ FAMILY INVESTMENT COMPANY INC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: C.R. STOLTZ FAMILY INVESTMENT COMPANY INC appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: RONALD WILHEIM appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: INDIANA MGT CO., LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: INDIANA MGT CO., LLC appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: I. ROSEDALE IRREVOCABLE TRUST appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: SXCY HOLDINGS, LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: SXCY HOLDINGS, LLC appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: JANE E TAYLOR appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: JANE E TAYLOR appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: RONALD S WILHEIM 2012 SPOUSAL TRUST appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 January 2023: APRIL STEINBERG no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
- 1 January 2023: JANE E TAYLOR appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-01-01.csv
Recent changes on this record
- 1 July 2026: RONALD S WILHEIM 2012 SPOUSAL TRUST 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: RONALD S WILHEIM 2012 SPOUSAL TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: RONALD S WILHEIM 2012 SPOUSAL TRUST appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: RONALD S WILHEIM 2012 SPOUSAL TRUST appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 October 2025: HEALTH CARE FACILITY MANAGEMENT, LLC no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: RICHARD ODENTHAL no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: C R STOLTZ II LLC no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: HEALTH CARE HOLDINGS, LLC no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: JANE E TAYLOR no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: R.S. WILHEIM IRREVOCABLE TRUST appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: HEALTH CARE LEASE FACILITIES, LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: HEALTH CARE LEASE FACILITIES, LLC appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: S.L. ROSEDALE IRREVOCABLE TRUST appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: ROSEDALE FAMILY INVESTMENT COMPANY, INC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: JOSEPH S PEYTON appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: JOSEPH S PEYTON appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: DONNA GROVES appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: SKILLED HC HOLDINGS, LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: SKILLED HC HOLDINGS, LLC appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: RRW, LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: WILHEIM FAMILY INVESTMENT COMPANY, INC. appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: C.R. STOLTZ IRREVOCABLE TRUST appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: DOMINIC A ROMEO appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: DOMINIC A ROMEO appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: C.R. STOLTZ FAMILY INVESTMENT COMPANY INC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: C.R. STOLTZ FAMILY INVESTMENT COMPANY INC appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: RONALD WILHEIM appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: INDIANA MGT CO., LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: INDIANA MGT CO., LLC appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: I. ROSEDALE IRREVOCABLE TRUST appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: SXCY HOLDINGS, LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: SXCY HOLDINGS, LLC appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: JANE E TAYLOR appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: JANE E TAYLOR appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 1 October 2025: RONALD S WILHEIM 2012 SPOUSAL TRUST appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-10-01.csv
- 28 August 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- 18 April 2025: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- 7 March 2024: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- 7 November 2023: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | 27 February 2025 | 27 February 2025 | 7 | 2 |
| 2 | 13 February 2023 | 13 February 2023 | 10 | 3 |
| 3 | 4 January 2020 | 4 January 2020 | 16 | 2 |
From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.
Deficiencies cited
33 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| 27 February 2025 | 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 | 21 March 2025 |
| 27 February 2025 | Health | F 0554 | Resident Rights Deficiencies | Allow residents to self-administer drugs if determined clinically appropriate. | D | No | Deficient, Provider has date of correction | 21 March 2025 |
| 27 February 2025 | Health | F 0583 | Resident Rights Deficiencies | Keep residents' personal and medical records private and confidential. | D | No | Deficient, Provider has date of correction | 21 March 2025 |
| 27 February 2025 | Health | F 0760 | Pharmacy Service Deficiencies | Ensure that residents are free from significant medication errors. | G | Yes | Deficient, Provider has date of correction | 21 March 2025 |
| 27 February 2025 | 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 | 21 March 2025 |
| 27 February 2025 | Health | F 0847 | Administration Deficiencies | Inform resident or representatives choice to enter into binding arbitration agreement and right to refuse. | D | No | Deficient, Provider has date of correction | 21 March 2025 |
| 27 February 2025 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | F | No | Deficient, Provider has date of correction | 21 March 2025 |
| 27 June 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 | Yes | Deficient, Provider has date of correction | 3 July 2024 |
| 13 February 2023 | Health | F 0641 | Resident Assessment and Care Planning Deficiencies | Ensure each resident receives an accurate assessment. | E | No | Deficient, Provider has date of correction | 6 March 2023 |
| 13 February 2023 | Health | F 0657 | Resident Assessment and Care Planning Deficiencies | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | No | Deficient, Provider has date of correction | 6 March 2023 |
| 13 February 2023 | Health | F 0679 | Quality of Life and Care Deficiencies | Provide activities to meet all resident's needs. | F | No | Deficient, Provider has date of correction | 6 March 2023 |
| 13 February 2023 | Health | F 0680 | Quality of Life and Care Deficiencies | Ensure the activities program is directed by a qualified professional. | F | No | Deficient, Provider has date of correction | 6 March 2023 |
| 13 February 2023 | Health | F 0684 | Quality of Life and Care Deficiencies | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | No | Deficient, Provider has date of correction | 6 March 2023 |
| 13 February 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. | D | No | Deficient, Provider has date of correction | 6 March 2023 |
| 13 February 2023 | Health | F 0693 | Quality of Life and Care Deficiencies | Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. | D | No | Deficient, Provider has date of correction | 6 March 2023 |
| 13 February 2023 | Health | F 0756 | Pharmacy Service Deficiencies | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | D | No | Deficient, Provider has date of correction | 6 March 2023 |
| 13 February 2023 | Health | F 0760 | Pharmacy Service Deficiencies | Ensure that residents are free from significant medication errors. | D | No | Deficient, Provider has date of correction | 6 March 2023 |
| 13 February 2023 | Health | F 0791 | Quality of Life and Care Deficiencies | Provide or obtain dental services for each resident. | D | No | Deficient, Provider has date of correction | 6 March 2023 |
| 4 January 2020 | Health | F 0558 | Resident Rights Deficiencies | Reasonably accommodate the needs and preferences of each resident. | D | No | Deficient, Provider has date of correction | 4 February 2020 |
| 4 January 2020 | 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 | 4 February 2020 |
| 4 January 2020 | Health | F 0603 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Protect each resident from separation (from other residents, his/her room, or confinement to his/her room). | E | No | Deficient, Provider has date of correction | 4 February 2020 |
| 4 January 2020 | Health | F 0623 | Resident Rights Deficiencies | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | D | No | Deficient, Provider has date of correction | 4 February 2020 |
| 4 January 2020 | Health | F 0640 | Resident Assessment and Care Planning Deficiencies | Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment. | D | No | Deficient, Provider has date of correction | 4 February 2020 |
| 4 January 2020 | 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 | 4 February 2020 |
| 4 January 2020 | 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 | 4 February 2020 |
| 4 January 2020 | Health | F 0698 | Quality of Life and Care Deficiencies | Provide safe, appropriate dialysis care/services for a resident who requires such services. | D | No | Deficient, Provider has date of correction | 4 February 2020 |
| 4 January 2020 | Health | F 0755 | Pharmacy Service Deficiencies | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | No | Deficient, Provider has date of correction | 4 February 2020 |
| 4 January 2020 | 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 | 4 February 2020 |
| 4 January 2020 | Health | F 0773 | Administration Deficiencies | Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results. | D | No | Deficient, Provider has date of correction | 4 February 2020 |
| 4 January 2020 | Health | F 0809 | Nutrition and Dietary Deficiencies | Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times. | F | No | Deficient, Provider has date of correction | 4 February 2020 |
| 4 January 2020 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | F | No | Deficient, Provider has date of correction | 4 February 2020 |
| 4 January 2020 | Health | F 0881 | Infection Control Deficiencies | Implement a program that monitors antibiotic use. | D | No | Deficient, Provider has date of correction | 4 February 2020 |
| 4 January 2020 | 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 | 4 February 2020 |
From the Care Compare health citations file NH_HealthCitations_Aug2026.csv, processed on 1 August 2026.
Penalties
Not yet extracted for this facility.
Care Compare provider information
| Field | As filed |
|---|---|
| Provider Type | Medicare and Medicaid |
| Ownership Type | For profit - Corporation |
| Legal Business Name | INDIANA LEASING CO LLC |
| Date First Approved to Provide Medicare and Medicaid Services | 1990-10-05 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | N |
| County/Parish | Auglaize |
| Telephone Number | 4193947611 |
| Chain Name | COMMUNICARE HEALTH |
| Chain ID | 153 |
| Provider Changed Ownership in Last 12 Months | N |
| With a Resident and Family Council | Resident |
| Automatic Sprinkler Systems in All Required Areas | Yes |
| Number of Certified Beds | 45 |
| Average Number of Residents per Day | 43.4 |
| Overall Rating | 3 |
| Health Inspection Rating | 3 |
| QM Rating | 4 |
| Long-Stay QM Rating | 5 |
| Short-Stay QM Rating | 3 |
| Processing Date | 2026-08-01 |
From the Care Compare Provider Information file NH_ProviderInfo_Aug2026.csv, processed on 1 August 2026.
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One email a day naming what moved on GRANDE LAKE HEALTHCARE CENTER: the field, the value before, the value after, and the date of the file that first showed it.
The facility alert follows this one record: a cost report filed or a figure on one changed, an inspection, a deficiency or a penalty recorded, an owner added or removed. The certification number arrives filled in.
On 1 July 2026: RONALD S WILHEIM 2012 SPOUSAL TRUST no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. That is one line of the alert.
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The citable document for GRANDE LAKE HEALTHCARE CENTER
This page shows the record as it stands today. The report is the citable document: the same figures with the cell each came from, and beyond this page — five facilities of a similar size in 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 365809.