Skilled nursing facility · CMS certification number 365953
OTTERBEIN ST MARYS RETIREMENT COMMUNITY
ST MARYS, Ohio · Medicare and Medicaid
Certified beds, as filed in Care Compare: 53
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, as submitted, processed by CMS on 28 May 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,467,713 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $3,126,157 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,341,556 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,777,275 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $564,281 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $518,128 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,082,409 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,082,409 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 19,398 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 2,845 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 6,689 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 7,312 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 16,846 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 82 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 36 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 89 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 207 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 34.7 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 185.81 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 81.38 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1424312, read from the public cost report file SNF10FY2024.zip.
Fiscal year 2023, ended 31 December 2023
Cost report for 1 January 2023 to 31 December 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 23 July 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,267,301 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,801,823 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,465,478 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,319,500 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $1,145,978 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $533,485 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,679,463 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,679,463 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,011 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 232 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 34.91 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 265.77 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 73.32 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1390097, 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 27 July 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,278,429 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $3,434,849 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,843,580 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,488,744 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$645,164 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | −$526,135 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$1,171,299 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,165,107 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,280 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 335 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 30.22 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 155.67 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 48.6 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1360091, 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 19 October 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $9,418,370 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $3,197,191 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,221,179 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,528,860 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$307,681 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $798,475 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $490,794 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $490,794 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 15,723 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 283 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 30.67 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 136.33 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 55.56 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1366900, 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 10 November 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,615,974 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,431,995 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,183,979 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,134,761 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $49,218 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $456,487 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $505,705 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $505,705 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 14,553 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 219 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 27.71 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 209.85 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 66.45 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1303874, 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 10 September 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $9,415,727 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $3,326,035 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,089,692 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,572,117 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $517,575 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $489,827 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,007,402 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,007,402 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,751 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 280 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 31.02 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 161.31 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 59.83 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1267109, 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 10 July 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $9,423,684 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $3,286,964 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,136,720 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,726,507 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $410,213 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | −$227,545 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $182,668 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $182,668 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,849 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 313 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 25.31 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 146.13 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 53.83 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1235736, 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 19 July 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,558,969 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,713,977 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,844,992 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,157,486 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $687,506 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $496,397 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,183,903 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,183,903 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,116 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 262 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 23.17 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 267.81 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 65.33 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1201218, 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 17 July 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,355,938 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,576,272 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,779,666 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,960,539 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $819,127 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $274,465 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,093,592 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,093,592 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,833 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 257 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 25.14 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 314.94 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 69.39 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1169354, 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 25 July 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,885,680 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,462,232 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,423,448 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,784,493 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $638,955 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | −$76,021 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $562,934 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $562,934 (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 | 53 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,347 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 229 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 26.92 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 415.69 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 75.75 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1137561, read from the public cost report file SNF10FY2015.zip.
Fiscal year 2014, ended 31 December 2014
Cost report for 1 January 2014 to 31 December 2014 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 25 July 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,962,244 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,450,181 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,512,063 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,757,381 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $754,682 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $90,003 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $844,685 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $844,685 (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 | 15,911 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 119 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 40.58 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 652.63 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 133.71 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1135148, 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 23 July 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,694,033 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,066,320 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,627,713 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,669,911 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $957,802 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $330,191 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,287,993 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,287,993 (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 | 15,833 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 104 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 27.58 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 288.09 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 152.24 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1071824, 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 23 July 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,778,122 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,224,619 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,553,503 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,536,948 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $1,016,555 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $371,178 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,387,733 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,387,733 (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 | 15,688 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 121 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 44.57 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 209.83 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 129.65 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1071823, 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 31 October 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,086,771 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $961,131 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,125,640 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,379,011 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $746,629 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $58,451 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $805,080 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $805,080 (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 | 15,941 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 114 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 36.03 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 329.44 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 139.83 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1017919, read from the public cost report file SNF10FY2011.zip.
Fiscal year 2010, ended 31 December 2010
Cost report for 1 January 2010 to 31 December 2010 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 24 September 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,278,625 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,452,267 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $826,358 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $279,523 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $1,105,881 (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 | 45 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 15,694 | 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 | 53.47 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 428.17 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 150.9 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 432429, 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 29 December 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,458,482 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,688,030 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $770,452 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $781,851 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $1,552,303 (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 | 45 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 16,194 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 119 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 78.86 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 188.66 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 136.08 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 391962, 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 July 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,074,956 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,371,999 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $702,957 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $293,674 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $1,306,306 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: −$309,675 (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 | 45 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 16,045 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 171 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 32.88 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 146.67 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 93.83 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 353032, 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 25 August 2008.
None of these figures is carried on this report.
CMS report record 324815, 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 6 May 2008.
None of these figures is carried on this report.
CMS report record 308384, 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 1 May 2007.
None of these figures is carried on this report.
CMS report record 277546, 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 1 May 2006.
None of these figures is carried on this report.
CMS report record 248262, 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 16 April 2005.
None of these figures is carried on this report.
CMS report record 213227, 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 19 May 2004.
None of these figures is carried on this report.
CMS report record 176883, 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 April 2003.
None of these figures is carried on this report.
CMS report record 139005, 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 18 March 2002.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $5,243,075 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,560,453 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $682,622 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | −$224,003 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $458,619 (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 | 112 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 26,251 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 22 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 49.62 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 756.5 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 1,193.23 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 48962, 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 25 June 2001.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,935,744 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,186,599 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $749,145 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | −$236,444 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $512,701 (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 | 112 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 26,206 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 31 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 117.71 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 352.4 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 845.35 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 48960, 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 18 January 2000.
Net income, stated at moderate confidence: −$18,573 (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 48958, 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 1 February 1999.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,173,739 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,001,212 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$1,827,473 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $249,919 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$1,577,554 (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 | 112 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 23,943 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 24 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 79.11 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 978.5 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 997.63 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 48956, 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 10 June 1998.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,781,939 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,362,110 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$1,580,171 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $52,817 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$1,527,354 (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 | 111 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,109 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 76 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 25.76 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 2,774 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 264.59 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 48955, 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 |
|---|---|---|---|---|
| OTTERBEIN LSC LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | 100% | since 01/01/2016 |
| OTTERBEIN HOME | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | Organization | 100% | since 12/01/2021 |
| FUNCTIONAL PATHWAYS OF TENNESSEE LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 04/04/2025 |
| HUNTER, RACHEL | ADP OF THE SNF | Individual | NOT APPLICABLE | since 12/01/2021 |
| OTTERBEIN HOME | ADP OF THE SNF | Organization | NOT APPLICABLE | since 12/01/2021 |
| POLARIS PHARMACY SERVICES OF OHIO LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 12/01/2018 |
| SIBERT, TARA | ADP OF THE SNF | Individual | NOT APPLICABLE | since 09/10/2024 |
| MEDAUGH, JOHN | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 01/01/2020 |
| SLAVIK, BRUCE | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 01/01/2017 |
| VONDERHAAR, STEVE | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 01/01/2020 |
| GREEN, JAMES | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 11/21/2005 |
| WILSON, JILL | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 05/01/2009 |
| BAKER, STEVE | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | Individual | NOT APPLICABLE | since 04/04/2025 |
| GALBUT, ABRAHAM | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | Individual | NOT APPLICABLE | since 04/04/2025 |
| GALBUT, DANIEL | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | Individual | NOT APPLICABLE | since 04/06/2025 |
| GALBUT, DAVID | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | Individual | NOT APPLICABLE | since 04/04/2025 |
| GALBUT, ERIC | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | Individual | NOT APPLICABLE | since 04/06/2025 |
| GALBUT, ROBERT | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | Individual | NOT APPLICABLE | since 04/04/2025 |
| PARITZKY, JONATHAN | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | Individual | NOT APPLICABLE | since 04/04/2025 |
| ROMBRO, DAVID | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | Individual | NOT APPLICABLE | since 04/04/2025 |
| ZISEK, TODD | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | Individual | NOT APPLICABLE | since 04/04/2025 |
| BORNS, DEBORAH | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 01/01/2017 |
| COFFIN, GORDON | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 01/01/2023 |
| DUES, STEVE | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 01/01/2013 |
| GAMBLE, CHARLES | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 07/01/2014 |
| IMWALLE, KAREN | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 01/01/2025 |
| INGRAHAM, JEFFREY | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 01/01/2024 |
| KROEGER, TYLER | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 01/01/2025 |
| STEINEMANN, JANE | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 12/01/2021 |
| VOISARD, DAVE | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 01/01/2021 |
| YOUNG, DANIEL | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 01/01/2025 |
| APP, LYNN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 12/01/2021 |
| BARTLETT, VICTORIA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 12/01/2021 |
| BAYLIFF, BECKY | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 12/01/2021 |
| BROWNSON, WILLIAM | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 12/01/2021 |
| BURKE, DANIEL | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 12/01/2021 |
| COLEMAN, ROBERT | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 12/01/2021 |
| FRALEY, RALPH | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 12/01/2021 |
| FUNCTIONAL PATHWAYS OF TENNESSEE LLC | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | since 12/01/2018 |
| GLOSSER, HEIDI | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 12/01/2021 |
| GREEN, JAMES | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 12/01/2021 |
| HAWKINS, RITA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 01/16/2006 |
| HAZELBAKER, TOMAS | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 12/01/2021 |
| HUNTER, RACHEL | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 10/01/2018 |
| MEDAUGH, JOHN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 01/01/2020 |
| OTTERBEIN HOME | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | since 12/01/2021 |
| SIBERT, TARA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 09/10/2024 |
| SLAVIK, BRUCE | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 01/01/2017 |
| VONDERHAAR, STEVE | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 12/01/2021 |
| BORNS, DEBORAH | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2017 |
| COFFIN, GORDON | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2023 |
| DUES, STEVE | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2013 |
| GAMBLE, CHARLES | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 07/01/2014 |
| IMWALLE, KAREN | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2025 |
| INGRAHAM, JEFFREY | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2024 |
| KROEGER, TYLER | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2025 |
| STEINEMANN, JANE | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 12/01/2021 |
| VOISARD, DAVE | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2021 |
| YOUNG, DANIEL | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2025 |
Medicare enrollment
As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of OTTERBEIN ST MARYS (enrollment ID O20021113000002).
| Owner | Individual or organization | Role | Ownership percentage | Association date | Described in the filing as |
|---|---|---|---|---|---|
| OTTERBEIN LSC LLC | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100 | 1/1/2016 | Private equity company: No Real estate investment trust: No Holding company: No |
| OTTERBEIN HOME | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100 | 12/1/2021 | Private equity company: No Real estate investment trust: No Holding company: No |
| FUNCTIONAL PATHWAYS OF TENNESSEE LLC | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 4/4/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| OTTERBEIN HOME | 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. | 12/1/2021 | Private equity company: No Real estate investment trust: No Holding company: No |
| POLARIS PHARMACY SERVICES OF OHIO 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. | 12/1/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| RACHEL LYNN HUNTER | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 12/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| TARA SIBERT | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 9/10/2024 | 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. |
| BRUCE SLAVIK | Individual | CORPORATE DIRECTOR | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2017 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| JOHN MEDAUGH | Individual | CORPORATE DIRECTOR | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2020 | 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. |
| STEVE VONDERHAAR | Individual | CORPORATE DIRECTOR | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2020 | 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. |
| JAMES CHRISTOPHER GREEN | 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. | 11/21/2005 | 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. |
| JILL WILSON | 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. | 5/1/2009 | 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. |
| CHARLES R GAMBLE | Individual | MANAGING CONTROL - GOVERNING BODY | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 7/1/2014 | 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. |
| DANIEL YOUNG | Individual | MANAGING CONTROL - GOVERNING BODY | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2025 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| DAVE VOISARD | Individual | MANAGING CONTROL - GOVERNING BODY | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2021 | 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. |
| DEBORAH BORNS | Individual | MANAGING CONTROL - GOVERNING BODY | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2017 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| GORDON COFFIN | Individual | MANAGING CONTROL - GOVERNING BODY | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2023 | 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. |
| JANE STEINEMANN | Individual | MANAGING CONTROL - GOVERNING BODY | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 12/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| JEFFREY INGRAHAM | Individual | MANAGING CONTROL - GOVERNING BODY | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2024 | 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. |
| KAREN IMWALLE | Individual | MANAGING CONTROL - GOVERNING BODY | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2025 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| STEVE DUES | Individual | MANAGING CONTROL - GOVERNING BODY | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2013 | 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. |
| TYLER KROEGER | Individual | MANAGING CONTROL - GOVERNING BODY | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2025 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| BECKY BAYLIFF | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 12/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| BRUCE SLAVIK | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2017 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| DANIEL BURKE | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 12/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| FUNCTIONAL PATHWAYS OF TENNESSEE 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. | 12/1/2018 | Private equity company: No Real estate investment trust: No Holding company: No |
| HEIDI GLOSSER | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 12/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| JAMES CHRISTOPHER GREEN | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 12/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| JOHN MEDAUGH | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2020 | 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. |
| LYNN APP | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 12/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| OTTERBEIN HOME | 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. | 12/1/2021 | Private equity company: No Real estate investment trust: No Holding company: No |
| RACHEL LYNN HUNTER | 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. | 10/1/2018 | 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. |
| RALPH REED FRALEY | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 12/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| RITA C HAWKINS | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/16/2006 | 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. |
| ROBERT COLEMAN | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 12/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| STEVE VONDERHAAR | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 12/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| TARA SIBERT | 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. | 9/10/2024 | 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. |
| TOMAS HAZELBAKER | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 12/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| VICTORIA BARTLETT | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 12/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| WILLIAM BROWNSON | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 12/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| CHARLES R GAMBLE | Individual | TRUSTEE OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 7/1/2014 | 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. |
| DANIEL YOUNG | Individual | TRUSTEE OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2025 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| DAVE VOISARD | Individual | TRUSTEE 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. | 1/1/2021 | 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. |
| DEBORAH BORNS | Individual | TRUSTEE 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. | 1/1/2017 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| GORDON COFFIN | Individual | TRUSTEE 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. | 1/1/2023 | 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. |
| JANE STEINEMANN | Individual | TRUSTEE OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 12/1/2021 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| JEFFREY INGRAHAM | Individual | TRUSTEE 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. | 1/1/2024 | 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. |
| KAREN IMWALLE | Individual | TRUSTEE OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2025 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| STEVE DUES | Individual | TRUSTEE 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. | 1/1/2013 | 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. |
| TYLER KROEGER | Individual | TRUSTEE OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2025 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
Changes in ownership
- 1 July 2026: POLARIS PHARMACY SERVICES OF OHIO LLC no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: OTTERBEIN LSC LLC 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: STEVE DUES no longer appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: STEVE DUES no longer appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: BECKY BAYLIFF no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: POLARIS PHARMACY SERVICES OF OHIO LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: OTTERBEIN LSC LLC 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: STEVE DUES appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: STEVE DUES appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: BECKY BAYLIFF appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 September 2025: DEBORAH BORNS no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: OTTERBEIN HOMES no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: DEBORA L GEIS no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: MARTIN BROWN no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: JILL WILSON no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: JILL WILSON no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: CHARLES R GAMBLE no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: DAVE VOISARD no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: STEVE DUES no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: MARGIE MANNING no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: STEVE VONDERHAAR appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: LYNN APP appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: TYLER KROEGER appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: TYLER KROEGER appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: DANIEL BURKE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: RACHEL LYNN HUNTER appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: RACHEL LYNN HUNTER appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: DEBORAH BORNS appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: DEBORAH BORNS appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: KAREN IMWALLE appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: KAREN IMWALLE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: ROBERT COLEMAN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: TARA SIBERT appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: TARA SIBERT appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: JAMES CHRISTOPHER GREEN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: OTTERBEIN HOME appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: OTTERBEIN HOME appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: OTTERBEIN HOME appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: GORDON COFFIN appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: GORDON COFFIN appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: JANE STEINEMANN appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: JANE STEINEMANN appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: CHARLES R GAMBLE appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: CHARLES R GAMBLE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: BRUCE SLAVIK appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: FUNCTIONAL PATHWAYS OF TENNESSEE LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: FUNCTIONAL PATHWAYS OF TENNESSEE LLC appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: RALPH REED FRALEY appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: TOMAS HAZELBAKER appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: JEFFREY INGRAHAM appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: JEFFREY INGRAHAM appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: WILLIAM BROWNSON appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: DANIEL YOUNG appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: DANIEL YOUNG appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: VICTORIA BARTLETT appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: HEIDI GLOSSER appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: JOHN MEDAUGH appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: DAVE VOISARD appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: DAVE VOISARD appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: POLARIS PHARMACY SERVICES OF OHIO LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: OTTERBEIN LSC LLC appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: STEVE DUES appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: STEVE DUES appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: BECKY BAYLIFF appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
Recent changes on this record
- 1 July 2026: POLARIS PHARMACY SERVICES OF OHIO LLC no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: OTTERBEIN LSC LLC 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: STEVE DUES no longer appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: STEVE DUES no longer appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: BECKY BAYLIFF no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: POLARIS PHARMACY SERVICES OF OHIO LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: OTTERBEIN LSC LLC 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: STEVE DUES appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: STEVE DUES appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: BECKY BAYLIFF appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 September 2025: DEBORAH BORNS no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: OTTERBEIN HOMES no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: DEBORA L GEIS no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: MARTIN BROWN no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: JILL WILSON no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: JILL WILSON no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: CHARLES R GAMBLE no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: DAVE VOISARD no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: STEVE DUES no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: MARGIE MANNING no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: STEVE VONDERHAAR appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: LYNN APP appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: TYLER KROEGER appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: TYLER KROEGER appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: DANIEL BURKE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: RACHEL LYNN HUNTER appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: RACHEL LYNN HUNTER appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: DEBORAH BORNS appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: DEBORAH BORNS appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: KAREN IMWALLE appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: KAREN IMWALLE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: ROBERT COLEMAN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: TARA SIBERT appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: TARA SIBERT appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: JAMES CHRISTOPHER GREEN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: OTTERBEIN HOME appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: OTTERBEIN HOME appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: OTTERBEIN HOME appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: GORDON COFFIN appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: GORDON COFFIN appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | 14 September 2023 | 14 September 2023 | 4 | 7 |
| 2 | 10 June 2021 | 10 June 2021 | 6 | 3 |
| 3 | 21 February 2019 | 21 February 2019 | 14 | 4 |
From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.
Deficiencies cited
24 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| 3 April 2024 | Health | F 0686 | Quality of Life and Care Deficiencies | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | Yes | Deficient, Provider has date of correction | 18 April 2024 |
| 11 January 2024 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Yes | Deficient, Provider has date of correction | 26 January 2024 |
| 14 November 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 | 8 December 2023 |
| 14 November 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 | 8 December 2023 |
| 14 September 2023 | 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 | 20 October 2023 |
| 14 September 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 | 20 October 2023 |
| 14 September 2023 | Health | F 0849 | Administration Deficiencies | Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services. | D | No | Deficient, Provider has date of correction | 20 October 2023 |
| 14 September 2023 | 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 | 20 October 2023 |
| 10 June 2021 | Health | F 0677 | Quality of Life and Care Deficiencies | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | No | Deficient, Provider has date of correction | 20 July 2021 |
| 10 June 2021 | 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 | 20 July 2021 |
| 10 June 2021 | 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 | 20 July 2021 |
| 10 June 2021 | 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 | 20 July 2021 |
| 10 June 2021 | Health | F 0759 | Pharmacy Service Deficiencies | Ensure medication error rates are not 5 percent or greater. | D | No | Deficient, Provider has date of correction | 20 July 2021 |
| 10 June 2021 | 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 | 20 July 2021 |
| 21 February 2019 | Health | F 0550 | Resident Rights Deficiencies | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | No | Deficient, Provider has date of correction | 5 April 2019 |
| 21 February 2019 | 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 | 5 April 2019 |
| 21 February 2019 | Health | F 0607 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | D | No | Deficient, Provider has date of correction | 5 April 2019 |
| 21 February 2019 | Health | F 0609 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | No | Deficient, Provider has date of correction | 5 April 2019 |
| 21 February 2019 | Health | F 0610 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Respond appropriately to all alleged violations. | D | No | Deficient, Provider has date of correction | 5 April 2019 |
| 21 February 2019 | Health | F 0677 | Quality of Life and Care Deficiencies | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | No | Deficient, Provider has date of correction | 5 April 2019 |
| 21 February 2019 | 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. | E | No | Deficient, Provider has date of correction | 5 April 2019 |
| 21 February 2019 | Health | F 0770 | Administration Deficiencies | Provide timely, quality laboratory services/tests to meet the needs of residents. | D | No | Deficient, Provider has date of correction | 5 April 2019 |
| 21 February 2019 | 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 | No | Deficient, Provider has date of correction | 5 April 2019 |
| 21 February 2019 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | F | No | Deficient, Provider has date of correction | 5 April 2019 |
From the Care Compare health citations file NH_HealthCitations_Aug2026.csv, processed on 1 August 2026.
Penalties
Not yet extracted for this facility.
Care Compare provider information
| Field | As filed |
|---|---|
| Provider Type | Medicare and Medicaid |
| Ownership Type | For profit - Corporation |
| Legal Business Name | OTTERBEIN ST MARYS |
| Date First Approved to Provide Medicare and Medicaid Services | 1994-02-09 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | Y |
| Urban | N |
| County/Parish | Auglaize |
| Telephone Number | 4193946330 |
| Chain Name | OTTERBEIN SENIORLIFE |
| Chain ID | 389 |
| Provider Changed Ownership in Last 12 Months | N |
| With a Resident and Family Council | Both |
| Automatic Sprinkler Systems in All Required Areas | Yes |
| Number of Certified Beds | 53 |
| Average Number of Residents per Day | 49.7 |
| Overall Rating | 4 |
| Health Inspection Rating | 4 |
| 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.
Get an email when this record changes
One email a day naming what moved on OTTERBEIN ST MARYS RETIREMENT COMMUNITY: 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: POLARIS PHARMACY SERVICES OF OHIO LLC 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 OTTERBEIN ST MARYS RETIREMENT COMMUNITY
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 365953.