Skilled nursing facility · CMS certification number 366050
OTTERBEIN-CRIDERSVILLE
CRIDERSVILLE, Ohio · Medicare and Medicaid
Certified beds, as filed in Care Compare: 50
Finances, as filed
From this facility’s Medicare cost reports on form CMS-2540, each figure with the worksheet, line and column it was read from.
Cost report for 1 January 2024 to 31 December 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 28 August 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,188,472 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $3,734,651 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,453,821 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,052,018 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $401,803 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $254,733 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $656,536 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $656,536 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 18,300 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 3,019 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 6,343 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 6,501 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 15,863 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 98 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 69 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 174 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 341 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 30.81 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 91.93 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 46.52 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1435109, 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 6 February 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $9,212,579 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $3,314,516 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,898,063 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,347,622 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $550,441 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $292,566 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $843,007 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $843,007 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 14,187 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 382 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 27.24 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 76.89 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 37.14 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1403325, 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 23 February 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,708,780 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $3,243,910 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,464,870 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,794,948 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$330,078 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | −$389,171 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$719,249 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$713,295 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 13,523 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 411 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 24.97 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 86.04 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 32.9 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1373779, 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 23 August 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,269,728 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,924,759 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,344,969 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,500,795 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$155,826 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $635,513 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $479,687 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $479,687 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 13,456 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 394 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 26.9 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 87.61 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 34.15 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1330416, 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 | $7,472,360 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,575,828 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,896,532 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,712,747 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $183,785 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $306,039 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $489,824 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $489,824 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 12,848 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 265 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 32.65 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 123.76 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 48.48 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1303876, 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 | $8,435,947 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,949,856 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,486,091 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,923,489 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $562,602 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $351,049 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $913,651 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $913,651 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 14,765 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 293 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 22.58 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 167.84 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 50.39 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1267117, 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 | $8,940,667 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $3,278,150 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,662,517 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,088,331 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $574,186 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | −$227,129 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $347,057 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $347,057 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 15,274 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 334 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 23.28 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 163.67 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 45.73 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1235740, 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 | $8,498,241 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,922,392 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,575,849 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,263,925 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $311,924 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $637,284 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $949,208 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $949,208 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 15,529 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 264 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 26.25 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 433.73 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 58.82 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1200016, 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 | $7,106,992 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,288,700 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,818,292 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,370,019 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $448,273 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $82,060 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $530,333 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $530,333 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 15,419 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 208 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 26.09 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 443.42 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 74.13 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1169356, 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 | $5,606,635 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,759,210 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,847,425 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,509,459 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $337,966 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $94,777 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $432,743 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $432,743 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 38 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 12,929 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 162 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 27.44 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 423.07 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 79.81 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1137563, 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 26 May 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,308,531 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,616,153 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,692,378 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,458,160 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $234,218 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $217,189 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $451,407 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $451,407 (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 | 38 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 12,815 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 150 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 36.36 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 302.32 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 85.43 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1124729, read from the public cost report file SNF10FY2014.zip.
Fiscal year 2013, ended 31 December 2013
Cost report for 1 January 2013 to 31 December 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 12 June 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,898,894 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,276,435 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,622,459 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,308,174 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $314,285 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $374,373 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $688,658 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $688,658 (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 | 38 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 12,921 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 113 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 39.41 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 577 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 114.35 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1096183, 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 15 October 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,225,398 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,311,856 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,913,542 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,296,685 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $616,857 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $150,652 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $767,509 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $767,509 (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 | 38 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 12,962 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 150 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 37.44 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 315.38 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 86.41 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1079027, 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 6 June 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,730,666 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $923,013 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,807,653 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,013,464 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $794,189 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | −$37,205 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $756,984 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $756,984 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 38 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 12,939 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 111 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 43.38 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 321.29 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 116.57 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1032497, 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 27 September 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,498,577 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,859,574 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $639,003 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $83,786 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $722,789 (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 | 38 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 12,301 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 105 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 39.76 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 287 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 117.15 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 432557, 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 22 March 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,678,644 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,971,344 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $707,300 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $75,226 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $28,104 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: $754,422 (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 | 38 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 13,162 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 149 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 47 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 167.36 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 88.34 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 396000, 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 14 July 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,397,027 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,184,007 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $213,020 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $95,873 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $308,893 (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 | 38 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 12,962 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 135 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 28.63 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 237.7 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 96.01 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 349483, 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 28 July 2008.
None of these figures is carried on this report.
CMS report record 321850, 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 18 March 2008.
None of these figures is carried on this report.
CMS report record 304880, read from the public cost report file SNFFY2006.zip.
Fiscal year 2005, ended 31 December 2005
Cost report for 1 January 2005 to 31 December 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 22 March 2007.
None of these figures is carried on this report.
CMS report record 275663, 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 16 March 2006.
None of these figures is carried on this report.
CMS report record 245143, 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 213241, read from the public cost report file SNFFY2003.zip.
Fiscal year 2002, ended 31 December 2002
Cost report for 1 January 2002 to 31 December 2002 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 28 May 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $5,084,672 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,596,813 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$512,141 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $144,171 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$367,970 (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 | 92 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 23,641 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 123 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 44.11 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 257.08 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 192.2 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 178764, 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 139633, 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 22 February 2002.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $5,092,842 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,794,591 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $298,251 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | −$272,052 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $26,199 (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 | 82 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 27,919 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 70 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 45.14 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 2,093 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 398.84 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 49639, 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 18 December 2000.
Net income, stated at moderate confidence: $215,618 (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 49637, 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 21 April 2000.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,530,588 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,047,913 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $482,675 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | −$233,844 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $248,831 (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 | 82 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 27,495 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 43 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 204 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 423.38 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 639.42 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 49635, 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 18 March 1999.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,262,989 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,723,106 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $539,883 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | −$289,771 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $250,112 (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 | 82 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 24,700 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 42 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 68.6 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 895.33 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 588.1 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 49633, read from the public cost report file SNFFY1997.zip.
Fiscal year 1996, ended 31 December 1996
Cost report for 8 March 1996 to 31 December 1996 — a reporting period of 298 days, not a full year, on form CMS-2540-96, settled, processed by CMS on 27 April 1998.
Net income, stated at moderate confidence: −$1,359,115 (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 49632, 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 |
| HANNA, SALIM | ADP OF THE SNF | Individual | NOT APPLICABLE | since 10/01/2018 |
| NICKLES, LANCE | ADP OF THE SNF | Individual | NOT APPLICABLE | since 09/23/2025 |
| 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 |
| BONIFAS, BARBARA | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 12/01/2021 |
| GREEN, JAMES | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 11/21/2005 |
| MILLER, JASON | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 08/04/2014 |
| STEPHENSON, JOHN | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 08/09/1982 |
| GREEN, JAMES | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 11/21/2005 |
| HAWKINS, RITA | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 01/16/2006 |
| MILLER, JASON | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 08/04/2014 |
| 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 |
| BONIFAS, BARBARA | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 12/01/2021 |
| DIRR, TONY | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 12/01/2024 |
| ELLERBROCK, ADAH | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 12/01/2024 |
| FRIED, NATHAN | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 12/01/2021 |
| KOCH, MARK | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 12/01/2024 |
| LOTZ, DAVE | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 12/01/2016 |
| MUZLESKI, CHARLOTTE | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 12/01/2021 |
| RADER, ANN | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 12/01/2024 |
| RANDALL, TIFFANY | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 12/01/2023 |
| SCHNEIDER, JOEL | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 01/01/2024 |
| SEESE, KAYE | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 12/01/2021 |
| WOLKE, JASON | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 01/01/2016 |
| 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, REBECCA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 05/21/2012 |
| 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 |
| HANNA, SALIM | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 12/01/2018 |
| HAZELBAKER, TOMAS | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 12/01/2021 |
| NICKLES, LANCE | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 09/15/2025 |
| OTTERBEIN HOME | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | since 12/01/2021 |
| POWELL, ANGIE | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 11/24/2014 |
| VONDERHAAR, STEVE | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 12/01/2021 |
| BONIFAS, BARBARA | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 12/01/2021 |
| DIRR, TONY | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 12/01/2024 |
| ELLERBROCK, ADAH | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 12/01/2024 |
| FRIED, NATHAN | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 12/01/2021 |
| KOCH, MARK | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 12/01/2024 |
| LOTZ, DAVE | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 12/01/2016 |
| MUZLESKI, CHARLOTTE | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 12/01/2021 |
| RADER, ANN | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 12/01/2024 |
| RANDALL, TIFFANY | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 12/01/2023 |
| SCHNEIDER, JOEL | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2024 |
| SEESE, KAYE | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 12/01/2021 |
| WOLKE, JASON | TRUSTEE OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2016 |
Medicare enrollment
As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of OTTERBEIN CRIDERSVILLE (enrollment ID O20021113000000).
| 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 |
| LANCE NICKLES | 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. | 9/23/2025 | 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. |
| 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 |
| SALIM W HANNA | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 10/1/2018 | 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. |
| BARBARA BONIFAS | 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. | 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 | 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. | 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. |
| JASON E MILLER | 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. | 8/4/2014 | 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. |
| JOHN STEPHENSON | 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. | 8/9/1982 | 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. |
| JASON E MILLER | 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. | 8/4/2014 | 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. |
| 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. |
| RITA C HAWKINS | Individual | CORPORATE OFFICER | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/16/2006 | 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. |
| ADAH ELLERBROCK | 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. | 12/1/2024 | 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. |
| ANN RADER | 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. | 12/1/2024 | 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. |
| BARBARA BONIFAS | 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. |
| CHARLOTTE MUZLESKI | 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. |
| DAVE LOTZ | 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. | 12/1/2016 | 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. |
| JASON WOLKE | 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. | 1/1/2016 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| JOEL SCHNEIDER | 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. |
| KAYE SEESE | 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. |
| MARK KOCH | 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. | 12/1/2024 | 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. |
| NATHAN FRIED | 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. |
| TIFFANY RANDALL | 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. | 12/1/2023 | 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. |
| TONY DIRR | 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. | 12/1/2024 | 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. |
| ANGIE POWELL | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 11/24/2014 | 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 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. |
| LANCE NICKLES | 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. | 9/15/2025 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| 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 |
| 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. |
| REBECCA 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. | 5/21/2012 | 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. |
| SALIM W HANNA | 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. | 12/1/2018 | 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. |
| 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. |
| 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. |
| ADAH ELLERBROCK | 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. | 12/1/2024 | 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. |
| ANN RADER | 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. | 12/1/2024 | 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. |
| BARBARA BONIFAS | 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. |
| CHARLOTTE MUZLESKI | 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. |
| DAVE LOTZ | 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. | 12/1/2016 | 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. |
| JASON WOLKE | 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. | 1/1/2016 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| JOEL SCHNEIDER | 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. |
| KAYE SEESE | 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. |
| MARK KOCH | 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. | 12/1/2024 | 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. |
| NATHAN FRIED | 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. |
| TIFFANY RANDALL | 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. | 12/1/2023 | 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. |
| TONY DIRR | 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. | 12/1/2024 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
Changes in ownership
- 1 July 2026: 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: MARK KOCH 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: MARK KOCH 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: KAYE SEESE 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: KAYE SEESE 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: 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: MARK KOCH appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: MARK KOCH appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: KAYE SEESE appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: KAYE SEESE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 December 2025: NICOLE C DANIELS no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: NICOLE C DANIELS no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: LANCE NICKLES appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: LANCE NICKLES appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 September 2025: JASON WOLKE no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: ROBERT SHENK no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: GLENN WEBB no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: CINDY MEFFERD no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: ELIZABETH WINGET 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 OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: GREG MYERS no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: REBECCA BAYLIFF no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: RITA C HAWKINS 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: CAROL SIMMONS no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: VANESSA LYNN LEE no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: JOHN STEPHENSON 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: NOLA HEILMAN no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: NATHAN FRIED appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: NATHAN FRIED appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: JASON WOLKE appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: JASON WOLKE appears as MANAGING CONTROL - GOVERNING BODY 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: 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: JOEL SCHNEIDER appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: JOEL SCHNEIDER 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: 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: SALIM W HANNA appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: SALIM W HANNA 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: ADAH ELLERBROCK appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: ADAH ELLERBROCK appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: BARBARA BONIFAS appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: BARBARA BONIFAS appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: BARBARA BONIFAS appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: TONY DIRR appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: TONY DIRR appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: NICOLE C DANIELS appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: NICOLE C DANIELS appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: TIFFANY RANDALL appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: TIFFANY RANDALL appears as MANAGING CONTROL - GOVERNING BODY 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: REBECCA BAYLIFF 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: RITA C HAWKINS appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: CHARLOTTE MUZLESKI appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: CHARLOTTE MUZLESKI 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: ANN RADER appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: ANN RADER 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: JOHN STEPHENSON appears as CORPORATE DIRECTOR 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: DAVE LOTZ 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 LOTZ 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: MARK KOCH appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: MARK KOCH appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: KAYE SEESE appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: KAYE SEESE appears as MANAGING CONTROL - GOVERNING BODY 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: MARK KOCH 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: MARK KOCH 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: KAYE SEESE 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: KAYE SEESE 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: 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: MARK KOCH appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: MARK KOCH appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: KAYE SEESE appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: KAYE SEESE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 December 2025: NICOLE C DANIELS no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: NICOLE C DANIELS no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: LANCE NICKLES appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 December 2025: LANCE NICKLES appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
- 1 September 2025: JASON WOLKE no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: ROBERT SHENK no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: GLENN WEBB no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: CINDY MEFFERD no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: ELIZABETH WINGET 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 OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: GREG MYERS no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: REBECCA BAYLIFF no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: RITA C HAWKINS 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: CAROL SIMMONS no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: VANESSA LYNN LEE no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: JOHN STEPHENSON 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: NOLA HEILMAN no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: NATHAN FRIED appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: NATHAN FRIED appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: JASON WOLKE appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: JASON WOLKE appears as MANAGING CONTROL - GOVERNING BODY 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: 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: JOEL SCHNEIDER appears as TRUSTEE OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: JOEL SCHNEIDER 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: 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: SALIM W HANNA appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-09-01.csv
- 1 September 2025: SALIM W HANNA appears as OPERATIONAL/MANAGERIAL CONTROL 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 | 23 April 2025 | 23 April 2025 | 10 | 0 |
| 2 | 22 June 2023 | 22 June 2023 | 6 | 5 |
| 3 | 24 May 2021 | 24 May 2021 | 6 | 3 |
From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.
Deficiencies cited
22 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| 26 November 2025 | Health | F 0583 | Resident Rights Deficiencies | Keep residents' personal and medical records private and confidential. | D | Yes | Past Non-Compliance | 25 November 2025 |
| 26 November 2025 | Health | F 0600 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | Yes | Past Non-Compliance | 25 November 2025 |
| 23 April 2025 | Health | F 0550 | Resident Rights Deficiencies | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | No | Deficient, Provider has date of correction | 8 May 2025 |
| 23 April 2025 | Health | F 0686 | Quality of Life and Care Deficiencies | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | No | Deficient, Provider has date of correction | 8 May 2025 |
| 23 April 2025 | Health | F 0687 | Quality of Life and Care Deficiencies | Provide appropriate foot care. | D | No | Deficient, Provider has date of correction | 8 May 2025 |
| 23 April 2025 | Health | F 0698 | Quality of Life and Care Deficiencies | Provide safe, appropriate dialysis care/services for a resident who requires such services. | D | No | Deficient, Provider has date of correction | 8 May 2025 |
| 23 April 2025 | 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 | 8 May 2025 |
| 23 April 2025 | Health | F 0812 | Nutrition and Dietary Deficiencies | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | No | Deficient, Provider has date of correction | 8 May 2025 |
| 23 April 2025 | 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 | 8 May 2025 |
| 23 April 2025 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | No | Deficient, Provider has date of correction | 8 May 2025 |
| 22 June 2023 | Health | F 0580 | Resident Rights Deficiencies | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | D | No | Deficient, Provider has date of correction | 14 July 2023 |
| 22 June 2023 | Health | F 0688 | Quality of Life and Care Deficiencies | Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | D | No | Deficient, Provider has date of correction | 14 July 2023 |
| 22 June 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. | E | No | Deficient, Provider has date of correction | 14 July 2023 |
| 22 June 2023 | Health | F 0697 | Quality of Life and Care Deficiencies | Provide safe, appropriate pain management for a resident who requires such services. | D | No | Deficient, Provider has date of correction | 14 July 2023 |
| 22 June 2023 | Health | F 0760 | Pharmacy Service Deficiencies | Ensure that residents are free from significant medication errors. | D | No | Deficient, Provider has date of correction | 14 July 2023 |
| 22 June 2023 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | F | No | Deficient, Provider has date of correction | 14 July 2023 |
| 24 May 2021 | Health | F 0580 | Resident Rights Deficiencies | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | D | No | Deficient, Provider has date of correction | 21 June 2021 |
| 24 May 2021 | Health | F 0656 | Resident Assessment and Care Planning Deficiencies | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | No | Deficient, Provider has date of correction | 21 June 2021 |
| 24 May 2021 | Health | F 0685 | Quality of Life and Care Deficiencies | Assist a resident in gaining access to vision and hearing services. | D | No | Deficient, Provider has date of correction | 21 June 2021 |
| 24 May 2021 | Health | F 0760 | Pharmacy Service Deficiencies | Ensure that residents are free from significant medication errors. | D | No | Deficient, Provider has date of correction | 21 June 2021 |
| 24 May 2021 | Health | F 0806 | Nutrition and Dietary Deficiencies | Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | D | No | Deficient, Provider has date of correction | 21 June 2021 |
| 24 May 2021 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | No | Deficient, Provider has date of correction | 21 June 2021 |
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 | Non profit - Corporation |
| Legal Business Name | OTTERBEIN CRIDERSVILLE |
| Date First Approved to Provide Medicare and Medicaid Services | 1996-03-08 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | Y |
| Urban | N |
| County/Parish | Auglaize |
| Telephone Number | 4196455114 |
| Chain Name | OTTERBEIN SENIORLIFE |
| Chain ID | 389 |
| Provider Changed Ownership in Last 12 Months | N |
| With a Resident and Family Council | Resident |
| Automatic Sprinkler Systems in All Required Areas | Yes |
| Number of Certified Beds | 50 |
| Average Number of Residents per Day | 44.6 |
| Overall Rating | 3 |
| Health Inspection Rating | 3 |
| QM Rating | 4 |
| Long-Stay QM Rating | 5 |
| Short-Stay QM Rating | 4 |
| Processing Date | 2026-08-01 |
From the Care Compare Provider Information file NH_ProviderInfo_Aug2026.csv, processed on 1 August 2026.
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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.
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The citable document for OTTERBEIN-CRIDERSVILLE
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